2024-05-13T08:23:08-05:00 2023-06-30 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2022-07-01 610965365 RUSSELL COUNTY KENTUCKY HOSPITAL DISTRICT HEALTH FACILITIES CORP RUSS 2708664753 PO BOX 1610 153 DOWELL ROAD RUSSELL SPRINGS KY 42642 SCOTT THOMPSON CEO 2708664753 2024-05-13 1 SCOTT THOMPSON 999009999 0 EMILIE M KNIERIEM CPA P01330194 5029923500 2024-05-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SCOTT THOMPSON PO BOX 1610 153 DOWELL ROAD RUSSELL SPRINGS KY 42642 40075369 0 X WWW.RUSSELLCOHOSPITAL.ORG X 1979 KY TO PROVIDE QUALITY, COMPASSIONATE HEALTHCARE CONSISTENT WITH THE TRUST AND SUPPORT OF THE COMMUNITIES WE SERVE. 5 5 346 50 0 0 1487772 997429 32441675 37903637 78541 105677 962630 1045820 34970618 40052563 7770 2775 0 0 20680544 21045216 0 0 0 13508343 13879039 34196657 34927030 773961 5125533 28774146 32981130 5884703 4897723 22889443 28083407 TO PROVIDE QUALITY, COMPASSIONATE HEALTHCARE CONSISTENT WITH THE TRUST AND SUPPORT OF THE COMMUNITIES WE SERVE. 0 0 29404320 2775 37955637 MEDICAL CARE PROVIDED BY HOSPITAL TO PATIENTS - CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY $250,859 FOR THE YEAR ENDED JUNE 30, 2023. THE HOSPITAL HOLDS AN ANNUAL HEALTH FAIR FOR THE COMMUNITY WHERE IT PROVIDES REDUCED COST TESTING. THE HOSPITAL SUPPORTS ITS EMPLOYEES' COMMUNITY INVOLVEMENT AND CONDUCTS OTHER PROGRAMS FOR COMMUNITY BENEFIT. 29404320 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 50 0 1 346 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 1 1 KY X NEQUILA NORRIS 2708664753 PO BOX 1610 153 DOWELL ROAD RUSSELL SPRINGS KY 42642 TOMMY SHELTON PHYSICIAN 40.00 X 658946 0 26607 RICHARD PERKINS PHYSICIAN 40.00 X 558082 0 43076 JONAS HURLEY PHYSICIAN 40.00 X 532673 0 40460 MILTON JACKSON PHYSICIAN 40.00 X 428657 0 35691 LEANN COOPER PHYSICIAN 40.00 X 300043 0 39204 JUDY WITHERS CNO 40.00 X 140512 0 28985 JANIE LANDIS CFO 40.00 X 138727 0 49283 SCOTT THOMPSON CEO 40.00 X 110864 0 13771 DARYL HAMMOND CHAIR/PRESIDENT 2.00 X X 0 0 0 NEAL DALTON CHAIR/PRESIDENT (END 12/22) 2.00 X X 0 0 0 WINFREY BATES VICE CHAIR 2.00 X X 0 0 0 LARRY HELM SECRETARY/TREASURER (01/23-06/23) 2.00 X X 0 0 0 STUART CARMAN BOARD MEMBER 2.00 X 0 0 0 STEVEN FLETCHER BOARD MEMBER 2.00 X 0 0 0 2868504 0 277077 26 0 1 0 PARK PLACE INTERNATIONAL 124 DOWELL ROAD RUSSELL SPRINGS KY 42629 IT MAINTENANCE 518686 BUSY BEE PLUMBING 2701 E INSIGHT WAY CHANDLER AZ 85286 CONTRACT SERVICES 469797 STEVE AITKEN CRNA 919 LILY CREEK RESORT ROAD JAMESTOWN KY 42629 ANESTHESIA SERVICES 298403 LABORATORY CORPORATION 276 G V HALE AVE RUSSELL SPRINGS KY 42642 LABORTATORY CONTRACT SERVICES 217842 DR JASBIR DHILLON 5040 MURRAY LANE BRENTWOOD TN 37027 PHYSICIAN SERVICES 197400 19 975519 21910 997429 NET PATIENT SERVICE REVENUE 621999 33294845 33294845 PHARMACY SERVICES - 340B 621399 4608792 4608792 37903637 100026 100026 12002 0 12002 12002 12002 28457 22806 5651 5651 5651 ADMIN TAX REVENUE 900099 981818 981818 CAFETERIA INCOME 722310 25237 25237 VENDING REVENUE 900099 866 866 25897 25897 1033818 40052563 37955637 0 1099497 2775 2775 496296 413813 82483 247804 206620 41184 16701629 13925864 2775765 279422 223538 55884 2210357 1768286 442071 1109708 887766 221942 14048 14048 53760 53760 2934924 2739880 195044 101145 651 100494 370656 325878 44778 861049 839165 21884 22590 20159 2431 6956 6859 97 53896 53896 851531 851531 353076 8893 344183 MEDICAL SUPPLIES & DRUG 6292782 6292782 REPAIRS AND MAINTENANCE 1234177 1213236 20941 PROVIDER TAX 347291 347291 FOOD & BEVERAGE 125599 125599 255559 55265 200294 34927030 29404320 5522710 0 191067 410546 11025800 14397344 4634435 4584733 810022 693510 806015 700240 28618353 22113976 5923438 6504377 1509403 1504054 3873966 4186326 28774146 32981130 2634750 2109703 1149066 0 1600708 1027560 500179 1760460 5884703 4897723 X 22889443 28083407 22889443 28083407 28774146 32981130 5125533 68431 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1554 1554 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES PAID TO KENTUCKY HOSPITAL ASSOCIATION FOR FYE 2023 THAT ARE RELATED TO LOBBYING ARE APPROXIMATELY 11.0%. 344100 344100 6207300 2460674 3746626 90077 59499 30578 21679116 19593803 2085313 297760 297760 6504377 ASSETS WHOSE USE IS LIMITED 4186326 4186326 THIRD PARTY PAYABLE - MEDICAID SETTLEMENT 706004 THIRD PARTY PAYABLE - MEDICARE SETTLEMENT 1054456 1760460 X 40052563 0 40052563 0 40052563 34927030 0 34927030 0 34927030 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 509(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 0 429313 429313 0.01230 7479429 9378454 0 0.00000 7908742 9378454 429313 0.01230 21474 21474 0.00060 21474 21474 0.00060 7930216 9378454 450787 0.01290 1 1469372 0 5332503 8099315 -2766812 X 1 1 1 1 RUSSELL COUNTY HOSPITAL PO BOX 1610 153 DOWELL ROAD RUSSELL SPRINGS KY 42642 WWW.RUSSELLCOHOSPITAL.ORG 600081 X X X X RUSSELL COUNTY HOSPITAL 0 0 1 X X X X X X X X X 23 1 0 0 1 X WWW.RUSSELLCOHOSPITAL.ORG/DOCS/RCH_CHNA_2023.PDF X 1 23 1 WWW.RUSSELLCOHOSPITAL.ORG/DOCS/RCH_CHNA_IMPLEMENTATION_STRATEGY_2020-2022 0 1 X 200.000000000000 200.000000000000 X 1 1 X X X 1 X WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE X WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE X WWW.RUSSELLCOHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIALASSISTANCE X X X X 1 X 0 X X X 1 X 0 0 RUSSELL COUNTY HOSPITAL PART V, SECTION B, LINE 5: DATA FOR THIS CHNA WAS COLLECTED FROM PRIMARY AND SECONDARY SOURCES TO IDENTIFY KEY FINDINGS AND GAPS THAT MAY EXIST BETWEEN HEALTH NEEDS AND SERVICES PROVIDED WITHIN THE COMMUNITY. THE METHOD OF COLLECTION FOR PRIMARY DATA WERE PERSONAL INTERVIEWS AND SURVEYS. SEVERAL SECONDARY DATA SOURCES WERE REVIEWED AND ANALYZED TO IDENTIFY KEY FINDINGS WITH STRATEGIC IMPLICATIONS AND FOR BENCHMARKING THE HOSPITAL'S SERVICE AREA. FINALLY, IT IS IMPORTANT TO NOTE THAT OUR DATA COLLECTION DID NOT INCLUDE A STATISTICALLY REPRESENTATIVE SAMPLE OF THE COMMUNITY, IN THAT MEMBERS OF DISADVANTAGED POPULATIONS WERE LESS LIKELY TO PARTICIPATE VIA A WEB-BASED SURVEY. THESE INDIVIDUALS MAY INCLUDE IMMIGRANTS, THE HOMELESS, AS WELL AS INDIVIDUALS WITH LOW EDUCATION AND INCOME LEVELS. RUSSELL COUNTY HOSPITAL PART V, SECTION B, LINE 11: PER A REVIEW OF THE UPDATES TO THE ACTION PLANS AND STRATEGIES LISTED IN THE IMPLEMENTATION STRATEGY, THE PRIORITIES ARE IN THE PROCESS OF BEING MET. RUSSELL COUNTY HOSPITAL PART V, SECTION B, LINE 13B: UNINSURED PATIENTS ARE CONSISTENTLY SUPPLIED WITH THE STATE DSH APPLICATION. THIS APPLICATION IS PROCESSED BY DISABILITY MEDICAL CONSULTANTS TO DETERMINE IF THE PATIENT QUALIFIES FOR KENTUCKY FINANCIAL ASSISTANCE THROUGH THE STATE PROGRAM, THEN THE PATIENT'S INFORMATION IS SCREENED FOR INTERNAL CHARITY ASSISTANCE. UNINSURED PATIENTS SCHEDULED FOR HIGH DOLLAR PROCEDURES ARE NOT SCREENED PRIOR TO SERVICE. THEY ARE SUBJECT TO THE SAME SCREENNG PROCESS AS OTHER PATIENTS. UNINSURED PATIENTS ARE NOT ROUTINELY VISITED BY FINANCIAL COUNSELORS. THEY ARE VISITED UPON REQUEST AND PROVIDED A DSH APPLICATION TO START THE SCREENING PROCESS. DISABILITY MEDICAL CONSULTANTS CONDUCT THE SCREENING FOR FINANCIAL ASSISTANCE REQUESTS. DMC REVIEWS THE PATIENT'S APPLICATION AND INCOME/ASSET INFORMATION. IN-HOUSE CHARITY ASSISTANCE IS AWARDED BASED ON A SLIDING SCALE OF INCOME AND FAMILY SIZE. A LEVEL OF ASSISTANCE IS AVAILABLE TO PATIENTS WITH INCOMES UP TO 200% OF FEDERAL POVERTY LEVEL. KENTUCKY STATE DSH ASSISTANCE IS AWARDED ONLY TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR MEDICAID. RUSSELL COUNTY HOSPITAL EXTENDS CHARITY ASSISTANCE TO ANY PATIENTS MEETING ITS INCOME GUIDELINE CRITERIA. CHARITY CARE RECIPIENTS MUST PAY TAXES IN RUSSELL COUNTY. THERE ARE NO CATASTROPHIC MAXIMUMS IN PLACE. PATIENTS CAN APPLY FOR CHARITY ASSISTANCE AND WILL BE JUDGED ON INCOME LEVELS AND FAMILY SIZE. ALSO, CHARITY CARE IS AWARDED FOR A PERIOD OF 6 MONTHS. 3 1 - FAMILY PRACTICE ASSOCIATES OF RUSSELL CO 124 DOWELL ROAD RUSSELL SPRINGS KY 42642 RURAL HEALTH CLINIC 2 - PRIMARY CARE ASSOCIATES OF RUSSELL CO 92 JOE T PETTY DR RUSSELL SPRINGS KY 42642 RURAL HEALTH CLINIC 3 - SURGICAL CONSULTANTS OF RUSSELL CO HOSP 169 JOE T PETTY DRIVE RUSSELL SPRINGS KY 42642 GENERAL SURGERY PART III, LINE 2: BAD DEBT AMOUNTS ON THE FINANCIAL STATEMENTS REPRESENT UNPAID CO-INSURANCE AND DEDUCTIBLES AND ALL SELF-PAY ACCOUNTS THAT GO UNPAID. AMOUNTS ARE NOT WRITTEN OFF UNTIL RUSSELL COUNTY HOSPITAL KNOWS THEY WILL NOT BE PAID. FOR LINE 3, ANY AMOUNTS THAT COULD BE LISTED WOULD BE NEGLIGIBLE AND THUS ARE NOT ESTIMATED. RUSSELL COUNTY HOSPITAL HAS A POLICY OF PROVIDING CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON FINANCIAL INFORMATION OBTAINED FROM THE PATIENT AND SUBSEQUENT ANALYSIS. SINCE RUSSELL COUNTY HOSPITAL DOES NOT EXPECT PAYMENT, ESTIMATED CHARGES FOR CHARITY CARE ARE NOT REPORTED IN NET REVENUE, AND THUS WOULD NOT BE WRITTEN OFF TO BAD DEBT EXPENSE. PART III, LINE 8: THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL. LINE 6 COSTS REPRESENT MEDICARE CHARGES MULTIPLIED BY A CALCULATED COST-TO-CHARGE RATIO FOR ANCILLARY SERVICES AND MEDICARE DAYS MULTIPLIED BY A CALCULATED PER DIEM AMOUNT FOR ROUTINE SERVICES. PART III, LINE 9B: FOR ANY PATIENT WHO MAY OR IS KNOWN TO QUALIFY FOR SERVICES UNDER CHARITY CARE, THE COLLECTION POLICY PROVIDES THAT THE HOSPITAL SHOULD GATHER SUPPORTING DOCUMENTATION AND DETERMINE WHETHER THE PATIENT NEEDS TO PAY. PART VI, LINE 2: THE ASSESSMENT PROCESS FOCUSED ON COLLECTING PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY CRITICAL AREAS OF CONCERN. RUSSELL COUNTY HOSPITAL DEVELOPED INTERVIEW QUESTIONS AND A SURVEY THAT WOULD BE THE TOOLS TO GATHER INFORMATION FROM KEY STAKEHOLDERS IN THE COMMUNITY. CONVERSATIONS WERE CONDUCTED WITH COMMUNITY LEADERS AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF OR SENT SURVEYS THAT COULD BE COMPLETED ONLINE. THE COMMUNITY OUTREACH DATA COLLECTION STRATEGY WAS TARGETED AT ENGAGING A CROSS-SECTION OF RESIDENTS FROM THE COMMUNITY. ONCE DATA HAD BEEN COLLECTED AND ANALYZED, MEETINGS WITH HOSPITAL LEADERSHIP WERE HELD TO DISCUSS KEY FINDINGS AND REFINE AND PRIORITIZE THE COMPREHENSIVE LIST OF COMMUNITY NEEDS, SERVICES, AND POTENTIAL GAPS. SIGNIFICANT NEEDS WERE FURTHER REVIEWED AND ANALYZED REGARDING HOW CLOSELY THE NEED ALIGNS WITH THE HOSPITAL'S MISSION, CURRENT AND KEY SERVICE LINES, AND/OR STRATEGIC PRIORITIES. PART VI, LINE 3: EACH PATIENT IS INSTRUCTED ABOUT THE FINANCIAL ASSISTANCE POLICY AS THEY REGISTER FOR SERVICE. PATIENTS WITHOUT INSURANCE ARE ASKED TO COMPLETE A SHORT FORM TO DETERMINE THEIR ELIGIBILITY FOR CHARITY OR GOVERNMENT PROGRAMS. PART VI, LINE 4: RUSSELL COUNTY HOSPITAL CONDUCTED THE CHNA DURING 2023 ON BEHALF OF THE APPROXIMATELY 18,156 (2020 US CENSUS) RESIDENTS OF RUSSELL COUNTY AND THE PATIENTS SERVED BY THE HOSPITAL FROM NEIGHBORING COMMUNITIES. ADDITIONALLY, THE HOSPITAL PROVIDES SERVICES TO MEMBERS OF THE BORDERING COUNTIES OF CASEY (NORTH), PULASKI (NORTHEAST), WAYNE (SOUTHEAST), CLINTON (SOUTH), RUSSELL (SOUTHWEST) AND ADAIR (WEST). RUSSELL COUNTY HOSPITAL'S PRIMARY SERVICE AREA INCLUDES RUSSELL COUNTY, WHICH COVERS ROUGHLY 283 SQUARE MILES, WITH THE LOCAL ECONOMY AND SURROUNDING AREAS FOCUSED ON MANUFACTURING, RETAIL TRADE, HEALTH CARE AND SOCIAL ASSISTANCE. 2022 CENSUS DATA ALSO REPORTS THAT THE MEDIAN AGE IN RUSSELL COUNTY IS 42.5. THE MEDIAN AGE FOR THE UNITED STATES IS 38.1 YEARS. THE NUMBER OF PERSONS PER HOUSEHOLD IN RUSSELL COUNTY IS 2.53. THE U.S. AVERAGE NUMBER OF PERSONS PER HOUSEHOLD IS 2.53. RACE IN RUSSELL COUNTY IS AS FOLLOWS: 96.7% WHITE, 0.9% BLACK OR AFRICAN AMERICAN, 0.5% NATIVE AMERICAN, 0.6% ASIAN, 0% PACIFIC ISLANDER, 0% FROM OTHER RACES, AND 1.3% FROM TWO OR MORE RACES. 3.9% OF THE POPULATION WERE HISPANIC OR LATINO OF ANY RACE. PERSONS 65 YEARS AND OLDER REPRESENT 20.6% OF THE POPULATION AND PERSONS UNDER THE AGE OF 18 YEARS REPRESENT 22.9% OF THE POPULATION OF THE COUNTY. IN RUSSELL COUNTY THERE IS 1 PRIMARY CARE DOCTOR TO 2,970. THE KENTUCKY AVERAGE IS 1,540 TO 1. THE OVERALL HEALTH RANKING FOR RUSSELL COUNTY IS 86 OUT OF 120, WITH THE GENERAL STATE RANKING BEING 45TH OUT OF 50 STATES. PART VI, LINE 5: RUSSELL COUNTY HOSPITAL HAS THE 340B DRUG PROGRAM, THE INDIGENT PORTION OF THE PROGRAM IS INCOME BASED. RCH ALSO PROVIDED LAB DRAWS FOR LOCAL FACTORIES AND THE LOCAL SCHOOL SYSTEM. X X 0 0 0 0 0 0 0 0 0 TOMMY SHELTON PHYSICIAN 658711 0 100 0 135 0 6100 0 20507 0 685553 0 0 0 RICHARD PERKINS PHYSICIAN 523814 0 100 0 34168 0 5185 0 37891 0 601158 0 0 0 JONAS HURLEY PHYSICIAN 525159 0 100 0 7414 0 4630 0 35830 0 573133 0 0 0 MILTON JACKSON PHYSICIAN 418969 0 100 0 9588 0 6100 0 29591 0 464348 0 0 0 LEANN COOPER PHYSICIAN 274862 0 25100 0 81 0 6068 0 33136 0 339247 0 0 0 JUDY WITHERS CNO 138562 0 100 0 1850 0 2825 0 26160 0 169497 0 0 0 JANIE LANDIS CFO 129653 0 100 0 8974 0 2802 0 46481 0 188010 0 0 0 DR LEANN COOPER DAUGHTER OF BOARD MEMBER 247804 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 8B PER THE BYLAWS, THERE IS NO OTHER COMMITTE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS, CEO AND CFO ARE PROVIDED WITH A COPY OF THE 990 TO REVIEW IN ITS ENTIRETY BEFORE IT IS ULTIMATELY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE PREPARED AND REVEIWED ANNUALLY TO DETERMINE IF ANY CONFLICTS EXIST. FURTHER, CONFLICT ACTIVITY IS MONITORED THROUGHOUT THE YEAR TO MAKE SURE THAT CONFLICTS OF INTEREST DO NOT ARISE. SHOULD A CONFLICT ARISE, THE BOARD MEMBER WILL ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: THE BOARD OF DIRECTORS DETERMINES THE CEO'S COMPENSATION AND REVIEWS IT ANNUALLY. COMPENSATION SURVEYS AND EMPLOYMENT CONTRACTS ARE USED DURING THE PROCESS. LINE 15B: THE CEO, WITH APPROVAL FROM THE BOARD, DETERMINES THE CFO AND OTHER TOP MANAGEMENT OFFICIALS' COMPENSATION. COMPENSATION SURVEYS AND EMPLOYMENT CONTRACTS ARE USED DURING THE PROCESS, WHICH IS REVEIWED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND AT THE DISCRETION OF THE BOARD OF DIRECTORS AND MANAGEMENT. RUSSELL COUNTY MEDICAL CLINIC PO BOX 1328 RUSSELL SPRINGS KY 42642 610965365 RENTAL KY RUSSELL COUNTY EXCLUDED 721 5861 0 0 0.85720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0