2025-02-14T12:14:20+00:00 2024-03-31 440160260 Forvis Mazars LLP 1222 Demonbreun St Suite 950 Nashville TN 372033357 990 2023-04-01 542142034 COMMONWEALTH REGIONAL SPECIALTY HOSPITAL INC COMM 2707451551 800 PARK STREET BOWLING GREEN KY 42101 MICHELE LAWLESS 2707451551 2025-02-14 true Jeff Smith P00289876 6154549800 2025-02-13 2023 2025-03-06 01:10:19Z CONNIE SMITH 800 PARK STREET BOWLING GREEN KY 42101 6606502 false X MEDCENTERHEALTH.ORG/LOCATION/COMMONWEALTH-REG X 2003 KY THE HOSPITAL IS DESIGNED TO MEET MEDICAL, THERAPEUTIC AND FAMILIAL NEEDS RELATED TO PROVIDING LONG-TERM ACUTE CARE SERVICES FOR INDIVIDUALS WITH CRITICAL DISEASES OR DISORDERS. 7 6 53 0 0 0 2200 6899242 6241845 -71541 17201 6907 6747 6834608 6267993 0 0 4274334 4314325 0 0 3485111 3356592 7759445 7670917 -924837 -1402924 3556605 2554162 1210779 1586482 2345826 967680 THE HOSPITAL IS DESIGNED TO MEET THE MEDICAL, THERAPEUTIC AND FAMILIAL NEEDS RELATED TO PROVIDING LONG-TERM ACUTE CARE SERVICES REQUIRED BY INDIVIDUALS WITH CRITICAL DISEASE OR DISORDERS. false false 6954346 6241845 Commonwealth Regional Specialty Hospital (CRSH) provides long-term acute care services in the community of Bowling Green, Warren County, Kentucky. CRSH provides medical treatment and rehabilitation to chronically and/or critically ill patients in its 16-bed long-term acute care facility. During fiscal year 2024, CRSH admitted 172 patients and provided 4,277 days of patient care. Commonwealth Health Corporation (CHC) formed Commonwealth Regional Specialty Hospital (CRSH) in 2003 to meet an existing need for long-term acute care hospital services in the community of Bowling Green, Warren County, Kentucky. CHC also recognized the need of the continuum of care to provide an appropriate venue for patients who needed acute services beyond those generally available in the acute care hospital setting. Long-term acute care hospitals (as recognized by 42 CFR 412.23 e) generally provide diagnostic, medical, and rehabilitative treatment for those patients with chronic and complex medical conditions whose average length of stay in the hospital exceeds 25 days. CRSH is primarily engaged in providing to inpatients, by or under the supervision of physicians, diagnostic and therapeutic services for medical diagnosis, treatment, and care of those patients with chronic illness and complex medical needs. It maintains clinical records on all patients and has bylaws in effect concerning its staff of physicians. It requires that every patient be under the care of a physician and provides 24-hour nursing service by or supervised by a registered professional nurse. It has a hospital utilization review plan and is licensed or is approved by the state of Kentucky as meeting the standards established for such licensing. It also meets other health and safety requirements of the secretary of health and human services. This hospital is not primarily for the care and treatment of mental diseases. Services offered include: . Acute medical care . Complicated wound care . Respiratory therapy . Laboratory services . Pharmacy services . Ventilator weaning services . Cardiac/cardiovascular conditions services . Renal insufficiency, renal failure, hemodialysis services . Post-traumatic stress with extensive acute medical needs . Extended intensive care needs . Radiology services . Long-term iv antibiotic therapy . Rehabilitation needs to accompany acute medical care The hospital's professional staff includes physicians who are engaged in the practice of medicine and who represent multiple specialties, including but not limited to family practice, internal medicine, pulmonary, cardiac, radiation therapy, and infectious disease. The staff includes nurses, physical, occupational, and speech therapists, respiratory therapists, pharmacists, social workers, dietitians, and others. Using an interdisciplinary team approach, the staff work collaboratively to provide care consisting of inpatient services of a general and specialized nature for patients requiring an extended length of stay due to the critical nature of their illness. 6954346 true false false true false false false false false true false false false true false true true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 5 0 true 53 true false false false false false false false false false false false false X 7 6 false false false false true true false true true false false true true true true true true false false false KY X JENNY GREENWELL 2707451551 PO BOX 9876 800 PARK STREET BOWLING GREEN KY 42101 MR JOE DAVIS VICE CHAIR 2.0 0.0 X X 0 0 0 MR TOMMY HOLDERFIELD CHAIRMAN 2.0 4.0 X X 0 0 0 MS VICKIE ELROD SECRETARY 2.0 0.0 X X 0 0 0 DR D GHAYTH HAMMAD DIRECTOR 2.0 4.0 X 4000 0 0 MR TOM FORTE DIRECTOR 2.0 0.0 X 0 0 0 MS CHERI NATCHER DIRECTOR 2.0 4.0 X 0 0 0 MS SUSAN JONES DIRECTOR 2.0 0.0 X 0 0 0 MR DAVID GRAY EXECUTIVE VICE PRESIDENT 2.0 50.0 X 0 427268 92783 MR WADE STONE EXECUTIVE VICE PRESIDENT 2.0 50.0 X 0 438705 61739 MS CONNIE D SMITH PRESIDENT / CEO 2.0 52.0 X 0 1317162 119091 MS KATRINA WOOD EVP/CHIEF NURSING OFFICER 2.0 50.0 X 0 258853 37153 MS MICHELE LAWLESS EXECUTIVE VICE PRESIDENT / CFO 2.0 50.0 X 0 481930 47348 MR ERIC HAGAN VP OF RURAL HOSPITALS 4.0 36.0 X 30808 277274 21317 DENISE ANDERSON MCH AGENCY NURSE 40.0 0.0 X 162343 0 0 MR SETH SMITH ADMINISTRATOR 40.0 0.0 X 102780 0 12384 MS ELIZABETH SCHMIDT PHARMACY MANAGER 32.0 0.0 X 109617 0 40053 MS JOELL BETH LOVE MCH AGENCY NURSE 40.0 0.0 X 166204 0 0 575752 3201192 431868 4 false true false 0 2200 2200 INPATIENT SVCS PROVIDED 623000 6241845 6241845 0 0 0 0 6241845 13747 13747 0 0 341963 338509 3454 0 3454 3454 MISC. INCOME 900099 6747 6747 0 0 0 0 6747 6267993 6241845 0 23948 X 36940 0 36940 0 3290970 3119070 171900 187274 175522 11752 551937 517302 34635 247204 230747 16457 338400 338400 2523 2523 36190 36190 2062 2062 1167468 1167092 376 0 1854 1854 172732 165818 6914 36464 36464 230056 210084 19972 24762 24762 8392 8392 19798 19798 138803 133132 5671 MEDICAL SUPPLIES 806986 806986 PROVIDER TAX 344092 344092 DUES & SUBSCRIPTIONS 15456 15456 RECRUITING FEES 7077 7077 3477 3477 0 0 7670917 6954346 716571 0 778427 185617 529048 593035 1565182 1475878 0 0 0 0 98835 98593 54492 37546 940245 836368 123675 103877 0 0 406946 59616 3556605 2554162 960324 1069067 0 0 250455 517415 1210779 1586482 X 2345826 967680 2345826 967680 3556605 2554162 -1402924 24779 0 X false true X true false X false false false false false false false false true 2062 2062 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE CORPORATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS. OF THE DUES PAID TO THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS, $2,062 WAS ALLOCATED TO LOBBYING ACTIVITIES. 937395 833518 103877 2850 2850 0 103877 DUE TO AFFILIATES 482295 LEASE LIABILITIES 35120 517415 6292772 24779 0 24779 6267993 0 0 6267993 7670918 0 0 7670918 0 0 7670918 Schedule D, Part X, Line 2 INCOME TAXES THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FOOTNOTE THAT ADDRESSED THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN48 (ASC 740). MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true true true false true true 0 5 216202 0 216202 0.0282 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 5 216202 0 216202 0.0282 1 0 99072 0 99072 0.0129 1 1 8441 0 8441 0.0011 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 2 1 107513 0 107513 0.0140 2 6 323715 0 323715 0.0422 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 1 23786 0 23786 0.0031 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 1 23786 0 23786 0.0031 true 23010 282410 3759307 5660924 -1901617 X true true 1 1 COMMONWEALTH REGIONAL SPECIALTY HOSPITAL INC 250 PARK STREET BOWLING GREEN KY 42101 WEBSITE-SEE SCHEDULE O FOR WEBSITE ADDRESS 100404 X COMMONWEALTH REGIONAL SPECIALTY HOSPITAL INC 1 false false true X X X X X X X X 22 true true true true X HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X true 22 true HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT false true X 200.0 400.0 X X X X X X true true X X X true X HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/ X HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/ X HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.. IN SEPTEMBER 2011, COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) JOINED WITH THE BARREN RIVER DISTRICT HEALTH DEPARTMENT AND NUMEROUS OTHER HEALTHCARE PROVIDERS, COMMUNITY ORGANIZATIONS AND LEADERS TO FORM THE BARREN RIVER COMMUNITY HEALTH PLANNING COUNCIL. THE GOAL OF THE COUNCIL WAS TO RECOGNIZE AND SERVE THOSE MOST IN NEED IN ORDER TO BENEFIT THE WHOLE COMMUNITY. THE COUNCIL IMPLEMENTED A COMMUNITY HEALTH NEEDS SURVEY AND ASSESSMENT PROCESS. KEY HEALTHCARE NEEDS FOR THE COMMUNITY WERE IDENTIFIED FOLLOWED BY THE DEVELOPMENT OF STRATEGIC PLANS TO MEET THOSE NEEDS. THE PROCESS USED WAS PRIMARILY BASED ON THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP), WHICH WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. COMMUNITY #1, #2, AND #3 SURVEYS WERE CONDUCTED IN 2011, 2015, AND 2018. COMMONWEALTH REGIONAL SPECIALTY HOSPITAL USED THE DATA COLLECTED THROUGH THE SURVEYS TO DEVELOP STRATEGIC PLANS THAT ADDRESSED STRENGTHENING PARTNERSHIPS WITH COMMUNITY HEALTH PROVIDERS AND ORGANIZATIONS, PREVENTATIVE CARE AND DISEASE MANAGEMENT AND ACCESS TO CARE. DURING THE FALL AND WINTER OF 2014-15, THE COUNCIL WAS RENAMED THE BARREN RIVER INITIATIVE TO GET HEALTHY TOGETHER (BRIGHT) COALITION. CYCLE #4 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR THE 2022-2024 TIME PERIOD. MED CENTER HEALTH USED PRIMARY DATA OBTAINED FROM A COMMUNITY SURVEY IN PARTNERSHIP WITH BRIGHT COALITION AND BARREN RIVER HEALTH DEPARTMENT. A SECONDARY SURVEY TO COMMUNITY LEADERSHIP WAS USED AS WELL AS SECONDARY MARKET RESEARCH. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.. OTHER FACILITIES THE HOSPITAL'S CHNA WAS CONDUCTED WITH INCLUDE THE BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER), THE MEDICAL CENTER AT FRANKLIN, MONROE COUNTY MEDICAL CENTER, AND TJ SAMSON COMMUNITY HOSPITAL. A FULL LIST OF THESE ORGANIZATIONS CAN BE FOUND ON PAGE 3 OF THE BRIGHT COALITION COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN 2019-2021 LOCATED AT HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. WITHIN BRIGHT, THESE STAKEHOLDERS JOINED FORCES TO DETERMINE HOW LEADERS OF SOUTH-CENTRAL KENTUCKY'S RURAL COMMUNITIES CAN WORK TOGETHER TO IMPROVE OVERALL HEALTH STATUSES, STRENGTHEN THE LOCAL ECONOMY, CONTRIBUTE TO EDUCATION SUCCESSES, AND IMPROVE THE QUALITY OF LIFE FOR ALL. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.. THERE MAY BE CIRCUMSTANCES WHERE A PATIENT/GUARANTOR MAY END UP OWING AN AMOUNT THAT IS LARGE IN RELATION TO HIS INCOME, BUT STILL NOT MEET OUR STANDARD FINANCIAL ASSISTANCE (CHARITY CARE) GUIDELINES, AND BECAUSE WE DO NOT WANT TO CREATE WHAT IS COMMONLY KNOWN AS "MEDICAL INDIGENCY," WE ALSO APPLY THE FOLLOWING GUIDELINES TO FINANCIAL ASSISTANCE APPLICATIONS: 1) ONLY PERSONS OR FAMILIES WHO MAKE LESS THAN 20 TIMES (2000%) OF THE SINGLE PERSON FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE. THE PURPOSE OF THIS REQUIREMENT IS TO LIMIT THE INCENTIVE TO NOT PURCHASE HEALTH INSURANCE IF A PERSON CAN AFFORD IT. 2) A SELF-PAY PORTION OF A BILL GREATER THAN 20% OF ANNUAL INCOME QUALIFIES A PERSON FOR CATASTROPHIC FINANCIAL ASSISTANCE. 3) THE AMOUNT DUE FROM CATASTROPHIC FINANCIAL ASSISTANCE APPLICANTS IS CAPPED AT 50% OF THEIR DOCUMENTED AND VERIFIED ANNUAL INCOME PLUS THE AMOUNT THE PATIENT'S LIQUID ASSETS ARE GREATER THAN $10,000. 4) WE ALLOW PAYMENT OF THIS CAPPED AMOUNT OVER A PERIOD OF UP TO 10 YEARS, OR UP TO 15 YEARS AVAILABLE WITH MANAGEMENT'S APPROVAL. 5) THESE PAYMENTS ARE TREATED AS LONG-TERM, INTEREST FREE PAYMENT AGREEMENTS AND REQUIRE A WRITTEN AGREEMENT. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.. PERSONS OR FAMILIES THAT QUALIFY FOR MEDICAID, FOOD STAMPS, AND OTHER INDIGENT CARE PROGRAMS THAT CAN BE AND ARE INDEPENDENTLY VERIFIED ARE DEEMED TO MEET THE FINANCIAL ASSISTANCE GUIDELINES, AS WILL ACCOUNTS IDENTIFIED THROUGH TOOLS OR PROGRAMS WHICH PROVIDE REASONABLE ASSURANCE THAT THE OBLIGATION MEETS OUR FINANCIAL ASSISTANCE GUIDELINES. 0 Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY ELIGIBILITY FOR FREE CARE IS LIMITED TO PATIENTS OR GUARANTOR'S WHO MEET ONE OF THE TWO FOLLOWING GUIDELINES AND APPLY FOR PUBLIC PROGRAMS THAT MAY PAY FOR THEIR HEALTHCARE SERVICES IF ELIGIBLE: (A) PATIENTS WHOSE INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LIMIT; (B) PATIENTS WHO QUALIFY FOR MEDICAID, FOOD STAMPS, OR OTHER INDIGENT CARE PROGRAMS. LIQUID ASSETS IN EXCESS OF $10,000 ARE INCLUDED AS INCOME. ELIGIBILITY FOR DISCOUNTED CARE IS LIMITED TO PATIENTS OR GUARANTOR'S WHOSE INCOME IS GREATER THAN 200% OF FEDERAL POVERTY LIMITS BUT LESS THAN OR EQUAL TO 400% OF FEDERAL POVERTY LIMITS. LIQUID ASSETS IN EXCESS OF $10,000 ARE INCLUDED AS INCOME. SEE THE NARRATIVES FOR LINES 13B AND 13H FOR MORE DETAIL. Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT THE ANNUAL REPORT TO THE COMMUNITY IS POSTED ON COMMONWEALTH HEALTH CORPORATION'S WEBSITE AT: HTTPS://MEDCENTERHEALTH.ORG/ABOUT-US/ Schedule H, Part I, Line 7 COSTING METHODOLOGY A COST ACCOUNTING SYSTEM WAS USED FOR CALCULATIONS ON IRS WORKSHEETS 1 AND 3. THE COSTS RELATED TO MEDICAID PATIENTS WERE DETERMINED USING A COST ACCOUNTING SYSTEM. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990. Schedule H, Part VI, Line 2 NEEDS ASSESSMENT COMMONWEALTH REGIONAL SPECIALTY HOSPITAL ("CRSH") IS BUILT UPON THE FOUNDATION OF SERVING OUR COMMUNITY, DAY IN AND DAY OUT, WITH QUALITY DEPENDABLE HEALTHCARE. CRSH'S CHNA AND STRATEGIC IMPLEMENTATION PLAN ARE POSTED AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE UPON REGISTRATION, PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY OF OUR FINANCIAL ASSISTANCE POLICY WITH INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE AND CONTACT INFORMATION FOR ADDITIONAL ASSISTANCE. SIGNAGE AND BROCHURES DESCRIBING FINANCIAL ASSISTANCE POLICIES ARE AVAILABLE. ADDITIONALLY, THE POLICY AND APPLICATION ARE PUBLICLY AVAILABLE ON THE MEDICAL CENTER'S WEBSITE. UNINSURED PATIENTS DISCUSS PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE WITH FINANCIAL COUNSELORS WHO INFORM THESE PATIENTS ABOUT OUR POLICY AND ASSIST THEM IN APPLYING IF NECESSARY. SUBSEQUENT PATIENT STATEMENTS RECEIVED BY THE PATIENT CONTAIN INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE. Schedule H, Part VI, Line 4 COMMUNITY INFORMATION COMMONWEALTH REGIONAL SPECIALTY HOSPITAL SERVES THE NEEDS OF PATIENTS AND PHYSICIANS OF BOWLING GREEN, KY AND SURROUNDING COUNTIES. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) FOCUSES ON TREATING COMPLEX, HIGH ACUITY PATIENTS WITH ADVANCED CLINICAL SKILLS, COMPASSION AND SENSITIVITY TO THE NEEDS OF THE PATIENT AND FAMILY. CRSH UTILIZES A MULTIDISCIPLINARY APPROACH, OFTEN NOT AVAILABLE IN THE SHORT STAY HOSPITAL. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) IS OWNED AND CONTROLLED BY COMMONWEALTH HEALTH CORPORATION, A RELATED 501(C)3) ORGANIZATION. COMMONWEALTH HEALTH CORPORATION (CHC) IS A HOLDING COMPANY FOR A TOTAL OF TWELVE FOR-PROFIT AND NONPROFIT CORPORATIONS AND PARTNERSHIPS COLLECTIVELY, THE "AFFILIATES" ENGAGED IN VARIOUS ASPECTS OF THE HEALTH CARE INDUSTRY. CHC OWNS AND OPERATES MULTIPLE PHYSICIAN PRACTICES, WHICH ARE DESIGNED TO ATTRACT AND RETAIN HIGHLY SKILLED PHYSICIANS IN SPECIALTIES THAT SUPPORT THE MISSION OF CHC AND ITS AFFILIATES. IN ADDITION, CHC OPERATES AND PROVIDES VARIOUS CORPORATE SUPPORT SERVICES INCLUDING PATIENT BILLING, COLLECTIONS, ACCOUNTING, MATERIALS MANAGEMENT, ENGINEERING, SECURITY, HUMAN RESOURCES, INFORMATION SYSTEMS, AND ADMINISTRATIVE SUPPORT TO ITS AFFILIATES. CHC HAS ESTABLISHED VARIOUS DIVISIONS FOR ITS OPERATIONS, INCLUDING THE NONPROFIT ORGANIZATIONS DESCRIBED BELOW (IN ADDITION TO CRSH) AND OTHER NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS. BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER): ----------------- BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER) IS A NONPROFIT KENTUCKY CORPORATION THAT OPERATES A 337-BED HOSPITAL FACILITY IN BOWLING GREEN, KENTUCKY UNDER THE NAME THE MEDICAL CENTER AT BOWLING GREEN AND SINCE OCTOBER 1996, A 25-BED CRITICAL ACCESS HOSPITAL AND 110-BED NURSING HOME FACILITY IN SCOTTSVILLE, KENTUCKY, UNDER THE NAME THE MEDICAL CENTER AT SCOTTSVILLE. IN ADDITION, SINCE JANUARY 2016, THE CORPORATION HAS OPERATED A 25-BED CRITICAL ACCESS ACUTE CARE HOSPITAL IN HORSE CAVE, KENTUCKY UNDER THE NAME THE MEDICAL CENTER AT CAVERNA. THE THREE FACILITIES ARE PART OF ONE CORPORATION BUT ARE LICENSED INDEPENDENTLY BY THE STATE OF KENTUCKY. THE MEDICAL CENTER AT BOWLING GREEN IS THE SOLE MEMBER OF MEDICAL CENTER EMS, LLC (EMS), MEDICAL CENTER PHARMACY OF BOWLING GREEN, LLC (RIVERSIDE PHARMACY) AND ENSPIRE QUALITY PARTNERS, LLC (MED CENTER HEALTH PARTNERS). EMS PROVIDES AMBULANCE SERVICES IN WARREN COUNTY, KENTUCKY. RIVERSIDE OFFERS RETAIL PHARMACY SERVICES IN BOWLING GREEN, KY. MED CENTER HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS, WORKING TOGETHER UNDER A PHYSICIAN-LED STRUCTURE TO IMPROVE POPULATION HEALTH, IMPROVE PATIENT EXPERIENCE AND REDUCE THE COST OF HEALTHCARE. THE CORPORATION IS BOTH THE LIMITED PARTNER AND A GENERAL PARTNER IN THE MEDICAL PLAZA PARTNERS, LLP WHICH PROVIDES ON-CAMPUS SPACE FOR HOSPITAL DEPARTMENTS AND OTHER NON-AFFILIATE MEDICAL-RELATED SERVICES. TOGETHER WITH ANOTHER AREA NON-PROFIT ACUTE CARE HOSPITAL CORPORATION, TMC IS AN EQUAL OWNER OF THE BARREN RIVER REGIONAL CANCER CENTER, INC., AN OUTPATIENT RADIATION THERAPY CARE SERVICE LOCATED IN GLASGOW, KENTUCKY. THE MEDICAL CENTER AT SCOTTSVILLE OPERATES TWO RURAL HEALTH CLINICS, ONE IN SCOTTSVILLE, KY AND ONE IN FOUNTAIN RUN, KY. THE MEDICAL CENTER AT CAVERNA OPERATES TWO RURAL HEALTH CLINICS, ONE IN MUNFORDVILLE, KY AND ONE IN HORSE CAVE, KY. COMMONWEALTH HEALTH FREE CLINIC, INC.: -------------------- COMMONWEALTH HEALTH FREE CLINIC, INC. (CHFC) WAS ORGANIZED TO OPERATE A CLINIC, WHICH PROVIDES BASIC MEDICAL AND DENTAL DIAGNOSTIC AND TREATMENT SERVICES FOR CHARITABLE PURPOSES FOR THE UNINSURED AND UNDERINSURED OF SOUTH-CENTRAL KENTUCKY AND ALSO SERVES INDIVIDUALS WHO MAY BE COVERED BY SOME FORM OF INSURANCE, BUT WHO ARE UNABLE TO ACCESS A PROVIDER FOR ACUTE OR CHRONIC HEALTHCARE ISSUES. THE CLINIC OFFERS SERVICES INCLUDING NON-EMERGENCY CLINICAL SERVICES, DENTISTRY, COMMUNITY HEALTH EDUCATION AND COUNSELING, DISEASE/CONDITION SPECIFIC EDUCATION AND COUNSELING, AND ACCESS TO PHARMACEUTICALS. THE MEDICAL CENTER AT FRANKLIN, INC.: --------------------- THE MEDICAL CENTER AT FRANKLIN, INC. (MCF) OPERATES A HOSPITAL IN THE COMMUNITY OF FRANKLIN, SIMPSON COUNTY, KENTUCKY. THIS LOCATION IS JUST 20 MILES FROM THE MEDICAL CENTER'S BOWLING GREEN CAMPUS. MCF IS A MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL OFFERING ACUTE CARE INPATIENT AND OUTPATIENT PROGRAMS IN ITS 25 BED ACUTE CARE FACILITY. THE MEDICAL CENTER AT FRANKLIN, INC. OPERATES A RURAL HEALTH CLINIC IN FRANKLIN, KENTUCKY. THE MEDICAL CENTER AT ALBANY: ------------------------ ON APRIL 1, 2016, COMMONWEALTH HEALTH CORPORATION, INC. (CHC) ACQUIRED THE NET ASSETS OF CLINTON COUNTY HOSPITAL, INC., AN ACUTE-CARE HOSPITAL. THE CORPORATION ASSIGNED THE NET ASSETS OF THE HOSPITAL TO ITS WHOLLY OWNED SUBSIDIARY, THE MEDICAL CENTER AT CLINTON COUNTY, INC., D/B/A THE MEDICAL CENTER AT ALBANY (MCA). MCA EARNS REVENUE BY PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN CLINTON COUNTY AND SURROUNDING COUNTIES IN KENTUCKY. COMMONWEALTH HEALTH FOUNDATION: ------------------------ CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION (THE FOUNDATION) FOR THE PURPOSE OF FOSTERING, SUPPORTING AND INITIATING ACTIVITIES FOR AFFILIATED NON-PROFIT 501(C)(3) ORGANIZATIONS. THE FOUNDATION BUILDS RELATIONSHIPS THAT INSPIRE CHARITABLE GIVING IN SUPPORT OF CHC'S MISSION TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. BLUEGRASS OUTPATIENT CENTER: --------------------------- SINCE 2008, CHC HAS BEEN THE SOLE OWNER OF BLUEGRASS OUTPATIENT CENTER OF BOWLING GREEN, LLC (BLUEGRASS). BLUEGRASS PROVIDES COMPREHENSIVE OUTPATIENT REHABILITATION THERAPY SERVICES. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH CRSH DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED MARCH 31, 2024. HOWEVER, CRSH INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. Schedule H, Part III, Line 3 Bad Debt Expense Methodology COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN FINANCIAL ASSISTANCE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, CRSH EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING OPTIONS FOR FINANCIAL ASSISTANCE. FOR THESE REASONS, CRSH BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS NEGLIGIBLE. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs COSTS REPORTED ON LINE 6 ARE OBTAINED FROM THE COST ACCOUNTING SYSTEM, WHICH ARE BASED UPON COST ACCOUNTING STANDARD PRINCIPALS OF ALLOCATING DIRECT AND INDIRECT EXPENSES TO SERVICES PERFORMED. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance COMMONWEALTH REGIONAL SPECIALTY HOSPITAL (CRSH) PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. CRSH DOES NOT PURSUE THE COLLECTION OF AMOUNTS DETERMINED TO BE TRADITIONAL FINANCIAL ASSISTANCE. BECAUSE CRSH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, REVENUE IS NOT RECORDED FOR SUCH SERVICES. THESE AMOUNTS ARE EXCLUDED FROM NET PATIENT SERVICE REVENUE. CRSH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF FINANCIAL ASSISTANCE THEY PROVIDE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THEIR FINANCIAL ASSISTANCE POLICY. OTHER UNCOMPENSATED CARE RELATES PRINCIPALLY TO CONTRACTUAL ALLOWANCES FOR GOVERNMENT PAYERS, DISCOUNTS TAKEN BY COMMERCIAL PAYERS AND BAD DEBTS. CRSH PROVIDES SERVICES TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES OR WHO ARE UNINSURED. Schedule H, Part V, Section B, Line 16a FAP website - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.: Line 16a URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16b FAP Application website - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.: Line 16b URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.: Line 16c URL: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/; false true false false false false false false false MS CONNIE D SMITH PRESIDENT / CEO 0 1036405 0 0 0 280757 0 98270 0 20821 0 1436253 0 0 MR WADE STONE EXECUTIVE VICE PRESIDENT 0 435730 0 0 0 2975 0 44704 0 17035 0 500444 0 0 MR DAVID GRAY EXECUTIVE VICE PRESIDENT 0 418139 0 0 0 9129 0 57983 0 34800 0 520051 0 0 MS MICHELE LAWLESS EXECUTIVE VICE PRESIDENT / CFO 0 475135 0 0 0 6795 0 43823 0 3525 0 529278 0 0 MS KATRINA WOOD EVP/CHIEF NURSING OFFICER 0 255207 0 0 0 3646 0 6499 0 30654 0 296006 0 0 MR ERIC HAGAN VP OF RURAL HOSPITALS 30099 270890 0 0 709 6384 0 0 2132 19185 32940 296459 0 0 MS JOELL BETH LOVE MCH AGENCY NURSE 166204 0 0 0 0 0 0 0 0 0 166204 0 0 0 DENISE ANDERSON MCH AGENCY NURSE 162343 0 0 0 0 0 0 0 0 0 162343 0 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CERTAIN EXECUTIVES OF COMMONWEALTH HEALTH CORPORATION PARTICIPATED IN A SUPPLEMENTAL RETIREMENT PLAN. THE CURRENT YEAR INCREASE IN THE ACCRUED BENEFIT, AS ACTUARIALLY DETERMINED, IS REPORTED AS COMPENSATION. THE FOLLOWING ARE THE INDIVIDUALS PARTICIPATING IN THE PLAN AND THE CURRENT YEAR INCREASES REPORTED AS COMPENSATION: CONNIE SMITH $262,117 WADE STONE $ -0- Schedule J, Part I, Line 3 COMPENSATION OF THE CEO THE CEO IS COMPENSATED BY COMMONWEALTH HEALTH CORPORATION (CHC), A RELATED ORGANIZATION. CHC USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSTION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Form 990, Part V, Line 2a MANAGEMENT SERVICES AGREEMENT COMMONWEALTH HEALTH CORPORATION HAS A MANAGEMENT SERVICES AGREEMENT FOR THE FOLLOWING RELATED ORGANIZATIONS: BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION, THE MEDICAL CENTER AT FRANKLIN, INC., THE MEDICAL CENTER AT CLINTON COUNTY, INC., AND COMMONWEALTH REGIONAL SPECIALTY HOSPITAL. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 31-1118087. Form 990, Part VI, Line 15a AND 15B - DETERMINING COMPENSATION COMMONWEALTH REGIONAL SPECIALTY HOSPITAL IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS COMMONWEALTH HEALTH CORPORATION, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH COMMONWEALTH HEALTH CORPORATION. THE ENTITY USES INDEPENDENT CONSULTANTS TO ANNUALLY REVIEW COMPENSATION. COMPENSATION-RELATED DETERMINATIONS ARE CONDUCTED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND REGULATIONS TO QUALIFY FOR THE PRESUMPTION THAT THE COMPENSATION IS REASONABLE, INCLUDING BUT NOT LIMITED TO APPROVAL BY AN AUTHORIZED COMMITTEE OF THE BOARD OF DIRECTORS WHO DO NOT HAVE A CONFLICT OF INTEREST, OBTAINING AND RELYING ON APPROPRIATE DATA AS TO COMPARABILITY, AND CONCURRENT DOCUMENTATION OF THE BASIS FOR THE COMPENSATION DETERMINATIONS. GALLAGHER CONDUCTED THE FY24 REVIEW IN JANUARY 2023. Form 990, Part VI, Line 6 Classes of members or stockholders THE CORPORATION'S ARTICLES OF INCORPORATION SPECIFY THE CORPORATION SHALL HAVE ONE (1) MEMBER. THE MEMBER SHALL BE COMMONWEALTH HEALTH CORPORATION, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body BYLAWS OF THE CORPORATION SPECIFY THAT THE SOLE MEMBER SHALL APPOINT A NOMINATING COMMITTEE WHICH SHALL MEET AND DESIGNATE NOMINEES FOR BOARD DIRECTORSHIPS. Form 990, Part VI, Line 11b Review of form 990 by governing body Form 990 is sent to board members via secure email. Each board member receives access to review the form prior to the designated filing date. Form 990, Part VI, Line 12c Conflict of interest policy THE COMMONWEALTH HEALTH CORPORATION (CHC) (APPLICABLE TO THE CORPORATION AND/OR ITS AFFILIATES) CODE OF CONDUCT EXPLICITLY STATES MEMBERS OF THE BOARD ADMINISTRATION, THE MEDICAL STAFF AND ALL EMPLOYEES ARE EXPECTED TO AVOID CONFLICTS OF INTEREST. FURTHER, IT REQUIRES DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST IN A TIMELY MANNER. ALL INDIVIDUALS SIGN AN ACKNOWLEDGEMENT UPON EMPLOYMENT THAT THEY HAVE RECEIVED A COPY OF THE CODE OF CONDUCT, ARE FAMILIAR WITH ITS CONTENT AND UNDERSTAND THEIR RESPONSIBILITIES TO AVOID NON-COMPLIANT ACTIVITY. CHC'S REGULATORY COMPLIANCE AND COMPENSATION COMMITTEE (RCC) RENEWS AND APPROVES ALL CONTRACTS BETWEEN CHC AND/OR ITS AFFILIATES AND DISQUALIFIED ENTITIES. THE REVIEW IS DESIGNED TO IDENTIY POTENTIAL CONFLICTS OF INTEREST BY BOARD MEMBERS AND/OR OFFICERS. RCC MEMBERS ARE PROHIBITED FROM TAKING PART IN DECISIONS REGARDING TRANSACTIONS WITH WHICH HE/SHE HAS A CONFLICT OF INTEREST. ANNUALLY, WRITTEN INQUIRY IS MADE - BY QUESTIONNAIRE - OF BOARD MEMBERS AND OFFICERS SEEKING DISCLOSURE OF CONFLICTS OF INTEREST OR INFORMATION THAT RELATES TO FAMILY MEMBERS. TRANSACTIONS ARISING ARE REVIEWED BY MANAGEMENT AS THEY OCCUR. Form 990, Part VI, Line 19 Required documents available to the public GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ONLY MADE AVAILABLE IF REQUESTED, AND IN THE MANNER REQUIRED, BY A GOVERNING AGENCY. Form 990, Part IX, Line 11g Other Fees COLLECTION AGENCY FEES - Total Expense: 376, Program Service Expense: , Management and General Expenses: 376, Fundraising Expenses: ; EMPLOYEE SUPPORT FEES - Total Expense: 54308, Program Service Expense: 54308, Management and General Expenses: , Fundraising Expenses: ; OTHER PROFESSIONAL FEES - Total Expense: 728440, Program Service Expense: 728440, Management and General Expenses: , Fundraising Expenses: ; LAB FEES - Total Expense: 280, Program Service Expense: 280, Management and General Expenses: , Fundraising Expenses: ; CONTRACT FEES - Total Expense: 184511, Program Service Expense: 184511, Management and General Expenses: , Fundraising Expenses: ; BILLING FEES - Total Expense: 8400, Program Service Expense: 8400, Management and General Expenses: , Fundraising Expenses: ; AGENCY NURSING FEES - Total Expense: 191153, Program Service Expense: 191153, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XII, Line 2c OVERSIGHT PROCESS THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. Schedule H, Part V, Section A LINE 1 HTTPS://MEDCENTERHEALTH.ORG/LOCATION/COMMONWEALTH-REGIONAL-SPECIALTY-HOSPITAL BOWLING GREEN-WARREN CTY COMM HOSP CORP 800 PARK STREET BOWLING GREEN KY 42101 610920842 HOSPITAL KY 501(c)(3) 3 CHC INC false COMMONWEALTH HEALTH FOUNDATION 800 PARK STREET BOWLING GREEN KY 42101 611362000 SUPPORT KY 501(c)(3) 7 CHC INC false COMMONWEALTH HEALTH FREE CLINIC 800 PARK STREET BOWLING GREEN KY 42101 611292739 HEALTH CARE KY 501(c)(3) 3 CHC INC false THE MEDICAL CENTER AT FRANKLIN 800 PARK STREET BOWLING GREEN KY 42101 611362001 HOSPITAL KY 501(c)(3) 3 CHC INC false COMMONWEALTH HEALTH CORPORATION 800 PARK STREET BOWLING GREEN KY 42101 311118087 SUPPORT KY 501(c)(3) 10 NA false THE MEDICAL CENTER AT ALBANY 800 PARK STREET BOWLING GREEN KY 42101 811312058 HOSPITAL KY 501(c)(3) 3 CHC INC false MED PLAZA PRTS LTD 800 PARK STREET BOWLING GREEN KY 42101 611080340 REAL ESTATE KY NA N/A 0 0 false 0 false false false false false false false false false false false true false true true true true true false false