2024-03-02T17:51:00-06:00 2023-04-30 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2022-05-01 610471581 TRIGG COUNTY HOSPITAL TRIG 2702063601 254 MAIN STREET CADIZ KY 42211 DON MICHAEL CFO 2702063601 2024-03-01 1 DON MICHAEL 999009999 0 EMILIE M KNIERIEM CPA P01330194 5029923500 2024-03-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN SUMNER 254 MAIN STREET CADIZ KY 42211 27136457 0 X WWW.TRIGGHOSPITAL.ORG X 1952 KY TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. WE PLEDGE TO MEET STANDARDS OF EXCELLENCE AND IMPROVE THE VALUE OF OUR SERVICE. 11 11 247 24 0 0 3004781 2202696 22920493 24577729 19777 174974 86067 181058 26031118 27136457 1618 1525 0 0 8865622 9934740 0 0 0 12864679 14099383 21731919 24035648 4299199 3100809 24037874 28741272 13959475 13337965 10078399 15403307 TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. IN ACHIEVING OUR MISSION, WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. 0 0 22693082 1525 24709416 OUR MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A CARING AND COST-EFFECTIVE MANNER. IN ACHIEVING OUR MISSION, WE PLEDGE TO MEET STANDARDS OF EXCELLENCE WHILE CONTINUOUSLY IMPROVING THE VALUE OF OUR SERVICE. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN THE TRIGG COUNTY, KENTUCKY AREA. 22693082 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 0 0 0 0 0 0 0 1 0 0 0 1 38 0 1 247 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 KY X DON MICHAEL 2702063602 254 MAIN STREET CADIZ KY 42211 JOHN SUMNER CEO 40.00 X 201388 0 0 JEANINE EVANS NURSE PRACTITIONER 40.00 X 157296 0 11120 ASHLAND T PRICE PHARMACIST 40.00 X 144390 0 28017 LISA KIGHT ACTING ASST CNO 40.00 X 119490 0 9902 CALLIE WELLS NURSE PRACTITIONER 40.00 X 114106 0 18189 LILLIAN GIERHART NURSE PRACTITIONER 40.00 X 113303 0 13357 DON MICHAEL CFO 40.00 X 109147 0 10548 FRIEDIA SMILEY CHIEF NURSING EXECUTIVE 40.00 X 99765 0 1885 MICHAEL GROSS CHAIRMAN 1.00 X X 0 0 0 STEPHANIE PERRY VICE CHAIRMAN 1.00 X X 0 0 0 GEORGE RADFORD SECRETARY/TREASURER 1.00 X X 0 0 0 JOE POWELL BOARD MEMBER 1.00 X 0 0 0 BOB NOEL BOARD MEMBER 1.00 X 0 0 0 TODD HARTON BOARD MEMBER 1.00 X 0 0 0 CRAIG FOWLER BOARD MEMBER 1.00 X 0 0 0 JOE NICHOLS BOARD MEMBER 1.00 X 0 0 0 TINA LOOMIS BOARD MEMBER 1.00 X 0 0 0 DR JOE THOMAS BOARD MEMBER 1.00 X 0 0 0 JERRY HOOKS BOARD MEMBER (BEG 03/23) 1.00 X 0 0 0 CHRISTY OLIPHANT BOARD MEMBER (END 03/23) 1.00 X 0 0 0 1058885 0 93018 8 0 1 0 ALIGN MD 5121 MARYLAND WAY SUITE 300 BRENTWOOD TN 37027 ER PHYSICIAN SERVICES 1693680 GEORGE GILLIAM MD PSC 3333 FREDERICA ST STE 5 OWENSBORO KY 42301 PHYSICIAN SERVICES 217618 JOLLY HEALTHCARE PLLC 4429 HOPKINSVILLE ROAD CADIZ KY 42211 PHYSICIAN SERVICES 193049 COVENANT ANESTHESIA 1371 ANTIOCH CHURCH ROAD HANSON KY 42413 PROVIDER/CRNA SERVICES 125533 4 2067413 135283 2202696 NET PATIENT SERVICE REVENUE 621999 23315235 23315235 PHARMACY SERVICES 621399 1204816 1204816 EHR INCENTIVE 900099 57678 57678 24577729 174974 174974 36253 0 36253 36253 36253 MEDICAID SUPPLEMENTAL PAYMENTS 900099 90240 90240 CAFETERIA 722310 32547 32547 REBATES 900099 9773 9773 12245 8900 3345 144805 27136457 24709416 0 224345 X 1525 1525 429129 411964 17165 8153037 7826916 326121 83025 79704 3321 638242 612712 25530 631307 606055 25252 7715 7715 126413 126413 6518318 6257585 260733 44991 43191 1800 634606 609222 25384 398491 383064 15427 18698 748 17950 273234 262305 10929 1290293 1238681 51612 396897 15876 381021 MEDICAL SUPPLIES & DRUG 3054233 3054233 REPAIRS & MAINTENANCE 925211 888203 37008 PROVIDER TAX 180653 180653 FOOD 140086 134483 5603 89544 85962 3582 24035648 22693082 1342566 0 1281 1287 6853662 12550144 3179923 4394008 360558 370671 113840 160869 24777649 16118886 7958649 8658763 5569961 2605530 24037874 28741272 2811242 2684641 1092558 245119 7866219 8336013 156676 158673 2032780 1913519 13959475 13337965 X 9853486 15178394 224913 224913 10078399 15403307 24037874 28741272 3100809 2224099 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 1261 1261 0 PART II-B, LINE 1: A PORTION OF THE ORGANIZATION'S KHA DUES ARE USED FOR LOBBYING ACTIVITIES. APPROXIMATELY 11.0% OF DUES IS FOR LOBBYING IN FYE 2022-2023. TOTAL DUES WERE $10,932.32. 89350 89350 12065812 8097217 3968595 9902578 8021669 1880909 2719909 2719909 8658763 ASSETS WHOSE USE IS LIMITED 2605530 2605530 THIRD PARTY PAYABLE 1913519 1913519 X 27136457 0 27136457 0 27136457 24035648 0 24035648 0 24035648 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 TAXES ON RELATED INCOME PURSUANT TO SECTION 501(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 1 0 1 1 100547 174933 0 0.00000 3429757 4501117 0 0.00000 3530304 4676050 0 0.00000 18575 18575 0.00080 18575 18575 0.00080 3548879 4676050 18575 0.00080 1 2527522 0 4668048 6706176 -2038128 X 1 1 1 1 TRIGG COUNTY HOSPITAL INC 254 MAIN STREET CADIZ KY 42211 WWW.TRIGGHOSPITAL.ORG 600055 X X X TRIGG COUNTY HOSPITAL INC 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X HTTP://WWW.TRIGGHOSPITAL.ORG X X 1 19 1 HTTP://WWW.TRIGGHOSPITAL.ORG 0 1 X 100.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.TRIGGHOSPITAL.ORG/GETPAGE.PHP?NAME=PATIENT_FINANCIAL_INFORMATIO X HTTPS://WWW.TRIGGHOSPITAL.ORG/GETPAGE.PHP?NAME=PATIENT_FINANCIAL_INFORMATIO X HTTPS://WWW.TRIGGHOSPITAL.ORG/GETPAGE.PHP?NAME=PATIENT_FINANCIAL_INFORMATIO X X X X X X 1 X 0 X X X X 1 X 0 0 TRIGG COUNTY HOSPITAL, INC. PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE COMMUNITY IT SERVED, INCLUDING THOSE WITH SPECIAL KNOWLEDGE, THROUGH FOCUS GROUP DISCUSSIONS AND SURVEYS. A STEERING COMMITTEE COMPRISED OF INDIVIDUALS WHO REPRESENTED ORGANIZATIONS AND AGENCIES FROM THE SERVICE AREA AND IN PARTICULAR, THE INDIVIDUALS WHO WERE WILLING TO VOLUNTEER, ENABLED THE HOSPITAL TO GET INPUT FROM POPULATIONS THAT WERE OFTEN NOT ENGAGED IN CONVERSATIONS ABOUT THEIR HEALTH NEEDS. THESE POPULATIONS CONSISTED OF THE SENIOR AND UNDERSERVED POPULATION, AS WELL AS CHILDREN, YOUTH, AND FAMILIES. THE FOLLOWING ORGANIZATIONS/AGENCIES WERE REPRESENTED ON THE STEERING COMMITTEE:TRIGG COUNTY HOSPITAL AUXILIARYTRIGG COUNTY HEALTH DEPARTMENTLOCAL PROFESSIONALS AND BUSINESS OWNERSTRIGG COUNTY JUDGE EXECUTIVETRIGG COUNTY SCHOOLSMAYOR TRIGG COUNTY SENIOR CITIZENS CENTERTRIGG COUNTY BOARD OF EDUCATIONTRIGG COUNTY HOUSING AUTHORITYTRIGG COUNTY SEASON BEHAVIORAL HEALTH TRIGG COUNTY HOSPITAL, INC. PART V, SECTION B, LINE 7D: HTTP://WWW.TRIGGHOSPITAL.ORG/GETPAGE.PHP?NAME=NEWS-COMMUNITY_HEALTH_NEEDS TRIGG COUNTY HOSPITAL, INC. PART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED IN THE 2019 CHNA ARE AS FOLLOWS: GOAL: INCREASE AVAILABILITY OF MENTAL HEALTH SERVICES. IMPLEMENT STRATEGIC GOALS FOR TRIGG COUNTY PRIMARY CARE TO BEGIN OFFERING BEHAVIORAL HEALTH SERVICES. IMPLEMENT STRATEGIC GOALS FOR TRIGG COUNTY HOSPITAL SEASON'S BEHAVIORAL HEALTH TO EXPAND BEHAVIORAL HEALTH SERVICES THROUGH STRUCTURED OUTPATIENT PROGRAM. HOST PERIODIC SUPPORT GROUP ACTIVITIES IN COMMUNITY (I.E. AT SENIOR CITIZENS). FINISH AGREEMENTS WITH TRICARE INSURANCE SO THAT BEHAVIORAL HEALTH CAN PROVIDE SERVICES TO VETERANS AND THEIR FAMILIES.GOAL: INCREASE COMMUNITY PHARMACY HOURS ON WEEKENDS. REACH OUT TO LOCAL PHARMACIES WITH INFORMATION ON PATIENT NEED DURING WEEKEND HOURS. COLLABORATE WITH LOCAL PHARMACIES TO ENCOURAGE WEEKEND HOURS FOR SHORT WINDOWS OF TIME AND PROMOTE THESE HOURS WITH CLINIC AND ED PATIENTS.GOAL: ADDRESS CHRONIC HEALTH CONDITIONS TO INCLUDE OBESITY, HIGH BLOOD PRESSURE, AND LACK OF PHYSICAL ACTIVITY. FOCUS TO BE PLACED ON MORE EDUCATIONAL PROGRAMS AND REVIVED COMMUNITY PARTNERSHIPS FOR LARGE ACTIVITIES. PARTNER WITH LOCAL LARGER BUSINESSES TO HOST HEALTH FAIRS. DEVELOP, IMPLEMENT AND PROMOTE HEALTH PLUS PROGRAM ROLL OUT IN HOSPITAL AND WITH INTERESTED BUSINESSES. EXPAND NUMBER OF FREE SCREENINGS AND EDUCATIONAL EVENTS AT HOSPITAL (CONTINUE EXISTING ACTIVITIES SKIN CANCER, COLON CANCER SCREENINGS, PINK-OUT ACTIVITIES). HOST HEALTHY EATING ACTIVITIES/COUNSELING. HOST FINANCIAL ASSISTANCE SUPPORT AND INFORMATION TO INCLUDE PATIENT EDUCATION ON NEEDED RESOURCES AVAILABLE TO THEM. UTILIZE CDC INFORMATION ON SIX KEY HEALTH TOPICS TO ADDRESS AND BUILD THIS INTO EDUCATIONAL CLASSES/EVENTS. RESTART AND PROMOTE TRIGG WELLNESS GROUP AGAIN PARTNERING WITH DIFFERENT COMMUNITY GROUPS/AGENCIES TO HELP DEVELOP AND IMPLEMENT PLAN. HOST WALK-A-THON, PARTICIPATE IN RELAY FOR LIFE, HOST BIGGEST LOSER EVENT YEARLY. PARTNER WITH THE SCHOOL SYSTEM AND SENIOR CITIZENS TO EDUCATE PEOPLE AND PROMOTE HEALTHIER LIFESTYLES. HOST COMPETITION WITH STUDENTS ON STEPS TAKEN, UTILIZING PHONES TO HELP TRACK. CONTINUE TO HOST MONTHLY SENIOR CITIZENS DANCES WITH EDUCATIONAL ACTIVITIES TO PROMOTE HEALTHIER LIFESTYLE. MORE AGGRESSIVELY USE SOCIAL MEDIA TO SHARE SUCCESS STORIES AND INFORMATION IN EFFORT TO REACH OTHERS AND ATTRACT NEW PARTICIPANTS.GOAL: RECRUIT AND RETAIN PRIMARY CARE PHYSICIANS. HOSPITAL STAFF WILL EXPLORE OPPORTUNITIES THROUGH HRSA FOR LOAN FORGIVENESS/REIMBURSEMENT AND USE THIS AS A RECRUITMENT TOOL. HOSPITAL STAFF WILL ASSESS THE NEED FOR AN ADDITIONAL PHYSICIAN WITH TRIGG COUNTY PRIMARY CARE (ASSESSING COST, POTENTIAL FOR PATIENT GROWTH, ETC.). HOSPITAL STAFF WILL LEARN MORE ABOUT INTERNSHIP/RESIDENCY OPTIONS THAT CAN BE PROVIDED THROUGH HOSPITAL IN ORDER TO GAIN MORE EXPOSURE TO POTENTIAL PCP'S. HOSPITAL STAFF WILL EXPLORE PART-TIME OPTIONS FOR INTERESTED PCP'S. HOSPITAL STAFF WILL RECRUIT PCP TO BE HOUSED IN MEDICAL ARTS, SEPARATE FROM TCPC.GOAL: EXPAND SPECIALTY MEDICAL SERVICES PROVIDED IN ASSOCIATION WITH HOSPITAL TO INCLUDE INCREASED PROMOTION OF EXITING SPECIALTY CLINICS (AND ANY NEW SPECIALTIES ADDED). CONTINUE TO MAKE "COLD CALLS" TO PHYSICIANS TO MAKE THEM AWARE OF OUR CLINIC SPACE AVAILABLE AND INTEREST IN PARTNERING WITH THEM. VISIT TO PHYSICIAN OFFICES TO ENSURE THEY KNOW WE ARE INTERESTED IN PARTNERING WITH THEM. UTILIZE CURRENT PHYSICIANS TO REACH OUT TO OTHER PHYSICIANS ABOUT OUR HOSPITAL AND TEAM.GOAL: AS A LOCAL EMPLOYER, TCH PARTICIPATES AND PARTNERS WITH ONGOING DEVELOPMENT EFFORTS. ATTEND CHAMBER OF COMMERCE LUNCH AND LEARN ACTIVITIES EVERY OTHER MONTH TO ENSURE HOSPITAL IS INVOLVED IN COMMUNITY DEVELOPMENT AND UNDERSTANDS SURROUNDING AREA. CONTINUED PARTICIPATION IN PURCHASE AREA DEVELOPMENT DISTRICT BOARD. REACH OUT TO THE ECONOMIC DEVELOPMENT COMMISSION FOR OUR AREA AND ENSURE THEY KNOW THE HOSPITAL IS AVAILABLE AND READY TO SUPPORT THEM. 1 1 - TRIGG COUNTY HOSPITAL PRIMARY CARE 254 MAIN ST CADIZ KY 42211 RURAL HEALTH CLINIC PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, TRIGG COUNTY HOSPITAL USES ASSET LEVEL AND INSURANCE STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: TRIGG COUNTY HOSPITAL, INC. USES THE IRS WORKSHEETS PROVIDED IN THE INSTRUCTIONS FOR FORM 990, SCHEDULE H TO CALCULATE A SINGLE COST TO CHARGE RATIO WHICH IS APPLIED TO THE CHARGES FOR FINANCIAL ASSISTANCE AND OTHER BENEFITS TO PROVIDE AMOUNTS AT COST. PART II, COMMUNITY BUILDING ACTIVITIES: TRIGG COUNTY HOSPITAL, INC. PROVIDED SIGNIFICANT COVID-19 TESTING AND WAS THE MAIN PROVIDER OF VACCINES IN THEIR COUNTY. PART III, LINE 2: THE HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE BAD DEBT EXPENSE IS BASED UPON THE REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. PART III, LINE 3: THE HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THEREFORE, NO PORTION OF BAD DEBT IS CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE: NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND SUCH ESTIMATED AMOUNTS ARE REVISED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED APRIL 30, 2023: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE OR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSED:IN ADDITION TO COMPLETING A CHNA EVERY THREE YEARS, THE HOSPITAL IS ALWAYS WILLING AND AVAILABLE TO MEET THE NEEDS OF THE COMMUNITY AS THEY ARISE. THE HOSPITAL ASSISTS OTHER AGENCIES, AS NEEDED, TO MEET THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION:UNINSURED AND UNDERINSURED PATIENTS ARE PROVIDED WITH INFORMATION ABOUT THE CHARITY CARE PROGRAM. THE HOSPITAL CONTRACTS WITH DISABILITY MEDICAL CONSULTANTS TO CONTACT EACH OF THESE IDENTIFIED PATIENTS AND PROVIDES THEM WITH INFORMATION ON HOW TO GET QUALIFIED FOR MEDICAID OR HOW TO ENROLL IN INSURANCE PROGRAMS AVAILABLE THROUGH THE AFFORDABLE CARE ACT. PART VI, LINE 4: COMMUNITY INFORMATION:THE HOSPITAL IS A RURAL COMMUNITY LOCATED IN WESTERN KENTUCKY WITH AN ESTIMATED POPULATION OF 14,444. APPROXIMATELY, 22.2% OF THE COUNTY RESIDENTS ARE AGE 65 AND OLDER. TRIGG COUNTY HAS BEEN DESIGNED AS A HEALTH PROFESSIONAL SHORTAGE AREA AND MEDICALLY UNDERSERVED AREA. THE MEDIAN HOUSEHOLD INCOME IS $47,963 AND ABOUT 8% OF THE COUNTY POPULATION IS UNINSURED. PART VI, LINE 5: TRIGG COUNTY HOSPITAL STRIVES TO SERVE OUR COMMUNITY BY PROVIDING GREATER ACCESSIBILITY TO CARE, PROVIDING INFORMATION AND TEACHING OUR COMMUNITY ABOUT THE RISKS AND SYMPTOMS OF DISEASES, AND ENSURING WE ARE PROVIDING THE NEEDED RESOURCES THE COMMUNITY IS REQUESTING. THE HOSPITAL HAS EXPANDED THE PATIENT-CENTERED EXPERIENCE WITH AN EMPHASIS ON EXPANDING THE SPECIALTY SERVICES AND PROVIDING A SURGICAL UNIT THAT WILL IMPACT THE UNIQUE NEEDS OF OUR COMMUNITY. WHILE MAINTAINING OUR COLLABORATIVE RELATIONSHIPS WITH LONGSTANDING SUPPORTIVE COMMUNITY PARTNERS AND MEDICAL STAFF, THE HOSPITAL CONTINUES TO RECRUIT PHYSICIANS, SERVICES, AND RESOURCES SO OUR LOCAL PATIENTS DO NOT HAVE TO TRAVEL OUTSIDE THE AREA TO RECEIVE NEEDED CARE. THE HOSPITAL IS COMMITTED AND LOOKS FORWARD TO FUTURE GROWTH DUE TO OUR PROMOTION OF HEALTH IN THE COMMUNITY. PART VI, LINE 6: TRIGG COUNTY HOSPITAL, INC. (HOSPITAL) IS AN ACUTE CARE HOSPITAL LOCATED IN CADIZ, KENTUCKY (CITY). THE HOSPITAL IS A COMPONENT UNIT OF TRIGG COUNTY, KENTUCKY (COUNTY) AND THE TRIGG COUNTY FISCAL COURT APPOINTS MEMBERS TO THE BOARD OF DIRECTORS OF THE HOSPITAL. THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN THE TRIGG COUNTY AREA.TRIGG COUNTY PUBLIC HOSPITAL CORPORATION (TCPHC) IS A RELATED ORGANIZATION, WHICH IS JOINTLY CONTROLLED BY THE TRIGG COUNTY FISCAL COURT AND CADIZ CITY COUNCIL. TCPHC ISSUED BONDS IN 1966, 1999, 2014 AND 2015 AND HAS TITLE TO SUBSTANTIALLY ALL REAL ESTATE AND FIXED EQUIPMENT WHICH IS OPERATED BY THE HOSPITAL. X X X 0 0 0 0 0 0 0 0 0 JOHN SUMNER CEO 196388 0 5000 0 0 0 0 0 0 0 201388 0 0 0 JEANINE EVANS NURSE PRACTITIONER 152296 0 5000 0 0 0 2795 0 8325 0 168416 0 0 0 ASHLAND T PRICE PHARMACIST 139390 0 5000 0 0 0 2864 0 25153 0 172407 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS REVIEWED BY MANAGEMENT. IT WAS NOT PROVIDED TO THE BOARD PRIOR TO FILING, HOWEVER IT WILL BE MADE AVAILABLE TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. ALL EMPLOYEES, STAFF, OFFICERS, AND BOARD MEMBERS ARE COVERED BY THIS POLICY. EACH YEAR, THE BOARD MEMBERS ARE ASKED TO SIGN A CONFLICT OF INTEREST STATEMENT. THE HOSPITAL HAS POLICIES AND PROCEDURES IN PLACE THAT WILL BE FOLLOWED SHOULD A CONFLICT OF INTEREST ARISE. A RECORD OF THE PROCEEDINGS WHERE CONFLICTS ARE ADDRESSED IS KEPT ON FILE ONCE REVIEWED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS USES A WAGE STUDY FROM THE RHG (RURAL HOSPITAL GROUP) TO ASSIST WITH DETERMINING THE CEO'S COMPENSATION. THE BOARD REVIEWS THE CEO COMPENSATION ANNUALLY. THE REVIEWS OF EMPLOYEES ARE DONE ANNUALLY BY THEIR SUPERVISOR OR UPPER MANAGEMENT. THE DATE OF THE COMPLETION DEPENDS ON THE EMPLOYEES' ANNIVERSARY DATE. FORM 990, PART VI, SECTION C, LINE 19 A LEGAL AD IS PUBLISHED ANNUALLY TO ADVISE OF THE AVAILABILITY OF AUDITED FINANCIAL STATEMENTS AT THE HOSPITAL. ALL OTHER GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,724,098. MANAGEMENT AND GENERAL EXPENSES 155,171. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,879,269. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,529,120. MANAGEMENT AND GENERAL EXPENSES 105,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,634,500. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 4,367. MANAGEMENT AND GENERAL EXPENSES 182. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,549. TRIGG COUNTY HOSPITAL FOUNDATION INC 254 MAIN STREET CADIZ KY 42211 061805018 EDUCATION KY 501(C)(3) LINE 7 1 TRIGG COUNTY PUBLIC HOSPITAL CORPORATION PO BOX 672 CADIZ KY 42211 611336530 GOV'T UNIT KY 501(A) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0