2024-01-15T15:14:54-07:00 2023-02-28 990 2022-03-01 310949874 MONROE MEDICAL FOUNDATION INC MONR 2704879231 529 CAPP HARLAN ROAD TOMPKINSVILLE KY 42167 Rickie Brown Chief Financial Officer 2704879231 2024-01-15 1 1 11 0 AAL2 2022 2023-04-26 12:10:37Z Monroe County Medical Center Caitlin Hagan CFO 529 Capp Harlan Rd Tompkinsville KY 42167 20903121 0 X www.mcmccares.com X 1979 KY ACUTE CARE HOSPITAL - Our mission is to be a rural healthcare organization who values compassion, respect and confidentiality, and to provide quality, safe, primary and specialty services for the citizens of Monroe County and surrounding area through detection, prevention and treatment of illness. We achieve this by operating a 49 bed acute care hospital, ambulance service, county 911 service, adult daycare service and 2 employed physician offices. 9 7 295 0 0 0 3349442 2454749 19927649 18098222 227883 343479 2943 6671 23507917 20903121 14700 12500 0 0 12781820 13386226 0 0 0 8622822 8446183 21419342 21844909 2088575 -941788 35516011 32054231 5950635 2798143 29565376 29256088 ACUTE CARE HOSPITAL - The mission of the Monroe Medical Foundation, Inc. is to be a rural healthcare organization who values compassion, respect and confidentiality, and provides quality, safe, primary and specialty services for the citizens of Monroe County and surrounding area through detection, prevention and treatment of illness. We achieve this by operating a 49 bed acute care hospital, ambulance service, county 911 service, 2 employed physicians and an adult daycare service. 0 0 19719806 12500 20903121 Inpatient Care - Monroe Medical Foundation, Inc. operates a 49 bed acute care hospital. The hospital admitted 922 patients, treated 5,291 patients in the emergency room, treated 21,404 patients as outpatient referrals and made 2,165 ambulance runs in FYE 2-28-23. The patients admitted to the hospital as regular inpatients consisted of approximately 72% Medicare patients and 17% Medicaid patients. Approximately 2% of patients admitted did not have Medicare or Medicaid, and did not have any type of insurance. The hospital also began providing Swing Bed services in December 2014. We admitted 23 patients to the swing bed status during the fiscal year, and we had 165 swing bed patient days. (Grants included 4 high school graduates' scholarships and 2 individuals in RN school). 0 0 0 19719806 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 17 0 1 295 1 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Caitlin Hagan CFO 2704879231 529 CAPP HARLAN ROAD TOMPKINSVILLE KY 42167 Anthony Carter MD Board Member/ Physician 40 X 712984 0 0 William Michael Carter MD Board Member/Physician 40 0 X 386930 0 0 Rickie Brown Chief Financial Officer 40 0 X 164394 0 0 Andrea L Rich McLerran Exec Director/CEO 40 0 X 159338 0 0 Andrea McAlpin Director of Pharmacy 40 0 X 149066 0 0 Ronnie Raines Nurse Practitioner 40 0 X 146673 0 0 Jenny Lynn Bartley Pharmacist 40 0 X 112787 0 0 Tracey Page Physical Therapist 32 0 X 111377 0 0 Judy Rowland Board Member 1 0 X 0 0 0 Fowler Ross JR OD Board Member 1 0 X 0 0 0 Jimmy Goodman Board Member 1 0 X 0 0 0 Polly Baker Board President 2 0 X 0 0 0 Kem Coe 2nd Vice President Sec Board Member 1 0 X 0 0 0 Greg Crabtree DMD Board Member 1 0 X 0 0 0 Donnie Peden Board Member 1 0 X 0 0 0 1943549 0 0 8 0 1 0 Inspire Medical Inc 2323 Lime Kiln Lane Louisville KY 40222 Emergency Room Physicians 1558336 MedHost of Tennessee Inc 2739 Momentum Place Chicago IL 60689 Computer Software Hardware and Maintenance 625074 Beckman Coulter 250 South Kraemer Boulevard Berea CA 928228000 Lab Equipment Service and Supplies 301358 Siemens Medical Solutions USA Inc 40 Liberty Boulevard Malvern PA 19355 Radiology Equipment Service Agreement 178683 Medteam Solutions Inc 2739 Momentum Place Chicago IL 60689 Billing Services 139160 5 0 0 0 0 2454749 0 0 2454749 Hospital Services Net of Contractual Adjustments Charity and Bad Debt 622000 18098222 18098222 0 0 0 0 0 0 18098222 341148 0 0 341148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2331 0 0 0 2331 2331 2331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6671 6671 0 0 6671 20903121 18107224 0 341148 12500 12500 0 0 0 0 1139283 800966 338317 0 0 0 0 0 10341632 9753257 588375 0 160841 146365 14476 0 957948 871733 86215 0 786522 722620 63902 0 0 0 0 0 7337 0 7337 0 34600 0 34600 0 0 0 0 0 0 0 0 0 0 0 606122 158621 447501 0 7349 7349 0 0 2479364 2446820 32544 0 420795 336636 84159 0 0 0 0 0 466671 350003 116668 0 36670 35640 1030 0 0 0 0 0 5077 5077 0 0 0 0 0 0 0 0 0 0 940048 926887 13161 0 150292 117228 33064 0 Physician fees 1943435 1943435 0 0 Repairs and maintenance 528514 521299 7215 0 Kentucky provider tax 353767 353767 0 0 466142 209603 256539 0 21844909 19719806 2125103 0 26816 26817 613588 425218 0 0 1797228 2046126 0 0 0 0 0 0 357831 415184 189739 198986 33605896 26700307 7472860 6905589 0 0 0 0 0 0 0 0 25057949 22036311 35516011 32054231 1299035 1256526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4651600 1541617 5950635 2798143 X 29082883 29090258 482493 165830 29565376 29256088 35516011 32054231 -941788 0 0 0 632500 0 X X 0 1 X 1 1 1 X 0 378922 378922 0 12500377 7627993 4872384 0 0 0 0 0 20726597 19072314 1654283 0 0 0 0 6905589 Funded depreciation 14973641 Savings accounts 6166898 Cash restricted for adult daycare 1841 Other receivables 886556 Other assets 7375 22036311 0 Estimated third party settlements 1220056 CARES Act COVID funds contingency payable 643 Medicare Advance Accelerated payments (Cares Act COVID 19 Funds) 70918 Education grant 250000 1541617 1 1 X 1 X 1 X 1 1 1 0 1 1 0 0 445296 0 445296 0.02 0 0 4144550 3782710 361840 0.017 0 0 0 0 0 0 0 0 4589846 3782710 807136 0.037 0 0 16743 0 16743 0.001 0 0 0 0 0 0 0 0 276251 219782 56469 0.003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292994 219782 73212 0.004 0 0 4882840 4002492 880348 0.041 1 554207 110841 4330600 4062003 268597 X 1 1 1 1 Monroe County Medical Center 529 Capp Harlan Road Tompkinsville KY 42167 mcmccares.com 100338 X X X Monroe County Medical Center 1 0 0 1 X X X X X X X X X 20 1 0 1 1 X mcmccares.com X 1 23 1 mcmccares.com 0 0 1 X 100 200 1 1 X X X X 1 X mcmccares.com X mcmccares.com X mcmccares.com X X X X X 1 X 0 X X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-Monroe County Medical Center In conducting the CHNA, the hospital facility took into account input from persons who represent broad interests of the community served by the hospital facility. The hospital developed a Community Steering Committee which included 12 local expert advisors from the county. They include representatives from Lifeline Home Health, Monroe County Medical Center, Helping Monroe, Lifeskills, Inc., Monroe County Health Department, Gamaliel Family Medical Center, Monroe County EMS, Monroe County Cooperative Extension, Monroe Family Medical Center, Inc., Community Outreach Shelter, Community and Economic Development Initiative of Kentucky at the University of Kentucky and other individuals in the community who complete the CHNA surveys. Schedule H, Part V, Section B, Line 6b-Monroe County Medical Center The hospital facility's CHNA was conducted with various organizations other than hospital facilities. It was conducted in conjunction with leaders and experts from the local county and the Community and Economic Development Initiative of Kentucky at the University of Kentucky. It included 12 local expert advisors from the county. They included representatives from Lifeline Home Health, the Health Department, Helping Monroe, Lifeskills, Inc., Monroe County Medical Center, EMS Service, Extension Board Members, Gamaliel Family Medical Center, Monroe Family Medical Center, Community Outreach Shelter, and other individuals of the community. Schedule H, Part V, Section B, Line 11-Monroe County Medical Center The most recent CHNA was approved by the Board of Directors on 2/20/23. This left 8 days of the fiscal year to begin to address the needs identified during the assessment. We will be able to address the community needs in the coming years with informative classes, specialists, etc. The needs identified were as follows: 1. Mental Health, 2. Substance Use/Addiction, 3. Nutrition Education/Food Access, 4. Increased Health Access, 5. Diabetes (Obesity/Physical Inactivity). Schedule H, Part V, Section B, Line 24-Monroe County Medical Center All patients are initially charged the same rates. If the patient meets the financial assistance policy provisions, the charges are discounted according to the provisions of the Financial Assistance policy. 5 Monroe County Ambulance Service 429 Capp Harlan Road Tompkinsville KY 42167 Ambulance Service operated for the county. Monroe County 911 Service 429 Capp Harlan Road Tompkinsville KY 42167 911 Service operated for the county. Monroe County Physician Associates 604 N Main Tompkinsville KY 42167 Physician Office Practice/Rural Health Clinic Monroe County Family Practice 606 N Main Street Tompkinsville KY 42167 Physician Office Practice/Rural Health Clinic Monroe County Medical Center Adult Daycare 417 Capp Harlan Road Tompkinsville KY 42167 Adult Daycare Service Schedule H, Part I, Line 7 Ratio of Patient Care Cost to Charges was used as the costing methodology. Schedule H, Part I, Line 7g There were no costs attributable to a physician clinic included as subsidized health services in line 7(g). Schedule H, Part III, Section A, Line 2 The costing methodology used to determine the amounts reported on Part III, Section A, Line 2 is based on the ratio of Patient Care Cost to Charges applied to the gross amounts written off as bad debts. Schedule H, Part III, Section A, Line 4 The notes in the financial statements that describe bad debt expense are located on pages 11 and 12 of the audit report. Schedule H, Part III, Section B, Line 8 There is no shortfall on Medicare patients. The costing methodology used is the Ratio of Patient Care Cost to Charges applied to the gross charges. Schedule H, Part III, Section C, Line 9b Upon registration, financial information is gathered, when possible, to determine if they qualify for charity or financial assistance. If they are not able to provide the information at that time, they are given a financial information form to complete later. If they are admitted to the hospital, the patient financial counselor goes to the patient room and discusses the charity and financial assistance information with the patient. If we are unable to obtain the necessary information from the patient at that time, we send the information to a contracted company to obtain the necessary information. They assist them in obtaining the information and financial assistance they qualify for. Schedule H, Part VI, Line 2 The hospital also has suggestion boxes for patients, visitors and employees to obtain suggestions for new or better health services. In addition, the hospital obtains input from the physicians and employees at the annual Board/Medical Staff planning retreat. Schedule H, Part VI, Line 3 The Financial Assistance Policy Plain Language Summary is posted on the wall in the registration offices. There are also copies of the Financial Assistance Applications in the registration areas available for the patients. In addition, the Financial Policy Plain Language Summary is posted in the exam rooms in the emergency department and in various ancillary outpatient waiting areas. If the patients do not have Medicare, Medicaid or any other type of insurance, the patient information is provided to a contracted company to follow up with patients to help them obtain medical cards and assist them in getting the necessary information to qualify for financial assistance. If the patient is admitted, the Patient Financial Counselor visits the patient in the patient room and discusses their financial options. The hospital's Financial Assistance policy is also posted on the hospital's website. Schedule H, Part VI, Line 4 The Monroe County Medical Center is located in Monroe County, Kentucky, which is a rural area of Kentucky. The hospital primarily serves the citizens of Monroe County and parts of the joining counties. The population of Monroe County is approximately 11,355. Only approximately 16.0% persons age 25 and above have a bachelor's degree or higher compared to 34.3% for the national average. The median household income is approximately $47,252 compared to the national median household income of $75,149. Approximately 20.9% of the persons in Monroe County live below the poverty level compared to 11.5% for the national average. The unemployment rate for Monroe County was 5.0% as of February 28, 2023. Schedule H, Part VI, Line 5 The Monroe County Medical Center has an open medical staff to promote patient care for the citizens of our community. The Board of Directors of the Monroe Medical Foundation, Inc. is made up of nine individuals. All of them reside in Monroe County and serve on the Board with no pay for providing those services. They serve because they are interested in the Community and want to give something back to the community by helping assure that good medical services are provided to the citizens of Monroe and surrounding counties. The current Board is made up of a local businessman, a pharmacist, a retired banker, a retired banker and farmer, a retired school teacher, a dentist, an optometrist, the Chief of the Medical Staff and the Vice Chief of the Medical Staff. Any surplus funds of the Monroe Medical Foundation, Inc. are used to upgrade the building, purchase updated equipment and provide other wellness services and quality healthcare for our community. 1 High School Senior Scholarships 4 5500 0 Nursing Students Tuition Reimbursement 2 7000 0 Schedule I, Part I, Line 2 The hospital Board of Directors approves the payments of all the grant and assistance funds. They are monitored by the CEO and CFO after approval by the Board. X 0 0 0 0 0 1 0 0 0 Anthony Carter MD Board Member/ Physician 200000 0 512984 0 0 0 6456 0 0 0 719440 0 0 0 William Michael Carter MD Board Member/Physician 386930 0 0 0 0 0 7427 0 5849 0 400206 0 0 0 Andrea L Rich McLerran Exec Director/CEO 159338 0 0 0 0 0 2563 0 5849 0 167750 0 0 0 Rickie Brown Chief Financial Officer 164394 0 0 0 0 0 3705 0 5849 0 173948 0 0 0 Andrea McAlpin Director of Pharmacy 149066 0 0 0 0 0 3381 0 5849 0 158296 0 0 0 Schedule J, Part I, Line 6 The agreements with the physicians state that the Monroe County Medical Center will pay the physician a base salary plus incentive compensation in an amount equal to a certain percentage of the excess of the Medical Center's total collections for physician's personally performed professional medical services over the amount of the Physician's salary and overhead expense. Jo Ann Brown Spouse of CFO 14323 Employee wages of RN 0 Emily Jill Shaw Daughter of CFO 59645 Employee wages of RN 0 Form 990, Part IV, Line 12a We are having an independent audit conducted, but the audit is not complete at this time. I will send it to you as soon as the independent audit is complete. I have attached the prior year audit. Form 990, Part VI, Section B, Line 11b The form 990 is prepared by the CFO and is reviewed with the CEO before it is filed. Form 990, Part VI, Section B, Line 12c Each member of the Board of Directors and the CEO and CFO completes a conflict-of-interest questionnaire annually. Any time there is a conflict of interest with any Board Member on any issue being discussed by the Board of Directors, the Board member who has the conflict abstains from any vote on the issue. Form 990, Part VI, Section B, Line 15 The process for determining compensation of the CEO and CFO includes a review and approval by the Board of Directors. The Board of Directors does the evaluation and approval of the CEO, and they review the evaluation of the CFO which is completed by the CEO. The Board of Directors then approves the pay rates for both the CEO and CFO. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request in the Administration office of the Monroe County Medical Center, 529 Capp Harlan Road, Tompkinsville, Kentucky 42167. Form 990, Part XII, Line 2b The organization's financial statements are in the process of being audited by an independent accounting firm; however, the audit is not complete at this time. I will forward the audit to you as soon as it is completed. Form 990, Part XII, Line 3b The organization's financial statements are in the process of being audited as set forth in the Single Audit Act by an independent accounting firm; however, the audit is not complete at this time. I will forward the audit to you as soon as it is completed. The annual audit has not yet completed. Monroe Medical Foundation Inc. tries to wait until the audit is complete in case there are any audit entries that need to be made in the fiscal year.