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T.J. SAMSON COMMUNITY HOSPITAL

Company Details

Name: T.J. SAMSON COMMUNITY HOSPITAL
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 08 Dec 1926 (98 years ago)
Organization Date: 08 Dec 1926 (98 years ago)
Last Annual Report: 03 Feb 2025 (a month ago)
Organization Number: 0046115
Industry: Health Services
Number of Employees: Large (100+)
Principal Office: 1301 NORTH RACE ST., GLASGOW, KY 421413483
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
T J SAMSON COMMUNITY HOSPITAL 403B PLAN 2021 610461767 2023-08-01 T J SAMSON COMMUNITY HOSPITAL 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-22
Business code 622000
Plan sponsor’s address 1301 NORTH RACE STREET, GLASGOW, KY, 42141

Signature of

Role Plan administrator
Date 2023-08-01
Name of individual signing MEI DENG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-08-01
Name of individual signing MEI DENG
Valid signature Filed with authorized/valid electronic signature
T J SAMSON COMMUNITY HOSPITAL 403B PLAN 2020 610461767 2021-06-16 T J SAMSON COMMUNITY HOSPITAL 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-22
Business code 622000
Plan sponsor’s address 1301 NORTH RACE STREET, GLASGOW, KY, 42141

Signature of

Role Plan administrator
Date 2021-06-16
Name of individual signing MEI DENG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-16
Name of individual signing MEI DENG
Valid signature Filed with authorized/valid electronic signature

Director

Name Role
Amy Cassady Director
Cornelius Faulkner Director
Joey Botts Director
Bo Matthews Director
Henry Royse Director
Ervin Sorrell Director
Dan Foutch Director
J. C. DOWNING Director
EUGENE AHELL Director
GLEN E. ROPP Director

Officer

Name Role
Ervin Sorrell Officer
Richard Alexander Officer
Brent Billingsley Officer
Neil C Thornbury Officer
Scott Young Officer

Incorporator

Name Role
W. L. PORTER Incorporator
F. N. BRADFORD Incorporator
T. J. SAMSON Incorporator
P. W. HOLMAN Incorporator
V. H. BAIRD Incorporator

Registered Agent

Name Role
NEIL C. THORNBURY , PRESIDENT AND CEO Registered Agent

Former Company Names

Name Action
THE COMMUNITY HOSPITAL Old Name

Assumed Names

Name Status Expiration Date
T. J. AMBULATORY CARE Active 2029-09-12
T. J. HEALTH PAVILION Active 2029-09-12
T.J. SAMSON PAVILION REHABILITATION AGENCY Inactive 2023-06-10
T.J. SAMSON AMBULATORY CARE CENTER Inactive 2018-06-10

Filings

Name File Date
Annual Report 2025-02-03
Certificate of Assumed Name 2024-09-12
Certificate of Assumed Name 2024-09-12
Annual Report 2024-03-06
Annual Report 2023-03-14
Annual Report 2022-07-15
Annual Report 2021-04-14
Annual Report 2020-02-11
Annual Report 2019-04-18
Registered Agent name/address change 2019-04-18

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
112357819 0452110 1991-03-21 N JACKSON HWY BOX 257, GLASGOW, KY, 42141
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 1991-07-30
Case Closed 1991-10-02

Related Activity

Type Complaint
Activity Nr 73107419
Health Yes

Violation Items

Citation ID 01001
Citaton Type Serious
Standard Cited 19101001 K01
Issuance Date 1991-09-18
Abatement Due Date 1991-09-21
Current Penalty 720.0
Initial Penalty 720.0
Nr Instances 1
Nr Exposed 5
Gravity 06

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
61-0461767 Corporation Unconditional Exemption 1301 N RACE ST, GLASGOW, KY, 42141-3454 1979-03
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-09
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 222203403
Income Amount 267537150
Form 990 Revenue Amount 236858071
National Taxonomy of Exempt Entities -
Sort Name T J SAMSON COMMUNITY HOSPITAL PROJ

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 202209
Filing Type E
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 202109
Filing Type E
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 202009
Filing Type E
Return Type 990
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 202009
Filing Type P
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201909
Filing Type P
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201809
Filing Type P
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201709
Filing Type E
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201609
Filing Type P
Return Type 990T
File View File
Organization Name TJ SAMSON COMMUNITY HOSPITAL
EIN 61-0461767
Tax Period 201609
Filing Type E
Return Type 990
File View File

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
906429 Intrastate Non-Hazmat - 30000 2000 2 3 Private(Property)
Legal Name T J SAMSON COMMUNITY HOSPITAL
DBA Name -
Physical Address 1301 N RACE ST, GLASGOW, KY, 42141-3454, US
Mailing Address 1301 N RACE ST, GLASGOW, KY, 42141-3454, US
Phone (270) 651-4430
Fax (270) 651-4862
E-mail -

Safety Measurement System - All Transportation

Total Number of Inspections for the measurement period (24 months) 0
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 0
Vehicle Maintenance BASIC Roadside Performance measure value 0
Total Number of Vehicle Inspections for the measurement period 0
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

Financial Incentive

Program Program Status Average Hourly Wage Project Cost Incentive Amount Initial Jobs New Jobs Date of Action Approval Type
GIA/BSSC Active 37.04 $875,999 $75,000 1111 25 2024-08-07 Final
GIA/BSSC Inactive 32.15 $699,714 $75,000 997 288 2022-08-03 Final
GIA/BSSC Inactive 31.75 $446,425 $75,000 1000 1 2021-01-27 Final
GIA/BSSC Inactive 23.99 $0 $40,354 0 0 2011-03-30 Final

Sources: Kentucky Secretary of State