2021-05-14T13:19:51-05:00 2020-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 250 W MAIN STREET STE 1400 LEXINGTON KY 40507 990 2019-07-01 610945743 KENTUCKY MEDICAL SERVICES FOUNDATION INC KENT 8592577910 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 JAY S GRIDER DO PHD MBA PRESIDENT 8592577910 2021-05-14 1 ALLISON C CARTER P01242412 8592552341 2019 2022-09-23 18:48:47Z JAY S GRIDER DO PHD M 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 412217666 0 X N/A X 1980 KY SUPPORTING THE UNIVERSITY OF KY SO IT MAY ACHIEVE ITS GOALS IN HEALTHCARE 28 2 242 28 0 0 0 2363742 363183395 388934996 756423 452125 18024580 20136199 381964398 411887062 1225894 1428883 0 0 8583814 3243343 0 0 0 380486150 409105930 390295858 413778156 -8331460 -1891094 212550231 235449897 184491084 209281844 28059147 26168053 X SEE SCHEDULE O 0 0 392248939 1428883 409069192 KMSF COLLECTS FEES FROM PROVISION OF PATIENT SERVICES PROVIDED BY THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE. BY PERFORMING THESE DUTIES KMSF SUPPORTS THE HOSPITAL AND HELPS THEM TO FULFILL THEIR EXEMPT PURPOSE. COLLECTIONS, AFTER PAYMENT OF DIRECT EXPENSES, ARE REMITTED TO THE COLLEGE WHICH USES THE FUNDS IN THE AREAS OF TEACHING, RESEARCH AND SERVICE. 392248939 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 183 0 1 242 1 0 0 0 0 0 0 0 0 0 0 0 0 X 28 2 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X X KATERINA MOLINA 8592577910 2333 ALUMNI PARK PLAZA SUITE 200 LEXINGTON KY 40517 MARK NEWMAN DIRECTOR 1.00 X 0 1554509 123105 PHILLIP TIBBS DIRECTOR 1.00 X 0 1023707 100965 JEFFREY SELBY DIRECTOR 1.00 X 0 930692 90128 JOSEPH ZWISCHENBERGER DIRECTOR 1.00 X 0 845082 83565 DAVID MOLITERNO DIRECTOR 1.00 X 0 820864 84242 ROBERT DIPAOLA DIRECTOR 1.00 X 0 791681 74489 MARCUS RANDALL DIRECTOR 1.00 X 0 730970 75732 MARY ELIZABETH OATES DIRECTOR 1.00 X 0 677391 72442 STEPHEN STRUP DIRECTOR 1.00 X 0 648707 68523 PATRICK MCGRATH DIRECTOR 1.00 X 0 648339 60628 PAUL PEARSON DIRECTOR 1.00 X 0 639537 66842 ROBERT GAISER DIRECTOR 1.00 X 0 633656 65942 SCOTTIE DAY DIRECTOR 1.00 X 0 632933 60109 WENDY HANSEN DIRECTOR 1.00 X 0 619939 65510 RALEIGH JONES DIRECTOR 1.00 X 0 619058 60578 ROGER HUMPHRIES DIRECTOR 1.00 X 0 613871 53245 PHILLIP CHANG DIRECTOR 1.00 X 0 587616 57742 CRAIG COLLINS DIRECTOR 1.00 X 0 595190 48961 JOHN ROTH DIRECTOR 1.00 X 0 562434 57595 SETH HIMELHOCH DIRECTOR 1.00 X 0 523602 54442 JAY GRIDER DIRECTOR 1.00 X 0 494901 57028 CHESTER JENNINGS DIRECTOR 1.00 X 0 488938 53732 LARRY GOLDSTEIN DIRECTOR 1.00 X 0 474116 48078 SUSAN MCDOWELL DIRECTOR 1.00 X 0 448345 47078 ROBERTO CARDARELLI DIRECTOR 1.00 X 0 391816 41078 AFTAB CHISHTI DIRECTOR 1.00 X 0 317187 31442 TIMOTHY CAUDILL DIRECTOR 1.00 X 0 299003 40442 DONNA GRIGSBY DIRECTOR 1.00 X 0 245015 28078 CARRIE MEEKER FORMER EXECUTIVE DIRECTOR 40.00 X 237082 0 32720 KATERINA MOLINA DIRECTOR OF FINANCE & ACCOUNTING 40.00 X 185495 0 34995 HERMAN WALTERS DIRECTOR OF IT 40.00 X 159026 0 31415 BRENDA NICHOLS DIRECTOR OF HUMAN RESOURCES 40.00 X 142409 0 20903 COLLETTE MINK DIRECTOR OF REVENUE CYCLE MANAGEMENT 40.00 X 139258 0 19475 MICHELLE MONTICELLO DIRECTOR OF PROJECT MANAGEMENT 40.00 X 128202 0 22780 991472 17859099 1934029 6 1 1 0 TODD HARGETT 6880 JACKS CREEK PIKE LEXINGTON KY 40515 CONTRACTOR SERVICES 1298274 IVEY MECHANICAL COMPANY LLC PO BOX 610 KOSCIUSKO MS 39090 REPAIR AND MAINTENANCE SERVICES 436636 HARRODSBURG ANESTHESIA 425 SHAWNEE RUN ROAD HARRODSBURG KY 40330 PROFESSIONAL SERVICES 368337 STOLL KEENON OGDEN PLLC PO BOX 11969 LEXINGTON KY 405791969 PROFESSIONAL LEGAL SERVICES 298528 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PROFESSIONAL SERVICES 264769 6 2363742 2363742 CLINIC SERVICE FEES 561000 382143067 382143067 RENT FROM SUPPORTED ORGANIZATION 531120 6791929 6791929 388934996 449109 449109 2003 2003 131883 330604 -198721 -198721 -198721 3016 0 3016 3016 3016 HONORARIUM & OTHER MISC INCOME 900099 20332917 20332917 20332917 411887062 409069192 0 454128 1428883 1428883 186419 186419 2307391 2307391 105653 105653 455032 455032 188848 188848 181079 181079 48840 48840 27085 27085 2449894 2449894 1229359 1229359 4963277 4963277 9125458 9125458 260882 260882 UK PHYSICIANS' SALARIES 255145679 255145679 CAPITAL & CURRENT OPERA 44617955 44617955 BAD DEBTS 44316447 44316447 PROFESSIONAL DEVELOPMEN 22822977 22822977 23916998 23916998 413778156 392248939 21529217 0 36607203 44869383 47318530 59919870 782904 607883 583653 520174 0 560868 160198772 54784474 104655170 105414298 22602771 23557421 212550231 235449897 8495996 14550967 18175117 17294531 58437165 62101064 99382806 115335282 184491084 209281844 X 28059147 26168053 28059147 26168053 212550231 235449897 -1891094 0 X X 0 1 X 1 0 X X X 1 UNIVERSITY OF KENTUCKY 616001218 6 1 392248939 0 1 392248939 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, PART I KMSF HAS BEEN ASSIGNED THE RESPONSIBILITY TO BILL, COLLECT, AND ADMINISTER ALL CLINICAL INCOME GENERATED BY THE PHYSICIANS OF THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE, THUS PROVIDING A SERVICE TO UK. PART IV, SECTION A, LINE 2: THE UNIVERISTY OF KENTUCKY IS A GOVERNMENTAL ENTITY DESCRIBED IN 170(B)(1)(A)(V). PART IV, SECTION B, LINE 1: PERSONS HOLDING CERTAIN POSITIONS WITHIN THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE SERVE AS EX OFFICIO VOTING DIRECTORS (THESE POSITIONS ARE THE DEAN AND CHAIR OF EACH CLINICAL DEPARTMENT); OTHER DIRECTORS ARE ELECTED BY THE FACULTY OF THE UK COLLEGE OF MEDICINE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2066767 2066767 125633933 32488007 93145926 10291464 9238219 1053245 22206608 13058248 9148360 105414298 DUE TO UNIVERSITY OF KENTUCKY 32234710 DUE TO UNIVERSITY OF KENTUCKY MALPRACTICE FUND 23656283 DUE TO COLLEGE OF MEDICINE DEPARTMENTS 58819070 DUE TO THIRD PARTY PAYERS 625219 115335282 378055904 11111383 11111383 366944521 44942541 44942541 411887062 379946998 11111383 11111383 368835615 44942541 44942541 413778156 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPNESES NETTED WITH RENTAL INCOME 330,604. PASS THROUGH INCOME 10,780,779. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 44,942,541. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPNESES NETTED WITH RENTAL INCOME 330,604. PASS THROUGH INCOME 10,780,779. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 44,942,541. 1 TUITION SUPPORT FOR DEPENDENTS OF UK FACULTY MEMBERS 119 1428883 PART I, LINE 2: KMSF REQUIRES TRANSCRIPTS AND PROOF OF ENROLLMENT EVERY SEMESTER TO MONITOR APPROPRIATE USE OF SCHOLARSHIP FUNDS. X 1 1 X X 0 0 0 0 0 0 0 0 0 MARK NEWMAN DIRECTOR 0 1133730 0 399073 0 21706 0 113373 0 9732 0 1677614 0 0 PHILLIP TIBBS DIRECTOR 0 912333 0 103119 0 8255 0 91233 0 9732 0 1124672 0 0 JEFFREY SELBY DIRECTOR 0 840500 0 86384 0 3808 0 84050 0 6078 0 1020820 0 0 JOSEPH ZWISCHENBERGER DIRECTOR 0 738333 0 88363 0 18386 0 73833 0 9732 0 928647 0 0 DAVID MOLITERNO DIRECTOR 0 728675 0 73115 0 19074 0 72800 0 11442 0 905106 0 0 ROBERT DIPAOLA DIRECTOR 0 630489 0 137330 0 23862 0 63047 0 11442 0 866170 0 0 MARCUS RANDALL DIRECTOR 0 660000 0 65656 0 5314 0 66000 0 9732 0 806702 0 0 MARY ELIZABETH OATES DIRECTOR 0 610000 0 51156 0 16235 0 61000 0 11442 0 749833 0 0 STEPHEN STRUP DIRECTOR 0 570810 0 62797 0 15100 0 57081 0 11442 0 717230 0 0 PATRICK MCGRATH DIRECTOR 0 545500 0 87410 0 15429 0 54550 0 6078 0 708967 0 0 PAUL PEARSON DIRECTOR 0 554000 0 56763 0 28774 0 55400 0 11442 0 706379 0 0 ROBERT GAISER DIRECTOR 0 563087 0 65263 0 5306 0 54500 0 11442 0 699598 0 0 SCOTTIE DAY DIRECTOR 0 595717 0 35656 0 1560 0 48667 0 11442 0 693042 0 0 WENDY HANSEN DIRECTOR 0 545000 0 59703 0 15236 0 54500 0 11010 0 685449 0 0 RALEIGH JONES DIRECTOR 0 545000 0 66106 0 7952 0 54500 0 6078 0 679636 0 0 ROGER HUMPHRIES DIRECTOR 0 556015 0 37138 0 20718 0 47167 0 6078 0 667116 0 0 PHILLIP CHANG DIRECTOR 0 497525 0 87269 0 2822 0 49738 0 8004 0 645358 0 0 CRAIG COLLINS DIRECTOR 0 489607 0 98565 0 7018 0 48961 0 0 0 644151 0 0 JOHN ROTH DIRECTOR 0 461530 0 97934 0 2970 0 46153 0 11442 0 620029 0 0 SETH HIMELHOCH DIRECTOR 0 430000 0 67059 0 26543 0 43000 0 11442 0 578044 0 0 JAY GRIDER DIRECTOR 0 455862 0 24132 0 14907 0 45586 0 11442 0 551929 0 0 CHESTER JENNINGS DIRECTOR 0 440000 0 34944 0 13994 0 44000 0 9732 0 542670 0 0 LARRY GOLDSTEIN DIRECTOR 0 420000 0 46813 0 7303 0 42000 0 6078 0 522194 0 0 SUSAN MCDOWELL DIRECTOR 0 410000 0 33481 0 4864 0 41000 0 6078 0 495423 0 0 ROBERTO CARDARELLI DIRECTOR 0 350000 0 40184 0 1632 0 35000 0 6078 0 432894 0 0 AFTAB CHISHTI DIRECTOR 0 254481 0 48616 0 14090 0 20000 0 11442 0 348629 0 0 TIMOTHY CAUDILL DIRECTOR 0 290000 0 3500 0 5503 0 29000 0 11442 0 339445 0 0 DONNA GRIGSBY DIRECTOR 0 220425 0 20732 0 3858 0 22000 0 6078 0 273093 0 0 CARRIE MEEKER FORMER EXECUTIVE DIRECTOR 237082 0 0 0 0 0 22319 0 10401 0 269802 0 0 0 KATERINA MOLINA DIRECTOR OF FINANCE & ACCOUNTING 185495 0 0 0 0 0 0 0 34995 0 220490 0 0 0 HERMAN WALTERS DIRECTOR OF IT 159026 0 0 0 0 0 0 0 31415 0 190441 0 0 0 BRENDA NICHOLS DIRECTOR OF HUMAN RESOURCES 142409 0 0 0 0 0 0 0 20903 0 163312 0 0 0 COLLETTE MINK DIRECTOR OF REVENUE CYCLE MANAGEMENT 139258 0 0 0 0 0 0 0 19475 0 158733 0 0 0 MICHELLE MONTICELLO DIRECTOR OF PROJECT MANAGEMENT 128202 0 0 0 0 0 0 0 22780 0 150982 0 0 0 A CLARK COUNTY KENTUCKY 2017-04-04 10000000 DEBT REFINANCE 0 0 0 B SCOTT COUNTY KENTUCKY 2017-04-21 9750000 DEBT REFINANCE 0 0 0 A 1214300 10000000 203524 9796476 2017 0 0 1 0 B 1140624 9750000 1005074 8744926 2017 0 0 1 0 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 A 1 B 1 BLAKE DIPAOLA CHILD OF BOARD MEMBER 12215 TUITION SUPPORT PROGRAM PAUL PEARSON CHILD OF BOARD MEMBER 11064 TUITION SUPPORT PROGRAM JACOB CAUDILL CHILD OF BOARD MEMBER 12360 TUITION SUPPORT PROGRAM EMAD CHISHTI CHILD OF BOARD MEMBER 12360 TUITION SUPPORT PROGRAM NICHOLAS GRIDER CHILD OF BOARD MEMBER 6180 TUITION SUPPORT PROGRAM MALKA HIMELHOCH CHILD OF BOARD MEMBER 12360 TUITION SUPPORT PROGRAM ABIGAIL PEARSON CHILD OF BOARD MEMBER 6180 TUITION SUPPORT PROGRAM BETHANY SELBY CHILD OF BOARD MEMBER 6180 TUITION SUPPORT PROGRAM SIDNEY STRUP CHILD OF BOARD MEMBER 12360 TUITION SUPPORT PROGRAM SCHEDULE L, PART III GRANTS LISTED ON SCHEDULE L ARE SCHOLARSHIPS PROVIDED TO CHILDREN OF BOARD MEMBERS WHO ARE FACULTY MEMBERS AT THE UNIVERSITY OF KENTUCKY. THE DEPENDENTS OF ALL FULL-TIME FACULTY ARE ELIGIBLE FOR THESE SCHOLARSHIPS AND ELIGIBILITY AND DISTRIBUTION ARE SUBJECT TO THE REQUIREMENTS OF THE PROGRAM. BOARD MEMBERS DO NOT SPECIFICALLY SELECT RECIPIENTS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 TAX RETURN IS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON THE INFORMATION OBTAINED FROM THE AUDIT AND INQUIRIES FROM MANAGEMENT. BEFORE THE RETURN IS FILED, A DRAFT OF THE INFORMATIONAL RETURN IS REVIEWED BY MANAGEMENT. THE BOARD WILL REVIEW THE 990 AT A MEETING SHORTLY AFTER FILING AND ANY NECESSARY CHANGES WILL BE MADE AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 12C EXECUTIVE LEADERSHIP HAS IMPLEMENTED A POLICY THAT OFFICERS, DIRECTORS, AND KEY EMPLOYEES SHOULD ANNUALLY DISCLOSE CONFLICTS AND THE CONFLICT OF INTEREST POLICY IS CONSISTENTLY MONITORED AND ENFORCED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DELIBERATED BY THE BOARD IN A CLOSED DOOR MEETING. AS PART OF THEIR REVIEW THEY USE AAMC GROUP ON FACULTY PRACTICE BENCHMARKS FOR COMPARISON. FORM 990, PART VI, SECTION C, LINE 19 FORMS 990 AND 990T ARE POSTED ON THE KMSF.COM WEBSITE AND ARE ALSO AVAILABLE UPON REQUEST. FORM 1023 IS PROVIDED UPON REQUEST. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART III, LINE 1 TO COORDINATE AND DEVELOP SUPERIOR PATIENT CARE IN A GROUP PRACTICE SETTING WITHIN THE ACADEMIC ENVIRONMENT OF THE MEDICAL CENTER OF THE UNIVERSITY OF KENTUCKY IN LEXINGTON, INCLUDING THE PROVISION OF FINANCIAL SUPPORT FOR THE MEDICAL CENTER'S TEACHING, RESEARCH AND SERVICE PROGRAMS AND FOR THE PERSONNEL AND EQUIPMENT NECESSARY FOR SUCH PROGRAMS, AND IN FURTHERANCE OF THIS GENERAL PURPOSE TO EXECUTE AND PERFORM A PUBLIC TRUST IN SUPPORTING, AIDING, AND ADVANCING THE STUDY AND INVESTIGATION OF HUMAN ILLNESSES AND INJURIES, AND THE CAUSES, PREVENTIONS, RELIEF AND CURE THEREOF, AND THE STUDY AND INVESTIGATION OF PROBLEMS OF HYGIENE AND HEALTH; TO ENCOURAGE, PROMOTE AND PERFORM MEDICAL, SURGICAL AND SCIENTIFIC LEARNING, SKILL, EDUCATION AND INVESTIGATION; TO PROMOTE MEDICAL, SURGICAL, AND SCIENTIFIC SERVICES; TO ATTRACT AND RETAIN HIGH QUALITY FACULTY TO TEACH, CONDUCT RESEARCH AND PROVIDE PATIENT CARE; TO PROVIDE SUPPORT TO ENABLE THE COLLEGE OF MEDICINE TO ACCOMPLISH ITS EDUCATIONAL, RESEARCH AND SERVICE GOALS; TO ASSIST PROGRAMS OF MEDICAL, SURGICAL AND SCIENTIFIC EDUCATION AND RESEARCH; TO CARRY ON SUCH PROGRAMS OF PUBLIC CHARITY AS MAY BE RELATED TO THE CARRYING OUT OF THE OTHER STATED PURPOSES OF THE CORPORATION, AND, SPECIFICALLY THE CHARITABLE PROGRAMS UTILIZING THE KNOWLEDGE AND SKILLS ACQUIRED BY THE CORPORATION THROUGH ITS ABOVE-DESCRIBED OPERATIONS FOR THE BENEFIT OF ALL PERSONS WHO MAY BE IN NEED THEREOF, REGARDLESS OF HIS OR HER ABILITY TO PAY. UNIVERSITY OF KENTUCKY 800 ROSE STREET LEXINGTON KY 40536 616001218 EDUCATIONAL DEVELOPMENT, HEALTHCARE KY 115 N/A N/A 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0