2018-02-09T14:41:30-06:00 2017-03-31 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2016-04-01 311118087 Commonwealth Health Corporation Inc COMM 2707451500 800 Park Street Bowling Green KY 42102 Ron Sowell EVP - CFO 2707451500 2018-01-18 1 Angela L Zirkelbach CPA P00572603 3176334705 2018-01-18 38.109.186.2 2018-01-18 16:36:27 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CEC041C7A28BF02AF1651001FA3B4F793CABA0CE 2016 2021-01-29 14:40:06Z Connie D Smith 800 Park Street Bowling Green KY 42102 82185083 0 X www.chc.net X 1984 KY Commonwealth health corporation's mission is to care for people and improve the quality of life in the communities we serve. 17 15 685 0 6159713 1960076 502537 489894 71765849 78969368 1344007 1719021 844196 871607 74456589 82049890 915895 838244 0 0 53296776 56609761 0 0 0 18185104 20647030 72397775 78095035 2058814 3954855 53770697 58356502 21191632 23328404 32579065 35028098 X COMMONWEALTH HEALTH CORPORATION'S MISSION IS TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN tHE COMMUNITIES WE SERVE. 0 0 15921912 838244 25117209 CHC HAS BEEN DETERMINED TO BE A PUBLICLY SUPPORTED ORGANIZATION DESCRIBED IN SECTION 509(A)(2) OF THE CODE AND A CHARITABLE ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXATION BY VIRTUE OF SECTIONS 501(A) AND 501(C)(3) OF THE CODE.CHC IS A HOLDING COMPANY FOR A TOTAL OF TWELVE NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS (COLLECTIVELY, THE "AFFILIATES") ENGAGED IN VARIOUS ASPECTS OF THE HEALTHCARE INDUSTRY. CHC HAS ESTABLISHED VARIOUS DIVISIONS FOR ITS OPERATIONS, INCLUDING (1) BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION ("THE MEDICAL CENTER"), (2) COMMONWEALTH HEALTH FREE CLINIC, INC., (3) THE MEDICAL CENTER AT FRANKLIN, INC., (4) COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC., AND (5) VARIOUS NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS.CHC OWNS AND OPERATES SEVERAL PHYSICIAN PRACTICES EMPLOYING GENERAL PRACTITIONERS, A BARIATRIC SURGEON, CARDIAC SURGEONS, VASCULAR SURGEONS, NEUROSURGEONS, OBSTETRIC/GYNECOLOGISTS, ONCOLOGISTS, GENERAL SURGEON, INTERNAL MEDICINE PHYSICIANS, HOSPITALISTS, INFECTIOUS DISEASE AND TRAVEL MEDICINE PHYSICIANS, OTOLARYNGOLOGISTS, ORTHOPAEDISTS AND PSYCHIATRISTS. CHC HAS ACQUIRED THE PHYSICIAN PRACTICES IN ORDER 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. SINCE 1990, CHC'S WHOLLY-OWNED CENTER CARE HEALTH BENEFITS PROGRAM ("CENTER CARE"), A PREFERRED PROVIDER ORGANIZATION (PPO), HAS ASSISTED EMPLOYERS AND PAYORS IN MANAGING THE RISING COST OF THEIR HEALTHCARE. THE PPO OFFERS EMPLOYER GROUPS AND PAYORS IN THIS REGION AND ACROSS KENTUCKY A COMPREHENSIVE NETWORK OF PHYSICIANS AND FACILITIES WITH GREATER COST SAVINGS POTENTIAL THAN OTHER NATIONAL ORGANIZATIONS. TODAY, CENTER CARE SERVES AS THE LOCAL, REGIONAL, OR STATEWIDE NETWORK SOLUTION FOR VARIOUS MANAGED CARE ORGANIZATIONS FOR THEIR COMMERCIAL, MEDICARE, AND/OR MEDICAID MEMBERSHIP. CENTER CARE PRESENTLY HAS OVER 500,000 MEMBERS BY PROVIDING ACCESS TO OVER 20,000 PROVIDERS IN KENTUCKY, TENNESSEE, INDIANA, OHIO, AND ILLINOIS.SINCE 2008, CHC HAS BEEN THE SOLE OWNER OF BLUEGRASS OUTPATIENT CENTER OF BOWLING GREEN, LLC ("BLUEGRASS"). BLUEGRASS PROVIDES COMPREHENSIVE OUTPATIENT REHABILITATION THERAPY SERVICES.BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION:THE BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION IS A NON-STOCK, NONPROFIT KENTUCKY CORPORATION THAT OPERATES A HOSPITAL FACILITY IN BOWLING GREEN, KENTUCKY, UNDER THE NAME "THE MEDICAL CENTER OR "THE MEDICAL CENTER AT BOWLING GREEN AND SINCE OCTOBER 1996, A HOSPITAL AND NURSING HOME FACILITY IN SCOTTSVILLE, KENTUCKY, UNDER THE NAME "THE MEDICAL CENTER AT SCOTTSVILLE." THE MEDICAL CENTER ALSO BEGAN OPERATING A HOSPITAL IN HORSE CAVE, KENTUCKY ON JANUARY 1, 2016 UNDER THE NAME "THE MEDICAL CENTER AT CAVERNA."THE MEDICAL CENTER AT BOWLING GREEN:BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL'S BOWLING GREEN FACILITY IS A GENERAL ACUTE CARE HOSPITAL LICENSED FOR 337 BEDS, WITH 333 BEDS IN USE. IN 1980, THE BOWLING GREEN FACILITY MOVED INTO A NEW, SIX-STORY, STATE-OF-THE-ART FACILITY, OCCUPYING 298,000 SQUARE FEET ON A 17-ACRE CAMPUS. SINCE 1980, BECAUSE OF AN EXPANDING DEMAND FOR OUTPATIENT SERVICES, SEVERAL ADDITIONS TO THE BOWLING GREEN FACILITY HAVE BEEN MADE AND BOTH CLINICAL AND PATIENT AREAS HAVE BEEN RENOVATED AND MODERNIZED. TODAY, THE CAMPUS INCLUDES 56 ACRES AND THE BUILDINGS ON THE CAMPUS CONTAIN A TOTAL OF APPROXIMATELY 462,000 SQUARE FEET OF SPACE. IN ADDITION, THE HOSPITAL OPERATES THE WHOLLY-OWNED MEDICAL CENTER PHARMACY OF BOWLING GREEN, LLC AND THE MEDICAL CENTER EMS, LLC WHICH PROVIDES THE ONLY EMERGENCY MEDICAL SERVICE IN WARREN COUNTY. THE HOSPITAL IS ALSO A 50% PARTNER WITH ANOTHER NON-PROFIT IN OPERATING THE NON-PROFIT BARREN RIVER REGIONAL CANCER CENTER, INC., AN OUTPATIENT ONCOLOGY CENTER LOCATED IN GLASGOW, KENTUCKY.THE MEDICAL CENTER AT SCOTTSVILLE: TO MORE FULLY SERVE THE HEALTH NEEDS OF SOUTH CENTRAL KENTUCKY, THE MEDICAL CENTER MERGED IN OCTOBER 1996 WITH AN AFFILIATED ENTITY, HEALTH ENDOWMENT PROPERTIES A-C, INC., A KENTUCKY NON-STOCK, NONPROFIT CORPORATION, WHICH OWNED AND OPERATED THE MEDICAL CENTER AT SCOTTSVILLE. THE SCOTTSVILLE FACILITY IS COMPRISED OF A 25-BED MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL AND 110 NURSING CARE BEDS. THESE BEDS ARE LOCATED IN AN APPROXIMATELY 85,000 SQUARE FOOT BUILDING ON APPROXIMATELY 13 ACRES OF LAND IN ALLEN COUNTY, NEAR SCOTTSVILLE, KENTUCKY.THE MEDICAL CENTER AT CAVERNA:ON JANUARY 1, 2016, THE BOWLING GREEN - WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (THE MEDICAL CENTER) ACQUIRED ALL THE ASSETS OF CAVERNA MEMORIAL HOSPITAL, INC. (CAVERNA) IN EXCHANGE FOR ASSUMPTION OF ALL THE LIABILITIES OF CAVERNA, AND PAYOFF OF THE LONG-TERM DEBT OF CAVERNA IN THE AMOUNT OF $4,786,512. THIS FACILITY OPERATES AS A 25-BED MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL AND IS LOCATED IN HORSE CAVE, KENTUCKY.COMMONWEALTH HEALTH FREE CLINIC, INC.:COMMONWEALTH HEALTH FREE CLINIC, INC. ("FREE CLINIC") IS A SECTION 501(C)(3) ORGANIZATION THAT 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.COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC.:COMMONWEALTH REGIONAL SPECIALTY HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL THAT OPERATES AS A HOSPITAL WITHIN A HOSPITAL BY LEASING 28 BEDS FROM THE MEDICAL CENTER ON THE MEDICAL CENTER'S BOWLING GREEN CAMPUS. IT IS AN ACUTE CARE HOSPITAL FOR THOSE PATIENTS REQUIRING AN EXTENDED HOSPITAL STAY (ANTICIPATED LENGTH OF STAY BETWEEN 18-35 DAYS) AND GENERALLY HAVING COMPLEX OR CHRONIC MEDICAL CONDITIONS. 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 Albany:On April 1, 2016, the Medical Center acquired the assets of Clinton County Hospital, Inc., an acute-care facility, in order to maintain the facility as an acute-care hospital. The Medical Center at Albany is a 42-bed acute care hospital that earns revenue by providing inpatient, outpatient, and emergency care services in Clinton County and surrounding counties in Kentucky. COMMONWEALTH HEALTH FOUNDATION:IN ADDITION, CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION ("THE FOUNDATION") FOR THE PURPOSE OF FOSTERING, SUPPORTING AND INITIATING ACTIVITIES FOR THE ADVANCEMENT OF THE HEALTH CARE OBJECTIVES OF CHC AND THE MEDICAL CENTER AND/OR AFFILIATED NON-PROFIT 501(C)(3) ORGANIZATIONS. THE CHAIRMAN OF CHC'S BOARD OF DIRECTORS OR HIS/HER DESIGNEE, CHC'S PRESIDENT AND CEO, AND THE CFO OF THE MEDICAL CENTER SERVE AS EX OFFICIO DIRECTORS OF THE FOUNDATION. ALL THREE ARE COUNTED FOR QUORUM PURPOSES AND HAVE THE RIGHTS AND PRIVILEGES OF OTHER DIRECTORS, INCLUDING THE RIGHT TO VOTE ON ALL MATTERS PROPERLY BEFORE THE BOARD.FULFILLING THE MISSION: COMMONWEALTH HEALTH CORPORATION ("CHC") WORKS TO FULFILL ITS MISSION OF CARING FOR PEOPLE AND IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES. IN FULFILLING ITS MISSION, CHC DIRECTLY OR INDIRECTLY SPONSORS OR PARTICIPATES IN THE FOLLOWING ACTIVITIES: OVERVIEW OF SPECIFIC COMMUNITY BENEFIT ACTIVITIES:THE COMMONWEALTH HEALTH FREE CLINIC, INC. ("FREE CLINIC") IS A SECTION501(C)(3) ORGANIZATION THAT 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. 32239094 38514864 THE CORPORATION PROMOTES HEALTHCARE IN SOUTH CENTRAL KENTUCKY BY OWNING AND MANAGING PHYSICIAN PRACTICES AND IMMEDIATE CARE Clinics. tHE PHYSICIAN PRACTICES COVER A WIDE RANGE OF MEDICAL SPECIALTIES, INCLUDING Orthopaedic, VASCULAR, and CARDIOTHORACIC SURGERY, OTORHINOLARYNGOLOGY (ENT), NEUROLOGY, HOSPITAliSTS, OBSTETRICS, GYNECOLOGY, RADIOLOGY, PSYCHIATRY AND GENERAL MEDICINE. 8349805 9873756 THE CORPORATION PROMOTES HEALTHCARE IN SOUTH CENTRAL KENTUCKY BY OPERATING A COMPREHENSIVE REHABILITATION FACILITY WHICH OFFERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. IN ADDITION, THE CORPORATION PROVIDES STAFFING FOR THERAPY SERVICES IN A RELATED HOME HEALTH AGENCY, AN ACUTE CARE HOSPITAL, TWO CRITICAL ACCESS HOSPITALS, A LONG-TERM ACUTE CARE HOSPITAL, AND ONE NURSING CARE FACILITY. 56510811 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 312 0 1 685 1 1 1 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 KY X James Larry Vaughn 2707451500 800 park street bowling green KY 42102 JOE NATCHER chairman 2.00 6.00 X X 0 0 0 cathy bishop vice chairperson 2.00 2.00 X X 0 0 0 eli jackson iii dmd secretary 2.00 2.00 X X 0 0 0 BEVERLY BOREN DIRECTOR 2.00 2.00 X 0 0 0 brad odil director 2.00 2.00 X 0 0 0 doug gorman director 2.00 0.00 X 0 0 0 DR KAL SAHETYA DIRECTOR 2.00 2.00 X 0 0 0 judge michael buchanon director 2.00 0.00 X 0 0 0 judge william fuqua director 2.00 2.00 X 0 0 0 mark bigler md director 2.00 0.00 X 0 0 0 MARK YURCHISIN MD director 2.00 0.00 X 810 1750 0 tommy holderfield director 2.00 4.00 X 0 0 0 Tommy loving director 2.00 4.00 X 0 0 0 tony witty director 2.00 2.00 X 0 0 0 Dr Hugh Sims III Director 40.00 0.00 X 365567 0 33853 Jacque Pope - Tarrence Director 2.00 2.00 X 0 0 0 connie d smith director/president & ceo 40.00 14.00 X X 868646 0 11764 ronald g sowell cfo/executive vice president 40.00 12.00 X 524676 0 10548 Barbara jean cherry cio/executive vice president 45.00 7.00 X 514333 0 11076 betsy kullman cno/executive vice president 40.00 12.00 X 287075 0 18694 Sarah Moore exec. vice pres. (retired 7/1/16) 45.00 6.00 X 165271 0 5540 WADE STONE executive vice president 45.00 6.00 X 287329 0 26818 Eric Hagan Vice President/ Administrator 25.00 26.00 X 258474 0 18182 Wallace R Carter MD cardiovascular surgeon 40.00 0.00 X 766403 0 29395 narendra nathoo MD physician 40.00 0.00 X 871890 0 37411 paul m moore MD cardiovascular surgeon 40.00 0.00 X 765044 0 30753 Clark Bernard MD Physician 40.00 X 871633 0 36766 Onyeoziri Nwanguma MD Physician 40.00 0.00 X 604664 0 36238 7151815 1750 307038 79 0 1 0 Kentucky Medical Services Foundation In PO Box 587 Lexington KY 40586 Physician SERVICES 1772250 Hoy P Hodges PO Box 1865 bowling green KY 42102 attorney services 1027032 Bottom Line Systems Inc 541 BUTTERMILK PIKE SUITE 401 Crescent Springs KY 41017 Professional Services 489608 ERX LLC 9724 KINGSTON PIKE SUITE 1300 Knoxville TN 37922 ER Services 447900 English Lucas Priest & Owsley PO Box 770 Bowling green KY 421020770 Attorney services 380441 19 489894 489894 Physician Services 621110 43978403 37818690 6159713 Net Patient Service Revenue 624310 25117209 25117209 Rehabilitative Services 561000 9873756 9873756 78969368 1580680 1580680 141114 135193 5921 5921 5921 138341 0 138341 138341 138341 Other Revenue 900099 688177 688177 Contract Labor 900099 169512 169512 EHR Incentive 900099 7997 7997 865686 82049890 73505829 6159713 1894454 X 818480 818480 19764 19764 2906814 2091247 815567 41114484 29578968 11535516 3882635 1786537 2096098 6059548 3902006 2157542 2646280 1805890 840390 311214 108951 202263 418656 5211 413445 11909092 9376389 2532703 437391 356880 80511 1316657 1028195 288462 421974 367371 54603 1740576 1630542 110034 350643 200062 150581 430962 387588 43374 586508 523156 63352 Medical Supplies 1180791 1180791 UBI Taxes 680189 680189 Recruiting 472182 417884 54298 Taxes & Licenses 82259 79190 3069 307936 165520 142416 78095035 56510811 21584224 0 7551923 8151815 24730346 27578295 1097549 5439723 2825448 3961779 3140246 5991089 21164 31875 7838259 634301 16786958 10674619 6080714 6112339 394048 364286 91000 91000 53770697 58356502 17538923 19675695 3652709 3652709 21191632 23328404 X 32579065 35028098 32579065 35028098 53770697 58356502 X 3954855 54704 -1560526 X X 0 1 X 1 0 X 372580 395540 439525 502537 489894 2200076 62475613 63896232 67155229 72586840 79835054 345948968 62848193 64291772 67594754 73089377 80324948 348149044 15320268 15320268 0 15320268 15320268 332828776 1613631 2483090 1219336 1485933 1721794 8523784 1613631 2483090 1219336 1485933 1721794 8523784 64461824 66774862 68814090 74575310 82046742 356672828 0.93310 0.88380 0.02390 0.02470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1139967 1139967 5892084 2564736 3327348 9732342 8109883 1622459 22565 22565 6112339 CHC Long Term Liabilities 3652709 3652709 X 82395867 54704 135193 189897 82205970 -156080 -156080 82049890 77580414 156080 156080 77424334 670701 670701 78095035 Part X, Line 2: Most of the income received by the corporation is exempt from taxation under section 501(a) of the internal revenue code. some of its income is subject to taxation as unrelated business income. The corporation files federal income tax returns, as well as a Form 990 with the Secretary of State for Kentucky. The corporation is no longer subject to U.S. federal income tax examinations by tax authorities for years before 2014. Financial accounting standards board (FASB) accounting standards codification topic 740 clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements and prescribes a recognition threshold and measurement of a tax position taken, or expected to be taken in a tax return. Topic 740 also provides guidance on description, classification, interest and penalties, accounting in interim periods, disclosure and transition. the corporation does not have any uncertain tax positions recognized for 2017 or 2016. The corporation's practice is to recognize interest and/or penalties related to income tax matters in income tax expense. Part XI, Line 2d - Other Adjustments: Rental Expenses 135,193. Part XI, Line 4b - Other Adjustments: Losses Included in Expenses -156,080. Part XII, Line 2d - Other Adjustments: Losses included in expenses 156,080. Part XII, Line 4b - Other Adjustments: Rental Expenses -135,193. Equity Transfer 805,894. 1 commonwealth health free clinic 800 park street bowling green KY 42101 611292739 501c3 499992 general support commonwealth health foundation 800 park street bowling green KY 42101 611362000 501c3 297034 general support College Heights Foundation 1906 College Heights Blvd Bowling green KY 42101 610459494 501c3 11454 Scholarship Support 101st airbourne division support fund PO Box 929 2703 Michigan Ave Fort Campbell KY 42223 751094916 501c3 10000 Scholarship Support 4 0 Herbert A Oldham Scholarship 1 9882 Floyd Ellis Scholarship 2 9882 X X X X X 0 1 0 0 0 0 0 0 0 Dr Hugh Sims III Director 362819 0 0 0 2748 0 5505 0 28348 0 399420 0 0 0 connie d smith director/president & ceo 684572 0 0 0 184074 0 0 0 11764 0 880410 0 0 0 ronald g sowell cfo/executive vice president 433521 0 0 0 91155 0 0 0 10548 0 535224 0 0 0 Barbara jean cherry cio/executive vice president 432993 0 0 0 81340 0 0 0 11076 0 525409 0 0 0 betsy kullman cno/executive vice president 278417 0 0 0 8658 0 0 0 18694 0 305769 0 0 0 Sarah Moore exec. vice pres. (retired 7/1/16) 151083 0 0 0 14188 0 0 0 5540 0 170811 0 0 0 WADE STONE executive vice president 285421 0 0 0 1908 0 0 0 26818 0 314147 0 0 0 Eric Hagan Vice President/ Administrator 250758 0 0 0 7716 0 0 0 18182 0 276656 0 0 0 Wallace R Carter MD cardiovascular surgeon 762335 0 0 0 4068 0 0 0 29395 0 795798 0 0 0 narendra nathoo MD physician 869142 0 0 0 2748 0 7950 0 29461 0 909301 0 0 0 paul m moore MD cardiovascular surgeon 760976 0 0 0 4068 0 0 0 30753 0 795797 0 0 0 Clark Bernard MD Physician 869413 0 0 0 2220 0 7950 0 28816 0 908399 0 0 0 Onyeoziri Nwanguma MD Physician 399941 0 201975 0 2748 0 7950 0 28288 0 640902 0 0 0 Part I, Line 4b CERTAIN EXECUTIVES OF COMMONWEALTH HEALTH CORPORATION PARTICIPATE 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 $171,036 RONALD SOWELL $80,028 JEAN CHERRY $72,099 Ronnie Moore Sarah Moore, Officer 75905 Sarah Moore serves as an officer of CHC. Mrs. Moore's husband, Ronnie Moore received compensation from CHC. 0 Form 990, Part III, Line 4a IN ADDITION TO THE FREE CLINIC'S SERVICES, FROM THE BEGINNING, CHC AND THE MEDICAL CENTER MADE A COMMITMENT TO BE NOT ONLY AN EXCELLENT MEDICAL FACILITY BUT ALSO THE PREEMINENT RESOURCE FOR HEALTH CARE INFORMATION IN WESTERN AND SOUTH CENTRAL KENTUCKY. THIS PHILOSOPHY GAVE BIRTH TO THE MEDICAL CENTER'S COMMUNITY WELLNESS PROGRAM. THIS PROGRAM PROVIDES FREE EDUCATIONAL PROGRAMS TO THE COMMUNITY AND WORK SITES ON PREVENTION, WELLNESS, HEALTH, LIFESTYLE, AND DISEASE MANAGEMENT. CHC AND THE MEDICAL CENTER SPONSOR THE HEALTH AND WELLNESS CENTER ("CENTER") ON PROPERTY ADJACENT TO THE GREENWOOD MALL IN BOWLING GREEN, KENTUCKY. THE CENTER PROVIDES FREE HEALTH EDUCATION SERVICES TO THE COMMUNITY AND IS STAFFED BY REGISTERED NURSES WHO ANSWER QUESTIONS, ASSIST WITH FREE HEALTH SCREENINGS AND COORDINATE OTHER ACTIVITIES. EACH MONTH THE CENTER FEATURES A DIFFERENT FREE SCREENING SUCH AS CHOLESTEROL, GLUCOSE, DEPRESSION, HEARING, OR PULMONARY FUNCTION. PRESENTATIONS AND PROGRAMS ARE PROVIDED DURING THE WEEK BY A VARIETY OF HEALTHCARE PROVIDERS. SUPPORT GROUPS ALSO MEET AT THE CENTER. ANNUALLY, CHC AND ITS CORPORATE AFFILIATES PROMOTE PARTICIPATION IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE PROGRAM AND THE AMERICAN HEART ASSOCIATION'S HEART WALK. IN ADDITION, CHC AND THE MEDICAL CENTER ENCOURAGE PHYSICAL ACTIVITY BY SPONSORING THE MEDICAL CENTER 10K CLASSIC AND CHILDREN'S CLASSIC, EVENTS WHICH COMBINE SEPARATE ACTIVITIES FOR THOSE WHO WANT TO WALK OR RUN COMPETITIVELY. ANNUALLY, OVER 2,000 INDIVIDUALS PARTICIPATE IN THE 10K AND CHILDREN'S CLASSIC EVENTS. ANNUALLY, CHC AND THE MEDICAL CENTER SPONSOR A COMMUNITY-WIDE HEALTH AND WELLNESS EXPO AT A LOCAL CONVENTION CENTER. THIS EVENT PROVIDES VARIOUS HEALTH SCREENINGS AND OFFERS CITIZENS CONCENTRATED ACCESS TO BOTH INFORMATION REGARDING MANY COMMUNITY HEALTHCARE RESOURCES AND TO THE STAFF WHO WORK WITH THESE COMMUNITY HEALTHCARE AGENCIES. CHC AND THE MEDICAL CENTER'S SENIOR HEALTH CARE NETWORK PROVIDE WEEKLY EXERCISE PROGRAMS TO MEET THE SPECIFIC NEEDS OF PEOPLE OVER 55. AS A COMPLEMENT TO MEMBERS REGULAR VISITS TO THEIR PERSONAL PHYSICIAN, ANNUALLY MEMBERS CAN RECEIVE FREE HEALTH SCREENINGS OF BLOOD PRESSURE, BLOOD SUGAR LEVELS, LIPID PROFILE AND MORE. IN ADDITION, MEMBERS RECEIVE A QUARTERLY NEWSLETTER TO HELP STAY ABREAST OF HEALTHCARE ISSUES AND INFORMED OF UPCOMING SPECIAL EVENTS. CHC AND THE MEDICAL CENTER SPONSOR THE WOMEN'S CENTER WHICH PROVIDES FOR THE SPECIAL NEEDS OF WOMEN INCLUDING HEALTHCARE SERVICES, PERSONAL EDUCATION ON SELF-EXAMINATIONS, EXERCISE AND NUTRITION, A LUNCHEON SERVICE ON WOMEN'S HEALTH AND PROFESSIONAL CONCERNS, AND A NEWSLETTER. IN ADDITION, CHC AND THE MEDICAL CENTER SPONSOR THE MEN'S HEALTH ALLIANCE WHICH OFFERS MEMBERS A VARIETY OF HEALTH-RELATED BENEFITS INCLUDING ANNUAL HEALTH SCREENINGS. WITH THE SUPPORT OF CHC, THE MEDICAL CENTER IS WELL EQUIPPED FOR ORTHOPAEDIC SURGERY, NEUROSURGERY AND THE MOST COMMON CARDIAC PROBLEMS INCLUDING THE ABILITY TO PERFORM CARDIAC CATHETERIZATIONS, OPEN HEART SURGERY AND TO PROVIDE CARDIAC REHABILITATION. THE MEDICAL CENTER ALSO OFFERS CHEMOTHERAPY AND DIAGNOSTIC RADIOGRAPHY FOR CANCER SCREENING AND TREATMENT. OTHER SERVICES THAT CAN BE PROVIDED ON AN OUTPATIENT BASIS INCLUDE: EEG/EMG, EKG, ENDOSCOPY, IV THERAPY, DIGITAL MAMMOGRAPHY, NUCLEAR MEDICINE, PHYSICAL THERAPY, RADIOLOGY (CT, ULTRASOUND) RESPIRATORY THERAPY, AND VASCULAR STUDIES. CHC'S CONTRIBUTION TO OUR COMMUNITIES DISPLAYED BELOW IS A DETAILED LIST OF HOW OVER $101.3 MILLION IN BENEFITS WERE PROVIDED DIRECTLY TO THE COMMUNITY BY COMMONWEALTH HEALTH CORPORATION AND ITS AFFILIATES INCLUDING: THE MEDICAL CENTER (BOWLING GREEN, caverna, AND SCOTTSVILLE CAMPUSES), THE MEDICAL CENTER AT FRANKLIN, The medical center at Albany, COMMONWEALTH HEALTH FREE CLINIC, AND COMMONWEALTH REGIONAL SPECIALTY HOSPITAL: FINANCIAL ASSISTANCE (FREE OR DISCOUNTED CARE FOR UNINSURED PEOPLE WHOSE INCOMES MET CERTAIN POVERTY GUIDELINES): $2,356,144 UNPAID COST OF MEDICAID: $23,095,943 COMMUNITY HEALTH SERVICES (INCLUDES FREE COMMUNITY HEALTH FAIRS, SCREENINGS, COMMUNITY HEALTH EDUCATION CLASSES AND HEALTH AND WELLNESS PROJECTS): $4,825,869 HEALTH PROFESSIONAL EDUCATION (SCHOLARSHIPS AND FUNDING FOR EDUCATION): $4,878,418 SUBSIDIZED HEALTH SERVICES (INCLUDES EMERGENCY CARE AND BEHAVIORAL HEALTH SERVICES FOR WHICH REIMBURSEMENTS DO NOT COVER THE FULL COST AND KENTUCKY PROVIDER TAX TO FUND CARE): $5,546,962 FINANCIAL AND IN-KIND CONTRIBUTIONS $87,623 COMMUNITY BUILDING ACTIVITIES: $420,400 BAD DEBT (SERVICES PROVIDED IN WHICH PAYMENT IS EXPECTED, BUT NEVER RECEIVED, STATED AT COST)*: $20,683,399 UNPAID COST OF MEDICARE: $39,425,517 TOTAL CHARITY CARE AND OTHER BENEFITs: $101,320,275 *AMOUNT INCLUDES THE BAD DEBT BALANCES OF A 50% OWNED ENTITY THAT WAS NOT CONSOLIDATED IN THE CORPORATION'S CONSOLIDATED FINANCIAL STATEMENTS. Form 990, Part VI, Section B, line 11b FORM 990 IS placED ELECTRONICALLY ON the COMPANY WEBSITE USED TO SHARE iNFORMATION WITH BOARD MEMBERS. EACH BOARD MEMBER IS PROVIDED ACCESS TO THIS WEBSITE AND IS ASKED TO REVIEW FORM 990 PRIOR TO A DESIGNATED DATE ON WHICH THE RETURN WILL BE FILED. AT LEAST TWO WEEKS OF ADVANCE NOTICE IS GIVEN TO BOARD MEMBERS SO THEY MAY REVIEW THE RETURN. Form 990, Part VI, Section B, line 12c 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 COMMITTEE (RCC) REVIEWS AND APPROVES ALL CONTRACTS between CHC and/or its affiliates and disqualified entities. THE REVIEW IS DESIGNED TO IDENTIFY 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, Section B, line 15 COMMoNWEALTH HEALTH CORPORATION USES INDEPENDENT CONSULTANTS TO ANNUALLY REVIEW COMPENSATION OF EMPLOYEE OFFICERS. 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. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ONLY MADE AVAILABLE IF REQUIRED, AND IN THE MANNER REQUIRED, BY A GOVERNING AGENCY. Form 990, Part IX, line 11g Collection Fees: Program service expenses 151,378. Management and general expenses 0. Fundraising expenses 0. Total expenses 151,378. Consulting Fees: Program service expenses 2,392,965. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,392,965. Billings Fees: Program service expenses 1,389,339. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,389,339. Contract Fees: Program service expenses 5,442,707. Management and general expenses 2,532,703. Fundraising expenses 0. Total expenses 7,975,410. Form 990, Part XI, line 9: Transfer of Net Assets -4,767,320. Sale of UCP 3,206,794. Form 990, Part XII, Line 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. BLUEGRASS OUTPATIENT CTR OF BOWLING GREEN 800 Park Street Bowling Green KY 42101 263564003 Outpatient KY -154526 1366354 N/A BOWLING GREEN WARREN CTY COMM HOSP CORP 800 Park Street Bowling Green KY 42101 610920842 Hospital KY 501(c)(3) Line 3 N/A 0 The Medical Center at Franklin 800 Park Street Bowling Green KY 42101 611362001 Hospital KY 501(c)(3) Line 3 N/A 0 Commonwealth Regional Specialty Hospital 800 Park Street Bowling Green KY 42101 542142034 Hospital KY 501(c)(3) Line 3 N/A 0 Commonwealth Health Free Clinic 800 Park Street Bowling Green KY 42101 611292739 Hospital KY 501(c)(3) Line 3 N/A 0 Commonwealth Health Foundation Inc 800 Park Street Bowling Green KY 42101 611362000 Foundation KY 501(c)(3) Line 3 N/A 0 The Medical Center at Albany 800 Park Street Bowling Green KY 42101 811312058 Hospital KY 501(c)(3) Line 3 N/A 0 URGENTCARE PROPERTIES 800 Park Street Bowling Green KY 42101 611197268 Real Estate KY N/A Excluded 2552474 525047 0 0 0.51000 Medical Plaza Partners 800 Park Street BOwling Green KY 42101 611080340 Real Estate KY N/A URGENTCARE OF BOWLING GREEN INC 800 Park Street Bowling Green KY 42101 611035393 Healthcare KY N/A C 0.51000 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 BOWLING GREEN WARREN CTY COMM HOSP CORP R 634128 cash and FMV BOWLING GREEN WARREN CTY COMM HOSP CORP D 2863000 fmv BOWLING GREEN WARREN CTY COMM HOSP CORP P 43127000 fmv commonwealth health foundation B 297034 fmv Commonwealth health Foundation C 489894 fmv commonwealth health free clinic B 499992 fmv The Medical Center at Franklin D 138845 fmv The Medical Center at Franklin P 2727000 fmv commonwealth regional specialty Hospital D 25221 fmv commonwealth regional specialty Hospital P 395000 fmv The Medical Center at Albany D 2522211 FMV THE Medical Center at Albany P 1092905 FMV