2016-07-28T10:01:27-05:00 2016-01-31 201518594 RFH PLLC 300 WEST VINE STREET SUITE 800 LEXINGTON KY 405071812 990 2015-02-01 610849776 BIG SANDY HEALTH CARE INC BIGS 6068868546 1709 KY ROUTE 321 NO 3 PRESTONSBURG KY 41653 ANCIL LEWIS CHIEF EXECUTIVE OFFICER 6068868546 2016-07-28 1 BRADLEY J HAYES CPA P01405593 8592311800 2015 2016-09-27 15:27:22Z ANCIL LEWIS 1709 KY ROUTE 321 PRESTONSBURG KY 41653 17577512 0 X WWW.BSHC.ORG X 1974 KY BIG SANDY HEALTH CARE, INC. (BSHC) IS ORGANIZED AS A NONPROFIT CORPORATION IN KENTUCKY AND IS A CHARITABLE ENTITY UNDER SECTION 501(C)(3). BSHC OPERATES EXCLUSIVELY FOR THE CHARITABLE PURPOSE OF PROVIDING PRIMARY HEALTH CARE SERVICES TO RESIDENTS OF AN ECONOMICALLY DISTRESSED REGION, INCLUDING UNINSURED PERSONS, MEDICAID RECIPIENTS AND MEDICARE BENEFICIARIES. BSHC OPERATES FIVE COMMUNITY HEALTH CENTER SITES PROVIDING A BROAD SCOPE OF PRIMARY CARE SERVICES IN EASTERN KENTUCKY. AS PART OF ITS COMMITMENT TO ITS CHARITABLE MISSION, BSHC HAS INSTITUTED A CHARITY DISCOUNT PROGRAM FOR PATIENTS WHOSE HOUSEHOLD INCOMES FALL BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. DURING FISCAL YEAR ENDED JANUARY 31, 2016, BSHC PROVIDED CHARITY DISCOUNTS OF $484,277 TO APPROXIMATELY 10% OF ITS OVER 18,800 PATIENTS. BSHC MANAGEMENT BELIEVES THAT CHARITY DISCOUNTS FOR SERVICES IS THE MOST IMPORTANT INDICATOR OF ITS FULFILLMENT OF ITS CHARITABLE PURPOSE AND, THEREFORE, FULLY DISCLOSES THIS INFORMATION. 20 20 188 1 0 0 2761743 2869187 10996818 14706709 363 1616 0 0 13758924 17577512 0 0 0 0 9237572 10840098 0 0 0 3566536 3966052 12804108 14806150 954816 2771362 6257148 8456214 2489024 1916728 3768124 6539486 X BIG SANDY HEALTH CARE (BSHC) IS ORGANIZED AS A NONPROFIT CORPORATION AND AN EXEMPT ENTITY UNDER IRC SECTION 501(C)(3). BSHC OPERATES EXCLUSIVELY FOR THE CHARITABLE PURPOSE OF PROVIDING PRIMARY HEALTH CARE SERVICES TO A LARGE NUMBER OF LOW-INCOME AND UNINSURED PERSONS THROUGH ITS FIVE PRIMARY CARE CENTERS IN RURAL, SOUTHEASTERN KENTUCKY. BSHC'S PRIMARY SERVICE AREA IS COMPRISED ON FLOYD, JOHNSON, MAGOFFIN, MARTIN AND PIKE COUNTIES. THE AREA IS RURAL AND ECONOMICALLY DISTRESSED. A DISPROPORTIONATE NUMBER OF PEOPLE HAVE NO HEALTH INSURANCE AND THE REGION'S MEDICAID ELIGIBILITY IS HIGH COMPARED TO STATE AND NATIONAL AVERAGES IN THIS CONTEXT, BSHC OFFERS CHARITABLE HEALTH CARE TO LOW-INCOME AND UNINSURED PERSONS AS PART OF ITS COMMITMENT TO ITS CHARITABLE MISSION, BSHC HAS INSTITUTED A CHARITY PROGRAM FOR UNINSURED PATIENTS WHO RECEIVE SERVICES AT ITS FACILITIES. THIS PROGRAM PROVIDES FINANCIAL RELIEF TO PERSONS WHO QUALIFY BASED ON A COMPARISON OF THEIR FINANCIAL RESOURCES AND/OR INCOME. 0 0 12469700 14708325 BIG SANDY HEALTH CARE (BSHC) CONTINUED TO PROVIDE A BROAD ARRAY OF PRIMARY CARE SERVICES, INCLUDING MEDICAL, DENTAL, BEHAVIORAL HEALTH, PHARMACY, DIAGNOSTIC X-RAY AND MEDICAL LABORATORY SERVICES. IN ADDITION TO THE SERVICES PROVIDED IN ITS FIVE HEALTH CENTER SITES, BSHC PROVIDES SERVICES IN HOSPITALS, NURSING HOMES AND SCHOOLS. DURING FISCAL YEAR ENDED JANUARY 31, 2016, BSHC PROVIDED SERVICES TO OVER 18,800 UNDUPLICATED INDIVIDUALS. BSHC SITES PROVIDE SERVICES TO ANY RESIDENT OF THE REGION, BUT ESPECIALLY ATTRACTS LOW-INCOME AND UNINSURED PERSONS. FOR THESE GROUPS, BSHC PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE. 12469700 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 29 0 188 1 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 KY X DEAN SHOFNER 6068868546 1709 KY ROUTE 321 PRESTONSBURG KY 41653 ANCIL LEWIS CEO 40.00 X X 128372 0 2000 JOANN ARNETT DIRECTOR 0.00 X 0 0 0 BILL BRANHAM DIRECTOR 0.00 X 0 0 0 JUDITH BRANHAM DIRECTOR 0.00 X 0 0 0 SUSAN CHAFIN DIRECTOR 0.00 X 0 0 0 ROY CONLEY DIRECTOR 0.00 X 0 0 0 BOBBY HALE DIRECTOR 0.00 X 0 0 0 KATHY HEMBREE DIRECTOR 0.00 X 0 0 0 PAUL HOPKINS DIRECTOR 0.00 X 0 0 0 RACHEL KENNEDY DIRECTOR 0.00 X 0 0 0 SUREKHA MADDIWAR DIRECTOR 0.00 X 0 0 0 MARY MCMASTERS DIRECTOR 0.00 X 0 0 0 HEATHER MCPEEK DIRECTOR 0.00 X 0 0 0 MELISSA PHELPS DIRECTOR 0.00 X 0 0 0 MIKE PRATER DIRECTOR 0.00 X 0 0 0 STEVEN GOBLE DIRECTOR 0.00 X 0 0 0 RANDY ROBERTS DIRECTOR 0.00 X 0 0 0 MICHAEL SHOEMAKER DIRECTOR 0.00 X 0 0 0 TINA TERRY DIRECTOR 0.00 X 0 0 0 KATHY TRIMBLE DIRECTOR 0.00 X 0 0 0 MELISSA TURNER DIRECTOR 0.00 X 0 0 0 DR GERALD DYSERT DOCTOR 40.00 X 284992 0 2000 DR ANTARA POTHULOORI DOCTOR 40.00 X 302315 0 2000 DR LESLEY DOTSON DOCTOR 40.00 X 203043 0 2000 DR LARRY LESLIE DOCTOR 40.00 X 218943 0 2000 DR ENRICO ASCANI DOCTOR 40.00 X 400011 0 2000 1537676 0 12000 23 0 1 0 J&S LEASING 81 WILLOW DRIVE AUXIER KY 41602 RENT 150397 STAFF CARE PO BOX 281923 ATLANTA GA 30384 TEMPORARY STAFFING 149241 2 2863615 5572 480 2869187 PROG.SERV.REVENUE-RELATED-990 621400 14706709 14706709 14706709 1616 1616 17577512 14708325 0 0 389441 106123 283318 8201873 7349754 852119 179989 148328 31661 1443758 1136431 307327 625037 511995 113042 754166 657484 96682 16323 7871 8452 331250 88352 242898 211948 122325 89623 54307 20896 33411 38608 38159 449 211008 195087 15921 59688 3801 55887 PHARMACY SUPPLIES 1153344 1153344 MEDICAL SUPPLIES 577352 577352 OTHER EXPENSE 303846 176988 126858 TELEPHONE AND UTILITIES 239104 160302 78802 15108 15108 14806150 12469700 2336450 0 1106725 2572694 474532 176748 1259319 2054130 212844 253132 321711 439067 5222580 2262137 2882017 2960443 6257148 8456214 831866 1000653 975050 836294 682108 79781 2489024 1916728 X 3581742 6354220 186382 185266 3768124 6539486 6257148 8456214 2771362 0 X X 0 1 X 1 1 1 X 2385832 2527227 3098717 2761743 2869187 13642706 2385832 2527227 3098717 2761743 2869187 13642706 13642706 748 504 241 363 1616 3472 13646178 0.99970 0.99800 X 228562 228562 2719387 842715 1876672 2274631 1419422 855209 2960443 CAPITAL LEASE PAYABLE 12550 FORGIVABLE NOTE PAYABLE 25000 ESTIMATED THIRD PARTY COST REIMBURSEMENT PAYABLE 42231 79781 X 17577512 0 17577512 0 17577512 14806150 0 14806150 0 14806150 PART X, LINE 2: THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. BIG SANDY HEALTH CARE, INC. HAS BEEN CLASSIFIED AS A CORPORATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE. THE CORPORATION MUST RECOGNIZE THE TAX BENEFIT ASSOCIATED WITH TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THE POSITION WILL BE SUSTAINED. THE CORPORATION DOES NOT BELIEVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS OR POSSIBLE RELATED INTEREST OR PENALTIES. THE CORPORATION IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2012. 0 0 0 0 0 0 0 0 0 DR GERALD DYSERT DOCTOR 284992 0 0 0 0 0 2000 0 0 0 286992 0 0 0 DR ANTARA POTHULOORI DOCTOR 302315 0 0 0 0 0 2000 0 0 0 304315 0 0 0 DR LESLEY DOTSON DOCTOR 203043 0 0 0 0 0 2000 0 0 0 205043 0 0 0 DR LARRY LESLIE DOCTOR 218943 0 0 0 0 0 2000 0 0 0 220943 0 0 0 DR ENRICO ASCANI DOCTOR 400011 0 0 0 0 0 2000 0 0 0 402011 0 0 0 FORM 990 - ORGANIZATION'S MISSION BIG SANDY HEALTH CARE, INC. (BSHC) IS ORGANIZED AS A NONPROFIT CORPORATION IN KENTUCKY AND IS A CHARITABLE ENTITY UNDER SECTION 501(C)(3). BSHC OPERATES EXCLUSIVELY FOR THE CHARITABLE PURPOSE OF PROVIDING PRIMARY HEALTH CARE SERVICES TO RESIDENTS OF AN ECONOMICALLY DISTRESSED REGION, INCLUDING UNINSURED PERSONS, MEDICAID RECIPIENTS AND MEDICARE BENEFICIARIES. BSHC OPERATES FIVE COMMUNITY HEALTH CENTER SITES PROVIDING A BROAD SCOPE OF PRIMARY CARE SERVICES IN EASTERN KENTUCKY. AS PART OF ITS COMMITMENT TO ITS CHARITABLE MISSION, BSHC HAS INSTITUTED A CHARITY DISCOUNT PROGRAM FOR PATIENTS WHOSE HOUSEHOLD INCOMES FALL BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. DURING FISCAL YEAR ENDED JANUARY 31, 2016, BSHC PROVIDED CHARITY DISCOUNTS OF $484,277 TO APPROXIMATELY 10% OF ITS OVER 18,800 PATIENTS. BSHC MANAGEMENT BELIEVES THAT CHARITY DISCOUNTS FOR SERVICES IS THE MOST IMPORTANT INDICATOR OF ITS FULFILLMENT OF ITS CHARITABLE PURPOSE AND, THEREFORE, FULLY DISCLOSES THIS INFORMATION. IN ADDITION TO ITS CHARITABLE MISSION, BSHC IS COMMITTED TO STRICT ADHERENCE TO ALL THE REQUIREMENTS FOR 501(C)(3) ORGANIZATIONS. PURSUANT TO THESE REQUIREMENTS, BSHC ENSURES THAT NONE OF ITS EARNINGS INURE TO ANY DIRECTOR OR OTHER INDIVIDUAL. BSHC MAKES NO ATTEMPT TO INFLUENCE LEGISLATION IN ANY SUBSTANTIAL WAY. FURTHERMORE, BSHC DOES NOT PARTICIPATE IN CAMPAIGN ACTIVITY FOR OR AGAINST ANY CANDIDATE FOR POLITICAL OFFICE. FORM 990, PART VI, SECTION B, LINE 11 ON JULY 7, 2016, BSHC SENT ITS FORM 990 ELECTRONICALLY TO ALL MEMBERS OF ITS BOARD OF DIRECTORS FOR REVIEW. SUBSEQUENTLY, DURING ITS JULY 25, 2016 MEETING, THE BSHC BOARD OF DIRECTORS' FINANCE COMMITTEE REVIEWED AND APPROVED FORM 990 FOR FISCAL YEAR ENDED JANUARY 31, 2016. FORM 990, PART VI, SECTION B, LINE 12C DURING A REGULAR MEETING OF THE BSHC BOARD OF DIRECTORS ON APRIL 25, 2016 JAMES HERALD, GERNERAL COUNSEL, REVIEWED THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. SUBSEQUENTLY, EACH DIRECTOR COMPLETED A STATEMENT DESIGNED TO REVEAL ANY CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A DURING A SPECIAL MEETING ON AUGUST 26, 2013, THE BSHC BOARD OF DIRECTORS' FINANCE COMMITTEE REVIEWED COMPARABILITY DATA WITH RESPECT TO SALARY RANGES FOR CHIEF EXECUTIVE OFFICERS IN COMMUNITY HEALTH CENTERS. DATA WAS REVIEWED FROM THE 2012 STUDY CONDUCTED BY MERCES CONSULTING GROUP AND A 2012 SURVEY CONDUCTED BY THE NATIONAL ASSOICATION OF COMMUNITY HEALTH CENTERS (NACHC). THE FINANCE COMMITTEE APPROVED A MOTION TO RECOMMEND TO THE BSHC BOARD OF DIRECTORS AN ANNUAL SALARY OF $111,463 FOR BSHC'S CHIEF EXECUTIVE OFFICER. DURING ITS REGULAR MEETING ON AUGUST 26, 2013, THE BSHC BOARD OF DIRECTORS REVIEWED THE COMPARABILITY DATA AND APPROVED THE RECOMMENDATION OF THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 DURING THE TAX YEAR, BSHC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WERE AVAILABLE TO THE PUBLIC, UPON REQUEST, AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART XII, LINE 2C: THE BSHC BOARD OF DIRECTORS HAS DESIGNATED ITS FINANCE COMMITTEE TO SERVE AS THE ORGANIZATION'S AUDIT COMMITTEE. AS SUCH, THE FINANCE COMMITTEE IS CHARGED WITH SELECTION OF AN INDEPENDENT AUDITING FIRM AND OVERSIGHT OF THE AUDIT REPORTS.