2014-05-14T14:08:08-05:00 2013-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 106 W VINE STREET SUITE 600 LEXINGTON KY 40507 990 2012-07-01 311139276 CONSOLIDATED HEALTH SYSTEMS INC CONS 6068869558 PO BOX 0787 PRESTONSBURG KY 41653 JACK BLACKWELL 6068869558 2014-05-14 1 LEIGH MCKEE P00169845 8592552341 2012 2015-11-30 17:44:51Z HIGHLANDS HEALTH SYSTEM JACK BLACKWELL PO BOX 0787 PRESTONSBURG KY 41653 18662486 0 X WWW.HIGHLANDSHEALTHSYSTEM.COM X 1984 KY THE ORGANIZATION SERVES TO FOSTER AND DEVELOP HEALTH CARE ACTIVITIES 8 7 65 7 307069 -115945 0 0 13485466 14387000 614002 1025424 993778 2164384 15093246 17576808 3450 62577 0 0 7245111 7459319 0 0 29495 7611144 7607944 14859705 15129840 233541 2446968 56664626 55302961 41276068 36158493 15388558 19144468 THE ORGANIZATION SERVES TO FOSTER AND DEVELOP HEALTH CARE ACTIVITIES IN THE SERVICE AREA OF HIGHLANDS REGIONAL MEDICAL CENTER, AN AFFILIATED HOSPITAL. 0 0 11076331 62577 17189230 THE ORGANIZATION SERVES TO FOSTER AND DEVELOP HEALTH CARE ACTIVITIES IN THE SERVICE AREA OF HIGHLANDS REGIONAL MEDICAL CENTER, AN AFFILIATED HOSPITAL. 11076331 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 34 0 1 65 1 1 1 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X THE ORGANIZATION 6068869558 PO BOX 0787 PRESTONSBURG KY 41653 HAROLD C WARMAN 40.00 X X 313247 0 32772 BURL WELLS SPURLOCK 2.00 X 0 0 0 DEWEY L BOCOOK JR 1.00 X 0 0 0 EDWARD R NAIRN 1.00 X 0 0 0 PAUL D NUNN 1.00 X 0 0 0 ROBERT M DUNCAN 1.00 X 0 0 0 GREGORY A WILSON 1.00 X 0 0 0 DENNIS DORTON 1.00 X 0 0 0 JACK BLACKWELL 40.00 X 204463 0 18684 SUSAN ELLIS 40.00 X 143511 0 27561 JAMES D JACKSON 40.00 X 133468 0 26871 TODD HIGHTOWER 40.00 X 146103 0 24666 TERRY D HALL 40.00 X 466234 0 27772 DARYL LARKE 40.00 X 548987 0 32772 BRETT AKERS 40.00 X 698263 0 31522 ROBERT N ROYALTY 40.00 X 328805 0 15947 JOEL A SHAPIRO 40.00 X 321393 0 14257 3304474 0 252824 16 0 1 0 PROGRESSIVE HEALTHCARE INC 109 WESTPARK DRIVE STE 150 BRENTWOOD TN 37027 CONSULTING 455729 AUTOMATIC DATA PROCESSING 225 2ND AVENUE BOSTON MA 02129 PAYROLL PROCESSING 130004 FAIRWAY OUTDOOR ADVERTISING 1749 US HWY NORTH PRESTONSBURG KY 41653 ADVERTISING 122453 GOGGANS CONSTRUCTION CORP 312 EUCLID AVENUE PAINTSVILLE KY 41240 CONTRACTOR 111330 STAFF CARE INC 5001 STATESMAN DR IRVING TX 75063 STAFFING 101528 5 PHYSICIAN SERVICES 621300 12235016 12235016 MANAGEMENT/CONSULTING 541610 7478243 7478243 REFUNDS/CONTRACT 900099 -5326259 -5326259 14387000 602410 602410 447832 1085678 -637846 -637846 -115945 -521901 423014 0 423014 423014 423014 MEANINGFUL USE FUNDS 900099 2378184 2378184 INTERDEPARTMENT BENEFITS 900099 424046 424046 2802230 17576808 17189230 307069 80509 X 62577 62577 1039236 1039236 5049373 5020168 29205 190650 190650 803694 778894 24800 376366 376366 9479 9479 90000 90000 4540508 4224785 315723 479923 479633 290 233087 233087 535427 535427 72243 72243 35900 35900 4856 4856 373325 373325 PROVISION FOR BAD DEBTS 457313 457313 SUPPLIES 453205 420932 32273 DUES & SUBSCRIPTIONS 127700 127700 EQUIPMENT RENTAL 91257 91257 103721 5000 98721 15129840 11076331 4024014 29495 1219700 790895 24472499 26938612 2960744 1262016 7028707 5150723 16250 16250 167900 117841 24616650 7496012 17477825 17120638 984927 1101683 2336074 2804303 56664626 55302961 1317118 1368407 229856 297571 889484 379037 38839610 34113478 41276068 36158493 X 15388558 19144468 15388558 19144468 56664626 55302961 2446968 1308942 0 X X 0 1 X 1 0 X X X X 0 0 0 HIGHLANDS HOSPITAL CORPORATION 610658773 3 1 1 1 0 1 0 11375859 1510411 12886270 10748641 927218 11375859 8800172 1948469 10748641 8365650 434522 8800172 10839794 -2474144 8365650 1.00000 0 0 2584885 2584885 17858015 4739223 13118792 577896 392680 185216 3155923 2356804 799119 439931 7305 432626 17120638 INTERCOMPANY RECEIVABLE 2804303 2804303 INTERCOMPANY LIABILITIES 34113478 34113478 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BOARD RESTRICTED NET ASSETS CONSIST OF ASSETS DESIGNATED BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE PARENT COMPANY, HHHC, THE HOSPITAL AND HCFA ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC), EXCEPT FOR ANY UNRELATED BUSINESS INCOME ACTIVITIES. NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE COMBINED FINANCIAL STATEMENTS FOR ANY OF THESE ENTITIES. CHE IS A FOR-PROFIT CORPORATION ON WHICH APPLICABLE CORPORATE INCOME TAXES APPLY. HMP I, HMP II, HS, HIGHLANDS PRESTONSBURG AND HIGHLANDS PAINTSVILLE ARE LIMITED LIABILITY ENTITIES. IN LIEU OF INCOME TAXES, THE OWNERS OF THE ENTITIES ARE REQUIRED TO REPORT THEIR RESPECTIVE SHARES OF THE ENTITIES' TAXABLE INCOME OR LOSS ON THEIR RESPECTIVE INCOME TAX RETURNS. THE HOSPITAL HAS UNRELATED BUSINESS INCOME FROM CERTAIN ACTIVITIES. THESE ACTIVITIES ARE GENERALLY CONDUCTED AT A LOSS AND HELP TO COVER OVERHEAD COSTS. BOTH THE HOSPITAL AND CHE HAVE SMALL NET OPERATING LOSS CARRYFORWARDS. MANAGEMENT HAS EVALUATED THE COMPANY'S TAX POSITIONS AND CONCLUDED THAT THE COMPANY TOOK NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE COMBINED FINANCIAL STATEMENTS TO COMPLY WITH GAAP. WITH FEW EXCEPTIONS, THE COMPANY IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2010. 1 BIG SANDY HEALTH CARE INC 1709 KY RT 321 SUITE 3 PRESTONSBURG KY 41653 610849776 501(C)(3) 50000 PROVIDE HEALTH CARE TO RESIDENTS OF SOUTHEASTERN KENTUCKY 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MAINTAINS RECORDS TO SUBSTANTIATE THE GRANTS PAID AND DOCUMENTATION RECEIVED FROM THE RECIPIENT ORGANIZATION REQUESTING THE GRANT. HOWEVER, THE ORGANIZATION DOES NOT MONITOR THE USE OF THE FUNDS BY THE RECIPIENT ORGANIZATION AT THIS TIME. X X X X 0 0 0 0 0 0 0 0 0 HAROLD C WARMAN 313247 0 0 0 0 0 12500 0 20272 0 346019 0 0 0 JACK BLACKWELL 204463 0 0 0 0 0 10237 0 8447 0 223147 0 0 0 SUSAN ELLIS 143511 0 0 0 0 0 7289 0 20272 0 171072 0 0 0 JAMES D JACKSON 133468 0 0 0 0 0 6599 0 20272 0 160339 0 0 0 TODD HIGHTOWER 146103 0 0 0 0 0 4394 0 20272 0 170769 0 0 0 TERRY D HALL 466234 0 0 0 0 0 7500 0 20272 0 494006 0 0 0 DARYL LARKE 548987 0 0 0 0 0 12500 0 20272 0 581759 0 0 0 BRETT AKERS 698263 0 0 0 0 0 11250 0 20272 0 729785 0 0 0 ROBERT N ROYALTY 328805 0 0 0 0 0 7500 0 8447 0 344752 0 0 0 JOEL A SHAPIRO 321393 0 0 0 0 0 7500 0 6757 0 335650 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE DIRECTOR OF ACCOUNTING, CFO AND BOARD OF DIRECTORS WILL REVIEW FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO EACH BOARD MEMBER ANNUALLY. THE POLICY IS DISTRIBUTED BY THE BOARD SECRETARY ALONG WITH A DISCLOSURE FORM. RESPONSES ARE REVIEWED BY THE CEO. IF THERE IS A PARTICULAR ISSUE THAT NEEDS TO BE BROUGHT TO THE ATTENTION OF THE BOARD, THE CEO WILL CONTACT THE BOARD CHAIR TO DISCUSS, AND IF NECESSARY, IT WILL BE PLACED ON THE BOARD AGENDA FOR REVIEW. ADDITIONALLY, IF A BOARD MEMBER OR THE CEO BECOME AWARE OF POTENTIAL CONFLICTS THEY CAN REPORT THIS TO THE BOARD CHAIR DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO AND OFFICERS IS DETERMINED BY A COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS PERFORMANCE ANNUALLY. THE BOARD CONSULTS WITH VARIOUS SOURCES TO DETERMINE MARKET RATES OF COMPENSATION AGAINST COMPARABLE ORGANIZATIONS. THE BOARD USES ACHE COMPENSATION SURVEYS, MODERN HEALTHCARE COMPENSATION SURVEYS, AND VERBALLY CONSULTS WITH THE KY HOSPITAL ASSOCIATION TO DETERMINE KY COMPENSATION. FROM TIME TO TIME, THE BOARD MAY USE OTHER SOURCES THAT ARE AVAILABLE. COMPENSATION IS BASED ON MARKET RATES AND PERFORMANCE AGAINST GOALS, WHICH ARE ESTABLISHED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,224,785. MANAGEMENT AND GENERAL EXPENSES 315,723. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,540,508. FORM 990, PART XI, LINE 2C THERE IS A COMMITTEE OF THE BOARD OF DIRECTORS THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HHS DEVELOPMENT COMPANY PRESTONSBURG LLC 5000 KY RT 321 PRESTONSBURG KY 41653 271260438 HOLD MEDICAL OFFICE BUILDING KY -272109 7075691 CONSOLIDATED HEALTH SYSTEMS INC HHS DEVELOPMENT COMPANY PAINTSVILEE LLC 5000 KY RT 321 PRESTONSBURG KY 41653 271259520 HOLD MEDICAL OFFICE BUILDING KY -186298 3854251 CONSOLIDATED HEALTH SYSTEMS INC HOMETOWN FAMILY CARE LLC 5000 KY RT 321 PRESTONSBURG KY 41653 202470645 FAMILY CARE CLINIC KY 446177 1101346 CONSOLIDATED HEALTH SYSTEMS INC HIGHLANDS HOME CARE INC 5032 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 611349726 HOME HEALTH SERVICES KY 501(C)(3) 9 CONSOLIDATED HEALTH SYSTEMS INC 1 HIGHLANDS HOSPITAL CORPORATION BOX 668 5032 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 610658773 HEALTH CARE SERVICES KY 501(C)(3) 3 CONSOLIDATED HEALTH SYSTEMS INC 1 HIGHLANDS FOUNDATION INC 5000 KY HIGHWAY 321 PRESTONSBURG KY 41653 208036784 PROMOTE HEALTH AND COMMUNITY EDUCATION AND INVOLVEMENT KY 501(C)(3) 7 CONSOLIDATED HEALTH SYSTEMS INC 1 HIGHLANDS CENTER FOR AUTISM INC 5000 KY HIGHWAY 321 PRESTONSBURG KY 41653 264541964 SCHOOL FOR AUTISM SPECTRUM DISORDER KY 501(C)(3) 9 CONSOLIDATED HEALTH SYSTEMS INC 1 HIGHLANDS MEDICAL PARTNERS II LLC 5000 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 311139276 MEDICAL SERIVCES - SLEEP LAB KY CONSOLIDATED HEALTH SYSTEMS INC RELATED -31300 33375 0 1 0.51000 CONSOLIDATED HEALTH ENTERPRISES BOX 668 5032 KY ROUTE 321 PRESTONSBURG KY 41653 611261592 PHARMACY KY CONSOLIDATED HEALTH SYSTEMS INC C -136678 743045 1.00000 1 HIGHLANDS STAFFING INC 5000 KY RT 321 PRESTONSBURG KY 41653 270835324 STAFFING KY CONSOLIDATED HEALTH SYSTEMS INC C 7291 400044 1.00000 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 HIGHLANDS HOSPITAL CORPORATION E 4333148 HIGHLANDS HOME CARE INC E 240615 HIGHLANDS FOUNDATION INC D 195119 HIGHLANDS CENTER FOR AUTISM D 156032 CONSOLIDATED HEALTH ENTERPRISES D 76594