2014-02-14T14:00:27-06:00 2013-06-30 610420207 JONES NALE & MATTINGLY PLC 642 SOUTH FOURTH ST STE 300 LOUISVILLE KY 40202 990 2012-07-01 610984463 OWSLEY COUNTY HEALTH CARE CENTER INC OWSL 6065936302 PO BOX 250 BOONEVILLE KY 413140250 WHITTNEY YOUNTS 6065936302 2014-02-14 1 DAVID R PRICE P01272254 5025830248 2012 2015-11-30 17:44:51Z WHITTNEY YOUNTS 20 COUNTRY BARN RD BOONEVILLE KY 413140250 5169963 0 X N/A X 1980 KY HEALTH CARE FACILITY FOR THE PUBLIC. TO MEET THE SPECIFIC INDIVIDUAL NEEDS OF EACH OF OUR RESIDENTS SO THEY WILL RESIDE IN THE CENTER WITH DIGNITY AND AN IMPROVED QUALITY OF LIFE. 8 8 177 0 0 0 0 0 5588859 5124582 4103 2507 36441 42874 5629403 5169963 0 0 0 0 3224517 2704220 0 0 0 2472963 2600699 5697480 5304919 -68077 -134956 2601419 2400114 843782 777433 1757637 1622681 X TO MEET THE SPECIFIC INDIVIDUAL NEEDS OF EACH OF OUR RESIDENTS SO THEY WILL RESIDE IN THE CENTER WITH DIGNITY AND AN IMPROVED QUALITY OF LIFE. 0 0 1801912 4799685 NURSING SERVICES 848725 324897 ANCILLARY SERVICES PHARMACY, OCCUPATIONAL, PHYSICAL & SPEECH THERAPIES, LAB, OXYGEN & ENTERAL NUTRITION PROGRAM. 954431 9037 GENERAL SERVICES DIETARY, HOUSEKEEPING, LAUNDRY, RECREATIONAL ACTIVITIES, SOCIAL SERVICES, MEDICAL RECORDS, AND PLANT OPERATIONS. 825083 33837 ADMINISTRATIVE SERVICES OTHER COSTS INCURRED AS A RESULT OF PROVIDING RESIDENTS WITH CARE. 825083 33837 4430151 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 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 17 0 1 177 1 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 X X OWSLEY COUNTY HEALTH CARE CENTER INC 6065936302 20 COUNTRY BARN RD BOONEVILLE KY 413140250 DALE ROBERTS 2.00 X X 0 0 0 DALE BISHOP 5.00 X X 2400 0 0 PHYLLIS REFFITT 0.00 X 0 0 0 ROGER ROBERTS 0.00 X 0 0 0 BOBBY SMITH 0.00 X 0 0 0 TRAVIS SMITH 0.00 X 0 0 0 ARNOLD WILSON 0.00 X 0 0 0 JASON WILSON 0.00 X 0 0 0 JUDY TERRY 40.00 X 85872 0 976 WHITTNEY YOUNTS 40.00 X 26100 0 0 114372 0 976 0 0 0 0 HERITAGE HEALTHCARE 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICE 562444 HEALTH SYSTEMS OF KENTUCKY 329 TOWNEPARK CIRCLE STE 100 LOUISVILLE KY 40243 MANAGEMENT CONSULTANT 265713 MEDCARE PHARMACY 11420 WATTERSON CT LOUISVILLE KY 40299 PHARMACY 168418 GORDON FOOD SERVICE 342 GORDON INDUSTRIAL DR SHEPHERDSVILLE KY 40165 FOOD SERVICE 136112 UNITED HEALTHCARE 2424 HARRODSBURG ROAD LEXINGTON KY 40503 HEALTH INSURANCE 122416 5 PATIENT HEALTH CARE 623000 4799685 4799685 REHABILITATION/SPEECH 623000 287538 287538 MEDICAL SUPP, OXYGEN 623000 34298 34298 PHARMACY 623000 3061 3061 5124582 2507 2507 MISCELLANEOUS 623000 33837 33837 EMPLOYEE MEALS 623000 9037 9037 42874 5169963 5167456 0 2507 112942 112942 2147476 2004109 143367 19412 16500 2912 243845 207268 36577 180545 153463 27082 196685 196685 75687 75687 71888 71888 3552 3552 38322 38322 19785 19785 111178 111178 76005 10929 65076 ANCILLARY SERVICES 902067 902067 GENERAL SERVICES 550994 550994 OTHER ADMIN 300515 219622 80893 NURSING SERVICES 217284 217284 36737 36737 5304919 4430151 874768 0 1097644 555367 484941 885728 20262 16141 58534 49111 3363771 2472527 939605 891244 433 2523 2601419 2400114 434557 386646 409225 390787 843782 777433 X 1757637 1622681 1757637 1622681 2601419 2400114 -134956 0 X 0 1 X 0 0 X 5152754 5412589 5776151 5588858 5124582 27054934 5152754 5412589 5776151 5588858 5124582 27054934 0 0 0 27054934 6029 9548 6806 4103 2507 28993 6029 9548 6806 4103 2507 28993 7119 27609 19870 36443 42873 133914 5165902 5449746 5802827 5629404 5169962 27217841 0.99400 0.99570 0.00110 0.00120 X 1816077 1478011 338066 956702 537982 418720 590992 456534 134458 891244 X 5169963 0 5169963 0 5169963 5304919 0 5304919 0 5304919 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER'S ACCOUNTING POLICY PROVIDES THAT A TAX EXPENSE/BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THE CENTER HAS NO UNCERTAIN TAX POSITIONS RESULTING IN AN ACCRUAL OF TAX EXPENSE OR BENEFIT. SAMMY SEBASTIAN FAMILY MEMBER OF BOARD DIRECTOR (PHYLLIS REFFITT) 38826 EMPLOYEETOTAL COMPENSATION: 43,798 0 KATHY ROBERTS FAMILY MEMBER OF BOARD DIRECTOR (DALE ROBERTS AND ROGER ROBERTS) 32413 EMPLOYEETOTAL COMPENSATION: 33,930 0 MARIE SEBASTIAN FAMILY MEMBER OF BOARD DIRECTOR (PHYLLIS REFFITT) 34210 EMPLOYEETOTAL COMPENSATION: 35,606 0 FORM 990, PART VI, SECTION A, LINE 2 DALE ROBERTS (CHAIRMAN & DIRECTOR) IS THE FATHER OF ROGER ROBERTS (DIRECTOR). ARNOLD WILSON (DIRECTOR) IS THE FATHER OF JASON WILSON (DIRECTOR). FORM 990, PART VI, SECTION B, LINE 11 ADMINISTRATOR JUDY TERRY WILL PROVIDE A COPY OF THE 990 TO ALL BOARD MEMBERS AND WILL REQUIRE THEM TO SIGN A STATEMENT AFFIRMING THAT THEY HAVE REVIEWED THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT AFFIRMING COMPLIANCE. FORM 990, PART VI, SECTION C, LINE 18 THE 990 IS AVAILABLE THROUGH WWW.GUIDESTAR.ORG AND BY REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS WILL BE MADE AVIALABLE TO THE PUBLIC UPON REQUEST. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII DALE ROBERTS - EAST SIDE APTS, #802, BOONEVILLE, KY 41314. DALE BISHOP - PO BOX 256, BOONEVILLE, KY 41314. PHYLLIS REFFITT - 1313 OLD U.S. 25 NORTH, BEREA, KY 40403. ROGER ROBERTS - PO BOX 112, BOONEVILLE, KY 41314. BOBBY SMITH - HC88 BOX 1980, BOONEVILLE, KY 41314. TRAVIS SMITH - 554 KY 399, VINCENT, KY 41364. ARNOLD WILSON - RT#23 BOX 220, BOONEVILLE, KY 41314. JASON WILSON - 110 WHISPERING WOODS STONEWALL ESTATES, RICHMOND, KY 40475.