2013-10-30T14:20:49-05:00 2012-12-31 351178661 BLUE & CO LLC 250 WEST MAIN STREET SUITE 2900 LEXINGTON KY 40507 990 2012-01-01 452710251 HEALTHFIRST BLUEGRASS INC HEAL 8592882334 650 NEWTOWN PIKE LEXINGTON KY 40508 THOMAS LESTER 8592882334 2013-10-29 1 R ALLEN NORVELL P00005513 8592531100 2013-10-29 2012 2016-03-07 17:11:31Z WILLAIM RASINEN 650 NEWTOWN PIKE LEXINGTON KY 40508 11652019 0 X NONE X 2011 KY THE PURPOSE OF THE HEALTHFIRST BLUEGRASS INC. BYLAWS IS TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES TO RESIDENTS OF THE BLUEGRASS REGION OF CENTRAL KENTUCKY, AND SPECIFICALLY MEDICALLY UNDER-SERVED AREAS WITHIN LEXINGTON-FAYETTE COUNT AND DESIGNATED SERVICE AREA. 13 13 0 0 0 0 3580296 3560882 3297271 7945554 0 0 84383 145583 6961950 11652019 0 0 0 0 3805852 7697769 0 0 0 1825586 4470067 5631438 12167836 1330512 -515817 2423789 3518633 1093277 2703938 1330512 814695 TO PROVIDE QUALITY HEALTHCARE FOR ALL WHO NEED US. HEALTHFIRST PROVIDES OUTPATIENT PRIMARY HEALTHCARE SERVICES TO THE UNDERSERVED AND UNINSURED RESIDENTS OF FAYETTE COUNTY AND SURROUNDING COUNTIES IN KENTUCKY. 0 0 7420877 5821778 MEDICAL CLINIC: PROVIDE CLINIC SERVICES TO APPROXIMATLY 15,000 MEMBERS. SIGNIFICANT PORTION OF PATIENTS SEEN ARE LOW-INCOME FAMILIES WHO CANNOT AFFORD MEDICAL SERVICES. 1918875 1709280 PHARMACY: PROVIDE MEDICATION FILLING SERVICES TO ORGANIZATION MEMBERS. SIGNIFICANT PORTION OF PATIENTS ARE LOW-INCOME FAMILIES WHO CANNOT AFFORD MEDICINES. PHARMACY FILLS PERSCRIPTION PRIMARILY THROUGH 340 B INVENTORY & MANUFACTURERS ASSISTANCE PROGRAM AND RETAIL PHARMACY. 871878 560079 DENTAL CLINIC: PROVIDE DENTAL SERVICES TO APPROXIMATLY 4,000 MEMBERS. SIGNIFICANT PORTION OF PATIENTS SEEN ARE LOW-INCOME FAMILIES WHO CANNOT AFFORD MEDICAL SERVICES. 10211630 1 1 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 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 KY X HEALTHFIRST BLUEGRASS INC 8592882334 650 NEWTOWN PIKE LEXINGTON KY 40508 HERMAN HARDESTY 1.00 X 0 0 0 THOMAS LESTER 1.00 X X 0 0 0 JOHN P LOVENTHAL MD 1.00 X X 0 0 0 GEORGIE MEDINA PHD 1.00 X X 0 0 0 ELENA CASTRO 1.00 X X 0 0 0 BOBBY THOMPSON DMD 1.00 X 0 0 0 TOM BURICH 1.00 X X 0 0 0 RICK WEST 1.00 X X 0 0 0 STEVE POLSTON 1.00 X X 0 0 0 JOYCE WALKER 1.00 X 0 0 0 JAMES SLEET 1.00 X X 0 0 0 BILL RASINEN 1.00 X 0 0 0 AMANDA JASON 1.00 X 0 0 0 DEBORAH STANLEY MD 40.00 X 172713 0 7385 NEELAKSHI UPRETI MD 40.00 X 131455 0 335 HINA ALI MD 40.00 X 116902 0 6985 421070 0 14705 6 0 1 0 LEXINGTON FAYETTE COUNTY HEALTH DEPARTME 650 NEWTOWN PIKE LEXINGTON KY 40508 MEDICAL 8491506 AMERISOURCE BERGEN 6305 LA SALLE DRIVE LOCKBOURNE OH 43137 MEDICAL 739696 GE HEALTH CARE ITTS USA CORP 15724 COLLECTIONS CTN DRIVE CHICAGO IL 60693 MEDICAL 198273 STAFF CARE INC PO BOX 281923 ATLANTA GA 303841923 STAFFING 135216 QUEST DIAGNOSTICS PO BOX 530458 ATLANTA GA 303530458 MEDICAL 131185 5 3560882 3560882 NET PATIENT SERVICE 624100 6069239 6069239 PHARMACY REVENUES 446110 1708280 1708280 OTHER CONTRACTS 624100 168035 168035 7945554 MISCELLANEOUS 621110 125269 125269 EMPLOYEE COURTESY 621110 20314 20314 145583 11652019 8091137 0 0 5508461 4632018 876443 2189308 1776357 412951 14930 14930 110434 110434 507596 445849 61747 12946 6444 6502 86247 68020 18227 216952 216952 284353 256954 27399 4542 2362 2180 29626 20573 9053 20542 20542 227796 227796 38260 38260 PHARMACY SUPPLIES 1109508 1109508 BAD DEBT EXPENSE 817332 817332 COMPUTER SERVICES 274311 60151 214160 LAB SERVICES 205527 205527 509165 483149 26016 12167836 10211630 1956206 0 109964 925246 863305 1239924 111821 102632 19656 12907 2942861 1728855 1319043 1214006 23918 2423789 3518633 100831 137572 992446 2566366 1093277 2703938 X 1330512 814695 1330512 814695 2423789 3518633 -515817 0 X X 0 1 X 1 1 1 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: HEALTHFIRST BLUEGRASS, INC. IS QUALIFIED AS A PUBLIC CHARITY UNDER IRC 170(B)(1)(A)(III) AS EVIDENCED ON THE ENCLOSED SCHEDULE A. HEALTHFIRST BLUEGRASS, INC. IS NOT LICENSED AS A HOSPITAL IN THE STATE OF KENTUCKY AND AS SUCH, SCHEDULE H IS NOT REQUIRED. THE CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER THAT PROVIDES HEALTH COVERAGE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1293411 760967 532444 1587926 933583 654343 61524 34305 27219 1214006 ACCRUED WAGES AND BENEFITS 376836 ACCRUED ANNUAL LEAVE 366656 DUE TO HEALTH DEPARTMENT 1822874 2566366 X 10834687 -817332 -817332 11652019 0 11652019 11350504 0 11350504 817332 817332 12167836 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: HEALTHFIRST IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE AND RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE IN 2012 AS A TAX EXEMPT ENTITY UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY HEALTHFIRST AND RECOGNIZE A TAX LIABILITY IF HEALTHFIRST HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. AS SUCH, HEALTHFIRST IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, HEALTHFIRST IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. HEALTHFIRST IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -817,332. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 817,332. X 0 0 0 0 0 0 0 0 0 DEBORAH STANLEY MD 172713 0 0 0 0 0 0 0 0 0 172713 0 0 0 CLARIFICATION CONCERNING EMPLOYEES FORM 990, PART V, LINE 2A ALL PERSONELL ARE PROVIDED TO HEALTHFIRST BY THE HEALTH DEPARTMENT OF LEXINGTON FAYETTE URBAN COUNTY GOVERNMENT. HEALTHFIRST REIMBURSES THE HEALTH DEPARTMENT FOR ALL PAYROLL, PAYROLL TAXES AND BENEFITS. FORM 990, PART VI, SECTION B, LINE 11 COPY OF 990 PROVIDED TO THE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE PROVIDED WITH AND ARE REQUIRED TO SIGN UPON INDUCTION AND ANNUALLY THE "STANDARDS OF CONDUCT FOR BOARD MEMBERS", WHICH OUTLINES THE HEALTHFIRST CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST AT HEALTHFIRST BLUEGRASS, INC'S OFFICE. RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT LIES WITH THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS.