Baptist Health Richmond Inc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Baptist Health Richmond Inc (EIN 61-0461940)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201233199349301978
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T13:12:56-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 EASTPOINT PARKWAY SUITE 300 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610461940 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATTIE A CLAY INFIRMARY ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PATT | NameControl |
| Phone | 8596233131 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1600 | AddressLine1 |
| City | RICHMOND | City |
| State | KY | State |
| ZIP Code | 404762603 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRIS MCCLURG | Name |
| Title | CFO | Title |
| Phone | 8596233131 | Phone |
| Date Signed | 2012-11-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARRIE A MERRILL CPA | Name |
| PTIN | P00832283 | PTIN |
| Phone | 5029923500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRIS MCCLURG | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1600 | AddressLine1 |
| City | RICHMOND | City |
| State | KY | State |
| ZIP Code | 404762603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 69690301 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PATTIEACLAY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1892 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | STATEMENT OF PURPOSE:THE PURPOSE OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE CULTURALLY COMPETENT QUALITY HEALTH CARE TO A DIVERSE POPULATION IN MADISON COUNTY AND NEIGHBORING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY.STATEMENT OF MISSION:THE MISSION OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTH CARE IN A MODERN FACILITY BY A TEAM OF HIGHLY-SKILLED PHYSICIANS AND STAFF THROUGH NURTURING, PERSONALIZED SERVICES.STATEMENT OF VISION:A CENTER OF EXCELLENCE: TO HONOR OUR OBLIGATION AS A CENTER OF EXCELLENCE BY OUR COMMITMENT TO CONSTANT AND NEVER-ENDING IMPROVEMENT IN THE QUALITY OF CARE OF OUR PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 761 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1183073 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1074391 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 61731567 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 66131586 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 344819 | InvestmentIncomePriorYear |
| Investment Income Current Year | 180206 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1519580 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1724276 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 64779039 | TotalRevenuePriorYear |
| Total Revenue Current Year | 69110459 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 29429394 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 30698562 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36381732 | OtherExpensePriorYear |
| Other Expenses Current Year | 40340550 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 65811126 | TotalExpensesPriorYear |
| Total Expenses Current Year | 71039112 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1032087 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1928653 | RevenuesLessExpensesCY |
| Total Assets BOY | 49632092 | TotalAssetsBOY |
| Total Assets EOY | 51208168 | TotalAssetsEOY |
| Total Liabilities BOY | 26307239 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 32266711 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 23324853 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18941457 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | STATEMENT OF MISSION:THE MISSION OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTH CARE IN A MODERN FACILITY BY A TEAM OF HIGHLY-SKILLED PHYSICIANS AND STAFF THROUGH NURTURING, PERSONALIZED SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 62067767 | Expense |
| Revenue | 66490812 | Revenue |
| Description | PATTIE A. CLAY REGIONAL MEDICAL CENTER (PAC) REALIZES THAT NOT ALL PATIENTS HAVE FINANCIAL RESOURCES TO PAY THEIR BILL. IN LIGHT OF THIS, PAC HAS CHARITY CARE POLICIES AND PROCEDURES IN PLACE TO DETERMINE A PATIENT'S ABILITY TO PAY FOR SERVICES. FOLLOWING THE CHARITY CARE POLICY, PAC PROVIDED $2,100,751 OF UN-REIMBURSED CHARITY CARE CHARGES FOR THE YEAR ENDED DECEMBER 31, 2011. UN-REIMBURSED CHARITY CARE CHARGES REPRESENTS 3.2% OF NET PATIENT SERVICE REVENUE FOR THE YEAR. 3,914 PATIENTS BENEFITED FROM CHARITY CARE PROVISIONS.PAC OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS A DAY, EVERY DAY. PATIENTS ARE TREATED WITHOUT REGARD TO THEIR PAYMENT ABILITY. PAC EXPERIENCED 28,224 EMERGENCY DEPARTMENT VISITS DURING 2011. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PAC PROVIDED INPATIENT SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 3,439 INPATIENTS WERE ADMITTED DURING 2011 RESULTING IN 13,168 INPATIENT DAYS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PAC PROVIDED OBSTETRIC SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 791 DELIVERIES WERE PERFORMED DURING 2011. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | IN ADDITION TO THE THREE LARGEST PROGRAM SERVICES, PAC ALSO PROVIDES OR SUPPORTS THE FOLLOWING COMMUNITY PROGRAMS AT FREE OR SUBSTANTIALLY REDUCED COST TO THE COMMUNITY:COMMUNITY HEALTH FAIR: PROVIDE FREE BLOOD PRESSURE, HEIGHT AND WEIGHT, PULMONARY FUNCTION, BODY FAT ANALYSIS, OSTEOPOROSIS SCREENING, PSA, BLOOD TYPING, BLOOD GLUCOSE, ANEMIA SCREENING, POSTURE, GLAUCOMA, COUNSELING, EDUCATIONAL MATERIALS. (APPROXIMATELY 200 PARTICIPANTS)TAKE YOUR HEALTH TO HEART PROGRAM AND SPONSORSHIP OF THE HOT WOMEN AND HEALTH SERIES WHERE WE BRING IN REGIONAL OR NATIONAL SPEAKERS TO DISCUSS THE WARNING SIGNS OF DECLINING HEART HEALTH. (APPROXIMATELY 200 PARTICIPANTS ANNUALLY)PATTIE CAKE BELLIES TO BABIES CELEBRATION IS AN ANNUAL MATERNITY FAIR DESIGNED TO PROVIDE EDUCATION AND RESOURCES FOR THOSE EXPECTING A CHILD. THE EVENT PROVIDES EDUCATION ON SHAKEN BABY SYNDROME, INFANT CPR, MOTHER/BABY NUTRITION, AND BREASTFEEDING IN ADDITION TO PRIZES AND NEEDED ITEMS FOR ATTENDEES. (APPROXIMATELY 250 ATTENDEES).FREE PROSTATE CANCER SCREENING AND PSA'S: FREE PSA BLOOD WORK AND DIGITAL RECTAL EXAM BY A UROLOGIST. (APPROXIMATELY 55 PARTICIPANTS).COMMUNITY BASED EDUCATIONAL PROGRAMS: CPR CLASSES, CHILDBIRTH CLASSES, BREAST FEEDING CLASSES, SAFE DRIVING CLASSES AND SMOKING CESSATION CLASSES.SUPPORT OF CITY AND COUNTY PROJECTS: PROVIDED PLANT OPERATIONS SUPPORT FOR VARIOUS CITY AND COUNTY FUNCTIONS.PARTICIPATION IN OTHER HEALTH FAIRS: PROVIDE STAFFING AND EDUCATIONAL MATERIALS FOR VARIOUS HEALTH FAIRS IN THE COMMUNITY (MORE THAN 2,500 COMMUNITY MEMBERS SERVED).PROVIDE SPEAKERS ON HEALTH CAREERS AND TOURS OF THE HOSPITAL: THIS COMMUNITY SERVICE BENEFITS APPROXIMATELY 500 STUDENTS.STARLIGHT MILE WALK/RUN: PROVIDE FUNDING FOR A ONE MILE WALK/RUN FOR CHILDREN AND ADULTS TO PROMOTE HEALTHY LIFESTYLES. (APPROXIMATELY 250 PARTICIPANTS).LEADERSHIP MADISON COUNTY: PROVIDE CLASSES FOR PARTICIPANTS, FOODS, SPACE, ETC. (APPROXIMATELY 40 LEADERS SERVED) | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 62067767 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 81 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 761 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRIS MCCLURG CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8596233131 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1600 | AddressLine1 |
| City | RICHMOND | City |
| State | KY | State |
| ZIP Code | 404762603 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (33 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| AARON THOMPSON MD | ||||||||
| CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| ALICE JANE BALLEW | ||||||||
| VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| LAURA STEIDLE | ||||||||
| 2ND VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| EMMA ESKER | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| EARL BALDWIN | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| DAVID GRAHAM | ||||||||
| IMMEDIATE PAST CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| DR KENT KESSLER | ||||||||
| MEDICAL STAFF REP | 2.00 | X | X | 0 | 0 | 0 | ||
| DEBBIE BARKLEY | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS CERVONI MD | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| RODNEY CHRISMAN | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| HELEN FARDO | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KATHY FLOOD | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| PEGGY HOLLINGSWORTH | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DR ANANTH KUMAR | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| PAULA MAIONCHI MD | ||||||||
| MEMBER | 2.00 | X | 42293 | 0 | 0 | |||
| HARRY MOBERLY JR | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| LAURA MELIUS | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KS PARK JR | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| REV MARY LOU STEPEHENS | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| JANROSE TUNNELL | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| BILL WALTERS | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KENNETH WEDEL | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| CHRISTOPHER T JONES | ||||||||
| CEO | 40.00 | X | 228417 | 0 | 43384 | |||
| CHRIS MCCLURG | ||||||||
| CFO | 40.00 | X | 136065 | 0 | 17490 | |||
| JILL CORNELISON | ||||||||
| CNO (1.1 - 7.31) | 40.00 | X | 112281 | 0 | 12758 | |||
| TAMMY SULLIVAN | ||||||||
| CNO (8.1 - 12.31) | 40.00 | X | 32675 | 0 | 4453 | |||
| PATRICIA OLDS | ||||||||
| VP SUPPORT SERVICES | 40.00 | X | 104757 | 0 | 14147 | |||
| DR ROSHAN PAIS | ||||||||
| PHYSICIAN | 40.00 | 250075 | 0 | 21178 | X | |||
| DR OLUBUNMI ADEGBOYEGA | ||||||||
| PHYSICIAN | 40.00 | 312463 | 0 | 20636 | X | |||
| DR GINA D'COSTA | ||||||||
| PHYSICIAN | 40.00 | 188856 | 0 | 3777 | X | |||
| DR NUZHAT NAQVI | ||||||||
| PHYSICIAN | 40.00 | 195528 | 0 | 15358 | X | |||
| DR RICHARD SHELTON | ||||||||
| PHYSICIAN | 40.00 | 204810 | 0 | 19822 | X | |||
| ROBERT HUDSON | ||||||||
| FORMER CEO | 40.00 | 145657 | 0 | 16373 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1953877 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 189376 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARAMARK | |||||
| 10510 TWIN LAKES PARKWAY | CHICAGO | IL | 60693 | EQUIPMENT MAINTENANCE SERVICE | 1220547 |
| ANESTHESIA SERVICES | |||||
| 795 EASTERN BYPASS | RICHMOND | KY | 40475 | ANESTHESIA SERVICES | 912853 |
| SOFTSCRIPT | |||||
| 2444 WILSHIRE BLVD SUITE 280 | SANTA MONICA | CA | 90403 | TRANSCRIPTION SERVICE | 443985 |
| BAPTIST VENTURES | |||||
| 4007 KRESGE WAY | LOUISVILLE | KY | 40207 | MANAGEMENT SERVICES | 417919 |
| LOGANS | |||||
| PO BOX 643958 | CINCINNATI | OH | 45264 | LINEN SERVICES | 295011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| Related Organizations | 245971 | RelatedOrganizations |
| All Other Contributions | 828420 | AllOtherContributions |
| Total Contributions | 1074391 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 623990 | BusinessCode |
| Total Revenue Column | 66131586 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66131586 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 66131586 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 202683 | TotalRevenueColumn |
| Exclusion | $202,683 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 661677 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 302451 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 359226 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 359226 | TotalRevenueColumn |
| Related Or Exempt Function Income | 359226 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 163112 | Securities |
| Other | 91802 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 104498 | Securities |
| Other | 172893 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 58614 | Securities |
| Other | -81091 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -22477 | TotalRevenueColumn |
| Exclusion | -$22,477 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| PHARMACY INCOME | 900099 | 867137 | $867,137 |
| MISC. INCOME | 900099 | 269042 | $269,042 |
| CAFETERIA INCOME | 900099 | 216042 | $216,042 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12829 | TotalRevenueColumn |
| Exclusion | $12,829 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1365050 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69110459 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66490812 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,545,256 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 706427 | Total |
| Program Services | 706427 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24603059 | Total |
| Program Services | 21894841 | ProgramServices |
| Management And General | 2708218 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 866619 | Total |
| Program Services | 866619 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2668791 | Total |
| Program Services | 2668791 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1853666 | Total |
| Program Services | 1853666 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101221 | Total |
| Management And General | 101221 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110911 | Total |
| Management And General | 110911 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1926439 | Total |
| Program Services | 1926439 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13490471 | Total |
| Program Services | 13103708 | ProgramServices |
| Management And General | 386763 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4093465 | Total |
| Program Services | 2796611 | ProgramServices |
| Management And General | 1296854 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87648 | Total |
| Program Services | 4445 | ProgramServices |
| Management And General | 83203 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 997965 | Total |
| Program Services | 997965 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3029574 | Total |
| Program Services | 3029574 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1198103 | Total |
| Program Services | 45647 | ProgramServices |
| Management And General | 1152456 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 9101657 | 9101657 | |
| PURCHASED SERVICES | 5483685 | 2984745 | 2498940 |
| PHYSICIAN RECRUTMENT | 557268 | 557268 | |
| DUES & SUBSCRIPTIONS | 90108 | 14597 | 75511 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72035 | Total |
| Program Services | 72035 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71039112 | Total |
| Program Services | 62067767 | ProgramServices |
| Management And General | 8971345 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7461608 | BOY |
| EOY | 7755665 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4336920 | BOY |
| EOY | 5068778 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1289983 | BOY |
| EOY | 577203 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1777008 | BOY |
| EOY | 2153723 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 726743 | BOY |
| EOY | 548740 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 82001882 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 47652060 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33379924 | BOY |
| EOY | 34349822 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 489352 | BOY |
| EOY | 455977 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 170554 | BOY |
| EOY | 298260 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49632092 | BOY |
| EOY | 51208168 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4266484 | BOY |
| EOY | 5871384 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12077147 | BOY |
| EOY | 15346438 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5739302 | BOY |
| EOY | 3919141 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4224306 | BOY |
| EOY | 7129748 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26307239 | BOY |
| EOY | 32266711 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18824956 | BOY |
| EOY | 14909613 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4499897 | BOY |
| EOY | 4031844 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23324853 | BOY |
| EOY | 18941457 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49632092 | BOY |
| EOY | 51208168 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1928653 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2454743 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $3,951 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3951 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE ABOVE AMOUNT REPRESENTS THE PORTION OF ANNUAL DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES CARRIED OUT BY KENTUCKY HOSPITAL ASSOCIATION. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4499897 | BeginningOfYearBalance |
| Other Expenditures | 468053 | OtherExpenditures |
| End Of Year Balance | 4031844 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4704618 | BeginningOfYearBalance |
| Contributions | 357693 | Contributions |
| Investment Earnings Or Losses | -62205 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 42118 | GrantsOrScholarships |
| Other Expenditures | 458091 | OtherExpenditures |
| End Of Year Balance | 4499897 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5226569 | BeginningOfYearBalance |
| Contributions | 31281 | Contributions |
| Investment Earnings Or Losses | -28741 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 68878 | GrantsOrScholarships |
| Other Expenditures | 455613 | OtherExpenditures |
| End Of Year Balance | 4704618 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5782965 | BeginningOfYearBalance |
| Contributions | 73558 | Contributions |
| Investment Earnings Or Losses | -36523 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 137816 | GrantsOrScholarships |
| Other Expenditures | 455615 | OtherExpenditures |
| End Of Year Balance | 5226569 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 352992 | OtherCostOrOtherBasis |
| Book Value | 352992 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44040510 | OtherCostOrOtherBasis |
| Depreciation | 19555669 | Depreciation |
| Book Value | 24484841 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 664658 | OtherCostOrOtherBasis |
| Depreciation | 98361 | Depreciation |
| Book Value | 566297 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36863977 | OtherCostOrOtherBasis |
| Depreciation | 27998030 | Depreciation |
| Book Value | 8865947 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 79745 | OtherCostOrOtherBasis |
| Book Value | 79745 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 34349822 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| THIRD PARTY PAYABLE | $1,050,000 |
| PENSION LIABILITY | $6,079,748 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7129748 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ASSETS WHOSE USE IS LIMITED INCLUDE ASSETS SET ASIDE BY THE HOSPITAL'S BOARD OF DIRECTORS FOR LONG-TERM USES, OVER WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES AND BOARD-DESIGNATED ASSETS ESTABLISHED FOR THE HOSPITAL THIRD AND FOURTH FLOOR RENOVATION PROJECT. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL 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 BY THE MEDICAL CENTER AND FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE MEDICAL CENTER AND FOUNDATION ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| FORM 990, PART IV LINE 12A HAS BEEN CHECKED YES. PART XI, XII, AND XIII OF SCHEDULE D ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3129258 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 823126 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2306132 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03720 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10666249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8980548 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1685701 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02720 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13795507 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9803674 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3991833 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06440 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11991 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 11991 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 431292 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 431292 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00700 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18427 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 461710 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 461710 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00750 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14257217 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9803674 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4453543 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07190 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2745 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 15 | DirectOffsettingRevenue |
| Net Community Building Expense | 2730 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 750 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 750 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 24953 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 24953 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 28448 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 15 | DirectOffsettingRevenue |
| Net Community Building Expense | 28433 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $3,471,995 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20136601 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 20571473 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -434872 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATTIE A CLAY INFIRMARY ASSOCIATIONINC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 EASTERN BYPASS | AddressLine1 |
| City | RICHMOND | City |
| State | KY | State |
| ZIP Code | 40475 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATTIE A CLAY INFIRMARY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| INSTANT CARE CENTER | ||||
| 648 UNIVERSITY SHOPPING CENTER | RICHMOND | KY | 40475 | NON-EMERGENT AMBULATORY CARE CENTER |
| OCCUPATIONAL MEDICINE CENTER | ||||
| 646 UNIVERSITY SHOPPING CENTER | RICHMOND | KY | 40475 | OCCUPATIONAL MEDICINE |
| WOUND CARE CENTER | ||||
| 114 BIG HILL AVE | RICHMOND | KY | 40475 | WOUND CARE |
| OUTPATIENT LAB ON BIG HILL | ||||
| 114 BIG HILL AVE | RICHMOND | KY | 40475 | OUTPATIENT LAB |
| HEALTH AND EDUCATION CENTER | ||||
| HARPERS SQ 2150 LEXINGTON RD STE A | RICHMOND | KY | 40475 | HEALTH CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: AS PROVIDED FOR IN THE WRITTEN CHARITY CARE POLICY, AN INDIVIDUAL MUST MEET ALL OF THE FOLLOWING CONDITIONS TO QUALIFY FOR CHARITY:A. THE INDIVIDUAL IS A RESIDENT OF KENTUCKYB. THE INDIVIDUAL IS NOT ELIGIBLE FOR MEDICAIDC. THE INDIVIDUAL IS NOT COVERED BY A 3RD PARTY PAYORD. THE INDIVIDUAL IS NOT IN THE CUSTODY OF A UNIT OF GOVERNMENT WHICH IS RESPONSIBLE FOR COVERAGE OF THE ACUTE CARE NEEDS OF THE INDIVIDUAL.THE INDIVIDUAL MEETS THE FOLLOWING INCOME AND RESOURCES CRITERIA:HOUSEHOLD SIZE MONTHLY INCOME LIMIT ANNUAL INCOME LIMIT1 $903.00 $10,830.002 $1,214.00 $14,570.003 $1,526.00 $18,310.004 $1,837.00 $22,050.005 $2,149.00 $25,790.00FOR EACH ADDITIONAL MEMBER ADD $311 MONTHLY AND $3,740 ANNUAL. | ||
| PART I, LINE 7: COST ACCOUNTING | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 9101657. | ||
| PART II: PAC'S COMMUNITY BUILDING ACTIVITY FOCUS IS ON IMPROVING THE HEALTH AND WELLNESS OF LOCAL COMMUNITIES THROUGH EDUCATION, AWARENESS, AND DIAGNOSTIC TREATMENTS. MUCH OF THE COMMUNITY BUILDING AWARENESS OF PAC AND EVEN PREFERENCE FOR SPONSORSHIPS ARE GIVEN FOR CAUSES THAT (1) SUPPORT OUR PURPOSE AND PROVIDE CULTURALLY COMPETENT QUALITY HEALTHCARE TO A DIVERSE POPULATION IN MADISON COUNTY AND NEIGHBORING COMMUNITIES, (2) ARE HEALTH CARE RELATED, (3) SUPPORT THE PRIORITIES IDENTIFIED AS COMMUNITY HEALTH INITIATIVES, (4) SUPPORT LOCAL (MADISON/GARRARD COUNTIES) WORK AND/OR EVENTS, AND (5) SERVE MANY RATHER THAN A FEW. COMMUNITY ACTIVITIES RANGE FROM ANNUAL HEALTH FAIRS AND FREE PROSTATE SCREENINGS TO PROVIDING FITNESS PROGRAMS IN LOCAL SCHOOLS AND SERVING IN LOCAL CIVIC AND COMMUNITY ORGANIZATIONS. | ||
| PART III, LINE 4: LINE 2 FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: THE HOSPITAL ESTIMATES AN ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE BASED ON AN EVALUATION OF THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 2 EXPLANATION FOR COSTING METHODOLOGY: THE COST TO CHARGE RATIO IS THE METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST.PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 3 EXPLANATION FOR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: NO OTHER BAD DEBT AMOUNTS HAVE BEEN INCLUDED AS COMMUNITY BENEFIT. THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE AND FOR THIS REASON, THE ORGANIZATION BELIEVES IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. | ||
| PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED DECEMBER 31, 2011: HOSPITAL STATEMENT OF REIMBURSABLE COST. THE NET AMOUNT WAS NOT TREATED AS COMMUNITY BENEFIT. THE REVENUE INCLUDED FROM MEDICARE FOR THIS CALCULATION INCLUDES REIMBURSABLE BAD DEBTS RECEIVED. THE BAD DEBT AMOUNTS DO NOT HAVE ANY ALLOWABLE COSTS FOR THE CURRENT PERIOD WHICH RESULTS IN A SURPLUS FOR PRESENTATION PURPOSES ON SCHEDULE H. | ||
| PART V, SECTION B, LINE 10: AS PROVIDED FOR IN THE WRITTEN CHARITY CARE POLICY, AN INDIVIDUAL MUST MEET ALL OF THE FOLLOWING CONDITIONS TO QUALIFY FOR CHARITY:A. THE INDIVIDUAL IS A RESIDENT OF KENTUCKYB. THE INDIVIDUAL IS NOT ELIGIBLE FOR MEDICAIDC. THE INDIVIDUAL IS NOT COVERED BY A 3RD PARTY PAYORD. THE INDIVIDUAL IS NOT IN THE CUSTODY OF A UNIT OF GOVERNMENT WHICH IS RESPONSIBLE FOR COVERAGE OF THE ACUTE CARE NEEDS OF THE INDIVIDUAL.THE INDIVIDUAL MEETS THE FOLLOWING INCOME AND RESOURCES CRITERIA:HOUSEHOLD SIZE MONTHLY INCOME LIMIT ANNUAL INCOME LIMIT1 $903.00 $10,830.002 $1,214.00 $14,570.003 $1,526.00 $18,310.004 $1,837.00 $22,050.005 $2,149.00 $25,790.00FOR EACH ADDITIONAL MEMBER ADD $311 MONTHLY AND $3,740 ANNUAL. | PATTIE A. CLAY INFIRMARY | |
| PART VI, LINE 2: PATTIE A. CLAY REGIONAL MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF OUR SERVED COMMUNITIES IN A VARIETY OF WAYS. ONE EXAMPLE IS COMMUNITY WORK GROUPS WHICH MEET MONTHLY TO DISCUSS VARIOUS CURRENT AND EMERGING COMMUNITY HEALTH ISSUES ULTIMATELY DETERMINING TREATMENT AND EDUCATION PROTOCOLS. THIS GROUP IS COMPRISED OF HOSPITAL CLINICAL PROFESSIONALS, SCHOOL ADMINISTRATORS, LOCAL COLLEGE ADMINISTRATORS, EMERGENCY PREPAREDNESS OFFICIALS AND LOCAL HEALTH DEPARTMENT OFFICIALS TO NAME A FEW. ANOTHER ASSESSMENT PAC CONDUCTS IS A PHYSICIAN NEEDS ANALYSIS ON A REGULAR BASIS TO ENSURE COMMUNITY HAS ADEQUATE PHYSICIAN COVERAGE IN ALL NEEDED DISCIPLINES. | ||
| PART VI, LINE 3: SIGNS AT REGISTRATION ARE POSTED STATING FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR INDIVIDUALS TO CONTACT THE FINANCIAL COUNSELOR IF INDIVIDUALS HAVE QUESTIONS. IN ADDITION ALL SELF PAY IN-PATIENTS ARE VISITED BY FINANCIAL COUNSELORS DURING THE HOSPITAL STAY AND THE FINANCIAL ASSITANCE PROGRAM IS EXPLAINED.SELF PAY STATEMENTS INDICATE FOR THE PATIENT TO CONTACT THE FINANCIAL COUNSELOR'S OFFICE WITH QUESTIONS IF HE/SHE FEELS THEY MIGHT BE ELIGIBLE FOR ASSISTANCE.ALL SELF PAY PATIENT VISITS ARE REVIEWED THE FOLLOWING DAY BY THE FINANCIAL COUNSELOR. A DAILY PRINTOUT IS REVIEWED WHICH INCLUDES PATIENTS' PHONE NUMBERS FOR THE FINANCIAL COUNSELOR TO CONTACT AND INFORM THE PATIENT ABOUT THE FINANCIAL ASSISTANCE PROGRAM. IF UNABLE TO CONTACT BY PHONE OR NO PHONE NUMBER IS AVAILABLE, A LETTER IS MAILED TO THE PATIENT TO PROVIDE THEM WITH A CONTACT FOR THE FINANCIAL COUNSELOR'S OFFICE.THE HOSPITAL WEB PAGE HAS THE FINANCIAL COUNSELOR'S PHONE NUMBER FOR CONTACT AND A BRIEF DESCRIPTION ABOUT THE PROGRAM FOR PATIENT WHO ARE INTERESTED AND POSSIBLY ELIGIBLE FOR ASSISTANCE. | ||
| PART VI, LINE 4: PATTIE A. CLAY REGIONAL MEDICAL CENTER IS LOCATED IN THE FOOTHILLS OF APPALACHIA, IN CENTRAL KENTUCKY IN THE COMMUNITY OF RICHMOND. LIKE MANY OTHER REGIONAL FACILITIES THROUGHOUT THE COUNTRY, PAC PROVIDES HEALTHCARE SERVICES TO A NUMBER OF COUNTIES. PAC'S IMMEDIATE SERVICE AREA IS MADISON, ESTILL, GARRARD, AND JACKSON COUNTIES. IN ADDITION, PEOPLE FROM OVER TEN SURROUNDING COUNTIES COME TO PAC TO TAKE ADVANTAGE OF THE WIDE VARIETY OF SPECIALTY MEDICAL SERVICES. PAC IS LOCATED IN MADISON COUNTY. FROM THE 2010 CENSUS, THERE WERE 82,916 PEOPLE, 29,720 HOUSEHOLDS, AND 18,812 FAMILIES RESIDING IN THE COUNTY. THERE WERE 33,806 HOUSING UNITS. THE RACIAL MAKEUP OF THE COUNTY WAS 91.6% WHITE, 4.4% BLACK OR AFRICAN AMERICAN, 0.28% NATIVE AMERICAN, 0.3% ASIAN, 0.34% FROM OTHER RACES, AND 2.0% FROM TWO OR MORE RACES. 2.12% OF THE POPULATION WERE HISPANICS OR LATINOS OF ANY RACE.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $40,241. THE PER CAPITA INCOME FOR THE COUNTY WAS $20,649. ABOUT 19.2% OF THE POPULATION WERE BELOW THE POVERTY LINE. | ||
| PART VI, LINE 5: THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH HAVING A MAJORITY OF INDEPENDENT GOVERNING BODY MEMBERS WHO ALL RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA; HAVING AN OPEN MEDICAL STAFF; AND RE-INVESTING ANY OPERATING SURPLUS TO CONTINUE PROVIDING QUALITY HEALTHCARE TO ALL IN THE HOSPITAL'S SERVICE AREA. | ||
| PART VI, LINE 6: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| KY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER T JONES | |||||||||||||
| 226549 | 0 | 0 | 0 | 1868 | 0 | 18615 | 0 | 24769 | 0 | 271801 | 0 | 0 | 0 |
| CHRIS MCCLURG | |||||||||||||
| 136065 | 0 | 0 | 0 | 0 | 0 | 2727 | 0 | 14763 | 0 | 153555 | 0 | 0 | 0 |
| DR ROSHAN PAIS | |||||||||||||
| 250075 | 0 | 0 | 0 | 0 | 0 | 4900 | 0 | 16278 | 0 | 271253 | 0 | 0 | 0 |
| DR OLUBUNMI ADEGBOYEGA | |||||||||||||
| 312463 | 0 | 0 | 0 | 0 | 0 | 4900 | 0 | 15736 | 0 | 333099 | 0 | 0 | 0 |
| DR GINA D'COSTA | |||||||||||||
| 188856 | 0 | 0 | 0 | 0 | 0 | 3777 | 0 | 0 | 0 | 192633 | 0 | 0 | 0 |
| DR NUZHAT NAQVI | |||||||||||||
| 195528 | 0 | 0 | 0 | 0 | 0 | 4026 | 0 | 11332 | 0 | 210886 | 0 | 0 | 0 |
| DR RICHARD SHELTON | |||||||||||||
| 204810 | 0 | 0 | 0 | 0 | 0 | 4102 | 0 | 15720 | 0 | 224632 | 0 | 0 | 0 |
| ROBERT HUDSON | |||||||||||||
| 145657 | 0 | 0 | 0 | 0 | 0 | 2967 | 0 | 13406 | 0 | 162030 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|
| HEALTHCARE SYSTEM REFUNDING REVENUE BONDS SERIES 2008 | |||||
| 2008-12-12 | 8000000 | REFUND EXISTING DEBT | 0 | 0 | 0 |
| HEALTHCARE SYSTEM REVENUE & REFUNDING REVENUE BONDS SERIES 2008 | |||||
| 2008-12-29 | 4500000 | CONSTRUCTION | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capital ExpendituresCapitalExpenditures |
|---|---|---|---|---|---|---|---|
| 8000000 | 16500 | 2009 | 1 | 0 | 1 | 1 | |
| 4500000 | 74859 | 2009 | 0 | 0 | 1 | 1 | 4023000 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | EMMA ESKER'S SPOUSE | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SPOUSE OF BOARD MEMBER | Relationship |
| Amount Of Transaction | 912853 | AmountOfTransaction |
| Description Of Transaction | MRS. ESKER'S HUSBAND IS AN ANESTHESIOLOGIST. HE WORKS FOR AN ANESTHESIA GROUP THAT PROVIDES SERVICES TO THE HOSPITAL. IN 2011 THE HOSPITAL PAID ANESTHESIA SERVICES $912,853 FOR SERVICES THAT THE COMPANY PROVIDED TO THE HOSPITAL. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | BOARD OF DIRECTORS ARE ELECTED BY INFIRMARY ASSOCIATION WITH SEVEN MEMBERS ELECTED ON RECOMMENDATION OF THE CURRENTLY RECOGNIZED CHURCHES OF RICHMOND AND FIVE MEMBERS SELECTED BY THE INFIRMARY ASSOCIATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS, ADMINISTRATIVE STAFF, AND DEPARTMENT DIRECTORS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE STATEMENT EDUCATES BOARD MEMBERS ON SITUATIONS THAT MIGHT CAUSE POTENTIAL CONFLICTS, DISCLOSES ANY POTENTIAL CONFLICT, AND PROVIDES DOCUMENTATION REGARDING FOLLOW UP PROCEDURES FOR ANY POTENTIAL CONFLICT. THE ORGANIZATION HAS A CORPORATE COMPLIANCE OFFICER WHO IS CHARGED WITH MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S DIRECTOR OF HUMAN RESOURCES (HR) COMPLETES AN ANNUAL SALARY SURVEY. DATA IS COMPILED FROM TWO SOURCES; THE KENTUCKY SOCIETY OF HEALTHCARE HUMAN RESOURCES ADMINISTRATORS (KSHHRA) AND THE KENTUCKY HOSPITAL ASSOCIATION (KHA). BOTH OF THESE RESOURCES USE A THIRD PARTY TO RETRIEVE AND ANALYZE DATA. KHA USES COMPDATA AND KSHHRA USES HR ADVANTAGE. THE DIRECTOR OF HR TAKES EVERY POSITION WITHIN THE ORGANIZATION AND MATCHES A POSITION FROM EACH GROUP AND COMPARES WHAT THE CURRENT COMPENSATION RATES ARE WITH THE SURVEY RESULTS AND ANALYZES EACH POSITION TO DETERMINE WHERE THE ORGANIZATION IS COMPARED TO THE MARKET. A LIST IS COMPILED FOR POSITIONS IN WHICH THE ORGANIZATION IS COMPENSATING LOWER THAN THE MARKET WITH RECOMMENDATIONS TO INCREASE THE COMPENSATION FOR THOSE POSITIONS. THE LIST AND RECOMMENDATIONS ARE GIVEN TO THE ADMINISTRATIVE TEAM. AFTER REVIEWING THE DATA PRESENTED AND THE RECOMMENDATIONS THE ADMINISTRATIVE TEAM WILL OFFER ITS SUGGESTIONS AND MAKE A FINAL RECOMMENDATION TO THE BOARD. THE BOARD OF DIRECTORS MAKES THE FINAL DECISION ON CHANGES TO THE ANNUAL COMPENSATION PACKAGE. THE ANNUAL COMPENSATION ADJUSTMENT FOR THE CEO IS ALWAYS PUT IN WRITING AS APPROVED BY THE BOARD AND FILED IN THE HR DEPARTMENT. FOR NEW EMPLOYEES A RANGE IS SET FOR ALL POSITIONS WITH THE EXCEPTION OF DEPARTMENT DIRECTORS AND THOSE IN HIGHER POSITIONS. THE SALARIES FOR DEPARTMENT DIRECTORS AND ABOVE ARE DETERMINED BY THE VP OVER THAT PARTICULAR AREA WITH INPUT FROM THE HR DIRECTOR BASED ON INFORMATION FROM THE SURVEYS MENTIONED ABOVE. THE DETERMINED COMPENSATION RATE IS COMMUNICATED TO THE NEW EMPLOYEE VIA AN OFFER LETTER AND DOCUMENTED ON THE REQUEST TO HIRE IN HIS/HER PERSONNEL FILE. | |
| 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. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS -237,266. CHANGE IN MINIMUM PENSION LIABILITY -2,217,477. TOTAL TO FORM 990, PART XI, LINE 5: -2,454,743. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. | AUDIT OVERSIGHT |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| PATTIE A CLAY HOSPITAL AUXILIARY | ||||||||||
| PO BOX 1600 | RICHMOND | KY | 404762603 | 510172717 | SUPPORTS PATTIE A. CLAY INFIRMARY ASSOCIATION | KY | 501(C)(3) | LINE 9, SCH A | PATTIE A CLAY INFIRMARY ASSOCIATION | 1 |
| PATTIE A CLAY FOUNDATION | ||||||||||
| PO BOX 1600 | RICHMOND | KY | 404762603 | 311506378 | ENHANCE,PROMOTE,& FINANCIALLY SUPPORT PATTIE A. CLAY REGIONAL MEDICAL CENTER | KY | 501(C)(3) | LINE 11C, SCH A | PATTIE A CLAY INFIRMARY ASSOCIATION | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Method Of Amt DeterminationMethodOfAmtDetermination | Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|---|
| PATTIE A CLAY HOSPITAL AUXILIARY | ||
| N/A | ||
| PATTIE A CLAY FOUNDATION | ||
| N/A | C | 245971 |