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Baptist Health Richmond Inc: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Baptist Health Richmond Inc (EIN 61-0461940)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-10
IRS object ID
201113149349302376
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-10T12:38:09-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12650 EASTPOINT PARKWAY SUITE 300AddressLine1
CityLOUISVILLECity
StateKYState
ZIP Code40223ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN610461940EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PATTIE A CLAY INFIRMARY ASSOCIATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPATTNameControl
Phone8596233131Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1600AddressLine1
CityRICHMONDCity
StateKYState
ZIP Code404762603ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHRIS MCCLURGName
TitleCFOTitle
Phone8596233131Phone
Date Signed2011-11-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCARRIE A MERRILL CPAName
Phone5029923500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHRIS MCCLURGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1600AddressLine1
CityRICHMONDCity
StateKYState
ZIP Code404762603ZIPCode
FieldValueIRS element (for citing)
Gross Receipts65586198GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PATTIEACLAY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1892YearFormation
State Legal DomicileKYStateLegalDomicile
Activity Or Mission DescriptionSTATEMENT 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 Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members21NbrIndependentVotingMembers
Total Nbr Employees777TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year940790ContributionsGrantsPriorYear
Contributions Grants Current Year1183073ContributionsGrantsCurrentYear
Program Service Revenue Prior Year64623605ProgramServiceRevenuePriorYear
Program Service Revenue CY61731567ProgramServiceRevenueCY
Investment Income Prior Year773826InvestmentIncomePriorYear
Investment Income Current Year344819InvestmentIncomeCurrentYear
Other Revenue Prior Year1609896OtherRevenuePriorYear
Other Revenue Current Year1519580OtherRevenueCurrentYear
Total Revenue Prior Year67948117TotalRevenuePriorYear
Total Revenue Current Year64779039TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30214744SalariesEtcPriorYear
Salaries Etc Current Year29429394SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year36030561OtherExpensePriorYear
Other Expenses Current Year36381732OtherExpensesCurrentYear
Total Expenses Prior Year66245305TotalExpensesPriorYear
Total Expenses Current Year65811126TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1702812RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1032087RevenuesLessExpensesCY
Total Assets BOY51897952TotalAssetsBOY
Total Assets EOY49632092TotalAssetsEOY
Total Liabilities BOY26902912TotalLiabilitiesBOY
Total Liabilities EOY26307239TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY24995040NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23324853NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSTATEMENT 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense57621484Expense
Revenue62008897Revenue
DescriptionPATTIE 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 $4,976,885 OF UN-REIMBURSED CHARITY CARE CHARGES FOR THE YEAR ENDED DECEMBER 31, 2010. UN-REIMBURSED CHARITY CARE CHARGES REPRESENTS 8.1% 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 27,976 EMERGENCY DEPARTMENT VISITS DURING 2010.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionPAC PROVIDED INPATIENT SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 3,466 INPATIENTS WERE ADMITTED DURING 2010 RESULTING IN 12,492 INPATIENT DAYS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
DescriptionPAC PROVIDED OBSTETRIC SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 800 DELIVERIES WERE PERFORMED DURING 2010.Description

Activity Other ActivityOther (2 entries)

DescriptionDescription
PAC PROVIDED SURGICAL SERVICES TO 7,233 PATIENTS DURING 2010.
IN ADDITION TO THE FOUR 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 300 PARTICIPANTS).WOMEN'S HEALTH FAIR: PROVIDE FREE BLOOD PRESSURE, HEIGHT AND WEIGHT, PULMONARY FUNCTION, BODY FAT ANALYSIS, BLOOD GLUCOSE, CHOLESTEROL, EDUCATIONAL MATERIALS AND DISPLAYS. (APPROXIMATELY 120 PARTICIPANTS).FREE PROSTATE CANCER SCREENING AND PSA'S: FREE PSA BLOOD WORK AND DIGITAL RECTAL EXAM BY A UROLOGIST. (APPROXIMATELY 60 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.MADISON COUNTY SCHOOL CALENDARS: CALENDARS FEATURING LOCAL CHILDREN IN MEDICAL CAREERS WITH INFORMATION REGARDING EDUCATION REQUIREMENTS. ALL SCHOOL FUNCTIONS LISTED FOR MADISON AND ESTILL COUNTIES.PARTICIPATION IN OTHER HEALTH FAIRS: PROVIDE STAFFING AND EDUCATIONAL MATERIALS FOR VARIOUS HEALTH FAIRS IN THE COMMUNITY.PROVIDE SPEAKERS ON HEALTH CAREERS AND TOURS OF THE HOSPITAL: THIS COMMUNITY SERVICE BENEFITS APPROXIMATELY 1,000 STUDENTS.STARLIGHT MILE WALK/RUN: PROVIDE FUNDING FOR A ONE MILE WALK/RUN FOR CHILDREN AND ADULTS TO PROMOTE HEALTHY LIFESTYLES. (APPROXIMATELY 80 PARTICIPANTS).BETTER BREATHERS CLUB: EDUCATIONAL MEETINGS AND EVENTS FOR PATIENTS WITH PULMONARY PROBLEMS.LEADERSHIP MADISON COUNTY: PROVIDE CLASSES FOR PARTICIPANTS, FOODS, SPACE, ETC.
FieldValueIRS element (for citing)
Total Program Service Expense57621484TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees777NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members21NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHRIS MCCLURG CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8596233131TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1600AddressLine1
CityRICHMONDCity
StateKYState
ZIP Code404762603ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
AARON THOMPSON MD
CHAIR2.00XX000
ALICE JANE BALLEW
VICE CHAIR2.00XX000
LAURA STEIDLE
2ND VICE CHAIR2.00XX000
SUSAN MOBERLY
SECRETARY2.00XX000
EARL BALDWIN
TREASURER2.00XX000
KATHY FLOOD
CO-TRESURER2.00XX000
DAVID GRAHAM
IMMEDIATE PAST CHAIR2.00XX000
PATRICIA BARNWELL
MEDICAL STAFF REP2.00XX000
RANDY ALLEN MD
MEMBER2.00X000
DEBBIE BARKLEY
MEMBER2.00X000
THOMAS CERVONI MD
MEMBER2.00X000
RODNEY CHRISMAN
MEMBER2.00X000
EMMA ESKER
MEMBER2.00X000
HELEN FARDO
MEMBER2.00X000
PEGGY HOLLINGSWORTH
MEMBER2.00X000
PAULA MAIONCHI MD
MEMBER2.00X000
LAURA MELIUS
MEMBER2.00X000
KS PARK JR
MEMBER2.00X000
REV MARY LOU STEPEHENS
MEMBER2.00X000
JANROSE TUNNELL
MEMBER2.00X000
BILL WALTERS
MEMBER2.00X000
KENNETH WEDEL
MEMBER2.00X000
ROBERT HUDSON
CEO - RETIRED NOV 201040.00X159751033167
CHRISTOPHER T JONES
CEO40.00X1923503585
CHRIS MCCLURG
CFO40.00X13119406977
JILL CORNELISON
CNO40.00X102163012445
PATRICIA OLDS
VP SUPPORT SERVICES40.00X82913019883
DR ROSHAN PAIS
PHYSICIAN40.00330657024120X
DR OLUBUNMI ADEGBOYEGA
PHYSICIAN40.00319887023850X
DR GINA D'COSTA
PHYSICIAN40.00192356022766X
DR NUZHAT NAQVI
PHYSICIAN40.00179942026127X
DR RICHARD SHELTON
PHYSICIAN40.00188258010100X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1706356TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation183020TotalOtherCompensation
Number Individuals GT100 K19NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ANESTHESIA SERVICES
995 EASTERN BYPASSRICHMONDKY40475ANESTHESIA SERVICES906009
ARAMARK
10510 TWIN LAKES PARKWAYCHICAGOIL60693EQUIPMENT MAINTENANCE SERVICE615539
KENTUCKY LITHOTRIPSY
PO BOX 847324DALLASTX75284LITHOTRIPSY SERVICE284425
HEALTHCARE CLAIMS MGMT
2424 E 55TH STREETINDIANAPOLISIN46220CLAIMS MANAGMENT264252
DR RAHUL REDDY
3012 LONG CREEK WAYLOUISVILLEKY40245HOSPITALIST SERVICE216038
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Related Organizations135003RelatedOrganizations
All Other Contributions1048070AllOtherContributions
Total Contributions1183073TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code623990BusinessCode
Total Revenue Column61731567TotalRevenueColumn
Related Or Exempt Function Income61731567RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue61731567TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column213598TotalRevenueColumn
Exclusion$213,598ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real609364Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real332034Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real277330Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column277330TotalRevenueColumn
Related Or Exempt Function Income277330RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities251544Securities
Other354802Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities109232Securities
Other365893Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities142312Securities
Other-11091Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column131221TotalRevenueColumn
Exclusion$131,221ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PHARMACY INCOME900099805202$805,202
MISC. INCOME900099224146$224,146
CAFETERIA INCOME900099201011$201,011

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column11891TotalRevenueColumn
Exclusion$11,891ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1242250TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column64779039TotalRevenueColumn
Related Or Exempt Function Income62008897RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,587,069ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total498841Total
Program Services498841ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23675446Total
Program Services20924543ProgramServices
Management And General2750903ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total852676Total
Program Services852676ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2622138Total
Program Services2622138ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1780293Total
Program Services1780293ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total149523Total
Management And General149523ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total99105Total
Management And General99105ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1375331Total
Program Services1375331ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total138844Total
Program Services11763ProgramServices
Management And General127081ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12330220Total
Program Services11984332ProgramServices
Management And General345888ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3676671Total
Program Services2304062ProgramServices
Management And General1372609ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total54639Total
Program Services266ProgramServices
Management And General54373ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1074320Total
Program Services1074320ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3352712Total
Program Services3352712ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1146116Total
Program Services14792ProgramServices
Management And General1131324ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE77048007704800
PURCHASED SERVICES458408730638821520205
PHYSICIAN RECRUTMENT531388531388
DUES & SUBSCRIPTIONS12030813065107243

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total43668Total
Program Services43668ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total65811126Total
Program Services57621484ProgramServices
Management And General8189642ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7180864BOY
EOY7461608EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4713844BOY
EOY4336920EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1638111BOY
EOY1289983EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1956125BOY
EOY1777008EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY861074BOY
EOY726743EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis78120277LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec44740353LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34999252BOY
EOY33379924EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY463413BOY
EOY489352EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY85269BOY
EOY170554EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY51897952BOY
EOY49632092EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4823545BOY
EOY4266484EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12644554BOY
EOY12077147EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6037814BOY
EOY5739302EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3396999BOY
EOY4224306EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY26902912BOY
EOY26307239EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY20290422BOY
EOY18824956EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4704618BOY
EOY4499897EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24995040BOY
EOY23324853EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51897952BOY
EOY49632092EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1032087ReconcilationRevenueExpenses
Reconcilation Other Changes-638100ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$3,592OtherActivitiesAmount
Total Lobbying Expenditures IIB3592TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationTHE 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

FieldValueIRS element (for citing)
Beginning Of Year Balance4704618BeginningOfYearBalance
Contributions357693Contributions
Investment Earnings Or Losses-62205InvestmentEarningsOrLosses
Grants Or Scholarships42118GrantsOrScholarships
Other Expenditures458091OtherExpenditures
End Of Year Balance4499897EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5226569BeginningOfYearBalance
Contributions31281Contributions
Investment Earnings Or Losses-28741InvestmentEarningsOrLosses
Grants Or Scholarships68878GrantsOrScholarships
Other Expenditures455613OtherExpenditures
End Of Year Balance4704618EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5782965BeginningOfYearBalance
Contributions73558Contributions
Investment Earnings Or Losses-36523InvestmentEarningsOrLosses
Grants Or Scholarships137816GrantsOrScholarships
Other Expenditures455615OtherExpenditures
End Of Year Balance5226569EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis352992OtherCostOrOtherBasis
Book Value352992BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43887169OtherCostOrOtherBasis
Depreciation18054965Depreciation
Book Value25832204BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis664658OtherCostOrOtherBasis
Depreciation91024Depreciation
Book Value573634BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32422508OtherCostOrOtherBasis
Depreciation26594364Depreciation
Book Value5828144BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis792950OtherCostOrOtherBasis
Book Value792950BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings33379924TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
THIRD PARTY PAYABLE$428,579
PENSION LIABILITY$3,795,727
FieldValueIRS element (for citing)
Total Of Amounts4224306TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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.
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

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3319555TotalCommunityBenefitExpense
Direct Offsetting Revenue1254043DirectOffsettingRevenue
Net Community Benefit Expense2065512NetCommunityBenefitExpense
Percent Of Total Expense0.03550PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10125744TotalCommunityBenefitExpense
Direct Offsetting Revenue8096828DirectOffsettingRevenue
Net Community Benefit Expense2028916NetCommunityBenefitExpense
Percent Of Total Expense0.03490PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13445299TotalCommunityBenefitExpense
Direct Offsetting Revenue9350871DirectOffsettingRevenue
Net Community Benefit Expense4094428NetCommunityBenefitExpense
Percent Of Total Expense0.07040PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense36110TotalCommunityBenefitExpense
Direct Offsetting Revenue3050DirectOffsettingRevenue
Net Community Benefit Expense33060NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense75336TotalCommunityBenefitExpense
Net Community Benefit Expense75336NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense28900TotalCommunityBenefitExpense
Net Community Benefit Expense28900NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense140346TotalCommunityBenefitExpense
Direct Offsetting Revenue3050DirectOffsettingRevenue
Net Community Benefit Expense137296NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense13585645TotalCommunityBenefitExpense
Direct Offsetting Revenue9353921DirectOffsettingRevenue
Net Community Benefit Expense4231724NetCommunityBenefitExpense
Percent Of Total Expense0.07280PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense10300TotalCommunityBuildingExpense
Net Community Building Expense10300NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense850TotalCommunityBuildingExpense
Net Community Building Expense850NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense740TotalCommunityBuildingExpense
Net Community Building Expense740NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense4230TotalCommunityBuildingExpense
Net Community Building Expense4230NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense725TotalCommunityBuildingExpense
Net Community Building Expense725NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense16845TotalCommunityBuildingExpense
Net Community Building Expense16845NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$3,338,858BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare19128827AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18500758CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall628069MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1PATTIE A CLAY INFIRMARY ASSOCIATIONINCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1801 EASTERN BYPASSAddressLine1
CityRICHMONDCity
StateKYState
ZIP Code40475ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIRED FOR 2010BusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
INSTANT CARE CENTER
648 UNIVERSITY SHOPPING CENTERRICHMONDKY40475NON-EMERGENT AMBULATORY CARE CENTER
OCCUPATIONAL MEDICINE CENTER
646 UNIVERSITY SHOPPING CENTERRICHMONDKY40475OCCUPATIONAL MEDICINE
WOUND CARE CENTER
114 BIG HILL AVERICHMONDKY40475WOUND CARE
GARRARD CO HEALTH CENTER
436 RICHMOND STLANCASTERKY40444PHYSICIAN OFFICE
OUTPATIENT LAB ON BIG HILL
114 BIG HILL AVERICHMONDKY40475OUTPATIENT LAB
HEALTH AND EDUCATION CENTER
HARPERS SQ 2150 LEXINGTON RD STE ARICHMONDKY40475HEALTH CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn 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 $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 $ 7704800.
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, 2010: 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. THE RESULTING SURPLUS SHOULD NOT BE CONSTRUED THAT MEDICARE REVENUE RECEIVED HAVE REIMBURSED THE TOTAL COSTS IN FULL.
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 6: 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 7: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
KYREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT HUDSON
1597510000029687034800192918000
DR ROSHAN PAIS
330657000002385002700354777000
DR OLUBUNMI ADEGBOYEGA
3198870000023850000343737000
DR GINA D'COSTA
1923560000022766000215122000
DR NUZHAT NAQVI
1799420000021007051200206069000
DR RICHARD SHELTON
18825800000963004700198358000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Date IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HEALTHCARE SYSTEM REFUNDING REVENUE BONDS SERIES 2008
2008-12-128000000REFUND EXISTING DEBT000
HEALTHCARE SYSTEM REVENUE & REFUNDING REVENUE BONDS SERIES 2008
2008-12-294500000CONSTRUCTION000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindWorking Capital ExpendituresWorkingCapitalExpenditures
80000001650020091011
450000074859200900114023000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
100000
100000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonEMMA ESKER'S SPOUSENamePerson
FieldValueIRS element (for citing)
RelationshipSPOUSE OF BOARD MEMBERRelationship
Amount Of Transaction906009AmountOfTransaction
Description Of TransactionMRS. ESKER'S HUSBAND IS AN ANESTHESIOLOGIST. HE WORKS FOR AN ANESTHESIA GROUP THAT PROVIDES SERVICES TO THE HOSPITAL. IN 2010 THE HOSPITAL PAID ANESTHESIA SERVICES $906,009 FOR SERVICES THAT THE COMPANY PROVIDED TO THE HOSPITAL.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 7ABOARD 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 11THE 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.
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 12C
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 B, LINE 15
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED LOSSES ON INVESTMENTS 105,510. CHANGE IN MINIMUM PENSION LIABILITY -743,610. TOTAL TO FORM 990, PART XI, LINE 5: -638,100.FORM 990, PART XI, LINE 5:
AUDIT OVERSIGHTTHE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.FORM 990, PART XI, LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
PATTIE A CLAY HOSPITAL AUXILIARY
PO BOX 1600RICHMONDKY404762603510172717SUPPORTS PATTIE A. CLAY INFIRMARY ASSOCIATIONKY501(C)(3)LINE 9, SCH APATTIE A CLAY INFIRMARY ASSOCIATION1
PATTIE A CLAY FOUNDATION
PO BOX 1600RICHMONDKY404762603311506378ENHANCE,PROMOTE,& FINANCIALLY SUPPORT PATTIE A. CLAY REGIONAL MEDICAL CENTERKY501(C)(3)LINE 11C, SCH APATTIE A CLAY INFIRMARY ASSOCIATION1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Amount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
PATTIE A CLAY HOSPITAL AUXILIARY
0N/A
PATTIE A CLAY FOUNDATION
0N/A