2022-02-21T14:08:52-06:00 2021-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 250 W MAIN STREET STE 1400 LEXINGTON KY 40507 990 2020-07-01 610945743 KENTUCKY MEDICAL SERVICES FOUNDATION INC KENT 8592577910 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 DR JAY GRIDER DO, CEO, AND PRESIDENT 8592577910 2022-02-18 1 DR JAY GRIDER 999009999 ALLISON C CARTER P01242412 8592552341 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAY S GRIDER 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 425750351 0 X KMSF.COM X 1980 KY SUPPORTING THE UNIVERSITY OF KY SO IT MAY ACHIEVE ITS GOALS IN HEALTHCARE 24 0 236 24 0 0 2363742 0 388934996 404253449 452125 325765 20136199 20861153 411887062 425440367 1428883 1159744 0 0 3243343 3020118 0 0 0 409105930 420799451 413778156 424979313 -1891094 461054 235449897 270966937 209281844 244337830 26168053 26629107 X SEE SCHEDULE O 0 0 402889706 1159744 425113028 KMSF COLLECTS FEES FROM PROVISION OF PATIENT SERVICES PROVIDED BY THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE. BY PERFORMING THESE DUTIES KMSF SUPPORTS THE HOSPITAL AND HELPS THEM TO FULFILL THEIR EXEMPT PURPOSE. COLLECTIONS, AFTER PAYMENT OF DIRECT EXPENSES, ARE REMITTED TO THE COLLEGE WHICH USES THE FUNDS IN THE AREAS OF TEACHING, RESEARCH AND SERVICE. 402889706 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 145 0 1 236 1 0 0 0 0 0 0 0 0 0 0 0 0 X 24 0 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X X KATERINA MOLINA 8592577910 2333 ALUMNI PARK PLAZA SUITE 200 LEXINGTON KY 40517 JAY GRIDER CEO 1.00 X 0 511517 48612 KATERINA MOLINA DIRECTOR OF FINANCE & ACCOUNTING 40.00 X 196140 0 37356 HERMAN WALTERS DIRECTOR OF IT 40.00 X 174587 0 35453 BRENDA NICHOLS DIRECTOR OF HUMAN RESOURCES 40.00 X 146548 0 22561 CHRISTINA DEYOUNG DIRECTOR OF INSURANCE FOLLOW-UP & CASH APP 40.00 X 137102 0 30758 MICHELLE MONTICELLO DIRECTOR OF PROJECT MANAGEMENT 40.00 X 132015 0 24696 JEFFREY SELBY DIRECTOR 1.00 X 0 921603 74352 WILLIAM INABNET DIRECTOR 1.00 X 0 874340 76597 ROBERT DIPAOLA DIRECTOR 1.00 X 0 654994 60575 CRAIG VAN HORNE DIRECTOR 1.00 X 0 640180 59282 MARY ELIZABETH OATES DIRECTOR 1.00 X 0 626654 57442 MARCUS RANDALL DIRECTOR 1.00 X 0 624660 58084 STEPHEN STRUP DIRECTOR 1.00 X 0 618424 57009 RALEIGH JONES DIRECTOR 1.00 X 0 575392 48397 PAUL PEARSON DIRECTOR 1.00 X 0 567298 53794 ROGER HUMPHRIES DIRECTOR 1.00 X 0 573235 42989 PATRICK MCGRATH DIRECTOR 1.00 X 0 565612 49271 WENDY HANSEN DIRECTOR 1.00 X 0 560352 51212 SCOTTIE DAY DIRECTOR 1.00 X 0 532700 48911 JOHN ROTH DIRECTOR 1.00 X 0 472833 47424 CHESTER JENNINGS DIRECTOR 1.00 X 0 463902 44076 SETH HIMELHOCH DIRECTOR 1.00 X 0 456463 44404 ZAKI HASSAN DIRECTOR 1.00 X 0 452528 39847 RICK MCCLURE DIRECTOR 1.00 X 0 438960 42949 LARRY GOLDSTEIN DIRECTOR 1.00 X 0 433259 38137 SUSAN MCDOWELL DIRECTOR 1.00 X 0 415310 37129 ROBERTO CARDARELLI DIRECTOR 1.00 X 0 405755 36644 TIMOTHY CAUDILL DIRECTOR 1.00 X 0 297825 33386 AFTAB CHISHTI DIRECTOR 1.00 X 0 276141 27126 CHRISTOPHER YOST DIRECTOR 1.00 X 0 193767 26240 786392 13153704 1354713 12 0 1 0 TODD HARGETT 6880 JACKS CREEK PIKE LEXINGTON KY 40515 CONTRACTOR SERVICES 1572342 STOLL KEENON OGDEN PLLC PO BOX 11969 LEXINGTON KY 40579 PROFESSIONAL LEGAL SERVICES 1067010 CHANGE HEALTHCARE SOLUTIONS LLC PO BOX 572490 MURRAY UT 84157 PROFESSIONAL SERVICES 332159 HARRODSBURG ANESTHESIA 425 SHAWNEE RUN ROAD HARRODSBURG KY 40330 PROFESSIONAL SERVICES 314417 ROI HOLDING COMPANY LLC PO BOX 734411 CHICAGO IL 60673 PROFESSIONAL SERVICES 258244 5 CLINIC SERVICE FEES 561000 394756694 394756694 RENT FROM SUPPORTED ORGANIZATION 531120 9496755 9496755 404253449 204017 204017 1574 1574 112251 309984 -197733 -197733 -197733 121748 0 121748 121748 121748 HONORARIUM & OTHER MISC INCOME 900099 21057312 21057312 21057312 425440367 425113028 0 327339 1159744 1159744 2263827 2263827 129334 129334 453774 453774 173183 173183 347511 347511 206830 206830 10130 10130 2749925 2749925 1206249 1206249 3556915 3556915 10748329 10748329 243600 243600 UK PHYSICIANS' SALARIES 210753134 210753134 CAPITAL & CURRENT OPERA 99450950 99450950 BAD DEBTS 37003218 37003218 PROFESSIONAL DEVELOPMEN 23898732 23898732 30623928 30623928 424979313 402889706 22089607 0 44869383 83910525 59919870 56069813 607883 731441 520174 508026 560868 358632 166659719 64848621 105414298 101811098 23557421 27577402 235449897 270966937 14550967 9584184 17294531 16400805 62101064 58907571 115335282 159445270 209281844 244337830 X 26168053 26629107 26168053 26629107 235449897 270966937 461054 0 X X 0 1 X 1 0 X X X 1 UNIVERSITY OF KENTUCKY 616001218 6 1 402889708 0 1 402889708 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, PART I KMSF HAS BEEN ASSIGNED THE RESPONSIBILITY TO BILL, COLLECT, AND ADMINISTER ALL CLINICAL INCOME GENERATED BY THE PHYSICIANS OF THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE, THUS PROVIDING A SERVICE TO UK. PART IV, SECTION A, LINE 2: THE UNIVERISTY OF KENTUCKY IS A GOVERNMENTAL ENTITY DESCRIBED IN 170(B)(1)(A)(V). PART IV, SECTION B, LINE 1: PERSONS HOLDING CERTAIN POSITIONS WITHIN THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE SERVE AS EX OFFICIO VOTING DIRECTORS (THESE POSITIONS ARE THE DEAN AND CHAIR OF EACH CLINICAL DEPARTMENT); OTHER DIRECTORS ARE ELECTED BY THE FACULTY OF THE UK COLLEGE OF MEDICINE. 2042805 2042805 133744361 38266566 95477795 9916334 9202803 713531 20956219 17379252 3576967 101811098 DUE TO UNIVERSITY OF KENTUCKY 798945 DUE TO UNIVERSITY OF KENTUCKY MALPRACTICE FUND 29820301 DUE TO COLLEGE OF MEDICINE DEPARTMENTS 128256550 DUE TO THIRD PARTY PAYERS 569474 159445270 398834755 10397606 10397606 388437149 37003218 37003218 425440367 398373701 10397606 10397606 387976095 37003218 37003218 424979313 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH RENTAL INCOME 309,984. PASS THROUGH INCOME 10,087,622. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 37,003,218. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH RENTAL INCOME 309,984. PASS THROUGH INCOME 10,087,622. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 37,003,218. 1 TUITION SUPPORT FOR DEPENDENTS OF UK FACULTY MEMBERS 109 1159744 PART I, LINE 2: KMSF REQUIRES TRANSCRIPTS AND PROOF OF ENROLLMENT EVERY SEMESTER TO MONITOR APPROPRIATE USE OF SCHOLARSHIP FUNDS. X 1 1 X X 0 0 0 0 0 0 0 0 0 JAY GRIDER CEO 0 450922 0 43430 0 17165 0 36449 0 12163 0 560129 0 0 KATERINA MOLINA DIRECTOR OF FINANCE & ACCOUNTING 196140 0 0 0 0 0 0 0 37356 0 233496 0 0 0 HERMAN WALTERS DIRECTOR OF IT 174587 0 0 0 0 0 0 0 35453 0 210040 0 0 0 BRENDA NICHOLS DIRECTOR OF HUMAN RESOURCES 146548 0 0 0 0 0 0 0 22561 0 169109 0 0 0 CHRISTINA DEYOUNG DIRECTOR OF INSURANCE FOLLOW-UP & CA 137102 0 0 0 0 0 0 0 30758 0 167860 0 0 0 MICHELLE MONTICELLO DIRECTOR OF PROJECT MANAGEMENT 132015 0 0 0 0 0 0 0 24696 0 156711 0 0 0 JEFFREY SELBY DIRECTOR 0 841503 0 63997 0 16103 0 67913 0 6439 0 995955 0 0 WILLIAM INABNET DIRECTOR 0 799797 0 50203 0 24340 0 63750 0 12847 0 950937 0 0 ROBERT DIPAOLA DIRECTOR 0 561100 0 75609 0 18285 0 47753 0 12822 0 715569 0 0 CRAIG VAN HORNE DIRECTOR 0 632396 0 2188 0 5596 0 47104 0 12178 0 699462 0 0 MARY ELIZABETH OATES DIRECTOR 0 567632 0 42868 0 16154 0 45750 0 11692 0 684096 0 0 MARCUS RANDALL DIRECTOR 0 580178 0 39572 0 4910 0 47738 0 10346 0 682744 0 0 STEPHEN STRUP DIRECTOR 0 581282 0 22016 0 15126 0 44833 0 12176 0 675433 0 0 RALEIGH JONES DIRECTOR 0 512325 0 47675 0 15392 0 42000 0 6397 0 623789 0 0 PAUL PEARSON DIRECTOR 0 520041 0 35509 0 11748 0 41625 0 12169 0 621092 0 0 ROGER HUMPHRIES DIRECTOR 0 541860 0 26535 0 4840 0 36600 0 6389 0 616224 0 0 PATRICK MCGRATH DIRECTOR 0 547394 0 2606 0 15612 0 42875 0 6396 0 614883 0 0 WENDY HANSEN DIRECTOR 0 500225 0 44963 0 15164 0 40875 0 10337 0 611564 0 0 SCOTTIE DAY DIRECTOR 0 490775 0 40425 0 1500 0 36750 0 12161 0 581611 0 0 JOHN ROTH DIRECTOR 0 404579 0 65321 0 2933 0 35265 0 12159 0 520257 0 0 CHESTER JENNINGS DIRECTOR 0 412875 0 37125 0 13902 0 33750 0 10326 0 507978 0 0 SETH HIMELHOCH DIRECTOR 0 366342 0 63845 0 26276 0 32250 0 12154 0 500867 0 0 ZAKI HASSAN DIRECTOR 0 440570 0 7680 0 4278 0 27700 0 12147 0 492375 0 0 RICK MCCLURE DIRECTOR 0 431088 0 3912 0 3960 0 32625 0 10324 0 481909 0 0 LARRY GOLDSTEIN DIRECTOR 0 387319 0 32681 0 13259 0 31500 0 6637 0 471396 0 0 SUSAN MCDOWELL DIRECTOR 0 393644 0 16856 0 4810 0 30750 0 6379 0 452439 0 0 ROBERTO CARDARELLI DIRECTOR 0 375337 0 28875 0 1543 0 30265 0 6379 0 442399 0 0 TIMOTHY CAUDILL DIRECTOR 0 280000 0 0 0 17825 0 21250 0 12136 0 331211 0 0 AFTAB CHISHTI DIRECTOR 0 201452 0 60535 0 14154 0 15000 0 12126 0 303267 0 0 CHRISTOPHER YOST DIRECTOR 0 185805 0 5961 0 2001 0 14115 0 12125 0 220007 0 0 A CLARK COUNTY KENTUCKY 2017-04-04 10000000 DEBT REFINANCE 0 0 0 B SCOTT COUNTY KENTUCKY 2017-04-21 9750000 DEBT REFINANCE 0 0 0 A 1622431 10000000 203524 9796476 2017 0 0 1 0 B 1537560 9750000 1005074 8744926 2017 0 0 1 0 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 A 1 B 1 JACOB CAUDILL CHILD OF BOARD MEMBER 12484 SCHOLARSHIP NICHOLAS GRIDER CHILD OF BOARD MEMBER/KMSF PRESIDENT 18664 SCHOLARSHIP MALKA HIMELHOCH CHILD OF BOARD MEMBER 12484 SCHOLARSHIP NAVA HIMELHOCH CHILD OF BOARD MEMBER 12484 SCHOLARSHIP ABIGAIL PEARSON CHILD OF BOARD MEMBER 12484 SCHOLARSHIP THOMAS PEARSON CHILD OF BOARD MEMBER 12484 SCHOLARSHIP HANNAH ROTH CHILD OF BOARD MEMBER 12484 SCHOLARSHIP CONNER SCHELL CHILD OF BOARD MEMBER 12484 SCHOLARSHIP BETHANY SELBY CHILD OF BOARD MEMBER 6242 SCHOLARSHIP SYDNEY STRUP CHILD OF BOARD MEMBER 12484 SCHOLARSHIP SCHEDULE L, PART III GRANTS LISTED ON SCHEDULE L ARE SCHOLARSHIPS PROVIDED TO CHILDREN OF BOARD MEMBERS WHO ARE FACULTY MEMBERS AT THE UNIVERSITY OF KENTUCKY. THE DEPENDENTS OF ALL FULL-TIME FACULTY ARE ELIGIBLE FOR THESE SCHOLARSHIPS AND ELIGIBILITY AND DISTRIBUTION ARE SUBJECT TO THE REQUIREMENTS OF THE PROGRAM. BOARD MEMBERS DO NOT SPECIFICALLY SELECT RECIPIENTS. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO KMSF BY-LAWS REGARDING ELECTED POSITIONS OF THE KMSF BOARD WERE APPROVED AND WILL GO INTO EFFECT WITH THE 2021 BOARD ELECTIONS. THE TWO AT-LARGE POSITIONS WILL BE REPLACED WITH TWO ADDITIONAL SPECIALTY GROUPINGS TO PROVIDE A BETTER OPPORTUNITY FOR DIVERSITY AND REPRESENTATION ACROSS ALL DEPARTMENTS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 TAX RETURN IS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON THE INFORMATION OBTAINED FROM THE AUDIT AND INQUIRIES FROM MANAGEMENT. BEFORE THE RETURN IS FILED, A DRAFT OF THE INFORMATIONAL RETURN IS REVIEWED BY MANAGEMENT. THE BOARD WILL REVIEW THE 990 AT A MEETING SHORTLY AFTER FILING AND ANY NECESSARY CHANGES WILL BE MADE AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 12C EXECUTIVE LEADERSHIP HAS IMPLEMENTED A POLICY THAT OFFICERS, DIRECTORS, AND KEY EMPLOYEES SHOULD ANNUALLY DISCLOSE CONFLICTS AND THE CONFLICT OF INTEREST POLICY IS CONSISTENTLY MONITORED AND ENFORCED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DELIBERATED BY THE BOARD IN A CLOSED DOOR MEETING. AS PART OF THEIR REVIEW THEY USE AAMC GROUP ON FACULTY PRACTICE BENCHMARKS FOR COMPARISON. FORM 990, PART VI, SECTION C, LINE 19 FORMS 990 AND 990T ARE POSTED ON THE KMSF.COM WEBSITE AND ARE ALSO AVAILABLE UPON REQUEST. FORM 1023 IS PROVIDED UPON REQUEST. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART III, LINE 1 TO COORDINATE AND DEVELOP SUPERIOR PATIENT CARE IN A GROUP PRACTICE SETTING WITHIN THE ACADEMIC ENVIRONMENT OF THE MEDICAL CENTER OF THE UNIVERSITY OF KENTUCKY IN LEXINGTON, INCLUDING THE PROVISION OF FINANCIAL SUPPORT FOR THE MEDICAL CENTER'S TEACHING, RESEARCH AND SERVICE PROGRAMS AND FOR THE PERSONNEL AND EQUIPMENT NECESSARY FOR SUCH PROGRAMS, AND IN FURTHERANCE OF THIS GENERAL PURPOSE TO EXECUTE AND PERFORM A PUBLIC TRUST IN SUPPORTING, AIDING, AND ADVANCING THE STUDY AND INVESTIGATION OF HUMAN ILLNESSES AND INJURIES, AND THE CAUSES, PREVENTIONS, RELIEF AND CURE THEREOF, AND THE STUDY AND INVESTIGATION OF PROBLEMS OF HYGIENE AND HEALTH; TO ENCOURAGE, PROMOTE AND PERFORM MEDICAL, SURGICAL AND SCIENTIFIC LEARNING, SKILL, EDUCATION AND INVESTIGATION; TO PROMOTE MEDICAL, SURGICAL, AND SCIENTIFIC SERVICES; TO ATTRACT AND RETAIN HIGH QUALITY FACULTY TO TEACH, CONDUCT RESEARCH AND PROVIDE PATIENT CARE; TO PROVIDE SUPPORT TO ENABLE THE COLLEGE OF MEDICINE TO ACCOMPLISH ITS EDUCATIONAL, RESEARCH AND SERVICE GOALS; TO ASSIST PROGRAMS OF MEDICAL, SURGICAL AND SCIENTIFIC EDUCATION AND RESEARCH; TO CARRY ON SUCH PROGRAMS OF PUBLIC CHARITY AS MAY BE RELATED TO THE CARRYING OUT OF THE OTHER STATED PURPOSES OF THE CORPORATION, AND, SPECIFICALLY THE CHARITABLE PROGRAMS UTILIZING THE KNOWLEDGE AND SKILLS ACQUIRED BY THE CORPORATION THROUGH ITS ABOVE-DESCRIBED OPERATIONS FOR THE BENEFIT OF ALL PERSONS WHO MAY BE IN NEED THEREOF, REGARDLESS OF HIS OR HER ABILITY TO PAY. UNIVERSITY OF KENTUCKY 800 ROSE STREET LEXINGTON KY 40536 616001218 EDUCATIONAL DEVELOPMENT, HEALTHCARE KY 115 N/A N/A 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0