2022-08-15T11:46:46-05:00 2021-09-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-10-01 264736971 KENTUCKY MEDICAL LOGISTICS INC KENT 8774075368 425 22ND STREET ASHLAND KY 41101 AUTUMN MCFANN TREASURER 8774075368 2022-08-12 1 AUTUMN MCFANN 999009999 KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KING'S DAUGHTERS MEDICAL TRANSPORT KRISTIE WHITLATCH 2201 LEXINGTON AVENUE ASHLAND KY 41101 3175612 0 X KINGSDAUGHTERSHEALTH.COM/SERVICES/MEDICAL-TRANSPO X 2009 KY TO PROVIDE COMMUNITY HEALTHCARE SERVICES AND ENSURE THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED. 8 8 0 8 0 0 58918 0 2438734 3175612 -337 0 0 0 2497315 3175612 0 0 0 0 1396905 1948527 0 0 0 638145 1032146 2035050 2980673 462265 194939 1579273 3050816 3700064 38574 -2120791 3012242 X TO PROVIDE COMMUNITY HEALTHCARE SERVICES AND ENSURE THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICES WILL BE AVAILABLE TO ALL THOSE IN NEED. 0 0 2889217 0 3175612 KING'S DAUGHTERS MEDICAL TRANSPORT (KDMT) SEEKS TO CONTINUOUSLY IMPROVE THE PRE- AND POST-HOSPITAL HEALTHCARE PROVIDED IN ALL OF ITS SERVICE AREAS WHILE ENSURING THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED. THE EQUIPMENT IS MODERN, STATE OF THE ART, SATISFACTORILY MAINTAINED, AND ADEQUATELY OPERATED. RESPONSE TIMES ARE MONITORED AND KEPT WITHIN INDUSTRY ACCEPTED PARAMETERS AS WELL AS UTILIZATION AND ADHERENCE TO CURRENT AND LOCAL MEDICAL PROTOCOLS.CONTINUED ON SCHEDULE O. KDMT STRIVES TO PROVIDE AMPLE TRAINING FOR EMS PERSONNEL, ON-GOING TRAINING FOR THE COMMUNITY, AND HIGH COMMITMENTS OF COMMUNITY HEALTH SERVICES. IN DEMONSTRATION OF THESE COMMITMENTS, KDMT RESPONDED TO 11,442 REQUESTS FOR AMBULANCE SERVICE IN 2021 AND TRANSPORTED 9,122 PATIENTS. KDMT ALSO RESPONDED TO 9,362 REQUESTS FOR WHEELCHAIR TRANSPORT AND COMPLETED 6,700 OF THESE TRANSPORTS. KDMT PROVIDES EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE TO THE COMMUNITIES OF GREENUP COUNTY, KENTUCKY; BOYD COUNTY, KENTUCKY; AND THE COUNTIES OF LAWRENCE AND SCIOTO IN OHIO. KDMT ALSO PROVIDES MUTUAL AID SERVICES TO OTHER ORGANIZATIONS THROUGHOUT THE PRIMARY SERVICE AREAS. DURING THE YEAR, KDMT HAS ALSO TAKEN AN ACTIVE ROLE IN THE PUBLIC HEALTH AND EDUCATION OF THE COMMUNITY. KDMT WAS INVOLVED IN MULTIPLE CAREER DAYS FOR LOCAL SCHOOLS AND LOCAL COMMUNITY EVENTS THAT TAUGHT CHILDREN OF ALL AGES WHAT EMS INVOLVES AND THE EQUIPMENT USED. KDMT PROVIDED DEDICATED MEDICAL STAND-BY COVERAGE INCLUDING PARAMEDICS AT MULTIPLE COMMUNITY EVENTS INCLUDING CONCERTS FOR THE PARAMOUNT ARTS CENTER, GREENUP COUNTY HIGH SCHOOL FOOTBALL GAMES, AS WELL AS MASS CASUALTY RESPONSE DRILLS AND TABLE TOP DRILLS WITH THE AREA'S EMERGENCY MANAGEMENT OFFICE. THESE SERVICES WERE ALL PROVIDED AT NO CHARGE AND DELIVERED AS PART OF THE COMMUNITY BENEFIT MISSION OF KDMT. 2889217 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 KY X LAURIE STEWART CONTROLLER 6064089640 2201 LEXINGTON AVENUE ASHLAND KY 41101 KRISTIE WHITLATCH NON-VOTING PRESIDENT 1.25 60.75 X X 0 935505 40469 AUTUMN MCFANN NON-VOTING TREASURER 1.25 60.75 X X 0 488592 37309 SHERYL MAHANEY NON-VOTING SECRETARY 1.25 60.75 X X 0 482139 43259 DAVID JONES BOARD CHAIRMAN 0.25 6.25 X X 0 0 0 MARK NEWMAN BOARD VICE CHAIR 0.25 6.25 X X 0 0 0 STEPHEN ADDINGTON DIRECTOR 0.25 2.50 X 0 0 0 MARK BIRDWHISTELL DIRECTOR 0.25 2.50 X 0 0 0 TOM BURNETTE DIRECTOR 0.25 2.50 X 0 0 0 CRAIG COLLINS DIRECTOR 0.25 2.50 X 0 0 0 ERIC MONDAY DIRECTOR 0.25 2.50 X 0 0 0 JOHN STEWART DIRECTOR 0.25 2.50 X 0 0 0 CHARLES CONLEY DO MEDICAL DIRECTOR 1.00 50.00 X 4000 449038 42881 SARA MARKS VP/COO 1.25 59.00 X 0 421725 47343 4000 2776999 211261 0 0 1 0 0 NET PATIENT SERV REV 621910 3175612 3175612 3175612 3175612 3175612 0 0 12000 12000 1755832 1679083 76749 180695 172799 7896 190023 190023 215 215 33665 32194 1471 101083 101083 206465 206465 14309 14309 BAD DEBT EXPENSE 160012 160012 FUEL EXPENSE 123716 123716 SUPPLIES 122187 116847 5340 REPAIRS & MAINTENANCE 62311 62311 18160 18160 2980673 2889217 91456 0 98389 787864 173123 276197 6845 12717 2225 5728 2274562 1318982 295261 955580 1003430 1012730 1579273 3050816 21644 38574 3678420 0 3700064 38574 X -2120791 3012242 -2120791 3012242 1579273 3050816 X 194939 4938094 X 0 1 X 1 0 X 58918 0 58918 1731318 2111248 2316949 2438734 3175612 11773861 1731318 2111248 2316949 2497652 3175612 11832779 0 0 0 11832779 1731318 2111248 2316949 2497652 3175612 11832779 1.00000 1.00000 0.00000 X 41904 26332 15572 2232658 1292650 940008 955580 GOODWILL 1000000 OTHER RECEIVABLES 30 DUE FROM AFFILIATES 12700 1012730 X PART X, LINE 2: THE MEDICAL CENTER, KHF, KBNH, CDC, KHI, KDMT, KDMS, KDHF, AND KDOH HAVE BEEN RECOGNIZED BY THE IRS AS SECTION 501(C)(3) CHARITABLE ORGANIZATIONS. SECTION 501(C)(3) ORGANIZATIONS ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. THESE ORGANIZATIONS DO NOT ENGAGE IN SIGNIFICANT UNRELATED ACTIVITIES; THEREFORE, NO TAX IS RECORDED. 0 1 0 0 0 0 0 1 0 KRISTIE WHITLATCH NON-VOTING PRESIDENT 0 677159 0 188424 0 69922 0 24625 0 15844 0 975974 0 33599 AUTUMN MCFANN NON-VOTING TREASURER 0 368175 0 105244 0 15173 0 21375 0 15934 0 525901 0 0 SHERYL MAHANEY NON-VOTING SECRETARY 0 337930 0 106630 0 37579 0 24625 0 18634 0 525398 0 27204 CHARLES CONLEY DO MEDICAL DIRECTOR 4000 438244 0 0 0 10794 0 17100 0 25781 4000 491919 0 0 SARA MARKS VP/COO 0 318464 0 99059 0 4202 0 21375 0 25968 0 469068 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS DETERMINED BY ASHLAND HOSPITAL CORPORATION (RELATED ORGANIZATION) USING THE FOLLOWING METHODS: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. PART I, LINE 4B FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: - KRISTIE WHITLATCH $26,376 - AUTUMN MCFANN $14,333 - SHERYL MAHANEY $6,828 - SARA MARKS $3,362 FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM 457(F) EXECUTIVE RETENTION PLAN PAYOUTS: - KRISTIE WHITLATCH $33,599 - SHERYL MAHANEY $27,204 THE CEO AND CERTAIN VICE PRESIDENTS, WHOSE BENEFIT IN THE QUALIFIED TAX SHELTERED ANNUITY PLAN IS LIMITED DUE TO THE IRS COMPENSATION AND BENEFIT LIMITS, RECEIVE A BENEFIT RESTORATION CONTRIBUTION UNDER THE DEFERRED ANNUITY PLAN THAT IS PAID AS A TAXABLE DISTRIBUTION TO THE PARTICIPANT ANNUALLY. PART I, LINE 7 NONFIXED PAYMENTS ARE MADE AS A PART OF THE MEDICAL CENTER'S TEAM INCENTIVE AWARD (TIA) PLAN. ALL TEAM MEMBERS ARE ELIGIBLE FOR THE TIA. THE TIA IS PAID OUT BASED UPON SUCCESSFUL COMPLETION OF BOTH QUANTITATIVE AND QUALITATIVE STRATEGIC GOALS, SET ANNUALLY BY THE MEDICAL CENTER LEADERSHIP TEAM AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART V, LINE 2: THERE ARE NO EMPLOYEES OF KENTUCKY MEDICAL LOGISTICS, INC. ("KML"). SALARIES REPORTED ON PART IX, LINE 7 REPRESENT THE ALLOCATED PAYROLL EXPENSE FOR THE TIME SPENT ON KML BY ASHLAND HOSPITAL CORPORATION ("AHC") EMPLOYEES. KML REIMBURSES KDMC FOR THIS APPORTIONED TIME. ALL PAYROLL FILINGS ARE COMPLETED BY AHC UNDER EIN 61-0444716. AHC IS THE PARENT ORGANIZATION OF KML. FORM 990, PART VI, SECTION A, LINE 6 ASHLAND HOSPITAL CORPORATION (AHC) IS THE SOLE CORPORATE MEMBER OF KENTUCKY MEDICAL LOGISTICS INC. (KML). AHC, A 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE KML BOARD IS FOLDED INTO THE MAIN BOARD OF TRUSTEES OF THE HEALTH SYSTEM. THE BUSINESS OF KML IS AN AGENDA ITEM OF THE FULL BOARD INDEPENDENTLY OR THROUGH ITS COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE CFO AND CONTROLLER BEFORE IT IS FILED WITH THE IRS. THE 990 WILL BE KEPT ON FILE AND AVAILABLE FOR REVIEW BY BOARD MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C KING'S DAUGHTERS MEDICAL CENTER REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO COMPLY WITH ITS CONFLICTS OF INTEREST POLICY, WHICH TRACKS THE IRS' RECOMMENDED POLICY WITH RESPECT TO SUCH OFFICERS AND DIRECTORS. MEMBERS OF THE MEDICAL CENTER'S BOARD OF DIRECTORS MUST ANNUALLY IDENTIFY, IN WRITING, ANY INTEREST THAT COULD GIVE RISE TO A CONFLICT, SUCH AS A LEADERSHIP POSITION IN A CONFLICTING ORGANIZATION; DISCLOSURE IS NOT LIMITED TO FINANCIAL CONFLICTS. LEADERSHIP EMPLOYEES MUST ANNUALLY CERTIFY, IN WRITING, THAT THEY KNOW OUR CONFLICTS OF INTEREST POLICY AND PROCEDURE AND HAVE NO CONFLICTS OF INTEREST. IN ADDITION, EMPLOYEES OF THE MEDICAL CENTER CERTIFY THAT NO CONFLICTS OF INTEREST EXIST OR OBTAIN AN ADVANCE WAIVER OF ANY CONFLICTS. THE MEDICAL CENTER'S HUMAN RESOURCES AND CORPORATE COMPLIANCE DEPARTMENTS MAINTAIN ALL RELEVANT DISCLOSURES AND SIGNATURES. ALL EMPLOYEES PROVIDE ANNUAL CONFLICT CHECKS. IF A CONFLICT OF INTEREST IS REPORTED, THE VICE PRESIDENT TO WHOM THE REPORTING EMPLOYEE DIRECTLY OR INDIRECTLY REPORTS, TOGETHER WITH THE CEO, CHIEF CORPORATE COMPLIANCE OFFICER AND GENERAL COUNSEL, DETERMINES IF A CONFLICT EXISTS. IF THE REPORTING EMPLOYEE IS A VICE PRESIDENT, THE CEO, IN CONSULTATION WITH THE GENERAL COUNSEL, DETERMINES IF A CONFLICT EXISTS. ANNUALLY, BOARD MEMBERS DISCLOSE PERSONAL AND PROFESSIONAL RELATIONSHIPS TO THE SECRETARY OF THE BOARD. IF A POTENTIAL CONFLICT EXISTS, THE BOARD SECRETARY OR A BOARD MEMBER WILL IDENTIFY THE CONFLICT, OR POTENTIAL CONFLICT, AND THE BOARD MEMBER WILL BE REMOVED FROM ANY PART OF THE DECISION-MAKING PROCESS, AND HAS NO ROLE IN THE INSTANCE IN WHICH THE CONFLICT EXISTS. A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST MUST ABSTAIN FROM ANY RELEVANT DISCUSSION OR VOTE. IF A CONFLICT OF INTEREST IS DISCOVERED AFTER THE FACT, THE CEO AND VICE PRESIDENT, TOGETHER WITH THE GENERAL COUNSEL, IF APPROPRIATE, REVIEW THE INSTANCE IN WHICH THE CONFLICT OCCURRED. THOSE LEADERS DETERMINE WHETHER THE CONFLICTED INDIVIDUAL INFLUENCED THE DECISION-MAKING OR PROFITED FROM THE CONFLICT. THE CONFLICTED INDIVIDUAL IS REMOVED FROM ANY FURTHER INVOLVEMENT. IN ADDITION, ANY FAILURE TO REPORT CONFLICTS OF INTEREST VIOLATES THE MEDICAL CENTER'S POLICY AND COULD RESULT IN DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR REMOVAL FROM THE MEDICAL CENTER'S BOARD OF DIRECTORS. MEDICAL STAFF MEMBERS ARE REQUIRED BY THE MEDICAL STAFF BYLAWS TO DISCLOSE CONFLICTS OF INTEREST. ONCE DISCLOSED, THE MEDICAL STAFF MEMBER IS REMOVED FROM ANY DISCUSSION, DECISION-MAKING, AND/OR VOTE ON ANY RELATED ISSUE. FORM 990, PART VI, SECTION B, LINE 15 AT THE DIRECTION OF THE BOARD OF DIRECTORS, KDMC SET COMPENSATION FOR THE TEAM MEMBERS AND LEADERS USING SEDONA PARTNERS AS WELL AS REVIEW OF LOCAL AND REGIONAL SALARY INFORMATION PROVIDED THROUGH A MARSHALL UNIVERSITY SURVEY. IN JANUARY 2021, MERCER PERFORMED A REIVEW OF EXECUTIVE COMPENSATION AND BENEFITS. THE PRIMARY OBJECTIVE OF KING'S DAUGHTERS COMPENSATION PHILOSOPHY IS TO HAVE COMPENSATION AND BENEFITS SET THAT REFLECT OTHER SIMILAR INDEPENDENT NOT FOR PROFIT HEALTHCARE SERVICES AS WELL AS THE WORK PERFORMANCE OF THE ORGANIZATION. SULLIVAN COTTER, AN INDEPENDENT COMPENSATION EXPERT, REVIEWS ALL PHYSICIAN COMPENSATION AND BENEFITS FOR DETERMINATION OF FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 ON A QUARTERLY BASIS, THE FINANCIAL STATEMENTS ARE REPORTED TO THE MUNICIPAL SECURITIES RULEMAKING BOARD AND MADE AVAILABLE ON THEIR WEBSITE. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: FORGIVENESS OF INTERCOMPANY PAYABLES DUE TO RESTRUCTURING 4,938,094. ASHLAND HOSPITAL CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 610444716 HEALTHCARE KY 501(C)(3) LINE 3 ROYAL BLUE HEALTH LLC 0 ASHLAND NURSING HOME CORPORATION 2500 STATE ROUTE 5 ASHLAND KY 41102 611386016 NURSING HOME KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 0 KENTUCKY HEART INSTITUTE INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611255904 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS HEALTH SYSTEM 2201 LEXINGTON AVENUE ASHLAND KY 41101 274553836 HEALTHCARE KY 501(C)(3) LINE 12B, II N/A 0 PORTSMOUTH HOSPITAL CORPORATION 1901 ARGONNE AVENUE PORTSMOUTH OH 45662 453215312 HEALTHCARE OH 501(C)(3) LINE 3 ROYAL BLUE HEALTH LLC 0 KENTUCKY HEART FOUNDATION INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 260791997 MEDICAL RESEARCH KY 501(C)(3) LINE 7 ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS HEALTH FOUNDATION INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611035701 FUNDRAISING KY 501(C)(3) LINE 12B, II ASHLAND HOSPITAL CORPORATION 0 CHILD DEVELOPMENT CENTER CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 010560598 DAYCARE KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS MEDICAL SPECIALTIES INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 264183569 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 0 ROYAL BLUE HEALTH LLC 2201 LEXINGTON AVENUE ASHLAND KY 41101 862993817 HEALTHCARE KY 501(C)(3) LINE 12B, II KING'S DAUGHTERS HEALTH SYSTEM 0 ASHLAND MEDICAL PROPERTIES INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611079090 RENTALS KY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1