2021-08-03T16:30:37-05:00 2021-04-30 610920132 RINEY HANCOCK CPAS PSC 2900 VEACH ROAD SUITE 2 OWENSBORO KY 42303 990 2020-05-01 611268014 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC COMM 2703385777 480 HOPKINSVILLE STREET GREENVILLE KY 42345 LINDSAY DURALL CFO 2703385777 2021-07-27 1 LINDSAY DURALL 999009999 SCOTT L CLAY CPA P00114132 2709264540 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROGER ARBUCKLE 480 HOPKINSVILLE ST GREENVILLE KY 42345 11826290 0 X N/A X 1994 KY TO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES 10 10 105 0 0 0 3036040 4267083 7200084 7422700 100954 76695 804 59812 10337882 11826290 0 0 0 0 5693403 5982702 0 0 0 3201197 3148394 8894600 9131096 1443282 2695194 13027538 15506105 1286697 1070070 11740841 14436035 TO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES IN MUHLENBERG AND LOGAN COUNTIES, KENTUCKY, AND IN MEDICALLY UNDER-SERVED URBAN, SUBURBAN, AND RURAL AREAS HAVING LIMITED AVAILABLE HEALTH RESOURCES. 0 0 8076857 7422700 OPERATION OF COMMUNITY HEALTH CENTER AS AUTHORIZED BY SECTION 330 OF THE PUBLIC HEALTH SERVICES GRANT 8076857 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 1 105 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 X LINDSAY DURALL 2703385777 480 HOPKINSVILLE ST GREENVILLE KY 42345 JIMMY OWENS BOARD MEMBER 1.00 X 0 0 0 ELIZABETH GENTRY BOARD MEMBER 1.00 X 0 0 0 ELIZABETH EAVES BOARD MEMBER 1.00 X 0 0 0 CARY DAVIS BOARD MEMBER 1.00 X 0 0 0 ANDREHIA HATFIELD BOARD MEMBER 1.00 X 0 0 0 RICHARD NEATHAMER BOARD MEMBER 1.00 X 0 0 0 CINDY BAIRD BOARD MEMBER 1.00 X 0 0 0 AMANDA HENSON BOARD MEMBER 1.00 X 0 0 0 BILLY STEELE BOARD MEMBER 1.00 X 0 0 0 ROSEMARY BUCK BOARD MEMBER 1.00 X 0 0 0 LINDSAY DURALL CFO CFO 40.00 X 50750 0 7856 JOSEPH A SWAB CFO CFO 40.00 X 104423 0 10539 ROGER ARBUCKLE CEO CEO 40.00 X 165000 0 16843 DAVID CONATSER MD PHYSICIAN 40.00 X 160000 0 8000 DEANDRA DAVIS PHYSICIAN 40.00 X 186162 0 8189 STEVEN R ZELLER MD PHYSICIAN 40.00 X 210000 0 25833 ELIZA WHITTEN PHYSICIAN 40.00 X 179265 0 23265 BILLIE GALYEN PHYSICIAN 40.00 X 191440 0 24563 LEE B SPARKS PHYSICIAN 40.00 X 220000 0 24301 1467040 0 149389 17 0 1 0 CHERYL BROTHERS 420 KING ROAD LEWISBURG KY 42256 HOUSEKEEPING SERVICES 123000 1 4267083 4267083 MEDICAL SERVICES 621110 7422700 7422700 7422700 76695 76695 MISCELLANEOUS 621110 59812 59812 59812 11826290 7422700 0 136507 X 523219 168000 355219 4447753 4279863 167890 175598 171104 4494 472591 405890 66701 363541 324254 39287 8442 8442 90465 90465 1580620 1396404 184216 44692 44692 179448 90360 89088 55687 55687 100848 28261 72587 53201 26037 27164 272843 272843 34851 34851 IMMUNIZATION EXPENSE 333506 333506 OPERATIONAL SUPPLIES 316414 316414 DUES & SUBSCRIPTIONS 72719 29202 43517 OTHER EXPENSES 4658 582 4076 9131096 8076857 1054239 0 2257924 4542173 5268164 5609290 757710 697530 120476 125526 44748 44823 6873977 2387214 4578516 4486763 13027538 15506105 389422 420925 56575 649145 840700 1286697 1070070 X 11567541 14268116 173300 167919 11740841 14436035 13027538 15506105 2695194 0 X X 0 1 X 1 1 1 X 2918975 2350109 2470221 3036040 4267083 15042428 5595883 5871372 6643958 7200084 7422700 32733997 8514858 8221481 9114179 10236124 11689783 47776425 0 0 0 47776425 27883 35904 77929 100954 76695 319365 27883 35904 77929 100954 76695 319365 510 367 804 59812 61493 8542741 8257895 9192475 10337882 11826290 48157283 0.99210 0.99160 0.00660 0.00600 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 510. 2018 AMOUNT: $ 367. 2019 AMOUNT: $ 804. 2020 AMOUNT: $ 59,812. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 248389 248389 5118542 1214406 3904136 15825 15078 747 1200451 978425 222026 290770 179305 111465 4486763 X 11826290 0 11826290 0 11826290 9131096 0 9131096 0 9131096 PART X, LINE 2: THE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THE CENTER BELIEVES THAT IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. X X 0 0 0 0 0 0 0 1 0 LEE B SPARKS PHYSICIAN 220000 0 0 0 0 0 11000 0 13301 0 244301 0 0 0 STEVEN R ZELLER MD PHYSICIAN 210000 0 0 0 0 0 10500 0 15333 0 235833 0 0 0 BILLIE GALYEN PHYSICIAN 191440 0 0 0 0 0 9500 0 15063 0 216003 0 0 0 ELIZA WHITTEN PHYSICIAN 179265 0 0 0 0 0 8963 0 14302 0 202530 0 0 0 DEANDRA DAVIS PHYSICIAN 186162 0 0 0 0 0 8189 0 0 0 194351 0 0 0 ROGER ARBUCKLE CEO CEO 165000 0 0 0 0 0 8250 0 8593 0 181843 0 0 0 DAVID CONATSER MD PHYSICIAN 160000 0 0 0 0 0 8000 0 0 0 168000 0 0 0 PART I, LINE 7 PROVIDERS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON A PRODUCTIVITY FORMULA. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PRESENTS THE FEDERAL FORM 990 TO THE BOARD AT THE REGULARLY SCHEDULED BOARD MEETING IMMEDIATELY PRECEDING THE RETURN'S DUE DATE. THE RETURN IS FILED AFTER BOARD REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DETERMINED THE CEO'S SALARY BASED ON SALARY SURVEY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE CEO DETERMINED THE CFO'S SALARY BASED ON THE SAME INFORMATION WHICH IS EVALUATED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. ANNUAL FORMS 990 ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,396,404. MANAGEMENT AND GENERAL EXPENSES 183,997. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,580,401. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 219. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.