KINGS DAUGHTERS MEDICAL SPECIALTIES INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- KINGS DAUGHTERS MEDICAL SPECIALTIES INC (EIN 26-4183569)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-16
- IRS object ID
- 202132289349303903
- Schema version
- 2019v5.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-16T15:25:38-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264183569 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KING'S DAUGHTERS MEDICAL SPECIALTIES | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KING | BusinessNameControlTxt |
| Phone | 6064084000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 LEXINGTON AVENUE | AddressLine1Txt |
| City | ASHLAND | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AUTUMN MCFANN | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 6064084000 | PhoneNum |
| Signature | 2021-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KERRI N BOGDA CPA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KRISTIE WHITLATCH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 LEXINGTON AVENUE | AddressLine1Txt |
| City | ASHLAND | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,747,722 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KINGSDAUGHTERSHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | TO DELIVER QUALITY HEALTHCARE SERVICES WHICH PROVIDE VALUE TO THE PATIENT, PAYER, AND KDHS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 180 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,379,977 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $54,133,927 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $51,182,102 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,449 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,380 | CYInvestmentIncomeAmt |
| PY Other Revenue | $28,636 | PYOtherRevenueAmt |
| CY Other Revenue | $184,263 | CYOtherRevenueAmt |
| PY Total Revenue | $54,171,012 | PYTotalRevenueAmt |
| CY Total Revenue | $52,747,722 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $59,864,030 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $63,163,720 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,309,773 | PYOtherExpensesAmt |
| CY Other Expenses | $9,733,613 | CYOtherExpensesAmt |
| PY Total Expenses | $68,173,803 | PYTotalExpensesAmt |
| CY Total Expenses | $72,897,333 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$14,002,791 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$20,149,611 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,359,074 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,238,680 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $125,775,950 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $148,805,167 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$108,416,876 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$128,566,487 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | KING'S DAUGHTERS MEDICAL SPECIALTIES (KDMS) IS AN INTERGRATED SYSTEM OF MEDICAL SPECIALISTS AND PRIMARY CARE PHYSICIANS DESIGNED TO PROVIDE AN AVENUE FOR PHYSICIAN RECRUITMENT, RETENTION, AND EMPLOYMENT. CONTINUED ON SCHEDULE "O".KDMS PROVIDES ACCESS TO INFORMATION TECHNOLOGY, AS WELL AS LEADERSHIP AND DIRECTION IN A RAPIDLY TRANSFORMING HEALTHCARE ENVIRONMENT WITH CHANGING PAYER DEMANDS. THE GOALS OF KDMS INCLUDE THE DELIVERY OF QUALITY SERVICE WHICH PROVIDES VALUE TO THE PATIENT, THE PAYER, AND KING'S DAUGHTERS HEALTH SYSTEM (KDHS). | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $72,897,333 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $51,182,102 | RevenueAmt |
| Desc | KDMS HAS 29 MEDICAL SPECIALTIES PLUS PRIMARY CARE PHYSICIANS PROVIDING SERVICES IN 39 DIFFERENT LOCATIONS. THERE ARE 105 PHYSICIANS AND 58 ADVANCED PRACTITIONERS THAT MAKE UP THE PROVIDERS. KDMS SAW APPROXIMATELY 75,476 PATIENTS DURING FY2020 AND PROVIDED $663,055 OF CHARITY CARE. | Desc |
| Total Program Service Expenses | $72,897,333 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 180 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURIE STEWART CONTROLLER | PersonNm |
| Phone | 6064089640 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 LEXINGTON AVENUE | AddressLine1Txt |
| City | ASHLAND | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| SRIHARSHA VELURY MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,601,026 | $0 | $16,908 | |||
| OMRAN ABUL-KHOUDOUD MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,526,452 | $0 | $38,444 | |||
| ZANE DARNELL MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,486,771 | $0 | $34,670 | |||
| JENNIFER LISTERMAN MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,221,365 | $0 | $34,670 | |||
| RODERICK TOMPKINS MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,191,695 | $0 | $41,394 | |||
| KRISTIE WHITLATCH | ||||||||
| PRESIDENT | 1.25 | $0 | $781,097 | $80,370 | 61.25 | Yes (X) | Yes (X) | |
| AUTUMN MCFANN NON-VOTING | ||||||||
| TREASURER | 1.25 | $0 | $522,077 | $76,217 | 61.25 | Yes (X) | Yes (X) | |
| SHERYL MAHANEY NON-VOTING | ||||||||
| SECRETARY | 1.25 | $0 | $409,633 | $80,728 | 61.25 | Yes (X) | Yes (X) | |
| DAVID JONES | ||||||||
| CHAIRMAN | 0.25 | $0 | $0 | $0 | 5.75 | Yes (X) | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,027,309 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,712,807 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $403,401 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 137 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RIVERSIDE ANESTHESIA PSC | |||||
| 425 LEWIS HARGETT CIRCLE | LEXINGTON | KY | 405033590 | ANESTHESIA SERVICES | $6,205,137 |
| KEVIN WILLIS MD | |||||
| 91 PRIVATE DR 1277 | IRONTON | OH | 45638 | PHYSICIAN | $616,336 |
| MILLENNIAL PSYCHIATRIC SERVICE | |||||
| 201 PROVIDENCE HILL DR | ASHLAND | KY | 41101 | BEHAVIORAL MEDICINE PHYSICIAN | $239,400 |
| UNIVERSITY PHYSICIANS & SURGEONS INC | |||||
| 1600 MEDICAL CTR DR | HUNTINGTON | WV | 25701 | ORTHOPEDIC PHYSICIANS | $119,832 |
| MOHAMMAD AL-MADANI MD | |||||
| 1532 MONTGOMERY AVE | VILLANOVA | PA | 190851917 | LOCUM TENENS PHYSICIAN | $110,501 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,379,977 | GovernmentGrantsAmt |
| Total Contributions | $1,379,977 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $51,006,382 | $51,006,382 |
| MEANINGFUL USE REVENUE | 900099 | $175,720 | $175,720 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $51,182,102 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,380 | TotalRevenueColumnAmt |
| Exclusion | $1,380 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,656 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,656 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,656 | TotalRevenueColumnAmt |
| Exclusion | $1,656 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE RETENTION CREDIT | 900099 | $163,998 | $163,998 |
| QUALITY INCENTIVE | 900099 | $18,534 | $18,534 |
| MEDICAL RECORDS | 900099 | $75 | $75 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $182,607 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,747,722 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $51,182,102 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $185,643 | ExclusionAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,466 | TotalAmt |
| Program Services | $80,466 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,339,457 | TotalAmt |
| Program Services | $58,339,457 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,906 | TotalAmt |
| Program Services | $499,906 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,195,706 | TotalAmt |
| Program Services | $2,195,706 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,048,185 | TotalAmt |
| Program Services | $2,048,185 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,106,833 | TotalAmt |
| Program Services | $3,106,833 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,989 | TotalAmt |
| Program Services | $15,989 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,282 | TotalAmt |
| Program Services | $39,282 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,540 | TotalAmt |
| Program Services | $41,540 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,587 | TotalAmt |
| Program Services | $103,587 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,378 | TotalAmt |
| Program Services | $11,378 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,888 | TotalAmt |
| Program Services | $369,888 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,425,023 | TotalAmt |
| Program Services | $2,425,023 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $3,514,805 | $3,514,805 |
| DUES & SUBSCRIPTIONS | $103,185 | $103,185 |
| REPAIRS AND MAINTENANCE | $1,727 | $1,727 |
| SUPPLIES | $376 | $376 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,897,333 | TotalAmt |
| Program Services | $72,897,333 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,990,881 | BOYAmt |
| EOY | $1,786,348 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,023,438 | BOYAmt |
| EOY | $6,707,473 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,696 | BOYAmt |
| EOY | $517,800 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,342,457 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,715,320 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,443,995 | BOYAmt |
| EOY | $2,627,137 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,453,064 | BOYAmt |
| EOY | $8,599,922 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,359,074 | BOYAmt |
| EOY | $20,238,680 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,572,172 | BOYAmt |
| EOY | $11,953,055 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,203,778 | BOYAmt |
| EOY | $136,852,112 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,775,950 | BOYAmt |
| EOY | $148,805,167 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$108,416,876 | BOYAmt |
| EOY | -$128,566,487 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$108,416,876 | BOYAmt |
| EOY | -$128,566,487 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,359,074 | BOYAmt |
| EOY | $20,238,680 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$20,149,611 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,379,977 | CurrentTaxYearAmt |
| Total | $1,379,977 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,017,760 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,401,502 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,254,249 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,133,927 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,182,102 | CurrentTaxYearAmt |
| Total | $259,989,540 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,017,760 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,401,502 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,254,249 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,133,927 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,562,079 | CurrentTaxYearAmt |
| Total | $261,369,517 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $261,369,517 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $73,690 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,575 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,191 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,036 | CurrentTaxYearAmt |
| Total | $98,772 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $73,690 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,575 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,191 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,036 | CurrentTaxYearAmt |
| Total | $98,772 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $409,224 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $105,075 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $67,614 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $182,607 | CurrentTaxYearAmt |
| Total | $791,500 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,500,674 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,511,152 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,329,143 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,171,098 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,747,722 | CurrentTaxYearAmt |
| Total | $262,259,789 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99660 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99540 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00080 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS - 2016 AMOUNT: $ 5. MEDICAL RECORDS - 2015 AMOUNT: $ 24,240. 2016 AMOUNT: $ 26,493. 2017 AMOUNT: $ 30,958. 2018 AMOUNT: $ 20,979. 2019 AMOUNT: $ 75. QUALITY INCENTIVE - 2015 AMOUNT: $ 384,984. 2016 AMOUNT: $ 78,577. 2017 AMOUNT: $ 36,656. 2018 AMOUNT: $ 6,001. 2019 AMOUNT: $ 18,534. EMPLOYEE RETENTION CREDIT - 2019 AMOUNT: $ 163,998. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $140,000 | OtherCostOrOtherBasisAmt |
| Book Value | $140,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,657,373 | OtherCostOrOtherBasisAmt |
| Depreciation | $660,786 | DepreciationAmt |
| Book Value | $996,587 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,545,084 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,054,534 | DepreciationAmt |
| Book Value | $1,490,550 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,627,137 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| GOODWILL | $5,451,812 |
| OPERATING LEASES | $1,071,339 |
| DUE TO KING'S DAUGHTERS MEDICAL CENTER - OHIO | $2,076,771 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,599,922 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO KING'S DAUGHTERS MEDICAL CENTER | $135,762,450 |
| KENTUCKY SALES TAX PAYABLE | $4,069 |
| DUE TO KHI | $14,254 |
| OPERATING LEASE LIABILITY | $1,071,339 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $136,852,112 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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 AND THEREFORE NO TAX IS RECORDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SRIHARSHA VELURY MD | ||||||||||||||
| PHYSICIAN | $1,597,692 | $0 | $0 | $0 | $3,334 | $0 | $15,600 | $0 | $1,308 | $0 | $1,617,934 | $0 | $0 | $0 |
| OMRAN ABUL-KHOUDOUD MD | ||||||||||||||
| PHYSICIAN | $1,506,289 | $0 | $0 | $0 | $20,163 | $0 | $12,600 | $0 | $25,844 | $0 | $1,564,896 | $0 | $0 | $0 |
| ZANE DARNELL MD | ||||||||||||||
| PHYSICIAN | $1,484,988 | $0 | $0 | $0 | $1,783 | $0 | $12,600 | $0 | $22,070 | $0 | $1,521,441 | $0 | $0 | $0 |
| JENNIFER LISTERMAN MD | ||||||||||||||
| PHYSICIAN | $1,220,590 | $0 | $0 | $0 | $775 | $0 | $12,600 | $0 | $22,070 | $0 | $1,256,035 | $0 | $0 | $0 |
| RODERICK TOMPKINS MD | ||||||||||||||
| PHYSICIAN | $1,189,912 | $0 | $0 | $0 | $1,783 | $0 | $15,600 | $0 | $25,794 | $0 | $1,233,089 | $0 | $0 | $0 |
| KRISTIE WHITLATCH | ||||||||||||||
| PRESIDENT | $0 | $602,821 | $0 | $126,776 | $0 | $51,500 | $0 | $65,600 | $0 | $14,770 | $0 | $861,467 | $0 | $27,321 |
| AUTUMN MCFANN NON-VOTING | ||||||||||||||
| TREASURER | $0 | $334,600 | $0 | $74,839 | $0 | $112,638 | $0 | $62,600 | $0 | $13,617 | $0 | $598,294 | $0 | $105,450 |
| SHERYL MAHANEY NON-VOTING | ||||||||||||||
| SECRETARY | $0 | $305,674 | $0 | $68,833 | $0 | $35,126 | $0 | $65,600 | $0 | $15,128 | $0 | $490,361 | $0 | $24,859 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $17,224 - AUTUMN MCFANN $2,607 - SHERYL MAHANEY $4,493 FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM 457(F) EXECUTIVE RETENTION PLAN PAYOUTS: - KRISTIE WHITLATCH $27,321 - AUTUMN MCFANN $105,450 - SHERYL MAHANEY $24,859 FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM 457(F) EXECUTIVE RETENTION PLAN DEFERRALS: - KRISTIE WHITLATCH $50,000 - SHERYL MAHANEY $50,000 - AUTUMN MCFANN $50,000 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BROOKE VASS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $80,466 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV: | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: BROOKE VASS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SISTER OF AUTUMN MCFANN (TREASURER)(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: | THERE IS NO SEPARATE FORM 1096 FILED BY KING'S DAUGHTERS MEDICAL SPECIALITIES, INC. ("KDMS"). ALL THE PAYMENTS ARE MADE BY ASHLAND HOSPITAL CORPORATION ("AHC"), AN AFFILIATE ENTITIY, UNDER ITS EIN 61-0444716. |
| FORM 990, PART VI, SECTION A, LINE 6 | ASHLAND HOSPITAL CORPORATION (AHC) IS THE SOLE CORPORATE MEMBER OF KING'S DAUGHTERS MEDICAL SPECIALTIES, INC. (KDMS). AHC, A 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | EFFECTIVE JUNE 2017, AHC EXECUTIVE MEMBERS MADE THE DECISION TO FOLD THE KDMS BOARD INTO THE MAIN BOARD OF TRUSTEES AND THAT THE BUSINESS OF KDMS BE MANAGED AS AN AGENDA ITEM BY THE FULL BOARD INDEPENDENTLY OR THROUGH ITS COMMITTEE STRUCTURE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE CONTROLLER AND THE CFO OF KING'S DAUGHTERS MEDICAL CENTER. AFTER THIS REVIEW, BUT BEFORE IT IS FILED WITH THE IRS, THE FINAL 990 WILL BE PROVIDED TO THE FULL BOARD OF DIRECTORS THROUGH AN E-MAIL SENT TO EACH BOARD MEMBER. |
| 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 EXECUTIVE COMMITTEE OF KING'S DAUGHTERS BOARD OF TRUSTEES, KDMC SET COMPENSATION FOR THE TEAM MEMBERS, LEADERS AND EXECUTIVES USING A 2016 SULLIVAN COTTER AND ASSOCIATES COMPENSATION REVIEW AS WELL AS REVIEW OF LOCAL AND REGIONAL SALARY INFORMATION. A NEW COMPENSATION STUDY FOR TEAM MEMBERS, LEADERS AND EXECUTIVES WAS NOT PERFORMED IN THE PAST YEAR. THE PRIMARY OBJECTIVE OF KING'S DAUGHTERS COMPENSATION PHILOSOPHY IS TO HAVE COMPENSATION AND BENEFITS SET THAT REFLECTS OTHER SIMILAR INDEPENDENT NOT FOR PROFIT HEALTHCARE SERVICES AS WELL AS REFLECTS THE WORK PERFORMANCE OF THE ORGANIZATION. HOWEVER, SULLIVAN COTTER, AN INDEPENDENT COMPENSATION EXPERT, DID REVIEW 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 XII, LINE 3B: | THE ORGANIZATION AND AFFILIATES RECEIVED FEDERAL FUNDING DURING THE YEAR WHICH REQUIRES A SINGLE AUDIT. THE AUDIT HAS NOT BEEN COMPLETED YET BUT IS SCHEDULED TO BE PREPARED IN ACCORDANCE WITH THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASHLAND HOSPITAL CORPORATION | |||||||||||
| 2201 LEXINGTON AVENUE | ASHLAND | KY | 41101 | 610444716 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | KING'S DAUGHTERS HEALTH SYSTEM | 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 MEDICAL LOGISTICS INC | |||||||||||
| 425 22ND STREET | ASHLAND | KY | 41101 | 264736971 | MEDICAL TRANSPORT | 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 | 0 | N/A | |
| PORTSMOUTH HOSPITAL CORPORATION | |||||||||||
| 1901 ARGONNE AVENUE | PORTSMOUTH | OH | 45662 | 453215312 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | KING'S DAUGHTERS HEALTH SYSTEM | 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 | |
| KENTUCKY HEART INSTITUTE INC | |||||||||||
| 2201 LEXINGTON AVENUE | ASHLAND | KY | 41101 | 611255904 | PHYSICIANS | KY | 501(C)(3) | LINE 10 | ASHLAND HOSPITAL CORPORATION | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND MEDICAL PROPERTIES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 LEXINGTON AVE | AddressLine1Txt |
| City | ASHLAND | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 41101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611079090 | EIN |
| Primary Activities | RENTALS | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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