2018-05-15T14:09:55-05:00 2017-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 106 W VINE STREET SUITE 600 LEXINGTON KY 40507 990 2016-07-01 610945743 KENTUCKY MEDICAL SERVICES FOUNDATION INC KENT 8592577910 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 DR MARCUS E RANDALL PRESIDENT 8592577910 2018-05-15 1 LEIGH MCKEE P00169845 8592552341 2016 2022-09-23 18:48:47Z CARRIE A CASSIS 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 358210145 0 X N/A X 1980 KY SUPPORTING THE UNIVERSITY OF KY SO IT MAY ACHIEVE ITS GOALS IN HEALTHCARE 26 26 231 0 0 0 0 0 315031569 348562535 224162 238763 11182538 9398815 326438269 358200113 1104261 1340217 0 0 7324382 8739363 0 0 0 315422809 350035303 323851452 360114883 2586817 -1914770 194926266 194624198 158830003 160442705 36096263 34181493 SEE SCHEDULE O 0 0 323421467 1340217 357859077 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. 323421467 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 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 1 183 0 1 231 1 0 0 0 0 0 0 0 0 0 0 X 26 26 0 0 0 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 ANDREW PEARSON MD DIRECTOR 1.00 X 0 583552 68108 BERNARD BOULANGER MD DIRECTOR 1.00 X 0 134861 12302 CARMELL WALLACE MD DIRECTOR 1.00 X 0 397811 49131 DARRELL JENNINGS MD DIRECTOR 1.00 X 0 446635 55175 DARREN JOHNSON MD DIRECTOR 1.00 X 0 750097 81239 DONNA GRIGSBY DIRECTOR 1.00 X 0 231109 26222 DAVID MOLITERNO MD DIRECTOR 1.00 X 0 829252 87142 EDWIN BOWE MD DIRECTOR 1.00 X 0 651852 73335 JAY GRIDER DIRECTOR 1.00 X 0 521793 48320 ELIZABETH OATES MD DIRECTOR 1.00 X 0 681385 75535 FREDERICK C DE BEER MD DIRECTOR 1.00 X 0 723527 86973 JOSEPH ZWISCHENBERGER MD DIRECTOR 1.00 X 0 911032 98683 KEVIN PEARCE MD DIRECTOR 1.00 X 0 341193 44724 LARRY CARY MD DIRECTOR 1.00 X 0 249496 28047 LARRY GOLDSTEIN MD DIRECTOR 1.00 X 0 452310 50936 LON HAYS MD DIRECTOR 1.00 X 0 375522 43048 LOUIS BEZOLD DIRECTOR 1.00 X 0 115393 15072 MARCUS RANDALL MD DIRECTOR 1.00 X 0 718194 78364 MICHAEL KARPF MD DIRECTOR 1.00 X 0 1123707 366789 MURRY CLARK DIRECTOR 1.00 X 0 461118 162552 PATRICK MCGRATH MD DIRECTOR 1.00 X 0 582112 59757 PHILIP CHANG DIRECTOR 1.00 X 0 531732 58547 PHILIP TIBBS MD DIRECTOR 1.00 X 0 1203220 121300 RALEIGH JONES MD DIRECTOR 1.00 X 0 578079 61627 ROGER HUMPHRIES MD DIRECTOR 1.00 X 0 597777 55467 SCOTT STEVENS MD DIRECTOR 1.00 X 0 392892 45689 SHAWN CAUDILL MD DIRECTOR 1.00 X 0 295383 39972 SHEILA SANDERS MD DIRECTOR 1.00 X 0 143090 17301 STEPHEN STRUP MD DIRECTOR 1.00 X 0 601214 64655 SUSAN MCDOWELL DO DIRECTOR 1.00 X 0 434713 47183 WENDY HANSEN MD DIRECTOR 1.00 X 0 577043 75809 SCOTTIE DAY DIRECTOR 1.00 X 0 374532 46385 JOHN ROTH DIRECTOR 1.00 X 0 429519 48541 ROBERT GAISER DIRECTOR 1.00 X 0 192958 23264 ROBERT DIPAOLA DIRECTOR 1.00 X 0 456709 56272 CRAIG COLLINS DIRECTOR 1.00 X 0 465512 46517 MORDIE EDELSTEIN DIRECTOR 1.00 X 0 313710 39034 CARRIE A CASSIS EXECUTIVE DIRECTOR 40.00 X 201477 0 19593 PEGGY SUSAN HALCOMB DIRECTOR OF BILLING OPERAT 40.00 X 355533 0 26500 DEBBIE FRYMAN MANAGER OF INSURANCE FOLLOW-UP 40.00 X 208884 0 19651 KATERINA MOLINA DIRECTOR OF FINANCE & ACCO 40.00 X 178712 0 16051 PATRICIA MICHALSKI MANAGER OF ACCOUNTS PAYABLE 40.00 X 163512 0 15391 JULIE FLOYD DIRECTOR OF REVENUE 40.00 X 142587 0 14258 1250705 18870034 2570461 15 0 1 0 DELOITTE CONSULTING LP PO BOX 844717 DALLAS TX 75284 CONSULTING SERVICES 3847079 APPALACHIAN HEART CENTER 200 MEDICAL CENTER DR HAZARD KY 41701 PHYSICIAN SERVICES 744383 IVEY MECHANICAL COMPANY LLC PO BOX 610 KOSCIUSKO MS 39090 REPAIR & MAINT. SERVICES 626328 SHEPPARD MULLIN RICHTER & HAMPTON 333 SOUTH HOPE ST 43RD FL LOS ANGELES CA 90071 PROFESSIONAL SERVICES 613004 SMS CONSULTING HEALTHCARE GROUP LLC 2804 SAGE WOOD DR NEWTON SQUARE PA 19073 CONSULTING SERVICES 523705 11 CLINIC SERVICE FEES 561000 343594560 343594560 RENT FROM SUPPORTED ORGANIZATION 531120 4967975 4967975 348562535 238420 238420 109944 7671 102273 102273 102273 2704 2361 343 343 343 HONORARIUM & OTHER MISC INCOME 900099 9296542 9296542 9296542 358200113 357859077 0 341036 1340217 1340217 215524 215524 6089362 6089362 999837 999837 511278 511278 923362 923362 516305 516305 94729 94729 57722 57722 3296870 3296870 1983672 1983672 3914425 3914425 3695801 3695801 6200571 6200571 UK PHYSICIANS' SALARIES 165108915 165108915 UK STAFF SALARIES & FRI 76360305 76360305 BAD DEBTS 36720082 36720082 PROFESSIONAL DEVELOPMEN 22156148 22156148 29929758 21735800 8193958 360114883 323421467 36693416 0 52120956 30027867 46751974 46124631 953841 1125228 83428 128865210 31216203 81903205 97649007 13129033 19614037 67257 0 194926266 194624198 7767266 6216093 19670012 45966769 43938463 105095968 90618137 158830003 160442705 X 36096263 34181493 36096263 34181493 194926266 194624198 -1914770 0 X X 0 1 X 1 0 X X X 1 UNIVERSITY OF KENTUCKY 616001218 6 1 360114884 0 1 360114884 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, 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 DIRETORS (THESE POSITIONS ARE THE DEAN AND CHAIR OF EACH CLINICAL DEPARTMENT); OTHER DIRECTORS ARE ELECTED BY THE FACULTY OF THE UK COLLEGE OF MEDICINE. 2066767 2066767 98451544 15260344 83191200 10580316 8448162 2132154 17766583 7507697 10258886 97649007 DUE TO UNIVERSITY OF KENTUCKY 20618860 DUE TO UNIVERSITY OF KENTUCKY MALPRACTICE FUND 19940008 DUE TO COLLEGE OF MEDICINE DEPARTMENTS 48967062 DUE TO THIRD PARTY PAYERS 1092207 90618137 1 TUITION SUPPORT FOR DEPENDENTS OF UK FACULTY MEMBERS 123 1340217 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 ANDREW PEARSON MD DIRECTOR 0 580972 0 0 0 2580 0 54967 0 13141 0 651660 0 0 CARMELL WALLACE MD DIRECTOR 0 390191 0 0 0 7620 0 35333 0 13798 0 446942 0 0 DARRELL JENNINGS MD DIRECTOR 0 442675 0 0 0 3960 0 41500 0 13675 0 501810 0 0 DARREN JOHNSON MD DIRECTOR 0 726533 0 0 0 23564 0 68633 0 12606 0 831336 0 0 DONNA GRIGSBY DIRECTOR 0 217437 0 0 0 13672 0 19633 0 6589 0 257331 0 0 DAVID MOLITERNO MD DIRECTOR 0 805412 0 0 0 23840 0 72800 0 14342 0 916394 0 0 EDWIN BOWE MD DIRECTOR 0 644232 0 0 0 7620 0 56553 0 16782 0 725187 0 0 JAY GRIDER DIRECTOR 0 520893 0 0 0 900 0 37015 0 11305 0 570113 0 0 ELIZABETH OATES MD DIRECTOR 0 666333 0 0 0 15052 0 60333 0 15202 0 756920 0 0 FREDERICK C DE BEER MD DIRECTOR 0 715907 0 0 0 7620 0 72047 0 14926 0 810500 0 0 JOSEPH ZWISCHENBERGER MD DIRECTOR 0 907072 0 0 0 3960 0 82000 0 16683 0 1009715 0 0 KEVIN PEARCE MD DIRECTOR 0 337233 0 0 0 3960 0 31834 0 12890 0 385917 0 0 LARRY CARY MD DIRECTOR 0 248956 0 0 0 540 0 22065 0 5982 0 277543 0 0 LARRY GOLDSTEIN MD DIRECTOR 0 448350 0 0 0 3960 0 42000 0 8936 0 503246 0 0 LON HAYS MD DIRECTOR 0 372942 0 0 0 2580 0 34667 0 8381 0 418570 0 0 MARCUS RANDALL MD DIRECTOR 0 714234 0 0 0 3960 0 64333 0 14031 0 796558 0 0 MICHAEL KARPF MD DIRECTOR 0 1109938 0 0 0 13769 0 340206 0 26583 0 1490496 0 0 MURRY CLARK DIRECTOR 0 459294 0 0 0 1824 0 40408 0 122144 0 623670 0 0 PATRICK MCGRATH MD DIRECTOR 0 578152 0 0 0 3960 0 50233 0 9524 0 641869 0 0 PHILIP CHANG DIRECTOR 0 530206 0 0 0 1526 0 48566 0 9981 0 590279 0 0 PHILIP TIBBS MD DIRECTOR 0 1195600 0 0 0 7620 0 112000 0 9300 0 1324520 0 0 RALEIGH JONES MD DIRECTOR 0 574119 0 0 0 3960 0 51900 0 9727 0 639706 0 0 ROGER HUMPHRIES MD DIRECTOR 0 574213 0 0 0 23564 0 45333 0 10134 0 653244 0 0 SCOTT STEVENS MD DIRECTOR 0 379220 0 0 0 13672 0 36329 0 9360 0 438581 0 0 SHAWN CAUDILL MD DIRECTOR 0 292803 0 0 0 2580 0 28233 0 11739 0 335355 0 0 SHEILA SANDERS MD DIRECTOR 0 130618 0 0 0 12472 0 11200 0 6101 0 160391 0 0 STEPHEN STRUP MD DIRECTOR 0 598634 0 0 0 2580 0 53842 0 10813 0 665869 0 0 SUSAN MCDOWELL DO DIRECTOR 0 433333 0 0 0 1380 0 40334 0 6849 0 481896 0 0 WENDY HANSEN MD DIRECTOR 0 573083 0 0 0 3960 0 53333 0 22476 0 652852 0 0 SCOTTIE DAY DIRECTOR 0 373932 0 0 0 600 0 35250 0 11135 0 420917 0 0 JOHN ROTH DIRECTOR 0 428619 0 0 0 900 0 37173 0 11368 0 478060 0 0 ROBERT GAISER DIRECTOR 0 192383 0 0 0 575 0 18978 0 4286 0 216222 0 0 ROBERT DIPAOLA DIRECTOR 0 452174 0 0 0 4535 0 45218 0 11054 0 512981 0 0 CRAIG COLLINS DIRECTOR 0 465064 0 0 0 448 0 41197 0 5320 0 512029 0 0 MORDIE EDELSTEIN DIRECTOR 0 313710 0 0 0 0 0 28000 0 11034 0 352744 0 0 CARRIE A CASSIS EXECUTIVE DIRECTOR 195931 0 0 0 5546 0 19593 0 0 0 221070 0 0 0 PEGGY SUSAN HALCOMB DIRECTOR OF BILLING OPERAT 355533 0 0 0 0 0 26500 0 0 0 382033 0 0 0 DEBBIE FRYMAN MANAGER OF INSURANCE FOLLOW-UP 208884 0 0 0 0 0 19651 0 0 0 228535 0 0 0 KATERINA MOLINA DIRECTOR OF FINANCE & ACCO 178712 0 0 0 0 0 16051 0 0 0 194763 0 0 0 PATRICIA MICHALSKI MANAGER OF ACCOUNTS PAYABLE 163512 0 0 0 0 0 15391 0 0 0 178903 0 0 0 JULIE FLOYD DIRECTOR OF REVENUE 142587 0 0 0 0 0 14258 0 0 0 156845 0 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 10000000 203524 9796476 2017 0 0 1 0 B 9750000 1005074 8744926 2017 0 0 1 0 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 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 ELAINA GRUBER CHILD OF EXECUTIVE DIRECTOR 11320 SCHOLARSHIP BLAKE DIPAOLA CHILD OF BOARD MEMBER 5660 SCHOLARSHIP LAUREN JOHNSON CHILD OF BOARD MEMBER 11320 SCHOLARSHIP BENJAMIN MOLITERNO CHILD OF BOARD MEMBER 5546 SCHOLARSHIP NATHANIEL MOLITERNO CHILD OF BOARD MEMBER 16866 SCHOLARSHIP CECILIA WINFREY CHILD OF BOARD MEMBER 11320 SCHOLARSHIP CHARLES GRIGSBY CHILD OF BOARD MEMBER 5446 SCHOLARSHIP JONATHAN HUMPHRIES CHILD OF BOARD MEMBER 5660 SCHOLARSHIP MADELINE HUMPHRIES CHILD OF BOARD MEMBER 5660 SCHOLARSHIP PAUL PEARSON CHILD OF BOARD MEMBER 5660 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 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