2014-08-15T08:03:10-05:00 2013-09-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-10-01 611386016 ASHLAND NURSING HOME CORP ASHL 6063241414 2500 STATE ROUTE 5 ASHLAND KY 41102 AUTUMN MCFANN 6063241414 2014-08-13 1 JULIUS C GREEN CPA JD P00350393 2159722352 2012 2015-11-30 17:44:51Z KINGSBROOK LIFECARE CENTER KRISTIE WHITLATCH 2201 LEXINGTON AVENUE ASHLAND KY 41101 15126117 0 X WWW.KINGSBROOK-LIFECARE.COM X 2002 KY PROVIDE QUALITY CARE TO INDIVIDUALS NEEDING SHORT-TERM REHAB AND/OR LONG-TERM HEALTHCARE. 8 5 367 60 0 0 0 0 13419109 15020791 2441 3806 110669 101520 13532219 15126117 2500 2500 0 0 7872360 7328225 0 0 0 5236515 6694552 13111375 14025277 420844 1100840 12963030 13174633 1142336 1522104 11820694 11652529 OUR MISSION IS TO MEET THE NEEDS OF RESIDENTS AT VARIOUS LEVELS OF CARE INCLUDING SHORT-TERM REHAB AND LONG-TERM HEALTHCARE. 0 0 12410933 2500 15020791 KINGSBROOK PROVIDES QUALITY CARE TO PATIENTS, MEETING THE NEEDS AND DESIRES OF RESIDENTS AT VARIOUS LEVELS OF CARE, INCLUDING SHORT-TERM AND LONG-TERM CARE. KINGSBROOK IS A 147-BED NURSING FACILITY WHICH PROVIDES SKILLED NURSING SERVICES AND REHABILITATION THERAPY TO RESIDENTS DESIRING TO RETURN HOME FROM AN ACUTE CARE HOSPITAL STAY. KINGSBROOK ALSO PROVIDES NURSING SERVICES AND CARE FOR RESIDENTS ON A LONG-TERM BASIS. 12410933 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 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 1 0 1 367 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X DAVID THOMAS DIRECTOR OF FINANCE 6063241414 2500 STATE ROUTE 5 ASHLAND KY 41102 DAVID JONES 0.30 6.50 X 0 0 0 WILLIE MCCULLOUGH 0.30 0.00 X 0 0 0 DR FLOYD PARIS 0.30 0.00 X 0 0 0 PHILIP FIORET MD 1.00 49.00 X 0 764484 140538 EB LOWMAN II 1.00 0.00 X X 0 0 0 FRED JACKSON 1.00 49.00 X X 0 5238125 32860 PAUL MCDOWELL 1.00 49.00 X X 0 544194 32357 SHERYL MAHANEY 1.00 49.00 X X 0 419810 135314 KRISTIE WHITLATCH 1.00 49.00 X 0 563857 170827 JEFF TREASURE 1.00 49.00 X X 0 0 0 TOM BURNETTE 0.30 1.00 X 0 0 0 ARTHUR MOORE 40.00 0.00 X 122342 0 0 122342 7530470 511896 1 0 1 0 FUNCTIONAL PATHWAYS INC 614 MABRY HOOD ROAD KNOXVILLE TN 30368 THERAPY CONTRACTING SERVICES 1736852 MEDCARE PHARMACY 350 ARISTOCRAT DRIVE FLORENCE KY 41042 PHARMACEUTICALS 758468 MAY CONTRACTING 12354 VIRGINIA BLVD ASHLAND KY 41102 CONSTRUCTION CONTRACTING SERVICES 220251 3 NET PATIENT SERVICE REVENUE 623000 15020791 15020791 15020791 3806 3806 CAFETERIA/LAUNDRY SERVICES 722210 55460 55460 BEAUTY/BARBER SHOP 812900 29682 29682 VENDING COMMISSION/REBATES 812300 1892 1892 14486 14486 101520 15126117 15020791 0 105326 X 2500 2500 5936339 5164615 771724 953457 829508 123949 438429 381433 56996 30000 26100 3900 7202 6266 936 4294 3736 558 2243997 1952277 291720 23454 20405 3049 47159 41028 6131 42600 37062 5538 425153 369883 55270 18959 16494 2465 3960 3445 515 230994 200965 30029 713791 620998 92793 77841 67722 10119 SUPPLIES 1032509 898283 134226 PHARMACY 825585 825585 BAD DEBT EXPENSE 398795 398795 PROVIDER TAX 313804 313804 254455 230029 24426 14025277 12410933 1614344 0 553187 1291927 1903513 1698815 20828 30701 58979 67469 82961 78967 16026750 7841594 8521964 8185156 1821598 1821598 12963030 13174633 898890 1173347 243446 348757 1142336 1522104 X 11820694 11652529 11820694 11652529 12963030 13174633 X 1100840 -1269005 X 0 1 X 1 0 X X X 0 0 0 ASHLAND HOSPITAL CORP DBA KING'S DAUGHTERS MEDICAL CENTER 610444716 3 1 1 0 1 0 0 0 0 0 0 0 0 0 1 4294 4294 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF DUES ARE PAID TO THE FOLLOWING: KY ASSOCIATION OF HEALTH CARE FACILITIES $3,934 THE AMERICAN HEALTHCARE SERVICES ASSOCIATION $218 KY ASSOCIATION OF HOMES AND SERVICES FOR THE AGING $142 348396 348396 12632681 5998568 6634113 2261214 1383477 877737 784459 459549 324910 8185156 NURSING HOME BED LICENSES 1819300 GOODWILL - PHARMACY 2298 1821598 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 263698 DUE TO KING'S DAUGHTERS MEDICAL CENTER 85059 348757 X 14727322 -398795 -398795 15126117 0 15126117 13626481 0 13626481 398795 398795 14025276 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE MEDICAL CENTER, KHF, KBNH, CDC, KHI, KDMT, KDMS, KDHF, AND PHC 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON F/S -398,795. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON F/S 398,795. X 0 1 0 1 0 0 0 0 0 0 0 PHILIP FIORET MD 0 451682 0 187905 0 124897 0 116679 0 23859 0 905022 0 86441 FRED JACKSON 0 831137 0 216673 0 4190315 0 14000 0 18860 0 5270985 0 3355889 PAUL MCDOWELL 0 285691 0 170293 0 88210 0 11250 0 21107 0 576551 0 69899 SHERYL MAHANEY 0 219538 0 136622 0 63650 0 110337 0 24977 0 555124 0 48202 KRISTIE WHITLATCH 0 350327 0 154240 0 59290 0 149850 0 20977 0 734684 0 45374 PART I, LINE 1A GROSS UP PAYMENTS: PAUL MCDOWELL $3,084 (100% TAXABLE), SHERYL MAHANEY $6,434 (100% TAXABLE). PART I, LINE 1B THE GROSS UPS ARE APPROVED BY THE CEO FOR THE VICE PRESIDENTS. PART I, LINE 3 COMPENSATION FOR THE CEO IS DETERMINED BY ASHLAND HOSPITAL CORPORATION (RELATED ORGANIZATION) USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY/STUDY AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: PAUL MCDOWELL $69,899 SHERYL MAHANEY $48,202 KRISTIE WHITLATCH $45,374 FRED JACKSON $4,117,216 THE CEO AND 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. IN ADDITION, FRED JACKSON WAS PROVIDED WITH A LUMP SUM SUPPLEMENTAL RETIREMENT BENEFIT SINCE HE WAS STILL EMPLOYED AT AGE 62. THE LUMP SUM PAYMENT, WHEN COMBINED WITH ALL OTHER RETIREMENT BENEFITS,WAS ESTIMATED TO PRODUCE A TARGET RETIREMENT INCOME REPLACEMENT EQUAL TO A PERCENTAGE OF FRED JACKSON'S FINAL AVERAGE PAY COMMENCING AT AGE 62. FORM 990, PART VI, SECTION A, LINE 6 ASHLAND HOSPITAL CORPORATION D/B/A KING'S DAUGHTERS MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF ASHLAND NURSING HOME CORPORATION. ASHLAND HOSPITAL CORPORATION, A 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTERGRATED HEALTHCARE DELIVERY SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A ASHLAND HOSPITAL CORPORATION ELECTS THE BOARD MEMBERS OF ASHLAND NURSING HOME CORPORATION ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 11 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 USING BOARD EFFECTS SOFTWARE. AN E-MAIL WITH A LINK TO THE POSTING WILL BE SENT TO EACH BOARD MEMBER ONCE THE REPORT HAS BEEN POSTED. FORM 990, PART VI, SECTION B, LINE 12C ANY EMPLOYEE, MANAGER, OR OFFICER WHO REGULARLY INFLUENCES OR MAKES DECISIONS INVOLVING THE EXPENDITURE OF FACILITY FUNDS SHALL SIGN A CONFLICT OF INTEREST STATEMENT. THE FORM SHALL BE REVIEWED YEARLY AND SHALL BE FILED IN THE HUMAN RESOURCES OFFICE. WHEN AN EMPLOYEE HAS REPORTED A POTENTIAL OR ACTUAL CONFLICT OF INTEREST TO THE IMMEDIATE SUPERVISOR, THE RESPONSIBLE MANAGER AND THE ADMINISTRATOR SHALL BE NOTIFIED OF ALL FACTS PERTAINING TO ANY POTENTIAL TRANSACTIONS. IF IT IS DETERMINED THAT A CONFLICT DOES EXIST, THEN THE EMPLOYEES SHALL BE REMOVED FROM ANY PART OF THE DECISION-MAKING PROCESS, AND SHALL HAVE NO ROLE IN THE INSTANCE WHERE THE CONFLICT OF INTEREST EXISTS. THE EMPLOYEE'S IMMEDIATE SUPERVISOR SHALL ASSUME OR ASSIGN THE AUTHORITY TO ACT ON BEHALF OF THE EMPLOYEE IN ALL ACTIONS INVOLVING THE AREA OF CONFLICT. FAILURE TO REPORT CONFLICTS OF INTEREST IS A DIRECT VIOLATION OF KINGSBROOK'S POLICY AND WILL RESULT IN DISCIPLINARY ACTION. WHEN A MANAGER OF THE FACILITY REPORTS A POTENTIAL CONFLICT, THE MANAGER SHALL REMOVE HIMSELF/HERSELF FROM ANY DISCUSSION OR VOTING REGARDING THE POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPARABILITY DATA IS USED FOR SALARY ADJUSTMENTS. THE HUMAN RESOURCE DEPARTMENT INITIATES THE ANNUAL EVALUATION AND THE ADMINISTRATOR APPROVES ALL ADJUSTMENTS OF KEY EMPLOYEES. THE GOVERNING BODY APPROVES SALARY ADJUSTMENTS OF THE ADMINISTRATOR. THE PROCESS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONSOLIDATED QUARTERLY FINANCIAL STATEMENTS AND AUDIT REPORT CAN BE ACCESSED AT HTTP://EMMA.MSRB.ORG (ELECTRONIC MUNICIPAL MARKET ACCESS). GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 52,277. MANAGEMENT AND GENERAL EXPENSES 291,720. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 343,997. PHYSICAL THERAPY FEES: PROGRAM SERVICE EXPENSES 1,900,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,900,000. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PARTIAL RETURN OF INVESTMENT TO AFFILIATE -1,269,005. ASHLAND HOSPITAL CORPORATION 2201 LEXINGTON AVE ASHLAND KY 41101 610444716 HEALTHCARE KY 501(C)(3) 3 KING'S DAUGHTERS HEALTH SYSTEM 0 KENTUCKY MEDICAL LOGISTICS INC (DBA KINGS DAUGHTERS TRANS) 425 22ND STREET ASHLAND KY 41101 264736971 MEDICAL TRANSPORT KY 501(C)(3) 9 ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS HEALTH SYSTEM 2201 LEXINGTON AVE ASHLAND KY 41101 274553836 HEALTHCARE KY 501(C)(3) 11-II N/A 0 PORTSMOUTH HOSPITAL CORP 2201 LEXINGTON AVE ASHLAND KY 41101 453215312 HEALTHCARE KY 501(C)(3) 3 ASHLAND HOSPITAL CORPORATION 0 KENTUCKY HEART FOUNDATION 2201 LEXINGTON AVE ASHLAND KY 41101 260791997 MEDICAL RESEARCH KY 501(C)(3) 7 ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS HEALTH FOUNDATION INC 2201 LEXINGTON AVE ASHLAND KY 41101 611035701 FUNDRAISING KY 501(C)(3) 11-III-FI ASHLAND HOSPITAL CORPORATION 0 CHILD DEVELOPMENT CENTER CORPORATION 2201 LEXINGTON AVE ASHLAND KY 41101 010560598 DAYCARE KY 501(C)(3) 11-I ASHLAND HOSPITAL CORPORATION 0 KING'S DAUGHTERS MEDICAL SPECIALTIES INC 2201 LEXINGTON AVE ASHLAND KY 41101 264183569 PHYSICIANS KY 501(C)(3) 9 ASHLAND HOSPITAL CORPORATION 0 KENTUCKY HEART INSTITUTE 2201 LEXINGTON AVE ASHLAND KY 41101 611255904 PHYSICIANS KY 501(C)(3) 9 ASHLAND HOSPITAL CORPORATION 0 ASHLAND MEDICAL PROPERTIES INC 2201 LEXINGTON AVE 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