2014-11-13T14:35:29-07:00 2014-03-31 990 2013-04-01 610712406 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION MOUN 6066334823 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 Teresa Fleming Chief Financial Officer 6066334823 2014-11-13 2013 2015-11-30 17:44:51Z LM Mike Caudill 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 23918882 0 X www.mchcky.com X 1972 KY Provide primary and specialty medical/dental care to the medically underserved/uninsured population of Southeastern Kentucky 15 15 299 0 4469664 5214857 18109442 18536792 12922 10610 146264 156623 22738292 23918882 0 0 0 0 15205888 15018232 0 0 46173 7962611 8123679 23168499 23141911 -430207 776971 14735541 13542535 5734742 3764765 9000799 9777770 Provide primary and specialty medical/dental care services to the medically underserved/uninsured population of Southeastern Kentucky 0 0 18745882 4854982 18543894 Patient Care/General Other: Mountain Comprehensive Health Corporation's mission states: MCHC will use its resources to meet the healthcare needs of its service area population. In calendar year 2013, MCHC provided medical and dental care to 26,739 individual patients. 0 0 0 18745882 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 22 0 1 299 1 0 0 0 0 0 0 X 15 15 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Mountain Comprehensive Health Corporation 6066334823 PO Box 40 226 Medical Plaza Lane Whitesburg KY 41858 JoAnne Shepherd Board Member 1 0 X 0 0 0 Danny Boggs Board Member- Chairman 1 0 X 0 0 0 Brenda Brandenburg Board Member 1 0 X 0 0 0 Arthur Ozz Jackson Board Member-Vice-Chairman 1 0 X 0 0 0 Tommye Banks Board Member 1 0 X 0 0 0 Cathie Day Board Member 1 0 X 0 0 0 Edgar Grubb Board Member- Treasurer 1 0 X 0 0 0 Janet Tucker Board Member- Secretary 1 0 X 0 0 0 Matilda Parks Board Member 1 0 X 0 0 0 Mary Ann Sparks Board Member 1 0 X 0 0 0 Tom Hammonds Board Memeber 1 0 X 0 0 0 Winston Meade Board Member 1 0 X 0 0 0 Deanna Richmond Board Member 1 0 X 0 0 0 Harold Kelly Jr Board Member 1 0 X 0 0 0 Lana Mullins Board Member 1 0 X 0 0 0 Phillip Hampton Chief Operating Officer 40 0 X 108772 0 10916 Teresa Fleming Chief Financial Officer 40 0 X 74894 0 8466 L M Mike Caudill Chief Executive Officer 40 0 X 185289 0 12850 Van Breeding MD Physician MD 40 0 X 1201063 0 21038 Mahmood Alam MD Physician Pulmonologist 40 0 X 390429 0 18961 Estate of Brian Banks MD Physician 40 0 X 299492 0 7372 Fares Khater MD Physician 40 0 X 372181 0 9663 April Hall Slone Physician 40 0 X 285946 0 6441 2918066 0 95707 22 1 1 0 Pikeville Medical Center 911 Bypass Rd Pikeville KY 41501 Cardiology Physician Group 341826 Quality Systems Inc PO Box 809390 Chicago IL 60680 Billing Services 841984 Lewis Brothers Inc 4847 Left Fork Maces Creek Rd Viper KY 41774 General Contractor 289465 3 0 0 0 0 4854982 359875 359875 5214857 Medicaid 621400 6137629 6137629 0 0 Medicare 621400 4670052 4670052 0 0 CI/UMWA 621400 3344803 3344803 0 0 Patient Fees 621400 1393409 1393409 0 0 2990899 2990899 0 0 18536792 10610 10610 0 0 0 0 0 0 0 0 0 0 156623 0 0 0 156623 0 156623 156623 0 0 0 0 0 0 23918882 18704025 0 0 380914 361868 19046 12338378 10455246 1860143 22989 300809 233426 67383 1213019 1006885 201996 4138 785112 662892 122220 7100 7100 52386 52386 97042 11060 85982 3759678 3665862 93816 198855 198855 54713 24038 30675 128426 52572 75854 47220 24986 22234 919498 803160 116338 70114 45483 24631 Consulting and contractual services 1328094 463810 864284 0 Repairs & maintenance 583569 500004 83565 0 Utilities 402904 250580 152324 0 Licenses/dues/membership/recruitment 256827 227963 28864 0 217253 119060 98193 23141911 18745882 4349856 46173 120589 508361 1104932 1114514 822000 361059 3145399 2827510 0 0 0 0 0 0 444000 285741 202964 201623 17284368 9040641 8895657 8243727 14735541 13542535 2982585 1985285 847742 368428 1797278 1244280 107137 166772 5734742 3764765 X 7968486 8737712 1032313 1040058 0 0 9000799 9777770 14735541 13542535 776971 0 0 0 0 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 273000 0 273000 8341938 0 4519290 3822648 1815043 0 983309 831734 6285895 0 3405418 2880477 568492 0 132624 435868 8243727 Interest Payable 33098 Unemployment tax payable 22597 Payroll taxes payable 65942 Retirement payable 45135 166772 23918882 0 0 0 0 0 23918882 0 0 0 23918882 23141911 0 0 0 0 0 23141911 0 0 0 23141911 X 0 0 0 1 0 0 0 0 0 L M Mike Caudill Chief Executive Officer 179000 0 557 0 12632 0 0 0 -6900 0 185289 0 181375 0 Van Breeding MD Physician MD 398077 0 741062 0 75298 0 0 0 -13372 0 1201065 0 925148 0 Mahmood Alam MD Physician Pulmonologist 325000 0 78690 0 24 0 0 0 -13286 0 390428 0 384736 0 Estate of Brian Banks MD Physician 242307 0 25562 0 39299 0 0 0 -7676 0 299492 0 316792 0 Fares Khater MD Physician 245000 0 127802 0 22 0 0 0 -643 0 372181 0 364287 0 April Hall Slone Physician 209282 0 62529 0 15000 0 0 0 -865 0 285946 0 0 0 Schedule J, Part I, Line 5 Some of our providers have compensation packages which include incentives based on clinic collections, hospital and nursing home collections or charges. Baker Properties LLC Brother to CEO 16800 rental of apartment and parking space 0 X 1 359875 FMV 0 0 0 0 Schedule M, Part I, Line 20 Drugs and supplies were donated to us by Direct Relief International to help low income, underinsured, uninsured, or indigent patients when able. Form 990, Part VI, Section A, Line 2 The CEO and the owner of Baker Properties LLC, Dr. Nathan Wade Baker, MD OB/GYn are brothers. Form 990, Part VI, Section A, Line 6 Mountain Comprehensive Health Corporation is a non profit corporation. We are a 330e grantee with 501(c)(3) status. Our governing board is comprised of board members who are consumers of our clinic an are members of the community. Form 990, Part VI, Section A, Line 7a The Board of Directors has a membership committee who nominates any new members ro be elected by the full Board of Directors. Form 990, Part VI, Section A, Line 7b The Board of Directors approves all grants, budgets, and policies for the Corporation. The Board is also responsible for hiring the Chief Executive Officer. Form 990, Part VI, Section B, Line 11b The 990 is prepared by the Director of Financial Affairs and the Chief Financial Officer. It is then presented to the Chief Executive Officer and Chief Operating Officer for review. After approval by officers, the 990 is available for the Board of Directors to review. Once reviewed, the Board members will approve the 990 to be submitted. Form 990, Part VI, Section B, Line 12c We are monitored throughout the year by our funding sources and additionally we have internal monitoring performed by our Corporate Compliance Officer. Form 990, Part VI, Section B, Line 15 The Chief Executive Officer handles all provider contracts and also establishes wages based on experience and local comparable wages. The CEO's contract is reviewed and approved by the Board of Directors. All providers are on different contact terms and are reviewed annually. Form 990, Part VI, Section C, Line 19 The 990, supporting financial statements, governing documents, and conflict of interest policies are available upon request.