2013-09-20T12:34:08-05:00 2012-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 106 W VINE STREET SUITE 600 LEXINGTON KY 40507 990 2011-07-01 610945743 KENTUCKY MEDICAL SERVICES FOUNDATION INC KENT 8592577910 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 DARRELL A GRIFFITH 8592577910 2013-09-17 1 LEIGH MCKEE P00169845 8592552341 2011 2016-02-24 21:20:13Z EMERY WILSON MD 2333 ALUMNI PARK PLAZA NO 200 LEXINGTON KY 40517 223858383 0 X N/A X 1980 KY SUPPORTING THE UNIVERSITY OF KY SO IT MAY ACHIEVE ITS GOALS IN HEALTHCARE 24 24 201 0 -116141 -116141 0 0 203252236 220437041 -31545 214346 592816 2452069 203813507 223103456 741046 868992 0 0 10596036 9976255 0 0 0 194868978 212398198 206206060 223243445 -2392553 -139989 113994488 124213754 97167297 107696838 16827191 16516916 SEE SCHEDULE O 0 0 202414547 868992 220437041 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. 202414547 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 208 0 1 201 1 1 1 0 0 0 0 0 0 0 0 0 X 24 24 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X DARRELL A GRIFFITH 8592577910 2333 ALUMNI PARK PLAZA SUITE 200 LEXINGTON KY 40517 WENDY HANSEN 1.00 X 0 517175 0 RALEIGH O JONES 1.00 X 0 416071 0 JAMSHED KANGA 1.00 X 0 207988 0 EDWIN A BOWE 1.00 X 0 549181 0 PHILLIP A TIBBS 1.00 X 0 1083757 0 MICHAEL L CIBULL 1.00 X 0 296173 0 WILLEM DE VILLIERS 1.00 X 0 330437 0 FREDERICK C DE BEER 1.00 X 0 622814 0 PAUL BACHNER 1.00 X 0 391771 0 DAVID MOLITERNO 1.00 X 0 728000 0 REGINA FRAGNETO 1.00 X 0 381780 0 LON R HAYES 1.00 X 0 315600 0 ROGER L HUMPHRIES 1.00 X 0 329736 0 DARREN L JOHNSON 1.00 X 0 598438 0 MARCUS RANDALL 1.00 X 0 660162 0 MARY ELIZABETH OATES 1.00 X 0 564286 0 JOSEPH ZWISCHENBERGER 1.00 X 0 810109 0 GERALD V KLIM 1.00 X 0 309399 0 PAUL A PEARSON 1.00 X 0 444285 0 KEVIN PEARCE 1.00 X 0 248580 0 CURTIS CARY 1.00 X 0 184584 0 JOSEPH R BERGER 1.00 X 0 461929 0 SHEILA FERGUSON PLUMLEE SANDERS 1.00 X 0 94679 0 CARMEL WALLACE 1.00 X 0 244454 0 DARRELL A GRIFFITH 45.00 X 378372 0 37837 PEGGY S HALCOMB 45.00 X 228282 0 22828 JAMES M TILLETT 45.00 X 121451 0 12145 JUDY B BENSON 45.00 X 128790 0 12879 RHONDA S HALE 45.00 X 105435 0 10544 962330 10791388 96233 6 0 1 0 KURT SALMON ASSOC PO BOX 930916 ATLANTA GA 31193 CONSULTING 745745 HARRODSBURG ANESTHESIA 425 SHAWNEE RUN ROAD HARRODSBURG KY 40330 MEDICAL SERVICES 344829 STITES & HARBISON PLLC 250 EAST MAIN ST LEXINGTON KY 40507 LEGAL SERVICES 292032 RIVER CITY ANESTHESIA 20 W OWL CREEK RD CAMPBELLSVILLE KY 42718 MEDICAL SERVICES 226283 JULIA M GOODMAN BRADLEY 709 EVERST COURT LEXINGTON KY 40515 TRANSCRIPTION 203723 8 CLINIC SERVICE FEES 561000 217585657 217585657 RENT FROM SUPPORTED OR 531120 2851384 2851384 220437041 99988 99988 109447 286599 -177152 -177152 -116141 -61011 582686 468328 114358 114358 114358 HONORARIUM & OTHER MIS 900099 2629221 2629221 2629221 223103456 220437041 -116141 2782556 X 868992 868992 416210 416210 6882154 6882154 717808 717808 684295 684295 1275788 1275788 388680 388680 95513 95513 117468 117468 1521281 1521281 801122 801122 1060898 1060898 1756628 1756628 1987495 1649460 338035 UK STAFF SALARIES & FRI 57862676 57862676 UK PHYSICIANS' SALARIES 57347173 57347173 PROFESSIONAL DEVELOPMEN 35201684 35106519 95165 BAD DEBTS 24358291 24358291 29899289 25221436 4677853 223243445 202414547 20828898 0 38580797 44024751 19830994 25595463 1643003 1477472 51506639 14160187 37853578 37346452 15370419 15258280 340571 170286 375126 341050 113994488 124213754 3537231 3730511 24313117 23190138 69316949 80776189 97167297 107696838 X 16827191 16516916 16827191 16516916 113994488 124213754 X -139989 -170286 X X 0 1 1 X 0 X X X X 0 0 0 UNIVERSITY OF KENTUCKY 616001218 2 1 1 1 223243297 1 223243297 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: 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. 2066767 2066767 38699373 7645908 31053465 10498314 6485016 4013298 242185 29263 212922 37346452 DUE TO UNIV. OF KENTUCKY 9182408 DUE TO UNIV. OF KENTUCKY MALPRACTICE FUND 15930079 DUE TO COLL. OF MEDICINE DEPARTMENTS 52383609 REFUNDS PAYABLE 326965 DUE TO THIRD PARTY PAYERS 2953128 80776189 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: KMSF IS A NON-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME. KMSF HAS EVALUATED THE TAX POSITIONS TAKEN ON ALL INCOME TAX RETURNS THAT REMAIN OPEN TO EXAMINATION BY THE RESPECTIVE TAXING AUTHORITIES. KMSF DOES NOT BELIEVE THAT THERE ARE ANY UNCERTAIN POSITIONS ON THOSE RETURNS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS (GENERALLY 2011-2009). 1 UNDERGRADUATE SCHOLARSHIPS FOR DEPENDENTS OF UK FACULTY MEMBERS 97 868992 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: KMSF REQUIRES TRANSCRIPTS AND PROOF OF ENROLLMENT EVERY SEMESTER TO MONITOR APPROPRIATE USE OF SCHOLARSHIP FUNDS. X X 0 0 0 0 0 0 0 0 0 WENDY HANSEN 0 494760 0 0 0 22415 0 0 0 0 0 517175 0 0 RALEIGH O JONES 0 416071 0 0 0 0 0 0 0 0 0 416071 0 0 JAMSHED KANGA 0 207988 0 0 0 0 0 0 0 0 0 207988 0 0 EDWIN A BOWE 0 549181 0 0 0 0 0 0 0 0 0 549181 0 0 PHILLIP A TIBBS 0 1083757 0 0 0 0 0 0 0 0 0 1083757 0 0 MICHAEL L CIBULL 0 296173 0 0 0 0 0 0 0 0 0 296173 0 0 WILLEM DE VILLIERS 0 330437 0 0 0 0 0 0 0 0 0 330437 0 0 FREDERICK C DE BEER 0 622814 0 0 0 0 0 0 0 0 0 622814 0 0 PAUL BACHNER 0 391771 0 0 0 0 0 0 0 0 0 391771 0 0 DAVID MOLITERNO 0 728000 0 0 0 0 0 0 0 0 0 728000 0 0 REGINA FRAGNETO 0 381780 0 0 0 0 0 0 0 0 0 381780 0 0 LON R HAYES 0 315600 0 0 0 0 0 0 0 0 0 315600 0 0 ROGER L HUMPHRIES 0 329736 0 0 0 0 0 0 0 0 0 329736 0 0 DARREN L JOHNSON 0 598438 0 0 0 0 0 0 0 0 0 598438 0 0 MARCUS RANDALL 0 655732 0 0 0 4430 0 0 0 0 0 660162 0 0 MARY ELIZABETH OATES 0 564286 0 0 0 0 0 0 0 0 0 564286 0 0 JOSEPH ZWISCHENBERGER 0 810109 0 0 0 0 0 0 0 0 0 810109 0 0 GERALD V KLIM 0 309399 0 0 0 0 0 0 0 0 0 309399 0 0 PAUL A PEARSON 0 444285 0 0 0 0 0 0 0 0 0 444285 0 0 KEVIN PEARCE 0 239455 0 0 0 9125 0 0 0 0 0 248580 0 0 CURTIS CARY 0 184584 0 0 0 0 0 0 0 0 0 184584 0 0 JOSEPH R BERGER 0 448639 0 0 0 13290 0 0 0 0 0 461929 0 0 CARMEL WALLACE 0 244454 0 0 0 0 0 0 0 0 0 244454 0 0 DARRELL A GRIFFITH 378372 0 0 0 0 0 0 0 37837 0 416209 0 0 0 PEGGY S HALCOMB 228282 0 0 0 0 0 0 0 22828 0 251110 0 0 0 MAEVE MCGRATH DAUGHTER OF BOARD MEMBER 9390 SCHOLARSHIP ERICA GRIFFITH DAUGHTER OF KEY EMPLOYEE 4695 SCHOLARSHIP CHRISTINA PEARCE DAUGHTER OF BOARD MEMBER 9390 SCHOLARSHIP ELLEN TALBOT SANDERS DAUGHTER OF BOARD MEMBER 4695 SCHOLARSHIP ANNE CHRISTINE HANSEN DAUGHTER OF BOARD MEMBER 4695 SCHOLARSHIP ELIZABETH ROSE HANSEN DAUGHTER OF BOARD MEMBER 4695 SCHOLARSHIP AMELIA BISCOMB HANSEN DAUGHTER OF BOARD MEMBER 9125 SCHOLARSHIP LUCAS ROY HANSEN SON OF BOARD MEMBER 9125 SCHOLARSHIP KATHRYN ANN HAYS DAUGHTER OF BOARD MEMBER 4695 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 A, LINE 4 THE ORGANIZATION BY LAWS WERE AMENDED TO CHANGE THE BOARD MEETING SCHEDULE FROM MONTHLY TO BI-MONTHLY, AND THE FINANCE AND AUDIT COMMITTEES WERE CHANGED FROM BEING TWO SEPARATE COMMITTEES TO ONE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11 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 AVAILABLE UPON REQUEST AND BOARD/MANAGEMENT APPROVAL ALL OTHER FUNCTIONAL EXPENSES FORM 990, PART X, LINE 24E CAPITAL & CURRENT OPERATING EXPENSE: PROGRAM SERVICE EXPENSES 14,344,210. MANAGEMENT AND GENERAL EXPENSES 1,083,088. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,427,298. ACADEMIC ENRICHMENT: PROGRAM SERVICE EXPENSES 5,451,488. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,451,488. MISCELLANEOUS EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,594,765. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,594,765. UK PHYSICIANS' FRINGE BENEFITS: PROGRAM SERVICE EXPENSES 2,300,192. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,300,192. KY CLINIC CENTRAL: PROGRAM SERVICE EXPENSES 2,212,366. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,212,366. HOUSESTAFF: PROGRAM SERVICE EXPENSES 654,642. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 654,642. KY CLINIC SOUTH EXPENSES: PROGRAM SERVICE EXPENSES 258,538. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 258,538. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: IMPAIRMENT LOSS -170,286. TOTAL TO FORM 990, PART XI, LINE 5: -170,286. FORM 990, PART XI, 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. DESCRIPTION OF ORGANIZATION MISSION 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 0 0 0 0 1 0 1 0 0 0 0 0 1 0