ST CLAIRE MEDICAL CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST CLAIRE MEDICAL CENTER INC (EIN 61-0605336)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201321339349303292
- Schema version
- 2011v1.5
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T14:18:01-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE AMERICAN SQUARE 2200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610605336 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CLAIRE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STCL | NameControl |
| Phone | 6067836500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 MEDICAL CIRCLE | AddressLine1 |
| City | MOREHEAD | City |
| State | KY | State |
| ZIP Code | 40351 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GR JONES JR | Name |
| Title | VICE PRESIDENT, FINANCE | Title |
| Phone | 6067836500 | Phone |
| Date Signed | 2013-05-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARRIE A MERRILL CPA | Name |
| PTIN | P00832283 | PTIN |
| Phone | 3176334705 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STCLAIRE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARK J NEFF | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 MEDICAL CIRCLE | AddressLine1 |
| City | MOREHEAD | City |
| State | KY | State |
| ZIP Code | 40351 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 130349858 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ST-CLAIRE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1963 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1614 | TotalNbrEmployees |
| Total Nbr Volunteers | 15 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1387266 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3221780 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 133822171 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 115452780 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 682002 | InvestmentIncomePriorYear |
| Investment Income Current Year | 639482 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2655892 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5061559 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 138547331 | TotalRevenuePriorYear |
| Total Revenue Current Year | 124375601 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 27376 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 32257 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 72769139 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 79794382 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 64322255 | OtherExpensePriorYear |
| Other Expenses Current Year | 46881560 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 137118770 | TotalExpensesPriorYear |
| Total Expenses Current Year | 126708199 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1428561 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2332598 | RevenuesLessExpensesCY |
| Total Assets BOY | 87852726 | TotalAssetsBOY |
| Total Assets EOY | 82813781 | TotalAssetsEOY |
| Total Liabilities BOY | 43628149 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 41967203 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 44224577 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 40846578 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF ST. CLAIRE REGIONAL MEDICAL CENTER IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KENTUCKY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 78536578 | Expense |
| Grants | 25886 | Grants |
| Revenue | 84028585 | Revenue |
| Description | ST. CLAIRE REGIONAL MEDICAL CENTER SERVES AS A 159-BED REGIONAL REFERRAL CENTER AND IS THE LARGEST RURAL HOSPITAL IN NORTHEASTERN KENTUCKY. SPONSORED BY THE SISTERS OF NOTRE DAME IN COVINGTON, KENTUCKY, ST. CLAIRE REGIONAL SERVES AS A NOT-FOR-PROFIT HOSPITAL. WITH NEARLY 1,500 EMPLOYEES, ST. CLAIRE REGIONAL IS THE SECOND-LARGEST EMPLOYER IN THE REGION. THE MEDICAL CENTER IS AN ESTABLISHED TRAINING SITE FOR THE UNIVERSITY OF KENTUCKY SCHOOL OF MEDICINES PHYSICIAN RESIDENCY PROGRAMS. ST. CLAIRE REGIONAL'S MEDICAL STAFF IS COMPRISED OF OVER 100 PHYSICIANS AND SURGEONS, REPRESENTING 31 MEDICAL AND SURGICAL SPECIALTIES.CONTINUE ON SCHEDULE O.IN ADDITION TO PROVIDING SERVICES AT THE MEDICAL CENTER'S MAIN CAMPUS IN MOREHEAD, ST. CLAIRE REGIONAL'S OPERATIONS CONSIST OF A ST. CLAIRE REGIONAL OUTPATIENT CENTER, CAVE RUN SURGICAL SPECIALISTS, MOREHEAD MEDICAL SPECIALISTS, FIVE COMPREHENSIVE FAMILY MEDICINE CLINICS AS WELL AS A FAMILY MEDICINE EXPRESS, A REGIONAL TELEMEDICINE SYSTEM, AND AN EIGHT-COUNTY HOME CARE SERVICE REGION COMPRISED OF HOME HEALTH, HOSPICE & PALLIATIVE CARE, AND HOME MEDICAL EQUIPMENT. ADDITIONALLY, ST. CLAIRE REGIONAL PARTNERS WITH THE UNIVERSITY OF KENTUCKY MEDICAL CENTER TO OFFER SERVICES THROUGH THE KENTUCKY CLINIC MOREHEAD CANCER TREATMENT CENTERST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10056772 | Expense |
| Grants | 0 | Grants |
| Revenue | 11050221 | Revenue |
| Description | HOME CAREST. CLAIRE HOMECARE IS A SERVICE PROVIDED BY ST. CLAIRE REGIONAL MEDICAL CENTER OFFERING A FULL RANGE OF HOME CARE SERVICES FOR PATIENTS TO RECOVER IN THEIR OWN HOMES. AS ONE OF THE LARGEST PROGRAMS IN THE STATE, ST. CLAIRE HOMECARE IS A COMPREHENSIVE IN-HOME SERVICE SYSTEM COMPRISED OF HOME HEALTH, HOSPICE, AND HOME MEDICAL EQUIPMENT. OUR COMMITTED STAFF INCLUDES NURSES, THERAPISTS AND AIDES WORKING AS A TEAM TO HELP MEET VIRTUALLY EVERY HOME CARE NEED. CONTINUE ON SCHEDULE O.THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) ACCREDITS BOTH ST. CLAIRE REGIONAL MEDICAL CENTER AND ST. CLAIRE HOMECARE. ST. CLAIRE HOMECARE IS MEDICARE-CERTIFIED AND LICENSED IN THE STATE OF KENTUCKY. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6390613 | Expense |
| Grants | 0 | Grants |
| Revenue | 6234538 | Revenue |
| Description | FAMILY MEDICINEST. CLAIRE REGIONAL FAMILY MEDICINE IS A SYSTEM OF FIVE FAMILY MEDICINE CLINICS THAT PROVIDE A FULL RANGE OF PREVENTIVE AND THERAPEUTIC HEALTHCARE SERVICES, FROM NEWBORN TO GERIATRICS, INCLUDING OBSTETRICAL SERVICES. THE ST. CLAIRE REGIONAL FAMILY MEDICINE MEDICAL STAFF INCLUDES BOARD CERTIFIED FAMILY AND INTERNAL MEDICINE PHYSICIANS AS WELL AS ADVANCED REGISTERED NURSE PRACTITIONERS, CERTIFIED PHYSICIAN ASSISTANTS, CERTIFIED NURSE MIDWIVES, AND FAMILY MEDICINE RESIDENTS AFFILIATED WITH THE UNIVERSITY OF KENTUCKY. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 16664586 | Expense |
| Grants | 0 | Grants |
| Revenue | 14469014 | Revenue |
| Description | PHYSICIAN SERVICESST. CLAIRE REGIONAL OFFERS A COMPREHENSIVE ARRAY OF PHYSICIAN SERVICES. SPECIALTIES EMPLOYED BY ST. CLAIRE INCLUDE RADIOLOGY, EMERGENCY MEDICINE, ONCOLOGY, NEPHROLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY, AND CARDIOLOGY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 16664586 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 14469014 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 111648549 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 78 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1614 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | KY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM BARTON DIRECTOR OF FINANCIAL SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6067836587 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 MEDICAL CIRCLE | AddressLine1 |
| City | MOREHEAD | City |
| State | KY | State |
| ZIP Code | 40351 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| ROBERT G STEVENS | ||||||||
| BOARD CHAIR | 2.00 | X | 0 | 0 | 0 | |||
| SISTER MARY LUANN BENDER | ||||||||
| BOARD VICE CHAIR | 2.00 | X | 0 | 0 | 0 | |||
| GARREN COLVIN | ||||||||
| BOARD TREASURER | 2.00 | X | 0 | 0 | 0 | |||
| JOHN NORTHCUT | ||||||||
| BOARD SECRETARY | 2.00 | X | 0 | 0 | 0 | |||
| SISTER MARY MARGARET DROEGE | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DAN MARKWELL | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| SAMUEL MATHENY MD | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| SISTER MARLA MONAHAN | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| O THOMAS NEWCOMB MD | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| GLEN TEAGER | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| BETH PATRICK | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| EWELL SCOTT MD | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| RICHARD TAPKE JR | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| AMY J CONLEY-SALLAZ MD | ||||||||
| NON-VOTING MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| MARK NEFF | ||||||||
| CEO | 50.00 | X | 322215 | 0 | 64214 | X | ||
| SONNY JONES | ||||||||
| VP FINANCIAL SERVICES, CFO | 50.00 | 167550 | 0 | 31807 | X | |||
| GREG BAUSCH | ||||||||
| VP, REGIONAL SERVICES | 50.00 | 154491 | 0 | 16900 | X | |||
| DR KIM WILLIAMS | ||||||||
| VP, SPECIAL PROJECTS | 50.00 | 227961 | 0 | 60975 | X | |||
| DR WILL MELAHN | ||||||||
| VP, MEDICAL DIRECTOR | 50.00 | 196131 | 0 | 39960 | X | |||
| DR WILLIAM LEWIS | ||||||||
| RADIOLOGIST | 40.00 | 650875 | 0 | 60631 | X | |||
| DR CRAIG BUTLER | ||||||||
| RADIOLOGIST | 40.00 | 587053 | 0 | 67631 | X | |||
| DR STEPHEN WILLIAMS | ||||||||
| RADIOLOGIST | 40.00 | 646515 | 0 | 52766 | X | |||
| DR CHARLES CROUSE | ||||||||
| ORTHOPEDIC SURGEON | 40.00 | 639004 | 0 | 62958 | X | |||
| DR MOHAMMAD ANWAR | ||||||||
| RADIOLOGIST | 40.00 | 351389 | 0 | 68124 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3943184 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 525966 | TotalOtherCompensation |
| Number Individuals GT100 K | 94 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARAMARK | |||||
| ONE SERVICE MASTER WAY | DOWNERS GROVE | IL | 60515 | CONTRACT SERVICE | 1885653 |
| PROFESSIONAL MEDICAL BILLING | |||||
| 7619 W JEFFERSON BLVD | FORT WAYNE | IN | 46804 | BILLING SERVICE | 612160 |
| KMSF-PATH FAC SERVICES | |||||
| 138 LEADER AVENUE | LEXINGTON | KY | 40506 | PHYSICIAN SERVICES | 593178 |
| PRECYSE SOLUTIONS | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 352461736 | TRANSCRIPTION SERVICE | 524849 |
| MEDICAL DOCTORS ASSOCIATES | |||||
| PO BOX 277185 | ATLANTA | GA | 303847185 | CONTRACT PHYSICIAN STAFFING | 407592 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| Government Grants | 966185 | GovernmentGrants |
| All Other Contributions | 2255595 | AllOtherContributions |
| Noncash Contributions | 81000 | NoncashContributions |
| Total Contributions | 3221780 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621110 | 102748667 | 102748667 |
| HOME CARE REVENUE | 621610 | 12704113 | 12704113 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 115452780 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 395259 | TotalRevenueColumn |
| Exclusion | $395,259 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 329578 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 329578 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 329578 | TotalRevenueColumn |
| Related Or Exempt Function Income | 329578 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5943322 | Securities |
| Other | 17628 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5716727 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 226595 | Securities |
| Other | 17628 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 244223 | TotalRevenueColumn |
| Exclusion | $244,223 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 150598 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 24275 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 126323 | TotalRevenueColumn |
| Exclusion | $126,323 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 146397 | GrossSalesOfInventory |
| Cost Of Goods Sold | 233255 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -86858 | TotalRevenueColumn |
| Exclusion | -$86,858 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| EHR INCENTIVE REVENUE | 900099 | 1120431 | $1,120,431 |
| CAFETERIA INCOME | 900099 | 744061 | $744,061 |
| CATERING | 900099 | 228219 | $228,219 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2599805 | TotalRevenueColumn |
| Exclusion | $2,599,805 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4692516 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 124375601 | TotalRevenueColumn |
| Related Or Exempt Function Income | 115782358 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $5,371,463 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32257 | Total |
| Program Services | 32257 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1992578 | Total |
| Program Services | 1811441 | ProgramServices |
| Management And General | 181137 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62660372 | Total |
| Program Services | 57145308 | ProgramServices |
| Management And General | 5515064 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2599353 | Total |
| Program Services | 2370446 | ProgramServices |
| Management And General | 228907 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8563106 | Total |
| Program Services | 7799021 | ProgramServices |
| Management And General | 764085 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3978973 | Total |
| Program Services | 3706753 | ProgramServices |
| Management And General | 272220 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551127 | Total |
| Program Services | 119471 | ProgramServices |
| Management And General | 431656 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80775 | Total |
| Management And General | 80775 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9380491 | Total |
| Program Services | 7720538 | ProgramServices |
| Management And General | 1659953 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 300911 | Total |
| Program Services | 297568 | ProgramServices |
| Management And General | 3343 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19266362 | Total |
| Program Services | 18906031 | ProgramServices |
| Management And General | 360331 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6005269 | Total |
| Program Services | 3729498 | ProgramServices |
| Management And General | 2275771 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171801 | Total |
| Program Services | 133819 | ProgramServices |
| Management And General | 37982 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 324180 | Total |
| Program Services | 301379 | ProgramServices |
| Management And General | 22801 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 657006 | Total |
| Program Services | 1918 | ProgramServices |
| Management And General | 655088 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5665980 | Total |
| Program Services | 5665980 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 792991 | Total |
| Program Services | 719543 | ProgramServices |
| Management And General | 73448 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVIDER TAX | 1512507 | 135073 | 1377434 |
| RECRUITMENT | 610815 | 159780 | 451035 |
| LICENSES & FEES | 501272 | 37462 | 463810 |
| DUES & SUBSCRIPTIONS | 262082 | 68531 | 193551 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 797991 | Total |
| Program Services | 786732 | ProgramServices |
| Management And General | 11259 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126708199 | Total |
| Program Services | 111648549 | ProgramServices |
| Management And General | 15059650 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7913154 | BOY |
| EOY | 10224317 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19587397 | BOY |
| EOY | 14626702 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6667 | BOY |
| EOY | 6668 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 603264 | BOY |
| EOY | 2124524 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2540791 | BOY |
| EOY | 2029437 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 624710 | BOY |
| EOY | 630316 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 90984415 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 56136296 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35718084 | BOY |
| EOY | 34848119 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18119390 | BOY |
| EOY | 15736459 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2739269 | BOY |
| EOY | 2587239 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87852726 | BOY |
| EOY | 82813781 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16216339 | BOY |
| EOY | 17349581 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18678290 | BOY |
| EOY | 17103292 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 717145 | BOY |
| EOY | 841805 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8016375 | BOY |
| EOY | 6672525 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43628149 | BOY |
| EOY | 41967203 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44224577 | BOY |
| EOY | 40184680 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 661898 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44224577 | BOY |
| EOY | 40846578 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87852726 | BOY |
| EOY | 82813781 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2332598 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1045401 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $13,155 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 13155 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | PAY MEMBERSHIP DUES TO TRADE ORGANIZATIONS OF WHICH A PORTION OF THE DUES ARE USED FOR LOBBY EXPENSES BY THE TRADE ORGANIZATIONS. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 0 | BeginningOfYearBalance |
| Contributions | 661898 | Contributions |
| End Of Year Balance | 661898 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 977373 | OtherCostOrOtherBasis |
| Book Value | 977373 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 46724764 | OtherCostOrOtherBasis |
| Depreciation | 28416152 | Depreciation |
| Book Value | 18308612 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 548481 | OtherCostOrOtherBasis |
| Depreciation | 548481 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 42284550 | OtherCostOrOtherBasis |
| Depreciation | 27171663 | Depreciation |
| Book Value | 15112887 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 449247 | OtherCostOrOtherBasis |
| Book Value | 449247 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 34848119 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED SETTLEMENTS PAYABLE | $1,450,000 |
| PROF. LIAB CLAIMS RESERVE | $2,723,599 |
| DEFERRED COMPENSATION | $1,630,041 |
| SWAP AGREEMENT | $868,885 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6672525 | TotalOfAmounts |
| Total Revenue | 124375601 | TotalRevenue |
| Total Expenses | 126708199 | TotalExpenses |
| Excess Or Deficit For Year | -2332598 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -1045401 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -1045401 | TotalAdjustments |
| Excess Or Deficit Per FS | -3377999 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 123587657 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -1045401 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -1045401 | RevenueNotRptdF990 |
| Revenue Subtotal | 124633058 | RevenueSubtotal |
| Other Revenues Not Included | -257457 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -257457 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 124375601 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 126965656 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 257457 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 257457 | ExpensesNotRptdF990 |
| Expenses Subtotal | 126708199 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 126708199 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE OR BY THE PASSAGE OF TIME. INCOME EARNED FROM THE PRINCIPLE AMOUNT IS UNRESTRICTED. THE DONOR-RESTRICTED NET ASSETS ARE TO BE USED FOR CURATIVE TREATMENT AND REHABILITATIVE THERAPY OF PEDIATRIC ILLNESS, DISEASE, OR DEFORMITY. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE MEDICAL CENTER AND RECOGNIZE A TAX LIABILITY IF THE MEDICAL CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE MEDICAL CENTER, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | COST OF GOOD SOLD -233,182. SPECIAL EVENT EXPENSE -24,275. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | COST OF GOODS SOLD 233,182. SPECIAL EVENT EXPENSES 24,275. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | CHARITY GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 129903 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 129903 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 6666 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 3600 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 1521 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 3695 | OtherDirectExpensesEvent1 |
| Name Of Event2 | MYSTERY DINNER THEATER | NameOfEvent2 |
| Gross Receipts Event2 | 20695 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 20695 | GrossRevenueEvent2 |
| Food And Beverage Event2 | 7167 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | 1626 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 150598 | GrossReceiptsTotal |
| Gross Revenue Total Events | 150598 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 6666 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 3600 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 8688 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 5321 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 24275 | DirectExpenseSummaryEvents |
| Net Income Summary | 126323 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7083045 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7083045 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05590 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15938659 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13800530 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2138129 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01690 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23021704 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13800530 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9221174 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07280 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3910600 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3910600 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03090 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3910600 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3910600 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03090 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26932304 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13800530 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13131774 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10370 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $6,159,703 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 32707381 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 34352086 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1644705 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CLAIRE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 MEDICAL CIRCLE DRIVE | AddressLine1 |
| City | MOREHEAD | City |
| State | KY | State |
| ZIP Code | 40391 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Teaching Hospital | X | TeachingHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CLAIRE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 125.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, L7 COL(F): TOTAL BAD DEBT EXPENSE HAS BEEN EXCLUDED FROM THE DENOMINATOR FOR THE PERCENTAGE CALCULATION PER IRS INSTRUCTIONS. HOWEVER, THE BAD DEBT EXPENSE OF $19,433,310 WAS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), DUE TO NEW ACCOUNTING PRONOUNCEMENT, ACCOUNTING STANDARD UPDATE 2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISIONS FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE STATEMENT OF OPERATIONS RATHER THAN AS AN OPERATING EXPENSE. | ||
| PART II: THE ORGANIZATION DOES NOT PROVIDE ANY COMMUNITY BUILDING ACTIVITIES. | ||
| PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 2 FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE MEDICAL CENTER'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE,FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTY THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR THE YEAR ENDED JUNE 30, 2012, THE MEDICAL CENTER INCREASED THE ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS TO INCLUDE 90 PERCENT OF ALL SELF-PAY ACCOUNTS LESS THAN 150 DAYS, AND INCLUDE ALL ACCOUNTS, 150 DAYS AND OLDER, NET OF CONTRACTUAL ALLOWANCES ALREADY TAKEN. THE PREVIOUS ESTIMATE RESERVED A LOWER PERCENTAGE OF SELF-PAY ACCOUNTS AND ALL ACCOUNTS 150 DAYS AND OLDER. THE EFFECT OF THIS CHANGE WAS A DECREASE IN INCOME (LOSS) FROM OPERATIONS OF APPROXIMATELY $3,200,000 FOR 2012. THE JUNE 30, 2012 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $15,190,851 WAS COMPRISED OF $10,600,070 RESERVED FOR SELF-PAY BALANCES AND $4,590,781 RESERVED FOR THIRD-PARTY PAYOR BALANCES.SECTION A. BAD DEBT EXPENSE. LINE 3 EXPLANATION FOR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: BAD DEBT EXPENSE IS RECORDED AS A GROSS AMOUNT ON THE FINANACIAL STATEMENTS. COSTS ASSOCIATED WITH THIS EXPENSE ARE CALCULATED BY USING THE COST TO CHARGE RATIO WITHIN EACH RESPECTIVE DIVISION OF THE MEDICAL CENTER. THE MEDICAL CENTER HAS A FINANCIAL ASSISTANCE POLICY THAT STATES PARTICIPATION IN CHARITY PROGRAM REQUIRES THAT CANDIDATES FULLY COOPERATE. THE MEDICAL CENTER EDUCATES PATIENTS WILL LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE AND PROVIDES ACCESS TO DEDICATED FINANCIAL COUNSELORS DAILY. FOR THIS REASON THE MEDICAL CENTER BELIEVES THAT IT IS ACCURATELY CAPTURING ALL CHARITY CARE DEDUCTIONS ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE UNDER THE ORGANIZATION CHARITY CARE POLICY IS NEGLIGIBLE. | ||
| PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2012 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. | ||
| PART III, LINE 9B: THE MEDICAL CENTER WILL ASSIST ALL PATIENTS AND THEIR RESPONSIBLE PARTY WITH METHODS OF PAYING ACCOUNTS GENERATED AS A RESULT OF NO THIRD PARTY COVERAGE OR BALANCES AFTER INSURANCE PAYMENTS. ACCEPTABLE PAYMENT ARRANGEMENTS ARE REQUESTED IF FULL PAYMENT CANNOT BE MADE. COMPUTER GENERATED STATEMENTS ARE MAILED TO THE RESPONSIBLE PARTY ON A REGULAR SCHEDULE. LETTERS ARE ALSO SENT AS SUPPLEMENT TO THE DATA STATEMENTS TO KEEP THE PATIENT/GUARANTOR INFORMED OF THE STATUS OF THE ACCOUNT. HEALTHCARE FINANCIAL ASSISTANCE WILL BE GRANTED IF THERE ARE NO OTHER RESOURCES AVAILABLE TO THE PATIENT AND THEY HAVE MET THE GUIDELINES AND FURNISHED REQUESTED VERIFICATION. | ||
| PART VI, LINE 2: THE ORGANIZATION ASSESS COMMUNITY NEEDS THROUGH VOLUNTEER BOARDS, COMMUNITY INVOLVEMENT, VOLUNTEERING, AND BOARD SERVICE. | ||
| PART VI, LINE 3: PATIENT FINANCIAL SERVICES' PATIENT ACCESS/REGISTRATION STAFF AND CASHIER ASSIST PATIENTS WITH INFORMING AND EDUCATING PATIENTS ABOUT THEIR ACCOUNTS AND CHARGES. | ||
| PART VI, LINE 4: ST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. | ||
| PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THESE VOLUNTEERS ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ANY SURPLUS FUNDS ARE APPLIED DIRECTLY OR INDIRECTLY TO IMPROVE SERVICES. | ||
| PART VI, LINE 6: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| KY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 5 | NumberOfRecipients |
| Amount Of Cash Grant | 32257 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: HOSPITAL MAKES SCHOLARSHIPS AVAILABLE TO ELIGIBLE PERSONS TO FURTHER HEALTHCARE IN THE COMMUNITY. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK NEFF | |||||||||||||
| 322215 | 0 | 0 | 0 | 0 | 0 | 50750 | 0 | 13464 | 0 | 386429 | 0 | 0 | 0 |
| SONNY JONES | |||||||||||||
| 167550 | 0 | 0 | 0 | 0 | 0 | 24982 | 0 | 6825 | 0 | 199357 | 0 | 0 | 0 |
| GREG BAUSCH | |||||||||||||
| 154491 | 0 | 0 | 0 | 0 | 0 | 7814 | 0 | 9086 | 0 | 171391 | 0 | 0 | 0 |
| DR KIM WILLIAMS | |||||||||||||
| 227961 | 0 | 0 | 0 | 0 | 0 | 50009 | 0 | 10966 | 0 | 288936 | 0 | 0 | 0 |
| DR WILL MELAHN | |||||||||||||
| 196131 | 0 | 0 | 0 | 0 | 0 | 23996 | 0 | 15964 | 0 | 236091 | 0 | 0 | 0 |
| DR WILLIAM LEWIS | |||||||||||||
| 650875 | 0 | 0 | 0 | 0 | 0 | 45250 | 0 | 15381 | 0 | 711506 | 0 | 0 | 0 |
| DR CRAIG BUTLER | |||||||||||||
| 587053 | 0 | 0 | 0 | 0 | 0 | 45250 | 0 | 22381 | 0 | 654684 | 0 | 0 | 0 |
| DR STEPHEN WILLIAMS | |||||||||||||
| 646515 | 0 | 0 | 0 | 0 | 0 | 45250 | 0 | 7516 | 0 | 699281 | 0 | 0 | 0 |
| DR CHARLES CROUSE | |||||||||||||
| 639004 | 0 | 0 | 0 | 0 | 0 | 45250 | 0 | 17708 | 0 | 701962 | 0 | 0 | 0 |
| DR MOHAMMAD ANWAR | |||||||||||||
| 351389 | 0 | 0 | 0 | 0 | 0 | 50750 | 0 | 17374 | 0 | 419513 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|
| ROWAN COUNTY KENTUCKY | ||||||
| 616000882 | 2010-03-22 | 6000000 | PURCHASE AND INSTALL MEDICAL EQUIPMENT | 0 | 0 | 0 |
| ROWAN COUNTY KENTUCKY | ||||||
| 616000882 | 2010-12-22 | 14000000 | AQUIRE, CONSTRUCT, EQUIP FACILITIES/ RETIRE 1994 ISSUANCE | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Other Spent ProceedsOtherSpentProceeds |
|---|---|---|---|---|---|---|---|---|
| 6000000 | 6000000 | 2010 | 0 | 0 | 1 | 1 | ||
| 14000000 | 2334385 | 2011 | 1 | 0 | 1 | 1 | 115000 | 11550615 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 1 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DR CHARLES CROUSE | NamePerson |
| Purpose Of Loan | SIGNING/EDUCATIONAL LOAN BONUS | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $200,000 | OriginalPrincipalAmount |
| Balance Due | 6668 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 6668 | TotalBalanceDue |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 8 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 81000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 1 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | PART I, COLUMN (B): | NUMBER OF CONTRIBUTIONS RECEIVED BY THE HOSPITAL. |
| THIRD PARTY USE: | PART I, LINE 32B: | THE ST. CLAIRE FOUNDATION SHALL RESERVE THE RIGHT TO ACCEPT OR REJECT ALL GIFT OFFERS. THE FINAL DECISION SHALL BE MADE BY THE EXECUTIVE DIRECTOR FOR DEVELOPMENT IN CONSULTATION WITH THE PRESIDENT OF THE ST. CLAIRE REGIONAL MEDICAL CENTER, WHEN APPROPRIATE. HE MAY ALSO REFER A PROPOSED GIFT TO THE FOUNDATION'S EXECUTIVE COMMITTEE FOR THEIR RECOMMENDATION. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE PRESIDENT OF THE SISTERS OF NOTRE DAME OF COVINGTON, KY IS THE PERSON WHO APPOINTS ALL THE DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE CFO AND BY THE ACCOUNTING DEPARTMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | MEMBERS OF THE BOARD OF DIRECTORS, BOARD COMMITTEES, AND MEDICAL CENTER LEADERSHIP SIGN A CONFLICT OF INTEREST STATEMENT ON INITIAL APPOINTMENT OR EMPLOYMENT AND ANNUALLY THEREAFTER. THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE DEPARTMENT HEAD OF BOARD/ADMINISTRATION. THE SCOPE OF THIS POLICY INCLUDES BOARD OF DIRECTORS, BOARD COMMITTEES, ADMINISTRATIVE STAFF, EMPLOYEES, AND MEDICAL STAFF. THE POLICY IS IN PLACE TO AVOID CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS BETWEEN PERSONAL INTERESTS AND ONE'S OFFICIAL RESPONSIBILITIES AND PERFORMANCE OF DUTIES ON BEHALF OF THE MEDICAL CENTER. THE COVERED PERSONS ARE TO AVOID BEING PLACED IN A POSITION FOR PERSONAL PROFIT, EITHER THROUGH MONEY, GOODS, OR INFLUENCE FROM THE CONDUCTING OF MEDICAL CENTER RESPONSIBILITIES. A SELF DISCLOSURE FROM COVERED PERSONS TO THE INTEGRITY OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFUSE FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S COMPENSATION IS ESTABLISHED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND IS BASED ON PERFORMANCE CRITERIA AND ON PUBLISHED MARKET SURVEY COMPARISONS FOR HEALTHCARE INSTITUTIONS SIMILAR IN SIZE AND SCOPE OF OPERATIONS. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO, BASED ON PERFORMANCE CRITERIA, AND PUBLISHED MARKET SURVEY COMPARISONS, AND IS REVIEWED AND BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -1,045,401. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. | OVERSIGHT OF AUDIT |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISTERS OF NOTRE DAME OF COVINGTON KENTUCKY INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 DIXIE HIGHWAY | AddressLine1 |
| City | COVINGTON | City |
| State | KY | State |
| ZIP Code | 41011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | RELIGIOUS ORDER | PrimaryActivities |
| Legal Domicile State | KY | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 1 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLAIRE-FRANCIS HEALTH SERVICES PLLC DBA INFUSION SOLUTIONS | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 MALL ROAD STE 3 | AddressLine1 |
| City | ASHLAND | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311517507 | EIN |
| Primary Activity | HOME INFUSION SERVICES | PrimaryActivity |
| Legal Domicile State | KY | LegalDomicileState |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
| Percentage Ownership | 0.33000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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