2013-11-14T09:38:07-07:00 2013-03-31 990 2012-04-01 610712406 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION MOUN 6066334823 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 Teresa Fleming 6066334823 2013-11-15 2012 2016-02-25 16:41:14Z LM Mike Caudill 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 22738292 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 15 313 0 0 0 4771308 4469664 16542704 18109442 22435 12922 145112 146264 21481559 22738292 0 0 0 0 15363502 15205888 0 0 48816 7153871 7962611 22517373 23168499 -1035814 -430207 14499637 14735541 5068631 5734742 9431006 9000799 Provide primary and specialty medical/dental care services to the medically underserved/uninsured population of Southeastern Kentucky 0 0 18381695 4318774 18109442 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 2012, MCHC provided medical and dental care to 27,917 individual patients. 0 0 0 18381695 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 27 0 1 313 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 1 X 0 0 0 Danny Boggs 1 X 0 0 0 Brenda Brandenburg 1 X 0 0 0 Arthur Ozz Jackson 1 X 0 0 0 Tommye Banks 1 X 0 0 0 Cathie Day 1 X 0 0 0 Edgar Grubb 1 X 0 0 0 Janet Tucker 1 X 0 0 0 Matilda Parks 1 X 0 0 0 Mary Ann Sparks 1 X 0 0 0 Tom Hammonds 1 X 0 0 0 Winston Meade 1 X 0 0 0 Deanna Richmond 1 X 0 0 0 Harold Kelly Jr 1 X 0 0 0 Lana Mullins 1 X 0 0 0 Phillip Hampton 40 X 108377 0 11002 Teresa Fleming 40 X 72356 0 7670 L M Mike Caudill 40 X 181375 0 13183 Van Breeding MD 40 X 925147 0 21021 Mahmood Alam MD 40 X 384735 0 19444 Brian Banks MD 40 X 316793 0 0 Fares Khater MD 40 X 364287 0 9558 Nathan W Baker MD 40 X 543035 0 15132 2896105 0 97010 23 1 1 0 Pikeville Medical Center 911 Bypass Rd Pikeville KY 41501 Cardiology Physician Group 321393 Quality Systems Inc PO Box 809390 Chicago IL 60680 Billing Services 378375 2 0 0 0 0 4318774 150890 150890 4469664 Medicaid 621400 5233060 5233060 0 0 Medicare 621400 4581536 4581536 0 0 CI/UMWA 621400 4474770 4474770 0 0 Patient Fee 621400 1099911 1099911 0 0 2720165 2720165 0 0 18109442 12922 12922 0 0 0 0 0 0 0 0 0 0 118200 0 0 0 118200 0 118200 118200 0 0 0 0 0 28064 28064 0 0 28064 22738292 18268628 0 0 0 0 0 0 0 0 0 0 379488 0 360514 18974 12514229 10479752 2009165 25312 0 0 0 0 277438 192025 85413 0 1285567 936632 344405 4530 749166 586475 162691 0 25889 0 25889 0 34291 0 34291 0 75413 3815 71598 3550943 3415564 135379 198295 198295 41885 12801 29084 0 114639 55918 58721 66693 41647 25046 915304 804354 110950 85051 59629 25422 Consulting and contracting services 1506267 607479 898788 0 Repairs & maintenance 698542 575965 122577 0 Utilities 382217 236799 145418 0 Licenses/dues/membership/recruitment 157117 124699 32418 110065 49846 60219 0 23168499 18381695 4737988 48816 293792 120589 1092392 1104932 176040 822000 3124928 3145399 0 0 0 0 0 0 201028 444000 162541 202964 17826532 8930875 9448916 8895657 14499637 14735541 2560059 2982585 179492 847742 2214792 1797278 114288 107137 5068631 5734742 X 8408849 7968486 1022157 1032313 0 0 9431006 9000799 14499637 14735541 -430207 0 0 0 0 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 273000 0 273000 8338128 0 4242268 4095860 1801343 0 916486 884857 7169256 0 3647570 3521686 244805 0 124551 120254 8895657 Interest Payable 34407 Unemployment tax payable 23448 Payroll taxes payable 25590 Retirement payable 23692 107137 22738292 0 0 0 0 0 22738292 0 0 0 22738292 23168499 0 0 0 0 0 23168499 0 0 0 23168499 X 0 0 0 1 0 0 0 0 0 L M Mike Caudill 179000 0 572 0 7588 0 0 0 -5785 0 181375 0 179621 0 Van Breeding MD 377164 0 465405 0 95307 0 0 0 -12728 0 925148 0 866823 0 Nathan W Baker MD 265904 0 131167 0 152370 0 0 0 -6405 0 543036 0 721564 0 Mahmood Alam MD 325000 0 72464 0 0 0 0 0 -12728 0 384736 0 362780 0 Brian Banks MD 300000 0 25572 0 0 0 0 0 -8780 0 316792 0 316633 0 Fares Khater MD 245000 0 119884 0 0 0 0 0 -597 0 364287 0 357667 0 SchJ_P01_S00_L05 Schedule J, Part I, Line 5 Some of the providers have compensation packages based on a combination of incentive based on either hopsital or nursing home charges or collections. Baker Properties LLC Owner was a highly compensated employee 16800 rental of apartment and parking space 0 N Wade Baker MD Brother to CEO 543035 salary and other compensation 0 X 1 150890 FMV of items 0 0 0 0 SchM_P01_S00_L33 Schedule M, Part I, Line 33 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. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 The CEO and one of our highest compensated employees Dr. Nathan Wade Baker, MD OG/GYN are brothers F990_P06_S0A_L06 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. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a The Board of Directors has a membership committee who nominates any new members to be elected by the full Board of Directors. F990_P06_S0A_L07b 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. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The 990 is prepared by the Chief Financial Officer and Comptroller. It is then presented to the Chief Executve Officer and the Chief Operating Officer for review. After approval by officers, the 990 is presented to the Board of Director's Finance Committee for review. The Finance Committee will then make a recommendation in the board meeting for the approval of the 990 to be submitted. Board members will vote on approval of the 990. F990_P06_S0B_L12c 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. F990_P06_S0B_L15 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 contract terms and are reviewed annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The 990, supporting financial statements, governing documents, and conflict of interest policies are available upon request.