BAPTIST HEALTH DEACONESS MADISONVILLE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BAPTIST HEALTH DEACONESS MADISONVILLE INC (EIN 61-0654587)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201213189349301811
Schema version
2011v1.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T09:50:55-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1400 E MAIN ST STE 200 PO BOX 1196AddressLine1
CityBOWLING GREENCity
StateKYState
ZIP Code421021196ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN610654587EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TROVER CLINIC FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% E BERTON WHITAKERInCareOfName
Name ControlTROVNameControl
Phone2708255201Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 HOSPITAL DRIVEAddressLine1
CityMADISONVILLECity
StateKYState
ZIP Code42431ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS MOOREName
TitleCHIEF FINANCIAL OFFICERTitle
Phone2708255201Phone
Date Signed2012-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2707810111Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1TROVER HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonE BERTON WHITAKERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 HOSPITAL DRIVEAddressLine1
CityMADISONVILLECity
StateKYState
ZIP Code42431ZIPCode
FieldValueIRS element (for citing)
Gross Receipts209923377GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.TROVERFOUNDATION.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileKYStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE AN ACUTE CARE HOSPITAL & MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE SERVING RURAL COMMUNITIES IN KENTUCKY. OUR MISSION IS TO PROVIDE EXCELLENT CARE, EVERY TIME.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees2035TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI81826TotalGrossUBI
Net Unrelated Business Txbl Income61820NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2713061ContributionsGrantsPriorYear
Contributions Grants Current Year2092427ContributionsGrantsCurrentYear
Program Service Revenue Prior Year160735893ProgramServiceRevenuePriorYear
Program Service Revenue CY150635633ProgramServiceRevenueCY
Investment Income Prior Year2022953InvestmentIncomePriorYear
Investment Income Current Year1903851InvestmentIncomeCurrentYear
Other Revenue Prior Year26921361OtherRevenuePriorYear
Other Revenue Current Year26718388OtherRevenueCurrentYear
Total Revenue Prior Year192393268TotalRevenuePriorYear
Total Revenue Current Year181350299TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year70919GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY57840GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year102580405SalariesEtcPriorYear
Salaries Etc Current Year94458019SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year92563938OtherExpensePriorYear
Other Expenses Current Year86787797OtherExpensesCurrentYear
Total Expenses Prior Year195215262TotalExpensesPriorYear
Total Expenses Current Year181303656TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2821994RevenuesLessExpensesPriorYear
Revenues Less Expenses CY46643RevenuesLessExpensesCY
Total Assets BOY176817645TotalAssetsBOY
Total Assets EOY179705649TotalAssetsEOY
Total Liabilities BOY53057317TotalLiabilitiesBOY
Total Liabilities EOY55058429TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY123760328NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY124647220NetAssetsOrFundBalancesEOY
Mission DescriptionTO OPERATE AN ACUTE CARE HOSPITAL & A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE SERVING RURAL COMMUNITIES IN KENTUCKY. OUR MISSION IS TO PROVIDE EXCELLENT CARE, EVERY TIME.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense156883817Expense
Grants57840Grants
Revenue173724522Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense156883817TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096256NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2035NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledKYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonE BERTON WHITAKERNamePerson
Telephone Number2708255201TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 HOSPITAL DRIVEAddressLine1
CityMADISONVILLECity
StateKYState
ZIP Code42431ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JANET BERRY
DIRECTOR1.0X000
G RUFFIN CHANDLER
DIRECTOR1.0X000
WILLIAM CORUM
DIRECTOR1.0X000
STEVE COX
DIRECTOR1.0X000
WILLIAM DONAN
DIRECTOR1.0X000
MARK E EASTIN III
DIRECTOR1.0X000
KENT MILLS
DIRECTOR1.0X000
JAMES MINER JR
DIRECTOR / CHAIRMAN1.0X000X
CHARLES ALLEN RUDD JR
DIRECTOR / VICE CHAIRMAN1.0X000X
HEATHER ROY
DIRECTOR1.0X000
BARRY HARDISON MD
DIRECTOR1.0X039401740181
BHASKARAN SREEKUMAR MD
DIRECTOR / PHYSICIAN1.0X000
R LAMONT WOOD MD
DIRECTOR / PHYSICIAN40.0X247984048156
MARK FITZMAURICE MD
DIRECTOR / PHYSICIAN40.0X339516050156
HEATHER RICKETTS MD
DIRECTOR / PHYSICIAN40.0X264291022658
E BERTON WHITAKER
DIRECT/CEO/PRESIDENT/SECRETARY40.0X75208800X
C THOMAS MOORE
CFO / TREASURER / SENIOR VP40.03076660124175X
ROBERT GROVES MD
CHIEF MEDICAL OFFICER40.0194224028244X
STACEY BEAVEN
VP NURSING40.0233993042196X
TIMOTHY DUKES
VP OPERATIONS40.0139707064161X
DAVID LANG
VP HUMAN RESOURCES40.0332505085295X
MOHAN ROA MD
PHYSICIAN40.0425678048156X
JOHN DACOSTA MD
PHYSICIAN40.0704560028169X
WILLIAM LOGAN MD
PHYSICIAN40.0417705050170X
THOMAS STANFIELD MD
PHYSICIAN40.0515351047173X
SCOTT BANUELOS MD
PHYSICIAN40.045701302502X
JACK L HAMMAN MD
PHYSICIAN40.0125886026472X
KAVITA ERICKSON MD
PHYSICIAN40.0234534032421X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5692701TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs394017TotalReportableCompFrmRltdOrgs
Total Other Compensation740285TotalOtherCompensation
Number Individuals GT100 K115NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCKESSON HBOC
PO BOX 98347CHICAGOIL60693COMPUTER SERVICES9404406
ARAMARK CTS INC
12483 COLLECTIONS CTR DRCHICAGOIL60693BIOMEDICAL SERVICES1705330
MUTUAL CREDIT SERVICES
PO BOX 149MADISONVILLEKY42431COLLECTION SERVICES923613
ARUP LABORATORIES
PO BOX 27694SALT LAKE CITYUT84127LAB SERVICES735910
INTERIM PHYSICIANS LLC
PO BOX 411161MST LOUISMO63141PHYSICIAN SERVICES806931
FieldValueIRS element (for citing)
Number Of Contractors GT100 K62NumberOfContractorsGT100K
Government Grants1875229GovernmentGrants
All Other Contributions217198AllOtherContributions
Total Contributions2092427TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE62111014088070614086036820338
HOME HEALTH & HOSPICE62161055851335585133
FAMILY PRACTICE RESIDENCY PROGRAM61160010699371069937
ANESTHESIA PROGRAM611600555843555843
OTHER61160025440142544014
FieldValueIRS element (for citing)
Total Program Service Revenue150635633TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1725472TotalRevenueColumn
Unrelated Business Revenue57089UnrelatedBusinessRevenue
Exclusion$1,668,383ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real377995Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real260027Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real117968Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column117968TotalRevenueColumn
Exclusion$117,968ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities16494743Securities
Other190463Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities16482923Securities
Other23904Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities11820Securities
Other166559Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column178379TotalRevenueColumn
Exclusion$178,379ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory33573062GrossSalesOfInventory
Cost Of Goods Sold11806224CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column21766838TotalRevenueColumn
Related Or Exempt Function Income21766838RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA SALES7222101438633$1,438,633
FITNESS FORMULA900099675376$675,376
GIFT SHOP453220107535$107,535

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2612038TotalRevenueColumn
Related Or Exempt Function Income1342389RelatedOrExemptFunctionIncome
Unrelated Business Revenue4399UnrelatedBusinessRevenue
Exclusion$1,265,250ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4833582TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column181350299TotalRevenueColumn
Related Or Exempt Function Income173724522RelatedOrExemptFunctionIncome
Unrelated Business Revenue81826UnrelatedBusinessRevenue
Exclusion$5,451,524ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total57840Total
Program Services57840ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3856946Total
Program Services2527284ProgramServices
Management And General1329662ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total345371Total
Program Services345371ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total76668642Total
Program Services65702323ProgramServices
Management And General10966319ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2135319Total
Program Services1834815ProgramServices
Management And General300504ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6414922Total
Program Services5464514ProgramServices
Management And General950408ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5036819Total
Program Services4281296ProgramServices
Management And General755523ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total256281Total
Program Services0ProgramServices
Management And General256281ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total118128Total
Program Services0ProgramServices
Management And General118128ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total35666Total
Program Services0ProgramServices
Management And General35666ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total23205075Total
Program Services18819316ProgramServices
Management And General4385759ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total354889Total
Program Services0ProgramServices
Management And General354889ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total19593733Total
Program Services19554546ProgramServices
Management And General39187ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3627734Total
Program Services2539414ProgramServices
Management And General1088320ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3049176Total
Program Services2439341ProgramServices
Management And General609835ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total775662Total
Program Services232698ProgramServices
Management And General542964ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total294105Total
Program Services294105ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total914424Total
Program Services914424ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11700792Total
Program Services10530713ProgramServices
Management And General1170079ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total493555Total
Program Services370166ProgramServices
Management And General123389ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS174477721744777200
PROVIDER TAX EXPENSE2559912255991200
MISCELLANEOUS EXPENSE236089396796713929260

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total181303656Total
Program Services156883817ProgramServices
Management And General24419839ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY13204BOY
EOY12979EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY25018725BOY
EOY31375021EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21318383BOY
EOY20241641EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2857407BOY
EOY7263038EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2188890BOY
EOY2509171EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4192446BOY
EOY3646965EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis238002184LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec178082485LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY66022671BOY
EOY59919699EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY45260511BOY
EOY46397825EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY197769BOY
EOY197679EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9747639BOY
EOY8141631EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY176817645BOY
EOY179705649EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13087257BOY
EOY12740742EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY25780000BOY
EOY25780000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3189517BOY
EOY2989680EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11000543BOY
EOY13548007EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY53057317BOY
EOY55058429EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY123607102BOY
EOY124493660EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY153226BOY
EOY153560EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY123760328BOY
EOY124647220EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY176817645BOY
EOY179705649EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses46643ReconcilationRevenueExpenses
Reconcilation Other Changes840249ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$267DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$41,399OtherActivitiesAmount
Total Lobbying Expenditures IIB41666TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING EXPENSESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationTHE FOUNDATION AND CERTAIN FOUNDATION EMPLOYEES ARE MEMBERS OF VARIOUS ASSOCIATIONS WHICH ATTRIBUTE A PORTION OF DUES TO LOBBYING EXPENSES. THE FOUNDATION HAS DISCLOSED A LOBBYING ALLOCATION OF $41,399 PER FORM 990. THESE ASSOCIATIONS INCLUDE THE AMERICAN HOSPITAL ASSOCIATION, AMERICAN MEDICAL ASSOCIATION, KENTUCKY MEDICAL ASSOCIATION, AS WELL AS VARIOUS OTHERS.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance153226BeginningOfYearBalance
Contributions12778Contributions
Other Expenditures12444OtherExpenditures
End Of Year Balance153560EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance116582BeginningOfYearBalance
Contributions47270Contributions
Other Expenditures10626OtherExpenditures
End Of Year Balance153226EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance82971BeginningOfYearBalance
Contributions100841Contributions
Other Expenditures67230OtherExpenditures
End Of Year Balance116582EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance61949BeginningOfYearBalance
Contributions35600Contributions
Other Expenditures14578OtherExpenditures
End Of Year Balance82971EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3218173OtherCostOrOtherBasis
Book Value3218173BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis66652341OtherCostOrOtherBasis
Depreciation39550729Depreciation
Book Value27101612BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis25967OtherCostOrOtherBasis
Depreciation25967Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis162181927OtherCostOrOtherBasis
Depreciation134862591Depreciation
Book Value27319336BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5923776OtherCostOrOtherBasis
Depreciation3643198Depreciation
Book Value2280578BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings59919699TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
AMOUNTS PAYABLE TO MEDICARE$3,330,038
ACCRUED INTEREST ON BONDS$19,624
ACCRUED SELF-INSURANCE LIABILI$8,429,000
OTHER LIABILITIES$675,179
WORKERS COMPENSATION ACCRUAL$1,094,166
FieldValueIRS element (for citing)
Total Of Amounts13548007TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USE OF ENDOWMENT FUNDSIdentifier
Return ReferenceSCH. D, PART V, LINE 4ReturnReference
ExplanationPATIENT CARE, HOSPICE BEREAVEMENT CAMP, MAHR CANCER CENTER, AND OTHER PATIENT CARE RELATED INITIATIVES.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6604783TotalCommunityBenefitExpense
Direct Offsetting Revenue870486DirectOffsettingRevenue
Net Community Benefit Expense5734297NetCommunityBenefitExpense
Percent Of Total Expense0.03500PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense18865325TotalCommunityBenefitExpense
Direct Offsetting Revenue9225737DirectOffsettingRevenue
Net Community Benefit Expense9639588NetCommunityBenefitExpense
Percent Of Total Expense0.05880PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense25470108TotalCommunityBenefitExpense
Direct Offsetting Revenue10096223DirectOffsettingRevenue
Net Community Benefit Expense15373885NetCommunityBenefitExpense
Percent Of Total Expense0.09380PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense666599TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense666599NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4819297TotalCommunityBenefitExpense
Direct Offsetting Revenue925996DirectOffsettingRevenue
Net Community Benefit Expense3893301NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense4400TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4400NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1085851TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1085851NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6576147TotalCommunityBenefitExpense
Direct Offsetting Revenue925996DirectOffsettingRevenue
Net Community Benefit Expense5650151NetCommunityBenefitExpense
Percent Of Total Expense0.03450PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense32046255TotalCommunityBenefitExpense
Direct Offsetting Revenue11022219DirectOffsettingRevenue
Net Community Benefit Expense21024036NetCommunityBenefitExpense
Percent Of Total Expense0.12830PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2633TotalCommunityBuildingExpense
Net Community Building Expense2633NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2633TotalCommunityBuildingExpense
Net Community Building Expense2633NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$17,447,772BadDebtExpenseAmount
Amount Reimbursed By Medicare59039991AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare60815996CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1776005MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1REGIONAL MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1900 HOSPITAL DRIVEAddressLine1
CityMADISONVILLECity
StateKYState
ZIP Code42431ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Other ReasonXOtherReason
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
TROVER CLINIC
200 CLINIC DRIVEMADISONVILLEKY42431PHYSICIAN OFFICES
REGIONAL MEDICAL CENTER HHA
107 EAST MAIN STREETEARLINGTONKY42410HOME HEALTH AGENCY
THE SPORTS MEDICINE REHABILITATION GROUP
500 CLINIC DRIVEHOPKINSVILLEKY42440REHAB SERVICES
REGIONAL MEDICAL CENTER OF HOPKINS COUNT
900 HOSPITAL DRIVEMADISONVILLEKY42442SKILLED NURSING FACILITY
GREEN RIVER HOSPICE
418 NORTH SCOTT STREETMADISONVILLEKY42431HOSPICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Criteria used to determine eligibilty for discounted carePART I, LINE 3C:PROFILING THE POPULATION TO DETERMINE KEY HEALTH RISK FACTORS THROUGH THE USE OF STATISTICAL DATA AND ANALYSIS OF EMPLOYMENT AND OCCUPATIONAL DISEASE.
Part 1, Column FPART I, LINE 7, COLUMN F:BAD DEBTS INCLUDED IN PART IX, LINE 24 TOTALED $17,447,772. THIS AMOUNT HAS BEEN REMOVED FROM TOTAL EXPENSES CALCULATED IN COLUMN F ON SCHEDULE H, PART I.
Bad Debt FootnotePART III, LINE 4:THE AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A FOOTNOTE WHICH DESCRIBES BAD DEBT.
Collection PracticesPART III, LINE 9B:ONCE A PATIENT HAS BEEN DETERMINED TO QUALIFY FOR CHARITY CARE, THE PATIENT IS CLASSIFIED AS SUCH FOR THREE MONTHS. IF THE PATIENT RETURNS FOR SERVICES WITHIN THREE MONTHS, THEY ARE AUTOMATICALLY QUALIFIED FOR CHARITY CARE, WHICH IMPROVES THEIR ACCESS TO HEALTHCARE SERVICES.
Needs AssessmentSchedule H, Part VI, Line 2THE ORGANIZATION ASSESSES THE HEALTH CARE NEED OF THE COMMUNITY BY PROFILING THE POPULATION TO DETERMINE KEY HEALTH RISK FACTORS THROUGH THE USE OF STATISTICAL DATA AND ANALYSIS OF EMPLOYMENT AND OCCUPATIONAL DISEASE. THE FOUNDATION IDENTIFIES UNINSURED PATIENTS BY REQUESTING INSURANCE INFORMATION AT THE TIME OF THE APPOINTMENT REQUEST. IF THE PATIENT HAS NO INSURANCE BENEFITS, APPOINTMENT SCHEDULING STAFF WILL INFORM THE PATIENT OF THE TROVER SELF-PAY POLICY. NEW PATIENTS WHO ARE UNABLE TO PAY AT THE TIME OF SERVICE MUST BE REFERRED TO FINANCIAL COUNSELING BEFORE AN APPOINTMENT CAN BE SCHEDULED. DURING FINANCIAL COUNSELING, PATIENTS WILL BE INFORMED OF THE KENTUCKY PHYSICIANS CARE PROGRAM (KPC) IN COORDINATION WITH THE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM. THEY WILL ALSO BE COUNSELED ON POTENTIAL ELIGIBILITY FOR MEDICAID AND DISABILITY PROGRAMS. PATIENTS WILL ALSO BE ADVISED OF THE TROVER FINANCIAL ASSISTANCE POLICY AND APPLICATION WILL BE PROVIDED.
Community InformationSchedule H, Part VI, Line 4THE ORGANIZATION IS BASED IN MADISONVILLE, KENTUCKY, SERVES NUMEROUS RURAL COMMUNITIES AND OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES. TROVER SERVES SIX COUNTY MARKETS WITH POPULATION BASE OF 195,000.
Promotion of Community HealthSchedule H, Part VI, Line 5TROVER HEALTH SYSTEM PROMOTES THE HEALTH OF THE COMMUNITY THROUGH OPEN MEDICAL STAFF, SERVICE ON COMMUNITY BOARDS, 24 HOUR EMERGENCY DEPARTMENT, OCCUMED PROGRAM, FREE ATHLETIC PHYSICALS, HEALTH FAIRS AND SCREENINGS, COURTESY MEMBERSHIP TO FITNESS FOR ATHLETES, POLICE OFFICERS AND FIRE DEPARTMENT, EDUCATIONAL PROGRAMS, ATHLETIC TRAINERS AT SCHOOL EVENTS, AND A CENTERING PREGNANCY PROGRAM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
CITY OF MADISONVILLE
PO BOX 705MADISONVILLEKY42431616001864CITY MADISONVIL7500GENERAL SUPPORT
HOPKINS COUNTY COMMUNITY CLINIC
PO BOX 1794MADISONVILLEKY42431611710391510(c)(3)6040GENERAL SUPPORT
MADISONVILLE COMMUNITY COLLEGE
2000 COLLEGE DRMADISONVILLEKY42431611320380501(c)(3)8000GENERAL SUPPORT
COMMUNITY FOUNDATION OF WEST KENTUCKY
PO BOX 7901PADUCAHKY42002611304905501(c)(3)14000GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING THE USE OF GRANT FUNDSIdentifier
Return ReferenceSCH. D, PART I, LINE 2ReturnReference
ExplanationTHERE IS ONE STAFF MEMBER WHO IS RESPONSIBLE FOR APPROVING ALL DONATIONS. THEY SELECT THE ORGANIZATION BASED ON NONPROFIT CRITERIA. AN ANNUAL BUDGET IS ESTABLISHED TO DETERMINE THE TOTAL AMOUNT OF FUNDS TO BE DISTRIBUTED EACH YEAR.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BARRY HARDISON MD
039401700000000039401700
R LAMONT WOOD MD
247964000200338100143460296140000
MARK FITZMAURICE MD
3229960001652000000339516000
HEATHER RICKETTS MD
2642710002000000264291000
E BERTON WHITAKER
702337000497510135429010303089782001420400
C THOMAS MOORE
2621070004555909891602525904318410401070
ROBERT GROVES MD
16124900032975027105011390222468000
STACEY BEAVEN
210082000239110313670108290276189059540
DAVID LANG
3120120002049307341301188204178000242990
TIMOTHY DUKES
126622000130850461240180370203868000
MOHAN ROA MD
409158000165200338100143460473834000
JOHN DACOSTA MD
70454000020069000212690732729000
WILLIAM LOGAN MD
401185000165200338100163600467875000
THOMAS STANFIELD MD
498831000165200338100133630562524000
SCOTT BANUELOS MD
40699305000002000025020459515000
JACK L HAMMAN MD
12586600020017700087720152358000
KAVITA ERICKSON MD
23453400000323660550266955000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BENEFITS PROVIDED TO CEOSCH. J, PART I, LINE 1ATHE FOUNDATION PAYS COUNTRY CLUB AND ROTARY CLUB DUES FOR BERTON WHITAKER, DIRECTOR/CEO/PRESIDENT. ONLY THE CEO IS ELIGIBLE FOR THIS BENEFIT. USE OF THE COUNTRY CLUB MEMBERSHIP IS EXCLUSIVELY FOR BUSINESS PURPOSE.
NON-FIXED PAYMENTSSCH. J, PART I, LINE 7SEVERAL FOUNDATION PHYSICIANS ARE COMPENSATED BASED UPON AN INCENTIVE COMPENSATION PLAN. THE INCENTIVE COMPENSATION PAYMENTS ARE NOT CONTINGENT UPON THE GROSS REVENUES OR NET EARNINGS OF THE ORGANIZATION, BUT ARE BASED UPON THE PHYSICIAN'S INDIVIDUAL PRODUCTIVITY AND QUALITY MEASURES.
NON-QUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BINCREASE IN ACTUARIAL VALUE OF NONQUALIFIED RETIREMENT PLAN: STACEY BEAVEN $15,954 TIM DUKES $13,720 DAVID LANG $24,299 C. THOMAS MOORE $61,587 BERTON WHITAKER $91,540

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF MADISONVILLE KENTUCKYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN616001864IssuerEIN
Date Issued2010-12-21DateIssued
Issue Price25780000IssuePrice
Description Of PurposeREFUND CERTAIN SERIES 2006 BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds25780000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds234600IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds23898065OtherSpentProceeds
Amount Unspent1647335AmountUnspent
Year Of Subst Completion2011YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementstrueAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0.00338PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00338TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
BEVERLY HAMMAN
FAMILY MEMBER - DIRECTOR14805EMPLOYEE COMPENSATIONfalse
AMANDA ROBINSON
FAMILY MEMBER - CHAIRMAN59768EMPLOYEE COMPENSATIONfalse
CARROL STEINFIELD
FAMILY MEMBER - DIRECTOR243271EMPLOYEE COMPENSATIONfalse
C THOMAS MOORE
WKMMS - OFFICER276955CONTRACT SERVICESfalse
CHAMBER OF COMMERCE
DIRECT RELATIONSHIP11680MEMBERSHIP DUESfalse
CHAMBER OF COMMERCE
DIRECT RELATIONSHIP38220GIFT CARDSfalse
CHAMBER OF COMMERCE
DIRECT RELATIONSHIP7559OTHER SUPPORTfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4* Regional Medical Center is an acute care hospital serving numerous rural communities and offering a broad range of inpatient and outpatient services. Regional Medical Center provides a substantial amount of charity care as detailed below in the Community Service section. Regional Medical Center provided care for 9,005 inpatient adult, pediatric, and nursery admissions during 2011. Patient days for 2011 totaled 38,139. There were 849 live births, of which over 63% were Medicaid births. Surgery visits totaled 6,377 for the year. Regional Medical Center's Mahr Cancer Center is accredited by the American College of Surgeons' Commission on Cancer. The Mahr Center provided services to over 19,195 patients during 2011, and is affiliated with the James Graham Brown Cancer Center at the University of Louisville. * Trover Clinic is a multi-specialty physician group practice with over 100 providers offering a broad range of medical services including specialty and subspecialty services. Trover Clinic operated five Clinics in rural communities bringing healthcare to medically underserved areas. Trover Clinic provided a total of 306,500 patient encounters during 2011. * Trover Foundation Residency Program is an educational program in which Foundation physicians instruct and work with Residents. The Residency Program is affiliated with the University Of Louisville School Of Medicine. Eighteen residents were involved in the Residency Program during 2011. * Trover Foundation Education Division provides numerous educational programs that benefit the communities of western Kentucky. In addition to the Family Practice Residency Program, the Foundation collaborates with Murray State University to offer a graduate degree in nurse anesthesia. The program is dedicated to graduating nurse anesthetists of the highest professional competence who are committed to returning to rural areas to practice. Regional Medical Center serves as the primary clinical site. The Foundation also coordinates the West Area Health Education Center (AHEC) program, connecting the academic health centers at the University of Kentucky and University of Louisville with medically underserved communities throughout the state, in an effort to address Kentucky health care access problems. The Foundation is a regional campus for the University Of Louisville School Of Medicine through the Foundation's Off-Campus Teaching Center. The Center provides individualized clinical training in a small-town environment, with a goal towards increasing the number of physicians in rural areas. The Foundation is a location for the University of Kentucky's Center for Rural Health, created to improve the health status of the rural population of the state. The Education Division sponsors the Delta Project for 20 counties in the state of Kentucky. The goal of the Delta Project is to improve the health status and health care system in each county served. During 2011, 26,509 students were contacted in approximately 58 different schools. * Green River Hospice is a program assisting terminally ill patients and their families through the death and bereavement process. The Hospice provided service for 15,943 hospice days during 2011. 2011 COMMUNITY SERVICE: Community Service Detail Hours No. of Events Contacts ------------------------------------------------------------- Educational Events 5,328 302 48,264 Community Events 1,051 23 5,703 Health Fairs/Screenings 94 7 1,260 Donations/Support 5,501 2,695 41,731 Support Groups 4,200 23 1,118 -------- ------- -------- Total 16,174 3,050 98,076 Total Events 3,050 Total Employee Hours 16,174 Total Community Contacts 98,076 Volunteer Hours 15,445
PROGRAM SERVICE ACCOMPLISHMENTS (CONT.)CHARITY AND COMMUNITY BENEFIT CARE Trover Foundation provides care to patients who meet guidelines established in the Foundation's charity care policy at no charge or at charges less than established rates. The following summary quantifies additional community benefit expense in terms of uncompensated care, services to the indigent and benefits to the broader community during 2011: Uncompensated care: Bad debt expense (at cost) $ 6,250,000 Benefits for the poor: Traditional Charity Care $5,734,000 Unpaid costs of Medicaid 9,640,000 ---------- TOTAL QUANTIFIABLE BENEFITS FOR THE POOR $15,374,000 Benefits for the broader community: Community Health Improvement Services $ 667,000 Health Professions Education 3,893,000 Research 4,000 Donations/Support 1,086,000 ---------- Total quantifiable benefits for the broader community $ 5,650,000 ----------- Total quantifiable community benefits $21,024,000 Community benefits expense represents approximately 13% of total Foundation expense for the year ended December 31, 2011. In addition to the above, the Foundation provides a wide range of community benefits including coordination of charitable activities by Foundation staff. EDUCATIONAL EVENTS ------------------ Trover's mission is excellent care every time. In order to support this mission, Trover Foundation strives to be involved in numerous educational programs. The Family Practice Residency Program completed training for five Family Practice physicians. Total number of residents in training during 2011 was 18. The Certified Registered Nurse Anesthesia Program has trained 199 nurses to become CRNAs since the program's inception. The University of Louisville/ Trover Foundation Medical Campus provided training for 18 3rd and 4th year medical students. It provided educational activities for high school students interested in a medical career, including shadowing and enhancement classes. Centering Pregnancy Smiles is a partnership between UK, the Foundation, the Hopkins County Health Department, the national Centering Pregnancy initiative and other federal, state, and local leaders. The alliance, established to end the cycle of preterm births, low birth weight, and poor oral health in Kentucky, has already saved Kentucky millions in medical procedures needed by those babies at birth. The program assisted over 704 local mothers during 2011. In 302 different events, the Foundation offered everything from tours to seminars to participation in community educational events. Thousand of students in western Kentucky benefited in some way from the Foundation's efforts. Nearly 5,400 hours were dedicated to educational events involving over 48,000 individuals throughout the service area. Foundation physicians also participated in a Women's Health Forum sponsored in part by the Foundation. Physicians gave presentations on women's health issues. There were also exhibits about women's health. The Foundation also participates in the World's Greatest Baby Showers throughout the service area. These events are held to help educate expectant mothers about their pregnancy and about taking care of their babies. An OB/GYN, a Family Practice physician, or pediatrician typically participates. Trover Foundation sponsors an annual Asthma Camp, a week-long day camp for children ages 6 to 12 who have documented asthma. A variety of supervised activities are planned for children whose asthma might prevent them from attending summer camp. Asthma education is an important component of the camp, with breathing exercises, relaxation techniques, proper use of medications, and monitoring routines among the topics covered. The Foundation provides 2 to 3 respiratory therapists each day of the camp. The Foundation maintains a website for consumer health education topics in both English and Spanish. The website includes daily consumer health news, and interactive consumer health tools such as quizzes and calculators. The fees for maintaining this website were over $12,000 in 2011. Other educational events sponsored or supported by the Foundation include the first Step Nursing Program, Rural Health Scholar Program, and shadowing opportunities for students.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT.)COMMUNITY EVENTS ---------------- Trover Foundation has always been an organization that the community looks to for support of community events. Whether it is financial support, the human resources of our employees, or both, the people of western Kentucky have come to rely on Trover to help make community events successful. Trover participation in community events during 2011 resulted in over 5,700 community contacts. In order to improve the general well being of the communities served, Trover is involved in many community events such as Clay Days, Dawson Springs Barbecue, Hopkins County Fair, and the Coalfield Festival just to name a few. Trover was again the sponsor of a downtown event, Friday Night Live. But Trover's real passion is health care. For that reason, we give emphasis to helping organizations with health care missions. A shining example is the monetary and physical support given to The American Cancer Society Relay for Life. Raising contributions in the thousands, Trover employees gave generously of their time to this effort in 2011. Other events such as this include the March of Dimes Walk, Muscular Dystrophy, Alzheimer's Walk, American Heart Walk, Cystic Fibrosis Foundation and Juvenile Diabetes. Other community organizations provided support by Trover Foundation include Big Brothers/Big Sisters, United Way of Hopkins County, Madisonville Community College, local Chambers of Commerce, Habitat for Humanity, American Red Cross, Lion's Club, Rotary Club, Kiwanis Club, Door of Hope, YMCA, Madisonville-Hopkins County Economic Development Corporation and many more. HEALTH FAIRS, SCREENINGS AND CLINICAL STUDIES --------------------------------------------- Trover Foundation served almost 1,300 individuals through health fairs and screenings in 2011. The Foundation provided blood sugar and blood pressure screenings regularly at satellite locations. Working with the Kentucky Cancer Program, The Mahr Cancer Center provided prostrate cancer screenings and colorectal screenings for several hundred people. Additionally the organization participated in a health fair at the local mall providing screenings and health education. The Foundation provided free sports physicals to over 1,700 high school students in Hopkins, Christian, Crittenden, Caldwell, McLean, Webster, Union, Muhlenburg, Ohio, Trigg, Todd and Lyon Counties. Trover Foundation also operates a full-time dedicated research center, established to ensure that the community has early access to promising new medicine and medical treatment. The Trover Center for Clinical Studies has participated in projects sponsored by Aventis, Merck, GlaxoSmithKline, Duke University, University of Louisville School of Medicine and others. Uncompensated expenses of operating the research center amounted to over $4,000 during 2011. DONATIONS/SUPPORT ----------------- Trover Foundation supported its communities through financial and in-kind donations valued at greater than $65,000. Approximately 2,695 events were supported. Examples include give-aways for local school events, tours, in-class speakers, sponsorship of both school and non-school related ball teams, cheerleading, dance teams, community events, high school bands, and similar events, as well as financial support for community events at the Glema Mahr Center for the Arts. The Foundation's Fitness Formula fitness center provided free or discounted memberships during 2011 valued at over $867,000. The free or discounted memberships were given to coaches, athletes, senior citizens, employees, and rehab patients, schools, and other community organizations During 2011, the Foundation provided over $8,400 in financial assistance to individuals in emergency need of medicine, transportation, etc. related to their health conditions. The Foundation was a major sponsor for Relay for Life in western Kentucky. Trover also provided support for charities such as United Way of Hopkins County, March of Dimes, American Red Cross, Big Brothers/Big Sisters, Project Graduation, Door of Hope, High school and youth athletic programs, Kiwanis Club, Rotary Club, YMCA, and many more. The Sports Medicine Center provided free athletic trainer coverage at 7 area schools for all sports. Seven hundred fifty two games were covered in 2011, as well as 1,885 practices for a total of 5,075 hours of employee time, valued at approximately $130,000. In 2011, the Foundation provided direct financial support as well as insurance coverage for Foundation care providers volunteering at the local community clinic. This clinic provides health care for the working poor.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT.)SUPPORT GROUPS -------------- The support groups offered at no cost by the Foundation served over 1,110 patients and families with almost 4,200 hours of employee time. These groups discuss such topics as Alzheimer's disease, cancer, diabetes, Fibromyalgia, Multiple Sclerosis, asthma, and several others. To enhance access, some support groups are held in the satellite locations. Most groups meet once or twice a month, typically at night for optimum patient convenience. This also requires staff to work additional hours above their normal workloads. The Foundation employs a full-time chaplain for our employees, patients, and guests, as well as a full-time chaplain for the Hospice program. These services, provided at a cost to the Foundation of almost $113,000, include consultation, pastoral care, counseling, and in-service seminars. EMERGENCY --------- The Regional Medical Center Emergency Department operates 24 hours a day, 365 days a year. In 2011, the department served over 30,281 patients. The department served as the area referral center for serious or traumatic injuries and disease. Care is provided regardless of ability to pay for medically necessary, non-elective care. VOLUNTEER DEPARTMENT -------------------- In 2011, Foundation volunteers gave 15,445 hours to the community. This program exists solely for service and is not a fund-raising group for the Foundation. Volunteers provide help to community members who use the hospital including the gift shop, waiting rooms, information desk, patient mail delivery, and other areas. The program also offers nursing scholarships.
REVIEW OF FORM 990FORM 990, PART VI, SECTION B, LINE 11The internally prepared Form 990 is reviewed and approved by tax consultants. Copies are given to each voting member of the Board prior to filing for their review. The board members who receive copies are the board members who are in place at the time of filing form 990.
MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE COMPLETED FOR EACH BOARD MEMBER, PRINCIPAL OFFICER, AND COMMITTEE MEMBER WITH BOARD DELEGATED POWERS. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR BEING FAMILIAR WITH THE STATEMENTS AND IDENTIFYING EXISTING OR CONTEMPLATED TRANSACTIONS OR RELATIONSHIPS WHICH MAY GIVE RISE TO A CONFLICT OF INTEREST. AFFECTED BOARD MEMBERS, OFFICERS, AND COMMITTEE MEMBERS ARE ALSO RESPONSIBLE FOR BRINGING CONFLICTS WHICH THEY MAY BE A PART OF TO THE ATTENTION OF THE BOARD. SUCH AFFECTED PARTIES ARE REQUIRED TO WITHDRAW FROM THE MEETINGS FOR THE TIME IN WHICH THE MATTER CONTINUES UNDER DISCUSSION. IF THE MATTER IS BROUGHT TO A VOTE, THE AFFECTED PARTY WILL NOT VOTE ON IT. IF THE MATTER REQUIRES A SPECIAL CALLED MEETING, THE AFFECTED PARTY WILL NOT BE COUNTED IN ESTABLISHING A QUORUM. THE BOARD WILL ALSO APPOINT A NON-INTERESTED PERSON TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, SECTION B, LINE 15A AND 15BCOMPENSATION PACKAGES FOR FOUNDATION EXECUTIVES AND OTHER OFFICERS AND KEY EMPLOYEES ARE COMPARED WITH INDEPENDENT SURVEYS & RECOMMENDATIONS OF CONSULTANTS. COMPENSATION IS ULTIMATELY APPROVED BY THE COMPENSATION COMMITTEE AND DOCUMENTED IN A WRITTEN EMPLOYMENT CONTRACT.
MAKING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST IN THE FOUNDATION'S ADMINISTRATIVE OFFICES.
RECONCILIATION OF NET ASSETSFORM 990, PART XI, LINE 5UNREALIZED GAIN ON INVESTMENTS $1,100,557 LOSS ON SWAPS -10,548 LOSS ON INVESTMENT IN SUBSIDIARY -187,142 UNRELATED BUSINESS INCOME -61,488 OTHER -1,130 ---------- OTHER CHANGES IN NET ASSETS $ 840,249
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BARRY HARDISON, MD TITLE:DIRECTOR HOURS:39

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MEDICAL CENTER AMBULANCE SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1629 LAFFOON STREETAddressLine1
CityMADISONVILLECity
StateKYState
ZIP Code42431ZIPCode
FieldValueIRS element (for citing)
EIN610946210EIN
Primary ActivitiesAMBULANCE SVCPrimaryActivities
Legal Domicile StateKYLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status9PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MUHLENBERG MEDICAL CENTER LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11010 MEDICAL CENTER DRIVEAddressLine1
CityPOWDERLYCity
StateKYState
ZIP Code42367ZIPCode
FieldValueIRS element (for citing)
EIN611303514EIN
Primary ActivityHEALTHCARE SVPrimaryActivity
Legal Domicile StateKYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1W KY MED MGT SVBusinessNameLine1
FieldValueIRS element (for citing)
Share Of Total Income477ShareOfTotalIncome
Share Of EOY Assets16127ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$477CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.19350PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
MUTUAL CREDIT SERVICES INC
PO BOX 149MADISONVILLEKY42431610660705COLLECTION AGKYNAC-117793555761.00000
REGIONAL SURGICAL ALLIANCE LLC
900 HOSPITAL DRIVEMADISONVILLEKY42431383734043HEALTHCARE SVKYNAC-19001.00000
WESTERN KY MEDICAL MANAGEMT SERVICES INC
900 HOSPITAL DRIVEMADISONVILLEKY42431371519513HC MSOKYNAC-667285627171.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
WESTERN KENTUCKY MEDICAL MANAGEMENT SERVICES
O728000COST/FMV
MUTUAL CREDIT SERVICES INC
O533153COST/FMV
WESTERN KENTUCKY MEDICAL MANAGEMENT SERVICES
P1029889COST/FMV
MUTUAL CREDIT SERVICES INC
P533153COST/FMV
MS COMMUNITY HEALTH LLC
P1130000COST/FMV
MS COMMUNITY HEALTHLLC
Q189965COST/FMV
MEDICAL CENTER AMBULANCE SERVICES INC
A42118COST/FMV
MEDICAL CENTER AMBULANCE SERVICES INC
O258495COST/FMV
MEDICAL CENTER AMBULANCE SERVICES INC
P172664COST/FMV

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