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HOSPICE Criteria used to determine eligibilty for discounted care PART 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 F PART 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 Footnote PART III, LINE 4: THE AUDITED FINANCIAL STATEMENTS DOES NOT CONTAIN A FOOTNOTE WHICH DESCRIBES BAD DEBT. Collection Practices PART 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 Assessment Schedule H, Part VI, Line 2 THE 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 Information Schedule H, Part VI, Line 4 THE 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 Health Schedule H, Part VI, Line 5 TROVER 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. true CITY OF MADISONVILLE PO BOX 705 MADISONVILLE KY 42431 616001864 CITY MADISONVIL 7500 GENERAL SUPPORT HOPKINS COUNTY COMMUNITY CLINIC PO BOX 1794 MADISONVILLE KY 42431 611710391 510(c)(3) 6040 GENERAL SUPPORT MADISONVILLE COMMUNITY COLLEGE 2000 COLLEGE DR MADISONVILLE KY 42431 611320380 501(c)(3) 8000 GENERAL SUPPORT COMMUNITY FOUNDATION OF WEST KENTUCKY PO BOX 7901 PADUCAH KY 42002 611304905 501(c)(3) 14000 GENERAL SUPPORT 4 0 MONITORING THE USE OF GRANT FUNDS SCH. D, PART I, LINE 2 THERE 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. X true true X X X X X false true false false false false false true false BARRY HARDISON MD 0 394017 0 0 0 0 0 0 0 0 0 394017 0 0 R LAMONT WOOD MD 247964 0 0 0 20 0 33810 0 14346 0 296140 0 0 0 MARK FITZMAURICE MD 322996 0 0 0 16520 0 0 0 0 0 339516 0 0 0 HEATHER RICKETTS MD 264271 0 0 0 20 0 0 0 0 0 264291 0 0 0 E BERTON WHITAKER 702337 0 0 0 49751 0 135429 0 10303 0 897820 0 142040 0 C THOMAS MOORE 262107 0 0 0 45559 0 98916 0 25259 0 431841 0 40107 0 ROBERT GROVES MD 161249 0 0 0 32975 0 27105 0 1139 0 222468 0 0 0 STACEY BEAVEN 210082 0 0 0 23911 0 31367 0 10829 0 276189 0 5954 0 DAVID LANG 312012 0 0 0 20493 0 73413 0 11882 0 417800 0 24299 0 TIMOTHY DUKES 126622 0 0 0 13085 0 46124 0 18037 0 203868 0 0 0 MOHAN ROA MD 409158 0 0 0 16520 0 33810 0 14346 0 473834 0 0 0 JOHN DACOSTA MD 704540 0 0 0 20 0 6900 0 21269 0 732729 0 0 0 WILLIAM LOGAN MD 401185 0 0 0 16520 0 33810 0 16360 0 467875 0 0 0 THOMAS STANFIELD MD 498831 0 0 0 16520 0 33810 0 13363 0 562524 0 0 0 SCOTT BANUELOS MD 406993 0 50000 0 20 0 0 0 2502 0 459515 0 0 0 JACK L HAMMAN MD 125866 0 0 0 20 0 17700 0 8772 0 152358 0 0 0 KAVITA ERICKSON MD 234534 0 0 0 0 0 32366 0 55 0 266955 0 0 0 BENEFITS PROVIDED TO CEO SCH. J, PART I, LINE 1A THE 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 PAYMENTS SCH. J, PART I, LINE 7 SEVERAL 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 PLAN SCHEDULE J, PART I, LINE 4B INCREASE 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 CITY OF MADISONVILLE KENTUCKY 616001864 2010-12-21 25780000 REFUND CERTAIN SERIES 2006 BONDS false false false 0 0 25780000 0 0 0 234600 0 0 0 23898065 1647335 2011 false false false true false true false false 0.00338 0.00000 0.00338 true false true false 0 false 0 false false BEVERLY HAMMAN FAMILY MEMBER - DIRECTOR 14805 EMPLOYEE COMPENSATION false AMANDA ROBINSON FAMILY MEMBER - CHAIRMAN 59768 EMPLOYEE COMPENSATION false CARROL STEINFIELD FAMILY MEMBER - DIRECTOR 243271 EMPLOYEE COMPENSATION false C THOMAS MOORE WKMMS - OFFICER 276955 CONTRACT SERVICES false CHAMBER OF COMMERCE DIRECT RELATIONSHIP 11680 MEMBERSHIP DUES false CHAMBER OF COMMERCE DIRECT RELATIONSHIP 38220 GIFT CARDS false CHAMBER OF COMMERCE DIRECT RELATIONSHIP 7559 OTHER SUPPORT false PROGRAM SERVICE ACCOMPLISHMENTS FORM 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 990 FORM 990, PART VI, SECTION B, LINE 11 The 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 POLICY FORM 990, PART VI, SECTION B, LINE 12C CONFLICT 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 COMPENSATION FORM 990, PART VI, SECTION B, LINE 15A AND 15B COMPENSATION 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 PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST IN THE FOUNDATION'S ADMINISTRATIVE OFFICES. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED 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 ORGANIZATION FORM 990 PART VII NAME:BARRY HARDISON, MD TITLE:DIRECTOR HOURS:39 MEDICAL CENTER AMBULANCE SERVICES INC 629 LAFFOON STREET MADISONVILLE KY 42431 610946210 AMBULANCE SVC KY 501(c)(3) 9 NA false MUHLENBERG MEDICAL CENTER LLC 1010 MEDICAL CENTER DRIVE POWDERLY KY 42367 611303514 HEALTHCARE SV KY W KY MED MGT SV 477 16127 false 477 false 0.19350 MUTUAL CREDIT SERVICES INC PO BOX 149 MADISONVILLE KY 42431 610660705 COLLECTION AG KY NA C -11779 355576 1.00000 REGIONAL SURGICAL ALLIANCE LLC 900 HOSPITAL DRIVE MADISONVILLE KY 42431 383734043 HEALTHCARE SV KY NA C -190 0 1.00000 WESTERN KY MEDICAL MANAGEMT SERVICES INC 900 HOSPITAL DRIVE MADISONVILLE KY 42431 371519513 HC MSO KY NA C -66728 562717 1.00000 true false false false false false false false false false false false false false true true true false WESTERN KENTUCKY MEDICAL MANAGEMENT SERVICES O 728000 COST/FMV MUTUAL CREDIT SERVICES INC O 533153 COST/FMV WESTERN KENTUCKY MEDICAL MANAGEMENT SERVICES P 1029889 COST/FMV MUTUAL CREDIT SERVICES INC P 533153 COST/FMV MS COMMUNITY HEALTH LLC P 1130000 COST/FMV MS COMMUNITY HEALTHLLC Q 189965 COST/FMV MEDICAL CENTER AMBULANCE SERVICES INC A 42118 COST/FMV MEDICAL CENTER AMBULANCE SERVICES INC O 258495 COST/FMV MEDICAL CENTER AMBULANCE SERVICES INC P 172664 COST/FMV