2012-11-13T13:41:15-06:00 2011-12-31 351178661 BLUE & CO LLC 2650 EASTPOINT PARKWAY SUITE 300 LOUISVILLE KY 40223 990 2011-01-01 311506378 PATTIE A CLAY FOUNDATION INC PATT 8596233131 PO BOX 1600 RICHMOND KY 404762603 CHRISTOPHER T JONES 8596233131 2012-11-07 1 CARRIE A MERRILL CPA P00832283 3176334705 2011 2016-02-24 21:20:13Z CHRISTOPHER T JONES PO BOX 1600 RICHMOND KY 404762603 447189 0 X WWW.PATTIEACLAY.ORG X 1999 KY PATTIE A. CLAY FOUNDATION INITIATES DEVELOPMENT OPPORTUNITIES AND ACHIEVES FUND RAISING GOALS TO ENHANCE, PROMOTE AND FINANCIALLY SUPPORT THE MISSION OF THE NOT-FOR-PROFIT PATTIE A. CLAY REGIONAL MEDICAL CENTER, THE ASSUMED NAME OF PATTIE A. CLAY INFIRMARY ASSOCIATION, INC. 22 20 0 0 0 0 91000 179634 0 0 -26022 34888 -1046 23116 63932 237638 100826 248288 0 0 0 0 0 0 0 29486 13982 130312 262270 -66380 -24632 1102891 1047570 6274 2092 1096617 1045478 X PATTIE A. CLAY FOUNDATION INITIATES DEVELOPMENT OPPORTUNITIES AND ACHIEVES FUND RAISING GOALS TO ENHANCE, PROMOTE AND FINANCIALLY SUPPORT THE MISSION OF THE NOT-FOR-PROFIT PATTIE A. CLAY REGIONAL MEDICAL CENTER, THE ASSUMED NAME OF PATTIE A. CLAY INFIRMARY ASSOCIATION, INC. 0 0 262005 248288 FOUNDATION STAFF WORK EXTENSIVELY WITH GRANT MAKERS, BUSINESSES AND INDIVIDUALS TO DEVELOP LONG LASTING PARTNERSHIPS TO ENHANCE THE SERVICES PROVIDED AT PATTIE A. CLAY REGIONAL MEDICAL CENTER. THE FOUNDATION IS GOVERNED BY A 22 MEMBER BOARD OF DIRECTORS, WITH DIVERSE REPRESENTATION FROM THE MEDICAL, BUSINESS AND PHILANTHROPIC COMMUNITY. 262005 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 22 20 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X KARL LAINHART 8596233131 PO BOX 1600 RICHMOND KY 404762603 BILL WALTERS 2.00 X X 0 0 0 EARL BALDWIN 2.00 X X 0 0 0 DOT BENNETT 2.00 X X 0 0 0 ALEX FASSAS 2.00 X X 0 0 0 ALICE JANE BALLEW 2.00 X 0 0 0 DAVID BOHANNON 2.00 X 0 0 0 RAY DESLOOVER 2.00 X 0 0 0 KATHY EDISON 2.00 X 0 0 0 PAUL ESKER 2.00 X 0 0 0 MAYOR CONNIE LAWSON 2.00 X 0 0 0 PAULA MAIONCHI MD 2.00 X 0 42293 0 JOHN WILSON 2.00 X 0 0 0 KS PARK JR 2.00 X 0 0 0 GEORGE E RIDINGS JR 2.00 X 0 0 0 FANNY RICE 2.00 X 0 0 0 LAURA STEIDLE 2.00 X 0 0 0 RICHARD THOMAS 2.00 X 0 0 0 AARON THOMPSON 2.00 X 0 0 0 BILLY RAY HUGHES 2.00 X 0 0 0 JEFF FULTZ 2.00 X 0 0 0 STEVE GATES 2.00 X 0 0 0 LARRY BAILEY 40.00 X 0 58957 0 CHRISTOPHER T JONES 2.00 X X 0 228417 43384 0 329667 43384 0 0 1 0 0 16000 30275 133359 179634 20630 20630 200614 186356 14258 14258 14258 46311 16000 23195 23116 23116 237638 0 0 58004 248288 248288 11244 11244 2473 2473 265 265 262270 262005 265 0 373990 325241 40000 40000 661386 658996 27515 23333 1102891 1047570 6274 2092 6274 2092 X 1096617 1045478 1096617 1045478 1102891 1047570 X -24632 -26507 X X 0 1 1 X 0 X X X 0 0 0 PATTIE A CLAY INFIRMARY ASSOCIATION 610461940 3 1 1 1 245971 1 245971 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 369802 295123 14028 7182 671771 353547 8804 10991 3540 369802 349603 1979 3705 1740 353547 293960 38995 16648 349603 1.00000 0 0 0 CHARITABLE GIFT ANNUITY 2092 2092 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BOARD DESIGNATED FUNDS INCLUDE ASSETS SET ASIDE BY THE ORGANIZATION'S BOARD OF DIRECTORS FOR LONG-TERM USES, OVER WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES AND BOARD-DESIGNATED ASSETS ESTABLISHED FOR THE HOSPITAL THIRD AND FOURTH FLOOR RENOVATION PROJECT. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE MEDICAL CENTER AND FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE MEDICAL CENTER AND FOUNDATION ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART IV LINE 12A HAS BEEN CHECKED YES. PART XI, XII, AND XIII OF SCHEDULE D ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. PRO AM GOLF TOURNAMENT 62311 16000 46311 4700 4130 2450 500 11415 62311 16000 46311 4700 4130 2450 500 11415 23195 23116 1 PATTIE A CLAY INFIRMARY ASSOCIATION INC PO BOX 1600 RICHMOND KY 404762603 610461940 501(C)(3) 245971 TO PROVIDE FUNDING FOR EQUIPMENT ACQUISITION. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FOUNDATION PROVIDES ASSISTANCE TO PATTIE A. CLAY INFIRMARY ASSOCIATION, INC. AS OUTLINED IN THE FOUNDATION'S MISSION STATEMENT. 0 0 0 0 0 0 0 0 0 CHRISTOPHER T JONES 0 226549 0 0 0 1868 0 18615 0 24769 0 271801 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -26,507. AUDIT OVERSIGHT FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS OF PATTIE A. CLAY REGIONAL MEDICAL CENTER ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. PATTIE A CLAY INFIRMARY ASSOCIATION INC PO BOX 1600 RICHMOND KY 404762603 610461940 HOSPITAL KY 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0