2012-11-15T09:09:28-07:00 2012-03-31 990 2011-04-01 610712406 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION MOUN 6066334823 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 Teresa Fleming 6066334823 2012-11-15 2011 2016-02-24 21:20:13Z LM Mike Caudill 226 Medical Plaza Lane PO Box 40 Whitesburg KY 41858 21481559 0 X www.mchcky.com X 1972 KY Provide primary and specialty medical/dental care to the medically underserved/uninsured population of Southeastern Kentucky 15 15 299 0 0 0 4938799 4771308 17245453 16542704 33332 22435 121969 145112 22339553 21481559 0 0 0 0 15002315 15363502 0 0 43096 7275621 7153871 22277936 22517373 61617 -1035814 15366855 14499637 4900035 5068631 10466820 9431006 Provide primary and specialty medical/dental care services to the medically underserved/uninsured population of Southeastern Kentucky 0 0 18719527 4771308 16542704 Patient Care/General Other: Mountain Comprehensive Health Corporation's mission states : MCHC will use its resources to meet the healthcare needs of its service area population" In calendar year 2011, MCHC provided medical and dental care to 28,980 individual patients 0 0 0 18719527 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 20 0 1 299 1 0 0 0 0 0 0 X 15 15 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Mountain Comprehensive Health Corporation 6066334823 PO Box 40 226 Medical Plaza Lane Whitesburg KY 41858 JoAnne Shepherd 1 X 0 0 0 Danny Boggs 1 X 0 0 0 Brenda Brandenburg 1 X 0 0 0 Arthur Ozz Jackson 1 X 0 0 0 Tommye Banks 1 X 0 0 0 Robert Campbell 1 X 0 0 0 Cathie Day 1 X 0 0 0 Kristi Dixon 1 X 0 0 0 Edgar Grubb 1 X 0 0 0 Janet Tucker 1 X 0 0 0 Matilda Parks 1 X 0 0 0 Mary Ann Sparks 1 X 0 0 0 Tom Hammonds 1 X 0 0 0 Winston Meade 1 X 0 0 0 Deanna Richmond 1 X 0 0 0 Phillip Hampton 40 X 106407 0 15831 Teresa Fleming 40 X 67767 0 8119 L M Mike Caudill 40 X 179621 0 13303 Van Breeding MD 40 X 866823 0 20945 Nathan W Baker MD 40 X 721564 0 20176 Mahmood Alam MD 40 X 362780 0 19676 Fares Khater MD 40 X 357667 0 9213 Brian Banks MD 40 X 316633 0 10075 2979262 0 117338 23 0 1 0 Pikeville Medical Center 911 Bypass Rd Pikeville KY 41501 Cardiology Physician Group 178248 Office Pro Services LLC PO Box 2451 Hazard KY 41702 Transcription Services 249983 2 0 0 0 0 4771308 0 0 4771308 Medicaid 621400 4561137 4561137 0 0 Medicare 621400 4059277 4059277 0 0 CI/UMWA 621400 4402477 4402477 0 0 Patient Fee 621400 927176 927176 0 0 2592637 2592637 0 0 16542704 22435 22435 0 0 0 0 0 0 0 0 0 0 119200 0 0 0 119200 0 119200 119200 0 0 0 0 0 25912 25912 0 0 25912 21481559 16710251 0 0 367965 349567 18398 0 0 0 0 12512421 10679673 1811406 21342 259834 170332 89502 1467644 1079390 384898 3356 755638 595787 159851 20770 0 20770 0 76719 0 76719 0 82014 16611 65403 3695795 3596502 99293 198295 198295 14086 5105 8981 59039 27291 31748 83217 47134 36083 930617 805775 124842 57133 37938 19195 Consulting and contracting services 646041 506918 139123 Repairs and maintenance 649750 590212 59538 Utilities 424431 239895 184536 Licenses/dues/membership/recruitment 114703 96180 18523 101261 26489 74772 22517373 18719527 3754750 43096 372684 293792 1413979 1092392 470751 176040 3000340 3124928 0 0 0 0 0 0 153447 201028 155323 162541 17492077 8043161 9800331 9448916 15366855 14499637 2237647 2560059 515408 179492 1900702 2214792 246278 114288 4900035 5068631 X 9116731 8408849 1350089 1022157 0 0 10466820 9431006 15366855 14499637 -1035814 0 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 273000 0 273000 8333237 0 3892518 4440719 1801343 0 841421 959922 6918804 0 3231826 3686978 165693 0 77396 88297 9448916 Interest Payable 35527 Unemployment tax payable 23634 Payroll taxes payable 21146 Retirement payable 33981 114288 21481559 22517373 -1035814 0 0 0 0 0 0 -1035814 21481559 0 0 0 0 0 21481559 0 0 0 21481559 22517373 0 0 0 0 0 22517373 0 0 0 22517373 SchD_P10_S00_L00 Schedule D, Part X Other current liabilities- Interest Due Federal Government- $32,355, Accrued Interest Payable- $3,172, Accrued Payroll Withholding- $21,146, Accrued 403(b) deductions and other withholdings- $33,981, Unemployment taxes payable- $23,634. Total $114,288 X X 0 0 0 1 0 0 0 0 0 Phillip Hampton 103400 0 555 0 4773 0 0 0 -2321 0 106407 0 102901 0 Teresa Fleming 66150 0 555 0 3600 0 0 0 -2538 0 67767 0 66506 0 L M Mike Caudill 176935 0 507 0 8848 0 0 0 -6669 0 179621 0 177289 0 Van Breeding MD 373558 0 425074 0 81289 0 0 0 -13098 0 866823 0 848839 0 Nathan W Baker MD 333808 0 229917 0 166388 0 0 0 -8549 0 721564 0 653439 0 Mahmood Alam MD 300823 0 75054 0 0 0 0 0 -13097 0 362780 0 328736 0 Fares Khater MD 231592 0 126658 0 22 0 0 0 -605 0 357667 0 320354 0 Brian Banks MD 300000 0 25507 0 0 0 0 0 -8874 0 316633 0 266171 0 SchJ_P01_S00_L05 Schedule J, Part I, Line 5 Some of the providers have compensation packages based on a combination of incentive based on either hospital or nursing home charges or collections. Baker Properties LLC Owner is a highly compensated employee 16800 rental of apartment and parking space 0 N Wade Baker MD Brother to CEO 721564 salary and other compensation 0 F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 The CEO and one of our highest compensated employees, Dr. Nathan Wade Baker, MD OB/GYN are brothers F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 Mountain Comprehensive Health Corporation is a non profit corporation. We are a 330e grantee, with 501(c)(3) status. Our governing board is comprised of board members who are consumers of our clinic and are members of the community. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a The Board of Directors has a membership committee who nominates any new members to be elected by the full Board of Directors. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b The Board of Directors approves all grants, budgets, and policies for the Corporation. The Board is also responsible for hiring the Chief Executive Officer. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The 990 is prepared by the Chief Financial Officer and Comptroller. It is then presented to the Chief Executive Officer and the Chief Operating Officer for review. After approval by officers, the 990 is presented to Board of Director's Finance Committee for review. The Finance Committee will then make a recommendation in the board meeting for the approval of the 990 to be submitted. Board members will vote on approval of the 990. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c We are monitored throughout the year by our funding sources, and additionally we have internal monitoring performed by our Corporate Compliance Officer. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The Chief Executive Officer handles all provider contracts, and also establishes wages based on experience and local comparable wages. The CEO's contract is reviewed and approved by the Board of Directors. All providers are on different contract terms and are reviewed annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The 990, supporting financial statements, governing documents, and conflict of interest policies are available upon request. The audited financial statements were not complete at the time of original due date