2012-11-09T08:16:25-06:00 2012-06-30 610420207 JONES NALE & MATTINGLY PLC 642 SOUTH FOURTH ST STE 300 LOUISVILLE KY 40202 990 2011-07-01 610541901 PINEVILLE COMMUNITY HOSPITAL ASSOC INC PINE 6063373051 850 RIVERVIEW AVENUE PINEVILLE KY 40977 J MILTON BROOKS 6063373051 2012-11-02 1 DAVID R PRICE P01272254 5025830248 2011 2016-02-24 21:20:13Z J MILTON BROOKS 850 RIVERVIEW AVENUE PINEVILLE KY 40977 31404045 0 X WWW.PINEVILLEHOSPITAL.COM X 1953 KY TO PROVIDE, WITHIN OUR MEANS, QUALITY HEALTH CARE TO THE PEOPLE OF SOUTHEAST KENTUCKY. 11 11 334 0 257083 -28119 0 0 28848840 29624002 340649 336877 1429706 1443166 30619195 31404045 0 0 0 0 17289267 17104233 0 0 0 14013118 15496208 31302385 32600441 -683190 -1196396 23303171 20706981 6487350 5370293 16815821 15336688 X TO PROVIDE, WITHIN OUR MEANS, QUALITY HEALTH CARE TO THE PEOPLE OF SOUTHEAST KENTUCKY. VALUES: THE STAFF OF PINEVILLE COMMUNITY HOSPITAL IS GUIDED BY THE FOLLOWING VALUES:A. RESPECT - WE WILL RECOGNIZE THE WORTH, DIGNITY, QUALITY AND IMPORTANCE OF EACH OTHER, THE PEOPLE WE SERVE AND THE INSTITUTION.B. QUALITY - CONTNUOUS IMPROVEMENTS IN ALL ASPECTS OF HEALTHCARE PROVIDED IS AN ATTITUDE WHICH MUST BE OUR NUMBER ONE PRIORITY.C. TEAM WORK - EACH OF US IS AN IMPORTANT PART OF THE TEAM; BY WORKING TOGETHER, OUR GOALS CAN BE ACHIEVED.D. COST EFFECTIVENESS - AN IMPORTANT DIMENSION OF QUALITY IS THE COST EFFECTIVENESS OF THE SERVICE WE OFFER; EACH OF THE TEAM MEMBERS IS COMMITTED TO THE WISE USE OF THE RESOURCES AVAILABLE.VISION: PINEIVLLE COMMUNITY HOSPITAL WILL BE PROFIDING TOP QUALITY ACUTE, OUTPATIENT, LONG TERM CARE (SNF) AND HOME HEALTH CARE WHILE MAINTAINING FINANCIAL STABILITY. 0 0 18147414 26995431 ACUTE CARE SERVICES; THE HOSPITAL IS LOCATED IN RURAL SOUTHEAST KENTUCKY WHICH IS IN THE HEART OF THE APPALACHIAN POVERTY BELT. THE HOSPITAL IS AN APPROVED DISPROPORTIONATE SHARE HOSPITAL (DSH) THAT PROVIDES EACH YEAR MORE CARE THAN IS REQUIRED TO QUALIFY FOR THE MAXIMUM DSH LEVELS. THE HOSPITAL ALSO SERVES A HIGH PERCENTAGE OF MEDICARE AND MEDICAID PAITIENTS. THE HOSPITAL IS LICENSED FOR 120 ACUTE BEDS AND PROVIDED 12,206 DAYS OF CARE TO THE TRI-COUNTY REGION OF SOUTHEAST KY DURING THE YEAR. 7,388 DAYS OF CARE WERE PROVIDED TO MEDICARE PATIENTS (61%) AND 2,039 DAYS WERE TO MEDICAID PATIENTS (17%). THE HOSPITAL PROVIDED 631 DAYS OF CHARITY CARE DURING THE YEAR ENDED JUNE 30, 2012. THE HOSPITAL ALSO HAD 615 BAD DEBT DAYS DURING THE YEAR. 2093924 2644140 LONG TERM CARE (SNF) UNIT - THE HOSPITAL IS LICENSED FOR 30 SKILLED BEDS. SNF PROVIDED 8,955 DAYS OF CARE TO THE TRI COUNTY ARE OF SOUTHEASTERN KY IN FYE JUNE 30, 2012. THE SNF UNIT PROVIDED 465 CHARITY CARE DAYS DURING THE YEAR. THE SNF UNIT HAD 204 BAD DEBT DAYS OF CARE DURING THE YEAR ENDED JUNE 30, 2012. 649432 952351 HOME HEALTH AGENCY - THE HOSPITAL IS LICENSED TO SERVE BELL COUNTY. DURING THE YEAR, THE HOME HEALTH AGENCY PROVIDED 7,738 HOME HEALTH VISITS TO BELL COUNTY RESIDENTS. 386 OF THOSE VISITS WERE CHARITY CARE AND 342 WERE BAD DEBT VISITS. 20890770 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 384 0 1 334 1 1 1 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X COLAN KELLY 6063373051 850 RIVERVIEW ROAD PINEVILLE KY 409771430 JOHN G HOWARD 1.00 X 0 0 0 AUBREY BAILEY 1.00 X 0 0 0 JOHN JONES 1.00 X 0 0 0 CHARLES BISHOP 1.00 X 0 0 0 MANSFIELD DIXON DMD 1.00 X 0 0 0 DAVID GRAMBREL 1.00 X 0 0 0 JERRY WOOLUM MD 1.00 X 0 0 0 TALMADGE HAYS MD 1.00 X 0 0 0 EMANUEL RADER MD 1.00 X 0 0 0 JOHN COMBS 1.00 X 0 0 0 ALBEN BROCK 1.00 X 0 0 0 J MILTON BROOKS 40.00 X 220307 0 18469 COLAN A KELLY 40.00 X 98606 0 16153 UYI-OGHOSA IDEMUDIA 40.00 X 223577 0 10899 JUDY SMITH 40.00 X 187531 0 16691 SHANNON SMITH 40.00 X 175209 0 9074 MICHAEL PETERSON 40.00 X 172031 0 14210 RHONDA KECK 40.00 X 152413 0 17410 1229674 0 102906 11 0 1 0 SODEXHO 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE 1271604 ACUTE CARE 1609 N ANKENY BLVD SUITE 200 ANKENY IA 50023 EMERGENCY ROOM PHYSICIANS 533024 MT REHAB PT 702 PHILLIPS ST CORBIN KY 40701 PHYSICAL THERAPY 360626 CPSI PO BOX 850309 MOBILE AL 36685 MIS VENDOR 334192 GE BOX 96483 CHICHAGO IL 60603 BIO-MEDICAL 308462 9 NET PATIENT SERVICE RE 623990 29624002 29624002 29624002 336077 336077 132031 0 132031 132031 132031 800 0 800 800 800 PHARMACY SALES 446110 1224203 967120 257083 MISCELLANEOUS 900099 80172 80172 MEDICAL TRANSCRIPT 623990 6760 6760 1311135 31404045 30591922 257083 555040 353535 353535 12707675 12096952 610723 46107 46107 3062679 3062679 934237 934237 17838 17838 30900 30900 1744387 1690507 53880 66303 66303 6893870 6015135 878735 827952 827952 35039 11958 23081 153134 153134 1133130 1133130 BAD DEBTS 2499023 2499023 FOOD SERVICE 957647 957647 PROVIDER TAX 575120 575120 MISCELLANEOUS 318470 103887 214583 243395 14684 228711 32600441 20890770 11709671 0 262282 71073 5347583 5402407 665201 626169 228570 247158 22969032 17061449 6380296 5907583 10227690 8210287 191549 242304 23303171 20706981 3411432 3309730 3075918 2060563 6487350 5370293 X 16815821 15336688 16815821 15336688 23303171 20706981 X -1196396 -282737 X X 0 1 1 X 0 X 488352 488352 10873125 8586024 2287101 11461499 8344988 3116511 146056 130437 15619 5907583 CASH & CD'S 4123 F EQUITY MUTUAL FUNDS 8206164 F 8210287 31404045 32600441 -1196396 -282737 -282737 -1479133 31404045 0 31404045 0 31404045 32600441 0 32600441 0 32600441 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL'S ACCOUNTING POLICY PROVIDES THAT A TAX EXPENSE/BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS RESULTING IN AN ACCRUAL OF TAX EXPENSE OR BENEFIT. 1 1 1 X 1 X 100.000000000000 1 1 1 0 1 1 2143023 444835 1698188 0.05210 8638144 6294549 2343595 0.07190 10781167 6739384 4041783 0.12400 26500 26500 0.00080 62204 62204 0.00190 1048807 1048807 0.03220 23919 23919 0.00070 1161430 1161430 0.03560 11942597 6739384 5203213 0.15960 1 1429441 0 13036588 14905158 -1868570 X 1 1 1 1 PINEVILLE COMMUNITY HOSPITAL

850 RIVERVIEW AVE PINEVILLE KY 40977

X X X PINEVILLE COMMUNITY HOSPITAL 1 1 1 100.000000000000 1 100.000000000000 1 X X X X X X 1 1 X X X X X 0 1 X X X X X X 1 X 0 0 5 PINEVILLE COMMUNITY HOSPITAL - SNF

850 RIVERVIEW AVE PINEVILLE KY 40977

SKILLED NURSING FACILITY PINEVILLE COMMUNITY HOSPITAL - HHA

121 VIRGINIA AVE PINEVILLE KY 40977

HOME HEALTH AGENCY PCH MEDICAL CLINIC

121 VIRGINIA AVE PINEVILLE KY 40977

MEDICAL CLINIC PCH MEDICAL CLINIC

HWY 119 LIGHTHOUSE MISSION PINEVILLE KY 40977

MEDICAL CLINIC PCH MEDICAL CLINIC

HWY 25E FLATLICK KY 40972

MEDICAL CLINIC PART I, LINE 7: E - COMMUNITY HEALTH BENEFIT OPERATIONS WERE PROVIDED BASED ON ACTUAL OR ESTIMATED COSTS AS FOLLOWS: FLU SHOT CLINIC - 760 SHOTS PROVIDED AT AN ACTUAL COST OF $25 EACH, RELAY FOR LIFE - THIS IS A PROJECT THAT THE EMPLOYEES ARE VERY INVOLVED WITH EACH YEAR AND AS SUCH THE HOSPITAL PREFERS THAT THERE BE A VERY VISIBLE HOSPITAL PRESENCE IN THIS CANCER AWARENESS EVENT. THE HOSPITAL ALLOWS FOR RELAY FOR LIFE WORK TO BE DONE DURING NORMAL WORK PERIODS. EMPLOYEE HOURS SPENT ON RELAY FOR LIFE ACTIVITIES ARE ESTIMATED AND CHARGED AS COMMUNITY BENEFIT.F - COSTS ARE ACTUAL EXPENDITURES.I - COSTS ARE ACTUAL EXPENDITURES. PART III, LINE 4: THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A DISCLOSURE FOR BAD DEBTS EXPENSE. BAD DEBTS EXPENSE IS RECORDED AS AN OPERATING EXPENSE. CHARITY CARE IS NOT REPORTED AS REVENUE ON THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE NOTES TO THE FINANCIAL STATEMENTS INCLUDE THE AMOUNT OF CHARGES EXCLUDED FROM REVENUE. THE COST TO CHARGE RATIO (PERCENTAGE) UTILIZED FOR CALCULATING THE COST OF BAD DEBTS IS FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE PERCENTAGE WAS CALCULATED BY DIVIDING THE ADJUSTED PATIENT CARE COST BY THE ADJUSTED PATIENT CARE CHARGES. PART III, LINE 8: PINEVILLE COMMUNITY HOSPITAL (PCH) CONSIDERS THIS SHORTFALL AS UNREIMBURSED COST. WHILE THE SHORTFALL IN MEDICARE REIMBURSEMENT WAS MINOR, PCH TREATS PATIENTS IN THEIR COMMUNITY BASED ON MEDICAL NEED, NOT FINANCIAL RESOURCES. MEDICARE AS A PERCENTAGE OF PATIENTS SERVED REPRESENTS THE HIGHEST PERCENTAGE. BASED ON THE NEED FOR MEDICARE SERVICES PCH WILL CONTINUE TO REACH OUT TO MEDICARE PATIENTS REGARDLESS OF THE GAIN OR LOSS ON THE SERVICE SINCE THIS IS SUCH A SIGNIFICANT PORTION OF OUR COMMUNITY. THE HOSPITAL WOULD PREFER THAT THE RETURN FROM TREATING MEDICARE PATIENTS BE A GAIN, WHICH WOULD ALLOW PCH TO DO MORE FOR THEIR COMMUNITY. AS SUCH, PCH REINVESTS IN THE COMMUNITY EARNINGS FROM OPERATIONS. PART III, LINE 9B: PATIENTS WHO HAVE PREVIOUSLY QUAILIFIED FOR CHARITY CARE PRIOR TO HAVING TREATMENT ARE PRESCREENED TO SEE IF THEY STILL MEET THE CHARITY GUIDELINES. THIS CAN BE DONE PRIOR TO A TEST BEING SCHEDULED. THE PATIENT'S INCOME LEVEL, DEPENDENT STATUS AND ASSET LEVELS ARE IDENTIFIED TO INSURE THAT THE PATIENT STILL QUAILIFIES FOR CHARITY CARE. IF THE PATIENT DOES NOT QUAILIFY FOR CHARITY CARE THEN THE HOSPITAL FOLLOWS ITS NORMAL COLLECTION POLICY JUST LIKE IT WOULD FOR ANY OTHER NON-CHARITY CARE PATIENT. PINEVILLE COMMUNITY HOSPITAL PART V, SECTION B, LINE 13G: PRIOR TO ANY PROCEDURE OR ADMISSION TO THE HOSPITAL (NON-EMERGENCY) PHYSICIAN OFFICES WILL SEND PATIENTS TO THE HOSPITAL CREDIT OFFICE FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: THE HOSPITAL DOES AN ANNUAL COMMUNITY BENEFIT REVIEW. WHILE THIS IS CONSIDERED A FULL COMMUNITY BENEFIT ASSESSMENT THAT THE HOSPITAL WILL BE COMPLETING IN THE FUTURE, THIS REVIEW DOES TAKE INTO CONSIDERATION THE POPULATION AGE, MORBIDITY, POVERTY LEVELS, EDUCATION STATUS AND GENERAL ECONOMIC STATUS OF THE COMMUNITY. THE PRIMARY GEOGRAPHIC AREA SERVED IS BELL CO., HARLAN CO. AND KNOX CO. THE SECONDARY MARKET AREA IS CLAY CO. AND THE TWO CONTINUOUS STATE'S THAT BORDER KENTUCKY IN THIS REGION, TENNESSEE AND VIRGINIA. THIS REGION HAS SIGNIFICANT HEALTH EXPOSURE ISSUES FOR RESIDENTS IN THIS AREA BASED ON OCCUPATION CATERGORIES AS FOLLOWS: COAL MINING - BLACK LUNG DISEASE IN EARLY STAGES AND COPD IN OLDER POPULATION; TIMBER INDUSTRY - LOGGING LEADS TO HEAVY INJURY AND DISABILITY RATE IN THE POPULATION. THIS WORK GROUP AS A WHOLE WAS FOUND TO BE VERY LOW ON EDUCATION LEVELS WITH THE NORM FOR THIS GROUP BEING LESS THAN A HIGH SCHOOL EDUCATION. THE OVERALL GENERAL POPULATION AS A GROUP HAS A VERY HIGH HEALTH RISK EXPOSURE FROM THE PREVALENCE OF TOBACCO USE, ORAL AND SMOKING, IS SIGNIFICANTLY HIGH; PLUS, THE OVERALL INCREASE IN THE AGING OF THE GENERAL POPULATION AND THE NEED FOR ADDITIONAL HEALTHCARE SERVICES IS A MAJOR FACTOR. PART VI, LINE 3: THE HOSPITAL INFORMS THE GENERAL POPULATION CONCERNING THE CHARITY CARE POLICY THROUGH THE GENERAL ADMISSION SCREENING PROCESS AND A SUMMARY OF THE CHARITY CARE FUNCTION IS IN ALL AREA'S OF THE HOSPITAL THAT HAVE PATIENT CARE REGISTRATION FUNCTION OR CONTACT. HOSPITAL EMPLOYEES ARE EDUCATED TO MAKE PATIENTS AWARE OF THE HOSPITAL'S CHARITY CARE POLICY AND HOW IT APPLIES TO EACH PATIENT AND WHERE PATIENTS CAN GO FOR ADDITIONAL INFORMATION OR EDUCATION ON THE HOSPITAL'S CHARITY CARE POLICY. ALL PHYSICIAN OFFICES IN THE GENERAL AREA OF THE HOSPITAL ARE FULLY AWARE OF THE HOSPITAL'S CHARITY CARE POLICY AND DIRECT PATIENTS TO THE HOSPITAL. PART VI, LINE 4: PINEVILLE HOSPITAL'S PRIMARY MARKET AREA IS IN THE HEART OF EASTERN APPALACHIA COMPRISED OF BELL CO., HARLAN CO. AND KNOX CO. THE HOSPITAL'S SECONDARY MARKET AREA IS COMPRISED OF CLAY CO. AND THE TWO CONTINUOUS STATE'S THAT BORDER KENTUCKY, TENNESSEE AND VIRGINIA. PART VI, LINE 5: PINEVILLE COMMUNITY HOSPITAL IS QUITE INVOLVED IN THE COMMUNITY THAT IT SERVES. THE HOSPITAL HAS AN OPEN MEDICAL STAFF THAT IS OPEN TO ALL QUALIFIED PHYSICIANS. THE MEDICAL STAFF OF THE HOSPITAL DOES NOT SOLELY LIVE IN ONE COMMUNITY BUT RESIDES IN OUTLAYING COMMUNITIES AS WELL. THE HOSPITAL'S MANAGING BOARD ARE ALL RESIDENTS OF THE HOSPITAL'S PRIMARY MARKET AREA. THEY LIVE, WORK, AND WORSHIP WITH THE COMMUNITY THAT THE HOSPITAL SERVICES. AS SUCH, THEY SEE AND HEAR THE NEEDS OF THE HOSPITAL'S MARKET AREA. X X X 0 1 0 0 0 1 0 0 0 J MILTON BROOKS 198307 0 0 0 22000 0 4259 0 14210 0 238776 0 0 0 UYI-OGHOSA IDEMUDIA 207397 0 0 0 16180 0 4426 0 6473 0 234476 0 0 0 JUDY SMITH 177131 0 0 0 10400 0 3590 0 13101 0 204222 0 0 0 SHANNON SMITH 159143 0 0 0 16066 0 1928 0 7146 0 184283 0 0 0 MICHAEL PETERSON 172031 0 0 0 0 0 0 0 14210 0 186241 0 0 0 RHONDA KECK 136547 0 0 0 15866 0 3200 0 14210 0 169823 0 0 0 PART I, LINE 4B MR. BROOKS PARTICIPATES IN A NONQUALIFIED RETIREMENT PLAN PAID FOR BY THE HOSPITAL. FOR FYE JUNE 30, 2012 THE HOSPITAL CONTRIBUTED $0 TO THE PLAN. PART I, LINE 6 TO BETTER SERVE THE NEEDS OF THE TRI-COUNTY AREA, IN 2008, THE HOSPITAL BEGAN HIRING PHYSICIAN EMPLOYEES. IN FULFILLMENT OF THE TERMS OF THEIR EMPLOYMENT CONTRACTS, DOCTORS CAN RECEIVE INCENTIVE PAY CALCULATED AS A PERCENTAGE OF THE NET PROFITS OF THE MEDICAL PRACTICE SERVICES THEY PROVIDE. DURING THE CURRENT YEAR NO BONUSES WERE ISSUED. H AUBREY BAILEY DIRECTOR MR. BAILEY SERVES ON THE BOARD OF THE HOSPITAL AND ALSO SERVES ON THE BOARD OF FIRST STATE FINANCIAL, A BANK THAT THE HOSPITAL HAS AN ONGOING BUSINESS RELATIONSHIP WITH. 0 FORM 990, PART VI, SECTION A, LINE 2 THERE ARE TWO MEMBERS OF THE BOARD OF DIRECTORS THAT ARE DIRECTLY RELATED IN AN EMPLOYER - EMPLOYEE RELATIONSHIP. MR. JOHN HOWARD IS THE OFFICE MANAGER OF DR. TALMADGE HAYS OFFICE PRACTICE. FORM 990, PART VI, SECTION B, LINE 11 THE FORMS 990 AND 990-T ARE REVIEWED BY THE OFFICERS OF THE COMPANY FOR COMPLETENESS AND ACCURACY. PRIOR TO FILING THE FORMS 990 AND 990-T THEY ARE PRESENTED TO THE BOARD FOR REVIEW AND DISCUSSION. FORM 990, PART VI, SECTION B, LINE 12C THE CHAIRMAN OF THE BOARD MAKES EACH BOARD MEMBER AWARE OF THEIR RESPONSIBILITIES AS IT RELATES TO THE COMPLETION OF THE CONFLICT OF INTEREST STATEMENT. EACH BOARD MEMBER IS GIVEN A PACKET CONTAINING THE STATEMENT TO BE SIGNED. THE CHAIRMAN IS RESPONSIBLE TO ENSURE THAT ALL STATEMENTS ARE SIGNED AND RETURNED. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY, EACH MEMBER OF THE BOARD OF DIRECTORS CREATE A WRITTEN EVALUATION OF THE CEO. THE INDIVIDUAL EVALUATIONS ARE COMPLIED INTO ONE PACKAGE PRIOR TO MEETING WITH THE CEO TO DISCUSS THE EVALUATION. AT THE MEETING GOALS ARE ESTABLISHED. COMPENSATION IS SET AT THE MEETING. THE BOARD MAY USE OUTSIDE ENTITIES TO DETEREMINE IF THE COMPENATION PACKAGE IS ADEQUATE / INADEQUATE. THE PRIMARY ADJUSTMENTS HAVE BEEN INCREASES DUE TO THE COST OF LIVING INCREASING. FORM 990, PART VI, SECTION C, LINE 18 THE 990 AND 990-T ARE AVAILABLE THROUGH WWW.GUIDESTAR.ORG AND BY REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTERTEST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE HOSPITAL PUBLISHES ANNUAL FINANCIAL OUTCOMES IN THE HOSPITAL NEWSLETTER WHICH IS MAILED TO MOST OF THE MARKET AREA SERVED BY THE HOSPITAL. COPIES OF THE NEWSLETTER ARE DISTRIBUTED TO PATIENTS, FAMILIES AND VISITORS TO THE HOSPITAL. ALSO, FINANCIAL STATEMENTS ARE POSTED WITH THE CREDIT AGENCY DUNN & BRADSTREET FOR COMMERCIAL USERS. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII JOHN G. HOWARD - 111 PAULA DRIVE, PINEVILLE, KY 40977. AUBREY BAILEY - 103 KINGSBURY HEIGHTS, MIDDLESBORO, KY 40965. JOHN JONES - 145 HORSESHOE DR, PINEVILLE, KY 40977. CHARLES BISHOP - 133 WOODLAND TR, PINEVILLE, KY 40977. MANSFIELD DIXON, DMD - 121 VIRGINIA AVE, PINEVILLE, KY 40977. DAVID GRAMBREL - 113 RIDGEWOOD CIRCLE, PINEVILLE, KY 40977. JERRY WOOLUM, MD - 121 VIRGINIA AVENUE, PINEVILLE, KY 40977. TALMADGE HAYS, MD - 121 VIRGINIA AVENUE, PINEVILLE, KY 40977. EMANUEL RADER, MD - P.O. BOX 70, PINEVILLE, KY 40977. JOHN COMBS - PO BOX 573, PINEVILLE, KY 40977. ALBEN BROCK - PO BOX 339, PINEVILLE, KY 40977. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -282,737. FORM 990, PART XI, 2C, SELECTION AND OVERSIGHT OF INDEPENDENT ACCOUNTANT: THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION AND OVERSIGHT OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SCH H, PART V, NUMBER AND TYPES OF OTHER HEALTH CARE FACILITIES: 2 MEDICAL CLINICS