2011-11-10T12:38:09-06:00 2010-12-31 BLUE & CO LLC 2650 EASTPOINT PARKWAY SUITE 300 LOUISVILLE KY 40223 990 2010-01-01 610461940 PATTIE A CLAY INFIRMARY ASSOCIATION INC PATT 8596233131 PO BOX 1600 RICHMOND KY 404762603 CHRIS MCCLURG 8596233131 2011-11-10 1 CARRIE A MERRILL CPA 5029923500 2010 2016-03-07 17:11:31Z CHRIS MCCLURG PO BOX 1600 RICHMOND KY 404762603 65586198 0 X WWW.PATTIEACLAY.ORG X 1892 KY STATEMENT OF PURPOSE:THE PURPOSE OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE CULTURALLY COMPETENT QUALITY HEALTH CARE TO A DIVERSE POPULATION IN MADISON COUNTY AND NEIGHBORING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY.STATEMENT OF MISSION:THE MISSION OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTH CARE IN A MODERN FACILITY BY A TEAM OF HIGHLY-SKILLED PHYSICIANS AND STAFF THROUGH NURTURING, PERSONALIZED SERVICES.STATEMENT OF VISION:A CENTER OF EXCELLENCE: TO HONOR OUR OBLIGATION AS A CENTER OF EXCELLENCE BY OUR COMMITMENT TO CONSTANT AND NEVER-ENDING IMPROVEMENT IN THE QUALITY OF CARE OF OUR PATIENTS. 22 21 777 20 0 0 940790 1183073 64623605 61731567 773826 344819 1609896 1519580 67948117 64779039 0 0 0 0 30214744 29429394 0 0 0 36030561 36381732 66245305 65811126 1702812 -1032087 51897952 49632092 26902912 26307239 24995040 23324853 X STATEMENT OF MISSION:THE MISSION OF PATTIE A. CLAY REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTH CARE IN A MODERN FACILITY BY A TEAM OF HIGHLY-SKILLED PHYSICIANS AND STAFF THROUGH NURTURING, PERSONALIZED SERVICES. 0 0 57621484 62008897 PATTIE A. CLAY REGIONAL MEDICAL CENTER (PAC) REALIZES THAT NOT ALL PATIENTS HAVE FINANCIAL RESOURCES TO PAY THEIR BILL. IN LIGHT OF THIS, PAC HAS CHARITY CARE POLICIES AND PROCEDURES IN PLACE TO DETERMINE A PATIENT'S ABILITY TO PAY FOR SERVICES. FOLLOWING THE CHARITY CARE POLICY, PAC PROVIDED $4,976,885 OF UN-REIMBURSED CHARITY CARE CHARGES FOR THE YEAR ENDED DECEMBER 31, 2010. UN-REIMBURSED CHARITY CARE CHARGES REPRESENTS 8.1% OF NET PATIENT SERVICE REVENUE FOR THE YEAR. 3,914 PATIENTS BENEFITED FROM CHARITY CARE PROVISIONS.PAC OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS A DAY, EVERY DAY. PATIENTS ARE TREATED WITHOUT REGARD TO THEIR PAYMENT ABILITY. PAC EXPERIENCED 27,976 EMERGENCY DEPARTMENT VISITS DURING 2010. PAC PROVIDED INPATIENT SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 3,466 INPATIENTS WERE ADMITTED DURING 2010 RESULTING IN 12,492 INPATIENT DAYS. PAC PROVIDED OBSTETRIC SERVICES TO THE CITIZENS OF MADISON AND SURROUNDING COUNTIES. A TOTAL OF 800 DELIVERIES WERE PERFORMED DURING 2010. PAC PROVIDED SURGICAL SERVICES TO 7,233 PATIENTS DURING 2010. IN ADDITION TO THE FOUR LARGEST PROGRAM SERVICES, PAC ALSO PROVIDES OR SUPPORTS THE FOLLOWING COMMUNITY PROGRAMS AT FREE OR SUBSTANTIALLY REDUCED COST TO THE COMMUNITY:COMMUNITY HEALTH FAIR: PROVIDE FREE BLOOD PRESSURE, HEIGHT AND WEIGHT, PULMONARY FUNCTION, BODY FAT ANALYSIS, OSTEOPOROSIS SCREENING, PSA, BLOOD TYPING, BLOOD GLUCOSE, ANEMIA SCREENING, POSTURE, GLAUCOMA, COUNSELING, EDUCATIONAL MATERIALS. (APPROXIMATELY 300 PARTICIPANTS).WOMEN'S HEALTH FAIR: PROVIDE FREE BLOOD PRESSURE, HEIGHT AND WEIGHT, PULMONARY FUNCTION, BODY FAT ANALYSIS, BLOOD GLUCOSE, CHOLESTEROL, EDUCATIONAL MATERIALS AND DISPLAYS. (APPROXIMATELY 120 PARTICIPANTS).FREE PROSTATE CANCER SCREENING AND PSA'S: FREE PSA BLOOD WORK AND DIGITAL RECTAL EXAM BY A UROLOGIST. (APPROXIMATELY 60 PARTICIPANTS).COMMUNITY BASED EDUCATIONAL PROGRAMS: CPR CLASSES, CHILDBIRTH CLASSES, BREAST FEEDING CLASSES, SAFE DRIVING CLASSES AND SMOKING CESSATION CLASSES.SUPPORT OF CITY AND COUNTY PROJECTS: PROVIDED PLANT OPERATIONS SUPPORT FOR VARIOUS CITY AND COUNTY FUNCTIONS.MADISON COUNTY SCHOOL CALENDARS: CALENDARS FEATURING LOCAL CHILDREN IN MEDICAL CAREERS WITH INFORMATION REGARDING EDUCATION REQUIREMENTS. ALL SCHOOL FUNCTIONS LISTED FOR MADISON AND ESTILL COUNTIES.PARTICIPATION IN OTHER HEALTH FAIRS: PROVIDE STAFFING AND EDUCATIONAL MATERIALS FOR VARIOUS HEALTH FAIRS IN THE COMMUNITY.PROVIDE SPEAKERS ON HEALTH CAREERS AND TOURS OF THE HOSPITAL: THIS COMMUNITY SERVICE BENEFITS APPROXIMATELY 1,000 STUDENTS.STARLIGHT MILE WALK/RUN: PROVIDE FUNDING FOR A ONE MILE WALK/RUN FOR CHILDREN AND ADULTS TO PROMOTE HEALTHY LIFESTYLES. (APPROXIMATELY 80 PARTICIPANTS).BETTER BREATHERS CLUB: EDUCATIONAL MEETINGS AND EVENTS FOR PATIENTS WITH PULMONARY PROBLEMS.LEADERSHIP MADISON COUNTY: PROVIDE CLASSES FOR PARTICIPANTS, FOODS, SPACE, ETC. 57621484 1 1 0 1 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 54 0 1 777 1 0 0 0 0 0 1 1 0 0 0 0 X 22 21 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CHRIS MCCLURG CFO 8596233131 PO BOX 1600 RICHMOND KY 404762603 AARON THOMPSON MD 2.00 X X 0 0 0 ALICE JANE BALLEW 2.00 X X 0 0 0 LAURA STEIDLE 2.00 X X 0 0 0 SUSAN MOBERLY 2.00 X X 0 0 0 EARL BALDWIN 2.00 X X 0 0 0 KATHY FLOOD 2.00 X X 0 0 0 DAVID GRAHAM 2.00 X X 0 0 0 PATRICIA BARNWELL 2.00 X X 0 0 0 RANDY ALLEN MD 2.00 X 0 0 0 DEBBIE BARKLEY 2.00 X 0 0 0 THOMAS CERVONI MD 2.00 X 0 0 0 RODNEY CHRISMAN 2.00 X 0 0 0 EMMA ESKER 2.00 X 0 0 0 HELEN FARDO 2.00 X 0 0 0 PEGGY HOLLINGSWORTH 2.00 X 0 0 0 PAULA MAIONCHI MD 2.00 X 0 0 0 LAURA MELIUS 2.00 X 0 0 0 KS PARK JR 2.00 X 0 0 0 REV MARY LOU STEPEHENS 2.00 X 0 0 0 JANROSE TUNNELL 2.00 X 0 0 0 BILL WALTERS 2.00 X 0 0 0 KENNETH WEDEL 2.00 X 0 0 0 ROBERT HUDSON 40.00 X 159751 0 33167 CHRISTOPHER T JONES 40.00 X 19235 0 3585 CHRIS MCCLURG 40.00 X 131194 0 6977 JILL CORNELISON 40.00 X 102163 0 12445 PATRICIA OLDS 40.00 X 82913 0 19883 DR ROSHAN PAIS 40.00 X 330657 0 24120 DR OLUBUNMI ADEGBOYEGA 40.00 X 319887 0 23850 DR GINA D'COSTA 40.00 X 192356 0 22766 DR NUZHAT NAQVI 40.00 X 179942 0 26127 DR RICHARD SHELTON 40.00 X 188258 0 10100 1706356 0 183020 19 0 1 0 ANESTHESIA SERVICES 995 EASTERN BYPASS RICHMOND KY 40475 ANESTHESIA SERVICES 906009 ARAMARK 10510 TWIN LAKES PARKWAY CHICAGO IL 60693 EQUIPMENT MAINTENANCE SERVICE 615539 KENTUCKY LITHOTRIPSY PO BOX 847324 DALLAS TX 75284 LITHOTRIPSY SERVICE 284425 HEALTHCARE CLAIMS MGMT 2424 E 55TH STREET INDIANAPOLIS IN 46220 CLAIMS MANAGMENT 264252 DR RAHUL REDDY 3012 LONG CREEK WAY LOUISVILLE KY 40245 HOSPITALIST SERVICE 216038 13 135003 1048070 1183073 NET PATIENT SERVICE RE 623990 61731567 61731567 61731567 213598 213598 609364 332034 277330 277330 277330 251544 354802 109232 365893 142312 -11091 131221 131221 PHARMACY INCOME 900099 805202 805202 MISC. INCOME 900099 224146 224146 CAFETERIA INCOME 900099 201011 201011 11891 11891 1242250 64779039 62008897 0 1587069 498841 498841 23675446 20924543 2750903 852676 852676 2622138 2622138 1780293 1780293 149523 149523 99105 99105 1375331 1375331 138844 11763 127081 12330220 11984332 345888 3676671 2304062 1372609 54639 266 54373 1074320 1074320 3352712 3352712 1146116 14792 1131324 BAD DEBT EXPENSE 7704800 7704800 PURCHASED SERVICES 4584087 3063882 1520205 PHYSICIAN RECRUTMENT 531388 531388 DUES & SUBSCRIPTIONS 120308 13065 107243 43668 43668 65811126 57621484 8189642 0 7180864 7461608 4713844 4336920 1638111 1289983 1956125 1777008 861074 726743 78120277 44740353 34999252 33379924 463413 489352 85269 170554 51897952 49632092 4823545 4266484 12644554 12077147 6037814 5739302 3396999 4224306 26902912 26307239 X 20290422 18824956 4704618 4499897 24995040 23324853 51897952 49632092 X -1032087 -638100 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3592 3592 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE ABOVE AMOUNT REPRESENTS THE PORTION OF ANNUAL DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES CARRIED OUT BY KENTUCKY HOSPITAL ASSOCIATION. 4704618 357693 -62205 42118 458091 4499897 5226569 31281 -28741 68878 455613 4704618 5782965 73558 -36523 137816 455615 5226569 1.00000 0 0 352992 352992 43887169 18054965 25832204 664658 91024 573634 32422508 26594364 5828144 792950 792950 33379924 THIRD PARTY PAYABLE 428579 PENSION LIABILITY 3795727 4224306 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ASSETS WHOSE USE IS LIMITED INCLUDE ASSETS SET ASIDE BY THE HOSPITAL'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. 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. 1 1 1 X 0 1 1 1 0 1 1 3319555 1254043 2065512 0.03550 10125744 8096828 2028916 0.03490 13445299 9350871 4094428 0.07040 36110 3050 33060 0.00060 75336 75336 0.00130 28900 28900 0.00050 140346 3050 137296 0.00240 13585645 9353921 4231724 0.07280 10300 10300 0.00020 850 850 0.00000 740 740 0.00000 4230 4230 0.00010 725 725 0.00000 16845 16845 0.00030 0 3338858 0 19128827 18500758 628069 X 1 0 1 1 PATTIE A CLAY INFIRMARY ASSOCIATIONINC

801 EASTERN BYPASS RICHMOND KY 40475

X NOT REQUIRED FOR 2010 1 6 INSTANT CARE CENTER

648 UNIVERSITY SHOPPING CENTER RICHMOND KY 40475

NON-EMERGENT AMBULATORY CARE CENTER OCCUPATIONAL MEDICINE CENTER

646 UNIVERSITY SHOPPING CENTER RICHMOND KY 40475

OCCUPATIONAL MEDICINE WOUND CARE CENTER

114 BIG HILL AVE RICHMOND KY 40475

WOUND CARE GARRARD CO HEALTH CENTER

436 RICHMOND ST LANCASTER KY 40444

PHYSICIAN OFFICE OUTPATIENT LAB ON BIG HILL

114 BIG HILL AVE RICHMOND KY 40475

OUTPATIENT LAB HEALTH AND EDUCATION CENTER

HARPERS SQ 2150 LEXINGTON RD STE A RICHMOND KY 40475

HEALTH CENTER PART I, LINE 3C: AS PROVIDED FOR IN THE WRITTEN CHARITY CARE POLICY, AN INDIVIDUAL MUST MEET ALL OF THE FOLLOWING CONDITIONS TO QUALIFY FOR CHARITY:A. THE INDIVIDUAL IS A RESIDENT OF KENTUCKYB. THE INDIVIDUAL IS NOT ELIGIBLE FOR MEDICAIDC. THE INDIVIDUAL IS NOT COVERED BY A 3RD PARTY PAYORD. THE INDIVIDUAL IS NOT IN THE CUSTODY OF A UNIT OF GOVERNMENT WHICH IS RESPONSIBLE FOR COVERAGE OF THE ACUTE CARE NEEDS OF THE INDIVIDUAL.THE INDIVIDUAL MEETS THE FOLLOWING INCOME AND RESOURCES CRITERIA:HOUSEHOLD SIZE MONTHLY INCOME LIMIT ANNUAL INCOME LIMIT1 $903.00 $10,830.002 $1,214.00 $14,570.003 $1,526.00 $18,310.004 $1,837.00 $22,050.005 $2,149.00 $25,790.00FOR EACH ADDITIONAL MEMBER ADD $3,740 ANNUAL. PART I, LINE 7: COST ACCOUNTING PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7704800. PART II: PAC'S COMMUNITY BUILDING ACTIVITY FOCUS IS ON IMPROVING THE HEALTH AND WELLNESS OF LOCAL COMMUNITIES THROUGH EDUCATION, AWARENESS, AND DIAGNOSTIC TREATMENTS. MUCH OF THE COMMUNITY BUILDING AWARENESS OF PAC AND EVEN PREFERENCE FOR SPONSORSHIPS ARE GIVEN FOR CAUSES THAT (1) SUPPORT OUR PURPOSE AND PROVIDE CULTURALLY COMPETENT QUALITY HEALTHCARE TO A DIVERSE POPULATION IN MADISON COUNTY AND NEIGHBORING COMMUNITIES, (2) ARE HEALTH CARE RELATED, (3) SUPPORT THE PRIORITIES IDENTIFIED AS COMMUNITY HEALTH INITIATIVES, (4) SUPPORT LOCAL (MADISON/GARRARD COUNTIES) WORK AND/OR EVENTS, AND (5) SERVE MANY RATHER THAN A FEW. COMMUNITY ACTIVITIES RANGE FROM ANNUAL HEALTH FAIRS AND FREE PROSTATE SCREENINGS TO PROVIDING FITNESS PROGRAMS IN LOCAL SCHOOLS AND SERVING IN LOCAL CIVIC AND COMMUNITY ORGANIZATIONS. PART III, LINE 4: LINE 2 FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: THE HOSPITAL ESTIMATES AN ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE BASED ON AN EVALUATION OF THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 2 EXPLANATION FOR COSTING METHODOLOGY: THE COST TO CHARGE RATIO IS THE METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST.PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 3 EXPLANATION FOR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: NO OTHER BAD DEBT AMOUNTS HAVE BEEN INCLUDED AS COMMUNITY BENEFIT. THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE AND FOR THIS REASON, THE ORGANIZATION BELIEVES IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED DECEMBER 31, 2010: HOSPITAL STATEMENT OF REIMBURSABLE COST. THE NET AMOUNT WAS NOT TREATED AS COMMUNITY BENEFIT. THE REVENUE INCLUDED FROM MEDICARE FOR THIS CALCULATION INCLUDES REIMBURSABLE BAD DEBTS RECEIVED. THE BAD DEBT AMOUNTS DO NOT HAVE ANY ALLOWABLE COSTS FOR THE CURRENT PERIOD WHICH RESULTS IN A SURPLUS FOR PRESENTATION PURPOSES ON SCHEDULE H. THE RESULTING SURPLUS SHOULD NOT BE CONSTRUED THAT MEDICARE REVENUE RECEIVED HAVE REIMBURSED THE TOTAL COSTS IN FULL. PART VI, LINE 2: PATTIE A. CLAY REGIONAL MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF OUR SERVED COMMUNITIES IN A VARIETY OF WAYS. ONE EXAMPLE IS COMMUNITY WORK GROUPS WHICH MEET MONTHLY TO DISCUSS VARIOUS CURRENT AND EMERGING COMMUNITY HEALTH ISSUES ULTIMATELY DETERMINING TREATMENT AND EDUCATION PROTOCOLS. THIS GROUP IS COMPRISED OF HOSPITAL CLINICAL PROFESSIONALS, SCHOOL ADMINISTRATORS, LOCAL COLLEGE ADMINISTRATORS, EMERGENCY PREPAREDNESS OFFICIALS AND LOCAL HEALTH DEPARTMENT OFFICIALS TO NAME A FEW. ANOTHER ASSESSMENT PAC CONDUCTS IS A PHYSICIAN NEEDS ANALYSIS ON A REGULAR BASIS TO ENSURE COMMUNITY HAS ADEQUATE PHYSICIAN COVERAGE IN ALL NEEDED DISCIPLINES. PART VI, LINE 3: SIGNS AT REGISTRATION ARE POSTED STATING FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR INDIVIDUALS TO CONTACT THE FINANCIAL COUNSELOR IF INDIVIDUALS HAVE QUESTIONS. IN ADDITION ALL SELF PAY IN-PATIENTS ARE VISITED BY FINANCIAL COUNSELORS DURING THE HOSPITAL STAY AND THE FINANCIAL ASSITANCE PROGRAM IS EXPLAINED.SELF PAY STATEMENTS INDICATE FOR THE PATIENT TO CONTACT THE FINANCIAL COUNSELOR'S OFFICE WITH QUESTIONS IF HE/SHE FEELS THEY MIGHT BE ELIGIBLE FOR ASSISTANCE.ALL SELF PAY PATIENT VISITS ARE REVIEWED THE FOLLOWING DAY BY THE FINANCIAL COUNSELOR. A DAILY PRINTOUT IS REVIEWED WHICH INCLUDES PATIENTS' PHONE NUMBERS FOR THE FINANCIAL COUNSELOR TO CONTACT AND INFORM THE PATIENT ABOUT THE FINANCIAL ASSISTANCE PROGRAM. IF UNABLE TO CONTACT BY PHONE OR NO PHONE NUMBER IS AVAILABLE, A LETTER IS MAILED TO THE PATIENT TO PROVIDE THEM WITH A CONTACT FOR THE FINANCIAL COUNSELOR'S OFFICE.THE HOSPITAL WEB PAGE HAS THE FINANCIAL COUNSELOR'S PHONE NUMBER FOR CONTACT AND A BRIEF DESCRIPTION ABOUT THE PROGRAM FOR PATIENT WHO ARE INTERESTED AND POSSIBLY ELIGIBLE FOR ASSISTANCE. PART VI, LINE 4: PATTIE A. CLAY REGIONAL MEDICAL CENTER IS LOCATED IN THE FOOTHILLS OF APPALACHIA, IN CENTRAL KENTUCKY IN THE COMMUNITY OF RICHMOND. LIKE MANY OTHER REGIONAL FACILITIES THROUGHOUT THE COUNTRY, PAC PROVIDES HEALTHCARE SERVICES TO A NUMBER OF COUNTIES. PAC'S IMMEDIATE SERVICE AREA IS MADISON, ESTILL, GARRARD, AND JACKSON COUNTIES. IN ADDITION, PEOPLE FROM OVER TEN SURROUNDING COUNTIES COME TO PAC TO TAKE ADVANTAGE OF THE WIDE VARIETY OF SPECIALTY MEDICAL SERVICES. PAC IS LOCATED IN MADISON COUNTY. FROM THE 2010 CENSUS, THERE WERE 82,916 PEOPLE, 29,720 HOUSEHOLDS, AND 18,812 FAMILIES RESIDING IN THE COUNTY. THERE WERE 33,806 HOUSING UNITS. THE RACIAL MAKEUP OF THE COUNTY WAS 91.6% WHITE, 4.4% BLACK OR AFRICAN AMERICAN, 0.28% NATIVE AMERICAN, 0.3% ASIAN, 0.34% FROM OTHER RACES, AND 2.0% FROM TWO OR MORE RACES. 2.12% OF THE POPULATION WERE HISPANICS OR LATINOS OF ANY RACE.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $40,241. THE PER CAPITA INCOME FOR THE COUNTY WAS $20,649. ABOUT 19.2% OF THE POPULATION WERE BELOW THE POVERTY LINE. PART VI, LINE 6: THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH HAVING A MAJORITY OF INDEPENDENT GOVERNING BODY MEMBERS WHO ALL RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA; HAVING AN OPEN MEDICAL STAFF; AND RE-INVESTING ANY OPERATING SURPLUS TO CONTINUE PROVIDING QUALITY HEALTHCARE TO ALL IN THE HOSPITAL'S SERVICE AREA. PART VI, LINE 7: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. REPORTS FILED WITH STATES PART VI, LINE 7 KY X X X X X 0 0 0 0 0 0 0 0 0 ROBERT HUDSON 159751 0 0 0 0 0 29687 0 3480 0 192918 0 0 0 DR ROSHAN PAIS 330657 0 0 0 0 0 23850 0 270 0 354777 0 0 0 DR OLUBUNMI ADEGBOYEGA 319887 0 0 0 0 0 23850 0 0 0 343737 0 0 0 DR GINA D'COSTA 192356 0 0 0 0 0 22766 0 0 0 215122 0 0 0 DR NUZHAT NAQVI 179942 0 0 0 0 0 21007 0 5120 0 206069 0 0 0 DR RICHARD SHELTON 188258 0 0 0 0 0 9630 0 470 0 198358 0 0 0 HEALTHCARE SYSTEM REFUNDING REVENUE BONDS SERIES 2008 2008-12-12 8000000 REFUND EXISTING DEBT 0 0 0 HEALTHCARE SYSTEM REVENUE & REFUNDING REVENUE BONDS SERIES 2008 2008-12-29 4500000 CONSTRUCTION 0 0 0 8000000 16500 2009 1 0 1 1 4500000 74859 4023000 2009 0 0 1 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 EMMA ESKER'S SPOUSE SPOUSE OF BOARD MEMBER 906009 MRS. ESKER'S HUSBAND IS AN ANESTHESIOLOGIST. HE WORKS FOR AN ANESTHESIA GROUP THAT PROVIDES SERVICES TO THE HOSPITAL. IN 2010 THE HOSPITAL PAID ANESTHESIA SERVICES $906,009 FOR SERVICES THAT THE COMPANY PROVIDED TO THE HOSPITAL. 0 FORM 990, PART VI, SECTION A, LINE 7A BOARD OF DIRECTORS ARE ELECTED BY INFIRMARY ASSOCIATION WITH SEVEN MEMBERS ELECTED ON RECOMMENDATION OF THE CURRENTLY RECOGNIZED CHURCHES OF RICHMOND AND FIVE MEMBERS SELECTED BY THE INFIRMARY ASSOCIATION. 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 A 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 B, LINE 12C BOARD MEMBERS, ADMINISTRATIVE STAFF, AND DEPARTMENT DIRECTORS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE STATEMENT EDUCATES BOARD MEMBERS ON SITUATIONS THAT MIGHT CAUSE POTENTIAL CONFLICTS, DISCLOSES ANY POTENTIAL CONFLICT, AND PROVIDES DOCUMENTATION REGARDING FOLLOW UP PROCEDURES FOR ANY POTENTIAL CONFLICT. THE ORGANIZATION HAS A CORPORATE COMPLIANCE OFFICER WHO IS CHARGED WITH MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S DIRECTOR OF HUMAN RESOURCES (HR) COMPLETES AN ANNUAL SALARY SURVEY. DATA IS COMPILED FROM TWO SOURCES; THE KENTUCKY SOCIETY OF HEALTHCARE HUMAN RESOURCES ADMINISTRATORS (KSHHRA) AND THE KENTUCKY HOSPITAL ASSOCIATION (KHA). BOTH OF THESE RESOURCES USE A THIRD PARTY TO RETRIEVE AND ANALYZE DATA. KHA USES COMPDATA AND KSHHRA USES HR ADVANTAGE. THE DIRECTOR OF HR TAKES EVERY POSITION WITHIN THE ORGANIZATION AND MATCHES A POSITION FROM EACH GROUP AND COMPARES WHAT THE CURRENT COMPENSATION RATES ARE WITH THE SURVEY RESULTS AND ANALYZES EACH POSITION TO DETERMINE WHERE THE ORGANIZATION IS COMPARED TO THE MARKET. A LIST IS COMPILED FOR POSITIONS IN WHICH THE ORGANIZATION IS COMPENSATING LOWER THAN THE MARKET WITH RECOMMENDATIONS TO INCREASE THE COMPENSATION FOR THOSE POSITIONS. THE LIST AND RECOMMENDATIONS ARE GIVEN TO THE ADMINISTRATIVE TEAM. AFTER REVIEWING THE DATA PRESENTED AND THE RECOMMENDATIONS THE ADMINISTRATIVE TEAM WILL OFFER ITS SUGGESTIONS AND MAKE A FINAL RECOMMENDATION TO THE BOARD. THE BOARD OF DIRECTORS MAKES THE FINAL DECISION ON CHANGES TO THE ANNUAL COMPENSATION PACKAGE. THE ANNUAL COMPENSATION ADJUSTMENT FOR THE CEO IS ALWAYS PUT IN WRITING AS APPROVED BY THE BOARD AND FILED IN THE HR DEPARTMENT. FOR NEW EMPLOYEES A RANGE IS SET FOR ALL POSITIONS WITH THE EXCEPTION OF DEPARTMENT DIRECTORS AND THOSE IN HIGHER POSITIONS. THE SALARIES FOR DEPARTMENT DIRECTORS AND ABOVE ARE DETERMINED BY THE VP OVER THAT PARTICULAR AREA WITH INPUT FROM THE HR DIRECTOR BASED ON INFORMATION FROM THE SURVEYS MENTIONED ABOVE. THE DETERMINED COMPENSATION RATE IS COMMUNICATED TO THE NEW EMPLOYEE VIA AN OFFER LETTER AND DOCUMENTED ON THE REQUEST TO HIRE IN HIS/HER PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS 105,510. CHANGE IN MINIMUM PENSION LIABILITY -743,610. TOTAL TO FORM 990, PART XI, LINE 5: -638,100. AUDIT OVERSIGHT FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. PATTIE A CLAY HOSPITAL AUXILIARY PO BOX 1600 RICHMOND KY 404762603 510172717 SUPPORTS PATTIE A. CLAY INFIRMARY ASSOCIATION KY 501(C)(3) LINE 9, SCH A PATTIE A CLAY INFIRMARY ASSOCIATION 1 PATTIE A CLAY FOUNDATION PO BOX 1600 RICHMOND KY 404762603 311506378 ENHANCE,PROMOTE,& FINANCIALLY SUPPORT PATTIE A. CLAY REGIONAL MEDICAL CENTER KY 501(C)(3) LINE 11C, SCH A PATTIE A CLAY INFIRMARY ASSOCIATION 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 PATTIE A CLAY HOSPITAL AUXILIARY 0 N/A PATTIE A CLAY FOUNDATION 0 N/A