2011-11-15T11:19:59-06:00 2010-12-31 MOSS ADAMS LLP PO BOX 22650 YAKIMA WA 989072650 990 2010-01-01 911266346 KADLEC HEALTH SYSTEM KADL 5099464611 888 SWIFT BLVD RICHLAND WA 993523583 JULIE MEEK 5099464611 2011-11-10 1 CATHY STERBENZ 5092487750 2010 2016-03-07 17:11:31Z JULIE MEEK 888 SWIFT BLVD RICHLAND WA 993523583 39485544 0 X WWW.KADLECMED.ORG X 1984 WA TO PROVIDE QUALITY HEALTHCARE FOR EVERY PATIENT. 11 11 344 0 6500 3550 0 0 30081677 39212414 0 142 193430 140309 30275107 39352865 0 0 0 0 23642192 32610162 0 0 0 17601242 18758869 41243434 51369031 -10968327 -12016166 15793870 17209514 6388966 5782915 9404904 11426599 X TO PROVIDE QUALITY HEALTHCARE FOR EVERY PATIENT. THROUGH THE SUPPORT OF KADLEC REGIONAL MEDICAL CENTER (KRMC), KADLEC MEDICAL ASSOCIATES IS DEDICATED TO INPATIENT CARE, DEFINED BY QUALITY AND COMPASSION.THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, KADLEC CLINIC SEEKS TO DELIVER EXCEPTIONAL, PATIENT-CENTERED CARE, TO PROVIDE A SUPERIOR PRACTICE ENVIRONMENT FOR ITS PHYSICIANS, AND TO ENSURE THE AVAILABILITY OF COMPREHENSIVE MEDICAL SERVICES FOR OUR COMMUNITIES. THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, KADLEC NEUROSCIENCE CENTER PROVIDES EXCEPTIONAL PATIENT-CENTERED NEUROLOGICAL CARE FOR OUR COMMUNITIES AND A SUPERIOR PRACTICE ENVIRONMENT FOR OUR PHYSICIANS AND PROVIDERS.THROUGH THE SUPPORT OF KADLEC HEALTH SYSTEM, TRICITIES NEPHROLOGY PROVIDES EXCEPTIONAL PATIENT-CENTERED NEPHROLOGY CARE FOR OUR COMMUNITIES AND A SUPERIOR PRACTICE ENVIRONMENT FOR OUR PHYSICIANS AND PROVIDERS. 1 0 9951522 11884049 KADLEC MEDICAL ASSOCIATES LLC (KMA) IS A DISREGARDED ENTITY WITHIN KHS WHICH PROVIDES HOSPITAL-BASED PHYSICIAN SERVICES TO KADLEC REGIONAL MEDICAL CENTER. THIS SERVICE ALLOWS PHYSICIANS IN THE COMMUNITY TO REMAIN IN THEIR OFFICE AND SERVICE MORE PATIENTS IN THE OUTPATIENT SETTING. 24113584 18784204 KADLEC CLINIC LLC (KC) IS A DISREGARDED ENTITY PROVIDING PHYSICIAN SERVICES AT LOCATIONS THROUGHOUT THE COMMUNITY. BRING PRIMARY CARE PHYSICIANS AND SPECIALISTS TO UNDERSERVED AREAS IRREGARDLESS OF ABILITY TO PAY. 8205713 8321591 KADLEC NEUROSCIENCE CENTER LLC (KNC) IS A DISREGARDED ENTITY AND WAS STARTED IN APRIL OF 2008 TO BRING A RANGE OF NEUROSCIENCE RELATED PHYSICIANS AND SERVICES TO THE AREA IN ORDER TO SERVE THIS PATIENT POPULATION. 1125563 332673 TRICITIES NEPHROLOGY LLC (TCN) IS A DISREGARDED ENTITY AND WAS ACQUIRED IN FEBRUARY OF 2009 TO BRING A NEPHROLOGY PHYSICIAN AND SERVICES TO THE AREA IN ORDER TO SERVE THIS PATIENT POPULATION. KHS IS A HEALTHCARE SYSTEM PROVIDING HOSPITAL AND PHYSICIANS SERVICES TO THE SURROUNDING COMMUNITY. 1125563 332673 43396382 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 41 0 1 344 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X JULIE L MEEK 5099464611 888 SWIFT BLVD RICHLAND WA 99352 RAND WORTMAN 50.00 X X 0 0 0 WILLIAM WINGO 2.00 X 0 0 0 MICHELE DICKINSON 2.00 X 0 0 0 DAVID LIPPES 2.00 X 0 0 0 SUSAN KREID 2.00 X 0 0 0 DAVID MERKLEY MD 2.00 X 0 0 0 THOMAS RADO MD 2.00 X 0 0 0 NEIL RAWLINS MD 2.00 X 150189 0 12407 RON SCHWARTZ MD 2.00 X 0 0 0 SAM VOLPENTEST 2.00 X 0 0 0 DAVIDSON WOOD 2.00 X 0 0 0 JOHN T SAMSELL MD 2.00 X 0 0 0 GREG BROWN MD 2.00 X 0 0 0 JAMES JOHNSON MD 2.00 X 0 0 0 WAYNE MARTIN 2.00 X 0 0 0 ERICK ISAACSON MD 2.00 X 0 0 0 BRIAN STALEY MD 2.00 X 0 0 0 JAMES MORASH 2.00 X 0 0 0 MICHAEL G HUPPE 50.00 X 211330 0 9663 W HUGH MALONEY 50.00 X 339181 0 17063 AL WICHTENDAHL 50.00 X 173293 0 2906 JEREMY BLANCHARD MD 2.00 X 391602 0 25498 MATTHEW FEWEL MD 2.00 X X 741427 83000 5467 GARY PODHAISKY MD 2.00 X 158957 0 11944 JOSH WELDIN MD 2.00 X 211530 0 8560 FRANK FLEMING 2.00 X 477172 0 8035 KEVIN TURNER MD 2.00 X 370691 23000 16176 WASSIM KHAWANDI MD 2.00 X 398009 31750 4830 MARK MULHOLLAND 60.00 X 585509 33000 17801 BRIAN O'GRADY MD 60.00 X 794712 0 5270 MELVIN WAHL MD 60.00 X 1313815 0 4934 ZIGA TRETJAK MD 60.00 X 539702 21000 3807 6857119 191750 154361 68 0 1 0 DELTA LOCUM TENENS PO BOX 202940 DALLAS TX 753202056 PHYSICAN LOCUM SERVICES 3342385 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 PHYSICAN LOCUM SERVICES 451005 HEALTHCARE PARTNERS PO BOX 720477 ATLANTA GA 30358 PHYSICIAN LOCUM SERVICES 321903 PRAXIS MEDICAL MANAGEMENT 5825 CALLAGHAN RD STE 203 SAN ANTONIO TX 78228 BILLING SERVICES FOR KMA 308784 LOCUM LEADERS 923 NORTH POINT PARKWAY SUITE 160 ALPHARETTA GA 30005 PHYSICAN LOCUM SERVICES 219061 7 NET PATIENT REVENUE 621400 32178701 32178701 PROFESSIONAL FEES FOR 621400 7033713 7033713 39212414 142 142 150142 6243 130277 2402 19865 3841 23706 23706 MEDICAL DIRECTOR FEES 900099 43888 43888 MISC. INCOME 900099 38861 32361 6500 RECOVERY EPIC EXPENSES 900099 33854 33854 116603 39352865 39322517 6500 23848 2999038 2999038 26563148 23956651 2606497 206718 177522 29196 1389458 1229102 160356 1451800 1257657 194143 13527 13527 60945 60945 228783 228783 5514067 5337344 176723 210796 63843 146953 3135434 2849436 285998 1515774 1515774 3357093 1881919 1475174 45275 25460 19815 303973 261364 42609 312037 312037 713156 254021 459135 910656 900572 10084 BAD DEBT 1178522 1174860 3662 TAXES 724718 607126 117592 DUES, SUBSCRIPTIONS, LI 205207 174839 30368 UTILITIES 168294 111920 56374 BANK FEES 91648 91648 0 68964 28533 40431 51369031 43396382 7972649 0 1207502 659657 3986152 4999775 10938 17301 84950 11466273 1884462 10208019 9581811 296309 1950970 15793870 17209514 1937980 1446181 4448554 4334302 2432 2432 6388966 5782915 X 9404904 11426599 9404904 11426599 15793870 17209514 X -12016166 14037861 X X 0 1 1 X 0 X 885486 885486 6478555 360751 6117804 1759203 290905 1468298 2343029 1232806 1110223 9581811 SECURITY DEPOSITS 23120 CONSTRUCTION IN PROGRESS 1927850 1950970 SECURITY DEPOSIT 2432 2432 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: KHS IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THESE ENTITIES ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2010 AND 2009, THERE WERE NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. X X 1 1 X X X 0 0 0 0 0 0 0 0 0 NEIL RAWLINS MD 150189 0 0 0 0 0 5250 0 7157 0 162596 0 0 0 MICHAEL G HUPPE 211330 0 0 0 0 0 6433 0 3230 0 220993 0 0 0 W HUGH MALONEY 301920 0 37261 0 0 0 10515 0 6548 0 356244 0 0 0 AL WICHTENDAHL 173293 0 0 0 0 0 0 0 2906 0 176199 0 0 0 JEREMY BLANCHARD MD 356598 0 0 0 35004 0 17016 0 8482 0 417100 0 0 0 MATTHEW FEWEL MD 741427 0 0 0 0 83000 0 0 5467 0 746894 83000 0 0 GARY PODHAISKY MD 158957 0 0 0 0 0 4735 0 7209 0 170901 0 0 0 JOSH WELDIN MD 186530 0 0 0 25000 0 1714 0 6846 0 220090 0 0 0 FRANK FLEMING 366639 0 110533 0 0 0 4543 0 3492 0 485207 0 0 0 KEVIN TURNER MD 255788 0 114903 0 0 23000 8934 0 7242 0 386867 23000 0 0 WASSIM KHAWANDI MD 316346 0 0 0 81663 31750 0 0 4830 0 402839 31750 0 0 MARK MULHOLLAND 301522 0 283987 0 0 33000 10666 0 7135 0 603310 33000 0 0 BRIAN O'GRADY MD 794712 0 0 0 0 0 0 0 5270 0 799982 0 0 0 MELVIN WAHL MD 775908 0 537907 0 0 0 0 0 4934 0 1318749 0 0 0 ZIGA TRETJAK MD 539702 0 0 0 0 21000 0 0 3807 0 543509 21000 0 0 PART I, LINE 1A THE BOARD IS ALLOWED TO TAKE THEIR COMPANION ON THE ANNUAL BOARD RETREAT. THE KC PRESIDENT MEADOW SPRINGS COUNTRY CLUB DUES ARE PAID BY THE CLINIC. NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 TRICITIES NEPHROLOGY BECAME PART OF THE ORGANIZATION PROVIDING NEPHROLOGY SERVICES. FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF DIRECTORS HIRED QUORUM HEALTH RESOURCES AS A MANAGEMENT COMPANY TO OVERSEE DAY TO DAY OPERATIONS OF THE HEALTH SYSTEM. THE PRESIDENT AND CEO IS AN EMPLOYEE OF QUORUM HEALTH RESOURCES. FORM 990, PART VI, SECTION B, LINE 11 IT IS PRESENTED TO THE GOVERNING BODY BY THE OUTSIDE GROUP USED TO PREPARE THE FORM. FORM 990, PART VI, SECTION B, LINE 12C IF SOMEONE IS SUSPECTED OF VIOLATING THE POLICY, THE COMPLIANCE OFFICER IS NOTIFIED AND RESEARCHES THE ISSUE. APPROPRIATE ACTIONS ARE TAKEN IF A VIOLATION OCCURS. EMPLOYEES MUST ANNUALLY ANSWER A NUMBER OF QUESTIONS REGARDING CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 15A - SALARY SURVEYS WERE USED AND FINAL COMP AMOUNTS ARE APPROVED BY THE EXECUTIVE TEAM. 15B - SALARY SURVEYS WERE USED AND MGMA PHYSICIAN COMP GUIDELINES WERE ALSO USED. FORM 990, PART VI, SECTION C, LINE 19 FORMS 990, FORMS 1023,GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT IN THE ACCOUNTING OFFICE AT KADLEC REGIONAL MEDICAL CENTER AND ARE AVAILABLE TO ANYONE UPON REQUEST. AUDITED FINANCIAL STATEMENTS ARE ALSO SENT OUT TO WHOEVER REQUESTS THEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: DISTRIBUTION TO RELATED ENTITY NOT REPORTED ON 990 14,037,861. TOTAL TO FORM 990, PART XI, LINE 5: 14,037,861. NO CHANGES HAVE BEEN MADE IN THE PAST YEAR. KADLEC CLINIC LLC 945 GOETHALS SUITE 220 RICHLAND WA 99352 204265899 PRIMARY CARE PHYSICIAN SERVICES WA 18784204 5224399 KADLEC HEALTH SYSTEM KADLEC MEDICAL ASSOCIATES LLC 888 SWIFT BLVD RICHLAND WA 993523583 203980865 INPATIENT HOSPITALISTS SERVICES WA 11884049 1384083 KADLEC HEALTH SYSTEM KADLEC NEUROSCIENCE CENTER LLC 800 SWIFT BLVD SUITE 300 RICHLAND WA 993523583 201613946 NEUROLOGICAL RELATED PHYSICIAN SERVICES WA 8321591 1612893 KADLEC HEALTH SYSTEM TRICITIES NEPHROLOGY LLC 309 BRADLEY SUITE 109 RICHLAND WA 99352 271041915 NEPHROLOGY PHYSICIAN SERVICES WA 341401 29787 KADLEC HEALTH SYSTEM KADLEC REGIONAL MEDICAL CENTER 888 SWIFT BLVD RICHLAND WA 99352 910655392 ACUTE CARE HOSPITAL WA 501(C)(3) LINE 3 KADLEC HEALTH SYSTEM 0 KADLEC FOUNDATION 800 SWIFT BLVD RICHLAND WA 99352 237005501 FUNDRAISING WA 501(C)(3) LINE 11A, I KADLEC HEALTH SYSTEM 0 KADLEC NEUROLOGICAL RESOURCE CENTER 712 SWIFT BLVD SUITE 1 RICHLAND WA 99352 911266345 EDUCATION ON NEUROLOGICAL DISORDERS WA 501(C)(3) LINE 7 KADLEC HEALTH SYSTEM 0 MID COLUMBIA MEDICAL ASSOCIATES 510 N COLORADO SUITE A KENNEWICK WA 99336 911987844 INFECTIOUS DISEASE AND NEPHROLOGY PHYSICIANS WA KADLEC HEALTH SYSTEM C 16689 22537 1.00000 KADLEC ENTERPRISES INC 888 SWIFT BOULEVARD RICHLAND WA 99352 911323736 ENGAGE IN BUSINESS RELATED TO HEALTHCARE AND TO SUPPORT KHS & AFFILIATES WA KADLEC HEALTH SYSTEM C 363 1.00000 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 KRMC I 16498 KHS KRMC J 1046317 KRMC N 618675 KRMC R 14037861