JENNIE STUART MEDICAL CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
JENNIE STUART MEDICAL CENTER INC (EIN 61-0482973)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201133189349306588
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T17:05:19-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1400 E MAIN ST STE 200 PO BOX 1196AddressLine1
CityBOWLING GREENCity
StateKYState
ZIP Code421021196ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN610482973EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JENNIE STUART MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJENNNameControl
Phone2708870100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1320 W 18TH STREETAddressLine1
CityHOPKINSVILLECity
StateKYState
ZIP Code42240ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSam BrownName
TitleChief Financial OfficerTitle
Date Signed2011-11-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM SCIFRESName
Phone2707810111Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonERIC LEENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1320 W 18TH STREETAddressLine1
CityHOPKINSVILLECity
StateKYState
ZIP Code42240ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112846027GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.JSMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1914YearFormation
State Legal DomicileKYStateLegalDomicile
Activity Or Mission DescriptionJSMC IS COMMITTED TO EXCELLENCE IN SERVICE, AND WE EXIST TO PROMOTE, PRESERVE AND ACCOMMODATE THE GROWING HEALTHCARE NEEDS OF OUR COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees977TotalNbrEmployees
Total Nbr Volunteers78TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year12315ContributionsGrantsPriorYear
Contributions Grants Current Year150ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11064477ProgramServiceRevenuePriorYear
Program Service Revenue CY105692900ProgramServiceRevenueCY
Investment Income Prior Year104987InvestmentIncomePriorYear
Investment Income Current Year623442InvestmentIncomeCurrentYear
Other Revenue Prior Year107038OtherRevenuePriorYear
Other Revenue Current Year1147783OtherRevenueCurrentYear
Total Revenue Prior Year11288817TotalRevenuePriorYear
Total Revenue Current Year107464275TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3361924SalariesEtcPriorYear
Salaries Etc Current Year44089533SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7243949OtherExpensePriorYear
Other Expenses Current Year62050406OtherExpensesCurrentYear
Total Expenses Prior Year10605873TotalExpensesPriorYear
Total Expenses Current Year106139939TotalExpensesCurrentYear
Revenues Less Expenses Prior Year682944RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1324336RevenuesLessExpensesCY
Total Assets BOY157798390TotalAssetsBOY
Total Assets EOY155997278TotalAssetsEOY
Total Liabilities BOY87291886TotalLiabilitiesBOY
Total Liabilities EOY85747308TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY70506504NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY70249970NetAssetsOrFundBalancesEOY
Mission DescriptionJSMC IS COMMITTED TO EXCELLENCE IN SERVICE, AND WE EXIST TO PROMOTE, PRESERVE AND ACCOMMODATE THE GROWING HEALTHCARE NEEDS OF OUR COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense96016421Expense
Revenue106210001Revenue
DescriptionPROVIDE HOSPITAL INPATIENT, OUTPATIENT, AND EMERGENCY ROOM SERVICES TO AREA RESIDENTS. IN RECOGNITION OF ITS MISSION, JSMC WILL STRIVE TO PASSIONATELY PURSUE A CULTURE OF EXCEPTIONAL SERVICE AND A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT. THE HOSPITAL PROVIDED APPROXIMATELY $5,443,000 IN CHARITY DURING 2010.Description
Total Program Service Expense96016421TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109699NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees977NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledKYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJIM BISHOPNamePerson
Telephone Number2708870251TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1320 W 18TH STREETAddressLine1
CityHOPKINSVILLECity
StateKYState
ZIP Code42240ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BRECK CAYCE
CHAIRMAN1.0XX000
THERESA NICHOL
SECRETARY/TREASURER1.0XX000
DAN KEMP
BOARD MEMBER1.0X000
STEVE TRIBBLE
BOARD MEMBER1.0X000
ALAN BEARD
BOARD MEMBER1.0X000
TOM BELL
BOARD MEMBER1.0X000
RAY COBB
VICE CHAIRMAN1.0XX000
EARL CALHOUN
BOARD MEMBER1.0X000
ALBERT SISK
BOARD MEMBER1.0X000
PAUL HERRELL MD
BOARD MEMBER1.0X000
KELLY WORKMAN
BOARD MEMBER1.0X000
DANIEL LOPEZ
BOARD MEMBER1.0X531300
TERRY PEEPLES
CEO40.0X271580077506
ERIC LEE
VP - DEVELOPMENT40.0X17743909211
SAM BROWN
CFO40.0X187001051445
AUSTIN MOSS
VP - HR40.0157060012876X
DEBBIE BAUER
VP - CLINICAL40.015461408619X
MARTY BOZARTH
DIRECTOR, RADIATION ONCOLOGY40.0152102013247X
MALLIKARJUN KAMISHETTI
PHYSICIAN40.0261217016910X
J D LITTLETON
PHYSICIAN40.027130504227X
PANKAJKUMARC SHAH
PHYSICIAN40.0262397016939X
PARTH SHAH
PHYSICIAN40.0261187016808X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2161215TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation227788TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THOR SYSTEMS
536 NOEL AVEHOPKINSVILLEKY42240I/S MANAGEMENT1627314
CHRISTIAN COUNTY ANESTHESIA
103 W 18TH STREETHOPKINSVILLEKY42240PHYSICIAN PAYMENT720000
MEDICAL STAFFING SOLUTIONS
8401 N KENTUCKY AVE STE GEVANSVILLEIN47725CONTRACT NURSING508100
QUORUM HEALTH RESOURCES
105 CONTINENTAL PLACEBRENTWOODTN37027MANAGEMENT SERVICES1081513
CCSTP LLC
320 W 18TH STREETHOPKINSVILLEKY42240PHYSICIAN PAYMENT435860
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
All Other Contributions150AllOtherContributions
Total Contributions150TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column105692900TotalRevenueColumn
Related Or Exempt Function Income105692900RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue105692900TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column686977TotalRevenueColumn
Exclusion$686,977ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real566504Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real336875Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real229629Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column229629TotalRevenueColumn
Exclusion$229,629ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4981342Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5030814Securities
Other14063Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-49472Securities
Other-14063Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-63535TotalRevenueColumn
Exclusion-$63,535ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA SALES722210365649$365,649
WESTERN STATE REVENUE621110488708488708
PHYSICIAN DUES6211101595015950

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column47847TotalRevenueColumn
Related Or Exempt Function Income12443RelatedOrExemptFunctionIncome
Exclusion$35,404ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue918154TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column107464275TotalRevenueColumn
Related Or Exempt Function Income106210001RelatedOrExemptFunctionIncome
Exclusion$1,254,124ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1107351Total
Management And General1107351ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total34463942Total
Program Services32594819ProgramServices
Management And General1869123ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total405694Total
Program Services371747ProgramServices
Management And General33947ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5570387Total
Program Services5104278ProgramServices
Management And General466109ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2542159Total
Program Services2329441ProgramServices
Management And General212718ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1446750Total
Program Services373785ProgramServices
Management And General1072965ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total307954Total
Program Services21892ProgramServices
Management And General286062ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total87414Total
Management And General87414ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10787529Total
Program Services10155324ProgramServices
Management And General632205ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total280503Total
Program Services34699ProgramServices
Management And General245804ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total18970160Total
Program Services18467303ProgramServices
Management And General502857ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1435126Total
Program Services1323626ProgramServices
Management And General111500ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2252761Total
Program Services2124486ProgramServices
Management And General128275ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total230333Total
Program Services168194ProgramServices
Management And General62139ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total3491045Total
Program Services3491045ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7232414Total
Program Services7232414ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total930758Total
Program Services152141ProgramServices
Management And General778617ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS1030462310304623
EXTENDED BUSINESS623323623323
REPAIRS & MAINTENANCE84039282029920093
PROVIDER TAX18370811837081
MALPRACTICE CLAIMS-290273-290273

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1282513Total
Program Services322982ProgramServices
Management And General959531ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total106139939Total
Program Services96016421ProgramServices
Management And General10123518ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15523328BOY
EOY19092796EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21274308BOY
EOY22897104EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14541723BOY
EOY13342465EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1470347BOY
EOY1372599EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1598286BOY
EOY1610484EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3980898BOY
EOY3823608EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis157810786LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec78541855LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY82881150BOY
EOY79268931EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY10054610BOY
EOY11698395EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1898849BOY
EOY1808849EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4574891BOY
EOY1082047EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY157798390BOY
EOY155997278EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8055706BOY
EOY8906319EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY379934BOY
EOY300845EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY58965351BOY
EOY59008852EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY16290895BOY
EOY13722431EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3600000BOY
EOY3808861EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY87291886BOY
EOY85747308EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY69495093BOY
EOY69186177EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY199080BOY
EOY199365EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY812331BOY
EOY864428EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70506504BOY
EOY70249970EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY157798390BOY
EOY155997278EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1324336ReconcilationRevenueExpenses
Reconcilation Other Changes-1580870ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$7,254OtherActivitiesAmount
Total Lobbying Expenditures IIB7254TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING EXPENSESIdentifier
Return ReferenceSCH C, PART II-B, LINE 1IReturnReference
ExplanationJENNIE STUART PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE FOR LOBBYING.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4217751OtherCostOrOtherBasis
Book Value4217751BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis92443186OtherCostOrOtherBasis
Depreciation36408261Depreciation
Book Value56034925BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis520457OtherCostOrOtherBasis
Depreciation452625Depreciation
Book Value67832BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis58867672OtherCostOrOtherBasis
Depreciation40824966Depreciation
Book Value18042706BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1761720OtherCostOrOtherBasis
Depreciation865003Depreciation
Book Value905717BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings79268931TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
THIRD PARTY SETTLEMENTS$900,000
MEDICAL MALPRACTICE LIABILITY$2,600,000
FAIR VALUE INTEREST RATE SWAP$308,861
FieldValueIRS element (for citing)
Total Of Amounts3808861TotalOfAmounts
Total Revenue107464275TotalRevenue
Total Expenses106139939TotalExpenses
Excess Or Deficit For Year1324336ExcessOrDeficitForYear
Net Unrealized GL On Investments1876938NetUnrealizedGLOnInvestments
Other-$3,457,808OtherAmount
Total Adjustments-1580870TotalAdjustments
Excess Or Deficit Per FS-256534ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt106220280TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1876938NetUnrealizedGainsInvestments
Other Revenues-3457808OtherRevenues
Revenue Not Rptd F990-1580870RevenueNotRptdF990
Revenue Subtotal107801150RevenueSubtotal
Other Revenues Not Included-336875OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-336875RevenueNotRptdOnFinStmt
Total Revenue Per Form990107464275TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt106476814TotExpensesEtcAuditedFinclStmt
Other Expenses Included336875OtherExpensesIncluded
Expenses Not Rptd F990336875ExpensesNotRptdF990
Expenses Subtotal106139939ExpensesSubtotal
Total Expenses Per Form990106139939TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION TO AUDIT REPORT - REVENUESSCH D, PART XII, LINE 2D & 4B-------------------------------- OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990 PART VIII: CHANGE IN FV OF INTEREST RATE SWAP ($1,777,548) INVESTMENT IN EQUITY INVESTEE $253,813 CHANGE IN MINIMUM PENSION LIABILITY ($1,934,073) ------------- ($3,457,808) OTHER ITEMS INCLUDED ON FORM 990 PART VII BUT NOT ON LINE 1: RENTAL EXPENSE NETTED AGAINST INCOME PER RETURN ($336,875)
RECONCILIATION TO AUDIT REPORT - EXPENSESSCH D, PART XIII, LINE 2D-------------------------------- OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990 PART IX: RENTAL EXPENSE NETTED AGAINST INCOME PER RETURN ($336,875)
RECONCILIATION TO AUDIT REPORT - NET ASSETSSCH D, PART XI, LINE 8------------------------- OTHER RECONCILING ITEMS: CHANGE IN FV OF INTEREST RATE SWAP ($1,777,548) CHANGE IN ADDITIONAL PENSION LIABILITY ($1,934,073) INVESTMENT IN EQUITY INVESTEE $253,813 ------------ ($3,457,808)
UNCERTAIN TAX POSITIONSSCH D, PART X, LINE 2------------------------ THE MEDICAL CENTER HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE MEDICAL CENTER IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE MEDICAL CENTER FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTIONS. WITH A FEW EXCEPTIONS, THE MEDICAL CENTER IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4210678TotalCommunityBenefitExpense
Direct Offsetting Revenue601691DirectOffsettingRevenue
Net Community Benefit Expense4210678NetCommunityBenefitExpense
Percent Of Total Expense0.04390PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11912143TotalCommunityBenefitExpense
Direct Offsetting Revenue10492358DirectOffsettingRevenue
Net Community Benefit Expense1419785NetCommunityBenefitExpense
Percent Of Total Expense0.01480PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense16122821TotalCommunityBenefitExpense
Direct Offsetting Revenue11094049DirectOffsettingRevenue
Net Community Benefit Expense5630463NetCommunityBenefitExpense
Percent Of Total Expense0.05870PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense60801TotalCommunityBenefitExpense
Direct Offsetting Revenue1185DirectOffsettingRevenue
Net Community Benefit Expense59616NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense17700TotalCommunityBenefitExpense
Net Community Benefit Expense17700NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense78501TotalCommunityBenefitExpense
Direct Offsetting Revenue1185DirectOffsettingRevenue
Net Community Benefit Expense77316NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16201322TotalCommunityBenefitExpense
Direct Offsetting Revenue11095234DirectOffsettingRevenue
Net Community Benefit Expense5707779NetCommunityBenefitExpense
Percent Of Total Expense0.05950PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense1000TotalCommunityBuildingExpense
Net Community Building Expense1000NetCommunityBuildingExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense64550TotalCommunityBuildingExpense
Net Community Building Expense64550NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense64954TotalCommunityBuildingExpense
Net Community Building Expense64954NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense6077TotalCommunityBuildingExpense
Net Community Building Expense6077NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense136581TotalCommunityBuildingExpense
Net Community Building Expense136581NetCommunityBuildingExpense
Percent Of Total Expense0.00150PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$4,206,867BadDebtExpenseAmount
Amount Attributable To3155150AmountAttributableTo
Amount Reimbursed By Medicare31829317AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare35240513CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3411196MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1PHYSICIANS HOLDINGSBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityOPERATE O/P DIAGNOSTIC CENTERDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.55500OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.45500PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1JENNIE STUART MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1320 WEST 18TH STREETAddressLine1
CityHOPKINSVILLECity
StateKYState
ZIP Code42240ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JENNIE STUART MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BAD DEBT EXPENSESCH H, PART III, LINE 4ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATIONS AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. Accounts are not classified as charity care until all charity care paperwork and supporting documentation is received by Jennie Stuart Medical Center. Approximately 75% of accounts written off as bad debt would qualify for charity care if the necessary documentation were received by Jennie Stuart Medical Center.
CALCULATION OF MEDICARE ALLOWABLE COSTSSCH H, PART III, LINE 8COSTS REPORTED ON LINE 6 ARE OBTAINED USING THE MEDICARE COST REPORT COST TO CHARGE RATIO.
NEEDS ASSESSMENTSCH H, PART VI, QUESTION 2During the strategic business planning session, the administrataive group analyzes new services that may be needed. This plan is based on 5 pillars, one of which is growth.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESCH H, PART VI, QUESTION 3Signs are displayed in all registration areas to notify regarding the programs available. Also, counselors are available to provide information and work with patients.
COMMUNITY INFORMATIONSCH H, PART VI, QUESTION 4JSMC is the only non-military acute care facility in Chrisitan County, Kentucky. Christian, Todd and Trigg Counties make up JSMC's primary service area. JSMC's secondary service area is comprised of Caldwell, Hopkins, and Muhlenberg Counties in Kentucky. Hopkinsivlle is the 7th largest city in Ky and is appx 75 miles from Nashville, TN.
PROMOTION OF COMMUNITY HEALTHSCH H, PART VI, QUESTION 5JSMC provides the facility for St Luke Clinic. This is a free clinic for the "working poor". JSMC mangages two offsite facilities that provide outpatient surgery and diagnostic imaging services. These facilities were designed to accommodate the needs of the patients regarding the best of new technology, accessibility, and streamlining of the experience for the patient. The board is composed of 12 members that represent various professions in the community. JSMC sponsors annually a Women's health fair, provides various other free screenings during the year.
STATE FILING OF COMMUNITY BENEFIT REPORT990 SCHEDULE H, PART VIKY,

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TERRY PEEPLES
260160000114200597050178010349086000
ERIC LEE
176359000108004693045180186650000
SAM BROWN
18592100010800393400121050238446000
AUSTIN MOSS
1559800001080000128760169936000
DEBBIE BAUER
153534000108004534040850163233000
MARTY BOZARTH
151022000108004211090360165349000
MALLIKARJUN KAMISHETTI
2601370001080040340128760278127000
J D LITTLETON
270225000108004227000275532000
PANKAJKUMARC SHAH
2613170001080040630128760279336000
PARTH SHAH
2601070001080039320128760277995000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanation
COMPENSATION FROM UNRELATED ORGANIZATIONTHE HOSPITAL CONTRACTS THE SERVICES OF THE CEO AND CFO WITH QHR, AN UNRELATED ORGANIZATION. SALARIES AND BENEFITS RECEIVED THROUGH QHR ARE REPORTED ON SCHEDULE J, PART II.
SCHEDULE J, PART I, QUESTION 1ACOUNTRY CLUB MEMBERSHIP DUES WERE PAID FOR THE CEO

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF CHRISTIAN KENTUCKYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN616000824IssuerEIN
CUSIP Number170692CK1CUSIPNumber
Date Issued2008-09-18DateIssued
Issue Price62375000IssuePrice
Description Of PurposeREFUND OUTSTDG BONDS/CAPTL PROJECTDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds62375000TotalProceeds
Amount In Reserve Fund3510878AmountInReserveFund
Refunding Escrow21663929RefundingEscrow
Issuance Costs From Proceeds509860IssuanceCostsFromProceeds
Credit Enhancement2473091CreditEnhancement
Capital Expenditures34217242CapitalExpenditures
Current RefundingtrueCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DELEGATION OF MANAGEMENT DUTIESFORM 990, PART VI, LINE 3------------------------ THE MEDICAL CENTER CONTRACTS WITH QUORUM HEALTH RESOURCES, LLC TO PROVIDE MANAGEMENT SERVICES UNDER AN AGREEMENT WHICH EXPIRES AUGUST 29, 2013.
MONITORING THE CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12B AND 12C------------------------ ALL DEPARTMENT MANAGERS, VICE PRESIDENTS, MEMBERS OF THE MEDICAL STAFF, QUALIFIED PROFESSIONAL OR LICENSED INDEPENDENT PRACTITIONER IS AN INTERESTED PERSON. A CONFLICT IS DISCUSSED AT THE BOARD OR COMMITTEE MEETING LEVEL. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON TO INVESTIGATE ALTERNATIVES TO THE TRANSACTION OR ARRANGEMENT OR DETERMINE IF AN ACTUAL CONFLICT OF INTEREST EXISTS.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, SECTION B, LINE 15A AND 15B------------------------ AN ANNUAL COMPENSATION REVIEW WAS CONDUCTED IN 2010 FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS AND OTHER OFFICERS AND KEY EMPLOYEES.
MAKING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, SECTION C, LINE 19------------------------ THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
REVIEW OF FORM 990FORM 990, PART VI, SECTION B, LINE 11------------------------ THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND IS REVIEWED BY THE HOSPITAL'S CONTROLLER, VP OF FINANCE, AND CFO PRIOR TO FILING.
RECONCILIATION OF NET ASSETSFORM 990, PART XI, LINE 5----------------------------- OTHER CHANGES IN NET ASSETS: UNREALIZED GAINS ON INVESTMENTS $1,876,938 CHANGE IN FMV OF INTEREST RATE SWAP ($1,777,548) INVESTMENT IN EQUITY INVESTEE $253,813 CHANGE IN ADDITIONAL PENSION LIABILITY ($1,934,073) ------------ ($1,580,870)

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PHYSCNS' HDGSLLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1320 W 18 STAddressLine1
CityHOPKINSVILLECity
StateKYState
ZIP Code42240ZIPCode
FieldValueIRS element (for citing)
EIN261608818EIN
Primary ActivityBUILDING RENTALPrimaryActivity
Legal Domicile StateKYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeEXCLUDEDPredominantIncomeType
Share Of Total Income144065ShareOfTotalIncome
Share Of EOY Assets1066880ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$0CodeVAmount
General Or Managing PartnertrueGeneralOrManagingPartner
Percentage Ownership0.56000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PHYSICIANS' HOLDINGS LLC
J559073
PHYSICIANS' HOLDINGS LLC
I27272

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