2011-11-14T17:05:19-06:00 2010-12-31 BKD LLP 400 E MAIN ST STE 200 PO BOX 1196 BOWLING GREEN KY 421021196 990 2010-01-01 610482973 JENNIE STUART MEDICAL CENTER JENN 2708870100 320 W 18TH STREET HOPKINSVILLE KY 42240 Sam Brown 2011-11-14 true KIM SCIFRES 2707810111 2010 2016-02-24 21:20:13Z ERIC LEE 320 W 18TH STREET HOPKINSVILLE KY 42240 112846027 false X WWW.JSMC.ORG X 1914 KY JSMC IS COMMITTED TO EXCELLENCE IN SERVICE, AND WE EXIST TO PROMOTE, PRESERVE AND ACCOMMODATE THE GROWING HEALTHCARE NEEDS OF OUR COMMUNITY. 12 12 977 78 0 0 12315 150 11064477 105692900 104987 623442 107038 1147783 11288817 107464275 0 0 0 0 3361924 44089533 0 0 0 7243949 62050406 10605873 106139939 682944 1324336 157798390 155997278 87291886 85747308 70506504 70249970 JSMC IS COMMITTED TO EXCELLENCE IN SERVICE, AND WE EXIST TO PROMOTE, PRESERVE AND ACCOMMODATE THE GROWING HEALTHCARE NEEDS OF OUR COMMUNITY. false false 96016421 106210001 PROVIDE 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. 96016421 true false false true false false false false false true false false false true true true false false false false false false false false false true false false false true true false false false false false false false false false false false false false false false true true false false false true 99 0 true 977 true false false false false false false false false false false X 12 12 false true false false false false false true true false false false true true true true true true true true true KY X JIM BISHOP 2708870251 320 W 18TH STREET HOPKINSVILLE KY 42240 BRECK CAYCE 1.0 X X 0 0 0 THERESA NICHOL 1.0 X X 0 0 0 DAN KEMP 1.0 X 0 0 0 STEVE TRIBBLE 1.0 X 0 0 0 ALAN BEARD 1.0 X 0 0 0 TOM BELL 1.0 X 0 0 0 RAY COBB 1.0 X X 0 0 0 EARL CALHOUN 1.0 X 0 0 0 ALBERT SISK 1.0 X 0 0 0 PAUL HERRELL MD 1.0 X 0 0 0 KELLY WORKMAN 1.0 X 0 0 0 DANIEL LOPEZ 1.0 X 5313 0 0 TERRY PEEPLES 40.0 X 271580 0 77506 ERIC LEE 40.0 X 177439 0 9211 SAM BROWN 40.0 X 187001 0 51445 AUSTIN MOSS 40.0 X 157060 0 12876 DEBBIE BAUER 40.0 X 154614 0 8619 MARTY BOZARTH 40.0 X 152102 0 13247 MALLIKARJUN KAMISHETTI 40.0 X 261217 0 16910 J D LITTLETON 40.0 X 271305 0 4227 PANKAJKUMARC SHAH 40.0 X 262397 0 16939 PARTH SHAH 40.0 X 261187 0 16808 2161215 0 227788 10 false true true THOR SYSTEMS 536 NOEL AVE HOPKINSVILLE KY 42240 I/S MANAGEMENT 1627314 CHRISTIAN COUNTY ANESTHESIA 103 W 18TH STREET HOPKINSVILLE KY 42240 PHYSICIAN PAYMENT 720000 MEDICAL STAFFING SOLUTIONS 8401 N KENTUCKY AVE STE G EVANSVILLE IN 47725 CONTRACT NURSING 508100 QUORUM HEALTH RESOURCES 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES 1081513 CCSTP LLC 320 W 18TH STREET HOPKINSVILLE KY 42240 PHYSICIAN PAYMENT 435860 13 150 150 NET PATIENT SERVICE REVENUE 621110 105692900 105692900 105692900 686977 686977 0 0 566504 336875 229629 229629 229629 4981342 5030814 14063 -49472 -14063 -63535 -63535 0 0 0 CAFETERIA SALES 722210 365649 365649 WESTERN STATE REVENUE 621110 488708 488708 PHYSICIAN DUES 621110 15950 15950 47847 12443 35404 918154 107464275 106210001 1254124 0 0 0 0 1107351 1107351 0 34463942 32594819 1869123 405694 371747 33947 5570387 5104278 466109 2542159 2329441 212718 1446750 373785 1072965 307954 21892 286062 87414 87414 0 0 0 10787529 10155324 632205 280503 34699 245804 18970160 18467303 502857 1435126 1323626 111500 0 2252761 2124486 128275 230333 168194 62139 0 0 3491045 3491045 0 7232414 7232414 930758 152141 778617 BAD DEBTS 10304623 10304623 EXTENDED BUSINESS 623323 623323 REPAIRS & MAINTENANCE 840392 820299 20093 PROVIDER TAX 1837081 1837081 MALPRACTICE CLAIMS -290273 -290273 1282513 322982 959531 0 106139939 96016421 10123518 0 15523328 19092796 21274308 22897104 14541723 13342465 1470347 1372599 1598286 1610484 3980898 3823608 157810786 78541855 82881150 79268931 10054610 11698395 1898849 1808849 4574891 1082047 157798390 155997278 8055706 8906319 379934 300845 58965351 59008852 16290895 13722431 3600000 3808861 87291886 85747308 X 69495093 69186177 199080 199365 812331 864428 70506504 70249970 157798390 155997278 X 1324336 -1580870 X false true true X false X false false false false false false false false true 7254 7254 false LOBBYING EXPENSES SCH C, PART II-B, LINE 1I JENNIE STUART PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE FOR LOBBYING. 4217751 4217751 92443186 36408261 56034925 520457 452625 67832 58867672 40824966 18042706 1761720 865003 905717 79268931 0 THIRD PARTY SETTLEMENTS 900000 MEDICAL MALPRACTICE LIABILITY 2600000 FAIR VALUE INTEREST RATE SWAP 308861 3808861 107464275 106139939 1324336 1876938 -3457808 -1580870 -256534 106220280 1876938 -3457808 -1580870 107801150 -336875 -336875 107464275 106476814 336875 336875 106139939 106139939 RECONCILIATION TO AUDIT REPORT - REVENUES SCH 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 - EXPENSES SCH 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 ASSETS SCH 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 POSITIONS SCH 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. true true X true X true X true true false false 4210678 601691 4210678 0.04390 11912143 10492358 1419785 0.01480 16122821 11094049 5630463 0.05870 60801 1185 59616 0.00060 17700 17700 0.00020 78501 1185 77316 0.00080 16201322 11095234 5707779 0.05950 1000 1000 64550 64550 0.00070 64954 64954 0.00070 6077 6077 0.00010 136581 136581 0.00150 false 4206867 3155150 31829317 35240513 -3411196 X PHYSICIANS HOLDINGS OPERATE O/P DIAGNOSTIC CENTER 0.55500 0.45500 1 1 JENNIE STUART MEDICAL CENTER

320 WEST 18TH STREET HOPKINSVILLE KY 42240

X X X JENNIE STUART MEDICAL CENTER 1 BAD DEBT EXPENSE SCH H, PART III, LINE 4 ACCOUNTS 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 COSTS SCH H, PART III, LINE 8 COSTS REPORTED ON LINE 6 ARE OBTAINED USING THE MEDICARE COST REPORT COST TO CHARGE RATIO. NEEDS ASSESSMENT SCH H, PART VI, QUESTION 2 During 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 ASSISTANCE SCH H, PART VI, QUESTION 3 Signs are displayed in all registration areas to notify regarding the programs available. Also, counselors are available to provide information and work with patients. COMMUNITY INFORMATION SCH H, PART VI, QUESTION 4 JSMC 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 HEALTH SCH H, PART VI, QUESTION 5 JSMC 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 REPORT 990 SCHEDULE H, PART VI KY, X true true X false false false false false false false false false TERRY PEEPLES 260160 0 0 0 11420 0 59705 0 17801 0 349086 0 0 0 ERIC LEE 176359 0 0 0 1080 0 4693 0 4518 0 186650 0 0 0 SAM BROWN 185921 0 0 0 1080 0 39340 0 12105 0 238446 0 0 0 AUSTIN MOSS 155980 0 0 0 1080 0 0 0 12876 0 169936 0 0 0 DEBBIE BAUER 153534 0 0 0 1080 0 4534 0 4085 0 163233 0 0 0 MARTY BOZARTH 151022 0 0 0 1080 0 4211 0 9036 0 165349 0 0 0 MALLIKARJUN KAMISHETTI 260137 0 0 0 1080 0 4034 0 12876 0 278127 0 0 0 J D LITTLETON 270225 0 0 0 1080 0 4227 0 0 0 275532 0 0 0 PANKAJKUMARC SHAH 261317 0 0 0 1080 0 4063 0 12876 0 279336 0 0 0 PARTH SHAH 260107 0 0 0 1080 0 3932 0 12876 0 277995 0 0 0 COMPENSATION FROM UNRELATED ORGANIZATION THE 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 1A COUNTRY CLUB MEMBERSHIP DUES WERE PAID FOR THE CEO COUNTY OF CHRISTIAN KENTUCKY 616000824 170692CK1 2008-09-18 62375000 REFUND OUTSTDG BONDS/CAPTL PROJECT false false false 62375000 3510878 21663929 509860 2473091 34217242 true true true true false false false false true 0.00000 0.00000 0.00000 true false false false false false true DELEGATION OF MANAGEMENT DUTIES FORM 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 POLICY FORM 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 COMPENSATION FORM 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 PUBLIC FORM 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 990 FORM 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 ASSETS FORM 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) PHYSCNS' HDGSLLC 320 W 18 ST HOPKINSVILLE KY 42240 261608818 BUILDING RENTAL KY na EXCLUDED 144065 1066880 false 0 true 0.56000 false false false false false false false false true true false false false false false false false false PHYSICIANS' HOLDINGS LLC J 559073 PHYSICIANS' HOLDINGS LLC I 27272