TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOHN G HOWARD CHAIRMAN/DIRECTOR	1.00	X			0	0
(2) AUBREY BAILEY VICE CHAIRMAN/DIRECTOR	1.00	X			0	0
(3) JAMES O ROAN DIRECTOR	1.00	X			0	0
(4) CHARLES BISHOP DIRECTOR	1.00	X			0	0
(5) SOUTH BEVINS DIRECTOR	1.00	X			0	0
(6) DAVID GRAMBREL DIRECTOR	1.00	X			0	0
(7) JERRY WOOLUM MD DIRECTOR	1.00	X			0	0
(8) TALMADGE HAYS MD DIRECTOR	1.00	X			0	0
(9) EMANUEL RADER MD DIRECTOR	1.00	X			0	0
(10) JOHN JONES DIRECTOR	1.00	X			0	0
(11) JOHN COMBS DIRECTOR	1.00	X			0	0
(12) J MILTON BROOKS CEO/DIRECTOR	40.00		X		206,149	21,156
(13) COLAN A KELLY CFO	40.00		X		95,300	16,452
(14) UYI-OGHOSA IDEMUDIA DOCTOR	40.00			X	257,664	15,124
(15) JUDY SMITH CRNA	40.00			X	191,132	13,377
(16) SHANNON SMITH CRNA	40.00			X	178,634	19,061
(17) MICHAEL PETERSON DOCTOR	40.00			X	140,492	15,912

(A) Name and business address	(B) Description of services	(C) Compensation
SODEXHO 4880 PAYSPHERE CIRCLE CHICAGO,IL60674	FOOD SERVICE	1,224,410
ACUTE CARE 1609 N ANKENY BLVD SUITE 200 ANKENY,IA50023	EMERGENCY ROOM PHYSICIANS	606,025
MT REHAB PT 702 PHILLIPS ST CORBIN,KY40701	PHYSICAL THERAPY	344,478
CPSI PO BOX 850309 MOBILE,AL36685	MIS VENDOR	332,051
GE BOX 96483 CHICHAGO,IL60603	BIO-MEDICAL	295,052
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 6

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	339,057		339,057
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	13,184,734	12,537,658	647,076
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	347,970		347,970
9	Other employee benefits .......	2,433,830		2,433,830
10	Payroll taxes ...........	983,676		983,676
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	15,060		15,060
c	Accounting ...........	56,600		56,600
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	1,402,519	1,332,431	70,088
12	Advertising and promotion ....	40,018		40,018
13	Office expenses .......	6,666,494	5,669,016	997,478
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	843,956		843,956
17	Travel ............	36,220	7,147	29,073
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	146,122		146,122
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	985,826		985,826
23	Insurance ..............
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	BAD DEBTS	1,810,198		1,810,198
b	FOOD SERVICE	937,382	937,382
c	PROVIDER TAX	573,575		573,575
d	MISCELLANEOUS	250,815	52,970	197,845
e	LAUNDRY SERVICES	118,153		118,153
f	All other expenses	130,180	39,526	90,654
25	Total functional expenses. Add lines 1 through 24f	31,302,385	20,576,130	10,726,255	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	331,274	1	262,282
2	Savings and temporary cash investments .......		2
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	4,819,239	4	5,347,583
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	597,886	8	665,201
9	Prepaid expenses and deferred charges ............	323,807	9	228,570
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	22,308,615
b	Less: accumulated depreciation. .....	10b	15,928,319	5,649,133	10c	6,380,296
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......	9,293,481	12	10,227,690
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	215,131	15	191,549
16	Total assets. Add lines 1 through 15 (must equal line 34)...	21,229,951	16	23,303,171
	17	Accounts payable and accrued expenses .	3,036,529	17	3,411,432
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	2,244,953	23	3,075,918
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	21,772	25	0
26	Total liabilities. Add lines 17 through 25.....	5,303,254	26	6,487,350
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	15,926,697	27	16,815,821
28	Temporarily restricted net assets .....		28
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	15,926,697	33	16,815,821
34	Total liabilities and net assets/fund balances .....	21,229,951	34	23,303,171

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Investment earnings or losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	488,352		488,352
b	Buildings ................	10,873,125	8,327,709	2,545,416
c	Leasehold improvements ............
d	Equipment ................	10,806,996	7,473,746	3,333,250
e	Other .................	140,142	126,864	13,278
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				6,380,296

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) CASH & CD'S	24,123	F
(B) EQUITY MUTUAL FUNDS	10,203,567	F







Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)	10,227,690

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes









Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	30,619,195
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	31,302,385
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	-683,190
4	Net unrealized gains (losses) on investments ..........................	4	1,572,314
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9	1,572,314
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	889,124

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	32,191,509
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	1,572,314
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................			2e	1,572,314
3	Subtract line 2e from line 1.....................			3	30,619,195
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	30,619,195

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1	31,302,385
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e	0
3	Subtract line 2e from line 1.....................		3	31,302,385
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c	0
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5	31,302,385

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
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.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other 10000.0000000000 %

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	2,982,733	534,313	2,448,420	8.300 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	7,772,182	6,165,091	1,607,091	5.450 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	10,754,915	6,699,404	4,055,511	13.750 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	27,414		27,414	0.090 %
f Health professions education (from Worksheet 5) ..	176,876		176,876	0.600 %
g Subsidized health services (from Worksheet 6) ..	1,191,000		1,191,000	4.040 %
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	18,082		18,082	0.060 %
jTotal Other Benefits ...	1,413,372		1,413,372	4.790 %
kTotal. Add lines 7d and 7j. ..	12,168,287	6,699,404	5,468,883	18.540 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

959,405

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

13,218,498

Enter Medicare allowable costs of care relating to payments on line 5.....

13,320,172

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-101,674

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?3 Name and address		Other (Describe)
1	PINEVILLE COMMUNITY HOSPITAL 850 RIVERVIEW AVE PINEVILLE,KY40977	X	X	X
2	PINEVILLE COMMUNITY HOSPITAL - HHA 850 RIVERVIEW AVE PINEVILLE,KY40977				HOME HEALTH AGENCY
3	PINEVILLE COMMUNITY HOSPITAL - SNF 850 RIVERVIEW AVE PINEVILLE,KY40977				SKILLED NURSING FACILITY

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:PINEVILLE COMMUNITY HOSPITAL

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.000000000000%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 100.000000000000%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14		No
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		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 $ 1810198.
		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.
PINEVILLE COMMUNITY HOSPITAL		PART V, SECTION B, LINE 19D: ALL PATIENTS ARE BILLED AT THE SAME CHARGE. PATIENTS THAT FALL UNDER THE HOSPITAL'S ASSISTANCE PROGRAM FALL INTO 2 CATEGORIES. ONE, THOSE THAT RECEIVE FULL CHARITY CARE BASED ON THEIR CRITERIA OR TWO, THOSE THAT ARE CHARGED BASED ON THE CHARGE BEING DISCOUNTED BY APPLYING THE MEDICARE COST TO CHARGE RATIO AND ADDING 1%.
		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 6: 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.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Yes

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) J MILTON BROOKS	(i) (ii)	184,149 0	0 0	22,000 0	8,616 0	12,540 0	227,305 0	0 0
(2) UYI-OGHOSA IDEMUDIA	(i) (ii)	248,786 0	0 0	8,878 0	9,236 0	5,888 0	272,788 0	0 0
(3) JUDY SMITH	(i) (ii)	180,332 0	0 0	10,800 0	7,489 0	5,888 0	204,509 0	0 0
(4) SHANNON SMITH	(i) (ii)	162,534 0	0 0	16,100 0	6,521 0	12,540 0	197,695 0	0 0
(5) MICHAEL PETERSON	(i) (ii)	140,492 0	0 0	0 0	3,372 0	12,540 0	156,404 0	0 0
(6) JEFFREY FREDERICH	(i) (ii)	135,172 0	0 0	0 0	3,374 0	12,540 0	151,086 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 4B	MR. BROOKS PARTICIPATES IN A NONQUALIFIED RETIREMENT PLAN PAID FOR BY THE HOSPITAL. FOR FYE JUNE 30, 2011 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 HIS EMPLOYMENT CONTRACT, DR. IDEMUDIA RECEIVED INCENTIVE PAY CALCULATED AS A PERCENTAGE OF THE NET PROFITS OF THE MEDICAL PRACTICE SERVICES HE PROVIDED.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) 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.		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

PINEVILLE COMMUNITY HOSPITAL ASSOC INC

Employer identification number

61-0541901

Identifier	Return Reference	Explanation
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 AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
	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. JAMES O. ROAN - 320 CATALPA, PINEVILLE, KY 40977. CHARLES BISHOP - 133 WOODLAND TR, PINEVILLE, KY 40977. SOUTH BEVINS - 114 TALL OAK TR, 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 JONES - 145 HORSESHOE DR, PINEVILLE, KY 40977. JOHN COMBS - PO BOX 573, PINEVILLE, KY 40977.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 1,572,314.
	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

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE, WITHIN OUR MEANS, QUALITY HEALTH CARE TO THE PEOPLE OF SOUTHEAST KENTUCKY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	11
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	357
6	Total number of volunteers (estimate if necessary) ....	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	245,802
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	-15,322

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	29,107,207	28,848,840
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	274,393	340,649
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,373,922	1,429,706
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	30,755,522	30,619,195
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	16,693,132	17,289,267
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	13,223,087	14,013,118
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	29,916,219	31,302,385
19	Revenue less expenses. Subtract line 18 from line 12......	839,303	-683,190
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	21,229,951	23,303,171
21	Total liabilities (Part X, line 26)............	5,303,254	6,487,350
22	Net assets or fund balances. Subtract line 21 from line 20 .....	15,926,697	16,815,821

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 17,961,302 including grants of $ ) (Revenue $ 26,527,856 )
	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 13,892 DAYS OF CARE TO THE TRI-COUNTY REGION OF SOUTHEAST KY DURING THE YEAR. 8,180 DAYS OF CARE WERE PROVIDED TO MEDICARE PATIENTS (59%) AND 2,751 DAYS WERE TO MEDICAID PATIENTS (20%). THE HOSPITAL PROVIDED 1,938 DAYS OF CHARITY CARE DURING THE YEAR ENDED JUNE 30, 2011. THE HOSPITAL ALSO HAD 1,167 BAD DEBT DAYS DURING THE YEAR.

4b	(Code: ) (Expenses $ 1,981,924 including grants of $ ) (Revenue $ 2,411,473 )
	LONG TERM CARE (SNF) UNIT - THE HOSPITAL IS LICENSED FOR 30 SKILLED BEDS. SNF PROVIDED 9,193 DAYS OF CARE TO THE TRI COUNTY ARE OF SOUTHEASTERN KY IN FYE JUNE 30, 2011. THE SNF UNIT PROVIDED 480 CHARITY CARE DAYS DURING THE YEAR. THE SNF UNIT HAD 330 BAD DEBT DAYS OF CARE DURING THE YEAR ENDED JUNE 30, 2011.

4c	(Code: ) (Expenses $ 632,904 including grants of $ ) (Revenue $ 834,695 )
	HOME HEALTH AGENCY - THE HOSPITAL IS LICENSED TO SERVE BELL COUNTY. DURING THE YEAR, THE HOME HEALTH AGENCY PROVIDED 7,796 HOME HEALTH VISITS TO BELL COUNTY RESIDENTS. 407 OF THOSE VISITS WERE CHARITY CARE AND 237 WERE BAD DEBT VISITS.

4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 20,576,130

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) JEFFREY FREDERICH DOCTOR	40.00	X	135,172	0	15,914

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,204,543	0	116,996

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......
			Business Code
2a	NET PATIENT SERVICE RE		623,990	28,848,840	28,848,840
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			28,848,840
3	Investment income (including dividends, interest
	and other similar amounts).....			340,149			340,149
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	142,527
b	Less: rental expenses
c	Rental income or (loss)	142,527
d	Net rental income or (loss).......			142,527			142,527
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		500
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		500
d	Net gain or (loss)..........			500	500
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	PHARMACY SALES		446,110	1,170,486	924,684	245,802
b	MISCELLANEOUS		900,099	107,209			107,209
c	MEDICAL TRANSCRIPT		623,990	9,484			9,484
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,287,179
12	Total revenue. See Instructions....			30,619,195	29,774,024	245,802	599,369


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			331,274	1	262,282
2	Savings and temporary cash investments .......				2
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			4,819,239	4	5,347,583
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			597,886	8	665,201
9	Prepaid expenses and deferred charges ............			323,807	9	228,570
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	22,308,615
b	Less: accumulated depreciation. .....	10b	15,928,319	5,649,133	10c	6,380,296
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......			9,293,481	12	10,227,690
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			215,131	15	191,549
16	Total assets. Add lines 1 through 15 (must equal line 34)...			21,229,951	16	23,303,171
17	Accounts payable and accrued expenses .			3,036,529	17	3,411,432
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			2,244,953	23	3,075,918
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			21,772	25	0
26	Total liabilities. Add lines 17 through 25.....			5,303,254	26	6,487,350
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			15,926,697	27	16,815,821
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			15,926,697	33	16,815,821
34	Total liabilities and net assets/fund balances .....			21,229,951	34	23,303,171