Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2011 and ending 09-30-2012
BCheck if applicable:
CName of organization
PIKEVILLE MEDICAL CENTER INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
911 BYPASS ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
PIKEVILLE, KY41501
D Employer identification number

61-0458376
E Telephone number

G Gross receipts $ 407,828,761
F Name and address of principal officer:
WALTER E MAY
911 BYPASS ROAD
PIKEVILLE,KY41501
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.PIKEVILLEHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1923
M State of legal domicile: KY
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE CENTER'S MISSION IS TO PROVIDE QUALITY REGIONAL HEALTH CARE IN A CHRISTIAN ENVIRONMENT
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 5
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 2,684
6 Total number of volunteers (estimate if necessary) .... 6 223
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,421,979
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -314,839
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 352,146 363,597
9 Program service revenue (Part VIII, line 2g) ......... 338,216,599 385,376,490
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,236,269 554,182
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 11,631,548 11,747,236
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 351,436,562 398,041,505
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 94,068 176,467
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) 160,481,295 179,449,038
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 159,881,424 195,894,960
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 320,456,787 375,520,465
19 Revenue less expenses. Subtract line 18 from line 12....... 30,979,775 22,521,040
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 384,559,071 426,453,584
21 Total liabilities (Part X, line 26)............. 174,114,008 193,391,387
22 Net assets or fund balances. Subtract line 21 from line 20..... 210,445,063 233,062,197
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: PIKEVILLE MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY REGIONAL HEALTHCARE IN A CHRISTIAN ENVIRONMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 76,115,807 including grants of $   ) (Revenue $ 38,499,114 )
PHYSICIAN PRACTICES:CURRENTLY, MORE THAN 250 HEALTH CARE PROVIDERS ARE CREDENTIALED TO PRACTICE MEDICINE AT PIKEVILLE MEDICAL CENTER (PMC).IN FY 2012, PMC WELCOMED 30 ADDITIONAL PHYSICIANS, THREE ADDITIONAL NURSE PRACTITIONERS AND ONE ADDITIONAL PHYSICIAN ASSISTANT TO ITS PHYSICIAN PRACTICE TEAM. THREE NEW SERVICES WERE ALSO ADDED - GASTROENTEROLOGY, INTERVENTIONAL RADIOLOGY AND ORTHOPEDIC TRAUMA SURGERY. THE MEDICAL PROFESSIONALS RECRUITED DURING THAT TIME PERIOD CONSIST OF FIVE ANESTHESIOLOGISTS, ONE BARIATRIC SURGEON, ONE CARDIOTHORACIC SURGEON, ONE DERMATOPATHOLOGIST, ONE ENDOCRINOLOGIST, ONE GASTROENTEROLOGIST, ONE GENERAL SURGEON, SIX HOSPITALISTS, ONE INTERVENTIONAL RADIOLOGIST, TWO NEONATOLOGISTS, THREE OBSTETRICIANS/GYNECOLOGISTS, ONE OPHTHALMOLOGIST, ONE ORTHOPEDIC TRAUMA SURGEON, ONE PAIN MANAGEMENT PHYSICIAN, ONE PLASTIC RECONSTRUCTIVE SURGEON, TWO PULMONOLOGY/CRITICAL CARE PHYSICIANS AND ONE VASCULAR SURGEON.THE HOSPITAL IS COMMITTED TO MEETING ITS PATIENTS' HEALTH CARE NEEDS CLOSE TO HOME, BY PROVIDING HIGH-QUALITY, SPECIALTY SERVICES. WITH THE ADDITION OF THESE NEW PHYSICIANS, PMC OFFERS MORE THAN 400 SERVICES, INCLUDING EVERY SPECIALTY AND MOST SUB-SPECIALTIES. IN MAY 2013, PIKEVILLE MEDICAL CENTER ANNOUNCED THAT IS NOW A MEMBER OF THE MAYO CLINIC CARE NETWORK. THROUGH THIS COLLABORATION, THE MAYO CLINIC CARE NETWORK WILL EXTEND MAYO CLINIC'S KNOWLEDGE AND EXPERTISE TO PHYSICIANS AND PROVIDERS INTERESTED IN WORKING TOGETHER IN THE BEST INTEREST OF THE PATIENT. PMC PHYSICIANS ARE ABLE TO CONNECT WITH MAYO CLINIC SPECIALISTS ON QUESTIONS OF COMPLEX MEDICAL CARE, USING AN ELECTRONIC CONSULTING TECHNIQUE CALLED ECONSULTS. THIS ALLOWS PATIENTS WHO DESIRE A SECOND OPINION ABOUT THEIR CARE TO GET IT FROM MAYO CLINIC. PMC PHYSICIANS WILL ALSO HAVE ACCESS TO MAYO-VETTED MEDICAL INFORMATION WITH THE ASKMAYOEXPERT TOOL. AS A MEMBER OF THE MAYO CLINIC CARE NETWORK, PMC HAS ACCESS TO THE LATEST INFORMATION, TOOLS AND TECHNOLOGIES TO PROVIDE THE BEST CARE FOR ITS PATIENTS AS WELL AS IMPROVE ITS SYSTEMS AND THE OVERALL HEALTH OF THE COMMUNITY.PMC'S VAST PHYSICIAN PRACTICE NETWORK INCLUDES: FAMILY PHYSICIAN PRACTICES IN HAROLD, PIKEVILLE AND SHELBY VALLEY (KENTUCKY); UROLOGY, GYNECOLOGICAL ONCOLOGY; PHYSIATRY; NEUROSURGERY; GENERAL SURGERY; GASTROENTEROLOGY; BARIATRIC SURGERY; OBSTETRICS AND GYNECOLOGY PRACTICES IN HAROLD AND PIKEVILLE; CARDIOTHORACIC SURGERY; INTERVENTIONAL RADIOLOGY; INFECTIOUS DISEASE; NEPHROLOGY; PLASTIC SURGERY; INTERVENTIONAL CARDIOLOGY; CONGESTIVE HEART FAILURE; CARDIOLOGY PRACTICES IN PIKEVILLE, HAZARD, LEXINGTON, PRESTONSBURG AND WHITESBURG (KENTUCKY) AND GRUNDY (VIRGINIA); ORTHOPEDIC SURGERY; SPORTS MEDICINE; RHEUMATOLOGY; PEDIATRIC ENDOCRINOLOGY; PAIN MANAGEMENT; OPHTHALMOLOGY; OTOLARYNGOLOGY; ONCOLOGY PRACTICES IN PIKEVILLE AND WHITESBURG (KENTUCKY) AND GRUNDY (VIRGINIA); PULMONOLOGY AND PULMONARY REHABILITATION.NEWLY RECRUITED PHYSICIANS, ALONG WITH EXISTING EMPLOYED PHYSICIANS, COMPLETED MORE THAN 190,500 PATIENT VISITS/CONSULTATIONS DURING FY 2012. THIS IS AN INCREASE OF 30% FROM VISITS DURING THE PREVIOUS YEAR. DURING THIS SAME TIME FRAME, PMC'S PHYSICIAN PRACTICES BECAME PAPERLESS WHEN STAFF SUCCESSFULLY COMPLETED THE IMPLEMENTATION OF NEXTGEN. NEXTGEN IS A NEW ELECTRONIC MEDICAL RECORDS SYSTEM THAT ALLOWS EVERYONE INVOLVED IN A PATIENT'S CARE TO RECEIVE IMMEDIATE DOCUMENTATION. IN ORDER TO MAKE HEALTH CARE MORE ACCESSIBLE, PMC IS CURRENTLY UNDERGOING A $150 MILLION EXPANSION ADDING AN 11-STORY CLINIC AND A 10-STORY PARKING GARAGE. THE CLINIC WILL HOUSE MOST OF PMC'S PHYSICIAN OFFICES, MAKING IT EASIER FOR PHYSICIANS TO SHARE INFORMATION AND INCREASING PATIENT CONVENIENCE. THE ENCLOSED PARKING GARAGE WILL HAVE SPACES FOR 1,162 VEHICLES.
4b (Code:   ) (Expenses $ 17,952,450 including grants of $   ) (Revenue $ 29,794,996 )
CARDIAC SERVICES:HEART DISEASE IS ONE OF THE MOST PREVALENT HEALTH PROBLEMS AFFECTING THE NATION AND OUR REGION. PIKEVILLE MEDICAL CENTER HAS MADE A COMMITMENT TO BUILD A WORLD-CLASS HEART PROGRAM. IN MAY 2012, THE SOCIETY OF CHEST PAIN CENTERS RECOGNIZED PMC AS A LEVEL IV CHEST PAIN ACCREDITED CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI). THIS HIGHLY ACCLAIMED DISTINCTION MADE PMC THE FIRST HOSPITAL IN THE STATE OF KENTUCKY AND ONE OF THE FIRST FIVE IN THE NATION TO RECEIVE THIS ACCREDITATION. THIS ACCREDITATION VALIDATES THAT PMC PROVIDES A CONTINUUM OF CARDIAC CARE, FROM DIAGNOSTICS TO HEART SURGERY PROCEDURES, ON SITE. SOME OF THE SERVICES OFFERED BY PMC'S HEART AND VASCULAR INSTITUTE INCLUDE: CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, ECHOCARDIOGRAPHY, HEART FAILURE CLINIC, CARDIOTHORACIC SURGERY, VASCULAR SURGERY, INTERVENTIONAL RADIOLOGY AND ELECTROPHYSIOLOGY AND AN EXTENSIVE CARDIAC REHABILITATION PROGRAM. WITH THE ADDITION OF AN INTERVENTIONAL RADIOLOGIST, CARDIOTHORACIC SURGEON AND VASCULAR SURGEON IN FY 2012, PMC'S HEART AND VASCULAR INSTITUTE CONTINUES TO EXPAND. CURRENTLY, THE HEART AND VASCULAR INSTITUTE EMPLOYS THREE CARDIOLOGISTS, TWO INVASIVE CARDIOLOGISTS, TWO INTERVENTIONAL CARDIOLOGISTS, THREE CARDIOTHORACIC AND VASCULAR SURGEONS, TWO INTERVENTIONAL RADIOLOGISTS AND TWO ELECTROPHYSIOLOGISTS, AS WELL AS SEVERAL PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS AND NURSES.PIKEVILLE MEDICAL CENTER IS COMMITTED TO PROVIDING THE MOST ADVANCED TECHNOLOGY AND FACILITIES AVAILABLE ANYWHERE. DURING FY 2012, PIKEVILLE MEDICAL CENTER'S HEART AND VASCULAR INSTITUTE COMPLETED A RENOVATION TO ITS EXISTING CATH LAB TO INSTALL A NEW ELECTROPHYSIOLOGY CATH LAB. THE ADDITION OF THE NEW CATH LAB AND NEW EQUIPMENT NEEDED TO PROVIDE THIS SERVICE WAS AN INVESTMENT OF NEARLY $1,528,000.RENOVATIONS TOTALING $427,000 WERE ALSO MADE TO THE HOSPITAL'S CARDIOTHORACIC VASCULAR UNIT. THIS CONSTRUCTION PROJECT PROVIDED SPACE FOR A NEW NURSE'S STATION AND ADDITIONAL PRIVATE CARDIAC PATIENT ROOMS. ALSO IN FY 2012, PMC REPLACED FIVE EXISTING ECHOCARDIOGRAPHY MACHINES WITH THE NEW PHILIPS-IE33 XMATRIX ECHOCARDIOGRAPHY ULTRASOUND SYSTEM. THIS UPGRADE COST MORE THAN $962,000 AND ENSURES PATIENTS ACCESS TO THE MOST ADVANCED TECHNOLOGY.WITH ADDITIONAL SPECIALISTS AND THE EXPANSIONS OF HEART-RELATED SERVICES, THE HOSPITAL COMPLETED NEARLY 46,000 CARDIAC CASES DURING FY 2012, INCLUDING 133 OPEN HEART CASES.
4c (Code:   ) (Expenses $ 12,239,535 including grants of $   ) (Revenue $ 25,402,047 )
EMERGENCY SERVICES:PIKEVILLE MEDICAL CENTER RECENTLY COMPLETED A NEARLY $11 MILLION EXPANSION AND RENOVATION TO ITS EMERGENCY DEPARTMENT (ED). THE NEW FACILITY ENCOMPASSES NEARLY 23,000 SQUARE FEET AND INCLUDES TWO SPECIALTY TRAUMA BAYS AND THREE TRIAGE BAYS, AS WELL AS A RADIOLOGY SUITE WITH ON-SITE CT SCANNING AND DIGITAL X-RAY. ALSO IN FY 2012, WELLSOFT, A NEW COMPUTER SOFTWARE SYSTEM, WAS INSTALLED TO CREATE MORE EFFICIENT WORKFLOW IN THE ED. THIS NEW SYSTEM ALLOWS FOR AUTOMATIC FEEDBACK PERTAINING TO PATIENTS' CARE AND TREATMENT. INTERIOR RENOVATIONS WERE ALSO COMPLETED TO HOUSE A NEW TOSHIBA 320-SLICE CT SCANNER. THIS NEW ADDITION, ALONG WITH THE COMPUTER SOFTWARE PROGRAM, COST THE HOSPITAL NEARLY $3.5 MILLION. RECENTLY, THE HOSPITAL WELCOMED A TEAM OF SIX TRAUMA SURGEONS WHO HAVE MORE THAN 100 YEARS EXPERIENCE COMBINED IN TREATING TRAUMA VICTIMS. PMC'S COMPREHENSIVE TRAUMA STAFF INCLUDES: NEUROSURGEONS, ORTHOPEDIC TRAUMA SURGEONS, PLASTIC SURGEONS, EMERGENCY MEDICINE PHYSICIANS AND INTERVENTIONAL RADIOLOGISTS.IN FY 2012, THE ED RECEIVED 640 TRAUMA CASES AND INCREASED ITS ANNUAL VISITS BY 10%, TREATING A TOTAL OF 44,753 PATIENTS. PMC IS CURRENTLY PURSUING A LEVEL II TRAUMA CENTER DESIGNATION AND PROVIDES 24/7 TRAUMA COVERAGE.
(Code:   ) (Expenses $ 228,379,719 including grants of $ 176,467 ) (Revenue $ 298,619,876 )
PIKEVILLE MEDICAL CENTER IS A 261-BED FACILITY OFFERING MORE THAN 400 SERVICES AND EMPLOYING MORE THAN 2,300 PEOPLE. THE NATION'S ONLY REPEAT WINNER OF NATIONAL HOSPITAL OF THE YEAR, PMC HAS BEEN NAMED ONE OF THE BEST PLACES TO WORK IN KENTUCKY FOR SIX YEARS, AS OF 2013. IN 2012, MODERN HEALTHCARE RANKED PMC THE #1 BEST PLACE TO WORK IN KENTUCKY AND 3RD IN THE NATION.PMC'S COMPASSIONATE EMPLOYEES AND DEDICATED PHYSICIANS PROVIDE UNSURPASSED SERVICE WITH STATE-OF-THE-ART TECHNOLOGY. KNOWN AS THE PREMIER HOSPITAL IN A MULTI-STATE REGION, PMC PROVIDES UNMATCHED GENEROSITY TO THE COMMUNITY AND IS CONTINUALLY GROWING AND LOOKING FOR NEW WAYS TO PROVIDE THE MOST ADVANCED HEALTH CARE AVAILABLE. PIKEVILLE MEDICAL LEONARD LAWSON CANCER CENTER (LLCC)PMC RECENTLY COMPLETED THE LEONARD LAWSON CANCER CENTER'S RELOCATION AND RENOVATIONS. PATIENTS NOW ENJOY EASY ACCESS, CONVENIENT PARKING AND A FACILITY DESIGNED WITH THE PATIENT IN MIND. THE NEW FACILITY INCLUDES 18 STATE-OF-THE-ART EXAM ROOMS, 18 CHEMOTHERAPY STATIONS, A TEAM OF 10 EXPERIENCED ONCOLOGISTS, PHYSICIAN OFFICES, AN ONCOLOGY LABORATORY, AN INFUSION ROOM AND AN ON-SITE PHARMACY. THE TOTAL RELOCATION COST WAS MORE THAN $3.7 MILLION. LLCC RECENTLY RECEIVED A THREE-YEAR ACCREDITATION WITH COMMENDATION FROM THE COMMISSION ON CANCER AND THE AMERICAN COLLEGE OF SURGEONS. THIS IS THE EIGHTH CONSECUTIVE TIME PMC HAS RECEIVED THIS STATUS AND THE THIRD CONSECUTIVE TIME THE STATUS HAS BEEN GIVEN WITH COMMENDATION.THIS ACCREDITATION DISTINGUISHES PMC AS A CANCER PROGRAM THAT NOT ONLY MEETS, BUT EXCEEDS NATIONAL STANDARDS. THE LLCC OFFERS COMPREHENSIVE CANCER CARE, BY PROVIDING PATIENTS WITH: STATE-OF-THE-ART SERVICES AND EQUIPMENT, A MULTISPECIALTY CANCER CARE TEAM, ACCESS TO INFORMATION FROM CLINICAL TRIALS, NEW TREATMENT OPTIONS, PSYCHO-SOCIAL SUPPORT, SURVIVORSHIP CARE AND LIFELONG MONITORING OF CARE.MANY DEPARTMENTS WORK TOGETHER TO COMPRISE PMC'S AWARD-WINNING CANCER PROGRAM. THESE DEPARTMENTS INCLUDE: THE LEONARD LAWSON CANCER CENTER, INPATIENT ONCOLOGY, MEDICAL, RADIATION AND SURGICAL ONCOLOGY, PATIENT NAVIGATION, PATHOLOGY, CHAPLAINCY SERVICES, PALLIATIVE CARE AND CASE MANAGEMENT. PIKEVILLE MEDICAL ORTHOPEDIC CENTERPIKEVILLE MEDICAL CENTER RECENTLY RELOCATED ITS ORTHOPEDIC CENTER TO A MORE CONVENIENT, SPACIOUS FACILITY. AS A MUCH NEEDED SERVICE TO THE AREA, THIS NEW LOCATION ALLOWED FOR MORE PATIENT ROOMS AND SPACE TO GROW. PMC'S ORTHOPEDIC CENTER IS HOME TO SIX EXPERIENCED SPECIALISTS INCLUDING, ONE HAND SURGEON, ONE SPORTS MEDICINE PHYSICIAN, TWO ORTHOPEDIC SURGEONS AND TWO ORTHOPEDIC TRAUMA SURGEONS. STEADILY INCREASING ITS PATIENT VOLUMES, THESE PHYSICIANS TREATED 16,000 ORTHOPEDIC CASES IN FY 2012, AN INCREASE OF 14% FROM FY 2011.OPHTHALMOLOGY SERVICESIN AUGUST 2012, PMC COMPLETED RENOVATIONS TO ITS OPHTHALMOLOGY PHYSICIAN PRACTICE TO INSTALL A NEW ALCON WAVELIGHT LASER SYSTEM AND OFFER LASIK SURGERY TO ITS PATIENTS. ALLOWING FOR CUSTOMIZED TREATMENT, WAVELIGHT PROVIDES 100 PERCENT ALL LASER LASIK AND IS ONE OF THE FASTEST PLATFORMS ON THE MARKET.THIS INSTALLATION COST NEARLY $860,000.IN ADDITION TO PROVIDING LASIK SURGERY, THE HOSPITAL OFFERS COMPREHENSIVE GENERAL AND RETINAL OPHTHALMOLOGY SERVICES. SOME OF THE SERVICES PROVIDED INCLUDE THE DIAGNOSIS AND TREATMENT OF CATARACTS, GLAUCOMA, MACULAR DEGENERATION, DIABETIC RETINOPATHY AND VITREOUS DISEASES.PMC TREATED 3,560 OPHTHALMOLOGY CASES IN FY 2012. PHYSICAL INPATIENT REHABILITATION HOSPITALPIKEVILLE MEDICAL CENTER'S STATE-OF-THE-ART INPATIENT PHYSICAL REHABILITATION (IPR) HOSPITAL CONSISTS OF 40 LICENSED BEDS AND COVERS 23,000 SQUARE FEET OF SPACE INCLUDING A DINING HALL, FULLY EQUIPPED KITCHEN AND LAUNDRY FACILITIES. BEING RANKED #1 IN PATIENT SATISFACTION OUT OF MORE THAN 400 HOSPITALS SURVEYED BY HEALTHSTREAM RESEARCH, PMC'S INPATIENT PHYSICAL REHABILITATION HOSPITAL IS DEDICATED TO HELPING PATIENTS WHO ARE DISABLED BY DISEASE OR INJURY. THE HOSPITAL'S FULLY STAFFED REHABILITATION TEAM CONSISTS OF MANY SPECIALISTS, INCLUDING: PHYSIATRISTS OCCUPATIONAL, SPEECH AND PHYSICAL THERAPISTS; REHABILITATION NURSES; CASE MANAGERS; SOCIAL WORKERS AND DIETICIANS. THE TEAM WORKS WITH THE PATIENT AND HIS/HER FAMILY TO DESIGN AND EXECUTE AN INDIVIDUALIZED, CAREFULLY MONITORED TREATMENT PLAN.THE GOAL OF PMC'S INPATIENT REHABILITATION HOSPITAL IS TO HELP PATIENTS REGAIN THE HIGHEST LEVEL OF INDEPENDENCE POSSIBLE.DURING FY 2012, PMC'S REHABILITATION PHYSICIAN PRACTICES HAD 964 CASES AND EXPERIENCED A 14% INCREASE IN PATIENT VISITS.NATIONAL RECOGNITIONPIKEVILLE MEDICAL CENTER, A PROUD MEMBER OF THE MAYO CLINIC CARE NETWORK, HAS ACHIEVED NATIONAL RECOGNITION MANY WOULD THINK UNATTAINABLE. THE HOSPITAL'S BOARD OF DIRECTORS, MORE THAN 350 CREDENTIALED PHYSICIANS AND MORE THAN 2,300 EMPLOYEES BELIEVE AND CARRY OUT THE HOSPITAL'S MISSION STATEMENT EVERYDAY "TO PROVIDE QUALITY, REGIONAL HEALTH CARE IN A CHRISTIAN ENVIRONMENT." IT IS BECAUSE OF THIS WORK ETHIC THAT PIKEVILLE MEDICAL CENTER REGULARLY RECEIVES RECOGNITION AND AWARDS SUCH AS: APRIL '13 - THREE YEAR ACCREDITATION WITH COMMENDATION FROM THE COMMISSION ON CANCER AND THE AMERICAN COLLEGE OF SURGEONSMARCH '13 - BARIATRIC SURGERY CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERYMARCH '13 - GET WITH THE GUIDELINES GOLD PLUS STROKE AWARD BY THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATIONMARCH '13 - BEST HOSPITALS FOR PATIENT EXPERIENCE IN ORTHOPEDICS BY WOMENCERTIFIEDFEBRUARY '13 - 18 AWARDS FROM THE KENTUCKY PRESS ASSOCIATION (MEDICAL LEADER - PMC WEEKLY NEWSPAPER)FEBRUARY '13 - BEST PLACES TO WORK IN KENTUCKY BY THE KENTUCKY CHAMBER OF COMMERCEJANUARY '13 - BEST HOSPITALS FOR PATIENT EXPERIENCE IN OBSTETRICS BY WOMENCERTIFIEDNOVEMBER '12 - DISTINGUISHED COMMUNITY EMPLOYER BY NATIONAL COLLEGE - PIKEVILLE CAMPUSOCTOBER '12 - HEALTHCARE ORGANIZATION OF THE MONTH BY STUDER GROUPOCTOBER '12 - EXCELLENCE IN PATIENT CARE AWARD FOR DOCTOR COMMUNICATION BY STUDER GROUPOCTOBER '12 - #1 BEST PLACE TO WORK IN HEALTHCARE IN KY AND #3 IN THE NATION BY MODERN HEALTHCARE MAGAZINESEPTEMBER '12 - HEALTHCARE'S HOTTEST COMPANIES BY MODERN HEALTHCARE MAGAZINE SEPTEMBER '12 - AMERICA'S BEST HOSPITALS FOR PATIENT EXPERIENCE BY WOMENCERTIFIEDJUNE '12 - NATIONAL HOSPITAL OF THE YEAR FOR AN UNPRECEDENTED THIRD CONSECUTIVE TIME AND HOSPITAL OF CHOICE EMERITUS THROUGH HARD WORK AND A FIRM COMMITMENT TO PLACE PATIENTS' NEEDS FIRST, PMC WILL CONTINUE TO GROW AND REDEFINE THE HEALTH CARE MODEL.
4d Other program services (Describe in Schedule O.)
(Expenses $ 228,379,719 including grants of $ 176,467 ) (Revenue $ 298,619,876 )
4e Total program service expensesMediumBullet$ 334,687,511
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
Click to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
128
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
2,684
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
15
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
5
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MICHELLE HAGY CFO
911 BYPASS ROAD
PIKEVILLE,KY41501
(606) 218-3974
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) WALTER BLANKENSHIP
BOARD MEMBER
2.00 X           0 0 0
(2) TT COLLEY
BOARD MEMBER
2.00 X           0 0 22,385
(3) DAVID COLLINS CPA
BOARD MEMBER
2.00 X           0 0 0
(4) DENNIS HALBERT MD
BOARD MEMBER
4.00 X           0 0 22,385
(5) JUDITH HINKLE
BOARD MEMBER
2.00 X           0 0 0
(6) HOBART CLAY JOHNSON
BOARD MEMBER
2.00 X           0 0 0
(7) JOHN LABRECHE
BOARD MEMBER
4.00 X           0 0 265
(8) ALEX POULOS MD
BOARD MEMBER
4.00 X           0 0 22,385
(9) JO NELL ROBINSON
BOARD MEMBER
4.00 X           0 0 8,443
(10) MARY SIMPSON PHD
BOARD MEMBER
2.00 X           0 0 0
(11) SUE SMALLWOOD
BOARD MEMBER
4.00 X           0 0 8,443
(12) JOE DEAN ANDERSON
BOARD SECRETARY
4.00 X   X       0 0 22,385
(13) RONALD BURCHETT
BOARD VICE-PRESIDENT
4.00 X   X       0 0 0
(14) NAVEED AHMED MD
BOARD-CHIEF OF STAFF- 1.1.12-9.30.12
2.00 X           0 0 0
(15) WILLIAM GAUNT MD
BOARD-CHIEF OF STAFF- 10.1.11-12.31.11
2.00 X           165,843 0 14,569
(16) LACY PUCKETT
EMERITUS BOARD MEMBER
0.00 X           0 0 0
(17) BURLIN COLEMAN
EMERITUS BOARD MEMBER
0.00 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) WALTER E MAY
PRESIDENT/CEO
40.00 X   X       596,180 0 37,245
(19) MICHELLE HAGY
CFO-VP FINANCE
40.00     X       234,432 0 30,957
(20) JUANITA DESKINS
CHIEF OPERATING OFFICER
40.00     X       301,160 0 30,529
(21) CHERYL HICKMAN
ASSISTANT TO PRESIDENT
40.00       X     225,717 0 38,192
(22) WILLIAM JOHNSON MD
CHIEF MEDICAL OFFICER
40.00       X     270,890 0 47,982
(23) ESTELLA CLARK
CHIEF NURSING OFFICER
40.00       X     159,085 0 30,834
(24) PEGGY JUSTICE
VP PHYSICIAN NETWORK
40.00       X     165,658 0 33,434
(25) TERENCE FARRELL
VP PROF/SUPPORT SERVICES
40.00       X     189,492 0 21,382
(26) DEBORAH PUCKETT
VP REHAB/WOUND CARE SERVIC
40.00       X     157,749 0 33,321
(27) TIM MARTIN
AVP IMAGING SERVICES
40.00       X     176,728 0 29,102
(28) MARCUS CONLEY
ACFO-PHYSICIAN NETWORK
40.00       X     154,945 0 29,428
(29) MARK SWOFFORD MD
UROLOGIST
40.00         X   1,030,292 0 10,314
(30) DUANE DENSLER MD
NEUROSURGEON
40.00         X   1,360,791 0 32,699
(31) NORMAN MAYER MD
NEUROSURGEON
40.00         X   1,460,791 0 32,699
(32) KEITH HALL MD
ORTHOPEDIC SURGEON
40.00         X   1,098,623 0 33,955
(33) KEVIN PUGH MD
ORTHOPEDIC SURGEON
40.00         X   1,033,708 0 33,955
(34) SUSAN SCHELL
FORMER ACFO-PHYSICIAN NETWORK
40.00           X 144,271 0 20,445
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,926,355 0 647,733
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet163
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
MESSER CONTRUCTION CO INC
5158 FISHWICK DR
CINCINNATI,OH45216
CONSTRUCTION SERVICES 15,395,810
ROSE BUILDERS
7 STACY STREET
HAROLD,KY41635
CONSTRUCTION SERVICES 4,241,587
PRECYSE SOLUTIONS LLC
1275 DRUMMERS LANE
WAYNE,PA19087
HIM SERVICES 2,440,304
GENERAL ELECTRIC
PO BOX 96483
CHICAGO,IL60693
PROFESSIONAL SERVICES 1,995,156
MCKESSON HBOC
PO BOX 98347
CHICAGO,IL60693
PROFESSIONAL SERVICES 1,859,518
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet50
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 280,221
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
83,376
g Noncash contributions included in lines 1a-1f:$ 30,293
h Total. Add lines 1a-1f.......MediumBullet 363,597
 Program Service Revenue Business Code
2a PATIENT SERVICE REVENU 621,110 385,376,490 385,376,490    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 385,376,490
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,228,939     1,228,939
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet 9,155     9,155
(i) Real (ii) Personal
6a Gross rents 371,679 708,150
b Less: rental expenses 565,229 0
c Rental income or (loss) -193,550 708,150
d Net rental income or (loss).......MediumBullet 514,600 -193,550 708,150  
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   64,695
b Less: cost or other basis and sales expenses   739,452
c Gain or (loss)   -674,757
d Net gain or (loss)..........MediumBullet -674,757     -674,757
8a Gross income from fundraising events (not including
$ 280,221
of contributions reported on line 1c). See Part IV, line 18 ...
a 114,030
b Less: direct expenses ...b 148,451
c Net income or (loss) from fundraising events..MediumBullet -34,421   -34,421
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...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a 9,739,183
b Less: cost of goods sold ..b 8,334,124
c Net income or (loss) from sales of inventory..MediumBullet 1,405,059   397,300 1,007,759
Miscellaneous Revenue Business Code
11a EHR REVENUE 900,099 3,479,766 3,479,766    
b INSURANCE SETTLEMENT 900,099 2,665,034 2,665,034    
c CAFETERIA 900,099 2,403,221     2,403,221
d All other revenue .... 1,304,822 988,293 316,529  
e Total. Add lines 11a–11d ......MediumBullet 9,852,843
12 Total revenue. See Instructions....MediumBullet 398,041,505 392,316,033 1,421,979 3,939,896
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
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 United States. See Part IV, line 21 126,618 126,618
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 49,849 49,849
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 2,952,272   2,952,272  
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 130,953,473 114,944,658 16,008,815  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,855,099 1,628,317 226,782  
9 Other employee benefits ....... 35,439,751 31,107,308 4,332,443  
10 Payroll taxes ........... 8,248,443 7,023,769 1,224,674  
11 Fees for services (non-employees):        
a Management ...... 553,151 333,214 219,937  
b Legal ......... 1,390,313   1,390,313  
c Accounting ........... 91,578   91,578  
d Lobbying ........... 61,779   61,779  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 59,076   59,076  
g Other .......... 10,488,392 8,016,456 2,471,936  
12 Advertising and promotion .... 2,898,939 87,334 2,811,605  
13 Office expenses ....... 933,829 673,169 260,660  
14 Information technology ...... 2,907,007 2,495,374 411,633  
15 Royalties ..        
16 Occupancy ........... 4,074,057 3,591,095 482,962  
17 Travel ............ 621,242 359,341 261,901  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 225,774 186,680 39,094  
20 Interest ........... 4,667,208 4,006,330 660,878  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 17,587,297 15,096,931 2,490,366  
23 Insurance .............. 4,911,099 4,864,166 46,933  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a SUPPLIES & DRUGS 61,274,475 60,978,695 295,780  
b BAD DEBT EXPENSE 59,915,274 59,915,274    
c MISCELLANEOUS 9,794,150 6,142,457 3,651,693  
d EQUIPMENT RENTAL & MAIN 6,556,121 6,176,277 379,844  
e
f All other expenses 6,884,199 6,884,199    
25 Total functional expenses. Add lines 1 through 24f 375,520,465 334,687,511 40,832,954 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 12,255 1 12,155
2 Savings and temporary cash investments ....... 120,750,346 2 121,311,526
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 40,695,824 4 60,612,948
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 31,995 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 .............. 10,703,096 8 11,313,528
9 Prepaid expenses and deferred charges ............ 2,867,950 9 3,273,243
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 319,843,705
b Less: accumulated depreciation. ..... 10b 119,798,797 142,713,314 10c 200,044,908
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 1,741,318 12 2,233,472
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 65,042,973 15 27,651,804
16 Total assets. Add lines 1 through 15 (must equal line 34)... 384,559,071 16 426,453,584
Liabilities 17 Accounts payable and accrued expenses . 31,417,884 17 42,822,459
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 135,795,572 20 133,738,775
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 .. 209,362 23 8,083,054
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 6,691,190 25 8,747,099
26 Total liabilities. Add lines 17 through 25..... 174,114,008 26 193,391,387
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 210,239,063 27 232,856,197
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets ..... 206,000 29 206,000
Organizations that do not follow SFAS 117, check here MediumBullet 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 ..... 210,445,063 33 233,062,197
34 Total liabilities and net assets/fund balances ..... 384,559,071 34 426,453,584
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
398,041,505
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
375,520,465
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
22,521,040
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
210,445,063
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
96,094
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
233,062,197
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(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?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  

Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in)
(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e))
         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))
         
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
61,779
i
Other activities? ..........................
Yes
 
16,452
j
Total. Add lines 1c through 1i ...............................
78,231
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PIKEVILLE MEDICAL CENTER ENGAGES THE SERVICES OF MCCARTHY STRATEGIC SOLUTIONS, LLC TO KEEP THEM UPDATED ON RELATED HEALTHCARE AND GOVERNMENT HAPPENINGS. OTHER ACTIVITY COSTS ARE THE CORPORATION'S PORTION OF TRADE DUES (I.E. KENTUCKY HOSPITAL ASSOCIATION)
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
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 .......    
5
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? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? ....................................
9
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.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 $  
2
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 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 .... 206,000 226,845 226,346 331,000
b Contributions ........     25,000 479,000
c Net investment earnings, gains, and losses ...        
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........
  20,845 24,501 583,654
f Administrative expenses ....        
g End of year balance ...... 206,000 206,000 226,845 226,346
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   7,343,349 7,343,349
b Buildings ................ 5,601,324 115,393,684 41,954,651 79,040,357
c Leasehold improvements ............   5,642,127 1,401,095 4,241,032
d Equipment ................   117,071,615 76,443,051 40,628,564
e Other .................   68,791,606   68,791,606
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 200,044,908
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program 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) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) INDENTURE 25,391,532
(2) GOODWILL 98,773
(3) BOND ISSUANCE COSTS 1,347,497
(4) LONG TERM PREPAID ASSET 814,002





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 27,651,804
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
RESERVE FOR RECIPROCAL OF AMER CLAIMS 3,421,182
ESTIMATED COST REPORT SETTLEMENTS 2,781,191
DEFERRED COMPENSATION LIABILITY 1,392,594
RESERVES FOR WORKERS COMPENSATION CLAIMS 901,401
CAPITAL LEASE OBLIGATION 250,731




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 8,747,099
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) 2011

Schedule D (Form 990) 2011
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) .................... 1 398,041,505
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 375,520,465
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 22,521,040
4 Net unrealized gains (losses) on investments .......................... 4 96,091
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 3
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 96,094
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 22,617,134
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 407,222,025
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 96,091
b Donated services and use of facilities ......... 2b 36,624
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 9,047,805
e Add lines 2a through 2d ..................... 2e 9,180,520
3 Subtract line 2e from line 1..................... 3 398,041,505
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 must equal Form 990, Part I, line 12.) ...... 5 398,041,505
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 384,604,892
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a 36,624
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d 9,047,803
e Add lines 2a through 2d...................... 2e 9,084,427
3 Subtract line 2e from line 1..................... 3 375,520,465
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 must equal Form 990, Part I, line 18.) ...... 5 375,520,465
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 INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE AMOUNT OF $206,000 IS A PERMANENT RESTRICTED ENDOWMENT-HERBERT FABER ENDOWMENT FUND.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL HAS RECEIVED A DETERMINATION FROM THE INTERNAL REVENUE SERVICE THAT IT IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FOUNDATION AND THE PIKEVILLE MEDICAL CENTER DEVELOPMENT CORPORATION ARE TAXABLE ENTITIES TO WHICH APPLICABLE CORPORATE INCOME TAXES APPLY. NO INCOME TAXES WERE OWED BY THE FOUNDATION OR THE PIKEVILLE MEDICAL CENTER DEVELOPMENT CORPORATION FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND 2011. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2012 AND 2011.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   ROUNDING 3.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSES RECLASSED TO REVENUE SECTION 8,899,353. FUNDRAISING EXPENSES 148,451. ROUNDING 1.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSES RECLASSED TO REVENUE SECTION 8,899,353. FUNDRAISING EXPENSES 148,451. ROUNDING -1.
    FORM 990, PART IV LINE 12 HAS BEEN CHECKED NO PER 990 INSTRUCTIONS. PART XI, XII, AND XIII ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENTS ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM AND PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. HOWEVER, THE ORGANIZATION OPTED TO VOLUNTARILY COMPLETE THESE SECTIONS.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

NEW YEARS EVE GALA
(event type)
(b) Event #2

 
(event type)
(c) Other Events

 
(total number)
(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 394,251     394,251
2 Less: Charitable
contributions . . .
280,221     280,221
3 Gross income (line 1
minus line 2) . . .
114,030     114,030
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . . 56,321     56,321
7 Food and beverages . . 55,757     55,757
8 Entertainment . . . 11,199     11,199
9 Other direct expenses . 25,174     25,174
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 148,451
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -34,421
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    13,324,464 2,543,408 10,781,056 2.870 %
b Medicaid (from Worksheet 3, column a) .....     55,978,178 34,134,281 21,843,897 5.820 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs .....
    69,302,642 36,677,689 32,624,953 8.690 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
298 6,073 387,258   387,258 0.100 %
f Health professions education
(from Worksheet 5) ..
19   1,265,184 442,117 823,067 0.220 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)            
i Cash and in-kind contributions for community benefit (from Worksheet 8) .... 55 596 129,129   129,129 0.030 %
jTotal Other Benefits ... 372 6,669 1,781,571 442,117 1,339,454 0.350 %
kTotal. Add lines 7d and 7j. .. 372 6,669 71,084,213 37,119,806 33,964,407 9.040 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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 94 13,825 227,926 2,119 225,807 0.060 %
4 Environmental improvements            
5 Leadership development and training for community members 3 104 453   453 0 %
6 Coalition building            
7 Community health improvement advocacy 3 444 5,716   5,716 0 %
8 Workforce development 29   886,440   886,440 0.240 %
9 Other            
10 Total 129 14,373 1,120,535 2,119 1,118,416 0.300 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
14,434,059
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
721,703
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
100,015,406
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
91,650,104
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
8,365,302
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(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) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 PIKEVILLE MEDICAL CENTER
911 BYPASS ROAD
PIKEVILLE,KY41501
X X   X     X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
PIKEVILLE MEDICAL CENTER
Name of Hospital Facility:  
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 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 150.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16 Yes  
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?38
Name and address Type of Facility (describe)
1 ENDOCRINOLOGY PRACTICE
140 ADAMS LANE STE 600-700
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
2 PEDIATRIC ENDOCRINOLOGY PRACTICE
140 ADAMS LANE STE 300
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
3 ENDOCRINOLOGY PRACTICE - HAZARD
145 CITIZENS LANE
HAZARD,KY41701
PHYSICIAN PRACTICE
4 OBGYN PHYSICIAN PRACTICE - HAROLD
246 KY ROUTE 979
HAROLD,KY41635
PHYSICIAN PRACTICE
5 WOMENS CARE CENTER
419 TOWN MOUNTAIN ROAD SUITE 206
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
6 ONCOLOGY GYNECOLOGY PRACTICE
246 KY ROUTE 979
HAROLD,KY41635
PHYSICIAN PRACTICE
7 GENERAL SURGERY PHYSICIAN PRACTICE AJKAY
1098 S MAYO TRAIL STE 301
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
8 GENERAL SURGERY PRACTICE WRIGHTSTEPHENS
255 CHURCH ST STE 201
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
9 BARIATRIC SURGERY PHYSICIAN PRACTICE
1098 S MAYO TRAIL STE 103
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
10 PLASTICRECONSTRUCTIVE SURGERY
387 TOWN MOUNTAIN RD - SUITE 104
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
11 GASTROENTEROLOGIST PHYS PRACTICE
387 TOWN MTN RD STE 206
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
12 ORTHOPEDIC PHYSICIAN PRACTICE
184 S MAYO TRAIL
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
13 SPORTS MEDICINE PHYSICIAN PRACTICE
184 S MAYO TRAIL
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
14 NEPHROLOGY PHYSICIAN PRACTICE
1098 S MAYO TRAIL SUITE 202
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
15 CARDIOLOGY PRACTICE - HAZARD
474 VILLAGE LANE
HAZARD,KY41701
PHYSICIAN PRACTICE
16 CARDIOLOGY PRACTICE - GRUNDY
1535 SLATE CREEK ROAD
GRUNDY,VA24614
PHYSICIAN PRACTICE
17 CARDIOLOGY PRACTICE - PAINTSVILLE
830 S MAYO TRAIL
PAINTSVILLE,KY41240
PHYSICIAN PRACTICE
18 CADIOLOGY PRACTICE - WHITESBURG
714 JENKINS RD
WHITESBURG,KY41858
PHYSICIAN PRACTICE
19 RHEUMATOLOGY PHYSICIAN PRACTICE - PAIN
830 SOUTH MAYO TRAIL
PAINTSVILLE,KY41240
PHYSICIAN PRACTICE
20 RHEUMATOLOGY PHYSICIAN PRACTICE
1370 S MAYO TRAIL
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
21 ONCOLOGY PHYSICIAN PRACTICE - LLCC
439 HAMBLEY BLVD
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
22 ONCOLOGY PHYSICIAN PRACTICE - PAINTSVILL
830 SOUTH MAYO TRAIL
PAINTSVILLE,KY41240
PHYSICIAN PRACTICE
23 PRIMARY CARE PRACTICE - PIKEVILLE WALMAR
251 CASSIDY BLVD
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
24 PRIMARY CARE PRACTICE - SHELBY VALLEY
6800 US HWY 23 S STE 3
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
25 PRIMARY CARE PRACTICE - HAROLD
246 KY RT 979
HAROLD,KY41635
PHYSICIAN PRACTICE
26 OPTHALMOLOGY PHYS PRACTICE - DR BROWN
1098 S MAYO TRAIL STE 305
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
27 OPTHALMOLOGY - DR ISON
1098 S MAYO TRAIL STE 203
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
28 OPTHALMOLOGY - HAZARD
474 VILLAGE LANE
HAZARD,KY41701
PHYSICIAN PRACTICE
29 ENT PHYSICIAN PRACTICE
1098 S MAYO TRAIL STE 304
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
30 UROLOGY PHYSICIAN PRACTICE
255 CHURCH ST STE 202
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
31 HOME HEALTH SERVICES
1370 S MAYO TRAIL
PIKEVILLE,KY41501
HOME HEALTH SERVICES
32 SLEEP STATE - HIGHLANDS PLAZA
203 COLLINS CIRCLE
PRESTONSBURG,KY41653
PHYSICIAN PRACTICE
33 WHITESBURG SLEEP LAB
60 MAIN STREET
WHITESBURG,KY41858
SLEEP LAB
34 PRESTONSBURG RADIOLOGY CENTER
204 COLLINS CIRCLE
PRESTONSBURG,KY41635
IMAGING CENTER
35 ULTRASOUND - HAROLD
246 KY ROUTE 979
HAROLD,KY41635
PHYSICIAN PRACTICE
36 ORTHOPEDIC DIAGNOSTIC RADIOLOGY
184 S MAYO TRAIL
PIKEVILLE,KY41501
IMAGING CENTER
37 ULTRASOUND-OBGYN PHYSICIAN PRACTICE
246 KY RT 979
HAROLD,KY41635
PHYSICIAN PRACTICE
38 HOME MEDICAL EQUIPMENT
1370 S MAYO TRAIL
PIKEVILLE,KY41501
MEDICAL EQUIPMENT CENTER
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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 II: THE HOSPITAL'S MISSION STATEMENT, "TO PROVIDE QUALITY REGIONAL HEALTH CARE IN A CHRISTIAN ENVIRONMENT" DRIVES PMC'S EFFORTS AS WE CONCENTRATE ON THE PHYSICAL, MENTAL AND SPIRITUAL WELL BEING OF THE PUBLIC. DURING FY 2012, PIKEVILLE MEDICAL CENTER REPORTED TAKING PART IN 129 DIFFERENT COMMUNITY BUILDING ACTIVITIES, AFFECTING OVER 14,373 PEOPLE AND TOTALING MORE THAN $1,118,000. THESE ACTIVITIES FOCUSED ON PROMOTING THE HEALTH AND WELLNESS OF THE COMMUNITIES WE SERVE THROUGH HEALTH EDUCATION, AWARENESS, PREVENTION AND TREATMENT, AS WELL AS, WORKFORCE DEVELOPMENT, ECONOMIC DEVELOPMENT AND FUTURE PLANNING. SOME OF THESE EVENTS LISTED UNDER THE COMMUNITY BUILDING ACTIVITIES SECTION INCLUDED: A VETERAN'S DAY TRIBUTE TO VETERAN'S AND FIRST RESPONDERS, A TORNADO RELIEF RADIO-THON FOR EASTERN KENTUCKY, RELAY FOR LIFE CANCER SURVIVOR'S DINNER, EASTER SUNRISE SERVICE AND HOLY WEEK SERVICES, A CHRISTMAS LIVE NATIVITY AND AN AVERAGE OF 485 MEALS PER MONTH PROVIDED TO MEALS ON WHEELS.
    PART III, LINE 4: THE HOSPITAL HAS A POLICY OF PROVIDING CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. SUCH PATIENTS ARE IDENTIFIED BASED ON FINANCIAL INFORMATION OBTAINED FROM THE PATIENT AND SUBSEQUENT ANALYSIS. SINCE THE HOSPITAL DOES NOT EXPECT PAYMENT, ESTIMATED CHARGES FOR CHARITY ARE NOT REPORTED IN REVENUE. THE COST TO CHARGE FACTOR USED IS 0.242 FROM WORKSHEET 2.
    PART III, LINE 8: NO SHORTFALL EXISTED IN FY 2012. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED SEPT 30, 2012 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.
    PART III, LINE 9B: IF DETERMINED THAT A PATIENT MIGHT QUALIFY FOR AN INDIGENT PROGRAM, THE PATIENT IS SENT THE REQUIRED FORMS (FINANCIAL ASSISTANCE APPLICATION) TO APPLY FOR CHARITY ASSISTANCE. WHEN THE PAPERWORK IS RETURNED BY THE PATIENT, THE APPLICATION IS SENT THROUGH THE ELIGIBILITY DETERMINATION REVIEW PROCESS. IF THE APPLICATION IS APPROVED, THE ACCOUNT BALANCE IS THEN ADJUSTED BY THE AMOUNT ALLOWED BY THE CHARITY ELIGIBILITY GUIDELINES.
PIKEVILLE MEDICAL CENTER   PART V, SECTION B, LINE 19D: PIKEVILLE MEDICAL CENTER FOLLOWS THE SAME CHARGING STRUCTURE FOR ALL PATIENTS; HOWEVER, IF A PATIENT PRESENTS AS A SELF PAY PATIENT, PMC HAS A SELF PAY DISCOUNT POLICY OF 70% OFF ESTIMATED GROSS CHARGES IF A PATIENT IS ABLE TO PAY ANY TIME PRIOR TO OR ON DAY OF SERVICE. IF IT IS AFTER THE DAY OF SERVICE THAT THEY ARE ABLE TO PAY, PMC OFFERS A 50% DISCOUNT OFF GROSS CHARGES, A PAYMENT PLAN, OR IF CANNOT PAY IN FULL WITH DISCOUNTS OR PAYMENT PLANS THEN THE PATIENT IS REFERRED TO THE FINANCIAL COUNSELOR WHERE PATIENT IS FURTHER NOTIFIED OF DSH PROGRAMS, MEDICAID ELIGIBILITY REQUIREMENTS OR PMC INTERNAL FINANCIAL ASSISTANCE PROGRAM.
PIKEVILLE MEDICAL CENTER   PART V, SECTION B, LINE 21: PIKEVILLE MEDICAL CENTER FOLLOWS THE SAME CHARGING STRUCTURE FOR ALL PATIENTS; HOWEVER, IF A PATIENT PRESENTS AS A SELF PAY PATIENT, PMC HAS A SELF PAY DISCOUNT POLICY OF 70% OFF ESTIMATED GROSS CHARGES IF A PATIENT IS ABLE TO PAY ANY TIME PRIOR TO OR ON DAY OF SERVICE. IF IT IS AFTER THE DAY OF SERVICE THAT THEY ARE ABLE TO PAY, PMC OFFERS A 50% DISCOUNT OFF GROSS CHARGES, A PAYMENT PLAN, OR IF CANNOT PAY IN FULL WITH DISCOUNTS OR PAYMENT PLANS THEN THE PATIENT IS REFERRED TO THE FINANCIAL COUNSELOR WHERE PATIENT IS FURTHER NOTIFIED OF DSH PROGRAMS, MEDICAID ELIGIBILITY REQUIREMENTS OR PMC INTERNAL FINANCIAL ASSISTANCE PROGRAM.
    PART VI, LINE 2: IN ORDER TO ASSESS OUR COMMUNITY'S HEALTH-RELATED NEEDS, PIKEVILLE MEDICAL CENTER UTILIZES SEVERAL REPORTS LOOKING AT THE SERVICES THEY PROVIDE, IN COMPARISON TO OTHER HOSPITALS, AS WELL AS, REPORTS INDICATING THE SPECIALTIES THAT ARE IMPACTED BY PHYSICIAN REFERRALS. PMC ALSO KEEPS A RECORD OF PREVIOUS COMMUNITY EVENTS HOSTED, TRACKING THEIR SUCCESS. FOR EXAMPLE: WHEN A FREE HEALTH SCREENING EVENT IS HELD, A RECORD IS KEPT OF THE NUMBER OF ATTENDEES INCLUDING THEIR RESULTS.
    PART VI, LINE 3: PIKEVILLE MEDICAL CENTER USES SEVERAL DIFFERENT MEANS TO COMMUNICATE AND EDUCATE OUR PATIENTS ON ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER FEDERAL, STATE AND LOCAL GOVERNMENTS. FIRST, A HANDOUT LABELED, "FINANCIAL SERVICES AND CONSULTATIONS" IS AVAILABLE TO EVERY PATIENT UPON REGISTRATION. SECOND, THE MANDATORY CONSENT FORM HAS THE PATIENT'S ACKNOWLEDGEMENT STATEMENT, "I ACKNOWLEDGE RECEIPT OF INFORMATION ON DSH, KCHIP, BILLING AND INSURANCE PROCEDURES AND AIDS QUESTIONS / ANSWERS." THIRD, THE FIRST BILL A PATIENT RECEIVES INCLUDES A STATEMENT REGARDING HOW ONE CAN CONTACT A COUNSELOR, IF THE FINANCIAL ASSISTANCE IS NEEDED. LASTLY, THE PATIENT ACCOUNTS STAFF AND PATIENT FINANCIAL COUNSELORS REGULARLY MAIL OUT DSH/PMC CHARITY APPLICATIONS. THESE APPLICATIONS, ALONG WITH DIRECTIONS, ARE ALSO AUTOMATICALLY PRINTED OFF WHEN REGISTERING A SELF-PAY PATIENT. THE PATIENT IS THEN DIRECTED TO OUR FINANCIAL COUNSELORS FOR FURTHER ASSISTANCE. IN THE EVENT A PATIENT IS ADMITTED TO THE FACILITY, FINANCIAL COUNSELORS MEET WITH EACH TO DISCUSS POSSIBLE FINANCIAL ASSISTANCE OPPORTUNITIES. ASSISTANCE FROM THE COUNSELORS BEGINS WITH THE APPLICATION AND CONTINUES THROUGH THE VERIFICATION PROCESS TO ALLOW EACH PATIENT TO TAKE ADVANTAGE OF THE AVAILABLE PROGRAMS.
    PART VI, LINE 4: PIKEVILLE MEDICAL CENTER USES THE MOST RECENT U.S. CENSUS BUREAU DATA AND INFORMATION FROM THE KY STATE DATA CENTER WHEN TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. INFORMATION IS PULLED FROM OUR IMMEDIATE SERVICE AREA ENCOMPASSING A SEVEN COUNTY REGION - PIKE, FLOYD, LETCHER, JOHNSON, MAGOFFIN AND MARTIN COUNTIES IN KENTUCKY AND WEST VIRGINIA'S MINGO COUNTY. ALL DATA PRESENTED HERE IS CURRENT AS OF THE 2011 U.S. CENSUS BUREAU AVAILABLE STATISTICS.THE SEVEN COUNTY AREA CONTAINS A TOTAL POPULATION OF 204,483 INDIVIDUALSWITH A RELATIVELY EVEN DISTRIBUTION OF MALES (100,401) TO FEMALES (104,082). THE MEDIAN POPULATION AGE IS 40.1 YEARS OLD AND THE AVERAGE HOUSEHOLD SIZE IS 2.53 INDIVIDUALS.PIKEVILLE MEDICAL CENTER RESIDES IN A MEDICALLY UNDERSERVED AND IMPOVERISHED AREA. THE MEDIAN HOUSEHOLD INCOME FOR OUR REGION WAS $33,148 IN 2011 WITH 30% OF THE REGION'S CHILDREN UNDER AGE 18 AND 18.1% OF ALL FAMILIES LIVING UNDER THE POVERTY LINE. PIKEVILLE MEDICAL CENTER SERVES AS A BEACON OF HOPE AND AN ECONOMIC BOOST TO THE MOUNTAIN COMMUNITY IN WHICH IT RESIDES. THE CITY OF PIKEVILLE, KY WHERE THE HOSPITAL IS CENTERED IS HOME TO 6,903 INDIVIDUALS. OVER 37.6% OF THE CITY'S RESIDENTS POSSESS A BACHELORS DEGREE OR HIGHER. 39.2% OF THE CITY'S POPULATION WORKS IN EDUCATION, HEALTH CARE, OR SOCIAL SERVICES.
    PART VI, LINE 5: PIKEVILLE MEDICAL CENTER (PMC) IS KNOWN FOR ITS COMPASSIONATE EMPLOYEES, UNSURPASSED SERVICE, STATE-OF-THE-ART TECHNOLOGY AND UNMATCHED GENEROSITY TO THE COMMUNITY. KNOWN AS THE PREMIER HOSPITAL IN A MULTI-STATE REGION, PMC IS CONTINUALLY GROWING AND LOOKING FOR NEW WAYS TO OFFER THE VERY BEST IN HEALTH CARE TO ITS PATIENTS AND THE BROADER POPULATION. PMC'S MISSION "TO PROVIDE QUALITY REGIONAL HEALTH CARE IN A CHRISTIAN ENVIRONMENT" IS FULFILLED ON A DAILY BASIS AS THE STAFF EMPLOYS TEAMWORK WITH A SINCERE PASSION TO HELP OTHERS.PMC HAS UNDERGONE SUBSTANTIAL CHANGES THROUGHOUT ITS 88-YEAR HISTORY. THE MEDICAL CENTER BEGAN AS A SMALL, RURAL, 50-BED FACILITY IN 1924. TODAY, THE HOSPITAL IS A COMPREHENSIVE 261-BED FACILITY ENCOMPASSING 1,180,000 SQUARE FEET INCLUDING BOTH THE MAIN FACILITY AND SURROUNDING SUPPORTIVE SERVICES. CURRENTLY PMC EMPLOYS OVER 2,300 PEOPLE, HAVING HIRED 614 EMPLOYEES OVER THE PAST YEAR. PMC OFFERS MORE THAN 400 SERVICES, INCLUDING EVERY MAJOR SPECIALTY AND MOST SUBSPECIALTIES, AND IS A PROUD MEMBER OF THE MAYO CLINIC CARE NETWORK. THIS TREMENDOUS PHYSICAL GROWTH, ALONG WITH A STRONG FINANCIAL POSITION, HAS ALLOWED PMC TO SIGNIFICANTLY EXPAND ITS SERVICE LINES. CURRENT SERVICES INCLUDE AN AWARD-WINNING, FULL-SERVICE CANCER CENTER; A LEVEL IIII CHEST PAIN ACCREDITED HEART AND VASCULAR INSTITUTE; A 40-BED INPATIENT PHYSICAL REHABILITATION HOSPITAL; AN ACCREDITED GOLD PLUS STROKE CENTER; STATE-OF-THE-ART EMERGENCY DEPARTMENT; NEUROSCIENCE CENTER; LEVEL III NEONATAL INTENSIVE CARE UNIT; WOUND CARE CENTER; ORTHOPEDIC CENTER; WEIGHT LOSS SURGERY CENTER; SLEEP CENTERS; A DIAGNOSTIC CENTER; AND PRIMARY AND SPECIALTY PHYSICIAN PRACTICES. PMC'S STATE-OF-THE-ART DIAGNOSTIC AND THERAPEUTIC RADIOLOGY EQUIPMENT CONSISTS OF TWO LINEAR ACCELERATORS, ONE 32-SLICE LARGE BORE CT SCANNER, TWO 64-SLICE CT SCANNERS, TWO 320-SLICE CT SCANNERS, A PET/CT SCANNER, A SPECT/CT SCANNER, TWO 1.5T OPEN MRIS, A 3.0T OPEN MRI AND THE MOST MODERN COMPUTER CALCULATION SYSTEM AVAILABLE. NOT ONLY HAS PMC'S CONTINUOUS GROWTH INCREASED THE RANGE AND COMPLEXITY OF HEALTH CARE SERVICES IT PROVIDES, IT HAS ALSO ALLOWED THE HOSPITAL TO ENHANCE ITS COMMUNITY OUTREACH EFFORTS. FOR THE PAST THREE YEARS, PMC HAS BEEN NAMED NATIONAL HOSPITAL OF THE YEAR BY THE AMERICAN ALLIANCE OF HEALTHCARE PROVIDERS. NO OTHER HEALTH CARE FACILITY HAS EARNED THIS DISTINCTION. THE RECOGNITION FROM THIS AWARD HAS CONTRIBUTED TO THE HOSPITAL'S INCREASING PATIENT VOLUMES. PMC TAKES PRIDE IN KEEPING THE PUBLIC INFORMED ABOUT INNOVATIVE MEDICAL ADVANCEMENTS AS WELL AS COMMUNITY NEWS THROUGH THE PUBLICATION OF A FREE WEEKLY NEWSPAPER CALLED MEDICAL LEADER - THE REGION'S ONLY "GOOD NEWS" NEWSPAPER. MORE THAN 8,700 NEWSPAPERS ARE DISTRIBUTED WEEKLY TO 150+ LOCATIONS THROUGHOUT THE COUNTIES OF PIKE, FLOYD, LETCHER (KENTUCKY) AND MINGO (WEST VIRGINIA). THE PUBLICATION HAS NEARLY 4,000 EMAIL SUBSCRIBERS AND 2,500 SOCIAL MEDIA FOLLOWERS. MEDICAL LEADER ALLOWED PMC TO GIVE BACK MORE THAN $211,000 COMMUNITY BENEFIT EXPENSE DURING FY 2012. PMC ALSO PROVIDES A VARIETY OF EDUCATIONAL, WELLNESS AND PREVENTIVE HEALTH SERVICES SUCH AS INDIGENT CARE ASSISTANCE, EDUCATIONAL/TRAINING SESSIONS, SUPPORT GROUPS, HEALTH FAIRS, FREE HEALTH SCREENINGS AND OTHER COMMUNITY EVENTS. PMC CONSIDERS ITS OUTREACH EFFORTS AN ESSENTIAL PART OF ITS CHRISTIAN MISSION.CHARITY CARE: PIKEVILLE MEDICAL CENTER SET A NEW RECORD FOR CHARITY CARE IN FY 2012. THROUGH DEFINED POLICIES AND PROCEDURES, PMC RECORDED UNCOMPENSATED CHARITY OF MORE THAN $41.6 MILLION (SERVICES AT HOSPITAL'S ESTABLISHED RATES). HEALTH CARE SUPPORT SERVICES: BLOOD DRIVES - PIKEVILLE MEDICAL CENTER HOSTS A BLOOD DRIVE ONCE A QUARTER. PREPARATION FOR BLOOD DRIVES INCLUDES PUBLICITY BEFORE AND AFTER THE EVENT, RESERVING A LOCATION, HELPING WITH SET-UP AND TAKE-DOWN, PRE-REGISTERING DONORS AND ASSURING THE EVENT'S SUCCESS. BLOOD DRIVES ARE CONDUCTED IN ACCORDANCE WITH THE KENTUCKY BLOOD CENTER (KBC). IN FY 2012, 122 DONORS PARTICIPATED IN PMC'S FOUR BLOOD DRIVES AND DONATED 107 UNITS OF BLOOD, WHICH HELPED SAVE UP TO 321 LIVES. THESE QUARTERLY EVENTS COST THE HOSPITAL MORE THAN $1,500.MEALS ON WHEELS - PMC PROVIDED 5,831 MEALS DURING FY 2012 AND INCURRED MORE THAN $35,782 IN EXPENSES RELATED TO THIS PROGRAM. FOOD DONATIONS - DURING FY 2012, PIKEVILLE MEDICAL CENTER DONATED 11,128 GUEST TRAYS AND/OR FOOD VOUCHERS. THIS SERVICE ALLOWED PMC TO GIVE BACK MORE THAN $74,000 TO ITS PATRONS. IN MAY 2012, THE HOSPITAL BEGAN A NEW PROGRAM BENEFITING NEW MOTHERS AND THEIR SIGNIFICANT OTHER AFTER THE BIRTH OF THEIR NEWBORN BABY. THE NEW MOM AND GUEST RECEIVE A COMPLIMENTARY MEAL WITH THEIR CHOICE OF LOBSTER TAIL, STEAK OR SHRIMP, SERVED ALONGSIDE THEIR CHOICE OF MASHED, BAKED OR OVEN ROASTED POTATOES. ALSO INCLUDED IN THE MEAL IS BROCCOLI, SALAD, DESSERT AND A DRINK.INDIGENT SUPPORT SERVICES - MANY PATIENTS NEED FINANCIAL ASSISTANCE WITH PRESCRIBED MEDICATIONS AND HEALTH CARE EQUIPMENT AT THE TIME OF DISCHARGE. IN HOPES OF RELIEVING FINANCIAL BURDEN, PMC'S CHAPLAIN SERVICES AND CASE MANAGEMENT DEPARTMENTS PROVIDED ASSISTANCE TO 184 PATIENTS TOTALING MORE THAN $39,000. THE HOSPITAL ALSO HELPED SEVERAL PATIENTS WITH TRANSPORTATION BETWEEN THE HOSPITAL, PHYSICIAN'S OFFICE AND THEIR RESIDENCE.SPIRITUAL -PMC'S CHAPLAINCY DEPARTMENT STAFF WORK HARD TO MAKE SURE THE PATIENTS' SPIRITUAL NEEDS ARE MET DURING THEIR HOSPITAL STAY. THEY ROUND DAILY ON EACH PATIENT, OFFERING WORDS OF ENCOURAGEMENT AND PRAYER. IN FY 2012, 2,000 HEALING WORD DEVOTIONALS AND 1,043 BIBLES FOR NEWBORNS WERE DISTRIBUTED. THIS SERVICE PROVIDED A COMMUNITY BENEFIT OF MORE THAN $4,000.COMMUNITY FINANCIAL DONATIONS: IN FY 2012, PIKEVILLE MEDICAL CENTER ONCE AGAIN PROVED TO BE AN ESTABLISHED COMMUNITY LEADER. ENCOURAGING EMPLOYEE PARTICIPATION IN LOCAL ACTIVITIES AND EVENTS, THE HOSPITAL OFFERED FINANCIAL SUPPORT TO AREA ORGANIZATIONS AND IMPORTANT CAUSES, GIVING NEARLY $128,000. PMC WAS PROUD TO HELP THE FOLLOWING ORGANIZATIONS:AMERICAN CANCER SOCIETYAMERICAN HEART ASSOCIATIONEASTERN KENTUCKY EXPOSITION CENTERHABITAT FOR HUMANITYHILLBILLY CHRISTMAS IN JULY INC. JENNY WILEY THEATRETHE KENNETH HUFFMAN MEMORIAL TENNIS FOUNDATIONKENTUCKY CHAMBER FOUNDATIONKENTUCKY CHAMBER OF COMMERCELETCHER COUNTY CENTRAL COUGAR BASKETBALLLIVING MEMORIAL FUND FLOYD COUNTYMARCH OF DIMESPIKE MINISTERIAL ASSOCIATION INC.PRICHARD COMMITTEE SOUTHEAST KENTUCKY CHAMBER OF COMMERCEUNITE FOUNDATIONUNIVERSITY OF KENTUCKY WYMT-TV MOUNTAIN CLASSIC ACADEMIC SCHOLARSHIP FUNDHEALTH SCREENINGS: PIKEVILLE MEDICAL CENTER HELD 18 FREE, COMMUNITY HEALTH SCREENINGS DURING FY 2012. AMONG THE SCREENINGS OFFERED WERE BLOOD PRESSURE, BLOOD SUGAR, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), BODY MASS INDEX (BMI) AND CHOLESTEROL CHECKS, AS WELL AS PROSTATE AND COLORECTAL CANCER SCREENINGS. FREE HEALTH-RELATED EDUCATIONAL MATERIALS WERE DISTRIBUTED AT EACH EVENT. ALL SCREENINGS WERE HOSTED BY PMC PHYSICIANS, NURSES AND/OR SUPPORT STAFF. MORE THAN 3,700 PEOPLE PARTICIPATED IN THESE SCREENINGS, COSTING THE HOSPITAL NEARLY $93,500. EVENTS DURING WHICH PMC HOSTED FREE HEALTH SCREENINGS INCLUDED: - BE RED-Y FOR HEART HEALTH, HEART HEALTH AWARENESS RUNWAY SHOW- COLORECTAL CANCER SCREENING- PROSTATE CANCER SCREENING - PARTNERSHIP FOR A FIT PIKE COUNTY HEALTHY MONDAY- HAZARD SENIOR CITIZENS HEALTH FAIR- DIABETES AWARENESS MONTH- PCDP BOOTH AT SHELBY VALLEY HIGH SCHOOL - SENIOR DIABETES HEALTH FAIR- FIRST-AID BOOTH AT HILLBILLY DAYS- TRIBUTE TO VETERANS AND FIRST RESPONDERS- TORNADO RELIEF CLINIC IN SALYERSVILLE, KY- EAST KENTUCKY EXPOSITION CENTER HEALTH FAIR- HEALTHY FUN FAIR AT NATIONAL COLLEGE- MARROWBONE & PIKEVILLE SENIOR CITIZEN HEALTH FAIR- PMC STROKE AWARENESS DAY - WHITESBURG DAYS FREE HEALTH SCREENING- KID'S HEALTH FAIR AT PCCBE RED-Y FOR HEART HEALTH - PIKEVILLE MEDICAL CENTER CELEBRATED HEART HEALTH AWARENESS MONTH BY HOSTING AN EDUCATIONAL HEART HEALTH FASHION SHOW AND HEALTH SCREENING. DURING THE EVENT, LADIES SHOWCASED THE LATEST STYLES IN RED FASHIONS, PROVIDED BY LOCAL VENDORS, WHILE PHYSICIANS MINGLED WITH THE CROWD AND DISCUSSED THE IMPORTANCE OF HEART HEALTH. PMC'S INTERVENTIONAL CARDIOLOGIST DR. BILL HARRIS WAS THE GUEST SPEAKER. THE HEALTH SCREENINGS OFFERED AT THIS EVENT WERE: BLOOD PRESSURE, BLOOD SUGAR, AND BODY MASS INDEX (BMI). FREE REFRESHMENTS WERE PROVIDED. TOTAL COMMUNITY BENEFIT COST WAS MORE THAN $500.TRIBUTE TO VETERANS AND FIRST RESPONDERS - DURING FY 2012, PMC HELD ITS FIRST TRIBUTE TO VETERANS ON NOVEMBER 10, 2011. PEOPLE FROM ALL OVER THE REGION GATHERED TO WATCH A PARADE, ORGANIZED BY PMC, WHICH ENDED WITH A MILITARY FLYOVER AND A 21 GUN SALUTE. THE PARADE WAS FOLLOWED BY A FREE PERFORMANCE BY COUNTRY MUSIC ARTIST LEE GREENWOOD AND SPECIAL PRESENTATION OF A MEDAL OF HONOR RECIPIENT.
    PART VI, LINE 6: HEALTH PROFESSIONS EDUCATION: STUDENT ROTATIONS - PMC SERVES AS A CLINICAL TRAINING SITE FOR HEALTH CARE STUDENTS FROM REGIONAL UNIVERSITIES AND COLLEGES. DURING FY 2012, PMC TRAINED 513 STUDENTS AFFILIATED WITH 64 INSTITUTIONS. SCHOOLS AFFILIATED WITH PMC INCLUDE:A.T. STILL UNIVERSITY - ARIZONA SCHOOL OF MEDICINEBECKFIELD COLLEGEBELFRY AREA TECHNOLOGY CENTERBELLARMINE UNIVERSITYCHATHAM UNIVERSITYDEVRY UNIVERSITYDUKE UNIVERSITYEASTERN KENTUCKY UNIVERSITYEDWARD VIA VIRGINIA COLLEGE OF OSTEOPATHIC MEDICINEEMERGENCY MEDICAL EDUCATORSFRONTIER SCHOOL OF MIDWIFERY AND FAMILY NURSINGHUNTINGTON JUNIOR COLLEGEHUTCHINSON COMMUNITY COLLEGEIOWA COLLEGE ACQUISITION CORP. D/B/A KAPLAN UNIVERSITYJEFFERSON COLLEGE OF HEALTH SCIENCESKANSAS CITY UNIVERSITY OF MEDICINE AND BIOSCIENCEKENTUCKY COMMUNITY TECHNICAL COLLEGE SYSTEMLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINELETCHER COUNTY AREA TECHNOLOGY CENTERLIBERTY UNIVERSITYLINCOLN MEMORIAL UNIVERSITYLINDSEY WILSON COLLEGEMARIETTA COLLEGEMARSHALL UNIVERSITYMERIDIAN INSTITUTE OF SURGICAL ASSISTINGMILLIGAN COLLEGEMOREHEAD STATE UNIVERSITYNATIONAL COLLEGE OF BUSINESS - LEXINGTON CAMPUSNATIONAL COLLEGE OF BUSINESS - PIKEVILLE CAMPUSNORTON RESIDENCY PROGRAMNORTHERN KENTUCKY UNIVERSITYNOVA SOUTHEASTERN UNIVERSITYOHIO UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINEPHLEBOTOMY EDUCATION INC.PHELPS VOCATIONAL SCHOOLROSS UNIVERSITYSAINT LOUIS UNIVERSITYST. JAMES SCHOOL OF MEDICINESHAWNEE STATE UNIVERSITYSOUTHERN WEST VIRGINIA COMMUNITY & TECHNICAL COLLEGESOUTHWEST VIRGINIA COMMUNITY COLLEGESPENCERIAN COLLEGESULLIVAN UNIVERSITY COLLEGE OF PHARMACYTENNESSEE TECHNOLOGY CENTER AT ELIZABETHTONTOURO UNIVERSITY NEVADATRANS STAR TRAINING ACADEMYUNION UNIVERSITYUNIVERSITY OF APPALACHIA COLLEGE OF PHARMACYUNIVERSITY OF CHARLESTONUNIVERSITY OF CINCINNATIUNIVERSITY OF CUMBERLANDSUNIVERSITY OF KENTUCKYUNIVERSITY OF LOUISVILLEUNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINEUNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTERUNIVERSITY OF NORTH CAROLINAUNIVERSITY OF PIKEVILLEVIRGINIA COMMONWEALTH UNIVERSITYWASHBURN UNIVERSITYWEBER STATE UNIVERSITYWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINEWEST VIRGINIA UNIVERSITY BOARD OF GOVERNORSWHEELING JESUIT UNIVERSITYWINDSOR UNIVERSITY SCHOOL OF MEDICINERESIDENCY PROGRAM-A-OPTIC (APPALACHIAN OSTEOPATHIC POSTGRADUATE TRAINING INSTITUTE CONSORTIUM): PMC OPERATES THE ONLY FAMILY PRACTICE/NEUROMUSCULAR MEDICINE RESIDENCY PROGRAM IN KENTUCKY, THE ONLY ONE YEAR PLUS ONE NEUROMUSCULAR MEDICINE/OSTEOPATHIC MANIPULATIVE MEDICINE (PLUS ONE) RESIDENCY PROGRAM IN KENTUCKY, AND ONE OF ONLY FOUR FAMILY PRACTICE AND OSTEOPATHIC MANIPULATIVE TREATMENT MEDICINE RESIDENCY PROGRAMS IN KENTUCKY. THE HOSPITAL, IN CONJUNCTION WITH THE RESIDENCY PROGRAM, OPERATES A FAMILY PRACTICE CLINIC WHICH SEES APPROXIMATELY 9,100 PATIENTS ANNUALLY.THIS SERVICE ALLOWS PMC TO EDUCATE AND RETAIN COMPETENT/SKILLED PHYSICIANS IN THE REGION. IN 2012, PMC TRAINED 18 RESIDENTS (RESIDENCY YEAR SPANS FROM JUNE TO JULY), COSTING THE HOSPITAL NEARLY $810,402.PHYSICIAN RECRUITMENT: THE PRIMARY GOAL OF PMC'S PHYSICIAN RECRUITMENT PROGRAM IS TO PROVIDE THE COMMUNITY WITH A HIGH QUALITY OF MEDICAL CARE. THESE RECRUITMENT EFFORTS ARE ESSENTIAL TO ENHANCING THE HEALTH AND WELL BEING OF THE REGION. OTHER LOCAL HOSPITALS LOOK TO PMC TO OFFER THE SPECIALTIES AND SUB-SPECIALTIES THEY ARE NOT ABLE TO PROVIDE. DURING FY 2012, PMC PHYSICIAN RECRUITERS ATTENDED 20 RECRUITMENT CONFERENCES AND SIGNED 30 NEW PHYSICIANS. THE TOTAL COMMUNITY BENEFIT ASSOCIATED WITH PHYSICIAN RECRUITMENT DURING THIS TIME PERIOD WAS $871,696. THE HOSPITAL ALSO WELCOMED THREE NEW NURSE PRACTITIONERS AND ONE PHYSICIAN ASSISTANT. THE RECRUITED PHYSICIANS PRACTICE IN THE FOLLOWING SPECIALTIES: - ANESTHESIOLOGY- BARIATRIC SURGERY- CARDIOTHORACIC SURGERY- DERMATOPATHOLOGY- ENDOCRINOLOGY- GASTROENTEROLOGY- GENERAL SURGERY- INTERNAL MEDICINE (HOSPITALISTS)- INTERVENTIONAL RADIOLOGY- FAMILY PRACTICE- NEONATOLOGIST- OBSTETRICS/GYNECOLOGY- OPHTHALMOLOGY- ORTHOPEDIC TRAUMA SURGERY- PAIN MANAGEMENT- PLASTIC RECONSTRUCTIVE SURGERY- PULMONARY/CRITICAL CARECONTINUING HEALTH PROFESSIONALS EDUCATION: PIKEVILLE MEDICAL CENTER HAS AN ACTIVE MEDICAL LIBRARY STAFF THAT COORDINATES AND OVERSEES MANY OF THE CONTINUING MEDICAL EDUCATION (CME) HOURS OFFERED AT THE HOSPITAL. MOST CMES ARE OPEN TO NOT ONLY OUR STAFF, BUT TO OTHER MEDICAL PROFESSIONALS THROUGHOUT THE REGION. IN FY 2012, PMC OFFERED 25 CME PRESENTATIONS, REACHING 139 PHYSICIANS AND NEARLY 400 NON-PHYSICIANS. THIS SERVICE COST THE HOSPITAL NEARLY $13,000. THE EDUCATIONAL OPPORTUNITIES OFFERED BY THE HOSPITAL DURING FY 2012 COVERED THE FOLLOWING TOPICS:- ACUTE CORONARY SYNDROME MANAGEMENT- EFFECTS OF VENOM ON SNAKEBITE TREATMENT - WHEN TIME MAKES A DIFFERENCE: GOLDEN HOUR EMERGENCIES- CANCER CASE CONFERENCE (HELD MONTHLY)- INFECTIOUS DISEASE CONFERENCE (SIX EVENTS)SUPPORT GROUPS: PMC SPONSORS AND PARTICIPATES IN SEVERAL COMMUNITY SUPPORT GROUPS. IN FY 2012, PMC TOOK PART IN 60 LOCAL SUPPORT GROUPS, REACHING 1,963 PEOPLE AND GIVING NEARLY $9,500 IN COMMUNITY BENEFITS. BELOW IS A LIST OF THE SUPPORT GROUPS PMC HOSTED/SPONSORED: - COPING WITH DIABETES SUPPORT GROUP- AFTER BREAST CANCER (ABC) SUPPORT GROUP- MAN TO MAN PROSTATE CANCER SUPPORT GROUP- STROKE SUPPORT GROUP- WEIGHT LOSS SURGERY SUPPORT GROUP- GRIEF GROUPOTHER COMMUNITY SUPPORT: THROUGHOUT THE YEAR, PIKEVILLE MEDICAL CENTER AND ITS EMPLOYEES PARTICIPATED IN SEVERAL EVENTS TO HELP THE COMMUNITY. SOME OF THE EVENTS AND COMMUNITY GROUPS THE HOSPITAL HELPED DURING FY 2012 INCLUDE: - TORNADO RELIEF RADIO-THON- COMMUNITY DINNERS- LIVE NATIVITY- DISASTER RECOVERY- NATIONAL DAY OF PRAYER- PASTOR'S APPRECIATION BRUNCH- RELAY FOR LIFE- PIKEVILLE MINISTERIAL ASSOCIATION- SCHOLAR HOUSE OF APPALACHIA- CHILD FATALITY REVIEW BOARD- CHILDREN'S PROJECT ON PALLIATIVE/HOSPICE SERVICES- PIKE COUNTY AFFORDABLE HOUSING BOARD - SANDY VALLEY HABITAT FOR HUMANITY- UNITED HELPING HANDS BOARDTORNADO RELIEF RADIO-THON - IN MARCH 2012, PMC WORKED TOGETHER WITH OTHER LOCAL ORGANIZATIONS TO HOST THE TORNADO RELIEF RADIO-THON. MANY EMPLOYEES GAVE UP TIME TO ORGANIZE AND PUBLICIZE THE EVENT, SET-UP, TAKE PHONE CALLS, COLLECT DRIVE-BY DONATIONS, TALLY THE RESULTS AND CLEAN UP. NEARLY $180,000 IN DONATIONS WERE RECEIVED. ALL PROCEEDS WENT TOWARD HELPING TORNADO VICTIMS IN MAGOFFIN, JOHNSON, MARTIN AND MORGAN COUNTIES.
DESCRIPTION OF COMMUNITY HEALTH PROMOTION (CONTINUED) SCH H PART VI LINE 5 VETERANS DATING BACK TO WWII WERE PERSONALLY RECOGNIZED AND THANKED FOR THEIR SERVICE DURING THIS EVENT. AFTER THE FESTIVITIES, FREE REFRESHMENTS AND HEALTH SCREENINGS WERE OFFERED TO THE PUBLIC. FREE SCREENINGS INCLUDED: BLOOD SUGAR, BLOOD PRESSURE, CHOLESTEROL AND BODY MASS INDEX (BMI). REPRESENTATIVES FROM DIABETES EDUCATION, THE HEART AND VASCULAR INSTITUTE AND THE WEIGHT LOSS SURGERY CENTER WERE PRESENT TO DISCUSS PATIENTS' SCREENING RESULTS AND ANSWER QUESTIONS. THIS EVENT CONTRIBUTED $80,995.55 TOWARD COMMUNITY BENEFITS. TORNADO RELIEF CLINIC - IN MARCH 2012, PMC'S ENDOCRINOLOGY DEPARTMENT TRAVELED TO SALYERSVILLE, KY TO PROVIDE FREE DIABETES SCREENINGS, GLUCOSE METERS AND TESTING STRIPS TO TORNADO VICTIMS WHO LOST THESE SUPPLIES. THIS WAS A COMMUNITY BENEFIT OF NEARLY $700.COMMUNITY HEALTH EDUCATION: PIKEVILLE MEDICAL CENTER'S STAFF REMAINS ACTIVE IN EDUCATING THE LOCAL COMMUNITY ON SEVERAL BENEFICIAL, HEALTH CARE TOPICS. THROUGHOUT THE YEAR, HOSPITAL REPRESENTATIVES FROM VARIOUS DEPARTMENTS SPEAK TO LOCAL CIVIC CLUBS, SCHOOLS, MEDICAL PROFESSIONALS AND THE PUBLIC AT LARGE. THROUGH PMC'S 140 COMMUNITY EDUCATION EFFORTS IN FY 2012, THE HOSPITAL REACHED NEARLY 3,000 PEOPLE. THIS WAS A COMMUNITY BENEFIT OF MORE THAN $118,500.PMC EMPLOYEES TOOK PART IN THE FOLLOWING LECTURES/PRESENTATIONS DURING FY 2012:- 44 CHILDBIRTH CLASSES - BICYCLE/ATV AWARENESS PRESENTATION AT DORTON ELEMENTARY- BOONE FORK SENIOR CITIZEN DIABETES PRESENTATION- DIABETES EDUCATION AT LOCAL KIWANIS MEETING- PCHD HELP OVERCOME TOBACCO YOUTH CONFERENCE- PIKEVILLE YMCA WELLNESS WEDNESDAY- 46 HEALTH TALKS - SENIOR CITIZEN HEALTH PRESENTATION - DIABETES EDUCATION- ELKHORN CITY & PIKEVILLE SENIOR CITIZEN STROKE EDUCATION/INPATIENT REHABILITATION DAY- DIABETES ALERT DAY- BLACKBERRY/MCCARR SENIOR CITIZEN HEART ATTACK EDUCATION/INPATIENT PHYSICAL REHAB DAY - MODEL CITY DAYCARE SNAKE BITE PREVENTION AND TREATMENT IN-SERVICE- STROKE AWARENESS VENDOR BOOTH AT JENNY WILEY - 38 WEIGHT LOSS SURGERY SEMINARSCHILDBIRTH CLASSES - PMC'S EDUCATION DEPARTMENT HOSTS FOUR CHILDBIRTH CLASSES A MONTH TO EDUCATE PARENTS-TO-BE ON WHAT TO EXPECT DURING LABOR AND AFTER BRINGING THEIR BABY HOME. INFORMATION DISCUSSED INCLUDES: WHAT TO BRING TO THE HOSPITAL, HOSPITAL SERVICES, AVAILABLE PEDIATRICIANS, KANGAROO CARE, MANAGING LABOR PAIN AND EPIDURALS, BASIC NEWBORN CARE, CIRCUMCISION, CORD CARE, INFANT CPR, IMMUNIZATIONS AND BREASTFEEDING. ATTENDEES ALSO RECEIVE A TOUR OF THE LABOR AND DELIVERY FLOOR. THIS SERVICE COST NEARLY $5,000 IN FY 2012. HEALTH TALK - EACH WEEK, PMC'S PUBLIC RELATIONS DEPARTMENT RECORDS A 30 MINUTE RADIO SHOW THAT IS AIRED ON NINE LOCAL RADIO STATIONS COVERING PIKE, FLOYD, LETCHER, JOHNSON, KNOTT, MAGOFFIN AND MARTIN COUNTIES IN KENTUCKY AND MINGO COUNTY, W.V. THROUGH THIS SHOW, PMC INFORMS LISTENERS OF NEW HEALTH SERVICES, PHYSICIANS AND TECHNOLOGY AT THE HOSPITAL. THIS PROGRAM ALSO EDUCATES THE PUBLIC ON OTHER HEALTH TOPICS OF INTEREST WHICH HAVE INCLUDED FAMILY MEDICINE SERVICES; FLU; PULMONARY REHABILITATION; CANCER SYMPTOMS, PREVENTION AND TREATMENT; AND DIABETES EDUCATION. IN FY 2012, THE TOTAL COST FOR THIS SERVICE WAS NEARLY $54,000.WEIGHT LOSS SURGERY SEMINARS - PMC'S WEIGHT LOSS SURGERY CENTER STAFF TRAVELS WEEKLY ACROSS THE REGION, EDUCATING THE PUBLIC ON THE BENEFITS OF BARIATRIC SURGERY. SEMINARS ARE ADVERTISED PRIOR TO THE EVENT, FOR MAXIMUM ATTENDANCE. DURING FY 2012, THIS COMMUNITY BENEFIT TOTALED NEARLY $59,000.
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number
61-0458376
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed
......................... lBullet
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) SMG FOOD AND BEVERAGE LLC DBA EASTERN KY EXPOSITION CENTER126 MAIN STREET
PIKEVILLE,KY41501
23-2511871   29,611       PRESENTING SPONSORSHIP "LANDAU MURPHY SHOW"
(2) UNITED HELPING HANDS OF PIKEVILLE INCPO BOX 342
PIKEVILLE,KY41502
31-1075698 501C3 25,000       DONATION FOR EASTERN KY TORNADO VICTIM RELIEF
(3) UNITE FOUNDATION INC2292 SOUTH HWY 27
SOMERSET,KY42501
56-2338443 501C3 12,500       SPONSORSHIP NATIONAL RX DRUG ABUSE SUMMIT EVENT
(4) JENNY WILEY DRAMA ASSOCIATION INCPO BOX 22
PRESTONSBURG,KY41653
61-0667976 501C3 10,000       SPONSORSHIP FOR "THE MARVELOUS WONDERETTES"
(5) AMERICAN HEART ASSOCIATION545 NORTH HIGH ST
COLUMBUS,OH43214
13-5613797 501C3 10,000       DONATION FOR 2012 CENTRAL KY HEART BALL
(6) SOUTHEAST KENTUCKY CHAMBER OF COMMERCE787 HAMBLEY BLVD
PIKEVILLE,KY41501
61-0544068 501C3 5,000       PLATINUM SPONSORSHIP FOR ANNUAL AWARDS CEREMONY & BANQUET
(7) KENTUCKY CHAMBER OF COMMERCE464 CHENAULT ROAD
FRANKFORT,KY40601
61-0405718 501C6 10,000       SILVER SPONSORSHIP 8TH ANNUAL BEST PLACES TO WORK & LEADERSHIP INSTITUTE SPONSORSHIP FOR PIKE COUNTY SCHOOL PRINCIPALS
(8) KENTUCKY CHAMBER FOUNDATION INC464 CHENAULT ROAD
FRANKFORT,KY40601
61-1284992 501C3 9,000       LEADERSHIP INSTITUTE SPONSORSHIP FOR PIKE COUNTY SCHOOL PRINCIPALS
(9) AMERICAN CANCER SOCIETY INC4324 13TH STREET
ASHLAND,KY41102
13-1788491 501C3 5,000       RELAY FOR LIFE PIKE COUNTY SPONSORSHIP






2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
1
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance
(1) ASSISTANCE FOR UNINSURED PATIENTS FOR PRESCRIPTIONS, CAFE VOUCHERS, TRANSPORTATION, MEDICAL EQUIPMENT, AND CANCER TREATMENT TRAVEL ASSISTANCE. THERE WERE 441 PRESCRIPTIONS PROVIDED, 703 CAFE VOUCHERS PROVIDED, AND 67 RECIPIENTS OF TRAVEL ASSISTANCE. 1215 49,746      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS ARE PROVIDED TO PUBLIC CHARITIES FOR GENERAL SUPPORT. PIKEVILLE MEDICAL CENTER, INC. DOES NOT MONITOR THE USE OF THESE FUNDS BY THESE PUBLIC CHARITIES.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


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
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
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? ....
2
Yes
 
3
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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
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:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
Yes
 
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) WILLIAM GAUNT MD (i)
(ii)
142,862
0
22,831
0
150
0
0
0
14,569
0
180,412
0
0
0
(2) WALTER E MAY (i)
(ii)
495,000
0
95,000
0
6,180
0
11,000
0
26,245
0
633,425
0
0
0
(3) MICHELLE HAGY (i)
(ii)
218,909
0
14,724
0
799
0
4,990
0
25,967
0
265,389
0
2,430
0
(4) JUANITA DESKINS (i)
(ii)
250,862
0
48,671
0
1,627
0
4,477
0
26,052
0
331,689
0
2,796
0
(5) CHERYL HICKMAN (i)
(ii)
182,541
0
41,531
0
1,645
0
11,132
0
27,060
0
263,909
0
2,042
0
(6) WILLIAM JOHNSON MD (i)
(ii)
265,525
0
100
0
5,265
0
22,257
0
25,725
0
318,872
0
0
0
(7) ESTELLA CLARK (i)
(ii)
150,000
0
7,999
0
1,086
0
1,949
0
28,885
0
189,919
0
141
0
(8) PEGGY JUSTICE (i)
(ii)
155,000
0
9,867
0
791
0
9,764
0
23,670
0
199,092
0
1,747
0
(9) TERENCE FARRELL (i)
(ii)
179,291
0
9,971
0
230
0
1,346
0
20,036
0
210,874
0
2,255
0
(10) DEBORAH PUCKETT (i)
(ii)
147,014
0
9,359
0
1,376
0
9,261
0
24,060
0
191,070
0
1,657
0
(11) TIM MARTIN (i)
(ii)
165,000
0
10,503
0
1,225
0
3,794
0
25,308
0
205,830
0
1,860
0
(12) MARCUS CONLEY (i)
(ii)
145,000
0
9,230
0
715
0
4,059
0
25,369
0
184,373
0
1,635
0
(13) MARK SWOFFORD MD (i)
(ii)
600,000
0
429,842
0
450
0
8,250
0
2,064
0
1,040,606
0
0
0
(14) DUANE DENSLER MD (i)
(ii)
805,000
0
555,491
0
300
0
8,250
0
24,449
0
1,393,490
0
0
0
(15) NORMAN MAYER MD (i)
(ii)
805,000
0
620,293
0
35,498
0
8,250
0
24,449
0
1,493,490
0
0
0
(16) KEITH HALL MD (i)
(ii)
1,040,273
0
58,080
0
270
0
8,250
0
25,705
0
1,132,578
0
0
0
(17) KEVIN PUGH MD (i)
(ii)
1,033,338
0
100
0
270
0
8,250
0
25,705
0
1,067,663
0
0
0
(18) SUSAN SCHELL (i)
(ii)
98,143
0
7,727
0
38,401
0
0
0
20,445
0
164,716
0
1,747
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 4A SUSAN SCHNELL RECEIVED SEVERANCE PAYMENTS TOTALING $38,154 DURING THE 2011 CALENDAR YEAR.
  PART I, LINE 5 DR. HALL AND DR. PUGH EARN QUARTERLY BONUSES BASED ON A PERCENTAGE OF THE NET COLLECTIONS OF THE PHYSICIANS PRACTICES OVER 150% OF THEIR BASE COMPENSATION.
SUPPLEMENTAL INFORMATION PART III PART II DR WILLIAM GAUNT RECEIVED COMPENSATION AND BENEFITS FROM THE HOSPITAL FOR HIS EMPLOYMENT AT PIKEVILLE MEDICAL CENTER AS A GENERAL SURGEON. HE WAS NOT COMPENSATED FOR HIS POSITION ON THE BOARD.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number
61-0458376
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer
(i) Pool
financing
Yes No Yes No Yes No
A CITY OF PIKEVILLE KY
 
61-6001897 72134PAR3 04-27-2011 90,370,651 SEE BELOW   X   X   X
B CITY OF PIKEVILLE KY
 
61-6001897 72134PAS1 04-27-2011 45,615,542 SEE BELOW   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 90,370,651 45,615,542    
4 Gross proceeds in reserve funds . . . . . . . . 3,563,671      
5 Capitalized interest from proceeds . . . . . . . . . . 1,798,867 1,798,867    
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 1,328,586 297,917    
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 28,107,242 42,180,758    
11 Other spent proceeds . . . . . . . . . . . 44,236,511      
12 Other unspent proceeds . . . . . . . . . . . 13,134,641 1,338,000    
13 Year of substantial completion . . . . . . . . . . .
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X     X        
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X        
16 Has the final allocation of proceeds been made? . . . . . .   X   X        
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X     X        
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . X     X        
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X        
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0.00000%   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000%   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0% 0.00000%   %   %
7 Does the bond issue meet the private security or payment test? . . . X   X          
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X          
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue?   X   X        
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X   X        
b Name of provider . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X        
6 Did the bond issue qualify for an exception to rebate? .   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X        
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
    THE BONDS AND NOTES WERE ISSUED FOR THE PURPOSES OF PROVIDING FUNDS TO BE USED TO 1)FINANCE A PORTION OF THE COSTS OF CERTAIN ADDITIONS, RENOVATIONS, IMPROVEMENTS AND EQUIPMENT FOR PIKEVILLE MEDICAL CENTER 2)REFUND KY ECONOMIC DEVELOPMENT FINANCE AUTHORITY HOSPITAL REVENUE AND REFUND REVENUE BONDS, SERIES 1997 3)RETIRE CERTAIN OUTSTANDING TAXABLE DEBT 4)FUND A DEBT SERVICE RESERVE FUND 5)FUND CAPITALIZED INTEREST DURING CONSTRUCTION OF THE PROJECT AND 6)PAY COST OF ISSUANCE OF THE BONDS.
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
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?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2011
Schedule L (Form 990 or 990-EZ) 2011
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?
Yes No
(1) VICKI BELL DAUGHTER-IN-LAW OF HOBART JOHNSON, PMC BOARD MEMBER 10,142 PIKEVILLE MEDICAL CENTER PURCHASES CATERING SERVICES FOR HOSPITAL FUNCTIONS FROM THIS VENDOR.   No
(2) COMMUNITY TRUST BANK
 
ENTITY OF WHICH BOARD MEMBERS HAVE BUSINESS RELATIONSHIPS 9,693,199 HOBART JOHNSON AND DAVID COLLINS SERVE AS BOARD MEMBERS OF BOTH ENTITIES. SERVICES PROVIDED BY COMMUNITY TRUST BANK TO PIKEVILLE MEDICAL CENTER: -INTEREST INCOME BANKING SERVICES & FUNDS IN TRUST, $959,183.19 -SAFE DEPOSIT BOX FEES/LINE OF CREDIT FEES/BOND ACCT MGMT FEES, $8,065.00 -INSTALLMENT LOAN PAYMENTS, $8,709,020.79 -ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $16,930.00   No
(3) CREATIVE LIGHTING & BATH
 
HUSBAND OF PATTY THOMPSON, PMC KEY EMPLOYEE OWNS BUSINESS 520,794 PIKEVILLE MEDICAL CENTER PURCHASES CONSTRUCTION/RENOVATION SERVICES AND FURNISHINGS FROM THIS ENTITY - $520,474.75 -ENTITY PROVIDES ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $319.00   No
(4) EAST KY BROADCASTING AND EAST KY RADIO NETWORK (TOTAL OF NINE RADIO STATION
 
ENTITIES MORE THAN 35% OWNED BY WALTER E. MAY, PMC PRESIDENT/CEO 618,933 ENTITIES PROVIDE ADVERTISING SERVICES TO PMC, $611,681.10 -ENTITIES PROVIDE ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $7,251.40   No
(5) KVWV TRAFFIC CONTROL
 
ENTITY OF WHICH T.T. COLLEY'S SON IS THE OWNER 12,263 ENTITY PROVIDES PARKING LOT STRIPING SERVICES TO PIKEVILLE MEDICAL CENTER   No
(6) MESA-ER PHYSICIAN GROUP
 
ENTITY OF WHICH SUE SMALLWOOD'S STEP GRANDSON IS THE MEDICAL DIRECTOR. 521,670 THE STEP GRANDSON OF PMC BOARD MEMBER SUE SMALLWOOD IS PIKEVILLE MEDICAL CENTER EMERGENCY DEAPARTMENT MEDICAL DIRECTOR AND AN EMPLOYEE FOR MESA. MESA PROVIDES EMERGENCY DEPARTMENT PHYSICIAN SERVICES FOR PIKEVILLE MEDICAL CENTER.   No
(7) PAM MAY LAW FIRM PSC
 
ENTITY MORE THAN 35% OWNED BY WIFE OF WALTER E. MAY, PMC PRESIDENT/CEO 1,147,424 FIRM PROVIDES LEGAL SERVICES TO PIKEVILLE MEDICAL CENTER.   No
(8) PIKEVILLE RADIOLOGY
 
ENTITY MORE THAN 35% OWNED BY TWO PMC BOARD MEMBERS 43,246 ALEX POULOS, M.D. & DENNIS HALBERT, M.D. ARE PARTNERS OF PIKEVILLE RADIOLOGY WITH WHOM PIKEVILLE MEDICAL CENTER CONTRACTS WITH FOR RADIOLOGY SERVICES.   No
(9) US BANK
 
ENTITY OF WHICH ALEX POULOS, M.D. IS A BOARD MEMBER 748,485 SERVICES PROVIDED BY US BANK TO PIKEVILLE MEDICAL CENTER: -INSTALLMENT LOAN PAYMENTS, $645,585.69 - RENT, $102,427.36 -ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PMC, $472.00   No
(10) ANDREA ALLARA DAUGHTER OF JOE DEAN ANDERSON, PMC BOARD MEMBER 42,708 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS RADIOLOGY COORDINATOR.   No
(11) ROBERT BELL STEP SON OF HOBART JOHNSON, PMC BOARD MEMBER 100,377 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS NUTRITIONAL SERVICES HEAD CHEF.   No
(12) CAMILLA DAMRON DAUGHTER OF JO NELL ROBINSON, PMC BOARD MEMBER 75,989 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS A SPEECH LANGUAGE PATHOLOGIST.   No
(13) SARAH HARRIS DAUGHTER OF CHERYL HICKMAN, PMC KEY EMPLOYEE 67,300 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS IT- PRACTICE PROJECT MANAGER.   No
(14) ASHLEY COLLINS JOHNSON DAUGHTER OF DAVID COLLINS, PMC BOARD MEMBER 65,689 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS MANAGER-EMPLOYEE RELATIONS.   No
(15) CINDY MAY JOHNSON DAUGHTER OF WALTER E. MAY, PMC PRESIDENT/CEO 95,325 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS DIRECTOR-MEDICAL LEADER/PUBLIC RELATIONS.   No
(16) RANDY L JOHNSON SON IN LAW OF WALTER E. MAY, PMC PRESIDENT/CEO 62,534 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS CHAPLAIN   No
(17) BRANDI MAY DAUGHTER IN LAW OF WALTER E. MAY, PMC PRESIDENT/CEO 38,942 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS PI OUTCOME SPECIALIST.   No
(18) KAMINSKI ROBINSON HUSBAND OF JO NELL ROBINSON, PMC BOARD MEMBER 66,439 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS DIRECTOR-CHAPLAIN SERVICES   No
(19) ANDREA ROBINETTE STEP DAUGHTER OF WALTER E. MAY, PMC PRESIDENT/CEO 16,124 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS PHYSICIAN RECRUITER.   No
(20) COLLEY STEVENS GRANDSON OF T.T. COLLEY, PMC BOARD MEMBER 60,108 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS ASSISTANT DIRECTOR - VALET SERVICES.   No
(21) CORDELL WEATHERFORD GRANDSON IN LAW OF WALTER E MAY, PMC PRESIDENT/CEO 72,537 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS DIRECTOR-CUSTOMER SERVICE/EMPLOYEE DEVELOPMENT.   No
(22) CAROLINA WEATHERFORD DBA CLW EDITIN GRANDDAUGHTER OF WALTER E. MAY, PMC PRESIDENT/CEO 18,750 ENTITY PROVIDES PROOFREADING SERVICES FOR PIKEVILLE MEDICAL CENTER'S MEDICAL LEADER PUBLICATION   No
(23) SUMMIT ENGINEERING
 
ENTITY OF WHICH PEGGY JUSTICE'S BROTHER IS A PARTNER 28,467 ENTITY PROVIDES ENGINEERING SERVICES TO PIKEVILLE MEDICAL CENTER.   No
(24) UNIVERSITY OF PIKEVILLE
 
ENTITY OF WHICH MARY R. SIMPSON IS CHAIR OF THE DIVISION OF NURSING 13,464 PMC BOARD MEMBER MARY R. SIMPSON PHD IS CHAIR OF THE UNIVERSITY OF PIKEVILLE DIVISION OF NURSING. SERVICES PROVIDED BY UNIVERSITY OF PIKEVILLE TO PIKEVILLE MEDICAL CENTER: -ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PMC, $1,464.00. RENT PAYMENTS TO UNIVERSITY OF PIKEVILLE FOR STORAGE LOT, $12,000.00   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) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Types of Property
(a)
Check if applicable
(b)
Number of Contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( OFFICE FURNITURE ) X 1 7,800 FAIR MARKET VALUE
26 Other Right pointing arrow large image ( BUILDING SUPPLIES ) X 1 22,493 FAIR MARKET VALUE
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
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
2011
Open to Public
Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Identifier Return Reference Explanation
  FORM 990, PART VI, SECTION A, LINE 2 DR ALEX POULOS & DR DENNIS HALBERT PARTNERS IN PIKEVILLE RADIOLOGY. HOBERT JOHNSON & DAVID COLLINS MEMBERS OF COMMUNITY TRUST BANK BOARD OF DIRECTORS.
  FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE CFO AND HOSPITAL ATTORNEY PRIOR TO FILING. ADDITIONALLY, THE GOVERNING BODY REVIEWS AND APPROVES THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES. COPIES ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY UPON REQUEST.
  FORM 990, PART VI, SECTION B, LINE 12C AS TO BOARD MEMBERS, UPDATES TO THE CONFLICT OF INTEREST FORMS ARE COMPLETED ANNUALLY WITH VOLUNTARY DISCLOSURE OF CONFLICT ON ANY PARTICULAR ISSUE. THERE IS NO PARTICIPATION, DISCUSSION OR VOTE TAKEN ON THESE; HOWEVER, THE BOARD ATTORNEY IS PROVIDED A COPY OF ALL INTERESTS OF EACH MEMBER TO ENSURE COMPLIANCE WITH THE POLICY. THESE ARE REGULARLY AND CONSISTENTLY MONITORED FOR ANY CHANGES. AS TO EMPLOYEES, THERE IS A WRITTEN CONFLICT OF INTEREST POLICY WHICH TOO IS REGULARLY AND CONSISTENTLY MONITORED AND ENFORCED BY HUMAN RESOURCES AND ADMINISTRATION AS NECESSARY. THIS POLICY IS INTENDED TO IDENTIFY AND RESOLVE CONFLICTS OF INTEREST WHICH MAY OCCUR RELATED TO FINANCIAL, BUSINESS, OR PROFESSIONAL INTERESTS. THE POLICY IS IN PLACE TO IDENTIFY AND RESOLVE A CONFLICT OF INTEREST WHICH MAY OCCUR ANY TIME THERE IS A SITUATION IN WHICH ONE'S ABILITY TO MAKE OBJECTIVE, JOB RELATED BUSINESS DECISIONS MAY BE INFLUENCED BY, OR HAVE THE APPEARANCE OF BEING INFLUENCED BY, OUTSIDE ACTIVITIES OR PERSONAL INTERESTS. POTENTIAL CONFLICTS OF INTEREST MAY INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: 1. WORKING A SECOND JOB AT A COMPETING HEALTHCARE ENTITY WHICH MAY ALLOW THE TRANSFER OF CONFIDENTIAL BUSINESS INFORMATION OR INFLUENCE REFERRAL PATTERNS. 2. ALLOWING THE DEMANDS OF OUTSIDE ACTIVITIES TO HINDER OR DISTRACT YOU FROM THE PERFORMANCE OF YOUR JOB OR CAUSE YOU TO USE PIKEVILLE MEDICAL CENTER RESOURCES FOR OTHER THAN PIKEVILLE MEDICAL CENTER PURPOSES. 3. HOLDING AN OWNERSHIP INTEREST, MANAGEMENT, OR BOARD OF DIRECTORS POSITION IN A COMPANY WITH WHOM PIKEVILLE MEDICAL CENTER DOES BUSINESS WHICH MAY LEAD TO THE INDIVIDUAL'S PERSONAL GAIN/BENEFIT. "OWNERSHIP INTEREST" MEANS SERVING AS A BOARD DIRECTOR OR OFFICER OR OWNING MORE THAN 5% OF THE BUSINESS OR CORPORATION. 4. HAVING AN IMMEDIATE FAMILY MEMBER OR SIGNIFICANT OTHER WHO HOLDS AN OWNERSHIP INTEREST IN A COMPANY WITH WHOM PIKEVILLE MEDICAL CENTER DOES BUSINESS WHICH MAY LEAD TO THE INDIVIDUAL'S PERSONAL GAIN/BENEFIT. "OWNERSHIP INTEREST" MEANS SERVING AS A BOARD DIRECTOR OR OFFICER OR OWNING MORE THAN 5% OF THE BUSINESS OR CORPORATION. 5. HAVING AN IMMEDIATE FAMILY MEMBER OR SIGNIFICANT OTHER EMPLOYED BY THE PIKEVILLE MEDICAL CENTER AND WORKING WITHIN THE SAME DIRECT LINE OF AUTHORITY (ABOVE OR BELOW) AS THE FIRST EMPLOYEE. IMMEDIATE FAMILY MEMBERS INCLUDE SPOUSES, CHILDREN, GRANDCHILDREN, BROTHERS AND SISTERS AND THE SPOUSES OF THOSE INDIVIDUALS. THE SCOPE OF THIS POLICY INCLUDES: PIKEVILLE MEDICAL CENTER AND ALL ITS DEPARTMENTS AND SERVICES WHEREVER LOCATED. THE COVERED INDIVIDUALS ARE TO FOLLOW THESE PROCEDURES: 1. ALL LICENSED CLINICAL STAFF, SUPERVISORS, AND MANAGEMENT PERSONNEL SHALL COMPLETE A DUALITY AND CONFLICT OF INTEREST FORM AT THE TIME OF INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER. 2. EMPLOYEE CONFLICT OF INTEREST FORMS SHALL BE FILED IN THEIR PERSONNEL FILES. 3. IN THE EVENT THAT AN EMPLOYEE'S JOB DESCRIPTION OR DUTIES REQUIRES A BUSINESS RELATED DECISION TO BE MADE IN AN AREA IN WHICH A PERSONAL CONFLICT OF INTEREST HAS BEEN IDENTIFIED, THE EMPLOYEE SHALL NOTIFY HIS/HER SUPERVISOR TO ARRANGE FOR AN ALTERNATIVE DECISION MAKING PROCESS WHICH WILL MAINTAIN OBJECTIVITY AND ELIMINATE PERSONAL BIAS, I.E. PERSONAL WITHDRAWAL FROM THE DECISION MAKING PROCESS, SOLICITATION OF CLOSED BIDS, OR UTILIZATION OF A INDEPENDENT SELECTION COMMITTEE. 4. IF AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF ETHICS IS IDENTIFIED INVOLVING PATIENT CARE OR TREATMENT, THE EMPLOYEE SHOULD SEEK ASSISTANCE FROM THEIR SUPERVISOR TO FIND A RESOLUTION WHICH WOULD HAVE MINIMUM IMPACT ON PATIENT CARE, TREATMENT, OR SERVICES.
  FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE SALARY OF THE ORGANIZATION'S CEO. THE COMMITTEE USES COMPARATIVE DATA FROM NATIONAL SALARY SURVEYS. MOTION AND APPROVALS FROM THE COMMITTEE ARE KEPT IN THE MINUTES.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES MAKE THE FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 96,091. ROUNDING 3. TOTAL TO FORM 990, PART XI, LINE 5: 96,094.
OVERSIGHT OF AUDIT FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PIKEVILLE MEDICAL CENTER INC
 
Employer identification number

61-0458376
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) PIKEVILLE MEDICAL CENTER FOUNDATION INC
911 BYPASS ROAD
PIKEVILLE,KY41501
61-1274046
INACTIVE KY N/A
C -307 47,040 100.000 %
(2) PIKEVILLE MEDICAL DEVELOPMENT CORPORATION
911 BYPASS ROAD
PIKEVILLE,KY41501
20-2487928
INACTIVE KY N/A
C -173 7,616 100.000 %










Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
(2)

(3)

(4)

(5)

(6)

Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: