Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENTUCKYONE HEALTH MEDICAL GROUP INC
Employer identification number
61-1352729
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
120,819
19,595
1,932
3,958
0
146,304
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......
96,909,350
109,587,741
61,209,467
125,363,989
156,388,547
549,459,094
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
97,030,169
109,607,336
61,211,399
125,367,947
156,388,547
549,605,398
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
0
0
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.
0
0
0
0
0
0
c
Add lines 7a and 7b..
0
0
0
0
0
0
8
Public support (Subtract line 7c from line 6.)
549,605,398
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
97,030,169
109,607,336
61,211,399
125,367,947
156,388,547
549,605,398
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
70,253
16,035
7,750
6,570
60,494
161,102
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
70,253
16,035
7,750
6,570
60,494
161,102
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
305,105
1,838
306,943
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
0
0
0
0
0
13
Total support. (Add lines 9, 10c, 11, and 12.)..
97,100,422
109,623,371
61,219,149
125,679,622
156,450,879
550,073,443
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
99.910 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.900 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.020 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.030 %
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
Additional Data
Software ID:
13000248
Software Version:
2013v3.1
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENTUCKYONE HEALTH MEDICAL GROUP INC
Employer identification number
61-1352729
Return Reference
Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICES
THE PRIMARY EXEMPT PURPOSE OF KENTUCKYONE HEALTH MEDICAL GROUP, INC. IS TO PROVIDE QUALITY MEDICAL CARE THROUGH PHYSICIAN SERVICES AT CLINIC LOCATIONS IN THE LOUISVILLE, KENTUCKY AREA REGARDLESS OF ABILITY TO PAY. KENTUCKYONE HEALTH MEDICAL GROUP, INC. IS THE PHYSICIAN COMPONENT OF AN INTEGRATED HEALTH DELIVERY SYSTEM IN LOUISVILLE, KENTUCKY. KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S SOLE CORPORATE MEMBER IS JEWISH HOSPITAL AND ST. MARY'S HEALTHCARE, INC., JHSMH, A KENTUCKY NONPROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE CLASSIFIED AS A HOSPITAL. KENTUCKYONE HEALTH MEDICAL GROUP, INC. PROVIDES CONVENIENT, QUALITY CARE AND PREVENTATIVE HEALTH SERVICES. THROUGH JUNE 30, 2014, KENTUCKYONE HEALTH MEDICAL GROUP, INC. ATTENDED TO OVER 1,050,000 OFFICE VISITS THROUGHOUT LOUISVILLE AND THE SURROUNDING AREAS. SOME OF THE KENTUCKYONE HEALTH MEDICAL GROUP, INC. OFFICES ARE LOCATED IN ECONOMICALLY DEPRESSED AREAS ALLOWING THE PRACTICE TO SERVICE A POPULATION UNABLE TO MEET ITS FINANCIAL OBLIGATION FOR PAYMENT OF SERVICES AND TO MAKE QUALITY HEALTHCARE ACCESSIBLE IN THESE AREAS. KENTUCKYONE HEALTH MEDICAL GROUP, INC. PROVIDES A BROAD RANGE OF MEDICAL SERVICES AT ITS CLINICS INCLUDING PRACTICE AREAS AS FOLLOWS: -CARDIOLOGY -NEUROLOGY -ORTHOPAEDICS -INTERNAL MEDICINE KENTUCKYONE HEALTH MEDICAL GROUP, INC. PROVIDES MEDICAL SERVICES ON A NONDISCRIMINATORY BASIS TO ALL PERSONS IN THE COMMUNITY ABLE TO PAY THE COST THEREOF EITHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT, AS WELL AS TO THOSE ENROLLED IN THE MEDICARE AND MEDICAID PROGRAMS. ADDITIONALLY, KENTUCKYONE HEALTH MEDICAL GROUP, INC. PROVIDES HEALTH CARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY IN ACCORDANCE WITH KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S CHARITY CARE POLICY.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders
ACCORDING TO THE BYLAWS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., THE ENTITY'S SOLE MEMBER IS JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC., A KENTUCKY NONPROFIT CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body
ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders
THE FOLLOWING MATTERS, IF PREVIOUSLY APPROVED BY THE BOARD OR ANY COMMITTEE OF THE BOARD, SHALL ALSO REQUIRE THE PRIOR APPROVAL OF THE CORPORATE MEMBER TO BE EFFECTIVE: APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF ANY FINANCIAL EXPENDITURE WHICH DEVIATE FROM ANY LINE ITEM OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S ANNUAL OPERATING OR CAPITAL BUDGETS BY MORE THAN $500,000; APPROVAL OF THE SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OR ENCUMBRANCE OF THE REAL PROPERTY OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF ANY SALE, LEASE, MORTGAGE OR OTHER TRANSFER OR ENCUMBRANCE OF THE PERSONAL PROPERTY AND ASSETS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC. IF THE SUM OF ANY SUCH TRANSFERS IN ANY YEAR EXCEEDS $500,000; APPROVAL OF THE MERGER, ACQUISITION, CONSOLIDATION, LIQUIDATION OR DISSOLUTION OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF THE ADOPTION, APPROVAL AND AMENDMENT OF SALARIES AND OTHER COMPENSATION (INCLUDING THE AWARD OF ANY INCENTIVE COMPENSATION) AND BENEFITS AND THE OTHER TERMS OF EMPLOYMENT (INCLUDING COMPENSATION PLANS, FORMULAS AND PHILOSOPHY) OR ENGAGEMENT OF THE OFFICERS AND EMPLOYEES, INCLUDING PHYSICIAN EMPLOYEES OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS FOR KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF ANY BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTY OF ANOTHER'S DEBT OR SIMILAR ACTION; APPROVAL OF ANY GIVING, SEEKING OR RECEIVING AND OVERSIGHT OF ADMINISTRATION OR USE OF GRANTS AND OTHER CONTRIBUTIONS AND GIFTS; APPROVAL OF THE COMMENCEMENT OR SETTLEMENT OF CLAIMS OR LITIGATION IN EXCESS OF A THRESHOLD AMOUNT; APPROVAL OF THE APPOINTMENT AND REMOVAL OF DIRECTORS OF THE BOARD OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION; APPROVAL OF THE ALTERATION, AMENDMENT OR REPEAL OF THE BYLAWS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF THE ALTERATION, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF THE ADOPTION OR MODIFICATION OF ANY STRATEGIC PLAN, BUSINESS PLAN, OR MISSION PLAN OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF ANY MATERIAL CHANGES IN THE SCOPE OF SERVICES OFFERED BY KENTUCKYONE HEALTH MEDICAL GROUP, INC., INCLUDING THE RANGE OF PHYSICIAN SPECIALTIES EMPLOYED BY OR CONTRACTED BY KENTUCKYONE HEALTH MEDICAL GROUP, INC.; APPROVAL OF THE ADDITION OF ANY NEW CORPORATE MEMBERS; AND APPROVAL OF THE ADOPTION, MODIFICATION OR REPEAL OF POLICIES OF KENTUCKYONE HEALTH MEDICAL GROUP, INC. PERTAINING TO CHARITY CARE AND NONDISCRIMINATION AGAINST MEDICARE AND MEDICAID PATIENTS. IN ADDITION TO THE RIGHTS RESERVED TO THE CORPORATE MEMBER PURSUANT TO THESE BYLAWS, THE CORPORATE MEMBER IS GRANTED AUTHORITY TO UNILATERALLY TAKE ANY ACTION ON BEHALF OF, OR WITH RESPECT TO, THE CORPORATION WHICH IS NOT INCONSISTENT WITH KENTUCKY LAW AND WHICH IS REQUIRED TO MAINTAIN THE FEDERAL AND STATE TAX EXEMPTIONS OF THE CORPORATION AND THE CORPORATE MEMBER, TO NOT RESULT IN THE CORPORATION HAVING MORE THAN AN INSUBSTANTIAL AMOUNT OF UNRELATED BUSINESS ACTIVITIES, AND TO RESULT IN THE CORPORATION ACTING IN FURTHERANCE OF ITS AND THE CORPORATE MEMBER'S TAX EXEMPT PURPOSES. IN ALL CASES, THESE DETERMINATIONS SHALL BE MADE BY THE CORPORATE MEMBER IN ITS DISCRETION REASONABLY EXERCISED BASED ON THE ADVICE OF LEGAL COUNSEL OR UPON ANY REASONABLE GROUND, INCLUDING, WITHOUT LIMITATION, A REQUEST OR DIRECTION OF ANY LEGISLATIVE, ADMINISTRATIVE, REGULATORY OR JUDICIAL AGENCY HAVING AUTHORITY WITH RESPECT TO THE SUBJECT MATTER UNDER CONSIDERATION.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body
ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE DIVISION VICE PRESIDENT AND AN ELECTRONIC COPY IS PROVIDED TO EACH MEMBER OF THE BOARD. AFTER THE RETURN IS REVIEWED BY THE DIVISION VICE PRESIDENT, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY THAT EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. SUBSEQUENT TO THE RETURN BEING FILED, THE PRESIDENT/CEO OF KENTUCKYONE HEALTH, INC., THE SOLE MEMBER OF THE ORGANIZATION, PRESENTS THE RETURN AT A KENTUCKYONE HEALTH MEDICAL GROUP, INC. BOARD MEETING.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy
ANNUAL STATEMENTS: EACH TRUSTEE, DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., SHALL ANNUALLY SIGN A STATEMENT, WHICH AFFIRMS THAT SUCH PERSON: HAS RECEIVED A COPY OF KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S CONFLICTS OF INTEREST POLICY; HAS READ AND UNDERSTANDS THIS POLICY; HAS AGREED TO COMPLY WITH THIS POLICY; AND UNDERSTANDS THAT KENTUCKYONE HEALTH MEDICAL GROUP, INC. IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSE. ANNUAL QUESTIONNAIRE: EACH TRUSTEE, DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., AND KEY EMPLOYEES OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., SHALL ANNUALLY COMPLETE A CONFLICTS OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY JHSMH'S GENERAL COUNSEL AND JHSMH'S CORPORATE COMPLIANCE OFFICER. PERIODIC REVIEWS: TO ENSURE THAT KENTUCKYONE HEALTH MEDICAL GROUP, INC. OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING. WHETHER ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S CHARITABLE PURPOSES AND DOES NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. IN CONDUCTING SUCH PERIODIC REVIEWS, KENTUCKYONE HEALTH MEDICAL GROUP, INC. MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. IF OUTSIDE EXPERTS ARE USED, THEIR USE SHALL NOT RELIEVE THE GOVERNING BOARD OF ITS RESPONSIBILITY FOR ENSURING THAT PERIODIC REVIEWS ARE CONDUCTED.
Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official
THE MANAGEMENT REVIEW COMMITTEE CONSISTS OF APPROXIMATELY 9 MEMBERS OF JHSMH'S BOARD, AND IS RESPONSIBLE FOR REVIEW AND APPROVAL OF TOP MANAGEMENT COMPENSATION. DURING 2012, THE COMMITTEE CONSISTED OF INDEPENDENT DIRECTORS. THE FULL COMMITTEE ADDRESSED THE OVERALL COMPENSATION PHILOSOPHY AND HOW THE ORGANIZATION'S GOALS CAN BE FURTHERED BY THE STRUCTURE OF COMPENSATION. THE INDEPENDENT MANAGEMENT REVIEW COMMITTEE AND ALL INDEPENDENT MEMBERS OF THE FULL BOARD APPROVED MAXIMUM COMPENSATION LEVELS FOR ALL DISQUALIFIED PERSONS. NON-INDEPENDENT DIRECTORS DID NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON COMPENSATION LEVELS FOR INDIVIDUALS. THE MANAGEMENT REVIEW COMMITTEE RETAINED AN OUTSIDE COMPENSATION CONSULTANT FROM A NATIONAL FIRM TO ADVISE IT REGARDING REASONABLE COMPENSATION LEVELS, AND RELIED ON THE CONSULTANT'S OPINION THAT COMPENSATION LEVELS ARE REASONABLE. THE COMMITTEE RECEIVES A MARKET REVIEW ON EACH DISQUALIFIED PERSON FROM THE COMPENSATION CONSULTANT. THE MANAGEMENT REVIEW COMMITTEE APPROVED THE PEER GROUP OF SIMILAR ENTITLES USED TO MEASURE COMPARABLE COMPENSATION LEVELS. THE MANAGEMENT REVIEW COMMITTEE FOLLOWS THE PROCESS NECESSARY TO OBTAIN THE REBUTTABLE PRESUMPTION THAT COMPENSATION LEVELS ARE REASONABLE, INCLUDING CONTEMPORANEOUS DOCUMENTATION OF DECISIONS.
Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees
PHYSICIAN COMPENSATION IS OVERSEEN BY THE PHYSICIAN TRANSACTION COMMITTEE OF THE JEWISH HOSPITAL & ST. MARY'S HEALTHCARE ("JHSMH") BOARD. THE PHYSICIAN TRANSACTION COMMITTEE HAS BEEN ESTABLISHED AS A SUBCOMMITTEE OF THE JHSMH FINANCE COMMITTEE AND IS COMPRISED OF BOARD MEMBERS FROM JHSMH, KENTUCKYONE HEALTH MEDICAL GROUP, INC.'S SOLE CORPORATE MEMBER. ALL MEMBERS OF THE PHYSICIAN TRANSACTION COMMITTEE ARE INDEPENDENT. THE PHYSICIAN TRANSACTION COMMITTEE IS RESPONSIBLE FOR ENSURING TRANSACTIONS BETWEEN KENTUCKYONE HEALTH MEDICAL GROUP, INC. AND PHYSICIANS, WHICH INCLUDES COMPENSATION, ARE CONDUCTED AT ARMS LENGTH AND FAIR MARKET VALUE. EACH PHYSICIAN EMPLOYEE OF KENTUCKYONE HEALTH MEDICAL GROUP, INC. WHO PROVIDES MEDICAL SERVICES DOES SO PURSUANT TO A PHYSICIAN EMPLOYMENT AGREEMENT. PHYSICIAN COMPENSATION LEVELS UNDER THE EMPLOYMENT AGREEMENT ARE BASED ON NATIONAL INDUSTRY STANDARDS (MEDICAL GROUP MANAGEMENT ASSOCIATION). IN ADDITION, CERTAIN BONUSES PAID TO KENTUCKYONE HEALTH MEDICAL GROUP, INC. PHYSICIANS TAKE INTO ACCOUNT THE PRODUCTIVITY OF EACH INDIVIDUAL PHYSICIAN. PHYSICIANS ARE NOT PENALIZED FOR PROVIDING CHARITY CARE. THUS, THE COMPENSATION ARRANGEMENT DOES NOT HAVE THE POTENTIAL FOR REDUCING THE CHARITABLE SERVICES KENTUCKYONE HEALTH MEDICAL GROUP, INC. PROVIDES. PHYSICIAN COMPENSATION IS REVIEWED ANNUALLY BY AN INDEPENDENT COMPENSATION CONSULTANT FOR REASONABLENESS. OUTCOMES FROM THIS REVIEW ARE PRESENTED TO THE PHYSICIAN TRANSACTION COMMITTEE FOR APPROVAL. THE PHYSICIAN TRANSACTION COMMITTEE RETAINED AN OUTSIDE COMPENSATION CONSULTANT TO ADVISE IT REGARDING REASONABLE COMPENSATION LEVELS, AND RELIED ON THE CONSULTANT'S OPINION THAT COMPENSATION LEVELS ARE REASONABLE. THE COMMITTEE RECEIVES A MARKET REVIEW ON EACH PHYSICIAN FROM THE COMPENSATION CONSULTANT. THE PHYSICIAN TRANSACTION COMMITTEE FOLLOWS THE PROCESS NECESSARY TO OBTAIN THE REBUTTABLE PRESUMPTION THAT COMPENSATION LEVELS ARE REASONABLE, INCLUDING CONTEMPORANEOUS DOCUMENTATION OF DECISIONS.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public
THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.