Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 10-01-2015 , and ending 09-30-2016
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 province, country, and ZIP or foreign postal code
Pikeville, KY41501
D Employer identification number

61-0458376
E Telephone number

G Gross receipts $ 488,071,535
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
subordinates?
H(b)
Are all subordinates
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 world class 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 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 6
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 3,125
6 Total number of volunteers (estimate if necessary) ............. 6 148
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,219,460
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -33,233
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 75,150 110,593
9 Program service revenue (Part VIII, line 2g) ......... 381,107,493 466,322,210
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 550,780 994,946
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 11,852,478 10,706,455
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 393,585,901 478,134,204
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 90,351 105,739
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) 217,429,086 249,357,328
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–24e).... 166,348,221 200,848,567
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 383,867,658 450,311,634
19 Revenue less expenses. Subtract line 18 from line 12....... 9,718,243 27,822,570
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 500,349,042 535,912,611
21 Total liabilities (Part X, line 26)............. 227,164,767 234,566,906
22 Net assets or fund balances. Subtract line 21 from line 20..... 273,184,275 301,345,705
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.
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Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: PIKEVILLE MEDICAL CENTER's Mission IS TO PROVIde world class health care 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 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 $ 87,817,270 including grants of $   ) (Revenue $ 47,380,061 )
PHYSICIAN PRACTICES:Currently, over 340 physicians are members of Pikeville Medical Center's Medical Staff.In FY 2016, PMC welcomed 47 physicians, five physician assistants, six certified registered nurse anesthetists, and 12 nurse practitioners.The physicians recruited during that time period consist of nine anesthesiologists, one colorectal surgeon, three intensivists, twelve emergency medicine physicians, one general surgeon, six hospitalists, one interventional radiologist, one nephrologist, two obstetricians/gynecologists, one ophthalmologist, two oral/maxillofacial surgeons, one orthopedic hand surgeon, two podiatrists, one orthopedic trauma surgeon, two pulmonologists, one trauma surgeon, and one vascular surgeon.With the addition of these new physicians, PMC offers more than 400 services, including every specialty and many subspecialties. PMC is a proud member of the Mayo Clinic Care Network. This partnership - the first of its kind to be formed in the area - is a powerful tool that extends Mayo Clinic's knowledge and expertise to physicians and providers interested in working together in the best interest of their patients. PMC providers have access to Mayo Clinic resources, including its online point-of-care information system and electronic consulting process that connects physicians with Mayo Clinic specialists on questions of diagnosis, therapy or care management. The primary goal of the Mayo Clinic Care Network is to provide the benefits of Mayo Clinic knowledge and expertise close to home, decreasing the patient's need to travel outside the region for healthcare.PMC recently completed a tremendous expansion. The addition of an 11-story clinic building and a 10-story parking garage to the main campus has made health care more accessible and efficient. The PMC Clinic houses eight additional operating rooms, six endoscopy suites, 23 pre-op rooms, 27 post-op rooms and most of PMC's physician practices including cardiothoracic surgery, vascular surgery, trauma surgery, general surgery, colorectal surgery, interventional radiology, gastroenterology, endocrinology, urology, orthopedic trauma surgery, orthopedic surgery, hand surgery, podiatry, sports medicine, obstetrics/gynecology, pediatrics, infectious disease, nephrology, neurology, neurosurgery, physiatry, pulmonology, ophthalmology, optometry, oral/maxillofacial surgery, otolaryngology, rheumatology, plastic/reconstructive surgery, and vitreoretinal surgery. The 1,162-space parking garage connects to the PMC Clinic on each floor, allowing patients to conveniently park on the same floor as their physician's office.In addition to physician practices found in the clinic, PMC offers: bariatric surgery in Pikeville (Kentucky); cardiology general/invasive/interventional/electrophysiology in Pikeville, Whitesburg, Prestonsburg, South Williamson and Lexington (Kentucky) and Grundy (Virginia); oncology medical/hematology/radiation/gynecologic in Pikeville (Kentucky); neurology in Whitesburg, McDowell, South Williamson, Paintsville and Prestonsburg (Kentucky); family medicine in Harold and Shelby Valley (Kentucky); obstetrics/gynecology in Harold (Kentucky); pain management; dermatopathology; pathology; psychology; cardiac rehabilitation and pulmonary rehabilitation in Pikeville (Kentucky).In addition to specialized medical/surgical services, PMC also offers emergency medicine services and utilizes around-the-clock Hospitalists, Intensivists and Neonatologists who devote their professional time to the care of hospitalized patients.PMC physicians completed 294,241 patient visits during FY 2016, an increase of 18 percent from the previous year. Many existing physician practices experienced significant growth during the year: obstetrics/gynecology (71% volume increase), pediatrics (65% volume increase) trauma surgery (45% volume increase), intensivists (37% volume increase), and hospitalists (36% volume increase). New practices in the specialties of emergency medicine, oral/maxillofacial surgery, optometry, and colorectal surgery encountered more than 13,700 patient visits during the fiscal year.The continued expansion of Pikeville Medical Center's specialty capabilities has resulted in fewer patients being transferred out of PMC to larger hospitals and an increase in the number of patient transfers in to PMC from other hospitals, rising from 1,346 in 2010 to 5,498 in 2016.PMC also operates the only Family Practice/Neuromuscular Medicine Residency Program in Kentucky, the only One-Year 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 Family Practice Clinic in conjunction with the Residency Program had more than 9,800 patient visits during FY 2016.PMC purchased the Invivo UroNavFusion Biopsy System during FY 2016 for treatment of urology practice patients. The system is on target to become the new standard in prostate care as it fuses pre-biopsy MRI images of the prostate with ultrasound guided biopsy images, in real time for superb delineation of suspicious lesions, as well as providing the physician with clear visualization of the biopsy needle. The Spectralis Tracking OCT System was purchased during FY 2016 for the vitreoretinal surgery practice. This ophthalmic imaging platform combines scanning laser imaging modalities including dye-based Fluorescan Angiography with simultaneous OCT imaging. The capital investment for physician practices totaled $338,643 during FY 2016.
4b (Code:   ) (Expenses $ 71,383,114 including grants of $   ) (Revenue $ 149,595,378 )
Surgical SERVICES:The surgical services division of Pikeville Medical Center is home to some of the most sophisticated, technologically advanced medical equipment available. The recruitment of new surgeons from varied specialties has not only resulted in substantial expansion of service offerings but has also led to the increase in the number of OR suites available to meet patient demand. PMC has 20 operating rooms, including 2 open heart surgery operating rooms, and six endoscopy rooms in operation currently. The number of surgical services cases increased by seven percent in FY 2016 from FY 2015. Cases included inpatient and outpatient endoscopy procedures, inpatient and outpatient surgical procedures, and C-sections.During FY 2016 PMC purchased the Siemens Cios Alpha C-arm for use in complex vascular surgical procedures such as percauteous valves. The Cios Alpha is a high-end X-ray C-arm that produces high-resolution images in both a fluoroscopy and single image mode. PMC purchased two Vitrectomy Constellation Laser Vision Systems in FY 2016 for use in vitreoretinal surgeries. The ophthalmic microsurgical systems are used in photocoagulation of both anterior and posterior segments of the eye. An additional Prosound F75 Premier EUS/EBUS Processor was purchased during FY 2016 to meet patient demand within Endoscopy. Two endo suites are now equipped and available for EBUS related procedures at all times. The EBUS processor is utilized in all bronchoscopy procedures, as well as in colorectal and gastroenterology procedures. A BK Medical Flex Focus Ultrasound System was purchased in FY 2016. This ultrasound is utilized with both the Davinci robotic surgical system as well as the Uronav navigation system. The capital investment for surgical services during FY 2016 totaled $784,204.
4c (Code:   ) (Expenses $ 12,976,919 including grants of $   ) (Revenue $ 56,157,345 )
Imaging ServicesPikeville Medical Center (PMC) takes pride in offering state-of-the-art diagnostic and therapeutic radiology services. The cutting-edge technology currently available includes 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 an IR Allura Xper FD 20 cardiovascular system.PMC completed phase 2 construction within the fully equipped Interventional Radiology Lab during FY 2016. IR specializes in minimally invasive image-guided procedures that diagnose and treat diseases in most every organ system in the body. In addition to procedure rooms, the IR Lab houses nine pre-operative and post-operative bays, a centralized nurse's station and two outpatient rooms for minor ultrasound procedures. Interventional Radiology performed more than 2,670 procedures during FY 2016, an increase of 121% over FY 2015. Additionally, imaging services upgraded two existing Easy Diagnost Fluoro R/F units to the latest hardware and software versions available during FY 2016. The upgrades provide digital imaging, reduction in radiation dose to the patient and staff, and a reduction in repeat images. Due to the increase in patient census during FY 2016 an additional mobile X-Ray unit was also purchased. The AMX4 Plus mobile unit is utilized throughout PMC's medical, surgical and critical care nursing units to provide bedside x-ray imaging of patients that cannot be transported to the Radiology department for imaging. The total capital investment in imaging services during FY 2016 was $1,663,056.
(Code:   ) (Expenses $ 224,332,406 including grants of $ 105,739 ) (Revenue $ 215,884,089 )
Pikeville Medical Center provides comprehensive health care services through its licensed 300-bed acute care and inpatient rehabilitation hospital, Level II Trauma Center, Outpatient Diagnostic Center, Orthopedic and Rehabilitation Center, Sleep Labs, Home Health, Home Medical Equipment, Family Practice Residency Program, Cancer Center, Pain Management Clinic and multi-specialty physician practices. PMC offers more than 400 services, including every major specialty and many subspecialties, and employs more than 3,200 people. PMC plays an essential role in the health care delivery system in Eastern Kentucky, the broad range of services offered has elevated PMC to the status of regional referral center for smaller community hospitals that have patients with complex needs whom they cannot serve. PMC was granted a Certificate of Need for 29 additional acute care beds during FY 2016 by the Kentucky Cabinet for Health and Family Services. PMC total inpatient admissions during FY 2016 was 14,705 an 11% increase over prior year, resulting in a total adult and neonatal inpatient occupancy rate of 88%. From 2009 to 2012, PMC was named National Hospital of the Year by the American Alliance of Healthcare Providers - the nation's only three time winner of this award. PMC was named one of the Best Places to Work in Kentucky for seven years and honored as one of the Best Places to Work in the nation by Modern Healthcare for five years. The hospital's compassionate, dedicated employees and physicians are focused on providing world class patient care in a Christian environment. As the premier hospital in a multi-state region, PMC is home to some of the most sophisticated, technologically advanced medical equipment in Eastern Kentucky and is continually growing and looking for new ways to provide the very best in health care to its patients and the broader population.PMC is a certified Kentucky Cabinet of Health and Family Services' Department of Public Health Level II Trauma Center and has also received Level II Trauma verification from the American College of Surgeons. PMC is the only Level II Trauma Center in the Commonwealth of Kentucky and is the designated hospital for all trauma cases in Eastern Kentucky. As a verified Trauma Center, PMC is equipped and staffed to provide comprehensive emergency care to patients suffering traumatic injuries. The spectrum of care encompasses the pre-hospital phase through the rehabilitation process. PMC's Trauma Center serves more than 400,000 people; significantly increasing those individuals' chance of survival should they be injured. The number of trauma patients PMC served increased by 43.2% between 2015 and 2016. Heart disease is one of the most prevalent health problems affecting the region that Pikeville Medical Center (PMC) serves. The hospital continues its mission to offer a world-class cardiac program so that patients can receive care close to home. PMC is an accredited Chest Pain Center with Primary PCI and is a Level IV Cycle V Chest Pain Center. PMC is also accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation for meeting strict standards of practice. Cardiac services offered by PMC include general cardiology, invasive cardiology, interventional cardiology, electrophysiology, cardiothoracic surgery, vascular surgery, echocardiography, and cardiac rehabilitation.PMC is a member of the American Heart Association's Mission: Lifeline. The American Heart Association developed Mission: Lifeline to transform heart attack patient outcomes by connecting healthcare providers, pre-hospital providers and community stakeholders in a proactive system of care that saves and improves lives - from symptom onset through cardiac rehabilitation. All Mission: Lifeline participants share a common commitment to American Heart Association guidelines and data-based quality measures. Since PMC began implementing the AHA best-practice strategies, Pike County, KY has gone from being ranked as one of the worst places in the nation to have a heart attack, to one of the safest.The increase in the offering of cardiac specialty services and the outreach of satellite cardiac clinics have contributed to a large volume increase in cardiac procedures during FY 2016. The hospital completed 62,093 cardiac procedures during the fiscal year, an increase of ten percent over the prior year.11th Floor May Tower Restaurant ConstructionThe interior construction of 24,000 square foot of space located on the 11th Floor of the May Tower to relocate and consolidate the PMC Cafeteria and Grille from the original locations on the 1st floor was completed during FY 2016. The ultra-modern PMC Restaurant, consists of food preparation areas for patients and the public, food serving area for the public, and dining area. The restaurant offers a room service program to patients that provides meal options based on the individual's dietary requirements. The project included the purchase of new kitchen equipment, smallwares, and dining furniture. The capital investment totaled $6,281,866.May Tower Elevator AdditionDuring FY 2016, the installation of two new elevators in the May Tower into existing shafts available from the original May Tower construction was completed. The new elevators were necessary to provide visitors and staff adequate access to the new PMC Restaurant located on the 11th Floor of the May Tower, as well as improving access to each of PMC's nursing units located throughout the May Tower and Elliott Building. The capital investment totaled $1,326,299.4th Floor Critical Care Unit RenovationThe interior renovation and equipment to convert nine existing patient rooms located on the 4th Floor of the May Tower to nine additional ICU rooms and a nurse's station was completed during FY 2016. Equipment purchased included a 9-bed patient monitoring system, SpoRT2 patient beds and a bronch cart. The capital investment totaled $1,024,888.10th Floor Medical Unit RenovationThe interior renovation to transform 13 patient rooms formerly designated for inpatient rehab occupancy on the 10th Floor of the May Tower to board medical nursing patients was completed during FY 2016. The total capital investment was $399,073.Other Capital InvestmentsImplementation of the PeopleSoft Financial and Human Capital Management computer software system was completed during FY 2016. PeopleSoft delivers a complete industry solution for healthcare providing automation and integration across the Finance, Materials Management, and Human Resource departments. This major capital investment totaled $5,989,755.During FY 2016, PMC purchased property located at 131 Summit Drive, within the city limits of Pikeville, for the expansion and development of health care services. The property will be used for the Medical Leader, the hospital's newspaper, as well as offices for financial services and other departments. The capital investment including renovations totaled $3,183,650.Upgrade of the Information Technology UPS Computer Room was finalized during FY 2016. The upgrade consisted of complete remodeling and rewiring of the area, in addition to installation of an HVAC unit. The capital investment totaled $383,022.National RecognitionPikeville Medical Center (PMC) strives to be recognized as a leader in healthcare. The commitment of PMC's leadership team, physicians, and staff to carry out the hospital's mission "to provide world-class health care in a Christian environment" led to notable recognition and awards during FY 2016 including: November '15 Chest Pain Center with Primary PCI accreditation from the Society of Cardiovascular Patient Care.November '15 America's Best Hospitals for Bariatric Surgery Women's Choice Award from WomenCertified.November '15 America's Best Hospitals for Obstetrics Women's Choice Award from WomenCertified.November '15 America's Best Hospitals for Orthopedics Women's Choice Award from WomenCertified.November '15 America's Best Stroke Centers Women's Choice Award from Women Certified.December '15 Silver Award Winner from U.S. Department of Health and Human Services for promoting enrollment in state organ donor registries.January '16 National Outstanding Achievement Award with Commendation Gold Status from Commission on Cancer of the American College of Surgeons for achieving excellence in providing highest quality care to cancer patients.
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
Other program services continued:May '16 - PMC named one of "America's 100 Best Hospitals for Patient Experience" by WomenCertified.August '16 - PMC among a select group of hospitals recognized by the U.S. Department of Health and Human Services Health Resources and Services Administration for promoting organ, eye, tissue donation in a national campaign sponsored by HRSA.PMC's commitment to provide world class care in a proactive, innovative, and visionary environment, where patients' needs are placed first, will allow the organization to continue on its path of growth while redefining the health care model.
4d Other program services (Describe in Schedule O.)
(Expenses $ 224,332,406 including grants of $ 105,739 ) (Revenue $ 215,884,089 )
4e Total program service expensesMediumBullet396,509,709
Form 990 (2015)
Form 990 (2015)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick 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 for escrow or custodial account liability; 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 IVClick 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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick 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 XClick 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 and XII 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 and XII 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, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions) ....Click to see attachment
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............ Click to see attachment
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...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? 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 statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government 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 or other assistance to or for domestic individuals 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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............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), 501(c)(4), and 501(c)(29) 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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? 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
Yes
 
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 direct or indirect 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 M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
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, Part II, III, or IV, and Part 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
Yes
 
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
Yes
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
138
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
3,125
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” to line 3b, 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, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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 as charitable contributions? ...
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
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 or note to any line 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
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
6
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 this 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
KY
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMichelle Hagy CFO911 Bypass Road   Pikeville,KY41501 (606) 218-3974
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) RonaLD BURCHETT......................................................................
board vice-president
4.00
.................
1.00
X           0 0 0
(2) JOE DEAN ANDERSON......................................................................
board secretary / Treasurer
4.00
.................
1.00
X           0 0 20,804
(3) AARON CRUM MD......................................................................
Board-CHIEF OF STAFF(10.1.15-12.31.15)
2.00
.................
0.00
X           445,750 0 33,133
(4) DEBra BLACKBURN......................................................................
BOARD MEMBER
2.00
.................
0.00
X           0 0 7,878
(5) Samuel L King MD......................................................................
Board-CHIEF OF STAFF(1.1.16-9.30.16)
2.00
.................
0.00
X           0 0 0
(6) DAVID COLLINS CPA......................................................................
board member
2.00
.................
0.00
X           0 0 20,804
(7) HOBERT CLAY JOHNSON......................................................................
board member
2.00
.................
0.00
X           0 0 0
(8) DENNIS HALBERT MD......................................................................
board member
4.00
.................
0.00
X           0 0 20,804
(9) JOHN LABRECHE......................................................................
board member
4.00
.................
1.00
X           0 0 5,969
(10) Julius CLINTON MARTIN II......................................................................
board member
2.00
.................
0.00
X           0 0 0
(11) ALEX POULOS MD......................................................................
BOARD MEMBER
4.00
.................
1.00
X           0 0 20,804
(12) JO NELL ROBINSON......................................................................
BOARD MEMBER
4.00
.................
1.00
X           0 0 7,878
(13) MARY SIMPSON PHD......................................................................
BOARD MEMBER
2.00
.................
0.00
X           0 0 0
(14) SUE SMALLWOOD......................................................................
board member
4.00
.................
1.00
X           0 0 7,878
(15) BURLIN COLEMAN......................................................................
EMERITUS BOARD MEMBER
0.00
.................
0.00
X           0 0 0
(16) JUDITH HINKLE......................................................................
EMERITUS BOARD MEMBER
0.00
.................
0.00
X           0 0 0
(17) LACeY PUCKETT......................................................................
EMERITUS BOARD MEMBER
0.00
.................
0.00
X           0 0 0
Form 990 (2015)
Form 990 (2015)
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 (list any hours for related organizations below dotted line)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) WALTER E MAY........................................................................
President/CEO
40.00
.......................1.00
X   X       658,511 0 35,373
(19) MICHELLE HAGY........................................................................
CFO - VP Finance
40.00
.......................0.00
    X       316,504 0 28,755
(20) JUANITA DESKINS........................................................................
Chief opERATING OFFICER
40.00
.......................0.00
    X       348,408 0 36,673
(21) DEBRA PARSONS........................................................................
CHIEF NURSING OFFICer
40.00
.......................0.00
      X     229,476 0 15,607
(22) cherYL HICKMAN........................................................................
Assistant to president
40.00
.......................0.00
      X     191,871 0 28,053
(23) russELL SHANKLIN........................................................................
Assistant Chief Informatio
40.00
.......................0.00
      X     175,324 0 30,403
(24) PEGGY JUSTICE........................................................................
VP PHYSICIAN NETWORK
40.00
.......................0.00
      X     166,184 0 29,821
(25) deborah Puckett........................................................................
VP rehAB SERVICes
40.00
.......................0.00
      X     156,204 0 30,156
(26) CATHERINE JORGENSEN........................................................................
VP Corporate Compliance &
40.00
.......................0.00
      X     193,712 0 32,652
(27) Ralph Lomma........................................................................
VP Facilities
40.00
.......................0.00
      X     211,597 0 13,956
(28) Michelle Rainey........................................................................
Assistant Chief Nursing Officer
40.00
.......................0.00
      X     161,061 0 28,123
(29) Sonja Elder........................................................................
Chief Information Officer
40.00
.......................0.00
      X     195,781 0 14,022
(30) Aaron Brown MD........................................................................
Trauma Surgeon
40.00
.......................0.00
        X   1,141,332 0 33,133
(31) Denzil Harris MD........................................................................
Cardiologist
40.00
.......................0.00
        X   1,191,878 0 27,600
(32) Kevin Pugh MD........................................................................
Orthopedic Surgeon
40.00
.......................0.00
        X   1,042,487 0 33,133
(33) Keith Hall MD........................................................................
Orthopedic Surgeon
40.00
.......................0.00
        X   1,046,908 0 33,133
(34) William Peery II MD........................................................................
Trauma Surgeon
40.00
.......................0.00
        X   1,141,332 0 33,133
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,014,320 0 629,678
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet232
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
 
No
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
Rose Builders

7 Stacy Street
Harold,KY41635
Construction services 6,333,042
GNC Consulting Inc

21195 S Lagrange Rd
Frankfort,IL60423
Professional services 3,525,851
Precyse Solutions LLC

1275 drummers lane
wayne,PA19087
him services 2,727,004
Laboratory Corporation of America

PO Box 12140
Burlington,NC27216
professional services 2,606,546
Philips Healthcare Inc

PO Box 100355
Atlanta,GA30384
Professional services 2,437,464
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet46
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 30,566
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 80,027
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 110,593
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621110 466,322,210 466,322,210    
b
c
d
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 466,322,210
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 1,174,420     1,174,420
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 5,247     5,247
(ii) Personal (i) Real
6a Gross rents 573,680 238,868
b Less: rental expenses 0 227,787
c Rental income or (loss) 573,680 11,081
d Net rental income or (loss)......MediumBullet 584,761 -17,535 602,296  
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 15,860  
b Less: cost or other basis and sales expenses 195,334  
c Gain or (loss) -179,474  
d Net gain or (loss).....MediumBullet -179,474     -179,474
8a Gross income from fundraising events (not including $ 30,566of contributions reported on line 1c). See Part IV, line 18 ....
a 19,776
b Less: direct expenses ...b 9,654
c Net income or (loss) from fundraising events..MediumBullet 10,122   10,122
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 13,055,787
b Less: cost of goods sold ..b 9,504,556
c Net income or (loss) from sales of inventory..MediumBullet 3,551,231   310,890 3,240,341
Business Code Miscellaneous Revenue
11a Cafeteria 900099 3,162,593     3,162,593
b Rebate Income 900099 1,477,642 1,477,642    
c EHR REVENUE 900099 1,234,556 1,234,556    
d All other revenue .... 680,303   306,274 374,029
e Total. Add lines 11a–11d ...... MediumBullet 6,555,094
12 Total revenue. See Instructions......MediumBullet 478,134,204 469,016,873 1,219,460 7,787,278
Form 990 (2015)
Form 990 (2015)
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).Check if Schedule O contains a response or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 76,550 76,550
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 29,189 29,189
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 .... 4,033,780   4,033,780  
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 176,271,851 159,008,611 17,263,240  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,274,081 2,005,475 268,606  
9 Other employee benefits ....... 56,254,538 49,609,965 6,644,573  
10 Payroll taxes ........... 10,523,078 8,893,856 1,629,222  
11 Fees for services (non-employees):        
a Management ...... 219,399 205,788 13,611  
b Legal ......... 2,169,582   2,169,582  
c Accounting ........... 66,023   66,023  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 97,595   97,595  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 27,492,199 22,443,601 5,048,598  
12 Advertising and promotion .... 3,468,182 376,949 3,091,233  
13 Office expenses ....... 933,343 674,114 259,229  
14 Information technology ...... 5,896,201 5,199,764 696,437  
15 Royalties ..        
16 Occupancy ........... 4,777,297 4,374,433 402,864  
17 Travel ............ 706,288 331,199 375,089  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 176,026 80,675 95,351  
20 Interest ........... 6,151,780 5,425,155 726,625  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 22,613,020 19,942,056 2,670,964  
23 Insurance ... 6,465,398 6,388,605 76,793  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a supplies & drugs 88,141,575 87,260,159 881,416  
b equipment rental & main 9,853,346 9,001,391 851,955  
c Professional Fees 6,652,923 6,652,923    
d Provider tax expense 3,234,696 3,234,696    
e All other expenses 11,733,694 5,294,555 6,439,139  
25 Total functional expenses. Add lines 1 through 24e 450,311,634 396,509,709 53,801,925 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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 10,439 1 10,954
2 Savings and temporary cash investments ......... 160,751,624 2 169,647,627
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 58,105,995 4 82,548,693
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 13,006,333 8 14,189,073
9 Prepaid expenses and deferred charges ...... 3,370,192 9 3,636,927
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 413,187,894
b Less: accumulated depreciation 10b 179,693,552 230,822,091 10c 233,494,342
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 6,464,616 12 8,544,748
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 0 14  
15 Other assets. See Part IV, line 11 ........... 27,817,752 15 23,840,247
16 Total assets. Add lines 1 through 15 (must equal line 34)... 500,349,042 16 535,912,611
Liabilities 17 Accounts payable and accrued expenses ..... 42,097,385 17 49,710,359
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 171,493,750 20 169,459,212
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other 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 ..   23 4,810,467
24 Unsecured notes and loans payable to unrelated third parties .. 256,341 24 241,251
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 13,317,291 25 10,345,617
26 Total liabilities. Add lines 17 through 25.. 227,164,767 26 234,566,906
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 272,559,653 27 300,693,337
28 Temporarily restricted net assets ........... 418,622 28 446,368
29 Permanently restricted net assets 206,000 29 206,000
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 273,184,275 33 301,345,705
34 Total liabilities and net assets/fund balances ........ 500,349,042 34 535,912,611
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
478,134,204
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
450,311,634
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
27,822,570
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
273,184,275
5
Net unrealized gains (losses) on investments ...............
5
322,246
6
Donated services and use of facilities .................
6
-11,130
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
27,744
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
301,345,705
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2015)
Form 990 (2015)
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
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 (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.) ..            
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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2015
(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2016. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the 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 its Form 990PF, Part I, line 2, 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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
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


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
Pikeville Medical Center Inc
 
Employer identification number

61-0458376
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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) (2015)

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 BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), 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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total
2a Lobbying nontaxable 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) 2015


Schedule C (Form 990 or 990-EZ) 2015
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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(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? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
9,930
j
Total. Add lines 1c through 1i ....................................................................................................
9,930
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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: Other Activity costs are the corporation's portion of trade dues (i.e. Kentucky Hospital Association).
Schedule C (Form 990 or 990EZ) 2015


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," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, 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" on 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 XIII, 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)
Revenue included on 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
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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" on 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 XIII 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, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on 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 .... 624,622 705,176 206,000 206,000 206,000
b Contributions ...     499,176    
c Net investment earnings, gains, and losses 27,746 -80,554      
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 652,368 624,622 705,176 206,000 206,000
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet32.000 %
c
Temporarily restricted endowment SchDMd Bullet68.000 %
The percentages on 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)
Yes
 
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. 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 ... 1,868,888 7,430,626 9,299,514
b Buildings 6,399,786 231,263,052 69,641,860 168,020,978
c Leasehold improvements   1,076,513 884,443 192,070
d Equipment ... 46,027 153,913,000 109,167,249 44,791,778
e Other ...   11,190,002   11,190,002
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 233,494,342
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c)Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
reserve for reciprocal of amer claims 2,382,282
Estimated Cost Report Settlements 1,497,551
Deferred Compensation Liability 3,758,141
reserves for workers compensation claims 2,509,806
Capital Lease Obligation 197,837
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 10,345,617
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 488,198,444
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 322,246
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 9,741,994
e Add lines 2a through 2d ..................... 2e 10,064,240
3 Subtract line 2e from line 1.................. 3 478,134,204
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 XIII.) ........... 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.) ...... 5 478,134,204
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 460,064,758
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a 11,130
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 9,741,994
e Add lines 2a through 2d.................... 2e 9,753,124
3 Subtract line 2e from line 1................... 3 450,311,634
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 XIII.) ............ 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.) ...... 5 450,311,634

Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part V, Line 4: THE AMOUNT OF $206,000 IS A PERMANENT RESTRICTED ENDOWMENT-HERBERT FABER ENDOWMENT FUND. THE JEAN H. JOHNSON CHARITABLE REMAINDER UNITRUST IS A TEMPORARILY RESTRICTED ENDOWMENT IN THE AMOUNT OF $446,368.
Part X, Line 2: THE HOSPITAL AND PIKEVILLE MEDICAL CENTER FOUNDATION FOR QUALITY HEALTHCARE, INC. ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PIKEVILLE MEDICAL CENTER DEVELOPMENT CORPORATION AND LANDMARK PROPERTIES OF PIKEVILLE, INC. ARE TAXABLE ENTITIES TO WHICH APPLICABLE CORPORATE INCOME TAXES APPLY. NO INCOME TAXES WERE OWED BY PIKEVILLE MEDICAL CENTER DEVELOPMENT CORPORATION OR LANDMARK PROPERTIES OF PIKEVILLE, INC. FOR THE YEARS ENDED SEPTEMBER 30, 2016 AND 2015. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2016 AND 2015. AT SEPTEMBER 30, 2016, TAX RETURNS FOR 2013 THROUGH 2015 ARE SUBJECT TO EXAMINATION BY THE IRS.
Part XI, Line 2d - Other Adjustments: Expenses reclassed to Revenue Section 9,732,340. Fundraising expenses 9,654.
Part XII, Line 2d - Other Adjustments: Expenses reclassed to revenue section 9,732,340. Fundraising Expenses 9,654.
Form 990, Part IV Line 12 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) 2015


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" on 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 arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
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.


(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 contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

Colors of Courage 5K Run/Walk
(event type)
(b) Event #2

Reclaim your life 5k run/walk
(event type)
(c) Other events

 
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

25,407

24,935

 

50,342

2

Less: Contributions . . . .

16,440

14,126

 

30,566
3 Gross income (line 1 minus
line 2) . . . . . .

8,967

10,809

 

19,776



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .        
6 Rent/facility costs . . . . 455 459   914
7 Food and beverages . . . 68 45   113
8 Entertainment . . . . 1,793 1,174   2,967
9 Other direct expenses . . . 2,717 2,943   5,660
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 9,654
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 10,122
Part III
Gaming. Complete if the organization answered "Yes" on 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

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

 

 

5

Other direct expenses . . .

2,717

2,943

 

5,660


6


Volunteer labor . . . .
%
%
%


7

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

 

8

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct 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:
 
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 3
11
Does the organization conduct 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? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter 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 of the third party:
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
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2015
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" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
Pikeville Medical Center Inc
 
Employer identification number

61-0458376
Part I
Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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, as a factor in determining 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) . . .
    5,688,210 2,386,312 3,301,898 0.730 %
b Medicaid (from Worksheet 3, column a) . . . . .     89,319,584 94,495,480 -5,175,896 0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     95,007,794 96,881,792 -1,873,998 0.730 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 286 1,194 521,992   521,992 0.120 %
f Health professions education (from Worksheet 5) . . . 88 1,933 1,458,875 782,214 676,661 0.150 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 53   85,152   85,152 0.020 %
j Total. Other Benefits . . 427 3,127 2,066,019 782,214 1,283,805 0.290 %
k Total. Add lines 7d and 7j . 427 3,127 97,073,813 97,664,006 -590,193 1.020 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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 162 18,164 251,955 3,243 248,712 0.060 %
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy 18 933 39,084 50,642 -11,558 0 %
8 Workforce development 12   467,715   467,715 0.100 %
9 Other            
10 Total 192 19,097 758,754 53,885 704,869 0.160 %
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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
37,258,719
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
132,444,483
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
115,904,169
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
16,540,314
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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 PIKEVILLE MEDICAL CENTER
911 bypass road
pikeville,KY41501
www.pikevillehospital.org
100366
X X   X     X      
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.pikevillehospital.org/patientsvisitors/2016-2019-community-healt
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.pikevillehospital.org/billing/financial-assistance-policy/
b
http://www.pikevillehospital.org/billing/financial-assistance-policy/
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PIKEVILLE MEDICAL CENTER Part V, Section B, Line 5: Pikeville Medical Center in collaboration with an Advisory Committee comprised of community leaders from Pike and Floyd Counties, whom are involved with local health departments, school systems, senior citizens programs, social work, post-secondary education, volunteer groups, and local business/industry developed a survey to obtain input concerning the needs of our community. The survey was made available online, published in Pikeville Medical Center's newspaper, The Medical Leader, and distributed at local health departments, senior citizens centers, apartment complexes, banks and churches. The survey was also distributed electronically to all students and faculty at the University of PIkevelle and to all patients at various PMC clinics. PMC's community survey was an overwhelming success as the hospital received over 1,000 responses.
PIKEVILLE MEDICAL CENTER Part V, Section B, Line 7d: http://www.pikevillehospital.org/patientsvisitors/2016-2019-community-health-needs-assessment/PMC mailed the CHNA report to the Chamber of Commerce, Civic Organization members, and local business people.
PIKEVILLE MEDICAL CENTER Part V, Section B, Line 22d: Pikeville Medical Center follows the same charging structure for all patients; however, PMC's In-House Sliding Scale Financial Assistance Program provides a range of discounts up to free care for those who qualify. Following a determination that an individual is eligible for assistance under the uninsured patient portion of the program, PMC will not bill that individual for emergency or other medically necessary care in an amount in excess of the Amount Generally Billed (utilizing the Medicare look-back method). Additional discounts of Free or 50% of AGB are also offered by PMC, dependent upon the patient's income and resource level and family size.
PIKEVILLE MEDICAL CENTER Part V, Section B, Line 24: Pikeville Medical Center follows the same charging structure for all patients; however, PMC's In-House Sliding Scale Financial Assistance Program provides a range of discounts up to free care for those who qualify. Following a determination that an individual is eligible for assistance under the uninsured patient portion of the program, PMC will not bill that individual for emergency or other medically necessary care in an amount in excess of the Amount Generally Billed (utilizing the Medicare look-back method). Additional discounts of Free or 50% of AGB are also offered by PMC, dependent upon the patient's income and resource level and family size.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. 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?18
Name and address Type of Facility (describe)
1 1 - OBGYN PHYSICIAN PRACTICE - HAROLD
246 KY ROUTE 979
Harold,KY41635
PHYSICIAN PRACTICE
2 2 - PMC-LEONARD LAWSON CANCER CENTER
172 SOUTH MAYO TRAIL
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
3 3 - HOME MEDICAL EQUIPMENT
1370 S MAYO TRAIL
PIKEVILLE,KY41501
MEDICAL EQUIPMENT
4 4 - HOME HEALTH SERVICES
1370 S MAYO TRAIL
PIKEVILLE,KY41501
Home Health Services
5 5 - pmc SPECIALTY CLINIC-WHITESBURG
255 MAIN ST
WHITESBURG,KY41858
pHYSICIAN PRACTICE
6 6 - BARIATRIC SURGERY PHYSICIAN PRACTICE
1098 S MAYO TRAIL STE 103
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
7 7 - PMC SPECIALTY CLINIC-PRESTONSBURG
311 NORTH ARNOLD AVE
PRESTONSBURG,KY41653
PHYSICIAN PRACTICE
8 8 - PMC Clinic - WALMART Pikeville
251 CASSIDY BLVD
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
9 9 - PMC SPECIALTY CLINIC-GRUNDY
1520 SLATE CREEK ROAD STE 205
GRUNDY,VA24614
PHYSICIAN PRACTICE
10 10 - SLEEP LAB - WHITESBURG
60 MAIN STREET
WHITESBURG,KY41858
sleep lab
11 11 - PRIMARY CARE PRACTICE - SHELBY VALLEY
6800 US HWY 23 S STE 3
PIKEVILLE,KY41501
phySICIAN PRACTICE
12 12 - PRIMARY CARE PRACTICE - HAROLD
246 KY RT 979
HAROLD,KY41635
PHYSICIAN PRACTICE
13 13 - PIKEVILLE FAMILY PRACTICE CLINIC
184 S MAYO TRAIL
PIKEVILLE,KY41501
PHYSICIAN PRACTICE
14 14 - PMC SPECIALTY CLINIC-SOUTH WILLIAMSON
411 CENTRAL AVE STE 7
SOUTH WILLIAMSON,KY41503
PHYSICIAN PRACTICE
15 15 - CARDIOLOGY PRACTICE - LEXINGTON
989 GOVERNORS LANE
LEXINGTON,KY40513
PHYSICIAN PRACTICE
16 16 - OPTHALMOLOGY - HAZARD
101 TOWN COUNTRY DRIVE STE 100
HAZARD,KY41701
PHYSICIAN PRACTICE
17 17 - PMC SPECIALTY CLINIC-PAINTSVILLE
826 SOUTH MAYO TRAIL
PAINTSVILLE,KY41240
PHYSICIAN PRACTICE
18 18 - PMC SPECIALTY CLINIC-MCDOWELL
ARH MCDOWELL BLDG
MCDOWELL,KY41647
PHYSICIAN PRACTICE
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Part II, Community Building Activities: PIKEVILLE MEDICAL CENTER'S MISSION STATEMENT, "TO PROVIDE WORLD CLASS HEALTH CARE IN A CHRISTIAN ENVIRONMENT" IS THE CATALYST BEHIND PMC'S EFFORTS TO IMPROVE THE PHYSICAL, MENTAL AND SPIRITUAL WELL BEING OF THE PUBLIC. DURING FY 2016, PIKEVILLE MEDICAL CENTER REPORTED TAKING PART IN 192 COMMUNITY BUILDING ACTIVITIES, SERVING OVER 19,000 PEOPLE AND TOTALING NEARLY $705,000. 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: FIRST-AID BOOTH AT HILLBILLY DAYS, SUPPORT OF THE MARCH OF DIMES WALK AND RELAY FOR LIFE PIKE COUNTY, COLORS OF COURAGE 5K RUN/WALK, SMOKING CESSATION CLASSES, RECLAIM YOUR LIFE 5K RUN/WALK, A CHRISTMAS LIVE NATIVITY, AND NEARLY 600 MEALS PER MONTH PROVIDED TO MEALS ON WHEELS.
Part III, Line 4: SEE PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.The hospital has a detailed Financial Assistance Policy and makes every effort to educate patients with limited ability to pay regarding financial assistance, in addition, PMC Patient Financial Counselors are available to assist those in need throughout the financial assistance application process. For this reason the organization believes that it accurately captures charity care deductions provided according to the financial assistance policy and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible.
Part III, Line 8: No shortfall existed in FY 2016. 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, 2016 report: Hospital Statement of Reimbursable Cost.
Part III, Line 9b: PMC will not engage in extraordinary collection actions (ECAs) against patients before making reasonable efforts to determine whether the individual is eligible for assistance under PMC's Financial Assistance Policy. PMC makes reasonable effort to orally notify the patient about PMC's financial assistance policy and how they may receive assistance with the application process. Each patient billing statement and all written communications concerning the patients' bill include a conspicuous written notice that informs recipients about the availability of financial assistance, the notice includes the telephone number of PMC's patient financial counseling department as well as the web site address where copies of the financial assistance policy, financial application forms, and a plain language summary of the financial assistance policy may be obtained. In addition, Billing department personnel inform each patient about PMC's FAP in all oral communications regarding amounts due. Once a patient has been determined eligible for financial assistance under the In-House Sliding Scale Program, their eligibility will remain intact for a term of one (1) year from the date of approval unless PMC becomes aware of a material change in the patient's financial circumstances.
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, AS WELL AS THE PMC IN-HOUSE SLIDING SCALE PROGRAM. THE FINANCIAL ASSISTANCE PROGRAM POLICY, THE DSH PROGRAM APPLICATION FORM, THE IN-HOUSE SLIDING SCALE PROGRAM APPLICATION FORM AND A PLAIN LANGUAGE SUMMARY OF THIS POLICY IS AVAILABLE FREE OF CHARGE ON PMC'S WEBSITE; PAPER COPIES OF THE POLICY, THE DSH PROGRAM APPLICATION FORM, THE IN-HOUSE SLIDING SCALE PROGRAM APPLICATION FORM AND A PLAIN LANGUAGE SUMMARY OF THE POLICY ARE AVAILABLE FREE OF CHARGE UPON REQUEST IN PMC'S EMERGENCY, REGISTRATION AND BILLING DEPARTMENTS AND BY MAIL; A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY OF THE POLICY IS OFFERED TO PATIENTS AS PART OF THE INTAKE PROCESS UNLESS IT IS NOT FEASIBLE TO DO SO DUE TO AN EMERGENCY OR OTHER CIRCUMSTANCES IN WHICH CASE PMC WILL OFFER A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY AS PART OF THE DISCHARGE PROCESS; VISITORS TO PMC ARE INFORMED AND NOTIFIED ABOUT THE POLICY THROUGH CONSPICUOUS PUBLIC DISPLAYS AT PMC; RESIDENTS OF THE COMMUNITY THAT PMC SERVES ARE INFORMED AND NOTIFIED OF THE POLICY BY STATEMENTS IN THE MEDICAL LEADER, ON PMC'S WEBSITE, AND IN MESSAGES PLAYED TO CALLERS TO PMC WHO ARE PLACED ON HOLD THAT PMC OFFERS FINANCIAL ASSISTANCE UNDER A FINANCIAL ASSISTANCE POLICY AND INFORMING THE READER/LISTENER HOW TO OBTAIN MORE INFORMATION; AND BY INCLUDING A CONSPICUOUS WRITTEN NOTICE ON ALL BILLING STATEMENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISATNCE UNDER THIS POLICY AND INCLUDES THE TELEPHONE NUMBER OF PMC'S PATIENT FINANCIAL COUNSELING DEPARTMENT ALONG WITH THE WEB SITE ADDRESS WHERE COPIES OF THIS POLICY, THE APPLICATION FORMS, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY MAY BE OBTAINED.
Part VI, Line 4: PIKEVILLE MEDICAL CENTER PROVIDES HEALTHCARE SERVICES TO RESIDENTS OF PIKE, FLOYD, JOHNSON, MAGOFFIN, MARTIN, LETCHER AND PERRY COUNTIES IN KENTUCKY, MINGO COUNTY IN WEST VIRGINIA AND BUCHANAN COUNTY IN VIRGINIA. PMC IS COMMITTED TO MAKING HIGH QUALITY SPECIALTY SERVICES AVAILABLE TO MEET ITS PATIENTS' NEEDS SO THEY CAN RECEIVE THEIR HEALTH CARE LOCALLY. PMC 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. BASED ON 2016 DATA AVAILABLE, PMC'S SERVICE AREA CONTAINS A POPULATION OF APPROXIMATELY 242,270 INDIVIDUALS. THERE IS A RELATIVELY EVEN DISTRIBUTION OF MALES (49.6%) TO FEMALES (50.4%). THE AVERAGE HOUSEHOLD SIZE IS 2 INDIVIDUALS AND 17.4% OF THE POPULATION IS AGE 65 AND OVER. THE IMPOVERISHED AREA SERVED BY PIKEVILLE MEDICAL CENTER HAS A MEDIAN FAMILY INCOME OF $31,005 WITH 28.8% OF THE POPULATION LIVING UNDER THE POVERTY LINE.
Part VI, Line 5: Pikeville Medical Center (PMC), a radiant gem located in the coalfields of eastern Kentucky, is known for its compassionate employees, unparalleled service, advanced technology, and unmatched generosity to the community. Regarded as the premier hospital in a multi-state region, PMC is continually growing and looking for new ways to offer the best in health care to its patients and the broader population. The mission of Pikeville Medical Center is "to provide world class health care in a Christian environment." This mission is fulfilled on a daily basis, as the dedicated staff portrays a sense of teamwork with a sincere passion to help others.PMC has undergone substantial change throughout its 92-year history, as the Hospital has continually responded to and met the healthcare needs of the community. Beginning as a small, rural, 50-bed facility at its inception in 1924, the Medical Center is today a comprehensive medical complex comprised of a 300-bed facility encompassing over one million square feet with both the main facility and surrounding supportive services. PMC recently opened a new 11-story clinic and 10-story parking garage on the hospital's main campus. This expansion increased efficiency in operations and enhanced patient convenience. A one-of-a-kind facility in the area, the PMC Clinic houses most of PMC's physician practices under one roof as well as clinical space for additional surgical and endoscopy suites. The enclosed 10-story parking garage added 1,162 parking spaces to the main campus and enables patients to conveniently park on the same floor as their physician's office.The Hospital also expanded in other areas. The outpatient Diagnostic Center was expanded to permit additional laboratory and radiology testing of patients. The Pain Management building expansion increased the number of patient exam rooms available to serve patients in need of quality pain management training by more than 100%. An Interventional Radiology suite was built with new state-of-the-art equipment. The Miner's Building was also the site for the development of an area for diagnosis and handling of patients with Ebola. In addition to physical expansion, PMC, accredited by The Joint Commission, has experienced significant growth in patient volumes. Admissions increased to 14,705 in FY 2016 from 13,240 in FY 2015; surgical procedures increased to 22,165 in FY 2016 from 20,922 in FY 2015; trauma cases increased to 1,437 in FY 2016 from 994 in FY 2015; and physician outpatient visits increased to 185,263 in FY 2016 from 182,185 in FY 2015.PMC continues to recruit highly-qualified professionals aspiring to practice in a progressive, growing medical community that demands quality and cultivates excellence. Currently, PMC employs more than 3,200 people. Approximately 400 providers are credentialed to practice at PMC. During FY 2016 the hospital engaged 47 new employed physicians and contracted 10 additional with start dates ranging from October 2016 to August 2020.The hospital offers over 400 services, including every major specialty and many subspecialties, and is a proud member of the Mayo Clinic Care Network. This tremendous physical growth, along with sound financial leadership, has allowed PMC to significantly expand the health care services offered to the region. Current services include: a verified Level II Trauma Center, an award-winning, full-service Cancer Treatment Center; Chest Pain Center with Primary PCI; 40-bed Inpatient Physical Rehabilitation Hospital; an Accredited Gold Plus Stroke Center: Neurosurgery; Level II Neonatal Intensive Care Unit; Bariatric Surgery Center of Excellence, Joint Commission Gold Seal Certified Orthopedic Program, Pain Management, Pulmonary Rehabilitation, two satellite Sleep Lab facilities; a Diagnostic Center; integrated family and specialty physician practices, along with a retail clinic at Walmart.Pikeville Medical Center is dedicated to providing patients with cutting edge treatment technology. PMC's state-of-the art diagnostic and therapeutic radiology services consists of two linear accelerators, one 32-slice large bore CT scanner, two 320-slice CT scanners, two 64-slice CT scanners, a PET/CT scanner, a Spect/CT scanner, two 1.5T open MRI's, a 3.0T open MRI, as well as a fully equipped Interventional Radiology Suite. PMC has been recognized at many levels for providing quality health care and being an employer of choice. The nation's only three-time winner of National Hospital of the Year. PMC was named one of the Best Places to Work in Kentucky for seven years and for five years, PMC was honored by Modern Healthcare as one of the best places to work in the nation. In addition to expanding the range and dimension of health care services provided to patients in the region, Pikeville Medical Center's growth has played an integral part in enhancing the Hospital's outreach to the community. PMC provides a variety of educational, wellness, and preventive health services that are essential to PMC's mission "to provide world class health care in a Christian environment." Charity Care: Through defined policies and procedures, PMC recorded uncompensated charity of more than $17,211,000 during FY 2016 (services at hospital's established rates). Health Care Support Services:Blood Drives - PMC was host to five blood drives during FY 2016. Preparation for blood drives includes publicity before and after the event, obtaining give-away items for donors; reserving a location, helping with set-up and take-down, and pre-registering donors. Blood drives are conducted in accordance with the Kentucky Blood Center. In FY 2016, 196 donors participated in PMC's five blood drives, providing life-saving blood products to an estimated 546 recipients. These events cost PMC $1,692.Meals on Wheels - In FY 2016, PMC provided 7,157 meals at a cost of $43,277.Guest Meals - PMC donated 4,514 food trays to guests at a cost of $29,317 in FY 2016.Indigent Support Services - Many patients need financial assistance with prescribed medications, in-home medical equipment, transportation, and other items or services. To help reduce financial burden, PMC's Chaplain Services, Case Management, and Leonard Lawson Cancer Center departments provided assistance to 293 patients totaling $25,544 in FY 2016. Assistance went to patients needing prescribed medications and transportation upon discharge. Transportation support was also provided to patients needing to travel to and from the hospital to receive care. In addition, the hospital purchased child car seats, home medical equipment, and medical supplies for patients in need.Spiritual - PMC's Chaplaincy department works around the clock to ensure patients' spiritual needs are met. The staff make rounds daily on each patient, offering words of encouragement and prayer. In FY 2016, 520 Bibles for newborns were distributed and Holy Week Services were conducted. This service provided a community benefit of more than $8,888.Community Financial Donations: In FY 2016, PMC once again proved to be a strong corporate citizen. In addition to encouraging employee participation in community activities and events, the hospital gave $76,550 in financial support to such entities as:American Cancer SocietyMarch of DimesKentucky Chamber FoundationUniversity of PikevilleOperation UNITEPikeville Rotary ClubBlessed Beyond MeasureOne East Kentucky CorporationAfter Breast Cancer Support GroupPikeville Medical Center is an avid supporter of Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education). Operation UNITE serves 32 counties in southern and eastern Kentucky by empowering community coalitions to combat drug abuse within the region. PMC also supports the One East Kentucky Corporation, a regional economic development organization whose mission is to recruit industry and investment to eastern Kentucky through implementation of economic development strategies and partnership of private businesses, communities and chambers of commerceFundraising: During August 2016, PMC hosted its third annual "Colors of Courage" 5K fundraiser in Pikeville to benefit underinsured cancer patients of the hospital's Leonard Lawson Cancer Center. Nearly 500 runners and walkers came together for this common cause. Hospital employees organized, publicized, and worked the event. The total community benefit was $20,374. The cost of fundraising was $5,033.The PMC Weight Loss Surgery Center Reclaim Your Life 5K & 1 Mile Fun Run/Walk fundraiser was held in April 2016 to promote the importance of health and fitness and to support those in various stages of their weight loss journey. More than 600 participants registered for the event. The total community benefit was $20,315. The cost of fundraising was $4,620.
Part VI line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUED)Health Screenings: PMC participated in 20 free community health fairs/screenings during FY 2016 including six diabetes screening events and a World Hepatitis Day health screening event. Health education materials were distributed at the events, which were attended by more than 1,505 people. All screenings were hosted by PMC physicians, nurses and/or support staff. The events provided a community benefit of $32,529.Other events during which PMC hosted free health screenings included: - First-Aid Booth Hillbilly Days Festival- Stroke Awareness Day- Whitesburg Days-Mountain Heritage Festival - Pikeville Senior Citizens Health Fair- Betsy Layne Senior Citizens Health Fair- American National University Healthy Fun Fair- Thankful Hearts Food Pantry Back to School Health Fair- Big Sandy Community Action Health Fair- Elkhorn City Library Health Fair- Elkhorn City Senior Citizens Health Fair- East KY Sport/Boat/RV ShowCommunity Health Education: PMC's staff remains involved in educating the community on important health care topics. Throughout FY 2016, hospital representatives from various departments spoke to local civic clubs, schools, medical professionals, and the public at large. Through its 162 community education efforts in FY 2016, PMC contributed $573,924PMC employees participated in the following lectures/presentations/publications during FY 2016:- American Diabetes Month Outreach Event- Pikeville YMCA Senior Injury Prevention and Safety Presentation- Millard Elementary Injury Prevention Presentation- Life is Cool-KODA Event (2)- Pike County Highway Safety Team Celebration Drive (2)- Senior Citizens Safety and Trauma Awareness Day- Betsy Layne Senior Citizen Center Safety Fair- Letcher County Farmers' Market Opening- Treatment of Burn Injuries Demonstration- Disaster Preparedness Demonstration Dyno Noble- Influenza Education Program- Heart Month Education Program- Childbirth Classes (51) - Health Talk Programs (12)- Mayo Minute Programs (9)- Back to School Safety Education Program- Medical Leader Community Publication and Website- Stroke Awareness Day- Trauma Outreach Education (9)- Weight Loss Surgery Education Seminars (12)- Whitesburg Days Mt Heritage Health FairChildbirth 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 $4,463 in FY 2016. 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, West Virginia. Through this show, PMC informs listeners of new health services, physicians and technology at the hospital. This program educates the public on health topics of interest which have included family medicine; flu; pulmonary rehabilitation; cancer symptoms, prevention and treatment; and diabetes. In FY 2016, the total cost for this program was nearly $83,336.Mayo Minute - PMC regularly sponsors Mayo Minute radio spots from Mayo Clinic as a Mayo Clinic Care Network Member. The 60-second radio spots are aired on nine local radio stations covering Pike, Floyd, Letcher, Johnson, Knott, Magoffin and Martin Counties in Kentucky and Mingo County, West Virginia. Mayo Minute covers a wide range of health topics. In FY 2016, the total cost for this program was $55,457.Medical Leader - PMC publishes a weekly newspaper, Medical Leader, in which health information is printed along with content about PMC services, physicians, and technology. The hospital prints 7,500 copies of Medical Leader weekly and distributes them, free of charge, to more than 150 locations in Pike, Floyd, and Letcher counties in Kentucky, and Mingo County, West Virginia. Medical Leader, which has its own website, has nearly 5,000 email subscribers and more than 5,800 social media followers. This community benefit exceeded $251,700 in FY 2016.Weight Loss Surgery Education Seminars - PMC's Weight Loss Surgery Center staff educates the public on various bariatric surgery, weight management, and nutrition topics. Seminars are advertised prior to the events to increase public awareness. During FY 2016, this community benefit totaled $78,210.Community Self-Help Education: Fifty-four smoking cessation classes were offered by PMC during FY 2016, reaching 45 participants at a cost of $8,324.Health Professions Education: During FY 2016, PMC invested $676,661 in health professions education. In affiliation with more than fifty academic institutions, PMC trained approximately 328 students during 2016, in more than twenty different specialties including: nursing, respiratory therapy, pharmacy, and radiology. Schools affiliated with PMC include:American National University-Cincinnati CampusAmerican National University-Florence CampusAmerican National University-Lexington CampusAmerican National University-Pikeville CampusAppalachian-Osteopathic Postgraduate Training Institute ConsortiumAspen UniversityA.T. Still University - Arizona School of MedicineA.T. Still University/Kirksville College of Osteopathic MedicineBeckfield CollegeBelfry Area Technology CenterBellarmine UniversityBelmont University School of Occupational TherapyBluefield CollegeCampbellsville UniversityChatham UniversityCollege of West VirginiaDes Moines UniversityDevry UniversityDuke UniversityEastern Kentucky UniversityEdward Via Virginia College of Osteopathic MedicineEmergency Medical EducatorsFrontier School of Midwifery and Family NursingHuntington Junior CollegeHutchinson Community CollegeIndiana Wesleyan UniversityIowa College Acquisition Corp. d/b/a Kaplan UniversityJefferson College of Health SciencesJohns Hopkins UniversityKentucky Community Technical College SystemLake Erie College of Osteopathic Medicine Letcher County Area Technology CenterLiberty UniversityLincoln Memorial UniversityLindsey Wilson CollegeMarietta CollegeMarshall UniversityMaryville UniversityMedical University of South Carolina, College of Health ProfessionsMeridian Institute of Surgical AssistingMilligan CollegeMorehead State UniversityNorthern Kentucky UniversityNorton Community Hospital Nova Southeastern UniversityPhelps Vocational SchoolRoss University School of MedicineShawnee State UniversitySouth University School of PharmacySouthern West Virginia Community & Technical CollegeSouthwest Virginia Community CollegeSpencerian CollegeSt James School of MedicineSullivan University College of PharmacyTennessee Board of Regents on behalf of Austin Peay State University, East Tennessee State University, Middle Tennessee State University, Tennessee State University, Tennessee Technological University and University of MemphisTennessee Technology Center at ElizabethtonTrans Star Training AcademyUnion UniversityUniversity of Alabama University of Appalachia College of PharmacyUniversity of CharlestonUniversity of CincinnatiUniversity of the CumberlandsUniversity of KentuckyUniversity of LouisvilleUniversity of North CarolinaUniversity of North Texas Health Science Center at Fort WorthUniversity of PikevilleUniversity of South AlabamaUniversity of Wisconsin Oshkosh Virginia Highland Community College, Mountain Empire Community College and Southwest Virginia Community College agencies of the Commonwealth of Virginia Appalachian Tri-college Nursing ProgramVirginia Commonwealth UniversityWalden UniversityWest Virginia School of Osteopathic MedicineWest Virginia University Board of GovernorsWestern Kentucky UniversityWheeling Jesuit University William Carey University College of Osteopathic MedicineWindsor University School of Medicine
Part VI line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUED)Residency Program - PMC's Residency Program is accredited by the American Osteopathic Association and is sponsored by the Appalachian Osteopathic Postgraduate Training Institute Consortium. PMC operates the only Integrated Osteopathic Family Medicine and Manipulative Treatment/Neuromusculoskeletal Medicine Residency Program in Kentucky, the only Plus-One Neuromusculoskeletal and Osteopathic Manipulative Medicine 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 treats approximately 9,850 patients annually. This service allows PMC to educate and retain competent, skilled physicians in the region. During the residency year of July 2015 to June 2016, PMC trained 11 residents. This program provided a community benefit of $657,503.Pikeville Medical Center has also partnered with the University of Pikeville - Kentucky College of Optometry, a not-for-profit Optometric education institution engaged in educating Optometric students and advancing Optometric education to provide clinical care space and equipment as a Core Site to accommodate optometry patient care for the education and training of Optometric students.Continuing Health Professionals Education - PMC has an active Medical Library staff that coordinates and oversees Continuing Medical Education (CME) hours offered at the hospital. Most CMEs are open to not only PMC staff, but to other medical professionals throughout the region. In FY 2016, PMC offered 76 CME presentations, reaching more than 1,900 attendees. This service provided a community benefit of $30,657. The educational opportunities offered by the hospital during FY 2016 covered the following topics:- Advanced Cardiovascular Life Support (13 events) - Breast Cancer Symposium: Challenges and Opportunities - Cancer Case Conference (12 events)- Heart Symposium: Time is Muscle- Infectious Disease conference (12 events)- Oncology Grand Rounds - Pediatric Abusive Head Trauma- Pediatric Advanced Life Support (9 events)- Research Procedure Training- Stroke Case Conference (12 events)- Stroke Symposium- Trauma Grand Rounds (12 events)Physician, Midlevel and Nursing Professional Recruitment: The primary goal of PMC's recruitment program is to provide patients within the service area with quality medical care by recruiting an adequate number of primary care physicians along with a desired mix of specialty physicians. Physician recruitment is essential to enhancing the health and well being of the region. PMC is a regional referral center for specialty and sub-specialty services not provided by other local hospitals. During FY 2016, PMC recruiters attended 12 physician recruitment conferences. Forty-seven physicians, twenty-three midlevel professionals and 206 registered nurses were added to PMC's team of healthcare providers during the fiscal year. The total community benefit associated with recruitment of these providers during FY 2016 was $467,715. The recruited physicians practice in the following specialties: - Anesthesiology- Cardiology- Colorectal Surgery- Critical Care- Emergency Medicine- Hospitalist Medicine- Interventional Radiology- Nephrology- Obstetrics/Gynecology- Oral/Maxillofacial Surgery- Orthopedic Surgery- Podiatry- Pulmonology- Retina Surgery- Trauma Surgery- Vascular SurgerySupport Groups: In FY 2016, PMC hosted/sponsored 38 support group meetings, reaching 438 people and providing $11,813 in community benefits. Below is a list of the support groups PMC hosted/sponsored: - After Breast Cancer (ABC) Support Group- Man to Man Prostate Cancer Support Group- Diabetes Support Group- Weight Loss Surgery Support GroupOther Community Support: Throughout FY 2016, PMC hosted, sponsored, or participated in several events to support the community including: - First-Aid Booth Hillbilly Days Festival--a nationally known annual event held in downtown Pikeville to benefit the Shriners' Children's Hospital- Kids Night at Elkhorn City Elementary- Live Nativity- March of Dimes Walk- PMC Booth at Nightmare on Main- Relay For Life- Shaping Our Appalachian Region (SOAR)- YMCA Healthy Kids Day & Easter Egg HuntPMC is a proud member of SOAR, an Appalachian Kentucky network committed to the common purpose of improving education, health and the economy for all citizens of the region through innovation. PMC executives and staff participate in the annual conferences to assist in shaping a better future for the region.The total community benefit for the other community support events was $61,630.
Schedule H (Form 990) 2015
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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC 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) 1 East Kentucky Corporation
1 Bert T Combs Drive Suite 205
Prestonsburg,KY41653
47-4557366 501c3 30,000       ECONOMIC DEVELOPMENT CONTRIBUTION
(2) Kentucky Chamber of Commerce
464 Chenault Road
Frankfort,KY40601
61-0405718 501c6 15,000       SPONSORSHIP CONGRESSIONAL FORUM
(3) Unite Foundation Inc
2292 South Hwy 27
Somerset,KY42501
56-2338443 501c3 15,000       SPONSORSHIP NATIONAL RX DRUG ABUSE SUMMIT
(4) March of Dimes Bluegrass Division
207 E Reynolds Road Suite 110
Lexington,KY40517
13-1846366 501c3 8,000       SPONSORSHIP CENTRAL APPALACHIA MARCH FOR BABIES
(5) AMERICAN CANCER SOCIETY INC
PO Box 1517
Pikeville,KY41502
13-1788491 501c3 5,000       SPONSORSHIP RELAY FOR LIFE PIKE COUNTY
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated 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. 458 26,478      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
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.
Part III, Column (A) ASSISTANCE FOR UNINSURED PATIENTS FOR PRESCRIPTIONS, CAFE VOUCHERS, TRANSPORTATION, MEDICAL EQUIPMENT AND CANCER TREATMENT TRAVEL ASSISTANCE. THERE WERE 634 PRESCRIPTIONS PROVIDED, 171 CAFe VOUCHERS PROVIDED, AND 414 instances OF TRAVEL ASSISTANCE.
Schedule I (Form 990) 2015



Additional Data


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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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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 on 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 of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used 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 on 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
 
No
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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
Yes
 
8
Were any amounts reported on 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" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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 on 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 (E) amounts for that individual.
(A) Name and Title (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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1AARON CRUM MDBoard-CHIEF OF STAFF(10.1.15-12.31.1 (i)

(ii)
445,283
-------------
0
0
-------------
0
467
-------------
0
10,256
-------------
0
22,877
-------------
0
478,883
-------------
0
0
-------------
0
2WALTER E MAYPresident/CEO (i)

(ii)
658,254
-------------
0
0
-------------
0
257
-------------
0
12,496
-------------
0
22,877
-------------
0
693,884
-------------
0
0
-------------
0
3MICHELLE HAGYCFO - VP Finance (i)

(ii)
311,018
-------------
0
4,326
-------------
0
1,160
-------------
0
6,165
-------------
0
22,590
-------------
0
345,259
-------------
0
2,181
-------------
0
4JUANITA DESKINSChief opERATING OFFICER (i)

(ii)
347,080
-------------
0
0
-------------
0
1,328
-------------
0
13,796
-------------
0
22,877
-------------
0
385,081
-------------
0
0
-------------
0
5DEBRA PARSONSCHIEF NURSING OFFICer (i)

(ii)
225,000
-------------
0
2,878
-------------
0
1,598
-------------
0
6,144
-------------
0
9,463
-------------
0
245,083
-------------
0
1,383
-------------
0
6cherYL HICKMANAssistant to president (i)

(ii)
187,250
-------------
0
2,793
-------------
0
1,828
-------------
0
11,610
-------------
0
16,443
-------------
0
219,924
-------------
0
1,474
-------------
0
7russELL SHANKLINAssistant Chief Informatio (i)

(ii)
171,695
-------------
0
2,544
-------------
0
1,085
-------------
0
8,663
-------------
0
21,740
-------------
0
205,727
-------------
0
1,342
-------------
0
8PEGGY JUSTICEVP PHYSICIAN NETWORK (i)

(ii)
162,750
-------------
0
2,390
-------------
0
1,044
-------------
0
8,138
-------------
0
21,683
-------------
0
196,005
-------------
0
1,261
-------------
0
9deborah PuckettVP rehAB SERVICes (i)

(ii)
152,378
-------------
0
2,266
-------------
0
1,560
-------------
0
8,518
-------------
0
21,638
-------------
0
186,360
-------------
0
1,196
-------------
0
10CATHERINE JORGENSENVP Corporate Compliance & (i)

(ii)
189,609
-------------
0
2,628
-------------
0
1,475
-------------
0
10,799
-------------
0
21,853
-------------
0
226,364
-------------
0
1,302
-------------
0
11Ralph LommaVP Facilities (i)

(ii)
193,673
-------------
0
2,875
-------------
0
15,049
-------------
0
5,021
-------------
0
8,935
-------------
0
225,553
-------------
0
0
-------------
0
12Michelle RaineyAssistant Chief Nursing Officer (i)

(ii)
154,569
-------------
0
2,150
-------------
0
4,342
-------------
0
6,468
-------------
0
21,655
-------------
0
189,184
-------------
0
0
-------------
0
13Sonja ElderChief Information Officer (i)

(ii)
192,752
-------------
0
2,769
-------------
0
260
-------------
0
166
-------------
0
13,856
-------------
0
209,803
-------------
0
1,790
-------------
0
14Aaron Brown MDTrauma Surgeon (i)

(ii)
1,141,052
-------------
0
0
-------------
0
280
-------------
0
10,256
-------------
0
22,877
-------------
0
1,174,465
-------------
0
0
-------------
0
15Denzil Harris MDCardiologist (i)

(ii)
564,402
-------------
0
627,196
-------------
0
280
-------------
0
9,000
-------------
0
18,600
-------------
0
1,219,478
-------------
0
0
-------------
0
16Kevin Pugh MDOrthopedic Surgeon (i)

(ii)
1,042,176
-------------
0
0
-------------
0
311
-------------
0
10,256
-------------
0
22,877
-------------
0
1,075,620
-------------
0
0
-------------
0
17Keith Hall MDOrthopedic Surgeon (i)

(ii)
1,046,596
-------------
0
0
-------------
0
312
-------------
0
10,256
-------------
0
22,877
-------------
0
1,080,041
-------------
0
0
-------------
0
18William Peery II MDTrauma Surgeon (i)

(ii)
1,141,052
-------------
0
0
-------------
0
280
-------------
0
10,256
-------------
0
22,877
-------------
0
1,174,465
-------------
0
0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 7 There was a bonus program during the year. The bonus percentage was calculated as a percentage of PMC's total margin for the quarter ended. The percentage was the same for all eligible employees each quarter and did not vary based on department or job title.
Schedule J (Form 990) 2015
Additional Data


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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.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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 72134PAW2 02-18-2016 45,649,350 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 45,649,350    
4 Gross proceeds in reserve funds ............. 3,563,671      
5 Capitalized interest from proceeds .............   482,500    
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,328,586 329,000    
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 41,241,831 42,996,595    
11 Other spent proceeds ............. 44,236,563 1,390,800    
12 Other unspent proceeds .............   450,455    
13 Year of substantial completion ............. 2014 2016
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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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   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? X   X          
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 1.020 % 0.750 %    
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        
6 Total of lines 4 and 5 ............. 1.020 % 0.750 %    
7 Does the bond issue meet the private security or payment test? ...   X   X        
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X        
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 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 the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X        
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X        
b Exception to rebate? ........   X   X        
c No rebate due? .........   X   X        
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X        
4a 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 the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a 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? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X   X        
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
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? X   X          
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Form 990, Sch K 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) 2015

Additional Data


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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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
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), section 501(c)(4), and 501(c)(29) 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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting 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 assistance (d) Type of assistance (e) Purpose of assistance
(1) BRANDI MAY Daughter in law of Walter E. May 7,847 employee educational assistance employee educational assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2015
Schedule L (Form 990 or 990-EZ) 2015
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) ADRIENNE ADKINS STEP GRANDDAUGHTER OF WALTER E. MAY, PMC PRESIDENT/CEO 73,451 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS STAFF REGISTERED NURSE.   No
(2) ANDREA ALLARA DAUGHTER OF JOE DEAN ANDERSON, PMC BOARD MEMBER 43,041 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS RADIOLOGY COORDINATOR.   No
(3) ANDREA ROBINETTE LOWE STEP DAUGHTER OF WALTER E. MAY, PMC PRESIDENT/CEO 131,489 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS VP- Human Resources.   No
(4) BART DAVIS Grandson of Jo Nell Robinson, PMC Board Member 51,928 Employed By Pikeville Medical Center as Director of Fleet.   No
(5) BRANDI MAY DAUGHTER IN LAW OF WALTER E. MAY, PMC PRESIDENT/CEO 91,346 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS A Clinic NURSE PRACTITIONER.   No
(6) CAMILLA DAMRON DAUGHTER OF JO NELL ROBINSON, PMC BOARD MEMBER 76,050 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS A SPEECH LANGUAGE PATHOLOGIST.   No
(7) City of Pikeville
 
ENTITY OF WHICH SPOUSE of DEBra BLACKBURN HAS BUSINESS relationship 822,444 SPOUSE OF PMC BOARD MEMBER, Debra BLACKBURN, EMPLOYED AS CITY MANAGER OF CITY OF PIKEVILLE. SERVICES PROVIDED BY CITY OF PIKEVILLE TO PIKEVILLE MEDICAL CENTER: GAS, TRASH, WATER, AND SEWER UTILITY PAYMENTS, $820,160.20 -ADVERTISING INCOME MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $2,283.70.   No
(8) COMMUNITY TRUST BANK
 
ENTITY OF WHICH BOARD MEMBER HAs BUSINESS RELATIONSHIP 8,028,298 DAVID COLLINS SERVES AS BOARD MEMBER OF BOTH ENTITIES. SERVICES PROVIDED BY COMMUNITY TRUST BANK TO PIKEVILLE MEDICAL CENTER: -INTEREST INCOME BANKING SERVICES & FUNDS IN TRUST, $632,380.25 -SAFE DEPOSIT BOX FEES/LINE OF CREDIT FEES/BOND ACCT MGMT FEES, $9,958.74 -INSTALLMENT LOAN PAYMENTS, $7,367,604.16 -ADVERTISING INCOME MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $18,354.80   No
(9) Cordell Weatherford Grandson in law of Walter E May, PMC President/CEO 93,856 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS ASSISTANT VICE PRESIDENT-ADMINISTRATION.   No
(10) EAST KY BROADCASTING & EAST KY RADIO NETWORK (TOTAL OF NINE RADIO STATIONs)
 
ENTITIES MORE THAN 35% OWNED BY WALTER E. MAY, PMC PRESIDENT/CEO 1,671,269 ENTITIES PROVIDE ADVERTISING SERVICES TO PMC, $1,581,508.48 -ENTITIES PROVIDE ADVERTISING INCOME-MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $89,760.40.   No
(11) KAMINSKI ROBINSON HUSBAND OF JO NELL ROBINSON, PMC BOARD MEMBER 65,978 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS DIRECTOR-CHAPLAIN SERVICES.   No
(12) Miranda Forsyth SISTER IN LAW OF Debra Blackburn, PMC BOARD MEMBER 63,327 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS STAFF REGISTERED NURSE.   No
(13) RANDY L JOHNSON SON IN LAW OF WALTER E. MAY, PMC PRESIDENT/CEO 59,625 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS assistant DIRECTOR-CHAPLAIN SERVICEs.   No
(14) Rhonda Coleman SISTER IN LAW OF Debra Blackburn, PMC BOARD MEMBER 31,197 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS AN INSURANCE COORDINATOR.   No
(15) Rita Crum SISTER IN LAW OF AARON CRUM, M.D., PMC BOARD MEMBER 72,415 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS DIRECTOR of EMPLOYEE DEVELOPMENT/EDUCATION.   No
(16) ROBERT BELL STEP SON OF HOBART JOHNSON, PMC BOARD MEMBER 101,628 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS Nutritional Services Head Chef.   No
(17) SARAH Taylor DAUGHTER OF CHERYL HICKMAN, PMC KEY EMPLOYEE 80,921 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS IT- Project Manager.   No
(18) TRISTAN BLACKBURN Son of Debra Blackburn, PMC Board Member 29,733 EMPLOYED BY PIKEVILLE MEDICAL CENTER AS Network Administrator.   No
(19) US BANK
 
ENTITY OF WHICH FAMILY MEMBER OF PEGGY JUSTICE HAS BUSINess Relationship 1,306,270 BROTHER OF KEY EMPLOYEE, PEGGY JUSTICE, SERVES AS BOARD MEMBER OF ENTITY. AARON CRUM, M.D., PMC BOARD CHIEF OF STAFF, SERVES AS BOARD MEMBER of both entities. SERVICES PROVIDED BY US BANK TO PIKEVILLE MEDICAL CENTER: INSTALLMENT LOAN PAYMENTS, $1,196,833.92 - RENT, $109,110.76 -ADVERTISING INCOME MEDICAL LEADER: PUBLICATION SOLELY OWNED BY PIKEVILLE MEDICAL CENTER, $325.00.   No
(20) East Kentucky Law Group PSC
 
Entity more than 35% owned by spouse of Walter E. May, PMC President/CEO 1,760,507 FIRM PROVIDES LEGAL SERVICES TO PIKEVILLE MEDICAL CENTER.   No
(21) Chloe Partners LLC
 
ENTITY OF WHICH PMC KEY EMPLOYEE, PEGGY JUSTICE'S FAMILY has OWNERSHIP 2,900,000 ENTITY SOLD COMMERCIAL REAL ESTATE TO PIKEVILLE MEDICAL CENTER.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2015


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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Pikeville Medical Center Inc
 
Employer identification number

61-0458376
Return Reference Explanation
Form 990, Part VI, Section A, line 2 Dr Alex Poulos & Dr Dennis Halbert partners in Pikeville Radiology.
Form 990, Part VI, Section B, line 11 The process of reviewing the form 990 entails a detailed review by the CFO prior to filing. Additionally, the governing body will review the final Form 990 including requested schedules at the next board meeting. 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 AN 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.
Form 990, Part XI, line 9: INTEREST IN CHARITABLE REMAINDER TRUST 27,743. rounding 1.
Form 990, Part XII Oversight of Audit Process The Board of Directors assumes responsibility 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) 2015


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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
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 (if applicable) 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 entity?
Yes No
(1)Pikeville Medical Center Foundation For Quality Healthcare
911 Bypass Road

Pikeville,KY41501
47-2020718
Support KY 501(c)(3) Line 11a, I Pikeville Medical Center Inc
 
Yes
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) PIKEVILLE mEDICAL DEVELOPMENT CORPORATION

911 bypass road
PIKeville,KY41501
20-2487928
INACTIVE KY N/A
C -349 6,920 100.000 %   No
(2) landmark properties of pikeville inc

PO Box 1259
Pikeville,KY41502
46-2494613
Lodging/Dining KY Pikeville Medical Center
 
C 742,453 4,830,043 100.000 % Yes  










Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
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 related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) landmark Properties

B 1,384,466 cash
(2) landmark Properties

D 274,469 cost
(3) landmark Properties

J 12 Cost
(4) landmark Properties

M 2,546,227 COST
(5) Landmark Properties

K 35,000 cost

Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


Software ID:  
Software Version: