TY 2022 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) RONALD BURCHETT...................................................................... BOARD VICE-CHAIR	7.00 ................. 1.00	X	X		28,661	0
(2) WILLIAM D BLACKBURN...................................................................... BOARD CHAIR/PRESIDENT/CEO	40.00 ................. 1.00	X	X		945,211	45,255
(3) JOE DEAN ANDERSON...................................................................... BOARD SECRETARY/TREASURER	4.00 ................. 1.00	X	X		23,000	0
(4) DAVID COLLINS CPA...................................................................... BOARD MEMBER	4.00 ................. 1.00	X			23,000	0
(5) JOHN LABRECHE...................................................................... BOARD MEMBER	5.00 ................. 1.00	X			23,702	0
(6) JULIUS CLINTON MARTIN II...................................................................... BOARD MEMBER	4.00 ................. 1.00	X			23,730	0
(7) MARY SIMPSON PHD...................................................................... BOARD MEMBER	3.00 .................	X			23,097	0
(8) JYOTHI METTU MD...................................................................... BOARD MEMBER	3.00 .................	X			23,661	0
(9) DAVID BAIRD...................................................................... BOARD MEMBER	3.00 .................	X			0	30,638
(10) AARON CRUM MD...................................................................... EX-OFFICIO/CMO/ASST CEO	40.00 ................. 1.00	X			893,382	14,117
(11) ROBERT SHURTLEFF...................................................................... BOARD MEMBER	3.00 .................	X			23,666	0
(12) LINDA WAGNER-JUSTICE...................................................................... BOARD MEMBER	3.00 .................	X			23,097	0
(13) PHILLIP D REED...................................................................... BOARD MEMBER	3.00 .................	X			23,000	0
(14) ERICH BLACKBURN...................................................................... EX-OFFICIO/CHIEF LEGAL OFF/SR. VP	40.00 .................	X			479,049	45,255
(15) JOHN WATSON MD...................................................................... BOD/CHIEF OF STAFF/HOSPITALIST	40.00 .................	X			370,491	42,005
(16) MICHELLE HAGY...................................................................... EX-OFFICIO/CFO/SR. VP FINANCE	40.00 .................	X	X		420,682	45,255
(17) MELISSA THACKER...................................................................... CHIEF QUALITY OFFICER-SR. VP	40.00 .................			X	277,865	14,578

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) KANSAS JUSTICE........................................................................ CHIEF OPERATING OFFICER-SR. VP	40.00 .......................	X			336,992	0	42,005
(19) CHERYL HICKMAN........................................................................ CHIEF REGULATORY OFFICER-SR. VP	40.00 .......................	X			282,464	0	41,387
(20) MICHELLE RAINEY........................................................................ CHIEF NURSING OFFICER-SR. VP	40.00 .......................	X			318,863	0	45,255
(21) TONY DAMRON........................................................................ CHIEF INFORMATION OFFICER-SR. VP	40.00 .......................	X			254,108	0	38,194
(22) MARCUS CONLEY........................................................................ VP FINANCE	40.00 .......................	X			232,110	0	37,637
(23) KEITH HALL MD........................................................................ ORTHOPEDIC SURGEON	40.00 .......................		X		1,694,852	0	42,005
(24) KEVIN PUGH MD........................................................................ ORTHOPEDIC SURGEON	40.00 .......................		X		1,648,830	0	42,005
(25) CHRISTOPHER REYNOLDS MD........................................................................ CARDIOLOGIST/ELECTROPHYSIOLOGIST	40.00 .......................		X		1,169,441	0	42,005
(26) AYORINDE MEDAIYESE MD........................................................................ CRITICAL CARE PHYSICIAN	40.00 .......................		X		1,096,492	0	45,255
(27) DERMOT HALPIN MD........................................................................ CARDIOTHORACIC SURGEON	40.00 .......................		X		1,018,931	0	45,255
(28) JUANITA DESKINS........................................................................ FORMER CHIEF OPERATING OFFICER	40.00 .......................			X	193,567	0	40,231
(29) DAVID HALCOMB........................................................................ FORMER ASST. CFO	40.00 .......................			X	182,756	0	39,001

(A) Name and business address	(B) Description of services	(C) Compensation
QUALIVIS LLC 5930 CORNERSTONE COURT WEST STE 30 SAN DIEGO,CA92121	PROFESSIONAL SERVICES	21,037,697
ELLIOTT CONTRACTING INC PO BOX 3038 PIKEVILLE,KY41502	CONSTRUCTION SERVICES	5,583,325
LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON,NC27216	LABORATORY SERVICES	3,671,876
PHILIPS HEALTHCARE INC 22100 BOTHELL EVERETT HIGHWAY BOTHELL,WA98041	PROFESSIONAL SERVICES	3,586,333
CROSS COUNTRY STAFFING INC 6551 PARK OF COMMERCE BOULEVARD BOCA RATON,FL33487	PROFESSIONAL SERVICES	3,151,280
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 71

- TIN:

SCHEDULE A
(Form 990)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

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 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2022

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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

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

First 5 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

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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

Schedule A (Form 990) 2022

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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.)..

First 5 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

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

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

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization PIKEVILLE MEDICAL CENTER INC

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Schedule B (Form 990) (2022)

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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

138,307

Total. Add lines 1c through 1i ....................................................................................................

138,307

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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) IN THE AMOUNT OF $18,307. $120,000 WAS PAID TO CORNERSTONE GOVERNMENT AFFAIRS FOR CONSULTING SERVICES AND GOVERNMENT RELATIONS.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 ........

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

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2021

Page 2

Part III

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

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	206,000	206,000	206,000	206,000	206,000
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	206,000	206,000	206,000	206,000	206,000

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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 .....	15,595,700		15,595,700
b	Buildings ....	331,652,200	136,851,044	194,801,156
c	Leasehold improvements	2,233,546	1,964,222	269,324
d	Equipment ....	225,523,065	154,479,876	71,043,189
e	Other .....	14,428,040	5,878,831	8,549,209
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				290,258,578

Schedule D (Form 990) 2021

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.)

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.)

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)INVESTMENT - CUSTODY ACCOUNT				7,687,684
(2)ASSETS WHOSE USE IS LIMITED - SELF INSURED TRUST				32,207,262
(3)CTIC - INVESTMENT MANAGEMENT ACCOUNT				78,764,729
(4)ROU ASSET - FINANCE LEASE				1,740,977
(5)ROU ASSET - OPERATING LEASE				1,052,305
(6)RELATED PARTY RECEIVABLE				1,117,003
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				122,569,960

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	10,821,660
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) 2021

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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 ENDOWMENT FUND IS UTILIZED TO SUPPORT THE CHARITABLE AND HEALTH ACTIVITES OF PIKEVILLE MEDICAL CENTER, INC.

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, 2023 AND 2022. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2023 AND 2022 THAT WOULD REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. AT SEPTEMBER 30, 2023, TAX RETURNS FILED FOR 2020 THROUGH 2022 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

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

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

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

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

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

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

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

Yes

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

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) . . .			2,663,158		2,663,158	0.430 %
b	Medicaid (from Worksheet 3, column a) . . . . .			147,001,835	141,785,459	5,216,376	0.840 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			149,664,993	141,785,459	7,879,534	1.270 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	145	1,148	51,054		51,054	0.010 %
f	Health professions education (from Worksheet 5) . . .	11	1,460	391,164	357,750	33,414	0.010 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	25		112,545		112,545	0.020 %
j	Total. Other Benefits . .	181	2,608	554,763	357,750	197,013	0.040 %
k	Total. Add lines 7d and 7j .	181	2,608	150,219,756	142,143,209	8,076,547	1.310 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	2		130,000	130,000	0.020 %
3	Community support	31	9,552	79,286	79,286	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	13	301	483	483	0 %
8	Workforce development	45	1,529	1,954,053	1,954,053	0.310 %
9	Other
10	Total	91	11,382	2,163,822	2,163,822	0.340 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,784,692

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. ......

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

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

95,346,758

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

97,451,458

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

-2,104,700

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2022

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?1Name, 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)
1	PIKEVILLE MEDICAL CENTER 911 BYPASS ROAD PIKEVILLE,KY41501 WWW.PIKEVILLEHOSPITAL.ORG 100366	X	X	X	X

Schedule H (Form 990) 2022

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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.PIKEVILLEHOSPITAL.ORG/2022-2025-COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.PIKEVILLEHOSPITAL.ORG/2022-2025-COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTP://WWW.PIKEVILLEHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/

The FAP application form was widely available on a website (list url):

HTTP://WWW.PIKEVILLEHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.PIKEVILLEHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	PIKEVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 CONDUCTED AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY DURING FY 2022. A COMMITTEE ADVISORY BOARD COMPRISED OF 27 MEMBERS FROM THE BUSINESS SECTOR, EDUCATIONAL INSTITUTIONS AND VARIED CIVIC ORGANIZATIONS, IN ADDITION TO, 10 PMC STAFF MEMBERS, FROM POSITIONS WITHIN ADMINISTRATION AND CLINICAL SUPPORT SERVICES, AS WELL AS LICENSED PROVIDERS WAS ASSEMBLED TO PROVIDE OVERSIGHT FOR THE SURVEY AND REPORTING PROCESSES. PMC GATHERED DATA FROM THE LOCAL, STATE AND NATIONAL PATIENT POPULATIONS RELATED TO THEIR SOCIOECONOMIC AND HEALTH-RELATED ISSUES TO FOCUS ON ADDRESSING HEALTH DISPARITIES AND OTHER FACTORS AFFECTING PEOPLE OF THE REGION SERVED BY PMC. THE SURVEY WAS DISTRIBUTED TO ALL ADVISORY COMMITTEE MEMBERS; MEMBERS PROMOTED THE SURVEY TO THEIR EMPLOYEES, CUSTOMERS AND TO THE PUBLIC AT LARGE FOR ALL TO TAKE AND GIVE INPUT. ADDITIONALLY, THE SURVEY WAS MADE AVAILABLE ONLINE AND MARKETED PUBLICLY VIA MULTIPLE MEDIA PLATFORMS INCLUDING PRINT, SOCIAL MEDIA AND OTHER ON-SITE SIGNAGE AND PUBLICATIONS TO ACHIEVE A DIVERSIFIED DISTRIBUTION OF THE SURVEY. PMC'S COMMUNITY SURVEY RESPONSES WERE AGGREGATED WITH OTHER DATA AND STATISTICS TO PROVIDE A CLEAR AND DETAILED PICTURE OF THE HEALTHCARE INDUSTRY NEEDS WITHIN THE PMC MARKET AREA.
PIKEVILLE MEDICAL CENTER	PART V, SECTION B, LINE 7D: THE PMC BOARD-APPROVED CHNA REPORT WAS DISTRIBUTED TO THE ADVISORY BOARD MEMBERS WHO WERE ENCOURAGED TO DISTRIBUTE THE REPORT TO LOCAL BUSINESS/INDUSTRY LEADERS, PUBLIC OFFICIALS, AND CIVIC ORGANIZATION MEMBERS, THE REPORT WAS MADE AVAILABLE AT VARIOUS LOCATIONS ACROSS THE PMC CAMPUS AND IS AVAILABLE PUBLICLY ONLINE.
PIKEVILLE MEDICAL CENTER	PART V, SECTION B, LINE 11: PIKEVILLE MEDICAL CENTER ADDRESSES THE COMMUNITY NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA BY PROMOTING HEALTHY LIFESTYLES AND GOOD HABITS NECESSARY TO PREVENT OR ALLEVIATE DEVELOPMENT OF DISEASE THROUGH NUMEROUS COMMUNITY INFORMATION EVENTS AND BY CONTINUING INVOLVEMENT IN A WIDE ARRAY OF PUBLIC ACTIVITIES SUCH AS HEALTH FAIRS, REMOTE AREA MEDICAL (RAM) CLINICS, AND SPONSORED OCCASIONS ACROSS THE REGION. HEALTH SCREENINGS ARE CONDUCTED THROUGHOUT THE REGION TO DETECT EARLY WARNING SIGNS OF DISEASE INCLUDING, BUT NOT LIMITED TO, CANCER, DIABETES, AND HEART DISEASE. PMC IS CONTINUING TO INCREASE AVAILABILITY OF PRIMARY AND PEDIATRIC CARE SERVICES BY AGGRESSIVELY RECRUITING ADDITIONAL PROVIDERS TO THE AREA AND EXPANDING LOCATIONS WHERE THESE SERVICES ARE OFFERED. PMC'S FOCUS ON EXPANDING PEDIATRIC SERVICES HAS LED TO THE OPENING OF THE REGION'S ONLY CHILDREN'S HOSPITAL AND EMERGENCY DEPARTMENT PEDIATRIC WING THAT HAS EARNED THE PEDIATRIC READINESS DESIGNATION. THESE TWO NEW PEDIATRIC FACILITIES HAVE ALLOWED FOR THE LAUNCH OF A MULTI-SPECIALTY PEDIATRIC PROGRAM THAT INCLUDES CARDIOLOGY, PULMONOLOGY, BMI AND PLASTICS SERVICES THROUGH A COOPERATIVE AGREEMENT WITH THE UNIVERSITY OF KENTUCKY CHILDREN'S HOSPITAL. APPALACHIA REMAINS AS ONE OF THE NATION'S MOST PREVALENT REGIONS FOR HEART DISEASE, OBESITY, AND CANCER RELATED ILLNESS. PMC IS CONTINUING TO EXPAND THE AVAILABILITY OF ADVANCED CARDIOLOGY SERVICES BY OFFERING THE LATEST IN LIFE SAVING PROCEDURES AND STATE OF THE ART THERAPIES, IN ADDITION TO EXPANDING CARDIOLOGY SERVICE OFFERINGS TO OUTLYING AREAS THROUGH SATELLITE CLINICS. TO EXPAND ONCOLOGY SERVICE OFFERINGS AND PROVIDE THE MOST COMPREHENSIVE CANCER CARE, PMC COMPLETED ANOTHER EXPANSION PROJECT TO DESIGNATE AN ADDITIONAL 7,085 SQUARE FEET OF SPACE TO THE EXISTING LAWSON CANCER CENTER TO BE UTILIZED FOR EXPANDED DIAGNOSTIC AND CHEMOTHERAPY INFUSION SERVICES. PMC HAS ALSO PURCHASED TWO NEW RAPIDARC TRUE BEAM LINEAR ACCELERATORS TO MEET THE INCREASED DEMAND FOR RADIOTHERAPY ONCOLOGY SERVICES. SUBSTANCE ABUSE PLAGUES THE PMC SERVICE AREA; PMC IS CONTINUING TO IMPLEMENT STRATEGIES TO PREVENT IMPROPER USAGE OF MEDICATIONS OF ALL KINDS THROUGH ELECTRONIC PRESCRIPTIONS, HEPATITIS C CLINICS AND PATIENT EDUCATION. ECONOMIC STABILITY HAS A DIRECT CORRELATION TO AN INDIVIDUAL'S OVERALL HEALTH AND IS A SIGNIFICANT AREA OF CONCERN ACROSS THE REGION. PMC IS COLLABORATING WITH MULTIPLE ORGANIZATIONS TO DEVELOP PROGRAMS TO ASSIST IN PROVIDING IMPROVED ECONOMIC OPPORTUNITY TO RESIDENTS ACROSS THE SERVICE AREA. THE PMC PROJECT HEART (HEALTHCARE EMPLOYMENT AROUND REGIONAL TRAINING) IS ONE SUCH PROGRAM THAT SUPPORTS JOB CREATION AND OPPORTUNITY THROUGH BRIDGING TOGETHER MANY ENTITIES, WHICH HAVE COMBINED FORCES TO PROVIDE FINANCIALLY ASSISTED TRAINING AND EDUCATION FOR SUSTAINABLE QUALITY HEALTHCARE CAREER OPPORTUNITIES ACROSS EASTERN KENTUCKY. PMC IS ALSO PARTNERING WITH MULTIPLE POST-SECONDARY EDUCATIONAL INSTITUTIONS TO IMPROVE THE REGISTRATION AND GRADUATION RATE OF NURSING AND OTHER HEALTHCARE RELATED STUDENTS TO ADDRESS THE CURRENT SHORTAGE OF AVAILABLE LICENSED STAFF IN THESE FIELDS DUE TO EXISTING AND GROWING DEMAND OF THE AGING PATIENT POPULATION. PMC HAS ALSO DEVELOPED SEVERAL IN-HOUSE TRAINING PROGRAMS FOR VARIOUS POSITIONS INCLUDING PHLEBOTOMISTS, PATIENT CARE TECHNICIANS AND MEDICAL ASSISTANTS ALLOWING STUDENTS TO OBTAIN THEIR CERTIFICATIONS IN THESE FIELDS WHILE WORKING AT PMC.
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) 2022

Page 9

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?10
Name and address		Type of Facility (describe)
1	1 - PMC URGENT CARE & FAMILY WELLNESS CENTER 238 CASSADY BLVD PIKEVILLE,KY41501	PHYSICIAN PRACTICE
2	2 - PMC APPALACHIAN VALLEY AUTISM CENTER 131 SUMMIT DRIVE PIKEVILLE,KY41501	AUTISM CENTER
3	3 - PMC PRESTONSBURG PRIMARY & URGENT CARE 723 SOUTH LAKE DRIVE PRESTONSBURG,KY41653	PHYSICIAN PRACTICE
4	4 - PMC PRIMARY CARE CLINIC 184 S MAYO TRAIL PIKEVILLE,KY41501	PHYSICIAN PRACTICE
5	5 - PMC SPECIALTY CLINIC-WHITESBURG 107 MEDICAL PLAZA LANE WHITESBURG,KY41858	PHYSICIAN PRACTICE
6	6 - PMC HOME MEDICAL EQUIPMENT 138 S MAYO TRAIL PIKEVILLE,KY41501	MEDICAL EQUIPMENT/SUPPLY RENTALS/SALES
7	7 - PMC APPALACHIAN VALLEY AUTISM CENTER-PRE 631 SOUTH LAKE DRIVE PRESTONBURG,KY41653	AUTISM CENTER
8	8 - PMC PRIMARY & SPECIALTY CLINIC 285 SOUTHSIDE MALL ROAD SOUTH WILLIAMSON,KY41503	PHYSICIAN PRACTICE
9	9 - PMC SPECIALTY CLINIC-PRESTONSBURG 311 NORTH ARNOLD AVE PRESTONSBURG,KY41653	PHYSICIAN PRACTICE
10	10 - PMC SPECIALTY CLINIC-GRUNDY 1520 SLATE CREEK ROAD STE 205 GRUNDY,VA24614	PHYSICIAN PRACTICE

Schedule H (Form 990) 2022

Page 10

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 ADVANCE THE HEALTH AND WELL-BEING OF OUR REGION THROUGH COMPREHENSIVE CARE IN A CHRISTIAN ENVIRONMENT" PROVIDES THE FOUNDATION FOR PMC'S EFFORTS TO NOT ONLY ADDRESS THE HEALTHCARE NEEDS OF THE PATIENT POPULATION BUT TO ALSO IMPROVE THE MENTAL AND SPIRITUAL WELL BEING OF THOSE WE SERVE, ALL VITAL COMPONENTS TO ADVANCING THE REGION BOTH SOCIALLY AND ECONOMICALLY. DURING FY 2023, PIKEVILLE MEDICAL CENTER REPORTED TAKING PART IN 91 COMMUNITY BUILDING ACTIVITIES, SERVING MORE THAN 11,000 PEOPLE AND TOTALING MORE THAN $2,160,000 THESE ACTIVITIES FOCUSED ON IMPROVING THE HEALTH AND WELLNESS OF THOSE WE SERVE THROUGH HEALTH EDUCATION, AWARENESS, PREVENTION AND TREATMENT, AS WELL AS, WORKFORCE DEVELOPMENT. SOME OF THE EVENTS LISTED UNDER THE COMMUNITY BUILDING ACTIVITIES SECTION INCLUDE; BLOOD DONATION DRIVES, BEREAVEMENT SUPPORT, BIBLE DISTRIBUTION, REMOTE AREA MEDICAL EVENT SUPPORT, ECONOMIC DEVELOPMENT PROGRAM SUPPORT, AND RECRUITMENT OF NEARLY 200 HEALTHCARE PROFESSIONALS.
PART III, LINE 3:	EXPLANATION FOR LINE 2 AND 3 OR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: [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 THROUGHOUT THE FINANCIAL ASSISTANCE APPLICATION PROCESS. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL 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.] THE COST TO CHARGE FACTOR UTILIZED TO CALCULATE NET COMMUNITY BENEFIT EXPENSE IS 0.179794 FROM WS S-10.
SCHEDULE H, PART II, LINE 7	COMMUNITY HEALTH EDUCATION: PMC'S STAFF IS ACTIVELY INVOLVED IN EDUCATING THE COMMUNITY ON IMPORTANT HEALTHCARE TOPICS. THROUGHOUT FY 2023, HOSPITAL REPRESENTATIVES FROM VARIOUS DEPARTMENTS PRESENTED TO LOCAL CIVIC CLUBS, MEDICAL PROFESSIONALS, AND THE PUBLIC AT LARGE. THROUGH ITS COMMUNITY EDUCATION EFFORTS IN FY 2023, PMC REACHED MORE THAN 500 PARTICIPANTS.PMC EMPLOYEES PARTICIPATED IN THE FOLLOWING LECTURES/PRESENTATIONS AND COMMUNITY EVENTS DURING FY 2023:- BELFRY AREA BACK TO SCHOOL BASH- COLORS OF COURAGE 5K RUN- HILLBILLY DAYS FIRST AID BOOTH- KIMPER ELEMENTARY TOBACCO/VAPING EDUCATION- LAWSON CANCER CENTER ICE CREAM SOCIAL- PMC BOOTH AT NIGHTMARE ON MAIN- SKIN CARE AWARENESS- SHAPING OUR APPALACHIAN REGION- REMEMBERING EASTERN KENTUCKY FLOOD VICTIMS EVENT- WORLD CANCER DAY AWARENESS - VALENTINE'S DAY CELEBRATION CANCER SURVIVORS
PART III, LINE 4:	SEE PAGE 10-11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. CURRENT OPERATIONS INCLUDE AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ESTIMATED BASED UPON THE AGE OF THE PATIENT ACCOUNTS RECEIVABLE, HISTORICAL WRITEOFFS AND RECOVERIES AND ANY UNUSUAL CIRCUMSTANCES (SUCH AS LOCAL, REGIONAL OR NATIONAL ECONOMIC CONDITIONS) WHICH MAY AFFECT THE COLLECTIBILITY OF RECEIVABLES, INCLUDING MANAGEMENT'S ASSUMPTIONS ABOUT CONDITIONS IT EXPECTS TO EXIST AND COURSES OF ACTION IT EXPECTS TO TAKE.
PART III, LINE 8:	FY 2023 AS FILED MEDICARE COST REPORT DATA WAS USED AS THE SOURCE FOR THE TOTAL REVENUE AND MEDICARE ALLOWABLE COSTS REPORTED IN SECTION B, THEREFORE THE COMMUNITY BENEFIT REPORTABLE AMOUNT OF SHORTFALL IS $2,104,700.
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 EFFORTS 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 PATIENT'S 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 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 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 EASTERN KENTUCKY, SOUTHWEST VIRGINIA AND SOUTHWEST WEST VIRGINIA. PMC REALIZES THE HEALTH AND ACCESS DISPARITIES IN OUR APPALACHIAN MARKET AND IS COMMITTED TO SURPASSING BARRIERS TO BE THE PROVIDER OF CHOICE FOR COMPREHENSIVE QUALITY HEALTHCARE SERVICES TO MEET THE NEEDS OF THE RESIDENTS OF THE REGION IT SERVES. PMC USES THE MOST RECENT U.S. CENSUS BUREAU DATA IN ADDITION TO INFORMATION FROM THE KY STATE DATA CENTER AND CENTERS FOR DISEASE CONTROL WHEN ASSESSING THE GEOGRAPHIC AREA AND DEMOGRAPHIC POPULATION CHARACTERISTICS OF THE REGION. BASED ON THE LATEST AVAILABLE DATA, PMC'S SERVICE AREA CONTAINS A POPULATION ESTIMATE OF 209,860 INDIVIDUALS. THERE IS AN EVEN DISTRIBUTION OF MALES TO FEMALES. THE AVERAGE HOUSEHOLD SIZE IS 2.5 INDIVIDUALS AND 20.91% OF THE POPULATION IS AGE 65 AND OVER. THE AREA SERVED BY PIKEVILLE MEDICAL CENTER HAS A MEDIAN FAMILY INCOME OF $39,568 WITH 28% OF THE POPULATION LIVING BELOW THE POVERTY LINE.
PART VI, LINE 6:	PIKEVILLE MEDICAL CENTER (PMC), A 348-BED TERTIARY CARE CENTER, PROVIDES HIGH QUALITY COMPREHENSIVE HEALTHCARE FOR EASTERN KENTUCKY AND THE CENTRAL APPALACHIAN REGION. FOR DECADES, THE REGION SERVED BY PMC BATTLED MANY CHALLENGES RELATED TO LIMITED ACCESS TO QUALITY MEDICAL CARE; PMC HAS STRIVED TO CONTINUALLY EXPAND SERVICE OFFERINGS AND IMPROVE ACCESS TO HEALTHCARE ACROSS THE REGION IN PURSUIT OF THE ORGANIZATION'S GOAL TO BE THE PROVIDER OF CHOICE THROUGH ITS DEDICATED SERVICE TO THE COMMUNITY AND COMMITMENT TO PROVIDING THE MOST ADVANCED HEALTHCARE TREATMENT AND TECHNOLOGY AVAILABLE. THE MISSION OF PIKEVILLE MEDICAL CENTER IS "TO ADVANCE THE HEALTH AND WELL-BEING OF OUR REGION THROUGH COMPREHENSIVE CARE IN A CHRISTIAN ENVIRONMENT." PMC'S MISSION ALONG WITH THE VISION OF THE ORGANIZATION: "TO BE THE PROVIDER AND EMPLOYER OF CHOICE FOR HEALTHCARE IN THE REGION WE SERVE", IS THE FOUNDATION FOR THE HIGH-QUALITY LEVEL OF CARE PROVIDED EACH DAY THROUGHOUT THE ORGANIZATION BY MORE THAN 3,000 EMPLOYEES INCLUDING NEARLY 600 LICENSED MEDICAL PROVIDERS. PMC BEGAN AS A SMALL, RURAL, 50-BED FACILITY AT ITS INCEPTION IN 1924, THE MEDICAL CENTER HAS GROWN EXPONENTIALLY AND IS TODAY A COMPREHENSIVE MEDICAL COMPLEX COMPRISED OF 10 CENTERS OF EXCELLENCE AND 328 LICENSED ACUTE CARE INPATIENT BEDS WHICH INCLUDE: 16 NEONATAL LEVEL II BASSINETS, 20 INPATIENT PHYSICAL REHABILITATION BEDS, 22 NURSERY BASSINETS, AND 17 AMBULATORY CLINIC LOCATIONS OFFERING 34 DIFFERENT SPECIALTIES; COVERING NEARLY 1.5 MILLION SQUARE FEET WITH BOTH THE MAIN FACILITY, SATELLITE CLINICS AND SUPPORTIVE SERVICE AREAS. PIKEVILLE MEDICAL CENTER IS A PILLAR OF THE REGIONAL ECONOMIC LANDSCAPE AS HEALTHCARE HAS EVOLVED INTO THE ECONOMY'S LARGEST SECTOR THROUGHOUT EASTERN KENTUCKY, SOUTHWEST VIRGINIA AND SOUTHWEST WEST VIRGINIA. PMC EMBRACES THE RESPONSIBILITY IN BEING ONE OF THE REGION'S LARGEST EMPLOYERS AND UNDERSTANDS THAT THE FUTURE HEALTH, SOCIAL AND ECONOMIC OUTCOMES FOR THE REGION DEPEND ON THE FINANCIAL STRENGTH OF THE ORGANIZATION. THE HOSPITAL IS COMMITTED TO CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF THE REGION AND NOW OFFERS MORE THAN 400 SERVICES, INCLUDING MOST MAJOR SPECIALTIES AND MANY SUBSPECIALTIES. THE PROGRESSIVE PHYSICAL GROWTH AND EXPANSION OF SPECIALTY SERVICE OFFERINGS, INCLUDING TRAUMA SERVICES AND PEDIATRIC SPECIALTY SERVICES, HAS TRANSFORMED PMC INTO A REGIONAL REFERRAL CENTER FOR SMALLER COMMUNITY HOSPITALS THAT HAVE PATIENTS WITH COMPLEX MEDICAL NEEDS WHOM THEY CANNOT SERVE. CURRENT SERVICES OFFERED AT PMC INCLUDE: A VERIFIED LEVEL II TRAUMA CENTER; A COMMISSION ON CANCER ACCREDITED, FULL-SERVICE CANCER TREATMENT CENTER; A HEART & VASCULAR INSTITUTE WITH PRIMARY PCI ACCREDITATION; 20-BED INPATIENT PHYSICAL REHABILITATION HOSPITAL; AN ACCREDITED GOLD PLUS NEUROSCIENCE CENTER; NEUROSURGERY; LEVEL II ADVANCED NEONATAL INTENSIVE CARE UNIT; A MBSAQIP ACCREDITED BARIATRIC & MINIMALLY INVASIVE SURGERY CENTER; JOINT COMMISSION GOLD SEAL CERTIFIED ORTHOPEDIC SURGERY & SPORTS MEDICINE PROGRAM; PULMONARY REHABILITATION; PEDIATRIC SPECIALTY SERVICES INCLUDING CARDIOLOGY, PULMONOLOGY, BMI, AND PLASTICS; THE REGION'S ONLY CHILDREN'S HOSPITAL; SLEEP LAB; A DIAGNOSTIC CENTER; AUTISM CENTERS; URGENT CARE CENTERS; INTEGRATED FAMILY AND SPECIALTY PHYSICIAN PRACTICES WITH SATELLITE LOCATIONS IN PIKEVILLE, PRESTONSBURG, SOUTH WILLIAMSON, WHITESBURG, KY AND GRUNDY, VA, ALONG WITH A SCHOOL TELE-HEALTH PROGRAM.PIKEVILLE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROVIDES THE ORGANIZATION WITH THE OPPORTUNITY AND KNOWLEDGE TO BETTER ALIGN EXISTING PROGRAMS AND TO DESIGN FUTURE PROGRAMS TO BEST MEET THE NEEDS OF OUR COMMUNITY. THE ISSUES IDENTIFIED AS MOST IMPORTANT DURING THE LATEST CHNA INCLUDE HEART HEALTH, CANCER, OBESITY, PEDIATRIC SERVICES, SUBSTANCE ABUSE AND ECONOMIC CONDITIONS. PIKEVILLE MEDICAL CENTER'S HEART AND VASCULAR INSTITUTE (HVI) IS RECOGNIZED AS HAVING ONE OF THE TOP HEART PROGRAMS IN KENTUCKY. HEART DISEASE HAS BEEN A PRIMARY FOCUS OF PMC FOR SEVERAL YEARS, A RECENTLY COMPLETED $35.2 MILLION 46,000 SQUARE FOOT CAPITAL INVESTMENT PROJECT EXPANDED THE HVI TO MAKE IT UNLIKE ANY OTHER PROGRAM IN STATE. THE MULTI-DISCIPLINARY TEAM OF PHYSICIANS UTILIZES THIS SPACE FOR INTERVENTIONAL CARDIOLOGY, ELECTROPHYSIOLOGY, INTERVENTIONAL RADIOLOGY, VASCULAR TREATMENTS, AND ENDOVASCULAR SURGERY. IN ADDITION TO THE MAIN CAMPUS SERVICE AREA, HVI CURRENTLY OFFERS LIFESAVING CARDIOLOGY SERVICES TO OUTLYING AREAS THROUGH SATELLITE CLINICS LOCATED IN PRESTONSBURG, KY, SOUTH WILLIAMSON, KY, WHITESBURG, KY, AND GRUNDY, VA. PMC'S COMMITMENT TO SERVE THE HEART HEALTH NEEDS OF THE COMMUNITY WILL CONTINUE TO INCORPORATE STATE OF THE ART THERAPIES AND CUTTING-EDGE TECHNOLOGY IN MINIMALLY INVASIVE INTERVENTIONS. NEW LIFE SAVING AND CURATIVE PROCEDURES THAT WERE NOT PREVIOUSLY OFFERED IN THE REGION THAT ARE NOW PERFORMED AT PMC'S HVI INCLUDE THE MAZE, TACTICATH, TAVR, WATCHMAN DEVICE, AND LEADLESS PACEMAKERS. PMC'S HVI VALVE CLINIC, THE FIRST OF ITS KIND IN THE REGION, DELIVERS QUALITY HEART CARE TO PATIENTS WITH COMPLEX VALVE DISORDERS. WITH STATE-OF-THE-ART CARDIOLOGY CATHETERIZATION LABS, INTERVENTIONAL CARDIOLOGISTS AND CARDIOTHORACIC SURGEONS HAVE JOINED FORCES TO COMPLETE VALVE PROCEDURES UTILIZING PERCUTANEOUS APPROACHES OR MINIMALLY INVASIVE APPROACHES FOR VALVE REPLACEMENTS, ALLEVIATING THE NEED FOR PATIENTS TO TRAVEL HOURS AWAY FROM HOME FOR MULTIPLE DOCTOR'S VISITS TO RECEIVE ADVANCED HEART CARE. ADDITIONALLY, HVI'S CARDIAC REHABILITATION CENTER, AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) CERTIFIED, OFFERS PATIENTS WITH HEART DISEASE LIFESTYLE MONITORING AND FITNESS PROGRAMS DESIGNED TO HELP RESTORE THEIR HEART TO MAXIMUM EFFICIENCY. PMC'S STAGE II AND STAGE III CARDIAC REHAB PROGRAMS HELP HEART PATIENTS INCORPORATE CHANGES INTO THEIR DAILY ROUTINES SUCH AS EXERCISING, TAKING MEDICATIONS AND EATING A HEART HEALTHY DIET TO ALLOW FOR AN ACTIVE LIFESTYLE RESULTING IN A BETTER QUALITY OF LIFE AND IMPROVED LONG TERM OUTCOMES. THE PMC LAWSON CANCER CENTER (LCC) PROVIDES ADVANCED CANCER CARE, HEALING, AND COMFORT CLOSE TO HOME FOR INDIVIDUALS AND FAMILIES NAVIGATING THE CHALLENGING JOURNEY OF A CANCER DIAGNOSIS AND TREATMENT. AS THE REGION'S ONLY HOSPITAL TO HAVE ACHIEVED THE COMMISSION ON CANCER'S OUTSTANDING ACHIEVEMENT AWARD WITH COMMENDATIONS FOR EXCEPTIONAL QUALITY, PIKEVILLE MEDICAL CENTER HAS MADE INVESTMENTS IN THE EXPERTISE AND LEADING-EDGE TECHNOLOGY TO FIGHT CANCER IMMEDIATELY UPON DIAGNOSIS. THE LCC AT PIKEVILLE MEDICAL CENTER IS CONVENIENTLY LOCATED ON PMC'S MAIN CAMPUS, WHERE PATIENTS HAVE ALL THEIR SERVICES AND PROVIDERS IN ONE LOCATION INCLUDING IMAGING, DIAGNOSTICS, CHEMOTHERAPY, INFUSION, AND RADIATION THERAPY; AS WELL AS GENETIC COUNSELING, FINANCIAL COUNSELING AND PATIENT NAVIGATION. HAVING ALL SERVICES IN ONE LOCATION ALLOWS EFFICIENCY FOR CLINICIANS AND EASE OF ACCESS FOR PATIENTS, WHICH CAN IMPROVE OUTCOMES. PMC HAS COMPLETED A 7,085 SQUARE FEET EXPANSION OF LCC, CREATING PRIVATE CHEMO INFUSION SUITES AND PROVIDING ADDITIONAL DIAGNOSTIC CAPABILITIES TO ENSURE THE UTMOST IN COMFORT AND CONVENIENCE TO THE PATIENT DURING THEIR FIGHT AGAINST CANCER. ADDITIONALLY, TWO NEW VARIAN RAPIDARC TRUE BEAM LINEAR ACCELERATORS WITH BRAINLAB TECHNOLOGY WERE RECENTLY PLACED IN SERVICE TO PROVIDE FAST AND PRECISE RADIOTHERAPY TREATMENT, ALLOWING LCC TO DELIVER LIFESAVING RADIATION TWO TO EIGHT TIMES FASTER THAN CONVENTIONAL FORMS OF RADIOTHERAPY. LCC IS ALSO PURSUING ADDITIONAL CLINICAL TRIAL OPPORTUNITIES TO ADD TO OUR PORTFOLIO OF SERVICES GIVING THE MOST RECENT TECHNOLOGY IN INTERVENTION TO OUR PATIENTS. MEDICAL TREATMENT IS ONLY PART OF THE BATTLE IN FIGHTING CANCER, THEREFORE, MULTIPLE AUXILIARY SERVICES TO APPROACH HEALING HOLISTICALLY ARE ALSO OFFERED. AUXILIARY SERVICE OFFERINGS INCLUDE CANCER SUPPORT GROUPS, LOOK GOOD-FEEL GOOD PROGRAM, PROVIDING FREE ACCESS TO WIGS, MAKE-UP AND SCARVES, AND THE ART OF HEALING PROGRAM, OFFERING ARTISTIC ACTIVITIES DESIGNED TO PROVIDE EMOTIONAL SUPPORT TO PEOPLE COPING WITH A CANCER DIAGNOSIS. SMOKING AND VAPING CESSATION CLASSES ARE ALSO OFFERED TO HELP SMOKING ADDICTED PEOPLE BREAK THE DANGEROUS HABIT AND HOPEFULLY PREVENT THEM FROM NEEDING THESE VAST ONCOLOGY SERVICES. THE AVAILABILITY OF THESE LIFE CHANGING AND LIFESAVING TREATMENTS LOCALLY REDUCES THE BURDEN AND EXPENSE OF TRAVEL ON OUR PATIENTS AND THEIR FAMILIES. PIKEVILLE MEDICAL CENTER RECOGNIZES THAT PREVENTATIVE CARE HAS LONG BEEN RECOGNIZED AS THE BEST FORM OF CARE. OBESITY WAS INDICATED TO BE THE NUMBER THREE CONCERN FOR ADULTS AND THE NUMBER ONE CONCERN FOR CHILDREN IN THE AREA ON PMC'S LATEST CHNA. TO HELP COMBAT THESE CONCERNS, PMC WILL CONTINUE TO BE THE COMMUNITY LEADER IN PROMOTING A HEALTHY LIFESTYLE. (CONTINUED)
SCHEDULE H PART VI, LINE 6	(CONTINUED)PMC'S BARIATRIC & MINIMALLY INVASIVE SURGERY CENTER SERVES PATIENTS WHO HAVE UNSUCCESSFULLY TRIED TO CONTROL THEIR WEIGHT BY OFFERING SEVERAL DIFFERENT PROCEDURE OPTIONS, COUNSELING, AND GROUP SUPPORT SESSIONS, ALONG WITH DIABETES AND NUTRITIONAL EDUCATION; SOME OF WHICH ARE CONDUCTED VIA REMOTE VIDEO VISITS, ALLOWING A BETTER OPPORTUNITY FOR PATIENTS TO SUCCEED IN THEIR WEIGHT LOSS PROGRAM. PMC OFFERS DIABETES MANAGEMENT APPOINTMENTS WITH OUR DIABETES SPECIALTY TEAM WHO WORK IN CONJUNCTION WITH OUR STAFF ENDOCRINOLOGIST TO ADDRESS DIABETES MELLITUS, THYROID DISORDERS, PARATHYROID DISORDERS, PITUITARY DISORDERS, ADRENAL DISORDERS, METABOLIC SYNDROME, AND METABOLISM. PMC ALSO SPONSORS DIABETES SUPPORT GROUPS FOR PATIENTS AND THE COMMUNITY AT LARGE. ADDITIONALLY, PMC TAKES STEPS TO ASSIST EMPLOYEES WITH A HEALTHIER LIFESTYLE THROUGH A CORPORATE SPONSORED WEIGHT WATCHERS PROGRAM, DISCOUNTED YMCA MEMBERSHIP OFFERING, AND PMC'S NUTRITIONAL TEAM OFFERS HEALTHY MEAL CHOICES IN THE CAFETERIA WHICH SERVES PATIENTS, VISITORS AND STAFF EACH DAY. TO MAKE A DYNAMIC SHIFT IN ONE'S LIFESTYLE REQUIRES A LONG-TERM MULTI-PRONGED APPROACH. PMC SUPPORTS THE COMMUNITY AT LARGE AND PROMOTES COMMUNITY ACTIVITIES TO ASSIST IN FIGHTING OBESITY BY SPONSORING EVENTS INCLUDING 5K WALKS/RUNS, COMMUNITY INFORMATION CAMPAIGNS TO PROMOTE GOOD HABITS NECESSARY TO PREVENT OR ALLEVIATE DEVELOPMENT OF DISEASE AND CONTINUING INVOLVEMENT IN A WIDE ARRAY OF PUBLIC ACTIVITIES SUCH AS HEALTH FAIRS, REMOTE AREA MEDICAL (RAM) CLINICS AND OTHER SPONSORED EVENTS.PIKEVILLE MEDICAL CENTER RECENTLY OPENED THE METTU CHILDREN'S HOSPITAL (MCH), THE ONLY CHILDREN'S HOSPITAL IN THE REGION, LOCATED IN 13,400 SQUARE FEET OF SPACE ON THE HOSPITAL'S MAIN CAMPUS, TO FILL A GAP IN PEDIATRIC CARE BY PROVIDING BOTH INPATIENT AND OUTPATIENT PEDIATRIC SERVICES. PMC ALSO OPENED A PEDIATRIC FOCUSED WING IN THE EMERGENCY DEPARTMENT, THIS WING HAS DESIGNATED EMERGENCY ROOM TREATMENT BAYS TO SERVE YOUNG PATIENTS, WITH NOT ONLY SPECIALTY EQUIPMENT BUT A FRIENDLY ENVIRONMENT TO REDUCE THEIR FEAR, WHILE THERE. PMC'S EMERGENCY DEPARTMENT EARNED A PEDIATRIC READY DESIGNATION AND IS ONE OF ONLY FOUR PEDIATRIC READY EDS IN THE STATE OF KENTUCKY. THESE TWO NEW PEDIATRIC FACILITIES PROVIDE PMC WITH THE CAPACITY TO LAUNCH A MULTI-SPECIALTY SPECTRUM OF CARE FOR PEDIATRIC PATIENTS. PEDIATRIC CARDIOLOGY, PULMONOLOGY, BMI, AND PLASTICS SPECIALTY SERVICES ARE NOW PROVIDED THROUGH A COOPERATIVE AGREEMENT WITH THE UNIVERSITY OF KENTUCKY CHILDREN'S HOSPITAL. WITH THE OPENING OF THE METTU CHILDREN'S HOSPITAL, PMC IS NOW POISED TO EXPAND THE RANGE OF CARE AND SERVICES TO THE FAMILIES OF THE REGION HERE AT HOME TO PREVENT LONG TRAVEL DISTANCES TO OBTAIN PEDIATRIC CARE. PMC'S APPALACHIAN VALLEY AUTISM (AVA) CENTER, CERTIFIED BY THE INTERNATIONAL BOARD OF CREDENTIALING AND CONTINUING EDUCATION STANDARDS (IBCCES) AS A CERTIFIED AUTISM CENTER, PROVIDES THERAPY FOR CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDER (ASD) WITH THE GOAL TO IDENTIFY CHILDREN AT THE EARLIEST SIGNS OF DETECTION WHICH IMPACTS THEIR PHYSICAL AND MENTAL HEALTH. THE AVA CENTER'S MULTI-DISCIPLINARY TEAMS ARE EQUIPPED TO OFFER FAMILIES UNRIVALED EXPERTISE IN UNDERSTANDING AND MEETING THE NEEDS OF TODDLERS AND BRIDGE THE HEALTHCARE GAP OF CHILDREN WITH AUTISM AND RELATED CHALLENGES. THE AVA CENTER'S PIKEVILLE, KY LOCATION HAS OVER 25,000 SQUARE FEET OF LEARNING SPACE AND FEATURES THERAPY ROOMS, A LIBRARY, AN INDOOR GYMNASIUM, STATE-OF-THE-ART INDOOR SENSORY ROOMS, AND A MULTI-SENSORY OUTDOOR STIMULATION AREA; THE CENTER CAN SERVE UP TO 100 CHILDREN AND IS CURRENTLY AT CAPACITY. WITH AN EXTENSIVE WAIT LIST OF LEARNERS IN NEED OF SERVICES, PMC RECENTLY OPENED THE AVA CENTER SATELLITE LOCATION IN PRESTONSBURG, KY. THE 5,500 SQUARE FOOT SATELLITE LOCATION ALLOWS PMC THERAPISTS TO PROVIDE SERVICES FOR 24 ADDITIONAL LEARNERS, OFFERING THE SAME SPECIALIZED SERVICES THAT ARE AVAILABLE AT THE PIKEVILLE LOCATION WHILE ACCOMMODATING THE GROWING NEED FOR AUTISM SERVICES IN EASTERN KENTUCKY. PMC PLANS TO CONTINUE DEVELOPING AND EXPANDING PEDIATRIC SPECIALTY SERVICES TO BECOME THE REGIONAL REFERRAL CENTER FOR ALMOST ALL PEDIATRIC CARE. KENTUCKY IS AMONG THE TOP TEN STATES WITH THE HIGHEST OPIOID PRESCRIBING RATES. PMC'S LEADERSHIP AND CLINICIANS TAKE VERY SERIOUSLY THE RESPONSIBILITY IN PROTECTING THE PUBLIC BY PREVENTING SUBSTANCE ABUSE IN OUR PATIENTS. PMC HAS A STRICTLY ENFORCED POLICY RELATING TO THE PRESCRIBING OF CONTROLLED SUBSTANCES AND ROUTINELY ANALYZES NARCOTIC PRESCRIBING DATA, IMPLEMENTING STRATEGIES THAT PREVENT IMPROPER USAGE OF MEDICATIONS OF ALL KINDS. STRATEGIES CURRENTLY IN PLACE INCLUDE ELECTRONIC PRESCRIPTIONS WITHIN THE CLINIC AND HOSPITAL SETTING, HEPATITIS C CLINICS, AND PATIENT EDUCATION AND PATIENT AUTHORIZATION FOR OPIOID TRACKING THROUGH REPORTABLE DATA. THERE HAS ALSO BEEN AN INCREASE IN NEONATAL ABSTINENCE SYNDROMES (NAS) AND NEONATAL OPIOID WITHDRAWAL SYMPTOMS (NOWS), BOTH NATIONALLY AND LOCALLY. PMC IS CONTINUING TO EXPLORE AND POSITION THE ORGANIZATION TO ADDRESS THIS UNIQUE SUBSTANCE ABUSE ISSUE AND IS PREPARED TO TAKE CARE OF THE SMALLEST AND MOST VULNERABLE OF OUR PATIENTS, THE NEWBORN BABY. TO SERVE THESE NEWBORN PATIENTS, PMC HAS INCREASED THE NEONATAL INTENSIVE CARE UNIT (NICU) TO INCLUDE 16 NEONATAL LEVEL II BASSINETS. PMC'S TENURED TEAM OF NEONATOLOGISTS AND HIGHLY SKILLED NURSES IS EQUIPPED TO BEGIN SPECIALIZED CARE WITHIN SECONDS OF BIRTH AND HAS ACHIEVED THE DESIGNATION OF ADVANCED CARE UNIT FOR PATIENTS BORN AT 28 WEEKS OF GESTATION OR WHO ARE RECOVERING FROM MORE SERIOUS CONDITIONS SUCH AS NAS OR NOWS. PIKEVILLE MEDICAL CENTER'S REGIONAL MARKET AREAS HAVE ECONOMICALLY DECLINED OVER THE PAST DECADE DUE TO VARIOUS REGULATORY AND OTHER ECONOMIC SITUATIONS ADVERSELY AFFECTING THE EMPLOYMENT RATE. THIS DECLINE HAS RESULTED IN A REDUCED OVERALL POPULATION ACROSS THE REGION DUE TO OUT-MIGRATION, IN ADDITION TO LOWER DISPOSABLE INCOME TO SPEND ON HEALTH CARE FOR THOSE REMAINING IN THE REGION. THE ECONOMIC DOWNTURN HAS RESULTED IN A SIGNIFICANT IMPACT ON THE OVERALL HEALTH OF THE GENERAL POPULATION OF THE REGION AND THE ORGANIZATIONS WHICH DELIVER THEIR CARE. PMC IS NOT, HOWEVER, EXPERIENCING A PATIENT SHORTAGE BUT A SKILLED WORKFORCE SHORTAGE. AS A RESULT OF THIS SHORTAGE, FROM THE GROWING DEMAND OF THE AGING POPULATION FOR HEALTHCARE SERVICES, PMC HAS SPEARHEADED AN INNOVATIVE INITIATIVE TO MEET THE NEED FOR A STRONG HEALTHCARE WORKFORCE ACROSS THE REGION. THE PMC PROJECT HEART (HEALTHCARE EMPLOYMENT AROUND REGIONAL TRAINING) INITIATIVE HAS FORMED AN EXCEPTIONAL TEAM OF COLLABORATIVE PARTNERS THAT CONSISTENTLY WORKS TOGETHER THROUGH INTEGRATED INITIATIVES THAT PRIORITIZE MOVING OUR REGION FORWARD, ON MULTIPLE FRONTS, TO MAXIMIZE THE TOTAL IMPACT WHILE BRIDGING TOGETHER THE STRENGTHS OF OTHERS TO CHALLENGE US TO THINK DIFFERENTLY ABOUT WHAT IS POSSIBLE WHEN WE UNITE AS ONE. PROJECT HEART IS THE LARGEST EFFORT TO SUPPORT JOB CREATION AND OPPORTUNITY IN EASTERN KENTUCKY SINCE THE EARLY 1970S AND HAS RESULTED IN THE DEVELOPMENT OF MULTIPLE STRATEGIES TO SERVE THE COMMUNITY, INCREASE TRAINING OPPORTUNITIES AND FURTHER DEVELOP OUR WORKFORCE, WITH THE ULTIMATE GOAL OF IMPROVING ACCESS TO ESSENTIAL HEALTHCARE SERVICES, RESULTING IN BETTER HEALTH, SOCIAL, AND ECONOMIC OUTCOMES FOR THE REGION. THE PROJECT PARTNERS HAVE MADE COMBINED INVESTMENTS TOTALING $26 MILLION IN PROGRAMS THAT WILL CREATE THOUSANDS OF SUSTAINABLE CAREER OPPORTUNITIES WITH GREAT BENEFITS HERE IN EASTERN KENTUCKY. PMC HAS WORKED WITH BIG SANDY COMMUNITY AND TECHNICAL COLLEGE, GALEN COLLEGE OF NURSING, UNIVERSITY OF PIKEVILLE'S ELLIOT SCHOOL OF NURSING AND AMERICAN NATIONAL UNIVERSITY TO EXPAND CAMPUS SPACE AND INCREASE CLASS SIZES, IN ADDITION TO OFFERING FELLOWSHIP PROGRAMS THAT PROVIDE FINANCIAL ASSISTANCE TO STUDENTS FOCUSING ON DEVELOPING MEDICAL SKILLS. PMC'S CONTINUED PARTNERSHIP WITH THESE POST-SECONDARY INSTITUTIONS ALONG WITH THE PMC IN-HOUSE TRAINING PROGRAMS DEVELOPED FOR CERTAIN POSITIONS INCLUDING PHLEBOTOMISTS, PATIENT CARE TECHNICIANS, AND MEDICAL ASSISTANTS, WHICH ALLOWS STUDENTS TO OBTAIN THEIR CERTIFICATIONS WHILE WORKING AT PMC, WILL SUBSTANTIALLY SOLVE THE PUBLIC HEALTH CRISIS OF INADEQUATE NURSING AND SKILLED HEALTHCARE STAFFING WHILE PROVIDING A PATH FOR THE YOUTH OF APPALACHIA TO PURSUE A REWARDING CAREER AND REMAIN IN THE AREA, WHICH IS CRITICAL FOR THE STABILITY OF OUR ENTIRE REGION. PIKEVILLE MEDICAL CENTER IS, AND WILL CONTINUE TO BE, THE CORPORATE LEADER TO DEVELOP EDUCATIONAL OPPORTUNITIES, ASSIST HEALTHCARE PROVIDERS AND CREATE HUNDREDS OF JOBS AROUND THE REGION. (CONTINUED)
SCHEDULE H PART VI, LINE 6	(CONTINUED)PIKEVILLE MEDICAL CENTER'S VISION TO BE THE REGION'S PROVIDER AND EMPLOYER OF CHOICE HAS NOT ONLY RESULTED IN THE EXPANSION OF HEALTH CARE SERVICES PROVIDED TO PATIENTS BUT HAS ALSO BEEN INTEGRAL IN ENHANCING THE HOSPITAL'S ABILITY TO PROVIDE COMMUNITY OUTREACH SERVICES. PMC PROVIDES A VARIETY OF EDUCATIONAL, WELLNESS, AND PREVENTIVE HEALTH SERVICES THAT ARE DERIVED FROM THE CORE OF PMC'S MISSION.

Schedule H (Form 990) 2022

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

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

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) CITY OF PIKEVILLE 234 MAIN STREET PIKEVILLE,KY41501	61-6001897	CITY OF PIKEVILLE	25,000	SPONSOR EVENT
(2) SOUTHEAST KENTUCKY CHAMBER OF COMMERCE 178 COLLEGE STREET PIKEVILLE,KY41501	61-0544068	501(C)(6)	22,500	SPONSOR EVENTS
(3) CEDAR INC PO BOX 2152 PIKEVILLE,KY41501	61-1244951	501(C)(3)	15,329	SPONSOR EVENTS
(4) PIKE COUNTY SCHOOL SYSTEM 316 SOUTH MAYO TRAIL PIKEVILLE,KY41501	61-6001345	PIKE COUNTY	10,000	SPONSOR EVENTS
(5) FIVCO AREA DEVELOPMENT DISTRICT 32 FIVCO COURT GRAYSON,KY41143	61-1874861	501(C)(2)	10,000	SPONSOR EVENT
(6) CHALLENGER LEARNING CENTER OF KENTUCKY INC PO BOX 2064 HAZARD,KY41702	31-1492348	501(C)(3)	7,000	SPONSOR PROGRAM

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2022

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) ASSISTANCE TO UNINSURED PATIENTS FOR PRESCRIPTIONS, TRANSPORTATION, MEDICAL EQUIPMENT, CANCER TREATMENT TRAVEL ASSISTANCE	477		49,104	463 RECIPIENTS OF 155 PRESCRIPTIONS PROVIDED, 376 INSTANCES OF TRAVEL ASSISTANCE, 9 MEDICAL EQUIPMENT PURCHASES/RENTALS, AND 14 RECIPIENTS OF LODGING AND OTHER FINANCIAL ASSISTANCE
(2) SCHOLARSHIPS	1	5,000		SUPPORT FOR TUITION
(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.

Schedule I (Form 990) 2022

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

PIKEVILLE MEDICAL CENTER INC

Employer identification number

61-0458376

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes on 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 .....

Yes

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 on Line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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:

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

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

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

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:

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

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

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

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

Yes

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 ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KEITH HALL MD ORTHOPEDIC SURGEON	(i) (ii)	980,232 ------------- 0	714,170 ------------- 0	450 ------------- 0	10,250 ------------- 0	31,755 ------------- 0	1,736,857 ------------- 0	0 ------------- 0
2KEVIN PUGH MD ORTHOPEDIC SURGEON	(i) (ii)	980,232 ------------- 0	634,151 ------------- 0	34,447 ------------- 0	10,250 ------------- 0	31,755 ------------- 0	1,690,835 ------------- 0	0 ------------- 0
3CHRISTOPHER REYNOLDS MD CARDIOLOGIST/ELECTROPHYSIOLOGIST	(i) (ii)	1,169,141 ------------- 0	0 ------------- 0	300 ------------- 0	10,250 ------------- 0	31,755 ------------- 0	1,211,446 ------------- 0	0 ------------- 0
4AYORINDE MEDAIYESE MD CRITICAL CARE PHYSICIAN	(i) (ii)	1,053,398 ------------- 0	0 ------------- 0	43,094 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	1,141,747 ------------- 0	0 ------------- 0
5DERMOT HALPIN MD CARDIOTHORACIC SURGEON	(i) (ii)	984,756 ------------- 0	0 ------------- 0	34,175 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	1,064,186 ------------- 0	0 ------------- 0
6WILLIAM D BLACKBURN BOARD CHAIR/PRESIDENT/CEO	(i) (ii)	883,911 ------------- 0	0 ------------- 0	61,300 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	990,466 ------------- 0	0 ------------- 0
7AARON CRUM MD EX-OFFICIO/CMO/ASST CEO	(i) (ii)	762,875 ------------- 0	0 ------------- 0	130,507 ------------- 0	13,000 ------------- 0	1,117 ------------- 0	907,499 ------------- 0	0 ------------- 0
8ERICH BLACKBURN EX-OFFICIO/CHIEF LEGAL OFF/SR. VP	(i) (ii)	477,641 ------------- 0	0 ------------- 0	1,408 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	524,304 ------------- 0	0 ------------- 0
9MICHELLE HAGY EX-OFFICIO/CFO/SR. VP FINANCE	(i) (ii)	390,171 ------------- 0	0 ------------- 0	30,511 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	465,937 ------------- 0	0 ------------- 0
10JOHN WATSON MD BOD/CHIEF OF STAFF/HOSPITALIST	(i) (ii)	316,850 ------------- 0	30,000 ------------- 0	23,641 ------------- 0	10,250 ------------- 0	31,755 ------------- 0	412,496 ------------- 0	0 ------------- 0
11KANSAS JUSTICE CHIEF OPERATING OFFICER-SR. VP	(i) (ii)	307,432 ------------- 0	0 ------------- 0	29,560 ------------- 0	10,250 ------------- 0	31,755 ------------- 0	378,997 ------------- 0	0 ------------- 0
12MICHELLE RAINEY CHIEF NURSING OFFICER-SR. VP	(i) (ii)	298,735 ------------- 0	0 ------------- 0	20,128 ------------- 0	13,500 ------------- 0	31,755 ------------- 0	364,118 ------------- 0	0 ------------- 0
13CHERYL HICKMAN CHIEF REGULATORY OFFICER-SR. VP	(i) (ii)	275,593 ------------- 0	0 ------------- 0	6,871 ------------- 0	9,649 ------------- 0	31,738 ------------- 0	323,851 ------------- 0	0 ------------- 0
14MELISSA THACKER CHIEF QUALITY OFFICER-SR. VP	(i) (ii)	253,330 ------------- 0	0 ------------- 0	24,535 ------------- 0	13,500 ------------- 0	1,078 ------------- 0	292,443 ------------- 0	0 ------------- 0
15TONY DAMRON CHIEF INFORMATION OFFICER-SR. VP	(i) (ii)	249,153 ------------- 0	0 ------------- 0	4,955 ------------- 0	6,478 ------------- 0	31,716 ------------- 0	292,302 ------------- 0	0 ------------- 0
16MARCUS CONLEY VP FINANCE	(i) (ii)	213,369 ------------- 0	500 ------------- 0	18,241 ------------- 0	5,944 ------------- 0	31,693 ------------- 0	269,747 ------------- 0	0 ------------- 0
17JUANITA DESKINS FORMER CHIEF OPERATING OFFICER	(i) (ii)	162,005 ------------- 0	0 ------------- 0	31,562 ------------- 0	8,500 ------------- 0	31,731 ------------- 0	233,798 ------------- 0	0 ------------- 0
18DAVID HALCOMB FORMER ASST. CFO	(i) (ii)	172,176 ------------- 0	500 ------------- 0	10,080 ------------- 0	7,509 ------------- 0	31,492 ------------- 0	221,757 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 1A	EXPENSES RELATED TO MEALS AND PORTERAGE FOR A TRAVEL COMPANION ATTENDING THE ANNUAL PMC BOARD RETREAT WERE APPROVED IN ADVANCE BY THE CEO AND REPORTED, AS APPLICABLE, AS A TAXABLE BENEFIT.
PART I, LINE 7	DR. PUGH'S AND DR. HALL'S PRODUCTIVITY BONUS IS BASED ON WRVU'S FOR SERVICES RENDERED IN EXCESS OF THEIR WRVU TARGET. DR. WATSON EARNED A QUARTERLY INCENTIVE BONUS FOR ACHIEVEMENT OF PROGRAM GOALS.

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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

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

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

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) ANDREA ANDERSON	DAUGHTER OF BOARD MEMBER	52,785	COMPENSATION		No
(2) ASHLEY JOHNSON	DAUGHTER OF BOARD MEMBER	98,551	COMPENSATION		No
(3) KIERSTEN WOODS SHURTLEFF	DAUGHTER-IN-LAW OF BOARD MEMBER	60,575	COMPENSATION		No
(4) MICHAEL CRUM MD	BROTHER OF CMO/BOARD MEMBER	152,450	COMPENSATION		No
(5) RHONDA BLACKBURN	SPOUSE OF CLO/EX-OFFICIO BOARD MEMBER	198,731	COMPENSATION		No
(6) ROBERT SHURTLEFF DO	SON OF BOARD MEMBER	208,000	COMPENSATION		No
(7) SARAH TAYLOR	DAUGHTER OF KEY EMPLOYEE	110,176	COMPENSATION		No
(8) SHELDON THACKER	SPOUSE OF KEY EMPLOYEE	117,245	COMPENSATION		No
(9) TRISTAN BLACKBURN	SON OF PMC PRESIDENT/CEO & BOARD CHAIRPERSON	129,482	COMPENSATION		No
(10) CHRISTIAN HAGY	SON OF PMC CFO/EX-OFFICIO BOARD MEMBER	75,788	COMPENSATION		No
(11) DEBRA BLACKBURN	SPOUSE OF PMC PRESIDENT/CEO & BOARD CHAIRPERSON	111,037	COMPENSATION		No
(12) AMY BLACKBURN	DAUGHTER-IN-LAW OF PMC PRESIDENT/CEO & BOARD CHAIRPERSON	38,689	COMPENSATION		No
(13) ANGELIA CRUM	SPOUSE OF CMO/BOARD MEMBER	37,651	COMPENSATION		No
(14) BRAXTON DAMRON	SON OF KEY EMPLOYEE	20,146	COMPENSATION		No
(15) BROOKE SHURTLEFF	DAUGHTER-IN-LAW OF BOARD MEMBER	27,889	COMPENSATION		No
(16) THOMAS BLACKBURN	SON OF CLO/EX-OFFICIO BOARD MEMBER	18,028	COMPENSATION		No
(17) AARON COLLINS	SON OF BOARD MEMBER	12,923	COMPENSATION		No
(18) ELIZABETH BURCHETT	SPOUSE OF BOARD MEMBER	24,360	COMPENSATION		No
(19) KETERAH WATSON	SPOUSE OF BOARD MEMBER	77,245	COMPENSATION		No
(20) MADISON RAINEY	DAUGHTER OF KEY EMPLOYEE	14,022	COMPENSATION		No
(21) MOUNTAIN TOP MEDIA LLC	SPOUSE OF BOARD MEMBER IS > 5% OWNER	111,927	COMPENSATION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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 B, LINE 11B	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. THE FINAL FORM 990 IS PROVIDED ELECTRONICALLY TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY.
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 HOSPITAL 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, ANCESTORS, CHILDREN, GRANDCHILDREN, GREAT 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 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 15	LINE 15A: THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE SALARY OF THE ORGANIZATION'S CEO. THE COMMITTEE USES COMPARATIVE DATA FROM NATIONAL SALARY SURVEYS AND FORM 990 OF OTHER SIMILAR ORGANIZATIONS. MOTIONS AND APPROVALS FROM THE COMMITTEE ARE DOCUMENTED AND KEPT IN THE BOARD MINUTES. THE SALARY IS ALSO INDEPENDENTLY REVIEWED WITH AN OPINION RENDERED BY AN EXTERNAL CONSULTING FIRM. THE PROCESS FOR REVIEW OF SALARIES IS PERFORMED ANNUALLY. LINE 15B: THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE SALARY OF THE ORGANIZATION'S OTHER OFFICERS/SENIOR VICE PRESIDENTS. THE COMMITTEE USES COMPARATIVE DATA FROM NATIONAL SALARY SURVEYS. MOTIONS AND APPROVALS FROM THE COMMITTEE ARE DOCUMENTED AND KEPT IN THE BOARD MINUTES. THE SALARY OF THE ASSISTANT CEO/CMO IS ALSO INDEPENDENTLY REVIEWED WITH AN OPINION RENDERED BY AN EXTERNAL CONSULTING FIRM.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES THE FORM 990, WHICH INCLUDES THE ANNUAL AUDITED FINANCIAL STATEMENTS, AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 31,505,708. MANAGEMENT AND GENERAL EXPENSES 3,890,803. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,396,511. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,465,735. MANAGEMENT AND GENERAL EXPENSES 1,045,477. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,511,212. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 16,300,776. MANAGEMENT AND GENERAL EXPENSES 2,013,067. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,313,843.
FORM 990, PART III, LINE 4A	(CONTINUED) THE INVESTMENT IN THE CONSTRUCTION AND EQUIPMENT FOR SENSORY ACTIVITIES AREA TOTALED $1.07 MILLION. PMC ALSO COMPLETED CONSTRUCTION RENOVATION OF THE AVA CENTER PRESTONSBURG CAMPUS DURING FY 2023. THE NEWLY OPENED PRESTONSBURG LOCATION IS A 5,500 SQUARE FOOT SATELLITE CENTER THAT FEATURES AN OCEAN THEME WITH 12 MULTIPLE LEARNING ROOMS, A FEEDING ROOM AND TWO SPECIALLY DESIGNED SENSORY STIMULATION ACTIVITY ROOMS. THIS CENTER ALLOWS PMC THERAPISTS TO PROVIDE SERVICES FOR 24 ADDITIONAL LEARNERS, OFFERING THE SAME SPECIALIZED SERVICES THAT ARE AVAILABLE AT THE PIKEVILLE LOCATION WHILE ACCOMMODATING THE GROWING NEED FOR AUTISM SERVICES IN EASTERN KENTUCKY. THE TOTAL INVESTMENT IN RENOVATIONS FOR THE AVA CENTER PRESTONSBURG CAMPUS WAS $2.1 MILLION. PIKEVILLE MEDICAL CENTER'S PRIMARY CARE AND FAMILY MEDICINE TEAM PROVIDES COMPREHENSIVE CARE FOR ALL GENERATIONS. BETTER HEALTH STARTS WITH A FAMILY DOCTOR, PMC'S EXPERIENCED FAMILY MEDICINE TEAM DOES MUCH MORE THAN TREAT PATIENTS WHEN SICK, THE TEAM FOCUSES ON ENCOURAGING PREVENTATIVE CARE AND A HEALTHY LIFESTYLE WHILE ALSO MANAGING CARE WHEN THERE IS A CHRONIC HEALTH CONCERN BY OPENING DOORS TO SPECIALIZED SERVICES IF THEY ARE NEEDED. TO IMPROVE ACCESS TO PIKEVILLE MEDICAL CENTER'S PRIMARY CARE TEAM; INCLUDING PEDIATRICS, ADULT PRIMARY CARE, AND URGENT CARE SPECIALISTS, PMC RECENTLY OPENED THE NEW URGENT CARE & FAMILY WELLNESS CENTER. THE RENOVATED 14,600 SQUARE FOOT OF SPACE IS IN A CONVENIENT LOCATION AND INCLUDES 14 YOUTH-THEMED EXAM ROOMS, 25 ADULT/URGENT CARE EXAM ROOMS, 14 PROVIDER WORKSTATIONS, NURSE STATIONS, AN ON-SITE LABORATORY FOR SPECIMEN COLLECTION, ON-SITE X-RAY SERVICES, AND RECEPTION/WAITING ROOMS. THE URGENT CARE AT PIKEVILLE NORTH IS OPEN 12 HOURS A DAY SEVEN DAYS A WEEK TO TREAT INJURIES, COMMON MEDICAL CONDITIONS, AND ILLNESSES. THE TOTAL CAPITAL INVESTMENT IN THE URGENT CARE & FAMILY WELLNESS CENTER EQUIPMENT AND RENOVATIONS TOTALED $3.7 MILLION. THE PMC ORTHOPEDIC SURGERY & SPORTS MEDICINE INSTITUTE OF EASTERN KENTUCKY, LOCATED IN THE PMC CLINIC BUILDING, INCLUDES THE SPECIALTIES OF FOOT AND ANKLE SURGERY, HAND SURGERY, ORTHOPEDIC JOINT SURGERY, ORTHOPEDIC TRAUMA SURGERY, PODIATRY, AND SPORTS MEDICINE. THE ORTHOPEDIC TEAM UTILIZES THE LATEST TECHNOLOGY, INCLUDING ULTRASOUND-GUIDED INJECTIONS AND DIGITAL X-RAYS TO OFFER PATIENTS THE MOST ADVANCED PROCEDURES CURRENTLY AVAILABLE, SUCH AS DIRECT ANTERIOR HIP REPLACEMENTS, PARTIAL KNEE REPLACEMENTS, SHOULDER REPLACEMENTS, ANATOMIC ACL SURGERY, ARTHROSCOPIC ROTATOR CUFF REPAIR, TOTAL HIP AND TOTAL KNEE REPLACEMENTS. THE ORTHOPEDIC SURGERY & SPORTS MEDICINE INSTITUTE HAS RECEIVED THE GOLD SEAL OF DISTINCTION FOR HIP FRACTURE, JOINT REPLACEMENT HIP, AND JOINT REPLACEMENT KNEE FROM THE JOINT COMMISSION, RECOGNIZING THE TEAM'S COMMITMENT TO MEDICAL EXCELLENCE. PMC IS THE ONLY HOSPITAL IN KENTUCKY TO RECEIVE ALL THREE CERTIFICATIONS. THE ORTHOPEDIC CLINIC SPECIALISTS COMPLETED 36,189 PATIENT VISITS DURING FY 2023.
FORM 990, PART III, LINE 4D	(CONTINUED) PIKEVILLE MEDICAL CENTER COMPLETED AN UPGRADE TO THE NIHON KHODEN TELEMETRY MONITORING SYSTEM DURING FY 2023. THE HOUSE WIDE UPGRADE INCLUDED THE REPLACEMENT OF CENTRAL STATION MONITORS, REMOTE STATION MONITORS, PRINTERS, TRANSMITTERS AND OTHER PERIPHERAL EQUIPMENT THROUGHOUT THE CENTRALIZED TELEMETRY MONITORING AREA, CRITICAL CARE UNITS, MEDICAL UNITS AND SURGICAL SERVICES DEPARTMENTS. THIS UPGRADE INCLUDED FEATURES FOR MORE RAPID VIEWING OF PATIENT RHYTHM EVENTS BY CARDIOLOGISTS, IN ADDITION TO IMPROVED INTEGRATION WITH THE NEW EPIC ELECTRONIC MEDICAL RECORD SYSTEM. THE CAPITAL INVESTMENT IN THE NIHON KHODEN UPGRADE WAS $1.4 MILLION. NATIONAL RECOGNITION: PIKEVILLE MEDICAL CENTER (PMC) STRIVES TO BE THE PROVIDER OF CHOICE FOR QUALITY HEALTHCARE THROUGHOUT CENTRAL APPALACHIA. TO ENSURE THAT QUALITY, PMC CONSISTENTLY PURSUES MULTIPLE DESIGNATIONS AND HAS EARNED THE FOLLOWING AWARDS AND RECOGNITIONS DURING FY 2023. SEPTEMBER '23 PMC PULMONARY REHABILITATION PROGRAM CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION; PMC LABORATORY RE-CERTIFIED BY THE ACCREDITATION COMMITTEE OF THE COLLEGE OF AMERICAN PATHOLOGISTS; PMC AVA CENTER AND METTU CHILDREN'S HOSPITAL RECEIVED RECOGNITION FROM THE SOUTHEAST KENTUCKY CHAMBER OF COMMERCE FOR OUTSTANDING CONTRIBUTION; PMC PRESENTED WITH THE EPIC GOOD INSTALL AWARD; PMC NAMED TO THE FORBES LIST OF BEST-IN-STATE EMPLOYERS. AUGUST '23 PMC CARDIAC REHABILITATION PROGRAM CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. JULY '23 PMC SPECIALTY PHARMACY SERVICES RECEIVED ACCREDITATION FROM THE ACCREDITATION COMMISSION FOR HEALTH CARE; PMC RECEIVED THE AMERICAN HEART ASSOCIATION'S MISSION: LIFELINE STEMI RECEIVING CENTER BRONZE RECOGNITION. JUNE '23 PMC RECEIVED AMERICAN COLLEGE OF CARDIOLOGY CHEST PAIN MI REGISTRY PLATINUM PERFORMANCE ACHIEVEMENT AWARD. FEBRUARY '23 PMC URGENT CARE & FAMILY WELLNESS CENTER RECOGNIZED AS A CERTIFIED AUTISM CENTER (CAC) BY THE INTERNATIONAL BOARD OF CREDENTIALING AND CONTINUING EDUCATION STANDARDS. JANUARY '23 PMC NAMED PRESS GANEY HUMAN EXPERIENCE (HX) GUARDIAN OF EXCELLENCE AWARD WINNER. DECEMBER '22 PMC RECEIVED WOMEN'S CHOICE AWARDS BEST HOSPITALS FOR EMERGENCY CARE AND BEST HOSPITAL FOR CANCER CARE; PMC LAWSON CANCER CENTER RECEIVED AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER RE-ACCREDITATION OCTOBER '22 PMC RECEIVED JOINT COMMISSION HIP FRACTURE, HIP AND KNEE REPLACEMENT RE-CERTIFICATION.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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?
(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	Yes	No
(1)PIKEVILLE MEDICAL CENTER FOUNDATION FOR QUALITY HEALTHCARE 911 BYPASS ROAD PIKEVILLE,KY41501 47-2020718	SUPPORT OF PIKEVILLE MEDICAL CENTER, INC.	KY	501(C)(3)	LINE 12B, II	PIKEVILLE MEDICAL CENTER INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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?
(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	Yes	No
(1) PIKEVILLE MEDICAL DEVELOPMENT CORPORATION 911 BYPASS ROAD PIKEVILLE,KY41501 20-2487928	INACTIVE	KY	N/A	C	-169	6,498	100.000 %	Yes
(2) LANDMARK PROPERTIES OF PIKEVILLE INC PO BOX 1259 PIKEVILLE,KY41502 46-2494613	LODGING	KY	PIKEVILLE MEDICAL CENTER INC	C	197,840	4,134,537	100.000 %	Yes

Schedule R (Form 990) 2021

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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 OF PIKEVILLE INC	J	16,788	COST
(2) LANDMARK PROPERTIES OF PIKEVILLE INC	M	190,000	COST
(3) LANDMARK PROPERTIES OF PIKEVILLE INC	P	55,165	COST
(4) LANDMARK PROPERTIES OF PIKEVILLE INC	Q	967,942	CASH
(5) PIKEVILLE MEDICAL CENTER FOUNDATION FOR QUALITY HEALTHCARE INC	C	529,670	CASH
(6) PIKEVILLE MEDICAL CENTER FOUNDATION FOR QUALITY HEALTHCARE INC	Q	298,390	CASH

Schedule R (Form 990) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE CENTER'S MISSION IS TO ADVANCE THE HEALTH AND WELL-BEING OF OUR REGION THROUGH COMPREHENSIVE CARE IN A CHRISTIAN ENVIRONMENT.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
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 2021 (Part V, line 2a) ......	5	3,884
6	Total number of volunteers (estimate if necessary) .............	6	185
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,344,167
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,191,510

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	31,064,636	6,667,394
9	Program service revenue (Part VIII, line 2g) .........	554,194,879	598,099,939
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,078,332	7,093,247
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	28,271,123	40,919,830
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	616,608,970	652,780,410
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	336,287	192,545
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)	333,721,475	327,557,003
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	289,109,628	295,502,376
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	623,167,390	623,251,924
19	Revenue less expenses. Subtract line 18 from line 12.......	-6,558,420	29,528,486
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	670,121,229	671,107,372
21	Total liabilities (Part X, line 26).............	351,963,401	315,762,040
22	Net assets or fund balances. Subtract line 21 from line 20.....	318,157,828	355,345,332

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 145,950,647 including grants of $ ) (Revenue $ 60,128,307 )
	PHYSICIAN PRACTICES:CURRENTLY, MORE THAN 400 CREDENTIALED HEALTHCARE PROVIDERS; INCLUDING PHYSICIANS, ADVANCED PRACTICE REGISTERED NURSES, AND PHYSICIAN ASSISTANTS, ARE MEMBERS OF PIKEVILLE MEDICAL CENTER'S MEDICAL STAFF. DURING FY 2023, PIKEVILLE MEDICAL CENTER (PMC) WELCOMED 21 PHYSICIANS, EIGHT NURSE PRACTITIONERS AND ONE CERTIFIED REGISTERED NURSE ANESTHETIST TO THE ORGANIZATION. THE PHYSICIANS RECRUITED DURING THIS TIME CONSIST OF ONE ANESTHESIOLOGIST, ONE CARDIOTHORACIC SURGEON, FOUR CARDIOLOGISTS, ONE CRITICAL CARE PHYSICIAN, TWO ELECTROPHYSIOLOGISTS, TWO HOSPITALISTS, ONE OTOLARYNGOLOGIST/FACIAL TRAUMA SURGEON, ONE PEDIATRIC HOSPITALIST, ONE PEDIATRICIAN, ONE PODIATRIC SURGEON, ONE INTERNAL MEDICINE PHYSICIAN, ONE RHEUMATOLOGIST, THREE ACUTE CARE SURGEONS AND ONE VASCULAR SURGEON. PMC'S 11-STORY CLINIC BUILDING LOCATED ON THE HOSPITAL'S MAIN CAMPUS HOUSES THE MAJORITY OF THE ORGANIZATION'S PHYSICIAN PRACTICES INCLUDING TRAUMA SURGERY, GENERAL SURGERY, BARIATRIC AND WEIGHT LOSS SURGERY, ENDOCRINOLOGY, INTERVENTIONAL RADIOLOGY, GASTROENTEROLOGY, UROLOGY, ORTHOPEDIC TRAUMA SURGERY, ORTHOPEDIC SURGERY, HAND SURGERY, PODIATRY, SPORTS MEDICINE, OBSTETRICS/GYNECOLOGY, INFECTIOUS DISEASE, NEPHROLOGY, NEUROLOGY, NEUROSURGERY, PHYSIATRY, PULMONOLOGY, OPHTHALMOLOGY, OPTOMETRY, OTOLARYNGOLOGY, AUDIOLOGY, RHEUMATOLOGY, SLEEP MEDICINE, MEDICAL ONCOLOGY, HEMATOLOGY AND SURGICAL ONCOLOGY. PMC OFFERS MORE THAN 400 SERVICES, INCLUDING MOST MAJOR SPECIALTIES AND MANY SUB-SPECIALTIES AND PROVIDES THE TEAM OF, HIGHLY SKILLED, DEDICATED PHYSICIANS WITH THE STATE-OF-THE ART TECHNOLOGY AND HIGHLY MOTIVATED SUPPORT STAFF NECESSARY TO PROVIDE QUALITY COMPREHENSIVE HEALTHCARE TO THE REGION.IN ADDITION TO PHYSICIAN PRACTICES FOUND IN THE CLINIC, PMC OFFERS: PEDIATRICS IN PIKEVILLE (KY); PEDIATRIC PSYCHIATRY IN PIKEVILLE (KY), PLASTIC SURGERY IN PIKEVILLE (KY); DERMATOLOGY IN PIKEVILLE (KY); CARDIOTHORACIC AND VASCULAR SURGERY IN PIKEVILLE (KY); CARDIOLOGY--GENERAL/INVASIVE/INTERVENTIONAL/ELECTROPHYSIOLOGY IN PIKEVILLE, WHITESBURG, PRESTONSBURG, SOUTH WILLIAMSON (KY) AND GRUNDY (VA); RADIATION ONCOLOGY IN PIKEVILLE (KY); NEUROLOGY IN WHITESBURG, SOUTH WILLIAMSON, AND PRESTONSBURG (KY); PRIMARY CARE MEDICINE IN PIKEVILLE, PRESTONSBURG, AND SOUTH WILLIAMSON (KY); OBSTETRICS/GYNECOLOGY IN PIKEVILLE (KY); URGENT CARE SERVICES IN PIKEVILLE AND PRESTONSBURG (KY); SCHOOL TELEHEALTH SERVICES IN PIKE COUNTY (KY); APPLIED BEHAVIOR ANALYSIS SERVICES IN PIKEVILLE (KY) AND PRESTONSBURG (KY); PSYCHOLOGY; WOUND CARE; CARDIAC REHABILITATION AND PULMONARY REHABILITATION IN PIKEVILLE (KY).PMC ALSO OFFERS EMERGENCY MEDICINE SERVICES, PALLIATIVE CARE SERVICES, AND UTILIZES AROUND-THE-CLOCK HOSPITALISTS, INTENSIVISTS AND NEONATOLOGISTS WHO DEVOTE THEIR PROFESSIONAL TIME TO THE CARE OF HOSPITALIZED PATIENTS.PMC PHYSICIANS COMPLETED 301,439 PATIENT CLINIC VISITS DURING FY 2023. PHYSICIAN PRACTICE LOCATIONS WITH NOTABLE ACTIVITY DURING THE YEAR: AVA CENTER PRACTICE-PIKEVILLE COMPLETED 13,685 LEARNER VISITS, AVA CENTER PRACTICE-PRESTONSBURG COMPLETED 2,328 LEARNER VISITS, CARDIOLOGY PRACTICE-PIKEVILLE COMPLETED 20,983 PATIENT VISITS, ONCOLOGY PRACTICE-PIKEVILLE COMPLETED 10,907 PATIENT VISITS, PEDIATRIC PRACTICE-PIKEVILLE COMPLETED 12,422 PATIENT VISITS, PRIMARY CARE PRACTICE-PIKEVILLE COMPLETED 11,886 PATIENT VISITS, PRIMARY CARE PRACTICE-PRESTONSBURG COMPLETED 7,378 PATIENT VISITS, PRIMARY CARE PRACTICE-SOUTH WILLIAMSON COMPLETED 3,932 PATIENT VISITS, RHEUMATOLOGY PRACTICE-PIKEVILLE COMPLETED 5,374 PATIENT VISITS, SCHOOL TELEHEALTH PROGRAM COMPLETED 371 TELEHEALTH PATIENT VISITS, URGENT CARE PRACTICE-PIKEVILLE COMPLETED 21,067 PATIENT VISITS AND URGENT CARE PRACTICE-PRESTONSBURG COMPLETED 8,652 PATIENT VISITS. THE PIKEVILLE MEDICAL CENTER HEART AND VASCULAR INSTITUTE OF EASTERN KENTUCKY (HVI) IS COMPRISED OF A TEAM OF CARDIAC SPECIALISTS WITH A BROAD RANGE OF EXPERTISE; THAT EXPERTISE, COUPLED WITH CUTTING-EDGE TECHNOLOGY HAS RESULTED IN A COMPREHENSIVE HEART CARE PROGRAM FOR THE PEOPLE OF THE REGION THAT IS SECOND TO NONE. THE HVI IS ACCREDITED BY THE AMERICAN HEART ASSOCIATION AND THE AMERICAN COLLEGE OF CARDIOLOGY IN HEART ATTACK TREATMENT, CARDIAC CATH LAB PERCUTANEOUS CORONARY INTERVENTION (PCI) ACCREDITATION, AND CHEST PAIN WITH PCI, IN ADDITION TO OFFERING AN AACVPR CERTIFIED CARDIAC REHABILITATION PROGRAM. THE HEART AND VASCULAR INSTITUTE TEAM PROVIDES A WIDE RANGE OF SERVICES TO ADDRESS VARIOUS CARDIOVASCULAR CONCERNS, FROM ROUTINE CHECK-UPS TO THE MANAGEMENT OF COMPLEX HEART CONDITIONS, GUIDING THE PATIENT THROUGH EVERY STEP OF THEIR HEART HEALTH JOURNEY. CARDIAC SERVICES OFFERED BY PMC INCLUDE GENERAL CARDIOLOGY, INVASIVE CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, ELECTROPHYSIOLOGY, CARDIOTHORACIC SURGERY, VASCULAR/ENDOVASCULAR SURGERY, ECHOCARDIOGRAPHY, AND CARDIAC REHABILITATION. THE PMC HEART AND VASCULAR INSTITUTE OCCUPIES 49,000 SQUARE FEET OF RECENTLY RENOVATED SPACE LOCATED ON THE HOSPITAL'S MAIN CAMPUS. THE AREA PROVIDES A FUNCTIONAL FLOW FOR IMPROVED PATIENT ACCESS INCLUDING A NEW REGISTRATION AREA, 29 EXAM ROOMS, TWO WAITING ROOMS AND INCLUDES THREE NEW STATE-OF-THE-ART INTERVENTIONAL CARDIAC CATHETERIZATION (CATH) LABS, TWO NEW ELECTROPHYSIOLOGY CATH LABS, SIX PRE/POST-OPERATIVE BAYS AND A MULTIPURPOSE CASE CONFERENCE ROOM. THE CAPITAL INVESTMENT IN THE HEART AND VASCULAR INSTITUTE RENOVATION AND EXPANSION WAS MORE THAN $35.2 MILLION.PIKEVILLE MEDICAL CENTER'S METTU CHILDREN'S HOSPITAL OPENED DURING FY 2022. THE NEWLY RENOVATED 13,400 SQUARE FEET OF SPACE HOUSES EASTERN KENTUCKY'S ONLY CHILDREN'S HOSPITAL, OFFERING BOTH INPATIENT AND OUTPATIENT PEDIATRIC SERVICES. THE CHILDREN'S HOSPITAL FILLS A GAP IN PROVIDING MUCH-NEEDED PEDIATRIC HEALTHCARE FOR THE REGION, ALLOWING FAMILIES TO STAY CLOSE TO HOME FOR SPECIALIZED PEDIATRIC CARE, THUS GREATLY REDUCING THE FINANCIAL BURDEN THAT COMES WITH TRAVELING TO HOSPITALS HUNDREDS OF MILES AWAY. THE CHILDREN'S HOSPITAL IS STAFFED BY PEDIATRIC HOSPITALISTS AND PEDIATRIC NURSES SPECIALLY TRAINED IN INPATIENT PEDIATRIC CARE. INPATIENT SERVICES ARE LOCATED IN AN 8,130 SQ FT AREA CONSISTING OF A FAMILY-FRIENDLY WAITING ROOM, 10 PRIVATE PATIENT ROOMS (INCLUDING TWO ISOLATION ROOMS), A CONSULTATION ROOM, A TREATMENT ROOM, MEDICATION ROOM, NOURISHMENT ROOM AND MORE. THE OUTPATIENT SERVICE AREA IS LOCATED IN A 5,290 SQ FT AREA CONSISTING OF SEPARATE SICK AND WELL CHILD WAITING ROOMS, CHECK-IN AND REGISTRATION AREAS, 13 EXAM ROOMS, A MEDICATION ROOM, AND A NURSE'S STATION. THIS NEW PEDIATRIC FACILITY HAS PROVIDED PMC WITH THE CAPACITY TO OFFER PEDIATRIC CARDIOLOGY, PULMONOLOGY, BMI, AND PLASTICS SPECIALTY SERVICES THROUGH A COOPERATIVE AGREEMENT WITH THE UNIVERSITY OF KENTUCKY CHILDREN'S HOSPITAL AT THE METTU CHILDREN'S HOSPITAL LOCATED ON PMC'S MAIN CAMPUS IN PIKEVILLE, KY. THESE NEW PEDIATRIC SERVICES BRIDGE THE GAP TO ENSURE ALL CHILDREN AND FAMILIES HAVE ADEQUATE ACCESS TO SPECIALIZED PEDIATRIC CARE. THE CAPITAL INVESTMENT IN THE CHILDREN'S HOSPITAL WAS MORE THAN $6.3 MILLION.THE PMC APPALACHIAN VALLEY AUTISM (AVA) CENTER IS A CERTIFIED AUTISM CENTER BY THE INTERNATIONAL BOARD OF CREDENTIALING AND CONTINUING EDUCATION STANDARDS SPECTRUM DISORDER (ASD). AS THE FIRST COMPREHENSIVE CENTER OF ITS KIND IN EASTERN KENTUCKY, THE AVA CENTER, WITH LOCATIONS IN PIKEVILLE, KY AND PRESTONSBURG, KY, OFFERS APPLIED BEHAVIOR ANALYSIS (ABA) THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, AND FEEDING THERAPIES FOR CHILDREN ON THE AUTISM SPECTRUM BETWEEN THE AGES OF 2 AND 12. THE PROGRAM STRIVES TO IDENTIFY CHILDREN AT THE EARLIEST SIGNS OF DETECTION, PROVIDE INTEGRATED CARE TO SUPPORT THE BEST POSSIBLE QUALITY OF LIFE FOR CHILDREN WITH ASD AND THEIR FAMILIES AND HELP CHILDREN WITH ASD REACH THEIR FULL POTENTIAL. THE SPECIALIZED EARLY INTERVENTION AND TREATMENT PROVIDED BY THE SPECIFICALLY TRAINED THERAPISTS AT THE AVA CENTER HAVE PROVEN EFFECTIVE IN INCREASING COMMUNICATION SKILLS, IMPROVING ATTENTION, AND DECREASING PROBLEM BEHAVIORS. THE PMC AVA CENTER PIKEVILLE CAMPUS OCCUPIES MORE THAN 25,000 SQ FT OF SPACE IN THE HEALTH & WELL-BEING LEARNING CENTER AND HAS THE CAPACITY TO SERVE UP TO 100 LEARNERS. A NEW OUTDOOR SENSORY ACTIVITIES AREA HAS BEEN CONSTRUCTED AT THE AVA CENTER PIKEVILLE CAMPUS, THIS AREA CONTAINS SENSORY-FRIENDLY PLAY AND LEARNING ACTIVITIES TO HELP LEARNERS RELAX AND FOCUS, WHICH PROMOTES NATURAL PLAY AND THE DEVELOPMENT OF SOCIAL LEARNING SKILLS SUCH AS NEGOTIATING, PLANNING, AND SHARING. ADAPTIVE EQUIPMENT, INCLUDED IN THE SENSORY ACTIVITIES AREA, DESIGNED FOR CHILDREN ON THE AUTISM SPECTRUM ALSO ENHANCES SOCIAL INTERACTIONS, COMMUNICATION, MOTOR CONTROL AND COORDINATION OR PHYSICAL HEALTH, WHICH SUPPORTS THE OVERALL THERAPY PROCESS. (CONTINUED ON SCH O)

4b	(Code: ) (Expenses $ 16,112,757 including grants of $ ) (Revenue $ 58,967,979 )
	IMAGING SERVICES:PIKEVILLE MEDICAL CENTER'S IMAGING SERVICES DIVISION OFFERS SOME OF THE MOST ADVANCED MEDICAL IMAGING AVAILABLE IN THE MODALITIES OF DIAGNOSTIC IMAGING, NUCLEAR MEDICINE, MAGNETIC RESONANCE IMAGING (MRI), COMPUTED TOMOGRAPHY (CT), POSITRON EMISSION TOMOGRAPHY (PET), MAMMOGRAPHY, AND ULTRASOUND. PMC'S IMAGING SERVICES HAS RECEIVED THREE-YEAR ACCREDITATION FROM THE AMERICAN COLLEGE OF RADIOLOGY, RECOGNIZED AS THE GOLD STANDARD IN DIAGNOSTIC IMAGING. THIS ACCREDITATION CERTIFIES THE IMAGING SERVICES DIVISION'S COMMITMENT TO IMAGE QUALITY, EQUIPMENT PERFORMANCE, SAFETY STANDARDS FOR STAFF AND PATIENTS, QUALITY ASSURANCE AND QUALITY CONTROL PROGRAMS, AS WELL AS STRICT PERSONNEL QUALIFICATIONS FOR BOTH PHYSICIANS AND TECHNOLOGISTS. CURRENT DIAGNOSTIC IMAGING EQUIPMENT INCLUDES TWO 3D MAMMOGRAPHY MACHINES, A DIGITAL PET/CT SCANNER, ONE 3T MRI, TWO 1.5T MRI SCANNERS, TWO FLASH CT SCANNERS, TWO 64 SLICE CT SCANNERS, THREE ULTRASOUND UNITS, SIX GENERAL X-RAY UNITS AND THREE NUCLEAR MEDICINE SCANNERS.PMC'S DIAGNOSTIC CENTER PROVIDES A LOCATION FOR PATIENTS TO OBTAIN A FULL RANGE OF ADVANCED OUTPATIENT DIAGNOSTIC IMAGING SERVICES IN AN "ALL-IN-ONE" SETTING FOR IMAGING SERVICES, LAB WORK, AND EKGS WITH EXTENDED SERVICE HOURS AND CONVENIENT PARKING. SINCE OPENING, THE DIAGNOSTIC CENTER HAS GONE THROUGH SEVERAL PERIODS OF RENOVATION TO ACCOMMODATE NEW EQUIPMENT AND TECHNOLOGY, THE MOST RECENT OF WHICH WAS COMPLETED IN 2023. THE FRONT LOBBY OF THE DIAGNOSTIC CENTER WAS EXPANDED TO INCREASE SEATING CAPACITY FOR PATIENTS AND A HOLOGIC HORIZON A BONE DENSITY SCANNER WAS INSTALLED TO MONITOR A PATIENT FOLLOWING THE ADMINISTRATION OF CERTAIN MEDICATIONS OR TO MEASURE THE SUCCESS OF VARIOUS TREATMENT TECHNIQUES. IN ADDITION, A NEWLY REMODELED BREAST CARE AREA WILL OFFER THE LATEST TECHNOLOGY IN 3D MAMMOGRAPHY, INCLUDING THE INSTALLATION OF A THIRD 3D MAMMOGRAPHY SYSTEM AND STATE-OF-THE-ART AI TECHNOLOGY SOFTWARE TO RAPIDLY AND ACCURATELY ANALYZE EACH 3D MAMMOGRAPHY IMAGE TO IDENTIFY POTENTIAL CANCEROUS TUMORS WITH PINPOINT ACCURACY IS SCHEDULED TO OPEN DURING 2024. THE TOTAL ANTICIPATED CAPITAL INVESTMENT IN THIS PHASE OF THE DIAGNOSTIC CENTER EXPANSION INCLUDING EQUIPMENT IS $2.1 MILLION.PMC'S IMAGING SERVICES HAS RECENTLY REACHED ANOTHER MILESTONE BY PERFORMING THE REGION'S FIRST PET SCAN DESIGNED SPECIFICALLY TO DETECT PROSTATE CANCER. THIS LATEST IN PET SCAN TECHNOLOGY UTILIZING ILLUCCIX RADIOACTIVE ISOTOPES ON THE NEWLY INSTALLED PHILIPS VEREOS DIGITAL PET/CT SCANNER IS PARTICULARLY BENEFICIAL TO UROLOGISTS TREATING PATIENTS WHO ARE AT HIGH RISK OF OR SUSPECTED OF HAVING PROSTATE CANCER BY OFFERING AN ADVANCED TOOL TO EXPEDITE A CANCER DIAGNOSIS AND TREATMENT, LEADING TO IMPROVED PATIENT OUTCOMES.DURING FY 2023 PMC PURCHASED TWO EPIQ CVX ULTRASOUND SYSTEMS, THE EPIQ PROVIDES PREMIUM 3D ECHO, DELIVERING AN UNCOMPROMISED LEVEL OF CLINICAL PERFORMANCE. THE SYSTEMS UTILIZE A LEADING-EDGE ANATOMICAL INTELLIGENCE PLATFORM DESIGNED FOR THE MOST DEMANDING OF CARDIOLOGY APPLICATIONS, SIGNIFYING PMC'S COMMITMENT TO CONTINUALLY UPGRADE TECHNOLOGY AND EQUIPMENT TO PROVIDE SPECIALIZED, ADVANCED, AND COMPREHENSIVE CARE IN AN EVER-ADVANCING DIAGNOSTIC IMAGING HEALTHCARE ENVIRONMENT. THIS EQUIPMENT INVESTMENT TOTALED $507,398.

4c	(Code: ) (Expenses $ 35,420,933 including grants of $ ) (Revenue $ 58,732,653 )
	ONCOLOGY SERVICES: PIKEVILLE MEDICAL CENTER'S LAWSON CANCER CENTER (LCC) HAS THE EXPERTISE AND LEADING-EDGE TECHNOLOGY TO FIGHT CANCER TODAY. WITH CAPABILITIES TO PROVIDE FULL-SERVICE CANCER TREATMENT AND FOLLOW-UP CARE, THE LAWSON CANCER CENTER IS ONE OF A SELECT FEW CANCER CENTERS IN KENTUCKY TO HOLD ACCREDITATION FROM THE COMMISSION ON CANCER WITH COMMENDATIONS. LCC IS STAFFED BY EXPERT ONCOLOGISTS, SURGICAL SPECIALISTS, NURSES, PHARMACISTS, PATIENT NAVIGATORS, AND MANY OTHER HIGHLY TRAINED HEALTHCARE PROFESSIONALS PROVIDING SERVICES IN A CONVENIENT AND COMPASSIONATE SETTING, ALLOWING PATIENTS ACROSS THE REGION TO RECEIVE ADVANCED CANCER CARE CLOSE TO HOME. THIS MULTIDISCIPLINARY APPROACH BRINGS TOGETHER A DIVERSE GROUP OF PATIENT CARE PROVIDERS TO EXAMINE AND DISCUSS THE PATIENT'S DIAGNOSIS, MEDICAL HISTORY, PREFERENCES, AND EMOTIONAL NEEDS TO COLLABORATE AND TAILOR SPECIFIC TREATMENT PLANS UNIQUE TO EACH PATIENT. THE LAWSON CANCER CENTER IS LOCATED ON THE PMC MAIN CAMPUS WHICH ALLOWS ENHANCED ACCESS AND CONVENIENCE FOR THE PATIENT BY PROVIDING ALL THEIR SERVICES AND PROVIDERS IN ONE LOCATION INCLUDING IMAGING, DIAGNOSTICS, CHEMOTHERAPY, INFUSION, AND RADIATION THERAPY; AS WELL AS GENETIC COUNSELING, FINANCIAL COUNSELING AND PATIENT NAVIGATION. HAVING ALL SERVICES IN ONE LOCATION ALLOWS FOR NOT ONLY EFFICIENCY FOR CLINICIANS, BUT ALSO EASE OF ACCESS FOR PATIENTS, WHICH CAN IMPROVE OUTCOMES. AS A RESULT OF THE INCREASED DEMAND FOR CANCER TREATMENT SERVICES, PMC COMPLETED AN ADDITIONAL 7,085 SQUARE FEET EXPANSION OF THE LCC ON THE MAIN CAMPUS TO MAKE AVAILABLE 14 PRIVATE CHEMO SUITES, 10 OPEN CHEMO TREATMENT BAYS, NURSING SUPPORT SPACE, AND ADDITIONAL DIAGNOSTIC CAPABILITIES. THE PMC LCC MAIN CAMPUS EXPANSION WAS COMPLETED DURING FY 2023 AND TOTALED $3.7 MILLION.THE LAWSON CANCER CENTER AT PIKEVILLE MEDICAL CENTER IS USING INNOVATIVE TECHNOLOGY TO TREAT PATIENTS WHOSE TREATMENT PLANS CALL FOR RADIATION THERAPY. PMC HAS PURCHASED AND INSTALLED TWO NEW VARIAN RAPIDARC TRUE BEAM LINEAR ACCELERATORS AND BRAIN LAB EXACTRAC DYNAMIC SYSTEMS. THE TRUE BEAM RADIOTHERAPY SYSTEMS PROVIDE A VARIETY OF TREATMENT TECHNIQUES TO ADDRESS A BROAD RANGE OF CANCER CASES, IN ADDITION TO ALLOWING PMC TO DELIVER LIFESAVING RADIATION TWO TO EIGHT TIMES FASTER THAN CONVENTIONAL FORMS OF RADIOTHERAPY. THE BRAIN LAB EXACTRAC SYSTEM IS AN ALL-IN-ONE REVOLUTIONARY NEW THERMAL-SURFACE CAMERA TECHNOLOGY THAT WORKS IN TANDEM WITH REAL-TIME X-RAY TRACKING TO ACHIEVE SUBMILLIMETRIC RADIOTHERAPY POSITIONING AND MONITORING ACCURACY. ADVANCED IMAGING AND HIGH PRECISION DOSAGE CONTROL WITH THE LATEST TRUE BEAM TECHNOLOGY THAT PRODUCES A RADIATION BEAM THAT IS CONTINUALLY SHAPED AND RESHAPED ACCORDING TO THE SIZE, SHAPE AND POSITION OF THE TUMOR, PROTECTING HEALTHY, SURROUNDING TISSUE, ENSURES RADIATION DELIVERY CONFORMALITY WITH BUILT-IN PATIENT SAFETY FEATURES THAT ALLOW CLINICIANS TO NAVIGATE THE COMPLEXITIES OF RADIATION THERAPY TREATMENT DELIVERY WITH CONFIDENCE. THE CAPITAL INVESTMENT IN THE VARIAN TRUE BEAM LINEAR ACCELERATOR AND BRAIN LAB EXACTRAC EQUIPMENT, INCLUDING INSTALLATION-RELATED RENOVATION TOTALED MORE THAN $8.4 MILLION.

	(Code: ) (Expenses $ 345,909,895 including grants of $ 192,545 ) (Revenue $ 425,760,060 )
	ALL OTHER PROGRAMS: PIKEVILLE MEDICAL CENTER IS A COMPREHENSIVE HEALTHCARE PROVIDER OF TERTIARY HEALTHCARE SERVICES THROUGH ITS LICENSED 348-BED ACUTE CARE AND INPATIENT REHABILITATION HOSPITAL, LEVEL II TRAUMA CENTER, OUTPATIENT DIAGNOSTIC CENTER, OCCUPATIONAL, PHYSICAL AND SPEECH THERAPY CENTER, SLEEP LAB, HOME MEDICAL EQUIPMENT, LEVEL II ADVANCED NEONATAL INTENSIVE CARE UNIT, CANCER TREATMENT CENTER, AND MULTI-SPECIALTY PHYSICIAN PRACTICES. PMC OFFERS MORE THAN 400 SERVICES, INCLUDING MOST MAJOR SPECIALTIES AND MANY SUBSPECIALTIES, WHICH HAS RESULTED IN PMC BEING RECOGNIZED AS A REGIONAL REFERRAL CENTER THROUGHOUT CENTRAL APPALACHIA FOR SMALLER COMMUNITY HOSPITALS THAT HAVE PATIENTS WITH COMPLEX NEEDS WHOM THEY CANNOT SERVE. WITH MORE THAN 3,000 EMPLOYEES AND OVER 400 CREDENTIALED PROVIDERS WHO REPRESENT MORE THAN 45 HOME COUNTIES IN KENTUCKY, VIRGINIA AND WEST VIRGINIA; PMC STRIVES TO BE THE PROVIDER AND EMPLOYER OF CHOICE FOR HEALTHCARE ACROSS THE REGION WE SERVE, WHICH INCLUDES THE EASTERN KENTUCKY COUNTIES OF PIKE, FLOYD, JOHNSON, LETCHER, MAGOFFIN, AND MARTIN; BUCHANAN COUNTY, VIRGINIA; AND MINGO COUNTY, WEST VIRGINIA. PMC'S RECORDED TOTAL INPATIENT ADMISSIONS DURING FY 2023 OF 10,789 AND RECEIVED 2,999 TRANSFERS IN FROM SMALLER HOSPITALS THROUGHOUT THE REGION DURING THE YEAR.THE U.S. BUREAU OF LABOR STATISTICS PROJECTS THAT EMPLOYMENT IN HEALTHCARE OCCUPATIONS WILL INCREASE BY 15% BY 2029, ADDING MORE JOBS THAN ANY OTHER OCCUPATIONAL GROUP. PIKEVILLE MEDICAL CENTER'S PRIMARY, SECONDARY AND TERTIARY MARKET AREAS HAVE ECONOMICALLY DECLINED OVER THE PAST DECADE DUE TO VARIOUS REGULATORY AND OTHER ECONOMIC SITUATIONS ADVERSELY AFFECTING THE EMPLOYMENT RATE, THIS DECLINE HAS RESULTED IN AN OUTMIGRATION OF THE REGION'S WORKFORCE, CREATING A SHORTAGE OF SKILLED HEALTHCARE LABOR TO FILL THE INCREASING NEED FOR NURSING AND OTHER SKILLED CLINICAL STAFF REQUIRED TO PROVIDE CARE FOR THE AGING POPULATION OF THE REGION. PMC IS A PRIMARY DRIVER OF THE ECONOMY WITHIN THE REGION IT SERVES AND HAS SPEARHEADED AN INITIATIVE TITLED "PROJECT HEART" (HEALTHCARE EMPLOYMENT AROUND REGIONAL TRAINING) TO ADDRESS THE GROWING SHORTAGE OF A SKILLED HEALTHCARE WORKFORCE. ALONG WITH AN EXCEPTIONAL TEAM OF COLLABORATIVE PARTNERS, PMC HAS DEVELOPED MULTIPLE STRATEGIES TO INCREASE TRAINING, FURTHER DEVELOP THE HEALTHCARE WORKFORCE AND PROVIDE CAREER OPPORTUNITIES FOR AS MANY AS POSSIBLE ACROSS THE REGION. PMC HAS WORKED WITH BIG SANDY COMMUNITY AND TECHNICAL COLLEGE, GALEN COLLEGE OF NURSING, UNIVERSITY OF PIKEVILLE ELLIOTT SCHOOL OF NURSING AND AMERICAN NATIONAL UNIVERSITY TO EXPAND CAMPUS SPACE AND INCREASE CLASS SIZES. THE UNIVERSITY OF PIKEVILLE (UPIKE) AND PMC HAVE PARTNERED TO OFFER THE RURAL HEALTH NURSING FELLOWSHIP PROGRAM EDUCATIONAL OPPORTUNITY TO STUDENTS EAGER TO PURSUE A CAREER IN NURSING, THE PROGRAM ALLOWS STUDENTS TO EARN AN ASSOCIATE DEGREE IN NURSING FROM UPIKE AND POTENTIALLY GRADUATE DEBT-FREE BY MAKING A COMMITMENT TO WORK FOR PMC UPON BECOMING A LICENSED RN. PMC HAS ALSO PARTNERED WITH THE KENTUCKY COMMUNITY AND TECHNICAL COLLEGE SYSTEM (KCTCS) TO OFFER THE TRAINS PROGRAM FOR THE POSITIONS OF PATIENT CARE TECHNICIAN, MEDICAL OFFICE TECHNICIAN, AND CERTIFIED NURSING AID; THE TRAINS PROGRAM PROVIDES CUSTOMIZED TRAINING FOR EMPLOYERS TO BUILD AND SUSTAIN THEIR TALENT PIPELINE, AT NO COST TO THE STUDENT. ADDITIONALLY, PMC PROJECT HEART PARTNERED WITH SOAR, A REGIONAL NONPARTISAN NONPROFIT THAT CHAMPIONS LOCAL PROGRAMS AND ADVOCACY FOR THE 54 ARC MANDATED COUNTIES IN EASTERN KENTUCKY, TO FILL THE ECONOMIC GAPS LEFT BY THE DECLINE OF THE COAL INDUSTRY. THE SOAR COLLABORATIVE HAS RESULTED IN THE DEVELOPMENT AND DEPLOYMENT OF THE EASTERN KENTUCKY HEALTHCARE ACTION PLAN TO HELP MEMBERS OF THE COMMUNITY LEARN HOW TO STABILIZE EASTERN KENTUCKY'S HOSPITALS AND PROTECT OUR REGION'S FUTURE. PMC INVESTED MORE THAN $1.2 MILLION IN EDUCATION ASSISTANCE RELATING TO PROJECT HEART INITIATIVES DURING FY 2023.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. PMC PROVIDES PATIENTS 24-HOUR IMMEDIATE COVERAGE BY TRAUMA SURGEONS, ORTHOPEDIC SURGEONS, NEUROSURGEONS, ANESTHESIOLOGY, EMERGENCY MEDICINE, CRITICAL CARE AND OTHER SURGEONS SPECIALIZING IN TRAUMATIC INJURIES. THE CONTINUUM OF CARE ENCOMPASSES THE PRE-HOSPITAL PHASE THROUGH THE REHABILITATION PROCESS. PMC'S TRAUMA CENTER SERVICE SIGNIFICANTLY INCREASES THE CHANCE OF SURVIVAL SHOULD AN INDIVIDUAL BE SERIOUSLY INJURED WITHIN THE PMC MULTI-COUNTY SERVICE AREA. PMC PROVIDED EMERGENT, POTENTIALLY LIFE-SAVING TRAUMA CARE TO 1,173 PATIENTS DURING FY 2023. PMC'S CRITICAL CARE UNITS (CCU) ARE COMPRISED OF 53 TOTAL BEDS IN SERVICE AND STAFFED BY BOARD-CERTIFIED PHYSICIAN SPECIALISTS AND DEDICATED STAFF TO PROVIDE 24/7 CARE TO PATIENTS WITH A WIDE VARIETY OF SEVERE ILLNESS OR INJURY. PMC HAS 69 ADULT VENTILATORS AND 35 PEDIATRIC/NICU VENTILATORS IMMEDIATELY AVAILABLE FOR SERVICE WITH 1,454 PATIENTS REQUIRING VENTILATOR MANAGEMENT DURING 2023. PMC IS ALSO ONE OF THE FEW HOSPITALS IN THE STATE AND THE ONLY HOSPITAL IN THE REGION TO PROVIDE THE EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) LIFE SUPPORT. PATIENTS REQUIRING ECMO HAVE A SEVERE, LIFE-THREATENING ILLNESS THAT PREVENTS THEIR HEART OR LUNGS FROM WORKING PROPERLY. THIS TECHNOLOGICALLY ADVANCED LIFESAVING MACHINE REPLACES THE FUNCTION OF THE HEART AND LUNGS, AND PUMPS BLOOD FROM THE PATIENT'S BODY TO AN OXYGENATOR THAT WORKS AS AN ARTIFICIAL LUNG. PIKEVILLE MEDICAL CENTER'S INPATIENT PHYSICAL REHABILITATION HOSPITAL IS A COMPREHENSIVE PROGRAM DEDICATED TO HELPING PATIENTS WHO ARE DISABLED BY DISEASE OR INJURY. A TEAM OF WELL-TRAINED REHABILITATION SPECIALISTS; INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, REHABILITATION NURSES, CASE MANAGERS, SOCIAL WORKERS, AND DIETICIANS, IN ADDITION TO, HIGHLY SKILLED, BOARD-CERTIFIED PHYSICAL MEDICINE PHYSICIANS HELP PATIENTS ACHIEVE THEIR GREATEST LEVEL OF INDEPENDENCE POSSIBLE BASED ON THEIR PHYSICAL AND MENTAL ABILITIES. THE 20-BED INPATIENT REHABILITATION FACILITY OFFERS A FULL RANGE OF INTENSIVE REHABILITATION SERVICES FOR ILL AND INJURED PATIENTS, ALLOWING THOSE PATIENTS TO REMAIN CLOSE TO HOME AND FAMILY WHILE RECEIVING REHABILITATIVE CARE. THE 23,000 SQUARE FOOT FACILITY IS DESIGNATED EXCLUSIVELY FOR REHABILITATION USE, INCLUDING A DINING HALL, FULLY EQUIPPED KITCHEN, LAUNDRY FACILITIES, AN APARTMENT-LIKE ROOM TO PRACTICE DAILY LIVING SKILLS, AND A THERAPEUTIC GYM WITH UNIQUE EQUIPMENT SPECIFICALLY SUITED FOR PATIENTS WORKING TO REGAIN MOTOR FUNCTIONS FROM INJURY OR ILLNESS, SUCH AS STROKE.PMC'S NEONATAL INTENSIVE CARE UNIT (NICU) IS A LICENSED 16 BED LEVEL II ADVANCED CARE FACILITY THAT PROVIDES AROUND-THE-CLOCK CARE FOR NEWBORNS WHO REQUIRE INTENSIVE NURSING AND MEDICAL CARE. AS THE ONLY LEVEL II ADVANCED NICU IN THE REGION, PMC NEONATOLOGISTS AND STAFF ARE TRAINED AND EQUIPPED TO CARE FOR BABIES BORN AS EARLY AS 28 WEEKS IN THE MOTHER'S PREGNANCY. HAVING THIS SPECIALIZED SERVICE AT PMC ALLOWS MANY FAMILIES TO STAY CLOSE TO HOME AND CLOSE TO THEIR NEWBORNS WHILE RECEIVING COMPASSIONATE CARE FROM THE TEAM OF SPECIALIZED MEDICAL PROVIDERS. THE PMC NICU HAD 124 NEWBORN ADMISSIONS AND 2,369 PATIENT DAYS OF CARE DURING FY 2023.THE PMC SPECIALTY PHARMACY IS PROUD TO BE THE ONLY SPECIALTY PHARMACY IN THE REGION ACCREDITED BY BOTH ACCREDITATION COMMISSION FOR HEALTH CARE (ACHC) AND THE UTILIZATION REVIEW ACCREDITATION COMMISSION (URAC). SPECIALTY DRUGS GENERALLY REQUIRE SPECIAL ADMINISTRATION AND ARE DEFINED AS EXPENSIVE MEDICATIONS USED TO TREAT CONDITIONS SUCH AS CANCER, RHEUMATOID ARTHRITIS, AND MULTIPLE SCLEROSIS. SPECIALTY PRESCRIPTIONS ARE SOMETIMES DIFFICULT TO NAVIGATE FOR THOSE WHO NEED THEM THE MOST AND PMC IS COMMITTED TO ASSISTING PATIENTS THROUGH THIS PROCESS. PRIOR TO PMC OPENING THE SPECIALTY PHARMACY, PATIENTS OFTEN HAD TO SEARCH FOR WAYS TO RECEIVE THEIR SPECIALTY MEDICATION. NOW, A TEAM OF DEDICATED PROFESSIONALS AT PMC ASSISTS PATIENTS WITH PRIOR AUTHORIZATIONS AND INSURANCE QUESTIONS IN ADDITION TO DISPENSING THE SPECIALIZED MEDICATION. PMC UTILIZES EFFICIENT PROCEDURES, OVERNIGHT SHIPPING, AND MEDICINE DELIVERY TO EXPEDITE THE PROCESS, ALLOWING PATIENTS TO RECEIVE NEEDED SPECIALTY MEDICATION MORE QUICKLY. PMC'S SPECIALTY PHARMACY FILLED 9,121 PRESCRIPTIONS DURING FY 2023, NEARLY TWICE THE VOLUME OF THE PRIOR YEAR.(CONTINUED ON SCH O)

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 345,909,895 including grants of $ 192,545 ) (Revenue $ 425,760,060 )
4e	Total program service expenses543,394,232

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	12,054,700	0	737,338

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	529,670
e	Government grants (contributions)		1e	4,312,514

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,825,210

g	Noncash contributions included in lines 1a - 1f:$		1g	1,010

h Total. Add lines 1a-1f.......		6,667,394

		Business Code
2a	NET PATIENT SERVICE RE	621999	598,099,939	598,099,939
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		598,099,939

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,279,230			7,279,230
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			6,049			6,049
		(ii) Personal	(i) Real
6a	Gross rents	1,027,700	263,121	6a
b	Less: rental expenses	0	351,995	6b
c	Rental income or (loss)	1,027,700	-88,874	6c
d	Net rental income or (loss).......			938,826	-86,041	1,024,867
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	347,464		7a
b	Less: cost or other basis and sales expenses	533,447		7b
c	Gain or (loss)	-185,983		7c
d	Net gain or (loss).........			-185,983			-185,983
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	72,254,152
b	Less: cost of goods sold ..		10b	39,336,135
c	Net income or (loss) from sales of inventory..			32,918,017		4,319,300	28,598,717
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722310	3,704,067	2,800,966		903,101
b	REBATE INCOME		900099	2,032,908	2,032,908
c	GIFT SHOP SALES		900099	578,736			578,736
d	All other revenue ....			741,227	741,227
e	Total. Add lines 11a–11d ......			7,056,938
12	Total revenue. See instructions.....			652,780,410	603,588,999	5,344,167	37,179,850

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	138,441	138,441
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	54,104	54,104
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	5,890,566	5,037,284	853,282
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	1,585,773	1,356,065	229,708
7	Other salaries and wages........	239,408,826	204,729,089	34,679,737
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,616,110	3,092,296	523,814
9	Other employee benefits .......	62,719,365	53,634,107	9,085,258
10	Payroll taxes ...........	14,336,363	12,259,659	2,076,704
11	Fees for services (non-employees):
a	Management ......	1,583,819	1,409,725	174,094
b	Legal .........	276,730		276,730
c	Accounting ...........	124,032		124,032
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	63,221,566	56,272,219	6,949,347
12	Advertising and promotion ....	2,286,166	2,034,869	251,297
13	Office expenses .......	2,635,645	2,345,933	289,712
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	6,988,259	6,220,106	768,153
17	Travel ............	714,055	635,566	78,489
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	403,340	359,005	44,335
20	Interest ...........	4,906,679	4,214,767	691,912
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	32,910,013	28,060,694	4,849,319
23	Insurance ...	16,911,778	15,052,826	1,858,952
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	MEDICAL SUPPLIES AND DR	102,984,993	91,664,828	11,320,165
b	DUES AND SUBSCRIPTIONS	17,340,898	15,434,777	1,906,121
c	PROVIDER TAX EXPENSE	16,500,110	16,500,110
d	EQUIPMENT RENTAL & MAIN	14,000,516	12,461,572	1,538,944
e	All other expenses	11,713,777	10,426,190	1,287,587
25	Total functional expenses. Add lines 1 through 24e	623,251,924	543,394,232	79,857,692	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			15,830	1	16,245
2	Savings and temporary cash investments .........			115,715,552	2	102,997,799
3	Pledges and grants receivable, net ......			3,115,788	3	12,016,123
4	Accounts receivable, net .............			76,750,114	4	103,157,063
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			18,659,998	8	21,531,155
9	Prepaid expenses and deferred charges ......			6,185,588	9	7,376,130
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	589,432,551
b	Less: accumulated depreciation	10b	299,173,973	302,523,220	10c	290,258,578
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			9,817,266	12	11,171,322
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			20,794	14	12,997
15	Other assets. See Part IV, line 11 ...........			137,317,079	15	122,569,960
16	Total assets. Add lines 1 through 15 (must equal line 33)...			670,121,229	16	671,107,372

17	Accounts payable and accrued expenses .....	108,009,275	17	95,945,769
18	Grants payable ...		18
19	Deferred revenue .........	10,982,686	19	14,767,834
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	202,360,203	23	194,226,777
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	30,611,237	25	10,821,660
26	Total liabilities. Add lines 17 through 25..	351,963,401	26	315,762,040

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	317,951,828	27	355,139,332
28	Net assets with donor restrictions ...........	206,000	28	206,000
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	318,157,828	32	355,345,332
33	Total liabilities and net assets/fund balances ........	670,121,229	33	671,107,372