2022-10-28T10:03:18-05:00 2021-12-31 351178661 BLUE & CO LLC 2650 EASTPOINT PARKWAY STE 300 LOUISVILLE KY 40223 990 2021-01-01 203131989 CUMBERLAND FAMILY MEDICAL CENTER INC CUMB 2708642889 PO BOX 1080 BURKESVILLE KY 42717 RYAN SMITH CFO 2708586655 2022-10-18 1 RYAN SMITH 999009999 NATHAN A RODGERS CPA P01568275 5029923500 2022-10-10 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z RYAN SMITH PO BOX 1080 BURKESVILLE KY 42717 114273656 0 X WWW.CUMBERLANDFAMILYMEDICALCENTER.COM X 2005 KY TO INCREASE ACCESS TO COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH CARE TO ELIMINATE HEALTH DISPARITIES TO THE MEDICALLY UNDERINSURED. WE STRIVE THROUGH CONTINUOUS QUALITY IMPROVEMENT TO MEET THE NEEDS OF THE SERVICE AREA BY PROVIDING PRIMARY PATIENT CARE IN AN ENVIRONMENT THAT FOCUSES ON PREVENTION OF ILLNESS, THEREFORE, IMPROVING THE QUALITY OF LIFE. 11 11 990 0 0 0 24080472 23886205 74986696 86986710 590802 86638 1477340 3314103 101135310 114273656 17105100 45147865 0 0 55370209 63498025 0 0 0 27098075 27296568 99573384 135942458 1561926 -21668802 84427430 65128853 6862804 9233029 77564626 55895824 X MISSION: TO INCREASE ACCESS TO COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH CARE TO ELIMINATE HEALTH DISPARITIES TO THE MEDICALLY UNDERINSURED. WE STRIVE THROUGH CONTINUOUS QUALITY IMPROVEMENT TO MEET THE NEEDS OF THE SERVICE AREA BY PROVIDING PRIMARY PATIENT CARE IN AN ENVIRONMENT THAT FOCUSES ON PREVENTION OF ILLNESS, THEREFORE, IMPROVING THE QUALITY OF LIFE. 0 0 119906754 45147865 90300813 THE PURPOSE OF THE MEDICAL CENTER IS TO OPERATE AS A NONPROFIT CORPORATION ENGAGED IN CHARITABLE ACTIVITIES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISIONS OF ANY FUTURE U.S. INTERNAL REVENUE LAW (THE "CODE"), TO PROMOTE THE AVAILABILITY OF AND ACCESS TO QUALITY AND AFFORDABLE HEALTH CARE AND RELATED SERVICES TO THE PEOPLE LIVING IN THE MEDICALLY UNDERSERVED AREAS OF ADAIR, ANDERSON, BARREN, BOYLE, CASEY, CLINTON, CUMBERLAND, FRANKLIN, GREEN, HARDIN, HART, KNOX, LARUE, LINCOLN, MARION, MCCREARY, METCALFE, MONROE, NELSON, PULASKI, RUSSELL, OWEN, WOODFORD, WASHINGTON AND WAYNE COUNTIES IN KENTUCKY. WE PROVIDED QUALITY HEALTH CARE SERVICES TO A TOTAL OF 128,944 PATIENTS WITH A TOTAL OF 448,304 ENCOUNTERS IN 2021. IN 2021, THE NUMBER OF PATIENTS INCREASED BY 3.8% AND PATIENT ENCOUNTERS INCREASED BY 17.15% 119906754 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 118 0 1 990 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 KY X ERIC LOY 2708642889 PO BOX 1080 BURKESVILLE KY 42717 BRIDGET BOOHER CHAIRPERSON 2.00 1.00 X 931 0 0 KEITH RIDDLE VICE CHAIRPERSON 1.00 0.00 X 1396 0 0 JOSH HARDEN SECRETARY 1.00 0.00 X 1163 0 0 BECKY RADFORD TREASURER 1.00 0.00 X 1396 0 0 PAULA LITTLE BOARD MEMBER 1.00 1.00 X 1047 0 0 JIM FLOWERS BOARD MEMBER 1.00 1.00 X 0 0 0 GARYON SCOTT BOARD MEMBER 1.00 0.00 X 1163 0 0 ELIZABETH EVERLEY BOARD MEMBER 1.00 0.00 X 931 0 0 TERRY GRIDER BOARD MEMBER 1.00 0.00 X 1163 0 0 LISA TARTER BOARD MEMBER 1.00 0.00 X 1280 0 0 LACEY TERRY BOARD MEMBER 1.00 0.00 X 1280 0 0 ERIC LOY MD CEO/MED DIR/PHYSICIAN 40.00 1.00 X 977827 0 35733 RYAN SMITH CFO (BEG 9/23/21) 40.00 0.00 X 102731 0 18413 KENNETH KIMSAL CFO (END 11/5/21) 40.00 0.00 X 188987 0 25311 STEPHEN HALL MD PHYSICIAN 40.00 0.00 X 573947 0 36006 AMANDA HESS MD PHYSICIAN 40.00 0.00 X 539499 0 36006 ANGELA SAXENA MD PHYSICIAN 40.00 0.00 X 539387 0 25647 MARK WAINWRIGHT DO PHYSICIAN 40.00 0.00 X 581458 0 31283 ROBERT CUNNINGHAM MD PHYSICIAN 40.00 0.00 X 518080 0 30248 4033666 0 238647 121 0 1 0 ROBERTS PHARMACY 190 WESTVIEW SHOPPING CENTER ALBANY KY 42602 340B PRESCRIPTION DISPENSING FEE 528224 JAMESTOWN PHARMACY PO BOX 499 JAMESTOWN KY 42629 340B PRESCRIPTION DISPENSING FEE 462640 GET WELL PHARMACY OF COLUMBIA PO BOX 1347 COLUMBIA KY 42728 340B PRESCRIPTION DISPENSING FEE 339808 MORGANS MEDICINE PO BOX 220 BURKESVILLE KY 42717 340B PRESCRIPTION DISPENSING FEE 296208 CLINTON COUNTY PHARMACY 903 N CROSS ST ALBANY KY 42602 340B PRESCRIPTION DISPENSING FEE 282484 15 22496330 1389875 23886205 NET PATIENT SERVICE REVENUE 900099 69311163 69311163 340B REVENUE 900099 17675547 17675547 86986710 85638 85638 1000 0 1000 1000 1000 OTHER REVENUE 900099 3314103 3314103 3314103 114273656 90300813 0 86638 45147865 45147865 1281295 1032479 248816 51023122 41114905 9908217 2232272 1798785 433487 5453994 4394879 1059115 3507342 2826249 681093 99687 80329 19358 156651 156651 1733309 1396716 336593 267283 215379 51904 2514401 2133846 380555 1102208 888169 214039 2711341 2184824 526517 390613 314760 75853 216119 174151 41968 1457375 1174366 283009 237036 191006 46030 340B EXPENSES 8312837 8312837 0 MEDICAL SUPPLIES & DRUG 7206005 5806666 1399339 REPAIRS & MAINTENANCE 470874 379435 91439 DUES & SUBSCRIPTIONS 159969 128905 31064 260860 210203 50657 135942458 119906754 16035704 0 5291691 12072246 49458997 13012307 445617 1555353 6595139 10598794 350039 328021 308182 258450 56132 700101 31533688 8099089 18885219 23434599 3036414 3168982 84427430 65128853 6264124 8025911 0 458768 598680 748350 6862804 9233029 X 77564626 55895824 77564626 55895824 84427430 65128853 -21668802 0 X X 0 1 X 1 1 1 X FORM 990, SCHEDULE A, PART I, LINE 3 CUMBERLAND FAMILY MEDICAL CENTER, INC. IS QUALIFIED AS A PUBLIC CHARITY UNDER IRC 170(B)(1)(A)(III) AS EVIDENCED ON THE ENCLOSED SCHEDULE A. CUMBERLAND FAMILY MEDICAL CENTER, INC. IS NOT LICENSED AS A HOSPITAL IN THE STATE OF KENTUCKY AND AS SUCH SCHEDULE H IS NOT REQUIRED. THE CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER THAT PROVIDES HEALTH COVERAGE THROUGH A NETWORK OF COMMUNITY-BASED HEALTH CENTERS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1896830 1896830 23180497 3598328 19582169 657638 359208 298430 5447244 4141553 1305691 351479 351479 23434599 DEFERRED COMPENSATION LIABILITY 748350 748350 X 105960819 0 105960819 8312837 8312837 114273656 127629621 0 127629621 8312837 8312837 135942458 PART X, LINE 2: FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 SUPERSEDED BY ASC 740-10: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY CFMC AND RECOGNIZE A TAX LIABILITY IF CFMC HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY CFMC, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. CFMC IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: 340B EXPENSES 8,312,837. PART XII, LINE 4B - OTHER ADJUSTMENTS: 340B EXPENSES 8,312,837. 1 FAMILY MEDICAL CENTERS COMMUNITY FOUNDATION INC PO BOX 2399 RUSSELL SPRINGS KY 42642 850638638 501(C)3 45080398 0 SUPPORT THE FOUNDATION 1 0 X X X X X 0 0 0 0 0 0 0 0 0 ERIC LOY MD CEO/MED DIR/PHYSICIAN 977827 0 0 0 0 0 17400 0 18333 0 1013560 0 0 0 KENNETH KIMSAL CFO (END 11/5/21) 188987 0 0 0 0 0 11339 0 13972 0 214298 0 0 0 STEPHEN HALL MD PHYSICIAN 573947 0 0 0 0 0 17400 0 18606 0 609953 0 0 0 AMANDA HESS MD PHYSICIAN 539499 0 0 0 0 0 17400 0 18606 0 575505 0 0 0 ANGELA SAXENA MD PHYSICIAN 539387 0 0 0 0 0 17400 0 8247 0 565034 0 0 0 MARK WAINWRIGHT DO PHYSICIAN 581458 0 0 0 0 0 17400 0 13883 0 612741 0 0 0 ROBERT CUNNINGHAM MD PHYSICIAN 518080 0 0 0 0 0 17400 0 12848 0 548328 0 0 0 LOY PROPERTIES ENTITY > 35% OWNED BY CEO OF CUMBERLAND, ERIC LOY. 421216 LEASING: ERIC LOY, CEO OWNS LOY PROPERTIES. LOY PROPERTIES IS LEASING 3 COMMERCIAL PROPERTIES TO CUMBERLAND MEDICAL CENTER. 0 WHITLEY LEASING ENTITY > 35% OWNED BY PHYSICIAN EMPLOYED BY THE ORG. 180000 LEASING: 1 COMMERCIAL PROPERTY TO CUMBERLAND MEDICAL CENTER. THIS ENTITY IS OWNED BY JOHN PATTON; EMPLOYED PHYSICIAN AT THE ORGANIZATION. 0 WCOTB ENTITY > 35% OWNED BY PHYSICIANS EMPLOYED BY THE ORGANIZATION 197358 LEASING: WCOTB SUBLEASES 1 COMMERCIAL PROPERTY TO CUMBERLAND MEDICAL CENTER. THIS ENTITY IS OWNED BY STEPHEN HALL, EVERETT HORN, ANGELA SAXENA, MARK WAINWRIGHT AND AMANDA HESS; ALL PHYSICIANS EMPLOYED AT THE ORGANIZATION. 0 LGL PARTNERSHIP ENTITY > 35% OWNED BY PHYSICIANS EMPLOYED BY THE ORG. 137913 LEASING: COMMERCIAL PROPERTY TO CUMBERLAND MEDICAL CENTER. THIS ENTITY IS OWNED BY ANNE TURCEA AND JENNIFER STIVERS; EMPLOYED PHYSICIANS AT THE ORGANIZATION. 0 FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION IS ORGANIZED AS A NON-PROFIT ORGANIZATION WITH A BOARD OF DIRECTORS. THE ORGANIZATION HAS MEMBERS OF WHICH 51% MUST BE INDIVIDUALS WHO ARE OR WILL BE SERVED BY THE MEDICAL CENTER AND WHO, AS A GROUP, REPRESENT THE INDIVIDUALS BEING SERVED OR TO BE SERVED IN TERMS OF DEMOGRAPHICS, RACE, ETHNICITY, AND GENDER. UPON A VACANCY OR EXPECTED VACANCY OF THE BOARD, THE OFFICERS SHALL MAKE NOMINATIONS OF A PERSON OR PERSONS TO FILL VACANCY AS DIRECTED BY THE BOARD. THE BOARD SHALL THEN ELECT MEMBERS TO FILL THE VACANCY. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVE PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY IS IN PLACE TO PROTECT THIS TAX-EXEMPT ORGANIZATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE SHALL DECIDE IF A CONFLICT OF INTERESTS EXISTS. IF THE GOVERNING BOARD OR COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH A GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY AND HAS AGREED TO COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD SHALL HAVE THE SOLE AUTHORITY TO HIRE, REVIEW THE PERFORMANCE OF AND DISMISS THE CEO. THE CEO SHALL BE RESPONSIBLE FOR THE HIRING AND RELEASE FROM EMPLOYMENT OF NECESSARY STAFF TO CARRY OUT THE DAY-TO-DAY OPERATIONS OF THE MEDICAL CENTER. THE BOARD SHALL ANNUALLY REVIEW THE DUTIES, PERFORMANCES AND BENEFITS OF THE CEO. DURING 2016, THE MEDICAL CENTER HIRED AN OUTSIDE FIRM TO REVIEW THE CEO/MEDICAL DIRECTOR'S COMPENSATION. THE COMPENSATION STUDY USED MANY DIFFERENT DATA SOURCES SUCH AS THE IRS FORM 990 AND COMPENSATION SURVEYS FOR OTHER ENTITES SIMILAR TO THE MEDICAL CENTER TAKING INTO CONSIDERATION LOCATION AND SIZE OF THE MEDICAL CENTER AND POSITION/JOB DUTIES OF THE CEO. THE RESULTS WERE DISTRIBUTED TO BOARD OF DIRECTORS UPON COMPLETION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC FORM 990, PART XII, LINE 2C: OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. FAMILY MEDICAL CENTERS COMMUNITY FOUNDATION INC PO BOX 2399 RUSSELL SPRINGS KY 42642 850638638 HEALTHCARE KY 501(C)(3) LINE 12A, I CUMBERLAND FAMILY MEDICAL CENTER 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FAMIY MEDICAL CENTERS COMMUNITY FOUNDATION INC B 45080398 CASH