2023-10-30T13:46:02-05:00 2022-12-31 351178661 BLUE & CO LLC 2650 EASTPOINT PARKWAY STE 300 LOUISVILLE KY 40223 990 2022-01-01 203131989 CUMBERLAND FAMILY MEDICAL CENTER INC CUMB 2708642889 PO BOX 1080 BURKESVILLE KY 42717 RYAN SMITH CFO 2708586655 2023-10-26 1 RYAN SMITH 999009999 0 EMILIE M KNIERIEM CPA P01330194 5029923500 2023-10-24 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RYAN SMITH PO BOX 1080 BURKESVILLE KY 42717 110863214 0 X WWW.CUMBERLANDFAMILYMEDICAL.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 1165 0 0 0 23886205 16880013 86986710 88777809 86638 171700 3314103 5033692 114273656 110863214 45147865 15299676 0 0 63498025 73378260 0 0 0 27296568 19481882 135942458 108159818 -21668802 2703396 65128853 69713449 9233029 11114229 55895824 58599220 X 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 91125187 15299676 93809501 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, TAYLOR, WOODFORD, WASHINGTON AND WAYNE COUNTIES IN KENTUCKY. WE PROVIDED QUALITY HEALTH CARE SERVICES TO A TOTAL OF 131,875 PATIENTS WITH A TOTAL OF 472,504 ENCOUNTERS IN 2022. IN 2022, THE NUMBER OF PATIENTS INCREASED BY 7.7% AND PATIENT ENCOUNTERS INCREASED BY 5.39% 91125187 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 1 114 0 1 1165 1 0 0 0 0 0 0 0 0 0 0 1 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 ERIC LOY MD CEO/MED DIR/PHYSICIAN 40.00 1.20 X 1168681 0 43885 MARK WAINWRIGHT DO PHYSICIAN 40.00 X 556233 0 32037 STEPHEN HALL MD PHYSICIAN 40.00 X 545932 0 32003 ANGELA SAXENA MD PHYSICIAN 40.00 X 524502 0 25846 ROBERT CUNNINGHAM MD PHYSICIAN 40.00 X 521744 0 36692 AMANDA HESS MD PHYSICIAN 40.00 X 504461 0 41864 RYAN SMITH CFO 40.00 0.20 X 130759 0 23875 BECKY RADFORD TREASURER 1.00 X X 2069 0 0 GARYON SCOTT BOARD MEMBER 1.00 X 1582 0 0 JIM FLOWERS BOARD MEMBER 1.00 1.00 X 1460 0 0 BRIDGET BOOHER CHAIRPERSON 2.00 1.00 X X 1338 0 0 KEITH RIDDLE VICE CHAIRPERSON 1.00 X X 1338 0 0 TERRY GRIDER BOARD MEMBER 1.00 X 1338 0 0 LACEY TERRY BOARD MEMBER 1.00 X 1338 0 0 PAULA LITTLE BOARD MEMBER 1.00 1.00 X 1217 0 0 LISA TARTER BOARD MEMBER 1.00 X 1217 0 0 JOSH HARDEN SECRETARY 1.00 X X 1095 0 0 ELIZABETH EVERLEY BOARD MEMBER 1.00 X 852 0 0 3967156 0 236202 128 0 1 0 GARY CLARK CONSTRUCTION AND PROPERTY MAN PO BOX 231 WHITLEY CITY KY 42653 CONSTRUCTION 325120 HARDIN'S CLEANING SOLUTIONS 3614 POTTSVILLE ROAD SPRINGFIELD KY 40069 JANITORIAL SERVICES 265550 MORROW HEATING AND AIR PO BOX 381 BURNSIDE KY 42519 HVAC SERVICES 158271 HINKLE HEATING AND AIR PO BOX 200 PARIS KY 40362 CONSTRUCTION 152372 LAWLESS MASONRY 11 ZIMMERMAN ROAD JAMESTOWN KY 42642 CONSTRUCTION 148468 17 16832353 47660 16880013 NET PATIENT SERVICE REVENUE 621999 78389033 78389033 340B REVENUE 621399 10312812 10312812 SLEEP DISORDER/PHARMACY CLINIC RE 621399 75964 75964 88777809 171700 171700 INSURANCE BONUS/INCENTIVES 900099 1375510 1375510 CONTRACT LABOR 900099 1346535 1346535 TEST TO STAY REVENUE 900099 1059840 1059840 1251807 1249807 2000 5033692 110863214 93809501 0 173700 15299676 15299676 1382045 1161587 220458 58512852 49179127 9333725 2514033 2113005 401028 6882634 5784745 1097889 4086696 3434803 651893 215710 165126 50584 122850 122850 3093511 2368078 725433 256124 74107 182017 1099674 1033186 66488 1324056 1013563 310493 3179344 1778453 1400891 454558 131522 323036 307159 88874 218285 1565540 1108650 456890 226976 65674 161302 MEDICAL SUPPLIES & DRUG 6329602 5946906 382696 REPAIRS & MAINTENANCE 463447 134094 329353 MINOR EQUIPMENT 370900 107317 263583 DUES AND SUBSCRIPTIONS 318799 92242 226557 153632 44452 109180 108159818 91125187 17034631 0 12072246 7450 13012307 27087077 1555353 844231 10598794 8595238 328021 280086 258450 380907 700101 987148 36931694 9666885 23434599 27264809 3168982 4266503 65128853 69713449 8025911 8989184 458768 333649 748350 1791396 9233029 11114229 X 55895824 58599220 55895824 58599220 65128853 69713449 2703396 0 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 2397495 2397495 23217412 4602063 18615349 926817 442082 484735 7178564 4622740 2555824 3211406 3211406 27264809 CASH VALUE OF LIFE INSURANCE 3189069 THIRD PARTY SETTLEMENTS 99320 INTERCOMPANY RECEIVABLE - FOUNDATION 84738 ROU ASSET - OPERATING LEASE 893376 4266503 DEFERRED COMPENSATION LIABILITY 898020 ROU LIABILITY - OPERATING LEASE 893376 1791396 X 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, 2022 AND 2021, 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. 1 FAMILY MEDICAL CENTERS COMMUNITY FOUNDATION INC PO BOX 2399 RUSSELL SPRINGS KY 42642 850638638 501(C)3 15134421 0 SUPPORT THE FOUNDATION 1 PART I, LINE 2: CFMC DOES TRACK/MONITOR FUNDS DISTRIBUTED TO THE CFMC FOUNDATION. THE SOLE FUNCTION OF THE FOUNDATION IS TO SUPPORT THE ACTIVITIES AND SCOPE OF WORK OF CFMC. THE BOARD OF THE FOUNDATION IS COMPRISED OF THE CEO OF CFMC AND 3 CURRENT BOARD MEMBERS OF CFMC AND MEETS QUARTERLY. THIS BOARD MAKES ALL DECISIONS FOR THE FOUNDATION. ALSO, THE CFO OF CFMC PREPARES MONTHLY FINANCIAL REPORTS FOR THE FOUNDATION THAT ARE DISTRIBUTED TO THE CFMC BOARD FOR INFORMATIONAL PURPOSES AS WELL AS THE FOUNDATION BOARD. X X X X 0 0 0 0 0 0 0 0 0 ERIC LOY MD CEO/MED DIR/PHYSICIAN 1124809 0 43872 0 0 0 18300 0 25585 0 1212566 0 0 0 MARK WAINWRIGHT DO PHYSICIAN 556233 0 0 0 0 0 18300 0 13737 0 588270 0 0 0 STEPHEN HALL MD PHYSICIAN 545932 0 0 0 0 0 18300 0 13703 0 577935 0 0 0 ANGELA SAXENA MD PHYSICIAN 524502 0 0 0 0 0 18300 0 7546 0 550348 0 0 0 ROBERT CUNNINGHAM MD PHYSICIAN 504948 0 16796 0 0 0 18300 0 18392 0 558436 0 0 0 AMANDA HESS MD PHYSICIAN 504461 0 0 0 0 0 18300 0 23564 0 546325 0 0 0 RYAN SMITH CFO 125654 0 5105 0 0 0 8167 0 15708 0 154634 0 0 0 LOY PROPERTIES CEO ERIC LOY OWNS LOY PROPERTIES 424324 LEASE OF SPACE TO CFMC 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 BOARD SHALL ANNUALLY REVIEW THE DUTIES, PERFORMANCES AND BENEFITS OF THE CEO. DURING 2021, 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 MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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 1 COMMONWEALTH CLINICAL PARTNERS LLC 901 S HUGH WALLIS ROAD LAFAYETTE LA 70508 465758603 HEALTHCARE SERVICES LA N/A RELATED 489111 5843 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FAMILY MEDICAL CENTERS COMMUNITY FOUNDATION INC B 15134421 CASH