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MEMORIAL HOSPITAL, INC.

Company Details

Name: MEMORIAL HOSPITAL, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 03 Nov 1917 (108 years ago)
Organization Date: 03 Nov 1917 (108 years ago)
Last Annual Report: 27 Jan 2025 (4 months ago)
Organization Number: 0034970
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40962
City: Manchester, Bluehole, Bright Shade, Chestnutburg, Er...
Primary County: Clay County
Principal Office: 210 MARIE LANGDON DRIVE, MANCHESTER, KY 40962
Place of Formation: KENTUCKY

Registered Agent

Name Role
C T CORPORATION SYSTEM Registered Agent

President

Name Role
Nick Bejarano President

Officer

Name Role
Lynn Addiscott Officer
Haney Vincent Officer
Robert Foltz Officer
Jeff Graff Officer
Michael Saunders Officer
Mandy Brady Officer
David Huffman Officer
David Banks Officer
Toni Berrios Officer

Director

Name Role
Anita Cornett Director
Mike Hewitt Director
Reecia Samples Director
REV. J. A. BURNS Director
Lucas Shepherd Director
Alan Guyton Director
W. W. RAWLINGS Director
Jennifer Hancock Director
Gregory Wilkens Director
James Philips Director

Incorporator

Name Role
ADELINE MCCONVILLE M. D. Incorporator
REV. J. A. BURNS Incorporator
W. W. RAWLINGS Incorporator

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
N7AGRP32EUH6
CAGE Code:
3TKC5
UEI Expiration Date:
2025-06-27

Business Information

Doing Business As:
ADVENTHEALTH MANCHESTER
Division Name:
MEMORIAL HOSPITAL, INC. (D/B/A ADVENTHEALTH MANCHESTER)
Activation Date:
2024-07-01
Initial Registration Date:
2004-04-01

National Provider Identifier

NPI Number:
1083499503
Certification Date:
2023-08-31

Authorized Person:

Name:
SISSEL JACOB
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6067121200

Former Company Names

Name Action
MARTIN COUNTY HOME HEALTH CARE, INC. Merger
ONEIDA MOUNTAIN HOSPITAL Old Name

Assumed Names

Name Status Expiration Date
ADVENTHEALTH PINEVILLE CLINIC Active 2029-01-25
ADVENTHEALTH MEDICAL GROUP Active 2028-10-06
ADVENTHEALTH MEDICAL GROUP EAR, NOSE & THROAT AT MANCHESTER Active 2028-10-06
ADVENHEALTH SPORTS MED & REHAB LONDON Active 2028-10-06
ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT LONDON PARKWAY Active 2028-10-06

Filings

Name File Date
Annual Report 2025-01-27
Annual Report Amendment 2025-01-27
Annual Report Amendment 2025-01-27
Annual Report 2024-06-18
Annual Report 2024-06-18

USAspending Awards / Contracts

Procurement Instrument Identifier:
DJBMANNB210117
Award Or Idv Flag:
AWARD
Award Type:
PO
Awarding Agency Name:
Department of Justice
Performance Start Date:
2013-12-09
Description:
IGF::OT::IGF OUTSIDE MEDICAL EMERGENCY ROOM
Naics Code:
622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE
Procurement Instrument Identifier:
DJBMANNB210116
Award Or Idv Flag:
AWARD
Award Type:
PO
Awarding Agency Name:
Department of Justice
Performance Start Date:
2013-12-09
Description:
IGF::OT::IGF OUTSIDE MEDICAL EMERGENCY ROOM
Naics Code:
622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE
Procurement Instrument Identifier:
DJBMAN210114
Award Or Idv Flag:
AWARD
Award Type:
PO
Awarding Agency Name:
Department of Justice
Performance Start Date:
2013-12-09
Description:
IGF::OT::IGF OUTSIDE MEDICAL EMERGENCY ROOM
Naics Code:
622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE

USAspending Awards / Financial Assistance

Date:
2024-09-27
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-IMPACT - ADVENTHEALTH MANCHESTER (AHM) (MEMORIAL HOSPITAL, INC.) PROPOSES TO IMPLEMENT A RURAL COMMUNITY OPIOID RESPONSE IMPACT PROGRAM ENTITLED “RECOVER-RURAL EMPOWERMENT FOR COMMUNITY-ORIENTED RECOVERY” TO IMPROVE ACCESS TO INTEGRATED, COORDINATED TREATMENT AND RECOVERY SERVICES FOR SUBSTANCE USE DISORDERS (SUD), INCLUDING OPIOID USE DISORDER (OUD), IN RURAL AREAS OF SOUTHEASTERN KENTUCKY. AHM’S RECOVER PROGRAM WILL INITIATE AND EXPAND COORDINATED AND INTEGRATED TREATMENT AND RECOVERY CARE FOR ALL IMPACTED BY SUD/OUD IN THE RURAL COUNTIES OF CLAY, BELL, KNOX, AND JACKSON, KENTUCKY. RECOVER AIMS TO ADDRESS THE SUD/OUD CRISIS IN SOUTHEASTERN KENTUCKY TO PROMOTE LONG-TERM, SUSTAINED RECOVERY. THE TARGET POPULATION FOR RECOVER INCLUDES THOSE WHO ARE EXPERIENCING SYMPTOMS OF SUD, IN TREATMENT FOR SUD, IN RECOVERY FOR SUD, ARE IMPACTED BY SUD, OR ARE FAMILY MEMBERS OR CAREGIVERS OF THOSE IN TREATMENT OR RECOVERY FOR SUD INCLUDING BUT NOT LIMITED TO ADULTS, CHILDREN/ADOLESCENTS, AND JUSTICE INVOLVED INDIVIDUALS. THE PROJECT’S GOALS ARE: 1. ESTABLISH AND EXPAND COORDINATED, COMPREHENSIVE SUD/OUD TREATMENT AND RECOVERY SERVICES IN RURAL SOUTHEASTERN KENTUCKY, 2. DEVELOP A RESPONSIVE SUD WORKFORCE THAT INCLUDES PEERS AND CLINICAL PROVIDERS WITH DIVERSE SCOPES OF PRACTICE, 3. ESTABLISH COORDINATION WITH SUPPORTIVE SOCIAL SERVICES TO ENSURE OPTIMIZED OPPORTUNITIES FOR SUSTAINED, LONG-TERM RECOVERY, AND 4. ENSURE CONTINUED VIABILITY AND SUSTAINABILITY OF THE RECOVER PROGRAM. RURAL APPALACHIAN KENTUCKY FACES SIGNIFICANT CHALLENGES WITH SUBSTANCE USE DISORDER (SUD) AND OPIOID USE DISORDER (OUD). KENTUCKY EXPERIENCES ONE OF THE HIGHEST OPIOID OVERDOSE MORTALITY RATES IN THE U.S. OVERDOSE DEATHS, PRIMARILY INVOLVING OPIOIDS LIKE FENTANYL, HAVE DOUBLED SINCE 2011. THE REGION EXPERIENCES HIGH HEALTHCARE PROFESSIONAL SHORTAGES, AND THE REGION HAS SIGNIFICANT SOCIO-ECONOMIC CHALLENGES. RECOVER WILL BRING INTEGRATED, COLLABORATIVE SOLUTIONS FOR TREATMENT AND RECOVERY OF SUD/OUD UNITING FIVE ORGANIZATIONS IN A JOINED EFFORT TO IMPROVE LONG-TERM RECOVERY FOR THE REGION’S POPULATIONS. THE ORGANIZATIONS INCLUDE THE CLAY COUNTY DETENTION CENTER, SECOND CHANCE BEHAVIORAL HEALTH, VOLUNTEERS OF AMERICA, AND CUMBERLAND RIVER BEHAVIORAL HEALTH ALONG WITH ADVENTHEALTH MANCHESTER. THE PROJECT EXPECTS TO PROVIDE OUD/SUD/MOUD TREATMENT AND RECOVER CARE TO 23,440 UNDUPLICATED INDIVIDUALS OVER A FOUR YEAR PERIOD.
Obligated Amount:
550000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2022-06-28
Awarding Agency Name:
Department of Agriculture
Transaction Description:
ARP ECONOMIC DEVELOPMENT GRANT FOR RURAL HEALTH CARE FACILITIES
Obligated Amount:
1000000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-09-17
Awarding Agency Name:
Department of Housing and Urban Development
Transaction Description:
OLDER ADULTS HOME MODIFICATION GRANT PROGRAM
Obligated Amount:
777120.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-01-05
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DLT GRANTS- CARES ACT - MEDICAL
Obligated Amount:
181210.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-07-27
Awarding Agency Name:
Department of Agriculture
Transaction Description:
COMMUNITY FACILITY 2019 DISASTER GRANTS - TORNADOES FLOODS OTHER
Obligated Amount:
400000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

OSHA's Inspections within Industry

Inspection Summary

Date:
1999-12-29
Type:
Complaint
Address:
401 MEMORIAL DR, MANCHESTER, KY, 40962
Safety Health:
Health
Scope:
Partial

Tax Exempt

Employer Identification Number (EIN) :
61-0594620
Classification:
Religious Organization
Ruling Date:
1969-10

Court Cases

Court Case Summary

Filing Date:
2021-11-22
Status:
Terminated
Nature Of Judgment:
no monetary award
Jury Demand:
Both plaintiff and defendant demand jury
Nature Of Suit:
Medical Malpractice

Parties

Party Name:
CHESNUT,
Party Role:
Plaintiff
Party Name:
MEMORIAL HOSPITAL, INC.
Party Role:
Defendant

Court Case Summary

Filing Date:
2020-08-10
Status:
Terminated
Nature Of Judgment:
no monetary award
Jury Demand:
Plaintiff demands jury
Nature Of Suit:
Qui Tam False Claims Act

Parties

Party Name:
COBB-MORGAN,
Party Role:
Plaintiff
Party Name:
MEMORIAL HOSPITAL, INC.
Party Role:
Defendant

Court Case Summary

Filing Date:
2017-03-30
Status:
Terminated
Nature Of Judgment:
no monetary award
Jury Demand:
Both plaintiff and defendant demand jury
Nature Of Suit:
Medical Malpractice

Parties

Party Name:
CHESNUT,
Party Role:
Plaintiff
Party Name:
MEMORIAL HOSPITAL, INC.
Party Role:
Defendant

Financial Incentive

Program Program Status Average Hourly Wage Project Cost Incentive Amount Initial Jobs New Jobs Date of Action Approval Type
GIA/BSSC Inactive 22.23 $0 $25,000 404 2 2012-12-05 Final

Sources: Kentucky Secretary of State