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  5. HOSPICE OF SOUTHERN KENTUCKY, INC.

HOSPICE OF SOUTHERN KENTUCKY, INC.

Company Details

Name: HOSPICE OF SOUTHERN KENTUCKY, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
Organization Date: 27 Jan 1981 (44 years ago)
Last Annual Report: 05 Mar 2025 (a month ago)
Organization Number: 0153316
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42104
City: Bowling Green
Primary County: Warren County
Principal Office: 5872 SCOTTSVILLE RD, BOWLING GREEN, KY 42104
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2023 311035478 2024-07-02 HOSPICE OF SOUTHERN KENTUCKY, INC. 64
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707469300
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2024-07-02
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2022 311035478 2023-05-31 HOSPICE OF SOUTHERN KENTUCKY, INC. 52
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707469300
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2023-05-31
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2021 311035478 2022-06-02 HOSPICE OF SOUTHERN KENTUCKY, INC. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2022-06-02
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2020 311035478 2021-03-16 HOSPICE OF SOUTHERN KENTUCKY, INC. 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2021-03-16
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2019 311035478 2020-04-27 HOSPICE OF SOUTHERN KENTUCKY, INC. 50
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2020-04-27
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2018 311035478 2019-05-22 HOSPICE OF SOUTHERN KENTUCKY, INC. 46
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2019-05-22
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-22
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY, INC. 401(K) PROFIT SHARING PLAN 2017 311035478 2018-05-23 HOSPICE OF SOUTHERN KENTUCKY, INC. 49
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2018-05-23
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-23
Name of individual signing MEGAN DICK
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY 403(B) PLAN 2016 311035478 2017-06-07 HOSPICE OF SOUTHERN KENTUCKY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY 403(B) PLAN 2016 311035478 2017-06-12 HOSPICE OF SOUTHERN KENTUCKY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
HOSPICE OF SOUTHERN KENTUCKY 403(B) PLAN 2016 311035478 2017-06-15 HOSPICE OF SOUTHERN KENTUCKY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/06/13/20170613122707P040004595799001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/03/01/20170301135531P040038781239002.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-03-01
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-01
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/06/13/20170613122707P040004595799002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/06/20/20170620091006P030014354919001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/03/07/20160307163435P030023448663002.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2016-03-04
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-04
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/06/22/20170622111549P040014431335001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/05/11/20150511075730P030202335687001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2015-05-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-07
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/06/22/20170622073429P040018513137001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2000-06-12
Business code 621900
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 421047853

Signature of
Role Plan administrator
Date 2017-06-21
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-21
Name of individual signing STACEY MARR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/01/20140801104105P030023010943005.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 623000
Sponsor’s telephone number 2707823402
Plan sponsor’s address 5872 SCOTTSVILLE ROAD, BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2014-08-01
Name of individual signing GARY MAXEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-01
Name of individual signing GARY MAXEY
Valid signature Filed with authorized/valid electronic signature

Secretary

Name Role
Kim Vickous Secretary

Director

Name Role
Dot Darby-Paschall Director
Steve Sinclair Director
Milli McIntosh Director
Alison Patton-Holland Director
Altricia Harrell Director
Julie Wedge Director
JANE VOAKES Director
Catherine Heltsley Director
Romanza Johnson Director
Dixie Mahurin Director

Officer

Name Role
Steve Jantz Officer

Registered Agent

Name Role
STEVE JANTZ Registered Agent

Incorporator

Name Role
C. WAYNE HIGGINS Incorporator
HEIDI WILSON Incorporator

Vice President

Name Role
Portia Pennington Vice President

President

Name Role
Ken Whitley President

Treasurer

Name Role
David Smith Treasurer

Former Company Names

Name Action
HOSPICE OF BOWLING GREEN, INC. Old Name

Assumed Names

Name Status Expiration Date
PALLIATIVE CARE OF SOUTHERN KENTUCKY Active 2028-12-15
PHYSICIANS' PALLIATIVE CARE OF SOUTHERN KENTUCKY Inactive 2016-01-11

Filings

Name File Date
Annual Report 2025-03-05
Annual Report 2024-06-27
Certificate of Assumed Name 2023-12-15
Annual Report 2023-06-28
Registered Agent name/address change 2022-09-29
Annual Report Amendment 2022-09-29
Annual Report 2022-06-02
Registered Agent name/address change 2022-06-02
Annual Report 2021-03-01
Annual Report 2020-04-27

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
31-1035478 Corporation Unconditional Exemption 5872 SCOTTSVILLE RD, BOWLING GREEN, KY, 42104-7853 1982-07
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2024-06
Asset 10,000,000 to 49,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 11494789
Income Amount 9548963
Form 990 Revenue Amount 9381381
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 202306
Filing Type E
Return Type 990
File View File
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 202006
Filing Type E
Return Type 990
File View File
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 201906
Filing Type E
Return Type 990
File View File
Organization Name HOSPICE OF SOUTHERN KENTUCKY INC
EIN 31-1035478
Tax Period 201706
Filing Type P
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7715107300 2020-04-30 0457 PPP 5872 SCOTTSVILLE RD, BOWLING GREEN, KY, 42104-7853
Loan Status Date 2022-03-26
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 398635
Loan Approval Amount (current) 398635
Undisbursed Amount 0
Franchise Name -
Lender Location ID 26775
Servicing Lender Name Auburn Banking Company
Servicing Lender Address 236 Sugar Maple Dr, Auburn, KY, 42206
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BOWLING GREEN, WARREN, KY, 42104-7853
Project Congressional District KY-02
Number of Employees 49
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 26775
Originating Lender Name Auburn Banking Company
Originating Lender Address Auburn, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 400622.71
Forgiveness Paid Date 2020-11-03

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Related by address

5872 SCOTTSVILLE RD, BOWLING GREEN, KY 42104

H AND M ARCHITECTS/ENGINEERS (KY), INC. STICK & RUDDER AVIATION, LLC

Sources: Kentucky Secretary of State

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