2022-11-03T05:41:24-05:00 2021-12-31 251408703 SCHNEIDER DOWNS & CO INC ONE PPG PLACE SUITE 1700 PITTSBURGH PA 15222 990 2021-01-01 311657206 MADISON COUNTY COMMUNITY HOSPITAL MADI 7408457015 210 NORTH MAIN STREET LONDON OH 43140 DANA E ENGLE CEO 7408457015 2022-10-28 1 DANA ENGLE 999009999 SUSAN M KIRSCH P00341397 4122613644 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MADISON HEALTH DANA E ENGLE 210 NORTH MAIN STREET LONDON OH 43140 73444250 0 X WWW.MADISON-HEALTH.COM X 1999 OH TO PROVIDE EXCEPTIONAL HEALTH CARE IN A RESPECTFUL, COMPASSIONATE, AND HEALING ENVIRONMENT. 9 8 437 26 0 0 4679502 6454380 53744534 65871354 327301 867503 126907 122318 58878244 73315555 3386885 4318657 0 0 20382553 22001399 0 0 0 29506327 33850674 53275765 60170730 5602479 13144825 40371164 49980292 15003015 9864681 25368149 40115611 X MADISON HEALTH'S VISION IS TO PROVIDE EXCEPTIONAL HEALTHCARE IN A RESPECTFUL, COMPASSIONATE, AND HEALING ENVIRONMENT. 0 0 54068038 4318657 65706577 SEE SCHEDULE O 54068038 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 69 0 1 437 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X MICHAEL S BROWNING 7408457015 210 NORTH MAIN STREET LONDON OH 43140 MITCHELL SPAHN MD BOARD MEMBER (EXITED 1/21) 2.00 3.00 X 35970 0 1399 KEELY CARABIN BOARD MEMBER (ENTERED 9/21) 2.00 0.00 X 0 0 0 VINAY CHITKARA BOARD MEMBER 2.00 0.00 X 0 0 0 JIM EVANS BOARD MEMBER (ENTERED 1/21) 2.00 0.00 X 0 0 0 DENISE MINOR BOARD MEMBER 2.00 0.00 X 0 0 0 STEPHEN OLSON MD BOARD MEMBER 2.00 0.00 X 0 0 0 TOM BLINCOE CHAIR 2.00 0.00 X X 0 0 0 GEORGE LOHSTROH VICE CHAIR 2.00 2.00 X X 0 0 0 ED GOODYEAR TREASURER (EXITED 9/21) 2.00 0.00 X X 0 0 0 MARVIN HOMAN TREASURER (ENTERED 9/21) 2.00 0.00 X X 0 0 0 ROBYN MORTON SECRETARY 2.00 0.00 X X 0 0 0 DANA E ENGLE MCCH CEO 40.00 6.00 X 525406 0 65442 MICHAEL S BROWNING CHIEF FINANCIAL OFFICER 40.00 6.00 X 317380 0 19019 ROBERT WALDECK VP-STRATEGY AND CONSTRUCTION 40.00 0.00 X 254539 0 44710 JODI WILSON CHIEF NURSING OFFICER (EXITED 7/21) 40.00 0.00 X 191304 0 19786 JOEL RICE CNP 40.00 0.00 X 156126 0 53839 BETH FORDYCE DIRECTOR OF PHARMACY 40.00 0.00 X 155421 0 38671 CINDY STOUT VP MARKETING AND PHYSICIAN 40.00 0.00 X 146935 0 32325 BETH MILLIKIN ENTERED 1021 CHIEF HUMAN RESOURCES 40.00 0.00 X 146106 0 22647 MARK COATE PHYSICIAN (EXITED 3/21) 40.00 0.00 X 145508 0 10130 2074695 0 307968 17 0 1 0 ASSOCIATED ANESTHESIOLOGISTS PO BOX 3000 SPRINGFIELD OH 45501 MEDICAL PROFESSIONAL SERVICES 850644 ABDAL RAHMAN ALHYARI MD 6260 POST ROAD DUBLIN OH 43017 HOSPITALIST PROVIDER SERVICES 426500 HAMZA HEALTHCARE LLC 4937 AMBER LANE DUBLIN OH 43017 MEDICAL PROFESSIONAL SERVICES 405200 PREMIER HEALTH CARE SERVICES INC PO BOX 634850 CINCINNATI OH 45263 MEDICAL PROFESSIONAL SERVICES 332732 QUEST DIAGNOSTICS PO BOX 775460 CHICAGO IL 60677 LAB SERVICES 296463 10 62684 6391696 6454380 NET PATIENT SERVICE 621990 65540060 65540060 PAIN JOINT VENTURE 900099 164777 164777 CAFETERIA SALES/VENDING 722514 99622 99622 PHYSICAL TRAINING 900099 40500 40500 FITNESS CENTER 713940 2675 2675 23720 23720 65871354 874094 874094 122318 0 122318 122318 122318 100104 22000 100153 28542 -49 -6542 -6591 -6591 73315555 65771732 0 1089443 X 4318657 4318657 1474955 1339915 135040 15779357 14359215 1420142 565934 514120 51814 2793605 2537837 255768 1387548 124879 1262669 86878 86878 92888 92888 6319 6319 107297 107297 7831109 5837165 1993944 267706 267706 342487 245392 97095 1350599 1310479 40120 3371215 3289376 81839 3353 705 2648 75752 67523 8229 1254915 1254915 376474 376474 MEDICAL SUPPLIES 9421941 9402627 19314 BAD DEBT EXPENSE 7480305 7480305 HOSPITAL FRANCHISE FEE 1396445 1396445 FOOD/DIETARY 195419 184627 10792 189572 27382 162190 60170730 54068038 6102692 0 5632613 3537434 9888665 4993004 6641679 7159260 1047283 989366 633411 1319105 24676676 18429478 6034505 6247198 10035552 25330630 440600 314153 16856 90142 40371164 49980292 5200344 5805594 1380587 1323239 4259032 0 4163052 2735848 15003015 9864681 X 25368149 40115611 25368149 40115611 40371164 49980292 13144825 1602637 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6319 6319 0 PART II-B, LINE 1: A PORTION OF THE ANNUAL DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND TO THE OHIO HOSPITAL ASSOCIATION HAS BEEN DEEMED TO BE LOBBYING-RELATED. THE TOTAL AMOUNT PAID IN 2021 THAT WAS ALLOCATED TO LOBBYING EXPENSES WAS $6,319. 5699827 3909698 1790129 18243141 14096609 4146532 733708 423171 310537 6247198 DUE TO AFFILIATES 2735848 2735848 X 67267906 1602637 1602637 65665269 107297 7542989 7650286 73315555 48264471 0 48264471 107297 11798962 11906259 60170730 PART X, LINE 2: THE HOSPITAL IS AN OHIO NONPROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS REQUIRING AN ACCRUAL OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED IN THE CONSOLIDATED STATEMENT OF ACTIVITIES FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020 RELATED TO UNCERTAIN TAX POSITIONS. THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE TAX EXAMINATIONS FOR YEARS PRIOR TO 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECORDED IN REVENUE 7,480,305. TRANSFER FROM MCHF 62,684. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECORDED IN REVENUE 7,480,305. TRANSFER TO MFHC 4,318,657. FORM 990, PART XI AND PART XII: THE REPORT ON AUDITS OF CONSOLIDATED FINANCIAL STATEMENTS IS PREPARED ON BEHALF OF THE MADISON COUNTY HOSPITAL, INC. AND AFFILIATES (MADISON HEALTH AND MADISON COUNTY HOSPITAL FOUNDATION). THE DISCLOSURES IN PARTS XI AND XII REPRESENT THE SEPARATE COMPANY ACTIVITY OF MADISON HEALTH AS PRESENTED IN THE STATEMENTS AND SUPPLEMENTAL SCHEDULES. 1 1 1 X 1 X 1 1 1 0 1 1 2 1345 611397 884190 0 0.00000 1 4588 10104090 5701622 4402468 0.07880 3 5933 10715487 6585812 4402468 0.07880 20 111 84940 3617 81323 0.00150 3 30 34 780 77055 77055 0.00140 57 921 161995 3617 158378 0.00290 60 6854 10877482 6589429 4560846 0.08170 1 7480305 8134840 9249015 -1114175 X 1 1 1 MADISON HEALTH PAIN MANAGEMENT LLC PAIN MANAGEMENT 0.51000 0.00000 0.00000 1 1 MADISON COUNTY COMMUNITY HOSPITAL 210 N MAIN STREET LONDON OH 43140 WWW.MADISON-HEALTH.COM 1011 X X X MADISON HEALTH 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X HTTP://WWW.MADISON-HEALTH.COM/ X 1 19 1 HTTP://WWW.MADISON-HEALTH.COM/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.MADISON-HEALTH.COM/ X HTTP://WWW.MADISON-HEALTH.COM/ X HTTP://WWW.MADISON-HEALTH.COM/ X 1 0 X X X X 1 X 0 0 MADISON HEALTH PART V, SECTION B, LINE 5: MADISON HEALTH CONSIDERED INPUT FROM THE PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. THE RESEARCH EFFORT HAS INCLUDED: A DEMOGRAPHIC ANALYSIS; A SURVEY OF 400 ADULT RESIDENTS SELECTED AT RANDOM; FOCUS GROUP SESSIONS WITH COMMUNITY PARTCIPANTS AND EMPLOYEES OF THE BOARD OF DEVELOPMENTAL DISABILITIES, SOURCES OF DATA FOR THIS REPORT INCLUDE THE OHIO DEPARTMENT OF HEALTH, OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, THE CENTER FOR DISEASE CONTROL AND PREVENTION, THE BUREAU OF THE CENSUS' AMERICAN COMMUNITY SURVEY, THE OHIO DEPARTMENT OF PUBLIC SAFETY, THE OHIO DEVELOPMENT SERVICES AGENCY, THE OHIO MENTAL HEALTH AND ADDICTION SERVICES, THE INSTITUTE FOR HEALTH METRICS AND EVALUATION, THE HEALTH RESOURCES AND SERVICES ASSOCIATION, THE USDA ECONOMIC RESEARCH SERVICE, AND THE ROBERT WOOD JOHNSON FOUNDATION.THE STEERING COMMITTEE HAS MET TO STUDY THE RESULTS AND IDENTIFY HEALTH PRIOROTIES. WRIGHT STATE WAS UTILIZED TO MODERATE AND HELPED LEAD THE DISCUSSION. MADISON HEALTH PART V, SECTION B, LINE 11: EACH OF THE PRIORITY HEALTH NEEDS LISTED IN THIS PLAN IS IMPORTANT AND IS BEING ADDRESSED BY COMMUNITY INITIATIVES WHETHER OR NOT IT IS INCLUDED IN THE MADISON HEALTH IMPLEMENTATION PLAN FOR NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. HOWEVER, DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO ADDRESS THE ACCESS TO HEALTH CARE ISSUE, MADISON COUNTY HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA AS PART OF THIS IMPLEMENTATION PLAN: MENTAL HEALTH, ALCOHOL AND TOBACCO USAGE, ADDICTION, SHORTAGE OF DENTAL HEALTH PROFESSIONALS, TRANSPORTATION ISSUES.SPECIFIC NEEDS IDENTIFIED IN CHNA: IMPROVE THE HEALTH AND WELL BEING OF WOMEN, INFANTS, CHILDREN AND FAMILIES. MATERNAL AND INFANT HEALTH INCLUDES INFANT AND MATERNAL MORTALITY, BIRTH OUTCOMES AND RELATED RISK FACTORS IMPACTING PRECONCEPTION, PREGNANCY AND INFANCY SUCH AS TEEN PREGNANCY. MADISON COUNTY HAS A 5 YEAR INFANT MORTALITY RATE OF 8.5 COMPARED TO A TARGET OF 6 AND OHIO 7.1. THE TARGET FOR MOTHERS WHO RECEIVE FIRST TRIMESTER CARE IS 77.9% AND MADISON COUNTY IS AT 72.2% OHIO AT 67.9%.REDUCE THE INFANT MORTALITY RATE BY PREVENTING THE LEADING CAUSES OF INFANT MORTALITY. LOW BIRTH WEIGHT CAN BE A PREDICTOR OF INFANT MORTALITY. IN 2015, PRETERM BIRTH AND LOW BIRTH WEIGHT ACCOUNTED FOR ABOUT 17% OF ALL INFANT DEATHS. AN ANALYSIS OF VITAL STATISTICS DATA FOR MADISON COUNTY SHOWS DISPARITIES AMONG PRETERM BIRTH, LOW BIRTH WEIGHT, AND INFANT MORTALITY BY RACE, PARTICULARLY FOR BLACK/AFRICAN AMERICANS, AS WELL AS DISPARATE RATES AMONG INFANTS OF OLDER MOTHERS. MADISON COUNTY HAS A HIGHER INFANT MORTALITY RATE THAN THE STATE'S RATE AND IS WELL ABOVE THE HEALTHY PEOPLE 2020 TARGET. THE 10-YEAR INFANT MORTALITY RATE IN MADISON COUNTY IS 9.1/1000 BIRTHS VERSUS 7.4/1000 FOR OHIO AND 5.9/1000 BIRTHS IN THE U.S.ACHIEVE IMPROVED BREASTFEEDING RATES IN THE COMMUNITY. WHILE PRETERM BIRTH AND LOW BIRTH WEIGHT CONTRIBUTE TO A PORTION OF INFANT DEATHS, THERE ARE OTHER PREVENTABLE CAUSES SUCH AS SIDS AND UNINTENTIONAL INJURIES. MANY STUDIES HAVE DEMONSTRATED THAT BREASTFEEDING PROVIDES PROTECTION AGAINST SIDS. BEYOND THAT, BREASTFEEDING PROVIDES MANY BENEFITS TO THE INFANT AND MOTHER SUCH AS REDUCED RISKS OF ASTHMA AND OBESITY AMONG CHILDREN AND REDUCED RISKS OF HIGH BLOOD PRESSURE AND TYPE 2 DIABETES AMONG MOTHERS. IN MADISON COUNTY, THE RATE OF MOTHERS WHO BREASTFEED IS INCREASING, BUT THE CURRENT RATE OF 69.7% IS BELOW THE STATE AND NATIONAL RATES OF 72.5% AND 83.8%, RESPECTIVELY. IN MADISON COUNTY, DISPARATE RATES ARE ESPECIALLY EVIDENT FOR BLACKS/AFRICAN AMERICANS (47.5%), UNMARRIED MOTHERS (55%), YOUNGER MOTHERS (54.4%), AND THOSE WITH LESS THAN A HIGH SCHOOL EDUCATION (48.9%).OBJECTIVES: REDUCE INFANT MORTALITY IN MADISON COUNTY THROUGH PROMOTION OF THE SAFE SLEEP PROGRAM, INCREASING THE RATE OF BREASTFEEDING AND IMPROVING ACCESS TO AND EDUCATION ABOUT THE IMPORTANCE OF PRENATAL CARE.CHRONIC DISEASES, INCLUDING OBESITY, CARDIOVASCULAR DISEASE, DIABETES AND CANCER STAND OUT AS CONCERNS FOR MADISON COUNTY. OBESITY AND HYPERTENSION FOR EXAMPLE ARE HIGHLY PREVALENT CONDITIONS IN THE COUNTY AFFECTING MORE THAN ONE THIRD OF THE POPULATION. DIABETES AFFECTS 16.1% OF THE POPULATION OF MADISON COUNTY COMPARED TO 11.3% OF OHIO AND 10.5% OF THE UNITED STATES.PARTNER IN DELIVERING FOOD PHARMACIES WHERE PATIENTS CAN ENHANCE THEIR COOKING SKILLS THROUGH COOKING DEMONSTRATIONS, RECEIVE NUTRITION AND HEALTH TIPS, UNDERGO HEALTH SCREENINGS, AND GET REFERRALS TO OTHER FOOD ASSISTANCE PROGRAMS. THE RATE OF OVERWEIGHT OR OBESITY FOR ADULTS IN MADISON COUNTY IS 71.4% COMPARED TO A RATE OF 66.8% AND 66.6% AMONG ADULTS IN OHIO AND THE U.S., RESPECTIVELY. DISEASES LINKED TO OBESITY INCLUDE: HEART DISEASE & STROKE, HIGH BLOOD PRESSURE, DIABETES, SOME CANCERS, GALLBLADDER DISEASE AND GALLSTONES, OSTEOARTHRITIS, GOUT, AND BREATHING PROBLEMS SUCH AS SLEEP APNEA AND ASTHMA.INCREASE PUBLIC KNOWLEDGE OF HOW ADEQUATE SLEEP AND TREATMENT OF SLEEP DISORDERS IMPROVE HEALTH FOR ADULTS AND CHILDREN. SLEEP DEPRIVATION IS MORE PREVALENT AMONG ADULTS IN MADISON COUNTY THAN FOR ADULTS IN OHIO OR THE U.S. IN MADISON COUNTY 41.5% OF ADULTS REPORT RECEIVING FEWER THAN 7 HOURS OF SLEEP PER NIGHT VERSUS 37.1% AND 35.2%, RESPECTIVELY FOR OHIO AND THE U.S. ESTIMATES FROM THE OHIO HEALTHY YOUTH ENVIRONMENTS SURVEY (OHYES) FOR MADISON COUNTY INDICATE THAT 65.1% OF YOUTH AGES 12- 17 IN MADISON COUNTY SCHOOLS PARTICIPATING IN THE OHYES GET LESS THAN 8 HOURS OF SLEEP ON AN AVERAGE SCHOOL NIGHT. THEREFORE, INTERVENTION PROGRAMS FOR ADULTS AND YOUTH ARE NECESSARY.IMPROVE ACCESS TO COMMUNITY-BASED PULMONARY HEALTH SUPPORT. THE RATE OF ADULTS HAVING HYPERTENSION IN MADISON COUNTY, 39.5%, IS SUBSTANTIALLY HIGHER THAN THE RATE AMONG OHIO AND U.S. ADULTS (34.7% AND 32.3%, RESPECTIVELY). ROUGHLY HALF THE PEOPLE WITH UNTREATED HYPERTENSION DIE OF HEART DISEASE RELATED TO POOR BLOOD FLOW (ISCHEMIC HEART DISEASE) AND ANOTHER THIRD DIE OF STROKE. HIGH BLOOD PRESSURE CAN ALSO INJURE BOTH THE BLOOD VESSELS IN AND LEADING TO KIDNEYS, THE EYES, AND CAN CAUSE TROUBLE SLEEPING DUE TO OBSTRUCTIVE SLEEP APNEA WHICH OCCURS IN MORE THAN HALF OF THOSE WITH HIGH BLOOD PRESSURE. IN ADDITION TO HIGHER RATES OF HIGH BLOOD PRESSURE, MADISON COUNTY ADULTS HAVE HIGHER RATES OF LUNG AND BRONCHUS CANCER AS COMPARED TO THE U.S. THE RATE FOR MADISON COUNTY WAS 101.7 PER 100,000 IN 2016 (THE LATEST YEAR FOR WHICH INCIDENCE DATA ARE AVAILABLE), WHILE THE OHIO RATE WAS 64.9 AND THE U.S. RATE WAS 56 PER 100,000 IN 2016.OBJECTIVES: PROVIDE HEALTH SCREENINGS, WOUND CARE PROGRAM, INCREASE PUBLIC KNOWLEDGE OF HOW ADEQUATE SLEEP AND TREATMENT OF SLEEP DISORDERS IMPROVES HEALTH FOR ADULTS AND CHILDREN, IMPROVE ACCESS TO COMMUNITY BASED PULMONARY HEALTH SUPPORT.ADEQUATE AFFORDABLE HOUSINGSPECIFIC NEEDS IDENTIFIED IN CHNA:AMONG THE LOWER INCOME SURVEY RESPONDENTS AFFORDABLE HOUSING WAS LISTED AS THE #1 NEIGHBOOD PROBLEM AND IT WAS #7 AMONG ALL RESPONDENTS. HELP PAYING FOR UTILITIES, HELP PAYING FOR HOUSING REPAIR AND HELP PAYING FOR HOUSING REHABILITATION WERE ALSO LISTED IN THE TOP 10 NEIGHBORHOOD ISSUES OF BOTH GROUPS.JOB PLACEMENT & TRAINING/CHILD CARESPECIFIC NEEDS IDENTIFIED IN CHNA: BOTH LOWER INCOME AND ALL HOUSEHOLDS IDENTIFIED JOB AND TECHNICAL TRAINING AS THE #3 ISSUE AND JOB PLACEMENT SERVICES AS THE #4 ISSUE IN THE SURVEY. IN HOUSEHOLDS WITH CHILDREN, SUPERVISED YOUTH AND AFTER SCHOOL ACTIVITIES WAS THE #1 ISSUE AND AFFORDABLE CHILD CARE SERVICES WAS #4.MENTAL HEALTH PROMOTION SPECIFIC NEEDS IDENTIFIED IN CHNA:THE DATA FROM THE SURVERY SHOWED A WIDE PREVALENCE OF ANXIETY AND DEPRESSION CHARACTERISTICS AMOUNG ADULTS. THE EMERGENCY DEPARTMENT AT MADISON HEALTH HAD AN INCREASE OF 32.3% IN DISCHARGE RATES FOR ADULT NEUROTIC DISORDERS FROM 2014 TO 2018 AND AN INCREASE OF 28.6% OVER THE SAME PERIOD FOR DISCHARGES DUE TO MENTAL AND BEHAVORIAL DISORDERS DUE TO PSYCHOACTIVE SUBSTANCE USE. MADISON COUNTY LEADERS IDENTIFIED MENTAL ILLNESS AS ONE OF THE TOP MAJOR PROBLEMS FACING THE COUNTY. MADISON COUNTY HAS A MENTAL HEALTH PROVIDER RATIO TO POPULATION OF 1,590:1 WHICH IS IMPROVED FROM THE LAST SURVEY (2,090:1) BUT CONTINUES TO BE WELL BELOW OHIO'S RATIO OF 410:1 AND THE NATIONAL OF 290:1.MADISON HEALTH WILL CONTINUE TO WORK AS A PARTNER WITH THE MADISON COUNTY-LONDON CITY HEALTH DISTRICT AND OTHER AGENCIES IN THE COMPLETION OF THE COMMUNITY HEALTH IMPROVEMENT PLAN AND PARTICIPATE IN ITS RESULTING STRATEGIES. AS WAS THE INTENT WITH THE AFFORDABLE CARE ACT, WE HAVE ENGAGED WITH COMMUNITY PARTNERS IN IDENTIFYING COMMUNITY HEALTH NEEDS AND RESPONDING TO THE IDENTIFIED NEEDS AND WILL CONTINUE TO COLLABORATE TO ENSURE ALL COMMUNITY MEMBERS, INCLUDING THE UNINSURED AND WORKING POOR HAVE ACCESS TO THE APPROPRIATE LEVEL OF HEALTHCARE, INCLUDING ACCESS TO PREVENTIVE CARE AND A MEDICAL HOME OFFICE. 86.2% OF ADULTS IN THE SURVEY IN 2019 RESPONDED THEY HAVE A PERSONAL DOCTOR OR HEALTH CARE PROVIDER ALTHOUGH 14.1% DELAYED CARE BECAUSE THEY COULD NOT GET AN APPOINTMENT SOON ENOUGH. IN 2016 5% OF MADISON COUNTY ADULTS SAY THEY USE THE EMERGENCY ROOM AS A REGULAR SOURCE OF HEALTHCARE. THE NUMBER OF PRIMARY CARE PROVIDERS HAS BEEN INCREASED ALONG WITH AVAILABLE HOURS ON WEEK ENDS AND EVENINGS TO PROVIDE ACCESS TO THE APPROPRIATE LEVEL OF CARE. AS A RESULT OF FOCUS GROUPS IN THE 2016 SURVEY INDICATING A NEED FOR AN ALTERNATIVE TO EMERGENCY ROOM VISITS AN URGENT CARE CENTER WAS OPENED IN MAY OF 2019. MADISON HEALTH PART V, SECTION B, LINE 13B: MEDICARE/MEDICAID STATE REGULATION PART I, LINE 6A: COMMUNITY BENEFIT INFORMATION IS PROVIDED TO THE OHIO HOSPITAL ASSOCIATION (OHA). OHA COMPILES THE INFORMATION AND ISSUES PRESS RELEASES AND PUBLISHES INFORMATION ON THEIR WEBSITE RELATING TO COMMUNITY BENEFITS PROVIDED BY OHIO HOSPITALS. THIS REPORT IS ALSO POSTED ONTO OHA'S WEBSITE. THE OHIO DEPARTMENT OF HEALTH ALSO COMPILES THE SCHEDULE H FORMS FOR ALL OHIO HOSPITALS AND ISSUES A REPORT ON THE OHIO DEPARTMENT OF HEALTH WEB SITE. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $7,480,305 WAS EXCLUDED FROM TOTAL EXPENSES FOR CALCULATING COLUMN 7(F).PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART II, COMMUNITY BUILDING ACTIVITIES: OUR INVOLVEMENT IN COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT KEEPS US IN TUNE WITH THE NEEDS OF THE COMMUNITY, INCLUDING THE HEALTHCARE NEEDS OF OUR POPULATION. OUR INVOLVEMENT ALLOWS US TO EDUCATE THE COMMUNITY ON LEADING HEALTH ISSUES AND ALLOWS THE COMMUNITY TO EDUCATE US ON THEIR PERSPECTIVES OF WHAT RESOURCES AND SERVICES ARE NEEDED TO MAKE THIS A HEALTHY AND VIBRANT COMMUNITY. IN 2019, MADISON HEALTH COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH OTHER COUNTY HEALTH ORGANIZATIONS AND AGENCIES INCLUDING BRIDGES COMMUNITY ACTION, CHAMBER OF COMMERCE, CITY OF LONDON, EDUCATIONAL SERVICES CENTER, FAMILY SERVICE, LONDON FIRST UNITED METHODIST CHURCH, MADISON COUNTY PREVENTION, MADISON PUBLIC HEALTH, MENTAL HEALTH AND RECOVERY BOARD. THE OHIO STATE UNIVERSITY EXTENSION, ROCKING HORSE CENTER, SHERIFF'S OFFICE, SISTERS ELDERLY CARE OF LONDON, AND THE UNITED WAY. THIS REPORT COMPILES A YEAR-LONG EFFORT TO GATHER AND ANALYZE DATA THAT ADDRESSES ISSUES OF COMMUNITY HEALTH AND WELLBEING FOR MADISON COUNTY AS WELL AS FOR THE MADISON HEALTH'S SPECIFIC SERVICE AREA. PART III, LINE 2: FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES NET REVENUE ON THE BASIS OF ITS DISCOUNTED RATE FOR SERVICES PROVIDED. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PART III, LINE 3: DISCOUNTED RATE FOR PATIENTS WHO APPLY AND QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY ARE NOT INCLUDED IN BAD DEBT EXPENSES. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE - THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS USING HISTORICAL COLLECTION INFORMATION AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. DELINQUENT RECEIVABLES ARE WRITTEN-OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYOR. PART III, LINE 8: MEDICARE SHORTFALLS PRIMARILY BENEFIT THE ELDER MEMBERS OF OUR COMMUNITY, WHICH IS A GROWING DEMOGRAPHIC IN MADISON COUNTY. IF WE CHOOSE NOT TO PARTICIPATE IN THE MEDICARE PROGRAM, HEALTHCARE SERVICES WOULD HAVE TO BE OBTAINED FROM PROVIDERS LOCATED OUTSIDE OUR COMMUNITY, PLACING INCREASED COSTS AND STRESS ON THIS POPULATION. MEDICARE ALLOWABLE COSTS WERE TAKEN FROM INFORMATION OFF OF THE 2020 MEDICARE COST REPORT. PART III, LINE 9B: MADISON HEALTH INFORMS OHIO RESIDENTS, WHO ARE NOT RECIPIENTS OF THE MEDICAID PROGRAM, WHOSE GROSS INCOME IS AT OR BELOW THE FEDERAL POVERTY LEVEL OR WHOSE GROSS INCOME FALLS WITHIN THE MADISON COUNTY FINANCIAL ASSISTANCE SLIDING SCALE, OF THEIR RIGHT TO RECEIVE BASIC MEDICALLY NECESSARY HOSPITAL SERVICES AT NO COST OR AT A DISCOUNTED COST. ADDITIONALLY, THE HOSPITAL HAS MADE THE HCAP CHARITY CARE AND THE COUNTY FINANCIAL ASSISTANCE APPLICATION PROCESS SYNONYMOUS, EASY TO UNDERSTAND,AND AVAILABLE TO ALL PATIENTS.NOTICES ARE POSTED IN REGISTRATION AREAS, THE EMERGENCY ROOM, THE CASHIER'S OFFICE, AND THE CUSTOMER SERVICE AREA SPECIFYING THE RIGHTS OF INDIVIDUALS WITH INCOMES AT OR BELOW THE FEDERAL POVERTY LEVEL TO RECEIVE, AT NO COST OR REDUCED COST, BASIC MEDICALLY NECESSARY HOSPITAL SERVICES. THE INCOME GUIDELINES AND A TELEPHONE NUMBER TO CALL FOR AN APPLICATION WILL BE PRINTED ON THE FRONT OF EACH MONTHLY STATEMENT.IF THE HOSPITAL RECEIVES NO RESPONSE AFTER A PATIENT HAS RECEIVED FOUR STATEMENTS REGARDING BALANCES OWED, OR IF A PATIENT ON A PAYMENT PLAN HAS MISSED TWO CONSECUTIVE PAYMENTS, THE HOSPITAL MAY TURN OVER THE ACCOUNT BALANCE TO A THIRD-PARTY COLLECTION SERVICE. MADISON HEALTH MAY DIRECT PATIENTS TO APPLY FOR MEDICAID, BUT WILL ACCEPT HCAP AND COUNTY FINANCIAL ASSISTANCE APPLICATIONS. APPLICANTS SHALL COOPERATE IN SUPPLYING INFORMATION ABOUT HEALTH INSURANCE OR MEDICAL BENEFITS AVAILABLE SO THE HOSPITAL MAY DETERMINE ANY POTENTIAL THIRD-PARTY RESOURCES THAT MAY BE AVAILABLE. A PATIENT WITH INSURANCE WILL NOT BE CONSIDERED FOR FINANCIAL ASSISTANCE UNTIL ALL INSURANCE PAYMENTS HAVE BEEN MADE.THE FEDERAL INCOME POVERTY LEVEL GUIDELINES (FIPLG) ARE USED AS THE THRESHOLD TO DETERMINE INCOME ELIGIBILITY FOR HCAP CHARITY CARE AND THROUGH 400% OF THE FIPLG SHALL BE USED AS THE THRESHOLD TO DETERMINE INCOME ELIGIBILITY FOR THE MADISON COUNTY FINANCIAL ASSISTANCE PROGRAM. THE SCALE SHALL BE UPDATED ANNUALLY BASED ON CHANGES TO THE ANNUALLY UPDATED FIPLG. PART VI, LINE 2: THE HOSPITAL WORKS WITH COMMUNITY LEADERS AND OTHER HEALTH ORGANIZATIONSIN OUR COMMUNITY TO DEVISE THE BEST WAYS TO PROVIDE FOR THE HEALTH NEEDS OF OUR SERVICE AREA. HOSPITAL LEADERS PARTICIPATE IN LOCAL ORGANIZATIONSTO KEEP IN TOUCH WITH COMMUNITY NEEDS.THE HOSPITAL HAS WORKED WITH OTHER COUNTY ORGANIZATIONS TO PROVIDE A COORDINATED EFFORT IN BUILDING A COMMUNITY NEEDS ASSESSMENT. WRIGHT STATE UNIVERSITY WAS SELECTED TO HELP LEAD THIS EFFORT. FOCUS GROUP INTERVIEWS AND TELEPHONE SURVEYS WERE COMPLETED. IN COLLABORATION WITH WRIGHT STATE UNIVERSITY, MADISON HEALTH COMPLETED THE CHNA IN 2019. MADISON HEALTH'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS FORMALLY ADOPTED ON NOVEMBER 21, 2019. PART VI, LINE 3: MADISON HEALTH INFORMS OHIO RESIDENTS, WHO ARE NOT PARTICIPANTS OF THE MEDICAID PROGRAM, WHOSE GROSS INCOME IS AT OR BELOW THE FEDERAL POVERTY LEVEL OR WHOSE GROSS INCOME FALLS WITHIN THE MADISON COUNTY FINANCIAL ASSISTANCE SLIDING SCALE, OF THEIR RIGHT TO RECEIVE BASIC, MEDICALLY NECESSARY HOSPITAL SERVICES AT NO COST OR AT A DISCOUNTED COST. ADDITIONALLY, THE HOSPITAL WILL MAKE THE HCAP CHARITY CARE AND THE COUNTY FINANCIAL ASSISTANCE APPLICATION PROCESS SYNONYMOUS, EASY TO UNDERSTAND,AND AVAILABLE TO ALL PATIENTS.NOTICES ARE POSTED IN REGISTRATION AREAS, THE EMERGENCY ROOM, THE CASHIER'S OFFICE AND THE CUSTOMER SERVICE AREA SPECIFYING THE RIGHTS OFINDIVIDUALS WITH INCOMES AT OR BELOW THE FEDERAL POVERTY LEVEL TO RECEIVE, AT NO COST OR REDUCED COST, BASIC MEDICALLY NECESSARY HOSPITAL SERVICES. THE INCOME GUIDELINES AND A TELEPHONE NUMBER TO CALL FOR AN APPLICATION WILL BE PRONTED ON THE FRONT OF EACH MONTHLY STATEMENT.IF THE HOSPITAL RECEIVES NO RESPONSE AFTER A PATIENT HAS RECEIVED FOUR STATEMENTS REGARDING BALANCES OWED, OR IF A PATIENT ON A PAYMENT PLAN HAS MISSED TWO CONSECUTIVE PAYMENTS, THE HOSPITAL MAY TURN OVER THE ACCOUNT BALANCE TO A THIRD-PARTY COLLECTION SERVICE. MADISON HEALTH MAY DIRECT PATIENTS TO APPLY FOR MEDICAID, BUT WILL ACCEPT HCAP AND COUNTY ASSISTANCE APPLICATIONS. APPLICANTS SHALL COOPERATE IN SUPPLYING INFORMATION ABOUT HEALTH INSURANCE OR MEDICAL BENEFITS AVAILABLE SO THE HOSPITAL MAY DETERMINE ANY POTENTIAL THIRD-PARTY RESOURCES THAT MAY BE AVAILABLE. A PATIENT WITH INSURANCE CANNOT BE CONSIDERED UNTIL ALL INSURANCE PAYMENTS HAVE BEEN MADE.THE FEDERAL INCOME POVERTY LEVEL GUIDELINES (FIPLG) ARE USED AS THE THRESHOLD TO DETERMINE INCOME ELIGIBILITY FOR HCAP CHARITY CARE AND THROUGH 400% OF THE FIPLG SHALL BE USED AS THE THRESHOLD TO DETERMINE INCOME ELIGIBILITY FOR THE MADISON COUNTY FINANCIAL ASSISTANCE PROGRAM. THE SCALE IS UPDATED ANNUALLY BASED ON CHANGES TO ANNUALLY UPDATED FIPLG. PART VI, LINE 4: MADISON COUNTY LIES BETWEEN SPRINGFIELD AND COLUMBUS, AND MORE THAN 37% OF ITS WORKING POPULATION DRIVES 30+ MINUTES TO WORK. BOTH I-70 AND I-71 GO THROUGH MADISON COUNTY. MADISON COUNTY IS PRIMARILY A RURAL COUNTY, WITH OVER 93% OF ITS LAND AREA BEING CROPLAND, PASTURE, AND FOREST. ABOUT 6.% OF ITS LAND COVER IS CONSIDERED TO BE DEVEOPED (THAT IS, RESIDENTIAL, COMMERCIAL, INDUSTRIAL).MADISON COUNTY'S TOTAL POPULATION IS 44,413. ITS LARGEST COMMUNITY AND SINGULAR CITY IS LONDON WITH 10,271 RESIDENTS. WEST JEFFERSON VILLAGE HAS A POPULATION OF ABOUT 4,411, PLAIN CITY HAS A POPULATION OF 3,582. OUTSIDE OF THOSE TWO JURISDICTIONS, MOST OF THE POPULATION IS DISTRIBUTED IN TOWNSHIPS. POPULATION PROJECTIONS FORECAST MADISON COUNTY'S POPULATION TO INCREASE BY 8% FROM 2015 TO THE YEAR 2030. LONDON CORRECTIONAL INSTITUTION AND MADISON CORRECTIONAL INSTITUTION ARE LOCATED IN MADISON COUNTY; PRISON INMATES ARE INCLUDED IN POPULATION COUNTS. MADISON COUNTY IS ALSO HOME TO THE OHIO PEACE OFFICER TRAINING ACADEMY (OPOTA) AND THE OHIO BUREAU OF CRIMINAL IDENTIFICATION & INVESTIGATION (BCI).IN MARCH OF 2020, COVID-19 CHANGED THE WAY MADISON HEALTH CONDUCTED BUSINESS. THE LEADERSHIP TEAM, EMPLOYEES AND PROVIDERS AT MADISON HEALTH WORKED TOGETHER TO CREATE AND IMPLEMENT SEVERAL ITEMS AS THE COVID-19 PANDEMIC EVOLVED. AS A HEALTHCARE ORGANIZATION, WE LEARNED TO ADAPT IN ORDER TO MEET THE NEEDS OF OUR COMMUNITY. SHORTLY AFTER THE PANDEMIC BEGAN, AN ORDER MADE BY THE DEPARTMENT OF HEALTH STOPPED ALL NON-ESSENTIAL ELECTIVE SURGERIES AND PROCEDURES, DRASTICALLY REDUCING REVENUE. OUR LEADERSHIP TEAM COLLABORATED TO SHIFT EMPLOYEES AND PROVIDERS TO AREAS WITH ANTICIPATED NEED. FOR INSTANCE, SURGICAL NURSES WERE CROSS TRAINED TO ASSIST WITH ER AND ICU PATIENTS. SURGEONS AND PRIMARY CARE PROVIDERS WERE GIVEN A CRASH COURSE TO ASSIST WITH TRIAGE IN THE ER IF NEEDED. SURGICAL TECHNICIANS WERE BUSY CLEANING AND DISINFECTING HIGH TOUCH AREAS ON A CONSISTENT BASIS. WE CONSULTED WITH A MICROBIOLOGIST FROM BATTELLE WHO WAS AN EXPERT IN BIO-HAZARD SAFETY. WE DID THIS TO ENSURE THAT WE WERE FOLLOWING ALL DISINFECTING PROTOCOLS TO KEEP OUR FACILITIES AS SAFE AS POSSIBLE. THE HEALTH AND WELL-BEING OF OUR EMPLOYEES BECAME PARAMOUNT, SO MANY WERE REQUIRED TO BEGIN WORKING FROM HOME. AS THE CRISIS EVOLVED, MADISON HEALTH JOINED FORCES WITH OTHERS IN THE COMMUNITY TO BATTLE THE PANDEMIC. IN COLLABORATION WITH THE LOCAL HEALTH DEPARTMENT, A FIELD ASSESSMENT TEAM WAS CREATED TO TEST RESIDENTS OF EXTENDED CARE FACILITIES AND LOCAL GROUP HOMES FOR THOSE WITH DEVELOPMENTAL DISABILITIES. THE TEAM WAS DEPLOYED TO THE FOLLOWING LOCATIONS: AN AREA GROUP HOME, LONDON HEALTH AND REHAB NURSING HOME, THE MADISON HOUSE ASSISTED LIVING FACILITY, AND THE MADISON COUNTY SENIOR CENTER. THE TEAM USED VARIOUS RESOURCES FROM THE HEALTH DEPARTMENT, THE MEDICAL RESERVE CORPS AND THE MADISON HEALTH EMERGENCY PREPAREDNESS COORDINATOR. THE HOSPITAL ALSO SHARED AND DELIVERED PPE AND AIRWAY FILTERS TO AREA EMS AGENCIES AND MAINTAINED "PUSH PACKS" FOR OUTBREAKS IN EXTENDED CARE FACILITIES. (PUSH PACKS ARE MADE UP OF A PREDETERMINED LIST OF SUPPLIES AND ARE ABLE TO BE SENT QUICKLY TO THE AREA WHERE THEY ARE NEEDED). MADISON HEALTH MAINTAINED A PRESENCE ON THE MADISON COUNTY COVID-19 WORKGROUP, WHICH IS A MULTIDISCIPLINARY TEAM INCLUDING SCHOOLS, THE HEALTH DEPARTMENT, LAW ENFORCEMENT, THE COURTS, AND AREA EMS AGENCIES. MADISON HEALTH ALSO ASSISTED ANOTHER HOSPITAL WITH AN URGENT NEED FOR PPE FOR PAPRS. A TESTING STATION WAS ESTABLISHED AT MADISON HEALTH TO PROVIDE TESTS TO MEMBERS OF THE COMMUNITY AS NEEDED. EMPLOYEES VISITED VARIOUS LOCAL BUSINESSES AND INDUSTRIES TO DISCUSS COVID AND MAKE OUR TESTING FACILITIES AVAILABLE. A HOTLINE WAS ESTABLISHED AND MANNED BY HOSPITAL EMPLOYEES, WHO ANSWERED COVID RELATED QUESTIONS FROM BOTH EMPLOYEES AND COMMUNITY MEMBERS. THE MADISON HEALTH SENIOR LEADERSHIP TEAM SPOKE AT MANY LOCAL MEETINGS (VIA ZOOM) TO PROVIDE INFORMATION REGARDING THE PANDEMIC. A SCREENING PACKAGE CONSISTING OF A SHELTER, TABLES, AND CHAIRS WAS PROVIDED TO THE HEALTH DEPARTMENT TO USE TEMPORARILY AS A VACCINATION CLINIC AT THE MOLLY CAREN CENTER. DAILY UPDATES WERE ALSO PROVIDED TO LOCAL, STATE AND FEDERAL PARTNERS REGARDING THE STATUS OF OUR FACILITY, SUPPLIES AND CENSUS TO FACILITATE PLANNING AND USE OF RESOURCES. WE CONTINUE TO MONITOR THE PANDEMIC ON A DAILY BASIS AND REMAIN COMMITTED TO SERVING OUR COMMUNITY. AS THE PANDEMIC CONTINUED INTO 2021, THE MADISON HEALTH LEADERSHIP TEAM, EMPLOYEES AND PROVIDERS WORKED WITH LOCAL ORGANIZATIONS TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. ONE OF THE FIRST ITEMS ADDRESSED WAS THE NEED FOR ASSISTANCE WITH VACCINATIONS. AS COVID-19 VACCINATIONS AND TREATMENTS BECAME AVAILABLE, MADISON HEALTH WAS PLEASED TO PROVIDE NURSES TO ASSIST THE LOCAL HEALTH DEPARTMENT WITH THEIR VACCINATION CLINICS WHERE LITERALLY THOUSANDS WERE SERVED. MADISON HEALTH ALSO ADMINISTERED MONOCLONAL ANTIBODIES TO THE COVID POSITIVE PATIENTS WITHIN THE COMMUNITY IN A NON-EMERGENT OUTPATIENT SETTING. IN AN EFFORT TO ISOLATE COVID PATIENTS FROM THE REST OF THE PATIENT POPULATION, THESE PATIENTS WERE FIRST TREATED IN THE ICU. AS THE ICU BEDS FILLED, THESE OUTPATIENT INFUSIONS WERE MOVED TO THE EMERGENCY DEPARTMENT AND EVENTUALLY TO AN UNUSED AREA OF THE HOSPITAL WHERE A TEMPORARY COVID INFUSION CENTER WAS CREATED. THE PATIENTS SERVED IN THESE INFUSION LOCATIONS CAME FROM AREA NURSING HOMES AND ASSISTED LIVING FACILITIES. SINCE EMPLOYEES OF MADISON HEALTH WERE ALSO INFECTED WITH COVID AND CONTRACT LABOR WAS VERY LIMITED, DAILY PLANNING CALLS WERE HELD TO DISCUSS STAFFING STRATEGIES AND ENSURE CONTINUITY OF CARE FOR OUR PATIENTS. REMOTE AND HYBRID WORKING OPTIONS WERE ALSO ESTABLISHED IN CERTAIN AREAS, WHICH HAD A POSITIVE IMPACT ON EMPLOYEES. THE BENEFITS INCLUDED: IMPROVED EMPLOYEE MORALE, EXTRA SPACE FOR PATIENT ACTIVITIES, AND INCREASED EFFICIENCY. IN ADDITION, TELEMEDICINE WAS OFFERED BY BOTH PRIMARY AND SPECIALTY CARE PROVIDERS IN ORDER TO MEET THE IMMEDIATE NEEDS OF THE COMMUNITY. THIS WAS SOMETHING THAT WAS WELL RECEIVED BY MANY. AS THE PANDEMIC CONTINUED, A DRIVE-UP COMMUNITY SCREENING STATION WAS ESTABLISHED AT THE HOSPITAL TO PROVIDE COVID TESTING. THAT STATION CONTINUED TO FUNCTION UNTIL SEPTEMBER 6, 2022. FINALLY, INITIAL WEEKLY EMAIL UPDATES THAT WERE CREATED DURING COVID, EVOLVED INTO A PERMANENT FORM OF COMMUNICATION ACROSS THE ORGANIZATION. THESE CONTINUE TO INFORM THE STAFF ABOUT COVID UPDATES AND OTHER IMPORTANT INFORMATION. A SPECIAL TRIVIA GAME IS ALSO INCLUDED EACH WEEK TO ENCOURAGE AND MOTIVATE EMPLOYEES AND PROVIDERS. PART VI, LINE 5: MADISON HEALTH HAS AN OPEN MEDICAL STAFF. ALL PHYSICIANS IN THE COMMUNITYWHO MEET MEMBERSHIP AND CLINICAL PRIVILEGE REQUIREMENTS MAY PRACTICE AT MCCH. WE CURRENTLY HAVE PHYSICIANS ON STAFF FROM VARIOUS LOCATIONS IN OUR COMMUNITY INCLUDING LONDON, WEST JEFFERSON, SPRINGFIELD, AND COLUMBUS.OUR BOARD OF TRUSTEES IS PRIMARILY COMPRISED OF COMMUNITY MEMBERS.MADISON HEALTH IS THE ONLY HOSPITAL IN MADISON COUNTY. THE MADISON HEALTH EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY, SEVEN DAYS A WEEK AND IS OPEN TO ALL PEOPLE REGARDLESS OF ABILITY TO PAY.THE NEAREST HOSPITAL TO MADISON HEALTH IS ABOUT 20 MILES IN ALL DIRECTIONS. AS THE COMMUNITY'S SOLE PROVIDER, MADISON HEALTH IS DEDICATED TO MAINTAINING SERVICES INCLUDING EMERGENCY CARE, MATERNITY CARE, AND BREAST CARE SERVICES. PART VI, LINE 6: MADISON HEALTH IS A PART OF THE OSU/MOUNT CARMEL HEALTH ALLIANCE. SINCE 1999 THE ALLIANCE WITH THESE TWO SYSTEMS IS ALL ABOUT BUILDING BETTER HEALTH CARE IN MADISON COUNTY AND THE SURROUNDING COMMUNITIES. THROUGH THE ALLIANCE, WE CAN PROVIDE ADDITIONAL HEALTHCARE RESOURCES AND IMPROVED ACCESS TO SPECIALIZED MEDICAL SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES OH 1 MADISON FAMILY HEALTH CORPORATION 210 NORTH MAIN STREET LONDON OH 43140 311514418 501(C)(3) 4318657 0 N/A N/A TO SUPPORT NON-PROFIT ACTIVITIES OF MADISON FAMILY HEALTH CORPORATION 1 0 PART I, LINE 2: MADISON COUNTY COMMUNITY HOSPITAL SUPPORTS NON-PROFIT ACTIVITIES OF MADISON FAMILY HEALTH CORPORATION, WHICH INCLUDES CAPITAL ACQUISITION AND OPERATING EXPENSE REIMBURSEMENTS. ALL SUCH SUPPORT IS REVIEWED AND APPROVED BY THE BOARD. X X X X 0 0 0 0 0 0 0 0 0 DANA E ENGLE MCCH CEO 494600 0 0 0 30806 0 18719 0 46723 0 590848 0 0 0 MICHAEL S BROWNING CHIEF FINANCIAL OFFICER 315574 0 0 0 1806 0 14953 0 4066 0 336399 0 0 0 ROBERT WALDECK VP-STRATEGY AND CONSTRUCTION 232267 0 0 0 22272 0 10622 0 34088 0 299249 0 0 0 JODI WILSON CHIEF NURSING OFFICER (EXITED 7/21) 189456 0 0 0 1848 0 9555 0 10231 0 211090 0 0 0 JOEL RICE CNP 155928 0 0 0 198 0 8204 0 45635 0 209965 0 0 0 BETH FORDYCE DIRECTOR OF PHARMACY 153484 0 0 0 1937 0 7496 0 31175 0 194092 0 0 0 CINDY STOUT VP MARKETING AND PHYSICIAN 146390 0 0 0 545 0 6027 0 26298 0 179260 0 0 0 BETH MILLIKIN ENTERED 1021 CHIEF HUMAN RESOURCES 145845 0 0 0 261 0 6505 0 16142 0 168753 0 0 0 MARK COATE PHYSICIAN (EXITED 3/21) 124777 0 0 0 20731 0 3946 0 6184 0 155638 0 0 0 P OUR MISSION OUR MISSION IS TO PROVIDE EXCEPTIONAL HEALTH CARE IN A RESPECTFUL, COMPASSIONATE, AND HEALING ENVIRONMENT. OUR VISION OUR VISION IS TO BE THE HEALTH CARE PROVIDER OF CHOICE FOR THE PEOPLE WHO LIVE AND WORK IN MADISON COUNTY AND THE SURROUNDING AREA. OUR VALUES RESPECT FOR PEOPLE WE TREAT EVERYONE WITH KINDNESS AND RESPECT. STEWARDSHIP OF RESOURCES WE MANAGE THE RESOURCES ENTRUSTED TO US IN A RESPONSIBLE AND EFFECTIVE MANNER. COMMITMENT TO EXCELLENCE WE CONTINUOUSLY STRIVE TO: - IMPROVE OUR PERFORMANCE IN ALL AREAS. - PROMOTE A CULTURE OF INTEGRITY AND HIGH ETHICAL STANDARDS. - MAINTAIN THE HIGHEST STANDARDS OF PATIENT CARE. - UNDERSTAND AND MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. MADISON HEALTH PROVIDES SERVICE TO ALL PERSONS WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, DISABILITY, DIAGNOSIS, AGE OR ABILITY TO PAY. SINCE OPENING IN 1962, OUR FAMILY-FRIENDLY SYSTEM HAS ENSURED THAT QUALITY HEALTH CARE IS AVAILABLE TO ALL WHO ENTER OUR DOORS. WHILE WE CONSTANTLY STRIVE TO IMPROVE OUR FACILITIES AND SERVICES, ONE GOAL REMAINS THE SAME: MADISON HEALTH IS A COMMUNITY HOSPITAL WITH A COMMUNITY SPIRIT; A PLACE WHERE PATIENTS AND THEIR FAMILIES CAN COUNT ON PERSONAL CARE, CLOSE TO HOME. ABOUT MADISON HEALTH QUALITY CARE IS ABOUT MORE THAN THE SIZE OF A HOSPITAL. IT'S ABOUT CARING FOR PATIENTS WITH COMPETENCE, COMMITMENT, AND COMPASSION. AT MADISON HEALTH, YOU WILL RECEIVE THE BEST POSSIBLE CARE FROM WELL-TRAINED PHYSICIANS AND EXPERIENCED, DEDICATED CAREGIVERS. OUR FACILITIES ALLOW FOR A COMFORTABLE STAY, WHETHER YOU ARE HERE FOR A FEW HOURS, A FEW DAYS, OR AN EXTENDED TIME. OUR STATE-OF-THE-ART EQUIPMENT, DIAGNOSTIC SERVICES, AND TREATMENT PROGRAMS HELP RESTORE YOU TO GOOD HEALTH IN THE SHORTEST TIME POSSIBLE. ON NOVEMBER 1, 1999, MADISON HEALTH FORMED A UNIQUE AFFILIATION WITH THE OSU/MOUNT CARMEL HEALTH ALLIANCE, EXPANDING OUR RANGE OF SERVICES. THESE MEDICAL FAMILY TIES ALLOW US TO PROVIDE YOU EVEN MORE OF THE BEST QUALITY CARE, CLOSE TO HOME. OUR TEAM OF CAREGIVERS MANAGES MORE THAN 50,000 PATIENT VISITS EACH YEAR, PROVIDING A BROAD RANGE OF HEALTH SERVICES. THESE SERVICES INCLUDE EXTENSIVE INPATIENT AND OUTPATIENT PROGRAMS, COMPREHENSIVE WOMEN'S HEALTHCARE RESOURCES, UP-TO-DATE IMAGING TECHNOLOGIES, AND EMERGENCY CARE. AND IF THE SERVICES YOU NEED AREN'T AVAILABLE IN LONDON, YOU CAN STILL COUNT ON US TO MANAGE YOUR CARE THROUGH OUR QUALITY CONNECTIONS. BEYOND THE MEDICAL EXPERTISE WE PROVIDE, WE'RE ALSO PROUD TO BE PART OF THE COMMUNITY. YOU'LL SEE OUR PHYSICIANS SITTING NEXT TO YOU IN CHURCH, OUR NURSES SHOPPING AT THE GROCERY STORE, AND OUR STAFF MEMBERS ACTIVELY INVOLVED IN THE COMMUNITIES WE SERVE. CARING FOR THE COMMUNITY IS OUR BUSINESS, AND THE ONLY WAY TO DO IT WELL IS TO DO IT RIGHT. CARDIOPULMONARY CARDIOLOGISTS AT MADISON HEALTH OFFER AN ARRAY OF TESTS AND PROCEDURES TO MAKE SURE YOUR HEART IS HEALTHY AND TO FIND ANY POTENTIAL PROBLEMS BEFORE THEY BECOME LIFE THREATENING. OUR CARDIOLOGISTS PROVIDE CONSULTATIONS TO DETERMINE THE BEST CARE FOR YOU. CARDIOLOGY SERVICES INCLUDE: - ELECTROCARDIOGRAPHY (EKGS) - RHYTHM MONITORING - CARDIAC EVENT RECORDING - 24-HOUR HALTER MONITORING - 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING - CARDIAC STRESS TESTING - HEAD-UP TILT TABLE TESTING - SIGNAL AVERAGED EKGS - ECHOCARDIOGRAPHY WITH 2-D COLOR FLOW DOPPLER RESPIRATORY THERAPY RESPIRATORY THERAPY PROVIDES HELP FOR PATIENTS SUFFERING FROM MANY KINDS OF ILLNESSES AND INJURIES RELATED TO THE LUNGS INCLUDING PATIENTS SUFFERING FROM ASTHMA, BRONCHITIS, EMPHYSEMA, HEART FAILURE, PNEUMONIA, STROKE, SMOKE INHALATION, DROWNING, AND OTHER CONDITIONS. RESPIRATORY CARE INCLUDES DIAGNOSTIC EVALUATIONS TO FIND THE CAUSES OF BREATHING DISORDERS AND HOW TO CARE FOR THEM. OUR THERAPISTS ALSO PROVIDE EDUCATION TO INFORM PATIENTS HOW TO USE BREATHING APPARATUS AND OTHER TOOLS TO HELP IMPROVE THEIR QUALITY OF LIFE. SLEEP LAB A GOOD NIGHT'S REST CAN BE HARD TO ACHIEVE, ESPECIALLY FOR THE APPROXIMATELY 20 MILLION AMERICANS WHO SUFFER FROM SLEEP APNEA. SLEEP APNEA IS CHARACTERIZED BY BRIEF INTERRUPTION OF BREATHING DURING SLEEP. THE DISORDER IS A SERIOUS, POTENTIALLY LIFE-THREATENING CONDITION. FOR INDIVIDUALS WHO THINK THEY MIGHT HAVE SLEEP APNEA, THE MADISON HEALTH SLEEP LAB, IN PARTNERSHIP WITH MOUNT CARMEL SLEEP MEDICINE, IS HERE TO HELP. THE HOSPITAL SLEEP LAB TESTS FOR TWO TYPES OF SLEEP APNEA: CENTRAL APNEA, WHICH OCCURS IN ROUGHLY 20 PERCENT OF APNEA PATIENTS, AND OBSTRUCTIVE SLEEP APNEA, THE MORE COMMON OF THE TWO CONDITIONS. THE ONLY WAY TO DIAGNOSE SLEEP APNEA IS THROUGH A SPECIALIZED TEST KNOWN AS A POLYSOMNOGRAPHY OR SLEEP STUDY. THE TESTING PROCESS IS SIMPLE. ANYONE WHO SUSPECTS THEY HAVE SLEEP APNEA, OR HAS A BED PARTNER WHO HAS NOTICED SNORING AND BREATHING IRREGULARITIES, IS ASKED TO CONSULT THEIR PHYSICIAN. THE DOCTOR THEN REFERS THE PATIENT TO THE HOSPITAL FOR A SLEEP STUDY. ONCE THE REFERRAL IS MADE, A MEMBER OF THE SLEEP CENTER STAFF CONTACTS THE PATIENT BY PHONE TO CONDUCT A PRE-SLEEP STUDY QUESTIONNAIRE. THE STAFF MEMBER EXPLAINS WHAT TO EXPECT OF THE TEST, WHAT TO WEAR, AND ASKS IF THE PATIENT HAS SPECIAL REQUESTS. FOR INSTANCE, SOME INDIVIDUALS MAY WANT TO BRING THEIR PILLOW FROM HOME OR HAVE A RADIO OR FAN RUNNING WHILE THEY SLEEP. THE CENTER DOES ITS BEST TO SIMULATE THE PATIENT'S NORMAL SLEEPING ENVIRONMENT. THE TEST REQUIRES JUST ONE NIGHT OF SLEEP FROM THE PATIENT, COMPRISED OF SIX TO EIGHT HOURS. A TECHNICIAN MONITORS THE INDIVIDUAL FROM THE ROOM NEXT DOOR. IN THE MORNING, THE PATIENT IS RELEASED AND THE DATA COLLECTED THE NIGHT BEFORE IS INTERPRETED BY A PULMONOLOGIST OR NEUROLOGIST. THE RESULTS ARE SENT TO THE PATIENT'S PHYSICIAN, WHO THEN EXPLAINS TREATMENT OPTIONS SHOULD THE DIAGNOSIS BE CONFIRMED. FOR PATIENTS WITH CENTRAL APNEA, MEDICATION IS THE MOST OFTEN PRESCRIBED TREATMENT. FOR THOSE WITH OBSTRUCTIVE APNEA, MORE OPTIONS ARE AVAILABLE. WEIGHT LOSS COULD REDUCE THE FREQUENCY AND/OR INTENSITY OF THE EPISODES. ALSO, SURGERY CAN REMOVE SOFT TISSUE AT THE BACK OF THE THROAT THAT RESTRICTS NIGHT-TIME BREATHING. THE MOST COMMON METHOD OF TREATMENT IS A CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE. THE DEVICE IS THE SIZE OF A SMALL RADIO AND SITS ON THE BEDSIDE TABLE. THE PATIENT WEARS A MASK OVER THE NOSE CONNECTED TO THE CPAP BY A HOSE. THE MACHINE FORCES AIR INTO THE PATIENT TO KEEP THE THROAT'S SOFT TISSUE OPEN. THOUGH IT SOUNDS UNCOMFORTABLE, MOST PATIENTS ADAPT QUICKLY AND PREFER THE GOOD NIGHT'S SLEEP OVER ANY INCONVENIENCE THE CPAP MIGHT CAUSE. WELLNESS CENTER LIVING AND ENJOYING LIFE TO THE FULLEST ARE KEY COMPONENTS OF A HEALTHY LIFESTYLE. FITNESS IS A WAY OF LIFE THAT ALLOWS YOU TO FUNCTION AND PERFORM AT YOUR BEST. IT'S A HARMONIC BALANCE OF PRESCRIBED EXERCISE, EATING HABITS AND PREVENTATIVE HEALTH CARE. THE WELLNESS CENTER IS DESIGNED TO IMPROVE AEROBIC EFFICIENCY, MUSCULAR ENDURANCE AND BODY COMPOSITION THROUGH THE USE OF TREADMILLS, STATIONARY BIKES, A STAIR CLIMBER AND STRENGTH-TRAINING EQUIPMENT. ONCOLOGY/CHEMOTHERAPY MADISON HEALTH OFFERS CANCER TREATMENT SERVICES INCLUDING DIAGNOSIS, SURGERY AND CHEMOTHERAPY. OUR ONCOLOGY PATIENTS HAVE ACCESS TO THE MOST ADVANCED TREATMENT OPTIONS AVAILABLE. OUR PATIENTS CAN RECEIVE OUTPATIENT CHEMOTHERAPY, PICC LINES AND ANTIANGIOGENIC THERAPY. IN 2014, MADISON HEALTH TEAMED UP WITH ONE OF THE NATION'S LEADING CANCER CARE PROVIDERS, THE OHIO STATE UNIVERSITY COMPREHENSIVE CANCER CENTER ARTHUR G. JAMES CANCER HOSPITAL AND RICHARD J. SOLOVE RESEARCH INSTITUTE (OSUCCC JAMES), TO PROVIDE MEDICAL ONCOLOGY SERVICES. BECAUSE OF THIS RELATIONSHIP, PATIENTS AT MADISON HEALTH WILL HAVE ACCESS TO THE LATEST IN MEDICAL ONCOLOGY CARE, DELIVERED BY A CANCER EXPERT FROM THE JAMES, RIGHT HERE IN OUR COMMUNITY. IN 2015, THE MADISON HEALTH CANCER CENTER BECAME AN OFFICIAL MEMBER OF THE JAMES CANCER NETWORK. P PEDIATRIC REHABILITATION SERVICES YOUR CHILD IS IMPORTANT TO US. OUR PEDIATRIC REHABILITATION PROGRAM WANTS TO HELP YOUR CHILD ACHIEVE MAXIMUM INDEPENDENCE. OUR SPECIALIZED TEAM OF PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS CAN HELP WITH A VARIETY OF NEUROLOGICAL, DEVELOPMENTAL AND REHABILITATIVE ISSUES SUCH AS: - ORTHOPEDIC INJURIES AND DISORDERS - DEVELOPMENTAL DELAYS - AUTISM - SENSORY PROCESSING DISORDERS - LEARNING DISABILITIES (EXECUTIVE FUNCTION AND ADHD) - FEEDING ISSUES (PICKY EATERS OR THOSE WITH G-TUBES) - ABNORMAL GAIT - CEREBRAL PALSY FOR SOME CHILDREN, THERAPY IS NEEDED TO IMPROVE JOINT RANGE OF MOTION OR STRENGTHENING. FOR MANY PATIENTS, THERAPY INVOLVES WORKING ON DEVELOPMENTAL SKILLS, I.E. ROLLING, SITTING, CRAWLING, WALKING AND JUMPING. WE USE CREATIVE PLAY TO ENHANCE AN ATMOSPHERE OF FUN, MOTIVATING THE CHILD TO ACQUIRE THE SKILLS NEEDED TO IMPROVE OR ADAPT TO HIS OR HER ENVIRONMENT. OTHER THERAPEUTIC INTERVENTIONS INCLUDE SENSORY INTEGRATION THERAPY, AUGMENTATIVE COMMUNICATION AND ASSISTIVE TECHNOLOGY. ADULT OUTPATIENT REHABILITATION SERVICES OUTPATIENT REHABILITATION AT MADISON HEALTH PROVIDES A WIDE RANGE OF SERVICES TO HELP YOU REGAIN YOUR HIGHEST LEVEL OF FUNCTION. WHETHER YOU ARE RECOVERING FROM AN INJURY OR ILLNESS, OR JUST NEED ASSISTANCE WITH THE CHALLENGES OF DAILY LIFE, OUR REHAB SERVICES TEAM WORKS WITH YOU TO MAXIMIZE YOUR ABILITIES. OCCUPATIONAL THERAPY THE GOAL OF OCCUPATIONAL THERAPY IS TO RESTORE FUNCTION TO THE BEST OF EACH PATIENT'S ABILITY. OCCUPATIONAL THERAPY ENABLES OUR PATIENTS TO GAIN SATISFACTION AND INDEPENDENCE BY PERFORMING ACTIVITIES OF DAILY LIVING - WORK, PLAY, OR SELF-CARE - FOR THEMSELVES. OUR DEDICATED TEAM OF PROFESSIONALS STRIVES TO HELP PATIENTS IMPROVE CIRCULATION, RESTORE MOTION, STRENGTHEN THEIR UPPER BODY, RELIEVE PAIN, AND CORRECT AND PREVENT DEFORMITY. OUR OCCUPATIONAL THERAPY STAFF CAN DESIGN CUSTOM SPLINTING, RECOMMEND ADAPTIVE EQUIPMENT, AND WORK TO RESTORE PSYCHOLOGICAL, PHYSICAL, AND COGNITIVE INDEPENDENCE. OUR OCCUPATIONAL THERAPY STAFF CAN HELP PATIENTS WITH VARIOUS CHALLENGES, GUIDING THEM THROUGH ACTIVITIES SUCH AS EXERCISE, SPLINTING, BATHING, DRESSING, AND COOKING. COMMON PROBLEMS TREATED WITH OCCUPATIONAL THERAPY: - CARPAL TUNNEL SYNDROME - STROKE - HAND INJURIES - BRAIN INJURIES - DEVELOPMENTAL DELAYS - ENERGY CONSERVATION/JOINT PROTECTION - NEUROLOGICAL IMPAIRMENTS - URINARY INCONTINENCE PHYSICAL THERAPY AND SPORTS MEDICINE PHYSICAL THERAPY PROMOTES HEALING AND ASSISTS PATIENTS TO REGAIN MOVEMENT, AND RESTORE FUNCTION TO AN INJURED BODY PART. OUR THERAPISTS ALSO AID IN REBUILDING A PATIENT'S CONFIDENCE AND RELIEVING PAIN AND DISCOMFORT WHILE WORKING TOWARD RECOVERY. COMMON PROBLEMS TREATED WITH PHYSICAL THERAPY: - ORTHOPEDIC INJURIES - SPORTS INJURIES - BACK INJURIES/PAIN - NECK PAIN/INJURIES - STROKE - VESTIBULAR IMPAIRMENTS - NEUROLOGICAL IMPAIRMENTS - BALANCE DEFICITS - LYMPHEDEMA - DEVELOPMENTAL DELAYS - PAIN DURING OR AFTER PREGNANCY TREATMENT MAY INCLUDE TECHNIQUES TO DECREASE PAIN AND SWELLING, AS WELL AS EXERCISES TO INCREASE STRENGTH AND MOBILITY. OTHER TREATMENTS INCLUDE THERAPEUTIC EXERCISE, PELVIC OR CERVICAL TRACTION, ELECTRICAL STIMULATION ULTRASOUND, WOUND CARE, GAIT TRAINING, MANUAL THERAPY, AND MASSAGE. OUR TREATMENT IS NOT ALL PHYSICAL. EDUCATION ON TOPICS LIKE JOINT PROTECTION, BACK SAFETY, BODY MECHANICS, POSTURE EDUCATION, AND HOME EXERCISE INSTRUCTION ALSO PLAY A ROLE IN THE RECOVERY PROCESS. OUR STAFF PLANS FOR THE NEEDS OF PATIENTS UPON DISCHARGE AND PROVIDES A CONTINUUM OF CARE. MADISON HEALTH'S SPORTS MEDICINE PROGRAM PROVIDES CARE FOR ALL SPORTS RELATED INJURIES AND HELPS TO IMPROVE ATHLETIC PERFORMANCE. WHATEVER YOUR SPORT, HAVING THE MADISON HEALTH SPORTS MEDICINE STAFF ROOTING FOR YOU CAN HELP YOU MAKE THE MOST OF YOUR ATHLETIC ABILITIES. SPEECH THERAPY SPEECH THERAPY PROVIDES A WIDE RANGE OF SERVICES TO PATIENTS WHO EXHIBIT DIFFICULTY WITH COMMUNICATION OR SWALLOWING DUE TO A STROKE, BRAIN INJURY, PROGRESSIVE DISEASE, CANCER, VOCAL ABUSE OR MISUSE, DEVELOPMENTAL DELAYS OR MENTAL RETARDATION. WE PROVIDE SPEECH THERAPY SERVICES INCLUDING: - LANGUAGE - SWALLOWING EVALUATIONS - MODIFIED BARIUM SWALLOW STUDIES - COGNITION AND MEMORY - VITALSTIM WOMEN'S HEALTH WOMEN'S HEALTH ISSUES CAN BE WIDE-RANGING, CONFUSING AND SOMETIMES FRIGHTENING, WHICH IS WHY WE OFFER A LITTLE EXTRA TLC DURING YOUR VISIT. WHETHER YOU HAVE QUESTIONS ABOUT PREGNANCY, MAMMOGRAMS, OR MENOPAUSE, OUR STAFF OF WOMEN'S HEALTH EXPERTS WILL HELP YOU FIND THE ANSWERS. YOU ARE MORE THAN A PATIENT. YOU ARE OUR PARTNER IN CARING FOR YOUR BODY AND YOUR HEALTH. THROUGH COMMUNICATION BETWEEN YOU AND YOUR CAREGIVERS, OUR COMPASSIONATE MEDICAL TEAM FOSTERS A PARTNERSHIP DESIGNED TO HELP YOU TAKE CONTROL OF YOUR HEALTH. P OBSTETRICS AND GYNECOLOGY AT MOUNT CARMEL MEDICAL GROUP OBGYN, CONVENIENTLY LOCATED AT 54 WEST HIGH STREET IN LONDON, IT IS UNDERSTOOD THAT WOMEN HAVE UNIQUE HEALTHCARE NEEDS. THE TEAM OF PHYSICIANS WORK TOGETHER COLLABORATIVELY TO PROVIDE CARE THAT SUITS THE INDIVIDUAL NEEDS OF EACH WOMAN AND HER FAMILY. FROM GYNECOLOGIC TO OBSTETRICAL CARE, THEY ARE HERE TO HELP SUPPORT YOUR HEALTH AND WELL-BEING THROUGHOUT ALL STAGES OF LIFE. WOMEN OF ALL AGES CAN EXPERIENCE THE FOLLOWING SERVICES IN THE MOST EASILY ACCESSIBLE, TECHNOLOGICALLY-ADVANCED MADISON COUNTY LOCATION FOR WOMEN'S HEALTH CARE: - ADOLESCENT GYNECOLOGY - BREASTFEEDING SUPPORT - CERVICAL CANCER SCREENING - CHRONIC PELVIC PAIN - DELIVERY AND POSTPARTUM CARE - INFERTILITY - ENDOMETRIAL ABLATION - ENDOMETRIOSIS - FAMILY PLANNING - FERTILITY CARE - GYNECOLOGIC INFECTIONS - HORMONE REPLACEMENT - HYSTERECTOMY - MENSTRUAL PROBLEMS - MINIMALLY INVASIVE PROCEDURES - OBSTETRIC ULTRASOUNDS - PELVIC FLOOR DISORDERS - POLYCYSTIC OVARIAN DISORDER - PRENATAL CARE - PRENATAL TESTING AND MONITORING FOR HIGH-RISK PREGNANCIES - VULVAR DISORDERS - WELL WOMAN EXAM - BONE DENSITOMETRY* - DIGITAL MAMMOGRAPHY* *SERVICE CONDUCTED AT THE WOMEN'S IMAGING CENTER, LOCATED IN THE PARK AVENUE MEDICAL BUILDING. BONE DENSITOMETRY AND OSTEOPOROSIS OSTEOPOROSIS IS A POTENTIALLY CRIPPLING DISEASE CHARACTERIZED BY THE LOSS OF BONE TISSUE AND A SUSCEPTIBILITY TO FRACTURE. IT AFFLICTS AN ESTIMATED 25 MILLION AMERICANS, 80 PERCENT OF WHOM ARE WOMEN. OSTEOPOROSIS IS OFTEN CALLED THE "SILENT DISEASE" BECAUSE IT DOES NOT PRODUCE ANY SYMPTOMS UNTIL A FRACTURE OCCURS. APPROXIMATELY 50 PERCENT OF WOMEN OVER THE AGE OF 50 ARE AT RISK OF SUSTAINING AN OSTEOPOROTIC FRACTURE. TODAY, DOCTORS ARE BETTER EQUIPPED TO DETECT AND TREAT BONE LOSS IN ITS EARLIEST STAGES, SO AS TO PREVENT THE DISEASE OR LESSEN ITS IMPACT. ALSO, SEVERAL DRUG THERAPIES NOW ON THE MARKET HAVE BEEN SHOWN TO BE CLINICALLY EFFECTIVE IN SLOWING DOWN OR REVERSING THE BONE-LOSS PROCESS. JUST AS NO PHYSICIAN WOULD PRESCRIBE A MEDICATION FOR HYPERTENSION WITHOUT FIRST TAKING THE PATIENT'S BLOOD PRESSURE, THE DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS SHOULD BEGIN WITH A MEASUREMENT OF THE PATIENT'S BONE MASS OR BONE DENSITY. BONE DENSITOMETRY USES AN ADVANCED TECHNOLOGY CALLED DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA) TO SAFELY, ACCURATELY, AND PAINLESSLY MEASURE BONE DENSITY AND THE MINERAL CONTENT OF BONE. DURING A COMPREHENSIVE BONE EVALUATION WITH DXA, THE PATIENT LIES COMFORTABLY STILL ON A PADDED TABLE WHILE THE DXA UNIT SCANS ONE OR MORE AREAS, USUALLY FRACTURE-PRONE AREAS SUCH AS THE SPINE OR HIP. RADIATION EXPOSURE DURING BONE DENSITOMETRY IS LESS THAN THE RADIATION EXPOSURE DURING A COAST-TO-COAST AIRLINE FLIGHT. THE ENTIRE PROCESS TAKES ONLY A FEW MINUTES TO COMPLETE, DEPENDING ON THE NUMBER OF SITES SCANNED. IT INVOLVES NO INJECTIONS OR INVASIVE PROCEDURES, AND PATIENTS REMAIN FULLY CLOTHED. A REPORT WILL BE SENT TO YOUR DOCTOR THAT CONSISTS OF YOUR DENSITY MEASUREMENTS AND RECOMMENDATIONS FOR TREATMENT OR PREVENTION OF OSTEOPOROSIS AND BONE LOSS. 3D MAMMOGRAPHY AT THE WOMEN'S IMAGING CENTER THE WOMEN'S IMAGING CENTER AT MADISON HEALTH IS PROUD TO OFFER GENIUS 3D MAMMOGRAPHY EXAMS, DEVELOPED BY HOLOGIC, INC., A WORLDWIDE LEADER IN WOMEN'S HEALTH. UTILIZING ADVANCED BREAST TOMOSYNTHESIS TECHNOLOGY, GENIUS EXAMS ARE CLINICALLY PROVEN TO SIGNIFICANTLY INCREASE THE DETECTION OF BREAST CANCERS, AND ALSO DECREASING THE NUMBER OF WOMEN ASKED TO RETURN FOR ADDITIONAL TESTING. IN CONVENTIONAL 2D MAMMOGRAPHY, OVERLAPPING TISSUE IS A LEADING REASON WHY SMALL BREAST CANCERS MAY BE MISSED AND NORMAL TISSUE MAY APPEAR ABNORMAL, LEADING TO UNNECESSARY CALLBACKS. A GENIUS EXAM INCLUDES A THREE-DIMENSIONAL METHOD OF IMAGING THAT CAN GREATLY REDUCE THE TISSUE OVERLAP EFFECT. A GENIUS EXAM INCLUDES BOTH 2D IMAGES AND TOMOSYNTHESIS SCANS. DURING THE TOMOSYNTHESIS PORTION OF THE EXAM, AN X-RAY ARM SWEEPS IN A SLIGHT ARC OVER THE BREAST, TAKING MULTIPLE IMAGES. A COMPUTER THEN CONVERTS THE IMAGES INTO A STACK OF THIN LAYERS, ALLOWING THE RADIOLOGIST TO REVIEW THE BREAST TISSUE ONE LAYER AT A TIME. A GENIUS EXAM REQUIRES NO ADDITIONAL COMPRESSION AND TAKES JUST A FEW SECONDS LONGER THAN A CONVENTIONAL 2D BREAST CANCER SCREENING EXAM. THE GENIUS 3D MAMMOGRAPHY EXAM, AVAILABLE ON THE 3DIMENSIONS AND SELENIA DIMENSIONS SYSTEMS FROM HOLOGIC, ARE REVOLUTIONIZING HOW BREAST CANCER IS DETECTED BY PROVIDING A BETTER OPTION FOR WOMEN OF ALL BREAST DENSITIES COMPARED TO 2D ALONE. RESEARCHERS HAVE FOUND THAT: -THE GENIUS 3D MAMMOGRAPHY EXAM FINDS 20-65% MORE INVASIVE BREAST CANCERS COMPARED TO 2D ALONE, AN AVERAGE INCREASE OF 41%. -ONLY THE GENIUS 3D MAMMOGRAPHY EXAM IS FDA APPROVED AS SUPERIOR FOR WOMEN WITH DENSE BREASTS COMPARED TO 2D ALONE. -THE GENIUS 3D MAMMOGRAPHY EXAM REDUCES CALLBACKS BY UP TO 40% COMPARED TO 2D ALONE. IT IS PART OF MADISON HEALTH'S MISSION TO PROVIDE HIGH QUALITY HEALTHCARE TO MADISON COUNTY AND THE SURROUNDING COMMUNITIES. WITH THE INTRODUCTION OF THIS INNOVATIVE TECHNOLOGY, PATIENTS HAVE ACCESS TO THE BEST IMAGING ON THE MARKET, CLOSE TO HOME. EMERGENCY DEPARTMENT SERVICES THE MADISON HEALTH EMERGENCY DEPARTMENT, STAFFED BY A QUALIFIED, CARING TEAM OF PHYSICIANS AND NURSES, IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK, TO PROVIDE YOU URGENT MEDICAL ATTENTION. OUR MEDICAL TEAM IS LINKED WITH THE PRIMARY LEVEL I TRAUMA CENTER IN CENTRAL OHIO THROUGH OUR AFFILIATION WITH THE OSU/MOUNT CARMEL HEALTH ALLIANCE. IF YOUR HEALTH SITUATION REQUIRES ADVANCED SPECIALIZED CARE, OUR MEDICAL TEAM CAN STABILIZE YOUR CONDITION FOR A SAFE AIR OR GROUND TRANSPORT BY MED FLIGHT OF OHIO. VISITING OUR EMERGENCY DEPARTMENT PRIOR TO SUCH A TRANSFER ENSURES YOUR SAFEST AND QUICKEST RECOVERY. NEW TECHNOLOGY IN THE EMERGENCY DEPARTMENT IS MAKING OUR STROKE RESPONSE FASTER AND MORE ACCURATE. IN JULY 2012, MADISON HEALTH LAUNCHED A TELESTROKE PROGRAM THAT ALLOWED EMERGENCY DEPARTMENT STAFF TO CONSULT BY INTERACTIVE VIDEO WITH NEUROSURGEONS AT THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER. WE ARE ONE OF APPROXIMATELY 14 OHIO HOSPITALS TAKING PART IN THE PROGRAM. ALSO, ON DECEMBER 11, 2013, MADISON HEALTH BECAME THE FIRST REMOTE TELEBURN CONSULT FOR THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER. TELEBURN IS ADVANCED TECHNOLOGY THAT ALLOWS PHYSICIANS TO EXAMINE PATIENTS OFF-SITE. IF A PATIENT COMES IN TO THE EMERGENCY ROOM WITH A BURN OF ANY KIND, A MOBILE DEVICE ALLOWS BURN SPECIALISTS TO SEE THE INJURY. AT THAT POINT, THE SPECIALIST CAN DECIDE IF TREATMENT CAN TAKE PLACE AT MADISON HEALTH OR IF THEY REQUIRE SPECIALTY CARE AT A BURN CLINIC. OUR EMERGENCY DEPARTMENT OFFERS 16 PRIVATE ROOMS IN OUR STATE-OF-THE-ART FACILITY. PREMIER IS A PRIVATE COMPANY THAT MANAGES AND STAFFS EMERGENCY DEPARTMENTS ACROSS THE UNITED STATES. OTHER PATIENT SERVICES WOUND CARE THE WOUND CARE CENTER AT MADISON HEALTH OFFERS ADVANCED WOUND CARE FOR PEOPLE LIVING WITH CHRONIC, NON-HEALING WOUNDS. MADISON HEALTH HAS PARTNERED WITH HEALOGICS, THE NATION'S LEADING PROVIDER OF ADVANCED, CHRONIC WOUND CARE SERVICES. HEALOGICS IS HEADQUARTERED IN JACKSONVILLE, FLORIDA, AND HAS A NATIONWIDE NETWORK OF NEARLY 700 WOUND CARE CENTERS. THE PHYSICIANS AND CLINICIANS AT THE WOUND CARE CENTER WILL UTILIZE LEADING-EDGE THERAPIES SUCH AS HYPERBARIC OXYGEN THERAPY (HBO) TO REINTRODUCE THE BODY'S INNATE ABILITY TO HEAL CHRONIC WOUNDS. HBO INCREASES THE AMOUNT OF OXYGEN TO WOUNDS ALLOWING THEM TO HEAL FROM THE INSIDE. DIABETIC SERVICES DIABETES IS A CHRONIC DISORDER THAT AFFECTS MILLIONS OF AMERICANS WITH VARYING DEGREES OF SEVERITY. THE POTENTIAL FOR SERIOUS COMPLICATIONS EXISTS IF GOOD BLOOD SUGAR CONTROL IS NOT MAINTAINED. THE DIABETIC RESOURCE STAFF AT MADISON HEALTH WORKS WITH PATIENTS TO INFORM THEM OF WAYS TO MAINTAIN THEIR HEALTH AND AVOID THE COMPLICATIONS ASSOCIATED WITH DIABETES. THE MANAGING DIABETES PROGRAM AT MADISON HEALTH HAS BEEN AWARDED THE PRESTIGIOUS AMERICAN DIABETES ASSOCIATION (ADA) EDUCATION RECOGNITION CERTIFICATE FOR A QUALITY DIABETES SELF-MANAGEMENT EDUCATION PROGRAM. P DIETITIAN WHETHER RECOVERING FROM AN INJURY OR ILLNESS OR LOOKING TO IMPROVE YOUR QUALITY OF LIFE, MADISON HEALTH WOULD LIKE TO HELP YOU GET BACK ON THE ROAD TO A HEALTHY LIFESTYLE. GOOD NUTRITION IS AN IMPORTANT PART OF THAT JOURNEY. WITH THE HELP OF OUR REGISTERED DIETITIAN, WE'LL HELP YOU DEVELOP A DIETARY PROGRAM THAT ACCOMPLISHES YOUR GOALS FROM WEIGHT LOSS, WEIGHT GAIN, OR THE NUTRITIONAL MANAGEMENT OF MEDICAL CONDITIONS LIKE DIABETES OR HEART DISEASE. PAIN MANAGEMENT CENTER IS PAIN IMPACTING YOUR LIFE OR THE LIFE OF SOMEONE YOU LOVE? IF SO, YOU ARE NOT ALONE. APPROXIMATELY 50 MILLION AMERICANS SUFFER FROM CHRONIC PAIN. A FEW KEY CHARACTERISTICS OF CHRONIC PAIN ARE: - IT IS ONGOING OR RECURRENT. - IT LASTS BEYOND THE USUAL COURSE OF AN ACUTE ILLNESS OR INJURY OR MORE THAN 3 TO 6 MONTHS. - IT OFTEN NEGATIVELY IMPACTS AN INDIVIDUAL'S WELL-BEING. CHRONIC PAIN VARIES IN INTENSITY AND FREQUENCY. SOME EXPERIENCE CHRONIC PAIN CONSTANTLY WHILE OTHERS ONLY FEEL IT IN EPISODES. IN ADDITION TO PHYSICAL EFFECTS, CHRONIC PAIN CAN HAVE PSYCHOLOGICAL EFFECTS, SUCH AS FATIGUE, MOOD CHANGES, STRESS, ANXIETY, DEPRESSION, IRRITABILITY, OR RESTLESS NIGHTS OF SLEEP. ACCORDING TO THE CDC, APPROXIMATELY 19.6 MILLION AMERICANS SUFFER FROM CHRONIC PAIN THAT HAS LIMITED THEIR DAILY ACTIVITIES ON MOST DAYS OR EVERY DAY DURING THE PAST 6 MONTHS. IF PAIN IS LIMITING YOUR ABILITY TO PERFORM DAILY TASKS, IT IS TIME TO GET HELP. THE MADISON HEALTH PAIN MANAGEMENT CENTER IS HERE TO HELP YOU BALANCE THE PAIN AND GET BACK TO YOUR LIFE. OUR HIGHLY SKILLED PAIN SPECIALISTS WILL CREATE A PERSONALIZED CARE PLAN TO HELP RESTORE FUNCTION FOR YOUR DAILY ACTIVITIES. WE OFFER HIGH-QUALITY PAIN MANAGEMENT SERVICES, INCLUDING THE DIAGNOSIS AND TREATMENT OF THE FOLLOWING CONDITIONS: - BACK AND NECK PAIN, INCLUDING SCIATICA AND WORK-RELATED INJURIES - PERSISTENT PAIN AFTER BACK OR NECK SURGERY - ARTHRITIS PAIN IN THE NECK OR BACK - COMPLEX REGIONAL PAIN SYNDROME (CRPS) - NERVE DAMAGE OR MUSCLE SPASM PAIN - SHINGLES PAIN AT THE MADISON HEALTH PAIN MANAGEMENT CENTER, WE ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY OF BALANCED CARE THROUGH TREATMENT PLANS TAILORED TO EACH PATIENT. OUR BALANCED TREATMENT OPTIONS INCLUDE MINIMALLY INVASIVE INTERVENTIONAL PROCEDURES, MEDICATION MANAGEMENT WHEN APPROPRIATE, AND REFERRALS TO OTHER SERVICES SUCH AS PHYSICAL THERAPY. HOME DELIVERED MEALS (MEALS ON WHEELS) MADISON HEALTH AND LIFE CARE ALLIANCE HAVE PARTNERED TO PROVIDE MEALS ON WHEELS SERVICES THROUGHOUT MADISON COUNTY. THE MEALS-ON-WHEELS PROGRAM PROVIDES HOME-DELIVERED MEALS FOR PEOPLE OVER THE AGE OF 60 WHO ARE UNABLE TO PREPARE HOT NUTRITIOUS MEALS FOR THEMSELVES. VOLUNTEERS DELIVER MEALS MONDAY THROUGH FRIDAY. THOSE WHO QUALIFY FOR THE PROGRAM MAY CHOOSE TO ENROLL IN THE HOME-DELIVERED MEAL PROGRAM, OR DINE AT CONGREGATE SITES IN SOUTH SOLON, WEST JEFFERSON, OR MOUNT STERLING. IF YOU OR SOMEONE YOU KNOW COULD BENEFIT FROM THE MEALS ON WHEELS PROGRAM OR IF YOU WOULD LIKE MORE INFORMATION ON BECOMING A VOLUNTEER, PLEASE CALL (740) 845-7325. LABORATORY MANY OF MADISON HEALTH'S LABORATORY TESTS ARE COMPLETED HERE IN OUR OWN HOSPITAL LABORATORY. THE MAIN HOSPITAL LABORATORY IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK WITH NO APPOINTMENT NECESSARY FOR OUTPATIENT LABORATORY WORK. INSURANCE IS ACCEPTED. THE OUTPATIENT LAB IS LOCATED IN THE PARK AVENUE MEDICAL BUILDING AND IS OPEN FROM 6:30 AM UNTIL 5:30 PM ON WEEKDAYS. THE MADISON HEALTH LAB CAN PERFORM LABORATORY WORK ORDERED BY ANY PHYSICIAN, NOT JUST THOSE ON MADISON HEALTH STAFF. IN COLLABORATION WITH OCCUPATIONAL HEALTH, THE LABORATORY PROVIDES A VARIETY OF OCCUPATIONAL DRUG SCREENING CHOICES INCLUDING TESTING, ACTING AS A COLLECTION SITE, BREATH ALCOHOL TESTING AND PROVIDING MRO SERVICES, IF NECESSARY. MADISON HEALTH ALSO OFFERS OUTPATIENT LABORATORY SERVICES AT MADISON MEDICAL CENTER IN LONDON, MADISON HEALTH DIAGNOSTIC CENTER IN WEST JEFFERSON AND MADISON HEALTH MOUNT STERLING. OCCUPATIONAL HEALTH MADISON HEALTH OCCUPATIONAL HEALTH SERVICES WORKS WITH MANY LOCAL EMPLOYERS AND PROVIDES SERVICES SUCH AS DRUG SCREENS, EMPLOYEE PHYSICALS, HEALTH EDUCATION AND TREATMENT OF WORK-RELATED INJURIES. WE ALSO COORDINATE SERVICES FOR INJURED EMPLOYEES AND MANAGE THE FOLLOW-UP REQUIRED ON WORKERS' COMPENSATION CASES. WE WORK CLOSELY WITH THE MADISON HEALTH STAFF IN OUR LABORATORY, AND PHYSICAL AND OCCUPATIONAL THERAPY DEPARTMENT TO PROVIDE THE NECESSARY TREATMENT. OTHER SERVICES THAT WE CAN PROVIDE INCLUDE: - REFERRALS FOR SPECIALTY EVALUATIONS - RETURN TO WORK INSTRUCTIONS - ON-SITE CONSULTATIONS AND SERVICES - IMMUNIZATIONS - COMPLETE LABORATORY SERVICES - PULMONARY FUNCTION TESTING - RESPIRATORY CLEARANCE EXAMINATIONS - DOT EXAMINATIONS - BREATH ALCOHOL TESTING URGENT CARE MADISON HEALTH PROVIDES CARE FOR MINOR HEALTH ISSUES THAT NEED SAME-DAY TREATMENT. MINOR INJURIES OR ILLNESSES THAT OCCUR AFTER REGULAR OFFICE HOURS ARE BEST SERVED BY MADISON HEALTH URGENT CARE. IMMEDIATE CARE IS AVAILABLE FOR ACUTE MINOR ILLNESSES AND INJURIES, SUCH AS COUGH, COLDS, SORE THROATS, URINARY TRACT INFECTIONS (UTI), RASHES AND BITES, MINOR CUTS, MINOR SPRAINS, STRAINS AND FRACTURES. IF YOU ARE SUFFERING FROM CHEST PAIN, SHORTNESS OF BREATH OR HEAD TRAUMA, CALL 9-1-1 OR GO TO THE NEAREST EMERGENCY DEPARTMENT. MADISON HEALTH URGENT CARE IS LOCATED AT 371 LAFAYETTE STREET IN LONDON (DIRECTLY IN FRONT OF WALMART). THE CENTER IS OPEN CONVENIENT DAYTIME, EVENING AND WEEKEND HOURS, AND NO APPOINTMENT IS NECESSARY. PATIENT CARE UNITS MADISON HEALTH PROVIDES PATIENT UNITS DEDICATED TO SPECIFIC CARE NEEDS. OUR INPATIENT CARE UNIT SERVES PATIENTS WHO ARE BEING TREATED FOR ILLNESSES AND INJURIES THAT REQUIRE CONSTANT CARE. OUR MATERNITY UNIT PROVIDES CARE FOR NEW FAMILIES IN A NON-INVASIVE, FAMILY FRIENDLY ATMOSPHERE. OUR INTENSIVE CARE UNIT PROVIDES CARE TO PATIENTS WHO REQUIRE ACUTE SERVICES. OUR TEAM OF DOCTORS AND NURSES PROVIDE CONSTANT CARE TO STABILIZE AND IMPROVE THE PATIENT'S CONDITION. RADIOLOGY MADISON HEALTH'S RADIOLOGY DEPARTMENT OFFERS A WIDE RANGE OF SERVICES, INCLUDING SPECIALTY SERVICES. WE PROVIDE DIAGNOSTIC OUTPATIENT, INPATIENT, AND EMERGENCY ROOM X-RAYS, INCLUDING FLUOROSCOPIC PROCEDURES SUCH AS UPPER GI'S AND BARIUM ENEMAS. UROLOGICAL PROCEDURES SUCH AS AN IVP OR KIDNEY X-RAYS CAN ALSO BE PERFORMED. OUR SPECIALTY SERVICES INCLUDE: PET/CT SCANS, ULTRASOUND, NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, BONE DENSITOMETRY, MRI, AND BREAST MRI. SOCIAL SERVICES MEDICAL SOCIAL WORKERS ARE ASSIGNED TO EACH PATIENT CARE AREA AND ARE TRAINED TO HELP PATIENTS AND FAMILY MEMBERS DEAL WITH FINANCIAL, SOCIAL AND EMOTIONAL PROBLEMS THAT RELATE TO A PATIENT'S ILLNESS OR HOSPITALIZATION. MEMBERS OF THE DEPARTMENT WORK WITH PATIENTS AND FAMILIES TO HELP DEAL WITH LONG-TERM ILLNESSES AND REHABILITATION. THEY ARE ALSO INVOLVED IN THE DISCHARGE PLANNING PROCESS. ULTRASOUND ULTRASOUND IS A TECHNIQUE BY WHICH SOUND WAVES ARE BOUNCED INTO YOUR BODY, AND THEIR REFLECTIONS CAPTURED BY A MACHINE, TRANSFORMING THEM INTO AN IMAGE. ULTRASOUND DOES NOT INVOLVE RADIATION AND DOES NOT USE DYES THAT NEED TO BE INJECTED OR SWALLOWED. ULTRASOUND TESTS ARE USED IN DIAGNOSING AND TREATING A VARIETY OF HEALTH ISSUES, INCLUDING HEART CONDITIONS, MUSCLE PAIN, ABDOMINAL CONDITIONS, THYROID CONDITIONS, PREGNANCY, AND MANY OTHERS. VASCULAR LABORATORY THE VASCULAR LABORATORY CONDUCTS TESTS RELATED TO ARTERY AND VEIN CONDITIONS. TESTS CAN BE CONDUCTED TO DETERMINE IF OBSTRUCTIONS OF THE VEINS OR ARTERIES EXIST. THESE TESTS ARE USED TO DIAGNOSE ANEURYSMS AND DISEASES OF THE ARTERIES. THE VASCULAR LAB ALSO HAS COLOR FLOW DUPLEX IMAGING (CDI) TECHNOLOGY. CDI IS USED TO EVALUATE VEINS FOR USE AS A GRAFT, OR TO DIAGNOSE VARICOSE VEINS AND VALVULAR INCOMPETENCY. SURGERY WE ALL GET A LITTLE NERVOUS WHEN FACED WITH SURGERY. BUT YOU CAN HAVE CONFIDENCE THAT THE SURGICAL TEAMS AT MADISON HEALTH MEET THE HIGHEST STANDARDS AND ARE COMMITTED TO EXCELLENCE. THE HOSPITAL'S SURGERY CENTER FEATURES THREE STATE-OF-THE-ART SURGICAL SUITES THAT CAN ACCOMMODATE ALL TYPES OF SURGERIES, INCLUDING TOTAL JOINT REPLACEMENT. OUR SURGEONS USE THE LATEST LASER AND MICROSURGICAL INSTRUMENTS, AND PATIENTS RECOVER IN OUR COMFORTABLE RECOVERY ROOM. WITH NEW TECHNOLOGICAL ADVANCES IN SURGICAL PROCEDURES, MANY OPERATIONS THAT USED TO REQUIRE A STAY IN THE HOSPITAL CAN NOW BE DONE ON AN OUTPATIENT BASIS. WHEN SURGERY IS A CHOICE YOU HAVE TO MAKE, YOU CAN BE ASSURED THAT THE SURGERY CENTER AT MADISON HEALTH PROVIDES THE MOST ADVANCED TREATMENTS AND TECHNOLOGY AVAILABLE ANYWHERE AND THE BEST CARE FOR YOU, CLOSE TO HOME. P SURGICAL SPECIALTIES MADISON HEALTH HAS AN OUTSTANDING GROUP OF SURGEONS WHO SPECIALIZE IN THE FIELDS OF: - BREAST SURGERY - COSMETIC & RECONSTRUCTIVE - EAR, NOSE & THROAT - ENDOSCOPY/COLONOSCOPY - GENERAL SURGERY - OBSTETRICS & GYNECOLOGY - ORTHOPEDICS - OPHTHALMOLOGY - PODIATRY - UROLOGY - VASCULAR SURGERY ROBOTIC SURGERY AT MADISON HEALTH, ROBOTIC SURGERY IS NOW AVAILABLE WITH THE DA VINCI XI SYSTEM, A STATE-OF-THE-ART DEVICE THAT SUPPORTS THE ORGANIZATION'S COMMITMENT TO IMPROVING SURGICAL OUTCOMES AND ALLOWING QUICKER PATIENT RECOVERY. ACCORDING TO INTUITIVE, THE DEVELOPERS BEHIND THE DA VINCI XI SYSTEM, THIS TECHNOLOGY "PROVIDES MADISON HEALTH SURGEONS AN ADVANCED SET OF INSTRUMENTS TO USE IN PERFORMING ROBOTIC-ASSISTED MINIMALLY INVASIVE SURGERY. IT ALSO TRANSLATES THE SURGEONS' HAND MOVEMENTS AT THE CONSOLE IN REAL TIME, BENDING AND ROTATING THE INSTRUMENTS WHILE PERFORMING THE PROCEDURE. THE TINY-WRISTED INSTRUMENTS MOVE LIKE A HUMAN HAND, BUT WITH A GREATER RANGE OF MOTION. THE DA VINCI VISION SYSTEM ALSO DELIVERS HIGHLY MAGNIFIED, 3D HIGH-DEFINITION VIEWS OF THE SURGICAL AREA AND MAKES IT POSSIBLE FOR SURGEONS TO OPERATE THROUGH ONE OR A FEW SMALL INCISIONS." AS A PATIENT AT MADISON HEALTH, YOU ARE AT THE CENTER OF A NETWORK OF DEDICATED PROFESSIONALS WORKING TOGETHER TO HELP YOU GET BACK TO WHAT MATTERS MOST. UROLOGY UROLOGY IS A SURGICAL SPECIALTY THAT DEALS WITH DISEASES OF THE MALE AND FEMALE URINARY TRACT AND THE MALE REPRODUCTIVE ORGANS. ALTHOUGH UROLOGY IS CLASSIFIED AS A SURGICAL SPECIALTY, THE UROLOGIST, BECAUSE OF THE WIDE VARIETY OF CLINICAL PROBLEMS ENCOUNTERED, REQUIRES KNOWLEDGE OF INTERNAL MEDICINE, PEDIATRICS, GYNECOLOGY, AND OTHER SPECIALTIES. UROLOGY TREATMENTS AVAILABLE AT MADISON HEALTH INCLUDE: - PEDIATRIC UROLOGY - UROLOGIC ONCOLOGY (CANCER) - PROSTATE CONDITIONS - MALE INFERTILITY - CALCULI (URINARY TRACT STONES) - FEMALE UROLOGY (URINARY INCONTINENCE AND PELVIC OUTLET RELAXATION DISORDERS) - NEUROUROLOGY (VOIDING DISORDERS, URODYNAMIC EVALUATION OF PATIENTS, AND ERECTILE DYSFUNCTION OR IMPOTENCE). THE SPECIALTY OF UROLOGY IS CONSTANTLY CHANGING. AS ADVANCES ARE MADE IN THE TREATMENT OF UROLOGIC CONDITIONS, MADISON HEALTH WILL BE AMONG THE FIRST TO MAKE THESE NEW TREATMENTS AVAILABLE TO ITS PATIENTS. ORTHOPEDICS AND TOTAL JOINT REPLACEMENTS MADISON HEALTH'S ORTHOPEDIC SURGEON AND PHYSICIAN ASSISTANT PROVIDE JOINT REPLACEMENT AND OTHER ORTHOPEDIC RELATED SURGERY CARE. THESE SURGERIES INCLUDE A FULL RANGE OF HIP REPLACEMENTS, KNEE REPLACEMENTS, AND SURGERIES RELATED TO MINOR OR MODERATE TRAUMA AND REPETITIVE WORK INJURIES. OUR NEW SURGICAL SUITES PROVIDE A FACILITY SPECIFIC FOR ORTHOPEDIC AND JOINT REPLACEMENT PROCEDURES. AFTER SURGERY, PATIENTS CAN STAY RIGHT HERE AT MADISON HEALTH TO TAKE ADVANTAGE OF OUR OUTSTANDING PHYSICAL THERAPY SERVICES. THERE IS NO NEED TO TRAVEL TO RECEIVE FOLLOW UP CARE. OUR COMPLETE OUTPATIENT REHAB SERVICES WILL GET YOU MOVING AGAIN AS QUICKLY AS POSSIBLE. ENDOSCOPY PROCEDURES ENDOSCOPY PROCEDURES CAN BE COMPLETED ON AN INPATIENT OR OUTPATIENT BASIS, DEPENDING ON THE DIAGNOSIS OR TREATMENT NEEDED. PROCEDURES PERFORMED IN OUR TWO NEWLY-REMODELED ENDOSCOPY ROOMS INCLUDE: - CYSTOSCOPY TO DIAGNOSE DISEASES OF THE BLADDER AND URETHRA - SIGMOIDOSCOPY AND COLONOSCOPY TO DIAGNOSE AND TREAT DISEASES OF THE COLON - ESOPHAGOGASTRODUODENOSCOPY (EGD) TO DIAGNOSE DISEASES OF THE STOMACH, ESOPHAGUS AND SMALL INTESTINE - BRONCHOSCOPY TO DIAGNOSE DISEASES OF THE TRACHEA AND LUNGS OTHER MINOR SURGICAL PROCEDURES ARE COMPLETED USING ENDOSCOPY, INCLUDING THE EXCISION OF LESIONS AND SKIN BIOPSIES. COMMUNITY OUTREACH AUXILIARY THE MADISON HEALTH AUXILIARY IS MADE UP OF DEDICATED VOLUNTEERS WHO ORGANIZE SPECIAL FUND-RAISING ACTIVITIES TO BENEFIT THE HOSPITAL. SINCE THE HOSPITAL OPENED IN 1962, AUXILIANS HAVE PROVIDED THE HOSPITAL WITH MORE THAN ONE MILLION DOLLARS IN CHARITABLE GIFTS AND PLEDGES TO USE FOR CAPITAL PROJECTS. AUXILIARY MEMBERS MEET THE SECOND MONDAY OF EVERY MONTH TO PLAN EVENTS AND PARTICIPATE IN EDUCATIONAL PROGRAMS. IF YOU ENJOY SPECIAL EVENTS AND FUND RAISING ACTIVITIES, THE MADISON HEALTH AUXILIARY MIGHT BE RIGHT PLACE FOR YOU! MEMBERS VOLUNTEER THEIR SKILLS TO HELP WITH ANY ONE OF THE AUXILIARY'S ANNUAL PROJECTS: - COUNTY WIDE BAKE SALE - FLOWER SALES - GIFT SHOP BREAST CANCER ENDOWMENT FUND MADISON HEALTH IS COMMITTED TO PROVIDING ALL WOMEN IN MADISON COUNTY RESOURCES FOR BREAST CARE SERVICES. AN ENDOWMENT FUND HAS BEEN ESTABLISHED THROUGH THE MADISON HEALTH FOUNDATION TO ASSIST WOMEN IN OUR COMMUNITY WHO CANNOT AFFORD BREAST CANCER DIAGNOSTICS OR TREATMENT SERVICES. FOR MORE INFORMATION, PLEASE CONTACT OUR BREAST CARE SPECIALIST AT THE WOMEN'S IMAGING CENTER AT 740.845.7884. THE LEADING CAUSE OF DEATH FOR WOMEN BETWEEN THE AGES OF 35 AND 55 IS BREAST CANCER. MADISON COUNTY HAS THE SECOND HIGHEST BREAST CANCER DEATH RATE IN OHIO AND THE HIGHEST PERCENTAGE OF LATE STAGE DIAGNOSIS. BREAST CARE CLINICS PROVIDE MAMMOGRAMS AND CLINICAL BREAST EXAMS AT NO OUT-OF-POCKET COST. CLINIC APPOINTMENTS ARE AVAILABLE TO ANY WOMAN, WHETHER SHE IS UNINSURED OR HAS INSURANCE BUT CANNOT AFFORD HER CO-PAY OR DEDUCTIBLE. TO MAKE AN APPOINTMENT CALL 740.845.7100 AND REFER TO THE "BREAST CARE CLINIC." ROCKING HORSE COMMUNITY HEALTH CENTER MADISON ROCKING HORSE COMMUNITY HEALTH CENTER MADISON (FORMERLY THE MADISON COUNTY HEALTH PARTNERS FREE CLINIC) PROVIDES PRIMARY HEALTHCARE FOR ADULTS OF ALL AGES, PEDIATRIC CARE, WOMEN'S HEALTH CARE, PRENATAL CARE, LAB TESTING, SICK VISITS, MEDICATION ASSISTANCE, INFORMATION AND REFERRALS TO COMMUNITY RESOURCES AND SOCIAL SERVICES PROGRAMS. THE CENTER ALSO PROVIDES MEDICAID AND MARKETPLACE INSURANCE APPLICATION ASSISTANCE. THE MISSION OF THE ROCKING HORSE COMMUNITY HEALTH CENTER IS TO RAISE HEALTHY FAMILIES IN A CARING COMMUNITY. THE ROCKING HORSE COMMUNITY HEALTH CENTER MADISON IS LOCATED AT 212 N. MAIN STREET IN LONDON (BRICK BUILDING BEHIND MADISON HEALTH). FOR MORE INFORMATION OR AN APPOINTMENT, PLEASE CALL 740.845.7286. TO VIEW THE ROCKING HORSE COMMUNITY HEALTH CENTER'S WEBSITE, VISIT WWW.ROCKINGHORSECENTER.ORG OR CALL 740.845.7286. VOLUNTEER OPPORTUNITIES MADISON HEALTH BENEFITS TREMENDOUSLY FROM HAVING VOLUNTEERS THROUGHOUT THE HOSPITAL, DOING EVERYTHING FROM GREETING PATIENTS TO MANAGING EDIE'S PLACE, THE MADISON HEALTH GIFT SHOP. VOLUNTEERS SUPPORT ALMOST EVERY DEPARTMENT IN THE HOSPITAL. OPPORTUNITIES INCLUDE: - GREETING PATIENTS AND ANSWERING QUESTIONS AT THE FRONT DESK - DELIVERING MAIL AND FLOWERS TO PATIENTS - GREETING AND ASSISTING PATIENTS IN THE EMERGENCY ROOM - STAFFING EDIE'S PLACE, THE HOSPITAL GIFT SHOP FOR MORE INFORMATION ON VOLUNTEER OPPORTUNITIES, PLEASE CALL 740.845.7012 EMERGENCY PREPAREDNESS MADISON HEALTH IS AN INTEGRAL PARTNER IN COMMUNITY AND REGIONAL EMERGENCY PLANNING. THE HOSPITAL PARTICIPATES IN THE CENTRAL OHIO TRAUMA SYSTEM'S REGIONAL HOSPITAL EMERGENCY PLANNING COMMITTEE AS WELL AS THE LOCAL EMERGENCY PLANNING COMMITTEE. EXERCISES ARE PERFORMED IN COOPERATION WITH LOCAL FIRE, EMS AND LAW ENFORCEMENT AGENCIES. THE HOSPITAL ALSO PARTICIPATES IN REGIONAL EMERGENCY PREPAREDNESS DRILLS. MADISON HEALTH STOCKPILES DISASTER SUPPLIES AND EQUIPMENT INCLUDING A THREE LANE DECONTAMINATION SHELTER. CPR CLASSES CPR CLASSES AVAILABLE THROUGH MADISON HEALTH INCLUDE: - BASIC LIFE SUPPORT FOR HEALTH CARE PROVIDERS - CPR PROGRAMS FOR HEALTH CARE PROFESSIONALS - HEART SAVER CPR PROGRAM FOR COMMUNITY GROUPS FIRST AID CLASSES MADISON HEALTH IS OFFERS FIRST AID CLASSES AVAILABLE TO THE COMMUNITY. THE THREE-HOUR CLASS USES THE AMERICAN HEART ASSOCIATION GUIDELINES. FIRST AID IS THE IMMEDIATE CARE THAT IS GIVEN TO SOMEONE WITH AN ILLNESS OR INJURY BEFORE TRAINED HELP ARRIVES OR TAKES OVER. TRAINED HELP INCLUDES SOMEONE WHOSE JOB IT TAKING CARE OF PEOPLE WHO ARE ILL OR INJURED SUCH AS AN EMS RESPONDER, NURSE OR DOCTOR. P FIRST AID CLASSES MADISON HEALTH IS OFFERS FIRST AID CLASSES AVAILABLE TO THE COMMUNITY. THE THREE-HOUR CLASS USES THE AMERICAN HEART ASSOCIATION GUIDELINES. FIRST AID IS THE IMMEDIATE CARE THAT IS GIVEN TO SOMEONE WITH AN ILLNESS OR INJURY BEFORE TRAINED HELP ARRIVES OR TAKES OVER. TRAINED HELP INCLUDES SOMEONE WHOSE JOB IT TAKING CARE OF PEOPLE WHO ARE ILL OR INJURED SUCH AS AN EMS RESPONDER, NURSE OR DOCTOR. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL MEET AS NEEDED TO FACILITATE DECISION-MAKING AND ACTION. IT SHALL ALSO BE RESPONSIBLE FOR AD-HOC ASSIGNMENTS. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD TO ACT DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY RESTRICTIONS ESTABLISHED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: DANA E. ENGLE, MICHAEL S. BROWNING, MITCHELL SPAHN, M.D. FORM 990, PART VI, SECTION A, LINE 6 MADISON HEALTH HAS TWO MEMBERS: MADISON COUNTY HOSPITAL, INC. AND OSU/MOUNT CARMEL HEALTH ALLIANCE. FORM 990, PART VI, SECTION A, LINE 7A BOTH MEMBERS OF MADISON HEALTH, (MADISON COUNTY HOSPITAL, INC. AND OSU/MOUNT CARMEL HEALTH ALLIANCE HAVE THE ABILITY TO APPOINT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B BOTH MEMBERS OF MADISON HEALTH, (MADISON COUNTY HOSPITAL, INC. AND OSU/MOUNT CARMEL HEALTH ALLIANCE HAVE THE ABILITY TO APPROVE MAJOR POLICY DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE MADE AVAILABLE PRIOR TO FILING TO ALL BOARD MEMBERS ONLY BY WAY OF SECURED WEB PORTAL. PRIOR TO POSTING ON THE WEB PORTAL, THE FORM 990 IS REVIEWED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CEO, MEMBERS OF THE BOARD OF TRUSTEES, ADMINISTRATIVE STAFF, DEPARTMENT MANAGEMENT STAFF, AND MEDICAL STAFF MEMBERS WITH ADMINISTRATIVE RESPONSIBILITIES, RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY. THEY ARE ASKED TO COMPLETE AND RETURN THE CONFLICT OF INTEREST AGREEMENT AND ANNUAL DISCLOSURE STATEMENT TO THE ADMINISTRATIVE OFFICE. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE COMMITTEE AND RETAINED ON FILE. ANY INTERESTS DISCLOSED ARE DEALT WITH APPROPRIATELY AS POTENTIAL CONFLICTS ARISE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEWS FOR THE CEO AND TOP MANAGEMENT OFFICIALS WERE CONDUCTED BY AN INDEPENDENT CONSULTING FIRM. COMPENSATION REVIEWS WERE PERFORMED IN 2016, 2017 AND 2019. IN ADDITION, REGIONAL AND STATE SALARY SURVEYS WERE UTILIZED IN THE REVIEW PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G TEMPORARY HELP: PROGRAM SERVICE EXPENSES 821,291. MANAGEMENT AND GENERAL EXPENSES 280,555. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,101,846. COLLECTION FEES: PROGRAM SERVICE EXPENSES 128,883. MANAGEMENT AND GENERAL EXPENSES 44,027. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 172,910. OTHER: PROGRAM SERVICE EXPENSES 1,486,953. MANAGEMENT AND GENERAL EXPENSES 507,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,994,853. MEDICAL EQUIPMENT RENT AND MAINTENANCE: PROGRAM SERVICE EXPENSES 308,419. MANAGEMENT AND GENERAL EXPENSES 105,357. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 413,776. RECRUITMENT: PROGRAM SERVICE EXPENSES 37,249. MANAGEMENT AND GENERAL EXPENSES 12,724. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,973. BUSINESS OFFICE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,054,370. MANAGEMENT AND GENERAL EXPENSES 1,043,381. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,097,751. FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES, COLUMN (D): NO FUNDRAISING EXPENSES ARE INCURRED IN CONNECTION WITH MONIES RECEIVED BY MADISON HEALTH. A RELATED 501(C)(3) ENTITY, MADISON COUNTY HOSPITAL FOUNDATION, CONDUCTS FUNDRAISING ACTIVITIES AND REPORTS EXPENSES ASSOCIATED WITH FUNDRAISING EFFORTS ON BEHALF OF MADISON HEALTH. FORM 990, PART XII, QUESTION 2C, OVERSIGHT OF FINANCIAL STATEMENT AUDIT: THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AUDITED ON A CONSOLIDATED BASIS WITH ITS AFFILIATES (MADISON COUNTY HOSPITAL, INC., MADISON FAMILY HEALTH CORPORATION AND MADISON COUNTY HOSPITAL FOUNDATION, INC.) BY AN INDEPENDENT ACCOUNTING FIRM. IN ADDITION, THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND ITS SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MADISON COUNTY HOSPITAL INC 210 NORTH MAIN STREET LONDON OH 43140 310876202 MANAGE INVESTMENT OH 501(C)(3) 509(A)(3) TYPE I N/A 0 MADISON COUNTY HOSPITAL FOUNDATION INC 210 NORTH MAIN STREET LONDON OH 43140 237423524 FOUNDATION OH 501(C)(3) LINE 7 N/A 0 MADISON FAMILY HEALTH CORPORATION 210 NORTH MAIN STREET LONDON OH 43140 311514418 PHYSICIAN SERVICES OH 501(C)(3) 509(A)(3) TYPE I MCCH (DBA - MADISON HEALTH) 1 MADISON HEALTH PAIN MANAGEMENT LLC 210 N MAIN STREET LONDON OH 43140 842913421 PAIN MANAGEMENT OH MADISON COUNTY COMMUNITY HOSPITAL RELATED INCOME 97784 90141 0 1 0.51000 0 1 1 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 MADISON FAMILY HEALTH CORPORATION B 4318657 CASH MADISON FAMILY HEALTH CORPORATION N 2679855 FMV MADISON FAMILY HOSITAL FOUNDATION C 62684 CASH PART V, LINE 1(D): MADISON COUNTY COMMUNITY HOSPITAL IS A MEMBER OF THE OBLIGATED GROUP WITH RESPECT TO MADISON COUNTY HOSPITAL'S REVENUE BONDS - OHIO, HOSPITAL FACILITIES MULTI-MODE FIXED RATE REVENUE REFUNDING BONDS, SERIES 2017. THE TOTAL AMOUNT OUTSTANDING AT 12/31/2021 WAS $36,545,000.