NORTON - KINGS DAUGHTERS HEALTH INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: NORTON - KINGS DAUGHTERS HEALTH INC (EIN 35-0895832)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-01
IRS object ID: 202113059349301751
Schema version: 2020v4.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-01T13:35:58-05:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	351178661	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BLUE & CO LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2650 EASTPOINT PKWY SUITE 300	AddressLine1Txt
City	LOUISVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40223	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	350895832	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE BETHANY CIRCLE OF KING'S DAUGHTERS'	BusinessNameLine1Txt
Business Name Line2	OF MADISON INDIANA INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	BETH	BusinessNameControlTxt
Phone	8128010800	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1373 EAST STATE ROAD 62 PO BOX 447	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANNIE SCHROEDER	PersonNm
Person Title	BOARD CHAIRWOMAN	PersonTitleTxt
Phone	8128010800	PhoneNum
Signature	2021-11-01	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	ANNIE	PersonFirstNm
Person Last	SCHROEDER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	CARRIE A MERRILL CPA	PreparerPersonNm
PTIN	P00832283	PTIN
Phone	5029923500	PhoneNum
Preparation	2021-11-01	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	KING'S DAUGHTERS' HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	JOHN PRICE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1373 EAST STATE ROAD 62 PO BOX 447	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$158,972,158	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.KDHMADISON.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1899	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1080	TotalEmployeeCnt
Total Volunteers	74	TotalVolunteersCnt
Total Gross UBI	$39,749	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$25,409	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$330,570	PYContributionsGrantsAmt
CY Contributions Grants	$13,788,547	CYContributionsGrantsAmt
PY Program Service Revenue	$123,174,153	PYProgramServiceRevenueAmt
CY Program Service Revenue	$119,279,872	CYProgramServiceRevenueAmt
PY Investment Income	$4,942,616	PYInvestmentIncomeAmt
CY Investment Income	$7,749,825	CYInvestmentIncomeAmt
PY Other Revenue	$549,491	PYOtherRevenueAmt
CY Other Revenue	$439,482	CYOtherRevenueAmt
PY Total Revenue	$128,996,830	PYTotalRevenueAmt
CY Total Revenue	$141,257,726	CYTotalRevenueAmt
PY Grants And Similar Paid	$28,860	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$11,705	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$64,060,009	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$62,868,207	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$98,016	CYTotalFundraisingExpenseAmt
PY Other Expenses	$60,985,056	PYOtherExpensesAmt
CY Other Expenses	$60,078,380	CYOtherExpensesAmt
PY Total Expenses	$125,073,925	PYTotalExpensesAmt
CY Total Expenses	$122,958,292	CYTotalExpensesAmt
PY Revenues Less Expenses	$3,922,905	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$18,299,434	CYRevenuesLessExpensesAmt
Total Assets BOY	$300,922,993	TotalAssetsBOYAmt
Total Assets EOY	$327,672,291	TotalAssetsEOYAmt
Total Liabilities BOY	$106,292,529	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$101,060,585	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$194,630,464	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$226,611,706	NetAssetsOrFundBalancesEOYAmt
Mission	THE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$92,476,742	ExpenseAmt
Grant	$11,705	GrantAmt
Revenue	$119,362,581	RevenueAmt
Desc	KING'S DAUGHTERS' HEALTH IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL OWNED BY THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON, INDIANA, INC., LOCATED IN MADISON, INDIANA. THE HOSPITAL IS ORGANIZED FOR THE PURPOSE OF PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.DURING THE CALENDAR YEAR 2020, THE HOSPITAL PROVIDED HEALTHCARE TO PATIENTS AT THE FOLLOWING LEVELS:9,909 DAYS OF CARE TO ACUTE INPATIENTS990 DAYS OF CARE TO NEWBORN INFANTS184,105 VISITS ASSOCIATED WITH HOSPITAL OUTPATIENTS115,971 VISITS ASSOCIATED WITH PHYSICIAN CLINICS	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,351,928	ExpenseAmt
Desc	THE HOSPITAL'S PRIMARY SOURCES OF SUPPORT ARE FROM PATIENT REVENUES. PATIENT REVENUES INCLUDE FUNDS RECEIVED FROM MEDICARE, STATE AGENCIES, INSURANCE COMPANIES, AND THE PATIENTS THEMSELVES. IN 2020, KING'S DAUGHTERS' HEALTH PROVIDED SERVICES TOTALING $1,351,928 IN GROSS CHARGES TO PATIENTS WHO MET THE HOSPITAL'S CHARITY CARE POLICY.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$93,828,670	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	77	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1080	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAWN NUNAN DIRECTOR OF ACCOUNTING	PersonNm
Phone	8128010800	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1373 EAST STATE ROAD 62 PO BOX 447	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
ANNIE SCHROEDER
BOARD CHAIRWOMAN	1.00	0.00	Yes (X)	$250	$0	$0
DARLEEN CONNOLLY
BOARD VICE-CHAIRWOMAN	1.00	0.00	Yes (X)	$500	$0	$0
SUSAN OHLENDORF
BOARD SECRETARY	1.00	0.00	Yes (X)	$500	$0	$0
MARY BETTE VOYLES
BOARD TREASURER	1.00	0.00	Yes (X)	$0	$0	$0
ANDREA FORRESTER
BOARD ASSN'T TREASURER	1.00	0.00	Yes (X)	$0	$0	$0
BONNIE COLEN
BOARD ASSN'T SECRETARY	1.00	0.00	Yes (X)	$0	$0	$0
JONATHAN HANSON MD
BOARD MEMBER/PHYSICIAN	40.00	0.00	Yes (X)	$454,702	$0	$34,881
TINA HENDRICK MD
BOARD MEMBER/PHYSICIAN	40.00	0.00	Yes (X)	$387,494	$0	$14,162
JOE CRAIG
BOARD MEMBER	1.00	0.00	Yes (X)	$500	$0	$0
MARY KAY MCCUBBIN
BOARD MEMBER	1.00	0.00	Yes (X)	$500	$0	$0
KEVIN TURNER
BOARD MEMBER	1.00	0.00	Yes (X)	$500	$0	$0
CAROL DOZIER
PRESIDENT/CEO	40.00	1.00		$432,203	$0	$14,555	Yes (X)
JOHN PRICE
VP FINANCE	40.00	0.00		$271,809	$0	$19,309	Yes (X)
LISA MORGAN
VP OUTPATIENT SERVICES	40.00	0.00		$197,177	$0	$17,129	Yes (X)
DENINE FALLIS-HALLGARTH
VP PHYSICIAN PRACTICES	40.00	0.00		$177,362	$0	$16,201	Yes (X)
JENNIFER LITER
VP INPATIENT SERVICES	40.00	0.00		$174,394	$0	$28,442	Yes (X)
NATHAN POLLEY MD
EMPLOYED PHYSICIAN	40.00	0.00		$1,036,680	$0	$37,637		Yes (X)
THOMAS ECKERT MD
EMPLOYED PHYSICIAN	40.00	0.00		$560,735	$0	$21,926		Yes (X)
MICHAEL SCHMIDT MD
EMPLOYED PHYSICIAN	40.00	0.00		$553,643	$0	$30,035		Yes (X)
RAYMONDA STEVENS MD
EMPLOYED PHYSICIAN	40.00	0.00		$548,531	$0	$13,950		Yes (X)
BRENT SINICROPE MD
EMPLOYED PHYSICIAN	40.00	0.00		$682,761	$0	$28,379		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,480,241	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$276,606	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	67	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
EMCARE INC
7032 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	CONTRACTED PHYSICIAN & MID LEVEL PROVIDE	$1,510,548
KAUFMAN HALL & ASSOCIATES
5202 OLD ORCHARD ROAD STE N700	SKOKIE	IL	60077	FINANCIAL CONSULTING SERVICES	$1,216,907
ARUP LABORATORIES
PO BOX 27964	SALT LAKE CITY	UT	84127	LABORATORY SERVICES	$917,169
COMPREHENSIVE MEDICAL MANAGEMENT
300 DAVE COWENS DRIVE STE 600	NEWPORT	KY	41071	CONTRACTED PHYSICIAN BILLING SERVICES	$639,019
WEATHERBY LOCUMS INC
PO BOX 972633	DALLAS	TX	75397	CONTRACTED PHYSICIAN & MID LEVEL PROVIDE	$562,685

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	30	CntrctRcvdGreaterThan100KCnt
Related Organizations	$359,768	RelatedOrganizationsAmt
Government Grants	$13,373,815	GovernmentGrantsAmt
All Other Contributions	$54,964	AllOtherContributionsAmt
Noncash Contributions	$15,130	NoncashContributionsAmt
Total Contributions	$13,788,547	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICE REVENUE	Desc
Business	621110	BusinessCd
Total Revenue Column	$119,279,872	TotalRevenueColumnAmt
Related Or Exempt Func Income	$119,279,872	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$119,279,872	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,419,259	TotalRevenueColumnAmt
Exclusion	$3,419,259	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$54,310	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$23,286	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$31,024	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$31,024	TotalRevenueColumnAmt
Related Or Exempt Func Income	$31,024	RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$21,988,481	SecuritiesAmt
Other	$33,231	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$17,690,956	SecuritiesAmt
Other	$190	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,297,525	SecuritiesAmt
Other	$33,041	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,330,566	TotalRevenueColumnAmt
Exclusion	$4,330,566	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA REVENUE	722210	$315,240	$315,240
LAB	621500	$34,415		$34,415
GIFT SHOP	453220	$1,784	$1,784

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$57,019	TotalRevenueColumnAmt
Related Or Exempt Func Income	$51,685	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$5,334	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$408,458	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$141,257,726	TotalRevenueColumnAmt
Related Or Exempt Func Income	$119,362,581	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$39,749	UnrelatedBusinessRevenueAmt
Exclusion	$8,066,849	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$11,705	TotalAmt
Program Services	$11,705	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,242,567	TotalAmt
Program Services	$1,711,288	ProgramServicesAmt
Management And General	$531,279	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$48,742,421	TotalAmt
Program Services	$37,120,228	ProgramServicesAmt
Management And General	$11,524,177	ManagementAndGeneralAmt
Fundraising	$98,016	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,955,716	TotalAmt
Program Services	$1,492,394	ProgramServicesAmt
Management And General	$463,322	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,501,624	TotalAmt
Program Services	$4,961,347	ProgramServicesAmt
Management And General	$1,540,277	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,425,879	TotalAmt
Program Services	$2,614,266	ProgramServicesAmt
Management And General	$811,613	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$345,836	TotalAmt
Management And General	$345,836	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$289,679	TotalAmt
Management And General	$289,679	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$660,587	TotalAmt
Management And General	$660,587	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$171,999	TotalAmt
Program Services	$131,251	ProgramServicesAmt
Management And General	$40,748	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$440,148	TotalAmt
Program Services	$335,874	ProgramServicesAmt
Management And General	$104,274	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$59,692	TotalAmt
Program Services	$45,551	ProgramServicesAmt
Management And General	$14,141	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,836,531	TotalAmt
Program Services	$1,401,445	ProgramServicesAmt
Management And General	$435,086	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$93,277	TotalAmt
Program Services	$71,179	ProgramServicesAmt
Management And General	$22,098	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,163,667	TotalAmt
Program Services	$3,940,361	ProgramServicesAmt
Management And General	$1,223,306	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,436,098	TotalAmt
Program Services	$6,437,531	ProgramServicesAmt
Management And General	$1,998,567	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,519,079	TotalAmt
Program Services	$1,159,199	ProgramServicesAmt
Management And General	$359,880	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PURCHASED SERVICES	$14,667,005	$11,192,296	$3,474,709
DRUGS	$10,869,022	$10,869,022
SUPPLIES	$7,112,538	$5,427,531	$1,685,007
HOSPITAL ASSESSMENT FEE	$3,665,202	$3,665,202

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,748,020	TotalAmt
Program Services	$1,241,000	ProgramServicesAmt
Management And General	$3,507,020	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$122,958,292	TotalAmt
Program Services	$93,828,670	ProgramServicesAmt
Management And General	$29,031,606	ManagementAndGeneralAmt
Fundraising	$98,016	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$9,524	BOYAmt
EOY	$9,524	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$14,385,357	BOYAmt
EOY	$26,905,533	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,960,805	BOYAmt
EOY	$10,759,153	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$34,165	BOYAmt
EOY	$24,363	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$544,859	BOYAmt
EOY	$1,309,750	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,442,862	BOYAmt
EOY	$3,056,386	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,114,174	BOYAmt
EOY	$1,752,074	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$186,267,149	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$96,173,325	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$95,921,827	BOYAmt
EOY	$90,093,824	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$163,970,770	BOYAmt
EOY	$184,274,988	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$9,538,650	BOYAmt
EOY	$9,486,696	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$300,922,993	BOYAmt
EOY	$327,672,291	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,479,384	BOYAmt
EOY	$9,737,204	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$169,810	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$90,825,285	BOYAmt
EOY	$89,181,804	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,206,861	BOYAmt
EOY	$569,952	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,780,999	BOYAmt
EOY	$1,401,815	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$106,292,529	BOYAmt
EOY	$101,060,585	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$194,617,343	BOYAmt
EOY	$226,591,151	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$13,121	BOYAmt
EOY	$20,555	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$194,630,464	BOYAmt
EOY	$226,611,706	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$300,922,993	BOYAmt
EOY	$327,672,291	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$18,299,434	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$13,430,544	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$251,264	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$10,196	OtherActivitiesAmt
Total Lobbying Expenditures	$10,196	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	PORTION OF INDIANA HOSPITAL ASSOCIATION DUES AND AMERICAN HOSPITAL ASSOCIATION DUES ATTRIBUTABLE TO LOBBYING EXPENSES AS DISCLOSED ON THE DUES NOTICES OF THE RESPECTIVE ASSOCIATIONS.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$13,121	BeginningYearBalanceAmt
Contributions	$15,965	ContributionsAmt
Other Expenditures	$8,531	OtherExpendituresAmt
End Year Balance	$20,555	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$12,850	BeginningYearBalanceAmt
Contributions	$4,035	ContributionsAmt
Other Expenditures	$3,764	OtherExpendituresAmt
End Year Balance	$13,121	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$12,957	BeginningYearBalanceAmt
Contributions	$3,208	ContributionsAmt
Other Expenditures	$3,315	OtherExpendituresAmt
End Year Balance	$12,850	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,194	BeginningYearBalanceAmt
Contributions	$28,678	ContributionsAmt
Other Expenditures	$35,915	OtherExpendituresAmt
End Year Balance	$12,957	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$28,255	BeginningYearBalanceAmt
Contributions	$356,398	ContributionsAmt
Other Expenditures	$364,459	OtherExpendituresAmt
End Year Balance	$20,194	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.48650	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.51350	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,989,556	OtherCostOrOtherBasisAmt
Book Value	$3,989,556	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$118,711,592	OtherCostOrOtherBasisAmt
Depreciation	$43,891,241	DepreciationAmt
Book Value	$74,820,351	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$63,151,848	OtherCostOrOtherBasisAmt
Depreciation	$52,282,084	DepreciationAmt
Book Value	$10,869,764	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$414,153	OtherCostOrOtherBasisAmt
Book Value	$414,153	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$90,093,824	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION	$53,992
THIRD PARTY PAYABLE	$850,041
LIFE INSURANCE POLICIES	$399,224
MEDICARE SETTLEMENT 2020	$98,558

Field	Value	IRS element (for citing)
Total Liability	$1,401,815	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$154,256,758	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$13,430,544	NetUnrealizedGainsInvstAmt
Other Revenue	$251,264	OtherRevenueAmt
Revenue Not Reported	$13,681,808	RevenueNotReportedAmt
Revenue Subtotal	$140,574,950	RevenueSubtotalAmt
Investment Expenses Not Incld	$660,587	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$22,189	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$682,776	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$141,257,726	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$122,275,516	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$122,275,516	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$660,587	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$22,189	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$682,776	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$122,958,292	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	PERMANENT ENDOWMENT - INTENT IS TO HOLD THE INVESTMENT IN PERPETUITY. PER AUDITED FINANCIAL STATEMENTS, "THE PORTION OF PERPETUAL ENDOWMENT FUNDS THAT IS REQUIRED TO BE RETAINED PERMANENTLY EITHER BY EXPLICIT DONOR STIPULATION OR UPMIFA" IS $10,000 AT 12/31/2020. TERM ENDOWMENT - TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE INCLUDING: INDIANA HOSPITAL ASSOCIATION FUND AND HIP 2.0 PREMIUM ASSISTANCE FUND.
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, AS OF THE DATE THE FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN SUBSCRIBER SAVINGS CUMULATIVE ACCOUNT 251,265. ROUNDING -1.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	OTHER RENTAL INCOME 10,484. OTHER EXPENSE NETTED WITH INCOME ON FINANCIAL STATEMENTS 11,705.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	OTHER RENTAL INCOME 10,484. OTHER EXPENSE NETTED WITH INCOME ON FINANCIAL STATEMENTS 11,705.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$437,977	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$437,977	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,396,130	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,814,528	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,581,602	NetCommunityBenefitExpnsAmt
Total Expense	0.07790	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,834,107	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,814,528	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,019,579	NetCommunityBenefitExpnsAmt
Total Expense	0.08150	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$189,137	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$53,612	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$135,525	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$174,945	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,425	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$125,520	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,417,592	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,781,941	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$635,651	NetCommunityBenefitExpnsAmt
Total Expense	0.00520	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,705	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$11,705	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,793,379	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,884,978	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$908,401	NetCommunityBenefitExpnsAmt
Total Expense	0.00740	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,627,486	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,699,506	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,927,980	NetCommunityBenefitExpnsAmt
Total Expense	0.08890	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$246,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$246,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$246,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$246,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$7,637,297	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$24,363,702	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$23,302,042	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,061,660	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KING'S DAUGHTERS' HEALTH	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1373 EAST STATE ROAD 62 PO BOX 447	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.KDHMADISON.ORG	WebsiteAddressTxt
State License	20-005063-1	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Emergency Room Other	Yes (X)	EmergencyRoomOtherInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	KING'S DAUGHTERS' HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.KDHMADISON.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSISTANCE/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.KDHMADISON.ORG/FORMS/FINANCIAL-ASSISTANCE-APPLICATION/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.KDHMADISON.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSISTANCE/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 3J: THE NEEDS ASSESSMENT PERFORMED BY THE HOSPITAL ALSO EXPLORED KEY ISSUES SUCH AS: CANCER, DIABETES, HEART DISEASE & STROKE, INJURY & VIOLENCE, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY, WEIGHT, RESPIRATORY DISEASES, SUBSTANCE ABUSE, TOBACCO USE, FAMILY PLANNING, INFANT/CHILD HEALTH, DEMENTIA/ALZHEIMER'S DISEASE, SEXUALLY TRANSMITTED DISEASES, ARTHRITIS/OSTEOPOROSIS/BACK CONDITIONS, ORAL HEALTH/DENTAL CARE, HIV/AIDS, IMMUNIZATION/INFECTIOUS DISEASES, AND HEARING & VISION PROBLEMS.
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS IN THE COMMUNITY BY UTILIZING THE FOLLOWING COMPONENTS: TELEPHONE INTERVIEWS OF A RANDOM SAMPLE OF 200 INDIVIDUALS AGE 18 AND OLDER IN THE PRIMARY SERVICE AREA. NOTE THAT THE SAMPLE CONSITED SOLELY OF AREA RESIDENTS AGE 18 AND OLDER. DATA ON CHILDREN WERE GIVEN BY PROXY BY THE PERSON MOST RESPONSIBLE FOR THAT CHILD'S HEALTHCARE NEEDS. ON-LINE KEY INFORMANT SURVEY DIRECTED AT PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BY KING'S DAUGHTERS' BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS THE COMMUNITY OVERALL. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS.
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 7D: RESULTS OF THE NEEDS ASSESSMENT HAVE BEEN MADE AVAILABLE THROUGH A VARIETY OF SOURCES: NEWSPAPER AND RADIO RELEASES, DISTRIBUTION OF INFORMATION IN THE COMMUNITY NEWSLETTER, THE VITAL SIGNS, THROUGH PUBLIC HEALTH FORUMS. IT IS ALSO AVAILABLE ON OUR WEBSITE @ WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 11: THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT IN 2019 WHOSE IMPLEMENTATION STRATEGY WAS ADOPTED IN MARCH 2020. THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2019 NEEDS ASSESSMENT INCLUDED THE FOLLOWING PRIORITY AREAS- SUBSTANCE ABUSE, MENTAL HEALTH, TOBACCO USE, NUTRITION/PHYSICAL ACTIVITY/WEIGHT, DIABETES, HEALTH DISEASE & STROKE, AND CANCER. THIS IMPLEMENTATION STRATEGY WILL GUIDE THE ACTIVITIES FOR THREE CONSECUTIVE YEARS FOLLOWING THE MOST RECENT NEEDS ASSESSMENT (AN UPDATE TO THIS STRATEGY PLAN WILL BE PROVIDED AT THE END OF EACH CALENDAR YEAR (2020, 2021, AND 2022).KDH GAPS: THERE DOES NOT APPEAR TO BE LARGE GAPS IN THE TOPICS OR TYPES OF COMMUNITY OUTREACH PROGRAMS THAT KDH HAS CONDUCTED IN THE PAST. HOWEVER, THERE MAY BE GAPS DUE TO FUNDING LEVELS OR STAFFING LEVELS IN THE NUMBER OF PROGRAMS AND THE GEOGRAPHIC REACH OF THE PROGRAMS THAT HAVE BEEN OFFERED. KDH WILL USE THE LIST OF MAJOR HEALTH ISSUES IN WHICH KDH IS EXPECTED TO HAVE A LEADERSHIP AND SUPPORTING ROLE AS WELL AS THE LIST OF SPECIFIC TOPICS SUGGESTED TO DEVELOP PROGRAMS AND APPLY FOR GRANTS TO IMPROVE HEALTH IN THE COMMUNITIES IT SERVES.IMPLEMENTATION STRATEGY 2020-2022 PRIORITY AREA 1 - SUBSTANCE ABUSE - 2020, YEAR 1 UPDATESTRATEGY: KDH WILL TAKE A LEAD ROLE FOR THE HEALTHY COMMUNITIES INITIATIVE (HCI) SUBSTANCE ABUSE TEAM.OUTCOME: KDH EMPLOYS A PAID HCI COORDINATOR WHO OVERSEES THE HCI SUBSTANCE ABUSE TEAM, SCHEDULING MEETINGS AND SPEAKERS.ADDITIONAL INFORMATION: KDH HAS 12 EMPLOYEES WHO RECEIVE MINUTES FROM THE HCI SUBSTANCE ABUSE TEAM MEETINGS. HALF OF THESE INDIVIDUALS ACTIVELY ATTEND MEETINGS AND BRING INFORMATION BACK TO THEIR WORKPLACE.STRATEGY: KDH WILL HAVE STAFF REPRESENTATIVES ACTIVELY SERVING ON THE FOLLOWING COUNTY SUBSTANCE ABUSE COALITIONS: - JCJTAP JEFFERSON COUNTY JUSTICE TREATMENT AND PREVENTION COALITION- SWITZERLAND COUNTY AWARENESS NETWORK AND/OR SIMILAR DRUG COALITIONOUTCOME: KDH HAS 3 EMPLOYEES WHO ACTIVELY SERVE ON THE JCJTAP COALITION. DESPITE COVID, THE GROUP MET VIA ZOOM DURING 2020. ADDITIONAL INFORMATION: IN ADDITION, THE HCI COORDINATOR IS AN OFFICER, SERVING AS SECRETARY FOR THE JCJTAP COALITION. STRATEGY: KDH WILL CREATE AND MAINTAIN AN EDUCATION AND COMMUNITY RESOURCE/REFERRAL BULLETIN BOARD FOR THE HOSPITAL EMERGENCY ROOM. OUTCOME: A SUBSTANCE ABUSE RESOURCE BULLETIN BOARD WAS PUT IN PLACE APRIL 15TH. THE BOARD WAS ON DISPLAY IN THE ER WAITING ROOM WHERE PATIENTS AND VISITORS COULD VIEW. ADDITIONAL INFORMATION: THE BOARD INCLUDES TOBACCO QUITLINE INFORMATION AND LOCAL RESOURCES FOR AA/NA MEETINGS. *PLANS ARE BEING MADE IN EARLY 2021 TO ADD A SUBSTANCE ABUSE BULLETIN BOARD TO THE CONVENIENT CARE CENTER LOBBY. PRIORITY AREA 2 MENTAL HEALTH 2020, YEAR 1 UPDATE STRATEGY: KDH WILL TAKE A LEAD ROLE FOR THE HEALTHY COMMUNITIES INITIATIVE MENTAL HEALTH/ZERO SUICIDE TEAM. OUTCOME: KDH EMPLOYS A PAID COORDINATOR WHO OVERSEES THE HCI PROGRAM. WHILE THE GENERAL MENTAL HEALTH/SUICIDE TEAM DID NOT MEET IN 2020, A SUBCOMMITTEE WAS FORMED TO BEGIN WORKING ON THE ACE INITIATIVE.ADDITIONAL INFORMATION: SPECIAL RECOGNITION TOOK PLACE FOR MENTAL HEALTH AWARENESS MONTH AND SUICIDE AWARENESS MONTH. A LIST OF LOCAL MENTAL HEALTH RESOURCES WAS CREATED AT THE BEGINNING OF THE COVID-19 CRISIS.STRATEGY: KDH STAFF WILL HELP LEAD HCI'S EFFORT TO BECOME A TRAUMA INFORMED COMMUNITY.OUTCOME: WORKING WITH THE LOCAL COMMUNITY FOUNDATION, KDH/HCI APPLIED FOR AND RECEIVED A PLANNING GRANT TO BEGIN WORK TO BECOME A TRAUMA INFORMED COMMUNITY. THIS FOCUSED ON THE ACE INITIATIVE (ADVERSE CHILDHOOD EXPERIENCES) KDH HOSTED TWO WORKSHOPS WITH COMMUNITY LEADERS TO BEGIN PLANNING EFFORTS.ADDITIONAL INFORMATION: FOLLOWING THE INITIAL PLANNING, KDH/HCI AND THE LOCAL COMMUNITY FOUNDATION APPLIED FOR AND RECEIVED A GRANT TO FUND A COMPREHENSIVE ACES PLAN WHICH WILL BE CALLED RESILIENT JEFFERSON COUNTY. A STEERING COMMITTEE WAS FORMED IN LATE 2020 TO MOVE FORWARD WITH THIS PLAN.STRATEGY: SCREENING TOOLS WILL BE UTILIZED AT KDH. THIS INCLUDES THE USE OF: - ANNUAL DEPRESSION SCREENING TOOL USED IN THE OUTPATIENT PHYSICIAN OFFICES. - EVERY EMERGENCY ROOM PATIENT RECEIVES A SUICIDAL SCREENING TOOL TO ASSESS FOR SUICIDAL RISKOUTCOME: THE PHQ-9 DEPRESSION SCREENING TOOL WAS UTILIZED IN 2020 IN THE KDH OUTPATIENT PROVIDER OFFICES. THE KDH EMERGENCY ROOM COMPLETED THE C-SSRS ASSESSMENT TOOL FOR ALL PATIENTS (EXCEPTION INFANT/TODDLERS). THE CSSRS DEPRESSION SCREENING TOOL IS A NATIONALLY RECOGNIZED PSYCH ASSESSMENT WITH 6 SIMPLE QUESTIONS. IF A PATIENT ANSWERS YES TO ANY QUESTIONS, ADDITIONAL STEPS ARE MADE FOR APPROPRIATE MENTAL HEALTH REFERRALSADDITIONAL INFORMATION: IN 2020, 58% OF PATIENTS AGE 12 AND OLDER RECEIVED THE PHQ-9 SCREENING TOOL IN THE OUTPATIENT PROVIDER OFFICES. A FORMER KDH STAFF MEMBERS DID A THESIS PROJECT ON THIS VERY SUBJECT WHICH HELPED TO IMPROVE THIS PROCESS FOR ALL CSSRS SCREENINGS. REPORTS ARE CREATED FOR PATIENTS WHO HAVE A BEHAVIORAL HEALTH REPORT AND CAN TRACK REOCCURRING ER VISITS. PRIORITY AREA 3 TOBACCO USE - 2020, YEAR 1 UPDATESTRATEGY: TOBACCO AWARENESS EDUCATION, INCLUDING PREVENTION AND CESSATION FOCUSED INFORMATION PROVIDED TO YOUTH OF JEFFERSON COUNTY. OUTCOME: COMPLETED THE STANDARDIZED TOBACCO ASSESSMENT FOR RETAIL SETTINGS (STARS) SURVEYS AT ALL 39 TOBACCO RETAILERS IN JEFFERSON COUNTY. PROVIDED SECONDHAND-SMOKE EDUCATION AT YOUTH "MOVIE IN THE PARK" EVENT. YOUTH TOBACCO CESSATION RESOURCES WERE GIVEN TO JEFFERSON COUNTY MIDDLE AND HIGH SCHOOL COUNSELORS. ADDITIONAL INFORMATION: STARS SURVEY DATA IS UTILIZED TO PRESENT POINT-OF-SALE INFORMATION AND HOW TOBACCO PRODUCTS ARE MARKETED TO YOUTH.STRATEGY: TOBACCO AWARENESS EDUCATION AND CESSATION RESOURCES PROVIDED TO EXPECTING MOTHERS IN JEFFERSON COUNTY.OUTCOME: WIC CLIENTS REFERRED TO THE INDIANA TOBACCO QUITLINE IN 2020 84. NUMBER OF OB/GYN PATIENTS REFERRED TO THE TOBACCO QUITLINE IN 2020 44. CESSATION LITERATURE IS PROVIDED TO TOBACCO USING PREGNANT WOMEN AT PERINATAL EDUCATION APPOINTMENT (LITERATURE IS PREPARED BY TOBACCO COORDINATOR AND GIVEN TO MOTHERS BY PERINATAL EDUCATOR). PARTICIPANTS ENROLLED IN BABY & ME TOBACCO FREE PROGRAM IN 2020 8. STRATEGY: MEASURE AND WORK TO INCREASE REFERRALS TO THE INDIANA STATE TOBACCO QUITLINE.OUTCOME: TOBACCO QUITLINE REFERRALS MADE BY KDH PROVIDERS 1,032 (INCREASE FROM 237 REFERRALS IN 2019). MONTHLY REFERRAL REPORTS SENT TO ALL KDH PHYSICIANS AND NURSES WITH QUITLINE/TOBACCO CESSATION EDUCATIONAL INFORMATION. TOBACCO QUITLINE FAX REFERRAL METHOD IMPLEMENTED IN THE KDH CANCER CENTER. PRIORITY AREA 4 NUTRITION, PHYSICAL ACTIVITY, WEIGHT - 2020, YEAR 1 UPDATESTRATEGY: KDH WILL TAKE A LEAD ROLE FOR THE HEALTHY COMMUNITIES INITIATIVE HEALTHY LIFESTYLES TEAM. THIS TEAM INCLUDES WORK FOCUSING ON DISEASE PREVENTION, HEALTHY NUTRITION, PHYSICAL ACTIVITY, OBESITY, AND TOBACCO.OUTCOME: THE KDH WELLNESS COORDINATOR SERVED AS THE CHAIR FOR THE HEALTHY LIFESTYLES TEAM. THREE KDH EMPLOYEES PARTICIPATE ON THIS TEAM, INCLUDING THE FULL-TIME KDH TOBACCO PREVENTION & CESSATION COORDINATOR.ADDITIONAL INFORMATION: ANY MEETING SUPPLIES, SPECIAL EVENTS MATERIALS, AND ADVERTISING FOR ACTIVITIES WERE SUPPLIED BY KDH AND/OR THE KDH FOUNDATION.STRATEGY: TARGET AREA YOUTH WITH PROGRAMMING AIMED AT INCREASING PHYSICAL ACTIVITY AND TEACHING HEALTHY NUTRITION HABITS AT A YOUNG AGE.OUTCOME: THE KDH FIT KIDS PROGRAM WAS TAUGHT IN JEFFERSON COUNTY 5TH GRADE CLASSROOMS. THIS 7-LESSON EDUCATION PROGRAM TARGETS CHILDHOOD OBESITY BY TEACHING AGE-APPROPRIATE HEALTH, NUTRITION, AND EXERCISE EDUCATION AND OFFERS WEEKLY TAKE HOME CHALLENGES FOR STUDENTS AND THEIR FAMILIES. THE HEALTH LIFESTYLES TEAM HOSTED A YOUTH HEALTH EVENT DURING A LOCAL MOVIE IN THE PARK EVENT. HEALTH EDUCATION AND COMMUNITY RESOURCE MATERIALS WERE PROVIDED TO YOUTH AND THEIR FAMILIES. TWO OF THE EVENT BOOTHS WERE SPECIFIC TO HEALTHY NUTRITION AND PHYSICAL ACTIVITY FOR YOUTH.ADDITIONAL INFORMATION: DUE TO COVID, NOT ALL SCHOOLS RECEIVED THE PROGRAM DURING THE 2019-2020 SCHOOL YEAR. A TOTAL OF 3 SCHOOLS, INCLUDING 6 CLASSROOMS AND 151 STUDENTS AND TEACHERS RECEIVED THE FIT KIDS PROGRAM. IN ADDITION, THE KDH WELLNESS COORDINATOR AND HEALTHY LIFESTYLES TEAM HOSTED A MONTH-LONG PARK HOP FOR AREA YOUTH. THIS EVENT PROMOTED THE VALUE OF PHYSICAL ACTIVITY AND INCENTIVIZED YOUTH AND THEIR FAMILIES TO VISIT AREA PARKS AND TRAILS.CONTINUED
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 16J: AT THE TIME OF REGISTRATION, THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT HE/SHE RECEIVED THIS INFORMATION. THE HOSPITAL ALSO HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. IN ADDITION TO THE ACTIONS PREVIOUSLY LISTED, A FINANCIAL AID COUNSELOR WILL ATTEMPT TO MEET (DURING NORMAL BUSINESS HOURS) WITH ANY UNINSURED INPATIENT PRIOR TO DISCHARGE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
KING'S DAUGHTERS' HEALTH	PART V, SECTION B, LINE 20E: AT THE TIME OF REGISTRATION, THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT HE/SHE RECEIVED THIS INFORMATION. THE HOSPITAL ALSO HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. IN ADDITION TO THE ACTIONS PREVIOUSLY LISTED, A FINANCIAL AID COUNSELOR WILL ATTEMPT TO MEET (DURING NORMAL BUSINESS HOURS) WITH ANY UNINSURED INPATIENT PRIOR TO DISCHARGE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
PART V, SECTION B, LINE 11 CONTINUED	PRIORITY AREA 4 NUTRITION, PHYSICAL ACTIVITY, WEIGHT -CONTINUEDSTRATEGY: KDH WELLNESS WILL HOST TWO COMMUNITY 5K RUN/WALK EVENTS TO ENCOURAGE PHYSICAL ACTIVITY.OUTCOME: DESPITE THE PANDEMIC, THE KDH RUN THE FALLS COMMUNITY 5K RUN/WALK TOOK PLACE IN SEPTEMBER WITH SPECIAL COVID PRECAUTIONS IN PLACE. 179 PARTICIPANTS FINISHED THE OUTDOOR EVENT AND A TOTAL OF 36 STAFF WORKED THE EVENT.ADDITIONAL INFORMATION: DUE TO COVID AND THE CANCELLATION OF THE FALL GIRLS ON THE RUN SEASON, THE GOTR 5K EVENT WAS NOT HELD. PRIORITY AREA 5 DIABETES - 2020, YEAR 1 UPDATESTRATEGY: EMPLOYEE A FULL TIME DIABETES COORDINATOR AT KDH TO PROVIDE SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS.OUTCOME: KDH HIRED A FULL-TIME COORDINATOR IN NOV. 2019, AND SHE BEGAN PROVIDING SERVICES FOR INPATIENTS AND OUTPATIENTS 12/2020.ADDITIONAL INFORMATION: PATIENTS ARE REFERRED TO THE DIABETES EDUCATOR WHEN THEY HAVE A NEW DIAGNOSIS, COMPLICATIONS, A CHANGE IN THERAPY, AN A1C >9%, HAVE GESTATIONAL DIABETES, OR IF A PATIENT REQUESTS DIABETES EDUCATION. THE EDUCATOR ALSO PERFORMS CONTINUOUS GLUCOSE MONITORING STUDIES ON PATIENTS. THE DIABETES COORDINATOR SAW APPROXIMATELY 250 PATIENTS IN 2020.STRATEGY: PROVIDE DIABETIC CONSULTS THROUGH POPULATION HEALTH PROGRAM, WORKING TO DECREASE A1C RATES AND INCREASE REFERRALS.OUTCOME: THE DIABETES EDUCATOR IN THE KDH QUALITY DEPARTMENT AND WORKS DIRECTLY WITH THE POPULATION HEALTH NURSING STAFF.ADDITIONAL INFORMATION: THE AVERAGE A1C RATE IN 2019 WAS 33.53%. WE WERE ABLE TO DECREASE THIS TO 27.7% IN 2020 (LOWER RATES INDICATE BETTER QUALITY). STRATEGY: PROVIDE COMMUNITY EDUCATION AND OUTREACH FOCUSING ON THE PREVENTION OF DIABETES, EARLY DETECTION, AND MANAGEMENT.OUTCOME: DUE TO COVID, THE DIABETES COORDINATOR DID NOT PROVIDE ANY COMMUNITY OUTREACH ACTIVITIES IN 2020. PRIORITY AREA 6 HEART DISEASE & STROKE 2020, YEAR 1 UPDATESTRATEGY: OFFER A STRUCTURED POPULATION HEALTH PROGRAM, WHICH PROVIDES ANNUAL WELLNESS VISITS FOR AT-RISK INDIVIDUALS WITH A GOAL OF INCREASING PREVENTATIVE TESTING.OUTCOME: 907 ANNUAL WELLNESS VISITS WERE PROVIDED TO MEDICARE PATIENTS IN 2020. THIS NUMBER WOULD HAVE BEEN HIGHER, BUT THE POPULATION HEALTH PROGRAM DID NOT SEE PATIENTS FOR 3 MONTHS DUE TO THE PANDEMIC.ADDITIONAL INFORMATION: THESE VISITS RESULTED IN 21 DIFFERENT SCREENING TOOLS BEING ORDERED FOR PATIENTS DURING WELLNESS VISITS.STRATEGY: PROVIDE COMMUNITY AND/OR CORPORATE BLOOD PRESSURE CHECKS AT AREA HEALTH FAIRS AND SCREENS.OUTCOME: DUE TO COVID, COMMUNITY OUTREACH ACTIVITIES WERE VERY LIMITED. NO FORMAL COMMUNITY OR CORPORATE CVD SCREENS WERE HELD IN 2020.ADDITIONAL INFORMATION: NOTE, KDH TRAINED A TOTAL OF 1,061 PEOPLE IN 2020 IN AHA CLASSES (COMBINATION OF BLS, PALS, ACLS).STRATEGY: PROVIDE COMMUNITY EDUCATION AND OUTREACH FOCUSING ON THE PREVENTION AND WARNING SIGNS FOR HEART DISEASE AND STROKE.OUTCOME: CVD EDUCATION WAS PROVIDED TO THE COMMUNITY IN 2020 THROUGH THE "TO YOUR HEALTH" RADIO/PODCAST SHOW. IN ADDITION, THE WELLNESS COORDINATOR HAD 3 COMMUNITY PRESENTATIONS RELATED TO HEART DISEASE PREVENTION.ADDITIONAL INFORMATION: KDH STAFF RECEIVED CVD EDUCATION THROUGHOUT THE YEAR WITH VARIOUS WELLNESS INCENTIVE PROGRAMS. THIS INCLUDED PARTICIPATION IN THE GO RED CAMPAIGN.IN ADDITION, A SOCIAL MEDIA "SHELTER IN PLACE HEALTH TIPS" CAMPAIGN TOOK PLACE DURING THE PANDEMIC, OFFERING HEALTHY LIFESTYLE TIPS INCLUDING HEART DISEASE PREVENTION. PRIORITY AREA 7 CANCER 2020, YEAR 1 UPDATESTRATEGY: OFFER A MINIMUM OF ONE CANCER-SPECIFIC SCREENING EVENT.OUTCOME: TAKE-HOME COLOR-RECTAL SCREENING KITS WERE DISTRIBUTED IN THE MONTH OF MARCH THROUGH PROVIDER OFFICES. A TOTAL OF 44 KITS WERE SUCCESSFULLY RETURNED TO THE LAB FOR PROCESSING. PATIENT FOLLOW-UP WAS PROVIDED FOR 7 POSITIVE TESTS.ADDITIONAL INFORMATION: DUE TO COVID, PLANS FOR A SKIN-CANCER SCREEN DID NOT TAKE PLACE.STRATEGY: OFFER A SUPPORT GROUP FOR CANCER SURVIVORS.OUTCOME: ONE WOMEN & CANCER SUPPORT GROUP WAS HELD AT KDH IN FEB. 2020. THE REMAINDER OF THE SCHEDULED SUPPORT GROUPS WERE CANCELLED DUE TO COVID.ADDITIONAL INFORMATION: THE CANCER TREATMENT CENTER IS PLANNING TO RESUME SUPPORT GROUP MEETINGS IN THE SPRING OF 2021 IF COVID-RELATED MEETING RESTRICTIONS ARE LIFTED.STRATEGY: PROVIDE COMMUNITY EDUCATION AND OUTREACH FOCUSING ON THE PREVENTION OF VARIOUS FORMS OF CANCER. OUTCOME: DESPITE SOME OUTREACH BEING CANCELLED DUE TO THE PANDEMIC, CANCER AWARENESS AND EDUCATION TOOK PLACE THROUGH THE "TO YOUR HEALTH" RADIO / PODCAST SHOW AND THE "SHELTER IN PLACE HEALTH TIPS" SOCIAL MEDIA CAMPAIGN.ADDITIONAL INFORMATION: KDH STAFF RECEIVED CANCER PREVENTION AND AWARENESS EDUCATION THROUGHOUT THE YEAR WITH VARIOUS WELLNESS INCENTIVE PROGRAMS. STAFF WERE ALSO GIVEN FREE SUNSCREEN WITH SKIN CANCER PREVENTION EDUCATION IN 2020.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - REHABILITATION CENTER AND HOME CARE
2670 N MICHIGAN ROAD	MADISON	IN	47250	OUTPATIENT REHABILITATION CENTER AND HOME CARE SERVICES
2 - CONVENIENT CARE CENTER
445 CLIFTY DRIVE	MADISON	IN	47250	CONVENIENT CARE CENTER
3 - VERSAILLES MEDICAL OFFICE BLDG-TYSON ST
206 W TYSON STREET	VERSAILLES	IN	47042	PHYSICIAN MEDICAL OFFICE
4 - TRIMBLE COUNTY MEDICAL OFFICE BLDG
10235 US HIGHWAY 421	MILTON	KY	40045	PHYSICIAN MEDICAL OFFICE
5 - CARROLLTON MEDICAL OFFICE BLDG
205 MARWILL DRIVE	CARROLLTON	KY	41008	PHYSICIAN MEDICAL OFFICE
6 - SWITZERLAND CNTY MEDICAL OFFICE BLDG
1190 WEST MAIN STREET	VEVAY	IN	47043	PHYSICIAN MEDICAL OFFICE
7 - HANOVER MEDICAL OFFICE BLDG
36 MEDICAL PLAZA	HANOVER	IN	47243	PHYSICIAN MEDICAL OFFICE
8 - DOWNTOWN MEDICAL OFFICE BLDG
630 NORTH BROADWAY	MADISON	IN	47250	PHYSICIAN MEDICAL OFFICE AND HOSPITAL STAFF

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:- ASSISTING COMMUNITY MEMBERS WITH MEDICAID PROGRAM ENROLLMENT VIA A FORMAL MEDICAID ENROLLMENT ASSISTANCE PROGRAM OFFERED BY THE HOSPITAL. THIS PROGRAM HELPS COMMUNITY MEMBERS ENROLL TO RECEIVE ALL TYPES OF MEDICAID ASSISTANCE (FOOD, HEALTHCARE, ETC.).
PART III, LINE 2:	IN 2018, THE HOSPITAL ADOPTED THE NEW REVENUE RECOGNITION ACCOUNTING STANDARD ISSUED BY FASB AND CODIFIED IN THE FASB ASC AS TOPIC 606 ("ASC 606"). AS A RESULT OF ADOPTING ASC 606, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR BAD DEBTS IN THE AUDITED FINANCIAL STATEMENTS (STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS) IS NOW REFLECTED AS IMPLICIT PRICE CONCESSIONS (AS DEFINED BY ASC 606) AND THEREFORE INCLUDED AS A REDUCTION TO NET PATIENT SERVICE REVENUE.UPON ADOPTION OF ASC 606, NET PATIENT SERVICE REVENUES ARE RECORDED AT THE TRANSACTION PRICE ESTIMATED BY THE HOSPITAL TO REFLECT THE TOTAL CONSIDERATION DUE FROM PATIENTS AND THIRD-PARTY PAYORS IN EXCHANGE FOR PROVIDING GOODS AND SERVICES IN PATIENT CARE. THE TRANSACTION PRICE, WHICH INVOLVES SIGNIFICANT ESTIMATES, IS DETERMINED BASED ON THE HOSPITAL'S STANDARD CHARGES FOR THE GOODS AND SERVICES PROVIDED, WITH A REDUCTION RECORDED FOR PRICE CONCESSIONS RELATED TO THIRD-PARTY CONTRACTUAL ARRANGEMENTS AS WELL AS PATIENT DISCOUNTS AND OTHER PATIENT PRICE CONCESSIONS. THE HOSPITAL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS.THE AMOUNT REPORTED ON LINE 2 IS "IMPLICIT PRICE CONCESSIONS" AS REFLECTED ON THE AUDITED, CONSOLIDATED TRIAL BALANCE FOR THE HOSPITAL. THE SPECIFIC AMOUNT OF IMPLICIT PRICE CONCESSIONS IS NOT REQUIRED TO BE DISCLOSED IN THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 3:	THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.
PART III, LINE 4:	IN 2018, THE HOSPITAL ADOPTED THE NEW REVENUE RECOGNITION ACCOUNTING STANDARD ISSUED BY FASB AND CODIFIED IN THE FASB ASC AS TOPIC 606 ("ASC 606"). AS A RESULT OF ADOPTING ASC 606, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR BAD DEBTS IN THE AUDITED FINANCIAL STATEMENTS (STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS) IS NOW REFLECTED AS IMPLICIT PRICE CONCESSIONS (AS DEFINED BY ASC 606) AND THEREFORE INCLUDED AS A REDUCTION TO NET PATIENT SERVICE REVENUE. THE SPECIFIC AMOUNT OF IMPLICIT PRICE CONCESSIONS IS NOT REQUIRED TO BE DISCLOSED IN THE AUDITED FINANCIAL STATEMENTS. PLEASE REFER TO THE ATTACHED AUDITED FINANCIAL STATEMENTS - PAGES 8-9 "PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE" PAGES 29-32 "NET PATIENT SERVICE REVENUE"
PART III, LINE 8:	THE MEDICARE COST REPORT WAS THE SOURCE OF INFORMATION REPORTED ON PART III LINE 6.
PART III, LINE 9B:	ALL UNINSURED PATIENTS RECEIVED AN AUTOMATIC 30% DISCOUNT FROM GROSS CHARGES. AT REGISTRATION, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEY ARE OFFERED PAMPHLETS DETAILING THE PROGRAM. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE A DISCOUNT OF UP TO 100% ON THE OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL ATTEMPT TO COLLECT ANY BALANCE REMAINING ON THE UNINSURED ACCOUNT AFTER ALL FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED USING A SERIES OF STATEMENTS, LETTERS, AND TELEPHONE CALLS. THE HOSPITAL WILL ALSO OFFER PATIENTS INTEREST-FREE EXTENDED PAYMENT PLANS. IF THE ACCOUNT REMAINS UNPAID, THE ACCOUNT MAY BE TURNED OVER TO A COLLECTION AGENCY.
PART VI, LINE 2:	THE HOSPITAL CONDUCTED ITS LATEST COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES INFORMATION SO THAT THE COMMUNITY MAY IDENTIFY ISSUES OF GREATEST CONCERN AND DECIDE TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS TOOK INTO .ACCOUNT INPUT FROM PERSONS IN THE COMMUNITY BY UTILIZING THE FOLLOWING COMPONENTS: TELEPHONE INTERVIEWS OF A RANDOM SAMPLE OF 200 INDIVIDUALS AGE 18 AND OLDER IN THE PRIMARY SERVICE AREA. NOTE THAT THE SAMPLE CONSISTED SOLELY OF AREA RESIDENTS AGE 18 AND OLDER. DATA ON CHILDREN WERE GIVEN BY PROXY BY THE PERSON MOST RESPONSIBLE FOR THAT CHILD'S HEALTHCARE NEEDS. ON-LINE KEY INFORMANT SURVEY DIRECTED AT PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BY KING'S DAUGHTERS' BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS THE COMMUNITY OVERALL. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, OR OTHER MEDICAL UNDERSERVED POPULATIONS.BASED ON THE INFORMATION GATHERED THROUGH THIS COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL WAS ABLE TO PUT TOGETHER A LIST OF "AREAS OF OPPORTUNITY" REPRESENTING SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY. THE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED; THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. THESE ALSO TAKE INTO ACCOUNT THOSE ISSUES OF GREATEST CONCERN TO THE COMMUNITY STAKEHOLDERS (KEY INFORMANTS) GIVING INPUT TO THIS PROCESS.THE PRIORITIZATION OF THE HEALTH NEEDS IDENTIFIED IN THIS ASSESSMENT WAS DETERMINED BASED ON A PRIORITIZATION EXERCISE CONDUCTED AMONG COMMUNITY STAKEHOLDERS (REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED AGENCIES AND ORGANIZATIONS) IN CONJUNCTION WITH THE ADMINISTRATION OF THE ONLINE KEY INFORMANT SURVEY. IN THIS PROCESS, THESE KEY INFORMANTS WERE ASKED TO RATE THE SEVERITY OF A VARIETY OF HEALTH ISSUES IN THE COMMUNITY. INSOFAR AS THESE HEALTH ISSUES WERE IDENTIFIED THROUGH THE DATA ABOVE AND/OR WERE IDENTIFIED AS TOP CONCERNS AMONG KEY INFORMANTS, THEIR RANKING OF THESE ISSUES INFORMED THE FOLLOWING PRIORITIES:1. SUBSTANCE ABUSE2. MENTAL HEALTH3. TOBACCO USE4. NUTRITION, PHYSICAL ACTIVITY & WEIGHT5. DIABETES6. HEART DISEASE & STROKE7. CANCER8. RESPIRATORY DISEASES9. INJURY & VIOLENCE10. ACCESS TO HEALTHCARE SERVICES
PART VI, LINE 3:	-AT THE TIME OF REGISTRATION, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH EACH PATIENT. THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT THEY RECEIVED THIS INFORMATION.-THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS.-PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF.-THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION.
PART VI, LINE 4:	KDH PROVIDES HEALTH CARE SERVICES TO FIVE COUNTIES IN SOUTHERN INDIANA AND NORTHERN KENTUCKY. THE 2019 KDH COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED ITS PRIMARY SERVICE AREAS OF JEFFERSON AND SWITZERLAND COUNTIES IN INDIANA AND TRIMBLE COUNTY IN KENTUCKY. THE ADDITIONAL TWO COUNTIES (RIPLEY IN INDIANA AND CARROL IN KENTUCKY) HAVE MULTIPLE HEALTH CARE FACILITIES THAT CURRENTLY CONDUCT A CHNA. TO AVOID DUPLICATION, THE THREE PRIMARY COUNTIES DESCRIBED WERE INCLUDED IN THE 2019 KDH CHNA. A FEWDESCRIPTIVE DEMOGRAPHIC HIGHLIGHTS FOR THE THREE COUNTIES DEFINED AS THE "PRIMARY SERVICE AREA" INCLUDE:- POPULATION: 51,607 (JEFFERSON CO= 32,293, SWITZERLAND CO= 10,617, TRIMBLE CO= 8,697)- URBAN VS. RURAL CLASSIFICATION: 35.2% URBAN AND 64.8% RURAL- AGE GROUP PERCENT: AGE 0-17 WAS 22.0%, AGE 18-64 WAS 61.4%, AGE+65 WAS 16.6%- MEDIAN AGE: JEFFERSON CO= 40.6, SWITZERLAND CO= 40.0, TRIMBLE CO= 41.9- RACE: 95.9% WHITE, 1.5% BLACK, 1.2% OTHER RACE, 1.4% MULTIPLE RACES- PERCENT POVERTY: 15.2%- EDUCATION LEVEL: 13.4% OF POPULATION AGE 25+ WITHOUT A HIGH SCHOOL DIPLOMA OR EQUIVALENT UNEMPLOYMENT RATE: 4.0%
PART VI, LINE 5:	THE MAJORITY OF KING'S DAUGHTERS' HEALTH BOARD OF MANAGERS IS COMPRISED OF INDIVIDUALS WHO LIVE AND WORK IN THE HOSPITAL SERVICES AREA. THE MAJORITY OF THESE INDIVIDUALS ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION ALSO APPLIES A PORTION OF SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE. HISTORICALLY, KDH HAS EMPLOYED A FULL TIME COMMUNITY WELLNESS COORDINATOR. THIS POSITION PROVIDES OUTREACH SERVICES IN AREAS OF NEED TO THE COMMUNITIES WE SERVE. IN ADDITION TO THESE SERVICES, KDH ALSO SERVES AS THE FISCAL AGENT FOR VARIOUS GRANTS. ALL OF THESE SERVICES HELP US MEET THE IDENTIFIED NEEDS OF THE COMMUNITIES WE SERVE.PARTICIPATION IN THE BELOW COMMUNITY ORGANIZATIONS IS PART OF THE HOSPITAL'S INDIANA STATE DEPARTMENT OF HEALTH COMMUNITY BENEFIT PLAN AND GOALS.2020 KING'S DAUGHTERS' HEALTH OVERVIEW OF COMMUNITY BENEFIT ACTIVITIES1. HEALTH SCREENS/HEALTH FAIRS: A. COMMUNITY HEALTH SCREENS / FAIRS: HOSTED A LUNG CANCER SCREENING EVENT FOR LOW INCOME PARTICIPANTS. *COVID NOTE ALL COMMUNITY AND CORPORATE HEALTH SCREENS AND FAIRS WERE CANCELLED IN 2020 DUE TO COVID. B. CORPORATE FLU SHOTS: 1 CORPORATE FLU SHOT CLINIC HELD WITH 10 EMPLOYEE RECEIVING THEIR FLU VACCINE. C. 4-H FAIR PARTICIPATION: BOTH JEFFERSON AND RIPLEY COUNTY INDIANA FAIRS WERE CANCELLED DUE TO COVID. D. FREE TAKE-HOME COLOR CANCER SCREENING KITS: 44 KITS WERE RETURNED FOR PROCESSING. THE NUMBER OF KITS DISTRIBUTED WAS NOT DOCUMENTED. PATIENT FOLLOW-UP WAS PROVIDED FOR ALL POSITIVE TEST RESULTS (7 OF 44). 2. COMMUNITY EDUCATION OPPORTUNITIES/CLASSES/SPECIAL EVENTS: A. WELLNESS DEPARTMENT 8 SPEAKING ENGAGEMENTS B. FIT KIDS PROGRAM (7 WEEK PROGRAM FOR AREA 5TH GRADE CLASSROOMS) DUE TO COVID, NOT ALL JEFFERSON COUNTY SCHOOLS RECEIVED THE FIT KIDS PROGRAM. WERE ABLE TO OFFER THE PROGRAM TO 3 SCHOOL SYSTEMS / 6 CLASSROOMS / 151 KIDS + TEACHERS. C. TOBACCO CESSATION & EDUCATION: -KING'S DAUGHTERS' HEALTH EMPLOYS A FULL TIME STATE GRANT FUNDED TOBACCO COORDINATOR. KDH DOCUMENTED 1,049 ELECTRONIC PATIENT REFERRALS TO THE INDIANA QUITLINE. -CONTRIBUTED TO WRITING THE INDIANA CANCER CONSORTIUM TOBACCO PREVENTION AND CESSATION HEALTH SYSTEMS CHANGE PROJECT GRANT. -ASSISTED IN CREATING AND IMPLEMENTING THE ICC TPC HEALTH SYSTEMS CHANGE PROJECT IN THE KDH CANCER CENTER BY CREATING A TOBACCO CESSATION PROGRAM. -COLLABORATED WITH THE JEFFERSON COUNTY SCHOOLS TO EDUCATE SCHOOL COUNSELORS ON TOBACCO CESSATION RESOURCES AVAILABLE TO YOUTH. - DISTRIBUTED "NO SMOKING WITHIN 8 FEET" SIGNAGE TO LOCAL BUSINESSES WITH THE HELP OF THE HCI OF JEFFERSON COUNTY HEALTHY LIFESTYLES TEAM. - RECEIVED GRANT FUNDING TO PROVIDE FREE NICOTINE REPLACEMENT THERAPY ALONG WITH CESSATION RESOURCES FOR COMMUNITY MEMBERS. - PARTNERED WITH THE JEFFERSON COUNTY HEALTH DEPARTMENT TO IMPLEMENT TOBACCO CESSATION BILLBOARDS. - PARTICIPATED IN STANDARDIZED TOBACCO ASSESSMENT OF RETAIL SETTINGS (STARS) SURVEY. - PARTICIPATED IN MULTI-UNIT HOUSING SURVEYS IN JEFFERSON COUNTY. - PARTNERED WITH JEFFERSON COUNTY WIC TO PROVIDE TOBACCO CESSATION RESOURCES TO TOBACCO USING MOTHERS. - HELD E-CIGARETTE EDUCATION EVENT FOR ADULTS TO LEARN MORE ABOUT DANGERS OF VAPING, TRENDS IN SCHOOLS, WHAT PARENTS SHOULD LOOK FOR AND HOW TO TALK TO TEENS ABOUT VAPING. D. CPR AND FIRST AID CLASSES: KDH SERVED AS AN AHA PROVIDER SITE HOSTING CPR/AED/FIRST AID COMMUNITY CLASSES AND BLS, PALS, AND ACLS TRAININGS FOR KDH EMPLOYEES AND AREA HEALTH CARE PROFESSIONALS. A TOTAL OF 1,061 PEOPLE RECEIVED TRAINING IN 2020. IN ADDITION, SEVERAL COMMUNITY CLASSES WERE CANCELLED IN 2020 DUE TO COVID. E. PRENATAL EDUCATION: OB PREP PROGRAM 405 EXPECTING MOTHERS SERVED WITH EDUCATIONAL PREP VISIT. IN ADDITION, 23 MOTHERS AND 21 SUPPORT PEOPLE ATTENDED THE CHILDBIRTH CLASS SERIES OFFERED BY KDH. ONE CLASS WAS CANCELLED DUE TO COVID. SERVED AS THE HOST SITE FOR LA LECHE LEAGUE COMMUNITY MEETINGS. TWO MEETINGS WERE HELD, WITH ADDITIONAL MEETINGS CANCELLED DUE TO COVID. F. GIRLS ON THE RUN NO FALL SEASON WAS HELD DUE TO COVID. G. MONTHLY "TO YOUR HEALTH" RADIO SHOW: 30-MINUTE HEALTH EDUCATION PROGRAM WITH VARIOUS TOPICS OFFERED EACH MONTH. H. KDH RUN THE FALLS 5K WALK/RUN: 180 PEOPLE PARTICIPATED I. CANCER SUPPORT ACTIVITES: WOMEN AND CANCER SUPPORT GROUP, MET ONLY 1 TIME IN 2020 DUE TO COVID. NO ADDITIONAL CANCER-RELATED ACTIVITIES WERE DOCUMENTED IN 2020 DUE TO COVID.3. EMPLOYEE HEALTH OPPORTUNITIES FOR KDH STAFF: WELLNESS NEWSLETTERS (ON-LINE AND PAPER VERSIONS AVAILABLE). WELLNESS COLUMN IN THE MONTHLY MONITOR NEWSLETTER. MONTHLY PADLET WELLNESS NEWSLETTER CREATED AND SENT TO ALL STAFF. FREE LIPID BLOOD TEST OFFERED FOR ALL STAFF WITH INSURANCE PREMIUM REDUCTION OPPORTUNITY. MONTH LONG STRESS LESS CAMPAIGN. 2020 GOAL SHEETS OFFERED FOR STAFF WITH INCENTIVE. HEART MONTH EDUCATION WITH PROMOTION OF GO RED CAMPAIGN. 5-A-DAY WELLNESS INCENTIVE NUTRITION CHALLENGE. MONTH LONG HABIT TRACKING CAMPAIGN HELD. FREE SUNSCREEN DISTRIBUTION FOR STAFF WITH SKIN CANCER PREVENTION EDUCATION. WALK-TOBER WALKING CAMPAIGN HELD. PROVIDES FREE NICOTINE REPLACEMENT THERAPY PRODUCTS FOR STAFF WHEN REQUESTED.4. COMMUNITY SERVICE ACTIVITIES: A. ACTIVE ATTENDANCE AND PARTICIPATION IN THE FOLLOWING COMMUNITY COALITIONS/GROUPS: JCJTAP JEFFERSON COUNTY JUSTICE TREATMENT AND PREVENTION COALITION MADISON CONSOLIDATED SCHOOLS WELLNESS COMMITTEE PURDUE EXTENSION HEALTH AND HUMAN SERVICES BOARD PERINATAL COMMUNITY TASK FORCE (JUST 1 MEETING IN 2020) B. EMS STAND-BY AT ALL COMMUNITY ACTIVITIES: EMS PROVIDES STAND-BY COVERAGE AT ALL JEFFERSON COUNTY ACTIVITIES. C. ATHLETIC TRAINING/REHAB SERVICES PROVIDED FOR THREE JEFFERSON COUNTY SCHOOLS. D. SUPPORT TO VARIOUS AREA SCHOOLS WITH INTERNSHIPS: SUPPORT MANY LOCAL AND AREA HIGH SCHOOLS AND COLLEGES WITH INTERNSHIPS AND JOB SHADOW EXPERIENCES: INCLUDES NURSING AND MEDICAL STUDENTS AMONG OTHERS.5. HEALTHY COMMUNITIES INITIATIVE (HCI): EFFORTS ARE LED BY KING'S DAUGHTERS' HEALTH WHICH INCLUDE A PAID COORDINATOR FUNDED BY THE KDH FOUNDATION. HCI IS COMPRISED OF THREE TEAMS WHICH INCLUDES KDH STAFF AND COMMUNITY MEMBERS. 2020 HCI TEAM ACCOMPLISHMENTS:SUBSTANCE ABUSE TEAM: WORKED WITH THE KDH TOBACCO COORDINATOR TO CREATE A "HIDDEN IN PLAIN SIGHT BACKPACK" DEMONSTRATION (VIDEO ALSO AVAILABLE) WHICH PROVIDES ABOUT WAYS YOUTH CAN HIDE TOBACCO AND OTHER DRUGS IN MATERIALS IN THEIR BACKPACK. RECEIVED A $500 GRANT TO PURCHASE MATERIALS TO PROMOTE RED RIBBON WEEK AND TO ENCOURAGE YOUTH TO REMAIN DRUG FREE. RECEIVED A $3,400 GRANT TO PURCHASE DRUG DISPOSAL POUCHES TO PROVIDE AN ENVIRONMENTALLY SAFE WAY FOR PERSONS TO DISPOSE OF UNUSED OR UNWANTED DRUGS IN THEIR HOUSEHOLD.MENTAL HEALTH/ZERO SUICIDE TEAM: RECOGNIZED MENTAL HEALTH AWARENESS MONTH AND SUICIDE AWARENESS MONTH. DEVELOPED A SET OF MENTAL HEALTH RESOURCES FOR COMMUNITY USE AT THE START OF THE PANDEMIC. WORKED WITH THE LOCAL COMMUNITY FOUNDATION TO RAISE AWARENESS OF ADVERSE CHILDHOOD EXPERIENCES (ACES) AND TO DEVELOP A PLAN TO COMBAT ACES. APPLIED FOR AND RECEIVED A GRANT FROM THE LILLY ENDOWMENT TO FUND A COMPREHENSIVE ACES PLAN CALLED RESILIENT JEFFERSON COUNTY WHICH WILL BEGIN IN 2021. A VIDEO WAS ALSO CREATED TO PROMOTE AWARENESS OF ACES. HEALTHY LIFESTYLES TEAM: (OVERWEIGHT/OBESITY, TOBACCO, CHRONIC DISEASE) PARTNERED WITH A LOCAL AGENCY TO OFFER A SPRING PARK HOP EVENT WHICH ENCOURAGED YOUTH AND THEIR FAMILIES TO EXPLORE AND USE PARKS IN JEFFERSON COUNTY. HELD A COMMUNITY CHALLENGE TITLED "47250" WHICH ENCOURAGED PARTICIPANTS TO MAKE DAILY HEALTHY CHOICES IN 5 CATEGORIES, EARNING POINTS FOR AN OPPORTUNITY TO WIN PRIZES. HOSTED A COMMUNITY WALKING HEALTHY SCAVENGER HUNT. HOSTED A HEALTH-FOCUSED YOUTH EVENT IN PARTNERSHIP WITH THE CITY OF MADISON MOVIE IN THE PARKS. THIS WAS HELD IN PLACE OF THE YOUTH TAILGATE PARTY WHICH WAS CANCELLED DUE TO COVID. ASSISTED THE TOBACCO COORDINATOR WITH THE STARS SURVEY PROJECT AND THE DISTRIBUTION OF REQUIRED BUSINESS TOBACCO SIGNAGE.
PART VI, LINE 6:	NA
PART VI, LINE 7, REPORTS FILED WITH STATES	IN

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY FOUNDATION OF MADISON AND JEFFERSON COUNTY INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 306	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	351847297	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$5,000	CashGrantAmt
Purpose Of Grant	DONATION	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	FUNDS ARE NOT GRANTED BUT ARE DONATED. DONATIONS ARE DETERMINED ON A DISCRETIONARY BASIS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JONATHAN HANSON MD
BOARD MEMBER/PHYSICIAN	$255,330	$0	$198,820	$0	$552	$0	$13,950	$0	$20,931	$0	$489,583	$0	$0	$0
TINA HENDRICK MD
BOARD MEMBER/PHYSICIAN	$260,217	$0	$127,037	$0	$240	$0	$13,950	$0	$212	$0	$401,656	$0	$0	$0
CAROL DOZIER
PRESIDENT/CEO	$423,562	$0	$0	$0	$8,641	$0	$13,950	$0	$605	$0	$446,758	$0	$0	$0
JOHN PRICE
VP FINANCE	$251,177	$0	$100	$0	$20,532	$0	$12,662	$0	$6,647	$0	$291,118	$0	$0	$0
LISA MORGAN
VP OUTPATIENT SERVICES	$176,545	$0	$100	$0	$20,532	$0	$8,990	$0	$8,139	$0	$214,306	$0	$0	$0
DENINE FALLIS-HALLGARTH
VP PHYSICIAN PRACTICES	$156,730	$0	$100	$0	$20,532	$0	$8,062	$0	$8,139	$0	$193,563	$0	$0	$0
JENNIFER LITER
VP INPATIENT SERVICES	$154,434	$0	$100	$0	$19,860	$0	$7,983	$0	$20,459	$0	$202,836	$0	$0	$0
NATHAN POLLEY MD
EMPLOYED PHYSICIAN	$636,561	$0	$370,353	$0	$29,766	$0	$13,950	$0	$23,687	$0	$1,074,317	$0	$0	$0
THOMAS ECKERT MD
EMPLOYED PHYSICIAN	$442,332	$0	$116,688	$0	$1,715	$0	$13,950	$0	$7,976	$0	$582,661	$0	$0	$0
MICHAEL SCHMIDT MD
EMPLOYED PHYSICIAN	$461,599	$0	$91,492	$0	$552	$0	$13,950	$0	$16,085	$0	$583,678	$0	$0	$0
RAYMONDA STEVENS MD
EMPLOYED PHYSICIAN	$467,307	$0	$80,672	$0	$552	$0	$13,950	$0	$0	$0	$562,481	$0	$0	$0
BRENT SINICROPE MD
EMPLOYED PHYSICIAN	$643,397	$0	$6,350	$0	$33,014	$0	$13,950	$0	$14,429	$0	$711,140	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 7

PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A CALENDAR YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE CALENDAR YEAR MULTIPLIED BY THE INCENTIVE RVU PAYMENT. NON-PHYSICIAN BONUS COMPENSATION IS DISCRETIONARY, SOLELY UP TO THE BOARD OF MANAGERS, AND THE CALCULATION FOR SAID BONUS COMPENSATION VARIES FROM YEAR TO YEAR.

ADDITIONAL SCHEDULE J DISCLOSURES

BOARD MEMBERS TINA HENDRICK, MD AND JONATHAN HANSON, MD LISTED ABOVE ARE EMPLOYED PHYSICIANS OF THE HOSPITAL. DR. HENDRICK AND DR. HANSON DO NOT RECEIVE COMPENSATION FOR SERVICES PROVIDED AS BOARD MEMBERS. THE COMPENSATION LISTED ABOVE FOR DR. HENDRICK AND DR. HANSON IS COMPENSATION RECEIVED FOR SERVICES PROVIDED AS EMPLOYED PHYSICIANS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	INDIANA FINANCE AUTHORITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	351602316	BondIssuerEIN
CUSIP	45471ACW0	CUSIPNum
Bond Issued	2010-11-03	BondIssuedDt
Issue Price	$97,847,058	IssuePriceAmt
Purpose	SEE PART VI	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$97,847,058	TotalProceedsAmt
In Reserve Fund	$6,756,861	InReserveFundAmt
Issuance Costs From Proceeds	$1,749,243	IssuanceCostsFromProceedsAmt
Capital Expenditures	$88,974,097	CapitalExpendituresAmt
Other Spent Proceeds	$266,857	OtherSpentProceedsAmt
Substantial Completion	2013	SubstantialCompletionYr
Refunding Tax Exempt Bonds	0	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	0	RefundingTaxableBondsInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (1)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	Yes (1)	MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts	Yes (1)	EngageBondCounselContractsInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00560	PrivateBusUseByOthersPct
Total Private Business Use	0.00560	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCH K PART I LINE A - PURPOSE	FormAndLineReferenceDesc
Explanation	THE PURPOSE OF THE BOND ISSUANCE IS TO FINANCE, REFINANCE, OR REIMBURSE A PORTION OF THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING VARIOUS HEALTH CARE FACILITIES OF THE HOSPITAL, INCLUDING A REPLACEMENT ACUTE CARE HOSPITAL FACILITY AND A MEDICAL OFFICE BUILDING.	ExplanationTxt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
NATHAN POLLEY MD
EMPLOYED PHYSICIAN - TOP 5 HIGHEST COMPENSATED EMPLOYEE	MEDICAL EDUCATION LOAN REPAYMENT ASSISTANCE	Yes (X)	$10,000	$6,094	0	Yes (1)	Yes (1)
BRENT SINICROPE MD
EMPLOYED PHYSICIAN - TOP 5 HIGHEST COMPENSATED EMPLOYEE	CONTRACT EXECUTION LOAN/PRACTICE COMMENCEMENT LOAN	Yes (X)	$50,000	$18,269	0	Yes (1)	Yes (1)

Field	Value	IRS element (for citing)
Total Balance Due	$24,363	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
A DATTILO FRUIT COMPANY
VP OF OUTPATIENT SERVICES OF KDH HAS A PERCENTAGE OWNERSHIP INTEREST	$15,843	LISA MORGAN IS THE VICE PRESIDENT OF OUTPATIENT SERVICES WITH KING'S DAUGHTERS' HEALTH. LISA OWNS A PERCENTAGE INTEREST IN A. DATTIOL FRUIT COMPANY. KING'S DAUGTHER'S HEALTH PURCHASED PRODUCE FROM A. DATTILO FRUIT COMPANY. KING'S DAUGHTERS' HEALTH MADE PURCHASES TOTALING $15,843 IN 2020.	0
MCCUBBIN MOTORS
BOARD MEMBER IS THE SPOUSE OF THE PRESIDENT OF MCCUBBIN MOTORS, INC.	$45,631	MARY KAY MCCUBBIN IS A KING'S DAUGHTERS' HEALTH BOARD MEMBER. MARY KAY MCCUBBIN IS MARRIED TO THE PRESIDENT OF MCCUBBIN MOTORS, INC. KING'S DAUGHTERS' HEALTH UTILIZED MCCUBBIN MOTORS FOR SERVICING AND/OR REPAIR OF EMERGENCY VEHICLES AND VEHCILE LEASING SERVICES IN 2020. KING'S DAUGHTERS' HEALTH PAID $45,631 TO MCCUBBIN MOTORS IN 2020 FOR THESE SERVICES.	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4	THE ORGANIZATION HAS UPDATED THE BYLAWS.
FORM 990, PART VI, SECTION A, LINE 6	PER THE BYLAWS, THE MEMBERSHIP OF THE ORGANIZATION SHALL BE NON-SECTARIAN, NON-POLITICAL AND NOT CONFINED TO ANY CHRISTIAN RELIGIOUS DENOMINATION OR SECT. ANY SUCH PERSON OF GOOD REPUTE WHO HOLDS HERSELF RESPONSIBLE TO THE KING, CHRIST, OUR LORD AND SAVIOR, MAY BECOME A MEMBER OF THE ORGANIZATION. ALL MEMBERS MUST BE AND REMAIN PERMANENT RESIDENTS OF THE SERVICE AREA OF THE HOSPITAL, AS DETERMINED FROM TIME TO TIME BY THE HOSPITAL BOARD OF MANAGERS, AS A CONTINUING REQUIREMENT FOR MEMBERSHIP. FAILURE TO MAINTAIN SUCH RESIDENCY STATUS AUTOMATICALLY TERMINATES A PERSON'S MEMBERSHIP. HOSPITAL EMPLOYEES, MEMBERS OF THE MEDICAL STAFF, AND THEIR IMMEDIATE FAMILY MEMBERS SHALL NOT BE ELIGIBLE FOR MEMBERSHIP IN THE ORGANIZATION. THE IMMEDIATE FAMILY SHALL BE DEFINED AS INCLUDING THE MOTHER, FATHER, HUSBAND, WIFE, SISTER, BROTHER, DAUGHTER, SON, AND STEPCHILDREN.
FORM 990, PART VI, SECTION A, LINE 7A	THE ORGANIZATION SHALL HAVE TWO (2) CLASSES OF MEMBERS, ACTIVE AND HONORARY, AND ALL MEMBERS SHALL HAVE THE RIGHTS, PRIVILEGES, DUTIES, LIABILITIES, LIMITATIONS AND RESTRICTIONS AS SET FORTH FROM TIME TO TIME IN THE STANDING RULES. ANY ACTIVE MEMBER OF THE ORGANIZATION MAY PROPOSE ANY OTHER PERSON MEETING THE ELIGIBILITY REQUIREMENTS OUTLINED IN PART VI, 7A ABOVE FOR MEMBERSHIP. ONLY ACTIVE MEMBERS IN GOOD STANDING THAT HAVE BEEN A MEMBER FOR AT LEAST TWO ANNIVERSARY YEARS CAN PRESENT A PERSON'S NAME FOR MEMBERSHIP OR TO SERVE ON THE BOARD OF DIRECTORS. A MAJORITY VOTE OF THOSE PRESENT AND VOTING AFFIRMATIVELY AT ANY REGULAR MEETING OF THE ORGANIZATION AT WHICH A QUORUM IS PRESENT SHALL BE SUFFICIENT TO ELECT SUCH PROPOSED PERSON TO MEMBERSHIP. ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME.
FORM 990, PART VI, SECTION A, LINE 7B	ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HIS/HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME.
FORM 990, PART VI, SECTION B, LINE 11B	THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S MANAGEMENT. THE BOARD OF MANAGERS RECEIVES A DRAFT COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES PRIOR TO FILING WITH THE IRS. CHANGES OR REVISIONS ARE SUGGESTED BY THE BOARD IF NECESSARY. THE 990 WILL BE REVIEWED AT THE NEXT BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	KING'S DAUGHTERS' HEALTH HAS A FORMAL CONFLICT OF INTEREST POLICY. THE CONFLICT OF INTEREST POLICY COVERS BOARD OF MANAGER MEMBERS, OFFICERS AND DIRECTORS. THE POLICY REQUIRES THE BOARD OF MANAGERS, OFFICERS AND DIRECTORS TO DISCLOSE ANNUALLY INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS TO BE DISCLOSED TO THE APPROPRIATE VICE PRESIDENT, THE PRESIDENT/CEO AND COMPLIANCE DEPARTMENT. SHOULD SUCH INFORMATION BE DISCLOSED, THE INTERESTED PERSON WILL REFRAIN FROM ANY SUBSEQUENT DISCUSSION AND DECISIONS RELATED TO THE OUTSIDE FIRM. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD OF MANAGERS CONCERNING AN EXISTING OR CONTEMPLATED TRANSACTION OR RELATIONSHIP BETWEEN THE HOSPITAL AND ANY PARTY MAY GIVE RISE TO A CONFLICT OF INTEREST 1.) THE BOARD OF MANAGERS MEMBER SHALL LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON THE TRANSACTION OR ARRANGEMENT. 2.) THE CHAIRPERSON OF THE BOARD OF MANAGERS SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. 3.) AFTER EXERCISING DUE DILIGENCE, THE BOARD OF MANAGERS SHALL DETERMINE WHETHER THE HOSPITAL CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 4.) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF MANAGERS SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. TO ENSURE THE HOSPITAL OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS INCLUDE, AT A MINIMUM, - 1.) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION AND THE RESULT OF ARM'S LENGTH BARGAINING. 2.) WHETHER PARTNERSHIPS, JOINT VENTURES AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE HOSPITAL'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. DISCIPLINARY AND CORRECTION ACTION, UP TO AND INCLUDING TERMINATION OF EMPLOYMENT, CAN BE TAKEN FOR FAILURE TO DISCLOSE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A	THE HOSPITAL'S BOARD OF MANAGERS REVIEWS ANNUAL CEO SURVEY INFORMATION FROM THE INDIANA HOSPITAL ASSOCIATION. THIS SURVEY COMPARES KDH'S CEO'S COMPENSATION WITH OTHER HOSPITAL CEO'S IN INDIANA. COMPARISONS ARE MADE WITH HOSPITALS THAT ARE IN KDH'S REGION IN INDIANA, HOSPITALS OF A SIMILAR SIZE, AND HOSPITALS THAT MIGHT REASONABLY BE EXPECTED TO COMPETE FOR SERVICES OF KDH'S CEO. THE BOARD OF MANAGERS, AFTER REVIEWING THE SURVEY AND A STATUS REPORT OF THE CEO'S ANNUAL GOALS, APPROVES THE CEO'S COMPENSATION. HOWEVER, PHYSICIAN BOARD MEMBERS WHO ARE ALSO HOSPITAL EMPLOYEES DO NOT PARTICIPATE IN VOTING FOR ANY CHANGES TO CEO COMPENSATION. MINUTES ARE TAKEN AT ALL OF THE BOARD OF MANAGERS MEETINGS AND EXECUTIVE SESSIONS.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, OR FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE FOR PUBLIC INSPECTION. THE FORM 990 TAX RETURN IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN SUBSCRIBER SAVINGS CUMULATIVE ACCOUNT 251,264.
FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHT	THE HOSPITAL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE SELECTION OF AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM TO PERFORM THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS. THE FINANCE COMMITTEE ALSO IS RESPONSIBLE FOR OVERSIGHT OF THAT AUDIT PROCESS. THE TREASURER OF THE HOSPITAL'S BOARD OF MANAGERS SERVES AS THE CHAIR OF THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REGULARLY MEETS EVERY OTHER MONTH, AND MEETS ONCE PER YEAR WITH THE INDEPENDENT AUDITORS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 447	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47250	ZIPCd

Field	Value	IRS element (for citing)
EIN	202148950	EIN
Primary Activities	FUNDRAISING TO SUPPORT THE PROVISION OF HEALTHCARE SERVICES	PrimaryActivitiesTxt
Legal Domicile State	IN	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	LINE 7	PublicCharityStatusTxt
Direct Controlling NA	N/A	DirectControllingNACd
Controlled Organization	0	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd