EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER (EIN 61-0492356)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-08-14
IRS object ID: 201942279349300609
Schema version: 2017v2.3
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 J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-08-14T14:34:54-05:00	ReturnTs
Tax Period End	2018-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	3102 WEST END AVENUE SUITE 1050	AddressLine1Txt
City	NASHVILLE	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	372031301	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	610492356	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% WILLIAM SNAPP III	InCareOfNm
Business Name Control	EPHR	BusinessNameControlTxt
Phone	8592392424	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 SOUTH THIRD STREET	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	WILLIAM SNAPP III	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8592392424	PhoneNum
Signature	2019-08-13	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JESSICA FREEMAN	PreparerPersonNm
PTIN	P01261457	PTIN
Phone	6159883600	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	62536020192265000004	FederalOriginalSubmissionId
Federal Original Submission Id	2019-08-14	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	D96EEA1EFD704BF3A6FD0CFD465A7C805E74B28F	AtSubmissionCreationDeviceId
At Submission Filing Device Id	D96EEA1EFD704BF3A6FD0CFD465A7C805E74B28F	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DANIEL MCKAY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 SOUTH THIRD STREET	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$184,521,730	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.EMHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1972	FormationYr
Legal Domicile State	KY	LegalDomicileStateCd
Activity Or Mission	THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO THE 155,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	1165	TotalEmployeeCnt
Total Volunteers	216	TotalVolunteersCnt
Total Gross UBI	$724,478	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$125,903	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,252,843	PYContributionsGrantsAmt
CY Contributions Grants	$145,906	CYContributionsGrantsAmt
PY Program Service Revenue	$173,940,374	PYProgramServiceRevenueAmt
CY Program Service Revenue	$183,516,590	CYProgramServiceRevenueAmt
PY Investment Income	-$152,789	PYInvestmentIncomeAmt
CY Investment Income	-$200,728	CYInvestmentIncomeAmt
PY Other Revenue	$851,247	PYOtherRevenueAmt
CY Other Revenue	$774,703	CYOtherRevenueAmt
PY Total Revenue	$175,891,675	PYTotalRevenueAmt
CY Total Revenue	$184,236,471	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$64,517,270	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$76,397,189	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$93,883,773	PYOtherExpensesAmt
CY Other Expenses	$107,185,669	CYOtherExpensesAmt
PY Total Expenses	$158,401,043	PYTotalExpensesAmt
CY Total Expenses	$183,582,858	CYTotalExpensesAmt
PY Revenues Less Expenses	$17,490,632	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$653,613	CYRevenuesLessExpensesAmt
Total Assets BOY	$273,971,724	TotalAssetsBOYAmt
Total Assets EOY	$243,858,157	TotalAssetsEOYAmt
Total Liabilities BOY	$11,493,864	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$11,502,949	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$262,477,860	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$232,355,208	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO THE 155,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$164,736,440	ExpenseAmt
Revenue	$183,516,590	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$164,736,440	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	93	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1165	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	15	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	KY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	WILLIAM SNAPP III	PersonNm
Phone	8592392424	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 SOUTH THIRD STREET	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ALLEN WHITE
CHAIR	3.0	5.0	Yes (X)	Yes (X)	$0	$3,300	$0
SCOTT BOTTOMS
VICE CHAIR	3.0	5.0	Yes (X)	Yes (X)	$0	$3,900	$0
JOHN D TRISLER
TREASURER	3.0	5.0	Yes (X)	Yes (X)	$0	$3,000	$0
JULIAN GANDER
SECRETARY	3.0	5.0	Yes (X)	Yes (X)	$0	$4,650	$0
HUSSAM HAMDALLA MD
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$884,754	$54,117
JAMES TURPIN MD
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,150	$0
REBECCA CHATHAM MD
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,150	$0
BRIAN ELLIS MD
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$246,146	$50,726
SHEREE GILLIAM
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,150	$0
CLIFF ED IRVIN
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,000	$0
SUSIE ROUSH
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,150	$0
AARON ROWLAND
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,150	$0
MIKE W TAYLOR
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,600	$0
JAMES W DUNN
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,300	$0
THOMAS HAGER
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$3,300	$0
DOUGLAS GREENBURG
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$0	$0
ERIC GUERRANT MD
BOARD MEMBER	3.0	5.0	Yes (X)		$0	$0	$0
SALLY DAVENPORT
PART YEAR CEO	30.0	29.0		Yes (X)	$0	$409,255	$45,499
DANIEL MCKAY
PART YEAR CEO	30.0	29.0		Yes (X)	$0	$0	$0
WILLIAM SNAPP III
VP & CFO	30.0	32.0		Yes (X)	$0	$314,216	$55,959
BURT PIPER
VP & COO	30.0	29.0		Yes (X)	$0	$266,207	$55,519
MARK MILNER
VP & CNO	30.0	20.0		Yes (X)	$0	$203,098	$50,433
LYNNE WARNER-LYNN
VP CLINICAL EFFECTIVENESS	40.0	0.0			$156,076	$0	$44,770	Yes (X)
JOAN HALTOM
PHARMACY DIRECTOR	40.0	0.0			$190,881	$0	$28,860		Yes (X)
RONALD BARBATO
REHAB DIRECTOR	40.0	0.0			$163,442	$0	$26,649		Yes (X)
MICHELLE DELUCA FRALEY
PHARMACIST	40.0	0.0			$155,003	$0	$37,695		Yes (X)
CHRISTINA COOLEY
PHARMACIST	40.0	0.0			$159,284	$0	$152		Yes (X)
MARK UPTON
PHARMACIST	40.0	0.0			$142,966	$0	$43,038		Yes (X)
VICKI DARNELL
FORMER CEO	0.0	0.0			$0	$512,346	$38,001			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$967,652	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,879,822	TotReportableCompRltdOrgAmt
Total Other Compensation	$531,418	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	43	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
IN COMPASS HEALTH INC
318 MAXWELL ROAD STE 500	ALPHARETTA	GA	30009	PHYSICIAN SERVICES	$2,058,727
AUREUS RADIOLOGY LLC
13609 CALIFORNIA ST	OMAHA	NE	68154	RADIOLOGY SERVICES	$741,299
LABORATORY CORP
PO BOX 12140	BURLINGTON	NC	27216	LAB SERVICES	$729,826
CENTRAL KENTUCKY BLOOD CENTER
3121 BEAUMONT CENTER CIRCLE	LEXINGTON	KY	40513	BLOOD SERVICES	$681,017
LOGAN'S HEALTHCARE LINEN DIVISION
PO BOX 643958	CINCINNATI	OH	452643958	LINEN SERVICES	$483,333

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	24	CntrctRcvdGreaterThan100KCnt
Related Organizations	$145,906	RelatedOrganizationsAmt
Total Contributions	$145,906	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE	621110	$176,911,549	$176,252,337	$659,212
PHARMACY REVENUE	446110	$4,741,980	$4,741,980
JOINT VENTURE INCOME	621110	$1,693,480	$1,693,480
OTHER OPERATING	621110	$104,315	$104,315
REFERENCE LAB	621400	$65,266		$65,266

Field	Value	IRS element (for citing)
Total Program Service Revenue	$183,516,590	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$71,367	TotalRevenueColumnAmt
Exclusion	$71,367	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$13,406	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$13,406	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,406	TotalRevenueColumnAmt
Exclusion	$13,406	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$13,164	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$285,259	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$272,095	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$272,095	TotalRevenueColumnAmt
Exclusion	-$272,095	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
VENDING COMMISSION	900099	$18,781	$18,781
CAFETERIA	722514	$697,033	$697,033
ALL OTHER MISC REVENUE	900099	$45,483	$45,483

Field	Value	IRS element (for citing)
Other Revenue Total	$761,297	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$184,236,471	TotalRevenueColumnAmt
Related Or Exempt Func Income	$182,792,112	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$724,478	UnrelatedBusinessRevenueAmt
Exclusion	$573,975	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$258,781	TotalAmt
Management And General	$258,781	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$60,315,827	TotalAmt
Program Services	$55,318,719	ProgramServicesAmt
Management And General	$4,997,108	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,764,281	TotalAmt
Program Services	$2,524,432	ProgramServicesAmt
Management And General	$239,849	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,011,416	TotalAmt
Program Services	$8,229,525	ProgramServicesAmt
Management And General	$781,891	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,046,884	TotalAmt
Program Services	$3,574,901	ProgramServicesAmt
Management And General	$471,983	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$62,708	TotalAmt
Management And General	$62,708	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$22,151,734	TotalAmt
Program Services	$17,355,340	ProgramServicesAmt
Management And General	$4,796,394	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,740	TotalAmt
Program Services	$7,513	ProgramServicesAmt
Management And General	$227	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,841,587	TotalAmt
Program Services	$4,602,536	ProgramServicesAmt
Management And General	$1,239,051	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,436,231	TotalAmt
Program Services	$525,409	ProgramServicesAmt
Management And General	$1,910,822	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,852,806	TotalAmt
Program Services	$2,610,195	ProgramServicesAmt
Management And General	$242,611	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$85,798	TotalAmt
Program Services	$59,841	ProgramServicesAmt
Management And General	$25,957	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$171,379	TotalAmt
Program Services	$140,178	ProgramServicesAmt
Management And General	$31,201	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,349,320	TotalAmt
Program Services	$1,349,320	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,529,819	TotalAmt
Program Services	$8,529,819	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$756,666	TotalAmt
Program Services	$27,276	ProgramServicesAmt
Management And General	$729,390	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$44,075,120	$44,075,120
BAD DEBTS	$10,496,954	$10,496,954
TAXES & LICENSES	$2,360,922	$2,323,589	$37,333
REPAIRS & MAINTENANCE	$3,468,402	$2,815,547	$652,855

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,538,483	TotalAmt
Program Services	$170,226	ProgramServicesAmt
Management And General	$2,368,257	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$183,582,858	TotalAmt
Program Services	$164,736,440	ProgramServicesAmt
Management And General	$18,846,418	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$6,242	BOYAmt
EOY	$30,776	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$147,675	BOYAmt
EOY	$147,219	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$20,570,109	BOYAmt
EOY	$20,153,911	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$6,474,648	BOYAmt
EOY	$6,885,629	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,399,841	BOYAmt
EOY	$2,263,609	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$171,190,410	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$115,499,761	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$56,929,224	BOYAmt
EOY	$55,690,649	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,309,558	BOYAmt
EOY	$1,343,238	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$186,134,427	BOYAmt
EOY	$157,343,126	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$273,971,724	BOYAmt
EOY	$243,858,157	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,620,351	BOYAmt
EOY	$11,502,949	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$873,513	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$11,493,864	BOYAmt
EOY	$11,502,949	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$262,462,070	BOYAmt
EOY	$232,339,918	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$15,790	BOYAmt
EOY	$15,290	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$262,477,860	BOYAmt
EOY	$232,355,208	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$273,971,724	BOYAmt
EOY	$243,858,157	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$653,613	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	-$503	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$30,775,762	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$8,208	OtherActivitiesAmt
Total Lobbying Expenditures	$8,208	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCH. C, PART III-B, LINE 1I	FormAndLineReferenceDesc
Explanation	LOBBYING EXPENDITURES --------------------- A PORTION OF DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION (KHA) ARE USED FOR LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,844,925	OtherCostOrOtherBasisAmt
Book Value	$2,844,925	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$80,103,568	OtherCostOrOtherBasisAmt
Depreciation	$46,383,915	DepreciationAmt
Book Value	$33,719,653	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,529,843	OtherCostOrOtherBasisAmt
Depreciation	$3,249,395	DepreciationAmt
Book Value	$280,448	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$79,663,137	OtherCostOrOtherBasisAmt
Depreciation	$62,785,918	DepreciationAmt
Book Value	$16,877,219	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,048,937	OtherCostOrOtherBasisAmt
Depreciation	$3,080,533	DepreciationAmt
Book Value	$1,968,404	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$55,690,649	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
SCHOLARSHIP ACCOUNT	$16,042
PHYSICIAN INCOME GUARANTEE	$210,814
DUE FROM RELATED PARTIES	$156,235,555
DUE FROM THIRD PARTY PAYORS	$880,715

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$157,343,126	TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt	$173,832,245	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$10,496,954	OtherRevenueAmt
Revenue Not Reported	-$10,496,954	RevenueNotReportedAmt
Revenue Subtotal	$184,329,199	RevenueSubtotalAmt
Other Revenues Not Included	-$92,728	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$92,728	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$184,236,471	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$173,179,148	TotExpnsEtcAuditedFinclStmtAmt
Prior Year Adjustments	$503	PriorYearAdjustmentsAmt
Other Expenses Included	$92,741	OtherExpensesIncludedAmt
Expenses Not Reported	$93,244	ExpensesNotReportedAmt
Expenses Subtotal	$173,085,904	ExpensesSubtotalAmt
Other Expenses Not Included	$10,496,954	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$10,496,954	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$183,582,858	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCH D, PART XI & XII

RECONCILIATION TO AUDIT REPORT ------------------------------ PART XI LINE 2D OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON 990 PART VIII -------------------------------------------------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT (10,496,954) PART XI LINE 4B AMOUNTS INCLUDED IN 990 PART VIII BUT NOT ON LINE 1 ---------------------------------------------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 145,906 OTHER RECONCILING 33,461 LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT (272,095) ------------ (92,728) PART XII LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON 990 PART IX --------------------------------------------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT (145,906) OTHER RECONCILING 33,474 LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT 272,095 ------------ 92,741 PART XII LINE 4B AMOUNTS INCLUDED ON 990 PART IX BUT NOT ON LINE 1 --------------------------------------------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT 10,496,954

SCH D, PART X, LINE 2

INCOME TAXES ------------ THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FOOTNOTE THAT ADDRESSED THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN48 (ASC 740). MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	125.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$93,307	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$93,307	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$27,632,069	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,042,090	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,589,979	NetCommunityBenefitExpnsAmt
Total Expense	0.09020	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$27,725,376	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,042,090	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,683,286	NetCommunityBenefitExpnsAmt
Total Expense	0.09070	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$27,725,376	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,042,090	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,683,286	NetCommunityBenefitExpnsAmt
Total Expense	0.09070	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,010	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,010	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$863	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$863	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$454	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$454	NetCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,831	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,831	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,158	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,158	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$10,496,954	BadDebtExpenseAmt
Bad Debt Expense Attributable	$5,248,477	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$53,476,444	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$53,019,113	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$457,331	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
CNTL KY SURGERY CTR
ASC	0.6	0.4
BLUEGRASS IMM CARE
URGENT TREATMENT CLINIC	0.73	0.27

Field	Value	IRS element (for citing)
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	EPHRAIM MCDOWELL REGIONAL MEDICAL CEN	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 SOUTH THIRD STREET	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.EMHEALTH.ORG	WebsiteAddressTxt
State License	100034	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	EPHRAIM MCDOWELL REGIONAL MEDICAL CEN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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
CHNA Conducted	17	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	125.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT --------------- THROUGH THE FOCUS GROUP AND ONLINE SURVEY, PARTICIPATION AND INPUT WAS GATHERED FROM REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY (INCLUDING HISPANIC, AFRICAN AMERICAN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (SPECIFICALLY, THE ELDERLY, DISABLED, YOUNG ADULTS, LGBT COMMUNITY, THE MENTALLY ILL, INMATES, HEARING IMPAIRED, MEDICAID RECIPIENTS, AND THE UNINSURED).
SCHEDULE H, PART V, SECTION B, LINE 7 & 10	CHNA / IMPLEMENTATION STRATEGY ----------------------- THE CHNA REPORT AND THE IMPLEMENTATION STRATEGY CAN BE OBTAINED AT: HTTP://WWW.EMHEALTH.ORG/INDEX.PHP/SERVICES/COMMUNITY-SERVICES
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING THE NEEDS OF THE COMMUNITY ------------------------------------- THE INTERNAL STAKEHOLDERS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER DETERMINED THE FOLLOWING TO BE THE TOP HEALTH PRIORITIES FOR THE HOSPITAL TO ADDRESS IN THE COMMUNITY FOR THE COMING YEARS: - CARDIOVASCULAR DISEASE (CVD) RELATED RISK FACTORS (E.G., HYPERTENSION, BMI, GLUCOSE, TOBACCO USE, PHYSICAL ACTIVITY, NUTRITION) - CANCER EARLY DETECTION AND PREVENTION - CHILDHOOD OBESITY - ACCESS TO HEALTH SERVICES - DEMENTIAS, INCLUDING ALZHEIMER'S DISEASE - MENTAL HEALTH & MENTAL DISORDERS THESE PRIORITY AREAS, AND PLANS TO ADDRESS THESE, WILL BE INTEGRATED INTO THE HOSPITAL'S IMPLEMENTATION STRATEGY. THE RATIONALE FOR SELECTING THESE AREAS IS AN UNDERSTANDING THAT IMPACTING THESE WOULD ALSO IMPACT MANY OTHER AREAS OF NEED IDENTIFIED IN THE ASSESSMENT, SUCH AS DIABETES, DEMENTIA, MENTAL HEALTH, SENSORY IMPAIRMENT, KIDNEY DISEASE, RESPIRATORY DISEASE, AND DISABILITY. THESE AREAS ALSO REPRESENT A CONTINUATION OF EXISTING WORK AND ALLOW THE HOSPITAL TO BUILD ON PAST SUCCESSES. THERE ARE ADDITIONAL NEEDS IDENTIFIED WITHIN THE CHNA REPORT THAT ARE NOT SPECIFICALLY ADDRESSED BY EMRMC, DUE TO NO EXPERTISE OR LIMITED RESOURCES, BUT ARE BEING ADDRESSED BY OTHER AGENICES WITHIN THE COMMUNITY.
SCHEDULE H, PART V, SECTION B, LINE 16	PUBLICATION OF FAP ------------------ HTTP://EMHEALTH.PATIENTSIMPLE.COM/GUEST/#INDEX

Field	Value	IRS element (for citing)
Facility	9	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CENTRAL KY SURGERY CENTER
230 WEST MAIN STREET	DANVILLE	KY	40422	OUTPATIENT SURGERY CENTER
EPHRAIM MCDOWELL DIAGNOSTIC CENTER
101 DANIEL DRIVE	DANVILLE	KY	40422	DIAGNOSTIC IMAGING & TEST/LAB
MEDSOURCE HOME MEDICAL
150 SOUTH THIRD STREET	DANVILLE	KY	40422	DUREABLE MEDICAL EQUIPMENT
EPHRAIM MCDOWELL SLEEP DISORDERS
440 WHIRL-A-WAY DR	DANVILLE	KY	40422	SLEEP DISORDER CENTER
EPHRAIM MCDOWELL SPINE PHYSICAL THERAPY
236 WEST MAIN ST	DANVILLE	KY	40422	OUTPATIENT REHAB FACILITY
EPHRAIM MCDOWELL CANCER SUPPORT CENTER
520 TECHWOOD DR	DANVILLE	KY	40422	OUTPATIENT SERVICES
EM DIABETES & ENDOCRINOLOGY CENTER
440 WHIRL-A-WAY DR	DANVILLE	KY	40422	DIABETES CENTER
CASEY COUNTY REHABILITATION
513 MIDDLEBURG ST	LIBERTY	KY	42539	OUTPATIENT REHAB FACILITY
EPHRAIM MCDOWELL EAR NOSE AND THROAT
120 DANIEL DRIVE	DANVILLE	KY	40422	OUTPATIENT SERVICES

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN (F)	% OF TOTAL EXPENSE CALCULATION ------------------------------ The amount of bad debt expense included on Form 990, Part IX, Line 25, column(A), but subtracted for purposes of calculating the percentage of total expense is $10,496,954.
SCHEDULE H, PART III, LINE 2	BAD DEBT EXPENSE ------------------ THE BAD DEBT EXPENSE ON LINE 2 IS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE ------------------------------------------------ THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS ESTIMATED PER HISTORICAL DATA.
SCHEDULE H, PART III, LINE 4	BAD DEBT EXPENSE ---------------- THE CORPORATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE CORPORATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CORPORATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.
SCHEDULE H, PART III, LINE 8	MEDICARE SHORTFALL ------------------ Amounts reported on Lines 5 and 6 were based on the corporation's Medicare Cost Report.
SCHEDULE H, PART III, LINE 9B	Written Debt Collection Policy and Financial Assistance ------------------------------------------------------- IF IT IS DETERMINED THAT A PATIENT OR RESPONSIBLE PARTY IS ELIGIBLE FOR FINANCIAL ASSISTANCE, EMH WILL: - SEND WRITTEN NOTIFICATION TO THE RESPONSIBLE INDIVIDUAL OF THE ASSISTANCE DETERMINATION AND - IF THE DISCOUNT IS LESS THAN 100%, EMH WILL: * PROVIDE THE RESPONSIBLE INDIVIDUAL WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED, HOW THE AMOUNT WAS DETERMINED, AND DESCRIBE HOW THE INDIVIDUAL CAN LEARN MORE ABOUT HOW THE HOSPITAL CALCULATES AGB; * ISSUE REFUNDS TO THE RESPONSIBLE INDIVIDUAL IF HE OR SHE PREVIOUSLY PAID AN AMOUNT TO EMH EXCEEDING WHAT HE OR SHE IS PERSONALLY RESPONSIBLE TO PAY; AND * TAKE ALL REASONABLE MEASURES TO REVERSE ANY ECAS (WITH THE EXCEPTION OF A SALE OF A DEBT OR DEFERRING OR DENYING CARE FOR NON-PAYMENT OF AMOUNTS FOR PREVIOUS CARE) TAKEN AGAINST THE RESPONSIBLE INDIVIDUAL TO THE EXTENT POSSIBLE. If a patient cannot satisfy standard payment expectations, a financial assistance screening process for alternative sources of balance resolution is completed. Those resolutions may include a discount on charges, Medicaid enrollment or application for charity care.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT ---------------- IN 2017, PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS ENGAGED TO CONDUCT A NEEDS ASSESSMENT OF EMRMC'S COMMUNITY, WHICH IS DEFINED AS THE PRINCIPAL RESIDENTIAL ZIP CODES IN BOYLE, CASEY, GARRARD, LINCOLN, MERCER AND WASHINGTON COUNTIES IN KENTUCKY. A SURVEY AND A COMMUNITY FOCUS GROUP WERE COMPLETED TO OBTAIN PRIMARY DATA FROM INDIVIDUALS WITHIN THE COMMUNITY. THE FOCUS GROUP WAS COMPRISED OF REPRESENTATIVES FROM PUBLIC HEALTH, SOCIAL SERVICE PROVIDERS, EMPLOYERS, AND OTHER COMMUNITY LEADERS. SELF REPORT DATA, MORTALITY, MORIDITY, LIFESTYLE, INCIDENCE OF CHRONIC DISEASE, INJURY DATA AND DISABILITY DATA ARE PART OF THE ASSESSMENT PROCESS. THE BENCH MARK IS ESTABLISHED USING HEALTHY PEOPLE 2020 DATA.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ----------------------------------------------- EMRMC's charity care policy is posted on the www.emhealth.org website. At registration of self-pay clients, information is given on reduced fee, charity application, and a referral to a financial counselor. The free community screenings are posted on the website and in area newspapers if the hosting organization invites community participation. Some events are discussed on local radio. Information regarding the free clinic is also given by healthcare providers, faith community nurses, case workers and other medical professionals.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION --------------------- THE HEALTH SYSTEM SERVES BOYLE, MERCER, CASEY, LINCOLN, GARRARD AND WASHINGTON COUNTIES, WHICH HAVE A RURAL POPULATION OF APPROXIMATELY 113,000. ACCESS IS AN ISSUE, DUE TO TRAVEL BARRIERS SUCH AS OUT-OF-DATE HIGHWAYS AND LACK OF PUBLIC TRANSPORTATION. THESE ACCESS ISSUES INFLUENCED THE DECISION TO SERVE WITH FREE SCREENINGS AT KEY GATHERING PLACES SUCH AS CHURCHES AND SCHOOLS,ETC. INSURANCE COVERAGE IS ANOTHER ISSUE. THE NUMBERS OF UNINSURED CONTINUES TO EXCEED THE NATIONAL AVERAGE AND THE UNDERINSURED IN THIS SERVICE AREA CONTINUES TO INCREASE POST ACA.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH ----------------------------- Officers and staff of EMRMC are engaged in leadership positions with the following: Boyle County Relay for Life; Boyle County Health Department; Mercer County Health Department; Chamber of Commerce and Economic Development agencies in Boyle, Lincoln and Garrard counties; Boyle County School System; 4-H Council; Danville Rotary Club; Heart of Danville; McDowell House; Christian Care Communities; Foundation for Healthy Kentucky; Kentucky Hospital Association and Danville Kiwanis. Staff has also given testimony at local, state, and federal levels related to our service area's health, education and economic issues. EMRMC has an open medical staff comprised of primary care, specialists and subspecialists. Physician recruitment is based upon community need with approval from the governing board. The EMRMC and EMH system boards are comprised of community members with representation from the medical staff and senior leadership and the Fort Logan Hospital Board. The governing board approved the establishment and funding of the Community Service department and the funding of the health risk behavior assessment of Boyle County. They also approved the charity care policy. There is never a fee for services provided by the Community Service department. With H1N1 outbreak, the Community Service department approached churches in the six-county area with hand-washing signs, "Cover your Cough" posters and floor-stand hand sanitizers to help reduce the risk of the spread of flu within congregations and communities. Preventative care, such as flu shots, are taken to the community. So, too, are annual skin cancer checks, monthly blood pressure checks, semi-annual glucose and cholesterol checks, along with nurse consults. Such services are offered in schools, churches, and other public entities in the region, including the stockyards in Lincoln County.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ----------------------------- EMRMC is a 222 licensed bed acute care hospital serving the community for nearly a century as part of Ephraim McDowell Health (EMH). EMH is a comprehensive, integrated healthcare delivery system that serves 113,000 residents from six counties in south central Kentucky. The EMH Board is comprised of community members and representation from Ft Logan Hospital, medical staff, and EMRMC leadership. Ft Logan Hospital is a critical access hospital located in Lincoln County. Health Resource is comprised of clinics, an early childhood development center, assisted living faculty, and durable medical equipment outlets. There are representatives from our six counties, medical staff, and leadership on the community board that oversees and coordinates the services of Ephraim McDowell Health. ON DECEMBER 1, 2017, EMH ACQUIRED JAMES B. HAGGIN HOSPITAL, A CRITICAL ACCESS HOSPITAL LOCATED IN MERCER COUNTY.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	Yes (true)	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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
HUSSAM HAMDALLA MD
BOARD MEMBER	$0	$518,456	$0	$347,272	$0	$19,026	$0	$18,000	$0	$36,117	$0	$938,871	$0	$0
BRIAN ELLIS MD
BOARD MEMBER	$0	$107,856	$0	$102,271	$0	$36,019	$0	$19,754	$0	$30,972	$0	$296,872	$0	$0
SALLY DAVENPORT
PART YEAR CEO	$0	$385,515	$0	$0	$0	$23,740	$0	$21,200	$0	$24,299	$0	$454,754	$0	$0
WILLIAM SNAPP III
VP & CFO	$0	$306,299	$0	$0	$0	$7,917	$0	$21,200	$0	$34,759	$0	$370,175	$0	$0
BURT PIPER
VP & COO	$0	$259,070	$0	$0	$0	$7,137	$0	$21,200	$0	$34,319	$0	$321,726	$0	$0
MARK MILNER
VP & CNO	$0	$193,164	$0	$0	$0	$9,934	$0	$16,364	$0	$34,069	$0	$253,531	$0	$0
LYNNE WARNER-LYNN
VP CLINICAL EFFECTIVENESS	$142,563	$0	$0	$0	$13,513	$0	$12,699	$0	$32,071	$0	$200,846	$0	$0	$0
JOAN HALTOM
PHARMACY DIRECTOR	$188,707	$0	$0	$0	$2,174	$0	$6,456	$0	$22,404	$0	$219,741	$0	$0	$0
RONALD BARBATO
REHAB DIRECTOR	$158,773	$0	$0	$0	$4,669	$0	$13,119	$0	$13,530	$0	$190,091	$0	$0	$0
MICHELLE DELUCA FRALEY
PHARMACIST	$150,795	$0	$0	$0	$4,208	$0	$13,033	$0	$24,662	$0	$192,698	$0	$0	$0
CHRISTINA COOLEY
PHARMACIST	$158,820	$0	$0	$0	$464	$0	$0	$0	$152	$0	$159,436	$0	$0	$0
MARK UPTON
PHARMACIST	$141,661	$0	$0	$0	$1,305	$0	$11,890	$0	$31,148	$0	$186,004	$0	$0	$0
VICKI DARNELL
FORMER CEO	$0	$0	$0	$0	$0	$512,346	$0	$0	$0	$38,001	$0	$550,347	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3	ESTABLISHING CEO COMPENSATION -------------------- THE CEO IS COMPENSATED BY EPHRAIM MCDOWELL HEALTH, INC. (EMH), A RELATED ORGANIZATION. EMH USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4A	SEVERANCE PAYMENTS ----------------------- VICKI DARNELL RETIRED AS CEO IN JANUARY 2016. HER SEVERANCE OF $550,347 IS REPORTED IN HER W-2.
SCHEDULE J, PART I, LINE 6A & 6B	MANAGEMENT INCENTIVE PLANS ---------------------------- EMRMC IS AN AFFILIATE OF EPHRAIM MCDOWELL HEALTH, INC. WHICH HAS MANAGEMENT INCENTIVE PLANS FOR CORPORATE OFFICERS, SENIOR VICE-PRESIDENTS, VICE-PRESIDENTS AND DIRECTORS. ANNUAL PAYOUTS RELATED TO THESE INCENTIVE PLANS HAVE TWO COMPONENTS. 30% OF THE ANNUAL PAYOUT IS BASED ON NET OPERATING INCOME GOALS COMPARED TO BUDGET. THE OTHER 70% IS BASED ON QUALITY MEASURES, PATIENT SATISFACTION GOALS, ASSOCIATE SATISFACTION GOALS, AND SAFETY MEASURES.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACCOMPLISHMENTS --------------------------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER (EMRMC) IS A NOT-FOR-PROFIT, 222-BED LICENSED LEVEL III TRAUMA CENTER DEDICATED TO SERVING THE HEALTH AND WELLNESS NEEDS OF THE POPULATIONS OF BOYLE, LINCOLN, MERCER, GARRARD, CASEY, AND WASHINGTON COUNTIES. THE FACILITY IS JOINT COMMISSION ACCREDITED. EMRMC'S SCOPE OF SERVICES INCLUDE: BEHAVIORAL HEALTH, CANCER CARE CENTER, OUTPATIENT CANCER CARE, CARDIAC CARE SERVICES, CRITICAL CARE, DIABETES AND ENDOCRINOLOGY, DIAGNOSTIC SERVICES, LEVEL III TRAUMA/EMERGENCY CARE CENTER, KIDS CAN DO PEDIATRIC THERAPY CENTER, LABROATORY SERVICES, MEDICAL-SURGICAL SERVICES, ORTHOPEDIC/SPINE CARE, PASTORAL CARE, PAIN MANAGEMENT CENTER, PULMONOLOGY, REHABILITATION, RESPIRATORY THERAPY, SURGICAL SERVICES, VASCULAR SERVICES, VOLUNTEER/AUXILIARY, WOMEN'S HEALTH SERVICES, WOMEN'S BREAST & HEALTH CENTER, WOUND HEALING CENTER, SLEEP DISORDERS CENTER, EAR, NOSE, AND THROAT SERVICES, UROLOGY, HOME HEALTH, NEUROLOGY, PODIATRY, GASTROENTEROLOGY AND DURABLE MEDICAL EQUIPMENT. EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER FOR FISCAL YEAR (FY) 2018 EXPERIENCED 6,810 ADMISSIONS INCLUDING NURSERY, AND 30,142 PATIENT DAYS FOR ALL SERVICES INCLUDING NURSERY AND OBSERVATION DAYS. OUTPATIENT REGISTRATIONS (INCLUDING ER VISITS) WERE 135,903 COMPARED TO 138,214 IN FY 2017. SURGICAL PROCEDURES AT EMRMC WERE 4,718 IN FY 2018 AS COMPARED TO 4,675 IN FY 2017, REFLECTING AN INCREASE IN PROCEDURES. THE AMBULATORY SURGICAL CENTER PROCEDURES IN FY 2018 WERE 5,340 VERSUS 6,181 IN FY 2017. EXPANDED SERVICES MODALITIES HAVE BEEN CONTINUED TO INCREASE ACCESS TO CARE NEEDED FOR THE ELDERLY, FRAIL, OR THOSE WITH CANCER (ALL HIGH VOLUME POPULATIONS WITHIN THE SIX COUNTIES) TO RECEIVE CARE CLOSE TO HOME. KEY SERVICE MODALITIES INCLUDED THE FOLLOWING: -RADIOFREQUENCY - WE CONTINUE TO PROVIDE TARGETED VERTEBRAL AUGMENTATION FOR THE TREATMENT OF SPINE FRACTURES (ALSO KNOWN AS VERTEBRAL COMPRESSION FRACTURES) AS COMMONLY SEEN IN OSTEOPOROSIS. KENTUCKY HAS ONE OF THE HIGHEST RATES OF CITIZENS OVER THE AGE OF 65, AND AGE IS A RISK FACTOR FOR SPINAL FRACTURES. -CANCER IS THE NUMBER TWO CAUSE OF DEATH IN THE SERVICE AREA; THEREFORE WE CONTINUE TO PROVIDE TARGETED-RADIOFREQUENCY ABLATION (T-RFA) THERAPY FOR RAPID PAIN RELIEF FROM METASTATIC SPINAL TUMORS AS A TREATMENT OPTION FOR CANCER CARE. COMMUNITY HEALTH EDUCATION - GENERAL -------------------------------------- CANCER EDUCATION - VARIOUS SPORTS GROUPS AND COMMUNITY ORGANIZATIONS RECEIVED SUN SAFETY PRODUCTS AND EDUCATION. EPA SUN SAFETY LITERATURE, SUN SCREEN AND LIP BALM WITH SUN SCREEN WERE DISTRIBUTED TO RE-ENFORCE THE MESSAGE OF SUN SAFETY. ALL FUNDED BY THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION (EMHCF). CPR/FIRST AID - A STAFF NURSE WITHIN THE EPHRAIM MCDOWELL HEALTH CARE SYSTEM DONATED TIME AND CONDUCTED CPR CLASSES AS VARIOUS SITES THROUGHOUT THE COMMUNITY. DUE TO THE LOSS OF A COMMUNITY CPR INSTRUCTOR, NUMBERS SERVED CONTINUE TO DROP. EDUCATION WEBSITE/COMMUNITY PUBLICATION - TWELVE EDITIONS OF THE HEALTH MINISTRY/FAITH COMMUNITY NURSING NEWSLETTER WERE PRODUCED, AND DISTRIBUTED IN KENTUCKY, TENNESSEE, INDIANA, OHIO, VIRGINIA, AND NORTH CAROLINA. THE INTENT IS TO PROVIDE RELEVANT AND CURRENT INFORMATION TO THE CONGREGATIONS RELATED TO SELF-CARE, OR EDUCATION ON DISEASE PROCESSES, TREATMENTS AND PREVENTION, INCLUDING BUT NOT LIMITED TO INTENTIONAL CARE OF THE SPIRIT. ALL INFORMATION CAN BE REPRODUCED AND USED FOR CONGREGATIONAL INFORMATION/EDUCATION. HEALTH FAIRS - SERVICES WERE OFFERED AT 22 EVENTS AT 18 SITES IN BOYLE, LINCOLN, GARRARD, MERCER, AND WASHINGTON COUNTIES WITH FOCUS ON REACHING AT RISK AND VULNERABLE POPULATIONS. INCLUDING ALL ADULT PROGRAMS, 10,615 COMMUNITY CONTACTS OCCURED (SCREENINGS, EDUCATION, SUPPORT GROUPS, ETC.). THIRTY-SIX PERCENT OF SCREENED PARTICIPANTS WERE MALE; SIXTY-FOUR PERCENT WERE FEMALE. NINETY-TWO PERCENT OF 410 CLIENTS SERVED DECLARING ETHNICITY WERE CAUCASIAN, AND THREE PERCENT WERE HISPANIC (A ONE PERCENT INCREASE FROM THE PRIOR YEAR). FIFTY-ONE PERCENT OF PARTICIPANTS SERVED BY COMMUNITY BENEFIT PROGRAMS HAD A HOUSEHOLD INCOME BELOW $35,000 (THIS IS A 2 PERCENT INCREASE). NINE PERCENT OF PARTICIPANTS SERVED WERE UNEMPLOYED; A ONE PERCENT DECREASE IN UNEMPLOYMENT FROM FY 2017. FORTY-ONE PERCENT OF THE POPULATION SERVED WERE RETIRED, A DECREASE OF 2% OVER 2017. THE UNINSURED SERVED INCREASED TO 8 PERCENT COMPARED TO 7% IN FY 2017 AND 8% IN 2016. SEVENTY-SIX PERCENT OF PARTICIPANTS REPORTED A PRIMARY CARE PROVIDER (PCP) COMPARED TO 82% IN FY 2017 AND 78% IN FY 2016. A REGISTERED NURSE (RN) MET WITH EACH CLIENT TO DEVELOP A WRITTEN PLAN TO DECREASE LIFESTYLE ASSOCIATED HEALTH RISK BEHAVIORS. AT EACH SCREENING, REFERRAL OPTIONS WERE PROVIDED, INCLUDING HOPE CLINIC, REDUCED FEE PROGRAM AND PRIMARY CARE PROVIDER (PCP) LISTING FOR THE REGION FOR THE UNINSURED PARTICIPANTS OR THOSE WITHOUT A PCP. FIFTY PERCENT OF SCREENING TESTS WERE ABNORMAL (A 1% DECREASE OVER 2017) WITH 17 PERCENT REQUIRING A REFERRAL FOR FOLLOW-UP (A 2% DECREASE OVER 2017). PARISH NURSING PROGRAM - GRANT FUNDING FROM EPHRAIM MCDOWELL HEALTH CARE FOUNDATION MADE POSSIBLE THE FAITH COMMUNITY NURSING EDUCATIONAL PROGRAMS. A FAITH COMMUNITY NURSING SYMPOSIUM WAS PRESENTED IN THE FALL OF 2016; THEREFORE ONE DID NOT TAKE PLACE IN 2017 BUT WILL AGAIN IN 2018, IT IS HOSTED EVERY OTHER YEAR. THE FAITH COMMUNITY NURSING FOUNDATION COURSE WAS HELD IN THE SPRING OF 2018 PRODUCING 5 NEW FAITH COMMUNITY NURSES WHO SERVED AS FACULTY FOR THE FAITH COMMUNITY NURSING ORGANIZATION IN JASPER, INDIANA. ONE HUNDRED AND EIGHT PARTICIPANTS HAVE COMPLETED THE FAITH COMMUNITY NURSING FOUNDATION COURSE SINCE ITS INCEPTION AT EMRMC IN 2008 AND SERVE AS VOLUNTEERS WITHIN THEIR CONGREGATIONS. THESE COMMUNITY PARTNERS SERVE IN 23 COUNTIES WITHIN THE COMMONWEALTH OF KENTUCKY, TENNESSEE, VIRGINIA, NORTH CAROLINA, AND OHIO AND SUPPORT PERSONS OF ALL DENOMINATIONS. TWELVE HEALTH MINISTRY NEWSLETTERS WERE CREATED AND DISSEMINATED TO HEALTH MINISTRY PARTNERS IN KENTUCKY, OHIO, ILLINOIS, TENNESSEE, VIRGINIA, AND NORTH CAROLINA. WITHIN THE IMMEDIATE SERVICE AREA THE FOLLOWING VOLUNTEER FAITH COMMUNITY NURSING SERVICES WERE ACTIVE: FIRST BAPTIST JUNCTION CITY, FIRST BAPTIST ON THE BYPASS, LEXINGTON AVENUE BAPTIST CHURCH, PERRYVILLE BAPTIST CHURCH, NEW SALEM BAPTIST CHURCH, FIRST BAPTIST CHURCH ON 2ND AND WALNUT STREET, INDIAN HILLS CHRISTIAN CHURCH, CENTENARY UNITED METHODIST CHURCH - DANVILLE, HARRODSBURG CHRISTIAN CHURCH, SAINTS PETER & PAUL CATHOLIC CHURCH, ST. ANDREW'S CATHOLIC CHURCH, LEAVEL GREEN CHRISTIAN, DANVILLE NEW COVENANT OF NAZARENE CHURCH, TRINITY CHURCH, SCIENCE HILL CHRISTIAN CHURCH, AND GETHSEMANE BAPTIST CHURCH. ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, HOME VISITS, NURSING HOME VISITS, BLOOD PRESSURE CHECKS, HEALTH AND WELLNESS PROGRAMS, SUPPORT GROUPS, REFERRALS FOR FOLLOW-UP CARE, ORGANIZING FLU CLINICS, ORGANIZING HEALTH SCREENINGS, ACUTE CARE VISITS, ARRANGING FOR MEAL DELIVERIES, AND EMERGENCY ASSISTANCE (SEIZURES, CHEST PAIN, FAINTING, HYPERTENSIVE CRISIS, ETC.). STATISTICAL ANALYSIS SHOWS THE MORE VISITS THE CONGREGANT HAS WITH THE FAITH COMMUNITY NURSE REGARDING THEIR BLOOD PRESSURE, THE BETTER THEIR BLOOD PRESSURE IS CONTROLLED. SCHOOL BASED PROGRAMS - THE SCHOOL BASED PROGRAMS WERE NO LONGER SPEARHEADED BY EPHRAIM COMMUNITY SERVICE STAFF DUE TO THE LACK OF PERSONNEL. HOWEVER, AREA SCHOOLS CONTINUED THE PERKINS ASSESSMENTS AND TRACKING OF BMI WHICH WE VIEW AS A MARK OF SUCCESS IN OUR EFFORTS TO EDUCATE THE COMMUNITY.
FORM 990, PART III, LINE 4A (CONT)	SPEAKERS BUREAU - OUTREACH GRANT FINDINGS WERE SHARED AT THE ANNUAL MEETINGS OF THE KENTUCKY ORGANIZATION OF RURAL HEALTH IN BOWLING GREEN, KENTUCKY AND THE KENTUCKY ORGANIZATION OF NURSING LEADERS IN LOUISVILLE, KENTUCKY. EARLY HEART ATTACK CARE BROCHURES WERE PLACED IN PRIMARY CARE AND SPECIALTY PRACTICE OFFICES. ALSO THE WARNING SIGNS OF A HEART ATTACK BOOK MARKS WERE PLACED IN CHURCHES, PRIMARY CARE AND SPECIALTY PRACTICE OFFICES. MAGNETS WITH SIGNS AND SYMPTOMS OF A STROKE WERE GIVEN AWAY AT SPEAKING EVENTS AND SCREENING EVENTS. MAGNETS WITH SIGNS AND SYMPTOMS OF A HEART ATTACK WERE ALSO DISTRIBUTED AT HEALTH SCREENINGS AND SPEAKING ENGAGEMENTS. EARLY HEART ATTACK CARE BROCHURES WERE DISTRIBUTED AT SCREENINGS AS WELL. STROKE PREVENTION AND RECOGNITION EDUCATION WAS PROVIDED IN THE COMMUNITY AS PART OF THE UK STROKE AFFILIATE NETWORK EFFORT TO REDUCE MORTALITY AND MORBIDITY RELATED TO CVD IN SOUTH CENTRAL KENTUCKY. THE COMMUNITY EDUCATION WAS ALL A COMPONENT OF THE CHNA IMPLEMENTATION PLAN. COMMUNITY HEALTH EDUCATION - SELF HELP --------------------------------------- FITNESS/EXERCISE - FIFTY ATTENDEES PARTICIPATED IN THE GET MOVING SPRING CHALLENGE, A SCAVENGER HUNT GROUP WALK AT THE SPEARS CREEK CONNECTOR (LOW TURNOUT WAS DUE TO INCLEMENT WEATHER). OVER EIGHT HUNDRED PARTICIPANTS TOOK PART IN THE SPRING GET MOVING CHALLENGE, WITH SEVEN HUNDRED AND FIFTY COMPLETING THE PROGRAM. TOBACCO/SMOKING CESSATION - WE SAW A DECREASE IN THE NUMBER OF INDIVIDUALS REPORTING TOBACCO USE; 39 COMPARED TO 69 IN 2017 AND 106 IN FY 2016. THE DECREASE MAY BE A CONTINUED EFFORT AT EDUCATION LOCALLY AND STATEWIDE, ALONG WITH THE STATE LEGISLATION TO INCREASE THE TAX ON CIGARETTES BY FIFTY CENTS. THIS MAY ALSO BE A REFLECTION OF THE DECREASED NUMBER OF SCREENINGS. THERE IS AN INCREASE IN E-CIGARETTE SHOPS IN THE BOYLE COUNTY AND SURROUNDING AREAS. EARLY RESEARCH INDICATES THAT USE OF E-CIGARETTES OR VAPOR DEVICES DO NOT DECREASE TOBACCO USE BUT ACTUALLY RESULTS IN INCREASED TOBACCO USE DUE TO THE NICOTINE USED IN THE DEVICES. THE STATEWIDE ORDINANCE DRAFTED BY SOME OF THE AGENCIES (FHK, SOAHEC, ETC.) FOR CONSIDERATION BY THE LEGISLATURE DURING THE 2016 SESSION DID NOT PASS BUT THERE IS A CONTINUED EFFORT TO PUSH THIS ORDINANCE THROUGH. A STATE-WIDE TOBACCO FREE SCHOOLS BILL (WHICH INCLUDES CIGARETTES, OTHER FORMS OF TOBACCO, AND VAPOR DEVICES) WAS PASSED UNANIMOUSLY IN COMMITTEE AND IS CURRENTLY WAITING TO COME BEFORE THE KENTUCKY LEGISLATURE. PLANS HAVE BEEN MADE BY THE HEALTH DEPARTMENTS AND SOAHEC FOR E-CIGARETTE AND VAPOR PRODUCTS TO BE PART OF BOTH THE LEGISLATIVE PROPOSAL AND PUBLIC EDUCATION DUE TO THE OBSERVATION OF INCREASED USE OF THESE PRODUCTS, ESPECIALLY BY THE YOUTH. SPECIAL EMPHASIS ON E-CIGARETTE USE WAS PART OF THE EPHRAIM MCDOWELL FAITH COMMUNITY NURSING SYMPOSIUM OF 2017. STRESS MANAGEMENT - ONLY 42 INDIVIDUALS WERE SCREENED USING THE PERCEIVED STRESS SCALE COMPARED TO 82 INDIVIDUALS IN 2017 AND 212 INDIVIDUALS IN 2016 BECAUSE SMALLER SITES WERE USED TO DO THE HEART RISK SCREENINGS. TWO PERCENT OF THOSE SCREENED WERE ABNORMAL COMPARED TO SIXTEEN PERCENT IN 2017 AND APPROPRIATE REFERRALS TO EITHER PRIMARY CARE PROVIDERS OR MENTAL HEALTH CARE PROVIDERS WERE MADE. TWO OUT OF 40 SCREENED FOR DEPRESSION USING THE BECK DEPRESSION SCALE WERE ABNORMAL. THE DECISION TO INCREASE THE USE OF THE PERCEIVED STRESS SCALE RELATES TO THE INCREASED EMPHASIS OF THE ROLE OF STRESS IN MORTALITY AND MORBIDITY OF CARDIOVASCULAR PATIENTS, ESPECIALLY WOMEN. ALL RECEIVED INFORMATION RELATED TO STRESS REDUCTION STRATEGIES. THIS IS CONSISTENT WITH THE 2015-2017 STRATEGIC OBJECTIVE RELATED TO MENTAL HEALTH IN THE EMRMC IMPLEMENTATION PLAN BUT NOT INCLUDED THE PLAN FOR 2018. A DECISION TO CONTINUE THESE SCREENINGS WAS MADE DUE TO THE DOCUMENTED CORRELATION BETWEEN DEPRESSION AND HEART ATTACKS. COMMUNITY HEALTH EDUCATION - SUPPORT GROUPS -------------------------------------------- ALZHEIMER'S - TEN ALZHEIMERS SUPPORT GROUP MEETINGS WERE FACILITATED BY AN ADVANCED PRACTICE MENTAL HEALTH NURSE PRACTITIONER. THE GROUP SERVES BOTH PATIENTS AND CARE-GIVERS/FAMILY. GIVEN THE INCIDENCE RATE OF STROKE AND THE AGING OF THE POPULATION IT IS ANTICIPATED THE NEED FOR THIS SERVICE WILL CONTINUE TO GROW IN THIS REGION. COMMUNITY-BASED CLINICAL SERVICES - HEALTH SCREENINGS ------------------------------------------------------ BLOOD PRESSURE SCREENING - BLOOD PRESSURE SCREENINGS WERE OFFERED AT 18 SITES (22 EVENTS), SOME MORE THAN ONCE, AND THIS DOES NOT INCLUDE BLOOD PRESSURE SCREENINGS DONE BY FAITH COMMUNITY NURSES IN THEIR OWN CONGREGATIONS; FOUR HUNDRED AND FIFTY NINE INDIVIDUALS WERE SERVED WITH 447 PERSONS HAVING THEIR BLOOD PRESSURE CHECKED. THIS REPRESENTS A DECREASE IN BLOOD PRESSURE SCREENINGS FROM THE PRIOR YEAR WHEN 599 INDIVIDUALS AND IN FY 2016 855 INDIVIDUALS WERE SERVED; THIS IS DUE TO THE DECREASE IN SITES AND SCREENINGS AS A RESULT OF STAFF REDUCTIONS AND BUDGET CONSTRAINTS IN FY 2018. THERE WAS A THREE PERCENT INCREASE OF CLIENTS WITH A BLOOD PRESSURE READING THAT EXCEEDED THE RECOMMENDED RANGE BY THE AMERICAN HEART ASSOCIATION (AHA): 86% IN FY 2018 COMPARED TO 83 PERCENT IN FY 2017, 90 PERCENT IN FY 2016, AND 83 PERCENT IN FY 2015. THOSE CLASSIFIED AS PRE-HYPERTENSIVE RECEIVED INSTRUCTIONS FOR MONITORING AND RECORDING AS WELL AS DIETARY INSTRUCTIONS RELATED TO LOW SODIUM DIET. THOSE THAT WERE ON MEDICATIONS BUT EXCEED THE RECOMMEND RANGE WERE INSTRUCTED TO SHARE THE FINDING WITH THEIR PRIMARY CARE PROVIDER (PCP). THOSE AT STROKE LEVEL WERE TRANSPORTED FOR IMMEDIATE FOLLOW-UP BY A PHYSICIAN. BLOOD PRESSURE CONTROL IS A MAJOR FACTOR IN CARDIOVASCULAR DISEASE RISK REDUCTION. THE INTENSE FOCUS ON BLOOD PRESSURE MONITORING, SELF-CARE EDUCATION AND FOLLOW-UP CONTINUES. BLOOD PRESSURE SCREENING IS ONE OF THE IMPLEMENTATION STRATEGIES RELATED TO MODIFIABLE LIFESTYLE RELATED CARDIOVASCULAR RISK FACTORS FROM THE 2017 CHNA IMPLEMENTATION PLAN. CANCER - COLORECTAL SCREENING - DURING MARCH THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION (EMHCF) FUNDED COLORECTAL SCREENINGS AT 24 ADDITIONAL SITES IN ADDITION TO NORMAL SCREENING SITES FOR A TOTAL DISTRIBUTION OF 147 KITS WITH A 60 PERCENT RETURN RATE; A 6% INCREASE IN RETURN FROM 2017. ELEVEN OF 147 (8%) HAD POSITIVE RESULTS AND WERE REFERRED TO THEIR PCP. KITS WERE DISTRIBUTED IN SIX COUNTIES. SITES INCLUDED CHURCHES, SENIOR CITIZEN CENTERS, THE WELLNESS CENTER, HEALTH DEPARTMENTS, CLINICS, HOSPITAL LOBBIES, AREA BUSINESSES, THE CANCER CENTER, HOSPICE, LOCAL BANK, AND THE COUNTY EXTENSION SERVICE OFFICES. THERE HAVE BEEN RADIO AND NEWSPAPER PUBLIC SERVICE AWARENESS CAMPAIGNS RELATED TO COLORECTAL CANCER DUE TO KENTUCKY RATING NUMBER ONE IN INCIDENCE AND NUMBER 3 IN DEATHS RELATED TO COLON CANCER. THIS IS ONE OF THE IMPLEMENTATION STRATEGIES FOR EARLY DETECTION OF CANCER BASED UPON THE IDENTIFIED NEED IN THE 2017 CHNA. CANCER - SKIN SCREENING - SKIN SCREENING BY A LICENSED INDEPENDENT PRACTITIONER (LIP) WAS NOT DONE IN FY 2018 BECAUSE THERE WAS NO LIP AVAILABLE TO DO THE SCREENING THROUGH COMMUNITY SERVICE... SUN SAFETY EDUCATION BEGINS WITH THE SCHOOL-AGE CHILDREN AND CONTINUES ACROSS THE LIFE SPAN AND HAS BEEN A CONSISTENT MESSAGE AND FOCUS OF THE COMMUNITY SERVICE WORK PLAN SINCE INCEPTION IN 2008. THIS IS ONE OF THE IMPLEMENTATION STRATEGIES FOR EARLY DETECTION/PREVENTION OF CANCER BASED UPON THE IDENTIFIED NEED IN THE 2017 CHNA.
FORM 990, PART III, LINE 4A (CONT)	CHOLESTEROL TESTING - TOTAL CHOLESTEROL WAS MEASURED FOR 398 CLIENTS IN FIVE COUNTIES AT 18 SITES WITHIN HEALTH MINISTRIES AND COMMUNITY SETTINGS WITH 40 PERCENT OF PARTICIPANTS EXCEEDING THE RECOMMEND RANGE AS SET BY THE AMERICAN HEART ASSOCIATION (AHA); THIS IS A 4 PERCENT INCREASE COMPARED TO 36 % IN 2017, 30.5% IN FY 2016 AND 31% FOR 2015. THIS TREND IS CONSISTENT WITH THE INCREASE SEEN NATIONALLY. WITHIN THE LIPID PANEL 44% OF PARTICIPANTS HAD ONE OR MORE MEASURE(S) OUTSIDE THE RECOMMENDED RANGE COMPARED TO 42.7 PERCENT IN FY 2017. LOW DENSITY LIPIDS BEING ELEVATED WAS THE LEADING CAUSE. EFFECTIVE FY 2013, WITH SUPPORT FROM AREA PEDIATRICIANS, THE DEPARTMENT BEGAN OFFERING LIPID SCREENINGS FOR CHILDREN AGE 12 AND ABOVE, IF ACCOMPANIED BY A PARENT. WE HAVE NOT SEEN A STATISTICALLY SIGNIFICANT NUMBER OF PARTICIPANTS IN THE PEDIATRIC AGE RANGE. LIPID PANEL SCREENING IS ONE OF THE IMPLEMENTATION STRATEGIES RELATED TO MODIFIABLE LIFESTYLE RELATED CARDIOVASCULAR RISK FACTORS FROM THE IMPLEMENTATION PLAN BASED ON THE 2017 CHNA. THIS IS PART OF BOTH THE STROKE RISK AND MYOCARDIAL RISK REEDUCATION STRATEGY. DIABETES SCREENING - BLOOD GLUCOSE TESTING WAS CONDUCTED ON 400 PARTICIPANTS. THIRTY SEVEN PERCENT EXCEEDED THE RECOMMENDED RANGE AS SET BY THE AMERICAN DIABETES ASSOCIATION (ADA) COMPARED TO 20% IN FY 2017, 21 PERCENT IN FY 2016, AND 13 PERCENT IN FY 2015. THIS IS CONSISTENT WITH THE INCREASE IN TYPE II DIABETES NATIONWIDE WITH KY BEING ONE OF THE LEADING STATES IN INCIDENCE OF DIABETES. NO ONE WAS BELOW THE RECOMMENDED RANGE. BASED UPON THE NATIONAL INCIDENCE TREAD AND THE LOCAL TREAD IN DIABETES, A1C MONITORING EQUIPMENT WAS PURCHASED WITH A GRANT THAT WAS SUBMITTED IN FY 2015 AND APPROVED. INDIVIDUALS AT RISK FOR DIABETES OR DIAGNOSED WITH DIABETES ARE NOW SCREENED WITH THE A1C MACHINE AS OF FY 2016. EIGHTY EIGHT INDIVIDUALS WERE SCREENED WITH THE A1C EQUIPMENT DUE TO PRIOR SCREENING OF INDIVIDUALS BY THEIR PRIMARY CARE PROVIDER. FORTY-ONE PERCENT OF THOSE SCREENED WERE ABOVE NORMAL COMPARED TO 48% OF ONE HUNDRED AND SIXTY INDIVIDUALS SCREENED IN FY 2017. LIFESTYLE CHANGE AND DIET EDUCATION WAS PROVIDED AS WELL AS REFERRALS TO PRIMARY CARE PHYSICIANS. GLUCOSE TESTING WAS OFFERED TO CHILDREN AGE 12-18, IF ACCOMPANIED BY A CUSTODIAL PARENT. AGAIN THE NUMBER OF PEDIATRIC PARTICIPANTS WAS NOT STATISTICALLY SIGNIFICANT. THIS STRATEGY IS PART OF THE CVD RISK REDUCTION IMPLEMENTATION PLAN THAT WAS BASED ON THE 2017 CHNA. NUTRITION/OBESITY SCREENING - HEIGHT, WEIGHT, PERCENT BODY FAT, AND CALCULATED BODY MASS INDEX (BMI) WAS OFFERED AT 18 SITES IN FIVE COUNTIES WITH 362 ADULT PARTICIPANTS. EIGHTY-ONE PERCENT OF THE PARTICIPANTS EXCEEDED THE RECOMMENDED RANGE; COMPARED TO SEVENTY-FIVE PERCENT IN 2017, EIGHTY-SEVEN PERCENT IN 2016 AND SEVENTY-FOUR PERCENT IN 2015. UNFORTUNATELY, THIS IS CONSISTENT WITH THE NATIONAL TREND ALSO, WITH KENTUCKY AND SEVERAL OTHER STATES LEADING THE NATIONAL TREND. BODY MASS INDEX IS A MAJOR CONTRIBUTOR TO CVD RISK FACTORS, SOME TYPES OF CANCER AND DIABETES. THIS IS CONSISTENT WITH THE NATIONAL TREND AND WITH KENTUCKY BEING ONE OF THE LEAST HEALTHY STATES. EIGHTY PERCENT OF LIFESTYLE CHANGE IS IMPLEMENTATION OF THE CHANGE; TWENTY PERCENT IS THE KNOWLEDGE. BMI WAS ONE OF THE MODIFIABLE LIFESTYLE CHANGES IDENTIFIED AS A STRATEGY TO REDUCE CVD RISK AND CANCER RISK FROM THE 2017 CHNA. STROKE SCREENING - THE AMERICAN STROKE ASSOCIATION STROKE RISK SCORECARD BECAME THE STANDARD TOOL FOR SCREENING FOR STROKE RISK WITHIN THE DEPARTMENT IN FISCAL YEAR 2012. STROKE RISK SCREENING WAS CONDUCTED AT 20 EVENTS IN FIVE COUNTIES INVOLVING 335 PARTICIPANTS WITH A 17 PERCENT REFERRAL RATE; WHICH REFLECTS A ONE PERCENT DECREASE COMPARED TO A TWO PERCENT INCREASE IN 2017 AND TO AN EIGHT PERCENT DECREASE IN REFERRALS IN FY 2016. THIS IS ONE OF THREE SCREENING TESTS THAT RESULTED IN DIRECT REFERRAL AND TRANSPORT TO EMERGENCY CARE: THE OTHERS INCLUDE BLOOD PRESSURE IN THE STROKE RANGE, AND EXTREME ELEVATION OF LAB VALUES. THIS IS ONE OF THE STRATEGIES TO REDUCE CVD RISK OUTLINED IN THE IMPLEMENTATION PLAN FOR THE CHNA. COMMUNITY-BASED CLINICAL SERVICES - IMMUNIZATIONS ----------------------------------------------------- FLU SHOTS - FLU SHOTS WERE ADMINISTERED AT 19 SITES AND 20 EVENTS COMPARED TO 17 IN FY 2017 AND TEN IN FY 2016 IN MERCER, LINCOLN, BOYLE, GARRARD, MADISON, AND WASHINGTON COUNTIES TO 531 INDIVIDUALS COMPARED TO 554 INDIVIDUALS IN FY 2017 AGE 12 AND ABOVE. PRIMARY SITES WERE CHURCHES AND THE STOCKYARDS. THIS REPRESENTS A 10% DECREASE OVER THE 30 PERCENT INCREASE IN THE NUMBER OF IMMUNIZATIONS DURING FY 2017. COMMUNITY-BASED CLINICAL SERVICES - NON-BILLED/REDUCED-FEE CLINIC ------------------------------------------------------------------ HOPE CLINIC AND PHARMACY - HOPE CLINIC AND PHARMACY PROVIDED SERVICE TO 34 PATIENTS SEEN A TOTAL OF 77 TIMES. DUE TO A LACK OF A PROVIDER FROM MAY TO SEPTEMBER, CLINIC FIGURES WERE DOWN FROM THE 136 TOTAL VISITS IN FY 2017. TO QUALIFY FOR HOPE CLINIC & PHARMACY AN INDIVIDUAL MUST HAVE ONE OR MORE OF THE FOLLOWING DIAGNOSES: HYPERTENSION, DIABETES, OBESITY, HYPERLIPIDEMIA, HEART FAILURE, PNEUMONIA OR GASTRO ESOPHAGEAL REFLUX DISEASE, BE UNINSURED AND WITH A HOUSEHOLD INCOME BETWEEN 139% -300% OF THE FEDERAL POVERTY LEVEL. ALL STAFF MEMBERS ARE VOLUNTEERS EXCEPT THE PART-TIME LIP AND PART-TIME OFFICE MANAGER. THE CLINIC IS MANAGED BY A COMMUNITY ADVISORY BOARD WITH MEMBERS FROM THE BOYLE COUNTY HEALTH DEPARTMENT, DANVILLE PRESBYTERIAN CHURCH, EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, HEART OF KENTUCKY UNITED WAY, AND THE SALVATION ARMY. THE CLINIC WAS STARTED DUE TO A COMMUNITY NEED BY A COLLABORATION OF THE KEY BOARD MEMBERS AND IS A DEPARTMENT OF EMRMC. THE AFFORDABLE CARE ACT HAS MADE POSSIBLE ACCESS TO EXPANDED MEDICAID IN KENTUCKY, RESULTING IN MANY FORMER HOPE CLIENTS HAVING INSURANCE AND ACCESS TO BOTH CHRONIC AND ACUTE CARE. BLOOD DRIVE - SIXTY-SEVEN UNITS OF BLOOD WERE DONATED THROUGH BLOOD DRIVES IN THE HEALTH SYSTEM IN FY 2018 COMPARED TO 80 UNITS IN FY 2017. INDIVIDUALS THAT ARE ON DUTY ARE PAID DURING THE TIME THEY ARE INVOLVED IN THE DONATION PROCESS.
FORM 990, PART III, LINE 4A (CONT)	HEALTH PROFESSIONS EDUCATION ---------------------------- CONTINUING HEALTH PROFESSIONS EDUCATION - THE DIRECTOR FOR REHABILITATION SERVICES DEPARTMENT SERVES ON THE FEDERATION OF STATE PHYSICAL THERAPY BOARD MEETING FOR THE COMMONWEALTH OF KENTUCKY. THIS BOARD MEETS MONTHLY FOR TWO HOURS AT AN ESTIMATED ORGANIZATIONAL COST OF $1,680. ISSUES OF THE PROFESSION WERE ADDRESSED INCLUDING EDUCATIONAL REQUIREMENTS, LICENSURE, REIMBURSEMENT, SCOPE OF SERVICE AND PROFESSIONAL PRACTICE STANDARDS. INTERNS, RESIDENTS, AND FELLOWS - IN FISCAL YEAR 2018 THERE WERE NEITHER INTERNS NOR FELLOWS AT EMRMC. THERE WERE ELEVEN EMERGENCY SERVICE RESIDENTS FROM UNIVERSITY OF KENTUCKY AND SEVEN ORTHOPAEDIC RESIDENTS FROM UNIVERSITY OF KENTUCKY. MEDICAL STUDENTS - FIVE MEDICAL STUDENTS ROTATED THROUGH EMERGENCY SERVICES AND FAMILY MEDICINE WITH EMRMC MEDICAL STAFF MENTORS. THIS REPRESENTS A SEVENTY-FIVE PERCENT DECREASE IN THE NUMBER OF MD STUDENTS. STUDENTS WERE FROM UNIVERSITY OF KENTUCKY. TWENTY-SEVEN PHYSICIAN ASSISTANT (PA) STUDENTS ROTATED THROUGH EMERGENCY, SURGICAL, ORTHOPAEDIC AND FAMILY MEDICINE SERVICES WITH A MENTOR. THIS REPRESENTS A SIXTY PERCENT INCREASE IN THE NUMBER OF PA STUDENTS. AFFILIATED PROGRAMS INCLUDED THE UNIVERSITY OF KENTUCKY, UNIVERSITY OF THE CUMBERLANDS AND MARIETTA COLLEGE. SEVEN NURSE PRACTITIONERS (NPS) OR ADVANCED PRACTICE NURSES (APRNS) ROTATED THROUGH EMERGENCY SERVICES OR PRIMARY CARE CLINICS IN FY 2018 WITH A LIP MENTOR. THIS REPRESENTS A SEVENTY PERCENT DECREASE IN THE NUMBER OF NP OR APRN STUDENTS. SCHOOLS INCLUDED: UNIVERSITY OF KENTUCKY, EASTERN KENTUCKY UNIVERSITY, CHAMBERLIN COLLEGE OF NURSING, UNIVERSITY OF CINCINNATI, NORTHERN KENTUCKY UNIVERSITY AND FRONTIER NURSING UNIVERSITY. NURSING - FIVE HUNDRED AND TWO NURSING STUDENTS COMPLETED THEIR CLINICAL EXPERIENCE AND/OR PRACTICUM AT EMRMC IN FY 2018. EDUCATIONAL PARTNERS INCLUDED CAMPBELLSVILLE UNIVERSITY, EASTERN KENTUCKY UNIVERSITY, MIDWAY UNIVERSITY, BLUEGRASS COMMUNITY & TECHNICAL COLLEGE, BECKFIELD COLLEGE, KENTUCKY STATE UNIVERSITY, WESTERN KENTUCKY UNIVERSITY AND BEREA COLLEGE. THIS REPRESENTS A 9.5 PERCENT INCREASE IN NURSING STUDENTS, LPN, AD, AND BSN. OTHER ALLIED HEALTH PROFESSIONS - THE CERTIFIED NURSING ASSISTANT COURSE HAD 0 STUDENTS ENROLLED IN 2018 COMPARED TO 9 IN 2017. THIS IS DUE TO THE DECLINE IN ENROLLED STUDENTS AND THE ABILITY TO ACCOMMODATE A CLASS. OTHER STUDENTS - EMRMC SERVED AS A CLINICAL SITE FOR STUDENTS FROM MULTIPLE DISCIPLINES FROM THE FOLLOWING INSTITUTIONS: BLUEGRASS COMMUNITY & TECHNICAL COLLEGE LEXINGTON AND SOMERSET, BECKFIELD COLLEGE, BEREA COLLEGE, CAMPBELLSVILLE UNIVERSITY, EASTERN KENTUCKY UNIVERSITY, KENTUCKY STATE UNIVERSITY AND MIDWAY UNIVERSITY. THERE WAS A DECLINE IN THE NUMBER OF ALLIED HEALTH STUDENTS IN THE FOLLOWING AREAS: RADIOGRAPHY, SONOGRAPHY, DIETETIC, PHYSICAL THERAPY ASSISTANTS, AND HEALTH INFORMATION AND PHLEBOTOMY STUDENTS. THERE WAS A NINE PERCENT INCREASE IN THE NUMBER OF PHARMACY STUDENTS AND AN INCREASE IN THE NUMBER OF SPEECH THERAPY STUDENTS AND OCCUPATIONAL THERAPY STUDENTS. ONE HUNDRED NINETY-THREE AREA STUDENTS HAD A JOB SHADOWING EXPERIENCE IN 40 DIFFERENT AREAS OF EMRMC IN FY 2018. THIS REFLECTS A TWO PERCENT INCREASE IN THE NUMBER OF STUDENTS JOB SHADOWING WITHIN THE ORGANIZATION. FINANCIAL DONATIONS FOR THE COMMUNITY - IN KIND ------------------------------------------------ PERSONNEL/ADMINISTRATIVE SUPPORT - AN ADVANCED PRACTICE NURSE SERVES ON THE MERCER COUNTY HEALTH DEPARTMENT BOARD. A STAFF MEMBER SERVES ON THE FOUNDATION FOR HEALTHY KENTUCKY BOARD AND SUBCOMMITTEES. THE REHABILITATION SERVICES DIRECTOR SERVES ON THE PHYSICAL THERAPY BOARD. COMMUNITY BUILDING ACTIVITIES ------------------------------- COALITION BUILDING - HEROIN OVERDOSE AND DEATHS IN THE SERVICE AREA HAVE INCREASED AT AN ALARMING RATE. A MENTAL HEALTH PROFESSIONAL FROM CENTRE COLLEGE HAS PUT TOGETHER A BROAD COMMUNITY COALITION TO ADDRESS THE MANY FACETS OF THIS PUBLIC HEALTH ISSUE. THE EMERGENCY DEPARTMENT NURSING AND MEDICAL DIRECTORS HAVE WORKED WITH THIS GROUP. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - REHABILITATION SERVICES STAFF SERVED ON THE FEDERATION OF STATE PHYSICAL THERAPY BOARD. WORKFORCE DEVELOPMENT - THE SOUTHERN AREA HEALTH EDUCATION COUNCIL IS INVOLVED IN THE EDUCATION OF HEALTHCARE PROFESSIONALS IN RURAL SOUTH-CENTRAL KENTUCKY AND HEALTH POLICY. COMMUNITY BENEFIT OPERATIONS ----------------------------- COMMUNITY HEALTH NEEDS ASSESSMENT - PROFESSIONAL RESEARCH CONSULTANTS OF OMAHA, NEBRASKA WERE ENGAGED TO CONDUCT A SCIENTIFICALLY VALID SIX COUNTY CHNA FOR THE SYSTEM, INCLUDING EMRMC, AT A COST OF $83,000. THE CONFIDENCE LEVEL IS 95 PERCENT FROM A SAMPLE OF 900 AREA RESIDENTS. A COMMUNITY FOCUS GROUP WAS CONVENED FOR INPUT FROM KEY INFORMANTS FROM THE SIX COUNTIES, WITH FINDINGS INCLUDED IN THE REPORT. THE RESULTS WERE MADE AVAILABLE TO THE GOVERNING BOARD IN HARD COPY ALONG WITH A SUMMARY PRESENTATION AND IMPLEMENTATION PLAN FOR 2018-2021. ONCE REVIEWED BY THE BOARD, THE REPORT AND IMPLEMENTATION PLAN WERE POSTED ON THE WEBSITE FOR PUBLIC ACCESS. SELECT SHARING WAS DONE UPON REQUEST BY COMMUNITY ORGANIZATIONS AND CENTRE COLLEGE STUDENTS. DEDICATED STAFF - THERE IS ONE STAFF MEMBER WHO WORKS PART TIME FOR COMMUNITY SERVICE AND SEVERAL FLEX RNS AND TECHNICIANS THAT WORK AS NEEDED WITHIN THE COMMUNITY SERVICE DEPARTMENT AND ARE FUNDED BY THE HEALTH SYSTEM. THE STAFF WAS COMPRISED OF A FAITH COMMUNITY NURSING COORDINATOR WHO WORKS OUT OF ANOTHER DEPARTMENT, AND A PART TIME PROJECT COORDINATOR, ALL REPORTING TO THE SYSTEM DIRECTOR, NURSING ADMINISTRATION, REGULATORY COMPLIANCE, ASSOCIATE EDUCATION, AND COMMUNITY SERVICES. TOTAL SALARY EXPENSES FOR DEDICATED COMMUNITY BENEFIT STAFF WERE $208,474 FOR FY 2018; WITH THE DECREASE REFLECTING THE REDUCTION IN HOURS WITHIN THE DEPARTMENT. COMMUNITY SERVICES TOTAL EXPENSES WERE $238,361. THERE WAS A PART TIME NURSE PRACTITIONER AND OFFICE MANAGER FOR THE HOPE CLINIC. SALARY EXPENSES WERE $7,477 FOR FY 2018. THE REPORTING STRUCTURE IS THAT ALL DEPARTMENT FUNCTIONS REPORT TO THE SYSTEM DIRECTOR. THE SYSTEM DIRECTOR THEN REPORTS TO THE EPHRAIM MCDOWELL HEALTH SYSTEM VICE PRESIDENT OF COMMUNITY ENGAGEMENT AND POPULATION HEALTH WHO REPORTS TO THE GOVERNING BOARD WITH THE ANNUAL WORK PLAN AND BUDGET APPROVED BY THE GOVERNING BOARD. IN THE SPRING OF 2017, THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WERE PRESENTED TO THE GOVERNING BOARD FOR APPROVAL. UNASSIGNED PROGRAM - EMRMC STAFF VOLUNTEERED IN AREA CHURCHES AND CHILDRENS MINISTRY PROGRAMS WITHIN THE SERVICE AREA THAT FOCUSED ON SPIRITUAL DEVELOPMENT AND WELL-BEING, APPROXIMATELY 800 CHILDREN WERE SERVED. OTHER SERVICES INCLUDE VOLUNTEER FAITH COMMUNITY NURSES SERVING WITHIN MANY OF THE LOCAL CONGREGATIONS. THE RESULT BEING BLOOD PRESSURE SCREENING, COORDINATION OF CARE, REFERRALS, AND EDUCATION RELATED TO HEALTH RISK, MEDICATIONS, MENTAL HEALTH, STROKE RISK EDUCATION, AND OTHER ISSUES. OTHERS SERVED IN MUSIC MINISTRY, VISITATION, OR CHURCH BASED COMMITTEES. MANY SERVED IN YOUTH SPORT LEAGUES AS VOLUNTEERS, EITHER COACHING OR RAISING FUNDS. OTHERS VOLUNTEERED WITH THE SCHOOL SYSTEM SERVING AS ROOM SPONSORS, BOOSTERS, PTA OFFICERS, MENTORING STUDENTS, OR OTHER NEEDED FUNCTIONS. EMRMC ASSOCIATES VOLUNTEERED AT THE LOCAL FESTIVALS INCLUDING, BUT NOT LIMITED TO: HARVEST FEST ON MAIN, KENTUCKY STATE BBQ FESTIVAL, GREAT AMERICAN BRASS BAND FESTIVAL, SOUL ON SECOND STREET, DANVILLES LAWN CHAIR THEATRE, APPLE FESTIVAL IN CASEY COUNTY, BEEF FESTIVAL IN MERCER COUNTY, PARTY ON THE SQUARE IN GARRARD COUNTY, FORKLAND HERITAGE FESTIVAL AND REVUE, BATTLE OF PERRYVILLE COMMEMORATION, CRUISE, BLUES & BAR-B-QUE, AND RAILROAD DAYS. THESE HOURS WERE NOT PAID HOURS, THEREFORE NOT INCLUDED IN THE COMMUNITY BENEFIT CALCULATIONS. NEVERTHELESS, THIS INVESTMENT OF TIME AND LABOR CONTRIBUTED SIGNIFICANTLY TO THE QUALITY OF LIFE IN THE REGION IMPACTING PHYSICAL, MENTAL, AND ECONOMIC WELL-BEING OF THE POPULACE OF THE SIX COUNTY SERVICE AREAS.
FORM 990, PART III, LINE 4A (CONT)	DEFERRED NEEDS FROM THE CHNA OF BOYLE AND THE SURROUNDING COUNTIES BASED UPON RESOURCES AND/OR EXPERTISE INCLUDED THE FOLLOWING: SUBSTANCE ABUSE IS AN ISSUE IN THE STATE AND REGION. ADDICTION SERVICES ARE OFFERED BY PRIVATE PROVIDERS, COMPREHENSIVE CARE, AND SELF-REFINED IN THE REGION. EMRMC BEHAVIORAL MEDICINE UNIT DOES TREAT DUAL DIAGNOSIS PATIENTS AND THE PSYCHIATRISTS AND COUNSELORS TREAT OUT PATIENTS. THERE IS AN ACTIVE ALCOHOLICS ANONYMOUS CHAPTER. CELEBRATE RECOVERY IS OFFERED AT VARIOUS SITES IN THE SERVICE AREA. SUBSTANCE ABUSE TASK FORCE RESOURCES AND COMMITTEES ARE IN THE SURROUNDING SERVICE AREA, AND COLLABORATION OCCURS AS NEEDED. DUE TO LACK OF EXPERTISE AND RESOURCES, ADDICTION WILL BE DEFERRED AS PART OF THE WORK PLAN BY EMRMC. CHRONIC KIDNEY DISEASE AND END STAGE RENAL FAILURE LINKS TO DIABETES. MODERATE EXERCISE, A HEALTHIER DIET, AND WEIGHT REDUCTION CAN PREVENT THE DEVELOPMENT OF TYPE 2 DIABETES IN PERSONS AT RISK (DIABETES PREVENTION PROGRAM FUNDED BY NIH). THE FREE SCREENINGS WILL PROVIDE EARLY DETECTION AND POSSIBLY PREVENTION WHEN ADDRESSING NUTRITION, BODY MASS INDEX AND EXERCISE. SOME FAITH COMMUNITY NURSES IN CONGREGATIONS ASSESS BLOOD PRESSURES AND MEDICATION ADHERENCE AS WELL AS PROVIDE EDUCATION. RENAL SPECIALISTS AND DIALYSIS CENTERS SERVE THIS POPULATION AS WELL. DEMENTIA LINKS TO CV HEALTH AND STROKE INCIDENCE AND VASCULAR ISSUES. IT ALSO LINKS TO THE AGING OF THE POPULATION IN THE REGION. THERE IS AN ALZHEIMERS SUPPORT GROUP IN BOYLE AND MERCER COUNTIES. ALSO, MENTAL EVALUATION AND MEDICATION MANAGEMENT IS AVAILABLE BY A PSYCHIATRIST AT THE MEDICAL CENTER. DANVILLE HEALTH & REHABILITATION CENTER AS WELL AS MORNING POINT HAS AN ALZHEIMERS LONG TERM CARE UNIT. THE SANDERS BROWN CENTER AT THE UNIVERSITY OF KENTUCKY HAS ON-GOING ALZHEIMERS RELATED RESEARCH AND SERVES AS A REFERRAL CENTER FOR THE REGION. BIRTHS TO TEENAGERS AND UNWED MOTHERS, AND LOW BIRTH-WEIGHT BIRTHS ARE BEING ADDRESSED BY THE HEALTH DEPARTMENTS AND THE SCHOOL HEALTH COLLATIONS. THE LINCOLN COUNTY HEALTH DEPARTMENT HAS A 5-YEAR GRANT TO ADDRESS SELF-ESTEEM AND CHARACTER BUILDING IN 6TH GRADE THROUGH MIDDLE SCHOOL. THE LINCOLN AND BOYLE COUNTY SCHOOL NURSES CONDUCT THE PERKINS ASSESSMENT IN MIDDLE SCHOOL THROUGH HIGH SCHOOL AS PART OF THE EFFORT TO HELP YOUTH MAKE FEWER HIGH RISK BEHAVIOR CHOICES. BOTH SCHOOL SYSTEMS HAVE CONTRACTS WITH THE UNIVERSITY OF KENTUCKY FOR THE SERVICES OF AN ADOLESCENT MEDICINE SPECIALIST FOR ON-SITE SERVICES. THE HAVEN CARE CENTER PROVIDES PREGNANCY RESOURCES AND SUPPORTS ALL SIX COUNTIES. CHRONIC LUNG/RESPIRATORY DISEASE IS BEING ADDRESSED WITH TOBACCO EDUCATION, STOP SMOKING CLASSES AT THE HEALTH DEPARTMENTS, PULMONARY REHAB AT EPHRAIM MCDOWELL SPECIALTY CENTER AND THROUGH PUBLIC POLICY. THE COMMUNITY SERVICE DEPARTMENT SCREENS FOR TOBACCO USE AT ALL VENUES AND REFERS CLIENTS TO THE HEALTH DEPARTMENTS. THE HEALTH DEPARTMENT OFFERS FREEDOM FROM SMOKING CLASSES TO HELP RESIDENTS STOP SMOKING. THE HEALTH DEPARTMENTS ALSO CONDUCT TOBACCO EDUCATION IN THE SCHOOL SYSTEMS. IN THE AREAS OF INFECTIOUS DISEASE THE COUNTY HEALTH DEPARTMENTS WILL CONTINUE TO ADDRESS HIV EDUCATION AND TESTING. HEPATITIS C VACCINE IS AVAILABLE AT THE HEALTH DEPARTMENTS. EMRMC WILL DEFER DUE TO RESOURCE ALLOCATION BOTH PERSONNEL AND TIME. INJURY AND VIOLENCE EDUCATION IS IN THE HEALTH DEPARTMENTS, COUNTY EXTENSION OFFICES, SCHOOL RESOURCE CENTERS, FAMILY COURT, AND LAW ENFORCEMENT IN ALL COUNTIES. EMRMC AND EMFLH OFFER THE SERVICES OF A SANE NURSE FOR RAPE VICTIMS. THE RAPE CRISIS CENTER SERVES THE REGION. EMRMC WILL DEFER FOCUS ON INJURY AND VIOLENCE AT THIS TIME DUE TO OTHER AGENCIES COVERING ALL ASPECTS, HAVING GREATER EXPERTISE AND DEPARTMENTAL RESOURCE LIMITATIONS. COLLABORATION WITH LOCAL ORGANIZATIONS WORKING ON SAFE COMMUNITIES WAS DISCUSSED AT THE PRIORITIZATION MEETING. ORAL HEALTH INCLUDING REGULAR DENTAL CARE AND DENTAL INSURANCE IS A REGIONAL ISSUE. EPHRAIM MCDOWELL HEALTH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. WORK PLAN INITIATIVES IN FY 2018 BASED UPON THE 2017 CHNA BY PROFESSIONAL RESEARCH CONSULTANTS INCLUDED: 1. TO SCREEN FOR MODIFIABLE LIFESTYLE FACTORS RELATED TO DIABETES AND EDUCATE REGARDING RISK REDUCTION STRATEGIES, AND REFER FOR FURTHER EVALUATION AS NEEDED. 2. TO IMPROVE BARRIERS TO ACCESS PRESCRIPTION MEDICATION REGIMEN, SUCH AS COST AND COMPLIANCE, BY COMMUNITY MEMBERS. 3. TO SCREEN FOR COLORECTAL AND SKIN CANCER AND TO PROVIDE EDUCATION REGARDING LIFESTYLE CHANGES RELATED TO RISK FACTOR REDUCTION; REFER FOR FURTHER EVALUATION AS NEEDED. 4. TO SCREEN FOR MODIFIABLE LIFESTYLE FACTORS RELATED TO CARDIOVASCULAR RISK AND PROVIDE EDUCATION REGARDING REDUCTION STRATEGIES; REFER FOR FURTHER EVALUATION AS NEEDED. CONCLUSION: ALL COMPONENTS OF THE WORK PLAN APPROVED BY THE GOVERNING BOARD WERE IMPLEMENTED AND THERE IS SOME HEALTH RISK IMPROVEMENTS NOTED: CHANGES IN TREND LINES SINCE 2016 OBSERVED IN 2018 INCLUDE THE FOLLOWING: 1. ABNORMAL TOTAL CHOLESTEROL VALUES ARE BASICALLY UNCHANGED FROM 2017 BUT INCREASING FROM 2015. 2. THERE WAS A SIGNIFICANT DECREASE IN BLOOD GLUCOSE VALUES ABOVE OF RECOMMENDED RANGE. 3. UNCONTROLLED BLOOD PRESSURE (HYPERTENSION) VALUES REMAINED RELATIVELY UNCHANGED FROM FY 2017 BUT HAVE DECREASED FROM 2016. 4. THE REFERRAL RATE TO PCP HAS DECREASED. THIS MAY REFLECT VALUES NOT BEING AS HIGH AS PREVIOUS YEARS. 5. THERE IS AN INCREASED TREND IN MORE INDIVIDUALS WITH A PRIMARY CARE PROVIDER. 6. MORE INDIVIDUALS WERE UNEMPLOYED AND RETIRED. 7. INCOME REMAINS CONSISTENT WITH FY 2017 BUT THERE IS AN INCREASE IN LOWER INCOME LEVELS FROM FY 2015. 8. THERE IS A CONTINUED TREND OF SEEING FEWER MALE SEEKING SCREENING AND AN INCREASE IN FEMALE SEEKING SCREENING. 9. THERE IS A DECREASING TREND IN TOBACCO USE. IN FY 2018, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INVESTED $14,000,688 IN COMMUNITY BENEFIT INCLUDING FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS. THE FINANCIAL INVESTMENT WAS ABOVE AND BEYOND THE HOURS OF VOLUNTEER TIME IN LEADERSHIP ROLES BY EMRMC STAFF TO IMPROVE HEALTH, EDUCATION, ENVIRONMENT, ECONOMIC DEVELOPMENT AND LEGISLATIVE ENDEAVORS WITHIN THE COMMUNITY, STATE AND AT THE NATIONAL LEVEL.
FORM 990, PART V, LINE 2A	COMMON PAYMASTER ------------------ EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR THE FOLLOWING RELATED ORGANIZATIONS: EPHRAIM MCDOWELL HEALTH, INC. EPHRAIM MCDOWELL HEALTH RESOURCE, INC. EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC. EMHFL, INC. COOPERATIVECARE, INC. AND JAMES B. HAGGIN MEMORIAL HOSPITAL, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356.
FORM 990, PART VI, SECTION B, LINE 6, 7A, & 7B	MEMBERS OF THE ORGANIZATION ----------------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC.
FORM 990 PART VI, SECTION B, LINE 11	PROCESS TO REVIEW FORM 990 -------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12B AND 12C	MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------------ ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXISTS, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT.
FORM 990, PART VI, SECTION B, LINE 15A AND 15B	PROCESS FOR DETERMINING COMPENSATION ------------------------------------ EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW AND PROVIDED MARKET DATA IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF THE CEO. FOR OTHER OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM, THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19	MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9	RECONCILIATION OF NET ASSETS - OTHER CHANGES ---------------------------------------------- TRANSFER OF NET ASSETS FROM EPHRAIM MCDOWELL HEALTH RESOURCE DUE TO CLINIC RESTRUCTURING: $(30,775,762)
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:14647560
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:7504174

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
JOHN HILL BAILEY CHILDREN'S LEARNING CTR
217 SOUTH THIRD STREET	DANVILLE	KY	40422	611186005	DAYCARE CTR	KY	501(C)(3)	2	EM HEALTH	false
EMHFL INC
217 SOUTH THIRD STREET	DANVILLE	KY	40422	611388556	CRITICAL HOSP	KY	501(C)(3)	3	EM HEALTH	false
EPHRAIM MCDOWELL HEALTH RESOURCE INC
217 SOUTH THIRD STREET	DANVILLE	KY	40422	311545520	HEALTHCARE	KY	501(C)(3)	3	EM HEALTH	false
EPHRAIM MCDOWELL HEALTH CARE FOUNDATION
217 SOUTH THIRD STREET	DANVILLE	KY	40422	611229333	FUNDRAISING	KY	501(C)(3)	12B-II	EM HEALTH	false
EPHRAIM MCDOWELL HEALTH INC
217 SOUTH THIRD STREET	DANVILLE	KY	40422	611324736	MGT SERVICES	KY	501(C)(3)	12B-II	NA	false
MCDOWELL HOME HEALTH AGENCY INC
217 SOUTH THIRD STREET	DANVILLE	KY	40422	610715227	HOME HEALTH	KY	501(c)(3)	3	EM HEALTH	false
JAMES B HAGGIN MEMORIAL HOSPITAL
464 LINDEN AVENUE	HARRODSBURG	KY	40330	610510934	CRITICAL HOSP	KY	501(C)(3)	3	EM HEALTH	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	CKSC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 S 3RD	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Field	Value	IRS element (for citing)
EIN	371509373	EIN
Primary Activities	MEDICAL SRVS	PrimaryActivitiesTxt
Legal Domicile State	KY	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	EMRMC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	$2,075,785	ShareOfTotalIncomeAmt
Share Of EOY Assets	$2,564,104	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
UBI Code V	$0	UBICodeVAmt
General Or Managing Partner	false	GeneralOrManagingPartnerInd
Ownership	0.60000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	COOPERATIVECARE INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	217 SOUTH THIRD STREET	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	40422	ZIPCd

Field	Value	IRS element (for citing)
EIN	611265715	EIN
Primary Activities	CONTRACTING SRVS	PrimaryActivitiesTxt
Legal Domicile State	KY	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C	EntityTypeTxt
Share Of Total Income	$0	ShareOfTotalIncomeAmt
Share Of EOY Assets	$0	ShareOfEOYAssetsAmt
Controlled Organization	false	ControlledOrganizationInd

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	CENTRAL KENTUCKY SURGERY CENTER LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	P	TransactionTypeTxt
Involved	$9,984,957	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt