NORTON - KINGS DAUGHTERS HEALTH INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- NORTON - KINGS DAUGHTERS HEALTH INC (EIN 35-0895832)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-09
- IRS object ID
- 201823139349301402
- 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 K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-09T09:25:01-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350895832 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE BETHANY CIRCLE OF KING'S DAUGHTERS' | BusinessNameLine1Txt |
| Business Name Line2 | OF MADISON INDIANA INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BETH | BusinessNameControlTxt |
| Phone | 8128010800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1373 EAST STATE ROAD 62 PO BOX 447 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47250 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAULA HEIDERMAN | PersonNm |
| Person Title | BOARD CHAIRWOMAN | PersonTitleTxt |
| Phone | 8128010800 | PhoneNum |
| Signature | 2018-10-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CARRIE A MERRILL CPA | PreparerPersonNm |
| PTIN | P00832283 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2018-10-30 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.109.186.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-30 | IPDt |
| IP Tm | 09:22:01 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CEC041C7A28BF02AF1651001FA3B4F793CABA0CE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KING'S DAUGHTERS' HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN PRICE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1373 EAST STATE ROAD 62 PO BOX 447 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $161,690,219 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KDHMADISON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1149 | TotalEmployeeCnt |
| Total Volunteers | 79 | TotalVolunteersCnt |
| Total Gross UBI | $37,663 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $408,019 | PYContributionsGrantsAmt |
| CY Contributions Grants | $140,093 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $125,312,917 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $127,224,164 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,734,690 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,937,314 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,152,739 | PYOtherRevenueAmt |
| CY Other Revenue | $1,374,463 | CYOtherRevenueAmt |
| PY Total Revenue | $129,608,365 | PYTotalRevenueAmt |
| CY Total Revenue | $133,676,034 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $131,389 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,664 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $63,171,103 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $64,434,304 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $59,706,871 | PYOtherExpensesAmt |
| CY Other Expenses | $59,643,999 | CYOtherExpensesAmt |
| PY Total Expenses | $123,009,363 | PYTotalExpensesAmt |
| CY Total Expenses | $124,082,967 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,599,002 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,593,067 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $257,036,707 | TotalAssetsBOYAmt |
| Total Assets EOY | $277,232,984 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $108,181,062 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $107,951,699 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $148,855,645 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $169,281,285 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $106,486,824 | ExpenseAmt |
| Grant | $4,664 | GrantAmt |
| Revenue | $128,072,332 | RevenueAmt |
| Desc | KING'S DAUGHTERS' HEALTH IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL OWNED BY THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON, INDIANA, INC., LOCATED IN MADISON, INDIANA. THE HOSPITAL IS ORGANIZED FOR THE PURPOSE OF PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.DURING THE CALENDAR YEAR 2017, THE HOSPITAL PROVIDED HEALTHCARE TO PATIENTS AT THE FOLLOWING LEVELS:11,818 DAYS OF CARE TO ACUTE INPATIENTS1,147 DAYS OF CARE TO NEWBORN INFANTS188,698 VISITS ASSOCIATED WITH HOSPITAL OUTPATIENTS130,501 VISITS ASSOCIATED WITH PHYSICIAN CLINICS | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,439,511 | ExpenseAmt |
| Desc | THE HOSPITAL'S PRIMARY SOURCES OF SUPPORT ARE FROM PATIENT REVENUES. PATIENT REVENUES INCLUDE FUNDS RECEIVED FROM MEDICARE, STATE AGENCIES, INSURANCE COMPANIES, AND THE PATIENTS THEMSELVES. IN 2017, KING'S DAUGHTERS' HEALTH PROVIDED SERVICES TOTALING $1,439,511 IN GROSS CHARGES TO PATIENTS WHO MET THE HOSPITAL'S CHARITY CARE POLICY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $107,926,335 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 77 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1149 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAWN NUNAN DIRECTOR OF ACCOUNTING | PersonNm |
| Phone | 8128010800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1373 EAST STATE ROAD 62 PO BOX 447 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47250 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PAULA HEIDERMAN | ||||||||
| BOARD CHAIRWOMAN | 1.00 | 1.00 | Yes (X) | $500 | $0 | $0 | ||
| MARJORIE HARE | ||||||||
| BOARD VICE CHAIRWOMAN | 1.00 | 0.00 | Yes (X) | $1,250 | $0 | $0 | ||
| ANNIE SCHROEDER | ||||||||
| BOARD SECRETARY | 1.00 | 0.00 | Yes (X) | $1,500 | $0 | $0 | ||
| MARY BETTE VOYLES | ||||||||
| BOARD TREASURER | 1.00 | 0.00 | Yes (X) | $1,250 | $0 | $0 | ||
| ANDREA FORRESTER | ||||||||
| BOARD ASSN'T TREASURER | 1.00 | 0.00 | Yes (X) | $1,250 | $0 | $0 | ||
| BONNIE COLEN | ||||||||
| BOARD ASSN'T SECRETARY | 1.00 | 0.00 | Yes (X) | $750 | $0 | $0 | ||
| JONATHAN HANSON MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $450,148 | $0 | $41,227 | ||
| PAT STACK MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $209,381 | $0 | $22,122 | ||
| JOE CRAIG | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $1,250 | $0 | $0 | ||
| MARY KAY MCCUBBIN | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $1,500 | $0 | $0 | ||
| KEVIN TURNER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $500 | $0 | $0 | ||
| CAROL DOZIER | ||||||||
| PRESIDENT/CEO | 40.00 | 1.00 | $411,027 | $0 | $14,816 | Yes (X) | ||
| JOHN PRICE | ||||||||
| VP FINANCE | 40.00 | 0.00 | $225,704 | $0 | $18,095 | Yes (X) | ||
| LISA MORGAN | ||||||||
| VP OUTPATIENT SERVICES | 40.00 | 0.00 | $159,474 | $0 | $16,513 | Yes (X) | ||
| DENINE FALLIS-HALLGARTH | ||||||||
| VP PHYSICIAN PRACTICES | 40.00 | 0.00 | $138,584 | $0 | $18,845 | Yes (X) | ||
| JENNIFER LITER | ||||||||
| VP INPATIENT SERVICES | 40.00 | 0.00 | $121,173 | $0 | $19,549 | Yes (X) | ||
| HOLLY ROBINSON MD | ||||||||
| VP QUALITY / PHYSICIAN | 40.00 | 0.00 | $279,069 | $0 | $40,756 | Yes (X) | ||
| THOMAS ECKERT MD | ||||||||
| EMPLOYED PHYSICIAN | 40.00 | 1.00 | $724,517 | $0 | $30,745 | Yes (X) | ||
| TRAVIS CLEGG MD | ||||||||
| EMPLOYED PHYSICIAN | 40.00 | 0.00 | $1,735,932 | $0 | $41,577 | Yes (X) | ||
| WILLIAM SKILES MD | ||||||||
| EMPLOYED PHYSICIAN | 40.00 | 0.00 | $637,523 | $0 | $27,691 | Yes (X) | ||
| MICHAEL SCHMIDT MD | ||||||||
| EMPLOYED PHYSICIAN | 40.00 | 0.00 | $615,502 | $0 | $42,531 | Yes (X) | ||
| RONALD AUER MD | ||||||||
| EMPLOYED PHYSICIAN | 40.00 | 0.00 | $818,365 | $0 | $42,101 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,536,149 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $376,568 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 60 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CLOUDWAVE | |||||
| 100 CROWLEY DRIVE | MARLBOROUGH | MA | 01752 | INFRASTRUCTURE SUPPORT - MAINT OF VIRTUA | $1,039,996 |
| COMPREHENSIVE MEDICAL MANAGEMENT | |||||
| 300 DAVE COWENS DRIVE STE 600 | NEWPORT | KY | 41071 | CONTRACTED PHYSICIAN BILLING SERVICES | $830,839 |
| MAYO COLLABORATIVE SERVICES INC | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 544809146 | LABORATORY SERVICES | $689,477 |
| EMCARE INC | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | CONTRACTED PHYSICIAN & MID LEVEL PROVIDE | $688,420 |
| ARUP LABORATORIES | |||||
| 500 CHIPETA WAY | SALT LAKE CITY | UT | 84108 | LABORATORY SERVICES | $488,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $49,055 | GovernmentGrantsAmt |
| All Other Contributions | $91,038 | AllOtherContributionsAmt |
| Noncash Contributions | $23,652 | NoncashContributionsAmt |
| Total Contributions | $140,093 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $127,224,164 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $127,224,164 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $127,224,164 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,719,516 | TotalRevenueColumnAmt |
| Exclusion | $2,719,516 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $76,178 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $23,286 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,892 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,892 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,892 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,563,909 | SecuritiesAmt |
| Other | $644,788 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $26,663,271 | SecuritiesAmt |
| Other | $1,327,628 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,900,638 | SecuritiesAmt |
| Other | -$682,840 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,217,798 | TotalRevenueColumnAmt |
| Exclusion | $2,217,798 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR INCOME | 900099 | $511,265 | $511,265 | |
| CAFETERIA REVENUE | 722210 | $366,454 | $366,454 | |
| GIFT SHOP | 453220 | $122,178 | $122,178 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $321,674 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $284,011 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $37,663 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,321,571 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $133,676,034 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $128,072,332 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $37,663 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,425,946 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,664 | TotalAmt |
| Program Services | $4,664 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,196,233 | TotalAmt |
| Program Services | $1,910,265 | ProgramServicesAmt |
| Management And General | $285,968 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,791,362 | TotalAmt |
| Program Services | $43,308,114 | ProgramServicesAmt |
| Management And General | $6,483,248 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,880,762 | TotalAmt |
| Program Services | $1,635,871 | ProgramServicesAmt |
| Management And General | $244,891 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,356,145 | TotalAmt |
| Program Services | $6,398,314 | ProgramServicesAmt |
| Management And General | $957,831 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,209,802 | TotalAmt |
| Program Services | $2,791,859 | ProgramServicesAmt |
| Management And General | $417,943 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,471 | TotalAmt |
| Management And General | $109,471 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,605 | TotalAmt |
| Management And General | $108,605 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,519 | TotalAmt |
| Management And General | $451,519 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,380 | TotalAmt |
| Management And General | $355,380 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,078 | TotalAmt |
| Program Services | $156,630 | ProgramServicesAmt |
| Management And General | $23,448 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $964,076 | TotalAmt |
| Program Services | $838,545 | ProgramServicesAmt |
| Management And General | $125,531 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $424,245 | TotalAmt |
| Program Services | $369,005 | ProgramServicesAmt |
| Management And General | $55,240 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,099,093 | TotalAmt |
| Program Services | $1,825,774 | ProgramServicesAmt |
| Management And General | $273,319 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,401 | TotalAmt |
| Program Services | $101,245 | ProgramServicesAmt |
| Management And General | $15,156 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,412,200 | TotalAmt |
| Program Services | $4,707,487 | ProgramServicesAmt |
| Management And General | $704,713 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,288,685 | TotalAmt |
| Program Services | $8,949,013 | ProgramServicesAmt |
| Management And General | $1,339,672 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,556,455 | TotalAmt |
| Program Services | $1,353,792 | ProgramServicesAmt |
| Management And General | $202,663 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $10,484,786 | $9,119,580 | $1,365,206 |
| DRUGS | $10,032,521 | $10,032,521 | |
| SUPPLIES | $9,009,725 | $7,836,584 | $1,173,141 |
| HOSPITAL ASSESSMENT FEE | $2,729,746 | $2,729,746 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,321,013 | TotalAmt |
| Program Services | $3,857,326 | ProgramServicesAmt |
| Management And General | $1,463,687 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,082,967 | TotalAmt |
| Program Services | $107,926,335 | ProgramServicesAmt |
| Management And General | $16,156,632 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $9,474 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,980,469 | BOYAmt |
| EOY | $16,294,366 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,121,632 | BOYAmt |
| EOY | $10,370,400 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $576,185 | BOYAmt |
| EOY | $456,146 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,464,740 | BOYAmt |
| EOY | $2,497,096 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,953,950 | BOYAmt |
| EOY | $2,917,927 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $185,700,096 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $78,694,337 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,550,461 | BOYAmt |
| EOY | $107,005,759 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,442,587 | BOYAmt |
| EOY | $129,961,696 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,946,683 | BOYAmt |
| EOY | $7,720,120 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,036,707 | BOYAmt |
| EOY | $277,232,984 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,106,378 | BOYAmt |
| EOY | $10,511,186 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,318,589 | BOYAmt |
| EOY | $93,886,785 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,417,437 | BOYAmt |
| EOY | $1,370,016 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,658 | BOYAmt |
| EOY | $2,183,712 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,181,062 | BOYAmt |
| EOY | $107,951,699 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,835,451 | BOYAmt |
| EOY | $169,268,328 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,194 | BOYAmt |
| EOY | $2,957 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,855,645 | BOYAmt |
| EOY | $169,281,285 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,036,707 | BOYAmt |
| EOY | $277,232,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $9,593,067 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $10,558,678 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $273,895 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,323 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,323 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PORTION OF INDIANA HOSPITAL ASSOCIATION DUES AND AMERICAN HOSPITAL ASSOCIATION DUES ATTRIBUTABLE TO LOBBYING EXPENSES AS DISCLOSED ON THE DUES NOTICES OF THE RESPECTIVE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,194 | BeginningYearBalanceAmt |
| Contributions | $28,678 | ContributionsAmt |
| Other Expenditures | $35,915 | OtherExpendituresAmt |
| End Year Balance | $12,957 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $28,255 | BeginningYearBalanceAmt |
| Contributions | $356,398 | ContributionsAmt |
| Other Expenditures | $364,459 | OtherExpendituresAmt |
| End Year Balance | $20,194 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $30,058 | BeginningYearBalanceAmt |
| Contributions | $506,513 | ContributionsAmt |
| Other Expenditures | $508,316 | OtherExpendituresAmt |
| End Year Balance | $28,255 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $208,725 | BeginningYearBalanceAmt |
| Contributions | $50,077 | ContributionsAmt |
| Other Expenditures | $228,744 | OtherExpendituresAmt |
| End Year Balance | $30,058 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $196,716 | BeginningYearBalanceAmt |
| Contributions | $48,484 | ContributionsAmt |
| Other Expenditures | $36,475 | OtherExpendituresAmt |
| End Year Balance | $208,725 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.77180 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.22820 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,045,918 | OtherCostOrOtherBasisAmt |
| Book Value | $4,045,918 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,987,460 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,916,975 | DepreciationAmt |
| Book Value | $87,070,485 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $63,480,802 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,777,362 | DepreciationAmt |
| Book Value | $15,703,440 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $185,916 | OtherCostOrOtherBasisAmt |
| Book Value | $185,916 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $107,005,759 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $40,735 |
| THIRD PARTY PAYABLE | $1,763,697 |
| LIFE INSURANCE POLICIES | $379,280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,183,712 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $144,047,102 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $10,558,678 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $273,895 | OtherRevenueAmt |
| Revenue Not Reported | $10,832,573 | RevenueNotReportedAmt |
| Revenue Subtotal | $133,214,529 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $451,519 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $9,986 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $461,505 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $133,676,034 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $123,621,462 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $123,621,462 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $451,519 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $9,986 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $461,505 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $124,082,967 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PERMANENT ENDOWMENT - INTENT IS TO HOLD THE INVESTMENT IN PERPETUITY. PER AUDITED FINANCIAL STATEMENTS, "THE PORTION OF PERPETUAL ENDOWMENT FUNDS THAT IS REQUIRED TO BE RETAINED PERMANENTLY EITHER BY EXPLICIT DONOR STIPULATION OR UPMIFA" IS $10,000 AT 12/31/2017. TERM ENDOWMENT - TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE INCLUDING: PRENATAL/POSTNATAL EDUCATION PROGRAM FUND, INDIANA HOSPITAL ASSOCIATION FUND, AND HIP 2.0 PREMIUM ASSISTANCE FUND. |
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2017 AND 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, AS OF THE DATE THE FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN SUBSCRIBER SAVINGS CUMULATIVE ACCOUNT 273,895. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | OTHER RENTAL INCOME 9,986. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | OTHER RENTAL INCOME 9,986. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $445,706 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $445,706 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,160,975 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,144,432 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,016,543 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,606,681 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,144,432 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,462,249 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $175,893 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $125,756 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,513 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $45,350 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $124,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,237,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,911,229 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $326,196 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,089 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,591,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,006,716 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $585,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,198,601 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,151,148 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,047,453 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08100 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $141,093 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $141,093 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $259 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $259 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $141,352 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $141,352 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,956,871 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,114,981 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,071,465 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,043,516 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KING'S DAUGHTERS' HEALTH | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1373 EAST STATE ROAD 62 PO BOX 447 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.KDHMADISON.ORG | WebsiteAddressTxt |
| State License | 17-005063-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KING'S DAUGHTERS' HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 3J: THE NEEDS ASSESSMENT PERFORMED BY THE HOSPITAL ALSO EXPLORED KEY ISSUES SUCH AS: PHYSICAL ACTIVITY, OVERWEIGHT AND OBESITY, TOBACCO USE, SUBSTANCE ABUSE/GAMBLING/ADDICTIONS, RESPONSIBLE SEXUAL BEHAVIOR, MENTAL HEALTH, INJURY AND VIOLENCE (INCLUDING DOMESTIC VIOLENCE AND SEXUAL ASSAULT), ENVIRONMENTAL QUALITY, IMMUNIZATION, ACCESS TO HEALTH CARE FOR THE INSURED AND UNINSURED, MATERNAL AND CHILD HEALTH, INFECTIOUS DISEASE, OCCUPATIONAL AND SAFETY HEALTH, SPECIAL NEEDS/DISABLED/IMPAIRED, AND CHRONIC DISEASE. |
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 5: THE FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS IN THE COMMUNITY BY UTILIZING THE FOLLOWING COMPONENTS:- ANALYSIS OF SECONDARY DATA TO DEVELOP A PROFILE OF THE RESIDENTS OF EACH COUNTY AND TO INDICATE, WHERE POSSIBLE FUTURE TRENDS AND TO SHOW COMPARISONS WITH STATE AND NATIONAL DATA;- IN-PERSON INTERVIEWS WITH 30 KEY LEADERS WITHIN KDH INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 44 COMMUNITY LEADERS INCLUDING GOVERNMENT, MEDICAL, EDUCATION, AND OTHER COMMUNITY LEADERSHIP POSITIONS IN ALL FIVE COUNTIES;- IN-PERSON SURVEYS OF 72 INDIVIDUALS IN LOW INCOME LOCATIONS;- IN-PERSON DISCUSSIONS WITH 19 SENIOR CITIZENS;- A WEB-BASED SURVEY OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 184 COMPLETED INTERVIEWS. THIS ASSESSMENT ALLOWED ALL INDIVIDUALS TO PROVIDE RESPONSES ON ANY COMMUNITY NEEDS NOT LISTED IN THE QUESTIONS AND ALLOWED INDIVIDUALS TO MAKE COMMENTS ON COMMUNITY HEALTH ISSUES ON WHICH KDH C |
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 7D: RESULTS OF THE NEEDS ASSESSMENT HAVE BEEN MADE AVAILABLE THROUGH A VARIETY OF SOURCES: NEWSPAPER AND RADIO RELEASES, DISTRIBUTION OF INFORMATION IN THE COMMUNITY NEWSLETTER, THE VITAL SIGNS, THROUGH PUBLIC HEALTH FORUMS. IT IS ALSO AVAILABLE ON OUR WEBSITE @WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT. |
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 11: AFTER REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2017, A SMALL COMMITTEE OF INTERESTED INDIVIDUALS WAS INVITED TO PARTICIPATE IN MEETINGS TO DETERMINE WAYS WE CAN WORK TOGETHER TO BETTER MEET THE NEEDS OF THE COMMUNITIES WE SERVE. THIS SMALL GROUP INCLUDED PARTICIPATION FROM THE JEFFERSON COUNTY HEALTH DEPARTMENT, OUR STATE GRANT FOR TOBACCO PREVENTION AND OUR KDH COMMUNITY RELATIONS PARTICIPANTS. AMONG THIS GROUP WAS INPUT FROM OTHER PARTIES, AND AN INTERESTED VOLUNTEER MEDICAL STUDENT. THE NEEDS ASSESSMENT FINDINGS, AND THE IMPLEMENTATION STRATEGY, WERE SHARED WITH THE BOARD OF MANAGERS AND ALL ACTION PLAN ITEMS WILL BE INCORPORATED INTO THE WORKING STRATEGIC PLAN FOR THE ORGANIZATION.KDH GAPS: THERE DOES NOT APPEAR TO BE LARGE GAPS IN THE TOPICS OR TYPES OF COMMUNITY OUTREACH PROGRAMS THAT KDH HAS CONDUCTED IN THE PAST. HOWEVER, THERE MAY BE GAPS DUE TO FUNDING LEVELS OR STAFFING LEVELS IN THE NUMBER OF PROGRAMS AND THE GEOGRAPHIC REACH OF THE PROGRAMS THAT HAVE BEEN OFFERED. KDH WILL USE THE LIST OF MAJOR HEALTH ISSUES IN WHICH KDH IS EXPECTED TO HAVE A LEADERSHIP AND SUPPORTING ROLE AS WELL AS THE LIST OF SPECIFIC TOPICS SUGGESTED TO DEVELOP PROGRAMS AND APPLY FOR GRANTS TO IMPROVE HEALTH IN THE COMMUNITIES IT SERVES.IMPLEMENTATION STRATEGY 2017-2019 SAFE DRUG DROP OFF PROGRAM: KING'S DAUGHTERS' HEALTH WILL SUPPORT THE JEFFERSON COUNTY HEALTH DEPARTMENT WITH MULTIPLE DRUG DROP OFF EVENTS EACH YEAR. MANY OF THESE EVENTS WILL BE HOSTED ON THE KDH CAMPUS. KDH WILL ADVERTISE ALL DROP OFF EVENTS TO MEDICAL PROVIDERS, INTERNALLY TO STAFF, AND THROUGH SOCIAL MEDIA EFFORTS. GOALS: TO PROVIDE A SAFE ALTERNATIVE TO DISPOSING OF UNWANTED PRESCRIPTION MEDICATIONS. MEDICATIONS ARE INCINERATED BY LAW ENFORCEMENT AFTER COLLECTION. EVALUATION: THE HEALTH DEPARTMENT WILL EVALUATE THE NUMBER OF SPECIAL DROP OFF EVENTS EACH CALENDAR YEAR. THE NUMBER OF INDIVIDUALS DROPPING OFF DRUGS/MEDICINE WILL BE TRACKED AS WELL AS THE TOTAL POUNDS OF DRUGS COLLECTED. KDH WILL PROMOTE THE DRUG DROP OFF PROGRAM BY OFFERING A MINIMUM OF THREE DIFFERENT PROMOTIONAL METHODS FOR EACH SPECIAL EVENT.YEAR 1 2017 UPDATE- NUMBER OF DRUG DROP OFF EVENTS IN 2017: 5 (4 HELD ON THE KDH CAMPUS AND 1 HELD AT A COMMUNITY WOMEN'S HEALTH EVENT, SPONSORED BY KDH). THE FOLLOWING NUMBERS WERE MEASURED FOR 3 OF THE 5 EVENTS. - NUMBER OF INDIVIDUALS DROPPING OFF DRUGS/MEDICINE: 142- TOTAL POUNDS OF DRUGS COLLECTED: 327 LBS.- TOTAL POUNDS OF SYRINGES COLLECTED: 69 LBS.- METHODS OF PROMOTING DRUG DROP OFF EVENTS: KDH WEBSITE, KDH SOCIAL MEDIA (FACEBOOK/TWITTER), FLIERS POSTED IN PHYSICIAN OFFICE AREAS, ALL STAFF KDH EMAIL REMINDERS SENT PRIOR TO EACH EVENT.A TOTAL OF 9 DIFFERENT DOCUMENTED METHODS OF PROMOTION WERE RECORDED FROM PARTICIPANTS WHO WERE ASKED HOW THEY HEARD ABOUT THE DRUG DROP OFF EVENTS.OVERWEIGHT AND OBESITY AND LACK OF PHYSICAL ACTIVITY FIT KIDS DESCRIPTION: FIT KIDS IS A CURRICULUM-BASED HEALTH EDUCATION PROGRAM OFFERED IN THE SCHOOL CLASSROOM SETTING. KDH STAFF VISIT 5TH GRADE SCHOOL CLASSROOMS FOR 7 WEEKS OFFERING LESSONS TARGETING THE SUBJECT OF CHILDHOOD OBESITY. AGE-APPROPRIATE EDUCATION AND WEEKLY TAKE-HOME CHALLENGES TO INVOLVE FAMILIES ARE OFFERED EACH LESSON. ALL HEALTH LESSONS FOCUS ON A SPECIFIC AREA OF NUTRITION AND PHYSICAL ACTIVITY. GOALS: TO EXTEND THE FIT KIDS PROGRAM TO BOTH SWITZERLAND COUNTY, IN AND TRIMBLE COUNTY, KY ELEMENTARY SCHOOLS. IN ADDITION, THE PROGRAM WILL CONTINUE TO BE OFFERED TO ALL JEFFERSON COUNTY ELEMENTARY SCHOOLS. ANTICIPATED OUTCOMES IMPROVED HEART HEALTH KNOWLEDGE, INCREASE PHYSICAL ACTIVITY FOR CHILDREN, AND IMPROVED NUTRITION CHOICES SUCH AS; INCREASE WATER INTAKE, DECREASE HIGH SUGARY BEVERAGES, INCREASE IN FRUIT AND VEGETABLE CONSUMPTION, CONTROLLED PORTION SIZES, AND INCREASE PERCENTAGE OF CHILDREN WHO CONSUME BREAKFAST EACH DAY. PLAN TO EVALUATE: PRE/POST SURVEYS, WEEKLY TAKE HOME CHALLENGE PARTICIPATION. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: A NEW PRE/POST SURVEY WILL BE DEVELOPED AND IMPLEMENTED FOR ALL PARTICIPATING STUDENTS. INSTRUCTORS WILL TRACK PERCENT OF STUDENTS WHO COMPLETE WEEKLY TAKE-HOME CHALLENGES.YEAR 1 2017 UPDATE:- THE PROGRAM WAS OFFERED AT FOUR SCHOOL SYSTEMS IN JEFFERSON COUNTY.- THE GOAL TO EXPAND THE PROGRAM TO SWITZERLAND COUNTY WILL BE ACHIEVED IN EARLY 2018 (ALL PREP WORK COMPLETED IN 2017).HEALTHY LIFESTYLES TEAM, COMMUNITY-WIDE WELLNESS CHALLENGES DESCRIPTION: THE NEWLY FORMED HEALTHY LIFESTYLES TEAM WILL CREATE AND IMPLEMENT A MINIMUM OF ONE COMMUNITY-WIDE WELLNESS CHALLENGE EACH CALENDAR YEAR. THESE CHALLENGES WILL BE INCENTIVE-BASED AND OPEN TO ALL COUNTY RESIDENTS. GOALS: CREATE CREATIVE CHALLENGES THAT WILL MOTIVATE PARTICIPANTS TO IMPROVE THEIR HEALTH. THE TEAM WILL WORK TO GET AS MANY LOCAL RESIDENTS INVOLVED BY TARGETING PROMOTION AND SIGNUPS TO INDUSTRIES/BUSINESSES, SCHOOLS, CHURCHES, AND CIVIC GROUPS. ANTICIPATED OUTCOMES: INCREASE PHYSICAL ACTIVITY, IMPROVE NUTRITIONAL HABITS, AND IMPROVE MISC. HEALTHY LIFESTYLE CHOICES LIKE STRESS MANAGEMENT AND QUALITY/QUANTITY OF SLEEP. THE ULTIMATE OUTCOME IS TO LOWER THE RATE OF OVERWEIGHT AND OBESE RESIDENTS IN THE COMMUNITY. PLAN TO EVALUATE: THE HEALTHY LIFESTYLES TEAM, UNDER THE LEADERSHIP OF THE HCI COORDINATOR AND WELLNESS COORDINATOR WILL EVALUATE PARTICIPATION LEVELS AND ANY BIOMETRIC MEASUREMENTS THAT CAN BE CAPTURED. PARTICIPATION SURVEYS WILL BE OFFERED WHEN POSSIBLE. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF CHALLENGES EACH CALENDAR YEAR WILL BE DOCUMENTED ALONG WITH NUMBER OF INDIVIDUALS PARTICIPATING AND PERCENT OF PEOPLE WHO COMPLETE/FINISH THE CHALLENGE. CHALLENGE TRACKING TOOLS WILL BE MEASURED, DEPENDING ON THE THEME/FOCUS OF THE CHALLENGE; EXAMPLE- CALCULATING TOTAL STEPS, EXERCISE MINUTES, CHANGE IN BMI, SERVINGS OF FRUITS/VEGETABLES, ETC. YEAR 1 2017 UPDATE:- HEALTHY LIFESTYLES TEAM MET 9 TIMES IN 2017. THE TEAM HAS 44 MEMBERS.STRIVE FOR 5 WEIGHT LOSS EDUCATION CLASS DESCRIPTION: THIS 5-WEEK CLASS SERIES TEACHES BASIC WEIGHT LOSS CONCEPTS AND FOCUSES ON DIFFERENT ASPECTS OF HEALTHY NUTRITION AND EXERCISE EACH WEEK. CLASS PARTICIPANTS WEIGH DURING THE FIRST AND LAST CLASS. THE ONE-TIME CLASS FEE OF $5 IS REFUNDED TO ANYONE WHO LOSES AT LEAST 5 POUNDS OF THEIR BODY WEIGHT. GOALS: OFFER A MINIMUM OF THREE 5-WEEK CLASS SERIES EACH CALENDAR YEAR, WITH A MINIMUM OF 30 PARTICIPANTS. ACHIEVE A 50% RATE EACH CLASS SERIES FOR PARTICIPANTS WHO LOSE THE MINIMUM OF 5 POUNDS OF BODY WEIGHT DURING THE 5 WEEK CLASS SERIES. ANTICIPATED OUTCOMES: IMPROVE NUTRITIONAL HABITS AND INCREASE PHYSICAL ACTIVITY FOR ALL CLASS PARTICIPANTS. MOTIVATE, EDUCATE, AND ASSIST CLASS PARTICIPANTS TO REDUCE BMI. PLAN TO EVALUATE: STRIVE FOR 5 INSTRUCTOR CALCULATIONS. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: TRACK NUMBER OF CLASS SERIES OFFERED, NUMBER OF PARTICIPANTS, AND ATTENDANCE. OFFER PRE AND POST BODY WEIGHT CHECKS AND MEASURE ANY WEIGHT CHANGE. YEAR 1 2017 UPDATE:- ONE 5-WEEK CLASS SERIES WAS HELD IN 2017 WITH 9 TOTAL PARTICIPANTS.TOBACCO USE DESCRIPTION: TOBACCO PREVENTION AND CESSATION COORDINATOR, EMPLOYED FULL TIME AT KDH, WILL PROVIDE EDUCATIONAL LITERATURE AND RESOURCES REGARDING THE HEALTH AND FINANCIAL EFFECTS OF SMOKING DURING PREGNANCY THROUGH WIC AND KDH OB/GYN PROVIDERS. THE COORDINATOR WILL MEET WITH WOMEN FACE TO FACE AS NECESSARY TO PROVIDE COUNSELING AND ADDITIONAL RESOURCES. GOALS: DECREASE SMOKING RATE AMONG PREGNANT WOMEN. ANTICIPATED OUTCOMES: THE MAIN ANTICIPATED OUTCOME IS A DECREASED SMOKING RATE AMONG PREGNANT WOMEN, WHICH WOULD ALSO LEAD TO DECREASED PRE-TERM BIRTHS, LOW BIRTH WEIGHT AND BIRTH DEFECTS DUE TO SMOKING. PLAN TO EVALUATE: WIC AND OB/GYN PROVIDER TRACKING, INDIANA STATE DEPARTMENT OF HEALTH/CDC STATISTICS AND REPORTS. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF PREGNANT WOMEN WHO RECEIVE EDUCATIONAL MATERIALS, RESOURCES, COUNSELING, ETC. YEAR 1 2017 UPDATE:- NUMBER OF OB/GYN PATIENTS REFERRED TO THE TOBACCO QUITLINE 9.- ALL NEW OB PATIENTS RECEIVED WRITTEN TOBACCO LITERATURE IN NEW PATIENT BAGS.- ADDITIONAL TRAINING PROVIDED TO WIC CLINIC AND OB/GYN PROVIDERS ON CESSATION RESOURCES.- 2017 JEFFERSON COUNTY SMOKING WHILE PREGNANT RATE DECREASED TO 30.4% (WAS 31.3% IN 2016). |
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 16J: AT THE TIME OF REGISTRATION, THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT HE/SHE RECEIVED THIS INFORMATION. THE HOSPITAL ALSO HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. IN ADDITION TO THE ACTIONS PREVIOUSLY LISTED, A FINANCIAL AID COUNSELOR WILL ATTEMPT TO MEET (DURING NORMAL BUSINESS HOURS) WITH ANY UNINSURED INPATIENT PRIOR TO DISCHARGE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. |
| KING'S DAUGHTERS' HEALTH | PART V, SECTION B, LINE 20E: AT THE TIME OF REGISTRATION, THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT HE/SHE RECEIVED THIS INFORMATION. THE HOSPITAL ALSO HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. IN ADDITION TO THE ACTIONS PREVIOUSLY LISTED, A FINANCIAL AID COUNSELOR WILL ATTEMPT TO MEET (DURING NORMAL BUSINESS HOURS) WITH ANY UNINSURED INPATIENT PRIOR TO DISCHARGE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. |
| PART V, SECTION B, LINE 11 CONTINUED | INDIANA TOBACCO QUITLINE DESCRIPTION: KDH TOBACCO PREVENTION AND CESSATION COORDINATOR WILL PROMOTE THE INDIANA TOBACCO QUITLINE IN ORDER TO INCREASE THE NUMBER OF PEOPLE WHO UTILIZE OR ARE REFERRED TO THE QUITLINE VIA THEIR MEDICAL PROVIDER OR EMPLOYER. THE QUITLINE IS A FREE RESOURCE FOR ALL IN RESIDENTS THAT CONNECTS THEM WITH A CESSATION COUNSELOR AND PROVIDES FREE NICOTINE REPLACEMENT PRODUCTS FOR THOSE ENROLLED IN MEDICARE, MEDICAID, OR ARE UNINSURED. GOALS: DECREASE SMOKING RATE AMONG ADULTS. ANTICIPATED OUTCOMES: THE MAIN ANTICIPATED OUTCOME IS A DECREASED SMOKING RATE AMONG ADULTS, WHICH WOULD ALSO LEAD TO A DECREASED INCIDENCE OF CHRONIC DISEASE AND ILLNESS DUE TO SMOKING. PLAN TO EVALUATE: TOBACCO PREVENTION AND CESSATION TRACKING AND REPORTS. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF QUITLINE CALLS, NUMBER OF QUITLINE REFERRALS, NUMBER OF PATIENTS WHO ACCEPT QUITLINE SERVICES, DATA REGARDING HOW PATIENTS ARE HEARING ABOUT THE QUITLINE. YEAR 1 2017 UPDATE:- NUMBER OF 2017 QUITLINE REFERRALS WAS 194. - NUMBER OF ACCEPTED SERVICES WAS 18. - NUMBER OF DECLINED SERVICES WAS 44.YOUTH OUTREACH THROUGH SCHOOLS AND YOUTH ORGANIZATIONS DESCRIPTION: KDH TOBACCO PREVENTION AND CESSATION COORDINATOR WILL HOLD PRESENTATIONS AND ORGANIZE ACTIVITIES AT SCHOOLS AND YOUTH ORGANIZATIONS REGARDING HEALTH EFFECTS OF TOBACCO USE, AND THE MARKETING TACTICS OF BIG TOBACCO AND E-CIGARETTES. GOALS: DECREASE CURRENT YOUTH SMOKING RATES AND DISCOURAGE YOUTH FROM SMOKING. EDUCATE YOUTH ABOUT MARKETING TACTICS OF BIG TOBACCO USED TO TARGET YOUNG PEOPLE. ANTICIPATED OUTCOMES: THE MAIN ANTICIPATED OUTCOME IS A DECREASED SMOKING RATE AMONG YOUTH, AS WELL AS A MORE EDUCATED GROUP OF YOUTH WHO DO NOT DESIRE TO START SMOKING AND CAN ALSO RECOGNIZE THE TACTICS BIG TOBACCO USES TO TARGET YOUNG PEOPLE. PLAN TO EVALUATE: SURVEYS, PRE AND POST TESTS, IN STATE DEPARTMENT OF HEALTH AND CDC STATISTICS AND REPORTS. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF PRESENTATIONS, NUMBER OF STUDENTS REACHED, SURVEY AND TEST RESULTS. YEAR 1 2017 UPDATE:- FOUR TOBACCO PRESENTATIONS WERE HELD AT ELEMENTARY SCHOOLS AND THE LOCAL BOYS & GIRLS CLUB WITH AN ESTIMATED TOTAL OF 400 YOUTH IN ATTENDANCE. OUTREACH THROUGH RESPIRATORY THERAPY DEPARTMENT DESCRIPTION: KDH TOBACCO PREVENTION AND CESSATION COORDINATOR WILL PROVIDE FREE NICOTINE PATCHES FOR RESPIRATORY THERAPY PATIENTS AT KDH. PATIENTS WHO SMOKE AND SUFFER FROM COPD WILL BE OFFERED NICOTINE REPLACEMENT PRODUCTS AND EDUCATIONAL INFORMATION REGARDING THE HEALTH EFFECTS OF SMOKING, AS WELL AS INFORMATION ABOUT THE IN TOBACCO QUITLINE. PATCHES WILL BE PURCHASED THROUGH A GRANT, FUNDED FROM THE JEFFERSON COUNTY JUSTICE, TREATMENT, AND PREVENTION COALITION. GOALS: ASSIST RESPIRATORY PATIENTS WITH SMOKING CESSATION. ANTICIPATED OUTCOMES: THE MAIN ANTICIPATED OUTCOME IS A DECREASED NUMBER OF RESPIRATORY PATIENTS THAT SMOKE, WHICH WOULD ALSO LEAD TO IMPROVED RESPIRATORY FUNCTION, AND POSSIBLY A DECREASED CHANCE OF HOSPITAL ADMISSIONS. PLAN TO EVALUATE: RESPIRATORY DEPARTMENT TRACKING. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF PATCHES DISTRIBUTED, NUMBER OF PATIENTS SEEN IN RESPIRATORY DEPARTMENT, NUMBER OF COPD PATIENTS WHO SMOKE. YEAR 1 2017 UPDATE:- NUMBER OF PATCHES GIVEN BY RESPIRATORY DEPARTMENT TO PATIENTS IN 2017: 15 SUPPLY OF THESE PATCHES RAN OUT. ADDITIONAL GRANT TO PURCHASE MORE PATCHES IS SECURED FOR THE FOLLOWING CALENDAR YEAR. - NUMBER OF PATIENTS IN RESPIRATORY DEPARTMENT TO RECEIVE SMOKING CESSATION INFORMATION IN 2017: 50CHRONIC DISEASE HOUSE OF HEALTH DESCRIPTION: THE KDH WELLNESS DEPARTMENT WILL OFFER A MONTHLY EDUCATION PROGRAM TARGETING CHRONIC DISEASE PREVENTION AND EARLY DETECTION AT THE HOUSE OF HEALTH FOOD PANTRY. THE HOUSE OF HEALTH PROGRAM IS THE LARGEST COMMUNITY FOOD PANTRY IN THE COUNTY. THE PROGRAM SERVES AN AVERAGE OF 400 LOW-INCOME FAMILIES PER MONTH. GOALS: LOWER CHRONIC DISEASE RISK BY OFFERING VALUABLE HEALTH INFORMATION AND FREE SCREENS TO A LOW-INCOME POPULATION. ANTICIPATED OUTCOMES: IMPROVE KNOWLEDGE AND HEALTH AWARENESS BY OFFERING INFORMATION ON SUCH TOPICS AS; HEART DISEASE, SKIN AND BREAST CANCER PREVENTION AND DETECTION, STD/HIV PREVENTION AND DETECTION, BASIC FIRST AID, ETC. PLAN TO EVALUATE: PERSONAL SUCCESS STORIES SHARED FROM PARTICIPANTS WILL BE DOCUMENTED. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF HOUSE OF HEALTH SESSIONS HELD. THE NUMBER OF PEOPLE IN ATTENDANCE WILL BE MEASURED. THE NUMBER OF PEOPLE PARTICIPATING IN FREE SCREENING SERVICES WILL BE MEASURED (EXAMPLE BLOOD PRESSURE, SKIN CANCER SCREEN).YEAR 1 2017 UPDATE:- TWELVE PROGRAMS WERE HELD IN 2017.- ATTENDANCE RANGED FROM 30-70 PEOPLE EACH MONTH.- TOPICS INCLUDED: HEALTHY GOAL SETTING, HEART HEALTH, NUTRITION, STD/HIV/HEP C, FIRST AID, MOSQUITOS, SKIN CANCER, IMMUNIZATIONS, TOBACCO, BREAST CANCER, FOOD SAFETY, WEIGHT LOSS.- THE ONLY BIOMETRIC SCREEN OFFERED IN 2017 WAS BLOOD PRESSURE. A TOTAL OF 21 INDIVIDUALS WERE SCREENED.CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) READMISSION PREVENTION PROGRAM DESCRIPTION: A MULTI-DISCIPLINARY TEAM OF STAFF AT KDH WILL TARGET COPD PATIENTS AND THE PROBLEM OF READMISSION. READMISSION IS COSTLY TO THE PATIENT, THE HEALTH CARE ORGANIZATION, THE INSURANCE COMPANY, AND READMISSIONS INCREASE HEALTH CONCERNS FOR THE PATIENT. EMERGENCY MEDICATION KITS WILL BE PROVIDED TO COPD PATIENTS WITH DETAILS INSTRUCTIONS FOR USE AND SELF-HOME CARE. TAKE-HOME BINDERS WITH HEALTH EDUCATION ARE ALSO GIVEN TO ALL COPD PATIENTS. GOALS: TO DECREASE READMISSION FOR COPD PATIENTS. ANTICIPATED OUTCOMES: IMPROVE CHRONIC DISEASE MANAGEMENT SKILLS SO THE PATIENT CAN MANAGE PROBLEMS SAFELY AND EFFECTIVELY AT HOME, TO AVOID A RETURN TO THE HOSPITAL FOR READMISSION. PLAN TO EVALUATE: READMISSION RATES ARE MEASURED BY A PROGRAM TITLED MEDISOLVE. FOLLOW UP PATIENT PHONE CALLS ARE ALSO DOCUMENTED. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: THE NUMBER OF COPD PATIENTS WILL BE MEASURED. THE NUMBER OF COPD EMERGENCY MED KITS AND THE NUMBER OF HEALTH EDUCATION BINDERS DISTRIBUTED WILL BE DOCUMENTED. YEAR 1 2017 UPDATE:- # OF EMERGENCY MED KIDS DISTRIBUTED TO COPD PATIENTS: 197- # OF HEALTH EDUCATION BINDERS DISTRIBUTED TO COPD PATIENTS: 226- ALL PATIENTS RECEIVED A MINIMUM OF TWO FOLLOW UP PHONE CALLS. |
| PART V, SECTION B, LINE 11 CONTINUED | CONGESTIVE HEART FAILURE (CHF) READMISSION PREVENTION PROGRAM DESCRIPTION: HOME SCALES TO TRACK BODY WEIGHT WILL BE GIVEN TO CHF PATIENTS IN NEED. CHF EDUCATION BINDERS WITH HEALTH INSTRUCTIONS FOR HOME CARE WILL ALSO BE GIVEN TO ALL CHF DIAGNOSED PATIENTS. IN ADDITION, THE ACO COORDINATOR WILL PROVIDE FOLLOW-UP WITH INDIVIDUALS ON AN OUT-PATIENT LEVEL, PROVIDING REMINDERS OF APPOINTMENTS, ATTENDING PHYSICIAN OFFICE VISITS IF NEEDED, AND WILL SERVE AS A RESOURCE TO HELP PATIENTS MEET NEEDS. GOALS: TO DECREASE READMISSION FOR CHF PATIENTS. ANTICIPATED OUTCOMES: IMPROVE CHRONIC DISEASE MANAGEMENT SKILLS SO THE PATIENT CAN RECOGNIZE PROBLEMS SAFELY AND EFFECTIVELY AT HOME, TO REDUCE RISK OF RETURNING TO THE HOSPITAL FOR A READMISSION. PLAN TO EVALUATE: READMISSION RATES ARE MEASURED BY A PROGRAM TITLED MEDISOLVE. FOLLOW UP PATIENT PHONE CALLS ARE DOCUMENTED ONE WEEK AFTER DISCHARGE. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: THE NUMBER OF CHF PATIENTS WILL BE MEASURED. THE NUMBER OF SCALES GIVEN FOR HOME USE AND THE NUMBER OF HEALTH EDUCATION BINDERS DISTRIBUTED WILL BE DOCUMENTED. THE NUMBER OF HOME PHONE CALLS WILL BE TRACKED AND STATISTICS WILL BE GATHERED FROM THE ACO COORDINATOR. YEAR 1 2017 UPDATE:- # OF SCALES DISTRIBUTED TO CHF PATIENTS: 18- # OF HEALTH EDUCATION BINDERS DISTRIBUTED TO COPD PATIENTS: 72- ALL PATIENTS RECEIVED A MINIMUM OF TWO FOLLOW UP PHONE CALLS. MENTAL HEALTH / SUICIDE MENTAL HEALTH/SUICIDE TEAM, RESOURCE GUIDE DESCRIPTION: THE NEWLY FORMED MENTAL HEALTH/SUICIDE TEAM WILL PROMOTE AVAILABLE TRAININGS DESIGNED TO TEACH PEOPLE HOW TO RECOGNIZE INDIVIDUALS WHO ARE AT RISK FOR SUICIDE AND OFFER EARLY INTERVENTION TO RESOURCES. GOALS: INCREASE THE NUMBER OF INDIVIDUALS WHO ARE TRAINED IN A STRUCTURED PROGRAM SUCH AS, BUT NOT LIMITED TO; QUESTION PERSUADE AND REFER (QPR) OR APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST). CREATE A RESOURCE GUIDE THAT HIGHLIGHTS ALL SUICIDE PREVENTION PERSONAL AND ANY/ALL LOCAL MENTAL HEALTH/SUICIDE RESOURCES IN THE COMMUNITY. PROMOTE AND ADVERTISE THIS RESOURCE GUIDE COUNTY-WIDE. IN ADDITION, KDH WILL INCREASE THE NUMBER OF KDH STAFF MEMBERS WHO ARE TRAINED IN QPR OR ASIST. ANTICIPATED OUTCOMES: BY INCREASING THE NUMBER OF PEOPLE TRAINED IN SUICIDE SUPPORT, THE ULTIMATE OUTCOME IS TO REDUCE THE NUMBER OF SUICIDE ATTEMPTS AND DEATHS. PLAN TO EVALUATE: MENTAL HEALTH/SUICIDE TEAM TRACKING. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: NUMBER OF TRAINED SUICIDE PREVENTION PERSONAL. WORK WITH KDH IT AND ER STAFF AND THE COUNTY CORONER'S OFFICE TO OBTAIN NUMBER OF SUICIDE ATTEMPTS AND NUMBER OF SUICIDE DEATHS EACH CALENDAR YEAR. NUMBER OF PROMOTIONAL METHODS FOR THE RESOURCE GUIDE WILL BE TABULATED. YEAR 1 2017 UPDATE:- THREE ASIST/QPR TRAININGS WERE HELD IN JEFFERSON COUNTY IN 2017. A KDH EMERGENCY DEPARTMENT WAS IN ATTENDANCE AT A TRAINING.- IN ADDITION, KDH HOSTED A SPEAKER IN 2017 WHO FACILITATED A COMMUNITY MEETINGS ON WHAT A ZERO SUICIDE INITIATIVE WOULD MEAN FOR JEFFERSON COUNTY. FOLLOWING THIS MEETING, A FORMAL GROUP WAS PUT IN PLACE TO BEGIN WORKING ON THIS INITIATIVE AND FUNDING OPPORTUNITIES. (SUCCESSFULLY SECURED, SEE NEXT INDICATOR). KDH STAFF MEMBERS WERE IN ATTENDANCE AT THIS EVENT.- KDH HOSTED A STATE SUICIDE PREVENTION COORDINATOR TO DISCUSS SUICIDE PREVENTION NEEDS IN THE COUNTY. KDH STAFF MEMBERS WERE IN ATTENDANCE AT THIS EVENT.- A FORMAL MENTAL HEALTH RESOURCE GUIDE WAS NOT FORMALLY CREATED IN 2017, BUT WORK WAS CONDUCTED TO INCLUDE JEFFERSON COUNTY IN THE LOOK UP INDIANA WEBSITE, WHICH IS A STATE-WIDE RESOURCE GUIDE.- JEFFERSON COUNTY IS NOW FULLY PARTICIPATING IN THE INDIANA VIOLENT DEATH REGISTRY SYSTEM, WHICH WILL ENABLE KDH TO WORK WITH THE CORONER'S OFFICE TO OBTAIN THE NUMBER OF SUICIDE DEATHS PER YEAR.MENTAL HEALTH/SUICIDE TEAM, SCHOOL BASED MENTAL HEALTH GRANT DESCRIPTION: A LARGE GRANT, WHICH WILL SUPPORT A COMPREHENSIVE MENTAL HEALTH/SUICIDE PREVENTION PROGRAM IN THE COUNTY'S LARGEST SCHOOL SYSTEM, WILL BE RESEARCHED, WRITTEN, AND SUBMITTED. IF GRANT FUNDING IS OBTAINED, THIS PROGRAM WILL BE BASED OUT OF THE MADISON CONSOLIDATED SCHOOL SYSTEM'S SPECIAL SERVICES AND COUNSELING DEPARTMENTS. THE HCI MENTAL HEALTH/SUICIDE TEAM WILL SUPPORT THE SCHOOL SYSTEM WITH ALL PROGRAMMING IMPLEMENTED FROM GRANT FUNDING. GOALS: OBTAIN GRANT TO BRING A COMPREHENSIVE MENTAL HEALTH / SUICIDE PROGRAM TO THE MADISON CONSOLIDATED SCHOOL SYSTEM. ANTICIPATED OUTCOMES: AWARDING OF GRANT FUNDING. THE ULTIMATE OUTCOME IS TO REDUCE THE NUMBER OF SUICIDE ATTEMPTS AND DEATHS FROM SUICIDE. SECONDARY OUTCOMES INCLUDE; REDUCE BULLYING CONCERNS, IMPROVE SELF-WORTH IN STUDENTS, INCREASE SUPPORTIVE RESOURCES FOR STUDENTS, SCHOOL STAFF, AND FAMILIES, AND IMPROVE COUNSELING SERVICES. PLAN TO EVALUATE: SEE BELOW, METRICS USED TO EVALUATE. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: SINCE GRANT FUNDING IS NOT CONFIRMED AT THE TIME OF IMPLEMENTATION STRATEGY SUBMISSION, METRICS WILL CURRENTLY NOT BE DETERMINED. IF/WHEN FUNDING IS ESTABLISHED, THE SPECIAL SERVICES AND COUNSELING DEPARTMENTS OF MCS WILL WORK WITH THE MENTAL HEALTH/SUICIDE TEAM TO DETERMINE EVALUATION METHODS AND METRICS. YEAR 1 2017 UPDATE:- TWO LARGE GRANTS WERE RECEIVED IN 2017 TARGETING MENTAL HEALTH/SUICIDE.- KDH SUPPORTED MCS AND THE HCI MENTAL HEALTH TEAM TO APPLY FOR A LILLY GRANT. THIS 3-YEAR GRANT WAS SUCCESSFULLY RECEIVED AND WORK IS IN PLACE TO BRING A COMPREHENSIVE MENTAL HEALTH/SUICIDE PROGRAM TO THE SCHOOL SYSTEM BEGINNING IN 2018. - A $40,000 GRANT FROM THE COMMUNITY FOUNDATION OF JEFFERSON COUNTY WAS AWARDED TO THE HCI MENTAL HEALTH/SUICIDE TEAM. THIS MONEY WILL BE USED TO ESTABLISH A ZERO SUICIDE INITIATIVE PLAN FOR THE JEFFERSON COUNTY. A CORE TEAM OF TWELVE INDIVIDUALS, INCLUDING A KDH REPRESENTATIVE, WILL WORK TO IMPLEMENT THE PLAN BEGINNING IN 2018.SUPPORT LOCAL SUICIDE SUPPORT GROUP(S) AND AREA AWARENESS ACTIVITIES DESCRIPTION: KDH WILL SUPPORT THE LOCAL SUICIDE SUPPORT GROUP AND ANY SUICIDE PREVENTION COMMUNITY ACTIVITIES. GOALS: PROMOTE SUICIDE SUPPORT GROUP TO ALL INTERNAL KDH STAFF AND PATIENTS. SUPPORT THE GROUP BY OFFERING MEETING SPACE IF NEEDED. SUPPORT LOCAL OUT OF THE DARKNESS SUICIDE AWARENESS COMMUNITY EVENT. PROMOTE THE EVENT TO STAFF, FORM A TEAM OF KDH EMPLOYEES, ENCOURAGE FINANCIAL DONATIONS, AND SECURE THAT DONATIONS ARE BEING USED ON A LOCAL LEVEL. ANTICIPATED OUTCOMES: INCREASE NUMBER OF ATTENDEES AT MONTHLY SUICIDE SUPPORT GROUP. INCREASE NUMBER OF PARTICIPANTS AND FUNDS RAISED FOR LOCAL SUICIDE AWARENESS WALK EVENT. PLAN TO EVALUATE: SOCIAL SERVICES STAFF AT KDH WILL WORK WITH SUICIDE SUPPORT GROUP FACILITATOR. METRICS USED TO EVALUATE THE PROGRAM/ACTIVITY/INITIATIVE: TRACK NUMBER OF PARTICIPANTS AT MONTHLY SUICIDE SUPPORT GROUP MEETINGS. REPORT NUMBER OF PARTICIPANTS AT COMMUNITY OUT OF THE DARKNESS AWARENESS EVENT, DOLLARS RAISED AT THE EVENT, AND % OF DOLLARS THAT WILL STAY LOCAL IN JEFFERSON COUNTY. YEAR 1 2017 UPDATE:- DUE TO STAFFING CHANGES, A KDH-LED TEAM DID NOT PARTICIPATE IN THE OUT OF THE DARKNESS WALK. KDH DID HELP TO PROMOTE THE EVENT AND SERVED AS A FINANCIAL SPONSOR. JEFFERSON COUNTY HOSTED 1 OF 18 WALKS IN INDIANA. $21,101 WAS RAISED AT THE 2017 JEFFERSON COUNTY WALK. FUNDS WERE DISTRIBUTED FOR PROGRAMS THROUGHOUT INDIANA BY THE AMERICAN FOUNDATION FOR SUICIDE PREVENTION (AFSP). A KDH EMPLOYEE SERVES AS ONE OF THE COORDINATORS FOR THE JEFFERSON COUNTY OUT OF THE DARKNESS WALK.- A FORMAL SUICIDE SUPPORT GROUP DID NOT MEET CONSISTENTLY IN 2017. WHEN MEETINGS RESUME, KDH WILL HELP TO PROMOTE THIS SUPPORT GROUP WITH ADVERTISING AND PATIENT REFERRALS.- ADDITIONAL COMMUNITY ACTIVITIES INCLUDE A SUICIDE SURVIVOR CANDLELIGHT SERVICE THAT WAS HELD IN 2017 THROUGH JOINT EFFORTS OF THE GREATER MINISTERIAL ASSOCIATION AND HCI/KDH. |
| 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 |
|---|---|---|---|---|
| 1 - REHABILITATION CENTER AND HOME CARE | ||||
| 2670 N MICHIGAN ROAD | MADISON | IN | 47250 | OUTPATIENT REHABILITATION CENTER AND HOME CARE SERVICES |
| 2 - CLIFTY DR MED OFFICE BLDG & CONV CARE | ||||
| 445 CLIFTY DRIVE | MADISON | IN | 47250 | PHYSICIAN MEDICAL OFFICE & CONVENIENT CARE CENTER |
| 3 - VERSAILLES MEDICAL OFFICE BLDG-MAIN ST | ||||
| 128 NORTH MAIN STREET | VERSAILLES | IN | 47042 | PHYSICIAN MEDICAL OFFICE |
| 4 - VERSAILLES MEDICAL OFFICE BLDG-TYSON ST | ||||
| 206 W TYSON STREET | VERSAILLES | IN | 47042 | PHYSICIAN MEDICAL OFFICE |
| 5 - TRIMBLE COUNTY MEDICAL OFFICE BLDG | ||||
| 10235 US HIGHWAY 421 | MILTON | KY | 40045 | PHYSICIAN MEDICAL OFFICE |
| 6 - CARROLLTON MEDICAL OFFICE BLDG | ||||
| 205 MARWILL DRIVE | CARROLLTON | KY | 41008 | PHYSICIAN MEDICAL OFFICE |
| 7 - SWITZERLAND CNTY MEDICAL OFFICE BLDG | ||||
| 1190 WEST MAIN STREET | VEVAY | IN | 47043 | PHYSICIAN MEDICAL OFFICE |
| 8 - HANOVER MEDICAL OFFICE BLDG | ||||
| 36 MEDICAL PLAZA | HANOVER | IN | 47243 | PHYSICIAN MEDICAL OFFICE |
| 9 - DOWNTOWN MEDICAL OFFICE BLDG | ||||
| 630 NORTH BROADWAY | MADISON | IN | 47250 | PHYSICIAN MEDICAL OFFICE AND HOSPITAL STAFF |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:- PROMOTING HEALTHCARE CAREERS TO POTENTIAL "FUTURE EMPLOYEES" THROUGH JOB FAIRS.- ASSISTING COMMUNITY MEMBERS WITH MEDICAID PROGRAM ENROLLMENT VIA A FORMAL MEDICAID ENROLLMENT ASSISTANCE PROGRAM OFFERED BY THE HOSPITAL. THIS PROGRAM HELPS COMMUNITY MEMBERS ENROLL TO RECEIVE ALL TYPES OF MEDICAID ASSISTANCE (FOOD, HEALTHCARE, ETC.). |
| PART III, LINE 2: | AS REPORTED ON THE ATTACHED FINANCIAL STATEMENTS, PAGE 4, "CONSOLIDATED STATEMENTS OF OPERATIONS YEARS ENDED DECEMBER 31, 2017 AND 2016". |
| PART III, LINE 3: | THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. |
| PART III, LINE 4: | SEE PAGES 8-10 ON THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE MEDICARE COST REPORT WAS THE SOURCE OF INFORMATION REPORTED ON PART III LINE 8. |
| PART III, LINE 9B: | ALL UNINSURED PATIENTS RECEIVED AN AUTOMATIC 30% DISCOUNT FROM GROSS CHARGES. AT REGISTRATION, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEY ARE OFFERED PAMPHLETS DETAILING THE PROGRAM. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE A DISCOUNT OF 100% ON THE OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL ATTEMPT TO COLLECT ANY BALANCE REMAINING ON THE UNINSURED ACCOUNT AFTER ALL FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED USING A SERIES OF STATEMENTS, LETTERS, AND TELEPHONE CALLS. THE HOSPITAL WILL ALSO OFFER PATIENTS INTEREST-FREE EXTENDED PAYMENT PLANS. IF THE ACCOUNT REMAINS UNPAID, THE ACCOUNT MAY BE TURNED OVER TO A COLLECTION AGENCY. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT IN 2016 WHOSE IMPLEMENTATION STRATEGY WAS ADOPTED IN APRIL 2017. - THE FOCUS OF THIS ASSESSMENT WAS ON THE HEALTH NEEDS THAT COULD BE ADDRESSED BY KDH AND CAN BE USED BY KDH IN PLANNING FUTURE SERVICES, APPLYING FOR GRANTS AND PLANNING OUTREACH EFFORTS.- THE STUDY INCLUDED THE FOLLOWING COMPONENTS:- ANALYSIS OF SECONDARY DATA TO DEVELOP A PROFILE OF THE RESIDENTS OF EACH COUNTY AND TO INDICATE, WHERE POSSIBLE FUTURE TRENDS AND TO SHOW COMPARISONS WITH STATE AND NATIONAL DATA;- IN-PERSON INTERVIEWS WITH 30 KEY LEADERS WITHIN KDH INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 44 COMMUNITY LEADERS INCLUDING GOVERNMENT, MEDICAL, EDUCATION, AND OTHER COMMUNITY LEADERSHIP POSITIONS IN ALL FIVE COUNTIES;- IN-PERSON SURVEYS OF 72 INDIVIDUALS IN LOW INCOME LOCATIONS;- IN-PERSON DISCUSSIONS WITH 19 SENIOR CITIZENS;- A WEB-BASED SURVEY WAS OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 184 COMPLETED INTERVIEWS.- THIS ASSESSMENT ALLOWED ALL INDIVIDUALS TO PROVIDE RESPONSES ON ANY COMMUNITY NEEDS NOT LISTED IN THE QUESTIONS AND ALLOWED INDIVIDUALS TO MAKE COMMENTS ON COMMUNITY HEALTH ISSUES ON WHICH KDH COULD HAVE AN IMPACT.- KEY HEALTH ISSUES EXPLORED WERE THE FOLLOWING:- PHYSICAL ACTIVITY- OVERWEIGHT AND OBESITY- TOBACCO USE- SUBSTANCE ABUSE/GAMBLING/ADDICTIONS- RESPONSIBLE SEXUAL BEHAVIOR- MENTAL HEALTH- INJURY AND VIOLENCE (INCLUDING DOMESTIC VIOLENCE AND SEXUAL ASSAULT)- ENVIRONMENTAL QUALITY- IMMUNIZATION- ACCESS TO HEALTH CARE FOR THE INSURED AND UNINSURED- MATERNAL AND CHILD HEALTH- INFECTIOUS DISEASE- OCCUPATIONAL AND SAFETY HEALTH- SPECIAL NEEDS/DISABLED/IMPAIRED- CHRONIC DISEASERESULTS OF THE NEEDS ASSESSMENT HAVE BEEN MADE AVAILABLE THROUGH A VARIETY OF SOURCES:NEWSPAPER AND RADIO RELEASES, DISTRIBUTION OF INFORMATION IN THE COMMUNITY NEWSLETTER, VITAL SIGNS, AND IS ALSO AVAILABLE ON OUR WEB SITE. |
| PART VI, LINE 3: | -AT THE TIME OF REGISTRATION, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH EACH PATIENT. THE PATIENT IS OFFERED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT THEY RECEIVED THIS INFORMATION.-THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS.-PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF.-THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. |
| PART VI, LINE 4: | KING'S DAUGHTER'S HEALTH PROVIDES HEALTH CARE SERVICES TO FIVE COUNTIES IN SOUTHERN INDIANA AND NORTHERN KENTUCKY. THE 2016 KDH CHNA INCLUDED ITS PRIMARY SERVICE AREAS OF JEFFERSON AND SWITZERLAND COUNTIES IN INDIANA AND TRIMBLE COUNTY IN KENTUCKY. THE ADDITIONAL TWO COUNTIES (RIPLEY IN INDIANA AND CARROLL IN KENTUCKY) HAVE MULTIPLE HEALTH CARE FACILITIES THAT CURRENTLY CONDUCT A CHNA. TO AVOID DUPLICATION, THE THREE PRIMARY COUNTIES DESCRIBED WERE INCLUDED IN THE 2016 KDH CHNA. A FEW DESCRIPTIVE DEMOGRAPHIC HIGHLIGHTS FOR THESE THREE COUNTIES INCLUDE:JEFFERSON COUNTY, INDIANA TOTAL POPULATION 32,428, MEDIAN AGE 40.9 (ABOVE STATE AVERAGE OF 37.0) RACIAL/ETHNIC COMPOSITION 95.4% CAUCASIAN PERCENT POVERTY 16.2% (ABOVE THE STATE AVERAGE OF 15.2%) PERCENT UNINSURED 14% ADULTS UNDER 65 HAVE NO INSURANCE (13.8% STATE AVERAGE) UNEMPLOYMENT RATE 6.0% (SAME AS STATE AVERAGE) EDUCATION LEVEL 15% OF ADULTS 25+ HAVE LESS THAN A HIGH SCHOOL DIPLOMA (STATE AVERAGE 12%)SWITZERLAND COUNTY, INDIANA TOTAL POPULATION 10,613 RACIAL/ETHNIC COMPOSITION 97.7% CAUCASIAN PERCENT POVERTY 28% PERCENT UNINSURED 15.7% ADULTS UNDER 65 HAVE NO INSURANCE UNEMPLOYMENT RATE 4.9% EDUCATION LEVEL 18% OF ADULTS 25+ HAVE LESS THAN A HIGH SCHOOL DIPLOMATRIMBLE COUNTY, KENTUCKY TOTAL POPULATION 8,769 RACIAL/ETHNIC COMPOSITION 94% CAUCASIAN PERCENT POVERTY 17.4% (BELOW STATE AVERAGE OF 18.9%) PERCENT UNINSURED 9.6% ADULTS UNDER 65 HAVE NO INSURANCE (9.8% STATE AVERAGE) UNEMPLOYMENT RATE 7.2% (ABOVE THE STATE AVERAGE OF 6.5%) EDUCATION LEVEL 15.8% OF ADULTS 25+ HAVE LESS THAN A HIGH SCHOOL DIPLOMA (SAME STATE AVERAGE) |
| PART VI, LINE 5: | THE MAJORITY OF KING'S DAUGHTERS' HEALTH BOARD OF MANAGERS IS COMPRISED OF INDIVIDUALS WHO LIVE AND WORK IN THE HOSPITAL SERVICES AREA. THE MAJORITY OF THESE INDIVIDUALS ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION ALSO APPLIES A PORTION OF SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE. HISTORICALLY, KDH HAS EMPLOYED A FULL TIME COMMUNITY WELLNESS COORDINATOR. THIS POSITION PROVIDES OUTREACH SERVICES IN AREAS OF NEED TO THE COMMUNITIES WE SERVE. IN ADDITION TO THESE SERVICES, KDH ALSO SERVES AS THE FISCAL AGENT FOR SEVERAL STATE AND FEDERAL GRANTS. ALL OF THESE SERVICES HELP US MEET THE IDENTIFIED NEEDS OF THE COMMUNITIES WE SERVE.PARTICIPATION IN THE BELOW COMMUNITY ORGANIZATIONS IS PART OF THE HOSPITAL'S INDIANA STATE DEPARTMENT OF HEALTH COMMUNITY BENEFIT PLAN AND GOALS.2017 KING'S DAUGHTERS' HEALTH OVERVIEW OF COMMUNITY BENEFIT ACTIVITIES1. HEALTH SCREENS/HEALTH FAIRS: A. CORPORATE HEALTH SCREENS / FAIRS ARVIN SANGO EMPLOYEE HEALTH FAIR. GROTE INDUSTRIES EMPLOYEE HEALTH FAIR. IKE EMPLOYEE HEALTH FAIR. BELTERRA EMPLOYEE HEALTH FAIR. B. COLON CANCER SCREENING KITS: 63 RETURNS. C. CORPORATE FLU SHOTS: ALCORN SAFE SCHWARTZ & MAGRATH LAW OFFICE: 10 MADISON ANIMAL CLINIC EMPLOYEES: 5 D. 4-H FAIR (HEALTH EDUCATION INFORMATION PROVIDED) RIPLEY COUNTY, IN JEFFERSON COUNTY, IN TRIMBLE COUNTY, KY E. REMC HEALTH FAIR FOR RIPLEY & DEARBORN COUNTIES 2. COMMUNITY EDUCATION OPPORTUNITIES/CLASSES/SPECIAL EVENTS: A. SPEAKERS BUREAU: WELLNESS: 17 SPEAKING ENGAGEMENTS TOBACCO: 10 SPEAKING ENGAGEMENTS B. FIT KIDS PROGRAM (7 WEEK PROGRAM FOR AREA 5TH GRADE CLASSROOMS) 5 SCHOOL SYSTEMS / 18 CLASSROOMS / 331 KIDS + TEACHERS C. TOBACCO CESSATION & EDUCATION: PROVIDED OUTREACH TO 15 COMMUNITY AND KDH OPPORTUNITIES. SEND CESSATION RECOURSES TO 20 INDIVIDUALS IN 2017. KDH DOCUMENTED 194 ELECTRONIC PATIENT REFERRALS TO THE INDIANA QUITLINE D. CPR AND FIRST AID CLASSES: COMMUNITY CLASSES HELD WITH 607 GRADUATES SCHOOL-BASED CLASSES HELD WITH 19 STUDENTS PARTICIPATING. E. STRIVE FOR 5 PROGRAM: COMMUNITY 5-WEEK WEIGHT LOSS EDUCATION PROGRAM. ONE CLASS HELD IN 2017, 9 PARTICIPANTS. F. PRENATAL EDUCATION: OB PREP PROGRAM 365 PEOPLE SERVED PREPARED CHILDCARE ESSENTIAL CLASSES 52 PEOPLE SERVED SIBLING CLASSES 4 PEOPLE SERVED G. GIRLS ON THE RUN FALL SEASON: 68 GIRLS / 8 SITES / 29 TRAINED COACHES / 10 WEEK PROGRAM FALL 5K: 162 PARTICIPANTS AND 50 VOLUNTEERS H. HOUSE OF HEALTH: MONTHLY EDUCATION OPPORTUNITY PROVIDED AT THE HOUSE OF HOPE FOOD PANTRY. APPROXIMATELY 25-70 PEOPLE ATTEND EACH MONTH. 12 TOPICS FOR 2017 INCLUDE: HEALTHY GOAL SETTING, HEART HEALTH, NUTRITION, STD/HIV/HEP C, FIRST AID, MOSQUITOS, SKIN CANCER, IMMUNIZATIONS, TOBACCO, BREAST CANCER, FOOD SAFETY, WEIGHT LOSS. I. EMBRACE WOMEN'S HEALTH CONFERENCE: 142 WOMEN IN ATTENDANCE. KDH PROVIDED: STEERING COMMITTEE SUPPORT FINANCIAL SPONSORSHIP, IN-KIND SUPPORT, & PARTICIPANT GIFT FREE CHOLESTEROL TESTING FOR ALL PARTICIPANTS 44% OF ALL BREAKOUT SESSIONS SPEAKERS WERE IN-KIND KDH STAFF J. MAN UP, MEN'S HEALTH EVENT: FREE HEALTH SCREENINGS AND HEALTH EDUCATION OPPORTUNITIES. 92 TOTAL PARTICIPANTS. K. MONTHLY "TO YOUR HEALTH" RADIO SHOW: 30-MINUTE HEALTH EDUCATION PROGRAM WITH VARIOUS TOPICS OFFERED EACH MONTH. L. WOMEN'S SAFETY & SELF-DEFENSE WORKSHOPS: THREE FREE WORKSHOPS OFFERED TO WOMEN IN 2017. 58 TOTAL PARTICIPANTS. M. KDH RUN THE FALLS 5K WALK/RUN: 181 PEOPLE PARTICIPATED N. CANCER SUPPORT ACTIVITES: WOMEN AND CANCER SUPPORT GROUP PARTICIPATION AT TRIMBLE CO. AND CARROLL CO. KY RELAY FOR LIFE EVENTS CANCER SURVIVOR'S DINNER HELD WITH 125 PARTICIPANTS 3. EMPLOYEE HEALTH OPPORTUNITIES FOR KDH STAFF: WELLNESS NEWSLETTERS (ON-LINE AND PAPER VERSIONS AVAILABLE) WELLNESS COLUMN IN THE MONTHLY MONITOR NEWSLETTER WELLNESS CALENDAR DISTRIBUTION TO ALL STAFF EMPLOYEE SKIN CANCER SCREEN HELD EMPLOYEE HEALTH SCREEN AVAILABLE FOR ALL STAFF WITH INSURANCE PREMIUM REDUCTION SEATED CHAIR MASSAGE SESSIONS, PART OF MONTH LONG STRESS LESS CAMPAIGN LUNCH & LEARN, PHYSICAL ACTIVITY 2017 GOAL SHEETS WITH INCENTIVE OFFERED 3 WELLNESS CHALLENGES: CLIMBING MT. EVEREST STAIR CLIMBING CHALLENGE 128 PARTICIPANTS EAT A RAINBOW, FRUIT & VEGETABLE NUTRITION CHALLENGE 160 PARTICIPANTS PARTICIPATION IN COMMUNITY-WIDE HEALTHY LIFESTYLES PHYSICAL ACTIVITY CHALLENGE 4. COMMUNITY SERVICE ACTIVITIES: A. ACTIVE ATTENDANCE AND PARTICIPATION IN: JC-JTP JEFFERSON COUNTY JUSTICE TREATMENT PREVENTION COALITION SCAN SWITZERLAND COUNTY AWARENESS NETWORK TPCC AND JEFFERSON COUNTY TOBACCO COALITION MADISON CONSOLIDATED SCHOOLS WELLNESS COMMITTEE MASHER (AREA CORPORATE SAFETY GROUP) LEADERSHIP AND ACTIVE PARTICIPATION FOR HEALTHY COMMUNITIES INITIATIVE TEAMS: SUBSTANCE ABUSE MENTAL HEALTH/SUICIDE (NOW CALLED ZERO SUICIDE INITIATIVE) HEALTHY LIFESTYLES B. EMS STAND-BY AT ALL COMMUNITY ACTIVITIES: EMS PROVIDES STAND-BY COVERAGE AT ALL JEFFERSON COUNTY ACTIVITIES. C. SUPPORT TO VARIOUS AREA SCHOOLS WITH INTERNSHIPS: SUPPORT MANY LOCAL AND AREA HIGH SCHOOLS AND COLLEGES WITH INTERNSHIPS AND JOB SHADOW EXPERIENCES: INCLUDES NURSING AND MEDICAL STUDENTS AMONG OTHERS.5. SUCCESSFUL GRANT ACTIVITY: TPCC: TOBACCO PREVENTION AND CESSATION COMMISION: FUNDING TO HIRE FULL TIME COORDINATOR, STARTING IN 2009, CONTINUES FOR JEFFERSON CO. 6. HEALTHY COMMUNITIES INITIATIVE (HCI): EFFORTS LED BY KING'S DAUGHTERS' HEALTH, PART-TIME COORDINATOR FUNDED BY KDH FOUNDATION THREE TEAMS, COMPRISED OF HOSPITAL STAFF AND COMMUNITY REPRESENTATIVES: MENTAL HEALTH/ZERO SUICIDE SUBSTANCE ABUSE MENTORS FOR MOMS AND ROAD TO RECOVERY SUBCOMMITTEE HEALTHY LIFESTYLES 2017 HCI ACCOMPLISHMENTS: HELD HEALTHY LIFESTYLES COMMUNITY HEALTH CHALLENGE 209 PARTICIPANTS. HOSTED OPIOID PRESENTATION 23 IN ATTENDANCE. HELD FAITH-BASED MEETINGS TO ENGAGE THE FAITH COMMUNITY. PRODUCED A HEALTHY LIFESTYLES COMMUNITY RESOURCE GUIDE. HELD HEALTHY YOUTH TAILGATE PARTY 400 PEOPLE IN ATTENDANCE, 50 VOLUNTEERS. SUPPORT WORLD SUICIDE DAY PRAYER SERVICE 45 IN ATTENDANCE. SUPPORT GO COLD TURKEY TOBACCO CESSATION INCENTIVE CHALLENGE 6 PARTICIPANTS. OFFERED 12 COMMUNITY PRESENTATIONS TO EXPLAIN HCI. NOW CURRENT MEMBER OF THE IN SUICIDE PREVENTION COALITION. JEFFERSON COUNTY IS NOW FULLY PARTICIPATING IN THE IN VIOLENT DEATH REGISTRY SYSTEM. GRANT LETTERS OF SUPPORT FOR TWO AREA SCHOOLS AND ONE COMMUNITY/ONE FAMILY. GRANTS RECEIVED: MENTORS FOR MOMS AND ROAD TO RECOVERY PROGRAMS. SUICIDE RISK TRAINING AND ASIST TRAINING FOR SCHOOL PERSONNEL. SECURED COMMUNITY FOUNDATION FUNDING FOR FUTURE ZERO SUICIDE PLAN. |
| PART VI, LINE 6: | NA |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JONATHAN HANSON MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $318,058 | $0 | $206,730 | $0 | -$74,640 | $0 | $13,500 | $0 | $27,727 | $0 | $491,375 | $0 | $0 | $0 |
| PAT STACK MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $144,572 | $0 | $63,225 | $0 | $1,584 | $0 | $10,663 | $0 | $11,459 | $0 | $231,503 | $0 | $0 | $0 |
| CAROL DOZIER | ||||||||||||||
| PRESIDENT/CEO | $417,672 | $0 | $0 | $0 | -$6,645 | $0 | $13,500 | $0 | $1,316 | $0 | $425,843 | $0 | $0 | $0 |
| JOHN PRICE | ||||||||||||||
| VP FINANCE | $225,152 | $0 | $0 | $0 | $552 | $0 | $11,302 | $0 | $6,793 | $0 | $243,799 | $0 | $0 | $0 |
| LISA MORGAN | ||||||||||||||
| VP OUTPATIENT SERVICES | $158,442 | $0 | $0 | $0 | $1,032 | $0 | $7,991 | $0 | $8,522 | $0 | $175,987 | $0 | $0 | $0 |
| DENINE FALLIS-HALLGARTH | ||||||||||||||
| VP PHYSICIAN PRACTICES | $138,032 | $0 | $0 | $0 | $552 | $0 | $7,130 | $0 | $11,715 | $0 | $157,429 | $0 | $0 | $0 |
| HOLLY ROBINSON MD | ||||||||||||||
| VP QUALITY / PHYSICIAN | $233,665 | $0 | $45,044 | $0 | $360 | $0 | $13,500 | $0 | $27,256 | $0 | $319,825 | $0 | $0 | $0 |
| THOMAS ECKERT MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $423,634 | $0 | $299,299 | $0 | $1,584 | $0 | $13,500 | $0 | $17,245 | $0 | $755,262 | $0 | $0 | $0 |
| TRAVIS CLEGG MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $699,267 | $0 | $1,236,449 | $0 | -$199,784 | $0 | $13,500 | $0 | $28,077 | $0 | $1,777,509 | $0 | $0 | $0 |
| WILLIAM SKILES MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $448,237 | $0 | $187,702 | $0 | $1,584 | $0 | $13,500 | $0 | $14,191 | $0 | $665,214 | $0 | $0 | $0 |
| MICHAEL SCHMIDT MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $445,325 | $0 | $169,817 | $0 | $360 | $0 | $13,500 | $0 | $29,031 | $0 | $658,033 | $0 | $0 | $0 |
| RONALD AUER MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $539,822 | $0 | $209,415 | $0 | $69,128 | $0 | $13,500 | $0 | $28,601 | $0 | $860,466 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A CALENDAR YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE CALENDAR YEAR MULTIPLIED BY THE INCENTIVE RVU PAYMENT. NON-PHYSICIAN BONUS COMPENSATION IS DISCRETIONARY, SOLELY UP TO THE BOARD OF MANAGERS, AND THE CALCULATION FOR SAID BONUS COMPENSATION VARIES FROM YEAR TO YEAR. |
| ADDITIONAL SCHEDULE J DISCLOSURES | BOARD MEMBERS PAT STACK, MD AND JONATHAN HANSON, MD LISTED ABOVE ARE EMPLOYED PHYSICIANS OF THE HOSPITAL. DR. STACK AND DR. HANSON DO NOT RECEIVE COMPENSATION FOR SERVICES PROVIDED AS BOARD MEMBERS. THE COMPENSATION LISTED ABOVE FOR DR. STACK AND DR. HANSON IS COMPENSATION RECEIVED FOR SERVICES PROVIDED AS EMPLOYED PHYSICIANS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 351602316 | BondIssuerEIN |
| CUSIP | 45471ACW0 | CUSIPNum |
| Bond Issued | 2010-11-03 | BondIssuedDt |
| Issue Price | $97,847,058 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $97,847,058 | TotalProceedsAmt |
| In Reserve Fund | $6,756,861 | InReserveFundAmt |
| Issuance Costs From Proceeds | $1,749,243 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $88,974,097 | CapitalExpendituresAmt |
| Other Spent Proceeds | $266,857 | OtherSpentProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00250 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00250 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH K PART I LINE A - PURPOSE | FormAndLineReferenceDesc |
| Explanation | THE PURPOSE OF THE BOND ISSUANCE IS TO FINANCE, REFINANCE, OR REIMBURSE A PORTION OF THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING VARIOUS HEALTH CARE FACILITIES OF THE HOSPITAL, INCLUDING A REPLACEMENT ACUTE CARE HOSPITAL FACILITY AND A MEDICAL OFFICE BUILDING. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DR RONALD AUER | |||||||
| DOCTOR | PRACTICE COMMENCEMENT ASSISTANCE | Yes (X) | $50,000 | $10,256 | 0 | Yes (1) | Yes (1) |
| DR RONALD AUER | |||||||
| DOCTOR | STUDENT LOAN REPAYMENT ASSISTANCE | Yes (X) | $150,000 | $30,830 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $41,086 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| A DATTILO FRUIT COMPANY | |||
| VICE PRESIDENT OF OUTPATIENT SERVICES OF KDH HAS 51% OWNERSHIP INTEREST | $23,826 | LISA MORGAN, VICE PRESIDENT OF OUTPATIENT SERVICES OF KDH OWNS A 51% INTEREST IN A. DATILLO FRUIT COMPANY. KDH PURCHASES PRODUCE FROM A. DATTILO FRUIT COMPANY. THE HOSPITAL MADE PURCHASES TOTALING $23,826 IN 2017. | 0 |
| GERMAN AMERICAN BANK | |||
| BOARD MEMBER IS THE SPOUSE OF THE REGIONAL CHAIRMAN OF THE GERMAN NATIONAL | ANDREA FORRESTER, BOARD ASST TREASURER, IS MARRIED TO THE REGIONAL CHAIRMAN OF THE GERMAN NATIONAL BANK. THE HOSPITAL'S OPERATING ACCOUNT IS WITH THE BANK. THE HOSPITAL RECORDED INTEREST INCOME OF $138,538 AND SERVICE FEES OF $7,779 IN 2017 FROM ACTIVITY WITH THE BANK. | 0 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | PER THE BYLAWS, THE MEMBERSHIP OF THE ORGANIZATION SHALL BE NON-SECTARIAN, NON-POLITICAL AND NOT CONFINED TO ANY CHRISTIAN RELIGIOUS DENOMINATION OR SECT. ANY SUCH PERSON OF GOOD REPUTE WHO HOLDS HERSELF RESPONSIBLE TO THE KING, CHRIST, OUR LORD AND SAVIOR, MAY BECOME A MEMBER OF THE ORGANIZATION. ALL MEMBERS MUST BE AND REMAIN PERMANENT RESIDENTS OF THE SERVICE AREA OF THE HOSPITAL, AS DETERMINED FROM TIME TO TIME BY THE HOSPITAL BOARD OF MANAGERS, AS A CONTINUING REQUIREMENT FOR MEMBERSHIP. FAILURE TO MAINTAIN SUCH RESIDENCY STATUS AUTOMATICALLY TERMINATES A PERSON'S MEMBERSHIP. HOSPITAL EMPLOYEES, MEMBERS OF THE MEDICAL STAFF, AND THEIR IMMEDIATE FAMILY MEMBERS SHALL NOT BE ELIGIBLE FOR MEMBERSHIP IN THE ORGANIZATION. THE IMMEDIATE FAMILY SHALL BE DEFINED AS INCLUDING THE MOTHER, FATHER, HUSBAND, WIFE, SISTER, BROTHER, DAUGHTER, SON, AND STEPCHILDREN. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION SHALL HAVE TWO (2) CLASSES OF MEMBERS, ACTIVE AND HONORARY, AND ALL MEMBERS SHALL HAVE THE RIGHTS, PRIVILEGES, DUTIES, LIABILITIES, LIMITATIONS AND RESTRICTIONS AS SET FORTH FROM TIME TO TIME IN THE STANDING RULES. ANY ACTIVE MEMBER OF THE ORGANIZATION MAY PROPOSE ANY OTHER PERSON MEETING THE ELIGIBILITY REQUIREMENTS OUTLINED IN PART VI, 7A ABOVE FOR MEMBERSHIP. ONLY ACTIVE MEMBERS IN GOOD STANDING THAT HAVE BEEN A MEMBER FOR AT LEAST TWO ANNIVERSARY YEARS CAN PRESENT A PERSON'S NAME FOR MEMBERSHIP OR TO SERVE ON THE BOARD OF DIRECTORS. A MAJORITY VOTE OF THOSE PRESENT AND VOTING AFFIRMATIVELY AT ANY REGULAR MEETING OF THE ORGANIZATION AT WHICH A QUORUM IS PRESENT SHALL BE SUFFICIENT TO ELECT SUCH PROPOSED PERSON TO MEMBERSHIP. ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME. |
| FORM 990, PART VI, SECTION A, LINE 7B | ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HIS/HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S MANAGEMENT. THE BOARD OF MANAGERS RECEIVES A DRAFT COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES PRIOR TO FILING WITH THE IRS. CHANGES OR REVISIONS ARE SUGGESTED BY THE BOARD IF NECESSARY. THE 990 WILL BE REVIEWED AT THE NEXT BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. OFFICERS AND KEY EMPLOYEES ARE NOT REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. HOWEVER THE HR CONFLICT OF INTEREST POLICY DOES STATE THAT ANY EMPLOYEE WHO IS AN OFFICER, OWNER, PARTNER OR EMPLOYEE OF AN ORGANIZATION WITH WHICH THE HOSPITAL MAY ENTER INTO A RELATIONSHIP OR TRANSACTION(OR WHOSE SPOUSE OR CHILD IS AN OFFICER, OWNER, PARTNER OR EMPLOYEE OF AN ORGANIZATION WITH WHICH THE HOSPITAL MAY ENTER INTO A RELATIONSHIP OR TRANSACTION) MUST DISCLOSE THIS INFORMATION TO THE APPROPRIATE VICE PRESIDENT AND THE PRESIDENT/CEO. SHOULD SUCH INFORMATION BE DISCLOSED, THE EMPLOYEE WILL REFRAIN FROM ANY SUBSEQUENT DISCUSSION AND DECISIONS RELATED TO THE OUTSIDE FIRM. A CONFLICT OF INTEREST STATEMENT MUST BE COMPLETED BY EVERY BOARD MEMBER EACH YEAR. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD CONCERNING AN EXISTING OR CONTEMPLATED TRANSACTION OR RELATIONSHIP BETWEEN THE ORGANIZATION AND ANY PARTY IN WHICH A BOARD MEMBER OR THE SPOUSE OR MINOR CHILDREN OF SUCH BOARD MEMBER HAS AN INTEREST OR OTHERWISE MAY GIVE RISE TO A CONFLICT OF INTEREST BETWEEN THE BOARD MEMBER AND THE ORGANIZATION, THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY HIS OR HER WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED OF HIM OR HER, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO A VOTE, THE AFFECTED BOARD MEMBER SHALL NOT VOTE ON IT. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE HOSPITAL'S BOARD OF MANAGERS REVIEWS ANNUAL CEO SURVEY INFORMATION FROM THE INDIANA HOSPITAL ASSOCIATION. THIS SURVEY COMPARES KDH'S CEO'S COMPENSATION WITH OTHER HOSPITAL CEO'S IN INDIANA. COMPARISONS ARE MADE WITH HOSPITALS THAT ARE IN KDH'S REGION IN INDIANA, HOSPITALS OF A SIMILAR SIZE, AND HOSPITALS THAT MIGHT REASONABLY BE EXPECTED TO COMPETE FOR SERVICES OF KDH'S CEO. THE BOARD OF MANAGERS,, AFTER REVIEWING THE SURVEY AND A STATUS REPORT OF THE CEO'S ANNUAL GOALS, APPROVES THE CEO'S COMPENSATION. HOWEVER, PHYSICIAN BOARD MEMBERS WHO ARE HOSPITAL EMPLOYEES DO NOT PARTICIPATE IN VOTING FOR ANY CHANGES TO CEO COMPENSATION. MINUTES ARE TAKEN AT ALL OF THE BOARD OF MANAGERS MEETINGS AND EXECUTIVE SESSIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, OR FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE FOR PUBLIC INSPECTION. THE FORM 990 TAX RETURN IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN SUBSCRIBER SAVINGS CUMULATIVE ACCOUNT 273,895. |
| FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHT | THE HOSPITAL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE SELECTION OF AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM TO PERFORM THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS. THE FINANCE COMMITTEE ALSO IS RESPONSIBLE FOR OVERSIGHT OF THAT AUDIT PROCESS. THE TREASURER OF THE HOSPITAL'S BOARD OF MANAGERS SERVES AS THE CHAIR OF THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REGULARLY MEETS EVERY OTHER MONTH, AND MEETS ONCE PER YEAR WITH THE INDEPENDENT AUDITORS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 447 | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202148950 | EIN |
| Primary Activities | FUNDRAISING TO SUPPORT THE PROVISION OF HEALTHCARE SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |