2018-11-09T09:25:01-06:00 2017-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2017-01-01 350895832 THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON INDIANA INC BETH 8128010800 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 PAULA HEIDERMAN BOARD CHAIRWOMAN 8128010800 2018-10-30 1 CARRIE A MERRILL CPA P00832283 3176334705 2018-10-30 38.109.186.2 2018-10-30 09:22:01 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CEC041C7A28BF02AF1651001FA3B4F793CABA0CE 2017 2019-02-21 02:37:17Z KING'S DAUGHTERS' HEALTH JOHN PRICE 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 161690219 0 X WWW.KDHMADISON.ORG X 1899 IN TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. 11 9 1149 79 37663 0 408019 140093 125312917 127224164 1734690 4937314 2152739 1374463 129608365 133676034 131389 4664 0 0 63171103 64434304 0 0 0 59706871 59643999 123009363 124082967 6599002 9593067 257036707 277232984 108181062 107951699 148855645 169281285 THE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. 0 0 106486824 4664 128072332 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 1439511 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. 107926335 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 1 77 0 1 1149 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X DAWN NUNAN DIRECTOR OF ACCOUNTING 8128010800 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 PAULA HEIDERMAN BOARD CHAIRWOMAN 1.00 1.00 X 500 0 0 MARJORIE HARE BOARD VICE CHAIRWOMAN 1.00 0.00 X 1250 0 0 ANNIE SCHROEDER BOARD SECRETARY 1.00 0.00 X 1500 0 0 MARY BETTE VOYLES BOARD TREASURER 1.00 0.00 X 1250 0 0 ANDREA FORRESTER BOARD ASSN'T TREASURER 1.00 0.00 X 1250 0 0 BONNIE COLEN BOARD ASSN'T SECRETARY 1.00 0.00 X 750 0 0 JONATHAN HANSON MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 450148 0 41227 PAT STACK MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 209381 0 22122 JOE CRAIG BOARD MEMBER 1.00 0.00 X 1250 0 0 MARY KAY MCCUBBIN BOARD MEMBER 1.00 0.00 X 1500 0 0 KEVIN TURNER BOARD MEMBER 1.00 0.00 X 500 0 0 CAROL DOZIER PRESIDENT/CEO 40.00 1.00 X 411027 0 14816 JOHN PRICE VP FINANCE 40.00 0.00 X 225704 0 18095 LISA MORGAN VP OUTPATIENT SERVICES 40.00 0.00 X 159474 0 16513 DENINE FALLIS-HALLGARTH VP PHYSICIAN PRACTICES 40.00 0.00 X 138584 0 18845 JENNIFER LITER VP INPATIENT SERVICES 40.00 0.00 X 121173 0 19549 HOLLY ROBINSON MD VP QUALITY / PHYSICIAN 40.00 0.00 X 279069 0 40756 THOMAS ECKERT MD EMPLOYED PHYSICIAN 40.00 1.00 X 724517 0 30745 TRAVIS CLEGG MD EMPLOYED PHYSICIAN 40.00 0.00 X 1735932 0 41577 WILLIAM SKILES MD EMPLOYED PHYSICIAN 40.00 0.00 X 637523 0 27691 MICHAEL SCHMIDT MD EMPLOYED PHYSICIAN 40.00 0.00 X 615502 0 42531 RONALD AUER MD EMPLOYED PHYSICIAN 40.00 0.00 X 818365 0 42101 6536149 0 376568 60 0 1 0 CLOUDWAVE 100 CROWLEY DRIVE MARLBOROUGH MA 01752 INFRASTRUCTURE SUPPORT - MAINT OF VIRTUA 1039996 COMPREHENSIVE MEDICAL MANAGEMENT 300 DAVE COWENS DRIVE STE 600 NEWPORT KY 41071 CONTRACTED PHYSICIAN BILLING SERVICES 830839 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 544809146 LABORATORY SERVICES 689477 EMCARE INC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 CONTRACTED PHYSICIAN & MID LEVEL PROVIDE 688420 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 LABORATORY SERVICES 488597 26 49055 91038 23652 140093 NET PATIENT SERVICE REVENUE 621110 127224164 127224164 127224164 2719516 2719516 76178 23286 52892 52892 52892 29563909 644788 26663271 1327628 2900638 -682840 2217798 2217798 EHR INCOME 900099 511265 511265 CAFETERIA REVENUE 722210 366454 366454 GIFT SHOP 453220 122178 122178 321674 284011 37663 1321571 133676034 128072332 37663 5425946 4664 4664 2196233 1910265 285968 49791362 43308114 6483248 1880762 1635871 244891 7356145 6398314 957831 3209802 2791859 417943 109471 109471 108605 108605 451519 451519 355380 355380 180078 156630 23448 964076 838545 125531 424245 369005 55240 2099093 1825774 273319 116401 101245 15156 5412200 4707487 704713 10288685 8949013 1339672 1556455 1353792 202663 PURCHASED SERVICES 10484786 9119580 1365206 DRUGS 10032521 10032521 SUPPLIES 9009725 7836584 1173141 HOSPITAL ASSESSMENT FEE 2729746 2729746 5321013 3857326 1463687 124082967 107926335 16156632 0 9474 20980469 16294366 12121632 10370400 576185 456146 2464740 2497096 1953950 2917927 185700096 78694337 115550461 107005759 96442587 129961696 6946683 7720120 257036707 277232984 11106378 10511186 95318589 93886785 1417437 1370016 338658 2183712 108181062 107951699 X 148835451 169268328 10194 2957 10000 10000 148855645 169281285 257036707 277232984 X 9593067 10558678 273895 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 8323 8323 0 PART II-B, LINE 1: 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. 20194 28678 35915 12957 28255 356398 364459 20194 30058 506513 508316 28255 208725 50077 228744 30058 196716 48484 36475 208725 0.00000 0.77180 0.22820 0 0 4045918 4045918 117987460 30916975 87070485 63480802 47777362 15703440 185916 185916 107005759 DEFERRED COMPENSATION 40735 THIRD PARTY PAYABLE 1763697 LIFE INSURANCE POLICIES 379280 2183712 X 144047102 10558678 273895 10832573 133214529 451519 9986 461505 133676034 123621462 0 123621462 451519 9986 461505 124082967 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. 1 1 1 X 1 X 1 1 0 1 1 445706 445706 0.00360 21160975 12144432 9016543 0.07270 21606681 12144432 9462249 0.07630 175893 50137 125756 0.00100 169513 45350 124163 0.00100 2237425 1911229 326196 0.00260 9089 9089 0.00010 2591920 2006716 585204 0.00470 24198601 14151148 10047453 0.08100 141093 141093 0.00110 259 259 0.00000 141352 141352 0.00110 0 11956871 0 29114981 28071465 1043516 X 1 1 1 1 KING'S DAUGHTERS' HEALTH 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 WWW.KDHMADISON.ORG 17-005063-1 X X X KING'S DAUGHTERS' HEALTH 1 0 0 1 X X X X X X X X X X 16 1 0 0 1 X WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT X X 1 17 1 HTTPS://WWW.KDHMADISON.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX X HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX X HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX X X X X X X 1 X 0 X X X X X 1 X 0 0 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. 9 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 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 X X X X X 0 0 0 0 0 0 0 1 0 JONATHAN HANSON MD BOARD MEMBER/PHYSICIAN 318058 0 206730 0 -74640 0 13500 0 27727 0 491375 0 0 0 PAT STACK MD BOARD MEMBER/PHYSICIAN 144572 0 63225 0 1584 0 10663 0 11459 0 231503 0 0 0 CAROL DOZIER PRESIDENT/CEO 417672 0 0 0 -6645 0 13500 0 1316 0 425843 0 0 0 JOHN PRICE VP FINANCE 225152 0 0 0 552 0 11302 0 6793 0 243799 0 0 0 LISA MORGAN VP OUTPATIENT SERVICES 158442 0 0 0 1032 0 7991 0 8522 0 175987 0 0 0 DENINE FALLIS-HALLGARTH VP PHYSICIAN PRACTICES 138032 0 0 0 552 0 7130 0 11715 0 157429 0 0 0 HOLLY ROBINSON MD VP QUALITY / PHYSICIAN 233665 0 45044 0 360 0 13500 0 27256 0 319825 0 0 0 THOMAS ECKERT MD EMPLOYED PHYSICIAN 423634 0 299299 0 1584 0 13500 0 17245 0 755262 0 0 0 TRAVIS CLEGG MD EMPLOYED PHYSICIAN 699267 0 1236449 0 -199784 0 13500 0 28077 0 1777509 0 0 0 WILLIAM SKILES MD EMPLOYED PHYSICIAN 448237 0 187702 0 1584 0 13500 0 14191 0 665214 0 0 0 MICHAEL SCHMIDT MD EMPLOYED PHYSICIAN 445325 0 169817 0 360 0 13500 0 29031 0 658033 0 0 0 RONALD AUER MD EMPLOYED PHYSICIAN 539822 0 209415 0 69128 0 13500 0 28601 0 860466 0 0 0 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. A INDIANA FINANCE AUTHORITY 351602316 45471ACW0 2010-11-03 97847058 SEE PART VI 0 0 0 A 97847058 6756861 1749243 88974097 266857 2013 0 0 1 1 A 0 1 1 1 0 0.00250 0.00250 0 0 0 A 0 0 0 0 0 0 0 0 1 A 1 SCH K PART I LINE A - PURPOSE 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. DR RONALD AUER DOCTOR PRACTICE COMMENCEMENT ASSISTANCE X 50000 10256 0 1 1 DR RONALD AUER DOCTOR STUDENT LOAN REPAYMENT ASSISTANCE X 150000 30830 0 1 1 41086 A DATTILO FRUIT COMPANY VICE PRESIDENT OF OUTPATIENT SERVICES OF KDH HAS 51% OWNERSHIP INTEREST 23826 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 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. THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INC PO BOX 447 MADISON IN 47250 202148950 FUNDRAISING TO SUPPORT THE PROVISION OF HEALTHCARE SERVICES IN 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0