2018-05-15T12:39:35-05:00 2017-06-30 273858252 DEAN DORTON ALLEN FORD PLLC 106 W VINE STREET SUITE 600 LEXINGTON KY 40507 990 2016-07-01 610658773 HIGHLANDS HOSPITAL CORPORATION DBA HIGHLANDS REGIONAL MEDICAL CENTER HIGH 6068868511 BOX 668 5032 KY ROUTE 321 PRESTONSBURG KY 41653 MICHAEL ROBERTS CIO 6068868511 2018-05-14 1 LEIGH MCKEE P00169845 8592552341 2016 2022-09-23 18:48:47Z HIGHLANDS REGIONAL MEDICAL CTR HAROLD C WARMAN JR BOX 668 5032 KY ROUTE 321 PRESTONSBURG KY 41653 82940342 0 X WWW.HRMC.ORG X 1966 KY COMMUNITY HEALTHCARE PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES 15 14 557 14 1093560 -14267 0 0 83830129 77479166 21444 47954 3930030 5159329 87781603 82686449 3227 2247 0 0 30841395 32756228 0 0 0 53938468 55889880 84783090 88648355 2998513 -5961906 51881845 51819468 26828131 31767128 25053714 20052340 COMMUNITY HEALTHCARE PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHEASTERN KENTUCKY. 0 0 85019551 2247 81169431 THE HOSPITAL PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY $41,000 FOR THE YEAR ENDED JUNE 30, 2017 AND $187,000 FOR THE YEAR ENDED JUNE 30, 2016. THE DECREASE IS DUE TO THE MEDICAID EXPANSION IN KENTUCKY. 85019551 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 87 0 1 557 1 1 1 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X THE ORGANIZATION 6068868511 BOX 668 5032 KY ROUTE 321 PRESTONSBURG KY 41653 EDWARD R NAIRN VICE CHAIRMAN 1.00 X 0 0 0 ROBERT M DUNCAN SECRETARY 1.00 X 0 0 0 PAUL D NUNN TREASURER 1.00 X 0 0 0 HAROLD C WARMAN JR PRESIDENT & CEO 16.00 24.00 X X 0 364935 31652 DEWEY L BOCOOK JR TRUSTEE 1.00 X 0 0 0 DENNIS T DORTON TRUSTEE 1.00 X 0 0 0 GREGORY A WILSON CHAIRMAN 2.00 X 0 0 0 CHARLES ARNETT MD TRUSTEE 1.00 X 0 0 0 BERTIE KAYE SALYER TRUSTEE 1.00 X 0 0 0 JOANNA SANTIESTEBANMD TRUSTEE 1.00 X 0 0 0 JAMES H BOOTH TRUSTEE 1.00 X 0 0 0 MARK E MCKENZIE TRUSTEE 1.00 X 0 0 0 MARK J VERONNEAU DO TRUSTEE 1.00 X 0 0 0 SABRINA ARNETT TRUSTEE 1.00 X 0 0 0 CHRIS TACKETT TRUSTEE 1.00 X 0 0 0 TAMARA CLARK VPHR 40.00 X 112496 0 13221 CHRIS HOFFMAN COO 40.00 X 222613 0 27327 SUSAN ELLIS VPNO 40.00 X 180670 0 12304 JACK BLACKWELL FORMER CFO 40.00 X 0 257845 19631 515779 622780 104135 3 1 1 0 PHARMACY SYSTEMS INC 65 E STATE ST STE 2100 COLUMBUS OH 43215 PHARMACISTS 1697255 ASSOCIATES IN REHAB 123 WEDDINGTON RD PIKEVILLE KY 41501 PHYSICAL THERAPY 1323560 KENTUCKY ANESTHESIA GROUP 3320 TATES CREEK RD STE 204 LEXINGTON KY 40502 ANESTHESIA 1094862 AYA HEALTHCARE INC 5930 CORNERSTONE CT W 300 SAN DIEGO CA 92121 CONTRACT NURSING 1017161 OHIO VALLEY PHYSICIANS 401 CAMDEN ROAD HUNTINGTON WV 25704 ED PHYSICIANS 735809 26 PATIENT SERVICE 621400 77479166 77479166 77479166 47735 47735 144434 251752 -107318 -107318 1069 -108387 2360 2141 219 219 219 MISCELLANEOUS INCOME 900099 3572079 3572079 LAB PROCESSING REVENUE 621500 1092491 1092491 CAFETERIA 624200 430486 430486 171591 118186 53405 5266647 82686449 81169431 1093560 423458 X 2247 2247 568632 568632 24229993 24229993 839768 839768 5499725 5499725 1618110 1618110 569904 569904 23516207 23516207 46036 46036 671270 671270 1270174 1270174 55445 55445 59769 59769 1082900 1082900 2169567 2169567 1895466 1895466 SUPPLIES 13139506 13139506 BAD DEBTS 5911691 5911691 REPAIRS/MAINTENANCE 3051972 3051972 PROVIDER TAX 1341258 1341258 1108715 559891 548824 88648355 85019551 3628804 0 2023074 1670445 12991405 10543495 28800 42000 1470894 1484146 1073361 767727 76460292 64841094 13008030 11619198 21286281 25692457 51881845 51819468 8189973 14695983 14647135 14293492 109374 54948 3881649 2722705 26828131 31767128 X 25053714 20052340 25053714 20052340 51881845 51819468 X -5961906 960532 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10315 10315 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE KENTUCKY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PERCENTAGE OF THE MEMBERSHIP DUES THAT ARE PAID TO THESE ORGANIZATIONS ARE USED FOR LOBBYING PURPOSES. THE HOSPITAL PAID DUES OF $33,120 TO KHA, OF WHICH 14.90% WAS USED FOR LOBBYING PURPOSES, AND PAID DUES OF $24,322 TO AHA, OF WHICH 22.12% WAS USED FOR LOBBYING PURPOSES. 742 742 802 60 742 910 108 802 1558977 1558977 910 1702626 143649 1558977 0.00000 0.00000 0.00000 0 0 84741 84741 34925023 26548207 8376816 218748 208429 10319 39197668 36630539 2567129 2034112 1453919 580193 11619198 INTERCOMPANY RECEIVABLES 25340551 UNAMORTIZED DEBT ISSUANCE COSTS 351906 25692457 INTERCOMPANY LIABILITIES 464571 EST COST REPORT SETTLEMENTS 735777 INTEREST RATE SWAP 1482357 PEER REVIEW & MEDICAL LIABILITY RESERVES 40000 2722705 1 1 1 X 1 X 1 1 0 0 1418968 0 1418968 0.01600 26891854 17461873 9429981 0.10640 28310822 17461873 10848949 0.12240 285982 0 285982 0.00320 0 0 3658463 835306 2823157 0.03180 0 0 3944445 835306 3109139 0.03500 32255267 18297179 13958088 0.15740 1 5911691 25104668 27157703 -2053035 X 1 1 1 CONSOLIDATED HEALTH SYSTEMS INC PARENT CORPORATION 1.00000 0.00000 0.00000 1 1 HIGHLANDS REGIONAL MEDICAL CENTER 5032 KY ROUTE 321 PRESTONSBURG KY 41653 X X X HIGHLANDS REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X WWW.HRMC.ORG X 1 16 1 WWW.HRMC.ORG 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X 1 X WWW.HRMC.ORG X 1 X 0 X 1 X 0 0 HIGHLANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: FOR THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), INPUT FROM THE COMMUNITY WAS COLLECTED THROUGH FOCUS GROUPS, SURVEYS, AND FROM A STEERING COMMITTEE, WHICH CONSISTED OF COMMUNITY STAKEHOLDERS WITH VARIOUS PUBLIC HEALTH EXPERTISE. STEERING COMMITTEE MEMBERS INCLUDED REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS, EXTENSION OFFICES, CITY REPRESENTATIVES, OTHER HEALTHCARE PROVIDERS, AND THE SCHOOL SYSTEMS. THE COMPLETE LIST OF STEERING COMMITTEE MEMBERS CAN BE FOUND ON PAGE 15 OF THE MOST RECENT CHNA. SIX FOCUS GROUPS WERE CONDUCTED, INCLUDING SOME WITH VOCATIONAL SCHOOL TEACHERS AND STUDENTS, HEAD START TEACHERS AND PARENTS, AND IN COUNTY HEALTH RELATED COUNCILS. HIGHLANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7D: THE PROVIDER ALSO MADE THE CHNA AVAILABLE THROUGH THE ORGANIZATION'S FACEBOOK PAGE AND SENT TO HUNDREDS OF PEOPLE VIA EBLAST. HIGHLANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THROUGH SURVEYS, FOCUS GROUPS, CENSUS DATA, COUNTY HEALTH DATA, HOSPITAL UTILIZATION DATA, AND STEERING COMMITTEE MEETINGS, IT WAS DETERMINED THAT OUR THREE GREATEST HEALTH PROBLEMS IN THE COMMUNITY ARE OBESITY, DIABETES, AND ADDICTION. ACCORDING TO OUR RESULTS, COMMUNITY NEEDS INCLUDED EDUCATIONAL PROGRAMS (INCLUDING NUTRITIONAL PROGRAMS, SMOKING CESSATION, AND SUBSTANCE ABUSE PREVENTION), INCREASED HEALTH EDUCATION FOR IN-SCHOOL YOUTH, MORE EDUCATION ON HEALTHCARE OPTIONS, INCREASED DIABETES CARE, IMPROVED ER WAIT TIMES, AND HEALTH LITERACY, AMONG OTHERS. IN RESPONSE TO THESE NEEDS, HHS OUTLINED THREE MAJOR GOALS FOR THE NEXT THREE YEARS.1. IMPROVED ACCESS TO SERVICES, EDUCATION, OUTREACH, AND SUPPORT2. INCREASED HEALTH EDUCATION FOR IN-SCHOOL YOUTH3. INCREASED PARTICIPATION IN COMMUNITY HEALTH INITIATIVESWHILE EACH OF THESE GOALS HAS EXTENSIVE PLANS AND KEY OBJECTIVES (FOUND ON PAGES 20-23 OF THE CHNA), WE ARE WELL ON OUR WAY TO ACHIEVING ALL OF THEM. IN THE YEAR 2017, THE HEALTH SYSTEM PROVIDED 685 FREE HEALTH SCREENINGS AT 26 HEALTH FAIRS AND/OR SCREENING EVENTS, PROVIDED EDUCATION ON NUMEROUS HEALTH TOPICS AT 57 EDUCATIONAL CLASSES OR EVENTS, HOSTED OR ATTENDED 7 DISEASE AWARENESS EVENTS, AND HOSTED 16 SUPPORT GROUPS (INCLUDING THOSE FOR DIABETES AND AUTISM). WE ARE PROVIDING HEALTH EDUCATION TO IN-SCHOOL YOUTH IN VARIOUS WAYS, INCLUDING SPONSORSHIP OF GONOODLE (WHICH LOGGED OVER 1.7 MILLION CHILD PHYSICAL ACTIVITY MINUTES FOR THE YEAR), SPONSORSHIP OF ALL AMERICAN HEART ASSOCIATION YOUTH PLATFORM PROGRAMS IN OUR SERVICE AREA (IN WHICH OVER 7,800 STUDENTS PARTICIPATED, TEACHING NUTRITION CLASSES AT AREA HEAD STARTS, AND PROVIDING CANCER EDUCATION/SMOKING CESSATION TO HIGH SCHOOLS IN OUR AREA. OUR DOCTORS AND STAFF HAVE PRESENTED AT EVENTS HIGHLIGHTING LADIES HEART HEALTH, AUTISM SPECTRUM DISORDER, COLON CANCER, NEONATAL ABSTINENCE SYNDROME, BREAST CANCER, AND MORE. THE HEALTH SYSTEM HAS INCREASED PARTICIPATION IN COMMUNITY HEALTH INITIATIVES; JOINING COUNTY HEALTH COALITIONS, SUBSTANCE ABUSE PREVENTION COUNCILS, EARLY CHILDHOOD COALITIONS, AND OTHERS THAT WORK TO BETTER THE HEALTH AND WELLNESS OF OUR REGION. OTHER BENEFITS TO COMMUNITY INCLUDE 431 FREE FLU IMMUNIZATIONS, 203 FREE PHYSICALS, AND OVER 150 FREE SPORTS INJURY EVALUATIONS.SOME OF THE NEEDS FOUND IN THE CHNA WILL NOT BE ADDRESSED AT THIS TIME AND/OR ARE ALREADY BEING ADDRESSED BY THE HEALTH SYSTEM OR OUR COMMUNITY PARTNERS. THESE INCLUDE INCREASED CARDIAC AND ORTHOPEDIC CARE, PHARMACEUTICAL LITERACY, DENTAL SERVICES FOR THE LOW INCOME POPULATION, AND DISPOSAL OF MEDICINES. THESE PRIORITIES CAN BE FOUND ON PAGE 23 OF OUR MOST RECENT CHNA, ALONG WITH EXPLANATION OF WHY THEY ARE UNADDRESSED THIS CYCLE. 3 1 - HIGHLANDS PSYCH UNIT 5000 KY ROUTE 321 PRESTONSBURG KY 41653 PROVIDER-BASED UNIT 2 - HAROLD PRIMARY CARE CENTER 273 OLD HAROLD ROAD HAROLD KY 41653 PROVIDER-BASED RHC 3 - HIGHLANDS PRIMARY CARE 100 BRIANNA BLVD SALYERSVILLE KY 41465 PROVIDER-BASED RHC PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT UNPAID BALANCES, NET OF ESTIMATED CONTRACTUAL ALLOWANCES AND UNCOLLECTIBLE ACCOUNTS. HRMC PROVIDES FOR LOSSES ON ACCOUNTS RECEIVABLE USING THE ALLOWANCE METHOD WHICH IS BASED ON EXPERIENCE, THIRD-PARTY CONTRACTS AND OTHER CIRCUMSTANCES THAT MAY AFFECT THE ABILITY OF PATIENTS TO MEET THEIR OBLIGATIONS. HRMC'S COLLECTION POLICY IS TO RESERVE BALANCES AFTER 120 DAYS OF COLLECTION ACTIVITY AND BALANCES ARE SENT TO COLLECTION AGENCIES AFTER 370 DAYS WITH NO PAYMENT ACTIVITY. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT WHEN THEY ARE RETURNED FROM THE COLLECTION AGENCIES. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT UNPAID BALANCES, NET OF ESTIMATED CONTRACTUAL ALLOWANCES FROM THIRD-PARTY PAYERS, LESS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE COMPANY PROVIDES FOR LOSSES ON ACCOUNTS RECEIVABLE USING THE ALLOWANCE METHOD. THE ALLOWANCE IS BASED ON EXPERIENCE, THIRD-PARTY CONTRACTS AND OTHER CIRCUMSTANCES THAT MAY AFFECT THE ABILITY OF PATIENTS TO MEET THEIR OBLIGATIONS. IT IS THE COMPANY'S POLICY TO CHARGE OFF UNCOLLECTIBLE ACCOUNTS RECEIVABLE TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN MANAGEMENT DETERMINES THE RECEIVABLE WILL NOT BE COLLECTED. THE COMPANY'S POLICY REGARDING COLLECTIONS IS AS FOLLOWS: AFTER 120 DAYS OF COLLECTION ACTIVITY, UNCOLLECTED BALANCES ARE RESERVED AND SENT TO COLLECTION AGENCIES; AFTER 370 DAYS WITH NO PAYMENT ACTIVITY, THESE ACCOUNTS ARE RETURNED TO THE COMPANY FROM THE COLLECTION AGENCIES AND SUBSEQUENTLY WRITTEN OFF. SEE NOTE 2 ON PAGE 10 OF THE FINANCIAL STATEMENTS ATTACHED.PART III, LINE 4:BAD DEBT EXPENSE AGREES TO THE TRIAL BALANCE. IT REPRESENTS UNPAID BALANCES OF PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE. SEE NOTE 2 ON PAGE 10 OF THE FINANCIAL STATEMENTS ATTACHED. PART III, LINE 8: MEDICARE COSTS WERE CALCULATED ON THE MEDICARE COST REPORT USING CALCULATED PER DIEM AMOUNTS FOR ROUTINE SERVICES AND COST TO CHARGE RATIOS FOR ANCILLARY SERVICES. THIS HOSPITAL IS A PPS HOSPITAL AND, THEREFORE, MEDICARE REVENUES ARE CALCULATED USING CALCULATED PPS AMOUNTS FOR EACH PROCEDURE. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR CHARITY CARE ARE NOT BILLED AND, THEREFORE, NO COLLECTION PROCEDURES ARE UNDERTAKEN. PART VI, LINE 2: THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BY PERIODICALLY CONSOLIDATING DATA AND PERSPECTIVES ABOUT THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY. THESE DATA SOURCES INCLUDE INFORMATION PROVIDED BY THE KENTUCKY EDUCATION AND WORKFORCE DEVELOPMENT CABINET AND THE FOUNDATION FOR A HEALTHY KENTUCKY AT KENTUCKYHEALTHFACTS.ORG. THE ASSESSMENT DATA ASSISTS IN THE DEVELOPMENT OF A PLAN FOR THE ENTIRE COMMUNITY, WITH A LINKAGE BETWEEN THE ORGANIZATION'S MISSION AND STRATEGIC PLAN, WITH SPECIAL ATTENTION GIVEN TO THOSE MOST IN NEED. PART VI, LINE 3: HIGHLANDS REGIONAL HOSPITAL PROVIDES FINANCIAL ASSISTANCE PROGRAMS TO ASSIST OUR PATIENTS WITH THE CHARGES FOR SERVICES RECEIVED HERE AT THE HOSPITAL. OUR PROGRAMS ASSIST UNINSURED PATIENTS AS WELL AS THOSE PATIENTS LEFT WITH SELF PAY BALANCES AFTER INSURANCE. OUR OUTPATIENT SCHEDULERS REFER UNINSURED PATIENTS TO THE FINANCIAL COUNSELOR WHEN SCHEDULED TESTS ARE REQUESTED. REGISTRATION STAFF IS TRAINED TO ASSIST UNINSURED PATIENTS WITH THE COMPLETION OF THE DSH (DISPROPORTIONATE SHARE HOSPITAL) APPLICATION AT THE TIME OF SERVICE. PATIENTS REQUESTING ASSISTANCE ON BALANCES AFTER INSURANCE WILL BE REFERRED TO THE FINANCIAL COUNSELOR OR OTHER BUSINESS OFFICE STAFF. THE HIGHLANDS PATIENT INFORMATION GUIDE IS GIVEN TO EACH INPATIENT AND OBSERVATION PATIENT AT THE TIME OF ADMISSION TO THE HOSPITAL. THE BOOKLET PROVIDES THE PHONE NUMBER FOR THE BUSINESS OFFICE AND THE FINANCIAL ASSISTANCE OFFICE FOR PATIENTS WHO WANT TO DISCUSS THEIR BILL OR INQUIRE ABOUT OUR FINANCIAL ASSISTANCE PROGRAMS. EACH PATIENT STATEMENT PROVIDES INFORMATION RELATING TO THE QUALIFICATIONS FOR THE DISPROPORTIONATE SHARE HOSPITAL PROGRAM. PATIENTS NOT APPROVED FOR THE DSH PROGRAM ARE AUTOMATICALLY REVIEWED FOR ELIGIBILITY IN THE HOSPITALS CHARITY ASSISTANCE PROGRAM. THE HOSPITAL WORKS WITH THE HEALTH DEPARTMENTS OF FLOYD, JOHNSON, MAGOFFIN, AND MARTIN COUNTIES TO PROVIDE SCREENING AND DIAGNOSTIC SERVICES TO UNINSURED PATIENTS AT REDUCED RATES. DURING FISCAL YEAR 2016, HRMC SERVICED 29 PATIENT CASES FROM THE FOUR COUNTIES. CHARGES FOR THESE 29 CASES TOTALED $21,564 AND PAYMENTS TOTALED $2,588. HEALTH DEPARTMENT STAFF OFTEN REFERS THESE PATIENTS TO THE HOSPITAL'S FINANCIAL COUNSELOR FOR FINANCIAL ASSISTANCE FOR OTHER SERVICES NOT COVERED THROUGH THE HEALTH DEPARTMENTS. KENTUCKY HOMEPLACE, A DIVISION OF THE COMMUNITY ACTION PROGRAM, ALSO REFERS PATIENTS TO THE FINANCIAL COUNSELOR FOR HELP IN OBTAINING MEDICAL SERVICES FOR WHICH THE PATIENTS HAVE NO INSURANCE COVERAGE. MANY OF OUR CLINICS AND OUR ON-STAFF PHYSICIANS ADVISE OUR UNINSURED PATIENTS OF OUR FINANCIAL ASSISTANCE PROGRAMS WHEN ORDERING TESTS NEEDED FOR THE DIAGNOSIS OF THE PATIENTS CONDITIONS. PART VI, LINE 4: PRESTONSBURG IS LOCATED IN FLOYD COUNTY, KENTUCKY IN THE FOOTHILLS OF THE APPALACHIAN MOUNTAINS AND ALONG THE BANKS OF THE LEVISA FORK OF THE BIG SANDY RIVER. THE PRIMARY SERVICE AREA CONSISTS OF FLOYD, MAGOFFIN, JOHNSON AND MARTIN COUNTIES OF KENTUCKY. ACCORDING TO THE 2016 CENSUS BUREAU, FLOYD COUNTY HAS A POPULATION OF APPROXIMATELY 37,110 AND IS COMPOSED OF APPROXIMATELY 51% FEMALE AND 49% MALE. 98% OF THE POPULATION IS CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $30,540 FROM 2012-2016, WHILE 30.4% OF THE POPULATION IS BELOW THE POVERTY LEVEL.THE POPULATION OF THE SERVICE AREA CONTINUES TO AGE AND OVERALL POPULATION NUMBERS DECLINE. THE GENERAL HEALTH STATUS OF THE PEOPLE OF THIS REGION IS MUCH POORER THAN THE STATE AND METROPOLITAN AREAS. HEART DISEASE, CANCER, STROKE, PULMONARY DISORDERS, OBESITY AND OCCUPATIONAL RELATED ILLNESSES (LARGERLY RELATED TO THE COAL INDUSTRY) ARE PREVALENT WITHIN THE POPULATION. ADOLESCENT AND ADULT SUBSTANCE ABUSE IS VERY PREVALENT, AS WELL. OTHER SOCIO-ECONOMIC ATTRIBUTES, SUCH AS A HIGH POVERTY LEVEL AND HIGH UNEMPLOYMENT, CREATE FURTHER HEALTH RELATED CHALLENGES FOR THE POPULATION OF THE SERVICE AREA.THE HOSPITAL PROVIDES SERVICE TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY, RACE, RELIGION, AGE OR SEX. PART VI, LINE 6: THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7: THE COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF KENTUCKY AND THE KENTUCKY HOSPITAL ASSOCIATION. IT IS ALSO MADE AVAILABLE TO THE PUBLIC. X X X X 0 0 0 0 0 0 0 0 0 HAROLD C WARMAN JR PRESIDENT & CEO 0 364935 0 0 0 0 0 13232 0 18420 0 396587 0 0 CHRIS HOFFMAN COO 222613 0 0 0 0 0 8907 0 18420 0 249940 0 0 0 SUSAN ELLIS VPNO 180670 0 0 0 0 0 9162 0 3142 0 192974 0 0 0 JACK BLACKWELL FORMER CFO 0 257845 0 0 0 0 0 12383 0 7248 0 277476 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF ACCOUNTING AND BOARD OF DIRECTORS WILL REVIEW FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO EACH BOARD MEMBER ANNUALLY. THE POLICY IS DISTRIBUTED BY THE BOARD SECRETARY ALONG WITH A DISCLOSURE FORM. RESPONSES ARE REVIEWED BY THE CEO. IF THERE IS A PARTICULAR ISSUE THAT NEEDS TO BE BROUGHT TO THE ATTENTION OF THE BOARD, THE CEO WILL CONTACT THE BOARD CHAIR TO DISCUSS, AND IF NECESSARY, IT WILL BE PLACED ON THE BOARD AGENDA FOR REVIEW. ADDITIONALLY, IF A BOARD MEMBER OR THE CEO BECOME AWARE OF POTENTIAL CONFLICTS THEY CAN REPORT THIS TO THE BOARD CHAIR DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO AND OFFICERS IS DETERMINED BY A COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS PERFORMANCE ANNUALLY. THE BOARD CONSULTS WITH VARIOUS SOURCES TO DETERMINE MARKET RATES OF COMPENSATION AGAINST COMPARABLE ORGANIZATIONS. THE BOARD USES ACHE COMPENSATION SURVEYS, MODERN HEALTHCARE COMPENSATION SURVEYS, AND VERBALLY CONSULTS WITH THE KY HOSPITAL ASSOCIATION TO DETERMINE KY COMPENSATION. FROM TIME TO TIME, THE BOARD MAY USE OTHER SOURCES THAT ARE AVAILABLE. COMPENSATION IS BASED ON MARKET RATES AND PERFORMANCE AGAINST GOALS, WHICH ARE ESTABLISHED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 23,516,207. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,516,207. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST RATE SWAP 960,532. FORM 990, PART XII, LINE 2C: THERE IS A COMMITTEE OF THE BOARD OF DIRECTORS THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CONSOLIDATED HEALTH SYSTEMS INC PO BOX 0787 PRESTONSBURG KY 41653 311139276 FOSTER AND DEVELOP HEALTH CARE ACTIVITIES KY 501(C)(3) 11A 0 HIGHLANDS HOME CARE INC 5032 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 611349726 HOME HEALTH CARE SERVICES KY 501(C)(3) 9 CONSOLIDATED HEALTH SYSTEMS INC 0 HIGHLANDS FOUNDATION INC 5000 KY HIGHWAY 321 PRESTONSBURG KY 41653 208036784 PROMOTE HEALTH AND COMMUNITY EDUCATION AND INVOLVEMENT KY 501(C)(3) 7 CONSOLIDATED HEALTH SYSTEMS INC 0 HIGHLANDS CENTER FOR AUTISM INC 5000 KENTUCKY ROUTE 321 PRESTONSBURG KY 41653 264541964 SCHOOL FOR AUTISM SPECTRUM DISORDER KY 501(C)(3) 9 CONSOLIDATED HEALTH SYSTEMS INC 0 HIGHLANDS MEDICAL PARTNERS II LLC 5000 KY ROUTE 321 PRESTONSBURG KY 41653 263714306 SLEEP LAB KY CONSOLIDATED HEALTH SYSTEMS INC N/A 0 0 HIGHLANDS HEART & VASCULAR LLC 5000 KY ROUTE 321 PRESTONSBURG KY 41653 463963059 HEART LAB KY CONSOLIDATED HEALTH SYSTEMS INC N/A -490276 179075 0 0 0.55000 CONSOLIDATED HEALTH ENTERPRISES INC BOX 668 US 23N PRESTONSBURG KY 41653 611261592 PHARMACY KY CONSOLIDATED HEALTH SYSTEMS INC C 0 HIGHLANDS STAFFING INC 5000 KY RT 321 PRESTONSBURG KY 41653 270835324 STAFFING KY CONSOLIDATED HEALTH SYSTEMS INC C 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 0 0 0 0