EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER (EIN 61-0492356)
Tax period: 2016-10-01 to 2017-09-30
Filed: 2018-08-15
IRS object ID: 201832279349300143
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-08-15T10:17:59-05:00	ReturnTs
Tax Period End	2017-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	360 E 8TH AVE STE 201 PO BOX 1196	AddressLine1Txt
City	BOWLING GREEN	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	421021196	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	610492356	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	WILLIAM SNAPP III	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8592392424	PhoneNum
Signature	2018-08-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JESSICA FREEMAN	PreparerPersonNm
PTIN	P01261457	PTIN
Phone	2707810111	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$176,106,109	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.EMHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1972	FormationYr
Legal Domicile State	KY	LegalDomicileStateCd
Activity Or Mission	THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO THE 155,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	14	VotingMembersIndependentCnt
Total Employee	1169	TotalEmployeeCnt
Total Volunteers	225	TotalVolunteersCnt
Total Gross UBI	$1,171,776	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$172,762	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$263,751	PYContributionsGrantsAmt
CY Contributions Grants	$1,252,843	CYContributionsGrantsAmt
PY Program Service Revenue	$169,330,305	PYProgramServiceRevenueAmt
CY Program Service Revenue	$173,940,374	CYProgramServiceRevenueAmt
PY Investment Income	$22,820	PYInvestmentIncomeAmt
CY Investment Income	-$152,789	CYInvestmentIncomeAmt
PY Other Revenue	$977,687	PYOtherRevenueAmt
CY Other Revenue	$851,247	CYOtherRevenueAmt
PY Total Revenue	$170,594,563	PYTotalRevenueAmt
CY Total Revenue	$175,891,675	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$62,325,352	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$64,517,270	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$92,391,546	PYOtherExpensesAmt
CY Other Expenses	$93,883,773	CYOtherExpensesAmt
PY Total Expenses	$154,716,898	PYTotalExpensesAmt
CY Total Expenses	$158,401,043	CYTotalExpensesAmt
PY Revenues Less Expenses	$15,877,665	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$17,490,632	CYRevenuesLessExpensesAmt
Total Assets BOY	$255,967,142	TotalAssetsBOYAmt
Total Assets EOY	$273,971,724	TotalAssetsEOYAmt
Total Liabilities BOY	$10,979,914	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$11,493,864	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$244,987,228	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$262,477,860	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO THE 155,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$142,908,186	ExpenseAmt
Revenue	$172,768,598	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$142,908,186	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	84	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1169	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	14	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	KY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

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

US Address USAddress

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

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

Form990 Part VII Section A Form990PartVIISectionAGrp (27 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
KRYDER E VANBUSKIRK III MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,150	$0
SHEREE GILLIAM
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,900	$0
REBECCA CHATHAM MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,300	$0
CLIFF ED IRVIN
BOARD MEMEBER	3.0	5.0	Yes (X)	$0	$3,150	$0
BRIAN ELLIS
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$241,236	$48,429
SUSIE ROUSH
BOARD MEMBER	1.0	7.0	Yes (X)	$0	$3,000	$0
AARON ROWLAND
BOARD MEMBER	1.0	7.0	Yes (X)	$0	$3,000	$0
MIKE TAYLOR
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,450	$0
HUSSAM HAMDALLA MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$867,655	$52,120
THOMAS HAGER
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$0	$0
JULIAN GANDER
SECRETARY	3.0	5.0	Yes (X)	$0	$4,500	$0	Yes (X)
JOHN D TRISLER
TREASURER	3.0	5.0	Yes (X)	$0	$3,300	$0	Yes (X)
SCOTT BOTTOMS
VICE CHAIR	3.0	5.0	Yes (X)	$0	$2,550	$0	Yes (X)
ALLEN WHITE
CHAIR	3.0	5.0	Yes (X)	$0	$3,300	$0	Yes (X)
JAMES TURPIN
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$4,050	$0
JAMES DUNN
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$750	$0
SALLY DAVENPORT
CEO	30.0	29.0		$0	$351,763	$44,690	Yes (X)
WILLIAM SNAPP III
VP & CFO	30.0	32.0		$0	$358,835	$53,815	Yes (X)
BURT PIPER
VP & COO	30.0	29.0		$0	$255,537	$53,276	Yes (X)
CARL METZ
VP HUMAN RESOURCES	40.0	0.0		$250,379	$0	$42,950		Yes (X)
LYNNE WARNER-LYNN
VP CLINICAL EFFECTIVENESS	40.0	0.0		$153,683	$0	$44,272		Yes (X)
MICHELLE DELUCA FRALEY
PHARMACIST	40.0	0.0		$147,115	$0	$43,180			Yes (X)
JOAN HALTOM
PHARMACY DIRECTOR	40.0	0.0		$194,124	$0	$36,681			Yes (X)
RONALD BARBATO
REHAB DIRECTOR	40.0	0.0		$166,430	$0	$26,842			Yes (X)
CHRISTINA COOLEY
PHARMACIST	40.0	0.0		$155,557	$0	$6,885			Yes (X)
MARK UPTON
PHARMACIST	40.0	0.0		$140,929	$0	$24,150			Yes (X)
VICKI DARNELL
FORMER CEO	0.0	0.0		$0	$886,025	$60,795				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,208,217	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,002,451	TotReportableCompRltdOrgAmt
Total Other Compensation	$538,085	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	43	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
IN COMPASS HEALTH INC
318 MAXWELL ROAD SUITE 500	ALPHARETTA	GA	30009	PHYSICIAN SERVICES	$1,948,300
KENTUCKY BLOOD CENTER
3121 BEAUMONT CENTER CIRCLE	LEXINGTON	KY	40512	BLOOD SERVICES	$710,617
LABORATORY CORP
PO BOX 12140	BURLINGTON	NC	27216	LAB SERVICES	$836,638
LOGAN'S HEALTHCARE LINEN DIVISION
PO BOX 643958	CINCINNATI	OH	452643954	LINEN SERVICES	$465,100
MESSER CONSTRUCTION
854 W MAIN STREET	LEXINGTON	KY	40508	CONSTRUCTION SERVICE	$1,023,017

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	24	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,248,622	RelatedOrganizationsAmt
All Other Contributions	$4,221	AllOtherContributionsAmt
Total Contributions	$1,252,843	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE	621110	$167,967,861	$167,034,826	$933,035
PHARMACY REVENUE	446110	$3,801,985	$3,720,506	$81,479
JOINT VENTURE INCOME	621110	$1,824,968	$1,824,968
OTHER OPERATING	621110	$188,298	$188,298
REFERENCE LAB	621400	$157,262		$157,262

Field	Value	IRS element (for citing)
Total Program Service Revenue	$173,940,374	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$33,645	TotalRevenueColumnAmt
Exclusion	$33,645	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$30,951	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$30,951	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,951	TotalRevenueColumnAmt
Exclusion	$30,951	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$28,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$214,434	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$186,434	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$186,434	TotalRevenueColumnAmt
Exclusion	-$186,434	ExclusionAmt

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
VENDING COMMISSION	900099	$19,024	$19,024
CAFETERIA	722514	$718,318	$718,318
ALL OTHER MISC REVENUE	900099	$82,954	$82,954

Field	Value	IRS element (for citing)
Other Revenue Total	$820,296	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$175,891,675	TotalRevenueColumnAmt
Related Or Exempt Func Income	$172,768,598	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,171,776	UnrelatedBusinessRevenueAmt
Exclusion	$698,458	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$341,877	TotalAmt
Management And General	$341,877	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$48,130,547	TotalAmt
Program Services	$43,159,060	ProgramServicesAmt
Management And General	$4,971,487	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,829,234	TotalAmt
Program Services	$2,519,104	ProgramServicesAmt
Management And General	$310,130	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,673,341	TotalAmt
Program Services	$8,612,986	ProgramServicesAmt
Management And General	$1,060,355	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,542,271	TotalAmt
Program Services	$3,153,981	ProgramServicesAmt
Management And General	$388,290	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

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

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$42,832	TotalAmt
Management And General	$42,832	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$21,414,601	TotalAmt
Program Services	$17,296,850	ProgramServicesAmt
Management And General	$4,117,751	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,551	TotalAmt
Program Services	$3,238	ProgramServicesAmt
Management And General	$313	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,235,651	TotalAmt
Program Services	$4,101,405	ProgramServicesAmt
Management And General	$1,134,246	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,165,419	TotalAmt
Program Services	$444,850	ProgramServicesAmt
Management And General	$1,720,569	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,514,928	TotalAmt
Program Services	$2,266,573	ProgramServicesAmt
Management And General	$248,355	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$70,939	TotalAmt
Program Services	$44,427	ProgramServicesAmt
Management And General	$26,512	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$66,179	TotalAmt
Program Services	$42,832	ProgramServicesAmt
Management And General	$23,347	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,121,866	TotalAmt
Program Services	$1,121,866	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,830,086	TotalAmt
Program Services	$7,830,086	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$597,063	TotalAmt
Program Services	$250	ProgramServicesAmt
Management And General	$596,813	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$40,009,570	$40,009,570
BAD DEBTS	$7,389,339	$7,389,339
TAXES & LICENSES	$2,420,245	$2,342,703	$77,542
REPAIRS & MAINTENANCE	$2,981,459	$2,419,516	$561,943

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,045	TotalAmt
Program Services	$149,550	ProgramServicesAmt
Management And General	-$129,505	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$158,401,043	TotalAmt
Program Services	$142,908,186	ProgramServicesAmt
Management And General	$15,492,857	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,639	BOYAmt
EOY	$6,242	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$156,118	BOYAmt
EOY	$147,675	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$18,500,291	BOYAmt
EOY	$20,570,109	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,511,778	BOYAmt
EOY	$6,474,648	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,680,543	BOYAmt
EOY	$2,399,841	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$171,598,868	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$114,669,644	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$57,187,954	BOYAmt
EOY	$56,929,224	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,346,590	BOYAmt
EOY	$1,309,558	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$171,578,229	BOYAmt
EOY	$186,134,427	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$255,967,142	BOYAmt
EOY	$273,971,724	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,971,042	BOYAmt
EOY	$10,620,351	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,872	BOYAmt
EOY	$873,513	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,979,914	BOYAmt
EOY	$11,493,864	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$244,971,438	BOYAmt
EOY	$262,462,070	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$244,987,228	BOYAmt
EOY	$262,477,860	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$255,967,142	BOYAmt
EOY	$273,971,724	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$17,490,632	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,557	OtherActivitiesAmt
Total Lobbying Expenditures	$7,557	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

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

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,353,765	OtherCostOrOtherBasisAmt
Book Value	$2,353,765	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$76,006,898	OtherCostOrOtherBasisAmt
Depreciation	$43,154,684	DepreciationAmt
Book Value	$32,852,214	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,944,334	OtherCostOrOtherBasisAmt
Depreciation	$2,786,827	DepreciationAmt
Book Value	$157,507	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$85,120,508	OtherCostOrOtherBasisAmt
Depreciation	$65,975,171	DepreciationAmt
Book Value	$19,145,337	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,173,363	OtherCostOrOtherBasisAmt
Depreciation	$2,752,962	DepreciationAmt
Book Value	$2,420,401	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$56,929,224	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
SCHOLARSHIP ACCOUNT	$16,536
PHYSICIAN INCOME GUARANTEE	$233,891
DUE FROM RELATED PARTIES	$185,884,000

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$186,134,427	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	Due to Third Party Payers	Desc
Amt	$873,513	Amt

Field	Value	IRS element (for citing)
Total Liability	$873,513	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$167,435,943	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$7,389,339	OtherRevenueAmt
Revenue Not Reported	-$7,389,339	RevenueNotReportedAmt
Revenue Subtotal	$174,825,282	RevenueSubtotalAmt
Other Revenues Not Included	$1,066,393	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$1,066,393	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$175,891,675	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$149,945,311	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	-$1,066,393	OtherExpensesIncludedAmt
Expenses Not Reported	-$1,066,393	ExpensesNotReportedAmt
Expenses Subtotal	$151,011,704	ExpensesSubtotalAmt
Other Expenses Not Included	$7,389,339	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,389,339	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$158,401,043	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCH D, PART XI & XII

RECONCILIATION TO AUDIT REPORT ------------------------------ PART XI LINE 2D OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON 990 PART VIII: ------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT (7,389,339) PART XI LINE 4B AMOUNTS INCLUDED IN 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 1,252,843 LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT (186,434) ROUNDING (16) --------- 1,066,393 PART XII LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON 990 PART IX: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT (1,252,843) LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT 186,434 ROUNDING 16 --------- (1,066,393) PART XII LINE 4B AMOUNTS INCLUDED ON 990 PART IX BUT NOT ON LINE 1: --------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT 7,389,339

SCH D, PART X, LINE 2

INCOME TAXES ------------ The organization's audited financial statements did not include a footnote that addressed the organization's liability for uncertain tax positions under FIN48 (ASC 740). Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$102,703	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$102,703	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$26,155,467	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,124,168	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,031,299	NetCommunityBenefitExpnsAmt
Total Expense	0.07340	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$26,258,170	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,124,168	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,134,002	NetCommunityBenefitExpnsAmt
Total Expense	0.07410	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$26,258,170	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,124,168	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,134,002	NetCommunityBenefitExpnsAmt
Total Expense	0.07410	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$7,389,340	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,694,670	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$53,134,080	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$55,330,753	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,196,673	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
CNTL KY SURGERY CTR
ASC	0.6	0.0	0.4
BLUEGRASS IMM CARE
URGENT TREATMENT CLINIC	0.73	0.0	0.27

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	17	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.emhealth.org	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.emhealth.org	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	125.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	www.emhealth.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.emhealth.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.emhealth.org	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
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE H, PART V, SECTION B, LINE 5

COMMUNITY INPUT --------------- THROUGH THE FOCUS GROUP AND ONLINE SURVEY, PARTICIPATION AND INPUT WAS GATHERED FROM REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY (INCLUDING HISPANIC, AFRICAN AMERICAN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (SPECIFICALLY, THE ELDERLY, DISABLED, YOUNG ADULTS, LGBT COMMUNITY, THE MENTALLY ILL, INMATES, HEARING IMPAIRED, MEDICAID RECIPIENTS, AND THE UNINSURED).

SCHEDULE H, PART V, SECTION B, LINE 11

ADDRESSING THE NEEDS OF THE COMMUNITY ------------------------------------- The internal stakeholders of Ephraim McDowell Regional Medical Center determined the following to be the top health priorities for the hospital to address in the community for the coming years: - Cardiovascular Disease (CVD) Related Risk Factors (e.g., hypertension, BMI, glucose, tobacco use, physical activity, nutrition) - Cancer Early Detection and Prevention - Childhood Obesity - Access to Health Services - Dementias, including Alzheimers Disease - Mental Health & Mental Disorders These priority areas, and plans to address these, will be integrated into the hospitals Implementation Strategy. The rationale for selecting these areas is an understanding that impacting these would also impact many other areas of need identified in the assessment, such as diabetes, dementia, mental health, sensory impairment, kidney disease, respiratory disease, and disability. These areas also represent a continuation of existing work and allow the hospital to build on past successes. THERE ARE ADDITIONAL NEEDS IDENTIFIED WITHIN THE CHNA REPORT THAT ARE NOT SPECIFICALLY ADDRESSED BY EMHFL, DUE TO NO EXPERTISE OR LIMITED RESOURCES, BUT ARE BEING ADDRESSED BY OTHER AGENCIES WITHIN THE COMMUNITY.

Field	Value	IRS element (for citing)
Facility	9	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

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

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART III, LINE 4	BAD DEBT EXPENSE ---------------- THE CORPORATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE CORPORATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CORPORATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.
SCHEDULE H, PART III, LINE 8	MEDICARE SHORTFALL ------------------ Amounts reported on Lines 5 and 6 were based on the corporation's Medicare Cost Report.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT ---------------- IN 2017, PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS ENGAGED TO CONDUCT A NEEDS ASSESSMENT OF EMRMC'S COMMUNITY, WHICH IS DEFINED AS THE PRINCIPAL RESIDENTIAL ZIP CODES IN BOYLE, CASEY, GARRARD, LINCOLN, MERCER AND WASHINGTON COUNTIES IN KENTUCKY. A SURVEY AND A COMMUNITY FOCUS GROUP WERE COMPLETED TO OBTAIN PRIMARY DATA FROM INDIVIDUALS WITHIN THE COMMUNITY. THE FOCUS GROUP WAS COMPRISED OF REPRESENTATIVES FROM PUBLIC HEALTH, SOCIAL SERVICE PROVIDERS, EMPLOYERS, AND OTHER COMMUNITY LEADERS. SELF REPORT DATA, MORTALITY, MORIDITY, LIFESTYLE, INCIDENCE OF CHRONIC DISEASE, INJURY DATA AND DISABILITY DATA ARE PART OF THE ASSESSMENT PROCESS. THE BENCH MARK IS ESTABLISHED USING HEALTHY PEOPLE 2020 DATA.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ----------------------------------------------- EMRMC's charity care policy is posted on the www.emhealth.org website. At registration of self-pay clients, information is given on reduced fee, charity application, and a referral to a financial counselor. The free community screenings are posted on the website and in area newspapers if the hosting organization invites community participation. Some events are discussed on local radio. Information regarding the free clinic is also given by healthcare providers, faith community nurses, case workers and other medical professionals.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION --------------------- THE HEALTH SYSTEM SERVES BOYLE, MERCER, CASEY, LINCOLN, GARRARD AND WASHINGTON COUNTIES, WHICH HAVE A RURAL POPULATION OF APPROXIMATELY 113,000. ACCESS IS AN ISSUE, DUE TO TRAVEL BARRIERS SUCH AS OUT-OF-DATE HIGHWAYS AND LACK OF PUBLIC TRANSPORTATION. THESE ACCESS ISSUES INFLUENCED THE DECISION TO SERVE WITH FREE SCREENINGS AT KEY GATHERING PLACES SUCH AS CHURCHES AND SCHOOLS,ETC. INSURANCE COVERAGE IS ANOTHER ISSUE. THE NUMBERS OF UNINSURED CONTINUES TO EXCEED THE NATIONAL AVERAGE AND THE UNDERINSURED IN THIS SERVICE AREA CONTINUES TO INCREASE POST ACA.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH ----------------------------- Officers and staff of EMRMC are engaged in leadership positions with the following: Boyle County Relay for Life; Boyle County Health Department; Mercer County Health Department; Chamber of Commerce and Economic Development agencies in Boyle, Lincoln and Garrard counties; Boyle County School System; 4-H Council; Danville Rotary Club; Heart of Danville; McDowell House; Christian Care Communities; Foundation for Healthy Kentucky; Kentucky Hospital Association and Danville Kiwanis. Staff has also given testimony at local, state, and federal levels related to our service area's health, education and economic issues. EMRMC has an open medical staff comprised of primary care, specialists and subspecialists. Physician recruitment is based upon community need with approval from the governing board. The EMRMC and EMH system boards are comprised of community members with representation from the medical staff and senior leadership and the Fort Logan Hospital Board. The governing board approved the establishment and funding of the Community Service department and the funding of the health risk behavior assessment of Boyle County. They also approved the charity care policy. There is never a fee for services provided by the Community Service department. With H1N1 outbreak, the Community Service department approached churches in the six-county area with hand-washing signs, "Cover your Cough" posters and floor-stand hand sanitizers to help reduce the risk of the spread of flu within congregations and communities. Preventative care, such as flu shots, are taken to the community. So, too, are annual skin cancer checks, monthly blood pressure checks, semi-annual glucose and cholesterol checks, along with nurse consults. Such services are offered in schools, churches, and other public entities in the region, including the stockyards in Lincoln County.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ----------------------------- EMRMC is a 222 licensed bed acute care hospital serving the community for nearly a century as part of Ephraim McDowell Health (EMH). EMH is a comprehensive, integrated healthcare delivery system that serves 113,000 residents from six counties in south central Kentucky. The EMH Board is comprised of community members and representation from Ft Logan Hospital, medical staff, and EMRMC leadership. Ft Logan Hospital is a critical access hospital located in Lincoln County. Health Resource is comprised of clinics, an early childhood development center, assisted living faculty, and durable medical equipment outlets. There are representatives from our six counties, medical staff, and leadership on the community board that oversees and coordinates the services of Ephraim McDowell Health.
SCHEDULE H, PART I, LINE 7, COLUMN (F)	% OF TOTAL EXPENSE CALCULATION ------------------------------ The amount of bad debt expense included on Form 990, Part IX, Line 25, column(A), but subtracted for purposes of calculating the percentage of total expense is $7,389,340.
SCHEDULE H, PART III, LINE 9B	Written Debt Collection Policy and Financial Assistance ------------------------------------------------------- If a patient cannot satisfy standard payment expectations, a financial assistance screening process for alternative sources of balance resolution is completed. Those resolutions may include a discount on charges, Medicaid enrollment or application for charity care.
SCHEDULE H, PART V, SECTION B, LINE 10	IMPLEMENTATION STRATEGY ----------------------- THE IMPLEMENTATION STRATEGY CAN BE OBTAINED AT: HTTPS://WWW.EMHEALTH.ORG

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRIAN ELLIS
BOARD MEMBER	$0	$98,544	$0	$120,070	$0	$22,622	$0	$19,487	$0	$28,942	$0	$289,665	$0	$0
HUSSAM HAMDALLA MD
BOARD MEMBER	$0	$517,975	$0	$307,497	$0	$42,183	$0	$18,000	$0	$34,120	$0	$919,775	$0	$0
VICKI DARNELL
FORMER CEO	$0	$137,157	$0	$120,277	$0	$628,591	$0	$22,585	$0	$38,210	$0	$946,820	$0	$120,277
CARL METZ
VP HUMAN RESOURCES	$204,003	$0	$24,330	$0	$22,046	$0	$18,468	$0	$24,482	$0	$293,329	$0	$24,330	$0
MICHELLE DELUCA FRALEY
PHARMACIST	$144,915	$0	$0	$0	$2,200	$0	$12,516	$0	$30,664	$0	$190,295	$0	$0	$0
JOAN HALTOM
PHARMACY DIRECTOR	$181,774	$0	$10,038	$0	$2,312	$0	$15,566	$0	$21,115	$0	$230,805	$0	$10,038	$0
RONALD BARBATO
REHAB DIRECTOR	$153,694	$0	$8,626	$0	$4,110	$0	$13,434	$0	$13,408	$0	$193,272	$0	$8,626	$0
CHRISTINA COOLEY
PHARMACIST	$155,279	$0	$0	$0	$278	$0	$5,961	$0	$924	$0	$162,442	$0	$0	$0
MARK UPTON
PHARMACIST	$139,674	$0	$0	$0	$1,255	$0	$3,507	$0	$20,643	$0	$165,079	$0	$0	$0
SALLY DAVENPORT
CEO	$0	$312,006	$0	$31,537	$0	$8,220	$0	$21,200	$0	$23,490	$0	$396,453	$0	$31,537
WILLIAM SNAPP III
VP & CFO	$0	$296,844	$0	$53,258	$0	$8,733	$0	$21,200	$0	$32,615	$0	$412,650	$0	$53,258
LYNNE WARNER-LYNN
VP CLINICAL EFFECTIVENESS	$135,452	$0	$7,750	$0	$10,481	$0	$12,598	$0	$31,674	$0	$197,955	$0	$0	$0
BURT PIPER
VP & COO	$0	$248,500	$0	$0	$0	$7,037	$0	$20,847	$0	$32,429	$0	$308,813	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 4A

SEVERANCE PAYMENTS ------------------ VICKI DARNELL RETIRED AS CEO IN JANUARY 2016. HER SEVERANCE IS REPORTED IN HER W-2.

SCHEDULE J, PART I, QUESTION 6A

MANAGEMENT INCENTIVE PLANS -------------------------- EMRMC IS AN AFFILIATE OF Ephraim McDowell Health, Inc. which has management incentive plans for corporate officers, senior vice-presidents, vice-presidents and directors. Annual payouts related to these incentive plans have two components. 30% of the annual payout is based on net operating income goals compared to budget. The other 70% is based on quality measures, patient satisfaction goals, associate satisfaction goals, and safety measures.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11	PROCESS TO REVIEW FORM 990 -------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12B AND 12C	MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------------ ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXISTS, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT.
FORM 990, PART VI, SECTION B, LINE 15A AND 15B	PROCESS FOR DETERMINING COMPENSATION ------------------------------------ EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS PART OF AN INTERGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEeN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW IN 2015 FOR ESTABLISHING REASONABLE COMPENSATION OF OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM. THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19	MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------ THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART V, LINE 2A	COMMON PAYMASTER ---------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR THE FOLLOWING RELATED ORGANIZATIONS: EPHRAIM MCDOWELL HEALTH, INC. EPHRAIM MCDOWELL HEALTH RESOURCE, INC. EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC. EMHFL, INC. COOPERATIVECARE, INC. & MCDOWELL HOME HEALTH. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356.
FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B	MEMBERS OF THE ORGANIZATION --------------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------- Ephraim McDowell Regional Medical Center (EMRMC) is a not-for-profit, 222-bed licensed level III trauma center dedicated to serving the health and wellness needs of the populations of Boyle, Lincoln, Mercer, Garrard, Casey and Washington Counties. EMRMC scope of services include: behavioral health, cancer care center, outpatient cancer care, cardiac care services, critical care, diabetes and endocrinology, diagnostic services, level III trauma/emergency care center, Kids Can Do pediatric therapy center, laboratory services, medical-surgical services, orthopedic/spine care, pastoral care, pain management center, pulmonology, rehabilitation, respiratory therapy, surgical services, vascular services, volunteer/auxiliary, womens health services, womens breast & health center, wound healing center, sleep disorders center, ear, nose, and throat services, urology, home health, neurology, podiatry, and durable medical equipment. Ephraim McDowell Regional Medical Center for Fiscal Year (FY) 2017 experienced 6,467 admissions including nursery, and 30,026 patient days for all services including nursery and observation days. Outpatient registrations (including ER visits) were 138,214 compared to 137, 481 in FY 2016. Surgical procedures at EMRMC were 4,675 in FY 2017 as compared to 4,409 in FY 2016, reflecting an increase in procedures. The ambulatory surgical center procedures in FY 2017 were 6,181 verses 6,819 in FY 2016. Expanded service modalities have been continued to increase access to care needed for the elderly, frail, or those with cancer (all high volume populations within the six counties) to receive care close to home. Key service modalities included the following: - Radiofrequency - We continue to provide targeted Vertebral Augmentation for the treatment of spine fractures (also known as vertebral compression fractures) as commonly seen in osteoporosis. Kentucky has one of the highest rates of citizens over the age of 65, and age is a risk factor for spinal fractures. - Cancer - is the number two cause of death in the service area; therefore we continue to provide targeted-Radiofrequency Ablation (t-RFA) therapy for rapid pain relief from metastatic spinal tumors as a treatment option for cancer care. Community Health Education General --------------------------------------- Cancer Education - Sun damage screening and education were provided at Centre College and Ephraim McDowell Cancer Commonwealth as well as distribution of sun screen, and lip balm. Additionally, various sports groups received sun safety products and education. EPA sun safety literature, sun screen and lip balm with sun screen were distributed to re-enforce the message of sun safety. All funded by the Ephraim McDowell Health Care Foundation (EMHCF). CPR/First Aid - A staff nurse within the Ephraim McDowell Health Care system donated time and conducted CPR classes as various sites throughout the community. Due to loss the loss of a community CPR instructor, numbers served continue to drop. Education Website/Community Publication - Twelve editions of the Health Ministry/Faith Community Nursing newsletter were produced, and distributed in Kentucky, Tennessee, Indiana, Ohio, Virginia, and North Carolina. The intent is to provide relevant and current information to the congregations related to self-care, or education on disease processes, treatments and prevention, including but not limited to intentional care of the spirit. All information can be reproduced and used for congregational information/education. Health Fairs - Services were offered at 24 events at 18 sites in Boyle, Lincoln, Garrard, Mercer, and Washington Counties with focus on reaching at risk and vulnerable populations. Including all adult programs, 14,000 community contacts occurred (screenings, education, support groups, etc.). Thirty-eight percent of screened participants were male; 62 percent were female both consistent with FY 2016. Ninety-one percent (down 1 percent) of clients served were Caucasian, seven percent were African America (a three percent increase from the prior year), and two percent were Hispanic (a one percent decline from the prior year). Forty-nine percent of participants served by community benefit programs had a household income below $35,000 (this is an 8 percent decrease). Ten percent of participants served were unemployed; a six percent decrease in unemployment from FY 2016. Forty-three percent of the population served were retired, an increase of 4% over 2016 and 2015. The uninsured served decreased to 7 percent compared to 8% in FY 2016 and to 6 percent in 2015. Eighty-two percent of participants reported a primary care provider (PCP) compared to 78% in FY 2016 and 86% in 2015. A registered nurse (RN) met with each client to develop a written plan to decrease life style associated health risk behaviors. At each screening, referral options were provided, including Hope Clinic, reduced fee program and primary care provider (PCP) listings for the region for the uninsured participant or those without a PCP. Fifty-one percent of screening tests were abnormal (a 4% increase over 2016) with 19 percent requiring a referral for follow-up (a 2 percent increase over 2016 compared to a 3 percent decrease from 2015). One possible explanation for the increase in referrals for follow-up relates to the frequently reported inability to pay deductibles at the doctors office. Parish Nursing Program - Grant funding from Ephraim McDowell Health Care Foundation made possible the Faith Community Nursing educational programs. A Faith Community Nursing Symposium was presented in the fall of 2016 with 26 attendees, while the Faith Community Nursing Foundation Course was held in the spring of 2017 producing 5 new Faith Community nurses who served as faculty for the Faith Community Nursing organization in Jasper, Indiana. Faith Community Nurse Faculty also served on the Foundation for a Healthy Kentucky as the Director at large, and attended quarterly meetings as a part of the executive and by laws committee. One hundred and three participants have completed the faith community nursing foundation course since its inception at EMRMC in 2008 and serve as volunteers within their congregations. These community partners serve in 23 counties within the Commonwealth of Kentucky, Tennessee, Virginia, North Carolina and Ohio and support persons of all denominations. Twelve health ministry newsletters were created and disseminated to health ministry partners in Kentucky, Ohio, Illinois, Indiana, Tennessee, Virginia and North Carolina. Within the immediate service area the following volunteer Faith Community Nursing services were active: Lexington Avenue Baptist Church, St. Andrews Catholic Church, Saints Peter & Paul Catholic Church, Gethsemane Baptist Church, Indian Hills Christian Church, First Baptist Church Junction City, Perryville Baptist Church, New Salem Baptist Church, Lebanon United Methodist Church, and Centenary United Methodist Church of Danville. Activities include, but are not limited to, home visits, nursing home visits, blood pressure checks, health and wellness programs, support groups, referrals for follow-up care, organizing flu clinics, organizing health screenings, acute care visits, arranging for meal deliveries, and emergency assistance (seizures, chest pain, fainting, hypertensive crisis, etc.). Statistical analysis shows the more visits the congregant has with the Faith Community Nurse regarding their blood pressure the better their blood pressure is controlled. School-Based Programs - The School based programs were no longer spearheaded by Ephraim Community Service staff due to the lack of personnel. However, area schools continued the Perkins Assessments and tracking of BMI which we view as a mark of success in our efforts to educate the community. Speakers Bureau - Outreach Grant findings were shared at the annual meetings of the Kentucky Organization of Rural Health in Bowling Green, Kentucky and the Kentucky Organization of Nursing Leaders in Louisville, Kentucky. Early Heart Attack Care brochures were placed in primary care and specialty practice offices. Also the warning signs of a heart attack book marks were placed in churches, primary care and specialty practice offices. Magnets with signs and symptoms of a stroke were given away at speaking events and screening events. Magnets with signs and symptoms of a heart attack were also distributed at health screenings and speaking engagements. Early Heart Attack Care brochures were distributed at screenings as well. Stroke prevention and recognition education was provided in the community as part of the UK Stroke Affiliate Network effort to reduce mortality and morbidity related to CVD in south central Kentucky. The community education was all a component of the CHNA implementation plan.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	Community Health Education Self Help -------------------------------------- Fitness/Exercise - Fifty attendees participated in the "Get Moving" event at Millennium Park in conjunction with the Danville School System, Community Service Department, McDowell Wellness Center and Centre college staff leading a 10,000 step challenge (low turnout was due to inclement weather). Over nine hundred participants took part in the spring "Get Moving" challenge, with six hundred completing the program. Tobacco/Smoking Cessation - We saw a decrease in the number of individuals reporting tobacco use; 69 compared to 106 in FY 2016 and 55 in FY 2015. The decrease may be a continued effort at education locally and statewide, along with the state legislation to increase the tax on cigarettes by fifty cents. There is an increase in e-cigarette shops in the Boyle county and surrounding areas. Early research indicates that use of e-cigarettes or vapor devices do not decrease tobacco use but actually results in increased tobacco use due to the nicotine used in the devices. The statewide ordinance drafted by some of the agencies (FHK, SoAHEC, etc.) for consideration by the legislature during the 2016 session did not pass but there is a continued effort to push this ordinance through. Plans have been made by the health departments and SOAHEC for e-cigarettes and vapor products to be part of both the legislative proposal and public education due to the observation of increase use of these products, especially by the youth. Special emphasis on e-cigarette use was part of the Faith Community Nursing Symposium. Stress Management - Only 82 individuals were screened using the perceived stress scale compared to 212 individuals in 2016 because smaller sites were used to do the Heart Risk screenings. Sixteen percent of those screened were abnormal and appropriate referrals to either primary care providers or mental health care providers were made. The decision to increase the use of the perceived stress scale relates to the increased emphasis of the role of stress in mortality and morbidity of cardiovascular patients, especially women. All received information related to stress reduction strategies. This is consistent with the 2015-2017 strategic objective related to mental health in the EMRMC implementation plan. This was an added area of focus based upon the 2014 CHNA. Community Health Education Support Groups ------------------------------------------- Alzheimers - Ten Alzheimers Support Group meetings were facilitated by an advanced practice mental health nurse practitioner. The group serves both patients and care-givers/family. Given the incidence rate of stroke and the aging of the population it is anticipated the need for this service will continue to grow in this region. This is one of the strategies to address dementia, including Alzheimers disease based upon the 2014 CHNA and implementation plan. Community-Based Clinical Services-Health Screenings --------------------------------------------------- Blood Pressure Screening - Blood pressure screenings were offered at 18 sites (24 events), some more than once, and this does not include blood pressure screenings done by Faith Community Nurses in their own congregations; Five hundred ninety-nine individuals were served. This represents a decrease in blood pressure screening from the prior year when 855 individuals were served; this is due to the decrease in sites and screenings as a result of staff reductions. There was a five percent decrease of clients with a blood pressure reading that exceeded the recommended range by the American Heart Association (AHA): 83 percent in FY 2017 compared to 90 percent in 2016 and 83 percent in FY 2015. Those classified as pre-hypertensive received instructions for monitoring and recording as well as dietary instructions related to low sodium diet. Those that were on medications but exceed the recommend range were instructed to share the finding with their primary care provider (PCP). Those at stroke level were transported for immediate follow-up by a physician. Blood pressure control is a major factor in cardiovascular disease risk reduction. The intense focus on blood pressure monitoring, self-care education and follow-up continues. Blood pressure screening is one of the implementation strategies related to modifiable lifestyle related cardiovascular risk factors from the 2014 CHNA implementation plan. Cancer Colorectal Screening - During March the Ephraim McDowell Health Care Foundation (EMHCF) funded colorectal screenings at 24 additional sites for a total distribution of 207 kits with a 54% percent return rate; a 10% increase in return from 2016. Kits were distributed in six counties. Sites included churches, senior citizen centers, the wellness center, health departments, clinics, hospital lobbies, area businesses, cancer center, Hospice, local bank, and the county extension service offices. There was a 5.2% referral rate for follow-up. There have been radio and newspaper public service awareness campaigns related to colorectal cancer due to Kentucky rating number one in incidence and number 3 in deaths related to colon cancer. An additional 122 colorectal screening kits were distributed during the 64 screening events. This is one of the implementation strategies for early detection of cancer based upon the identified need in the 2014 CHNA. Cancer- Skin Screening - Skin screening by a licensed independent practitioner (LIP) was not done in FY 2017 because there was no LIP available to do the screening through Community Service. However, a LIP was available to do skin screening at the Ephraim McDowell Commonwealth Cancer Center cancer screening event. Twenty-two individuals participated in the screening by an LIP with no referrals. Sun safety education begins with the school-age children and continues across the life span and has been a consistent message and focus of the community service work plan since inception in 2008. This is one of the implementation strategies for early detection/prevention of cancer based upon the identified need in the 2014 CHNA. Cholesterol Testing - Total cholesterol was measured for 550 clients in five counties at 18 sites within health ministries and community settings with 36 percent of participants exceeding the recommend range as set by American Heart Association (AHA); this is a 5.5 percent increase compared to 30.5% in FY 2016 and 31% for 2015. This trend is consistent with the increase seen nationally. Within the lipid panel 42.7 percent of participants had one or more measure(s) outside the recommended range. Low Density Lipids being elevated was the leading cause, followed by elevated triglycerides. Effective FY 2013, with support from area pediatricians, the department began offering lipid screening for children age 12 and above, if accompanied by a parent. We have not seen a statistically significant number of participants in the pediatric age range. Lipid panel screening is one of the implementation strategies related to modifiable lifestyle related cardiovascular risk factors from the implementation plan based on the 2014 CHNA. This is part of both the stroke risk and myocardial risk reeducation strategy. Derma Scan for Sun Damage - EMHCF funded the purchase of the DermaView equipment for screening for sun damage in the region due to the increase in skin cancer and the agrarian lifestyle in the region. Only 70 individuals compared to 111 in FY 2016 and 160 in FY 2015 were screened for sun damage. This was due to a decrease in staffing resulting in a need to prioritize screening for stroke and heart risk. Sixty-five percent screened in FY 2017 compared to ninety-seven percent of participants in FY 2016 and 55% in FY 2015 were referred to their primary care provider for follow-up care. This is one of the implementation strategies for education, prevention and early detection of cancer based upon the identified need in the 2014 CHNA. Diabetes Screening - Blood glucose testing was conducted on 552 participants. Twenty percent exceeded the recommended range as set by the American Diabetes Association (ADA) compared to 21 percent in FY 2016 and 13 percent in FY 2015. This is consistent with the increase in type II diabetes nationwide with KY being one of the leading states in incidence of diabetes. No one was below the recommended range. Based upon the national incidence tread and the local tread in diabetes, A1C monitoring equipment was purchased with a grant that was submitted in FY 2015 and approved. Individuals at risk for diabetes or diagnosed with diabetes are now screened with the A1C machine as of FY 2016. One hundred and sixty individuals were screened and forty-eight percent were abnormal. Lifestyle change and diet education was provided.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	----------------------------- Glucose testing was offered to children age 12-18, if accompanied by a custodial parent. Again the number of pediatric participants was not statistically significant. This strategy is part of the CVD risk reduction implementation plan that was based on the 2014 CHNA. Nutrition/Obesity Screening - Height, weight, percent body fat, calculated body mass index (BMI) was offered at 18 sites in five counties with 516 adult participants. Seventy-five percent of the participants exceeded the recommend range; compared to eighty-seven percent in 2016 and seventy-four percent in 2015. Body Mass Index is a major contributor to CVD risk factors, some types of cancer and diabetes. This is consistent with the national trend and with Kentucky being one of the least healthy states. Eighty percent of life style change is implementation of the change; twenty percent is the knowledge. BMI was one of the modifiable life style changes identified as a strategy to reduce CVD risk and cancer risk from the CHNA. Stroke Screening - The American Stroke Association Stroke Risk Scorecard became the standard tool for screening for stroke risk within the department in fiscal year 2012. Stroke risk screening was conducted at 18 events in five counties involving 438 participants with an 18 percent referral rate; which reflects a two percent increase compared to an eight percent decrease in referrals in FY 2016. This is one of three screening tests that resulted in direct referral and transport to emergency care: the others include blood pressure in the stroke range, and extreme elevation of lab values. This is one of the strategies to reduce CVD risk outlined in the implementation plan for the CHNA. Community-Based Clinical Services-Immunizations ----------------------------------------------- Flu Shots - Flu shots were administered at 17 sites compared to ten in FY 2016 in Mercer, Lincoln, Boyle, Garrard, Madison, and Washington Counties to 554 individuals age 12 and above. Primary sites were churches and the stockyards. This represents a 30 percent increase in the number of immunizations. Community-Based Clinical Services-Non-billed/Reducedfee Clinic (Hospital Based) ------------------------------------------------------------------------ Hope Clinic & Pharmacy - Hope Clinic and Pharmacy provided service to 44 patients seen a total of 136 times. To qualify for Hope Clinic & Pharmacy an individual must have one or more of the following diagnoses: hypertension, diabetes, obesity, hyperlipidemia, heart failure, pneumonia or gastro esophageal reflux disease, be uninsured and with a household income between 139% -300% of the federal poverty level. All staff members are volunteers except the part-time LIP and part-time office manager. The clinic is managed by a community advisory board with members from the Boyle County Health Department, Danville Presbyterian Church, Ephraim McDowell Health Care Foundation, Ephraim McDowell Regional Medical Center, Heart of Kentucky United Way, and the Salvation Army. The clinic was started due to a community need by a collaboration of the key board members and is a department of EMRMC. The Affordable Care Act has made possible access to expanded Medicaid in Kentucky, resulting in many former Hope clients having insurance and access to both chronic and acute care. Blood Drive - Eighty units of blood were donated through blood drives at the health system in FY 2017 compared to 72 units in FY 2016. Individuals that are on duty are paid during the time they are involved in the donation process. Continuing Health Professions Education - The Director for Rehabilitation Services Department serves on the Federation of State Physical Therapy Board Meeting for the Commonwealth of Kentucky. This board meets monthly for two hours at an estimated organizational cost of $1,967. Issues of the profession were addressed including educational requirements, licensure, reimbursement, scope of service and professional practice standards. Interns, Residents and Fellows - Fiscal year 2017 there were neither interns nor Fellows at EMRMC. There were ten Emergency Service Residents from University of Kentucky. Medical Students - Sixteen medical students rotated through emergency services, anesthesia, Urology and pediatrics with EMRMC medical staff mentors. This represents a four hundred percent increase in the number of MD students. Students were from University of Kentucky and University of Louisville. Seventeen physician assistant (PA) students rotated through emergency and surgical services with a mentor. This represents a forty percent increase in the number of PA students. Affiliated programs included the University of Kentucky, University of the Cumberlands and Marietta College. Twenty-three advanced practice nurses (APRNs) rotated through emergency services or primary care clinics in FY 2017 with a LIP mentor. This represents a 4 percent decrease in the number of NP or APRN students. Schools included: University of Kentucky, Walden University, Indiana Wesleyan University, Eastern Kentucky University, Chamberlin College of Nursing, University of Cincinnati, and University of S. Alabama. Nursing - Four hundred and fifty-nine nursing students completed their clinical experience and/or practicum at EMRMC in FY 2017. Educational partners included Campbellsville University, Eastern Kentucky University, Midway College, Bluegrass Community & Technical College, Beckfield College, Breckenridge, St. Katherines, Western Kentucky University and Berea College. This represents a 20 percent decrease in nursing students, LPN, AD, and BSN. Other Allied Health Professions - The Certified Nursing Assistant Course had 9 students enrolled in 2017 compared to 17 in 2016 (50% decrease). This is similar to the decline seen in nursing student enrollment. EMRMC served as a clinical site for students from multiple disciplines from the following institutions: Bluegrass Community & Technical College Lexington and Somerset, Beckfield College, Berea College, Campbellsville University, Eastern Kentucky University, and Midway University. There was a decline in the number of allied health students in the following areas: speech therapy, occupational therapy, physical therapy assistants, and phlebotomy students. There was a twenty percent increase in the number of pharmacy students and an increase in the number of radiography, sonography, health information, med tech and phlebotomy students. One hundred eighty-nine area students had a job shadowing experience in 55 different areas of EMRMC in FY 2017. This reflects a twenty-three percent decrease in the number of students job shadowing within the organization. Community Health Research- Data collection and follow-up with HRSA Outreach Grant was completed in May of 2016 which is not in this fiscal year. Financial Donations for the Community In Kind ----------------------------------------------- Personnel/Administrative Support - An advanced practice nurse serves on the Mercer County Health Department Board. A staff member serves on the Foundation for Healthy Kentucky Board and subcommittees. The rehabilitation services director serves on the Physical Therapy Board. A staff member from the Foundation serves on the Rotary Board. This civic group works on both local and international projects to improve community life. Community Building Activities ----------------------------- Coalition Building - Heroin overdose and deaths in the service area have increased at an alarming rate. A mental health professional from Centre College has put together a broad community coalition to address the many facets of this public health issue. The emergency department nursing and medical directors have worked with this group. Community Health Improvement Advocacy - Community Service staff served on the board of the Foundation for Healthy Kentucky (FHK) and served on the executive, finance and ambassador committees in addition to their board membership advocating for improved access to care, better built environment and improved nutrition. FHK endowed chairs at the University of Kentucky and University of Louisville to focus on public health issues in rural Kentucky. Community Service staff served on the board of the Mercer County Health Department. Rehabilitation Services staff served on the Federation of State Physical Therapy Board. Workforce Development - The Southern Area Health Education Council is involved in the education of healthcare professionals in rural South-Central Kentucky and health policy.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	Community Benefit Operations ---------------------------- Community Health Needs Assessment - Professional Research Consultants of Omaha, Nebraska were engaged to conduct a scientifically valid six county CHNA for the system, including EMRMC, at a cost of $83,000. The confidence level is 95 percent from a sample of 902 area residents. A community focus group was convened for input from key informants from the six counties, with finding included in the report. The results were made available to the governing board in hard copy along with a summary presentation and implementation plan for 2018-2021. Once reviewed by the board, the report and implementation plan were posted on the website for public access. Select sharing was done upon request by community organizations and Centre College students. Dedicated Staff - There was a dedicated staff of two full time, two part time individuals and flex RNs and Technicians that work as needed within the community service department and are funded by the health system. The staff was comprised of a faith community nursing coordinator part of the year, and a part time project coordinator, all reporting to the System Director, Nursing Administration, Regulatory Compliance, Associate Education, and Community Services. Total salary expenses for dedicated community benefit staff were $166,998 for FY 2017; with the decrease reflecting the reduction in hours within the department. Community Services total expenses were $274,162. There was a part time nurse practitioner and office manager for the Hope Clinic. Salary expenses were $8,593 for FY 2017. The reporting structure is that all department functions report to the system director, share space and resources. The system director then reports to the Ephraim McDowell Health System CNO/COO who reports to the governing board with the annual work plan and budget approved by the governing board. In FY 2014, the new Community Health Needs Assessment and implementation plan were presented to the governing board for approval. In FY 2017 there were no revisions of the implementation plan requiring board action, just approval of the budget. In the spring of 2017 a new Community Health Needs Assessment and implementation plan was presented to the governing board for approval. The top priorities from the 2017 CHNA are: 1. Diabetes 2. Access to Healthcare Services 3. Cancer-Early Detection & Prevention 4. Cardiovascular Disease & Related Risk Factors 5. Nutrition, Physical Activity & Weight EMRMC staff volunteered in area churches and Childrens ministry programs within the service area that focused on spiritual development and well-being, approximately 800 children were served. Other services include volunteer faith community nurses serving within many of the local congregations. The result being blood pressure screening, coordination of care, referrals, and education related to health risk, medications, mental health, stroke risk education, and other issues. Others served in music ministry, visitation, or church based committees. Many served in youth sport leagues as volunteers, either coaching or raising funds. Others volunteered with the school system serving as room sponsors, boosters, PTA officers, mentoring students, or other needed functions. EMRMC Associates volunteered at the local festivals including, but not limited to: Octoberfest on Main, Kentucky State BBQ Festival, Great American Brass Band Festival, Soul on Second Street, Danvilles Lawn Chair Theatre, Apple Festival in Casey County, Beef Festival in Mercer County, Party on the Square in Garrard County, Forkland Heritage Festival and Revue, Battle of Perryville Commemoration, Cruise, Blues & Bar-B-Que, and Railroad Days. These hours were not paid hours, therefore not included in the community benefit calculations. Nevertheless, this investment of time and labor contributed significantly to the quality of life in the region impacting physical, mental, and economic well-being of the populace of the six county service areas. Deferred needs from the CHNA of Boyle and the surrounding counties based upon resources and/or expertise included the following: Arthritis/rheumatism is an issue. This links to the high obesity rate and the lack of a built environment that facilitates mobility. This issue is deferred by EMRMC due to resources but the factors to decrease cardiovascular (CV) risks will assist with mobility, i.e. weight reduction, improved nutrition, decreased inflammatory markers, etc. Both Lincoln and Garrard County Health Departments offer a self-help program for managing arthritis. Lincoln County has plans to expand the offering. The McDowell Wellness Center offers pool exercises for those with arthritis and silver sneakers as options to assist in managing both mobility and pain. There is a rheumatologist at the specialty clinic in Boyle County. The closest arthritis support group is in Lexington, Kentucky. Osteoporosis is addressed as a nutritional issue. This links with the high consumption of carbonated beverages and poor nutrition in the region. This is being deferred due to resources but is part of the farm to school dialogue in the school coalitions. Migraine headaches are treated by primary care physicians and referred as needed. A neurologist has been recruited to make access for evaluation and specialty care easier to access and closer to home. Twenty-five percent of the population suffers from chronic back pain or sciatica. There are pain centers in Boyle County. Chiropractic and physical therapy services are available in all six counties. Obesity, inactivity, and a diet high in fat and calories compound the issues related to arthritis, back and sciatica pain. Addiction to pain-killers and other drugs is an issue in the state and region. Addiction services are offered by private providers, Comprehensive Care, and Self-Refined in the region. EMRMC behavioral medicine unit does treat dual diagnosis patients and the psychiatrists and counselors treat out patients. There is an active Alcoholics Anonymous chapter. Celebrate Recovery is offered at various sites in the service area. Due to lack of expertise and resources, addiction will be deferred as part of the work plan by EMRMC. Chronic kidney disease and end stage renal failure links to diabetes. Moderate exercise, a healthier diet, and weight reduction can prevent the development of type 2 diabetes in persons at risk (Diabetes Prevention Program funded by NIH). The free screenings will provide early detection and possibly prevention when addressing nutrition, body mass index and exercise. The health departments collaborate with the kidney foundation to conduct screening and education related to kidney health. Disabilities and activity limitations correlates with the poverty of resources. Those with a disability report not getting preventative care, i.e., annual dental visit, mammogram, pap smear, additional findings include lifestyle issues, such as use of tobacco and inactive lifestyles, health issues such as obesity, high blood pressure, high stress and poor mental health, lower employment rates, lower income, and less social support. The screening for obesity, diabetes, high blood pressure, tobacco use, high cholesterol and the risk factor reduction education for adults provides early detection and can be preventative. For those individuals with one of the chronic diseases the RN consult can improve self-care health management. Dementia links to CV health and stroke incidence and vascular issues. It also links to the aging of the population in the region. There is an Alzheimers support group in Boyle and Mercer Counties. Also, mental evaluation and medication management is available by a psychiatrist at the medical center. James B. Haggin Hospital offers adult day care that serves some clients. Danville Health & Rehabilitation Center as well as Morning Point has an Alzheimers long term care unit. The Sanders Brown Center at the University of Kentucky has on-going Alzheimers related research and serves as a referral center for the region.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	-------------------------------------- Births to teenagers and unwed mothers, and low birth-weight births are being addressed by the health departments and the school health collations. The Lincoln County Health Department has a 5-year grant to address self-esteem and character building in 6th grade through middle school. The Lincoln and Boyle County school nurses conduct the Perkins Assessment in middle school through high school as part of the effort to help youth make fewer high risk behavior choices. Both school systems have contracts with the University of Kentucky for the services of an adolescent medicine specialist for on-site services. The Haven Care Center provides pregnancy resources and supports all six counties. Fair/poor mental health and major depression was cited by the county residents as a major issue. The health system does have mental health providers on their recruitment plan. Community Service does conduct depression screening for adults and refer if needed. Community Service staff no longer assist school nurses to conduct the Perkins Assessment in the school systems due to staff reductions. No leisure time physical activity, not meeting physical activity guidelines, links to the lack of built environment biking & walking paths/trails in a large rural environment. Boyle County has ongoing dialogue about the need for a biking/walking path to connect the county both for health and economic reasons. In 2015 the Boyle County Fiscal Court approved expansion of the walking trail/biking paths project and this project has continued into 2016 and 2017. There is no public transportation system to make it easy to access a central gym/wellness faculty for families living in the counties. The Stanford Rotary Club talked about the need for a Wellness Center in Stanford for access by the community and the youth after school. The Lincoln County Fiscal Court is funding a walking track in Lincoln County. Chronic lung/respiratory disease is being addressed with tobacco education, stop smoking classes at the health departments, pulmonary rehab at the Wellness Center in Danville and through public policy. The Community Service department screens for tobacco use at all venues and refers clients to the health departments. The health department offers Freedom from Smoking classes to help residents stop smoking. The health departments also conduct tobacco education in the school systems. Respiratory disease has a genetic, environmental and a cultural component in the six county regions. The exposure to tobacco smoke, agrichemicals, dust and pollen all contribute to asthma and chronic lower respiratory disease. The health departments address smoking cessation. The extension offices address safe handling of agrichemicals. The school health nurses are addressing childhood asthma. Asthma care was a high priority in the Lincoln County School Health Index. Lincoln County School System reflects improved attendance. Community Service screens for tobacco use and makes referrals to the county health department and the QUIT Line at all screening events. Community Service screens for obesity using a calculated BMI for both children and adults. Upon request education is provided for the class regarding how to impact BMI by nutrition, exercise and sleep. Model legislation was drafted and sent to the legislator in Frankfort by AHEC with EMRMC staff serving on that board and input from the county health departments. In the areas of infectious disease the county health departments will continue to address HIV education and testing. Hepatitis C vaccine is available at the health departments. EMRMC will defer due to resource allocation both personnel and time. Injury and violence education is in the health departments, county extension offices, school resource centers, family court, and law enforcement in all counties. EMRMC and EMFLH offer the services of a SANE nurse for rape victims. The rape crisis center serves the region. EMRMC will defer focus on injury and violence at this time due to other agencies covering all aspects, having greater expertise and departmental resource limitations. Nasal/hay fever/allergies are treated symptomatically by the primary care providers and referred to the specialist in Boyle County, as needed. Air quality issues are a topic of public dialogue. Pollen counts are high in the Bluegrass Region so reporting of high pollen counts and recommended precautions are part of the regional news and public service announcements. Oral health including regular dental care and dental insurance is a regional issue. The UK mobile dental unit comes to area schools to assist in meeting this need. There is a lack of providers that accept Medicaid for dental services. This is an issue that is being addressed by the school health collations but is being deferred by EMRMC due to resource limitations and lack of expertise. Through the UK Heart Health Research Project 2010-2012 Community Services did contribute to the scientific knowledge related to the correlation between dental health and modifiable CV risk factors. Vision issues link to the aging population, uncontrolled hypertension, and uncontrolled diabetes. Screening for hypertension, diabetes and referring as needed is part of the risk reduction for CVD that also helps with vision care and prevention of blindness. The Lions Club assists with some eye exams and glasses for at risk residents. Work plan initiatives in 2017 based upon the 2014 CHNA by Professional Research Consultants included: 1. Continue focus on CVD, cancer and obesity due to resource limitations and proven impact 2. Extend focus to the six county areas based upon need 3. Continue to work in partnership with the community 4. Extend the stroke risk screening to children age 12 and above when custodial parent/guardian is present 5. Conduct RN consult for the family group when children are involved 6. Extend flu vaccine to age 12 and above when custodial parent/guardian is present. 7. Participate in the University of Kentucky Stroke Network 8. Implement the community education and early heart attack care (EHAC) evidence based standards from the Society of Cardiovascular Patient Care related chest pain 9. Continue Alzheimers Support group and referrals 10. Early identification of care needs and patient safety resulting in reduced school age suicides in partnership with the school systems data not yet available. This project continues now, led primarily by the school systems due to staff turnover. 11. Reduce trauma and related fatalities due to lack of seat belt use data not yet available In FY 2017, Ephraim McDowell Regional Medical Center invested $11,134,002 in community benefit including financial assistance and means-tested programs. The financial investment was above and beyond the hours of volunteer time in leadership roles by EMRMC staff to improve health, education, environment, economic development and legislative endeavors within the community, state and at the national level.
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:14736824
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:6677777

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