2016-10-21T14:07:15-05:00 2015-12-31 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2015-01-01 350895832 The Bethany Circle of King's Daughters' of Madison Indiana Inc BETH 8128010800 PO Box 447 Madison IN 47250 PAULA HEIDERMAN Board Chairwoman 8128010800 2016-10-21 1 Carrie A Merrill CPA P00832283 3176334705 2016-09-20 2015 2017-02-10 21:41:12Z King's Daughters' Health John Price PO Box 447 Madison IN 47250 151075692 0 X www.kdhmadison.org X 1899 IN To improve the health of the hospital's patients through care, service, and education. 11 9 1147 115 16894 -8965 66466 568158 116873806 132837067 3082095 2407230 2338156 735637 122360523 136548092 19566 43737 0 0 62334347 62858895 0 0 0 55677874 58362666 118031787 121265298 4328736 15282794 241257319 248968944 114823185 110636308 126434134 138332636 The mission of the hospital is to improve the health of the hospital's patients through care, service, and education. 0 0 101694158 43737 133041877 KING'S DAUGHTERS' HEALTH IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL OWNED BY THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON, INDIANA, INC., LOCATED IN MADISON, INDIANA. THE HOSPITAL IS ORGANIZED FOR THE PURPOSE OF PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.DURING THE CALENDAR YEAR 2015, THE HOSPITAL PROVIDED HEALTHCARE TO PATIENTS AT THE FOLLOWING LEVELS:12,467 DAYS OF CARE TO ACUTE INPATIENTS1,190 DAYS OF CARE TO NEWBORN INFANTS200,503 VISITS ASSOCIATED WITH HOSPITAL OUTPATIENTS131,061 VISITS ASSOCIATED WITH PHYSICIAN CLINICS 2129004 THE HOSPITAL'S PRIMARY SOURCES OF SUPPORT ARE FROM PATIENT REVENUES. PATIENT REVENUES INCLUDE FUNDS RECEIVED FROM MEDICARE, STATE AGENCIES, INSURANCE COMPANIES, AND THE PATIENTS THEMSELVES. IN 2015, THE KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES PROVIDED SERVICES TOTALING $2,129,004 IN GROSS CHARGES TO PATIENTS WHO MET THE HOSPITAL'S CHARITY CARE POLICY. 103823162 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 59 0 1 1147 1 1 1 0 0 0 0 1 1 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X DAWN NUNAN DIRECTOR OF ACCOUNTING 8128010800 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 PAULA HEIDERMAN Board Chairwoman 1.00 1.00 X X 1750 0 0 MARJORIE HARE Board Vice Chairwoman 1.00 1.00 X X 1250 0 0 PAM KIMMEL Board Secretary 1.00 1.00 X X 500 0 0 MARY BETTE VOYLES Assn't Secretary (Jan-May '15) & Board Treasurer 1.00 1.00 X X 1250 0 0 Bonnie Colen Board Assn't Secretary (6.1.15-12.31.15) 1.00 0.00 X X 500 0 0 ANDREA FORRESTER Board Assn't Treasurer 1.00 1.00 X X 500 0 0 LINDA SLOFFER Board Treasurer (1.1.15-5.1.15) 1.00 1.00 X X 500 0 0 JONATHAN HANSON MD BOARD MEMBER/PHYSIcian 40.00 0.00 X 389635 0 42269 PAT STACK MD Board Member/Physician 40.00 0.00 X 237323 0 37636 JOE CRAIG Board Member 1.00 0.00 X 500 0 0 Mary Kay McCubbin Board Member 1.00 0.00 X 750 0 0 KEVIN TURNER Board member 1.00 0.00 X 500 0 0 CAROL DOZIER PRESIDENT/CEO 40.00 1.00 X 349564 0 14552 Steve Meacham VP Finance 40.00 0.00 X 198745 0 48912 Lisa Morgan VP Patient Services 40.00 0.00 X 148754 0 51727 Denine Fallis-Hallgarth VP Physician Practices 40.00 0.00 X 130738 0 36411 HOLLY ROBINSON MD VP QUALITY / Physician 40.00 0.00 X 270137 0 51070 Thomas Eckert MD Employed Physician 40.00 1.00 X 743243 0 31624 Travis Clegg MD Employed Physician 40.00 0.00 X 1698001 0 42171 William Skiles MD Employed Physician 40.00 0.00 X 649238 0 28379 Michael Schmidt MD Employed Physician 40.00 0.00 X 664430 0 44451 George Alcorn MD EMployed Physician 40.00 0.00 X 606498 0 22366 6094306 0 451568 65 0 1 0 MEDASSETS INC PO Box 405652 Atlanta GA 303845652 Revenue Cycle Consulting Services & Soft 1503982 WEHR CONSTRUCTORS INC 2517 Plantside Drive Louisville KY 40299 Contractor services for the construction 1176622 Comprehensive Medical Management 300 Dave Cowens Drive Ste 600 Newport KY 41071 Contracted Physician Billing Services 926536 MAYO COLLABORATIVE SERVICES INC PO Box 9146 Minneapolis MN 554809146 Laboratory Services 779274 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Contracted Physician and Mid Level Provi 638562 31 500000 52062 16096 568158 Net Patient Service Revenue 621110 132837067 132820173 16894 132837067 1818718 1818718 95151 15525 79626 79626 79626 15100587 14501196 10879 599391 -10879 588512 588512 Cafeteria Revenue 722210 332066 332066 Gift Shop 453220 181867 181867 Other 621110 105528 105528 36550 36550 656011 136548092 133041877 16894 2921163 18830 18830 24907 24907 2015474 1725579 289895 48585014 40838189 7746825 1702855 1457926 244929 7408195 6342641 1065554 3147357 2694658 452699 249715 249715 1220446 1220446 291866 291866 169376 145014 24362 1984519 1699077 285442 368509 315505 53004 1743815 1492994 250821 127120 108836 18284 5445574 4662312 783262 12554036 10748332 1805704 1478716 1266026 212690 Drugs 8386368 8386368 Purchased Services 8272105 7082291 1189814 Supplies 7597159 6504425 1092734 Hospital Assessment Fee 1586599 1586599 6886743 6722653 164090 121265298 103823162 17442136 0 18557562 16615294 12046508 12214616 54039 2653683 2942043 2667423 2580826 996157 1448508 186952282 61995327 133636096 124956955 63987854 84030981 6657997 4179721 241257319 248968944 12650373 11528709 98015768 96691235 969093 644324 3187951 1772040 114823185 110636308 X 126404076 138304381 20058 18255 10000 10000 126434134 138332636 241257319 248968944 X 15282794 -3565465 181173 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7537 7537 0 Part II-B, Line 1: Portion of Indiana Hospital Association dues and American Hospital Association dues attributable to lobbying expenses as disclosed on the dues notices of the respective associations. 30058 506513 508316 28255 208725 50077 228744 30058 196716 48484 36475 208725 129738 86924 19946 196716 137154 40020 47436 129738 0.00000 0.35390 0.64610 0 0 4937784 4937784 119123429 22584024 96539405 62831096 39411303 23419793 59973 59973 124956955 Deferred Compensation 59556 Third party payable 765000 Life Insurance Policies 947484 1772040 X 132829994 -3565465 171146 -3394319 136224313 291866 31913 323779 136548092 120931492 -10027 -10027 120941519 291866 31913 323779 121265298 Part V, Line 4: PERMANENT ENDOWMENT - INTENT IS TO HOLD THE INVESTMENT IN PERPETUITY. PER AUDITED FINANCIAL STATEMENTS, "THE PORTION OF PERPETUAL ENDOWMENT FUNDS THAT IS REQUIRED TO BE RETAINED PERMANENTLY EITHER BY EXPLICIT DONOR STIPULATION OR UPMIFA" IS $10,000 AT 12/31/2015. TERM ENDOWMENT - TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE INCLUDING: PRENATAL/POSTNATAL EDUCATION PROGRAM FUND, TEEN EVENT FUND, MAY LIBRARY FUND, FIT KIDS FUND, National Nurses week Fund, Patient Scales Fund, nicotine replacement therapy fund, and coalition against substance abuse fund. Part X, Line 2: Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Hospital and recognize a tax liability if the Hospital has taken an uncertain tax position that more likely than not would not be sustained upon examination by various federal and state taxing authorities. Management has analyzed the tax positions taken by the Hospital, and has concluded that as of December 31, 2015 and 2014, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the accompanying consolidated financial statements. The Hospital is subject to routine audits by taxing jurisdictions; however, as of the date the financial statements were issued, there were no audits for any tax periods in progress. Part XI, Line 2d - Other Adjustments: Rental Expenses -10,026. change in subscriber savings cumulative account 181,172. Part XI, Line 4b - Other Adjustments: Grants 31,913. Part XII, Line 2d - Other Adjustments: Rental Expenses -10,026. Rounding -1. Part XII, Line 4b - Other Adjustments: Grants 31,913. 1 1 1 1 1 1 0 1 1 698544 698544 0.00580 18690513 15812567 2877946 0.02370 19389057 15812567 3576490 0.02950 1263 184364 54352 130012 0.00110 79 204554 36550 168004 0.00140 4792 4333841 3675463 658378 0.00540 42763 42763 0.00040 6134 4765522 3766365 999157 0.00830 6134 24154579 19578932 4575647 0.03780 80 208 208 0.00000 937 149920 149920 0.00120 1 113 113 0.00000 1018 150241 150241 0.00120 0 12702335 0 25681631 26100685 -419054 X 1 1 1 1 KING'S DAUGHTERS' HEALTH 1373 East State Road 62 PO Box 447 Madison IN 47250 www.kdhmadison.org 15-005063-1 X X X KING'S DAUGHTERS' HEALTH 1 0 0 1 X X X X X X X X X X 13 1 0 0 1 X www.kdhmadison.org/about_needsAssessment.aspx X X 1 13 1 www.kdhmadison.org/about_needsAssessment.aspx 0 0 1 X X X X X 1 1 X X X 1 X http://www.kdhmadison.org/patients_financial.aspx X HTTP://WWW.KDHMADISON.ORG/PATIENTS_FINANCIAL.ASPX X http://www.kdhmadison.org/patients_financial.aspx X X X X X 1 X 0 X X X 1 X 0 0 KING'S DAUGHTERS' HEALTH Part V, Section B, Line 3j: The Needs Assessment Performed by the Hospital also explored key issues such as: Physical Activity, overweight and obesity, tobacco use, substance abuse/gambling/addictions, responsible sexual behavior, mental health, injury and violence (including domestic violence and sexual assault), environmental quality, immunization, access to health care for the insured and uninsured, maternal and child health, infectious disease, occupational and safety health, special needs/disabled/impaired, and chronic disease. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 5: The Facility took into account input from persons in the community by utilizing the following components:- Analysis of secondary data to develop a profile of the residents of each county and to indicate, where possible future trends and to show comparisons with state and national data;- In-person interviews with 30 key leaders within KDH including Board, staff and medical staff;- In-depth-interviews by telephone or in-person with 44 community leaders including government, medical, education, and other community leadership positions in all five counties;- In-person surveys of 72 individuals in low income locations;- In-person discussions with 19 senior citizens;- A web-based survey open to the general public which resulted in 184 completed interviews. This assessment allowed all individuals to provide responses on any community needs not listed in the questions and allowed individuals to make comments on community health issues on which KDH could have an impact. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 7d: Results of the Needs Assessment have been made available through a variety of sources: Newspaper and Radio Releases, Distribution of information in the Community Newsletter, The Vital Signs, through Public Health Forums. It is also available on our website @www.kdhmadison.org/about_needsAssessment.aspx. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 11: After review of the community health needs assessment conducted in 2013, a small committee of interested individuals was invited to participate in meetings to determine ways we can work together to better meet the needs of the communities we serve. This small group included participation from the Jefferson County Health Department, our state grant for Tobacco Prevention and our KDH Community Relations participants. Among this group was input from other parties, and an interested Volunteer Medical Student. The needs assessment findings, and the implementation strategy, were shared with the Board of Managers and all action plan items will be incorporated into the working Strategic Plan for the organization.KDH Gaps: There do not appear to be large gaps in the topics or types of community outreach programs that KDH has conducted in the past. However, there may be gaps due to funding levels or staffing levels in the number of programs and the geographic reach of the programs that have been offered. KDH will use the list of major health issues in which KDH is expected to have a leadership and supporting role as well as the list of specific topics suggested to develop programs and apply for grants to improve health in the communities it serves.Implementation Strategy 2013-2016Obesity, Lack of Physical Activity and Smoking leading to Chronic Disease: Several of the top major community health concerns involve addressing the frequently inter-related issues of obesity, lack of physical activity, and smoking. These health issues lead to chronic disease, such as stroke where the death rate in Jefferson County is nearly double the nation's death rate, and have an impact on patients served by KDH facilities. The majority of community leaders expect KDH to take a leadership role in addressing overweight and obesity and tobacco use. Those in outlying counties have asked that KDH programs available in Jefferson County be offered in their own counties or at a minimum that the Jefferson County programs be promoted to citizens in these other counties for their potential attendance. Action Plan: Leadership RoleOffer onsite and community based outreach events to improve patient and community education on prevention and management of chronic diseases. Target: At risk populations based on lifestyle, and those with chronic diseases. Evaluation: Number of events offered, Number of participants. Number of outreach efforts in outlying counties and / or promotion of such efforts.2015 UpdateIn 2015 KDH participated in nine community health fairs and screens where education information about healthy lifestyle were distributed. Education included tools on exercise, healthy eating, healthy weight loss, and disease prevention including tobacco cessation. The Wellness Coordinator and Tobacco Educator provided a combined 23 speaking engagements to community groups in 2015 with health education messages. In addition the tobacco educator provided outreach services to area businesses, schools, and physician offices. To lower smoking rates, free nicotine replacement products and cessation counseling were also available to community members when requested. The 7-week 2015 KDH Fit Kids program reached 249 students in six area schools. This 5th grade program, which centers on childhood obesity, offers lessons on healthy eating and physical activity. In addition, KDH serves as a Girls on the Run Council. This is a 10-week character-development program that uses the power of running for 3rd-5th grade girls to promote exercise and teach healthy lifestyle concepts. KDH holds a community Girls on the Run 5K event and a community Run the Falls 5K Run/Walk. These two fitness opportunities brought in over 400 participants in 2015. The Speaking of Women's Health program offered both an exercise and nutrition breakout session at the 2015 event and 7 of the 12 House of Health events provided education on healthy lifestyles and behaviors to lower chronic disease risk. In 2015 a new healthy weight loss class, titled Strive for 5, was offered to the community.Employee Wellness: KDH should consider ways in which it can set an example at its own facilities for the community; an expanded and enforced tobacco-free campus, healthy food offerings in its cafeteria and vending machines, a wellness program which focuses on all employees including those at satellite offices. Action Plan: Leadership RoleImprove opportunities for our own staff to access healthy activities and offerings. Offer insurance-based incentives for a variety of healthy choices. (Ex: Non Smoking Family Plans) Expand and improve healthy eating options in the hospital cafe. Target: KDH Employees. Evaluation: Number of events / options offered, number of employees participating.2015 UpdateThe KDH Employee Wellness program continued in 2015. A free health screen, which includes a financial incentive for achieving set biometric parameters, was offered for all employees. During the year three health incentive challenges were offered to staff. Four on-site classes were held, including a new weight loss education class. Healthy emails and newsletters were also sent to all employees. A 30-day walking campaign was offered in 2015. In addition, tobacco free employees have an opportunity for a reduced health insurance premium and cessation assistance is available for all staff and their family members. KDH supports a tobacco free campus policy for all facilities. KDH recognized the Great American Smokeout campaign and the Wear Red for Women campaign. The employee cafeteria continues to introduce new healthy food and beverage options for employees in the cafeteria. Vending machines continue to meet heart healthy option standards.Substance Abuse: Substance Abuse - particularly narcotic (primarily heroin), methamphetamine, and prescription drugs, was one of the top major health needs cited by all groups interviewed. It is prevalent in all counties served by KDH. - The lack of substance treatment centers and mental care facilities to refer these types of patients to is a major concern. - Many interviewed felt the public needs to be aware of how much of an issue substance abuse is in the community i.e. amount of babies born addicted to meth/heroin and the detoxification required. - The need for further drug education in the schools from elementary on up was mentioned numerous times - Better communication between KDH and the local legal system is needed. Documentation of overdose cases in the ER with statistics of the types of drugs causing the overdose (street versus prescription) is the type of information helpful to the legal system. KDH physicians mentioned that they would like to know from the legal system when one of the drugs they prescribed is involved in a case. - There is a need for a quarterly prescription drug disposal program where such drugs can be disposed with no questions asked. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 13h: The Hospital's financial assistance policy changed midyear 2015. It detailed eligibility criteria for free or discounted care based on the following guidelines.Free Care: - From January to May 2015, the FPG family income limit for eligibility for free care was 200% - From June to December 2015, the FPG family income limit for eligibility for free care was 150%Discounted Care: - From January to May 2015, all uninsured patients received an automatic 20% discount from gross charges. - From June to December 2015, all uninsured patients received an automatic 30% discount from gross charges. For the outstanding balance due after applying the 30% discount, they could further qualify for additional discounted care using the FPG family income limit for eligibility of 250%. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 16i: At the time of registration, the Hospital's financial assistance policy is discussed with each patient. The patient is provided a pamphlet regarding the policy, eligibility requirements and the associated application process. The patient must sign a form indicating that he/she received this information. The hospital also has a representative on site to assist patients with the financial aid application process. Patients are reminded to contact customer service regarding financial aid and federal/state assistance directly on the patient bill itself. The hospital's website has a link to the financial aid application. In addition to the actions previously listed, a financial aid counselor will meet with any uninsured inpatient prior to discharge to discuss the Hospital's financial assistance policy. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 20e: At the time of registration, the Hospital's financial assistance policy is discussed with each patient. The patient is provided a pamphlet regarding the policy, eligibility requirements and the associated application process. The patient must sign a form indicating that he/she received this information. The hospital also has a representative on site to assist patients with the financial aid application process. Patients are reminded to contact customer service regarding financial aid and federal/state assistance directly on the patient bill itself. The hospital's website has a link to the financial aid application. In addition to the actions previously listed, a financial aid counselor will meet with any uninsured inpatient prior to discharge to discuss the Hospital's financial assistance policy. KING'S DAUGHTERS' HEALTH Part V, Section B, Line 22d: THE HOSPITAL CHANGED ITS POLICY MIDYEAR 2015. FROM JANUARYMAY 2015, ALL UNINSURED PATIENTS RECEIVED AN AUTOMATIC 20% DISCOUNT FROM GROSS CHARGES. FROM JUNEDECEMBER 2015, ALL UNINSURED PATIENTS RECEIVED AN AUTOMATIC 30% DISCOUNT FROM GROSS CHARGES. AT REGISTRATION, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEY ARE PROVIDED PAMPHLETS DETAILING THE PROGRAM. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE A DISCOUNT OF 100% ON THE OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL ATTEMPT TO COLLECT ANY BALANCE REMAINING ON THE UNINSURED ACCOUNT AFTER ALL FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED USING A SERIES OF STATEMENTS, LETTERS, AND TELEPHONE CALLS. THE HOSPITAL WILL ALSO OFFER PATIENTS INTERESTFREE EXTENDED PAYMENT PLANS. IF THE ACCOUNT REMAINS UNPAID, THE ACCOUNT MAY BE TURNED OVER TO A COLLECTION AGENCY. Part V, Section B, Line 11 Continued Action Plan: Supportive RoleContinue to work closely with local Coalitions Against Substance Abuse and the Health Department to implement workable solutions to the above mentioned problems. Develop and assist in implementing a plan of action. Also, continue to intervene with pregnant women during pregnancy and delivery. Target: CASA in Jefferson County and SCAT in Switzerland County. Work with the Health Department to get physicians and law enforcement in the same room to develop an action plan. Evaluation: Number of meetings attended / number of action plans developed with these organizations. Number of documented substance abuse cases on OB/GYN.2015 UpdateWe continue to work closely with the Jefferson and Switzerland County Coalitions Against Substance Abuse. KDH is represented at meetings and continues to attend other outreach efforts. The OB offices address the problem with their prenatal care. Unfortunately the ORCHARD program was not successful, with no attendance from using mothers. Mothers are now being referred to the Norton Inpatient Detox Program if intrauterine drug exposure is identified. We are in the process of trying to track the number of Umbilical Cord Screens in suspicious cases that are returned positive for drug exposure. We are working closely with Child Protective Services. Preparation visits continue prior to delivery. If the Mother is using certain medications, such as Subutex or Methadone, or Seboxon, babies remain hospitalized a minimum of 72 to 96 hours to ensure the health of the baby. If scores are too high, they are treated longer as an inpatient. Follow up is also done by our Home Health agency in cases of active withdrawal.Supporting data: Due to the changes in the coding process from ICD9 codes to ICD10 coding we are no longer able to track admissions to the ER in the same way. Data reflected here is partial, and can be seen to show a definite increase, or upward trend.ER Admissions for Drug Abuse / Drug Dependency / Drug Overdose 2014 ; 2015 (1-15 through 9-15):Switzerland County 0 ; 237Jefferson County 2,430 ; 2,602Trimble County 224 ; 255Neonatal Abstinence Syndrome Births:2014: 102015 (9 months): 13Mental Health Issues:While KDH may not be expected to take a leadership role in addressing mental health issues, it cannot ignore the need for mental health services in all the counties it serves. Many interviewed mentioned the need for expanding TeleMed as a mental health resource, recruiting an on-staff psychiatrist or an improved referral program for those with mental illness. KDH leaders interviewed stressed the hours of staff time that is currently spent finding facilities to refer patients to with open beds. This issue is worth further study by KDH to determine what supporting role it can provide to the community in this area. Action Plan: Supportive RoleKDH will continue to explore ways to collaborate with local agencies to improve access to mental health resources. Improvement in other risk factor areas, such as lack of physical activity will affect mental health as well as other risk factors. Target: KDH Patients in need of mental health services. Evaluation: Number of referrals for mental health Services/Number of providers KDH is able to access.2015 UpdateIn 2015, KDH made a total of 1,604 referrals. This data is probably more accurate as an effort to obtain more accurate data is in place. Our Pediatric Service Coordinator completed 26 mental health referrals from the outpatient OB office. ED providers began managing an increasing number of mental health patients via tele-assessment resulting in inpatient mental health transfers and outpatient referrals without involving Social Services. Emergency department documentation is narrative and would not be captured by data pulled from our Information Technology department.Transportation: The lack of transportation was cited numerous times as a health issue particularly for those of lower income. Catch-a-Ride and Medi-cab are well utilized in the KDH service area, but they do not operate after 5 p.m. nor do they run on weekends. For some, the fee associated for the service is costprohibitive. KDH may want to consider offering alternative transportation and/or explore offering preventative health screenings such as blood pressure, glucose etc. at events where those of lower income may gather such as the Salvation Army End of the Month Meal, the distribution at the House of Hope Food Pantry, etc. Action Plan: Supportive RoleDevelop a series of classes and screens to be offered in low income areas. To take services to those in need, who are unable to come to KDH. Target: Low income populations as identified through the House of Hope and / or the Salvation Army. Evaluation: Number of classes and screens held / Number of individuals participating.2015 UpdateThe House of Health program, which was developed half way through the 2014 calendar year, continued as a monthly program in 2015. This program is held at the Jefferson County Clearinghouse House of Hope food pantry. Each month featured a new health topic targeting a low income population and a free blood pressure screening was provided during two months. Attendance ranged from 35-80 participants each month.Awareness of Services and Programs: Some individuals also expressed the idea that residents in the community served by KDH may not be aware of the existing programs and services offered and may not be aware of the level of expertise of the staff. These are ideas that could be addressed in a strategic, well-planned, long-term public relations campaign. Action Plan: Leadership RoleDevelop and implement a public relations campaign to let people know of services and outreach through KDH. Target: Individuals in the KDH Primary Market. Evaluation: Number of promotional pieces and marketing activities geared toward the community to improve knowledge and education of outreach screens / classes / programs.2015 UpdateCommunity People, Quality Care - We continued to use this theme as our tagline and branding line on print, web, and audio marketing materials. It reflects who we are (Community People) and our mission (to provide Quality Care).Cancer Treatment Center - We opened our new Cancer Treatment Center in February.Marketing efforts included: development of a microsite (mini-website: www.kdhcancercare.org) to integrate with our current site. Further efforts included a print campaign for both PSA and SSA markets, focusing on the new technology, space, and staff. Print ads featured our staff members and their connection to cancer care. We launched several new videos that featured our staff and team members talking about what they do. We produced several radio spots using team members talking about why they chose cancer care. Staff members were also included on To Your Health programs and a feature in the Vital Signs Magazine. We had electronic banners on various websites including the Madison Courier, WIKI, and WKMNews.Carrollton Campaign - To increase awareness of Dr. Bessinger at the Carrollton office, we launched a multi-month campaign using targeted markets that focused on Dr. Bessinger and her team at the Carrollton Medical Building. In addition to family care, we promoted her OB services and pediatrics. Our purpose was to try and increase her patient base while also attracting new OB patients from the Carrollton area, along with new pediatric patients.New Providers / Physicians - Campaigns included the arrival of Dr. Patrick Matthiessen(Neurology), Sarah Hartman (NP-Family Practice), Dr. William Porter (Radiation Oncology), and Dr. Ronald Auer (Orthopedics). We also targeted a print, radio, and magazine campaign, along with web banners, to introduce our new Patient Access Line - a tool implemented to help us manage and engage potential new patients.Neurology - Two-month campaign featured the arrival of Dr. Patrick Matthiessen. He was also featured in the Vital Signs magazine. We promoted Neurology services via print, radio, social media, web banners, and a new Neurology section of the website. We also created a new physician pamphlet about Dr. Matthiessen for all physician office locations and integrated his concepts and programs into our Rehab/Therapy information (print/web). PART V, SECTION B, LINE 11 CONTINUED INTRODUCTION OF SEO - IN MARCH, WE BEGAN WORKING WITH LINK MEDIA 360 ON SEARCH ENGINE OPTIMIZATION (SEO). THE GOAL OF THIS PROGRAM WAS TO IMPROVE ONLINE SEARCH RESULTS IN THREE KEY AREAS - ORTHOPEDICS/JOINTS, CANCER TREATMENT CENTER, AND MOTHER-BABY. WE ALSO TRIALED A THREE-MONTH CAMPAIGN USING TARGETED FACEBOOK ADVERTISING SPECIFIC TO THESE THREE SERVICE LINES. DATA (ROI) SUGGESTED THAT WE MADE NUMEROUS IMPRESSIONS, ALTHOUGH ACTUAL RESPONSE (PHONE CALLS) WAS LOW. WE UNDERSTOOD THAT TO BE COMMON AND BELIEVE THE CAMPAIGN ITSELF, IN TERMS OF AWARENESS, WAS A SUCCESS. WE CONTINUE TO SEE GROWTH IN WEBSITE USAGE AND ACTIVITY BASED ON OUR SEO EFFORTS AND THROUGH THE INTEGRATION OF A NEW LOCATIONS SECTION OF THE WEBSITE THAT FOCUSED ON THOSE SEO EFFORTS AND GOOGLE-PLUS PAGES.PROMOTION OF SCREENINGS/EVENTS - THESE INCLUDED OUR LUNG CANCER SCREENING AND NAVIGATIONAL BRONCHOSCOPY, RUN THE FALLS 5K, DIRECT ACCESS TESTING, SPEAKING OF WOMEN'S HEALTH, HEALTH INSURANCE EXCHANGE PROGRAMS/NAVIGATORS (BUSINESS OFFICE FOR INSURANCE SETUP), DOCTOR'S DAY.VEVAY CAMPAIGN - WE FEATURED A THREE-MONTH CAMPAIGN IN VEVAY TO IMPROVE THE VISIBILITY OF OUR VEVAY OFFICE, INCLUDING DR. SCOTT FREDE AND RESOURCES SUCH AS MEDICAL IMAGING AND REHAB/THERAPY SERVICES. WE INTEGRATED PHOTOS OF THE STAFF IN PRINT ADS IN THE LOCAL PAPER AND RIVER TIMES, ALONG WITH RADIO ADS ON THE LOCAL STATION (FROGGY 95.9 FM).ORTHOPEDICS - WE CONTINUED TO FEATURE THE JOINT REPLACEMENT PROGRAM AND ORTHOPEDICS VIA WEB, SOCIAL MARKETING, AND THE VITAL SIGNS MAGAZINE. THIS INCLUDED THE ARRIVAL OF DR. RONALD AUER, A NEW MEMBER OF THE TEAM.MYKDH PORTAL - TO FURTHER FACILITATE PATIENT PORTAL REGISTRATIONS, WE WORKED WITH IT AND HIMS TO PROMOTE THE PORTAL FOR PATIENTS DURING ARRIVAL FOR APPOINTMENTS AND PRIOR TO DEPARTURE FROM INPATIENT SERVICES. WE ALSO USED SOCIAL MEDIA TO REMIND PATIENTS ABOUT THE BENEFITS OF THE PORTAL, FEATURED THE PORTAL IN THE VITAL SIGNS MAGAZINE, AND ENCOURAGED PROVIDERS TO PROMOTE THE SERVICE. TABLE TENTS AND FLYERS REMAIN IN PLACE.FOUNDATION - IN 2015, WE INHERITED THE KDH FOUNDATION. NEW EFFORTS INCLUDED PLANNING, ORGANIZATION, AND PROMOTION OF THE 2015 GOLF BENEFIT AND 2015 FOUNDATION GALA. MARKETING EFFORTS INCLUDED EVENT MATERIALS, POSTERS, INVITATIONS, AND CARDS. WE ALSO BEGAN WORKING TO IMPROVE THE APPEARANCE AND USAGE OF THE FOUNDATION TV MONITOR IN THE LOBBY OF THE MAIN HOSPITAL.NEWS RELEASES - GIRLS ON THE RUN REGISTRATION, ART OF HEALING RECEPTIONS, HEALTH INSURANCE ENROLLMENT, HIP 2.0 INFORMATION, KDH EMS AND SWITZERLAND COUNTY, COLON CANCER KITS/AWARENESS MONTH, PILOT CLUB DONATION (TO CANCER CENTER), SMOKING CESSATION COURSE, ANTHEM AND TOBACCO CESSATION, SPEAKING OF WOMEN'S HEALTH, NURSE PRACTITIONER SARAH HARTMAN, DR. RONALD AUER, DR. PATRICK MATTHIESSEN, MEDICAL EXPLORERS, CANCER CENTER - GOLD STATUS/OUTSTANDING ACHIEVEMENT AWARD, RUN THE FALLS 5K, LUNG CANCER SCREENINGS - NEW GUIDELINES, MARCH OF DIMES QUALITY AWARD (MOTHER-BABY).MEDICAL SERVICES AND PROVIDERS:GAPS IN THE CURRENT MEDICAL SERVICE LINES AND THE MEDICAL SPECIALTIES DESIRED ARE WORTH EXPLORING. ACTION PLAN: LEADERSHIP ROLECONTINUE TO IDENTIFY AREAS WHERE MEDICAL SERVICES ARE LACKING, AND TO RECRUIT MEDICAL PROVIDERS TO MEET THE NEEDS OF THE COMMUNITY. TARGET: PRIMARY SERVICE AREA. EVALUATION: NUMBER OF PROVIDERS (PRIMARY AND SECONDARY) PLACED IN PRACTICES IN OUR PRIMARY SERVICE AREA. 2015 UPDATETHE FOLLOWING SERVES / PROVIDERS WERE ADDED IN 2015 TO SERVE OUR AREA: DR. PATRICK MATTHIESSEN, NEUROLOGY DR. GENE SHILKROT, ANESTHESIA ALICIA MINCER, APN: NOCTURNIST DR. WILLIAM PORTER, RADIATION ONCOLOGY DR. RON AUER, ORTHOPEDIC SURGEON SARAH HARTMAN, APN: FAMILY PRACTICE DR. JENNIFER CHANG, ANESTHESIA DR. MAGDY KHALIL, ANESTHESIA, PRN 10 1 - REHABILITATION CENTER AND HOME CARE 2670 N MICHIGAN ROAD MADison IN 47250 outpatient rehabilitation center and home care services 2 - CLIFTY DR MED OFFICE BLDG & CONV CARE 445 Clifty Drive Madison IN 47250 PHYSICIAN MEDICAL OFFICE & CONVENIENT CARE CENTER 3 - VERSAILLES MEDICAL OFFICE BLDG-MAIN ST 128 North Main Street Versailles IN 47042 Physician Medical Office 4 - VERSAILLES MEDICAL OFFICE BLDG-TYSON ST 206 W Tyson Street Versailles IN 47042 Physician Medical Office 5 - TRIMBLE COUNTY MEDICAL OFFICE BLDG 10235 US Highway 421 Milton KY 40045 physician Medical Office 6 - CARROLLTON MEDICAL OFFICE BLDG 205 Marwill Drive Carrollton KY 41008 Physician Medical Office 7 - SWITZERLAND CNTY MEDICAL OFFICE BLDG 727 State Rd 56 Vevay IN 47043 Physician Medical Office 8 - HANOVER MEDICAL OFFICE BLDG 36 Medical Plaza Hanover IN 47243 Physician Medical Office 9 - CANCER TREATMENT CENTER 621 West street madison IN 47250 physician Medical Office 11 - DOWNTOWN MEDICAL OFFICE BLDG 630 North Broadway Madison IN 47250 physician Medical Office and hospital staff Part I, Line 3c: The Hospital changed its policies regarding free and discounted care mid-year 2015.Free Care:- From January to May 2015, the FPG family income limit for eligibility for free care was 200%- From June to December 2015, the FPG family income limit for eligibility for free care was 150%Discounted Care:- From January to May 2015, all uninsured patients received an automatic 20% discount from gross charges.- From June to December 2015, all uninsured patients received an automatic 30% discount from gross charges. For the outstanding balance due after applying the 30% discount, they could further qualify for additional discounted care using the FPG family income limit for eligibility of 250%. Part II, Community Building Activities: Community Building Activities promoted the health of the community in the following ways:- Promoting healthcare careers to potential "future employees" through Job Fairs at the local community college- Participation in "Women in Business" events - speaking engagements to promote leadership development- Assisting community members with Medicaid program enrollment via a formal Medicaid Enrollment Assistance Program offered by the Hospital. This program helps community members enroll to receive all types of Medicaid assistance (food, healthcare, etc.) Part III, Line 2: As reported on the attached financial statements, page 4, "Consolidated Statements of Operations Years Ended December 31, 2015 and 2014". Part III, Line 3: The hospital has a detailed Financial Assistance Policy which states that to participate in charity care candidates must cooperate fully. In addition the hospital educates patients with limited ability to pay regarding financial assistance. For this reason the organization believes that it accurately captures all charity care deductions provided according to the financial assistance policy and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible. Part III, Line 4: See pages 8-10 on the attached financial statements. Part III, Line 8: This should be treated as community benefit as more services were provided to the elderly population than were reimbursed. The source used to determine the amount of Medicare allowable costs reported for Part III, Section B, Medicare has been provided from the Year Ended 12/31/2015 report: Hospital Statement of Reimbursable Cost. Part III, Line 9b: The Hospital changed its policy mid-year 2015. From January-May 2015, all uninsured patients received an automatic 20% discount from gross charges. From June-December 2015, all uninsured patients received an automatic 30% discount from gross charges. At registration, patients are notified of the Hospital's financial assistance program. They are provided pamphlets detailing the program. If the patient is known to qualify for financial assistance and is approved for financial assistance, the patient will receive a discount of 100% on the outstanding account balance. The Hospital will attempt to collect any balance remaining on the uninsured account after all financial assistance discounts have been applied using a series of statements, letters, and telephone calls. The Hospital will also offer patients interest-free extended payment plans. If the account remains unpaid, the account may be turned over to a collection agency. Part VI, Line 2: KING'S DAUGHTERS' HEALTH, (KDH), CONDUCTED A COMMUNITY NEEDS ANALYSIS IN 2013 THAT INVOLVED BOTH ITS PRIMARY SERVICE AREA (JEFFERSON COUNTY, RIPLEY COUNTY, AND SWITZERLAND COUNTY, INDIANA) AND ITS SECONDARY SERVICE AREA (TRIMBLE COUNTY AND CARROLL COUNTY, KENTUCKY). PRIOR TO THIS A COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED IN 2010.- THE FOCUS OF THIS ASSESSMENT WAS ON THE HEALTH NEEDS THAT COULD BE ADDRESSED BY KDH AND CAN BE USED BY KDH IN PLANNING FUTURE SERVICES, APPLYING FOR GRANTS AND PLANNING OUTREACH EFFORTS.- THE STUDY INCLUDED THE FOLLOWING COMPONENTS:- ANALYSIS OF SECONDARY DATA TO DEVELOP A PROFILE OF THE RESIDENTS OF EACH COUNTY AND TO INDICATE, WHERE POSSIBLE FUTURE TRENDS AND TO SHOW COMPARISONS WITH STATE AND NATIONAL DATA;- IN-PERSON INTERVIEWS WITH 30 KEY LEADERS WITHIN KDH INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 44 COMMUNITY LEADERS INCLUDING GOVERNMENT, MEDICAL, EDUCATION, AND OTHER COMMUNITY LEADERSHIP POSITIONS IN ALL FIVE COUNTIES;- IN-PERSON SURVEYS OF 72 INDIVIDUALS IN LOW INCOME LOCATIONS;- IN-PERSON DISCUSSIONS WITH 19 SENIOR CITIZENS;- A WEB-BASED SURVEY WAS OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 184 COMPLETED INTERVIEWS.- THIS ASSESSMENT ALLOWED ALL INDIVIDUALS TO PROVIDE RESPONSES ON ANY COMMUNITY NEEDS NOT LISTED IN THE QUESTIONS AND ALLOWED INDIVIDUALS TO MAKE COMMENTS ON COMMUNITY HEALTH ISSUES ON WHICH KDH COULD HAVE AN IMPACT.- KEY HEALTH ISSUES EXPLORED WERE THE FOLLOWING:- PHYSICAL ACTIVITY- OVERWEIGHT AND OBESITY- TOBACCO USE- SUBSTANCE ABUSE/GAMBLING/ADDICTIONS- RESPONSIBLE SEXUAL BEHAVIOR- MENTAL HEALTH- INJURY AND VIOLENCE (INCLUDING DOMESTIC VIOLENCE AND SEXUAL ASSAULT)- ENVIRONMENTAL QUALITY- IMMUNIZATION- ACCESS TO HEALTH CARE FOR THE INSURED AND UNINSURED- MATERNAL AND CHILD HEALTH- INFECTIOUS DISEASE- OCCUPATIONAL AND SAFETY HEALTH- SPECIAL NEEDS/DISABLED/IMPAIRED- CHRONIC DISEASERESULTS OF THE NEEDS ASSESSMENT HAVE BEEN MADE AVAILABLE THROUGH A VARIETY OF SOURCES:NEWSPAPER AND RADIO RELEASES, DISTRIBUTION OF INFORMATION IN THE COMMUNITY NEWSLETTER, VITAL SIGNS, AND IS ALSO AVAILABLE ON OUR WEB SITE. Part VI, Line 3: -At the time of registration, the Hospital's Financial Assistance Policy is discussed with each patient. The patient is provided a pamphlet regarding the policy, eligibility requirements and the associated application process. The patient must sign a form indicating that they received this information.-The Hospital has a representative on site to assist patients with the financial aid application process.-Patients are reminded to contact customer service regarding financial aid and federal/state assistance directly on the patient bill itself.-The Hospital's website has a link to the financial aid application. Part VI, Line 4: Jefferson County- Jefferson County is experiencing a slow growth in total population, currently at 32,554. By 2020, the population is expected to be about 38,811. It has a median age of 37.1, nearly identical to the state average of 37.0. The unemployment rate of 8.4% is slightly above the Indiana rate of 8.2%.- The population is fairly homogeneous with a largely Caucasian population, 96%- The median average household income, of $40,386, is lower than that for Indiana and the nation. In Jefferson County, about 14.3% of the individuals, or about 4,326, live below the poverty level, below the 15.8% poverty rate of individuals in Indiana and the 15.9% rate for the entire U.S.- 35% of all families in Jefferson County are single parent families with 28.3% of these families in poverty. In Indiana, 32.9% of all families are single parent families with 27.4% of these families in poverty.- Jefferson County ranks first in Indiana in terms of the number of acres devoted to tobacco with tobacco crop sales of $1.6 million in 2007. 28% of adults in Jefferson County use tobacco compared to 24% of adults living in the state of Indiana.- According to the Indiana State Department of Health 2012 report, Jefferson County was not listed as a county that had a shortage of healthcare professionals or of mental health professionals. However, the 2012 report lists Milton, Shelby and Smyrna townships as medically underserved.- The rate of all cancer incidence is higher in Jefferson County, at 502 for 100,000 population, than for Indiana, at 476 for 100,000 population. The rate of lung cancer is higher in Jefferson, at 96 per 100,000 population than for Indiana at 80 per 100,000. The rate of prostate cancer is higher in Jefferson, at 152 per 100,000 population than for Indiana at 136 per 100,000. The rate of breast cancer in Jefferson is slightly lower, at 115 per 100,000 population than for Indiana at 116 per 100,000 population. The rate of colorectal cancer is lower in Jefferson, at 48 per 100,000, than the rate for Indiana, at 51 per 100,000.- The rate of adult asthma in Jefferson County, at 7.3%, is slightly higher than the rate for Indiana, at 7.2%, as is the rate of chronic bronchitis (3.4% for Jefferson; 3.3% for Indiana) and for emphysema (1.6% for Jefferson; 1.4% for Indiana.)- The percent of mothers who smoked during pregnancy in Jefferson County is 25.8% significantly higher than the state of Indiana average of 17.1%. In 2010, the percent of lowweight births for Jefferson County was 9.6%, above the 8.0% for Indiana.- The number of teen pregnancies among women 15 to 19 years old has slightly decreased in Jefferson County from 2007 to the most recent measurement in 2010. In Jefferson County, there were 46 teen pregnancies in 2007 and 44 teen pregnancies in 2010. In Indiana, a significant decrease took place - there were 11,683 teen pregnancies in 2007 and 8,654 in 2010.- Jefferson County reported 97 newly diagnosed cases of Chlamydia in 2011, an increase from the 82 reported in 2009. There were 12 cases of gonorrhea in 2011 and increase from the less than five reported in Jefferson County in 2009.- The most recent information from the Indiana Family and Social Service Administration in 2008 shows 1,324 adults in Jefferson County with serious mental illness and 247 seriously emotionally disturbed children.- The rate of deaths related to major cardio vascular diseases in Jefferson County increased from 2008 - 249.8 per 100,000 population to 2010 - 372.1 per 100,000 population. The opposite trend occurred in Indiana with 214.3 per 100,000 deaths recorded in 2008 falling to 206.5 per 100,000 in 2010.- The stroke death rate in Jefferson, at 79.4 per 100,000 population in 2010, was significantly higher than the 47.5 per 100,000 population for Indiana and the 41.9 per 100,000 for the nation.- The incidence of cancer rate (all sites) was higher in Jefferson County - 502 per 100,000 population compared to Indiana's rate of 476 per 100,000. Ripley County- Ripley County has a current population of 28,583. There is a net outward migration. By the year 2020, the population will be about 30,754.- The population is 97.8% Caucasian.- The median household income in Ripley is $47,900 - lower than the national average of $50,502, but higher than the Indiana average of $46,438.- The percent of families below poverty in Ripley is 15.4%, lower than the Indiana average of 20.6% and the national average of 20.8%.- 29.8% of all families in Ripley County are single parent families with 27% of these families in poverty. In Indiana, 32.9% of all families are single parent families with 27.4% of these families in poverty.- The percent of mothers in Ripley County who smoke during pregnancy is 22.8%, compared to 17.1% in Indiana. The percent of low birth weight in Ripley County is 7%, compared to 8% in Indiana.- The most recent information from the Indiana Family and Social Service Administration in 2008 shows 1,071 adults in Ripley County with serious mental illness and 250 seriously emotionally disturbed children.- Ripley County does not have a shortage of health care professionals. The townships of Delaware, Center and Brown are considered medically underserved. Ripley has a shortage of mental health professionals.- The rate of individuals with prostate cancer in Ripley was 146 per 100,000 populations compared to 136 for Indiana in 2008.- The death rate from major cardiovascular disease was 246.6 per 100,000 population for Ripley County in 2010. This is higher than Indiana's 206.5 and the nation's 193.6 per 100,000 during the same period.- The incidence of cancer rate (all sites) was higher in Ripley County - 518 per 100,000 population compared to Indiana's rate of 476 per 100,000. Switzerland County- Switzerland County has a population of 10,424 and has a slow growth rate of 0.5 which mirrors that for Indiana. There is a net migration into the county. By 2020, the population will be 11,950.- The ethnicity is 98.1% white.- The unemployment rate is 6.9% in Switzerland County, lower than the Indiana rate of 8.4%.- The median household income is $42,285, compared to $46,438 for Indiana and $50,502 for the nation. In Switzerland, 28% of the families are below the poverty level, compared to 20.6% of Indiana families, and 20.8% of families in the nation. 29.4% of the children in Switzerland County are below the poverty level.- In 2010, 22.5% of all adults age 25+ had less than a high school diploma.- The teen birth rate for Switzerland County in 2009 was 37.8 per 1,000 females age 15-17. This is significantly higher than the rate for Indiana of 20.8 per 1,000.- The rate of mothers smoking during pregnancy is 27.3% in Switzerland County, compared to 17.1% in Indiana. In Switzerland, there is a 6.8% low birth weight, compared to 8.0% in Indiana.- Switzerland County has a shortage of health care professionals. All areas of Switzerland County are considered medically underserved. Switzerland County also has a shortage of mental health professionals.- The rate of chronic bronchitis in Switzerland County and in Indiana is 3.0%. The rate of emphysema in Switzerland is 1.5%, slightly higher than the Indiana rate of 1.4%.- There are 379 adults with serious mental illness in Switzerland County and 78 seriously emotionally disturbed children.- The death rate from major cardiovascular disease was 347.0 per 100,000 population for Switzerland County in 2010. This is significantly higher than Indiana's 206.5 and the nation's 193.6 per 100,000 during the same period.- The incidence of cancer rate (all sites) was higher in Switzerland County - 562 per 100,000 population compared to Indiana's rate of 476 per 100,000. The only type of cancer in which Switzerland County recorded an incidence rate lower than Indiana was Breast Cancer - Switzerland County 82 per 100,000 versus Indiana's 116 per 100,000 population. Carroll County, Kentucky- Carroll County Kentucky currently has a population of 11,013 with a total of 4,195 households. The population is projected to be about 11,440 by 2020.- The population is 95.1% Caucasian.- The average median household income in 2011 was $40,685 - higher than the $41,141 for Kentucky, but lower than the $50,512 for the nation.- The average percent of mothers who smoke during pregnancy for Carroll County is 30%, compared to 24% for Kentucky.- As far as smoking prevalence is concerned, 30% of the adults in Carroll smoke, compared to 29% of Kentucky and 21% of the nation. The percent of high school students in Carroll who smoke is 31%, compared to 25% for Kentucky and 19% for the nation.- Carroll County Kentucky has 25% of the population obese, compared to 29% of Kentucky and 24% of the nation.- In Carroll, 43% of the population lack physical activity, compared to 32% in Kentucky and 24% in the nation. Part VI, Line 5: The majority of King's Daughters' Health Board of Managers is comprised of individuals who live and work in the Hospital services area. The majority of these individuals are neither employees, nor contractors of the organization, nor family members thereof. The Hospital extends medical staff privileges to all qualified physicians in its community for some or all of its departments. The organization also applies a portion of surplus funds to improvements in patient care. Historically, KDH has employed a full time Community Wellness Coordinator. This position provides outreach services in areas of need to the Communities we serve. In addition to these services, KDH also serves as the fiscal agent for several state and federal grants. All of these services help us meet the identified needs of the communities we serve.Participation in the below community organizations is part of the Hospital's Indiana State Department of Health Community Benefit Plan and Goals.2015 KING'S DAUGHTERS' HEALTH OVERVIEW OF COMMUNITY BENEFIT ACTIVITIES1. HEALTH SCREENS: A. CORPORATE HEALTH SCREENS / FAIRS Clifty Engineering Screen: 15 Belterra Health Fair participation (no screenings provided) B. COLON CANCER SCREENING KITS: 30 returns. C. CORPORATE FLU SHOTS: (172 total) Animal Clinic: 6 AGS Law Office: 9 SET Enterprises: 17 140 sold to IVY Tech for selfadministration2. COMMUNITY HEALTH FAIRS: (Participated by offering a booth with health education) A. RIPLEY COUNTY 4H FAIR B. JEFFERSON COUNTY 4H FAIR C. REMC HEALTH FAIR IN VERSAILLES D. WAL-MART CANCER AWARENESS EVENT E. HEALTHY KIDS DAY AT SWITZERLAND CO. YMCA F. BACK TO SCHOOL HEALTH FAIR G. Community Day/Health Fair at Local Low-Income housing complex 3. COMMUNITY EDUCATION OPPORTUNITIES/CLASSES/SPECIAL EVENTS: A. SPEAKERS BUREAU: Heather (Wellness): 12 speaking engagements Stephanie (Tobacco): 11 speaking engagements B. FIT KIDS PROGRAM (7 WK program for area 5th grade classrooms) 6 Schools / 10 Classrooms / 249 Kids + teachers C. TOBACCO CESSATION & EDUCATION: Provided outreach to: 8 businesses 15 School Visits KDH Physician Offices D. CPR AND FIRST AID CLASSES: Community classes held with 672 graduates School-based classes held with 97 students participating E. Strive for 5 Program: Community 5-week weight loss education program One class held in 2015, 11 total participants F. PRENATAL EDUCATION: OB Prep Program - 392 people served Prepared Childcare Essential classes - 11 people served Lamaze classes - 3 people served Sibling classes - 5 people served G. GIRLS ON THE RUN Fall Season: 56 girls / 5 sites / 26 trained coaches / 10 week program Fall 5K: 200 participants and 50 volunteers H. HOUSE OF HEALTH: Monthly education opportunity provided at the House of Hope food pantry. Approximately 25-70 people attend each month. 12 Topics for 2015 include: CPR Friends & Family, Heart Health, Nutrition, Emergency Preparedness, Car Seat Safety, Sun Safety, Tobacco, Kids Health, Safe Drug Drop Off/HIV testing, Breast Cancer, Diabetes, and Holiday Food Safety. I. SPEAKING OF WOMEN'S HEALTH 331 women in attendance. KDH provided: Steering committee support Financial sponsorship and in-kind support Free cholesterol testing for all participants 80% of all breakout sessions speakers were in-kind KDH staff Gift for participant gift bag J. Monthly "To your health" radio show 30 Minute health education program with various topics offered each month4. EMPLOYEE HEALTH OPPORTUNITIES FOR KDH STAFF: Wellness newsletters (on-line and paper versions available) Wellness Column in the monthly Monitor newsletter Wellness Calendar distribution to all staff Employee Health Screen available for all staff with Insurance Premium Reduction Incentive Program available for employees with health insurance. 3 Wellness Challenges: 47250 healthy habit challenge 30day Walking campaign 2 onsite employee Wellness classes Heart month activities Wear Red Day participation (heart health education) Two Strive for 5 weight loss classes held (5 week series)5. COMMUNITY SERVICE ACTIVITIES: A. SUPPORT GROUPS: Breast Cancer Support Group B. ACTIVE ATTENDANCE AND PARTICIPATION IN: CASA (Coalition Against Substance Abuse, Jefferson County) SCAT (Switzerland County Awareness Team) TPCC and Jefferson County Tobacco Coalition (State & Local tobacco efforts) Active Living Committee Envision Jefferson County MASHER (area corporate health and safety group) C. KDH RUN THE FALLS 5K WALK/RUN HELD AT CLIFTY FALLS STATE PARK 202 People participated D. EMS STANDBY AT ALL COMMUNITY ACTIVITIES: EMS provides standby coverage at all Jefferson County activities. E. SUPPORT TO VARIOUS AREA SCHOOLS WITH INTERNSHIPS: Support many Local and area High Schools and Colleges with Internships and Job Shadow experiences: Includes Nursing and Medical Students among others.6. SUCCESSFUL GRANT ACTIVITY: A. TPCC: TOBACCO PREVENTION AND CESSATION COMMISsION: Funding to hire full time coordinator, starting in 2009, continues for Jefferson Co. B. CASA / SCAT GRANTS: To fund Nicotine Replacement Therapy for individuals wishing to quit tobacco. Part VI, Line 6: NA Part VI, Line 7, Reports Filed With States IN Part VI, Line 4 continued Carroll County, Kentucky (continued)- The unemployment rate in Carroll County is 9.6%, higher than both Kentucky's 8.2% and the nation's 8.1%.- The death rate from heart disease in Carroll County is 299.8 per 100,000 compared to 205.6 per 100,000 for Kentucky and 173.7 per 100,000 for the nation.- The death rate per 100,000 due to Chronic Respiratory Disease in 2011 was 112.1 for Carroll County compared to 63.1 per 100,000 for Kentucky and 42.7 per 100,000 for the nation.- In 2011, Carroll County had nearly two and half times the number of Drug Arrests per 100,000 in comparison to Kentucky: 2,162 versus 870. Trimble County, Kentucky- Trimble County, Kentucky, has a population of 8,725 and a declining growth rate of -1.0 per 1,000 population, compared to 0.6% increased growth for Kentucky. By 2020, the population will be 9,514.- The population is 97.2% white.- The average median household income in Trimble County is $44,141 compared to $43,677 in Kentucky and $50,502 in the nation. The unemployment rate is 8.2%, compared to 8.2% for Kentucky and 8.1% for the nation.- The rate of smoking during pregnancy in Trimble County is 44%, compared to 24% in Kentucky. The low birth weight rate in Trimble County is 6% which is below Kentucky's 9%.- In Trimble County, 30% of adults smoke, which is higher than the 29% for Kentucky and the 19% for the nation. In Trimble County, 25% of high school students smoke, the same as in Kentucky, but higher than the 23% in the nation.- In Trimble County, 29% of the adults are obese, the same as for Kentucky, but higher than the 24% for the nation. In Trimble, 14% lack physical activity, compared to 32% in Kentucky and 24% in the nation.- In Trimble County, there is an 9% rate of adult diabetes, compared to 8% in Kentucky and 10% for the nation. The death rate per 100,000 due to diabetes was 55.4 for Trimble County, compared to 28.0 for Kentucky and 25.3 for the nation.- Deaths due to Breast Cancer were 15 per 100,000 for Trimble County compared to 14 per 100,000 for Kentucky. Deaths due to Prostate Cancer were 23 per 100,000 for Trimble County and 18 per 100,000 for Kentucky. 1 Ivy Tech Foundation Inc 50 WEst Fall Creek Parkway North Indianapolis IN 46208 237073977 501(c)(3) 5000 Donation Indiana Hospital Assistance Foundation Inc 1 American Square Suite 1900 Indianapolis IN 46282 455573749 501(c)(3) 13830 Donation 2 0 Medical Supplies 18033 FMV Various Medical Supplies Part I, Line 2: Funds are not granted to organizations but are donated. Donations are determined on a discretionary basis. X X X X X 0 0 0 0 0 0 0 0 0 JONATHAN HANSON MD BOARD MEMBER/PHYSIcian 272679 0 116596 0 360 0 13250 0 29019 0 431904 0 0 0 PAT STACK MD Board Member/Physician 148932 0 86807 0 1584 0 12271 0 25365 0 274959 0 0 0 CAROL DOZIER PRESIDENT/CEO 348817 0 195 0 552 0 13250 0 1302 0 364116 0 0 0 Steve Meacham VP Finance 196966 0 195 0 1584 0 27636 0 21276 0 247657 0 0 0 Lisa Morgan VP Patient Services 148007 0 195 0 552 0 25104 0 26623 0 200481 0 0 0 Denine Fallis-Hallgarth VP Physician Practices 129991 0 195 0 552 0 24228 0 12183 0 167149 0 0 0 HOLLY ROBINSON MD VP QUALITY / Physician 210304 0 59593 0 240 0 22000 0 29070 0 321207 0 0 0 Thomas Eckert MD Employed Physician 424300 0 317359 0 1584 0 13250 0 18374 0 774867 0 0 0 Travis Clegg MD Employed Physician 478474 0 1173450 0 46077 0 13250 0 28921 0 1740172 0 0 0 William Skiles MD Employed Physician 448466 0 199740 0 1032 0 13250 0 15129 0 677617 0 0 0 Michael Schmidt MD Employed Physician 445579 0 208355 0 10496 0 13250 0 31201 0 708881 0 0 0 George Alcorn MD EMployed Physician 307502 0 297412 0 1584 0 13250 0 9116 0 628864 0 0 0 ADDITIONAL SCHEDULE J DISCLOSURES Board members Pat Stack, MD and Jonathan Hanson, MD listed above are employed physicians of the Hospital. Dr. Stack and Dr. Hanson do not receive compensation for services provided as board members. The compensation listed above for Dr. Stack and Dr. Hanson is compensation received for services provided as employed physicians. A Indiana Finance Authority 351602316 45471ACW0 2010-11-03 97847058 See Part VI 0 0 0 A 97847058 6756861 1749243 88974097 366857 2013 0 0 1 1 A 0 0 1 1 0 0 0 0 A 0 0 0 0 0 0 0 0 1 A 1 Sch K Part I Line A - Purpose THE PURPOSE OF THE BOND ISSUANCE IS TO FINANCE, REFINANCE, OR REIMBURSE A PORTION OF THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING VARIOUS HEALTH CARE FACILITIES OF THE HOSPITAL, INCLUDING A REPLACEMENT ACUTE CARE HOSPITAL FACILITY AND A MEDICAL OFFICE BUILDING. A DATTILO FRUIT COMPANY Vice President of Patient Services of KDH has 51% ownership interest 41827 Lisa Morgan, Vice President of Patient Services of KDH owns a 51% interest in A. Datillo Fruit Company. KDH purchases produce from A. Dattilo Fruit Company. The Hospital made purchases totaling $41,827 in 2015. 0 RIVER VALLEY FINANCIAL BANK Board member is the spouse of president and CEO of River Valley Fin. Bank Andrea Forrester, Board Asst Treasurer, is married to the Pres and CEO of River Valley Financial Bank. The Hospital's operating account is with the bank. The Hospital recorded interest income of $126,896 and service fees of $8,102 from activity with the bank. 0 Form 990, Part VI, Section A, line 6 Per the bylaws, the membership of the Organization shall be non-sectarian, non-political and not confined to any Christian religious denomination or sect. Any such person of good repute who holds herself responsible to the King, Christ, our Lord and Savior, may become a member of the organization. All members must be and remain permanent residents of the service area of the Hospital, as determined from time to time by the Hospital Board of Managers, as a continuing requirement for membership. Failure to maintain such residency status automatically terminates a person's membership. Hospital employees, members of the Medical Staff, and their immediate family members shall not be eligible for membership in the organization. The immediate family shall be defined as including the mother, father, husband, wife, sister, brother, daughter, son, and stepchildren. Form 990, Part VI, Section A, line 7a The Organization shall have two (2) classes of members, Active and Honorary, and all members shall have the rights, privileges, duties, liabilities, limitations and restrictions as set forth from time to time in the Standing Rules. Any Active Member of the Organization may propose any other person meeting the eligibility requirements outlined in Part VI, 7a above for membership. Only Active members in good standing that have been a member for at least two anniversary years can present a person's name for membership or to serve on the Board of Directors. A majority vote of those present and voting affirmatively at any regular meeting of the Organization at which a quorum is present shall be sufficient to elect such proposed person to membership. Only Active Members shall have the right at every meeting of the members to cast one (1) vote for her membership. This right to vote must be exercised in person, or as the Bylaws may provide from time to time. Form 990, Part VI, Section A, line 7b Only Active Members shall have the right at every meeting of the members to cast one (1) vote for his/her membership. This right to vote must be exercised in person, or as the Bylaws may provide from time to time. Form 990, Part VI, Section B, line 11 The process of reviewing the Form 990 entails a detailed review by the organization's management. the Board of Managers receives a draft copy of the Form 990 including requested schedules prior to filing with the IRS. Changes or revisions are suggested by the board if necessary. The 990 will be reviewed at the next board meeting. Form 990, Part VI, Section B, line 12c Board members are required to disclose annually interests that could give rise to conflict. Officers and key employees are not required to annually disclose interests that could give rise to conflicts. However the HR Conflict of Interest policy does state that any employee who is an officer, owner, partner or employee of an organization with which the hospital may enter into a relationship or transaction(or whose spouse or child is an officer, owner, partner or employee of an organization with which the hospital may enter into a relationship or transaction) must disclose this information to the appropriate Vice President and the President/CEO. Should such information be disclosed, the employee will refrain from any subsequent discussion and decisions related to the outside firm. A conflict of interest statement must be completed by every board member each year. At such time as any matter comes before the Board concerning an existing or contemplated transaction or relationship between the Organization and any party in which a Board member or the spouse or minor children of such Board member has an interest or otherwise may give rise to a conflict of interest between the Board member and the organization, the affected Board member shall make known the potential conflict, whether disclosed by his or her written statement or not, and after answering any questions that might be asked of him or her, shall withdraw from the meeting for so long as the matter shall continue under discussion. Should the matter be brought to a vote, the affected Board member shall not vote on it. Form 990, Part VI, Section B, line 15a The Hospital's Board Executive Committee reviews annual CEO survey information from the Indiana Hospital Association that compares the Hospital's CEO's compensation with other hospital CEO's in Indiana. Comparisons are made with hospitals that are in the Hospital's region in Indiana, hospitals similar in size to KDHHS, and hospitals that might reasonably be expected to compete for services of the Hospital's CEO. The Consumer Price Index for All Urban Consumers (CPI-U) for the prior twelve month period is also reviewed and considered. The Executive Committee, after reviewing a status report of the CEO's annual goals, recommends changes in the CEO's compensation to the full Board of Managers. Any action taken on the recommendation is made by the full board. However, physician board members who are hospital employees do not participate in voting for any change to CEO compensation. Minutes are taken at all Board Executive Committee and full board meetings. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest, or financial statements are not made available for public inspection. The Form 990 tax return is available for public inspection upon request. Form 990, Part XI, line 9: change in subscriber savings cumulative account 181,173. Form 990, Part XI, Line 2c, Audit Oversight The Hospital's Finance Committee assumes responsibility for the selection of an independent certified public accounting firm to perform the annual audit of the financial statements. The Finance Committee also is responsible for oversight of that audit process. The treasurer of the Hospital's Board of Managers serves as the Chair of the Finance Committee. The Finance Committee regularly meets every month, and meets once per year with the independent auditors. The King's Daughters' Hospital Foundation Inc PO Box 447 Madison IN 47250 202148950 Fundraising to support the provision of healthcare services IN 501(c)(3) Line 7 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0