EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: EPHRAIM MCDOWELL REGIONAL MEDICAL C ENTER (EIN 61-0492356)
Tax period: 2014-10-01 to 2015-09-30
Filed: 2016-08-15
IRS object ID: 201632289349301768
Schema version: 2014v6.0
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	2016-08-15T09:17:50-05:00	ReturnTs
Tax Period End	2015-09-30	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	2014-10-01	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	2016-08-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KIM SCIFRES	PreparerPersonNm
PTIN	P01316095	PTIN
Phone	2707810111	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-09-27 15:27:22Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SALLY DAVENPORT	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	$173,771,408	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	17	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	1172	TotalEmployeeCnt
Total Volunteers	260	TotalVolunteersCnt
Total Gross UBI	$1,160,323	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$295,113	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$109,523	PYContributionsGrantsAmt
CY Contributions Grants	$135,874	CYContributionsGrantsAmt
PY Program Service Revenue	$165,479,655	PYProgramServiceRevenueAmt
CY Program Service Revenue	$172,107,933	CYProgramServiceRevenueAmt
PY Investment Income	$53,842	PYInvestmentIncomeAmt
CY Investment Income	-$211,586	CYInvestmentIncomeAmt
PY Other Revenue	$1,640,710	PYOtherRevenueAmt
CY Other Revenue	$1,482,602	CYOtherRevenueAmt
PY Total Revenue	$167,283,730	PYTotalRevenueAmt
CY Total Revenue	$173,514,823	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	$62,401,009	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$61,655,290	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$90,272,953	PYOtherExpensesAmt
CY Other Expenses	$88,065,452	CYOtherExpensesAmt
PY Total Expenses	$152,673,962	PYTotalExpensesAmt
CY Total Expenses	$149,720,742	CYTotalExpensesAmt
PY Revenues Less Expenses	$14,609,768	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$23,794,081	CYRevenuesLessExpensesAmt
Total Assets BOY	$216,585,521	TotalAssetsBOYAmt
Total Assets EOY	$241,789,969	TotalAssetsEOYAmt
Total Liabilities BOY	$11,270,042	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$12,680,406	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$205,315,479	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$229,109,563	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	$134,876,932	ExpenseAmt
Revenue	$170,947,610	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$134,876,932	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	false	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
IRP Document	79	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1172	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	17	GoverningBodyVotingMembersCnt
Independent Voting Member	15	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
Kryder E VanBuskirk III MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,300	$0
sheree gilliam
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$1,650	$0
DAVID HOPPER 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	$3,300	$0
MARK MORGAN
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,000	$0
SUSIE ROUSH
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,150	$0
AARON ROWLAND
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,300	$0
WILLIAM RUTH III
PAST CHAIR	3.0	5.0	Yes (X)	$0	$3,000	$0
REV QUENTIN SCHOLTZ III
TREASURER	3.0	5.0	Yes (X)	$0	$3,300	$0	Yes (X)
DALE KIHLMAN
CHAIR	3.0	5.0	Yes (X)	$0	$3,300	$0	Yes (X)
DONALD HAMNER MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$238,434	$10,815
ERIC GUERRANT MD
BOARD MEMBER	3.0	5.0	Yes (X)	$18,000	$3,300	$0
JULIAN GANDER
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$1,650	$0
JOHN D TRISLER
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$3,300	$0
SCOTT BOTTOMS
SECRETARY	3.0	5.0	Yes (X)	$0	$3,300	$0	Yes (X)
WILLIAM DEMROW
PART YEAR VICE CHAIR	3.0	5.0	Yes (X)	$0	$4,800	$0	Yes (X)
ALLEN WHITE
PART YEAR VICE CHAIR	3.0	5.0	Yes (X)	$0	$3,150	$0	Yes (X)
JAMES TURPIN MD
BOARD MEMBER	3.0	5.0	Yes (X)	$0	$1,050	$0
WILLIAM SNAPP
VP & CFO	30.0	32.0		$0	$381,276	$125,210	Yes (X)
VICKI DARNELL
CEO	30.0	29.0		$0	$720,700	$263,513	Yes (X)
CARL METZ
VP HUMAN RESOURCES	40.0	0.0		$271,794	$0	$62,046		Yes (X)
MARK MILNER
VP CLINICAL EFFECTIVENESS	40.0	0.0		$155,691	$0	$49,575		Yes (X)
MICHELLE DELUCA FRALEY
PHARMACIST	40.0	0.0		$141,404	$0	$36,442			Yes (X)
JOAN HALTOM
PHARMACY DIRECTOR	40.0	0.0		$205,513	$0	$44,964			Yes (X)
RONALD BARBATO
REHAB DIRECTOR	40.0	0.0		$180,867	$0	$39,634			Yes (X)
ANDREW LOSCH
PHARMACIST	40.0	0.0		$149,466	$0	$19,048			Yes (X)
TINA COOLEY
PHARMACIST	40.0	0.0		$146,393	$0	$11,457			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,269,128	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,391,560	TotReportableCompRltdOrgAmt
Total Other Compensation	$662,704	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	44	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	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
MARSHALL MEDICAL MANAGEMENT LLC
1792 ALYSHEBA WAY STE 150	LEXINGTON	KY	40509	PHYSICIAN SERVICES	$1,259,292
KENTUCKY BLOOD CENTER
3121 BEAUMONT CENTER CIRCLE	LEXINGTON	KY	40512	BLOOD SERVICES	$722,655
LABORATORY CORP
PO BOX 12140	BURLINGTON	NC	27216	LAB SERVICES	$717,144
COMPUTER INFORMATION SERVICES
513 S MAIN ST SUITE A	CORBIN	KY	40508	COMPUTER SERVICES	$891,658
MESSER CONSTRUCTION
854 W MAIN STREET	LEXINGTON	KY	40508	CONSTRUCTION SERVICE	$793,300

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	17	CntrctRcvdGreaterThan100KCnt
Related Organizations	$126,348	RelatedOrganizationsAmt
All Other Contributions	$9,526	AllOtherContributionsAmt
Total Contributions	$135,874	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE	621110	$166,751,814	$165,846,446	$905,368
PHARMACY REVENUE	446110	$2,935,382	$2,872,003	$63,379
JOINT VENTURE INCOME	621110	$2,029,107	$2,029,107
OTHER OPERATING	621110	$200,054	$200,054
REFERENCE LAB	621400	$191,576		$191,576

Field	Value	IRS element (for citing)
Total Program Service Revenue	$172,107,933	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$25,781	TotalRevenueColumnAmt
Exclusion	$25,781	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	$77,849	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$77,849	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,849	TotalRevenueColumnAmt
Exclusion	$77,849	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$19,218	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$256,585	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$237,367	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$237,367	TotalRevenueColumnAmt
Exclusion	-$237,367	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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	$20,519	$20,519
CAFETERIA	722514	$717,127	$717,127
All Other Misc Revenue	900099	$667,107	$667,107

Field	Value	IRS element (for citing)
Other Revenue Total	$1,404,753	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$173,514,823	TotalRevenueColumnAmt
Related Or Exempt Func Income	$170,947,610	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,160,323	UnrelatedBusinessRevenueAmt
Exclusion	$1,271,016	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	$623,468	TotalAmt
Management And General	$623,468	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	$47,592,034	TotalAmt
Program Services	$42,851,787	ProgramServicesAmt
Management And General	$4,740,247	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,766,750	TotalAmt
Program Services	$2,459,881	ProgramServicesAmt
Management And General	$306,869	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$7,141,894	TotalAmt
Program Services	$6,349,763	ProgramServicesAmt
Management And General	$792,131	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,531,144	TotalAmt
Program Services	$3,139,493	ProgramServicesAmt
Management And General	$391,651	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	$85,000	TotalAmt
Management And General	$85,000	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$73,700	TotalAmt
Management And General	$73,700	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	$19,589,802	TotalAmt
Program Services	$16,155,816	ProgramServicesAmt
Management And General	$3,433,986	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,807	TotalAmt
Program Services	$1,807	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,300,939	TotalAmt
Program Services	$4,295,463	ProgramServicesAmt
Management And General	$1,005,476	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,624,176	TotalAmt
Program Services	$364,762	ProgramServicesAmt
Management And General	$1,259,414	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,404,112	TotalAmt
Program Services	$2,278,013	ProgramServicesAmt
Management And General	$126,099	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$81,781	TotalAmt
Program Services	$52,377	ProgramServicesAmt
Management And General	$29,404	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	$55,673	TotalAmt
Program Services	$46,410	ProgramServicesAmt
Management And General	$9,263	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$978,135	TotalAmt
Program Services	$977,673	ProgramServicesAmt
Management And General	$462	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,244,300	TotalAmt
Program Services	$7,244,300	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$573,279	TotalAmt
Program Services	$250	ProgramServicesAmt
Management And General	$573,029	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$35,907,407	$35,907,407
BAD DEBTS	$7,739,673	$7,739,673
TAXES & LICENSES	$2,236,732	$2,236,732
REPAIRS & MAINTENANCE	$3,412,047	$2,672,601	$739,446

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$756,889	TotalAmt
Program Services	$102,724	ProgramServicesAmt
Management And General	$654,165	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$149,720,742	TotalAmt
Program Services	$134,876,932	ProgramServicesAmt
Management And General	$14,843,810	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,610	BOYAmt
EOY	$5,916	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$184,313	BOYAmt
EOY	$175,324	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	$19,069,010	BOYAmt
EOY	$20,431,578	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	$4,139,108	BOYAmt
EOY	$4,906,336	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,370,907	BOYAmt
EOY	$1,594,173	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$161,081,587	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$102,235,346	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$58,300,314	BOYAmt
EOY	$58,846,241	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	$1,402,350	BOYAmt
EOY	$1,415,231	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	$132,113,909	BOYAmt
EOY	$154,415,170	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$216,585,521	BOYAmt
EOY	$241,789,969	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,270,042	BOYAmt
EOY	$12,680,406	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	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$11,270,042	BOYAmt
EOY	$12,680,406	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$205,298,689	BOYAmt
EOY	$229,093,273	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,790	BOYAmt
EOY	$16,290	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	$205,315,479	BOYAmt
EOY	$229,109,563	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$216,585,521	BOYAmt
EOY	$241,789,969	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$23,794,081	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$3	OtherChangesInNetAssetsAmt
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	$5,936	OtherActivitiesAmt
Total Lobbying Expenditures	$5,936	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) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) 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	$70,945,798	OtherCostOrOtherBasisAmt
Depreciation	$37,821,291	DepreciationAmt
Book Value	$33,124,507	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,936,809	OtherCostOrOtherBasisAmt
Depreciation	$2,379,858	DepreciationAmt
Book Value	$556,951	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$76,899,649	OtherCostOrOtherBasisAmt
Depreciation	$59,767,831	DepreciationAmt
Book Value	$17,131,818	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,945,566	OtherCostOrOtherBasisAmt
Depreciation	$2,266,366	DepreciationAmt
Book Value	$5,679,200	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$58,846,241	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Scholarship Account	$17,022
Physician Income Guarantee	$217,062
Due from Related Parties	$153,084,536
DUE FROM THIRD PARTIES	$1,096,550

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$154,415,170	TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt	$165,876,668	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$7,739,673	OtherRevenueAmt
Revenue Not Reported	-$7,739,673	RevenueNotReportedAmt
Revenue Subtotal	$173,616,341	RevenueSubtotalAmt
Other Revenues Not Included	-$101,518	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$101,518	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$173,514,823	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$142,082,584	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$101,515	OtherExpensesIncludedAmt
Expenses Not Reported	$101,515	ExpensesNotReportedAmt
Expenses Subtotal	$141,981,069	ExpensesSubtotalAmt
Other Expenses Not Included	$7,739,673	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,739,673	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$149,720,742	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 (7,739,673) PART XI LINE 4B AMOUNTS INCLUDED IN 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 135,874 LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT (237,367) ROUNDING (25) --------- (101,518) PART XII LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON 990 PART IX: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 135,874 LOSS ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT (237,367) ROUNDING (22) --------- (101,515) PART XII LINE 4B AMOUNTS INCLUDED ON 990 PART IX BUT NOT ON LINE 1: --------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT 7,739,673

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	$312,204	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$312,204	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$24,706,280	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,481,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,225,030	NetCommunityBenefitExpnsAmt
Total Expense	0.05810	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$25,018,484	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,481,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,537,234	NetCommunityBenefitExpnsAmt
Total Expense	0.06030	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	231	ActivitiesOrProgramsCnt
Persons Served	6374	PersonsServedCnt
Total Community Benefit Expns	$8,580	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,580	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	13	ActivitiesOrProgramsCnt
Persons Served	20	PersonsServedCnt
Total Community Benefit Expns	$5,384	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,384	NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	216	PersonsServedCnt
Total Community Benefit Expns	$4,638	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,638	NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	276	ActivitiesOrProgramsCnt
Persons Served	6625	PersonsServedCnt
Total Community Benefit Expns	$18,602	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$18,602	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	278	ActivitiesOrProgramsCnt
Persons Served	6625	PersonsServedCnt
Total Community Benefit Expns	$25,037,086	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,481,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,555,836	NetCommunityBenefitExpnsAmt
Total Expense	0.06040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$7,739,672	BadDebtExpenseAmt
Bad Debt Expense Attributable	$6,791,991	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$51,083,280	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$53,912,314	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,829,034	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	0.60000	0.00000	0.40000
BLUEGRASS IMM CARE
URGENT TREATMENT CLINIC	0.73000	0.00000	0.27000

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
Information Gaps	Yes (X)	InformationGapsInd
Other	Yes (X)	OtherInd
CHNA Conducted	14	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	14	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
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
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 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.
SCHEDULE H, PART V, SECTION B, LINE 22	INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE --------------------------------------------- THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON INCOME GUIDELINES AND ACTUAL CHARGES STATED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 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

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 2014, 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 $7,739,672.
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 HTTP://WWW.EMHEALTH.ORG/INDEX.PHP/SERVICES/COMMUNITY-SERVICES

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	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	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	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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
DONALD HAMNER MD
BOARD MEMBER	$0	$169,112	$0	$69,322	$0	$0	$0	$7,869	$0	$2,945	$0	$249,248	$0	$0
WILLIAM SNAPP
VP & CFO	$0	$327,641	$0	$46,097	$0	$7,538	$0	$100,900	$0	$24,310	$0	$506,486	$0	$46,097
VICKI DARNELL
CEO	$0	$605,668	$0	$81,754	$0	$33,278	$0	$235,934	$0	$27,579	$0	$984,213	$0	$81,754
CARL METZ
VP HUMAN RESOURCES	$232,509	$0	$21,021	$0	$18,264	$0	$46,706	$0	$15,340	$0	$333,840	$0	$21,021	$0
MICHELLE DELUCA FRALEY
PHARMACIST	$139,353	$0	$0	$0	$2,051	$0	$11,778	$0	$24,664	$0	$177,846	$0	$0	$0
JOAN HALTOM
PHARMACY DIRECTOR	$191,285	$0	$12,023	$0	$2,205	$0	$29,903	$0	$15,061	$0	$250,477	$0	$12,023	$0
RONALD BARBATO
REHAB DIRECTOR	$162,225	$0	$10,154	$0	$8,488	$0	$25,063	$0	$14,571	$0	$220,501	$0	$10,154	$0
ANDREW LOSCH
PHARMACIST	$142,803	$0	$0	$0	$6,663	$0	$11,320	$0	$7,728	$0	$168,514	$0	$0	$0
TINA COOLEY
PHARMACIST	$146,102	$0	$0	$0	$291	$0	$10,529	$0	$928	$0	$157,850	$0	$0	$0
MARK MILNER
VP CLINICAL EFFECTIVENESS	$139,997	$0	$0	$0	$15,694	$0	$34,826	$0	$14,749	$0	$205,266	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, QUESTION 6A

MANAGEMENT INCENTIVE PLANS -------------------------- Ephraim McDowell Health, Inc. and its affiliates have 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.

SCH J, PART I, LINE 4B

SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ----------------------------------------- VICKI A DARNELL PARTICIPATED IN A 457(F) PLAN DURING THE YEAR. THE ENDING BALANCE IN THE ACTUARIAL VALUE OF HER NONQUALIFIED RETIREMENT PLAN WAS $153,430. NOTE: THIS AMOUNT REPRESENTS THE ACCRUED BENEFIT AMOUNT AND IS SUBJECT TO RISK OF FORFEITURE.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 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. 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, women's health services and wound healing center. Ephraim McDowell Regional Medical Center for Fiscal Year (FY) 2015 experienced 8,028 admissions including nursery, and 37,011 patient days for all services including nursery, but excluding observation days. Observation patient days for FY 2015 totaled 3,017. Outpatient registrations (including ER visits) was131,208 compared to 139,064 in FY 2014. Surgical procedures at EMRMC were 4,521 in FY 2015 as compared to 4,537 in FY 2014, reflecting a decline in procedures. The ambulatory surgical center procedures in FY 2015 were 6,564 verses 6,510 in FY 2014. Expanded service modalities were added 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 additions included the following: - Radio frequency-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 Targeted-Radiofrequency Ablation (t-RFA) therapy for rapid pain relief from metastatic spinal tumors was added as a treatment option for cancer care. - The Xenex robot was added to the infection control process to destroy highly contagious germs such as, MRSA, C-diff, and Ebola. This is especially critical given the age of the population in the service area, the number of nursing home clients served, and Centre College's sponsorship of studies abroad for both students and facility members. Community Health Education - GeneraL ------------------------------------ Cancer Education - Over 1,000 individuals participated in skin cancer awareness events at InterCounty Energy; 250 each at Lincoln and Boyle County Relay for Life events, and 250 at Casey County Apple Festival. Approximately 900 regional 4-H campers received sun screen, lip balm and sun safety education. Additionally, various sports groups received sun safety products and education. EPA sun safety literature, sun screen and lip balm with sun screen was distributed to re-enforce the message of sun safety. In total, two thousand nine hundred and twenty-five individuals received sun safety items distributed at eighteen sites. All funded by Ephraim McDowell Health Care Foundation (EMHCF). CPR/First Aid - A total of 25 community members from the service area, spanning in age from teens to senior citizens, were trained in CPR/first aid at no cost to the individuals or host organization. This service was funded by the EMHCF. This is down 200 individuals from FY 2014 due to loss the loss of a community CPR instructor. As of FY 2016, a new instructor has been contracted to provide this service and there is a waiting list for classes. Education Website/Community Publication - Eleven 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, including but not limited to intentional care of the spirit. All information can be reproduced and used for congregational information/education. Exercise/Fitness - In collaboration with the regional 4-H chapter, Wilderness Trace YMCA, The Salvation Army, Boyle, Lincoln, and Danville school systems and McDowell Wellness Center 5,970 children school age through teens were served. Venues included, but were not limited to: Mercer County horse camp, Healthy Kids Day, Bunny Davis Center, Wilderness Trace YMCA, The Salvation Army day camp and Feltner 4H camp. The programs focused on developing leadership skills, promoting physical activity, and encouraging healthy life style Health Fairs - Services were offered at 60 events at 42 sites in Boyle, Lincoln, Garrard, Mercer, Casey, Washington, and Madison Counties with focus on reaching at risk and vulnerable populations. Including all adult programs, 16,286 community contacts occurred (screenings, education, support groups, etc.). Forty-two percent of participants were male (an 8 percent increase from the prior year); 62 percent were female. Ninety-five percent of clients served were Caucasian, two percent were African America (a four percent decline from the prior year), and two percent Hispanic (a two percent decline from the prior year). Thirty percent of participants served by community benefit programs had a household income below $35,000 (this is a 15 percent decline). Ten percent of participants served were unemployed; a two percent decrease in unemployment from FY 2014. Thirty-nine percent in the population served were retired; compared to 26 percent in 2014. The increase in retirees reflects both early retirement for some individuals unable to find work and therefore no longer seeking employment and the aging of the population. The uninsured served decreased to six percent in FY 2015 compared 11 percent in 2014. Eighty-six percent of participants reported a primary care provider (PCP) compared to 68 percent in 2014. 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) listing for the region for the uninsured participant or those without a PCP. Forty-nine percent of screening tests were abnormal (a five percent increase over 2014) with 17 percent requiring a referral for follow-up (a 5 percent increase from 2014). One explanation for the increase in referrals for follow-up relates to the addition of some new screening sites. Parish Nursing Program - Grant funding from Ephraim McDowell Health Care Foundation made possible the Faith Community Nursing educational programs. The Faith Community Nursing Foundation Course in the fall of 2015 produced nine graduates. A partnership with University of Kentucky (UK) College of Nursing made possible both KBN and ANCC credits for the course participants. Faith Community Nursing (FCN) faculty provided consultation and served as faculty for the Tri-State Foundation Course in Southern Indiana in collaboration with the University of Southern Indiana. Ninety-six 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. Eleven 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, and Centenary United Methodist Church of Danville. Actives include, but are not limited to, home visits, nursing home visits, blood pressure checks, health and wellness programs, support groups, referrals for follow care organizing flu clinics, organizing health screenings, home visits, 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 FCN regarding their blood pressure the better their blood pressure control. School-Based Programs - High school aged students were involved in the building of a canvas and producing an original piece for an opening night at the Community Art Center. This is both a skill building project and a self-esteem enhancing project (Rosenbum). Students from Boyle County, Danville, and Bruce Hall Day Treatment Center participated in the program, producing 47 paintings. The exhibit was viewed by 1,684 community visitors du
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	Community Health Education - Self Help ------------------------------------- Fitness/Exercise - One hundred and seventy-seven attendees participated in the "Get Moving" event at Millennium Part in conjunction with the Danville School System, Community Service Department, McDowell Wellness Center and Centre college staff leading a 10,000 step challenge. Jump ropes, water bottles, pedometers were proved to the participants. Nerf footballs and water bottles were provided The Salvation Army - Day Camp and A Children's Place for a summer fitness project with school aged children conducted a summer fitness program. Four hundred school age children participated in the Boyle County Healthy Kids Day as part of the student fitness project. Tobacco/Smoking Cessation - There was a 39 percent decrease in the number for individuals referred to the area health departments for smoking cessation assistance: 55 in FY 2015 verses 90 the prior year. The continued decline in adults reporting tobacco use is believed to be attributed to the passage of no smoking ordinance in some of the communities served and massive public awareness campaign. A statewide ordinance has been drafted by some of the agencies (FHK, SoAHEC, etc.) for consideration by the legislature during the 2016 session. Plans have been made by the health departments and SoAHEC for e-cigarette and vapor products to be part of the both the legislative proposal and public education due to the observation of increase use of these products, especially by the youth. Stress Management - One hundred sixty two individuals were screened using the perceived stress scale: a 62 percent increase from 2014. 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. Eighteen percent received a recommendation for follow-up. 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 ------------------------------------------- Alzheimer's - Ten Alzheimer's 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 Alzheimer's Disease based upon the 2014 CHNA and implementation plan. Community-Based Clinical Services-Health Screenings --------------------------------------------------- Blood Pressure Screening - Blood pressure screenings were offered at 37 sites, serving 855 individuals this represents a 59 percent decrease in blood pressure screening from the prior year. There was a six percent increase of clients with a blood pressure reading that exceeded the recommended range by the American Heart Association (AHA): 83 percent versus 77 percent in FY 2014. 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. Data analysis by our Centre intern for health economics reveals that for each repeat blood pressure screening there is a 3.9% improvement in client systolic blood pressure reading. 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 - The Ephraim McDowell Health Care Foundation (EMHCF) funded colorectal screening at 21 sites for a total distribution 214 kits with a 50.5 percent return rate; a 7% improvement from 2014 return rate. Kits were distributed in six counties. Sites included churches, senior citizen centers, wellness center, assisted living facilities, health departments, clinics, hospital lobbies, and the county extension service offices. There was a three percent referral rate for follow-up. There has 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. This is one of the implementation strategies for early detection of cancer based upon the identified need in the 2014 CHNA. Cancer- Skin Screening - The Ephraim McDowell Health Care Foundation (EMHCF) funded skin cancer screening by a licensed independent practitioner (LIP) May thru July. Fifty four individuals were seen. Seventy percent were female; 30 percent male. Fifty-eight percent had never been screened for skin cancer. Forty-six percent stated on an exit survey that they would not have seen their doctor for a skin cancer screen. Ninety-one percent had a primary care provider; compared to 94 percent the prior year. Thirty-three percent were referred to a specialist for follow-up care compared to 43 percent in FY 2014. 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 676 clients in seven counties at 23 sites within health ministries and community settings with 31 percent of participants exceeding the recommend range as set by American Heart Association (AHA); this is a 7 percent increase in total lipids exceeding range from 2014. Thirty eight percent was seen in the Healthy People:Healthy Community study group that seeks to reduce cardiovascular disease risk by client education and life-style changes compared to 31 percent seen in the general population. We attribute the change to the fact that one or more modifiable CVD risk factors must be present to enroll in the HRSA Outreach project due to the focus being to teach the clients how to track and improve their cardiovascular (CVD) risk profile. Within the lipid panel 67 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. One hundred sixty individuals were screened with 55 percent of participants being referred to their primary care provider for follow-up care. There was over a 200 percent increase in the number of individuals screened due to adding additional sites including the local golf courses and the Ephraim McDowell Commonwealth Cancer Center as partners in this effort for prevention and early detection of the most common type of cancer and fastest grow incidence of cancer in the Commonwealth. 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 676 participants. Thirteen percent exceeded the recommended range as set by the American Diabetes Association (ADA) compared to 11 percent in FY 2014. 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 a grant was submitted for A1c monitoring equipment for future screenings of individuals at risk for diabetes or diagnosed with diabetes. 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
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	Health Professions Education ----------------------------- Continuing Health Professions Education - The Director for Rehabilitation Services Department serves on Physical Therapy Health Professions Board Meeting for the Commonwealth of Kentucky. This board meets monthly for two hours at an estimated organizational cost of $1,512. Issues of the profession were addressed including educational requirements, licensure, reimbursement, scope of service and professional practice standards. Interns, Residents and Fellows - Fiscal year 2015 there were neither interns nor Fellows at EMRMC. There were ten Emergency Service Residents from University of Kentucky and University of PikevillE. Medical Students - Twenty-four medical students rotated through emergency services, anesthesia, OB, pediatrics, psychiatry, family medicine and/or surgical services with EMRMC medical staff mentors. Students were from University of Kentucky, University of Pikeville, and Des Moines University College of Osteopathic Medicine. Twelve physician assistant (PA) students rotated though emergency, and surgical services with a mentor; this represents a 25 percent increase in PA student rotations. Affiliated programs included: University of Kentucky, Lincoln Memorial University, and University of the Cumberland's Sixteen advanced practice nurses (APRNs) rotated through emergency services or primary care clinics in FY 2015 with a LIP mentor. This represents an 81 percent increase in the number of NP or APRN students. Schools included: Frontier Nursing, Eastern Kentucky University, South University and Indiana Wesleyan University. Nursing - Three hundred fifty-seven nursing students completed their clinical experience and/or practicum at EMRMC in FY 2015. Educational partners included Campbellsville University, University of Kentucky, Eastern Kentucky University, Midway College, St. Catherine's College, Bluegrass Community & Technical College, Beckfield College, and Breckenridge School of Nursing & Health Sciences at ITT Technical Institute, Somerset College. This represents a 20 percent decrease in nursing students, LPN, AD, and BSN. Affiliated nursing schools reported a decline in enrollment. Other Allied Health Professions - The Certified Nursing Assistant Course had 25 students enrolled in 2015 compared to 43 in 2014 (42% 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, Sullivan, Marshal, St. Catharine's College - Springfield, Spaulding University, Bellarmine University, Belmont University, Jefferson Community College, Eastern Kentucky University, University of Kentucky, Western Kentucky University, Shawnee, Midway College, Lindsey Wilson College, , Indiana Wesleyan, Campbellsville University, Centre College, Cumberland University, and University of Louisville Health Sciences. There was a decline in the number of allied health students in the following areas: medical technologist, phlebotomy, radiography technician, scrub tech, information services, and Echo technicians. Physical therapy assistant student rotation is scheduled for 2016.There was a 31 percent increase in the number of pharmacy students. One hundred forty-five area students had a job shadowing experience in 35 different areas of EMRMC in FY 2015 This reflects a fifteen percent decrease in the number of students job shadowing within the organization. This is consistent with the decreased enrollment seen in the nursing programs. Research -------- Community Health Research - HRSA Outreach Grant: Healthy People: Healthy Communities targeted cardiovascular disease (CVD) risk factor reduction in an austere rural population. Lincoln, Garrard, Mercer and Boyle County Health Departments and Boyle County Extension Office collaborate with EMRMC on this grant. The intended scope of the project was to reach 400 individuals for participation in the grant project with RN follow up and coaching. The goal was exceeded. Screening included cholesterol (either total or lipid panel), glucose (either fasting or non-fasting), body mass index, blood pressure, pulse check for atrial fibrillation, family history of stroke, tobacco use, and activity level. Results of testing were recorded on the Stroke Risk Scorecard. A copy of all information was given to the participant. The Healthy People: Healthy Communities study had institutional review board approval. Enrollment for the study opened in September 1, 2012. The IRB was updated annually with renewal of the approval to continue the project. There were no untoward events during the 3 year project. In FY 2015 there were 2,739 contacts made with those enrolled in the Healthy People:Healthy Communities research program by the RN case managers. The monthly contacts were designed to assist in removing barriers to making the necessary life style changes required for reduction of cardiovascular risk factor related behaviors. The program was evaluated by client feedback at each screening and at the close of the project plus an outside reviewer for the biometrics/outcomes component of the study. Georgia State University provided a return on investment analytic tool. Data analysis revealed women had a worse risk factor profile than men, this was noteworthy and further study is needed. The one factor that did change over time was an increase in HDL, which is heart protective. There was a tread toward the lowering of other risk factors, but not at a statically significant level. Further recommendations include a stronger intervention and a longer follow-up period, potentially 5 years. . Financial Donations for the Community - In Kind ----------------------------------------------- Personnel/Administrative Support - A staff member serves on the Boyle County 4-H Counsel. Community Service staff participate in both the Boyle and Lincoln Counties Integrated School Health Committees. This all volunteer group works to improve the School Health Index issues that have community impact. Staff also served on the Danville PEP grant implementation team. 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. A staff member serves on the governing board for Christian Care Communities, addressing affordable, safe housing for the elderly in the commonwealth across the health care spectrum from independent living to skilled care. The rehabilitation services director serves on the Physical Therapy Board. A staff member from marketing serves on The Salvation Army Board. A staff member from marketing serves on the Rotary Board. This civic group works on both local and international projects to improve community life. A Community Service staff member serves on the board of Area Health Education Center (AHEC). Southern AHEC has focused on the education of rural health care providers. Programs include career days for high school students in the region, Health Career Camps for high school students for exposure to potential careers and mentors, continuing education programs for health career providers, clinical rotation placement (including housing, if needed) for health care shortage providers and areas Community Building Activities ----------------------------- Coalition Building - Heroin overdose and deaths in the service area have increased at an alarming rate. A mental health professional from the Centre College has put together a broad community coalition to address the many faucets of this public health issue. The emergency department nursing and medical directors have worked with this group. An Ephraim McDowell administrative assistant services as the recording secretary for the task force. A case manager also serves on the task force. Community Service staff served in two statewide planning sessions with District 4-H leaders related to the annual Kentucky youth leadership conference. There were a total of 75 community members involved in the conference planning process. 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 governance, and workforce committees for Christian Care Communities Board advocating for safe housing and care for the elderly. Community Service staff supported the education of health care professionals by serving on the board of the Southern Area Health Education Council assisting with the draft of smoke free Kentucky legislation. Community Service st
PROGRAM SERVICE ACCOMPLISHMENTS (CONT)	Community Benefit Operations ---------------------------- Community Health Needs Assessment - Professional Research Consultants of Omaha, Nebraska was engaged to conduct a scientifically valid six county CHNA for the system, including EMRMC, at a cost of $84,537. The confidence level is 95 percent for a sample of 1,000 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 2015-2017. Once reviewed by the board, the report and implementation plan were posted on the website for public access. Findings were shared with community partners and speaking engagements were set up to share the findings throughout the service area during the FY 2015. 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 children's program coordinator, faith community nursing coordinator, a part-time community benefit coordinator and part time project coordinator all reporting to System Director, Nursing Administration, Regulatory Compliance, Associate Education, and Community Services. Total salary expense for dedicated community benefit staff was $2754,143 for FY 2015; with the decrease reflecting the reduction in hours within the department. Community Services total expense was $373,437. There was a part-time RN project director dedicated to the Healthy People: Health Community research and outreach program funded by the HRSA outreach grant. The cardiovascular risk reduction grant expended $165,436 in HRSA funds during FY 2015. There was a part time nurse practitioner and office manager for the Hope Clinic. Salary expenses were $12,526 for FY 2015. The reporting structure is that all department functions report to the system director and 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. FY 2015 there was no revisions of the implementation plan requiring board action, just approval of the budget. EMRMC staff volunteered in area churches and Children's ministry programs within the service area that focused on spiritual development and well-being served 1,060 children. Other services include volunteer faith community nurses serving within many of the local congregations. The result being blood pressure screening, coordination of care, referrals, education related to health risk, end of life care decisions, 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 Band Festival, 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 area. 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, health issues such as obesity, high blood pressure, high stress and poor mental health, lower employment rates, lower income, and less social support. This area will be deferred, but the work with school age children related to diet, activity, and self-esteem has preventative value (DPP). 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 Alzheimer's support group in Boyle and Mercer Counties. Also there is mental evaluation and medication management available by a psychiatrist at the medical center. James B. Haggin Hospital offers adult day care that serves some clients. Danville Health & Rehabilitation Center has an Alzheimer long term care unit. The Sanders Brown Center at the University of Kentucky has on-going Alzheimer's related research and serves as a referral center for the region. 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 and Community Service staff 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
FORM 990, PART VII, SECTION A	PART-YEAR OFFICERS ------------------ BILL DEMROW SERVED ON THE BOARD AS VICE CHAIRMAN UNTIL MARCH 2015 WITH ALLEN WHITE REPLACING HIM THROUGH THE REST OF THE YEAR.
FORM 990, PART XI, LINE 8	RECONCILIATION OF NET ASSETS ---------------------------- ROUNDING $3
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:16269426
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:3320376

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