2014-10-13T07:11:38-05:00 2013-12-31 351178661 BLUE & CO LLC ONE AMERICAN SQUARE 2200 INDIANAPOLIS IN 46282 990 2013-01-01 350895832 THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON INDIANA INC BETH 8128010800 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 STEVE MEACHAM VP OF FINANCE 8128010800 2014-10-13 1 CARRIE A MERRILL CPA P00832283 3176334705 2013 2015-11-30 17:44:51Z X KING'S DAUGHTERS' HEALTH STEVE MEACHAM 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 138667827 0 X WWW.KDHMADISON.ORG X 1899 IN TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. 10 8 1168 70 11105 -10170 109631 1086439 107522048 111685302 -584888 -1787533 0 2948480 107046791 113932688 59688 64750 0 0 61610729 66191410 0 0 0 42011317 55574589 103681734 121830749 3365057 -7898061 239072764 235555035 114496229 115305835 124576535 120249200 THE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION. 0 0 100745155 64750 114241985 THE KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL OWNED BY THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON, INDIANA, INC., LOCATED IN MADISON, INDIANA. THE HOSPITAL IS ORGANIZED FOR THE PURPOSE OF PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA. THE HOSPITAL PROVIDED HEALTHCARE TO PATIENTS AT THE FOLLOWING LEVELS FOR 2013: 14,111 DAYS OF CARE TO ACUTE INPATIENTS 1,046 DAYS OF CARE TO NEWBORN INFANTS 185,184 VISITS ASSOCIATED WITH HOSPITAL OUTPATIENTS 137,291 VISITS ASSOCIATED WITH PHYSICIAN CLINICS 6508098 THE HOSPITAL'S PRIMARY SOURCES OF SUPPORT ARE FROM PATIENT REVENUES. PATIENT REVENUES INCLUDE FUNDS RECEIVED FROM MEDICARE, STATE AGENCIES, INSURANCE COMPANIES, AND THE PATIENTS THEMSELVES. IN 2013, THE KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES PROVIDED SERVICES TOTALING $6,508,098 IN GROSS CHARGES TO PATIENTS WHO MET THE HOSPITAL'S CHARITY CARE POLICY. 107253253 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 1 78 0 1 1168 1 1 1 0 0 0 0 1 1 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X DAWN NUNAN DIRECTOR OF ACCOUNTING 8128010193 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 MAUREEN GETZ BOARD CHAIRWOMAN 1.00 1.00 X X 750 0 0 PAULA HEIDERMAN BOARD VICE CHAIRWOMAN 1.00 1.00 X X 750 0 0 PAM KIMMEL BOARD SECRETARY 1.00 0.00 X X 750 0 0 JEAN DONNELLON BOARD ASSN'T SECRETARY 1.00 0.00 X X 500 0 0 LINDA SLOFFER BOARD TREASURER 1.00 1.00 X X 750 0 0 ANDREA FORRESTER BOARD ASSN'T TREASURER 1.00 0.00 X X 750 0 0 GARY KENNON BOARD MEMBER 1.00 0.00 X 0 0 0 JONATHAN HANSON MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 487790 0 38365 PAT STACK MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 277745 0 38470 MARY BETTE VOYLES BOARD MEMBER 1.00 0.00 X 750 0 0 ROGER ALLMAN PRESIDENT/CEO 1/1/13-6/21/13 40.00 1.00 X 1191145 0 21510 CAROL DOZIER PRESIDENT/CEO 7/15/13-12/31/13 40.00 1.00 X 161221 0 7224 STEVE MEACHAM VP FINANCE 40.00 0.00 X 216374 0 28661 LARRY KEITH VP CLINICAL SERVICES 1/1/13-9/3/13 40.00 0.00 X 118353 0 10883 LISA MORGAN VP PATIENT SERVICES 40.00 0.00 X 162785 0 24334 DENINE FALLIS-HALLGARTH VP PHYSICIAN PRACTICES 40.00 0.00 X 143073 0 16810 HOLLY ROBINSON CHIEF MEDICAL OFFICER 40.00 0.00 X 291866 0 38307 THOMAS ECKERT MD EMPLOYED PHYSICIAN 40.00 0.00 X 733327 0 36342 TRAVIS CLEGG MD EMPLOYED PHYSICIAN 40.00 0.00 X 1144237 0 38802 WILLIAM SKILES MD EMPLOYED PHYSICIAN 40.00 0.00 X 655144 0 25836 MICHAEL SCHMIDT MD EMPLOYED PHYSICIAN 40.00 0.00 X 647676 0 39498 GEORGE ALCORN MD EMPLOYED PHYSICIAN 40.00 0.00 X 837172 0 28537 7072908 0 393579 66 0 1 0 WEHR CONSTRUCTORS INC 2517 PLANTSIDE DRIVE LOUISVILLE IN 40299 CONTRACTOR SERVICES FOR THE CONSTRUCTION 1443832 JACOBUS CONSULTING 29883 SANTA MARGARITA PKWY RANCHO SANTA MARGARITA CA 92688 HEALTHCARE CONSULTING 866345 FIRST UROLOGY PSC PO BOX 1087 JEFFERSONVILLE IN 47131 CONTRACTED PHYSICIAN MEDICAL SERVICES 616778 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY SERVICES 609719 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 CONTRACTED PHYSICIAN MEDICAL SERVICES 605909 32 1009059 76615 765 1086439 NET PATIENT SERVICE REVENUE 621110 111685302 111674197 11105 111685302 1406252 1406252 54107 52953 1154 1154 1154 20990981 497420 18696907 5985279 2294074 -5487859 -3193785 -3193785 EHR REVENUE 621110 2370500 2370500 CAFETERIA REVENUE 722210 284316 284316 OTHER 621110 196134 196134 96376 96376 2947326 113932688 114241985 11105 -1406841 64750 64750 3279916 2623933 655983 49994030 44449043 5544987 1941927 1747734 194193 7651774 6886597 765177 3323763 2991387 332376 321297 321297 413970 413970 262226 262226 244483 220035 24448 1658586 1360041 298545 398153 358338 39815 1906549 1715894 190655 149450 134505 14945 4702261 4232035 470226 11162837 10046553 1116284 1267119 1140407 126712 PURCHASED SERVICES 8076736 7269062 807674 DRUGS 7748813 7748813 SUPPLIES 6001451 5101233 900218 HOSPITAL ASSESSMENT FEE 4026986 4026986 7233672 5135907 2097765 121830749 107253253 14577496 0 11850571 7422970 1000000 10420027 10039288 39808 195049 683767 422538 2316588 2323063 1352381 943738 175200077 38579141 130930226 136620936 77401757 68718897 4077639 7868556 239072764 235555035 13683682 13166714 97934743 97975255 489902 1306836 2387902 2857030 114496229 115305835 X 124379819 120040475 186716 198725 10000 10000 124576535 120249200 239072764 235555035 X -7898061 3983718 -412992 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7863 7863 0 PART II-B, LINE 1: PORTION OF INDIANA HOSPITAL ASSOCIATION DUES AND AMERICAN HOSPITAL ASSOCIATION DUES ATTRIBUTABLE TO LOBBYING EXPENSES AS DISCLOSED ON THE DUES NOTICES OF THE RESPECTIVE ASSOCIATIONS. 196716 48484 36475 208725 129738 86924 19946 196716 137154 40020 47436 129738 127555 62386 52787 137154 89334 84150 45929 127555 0.04790 0.95210 0 0 5622068 5622068 112551672 13398628 99153044 56126079 25180513 30945566 900258 900258 136620936 DEFERRED COMPENSATION 123040 THIRD PARTY PAYABLE 1300000 LIFE INSURANCE POLICIES 1433990 2857030 X 118631014 3983718 994028 4977746 113653268 262226 17194 279420 113932688 121604282 52953 52953 121551329 262226 17194 279420 121830749 PART V, LINE 4: PERMANENT ENDOWMENT - INTENT IS TO HOLD THE INVESTMENT IN PERPETUITY. PER AUDITED FINANCIAL STATEMENTS, "THE PORTION OF PERPETUAL ENDOWMENT FUNDS THAT IS REQUIRED TO BE RETAINED PERMANENTLY EITHER BY EXPLICIT DONOR STIPULATION OR UPMIFA" IS $10,000 AT 12/31/2013. TERM ENDOWMENT - TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE INCLUDING: PRENATAL/POSTNATAL EDUCATION PROGRAM FUND, TOBACCO SETTLEMENT FUND, TEEN EVENT FUND, GIRLS ON THE RUN FUND, MAY LIBRARY FUND, AND FIT KIDS FUND. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 52,953. CHANGE IN CAPTIVE INSURANCE COMPANY 941,075. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANTS 17,194. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 52,953. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS 17,194. 1 1 1 X 0 1 1 1 0 1 1 2411706 2411706 0.01980 19884449 9529455 10354994 0.08500 22296155 9529455 12766700 0.10480 2533 207529 49404 158125 0.00130 60 297879 36250 261629 0.00210 4727 4387899 3782900 604999 0.00500 250 74706 74706 0.00060 7570 4968013 3868554 1099459 0.00900 7570 27264168 13398009 13866159 0.11380 50 195 195 0.00000 128 1056 1056 0.00000 1007 161120 161120 0.00130 1010 1377 1377 0.00000 2195 163748 163748 0.00130 0 14239677 0 21146638 24678149 -3531511 X 1 1 1 MADISON CATHETERIZATION SERVICES LLC PROVIDES CATHETERIZATION SERVICES 0.51000 0.00000 0.00000 1 1 KING'S DAUGHTERS' HEALTH 1373 EAST STATE ROAD 62 PO BOX 447 MADISON IN 47250 WWW.KDHMADISON.ORG 14-005063-1 X X X KING'S DAUGHTERS' HEALTH 1 1 X X X X X X X X X X 13 1 0 1 X WWW.KDHMADISON.ORG/ABOUT_NEEDSASSESSMENT. X X X X X X X X X X X 0 0 1 1 200.000000000000 0 1 X X X X X X X 1 1 X X X 1 0 X X X X X 1 X 0 0 KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 1J: THE NEEDS ASSESSMENT PERFORMED BY THE HOSPITAL ALSO EXPLORED KEY ISSUES SUCH AS: PHYSICAL ACTIVITY, OVERWEIGHT AND OBESITY, TOBACCO USE, SUBSTANCE ABUSE/GAMBLING/ADDICTIONS, RESPONSIBLE SEXUAL BEHAVIOR, MENTAL HEALTH, INJURY AND VIOLENCE (INCLUDING DOMESTIC VIOLENCE AND SEXUAL ASSAULT), ENVIRONMENTAL QUALITY, IMMUNIZATION, ACCESS TO HEALTH CARE FOR THE INSURED AND UNINSURED, MATERNAL AND CHILD HEALTH, INFECTIOUS DISEASE, OCCUPATIONAL AND SAFETY HEALTH, SPECIAL NEEDS/DISABLED/IMPAIRED, AND CHRONIC DISEASE. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 3: THE FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS IN THE COMMUNITY BY UTILIZING THE FOLLOWING COMPONENTS:- ANALYSIS OF SECONDARY DATA TO DEVELOP A PROFILE OF THE RESIDENTS OF EACH COUNTY AND TO INDICATE, WHERE POSSIBLE FUTURE TRENDS AND TO SHOW COMPARISONS WITH STATE AND NATIONAL DATA;- IN-PERSON INTERVIEWS WITH 30 KEY LEADERS WITHIN KDH INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 44 COMMUNITY LEADERS INCLUDING GOVERNMENT, MEDICAL, EDUCATION, AND OTHER COMMUNITY LEADERSHIP POSITIONS IN ALL FIVE COUNTIES;- IN-PERSON SURVEYS OF 72 INDIVIDUALS IN LOW INCOME LOCATIONS;- IN-PERSON DISCUSSIONS WITH 19 SENIOR CITIZENS;- A WEB-BASED SURVEY OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 184 COMPLETED INTERVIEWS. THIS ASSESSMENT ALLOWED ALL INDIVIDUALS TO PROVIDE RESPONSES ON ANY COMMUNITY NEEDS NOT LISTED IN THE QUESTIONS AND ALLOWED INDIVIDUALS TO MAKE COMMENTS ON COMMUNITY HEALTH ISSUES ON WHICH KDH COULD HAVE AN IMPACT. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 5D: RESULTS OF THE NEEDS ASSESSMENT HAVE BEEN MADE AVAILABLE THROUGH A VARIETY OF SOURCES: NEWSPAPER AND RADIO RELEASES, DISTRIBUTION OF INFORMATION IN THE COMMUNITY NEWSLETTER, THE VITAL SIGNS, THROUGH PUBLIC HEALTH FORUMS. IT IS ALSO AVAILABLE ON OUR WEBSITE @WWW.KDHMADISON.ORG/ABOUT_NEEDSASSESSMENT.ASPX. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 6I: A SMALL COMMITTEE OF INTERESTED INDIVIDUALS WAS INVITED TO PARTICIPATE IN MEETINGS TO DETERMINE WAYS WE CAN WORK TOGETHER TO BETTER MEET THE NEEDS OF THE COMMUNITIES WE SERVE. THIS SMALL GROUP INCLUDED PARTICIPATION FROM THE JEFFERSON COUNTY HEALTH DEPARTMENT, OUR STATE GRANT FOR TOBACCO PREVENTION AND OUR KDH COMMUNITY RELATIONS PARTICIPANTS. AMONG THIS GROUP WAS INPUT FROM OTHER PARTIES AND AN INTERESTED VOLUNTEER MEDICAL STUDENT. THE NEEDS ASSESSMENT FINDINGS, AND THE IMPLEMENTATION STRATEGY, WERE SHARED WITH THE BOARD OF MANAGERS AND ALL ACTION PLAN ITEMS WILL BE INCORPORATED INTO THE WORKING STRATEGIC PLAN FOR THE ORGANIZATION. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 7: AS A RESULT OF THE 2013 COMMUNITY NEEDS ASSESSMENT, KDH WAS ABLE TO IDENTIFY 'GAPS' WHICH EXIST BETWEEN THE HOSPITAL'S COMMUNITY INVOLVEMENT AND THE UNFULFILLED NEEDS OF THE COMMUNITY WHICH IT SERVES. THESE NEEDS WERE IDENTIFIED VIA INQUIRIES OF COMMUNITY MEMBERS WHICH ARE DETAILED AT PART V LINE 3. THE EXAMPLES OF THESE ARE AS FOLLOWS:- THERE DO NOT APPEAR TO BE LARGE GAPS IN THE TOPICS OR TYPES OF COMMUNITY OUTREACH PROGRAMS THAT KDH HAS CONDUCTED IN THE PAST. HOWEVER, THERE MAY BE GAPS DUE TO FUNDING LEVELS OR STAFFING LEVELS IN THE NUMBER OF PROGRAMS AND THE GEOGRAPHIC REACH OF THE PROGRAMS THAT HAVE BEEN OFFERED. UPDATE: IN 2011 IT BECAME NECESSARY TO ELIMINATE SOME OUTREACH PROGRAMS DUE TO FINANCIAL CONSIDERATIONS. UPDATE 2012: NO INCREASE IN OUTREACH OCCURRED IN 2012. UPDATE 2013: IN 2013 WE WERE ABLE TO BRING BACK SOME OF OUR OUTREACH PROGRAMS SUCH AS GIRLS ON THE RUN AND FIT KIDS IN AREA SCHOOLS. (PLEASE SEE COMMUNITY OUTREACH SUMMARY).- SOME INDIVIDUALS ALSO EXPRESSED THE IDEA THAT RESIDENTS IN THE COMMUNITY SERVED BY KDH MAY NOT BE AWARE OF THE EXISTING PROGRAMS AND SERVICES OFFERED AND MAY NOT BE AWARE OF THE LEVEL OF EXPERTISE OF THE STAFF. THESE ARE IDEAS THAT COULD BE ADDRESSED IN A STRATEGIC, WELL-PLANNED, LONG-TERM PUBLIC RELATIONS CAMPAIGN. UPDATE: FINANCIAL CONSTRAINTS HAVE ENCOURAGED US TO INCREASE AWARENESS OF PROGRAMS AND SERVICES THROUGH EXISTING RESOURCES SUCH AS THE QUARTERLY NEWSLETTER. UPDATE 2012: WE CONTINUE TO USE OUR QUARTERLY NEWSLETTER FOR AWARENESS. UPDATE 2013: WE CONTINUE TO USE MANY FORMS OF ADVERTISING TO PROMOTE COMMUNITY OUTREACH. QUARTERLY NEWSLETTERS CONTINUE, AS WELL AS MANY OTHER FORMS OF PROMOTION, SUCH AS SOCIAL MEDIA.- THE GAPS IN THE CURRENT MEDICAL SERVICE LINES AND THE MEDICAL SPECIALTIES DESIRED ARE WORTH EXPLORING. HOWEVER, THIS ANALYSIS FOCUSES ONLY ON EXPRESSED NEEDS AND DOES NOT CONTAIN PATIENT PROJECTION INFORMATION OR FINANCIAL ANALYSIS FOR A BUSINESS CASE ANALYSIS. UPDATE: THE FOLLOWING ADDITIONS OCCURRED IN A VARIETY OF MEDICAL SPECIALTY SERVICES IN 2011: ADDITION OF NEUROLOGY SERVICES IN MADISON, THE EXPANSION OF NEPHROLOGY SERVICES IN MADISON, THE EXTENSION OF OFFICE HOURS IN SOME PHYSICIAN PRACTICES, AND THE EXPANSION OF LABORATORY AND IMAGING SERVICES IN OUR CONVENIENT CARE CENTER. UPDATE 2012: THE FOLLOWING ADDITIONS OCCURRED IN A VARIETY OF MEDICAL SPECIALTY SERVICES IN 2012: ADDITIONAL CARDIOLOGY SERVICES, ADDITIONAL INTERNAL MEDICINE SERVICES, ADDITIONAL ORTHOPEDIC SERVICES, AND ADDITIONAL FAMILY PRACTICE IN ONE OF OUR OUTLYING CLINICS IN KENTUCKY. UROLOGY SERVICES WERE ALSO ADDED, AS WELL AS FURTHER EXPANSION OF NEUROLOGY SERVICES. THESE CHANGES HAVE HELPED US MEET THE NEEDS OF THE AREAS WE SERVE. UPDATE 2013: IN 2013 WE WERE ABLE TO ADD THE FOLLOWING SERVICES: INPATIENT DIALYSIS, ED PSYCH ASSESSMENT, AND AN AFFILIATION WITH NORTON CANCER CENTER. OUR ORTHOPEDIC SURGEON BEGAN TO SEE PEOPLE IN RIPLEY COUNTY AT OUR CLINIC THERE. IN ADDITION IN 2013 KDH OPENED A NEW HOSPITAL WITH IMPROVED SERVICES AND IMPROVED PRIVACY FOR PATIENTS. WE ALSO ADDED ONE GENERAL SURGEON, AND ONE FAMILY PRACTITIONER.- SEVERAL OF THE TOP MAJOR COMMUNITY HEALTH CONCERNS INVOLVE ADDRESSING THE FREQUENTLY INTER-RELATED ISSUES OF OBESITY, LACK OF PHYSICAL ACTIVITY, AND SMOKING. THESE HEALTH ISSUES LEAD TO CHRONIC DISEASE AND HAVE AN IMPACT ON PATIENTS SERVED BY KDH FACILITIES. THE MAJORITY OF COMMUNITY LEADERS EXPECT KDH TO TAKE A LEADERSHIP ROLE IN ADDRESSING OVERWEIGHT AND OBESITY AND TOBACCO USE. THOSE IN OUTLYING COUNTIES HAVE ASKED THAT CURRENT KDH PROGRAMS AVAILABLE IN JEFFERSON COUNTY BE OFFERED IN THEIR OWN COUNTIES OR AT A MINIMUM THAT THE JEFFERSON COUNTY PROGRAMS BE PROMOTED TO CITIZENS IN THESE OTHER COUNTIES FOR THEIR POTENTIAL ATTENDANCE. - KDH SHOULD CONSIDER WAYS IN WHICH IT CAN SET AN EXAMPLE AT ITS OWN FACILITIES FOR THE COMMUNITY; TOBACCO-FREE CAMPUS, HEALTHY FOOD OFFERINGS IN ITS CAFETERIA, WELLNESS PROGRAM. UPDATE: AT THE END OF 2011 A POSITION WAS ADDED TO SPECIFICALLY REACH OUT TO EMPLOYEES OF KDH AND OTHER AREA EMPLOYERS. THIS WAS DONE IN AN EFFORT TO "LEAD THE WAY" IN TERMS OF EMPLOYEE HEALTH AND WELLNESS. OUR CAMPUS REMAINED TOBACCO-FREE IN 2011. UPDATE 2012: WE CONTINUE TO WORK WITH EMPLOYEE HEALTH AND CORPORATE OUTREACH. ALL FACILITIES ARE TOBACCO-FREE. UPDATE 2013: IN 2013 WE EXPANDED OUR EMPLOYEE WELLNESS PROGRAM ADDING ADDITIONAL EMPLOYEE CHALLENGES AND HEALTH RELATED OPTIONS IN OUR CAFETERIA. WE ALSO REMAIN TOBACCO FREE AND HAVE UPDATED OUR TOBACCO FREE CAMPUS POLICY TO INCLUDE E-CIGARETTES. - IT SHOULD CONSIDER ASKING FOR GRANTS TO OFFER COMMUNITY OUTREACH PROGRAMS TO EDUCATE INDIVIDUALS ON TOPICS SUCH AS NUTRITION, HEALTHY WEIGHT, HEALTHY EATING, AND EXERCISE. UPDATE: IN 2011 SEVERAL GRANTS WERE OBTAINED TO ADDRESS COMMUNITY HEALTH AND WELLNESS. EX: TPPC: TOBACCO PREVENTION GRANTS FOR JEFFERSON, SWITZERLAND, AND DEARBORN COUNTIES IN INDIANA. UPDATE 2012: WE CONTINUE TO ACCESS AND USE FUNDS THROUGH THE TPPC PROGRAM. UPDATE 2013: IN 2013 WE WERE ABLE TO CONTINUE OFFERING TOBACCO PREVENTION PROGRAMMING THROUGH THE ISDH GRANT. THIS GRANT DOES NOT COVER DEARBORN COUNTY OR SWITZERLAND COUNTY. SEVERAL SMALLER GRANTS WERE OBTAINED TO ASSIST PEOPLE IN QUITTING THE USE OF TOBACCO.SUBSTANCE ABUSE - PARTICULARLY NARCOTIC AND PRESCRIPTION DRUGS, WAS ANOTHER TOP MAJOR HEALTH NEED CITED BY ALL GROUPS INTERVIEWED. IT IS PREVALENT IN ALL COUNTIES SERVED BY KDH. - THE LACK OF SUBSTANCE TREATMENT CENTERS AND MENTAL CARE FACILITIES TO REFER THESE TYPE OF PATIENTS TO IS A MAJOR CONCERN. UPDATE: KDH DOES NOT HAVE SUBSTANCE ABUSE TREATMENT CENTERS OR MENTAL HEALTH CENTERS. WE WORK CLOSELY WITH THE LOCAL COALITION AGAINST SUBSTANCE ABUSE (CASA) TO HELP ADDRESS THIS COMMUNITY PROBLEM. WE HAVE INCREASED PARTICIPATION OF HEALTHCARE PROVIDERS IN THIS ACTIVE COALITION, AND ARE BEGINNING TO INVESTIGATE HOW WE CAN HELP MOTHERS AND BABIES WHO DELIVER AT KDH DEAL WITH THIS ISSUE. UPDATE 2012: WORK CONTINUES WITH CASA TO IMPROVE ACCESS TO HELP FOR INDIVIDUALS NEEDING ASSISTANCE WITH SUBSTANCE ABUSE ISSUES. UPDATE 2013: IN 2013 KDH CONTINUES TO ACTIVELY WORK WITH OUR LOCAL COALITION AGAINST SUBSTANCE ABUSE. WE ALSO ADDED A SPECIAL "OBSERVATION ROOM" IN THE ER TO FACILITATE CARE FOR ACUTE SUBSTANCE ABUSE PATIENTS WHO PRESENT IN THE ER. - MANY INTERVIEWED FELT THE PUBLIC NEEDS TO BE AWARE OF HOW MUCH OF AN ISSUE SUBSTANCE ABUSE IS IN THE COMMUNITY I.E. AMOUNT OF BABIES BORN ADDICTED TO METH/DETOXIFICATION REQUIRED. UPDATE: THE CURRENT INCREASED PARTICIPATION IN OUR LOCAL COALITION AGAINST SUBSTANCE ABUSE, (CASA) WILL ENABLE US TO REACH OUT TO THE COMMUNITY TO ADDRESS THIS CONCERN. UPDATE 2012: CONTINUE TO WORK WITH CASA TO INCREASE AWARENESS INCLUDING PRINT ADS AND RADIO SPOTS. UPDATE 2013: IN 2013 KDH CONTINUED TO WORK WITH CASA (COALITION AGAINST SUBSTANCE ABUSE) TO INCREASE AWARENESS OF DRUG ISSUES. - THE NEED FOR FURTHER DRUG EDUCATION IN THE SCHOOLS FROM ELEMENTARY ON UP WAS MENTIONED NUMEROUS TIMES. UPDATE: CURRENTLY THE DARE PROGRAM IS BEING TAUGHT IN JEFFERSON COUNTY IN THE ELEMENTARY SCHOOLS. THE LIFESKILLS PROGRAM IS ALSO BEING TAUGHT AT THE MIDDLE SCHOOL LEVEL. UPDATE 2012: THESE TWO PROGRAMS CONTINUE IN THE JEFFERSON COUNTY AREA. UPDATE 2013: THESE TWO PROGRAMS CONTINUE IN JEFFERSON COUNTY. - BETTER COMMUNICATION BETWEEN KDH AND THE LOCAL LEGAL SYSTEM IS NEEDED. DOCUMENTATION OF OVERDOSE CASES IN THE ER WITH STATISTICS OF THE TYPES OF DRUGS CAUSING THE OVERDOSE (STREET VERSUS PRESCRIPTION) IS THE TYPE OF INFORMATION HELPFUL TO THE LEGAL SYSTEM. KDH PHYSICIANS MENTIONED THAT THEY WOULD LIKE TO KNOW FROM THE LEGAL SYSTEM WHEN ONE OF THE DRUGS THEY PRESCRIBED IS INVOLVED IN A CASE. UPDATE: WE CURRENTLY HAVE PHYSICIANS AND LAW ENFORCEMENT OFFICERS WORKING TOGETHER TO ADDRESS THIS ISSUE THROUGH THE LOCAL DRUG COALITION, (CASA). UPDATE 2012: SOME INVOLVEMENT CONTINUES WITH THE LOCAL DRUG COALITION. UPDATE 2013: KDH REMAINS ACTIVE WITH THE COALITION AGAINST SUBSTANCE ABUSE. THE PROSECUTOR COMMUNICATES FREQUENTLY AND HELPS WHEN NEEDED. - THERE IS A NEED FOR A QUARTERLY PRESCRIPTION DRUG DISPOSAL PROGRAM WHERE SUCH DRUGS CAN BE DISPOSED WITH NO QUESTIONS ASKED. UPDATE: A SITE IS CURRENTLY BEING DEVELOPED FOR SAFE PRESCRIPTION DRUG DISPOSAL. SHOULD BE IN PLACE IN 2012. UPDATE 2012: THIS SITE IS AVAILABLE IN JEFFERSON COUNTY. UPDATE 2013: THIS SITE REMAINS AVAILABLE.WHILE KDH MAY NOT BE EXPECTED TO TAKE A LEADERSHIP ROLE IN ADDRESSING MENTAL HEALTH ISSUES, IT CANNOT IGNORE THE NEED FOR MENTAL HEALTH SERVICES IN ALL THE COUNTIES IT SERVES. MANY INTERVIEWED MENTIONED THE NEED FOR AN ON-STAFF PSYCHIATRIST OR AN IMPROVED REFERRAL PROGRAM FOR THOSE WITH MENTAL ILLNESS. KDH LEADERS INTERVIEWED STRESSED THE HOURS OF STAFF TIME THAT IS CURRENTLY SPENT FINDING FACILITIES TO REFER PATIENTS TO WITH OPEN BEDS. CONTINUED KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 11: THE HOSPITAL USED FACTORS OTHER THAN FPG IN DETERMINING ELIGIBILITY FOR DISCOUNTED CARE. A PATIENT CAN APPLY FOR THE HOSPITAL'S CATASTROPHIC DISCOUNT PROGRAM. THIS POLICY WILL LIMIT THE PATIENT'S TOTAL FINANCIAL OBLIGATION TO 20% OF THE PATIENT'S TOTAL ANNUAL FAMILY INCOME. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 14G: AT THE TIME OF REGISTRATION, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH EACH PATIENT. THE PATIENT IS PROVIDED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT THEY RECEIVED THIS INFORMATION.THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF.THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 18E: IN ADDITION TO THE ACTIONS PREVIOUSLY LISTED, A FINANCIAL AID COUNSELOR WILL MEET WITH ANY UNINSURED INPATIENT PRIOR TO DISCHARGE TO DISCUSS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. KING'S DAUGHTERS' HEALTH PART V, SECTION B, LINE 20D: ALL UNINSURED PATIENTS RECEIVE AN AUTOMATIC 20% DISCOUNT FROM GROSS CHARGES. AT REGISTRATION, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEY ARE PROVIDED PAMPHLETS DETAILING THE PROGRAM. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE A DISCOUNT OF 100% ON THE OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL ATTEMPT TO COLLECT ANY BALANCE REMAINING ON THE UNINSURED ACCOUNT AFTER ALL FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED USING A SERIES OF STATEMENTS, LETTERS, AND TELEPHONE CALLS. THE HOSPITAL WILL ALSO OFFER PATIENTS INTEREST-FREE EXTENDED PAYMENT PLANS. IF THE ACCOUNT REMAINS UNPAID, THE ACCOUNT MAY BE TURNED OVER TO A COLLECTION AGENCY. PART V, SECTION B, LINE 7 CONTINUED THIS ISSUE IS WORTH FURTHER STUDY BY KDH TO DETERMINE WHAT SUPPORTING ROLE IT CAN PROVIDE TO THE COMMUNITY IN THIS AREA. UPDATE: KDH CURRENTLY REFERS ACUTE NEEDS TO OTHER PROVIDERS. SOME LONG TERM NEEDS SUCH AS COUNSELING CAN BE MET BY AREA AGENCIES. UPDATE 2012: NO FURTHER UPDATE AT THIS TIME. UPDATE 2013: IN 2013 KDH ADDED ER PSYCHIATRIC ASSESSMENT.ACCESS TO HEALTH CARE WAS VIEWED AS A MAJOR ISSUE BY THOSE RESPONDENTS OF THE WEB-BASED SURVEY AND BY THE LOWER INCOME CATEGORY. THERE APPEARS TO BE A NEED TO MAKE INDIVIDUALS WITHIN THE COMMUNITY MORE AWARE OF HEALTH CARE SERVICES AVAILABLE TO THEM WHETHER THEY ARE INSURED OR UNINSURED. THE VAST MAJORITY OF COMMUNITY LEADERS EXPECT KDH TO TAKE A LEADERSHIP ROLE IN ACCESS TO HEALTH CARE. UPDATE: KDH CONTINUES TO EVOLVE IN THE AREA OF CARE TO THE UNINSURED AND UNDERINSURED. PLEASE SEE ATTACHED FISCAL REPORTS. UPDATE 2012: WE CONTINUE TO OFFER OPTIONS TO THOSE WHO ARE UNINSURED AND UNDERINSURED. UPDATE 2013: IN 2013 WE CONTINUE TO OFFER OPTIONS FOR THOSE WHO ARE UNINSURED AND UNDERINSURED. IN ADDITION TO CONCERNS ABOUT ACCESS FOR LOW-INCOME OR THE UNDERINSURED OR UNINSURED, THERE ARE SOME CONCERNS ABOUT ACCESS TO: - GETTING AN APPOINTMENT WITH A PHYSICIAN QUICKLY WHEN NEEDED. UPDATE: WE HAVE IMPROVED ACCESS TO CARE BY EXTENDING OFFICE HOURS AND ADDING PROVIDERS. UPDATE 2012: THIS ACTIVITY CONTINUES. UPDATE 2013: THIS ACTIVITY CONTINUES. - GETTING SEEN IN THE EMERGENCY DEPARTMENT QUICKLY. UPDATE: IN 2011 A CONCERTED EFFORT HAS BEEN MADE TO ADDRESS WAIT TIMES AND PROVIDE QUICK, EFFECTIVE SERVICE TO THOSE UTILIZING THE ED FOR CARE. ALSO IN 2011 KDH ADDED SERVICES TO ITS CONVENIENT CARE CENTER TO GIVE INDIVIDUALS AN OPTION OTHER THAN THE ED FOR NON URGENT CARE. UPDATE 2012: NO FURTHER CHANGES THIS YEAR. UPDATE 2013: IN 2013 KDH OPENED A NEW HOSPITAL AND EXPANDED ER SERVICES TO THE COMMUNITY. - EVENING APPOINTMENTS FOR THOSE UNABLE TO LEAVE WORK DURING THE DAY. UPDATE: SOME PROVIDER HOURS HAVE BEEN EXTENDED. (LATER APPOINTMENT TIMES AND SOME SATURDAY APPOINTMENT TIMES.) UPDATE 2012: THIS PROCESS CONTINUES. UPDATE 2013: THIS PROCESS CONTINUES.DUE TO AN AGING WORKFORCE, IT IS ADVISABLE FOR KDH TO PUT A CONTINGENCY PLAN IN PLACE TO DEAL WITH ITS AGING NURSING WORKFORCE. UPDATE: EACH DIRECTOR AND VICE PRESIDENT WAS ASKED TO SUBMIT A SUCCESSION PLAN TO BEGIN DEALING WITH OUR AGING WORKFORCE. KDH ALSO WORKS VERY CLOSELY WITH IVY TECH COMMUNITY COLLEGE TO ENHANCE THE OPPORTUNITY FOR YOUNG PEOPLE TO CHOOSE NURSING AS A CAREER. WE PROVIDE CLINICAL PRACTICE AREAS AND FINANCIAL AND RESOURCE ASSISTANCE. OUR RN TURNOVER RATE IS WELL BELOW THE INDIANA STATE AND NATIONAL AVERAGE. UPDATE 2012: NO FURTHER UPDATE AT THIS TIME. UPDATE 2013: NO FURTHER UPDATE AT THIS TIME.IMPLEMENTATION STRATEGY 2013-2016OBESITY, LACK OF PHYSICAL ACTIVITY AND SMOKING LEADING TO CHRONIC DISEASE:SEVERAL OF THE TOP MAJOR COMMUNITY HEALTH CONCERNS INVOLVE ADDRESSING THE FREQUENTLY INTER-RELATED ISSUES OF OBESITY, LACK OF PHYSICAL ACTIVITY, AND SMOKING. THESE HEALTH ISSUES LEAD TO CHRONIC DISEASE, SUCH AS STROKE WHERE THE DEATH RATE IN JEFFERSON COUNTY IS NEARLY DOUBLE THE NATION'S DEATH RATE, AND HAVE AN IMPACT ON PATIENTS SERVED BY KDH FACILITIES. THE MAJORITY OF COMMUNITY LEADERS EXPECT KDH TO TAKE A LEADERSHIP ROLE IN ADDRESSING OVERWEIGHT AND OBESITY AND TOBACCO USE. THOSE IN OUTLYING COUNTIES HAVE ASKED THAT KDH PROGRAMS AVAILABLE IN JEFFERSON COUNTY BE OFFERED IN THEIR OWN COUNTIES OR AT A MINIMUM THAT THE JEFFERSON COUNTY PROGRAMS BE PROMOTED TO CITIZENS IN THESE OTHER COUNTIES FOR THEIR POTENTIAL ATTENDANCE. ACTION PLAN: LEADERSHIP ROLEOFFER ONSITE AND COMMUNITY BASED OUTREACH EVENTS TO IMPROVE PATIENT AND COMMUNITY EDUCATION ON PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TARGET: AT RISK POPULATIONS BASED ON LIFESTYLE, AND THOSE WITH CHRONIC DISEASES. EVALUATION: NUMBER OF EVENTS OFFERED, NUMBER OF PARTICIPANTS. NUMBER OF OUTREACH EFFORTS IN OUTLYING COUNTIES AND / OR PROMOTION OF SUCH EFFORTS.EMPLOYEE WELLNESS: KDH SHOULD CONSIDER WAYS IN WHICH IT CAN SET AN EXAMPLE AT ITS OWN FACILITIES FOR THE COMMUNITY; AN EXPANDED AND ENFORCED TOBACCO-FREE CAMPUS, HEALTHY FOOD OFFERINGS IN ITS CAFETERIA AND VENDING MACHINES, A WELLNESS PROGRAM WHICH FOCUSES ON ALL EMPLOYEES INCLUDING THOSE AT SATELLITE OFFICES. ACTION PLAN: LEADERSHIP ROLEIMPROVE OPPORTUNITIES FOR OUR OWN STAFF TO ACCESS HEALTHY ACTIVITIES AND OFFERINGS. OFFER INSURANCE-BASED INCENTIVES FOR A VARIETY OF HEALTHY CHOICES. (EX: NON SMOKING FAMILY PLANS) EXPAND AND IMPROVE HEALTHY EATING OPTIONS IN THE HOSPITAL CAFE. TARGET: KDH EMPLOYEES. EVALUATION: NUMBER OF EVENTS / OPTIONS OFFERED, NUMBER OF EMPLOYEES PARTICIPATING.SUBSTANCE ABUSE: SUBSTANCE ABUSE - PARTICULARLY NARCOTIC (PRIMARILY HEROIN), METHAMPHETAMINE, AND PRESCRIPTION DRUGS, WAS ONE OF THE TOP MAJOR HEALTH NEEDS CITED BY ALL GROUPS INTERVIEWED. IT IS PREVALENT IN ALL COUNTIES SERVED BY KDH. - THE LACK OF SUBSTANCE TREATMENT CENTERS AND MENTAL CARE FACILITIES TO REFER THESE TYPES OF PATIENTS TO IS A MAJOR CONCERN. - MANY INTERVIEWED FELT THE PUBLIC NEEDS TO BE AWARE OF HOW MUCH OF AN ISSUE SUBSTANCE ABUSE IS IN THE COMMUNITY I.E. AMOUNT OF BABIES BORN ADDICTED TO METH/HEROIN AND THE DETOXIFICATION REQUIRED. - THE NEED FOR FURTHER DRUG EDUCATION IN THE SCHOOLS FROM ELEMENTARY ON UP WAS MENTIONED NUMEROUS TIMES - BETTER COMMUNICATION BETWEEN KDH AND THE LOCAL LEGAL SYSTEM IS NEEDED. DOCUMENTATION OF OVERDOSE CASES IN THE ER WITH STATISTICS OF THE TYPES OF DRUGS CAUSING THE OVERDOSE (STREET VERSUS PRESCRIPTION) IS THE TYPE OF INFORMATION HELPFUL TO THE LEGAL SYSTEM. KDH PHYSICIANS MENTIONED THAT THEY WOULD LIKE TO KNOW FROM THE LEGAL SYSTEM WHEN ONE OF THE DRUGS THEY PRESCRIBED IS INVOLVED IN A CASE. - THERE IS A NEED FOR A QUARTERLY PRESCRIPTION DRUG DISPOSAL PROGRAM WHERE SUCH DRUGS CAN BE DISPOSED WITH NO QUESTIONS ASKED. ACTION PLAN: SUPPORTIVE ROLECONTINUE TO WORK CLOSELY WITH LOCAL COALITIONS AGAINST SUBSTANCE ABUSE AND THE HEALTH DEPARTMENT TO IMPLEMENT WORKABLE SOLUTIONS TO THE ABOVE MENTIONED PROBLEMS. DEVELOP AND ASSIST IN IMPLEMENTING A PLAN OF ACTION. ALSO, CONTINUE TO INTERVENE WITH PREGNANT WOMEN DURING PREGNANCY AND DELIVERY. TARGET: CASA IN JEFFERSON COUNTY AND SCAT IN SWITZERLAND COUNTY. WORK WITH THE HEALTH DEPARTMENT TO GET PHYSICIANS AND LAW ENFORCEMENT IN THE SAME ROOM TO DEVELOP AN ACTION PLAN. EVALUATION: NUMBER OF MEETINGS ATTENDED / NUMBER OF ACTION PLANS DEVELOPED WITH THESE ORGANIZATIONS. NUMBER OF DOCUMENTED SUBSTANCE ABUSE CASES ON OB /GYN.MENTAL HEALTH ISSUES: WHILE KDH MAY NOT BE EXPECTED TO TAKE A LEADERSHIP ROLE IN ADDRESSING MENTAL HEALTH ISSUES, IT CANNOT IGNORE THE NEED FOR MENTAL HEALTH SERVICES IN ALL THE COUNTIES IT SERVES. MANY INTERVIEWED MENTIONED THE NEED FOR EXPANDING TELEMED AS A MENTAL HEALTH RESOURCE, RECRUITING AN ON-STAFF PSYCHIATRIST OR AN IMPROVED REFERRAL PROGRAM FOR THOSE WITH MENTAL ILLNESS. KDH LEADERS INTERVIEWED STRESSED THE HOURS OF STAFF TIME THAT IS CURRENTLY SPENT FINDING FACILITIES TO REFER PATIENTS TO WITH OPEN BEDS. THIS ISSUE IS WORTH FURTHER STUDY BY KDH TO DETERMINE WHAT SUPPORTING ROLE IT CAN PROVIDE TO THE COMMUNITY IN THIS AREA. ACTION PLAN: SUPPORTIVE ROLEKDH WILL CONTINUE TO EXPLORE WAYS TO COLLABORATE WITH LOCAL AGENCIES TO IMPROVE ACCESS TO MENTAL HEALTH RESOURCES. IMPROVEMENT IN OTHER RISK FACTOR AREAS, SUCH AS LACK OF PHYSICAL ACTIVITY WILL AFFECT MENTAL HEALTH AS WELL AS OTHER RISK FACTORS. TARGET: KDH PATIENTS IN NEED OF MENTAL HEALTH SERVICES. EVALUATION: NUMBER OF REFERRALS FOR MENTAL HEALTH SERVICES / NUMBER OF PROVIDERS KDH IS ABLE TO ACCESS.TRANSPORTATION: THE LACK OF TRANSPORTATION WAS CITED NUMEROUS TIMES AS A HEALTH ISSUE PARTICULARLY FOR THOSE OF LOWER INCOME. CATCH-A-RIDE AND MEDI-CAB ARE WELL UTILIZED IN THE KDH SERVICE AREA, BUT THEY DO NOT OPERATE AFTER 5 P.M. NOR DO THEY RUN ON WEEKENDS. FOR SOME, THE FEE ASSOCIATED FOR THE SERVICE IS COST-PROHIBITIVE. KDH MAY WANT TO CONSIDER OFFERING ALTERNATIVE TRANSPORTATION AND/OR EXPLORE OFFERING PREVENTATIVE HEALTH SCREENINGS SUCH AS BLOOD PRESSURE, GLUCOSE ETC. AT EVENTS WHERE THOSE OF LOWER INCOME MAY GATHER SUCH AS THE SALVATION ARMY END OF THE MONTH MEAL, THE DISTRIBUTION AT THE HOUSE OF HOPE FOOD PANTRY, ETC.CONTINUED BELOW PART V, SECTION B, LINE 7 CONTINUED ACTION PLAN: SUPPORTIVE ROLEDEVELOP A SERIES OF CLASSES AND SCREENS TO BE OFFERED IN LOW INCOME AREAS. TO TAKE SERVICES TO THOSE IN NEED, WHO ARE UNABLE TO COME TO KDH. TARGET: LOW INCOME POPULATIONS AS IDENTIFIED THROUGH THE HOUSE OF HOPE AND / OR THE SALVATION ARMY. EVALUATION: NUMBER OF CLASSES AND SCREENS HELD / NUMBER OF INDIVIDUALS PARTICIPATING.AWARENESS OF SERVICES AND PROGRAMS: SOME INDIVIDUALS ALSO EXPRESSED THE IDEA THAT RESIDENTS IN THE COMMUNITY SERVED BY KDH MAY NOT BE AWARE OF THE EXISTING PROGRAMS AND SERVICES OFFERED AND MAY NOT BE AWARE OF THE LEVEL OF EXPERTISE OF THE STAFF. THESE ARE IDEAS THAT COULD BE ADDRESSCOULD BE ADDRESSED IN A STRATEGIC, WELL-PLANNED, LONG-TERM PUBLIC RELATIONS CAMPAIGN. ACTION PLAN: LEADERSHIP ROLEDEVELOP AND IMPLEMENT A PUBLIC RELATIONS CAMPAIGN TO LET PEOPLE KNOW OF SERVICES AND OUTREACH THROUGH KDH. TARGET: INDIVIDUALS IN THE KDH PRIMARY MARKET. EVALUATION: NUMBER OF PROMOTIONAL PIECES AND MARKETING ACTIVITIES GEARED TOWARD THE COMMUNITY TO IMPROVE KNOWLEDGE AND EDUCATION OF OUTREACH SCREENS / CLASSES / PROGRAMS.MEDICAL SERVICES AND PROVIDERS:GAPS IN THE CURRENT MEDICAL SERVICE LINES AND THE MEDICAL SPECIALTIES DESIRED ARE WORTH EXPLORING. ACTION PLAN: LEADERSHIP ROLECONTINUE TO IDENTIFY AREAS WHERE MEDICAL SERVICES ARE LACKING, AND TO RECRUIT MEDICAL PROVIDERS TO MEET THE NEEDS OF THE COMMUNITY. TARGET: PRIMARY SERVICE AREA. EVALUATION: NUMBER OF PROVIDERS (PRIMARY AND SECONDARY) PLACED IN PRACTICES IN OUR PRIMARY SERVICE AREA 12 REHABILITATION CENTER AND HOME CARE 2670 N MICHIGAN ROAD MADISON IN 47250 OUTPATIENT REHABILITATION CENTER AND HOME CARE SERVICES CLIFTY DRIVE MEDICAL OFFICE BUILDING 445 CLIFTY DRIVE MADISON IN 47250 PHYSICIAN MEDICAL OFFICE VERSAILLES MEDICAL OFFICE BLDG-MAIN ST 128 NORTH MAIN STREET VERSAILLES IN 47042 PHYSICIAN MEDICAL OFFICE VERSAILLES MEDICAL OFFICE BLDG-TYSON ST 206 W TYSON STREET VERSAILLES IN 47042 PHYSICIAN MEDICAL OFFICE TRIMBLE COUNTY MEDICAL OFFICE BLDG 10235 US HIGHWAY 421 MILTON KY 40045 PHYSICIAN MEDICAL OFFICE CARROLLTON MEDICAL OFFICE BLDG 205 MARWILL DRIVE CARROLLTON KY 41008 PHYSICIAN MEDICAL OFFICE SWITZERLAND CNTY MEDICAL OFFICE BLDG 727 STATE RD 56 VEVAY IN 47043 PHYSICIAN MEDICAL OFFICE HANOVER MEDICAL OFFICE BLDG 36 MEDICAL PLAZA HANOVER IN 47243 PHYSICIAN MEDICAL OFFICE VEVAY MEDICAL OFFICE BLDG 213 WEST MAIN STREET VEVAY IN 47043 PHYSICIAN MEDICAL OFFICE CONVENIENT CARE CENTER 445 CLIFTY DRIVE MADISON IN 47250 PHYSICIAN MEDICAL OFFICE DOWNTOWN MEDICAL OFFICE BLDG 630 NORTH BROADWAY MADISON IN 47250 PHYSICIAN MEDICAL OFFICE AND HOSPITAL STAFF CANCER TREATMENT CENTER 621 WEST STREET MADISON IN 47250 PHYSICIAN MEDICAL OFFICE PART I, LINE 3C: THE HOSPITAL USED FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR DISCOUNTED CARE. A PATIENT CAN APPLY FOR THE HOSPITAL'S CATASTROPHIC DISCOUNT PROGRAM. THIS POLICY WILL LIMIT THE PATIENT'S TOTAL FINANCIAL OBLIGATION TO 20% OF THE PATIENT'S TOTAL ANNUAL FAMILY INCOME. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:(1) PROVIDING CPR CLASSES FOR STUDENTS IN LOCAL SCHOOLS(2) PROMOTING HEALTHCARE CAREERS TO POTENTIAL "FUTURE EMPLOYEES" THROUGH CAREER DAYS AT LOCAL SCHOOLS AND JOBFAIRS AT THE LOCAL COMMUNITY COLLEGE(3) ASSISTING COMMUNITY MEMBERS WITH MEDICAID PROGRAM ENROLLMENT - FORMAL MEDICAID ENROLLMENT ASSISTANCE PROGRAM OFFERED BY KDHHS TO HELP COMMUNITY MEMBERS ENROLL TO RECEIVE ALL TYPES OF MEDICAID ASSISTANCE (HEALTHCARE, FOOD, ETC.) PART III, LINE 2: AS REPORTED ON THE FINANCIAL STATEMENTS PAGE 5. PART III, LINE 3: THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THESE REASONS, THE HOSPITAL BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE - THE HOSPITAL RECOGNIZES NET PATIENT SERVICE REVENUES ON THE ACCRUAL BASIS OF ACCOUNTING IN THE REPORTING PERIOD IN WHICH SERVICES ARE PERFORMED BASED ON THE CURRENT GROSS CHARGE STRUCTURE, LESS ACTUAL ADJUSTMENTS AND ESTIMATED DISCOUNTS FOR CONTRACTUAL ALLOWANCES, PRINCIPALLY FOR PATIENTS COVERED BY MEDICARE, MEDICAID, MANAGED CARE, AND OTHER HEALTH PLANS. GROSS PATIENT SERVICE REVENUE IS RECORDED IN THE ACCOUNTING RECORDS USING THE ESTABLISHED RATES FOR THE TYPES OF SERVICE PROVIDED TO THE PATIENT. THE HOSPITAL RECOGNIZES AN ESTIMATED CONTRACTUAL ALLOWANCE TO REDUCE GROSS PATIENT CHARGES TO THE ESTIMATED NET REALIZABLE AMOUNT FOR SERVICE RENDERED BASED UPON PREVIOUSLY AGREED-TO RATES WITH A PAYOR. THE HOSPITAL UTILIZES THE PATIENT ACCOUNTING SYSTEM TO CALCULATE CONTRACTUAL ALLOWANCES ON A PAYOR-BY-PAYOR BASIS BASED ON THE RATES IN EFFECT FOR EACH PRIMARY THIRD-PARTY PAYOR. ANOTHER FACTOR THAT IS CONSIDERED AND COULD FURTHER INFLUENCE THE LEVEL OF THE CONTRACTUAL RESERVES INCLUDES THE STATUS OF ACCOUNTS RECEIVABLE BALANCES AS INPATIENT OR OUTPATIENT. THE HOSPITAL'S MANAGEMENT CONTINUALLY REVIEWS THE CONTRACTUAL ESTIMATION PROCESS TO CONSIDER AND INCORPORATE UPDATED LAWS AND REGULATIONS AND THE FREQUENT CHANGES IN MANAGED CARE CONTRACTUAL TERMS THAT RESULT FROM CONTRACT NEGOTIATIONS AND RENEWALS. PAYORS INCLUDE FEDERAL AND STATE AGENCIES, INCLUDING MEDICARE AND MEDICAID, MANAGED CARE HEALTH PLANS, COMMERCIAL INSURANCE COMPANIES, AND PATIENTS. THESE THIRD-PARTY PAYORS PROVIDE PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES BASED ON NEGOTIATED REIMBURSEMENT AGREEMENTS. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND FEE SCHEDULE PAYMENTS. RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ALLOWANCES FOR DOUBTFUL ACCOUNTS - ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE HOSPITAL'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THE SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTY THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S CURRENT ALLOWANCE FOR DOUBTFUL ACCOUNTS POLICY IS TO RESERVE 85 PERCENT OF SELF-PAY ACCOUNTS LESS THAN 150 DAYS, 100 PERCENT OF SELF-PAY ACCOUNTS 150 AND OLDER, AND 100 PERCENT OF ALL OTHER PAYOR ACCOUNTS 150 DAYS AND OLDER, NET OF CONTRACTUAL ALLOWANCES ALREADY TAKEN. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BALANCE WAS COMPRISED OF A $8,554,563 RESERVE FOR SELF-PAY BALANCES AND A $2,288,019 RESERVE FOR THIRD-PARTY PAYOR BALANCES. PART III, LINE 8: THIS SHOULD BE TREATED AS COMMUNITY BENEFIT AS MORE SERVICES WERE PROVIDED TO THE ELDERLY POPULATION THAN WERE REIMBURSED. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED 12/31/2013 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST (MEDICARE COST REPORT). PART III, LINE 9B: ALL UNINSURED PATIENTS RECEIVE AN AUTOMATIC 20% DISCOUNT FROM GROSS CHARGES. AT REGISTRATION, PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEY ARE PROVIDED PAMPHLETS DETAILING THE PROGRAM. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE A DISCOUNT OF 100% ON THE OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL ATTEMPT TO COLLECT ANY BALANCE REMAINING ON THE UNINSURED ACCOUNT AFTER ALL FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED USING A SERIES OF STATEMENTS, LETTERS, AND TELEPHONE CALLS. THE HOSPITAL WILL ALSO OFFER PATIENTS INTEREST-FREE EXTENDED PAYMENT PLANS. IF THE ACCOUNT REMAINS UNPAID, THE ACCOUNT MAY BE TURNED OVER TO A COLLECTION AGENCY. PART VI, LINE 2: KING'S DAUGHTERS' HEALTH SERVICES CONDUCTED A COMMUNITY NEEDS ANALYSIS DURING 2013 THAT INVOLVED BOTH ITS PRIMARY SERVICE AREA (JEFFERSON COUNTY, RIPLEY COUNTY, AND SWITZERLAND COUNTY, INDIANA) AND ITS SECONDARY SERVICE AREA (TRIMBLE COUNTY AND CARROLL COUNTY, KENTUCKY). PRIOR TO THIS A COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED IN 2010. THE FOCUS OF THIS ASSESSMENT WAS ON THE HEALTH NEEDS THAT COULD BE ADDRESSED BY KDH AND CAN BE USED BY KDH IN PLANNING FUTURE SERVICES, APPLYING FOR GRANTS AND PLANNING OUTREACH EFFORTS. THE STUDY INCLUDED THE FOLLOWING COMPONENTS:- ANALYSIS OF SECONDARY DATA TO DEVELOP A PROFILE OF THE RESIDENTS OF EACH COUNTY AND TO INDICATE, WHERE POSSIBLE FUTURE TRENDS AND TO SHOW COMPARISONS WITH STATE AND NATIONAL DATA;- IN-PERSON INTERVIEWS WITH 30 KEY LEADERS WITHIN KDH INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 44 COMMUNITY LEADERS INCLUDING GOVERNMENT, MEDICAL, EDUCATION, AND OTHER COMMUNITY LEADERSHIP POSITIONS IN ALL FIVE COUNTIES;- IN-PERSON SURVEYS OF 72 INDIVIDUALS IN LOW INCOME LOCATIONS;- IN-PERSON DISCUSSIONS WITH 19 SENIOR CITIZENS;- A WEB-BASED SURVEY WAS OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 184 COMPLETED INTERVIEWS. - THIS ASSESSMENT ALLOWED ALL INDIVIDUALS TO PROVIDE RESPONSES ON ANY COMMUNITY NEEDS NOT LISTED IN THE QUESTIONS AND ALLOWED INDIVIDUALS TO MAKE COMMENTS ON COMMUNITY HEALTH ISSUES ON WHICH KDH COULD HAVE AN IMPACT.KEY HEALTH ISSUES EXPLORED WERE THE FOLLOWING- PHYSICAL ACTIVITY- OVERWEIGHT AND OBESITY- TOBACCO USE- SUBSTANCE ABUSE/GAMBLING/ADDICTIONS- RESPONSIBLE SEXUAL BEHAVIOR- MENTAL HEALTH- INJURY AND VIOLENCE (INCLUDING DOMESTIC VIOLENCE AND SEXUAL ASSAULT)- ENVIRONMENTAL QUALITY- IMMUNIZATION- ACCESS TO HEALTH CARE FOR THE INSURED AND UNINSURED- MATERNAL AND CHILD HEALTH- INFECTIOUS DISEASE- OCCUPATIONAL AND SAFETY HEALTH- SPECIAL NEEDS/DISABLED/IMPAIRED- CHRONIC DISEASE PART VI, LINE 3: AT THE TIME OF REGISTRATION, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH EACH PATIENT. THE PATIENT IS PROVIDED A PAMPHLET REGARDING THE POLICY, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS. THE PATIENT MUST SIGN A FORM INDICATING THAT THEY RECEIVED THIS INFORMATION. THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. THE HOSPITAL'S WEBSITE HAS A LINK TO THE FINANCIAL AID APPLICATION. PART VI, LINE 4: JEFFERSON COUNTYJEFFERSON COUNTY IS EXPERIENCING A SLOW GROWTH IN TOTAL POPULATION, CURRENTLY AT 32,554. BY 2020, THE POPULATION IS EXPECTED TO BE ABOUT 38,811. IT HAS A MEDIAN AGE OF 37.1, NEARLY IDENTICAL TO THE STATE AVERAGE OF 37.0. THE UNEMPLOYMENT RATE OF 8.4% IS SLIGHTLY ABOVE THE INDIANA RATE OF 8.2%. THE POPULATION IS FAIRLY HOMOGENEOUS WITH A LARGELY CAUCASIAN POPULATION, 96%. THE MEDIAN AVERAGE HOUSEHOLD INCOME, OF $40,386, IS LOWER THAN THAT FOR INDIANA AND THE NATION. IN JEFFERSON CTY, ABOUT 14.3% OF THE INDIVIDUALS, OR ABOUT 4,326, LIVE BELOW THE POVERTY LEVEL, BELOW THE 15.8% POVERTY RATE OF INDIVIDUALS IN INDIANA AND THE 15.9% RATE FOR THE ENTIRE U.S. 35% OF ALL FAMILIES IN JEFFERSON COUNTY ARE SINGLE PARENT FAMILIES WITH 28.3% OF THESE FAMILIES IN POVERTY. IN INDIANA, 32.9% OF ALL FAMILIES ARE SINGLE PARENT FAMILIES WITH 27.4% OF THESE FAMILIES IN POVERTY. JEFFERSON CTY RANKS FIRST IN INDIANA IN TERMS OF THE NUMBER OF ACRES DEVOTED TO TOBACCO WITH TOBACCO CROP SALES OF $1.6 MILLION IN 2007. 28% OF ADULTS IN JEFFERSON CTY USE TOBACCO COMPARED TO 24% OF ADULTS LIVING IN THE STATE OF INDIANA. ACCORDING TO THE INDIANA STATE DEPARTMENT OF HEALTH 2012 REPORT, JEFFERSON COUNTY WAS NOT LISTED AS A COUNTY THAT HAD A SHORTAGE OF HEALTHCARE PROFESSIONALS OR OF MENTAL HEALTH PROFESSIONALS. HOWEVER, THE 2012 REPORT LISTS MILTON, SHELBY AND SMYRNA TOWNSHIPS AS MEDICALLY UNDERSERVED. THE RATE OF ALL CANCER INCIDENCE IS HIGHER IN JEFFERSON COUNTY, AT 502 FOR 100,000 POPULATION, THAN FOR INDIANA, AT 476 FOR 100,000 POPULATION. THE RATE OF LUNG CANCER IS HIGHER IN JEFFERSON, AT 96 PER 100,000 POPULATION THAN FOR INDIANA AT 80 PER 100,000. THE RATE OF PROSTATE CANCER IS HIGHER IN JEFFERSON, AT 152 PER 100,000 POPULATION THAN FOR INDIANA AT 136 PER 100,000. THE RATE OF BREAST CANCER IN JEFFERSON IS SLIGHTLY LOWER, AT 115 PER 100,000 POPULATION THAN FOR INDIANA AT 116 PER 100,000 POPULATION. THE RATE OF COLORECTAL CANCER IS LOWER IN JEFFERSON, AT 48 PER 100,000, THAN THE RATE FOR INDIANA, AT 51 PER 100,000. THE RATE OF ADULT ASTHMA IN JEFFERSON COUNTY, AT 7.3%, IS SLIGHTLY HIGHER THAN THE RATE FOR INDIANA, AT 7.2%, AS IS THE RATE OF CHRONIC BRONCHITIS (3.4% FOR JEFFERSON; 3.3% FOR INDIANA) AND FOR EMPHYSEMA (1.6% FOR JEFFERSON; 1.4% FOR INDIANA.) THE PERCENT OF MOTHERS WHO SMOKED DURING PREGNANCY IN JEFFERSON COUNTY IS 25.8% SIGNIFICANTLY HIGHER THAN THE STATE OF INDIANA AVERAGE OF 17.1%. IN 2010, THE PERCENT OF LOW-WEIGHT BIRTHS FOR JEFFERSON CTY WAS 9.6%, ABOVE THE 8.0% FOR INDIANA. THE NUMBER OF TEEN PREGNANCIES AMONG WOMEN 15 TO 19 YEARS OLD HAS SLIGHTLY DECREASED IN JEFFERSON CTY FROM 2007 TO THE MOST RECENT MEASUREMENT IN 2010. IN JEFFERSON COUNTY, THERE WERE 46 TEEN PREGNANCIES IN 2007 AND 44 TEEN PREGNANCIES IN 2010. IN INDIANA A SIGNIFICANT DECREASE TOOK PLACE-THERE WERE 11,683 TEEN PREGNANCIES IN 2007 AND 8,654 IN 2010. JEFFERSON CTY REPORTED 97 NEWLY DIAGNOSED CASES OF CHLAMYDIA IN 2011, AN INCREASE FROM THE 82 REPORTED IN 2009. THERE WERE 12 CASES OF GONORRHEA IN 2011 AND INCREASE FROM THE LESS THAN FIVE REPORTED IN JEFFERSON COUNTY IN 2009. THE MOST RECENT INFORMATION FROM THE INDIANA FAMILY AND SOCIAL SERVICE ADMINISTRATION IN 2008 SHOWS 1,324 ADULTS IN JEFFERSON COUNTY WITH SERIOUS MENTAL ILLNESS AND 247 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. THE RATE OF DEATHS RELATED TO MAJOR CARDIOVASCULAR DISEASES IN JEFFERSON CTY INCREASED FROM 2008-249.8 PER 100,000 POPULATION TO 2010-372.1 PER 100,000 POPULATION. THE OPPOSITE TREND OCCURRED IN INDIANA WITH 214.3 PER 100,000 DEATHS RECORDED IN 2008 FALLING TO 206.5 PER 100,000 IN 2010. THE STROKE DEATH RATE IN JEFFERSON, AT 79.4 PER 100,000 POPULATION IN 2010, WAS SIGNIFICANTLY HIGHER THAN THE 47.5 PER 100,000 POPULATION FOR INDIANA AND THE 41.9 PER 100,000 FOR THE NATION. THE INCIDENCE OF CANCER RATE (ALL SITES) WAS HIGHER IN JEFFERSON CTY -502 PER 100,000 POPULATION COMPARED TO INDIANA'S RATE OF 476 PER 100,000.RIPLEY COUNTY RIPLEY CTY HAS A CURRENT POPULATION OF 28.583. THERE IS A NET OUTWARD MIGRATION. BY THE YEAR 2020, THE POPULATION WILL BE ABOUT 30,754. THE POPULATION IS 97.8% CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IN RIPLEY IS $47,900 - LOWER THAN THE NATIONAL AVERAGE OF $50,502, BUT HIGHER THAN THE INDIANA AVERAGE OF $46,438. THE PERCENT OF FAMILIES BELOW POVERTY IN RIPLEY IS 15.4%, LOWER THAN THE INDIANA AVERAGE OF 20.6% AND THE NATIONAL AVERAGE OF 20.8%. 29.8% OF ALL FAMILIES IN RIPLEY CTY ARE SINGLE PARENT FAMILIES WITH 27% OF THESE FAMILIES IN POVERTY. IN INDIANA, 32.9% OF ALL FAMILIES ARE SINGLE PARENT FAMILIES WITH 27.4% OF THESE FAMILIES IN POVERTY. THE PERCENT OF MOTHER IN RIPLEY CTY WHO SMOKE DURING PREGNANCY IS 22.8%, COMPARED TO 17.1% IN INDIANA. THE PERCENT OF LOW BIRTH WEIGHT IN RIPLEY CTY IS 7%, COMPARED TO 8% IN INDIANA. THE MOST RECENT INFORMATION FROM THE INDIANA FAMILY AND SOCIAL SERVICE ADMINISTRATION IN 2008 SHOWS 1,071 ADULTS IN RIPLEY CTY WITH SERIOUS MENTAL ILLNESS AND 250 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. RIPLEY CTY DOES NOT HAVE A SHORTAGE OF HEALTH CARE PROFESSIONALS. THE TOWNSHIPS OF DELAWARE, CENTER AND BROWN ARE CONSIDERED MEDICALLY UNDERSERVED. RIPLEY HAS A SHORTAGE OF MENTAL HEALTH PROFESSIONALS. THE RATE OF INDIVIDUALS WITH PROSTATE CANCER IN RIPLEY WAS 146 PER 100,000 POPULATIONS COMPARED TO 136 FOR INDIANA IN 2008. THE DEATH RATE FROM MAJOR CARDIOVASCULAR DISEASE WAS 246.6 PER 100,000 POPULATION FOR RIPLEY CTY IN 2010. THIS IS HIGHER THAN INDIANA'S 206.5 AND THE NATION'S 193.6 PER 100,000 DURING THE SAME PERIOD.THE INCIDENCE OF CANCER RATE (ALL SITES) WAS HIGHER IN RIPLEY CTY-518 PER 100,000 POPULATION COMPARED TO INDIANA'S RATE OF 476 PER 100,000. SWITZERLAND COUNTYSWITZERLAND CTY HAS A POPULATION OF 10,424 AND HAS A SLOW GROWTH RATE OF 0.5 WHICH MIRRORS THAT FOR INDIANA. THERE IS A NET MIGRATION INTO THE COUNTY. BY 2020, THE POPULATION WILL BE 11,950. THE ETHNICITY IS 98.1% WHITE. THE UNEMPLOYMENT RATE IS 6.9% IN SWITZERLAND COUNTY, LOWER THAN THE INDIANA RATE OF 8.4%. THE MEDIAN HOUSEHOLD INCOME IS $42,285, COMPARED TO $46,438 FOR INDIANA AND $50,502 FOR THE NATION. IN SWITZERLAND, 28% OF THE FAMILIES ARE BELOW THE POVERTY LEVEL, COMPARED TO 20.6% OF INDIANA FAMILIES, AND 20.8% OF FAMILIES IN THE NATION. 29.4% OF THE CHILDREN IN SWITZERLAND CTY ARE BELOW THE POVERTY LEVEL. IN 2010, 22.5% OF ALL ADULTS AGE 25+ HAD LESS THAN A HIGH SCHOOL DIPLOMA. THE TEEN BIRTH RATE FOR SWITZERLAND CTY IN 2009 WAS 37.8 PER 1,000 FEMALES AGE 15-17. THIS IS SIGNIFICANTLY HIGHER THAN THE RATE FOR INDIANA OF 20.8 PER 1,000. THE RATE OF MOTHERS SMOKING DURING PREGNANCY IS 27.3% IN SWITZERLAND COUNTY, COMPARED TO 17.1% IN INDIANA. IN SWITZERLAND, THERE IS A 6.8% LOW BIRTH WEIGHT, COMPARED TO 8.0% IN INDIANA. SWITZERLAND CTY HAS A SHORTAGE OF HEALTH CARE PROFESSIONALS. ALL AREAS OF SWITZERLAND CTY ARE CONSIDERED MEDICALLY UNDERSERVED. SWITZERLAND CTY ALSO HAS A SHORTAGE OF MENTAL HEALTH PROFESSIONALS. THE RATE OF CHRONIC BRONCHITIS IN SWITZERLAND CTY AND IN INDIANA IS 3.0%. THE RATE OF EMPHYSEMA IN SWITZERLAND IS 1.5%, SLIGHTLY HIGHER THAN THE INDIANA RATE OF 1.4%. THERE ARE 379 ADULTS WITH SERIOUS MENTAL ILLNESS IN SWITZERLAND CTY AND 78 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. THE DEATH RATE FROM MAJOR CARDIOVASCULAR DISEASE WAS 347.0 PER 100,000 POPULATION FOR SWITZERLAND CTY IN 2010. THIS IS SIGNIFICANTLY HIGHER THAN INDIANA'S 206.5 AND THE NATION'S 193.6 PER 100,000 DURING THE SAME PERIOD. THE INCIDENCE OF CANCER RATE (ALL SITES) WAS HIGHER IN SWITZERLAND CTY-562 PER 100,000 POPULATION COMPARED TO INDIANA'S RATE OF 476 PER 100,000. THE ONLY TYPE OF CANCER IN WHICH SWITZERLAND CTY RECORDED AN INCIDENCE RATE LOWER THAN INDIANA WAS BREAST CANCER-SWITZERLAND CTY 82 PER 100,000 VERSUS INDIANA'S 116 PER 100,000 POPULATION.CARROLL COUNTY KENTUCKYCARROLL CTY KENTUCKY CURRENTLY HAS A POPULATION OF 11,013 WITH A TOTAL OF 4,195 HOUSEHOLDS. THE POPULATION IS PROJECTED TO BE ABOUT 11,440 BY 2020. THE POPULATION IS 95.1% CAUCASIAN. THE AVERAGE MEDIAN HOUSEHOLD INCOME IN 2011 WAS $40,685 - HIGHER THAN THE $41,141 FOR KENTUCKY, BUT LOWER THAN THE $50,512 FOR THE NATION.THE AVERAGE PERCENT OF MOTHERS WHO SMOKE DURING PREGNANCY FOR CARROLL CTY IS 30% COMPARED TO 24% FOR KENTUCKY. AS FAR AS SMOKING PREVALENCE IS CONCERNED, 30% OF THE ADULTS IN CARROLL SMOKE, COMPARED TO 29% OF KENTUCKY AND 21% OF THE NATION. THE PERCENT OF HIGH SCHOOL STUDENTS IN CARROLL WHO SMOKE IS 31%, COMPARED TO 25% FOR KENTUCKY AND 19% FOR THE NATION. CARROLL CTY KENTUCKY HAS 25% OF THE POPULATION OBESE, COMPARED TO 29% OF KENTUCKY AND 24% OF THE NATION. IN CARROLL, 43% OF THE POPULATION LACK PHYSICAL ACTIVITY, COMPARED TO 32% IN KENTUCKY AND 24% IN THE NATION. THE UNEMPLOYMENT RATE IN CARROLL CTY IS 9.6%, HIGHER THAN BOTH KENTUCKY'S 8.2% AND THE NATION'S 8.1%. THE DEATH RATE FROM HEART DISEASE IN CARROLL CTY IS 299.8 PER 100,000 COMPARED TO 205.6 PER 100,000 FOR KENTUCKY AND 173.7 PER 100,000 FOR THE NATION. CONTINUED PART VI, LINE 5: THE MAJORITY OF KING'S DAUGHTERS' HEALTH BOARD OF MANAGERS IS COMPRISED OF INDIVIDUALS WHO LIVE AND WORK IN THE HOSPITAL SERVICES AREA. THE MAJORITY OF THESE INDIVIDUALS ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION ALSO APPLIES A PORTION OF SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE. HISTORICALLY, KDH HAS EMPLOYED A FULL TIME COMMUNITY WELLNESS COORDINATOR. THIS POSITION PROVIDES OUTREACH SERVICES IN AREAS OF NEED TO THE COMMUNITIES WE SERVE. IN ADDITION TO THESE SERVICES, KDH ALSO SERVES AS THE FISCAL AGENT FOR SEVERAL STATE AND FEDERAL GRANTS. ALL OF THESE SERVICES HELP US MEET THE IDENTIFIED NEEDS OF THE COMMUNITIES WE SERVE.PARTICIPATION IN THE BELOW COMMUNITY ORGANIZATIONS IS PART OF THE HOSPITAL'S INDIANA STATE DEPARTMENT OF HEALTH COMMUNITY BENEFIT PLAN AND GOALS.OVERVIEW OF 2013 COMMUNITY BENEFIT ACTIVITIES- PARTICIPATED IN FIVE HEALTH FAIRS.- ORCHESTRATED FOUR CORPORATE HEALTH SCREENING SESSIONS.- ADMINISTERED SPECIFIC SCREENINGS FOR SKIN CANCER, PROSTATE CANCER, COLON CANCER AND BREAST CANCER.- PROVIDED CORPORATE FLU SHOTS.- EXHIBITED AT REGIONAL EXPO- CONDUCTED 26 SPEAKING ENGAGEMENTS.- HELD CLASSES ON: FIT KIDS PROGRAM, SMOKING CESSATION, PRE-NATAL PREP/CHILDBIRTH EDUCATION/LAMAZE TECHNIQUES AND CPR & FIRST AID.- ORGANIZED KDH EMPLOYEE WELLNESS, WEIGHT WATCHERS, AND HEALTH SCREENS IN ADDITION TO PROVIDING NEWSLETTERS ABOUT HEALTH ISSUES.- IMPLEMENTED INSURANCE PREMIUM REDUCTION INCENTIVE PROGRAM IN CONJUNCTION WITH EMPLOYEE HEALTH SCREENS AND EMPLOYEE HEALTH RISK ASSESSMENT. - COORDINATED A LOCAL COUNCIL OF GIRLS ON THE RUN, PART OF A NATIONAL PROGRAM, DESIGNED TO EDUCATE AND PREPARE PRETEEN GIRLS FOR A LIFETIME OF SELF-RESPECT AND HEALTHY LIVING. FALL SEASON AND 5K.- CONDUCTED ANNUAL 5K WALK/RUNS.- OFFERED A CANCER SURVIVORS DINNER IN CONJUNCTION WITH THE RELAY FOR LIFE- OFFERED LARGE COMMUNITY WOMEN'S HEALTH EVENT: SPEAKING OF WOMEN'S HEALTH AT IVY TECH COLLEGE IN FEBRUARY.- PARTICIPATED IN NUMEROUS COMMUNITY PROGRAMS INVOLVING DEALING WITH SUBSTANCE ABUSE, ANTI-SMOKING, AND WELLNESS.- OFFERED BREAST CANCER SUPPORT GROUPS. DIABETES EDUCATION GROUPS- SUPPORTED LOCAL HIGH SCHOOL AND COLLEGES' MEDICAL INTERNSHIPS AND MEDICAL JOB SHADOWING EXPERIENCES.- OBTAINED GRANTS TO ADDRESS SMOKING PREVENTION & CESSATION.- EMS STANDBY AT LOCAL EVENTS AND ACTIVITIES. PART VI, LINE 6: NA PART VI, LINE 7, REPORTS FILED WITH STATES IN PART VI, LINE 4 CONTINUED CARROLL COUNTY, KENTUCKY (CONTINUED)THE DEATH RATE PER 100,000 DUE TO CHRONIC RESPIRATORY DISEASE IN 2011 WAS 112.1 FOR CARROLL COUNTY COMPARED TO 63.1 PER 100,000 FOR KENTUCKY AND 42.7 PER 100,000 FOR THE NATION. IN 2011, CARROLL COUNTY HAD NEARLY TWO AND HALF TIMES THE NUMBER OF DRUG ARRESTS PER 100,000 IN COMPARISON TO KENTUCKY: 2,162 VERSUS 870.TRIMBLE COUNTY, KENTUCKYTRIMBLE COUNTY, KENTUCKY, HAS A POPULATION OF 8,725 AND A DECLINING GROWTH RATE OF -1.0 PER 1,000 POPULATION, COMPARED TO 0.6% INCREASED GROWTH FOR KENTUCKY. BY 2020, THE POPULATION WILL BE 9,514. THE POPULATION IS 97.2% WHITE. THE AVERAGE MEDIAN HOUSEHOLD INCOME IN TRIMBLE COUNTY IS $44,141 COMPARED TO $43,677 IN KENTUCKY AND $50,502 IN THE NATION. THE UNEMPLOYMENT RATE IS 8.2%, COMPARED TO 8.2% FOR KENTUCKY AND 8.1% FOR THE NATION. THE RATE OF SMOKING DURING PREGNANCY IN TRIMBLE COUNTY IS 44%, COMPARED TO 24% IN KENTUCKY. THE LOW BIRTH WEIGHT RATE IN TRIMBLE COUNTY IS 6% WHICH IS BELOW KENTUCKY'S 9%. IN TRIMBLE COUNTY, 30% OF ADULTS SMOKE, WHICH IS HIGHER THAN THE 29% FOR KENTUCKY AND THE 19% FOR THE NATION. IN TRIMBLE COUNTY, 25% OF HIGH SCHOOL STUDENTS SMOKE, THE SAME AS IN KENTUCKY, BUT HIGHER THAN THE 23% IN THE NATION. IN TRIMBLE COUNTY, 29% OF THE ADULTS ARE OBESE, THE SAME AS FOR KENTUCKY, BUT HIGHER THAN THE 24% FOR THE NATION. IN TRIMBLE, 14% LACK PHYSICAL ACTIVITY, COMPARED TO 32% IN KENTUCKY AND 24% IN THE NATION. IN TRIMBLE COUNTY, THERE IS AN 9% RATE OF ADULT DIABETES, COMPARED TO 8% IN KENTUCKY AND 10% FOR THE NATION. THE DEATH RATE PER 100,000 DUE TO DIABETES WAS 55.4 FOR TRIMBLE COUNTY, COMPARED TO 28.0 FOR KENTUCKY AND 25.3 FOR THE NATION. DEATHS DUE TO BREAST CANCER WERE 15 PER 100,000 FOR TRIMBLE COUNTY COMPARED TO 14 PER 100,000 FOR KENTUCKY. DEATHS DUE TO PROSTATE CANCER WERE 23 PER 100,000 FOR TRIMBLE COUNTY AND 18 PER 100,000 FOR KENTUCKY. 1 THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INC PO BOX 447 MADISON IN 47250 202148950 501(C)(3) 54750 SUPPORT ORGANIZATION'S MISSION. IVY TECH FOUNDATION 50 WEST FALL CREEK PARKWAY NORTH DRIVE INDIANAPOLIS IN 46208 237073977 501(C)(3) 5000 SUPPORT ORGANIZATION'S MISSION MIDCOR CORPORATION-ECONOMIC DEVELOPMENT PARTNERS 301 EAST MAIN STREET PO BOX 258 MADISON IN 47250 351695852 501(C)(4) 5000 SUPPORT ORGANIZATION'S MISSION 2 1 PART I, LINE 2: FUNDS ARE NOT GRANTED TO ORGANIZATIONS BUT ARE DONATED. DONATIONS ARE DETERMINED ON A DISCRETIONARY BASIS. X X X X 0 0 0 0 0 0 0 0 0 JONATHAN HANSON MD BOARD MEMBER/PHYSICIAN 354005 0 133545 0 240 0 12750 0 25615 0 526155 0 0 0 PAT STACK MD BOARD MEMBER/PHYSICIAN 171682 0 105031 0 1032 0 12750 0 25720 0 316215 0 0 0 ROGER ALLMAN PRESIDENT/CEO 1/1/13-6/21/13 248578 0 3557 0 939010 0 9483 0 12027 0 1212655 0 0 0 CAROL DOZIER PRESIDENT/CEO 7/15/13-12/31/13 152838 0 35 0 8348 0 6648 0 576 0 168445 0 0 0 STEVE MEACHAM VP FINANCE 195278 0 2012 0 19084 0 10089 0 18572 0 245035 0 0 0 LISA MORGAN VP PATIENT SERVICES 143355 0 1378 0 18052 0 7493 0 16841 0 187119 0 0 0 DENINE FALLIS-HALLGARTH VP PHYSICIAN PRACTICES 125178 0 35 0 17860 0 6435 0 10375 0 159883 0 0 0 HOLLY ROBINSON CHIEF MEDICAL OFFICER 205903 0 68223 0 17740 0 12750 0 25557 0 330173 0 0 0 THOMAS ECKERT MD EMPLOYED PHYSICIAN 422006 0 310289 0 1032 0 12749 0 23593 0 769669 0 0 0 TRAVIS CLEGG MD EMPLOYED PHYSICIAN 575252 0 489302 0 79683 0 12750 0 26052 0 1183039 0 0 0 WILLIAM SKILES MD EMPLOYED PHYSICIAN 435837 0 218275 0 1032 0 12750 0 13086 0 680980 0 0 0 MICHAEL SCHMIDT MD EMPLOYED PHYSICIAN 431136 0 200812 0 15728 0 12750 0 26748 0 687174 0 0 0 GEORGE ALCORN MD EMPLOYED PHYSICIAN 295454 0 524318 0 17400 0 12750 0 15787 0 865709 0 0 0 PART II BOARD MEMBERS PAT STACK, MD AND JON HANSON, MD LISTED ABOVE ARE EMPLOYED PHYSICIANS OF THE HOSPITAL. DR. STACK AND DR. HANSON DO NOT RECEIVE COMPENSATION FOR SERVICES PROVIDED AS BOARD MEMBERS. THE COMPENSATION LISTED ABOVE FOR DR. STACK AND DR. HANSON IS COMPENSATION RECEIVED FOR SERVICES PROVIDED AS EMPLOYED PHYSICIANS. A INDIANA FINANCE AUTHORITY 351602316 45471ACW0 2010-11-03 97847058 SEE PART VI 0 0 0 A 97847058 6756861 1749243 88974097 366857 2013 0 0 1 1 A 0 0 1 1 0 0 0 0 A 0 0 0 0 0 0 0 0 1 A 1 SCH K PART 1 LINE A - PURPOSE THE PURPOSE OF THE BOND ISSUANCE IS TO FINANCE, REFINANCE, OR REIMBURSE A PORTION OF THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING VARIOUS HEALTH CARE FACILITIES OF THE HOSPITAL, INCLUDING A REPLACEMENT ACUTE CARE HOSPITAL FACILITY AND A COMMUNITY AND MEDICAL ARTS CENTER. DR MICHAEL SCHMIDT PRATICE COMMENCEMENT ASSISTANCE X 75000 24808 0 1 1 DR TRAVIS CLEGG PRATICE COMMENCEMENT ASSISTANCE X 176664 68334 0 1 1 DR TRAVIS CLEGG INTERIM LIVING EXPENSE ASSISTANCE X 93333 52564 0 1 1 DR GEORGE ALCORN PRACTICE COMMENCEMENT RETENTION PAYMENT X 30000 7205 0 1 1 DR GEORGE ALCORN LOAN X 136000 32663 0 1 1 DR GEORGE ALCORN REIMBURSEMENT FOR COST OF TAIL INSURANCE COVERAGE X 39454 9475 0 1 1 195049 A DATTILO FRUIT COMPANY VICE PRESIDENT OF PATIENT SERVICES OF KDHHS HAS 51% OWNERSHIP INTEREST 39628 LISA MORGAN, VICE PRESIDENT OF PATIENT SERVICES OF KDHHS OWNS A 51% INTEREST IN A. DATILLO FRUIT COMPANY. KDHHS PURCHASES PRODUCE FROM A. DATTILO FRUIT COMPANY. 0 RIVER VALLEY FINANCIAL BANK BOARD MEMBER IS THE SPOUSE OF PRESIDENT AND CEO OF RIVER VALLEY FIN. BANK ANDREA FORRESTER, BOARD ASST TREASURER, IS MARRIED TO THE PRESIDENT AND CEO OF RIVER VALLEY FINANCIAL BANK. THE HOSPITAL'S OPERATING ACCOUNT IS WITH THE BANK ALONG WITH INVESTMENTS TOTALING 1,000,000. THE HOSPITAL RECORDED INTEREST INCOME OF $72,996, DIVIDEND INCOME OF $72,500 AND SERVICE FEES OF $9,208 FROM ACTIVITY WITH THE BANK. 0 FORM 990, PART VI, SECTION A, LINE 6 PER THE BYLAWS, THE MEMBERSHIP OF THE ORGANIZATION SHALL BE NON-SECTARIAN, NON-POLITICAL AND NOT CONFINED TO ANY CHRISTIAN RELIGIOUS DENOMINATION OR SECT. ANY SUCH PERSON OF GOOD REPUTE WHO HOLDS HERSELF RESPONSIBLE TO THE KING, CHRIST, OUR LORD AND SAVIOR, MAY BECOME A MEMBER OF THE ORGANIZATION. ALL MEMBERS MUST BE AND REMAIN PERMANENT RESIDENTS OF THE SERVICE AREA OF THE HOSPITAL, AS DETERMINED FROM TIME TO TIME BY THE HOSPITAL BOARD OF MANAGERS, AS A CONTINUING REQUIREMENT FOR MEMBERSHIP. FAILURE TO MAINTAIN SUCH RESIDENCY STATUS AUTOMATICALLY TERMINATES A PERSON'S MEMBERSHIP. HOSPITAL EMPLOYEES, MEMBERS OF THE MEDICAL STAFF, AND THEIR IMMEDIATE FAMILY MEMBERS SHALL NOT BE ELIGIBLE FOR MEMBERSHIP IN THE ORGANIZATION. THE IMMEDIATE FAMILY SHALL BE DEFINED AS INCLUDING THE MOTHER, FATHER, HUSBAND, WIFE, SISTER, BROTHER, DAUGHTER, SON, AND STEPCHILDREN. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION SHALL HAVE TWO (2) CLASSES OF MEMBERS, ACTIVE AND HONORARY, AND ALL MEMBERS SHALL HAVE THE RIGHTS, PRIVILEGES, DUTIES, LIABILITIES, LIMITATIONS AND RESTRICTIONS AS SET FORTH FROM TIME TO TIME IN THE STANDING RULES. ANY ACTIVE MEMBER OF THE ORGANIZATION MAY PROPOSE ANY OTHER PERSON MEETING THE ELIGIBILITY REQUIREMENTS OUTLINED IN PART VI, 7A ABOVE FOR MEMBERSHIP. ONLY ACTIVE MEMBERS IN GOOD STANDING THAT HAVE BEEN A MEMBER FOR AT LEAST TWO ANNIVERSARY YEARS CAN PRESENT A PERSON'S NAME FOR MEMBERSHIP OR TO SERVE ON THE BOARD OF DIRECTORS. A MAJORITY VOTE OF THOSE PRESENT AND VOTING AFFIRMATIVELY AT ANY REGULAR MEETING OF THE ORGANIZATION AT WHICH A QUORUM IS PRESENT SHALL BE SUFFICIENT TO ELECT SUCH PROPOSED PERSON TO MEMBERSHIP. ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME. FORM 990, PART VI, SECTION A, LINE 7B ONLY ACTIVE MEMBERS SHALL HAVE THE RIGHT AT EVERY MEETING OF THE MEMBERS TO CAST ONE (1) VOTE FOR HIS/HER MEMBERSHIP. THIS RIGHT TO VOTE MUST BE EXERCISED IN PERSON, OR AS THE BYLAWS MAY PROVIDE FROM TIME TO TIME. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S MANAGEMENT. THE BOARD OF MANAGERS RECEIVES A DRAFT COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES PRIOR TO FILING WITH THE IRS. CHANGES OR REVISIONS ARE SUGGESTED BY THE BOARD IF NECESSARY. THE 990 WILL BE REVIEWED AT THE NEXT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. OFFICERS AND KEY EMPLOYEES ARE NOT REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. HOWEVER THE HR CONFLICT OF INTEREST POLICY DOES STATE THAT ANY EMPLOYEE WHO IS AN OFFICER, OWNER, PARTNER OR EMPLOYEE OF AN ORGANIZATION WITH WHICH THE HOSPITAL MAY ENTER INTO A RELATIONSHIP OR TRANSACTION(OR WHOSE SPOUSE OR CHILD IS AN OFFICER, OWNER, PARTNER OR EMPLOYEE OF AN ORGANIZATION WITH WHICH THE HOSPITAL MAY ENTER INTO A RELATIONSHIP OR TRANSACTION) MUST DISCLOSE THIS INFORMATION TO THE APPROPRIATE VICE PRESIDENT AND THE PRESIDENT/CEO. SHOULD SUCH INFORMATION BE DISCLOSED, THE EMPLOYEE WILL REFRAIN FROM ANY SUBSEQUENT DISCUSSION AND DECISIONS RELATED TO THE OUTSIDE FIRM. A CONFLICT OF INTEREST STATEMENT MUST BE COMPLETED BY EVERY BOARD MEMBER EACH YEAR. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD CONCERNING AN EXISTING OR CONTEMPLATED TRANSACTION OR RELATIONSHIP BETWEEN THE ORGANIZATION AND ANY PARTY IN WHICH A BOARD MEMBER OR THE SPOUSE OR MINOR CHILDREN OF SUCH BOARD MEMBER HAS AN INTEREST OR OTHERWISE MAY GIVE RISE TO A CONFLICT OF INTEREST BETWEEN THE BOARD MEMBER AND THE ORGANIZATION, THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY HIS OR HER WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED OF HIM OR HER, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO A VOTE, THE AFFECTED BOARD MEMBER SHALL NOT VOTE ON IT. FORM 990, PART VI, SECTION B, LINE 15A THE HOSPITAL'S BOARD EXECUTIVE COMMITTEE REVIEWS ANNUAL CEO SURVEY INFORMATION FROM THE INDIANA HOSPITAL ASSOCIATION THAT COMPARES THE HOSPITAL'S CEO'S COMPENSATION WITH OTHER HOSPITAL CEO'S IN INDIANA. COMPARISONS ARE MADE WITH HOSPITALS THAT ARE IN THE HOSPITAL'S REGION IN INDIANA, HOSPITALS SIMILAR IN SIZE TO KDHHS, AND HOSPITALS THAT MIGHT REASONABLY BE EXPECTED TO COMPETE FOR SERVICES OF THE HOSPITAL'S CEO. THE CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS (CPI-U) FOR THE PRIOR TWELVE MONTH PERIOD IS ALSO REVIEWED AND CONSIDERED. THE EXECUTIVE COMMITTEE, AFTER REVIEWING A STATUS REPORT OF THE CEO'S ANNUAL GOALS, RECOMMENDS CHANGES IN THE CEO'S COMPENSATION TO THE FULL BOARD OF MANAGERS. ANY ACTION TAKEN ON THE RECOMMENDATION IS MADE BY THE FULL BOARD. HOWEVER, PHYSICIAN BOARD MEMBERS WHO ARE HOSPITAL EMPLOYEES DO NOT PARTICIPATE IN VOTING FOR ANY CHANGE TO CEO COMPENSATION. MINUTES ARE TAKEN AT ALL BOARD EXECUTIVE COMMITTEE AND FULL BOARD MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, OR FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE FOR PUBLIC INSPECTION. THE FORM 990 TAX RETURN IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN SUBSCRIBER SAVINGS CUMULATIVE ACCOUNT 941,075. GOODWILL IMPAIRMENT -1,354,067. FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHT THE HOSPITAL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE SELECTION OF AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM TO PERFORM THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS. THE FINANCE COMMITTEE ALSO IS RESPONSIBLE FOR OVERSIGHT OF THAT AUDIT PROCESS. THE TREASURER OF THE HOSPITAL'S BOARD OF MANAGERS SERVES AS THE CHAIR OF THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REGULARLY MEETS EVERY OTHER MONTH, AND MEETS ONCE PER YEAR WITH THE INDEPENDENT AUDITORS. THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INC PO BOX 447 MADISON IN 47250 202148950 FUNDRAISING TO SUPPORT THE PROVISION OF HEALTHCARE SERVICES IN 501(C)(3) LINE 7 N/A 0 MADISON CATHETERIZATION SERVICES LLC PO BOX 447 MADISON IN 47250 203391301 CATHETERIZATION SERVICES IN N/A RELATED 20186 0 1 0.51000 0 1 1 0 0 0 0 1 0 0 0 0 0 1 1 0 1 0 0 THE KING'S DUAGHTERS' HOSPITAL FOUNDATION INCORPORATED C 1009059