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HOWEVER, THE CORPORATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. CONSOLIDATED SUBSIDIARIES THAT ARE NOT EXEMPT FROM INCOME TAXES HAD NO MATERIAL TAX LIABILITY. THE CORPORATION FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. true true X true true X true false true true 1 5024450 5024450 0.04000 1 15305851 12581991 2723860 0.02170 2 20330301 12581991 7748310 0.06170 447 18770 1059007 1059007 0.00840 2 576 4751925 4323820 428105 0.00340 1 10 132 132 504 30038 5811064 4323820 1487244 0.01180 506 30038 26141365 16905811 9235554 0.07350 true 13742891 12060149 46504279 52232514 -5728235 X true true CNTL KY SURGERY CTR ASC 0.60000 0.40000 BLUEGRASS IMM CARE URGENT TREATMENT CLINIC 0.73000 0.27000 1 1 EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER

217 SOUTH THIRD STREET DANVILLE KY 40422

X X X EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER 1 true X X X X X X X X X X 11 true true true X X X X X X X X X X X false true true 125. true 300. true X X X X true true X X X X X true false X X X X true X false false 8 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 BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 ------------------- 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. COSTING METHODOLOGY SCHEDULE H, PART III, LINE 8 ------------------- Amounts reported on Lines 5 and 6 were based on the corporation's Medicare Cost Report. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 ------------------- In 2008, Professional Research Consultants (PRC) was engaged to conduct a needs assessment of Boyle County. The scope of the assessment was only Boyle County due to financial limitations and similarities of the other counties. Three years later, PRC was again engaged to re-assess the service area that includes Boyle and the surrounding counties. The 2011 survey consisted of a telephone interview process and a community focus group. Telephone interviews were stratified by ethnicity, age, gender and economic status proportionate to the population base. The focus group were comprised of invitees from all six counties, including representation from the medical staff leadership of Ephraim McDowell Health (EMH), health department directors, county judge executives, educators, the Salvation Army, Heart of Kentucky United Way and other social agencies. 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 ------------------- 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. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 ------------------- 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. There are large numbers of uninsured or underinsured in this service area, and their numbers have increased as some industries have moved out. There is also literacy issues linked to high drop-out rates within the school systems. Literacy issues translate to poverty and poor health. The 2011 community health risk behavior assessment of need exceeded the resources of Ephraim McDowell Health system. The entire report was made available to anyone upon request, shared, discussed and prioritized with input from the Boyle County Health Department, The Salvation Army, Heart of Kentucky United Way and EMH leaders. The focus of resources has been on cardiovascular disease since this is the number-one killer in the world, the US, our state and our region. In fact, the local incidence exceeds state levels. Second priority has been education, early detection and prevention related to skin, colorectal and prostate cancer - again due to local incidence exceeding the state rate. Because of a federal grant, there has been funding for personnel as well as for free mammograms and cervical cancer screening for all six counties. This was done in collaboration with the county health departments. The third priority has been obesity. Again Kentucky is the least active state, and rates of obesity are rising faster here than in the nation generally. Priority groups to reach are low income, uninsured, minority populations, elderly, school age children, and rural populations. We take our screening services to the communities served rather than being hospital or clinic based in an effort to increase access. Schools, county extension offices, health departments, churches and stockyards are the most common venues for services. Much work has been done in collaboration with the school systems to measure body mass index (BMI) starting in middle school and track through to graduation. Course materials to address how to alter BMI have been addressed within the school systems. EMH's Community Service staff collaborated with the Coordinated School Health Committees that were formed in Lincoln and Boyle counties to address the health needs of students and staff. The Basic Faith Community Nursing Course is taught by EMH's Community Service staff to assist churches with establishing health ministries, which help monitor the health of their congregation and act as health advocates for their members. An Alzheimer's Support Group is led by an adult psychiatric and mental nurse practitioner at McDowell Place on a monthly basis to support our dementia patients and their families. Given that Kentucky has an older-than-normal population, the incidence is higher and growing. Reduced-fee clinics are available for those meeting the federal guidelines. We also work with the local health departments for assistance for those that meet guidelines. The Hope Clinic & Pharmacy was founded to provide free care for uninsured clients with diagnoses that most frequently use emergency departments for management of their chronic disease(s) type II diabetes, hypertension, hyperlipidemia, GERDs and obesity. Those that are at 150% or less of the federal poverty guidelines are provided free primary care services and medications as the result of a collaboration among EMH, The Salvation Army, Heart of Kentucky United Way, The Presbyterian Church of Danville, the Boyle County Health Department and the Ephraim McDowell Health Care Foundation. Other needs are often impacted and improved by addressing the top priorities. The advisory group has met annually to assess progress and discuss the next year's work plan. Priorities have not changed since the establishment of the community service department due to the region's vast need. Case finding and early intervention have increased. For those needs identified within the survey that are not directly addressed by our plan due to resource limitations (both financial and human), referrals are made on a case-by-case basis in collaboration with social agencies and other health systems. Also, many of the needs are met through the charity care program. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 ------------------- 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. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 ------------------- 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. % OF TOTAL EXPENSE CALCULATION Schedule H, Part I, Line 7, column (f) ------------------- 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 $13,742,891. Written Debt Collection Policy and Financial Assistance Schedule H, Part III, Line 9b ------------------- 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. COMMUNITY HEALTH NEEDS ASSESSMENT SCHEDULE H, PART V, SECTION B ------------------- LINE 1J: THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO DESCRIBES THE ASSESSMENT OF MODIFIABLE HEALTH RISKS, ASSESSMENT OF HEALTH EDUCATION AND OUTREACH AND PERCEPTIONS OF HEALTHCARE. LINE 3: THE HOSPITAL CONSULTED WITH EMS DIRECTORS, JUDGE EXECUTIVES, HEALTH DEPARTMENT DIRECTORS, SCHOOL NURSES, SCHOOL SUPERINTENDENTS, FAITH COMMUNITY NURSES, SALVATION ARMY COMMANDER, HEART OF KY UNITED WAY, COUNTY EXTENSION OFFICES, SOCIAL WORKERS, LEGISLATORS, CLERGY, PHYSICIANS AND FREE CLINIC STAFF. LINE 4: THE NEEDS ASSESSMENT WAS CONDUCTED WITH EPHRAIM MCDOWELL FORT LOGAN HOSPITAL DUE TO OVERLAP OF POPULATION SERVED. LINE 5: THE NEEDS ASSESSMENT WAS ALSO PROVIDED TO VARIOUS EDUCATION FACILITIES - CENTRE COLLEGE, EASTERN KENTUCKY UNIVERSITY SCHOOL OF NURSING, UNIVERSITY OF KENTUCKY SCHOOL OF NURSING AND SCHOOL OF PUBLIC HEALTH. LINE 7: Deferred needs from the Health Risk Assessment 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 facilities 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 snickers 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 is on the physician recruitment plan 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. 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 weigh 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 Danville. 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 Pregnancy Resource Center supports all six counties. Fair/poor mental health and major depression was cited by the county residents as a major issue. The health system does have mental health providers on their recruitment plan. Community Service does conduct depression screening for adults and refer if needed. For children in middle school and high school the Community Service department works with the school nurses to conduct the Perkins Assessment. High school students have the option to participate in the High School Artist project annually. No leisure time physical activity, not meeting physical activity guidelines, links to the lack of built environment - bike & walking paths/trails in a large rural environment. Boyle County has ongoing dialogue about the need for a biking/walking path to connect the county both for health and economic reasons. There is no public transportation system to make it easy to access a central gym/wellness faculty for families living in the counties. The Stanford Rotary Club talked about the need for a Wellness Center in Stanford for access by the community and the youth after school. The Lincoln County Fiscal Court is funding a walking track in Lincoln County. One of the Lincoln County elementary schools uses jump ropes from Community Service as an opportunity for brief activity breaks for students. Boyle County School System will be implementing the SPARK curriculum. Camp Dick Robinson Elementary has created an exercise room for students that is highly utilized. Chronic lung/respiratory disease is being addressed with tobacco education, stop smoking classes at the health departments, pulmonary rehab at the Wellness Center in Danville and public policy. The Community Service department screens for tobacco use in all venues and refers to the health departments. The health departments offer Cooper Clayton classes to help residents stop smoking. The health departments also conduct tobacco education in the school systems. Respiratory disease has a genetic, environmental and a cultural component in the six county region. The exposure to tobacco smoke, agrichemicals, dust, pollen all contribute to asthma and chronic lower respiratory disease. The health departments address smoking cessation. The extension offices address safe handling of agrichemicals. The school health nurses are addressing childhood asthma. Community Service provided the peek flow meters for the Lincoln County School System given the School Health Index priority. Community Service also provided the competency education for the Lincoln County School Nurses related to childhood asthma. Community Service screens for tobacco use and refers at all screening events. Community Service screens for obesity using a calculated BMI for both children and adults. Starting in middle school, Community Services staff and volunteers help map student BMI and chart against the norms. Upon request education is provided for the class regarding how to impact BMI by nutrition, exercise and sleep. Screening for lung capacity occurs in high risk populations given the link between respiratory disease and CV disease. Community Services has given testimony related to smoking in public places at the local and state level. Model legislation was drafted and sent to the legislator in Frankfort by AHEC with EMRMC staff serving on that board and input from the c Individuals Eligible for Financial Assistance Schedule H,Part V, Line 19d The maximum amount that can be charged to FAP-Eligible individuals for emergency or other medically necessary care is based upon income guidelines stated in the Hospital's Financial Assistance Policy. X X X X X false false false false false true false false false WILLIAM SNAPP 0 232219 0 29959 0 12235 0 66979 0 25858 0 367250 0 29959 VICKI DARNELL 0 386204 0 45486 0 26814 0 112386 0 31787 0 602677 0 45486 SALLY DAVENPORT 176624 0 14959 0 5184 0 74321 0 17655 0 288743 0 14959 0 CARL METZ 163938 0 13509 0 16350 0 38007 0 18464 0 250268 0 13509 0 MICHELLE FRALEY 125386 0 0 0 97 0 10562 0 25386 0 161431 0 0 0 JOAN HALTOM 151899 0 8221 0 1918 0 23228 0 15254 0 200520 0 8221 0 RONALD BARBATO 126209 0 7361 0 7148 0 21620 0 15410 0 177748 0 7361 0 ANDREW LOSCH 136747 0 0 0 6235 0 11116 0 6541 0 160639 0 0 0 TINA COOLEY 139143 0 0 0 281 0 11194 0 922 0 151540 0 0 0 MANAGEMENT INCENTIVE PLANS Schedule J, Part I, Question 6a ------------------------- 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. PROCESS TO REVIEW FORM 990 FORM 990, PART VI, SECTION B, LINE 11 --------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. MONITORING THE CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12B AND 12C --------------------------- THE GOVERNING BOARD MEMBERS FILL OUT CONFLICT OF INTEREST FORMS ANNUALLY. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINE 15A AND 15B --------------------------- 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 2012 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. MAKING FORMS AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 --------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COMMON PAYMASTER FORM 990, PART V, LINE 2A --------------------------- 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. MEMBERS OF THE ORGANIZATION FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B --------------------------- 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. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A --------------------------- 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 2012 experienced 7,512 admissions and 35,040 patient days or a .29% increase in admissions and a 3.03% decrease in patient days as compared to 2011. Observation patient days for 2012 totaled 2,429 vs. 2,225, a 9.17% increase over 2011 volume. Outpatient registrations (including ER visits) increased 2.14% to 122,536 as compared to 119,966 in 2011. Surgical procedures at EMRMC fell 19% to 5,155 as compared to 2011 volume of 6,359. The ambulatory surgical center volume increased 3.6% to 6,614 procedures vs. 6,387 in 2011. Community Health Education --------------------------- Cancer Education - One thousand five hundred individuals participated in skin cancer awareness events at Millinum Park and Garrard County Party on the Square. EPA sun safety literature, sun screen and lip balm with sun screen was distributed to re-enforce the message of sun safety. Funding was provided by Ephraim McDowell Health Care Foundation (EMHCF). CPR/First Aid - Ephraim McDowell Health Care Foundation (EMHCF) funded CPR/AED/First Aid education for seventy-one 9th Grade Academy students in Mercer County. Education Website/Community Publication - Eleven editions of the Health Ministry/Faith Community Nursing newsletter were produced, and distributed in Kentucky, Indiana, Ohio, Virginia, and North Carolina. The intent is to provide relevant and current information to the congregations. All information can be reproduced and used for congregation information/education. Exercise/Fitness - In collaboration with the regional 4-H chapter, Wilderness Trace YMCA, and McDowell Wellness Center 637 children school age through teens were served. Venues included Mercer County horse camp, Healthy Kids Day and Feltner 4H camp. The focus was developing leadership skills, promoting physical activity, and encouraging healthy life style habits. Health Fairs - Services were offered at 148 events at 58 sites in Boyle, Lincoln, Garrard, Mercer, Casey, and Washington Counties with focus on reaching at risk and vulnerable populations. Including all programs 36,459 community contacts occurred (screenings, education, support groups, awareness events, etc.). Forty-five percent of participants were male; 55 percent were female. Ninety-three percent of clients served were Caucasian, seven percent were African America and less than one percent were other; this reflects the population of the region. Over seventy percent of participants served within our health ministries programs had a household income below $35,000; total population 56% had a household income less than $35, 000. Twenty-six percent were unemployed that were served within the health ministries program; 20 percent of the total population served was unemployed. Five percent of the participants within the health ministries program were retired, compared to 25 percent in the total population served. Fifteen percent of those served were uninsured. Twenty-seven percent of those served through the health ministries program did not have a primary care provider compared to 15 percent of all participants served. A registered nurse (RN) met with each client to develop a written plan to decrease their life style associated risk factors. At each screening, referral options were provided including Hope Clinic, reduced fee program and primary provider listing for the region for the uninsured. Forty-six percent of screening tests were abnormal with 25 percent requiring a referral to primary care. Parish Nursing Program - Grant funding from Ephraim McDowell Health Care Foundation, O'Donnell Scholars, Northwestern Mutual Insurance and Margaret T. Stoeckinger Foundation made possible the Faith Community Nursing educational programs. The Faith Community Nursing Foundation Course in the spring of 2012 with 19 graduates and an Advanced Faith Community Nursing Module: Mental Health First Aid in the fall of 2012. This was the first time Mental Health First Aid has been offered in the service area. Twenty-four participants completed the 12 hour course. A partnership with Eastern Kentucky University (EKU) made possible both KBN and ANCC credits for the course participants. Faith Community Nursing (FCN) faculty provided consultation to the Central Baptist Hospital Magnet committee regarding a hospital based faith community nursing service. There were 16 participants representing multiple disciplines including volunteers, chaplain, nursing, senior leadership and others. FCN faculty also served as faculty for the Tri-State Foundations Course in Southern Indiana. Nineteen participants completed the program. FCN faculty met with members of Trinity Episcopal Church in Danville regarding decisions related to aging in place, such as, home safety, living will, management of chronic disease, etc. Continuing education was provided for 8 area FCNs with CEUs related to the revised scope and standards of practice. Seventy-two participants have completed the faith community nursing foundations course since its inception at EMRMC in 2009 and serve as volunteers within their congregations. These community partners serve in 23 counties within the Commonwealth of Kentucky and support persons of all denominations. Eleven health ministry newsletters were created and disseated to health ministry partners in Kentucky, Ohio, Illinois, Indiana, Virginia and North Carolina. School-Based Programs - High school aged students were involved in the building of a canvas, selection of a famous painting, reproducing a painting, and an opening night at the Community Art Center culminating in the auction of their painting. 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 74 paintings. There were 150 community patrons on opening night, an additional 650 community visitors viewed the showing at the Community Art Center during the month of May. In collaboration with the Boyle County School District nurses, height/weight/body mass index was completed for 716 middle school students. The Perkins risk assessment was completed for 850 high school students. Nine hundred Boyle County High School students participated in the spring safety fair. The focus was the role of alcohol and driving impaired using the breathalyzer to demonstrate. Seventy area teens participated in the District 4-H Teen Summit. Community Service staff collaborated with Boyle County 4-H on this project. A total of 3,450 youth from Mercer, Boyle, Casey, Garrard, Lincoln, Powell, Estill, Jessamine counties were served through these venues. Speakers Bureau (Health Topics) - The speakers' bureau reached 2,360 individuals, through venues including service clubs, churches, professional groups, teen programs, governing boards and colleges. Topics included heart health, stroke risk, leadership, health ministry, care for the care giver, end of life decisions, and skin cancer prevention and warning signs. There were eighteen sites across the commonwealth. Community Health Education -Self Help -------------------------------------- Fitness/Exercise Nutrition/Weight Management - Twenty-one teens participated in pilot program sponsored by 4-H and Community Service. The focus was to help teens make healthy choices, control portions, food handling principles, and prep. The group celebrated by eating what they prepared. Tobacco/Smoking Cessation - Two hundred thirty nine individuals were referred to the area health departments for smoking cessation assistance. This is a sixteen percent referral rate. The decline in adults reporting tobacco use is believed to be attributed to the passage of no smoking ordinance in some of the communities served. A statewide ordinance has been drafted by some of the agencies (FHK, SoAHEC, etc) for consideration by the legislature during the 2013 session. PROGRAM SERVICE ACCOMPLISHMENTS (CONT) Community Health Education - Support Groups ------------------------------------------ Alzheimer's - Twelve Alzheimer's Support Group meetings were facilitated by an advanced practice mental health practitioner. The average attendance was eight participants. The group serves both patients and care-givers/family. Community-Based Clinical Services-Health Screenings --------------------------------------------------- Asthma Screening - Lung capacity was used to screen for lung function at five sites. Two hundred-ninety individuals were screened. Thirty-three percent were referred for further evaluation. Blood Pressure Screening - Blood pressure screenings were offered at 47 sites, serving 1,269 individuals. Eighty-one percent of clients had a blood pressure reading that exceeded the recommended range by the American Heart Association (AHA). Those classified as pre-hypertension 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. Those at stroke level were transported for immediate follow-up by a physician. Cancer -Colorectal Screening - The Ephraim McDowell Health Care Foundation (EMHCF) funded colorectal screening at 25 sites for a total distribution of 369 kits with a 42 percent 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 two percent referral rate. Cancer -Mammography/Breast - A HRSA Outreach grant funded a fourth year for screening and early detection of breast cancer through the Woman to Woman program in the six county service area. There were seventy-seven mammograms provided through the outreach service in partnership with the six county health departments. Cancer- Skin Screening - The Ephraim McDowell Health Care Foundation (EMHCF) funded skin cancer screening by a licensed independent practitioner during May and June. One hundred thirteen individuals were seen. Seventy percent were female; 30 percent male. Sixty-two percent stated on an exit survey that they would not have seen their doctor for a skin cancer screen even though 89 percent had a primary care provider. Forty-two percent were referred to a specialist for follow-up care. Cholesterol Testing - Total cholesterol was measured for 1,020 clients in six counties at 36 sites within health ministries and community settings (excludes grant projects) with 32 percent of participants exceeding the recommend range as set by AHA. Within the lipid panel 60 percent of participants had one or more measure outside the recommended range. 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. .Two hundred ninety-six individuals were screened at 7 sites with 36 percent of participants were referred to their primary care provider for follow-up care. Diabetes Screening - Participants were screened at 36 sites in six counties (excluding grant projects) for diabetes. Twenty-eight percent of the 1,006 individuals screened had a glucose level that exceeded the recommend level by the American Diabetes Association (ADA). No one was below the recommended level. This is one of three screening measures that has resulted in immediate referral and transport to emergency care. Mental Health/Depression Screening - The Beck Depression Scale was used to screen for depression in at risk groups at six sites involving 95 individuals. Eight individuals (8%) were referred for follow-up by a mental health provider. Nutrition/Obesity Screening - Height, weight, percent body fat, calculated body mass index (BMI) was offered at 43 sites in six counties with 1,053 adult participants. Seventy-five percent of the participants exceeded the recommend range. Stroke Screening - The American Stroke Association Stroke Risk Scorecard became the standard tool for screening for stroke risk within the department in fiscal year 2012. Stroke risk screening was conducted at 33 sites in six counties involving 913 participants with a 23 percent referral rate. This is one of three screening tests that has resulted in direct referral and transport to emergency care Two hundred seventy-five clients were screened for signs and symptoms of sleep apnea or sleepiness using the Kentucky Sleep Society assessment tool. Fifteen percent reported sleepiness in the moderate or above category; 31percent reported three or more symptoms of obstructive sleep apnea and were provide information for further evaluation. Women's Health Screening - Funding by HRSA Outreach grant contributed $94,931 for women's health screenings for the purpose of prevention and early detection. Services offered included: - Mammograms - Pap smears - Lipid panel - Glucose - Dexa scan for osteoporosis - Lung function - Body Mass Index - DermaView for sun damage - Blood pressure - Stress vulnerability scale - Patient education material - RN consult Other providers were present to offer services such as Heritage Hospice and Coventry Medicaid brokers. Community-Based Clinical Services-Immunizations -------------------------------------------------- Flu Shots - Flu shots were administered at 15 sites in Mercer, Lincoln, Boyle, Garrard, and Washington Counties to 327 individuals age 12 and above. Primary sites were churches and the stockyards. Community-Based Clinical Services-Nonbilled/Reduced -fee Clinic (Hospital Based) -------------------------------------- Hope Clinic & Pharmacy - served 255 patients and provided 888 clients visits for chronic disease management, a record. Eighty-one individuals were screened by The Salvation Army for Hope Clinic; 77 were seen. To qualify for Hope Clinic & Pharmacy an individual must have one or more of the following diagnoses: hypertension, diabetes, obesity, hyperlipidemia, and/or gastro esophageal reflux disease, be uninsured and with a household income below 150% of the federal poverty level. All staff members are volunteers except the part-time LIP and part-time office manager. The clinic is managed by a community advisory board with members from the Boyle County Health Department, Danville Presbyterian Church, Ephraim McDowell Health Care Foundation, Ephraim McDowell Regional Medical Center, Heart of Kentucky United Way, and the Salvation Army. The clinic was started due to community need by a collaboration of the key board members and is a department of EMRMC. PROGRAM SERVICE ACCOMPLISHMENTS (CONT) Health Professions Education ----------------------------- Continuing Health Professions Education Interns, Residents and Fellows - EMRMC did not have medical school interns or residents in FY 2012. Medical Students - Twenty seven medical students rotated through emergency services, anesthesia or surgical services with EMRMC medical staff mentors. Nursing - Two hundred ninety six nursing students completed their clinical or practicum at EMRMC in FY 2012. Educational partners included Campbellsville University, University of Kentucky, Eastern Kentucky University, Midway College, Kentucky State University, and Bluegrass Community & Technical College,. Other Allied Health Professions - Forty-three individuals enrolled and 41 completed the Medicare CNA course with a pass rate of 92 percent. Clinical instruction hours totaled. EMRMC served as a clinical site for students from multiple disciplines from the following institutions: Eastern Kentucky University, University of Kentucky, St. Catherine's College, Midway College, Central Kentucky Technical College, Lindsay Wilson College, Kentucky State University, Indiana Wesleyan, Campbellsville University and University of Louisville health sciences. Research ------------- Community Health Research - HRSA Outreach Grant: Healthy People: Healthy Communities targeted cardiovascular disease (CVD) risk factor reduction in a rural population. Lincoln, Garrard, Mercer and Boyle County Health Departments and Boyle County Extension Office collaborate with EMRMC on this grant. Four hundred and nine individuals were screened by this project in FY 2012. 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, activity level. Results of testing are recorded on the Stroke Risk Scorecard. The Healthy People: Healthy Communities study has institutional review board approval. Enrollment for the study opened in September 1, 2012 with 568 tests completed, with 47% of test results exceeding the recommended range and 17 referrals for follow by primary care providers. Forty-eight individuals consented to participate in the study with follow-up by an RN. These services were funded by HRSA at a cost of $26,915. Good Samaritan Foundation- Group Visits for Management of Chronic Disease in a Rural Free Clinic - This grant funding cycle begin in August of 2012, therefore there were only two groups formed - one for hypertension and one for diabetes. A total of fifteen clients were enrolled in the study. HeartHealth Study Phase II - This grant was funded through a sub-award from University of Kentucky. Biometric testing with the grant included: cholesterol, ratio HDL/LDL, HDL, LDL, triglycerides, dental assessment, A1C, heart sensitive C-reactive protein, height, weight, body mass index, waist circumference, obesity (European caliper measurement). An additional option was to participate in the gene typing for those whose risk did not respond to standard interventions. Another option was to participate in the lycopene study if C-reactive protein was elevated. A total of 10,682 biometric tests were completed. Self-reported measures include family history, medication history, diet history, behavioral questionnaire, symptom inventory, health views, MOS-SAS, perceived social support scale, patient health questionnaire, SF-12 v2 questionnaire, Crandell Cognition Inventory, family caregiver questionnaire, and ice cream label reading test. Funding was provided through a HRSA grant sub-award from UK. The total cost of services in 2012 was $101,208. Financial Donations for the Community - In Kind ---------------------------------------------- Personnel/Administrative Support - Information Systems Specialist provided SKYPE setup to assist the Heart of Danville in their search for a Director at no charge to the community for labor or materials. The result was an expedited search at a lower cost to the community and less time for the 10 volunteer community board members. Community Building Activities ----------------------------- Coalition Building - Community Service staff served in two statewide planning sessions with District 4-H leaders related to the annual Kentucky youth leadership conference. A total of 75 individuals were involved in the conference planning process. Community Health Improvement Advocacy - Community Service Staff served on the boards of Foundation for Healthy Kentucky and served on the finance and ambassador committees in addition to their board membership advocating for improve access to care, better built environment and improved nutrition. FHK endowed chairs at the University of Kentucky to focus on public health issues in rural Kentucky. Community Service Staff served on the executive, governance, and workforce committees for Christian Care Communities 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. Community Service Staff served as community faculty for University of Kentucky with participation in community research, education and performance improvement. Community Service Staff served on the board of the Mercer County Health Department. Leadership Development/Training for Community Members - Community Service staff collaborated with 4-H staff related to three events to provide leadership and skill development for a total of 40 students within the district. Workforce Development - The Southern Area Health Education Council is involved in the education of health professionals in rural South-Central Kentucky and health policy. . Staff participated in three regional board meetings and the screening and selection for the Youth Health Careers Camp (an on campus emergence in health science experience for high school age students) at the University of Kentucky Community Benefit Operations ----------------------------- Dedicated Staff - There was a dedicated staff of 4 full time staff plus flex RNs and Technicians that work as needed within the community service department and funded by the health system. The staff was comprised of a grant writer, children's programs coordinator, faith community nursing coordinator and the executive director. Total salary expense for dedicated community benefit staff was $280,916 for FY 2012. There was a part-time RN project director dedicated to the to the HeartHealth Phase II Program funded through a UK grant sub-award plus one full time RN and two part time RNs The HeartHealth Phase II program expenses were $101,208 in FY 2012.There was a part-time RN project director dedicated to the to the. Healthy People: Health Community research and outreach program funded by the HRSA outreach grant.$26,915. There is a full time project director for the Woman to Woman HRSA Outreach grant. Granted funded expenses for FY 2012 were$111,891. There was a full time program director for the University of Kentucky Center for Rural Health - Danville that worked on outreach and access issues and funded by a UK grant. UK Rural Health Center - Danville had expenses of $94,931 for FY 2012. All report to community services and share space and office and resources. The SANE grant funded the purchase of equipment and supplies to expand sexual assault services to Ephraim McDowell Fort Logan at a cost of $36,732. This expands services in the region for victims of sexual assault. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DENA DEMAREE TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JUDY HAMMONS TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID HOPPER MD TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES JACOBUS TITLE:VICE CHAIR HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK MORGAN TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KIM RAGLAND PH D TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN CUNY TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BOB ROWLAND TITLE:TREASURER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM RUTH III TITLE:CHAIR HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:REV. QUENTIN SCHOLTZ III TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SHEREE GILLIAM TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DALE KIHLMAN TITLE:SECRETARY HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONALD HAMNER MD TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ERIC GUERRANT MD TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RODNEY BATES MD TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GARY AHNQUIST MD TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM SNAPP TITLE:VP & CFO HOURS:29 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:VICKI DARNELL TITLE:CEO HOURS:29 JOHN HILL BAILEY CHILDREN'S LEARNING CTR 217 SOUTH THIRD STREET DANVILLE KY 40422 611186005 DAYCARE CTR KY 501(C)(3) 2 EM HEALTH false EMHFL INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611388556 CRITICAL HOSP KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEALTH RESOURCE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 311545520 HEALTHCARE KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEALTH CARE FOUNDATION 217 SOUTH THIRD STREET DANVILLE KY 40422 611229333 FUNDRAISING KY 501(C)(3) 11-II EM HEALTH false EPHRAIM MCDOWELL HEALTH INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611324736 MGT SERVICES KY 501(C)(3) 11-II NA false CKSC 217 S 3RD DANVILLE KY 40422 371509373 MEDICAL SERVICES KY NA RELATED 2069303 2904660 false 0 false 0.60000 COOPERATIVECARE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611265715 CONTRACTING SERV KY NA C 0 0 0.00000 EPHRAIM MCDOWELL SERVICES INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611339437 MGT SERVICES KY NA C 0 0 0.00000 false false true false false false false false false false false false false false true true false false CENTRAL KENTUCKY SURGERY CENTER LLC O 11032097 fmv