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NORTON - KINGS DAUGHTERS HEALTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NORTON - KINGS DAUGHTERS HEALTH INC (EIN 35-0895832)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349304766
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T11:17:23-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN351178661EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12650 EASTPOINT PKYAddressLine1
CityLOUSIVILLECity
StateKYState
ZIP Code40223ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN350895832EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE BETHANY CIRCLE OF KING'S DAUGHTERS'BusinessNameLine1
Business Name Line2OF MADISON INDIANA INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlBETHNameControl
Phone8122655211Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEVE MEACHAMName
TitleVP OF FINANCETitle
Phone8122655211Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCARRIE A MERRILL CPAName
PTINP00832283PTIN
Phone5029923500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1KING'S DAUGHTERS' HEALTHBusinessNameLine1
Business Name Line2AND HEALTH SERVICESBusinessNameLine2
FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVE MEACHAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode
FieldValueIRS element (for citing)
Gross Receipts241190147GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.KDHMADISON.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1899YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees64TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI31703TotalGrossUBI
Net Unrelated Business Txbl Income-3NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year77604ContributionsGrantsPriorYear
Contributions Grants Current Year109631ContributionsGrantsCurrentYear
Program Service Revenue Prior Year109149858ProgramServiceRevenuePriorYear
Program Service Revenue CY107522048ProgramServiceRevenueCY
Investment Income Prior Year5387494InvestmentIncomePriorYear
Investment Income Current Year-584888InvestmentIncomeCurrentYear
Other Revenue Prior Year437378OtherRevenuePriorYear
Other Revenue Current Year572498OtherRevenueCurrentYear
Total Revenue Prior Year115052334TotalRevenuePriorYear
Total Revenue Current Year107619289TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year71556GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY59688GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year60450134SalariesEtcPriorYear
Salaries Etc Current Year61610729SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year46550821OtherExpensePriorYear
Other Expenses Current Year42011317OtherExpensesCurrentYear
Total Expenses Prior Year107072511TotalExpensesPriorYear
Total Expenses Current Year103681734TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7979823RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3937555RevenuesLessExpensesCY
Total Assets BOY229029066TotalAssetsBOY
Total Assets EOY239072764TotalAssetsEOY
Total Liabilities BOY114312729TotalLiabilitiesBOY
Total Liabilities EOY114496229TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY114716337NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY124576535NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF THE HOSPITAL IS TO IMPROVE THE HEALTH OF THE HOSPITAL'S PATIENTS THROUGH CARE, SERVICE, AND EDUCATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense86414000Expense
Grants59688Grants
Revenue107706656Revenue
DescriptionKING'S DAUGHTERS' HEALTH IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL OWNED BY THE BETHANY CIRCLE OF KING'S DAUGHTERS' OF MADISON, INDIANA, INC., LOCATED IN MADISON, INDIANA. THE HOSPITAL IS ORGANIZED FOR THE PURPOSE OF PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.DURING CALENDAR YEAR 2012, THE HOSPITAL PROVIDED HEALTHCARE TO PATIENTS AT THE FOLLOWING LEVELS:14,111 DAYS OF CARE TO ACUTE INPATIENTS1,030 DAYS OF CARE TO NEWBORN INFANTS177,681 VISITS ASSOCIATED WITH HOSPITAL OUTPATIENTS134,950 VISITS ASSOCIATED WITH PHYSICIAN CLINICSDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4520666Expense
DescriptionTHE 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 2012, KING'S DAUGHTERS' HEALTH PROVIDED $4,520,666 IN GROSS CHARGES TO PATIENTS WHO MET THE HOSPITAL'S CHARITY CARE POLICY.Description
FieldValueIRS element (for citing)
Total Program Service Expense90934666TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961062NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees64NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAWN NUNAN DIRECTOR OF ACCOUNTINGNamePerson
Telephone Number8122650193TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MAUREEN GETZ
BOARD CHAIRWOMAN1.00XX000
PAULA HEIDERMAN
BOARD VICE CHAIRWOMAN1.00XX50000
PAM KIMMEL
BOARD SECRETARY1.00XX000
JEAN DONNELLON
BOARD ASSN'T SECRETARY1.00XX000
LINDA SLOFFER
BOARD TREASURER1.00XX50000
ANDREA FORRESTER
BOARD ASSN'T TREASURER1.00XX75000
GARY KENNON
BOARD MEMBER1.00X000
PAT STACK MD
BOARD MEMBER/PHYSICIAN40.00X224013036134
MARY BETTE VOYLES
BOARD MEMBER1.00X50000
TONY WALTZ
BOARD MEMBER1.00X000
HOLLY ROBINSON
CHIEF MEDICAL OFFICER40.00XX236223038069
JONATHAN HANSON MD
BOARD MEMBER/PHYSICIAN40.00X427779037090
ROGER ALLMAN
PRESIDENT/CEO40.00X3318960139388
STEVE MEACHAM
VP FINANCE40.00X185385027999
LARRY KEITH
VP CLINICAL SERVICES40.00X129137017012
LISA MORGAN
VP PATIENT SERVICES40.00X127881022785
DENINE FALLIS-HALLGARTH
VP PHYSICIAN PRACTICES40.00X109189016304
THOMAS ECKERT MD
EMPLOYED PHYSICIAN40.00744231035561X
PAUL ROSENBURG MD
EMPLOYED PHYSICIAN40.00508957038215X
WILLIAM SKILES MD
EMPLOYED PHYSICIAN40.00736056024867X
MICHAEL SCHMIDT MD
EMPLOYED PHYSICIAN40.00741032037594X
SCOTT FREDE
EMPLOYED PHYSICIAN40.00423202037156X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4927231TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation508174TotalOtherCompensation
Number Individuals GT100 K63NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
JACOBUS CONSULTING
29883 SANTA MARGARITA PARKWAYRANCHO SANTA MARGARITACA92688HEALTHCARE CONSULTING938549
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397CONTRACTED PHYSICIAN MEDICAL SERVICES800057
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN554809146LABORATORY SERVICES646899
MADISON CATHETERIZATION SERVICES
ONE KINGS DAUGHTERS DRIVEMADISONIN47250CARDIAC CATHETERIZATION SERVICES503880
SOUTHEASTERN EMERGENCY PHYSICIANS INC
PO BOX 634850CINCINNATIOH45263CONTRACTED PHYSICIAN MEDICAL SERVICES413211
FieldValueIRS element (for citing)
Number Of Contractors GT100 K76NumberOfContractorsGT100K
Government Grants109631GovernmentGrants
Total Contributions109631TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column107522048TotalRevenueColumn
Related Or Exempt Function Income107490345RelatedOrExemptFunctionIncome
Unrelated Business Revenue31703UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue107522048TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1391687TotalRevenueColumn
Exclusion$1,391,687ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real61976Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real77312Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-15336Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-15336TotalRevenueColumn
Related Or Exempt Function Income-15336RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities131496194Securities
Other20777Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities132962057Securities
Other531489Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1465863Securities
Other-510712Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1976575TotalRevenueColumn
Exclusion-$1,976,575ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA REVENUE722210249186$249,186
MISC REVENUE624110194947194947
GIFT SHOP453220107001$107,001

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column36700TotalRevenueColumn
Related Or Exempt Function Income36700RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue587834TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column107619289TotalRevenueColumn
Related Or Exempt Function Income107706656RelatedOrExemptFunctionIncome
Unrelated Business Revenue31703UnrelatedBusinessRevenue
Exclusion-$228,701ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total59688Total
Program Services59688ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2108533Total
Program Services1686826ProgramServices
Management And General421707ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total47037805Total
Program Services41788441ProgramServices
Management And General5249364ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1912602Total
Program Services1721342ProgramServices
Management And General191260ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7436657Total
Program Services6692991ProgramServices
Management And General743666ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3115132Total
Program Services2803619ProgramServices
Management And General311513ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total245415Total
Management And General245415ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total621718Total
Management And General621718ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total248370Total
Management And General248370ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total146670Total
Program Services132003ProgramServices
Management And General14667ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1920340Total
Program Services1574679ProgramServices
Management And General345661ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total361722Total
Program Services325550ProgramServices
Management And General36172ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1623216Total
Program Services1460894ProgramServices
Management And General162322ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total164732Total
Program Services148259ProgramServices
Management And General16473ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total34836Total
Program Services31352ProgramServices
Management And General3484ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6152439Total
Program Services5537195ProgramServices
Management And General615244ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1165190Total
Program Services1048671ProgramServices
Management And General116519ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DRUGS70962077096207
PURCHASED SERVICES67691416092227676914
SUPPLIES49305604190976739584
HOSPITAL ASSESSMENT FEE44547454454745

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6076016Total
Program Services4089001ProgramServices
Management And General1987015ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total103681734Total
Program Services90934666ProgramServices
Management And General12747068ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7459837BOY
EOY11850571EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10973022BOY
EOY10420027EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY320859BOY
EOY39808EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY444959BOY
EOY683767EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2113551BOY
EOY2316588EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY969902BOY
EOY1352381EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis190904249LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec59974023LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY76074230BOY
EOY130930226EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY127169120BOY
EOY77401757EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3503586BOY
EOY4077639EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY229029066BOY
EOY239072764EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13521658BOY
EOY13683682EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY97894119BOY
EOY97934743EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY857960BOY
EOY489902EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2038992BOY
EOY2387902EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY114312729BOY
EOY114496229EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY114586599BOY
EOY124379819EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY119738BOY
EOY186716EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10000BOY
EOY10000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY114716337BOY
EOY124576535EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY229029066BOY
EOY239072764EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3937555ReconcilationRevenueExpenses
Reconciliation Unrealized Invest5300952ReconciliationUnrealizedInvest
Reconcilation Other Changes621691ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$8,165OtherActivitiesAmount
Total Lobbying Expenditures IIB8165TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPORTION OF INDIANA HOSPITAL ASSOCIATION DUES AND AMERICAN HOSPITAL ASSOCIATION DUES ATTRIBUTABLE TO LOBBYING EXPENSES AS DISCLOSED ON THE DUES NOTICES OF THE RESPECTIVE ASSOCIATIONS.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance129738BeginningOfYearBalance
Contributions86924Contributions
Other Expenditures19946OtherExpenditures
End Of Year Balance196716EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance137154BeginningOfYearBalance
Contributions40020Contributions
Other Expenditures47436OtherExpenditures
End Of Year Balance129738EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance127555BeginningOfYearBalance
Contributions62386Contributions
Other Expenditures52787OtherExpenditures
End Of Year Balance137154EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance89334BeginningOfYearBalance
Contributions84150Contributions
Other Expenditures45929OtherExpenditures
End Of Year Balance127555EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance105321BeginningOfYearBalance
Contributions20051Contributions
Other Expenditures36038OtherExpenditures
End Of Year Balance89334EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.05080PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.94920TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5157538OtherCostOrOtherBasis
Book Value5157538BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis42561170OtherCostOrOtherBasis
Depreciation28667935Depreciation
Book Value13893235BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis57706OtherCostOrOtherBasis
Depreciation9715Depreciation
Book Value47991BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis46189695OtherCostOrOtherBasis
Depreciation31296373Depreciation
Book Value14893322BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis96938140OtherCostOrOtherBasis
Book Value96938140BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings130930226TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$1,087,902
THIRD PARTY PAYABLE$1,300,000
FieldValueIRS element (for citing)
Total Of Amounts2387902TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt113363794TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5300952NetUnrealizedGainsInvestments
Other Revenues699003OtherRevenues
Revenue Not Rptd F9905999955RevenueNotRptdF990
Revenue Subtotal107363839RevenueSubtotal
Other Revenues Not Included255450OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt255450RevenueNotRptdOnFinStmt
Total Revenue Per Form990107619289TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt103503596TotExpensesEtcAuditedFinclStmt
Other Expenses Included77312OtherExpensesIncluded
Expenses Not Rptd F99077312ExpensesNotRptdF990
Expenses Subtotal103426284ExpensesSubtotal
Other Expenses Not Included255450OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt255450ExpensesNotRptdOnFinStmt
Total Expenses Per Form990103681734TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: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 12/31/2012. 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, AND MAY LIBRARY FUND.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: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, 2012 AND 2011, 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 77,312. CHANGE IN CAPTIVE INSURANCE COMPANY 621,691.
PART XI, LINE 4B - OTHER ADJUSTMENTS:GRANTS 7,080. INVESTMENT EXPENSES 248,370.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 77,312.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GRANTS 7,080. INVESTMENT EXPENSES 248,370.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1570475TotalCommunityBenefitExpense
Net Community Benefit Expense1570475NetCommunityBenefitExpense
Percent Of Total Expense0.01780PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense19123299TotalCommunityBenefitExpense
Direct Offsetting Revenue9950375DirectOffsettingRevenue
Net Community Benefit Expense9172924NetCommunityBenefitExpense
Percent Of Total Expense0.10370PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense20693774TotalCommunityBenefitExpense
Direct Offsetting Revenue9950375DirectOffsettingRevenue
Net Community Benefit Expense10743399NetCommunityBenefitExpense
Percent Of Total Expense0.12150PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense13353TotalCommunityBenefitExpense
Direct Offsetting Revenue75DirectOffsettingRevenue
Net Community Benefit Expense13278NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense180471TotalCommunityBenefitExpense
Net Community Benefit Expense180471NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1943745TotalCommunityBenefitExpense
Direct Offsetting Revenue1742396DirectOffsettingRevenue
Net Community Benefit Expense201349NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense63891TotalCommunityBenefitExpense
Net Community Benefit Expense63891NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2201460TotalCommunityBenefitExpense
Direct Offsetting Revenue1742471DirectOffsettingRevenue
Net Community Benefit Expense458989NetCommunityBenefitExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22895234TotalCommunityBenefitExpense
Direct Offsetting Revenue11692846DirectOffsettingRevenue
Net Community Benefit Expense11202388NetCommunityBenefitExpense
Percent Of Total Expense0.12670PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense43275TotalCommunityBuildingExpense
Net Community Building Expense43275NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense12853TotalCommunityBuildingExpense
Net Community Building Expense12853NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense302914TotalCommunityBuildingExpense
Net Community Building Expense302914NetCommunityBuildingExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense196TotalCommunityBuildingExpense
Net Community Building Expense196NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense1776TotalCommunityBuildingExpense
Net Community Building Expense1776NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense361014TotalCommunityBuildingExpense
Net Community Building Expense361014NetCommunityBuildingExpense
Percent Of Total Expense0.00400PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$5,331,347BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare24460093AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare26894326CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2434233MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 MADISON CATHETERIZATION SERVICES LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityPROVIDES CATHETERIZATION SERVICESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.51000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.00000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1KING'S DAUGHTERS' HEALTHBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1KING'S DAUGHTERS' HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted10NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities1CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
REHABILITATION CENTER AND HOME CARE
2670 N MICHIGAN ROADMADISONIN47043PHYSICIAN MEDICAL OFFICE
HILLTOP CLINIC
445 CLIFTY DRIVEMADISONIN47250PHYSICIAN MEDICAL OFFICE
VERSAILLES CLINIC - MAIN STREET
128 NORTH MAIN STREETVERSAILLESIN47042PHYSICIAN MEDICAL OFFICE
KING'S DAUGHTER'S MEDICAL BUILDING
206 W TYSON STREETVERSAILLESIN47042PHYSICIAN MEDICAL OFFICE
TRIMBLE COUNTY MEDICAL BUILDING
10235 US HIGHWAY 421MILTONKY40045PHYSICIAN MEDICAL OFFICE
RIVERBOURNE MEDICAL CENTER
205 MARWILL DRIVECARROLLTONKY41008PHYSICIAN MEDICAL OFFICE
SWITZERLAND COUNTY MEDICAL BUILDING
745 WEST HIGHWAY 56VEVAYIN47043PHYSICIAN MEDICAL OFFICE
HANOVER CLINIC
36 MEDICAL PLAZAHANOVERIN47243PHYSICIAN MEDICAL OFFICE
VEVAY CLINIC
213 WEST MAIN STREETVEVAYIN47043PHYSICIAN MEDICAL OFFICE
CONVENIENT CARE CENTER
443 EAST CLIFTY DRIVEMADISONIN47043PHYSICIAN MEDICAL OFFICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: THE HOSPITAL USES A SLIDING FEE SCALE ARRANGEMENT TO PROVIDE DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. THE SCALE IS AS FOLLOWS:INCOME EQUAL TO 0-150% OF FPG = 100% WRITEOFFINCOME EQUAL TO 151-175% OF FPG = 80% WRITEOFFINCOME EQUAL TO 176-200% OF FPG = 60% WRITEOFFINCOME EQUAL TO 201-225% OF FPG = 40% WRITEOFFINCOME EQUAL TO 226-250% OF FPG = 20% WRITEOFF
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 15232421.
PART II: COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:(1) PROVIDING CPR AND FIRST AID CLASSES FOR THE COMMUNITY MEMBERS (2) PROVIDING CPR CLASSES FOR STUDENTS IN LOCAL SCHOOLS(3) PROMOTING HEALTHCARE CAREERS TO POTENTIAL "FUTURE EMPLOYEES" THROUGH CAREER DAYS AT LOCAL SCHOOLS AND CAREER NIGHTS AT LOCAL COLLEGES(4) 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 4: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE - THE HOSPITAL RECOGNIZES NET PATIENT SERVICE REVENUES ON THE ACCRUAL BASIS OF ACCOUNTING 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. 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 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 PATIENT UNCOLLECTIBLE 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 THE 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 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $11,062,908 WAS COMPRISED OF $8,333,174 RESERVED FOR SELF-PAY BALANCES AND $2,729,734 RESERVED FOR THIRD-PARTY PAYOR BALANCES.THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 2 IS APPLICATION OF THE COST-TO-CHARGE RATIO (AS COMPUTED PER WORKSHEET 2 IN 990 INSTRUCTIONS).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 8: THE HOSPITAL DETERMINED AMOUNTS FROM DATA SUBMITTED IN ITS 2012 MEDICARE COST REPORT.
PART III, LINE 9B: ALL UNINSURED PATIENTS RECEIVE AN AUTOMATIC 20% DISCOUNT FROM GROSS CHARGES. IF THE PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE AND IS APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT WILL RECEIVE ANOTHER DISCOUNT (100%, 80%, 60%, OR 20%), DEPENDING ON FAMILY INCOME, 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 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 32 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 23 SENIOR CITIZENS;- A WEB-BASED SURVEY OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 61 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 5C: 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 7: AS A RESULT OF THE 2010 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 KDHHS 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. IN 2011 IT BECAME NECESSARY TO ELIMINATE SOME OUTREACH PROGRAMS DUE TO FINANCIAL CONSIDERATIONS. - 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. FINANCIAL CONSTRAINTS HAVE ENCOURAGED US TO INCREASE AWARENESS OF PROGRAMS AND SERVICES THROUGH EXISTING RESOURCES SUCH AS THE QUARTERLY NEWSLETTER. WE CONTINUE TO USE THE QUARTERLY NEWSLETTER FOR AWARENESS. - 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. 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. 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. - 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. 1. 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. 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 AND 2012.2. 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. IN 2011 AND 2012 SEVERAL GRANTS WERE OBTAINED TO ADDRESS COMMUNITY HEALTH AND WELLNESS. EX: TPPC: TOBACCO PREVENTION GRANTS FOR JEFFERSON, SWITZERLAND, AND DEARBORN COUNTIES IN INDIANA. - 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.1. THE LACK OF SUBSTANCE TREATMENT CENTERS AND MENTAL CARE FACILITIES TO REFER THESE TYPES OF PATIENTS TO IS A MAJOR CONCERN. KDH DOES NOT HAVE SUBSTANCE ABUSE TREATMENT CENTERS OR MENTAL HEALTH CENTERS. WE WORK CLOSELY WITH THE LOCAL COALITION AGAINST SUBSTANCE ABUSE 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. KDH CONTINUES TO WORK WITH CASA TO IMPROVE ACCESS.2. 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. 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. KDH CONTINUES TO WORK WITH CASA TO INCREASE AWARENESS THROUGH PRINT ADS AND RADIO SPOTS. 3. THE NEED FOR FURTHER DRUG EDUCATION IN THE SCHOOLS FROM ELEMENTARY ON UP WAS MENTIONED NUMEROUS TIMES. 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. 4. 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. WE CURRENTLY HAVE PHYSICIANS AND LAW ENFORCEMENT OFFICERS WORKING TOGETHER TO ADDRESS THIS ISSUE THROUGH THE LOCAL DRUG COALITION, (CASA).5. THERE IS A NEED FOR A QUARTERLY PRESCRIPTION DRUG DISPOSAL PROGRAM WHERE SUCH DRUGS CAN BE DISPOSED WITH NO QUESTIONS ASKED. A SITE IS NOW AVAILABLE FOR SAFE PRESCRIPTION DRUG DISPOSAL IN JEFFERSON COUNTY.- 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. THIS ISSUE IS WORTH FURTHER STUDY BY KDH TO DETERMINE WHAT SUPPORTING ROLE IT CAN PROVIDE TO THE COMMUNITY IN THIS AREA. KDH CURRENTLY REFERS ACUTE NEEDS TO OTHER PROVIDERS. SOME LONG TERM NEEDS SUCH AS COUNSELING CAN BE MET BY AREA AGENCIES.- 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 RATHER THEY BE INSURED OR UNINSURED. THE VAST MAJORITY OF COMMUNITY LEADERS EXPECT KDH TO TAKE A LEADERSHIP ROLE IN ACCESS TO HEALTH CARE. KDH CONTINUES TO EVOLVE IN THE AREA OF CARE TO THE UNINSURED AND UNDERINSURED. PLEASE SEE ATTACHED FISCAL REPORTS. IN ADDITION TO CONCERNS ABOUT ACCESS FOR LOW-INCOME OR THE UNDERINSURED OR UNINSURED, THERE ARE SOME CONCERNS ABOUT ACCESS TO:1. GETTING AN APPOINTMENT WITH A PHYSICIAN QUICKLY WHEN NEEDED. WE HAVE IMPROVED ACCESS TO CARE BY EXTENDING OFFICE HOURS AND ADDING PROVIDERS.2. GETTING SEEN IN THE EMERGENCY DEPARTMENT QUICKLY. 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 ER FOR NON URGENT CARE. 3. EVENING APPOINTMENTS FOR THOSE UNABLE TO LEAVE WORK DURING THE DAY. SOME PROVIDER HOURS HAVE BEEN EXTENDED. (LATER APPOINTMENT TIMES AND SOME SATURDAY APPOINTMENT TIMES.)-DUE TO AN AGING WORKFORCE, IT IS ADVISABLE FOR KDH TO PUT A CONTINGENCY PLAN IN PLACE TO DEAL WITH ITS AGING NURSING WORKFORCE. 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.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 INPATIENTS PRIOR TO DISCHARGE TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.KING'S DAUGHTERS' HEALTH
PART V, SECTION B, LINE 20D: PATIENTS WITHOUT INSURANCE COVERAGE WILL RECEIVE A DISCOUNT BASED ON THE GREATER OF THE FOLLOWING:1) 20% DISCOUNT FROM GROSS CHARGES (WHICH IS HIGHER THAN ANY NEGOTIATED COMMERCIAL INSURANCE DISCOUNT FROM CHARGES CONTRACT)2) THE APPLICABLE SLIDING FEE SCALE ADJUSTMENT BASED ON THE PATIENT'S COMPLETED FINANCIAL ASSISTANCE APPLICATIONKING'S DAUGHTERS' HEALTH
PART VI, LINE 2: KING'S DAUGHTERS' HEALTH SERVICES CONDUCTED A COMMUNITY NEEDS ANALYSIS DURING 2010 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 2007. THE NEXT NEEDS ASSESSMENT WILL TAKE PLACE IN THE 3RD AND 4TH QUARTER OF 2013.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 KDHHS INCLUDING BOARD, STAFF AND MEDICAL STAFF;- IN-DEPTH-INTERVIEWS BY TELEPHONE OR IN-PERSON WITH 32 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 23 SENIOR CITIZENS;- A WEB-BASED SURVEY OPEN TO THE GENERAL PUBLIC WHICH RESULTED IN 61 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: 1) THE HOSPITAL HAS SIGNAGE WHICH ENCOURAGES PATIENTS TO CONTACT CUSTOMER SERVICE FOR INFORMATION REGARDING BILLS, ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL/STATE GOVERNMENT PROGRAMS AND THE HOSPITAL'S CHARITY CARE POLICY. SIGNS ARE POSTED IN SEVERAL AREAS FREQUENTLY ACCESSED BY PATIENTS. 2) DISCUSSIONS REGARDING FINANCIAL ISSUES, AVAILABILITY OF FINANCIAL AID PROGRAMS, ELIGIBILITY REQUIREMENTS AND THE ASSOCIATED APPLICATION PROCESS ARE TYPICALLY DISCUSSED AT THE TIME OF REGISTRATION. 3) THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WITH THE FINANCIAL AID APPLICATION PROCESS. 4) INFORMATION REGARDING THE HOSPITAL'S CHARITY CARE POLICY IS MADE AVAILABLE TO PATIENTS UPON REQUEST VIA A BROCHURE WHICH SUMMARIZES THE PROGRAM ELIGIBILITY REQUIREMENTS AND APPLICATION PROCESS. 5) PATIENTS ARE REMINDED TO CONTACT CUSTOMER SERVICE REGARDING FINANCIAL AID AND FEDERAL/STATE ASSISTANCE DIRECTLY ON THE PATIENT BILL ITSELF. 6) THE HOSPITAL'S WEBSITE INCLUDES LINKS TO THE FOLLOWING: "REQUEST A PRICE ESTIMATE", "ASK A BILLING QUESTION", "VIEW A SAMPLE BILL", "FINANCIAL AID APPLICATION", AND "INSURANCE PROVIDERS".
PART VI, LINE 4: KING'S DAUGHTERS' HEALTH IDENTIFIES THE FOLLOWING AREAS AS ITS PRIMARY AND SECONDARY SERVICE AREAS:JEFFERSON COUNTY, IN: POPULATION 33,010PORTIONS OF RIPLEY COUNTY, INPORTIONS OF SWITZERLAND COUNTY, INPORTIONS OF TRIMBLE AND CARROLL COUNTIES, KYJEFFERSON COUNTY- JEFFERSON COUNTY IS EXPERIENCING A SLOW GROWTH IN TOTAL POPULATION, CURRENTLY AT 33,010, AND IS EXPERIENCING AN INWARD MIGRATION. BY 2020, THE POPULATION IS EXPECTED TO BE ABOUT 34,209. IT HAS A MEDIAN AGE OF 39.6, A SOMEWHAT OLDER POPULATION THAN THE STATE AVERAGE OF 36.7. THE UNEMPLOYMENT RATE OF 10.6% IS ABOVE THE INDIANA RATE OF 10.1%. THE POPULATION IS FAIRLY HOMOGENEOUS WITH A LARGELY CAUCASIAN POPULATION, 95%. THE AVERAGE HOUSEHOLD INCOME, OF $42,646, IS LOWER THAN THAT FOR INDIANA AND THE NATION. IN JEFFERSON COUNTY, ABOUT 13.2% OF THE INDIVIDUALS, OR ABOUT 4,357, LIVE BELOW THE POVERTY LEVEL, SIMILAR TO THE 12.9% POVERTY RATE OF INDIVIDUALS IN INDIANA AND MIRRORING THE 13.2% RATE FOR THE ENTIRE U.S. 53.9% OF ALL FAMILIES IN JEFFERSON COUNTY ARE SINGLE PARENT FAMILIES WITH 27.8% OF THESE FAMILIES IN POVERTY. IN INDIANA, 32.4% OF ALL FAMILIES ARE SINGLE PARENT FAMILIES WITH 27.6% OF THESE FAMILIES IN POVERTY. JEFFERSON COUNTY RANKS FIRST IN INDIANA IN TERMS OF THE NUMBER OF ACRES DEVOTED TO TOBACCO WITH TOBACCO CROP SALES OF $1.6 MILLION IN 2007. 30% OF ADULTS IN JEFFERSON COUNTY USE TOBACCO COMPARED TO 23% OF ADULTS LIVING IN THE STATE OF INDIANA. AN ESTIMATED 26.9% OF THE POPULATION AGE 18+ IS UNINSURED. 6% OF INDIVIDUALS WITH INSURANCE HAVE MEDICAID, A HIGHER PERCENT THAN INDIANA/4.9% OR THE NATION/4.5%. ACCORDING TO THE INDIANA STATE DEPARTMENT OF HEALTH 2009 REPORT, JEFFERSON COUNTY WAS NOT LISTED AS A COUNTY THAT HAD A SHORTAGE OF HEALTHCARE PROFESSIONALS OR OF MENTAL HEALTH PROFESSIONALS. HOWEVER, THE 2009 REPORT LISTS MILTON, SHELBY AND SMYRNA TOWNSHIPS AS MEDICALLY UNDERSERVED. THE RATE OF ALL CANCER INCIDENCE IS HIGHER IN JEFFERSON COUNTY, AT 521.6 FOR 100,000 POPULATION, THAN FOR INDIANA, AT 479.4 FOR 100,000 POPULATION. THE RATE OF LUNG AND BRONCHUS CANCER IS HIGHER IN JEFFERSON, AT 101.6 PER 100,000 POPULATION THAN FOR INDIANA AT 79.8 PER 100,000. THE RATE OF PROSTATE CANCER IS HIGHER IN JEFFERSON, AT 166.2 PER 100,000 POPULATION THAN FOR INDIANA AT 137.5 PER 100,000. THE RATE OF BREAST CANCER IN JEFFERSON IS HIGHER, AT 126.4 PER 100,000 POPULATION THAN FOR INDIANA AT 113.8 PER 100,000 POPULATION. THE RATE OF COLORECTAL CANCER IS LOWER IN JEFFERSON, AT 50.3 PER 100,000, THAN THE RATE FOR INDIANA, AT 52.2 PER 100,000. THE RATE OF ADULT ASTHMA IN JEFFERSON COUNTY, AT 7.13%, IS HIGHER THAN THE RATE FOR INDIANA, AT 6.88%, AS IS THE RATE OF CHRONIC BRONCHITIS (3.4% FOR JEFFERSON; 3.2% FOR INDIANA) AND FOR EMPHYSEMA (1.4% FOR JEFFERSON; 1.28% FOR INDIANA.) THE PERCENT OF MOTHERS WHO SMOKED DURING PREGNANCY IN JEFFERSON COUNTY IS 25.1% COMPARED TO THE STATE OF INDIANA AVERAGE OF 18.5%. IN 2007, THE PERCENT OF LOW-WEIGHT BIRTHS FOR JEFFERSON COUNTY WAS 8.9%, ABOVE THE 8.5% FOR INDIANA. THE NUMBER OF TEEN PREGNANCIES AMONG WOMEN 15 TO 19 YEARS OLD HAS DECREASED IN JEFFERSON COUNTY FROM 2002 TO THE MOST RECENT MEASUREMENT IN 2007. IN JEFFERSON COUNTY, THERE WERE 52 TEEN PREGNANCIES IN 2002 AND 46 TEEN PREGNANCIES IN 2007. IN INDIANA, AN OPPOSITE TREND TOOK PLACE - THERE WERE 11,378 TEEN PREGNANCIES IN 2002 AND 11,683 IN 2007. JEFFERSON COUNTY REPORTED 72 NEWLY DIAGNOSED CASES OF CHLAMYDIA IN 2008, AN INCREASE FROM THE 69 REPORTED IN 2007, BUT A DECREASE FROM THE 75 REPORTED IN 2006. THERE WERE 4 CASES OF GONORRHEA AND ONE CASE OF SYPHILIS REPORTED IN JEFFERSON COUNTY IN 2008. THE MOST RECENT INFORMATION FROM THE INDIANA FAMILY AND SOCIAL SERVICE ADMINISTRATION IN 2008 SHOWS 1,324 ADULTS IN JEFFERSON COUNTY WITH SERIOUS MENTAL ILLNESS AND 247 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. THE RATE OF DEATHS RELATED TO MAJOR CARDIO VASCULAR DISEASES IN JEFFERSON COUNTY DECREASED FROM 2005 - 359.9 PER 100,000 POPULATION TO 2007 - 309.1 PER 100,000 POPULATION. HOWEVER, THE 309.1 PER 100,000 POPULATION RATE IN 2007 IS HIGHER THAN BOTH THE INDIANA RATE OF 267.2 PER 100,000 AND THE NATIONAL RATE OF 190.9 PER 100,000. THE STROKE DEATH RATE IN JEFFERSON, AT 53.3 PER 100,000 POPULATION IN 2007, WAS HIGHER THAN THE 44.5 PER 100,000 POPULATION FOR INDIANA AND THE 45.1 PER 100,000 FOR THE NATION. RIPLEY COUNTY- RIPLEY COUNTY HAS A CURRENT POPULATION OF 27,421. THERE IS A NET OUTWARD MIGRATION. BY THE YEAR 2020, THE POPULATION WILL BE ABOUT 29,855. THE POPULATION IS 96.9% CAUCASIAN. THE HOUSEHOLD INCOME IN RIPLEY IS $51,603 - LOWER THAN THE NATIONAL AVERAGE OF $52,029, BUT HIGHER THAN THE INDIANA AVERAGE OF $48,010. THE PERCENT OF FAMILIES BELOW POVERTY IN RIPLEY IS 12.2%, LOWER THAN THE INDIANA AVERAGE OF 15.9% AND THE NATIONAL AVERAGE OF 16.5%. 42.3% OF ALL FAMILIES IN RIPLEY COUNTY ARE SINGLE PARENT FAMILIES WITH 26.8% OF THESE FAMILIES IN POVERTY. IN INDIANA, 32.4% OF ALL FAMILIES ARE SINGLE PARENT FAMILIES WITH 27.6% OF THESE FAMILIES IN POVERTY. THE PERCENT OF THOSE AGE 18+ WHO ARE UNINSURED IS 26%, COMPARED TO 27% FOR INDIANA AND 27.3% FOR THE NATION. IN RIPLEY COUNTY, 2,955 CHILDREN ARE ENROLLED IN HOOSIER HEALTHWISE. THE PERCENT OF MOTHER IN RIPLEY COUNTY WHO SMOKE DURING PREGNANCY IS 26.6%, COMPARED TO 18.5% IN INDIANA. THE PERCENT OF LOW BIRTH WEIGHT IN RIPLEY COUNTY IS 6.5%, COMPARED TO 8.5% IN INDIANA. IN RIPLEY COUNTY, THE NUMBER OF TEEN PREGNANCIES (GIRLS 15 TO 19) DECREASED FROM 48 IN 2002 TO 45 IN 2007. THIS REPRESENTS A 8.9% TEEN BIRTH RATE IN RIPLEY, COMPARED TO A 20.8% TEEN BIRTH RATE IN INDIANA. THE MOST RECENT INFORMATION FROM THE INDIANA FAMILY AND SOCIAL SERVICE ADMINISTRATION IN 2008 SHOWS 1,071 ADULTS IN RIPLEY COUNTY WITH SERIOUS MENTAL ILLNESS AND 250 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. RIPLEY COUNTY DOES NOT HAVE A SHORTAGE OF HEALTH CARE PROFESSIONALS. THE TOWNSHIPS OF DELAWARE, CENTER AND BROWN ARE CONSIDERED MEDICALLY UNDERSERVED. RIPLEY HAS A SHORTAGE OF MENTAL HEALTH PROFESSIONALS. THE RATE OF INDIVIDUALS WITH LUNG CANCER IN RIPLEY WAS 119.7 PER 100,000 POPULATIONS COMPARED TO 59.7 FOR INDIANA IN 2007. THE PNEUMONIA/INFLUENZA DEATH RATE IN 2007 FOR RIPLEY COUNTY WAS 22.65 PER 100,000 WHICH IS HIGHER THAN INDIANA AT 16.04 AND THE NATION AT 17.5.SWITZERLAND COUNTY- SWITZERLAND COUNTY HAS A POPULATION OF 9,675 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 11,041. THE ETHNICITY IS 97.6% WHITE. THE UNEMPLOYMENT RATE IS 7.9% IN SWITZERLAND COUNTY, LOWER THAN THE INDIANA RATE OF 10.1%. THE AVERAGE ANNUAL HOUSEHOLD INCOME IS $42,209, COMPARED TO $48,010 FOR INDIANA AND $52,029 FOR THE NATION. IN SWITZERLAND, 23.9% OF THE FAMILIES ARE BELOW THE POVERTY LEVEL, COMPARED TO 15.9% OF INDIANA FAMILIES, AND 16.5% OF FAMILIES IN THE NATION. 26.8% OF THE CHILDREN IN SWITZERLAND COUNTY ARE BELOW THE POVERTY LEVEL. IN 2007, 26.3% OF ALL ADULTS AGE 25+ HAD LESS THAN A HIGH SCHOOL DIPLOMA, WHILE 26.8% OF THOSE AGE 18+ ARE UNINSURED, COMPARED TO 27% IN INDIANA AND 27.3% IN THE NATION. 864 CHILDREN IN SWITZERLAND COUNTY ARE ENROLLED IN HOOSIER HEALTHWISE. 8.1% OF INDIVIDUALS WITH INSURANCE HAVE MEDICAID, A HIGHER PERCENT THAN INDIANA/4.9% OR THE NATION/4.5%. THE TEEN BIRTH RATE FOR SWITZERLAND COUNTY IN 2007 WAS 36.3 PER 1,000 FEMALES AGE 15-17. THIS IS SIGNIFICANTLY HIGHER THAN THE RATE FOR INDIANA OF 22 PER 1,000. THE RATE OF MOTHERS SMOKING DURING PREGNANCY IS 29.6% IN SWITZERLAND COUNTY, COMPARED TO 18.5% IN INDIANA. IN SWITZERLAND, THERE IS A 9.6% LOW BIRTH WEIGHT, COMPARED TO 8.5% IN INDIANA. IN 2009, 30% OF ALCOHOL RELATED FATALITIES IN SWITZERLAND COUNTY HAD A BLOOD ALCOHOL CONCENTRATION (BAC) OF 0.1 OR HIGHER COMPARED TO 29% FOR INDIANA. SWITZERLAND COUNTY HAS A SHORTAGE OF HEALTH CARE PROFESSIONALS. ALL AREAS OF SWITZERLAND COUNTY ARE CONSIDERED MEDICALLY UNDERSERVED. SWITZERLAND COUNTY HAS A SHORTAGE OF MENTAL HEALTH PROFESSIONALS. THE RATE OF CHRONIC BRONCHITIS IN SWITZERLAND COUNTY, IS 3.4%, SIMILAR TO THE INDIANA RATE OF 3.2%. THE RATE OF EMPHYSEMA IN SWITZERLAND IS 1.38%, SIMILAR TO THE INDIANA RATE OF 1.28%. THERE ARE 379 ADULTS WITH SERIOUS MENTAL ILLNESS IN SWITZERLAND COUNTY AND 78 SERIOUSLY EMOTIONALLY DISTURBED CHILDREN. THE STROKE DEATH RATE PER 100,000 POPULATION IN 2007 WAS 67.9 FOR SWITZERLAND COUNTY COMPARED TO 44.5 FOR INDIANA AND 45.1 FOR THE NATION.
PART VI, LINE 5: THE MAJORITY OF KING'S DAUGHTERS' HEALTH BOARD OF MANAGERS IS COMPRISED OF INDIVIDUALS WHO LIVE AND WORK IN THE HOSPITAL SERVICES AREA. THE MAJORITY OF THESE INDIVIDUALS ARE NEITHER EMPLOYEES, NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION ALSO APPLIES A PORTION OF SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE. HISTORICALLY, KDH HAS EMPLOYED A FULL TIME COMMUNITY WELLNESS COORDINATOR. THIS POSITION PROVIDES OUTREACH SERVICES IN AREAS OF NEED TO THE COMMUNITIES WE SERVE. IN ADDITION TO THESE SERVICES, KDH ALSO SERVES AS THE FISCAL AGENT FOR SEVERAL STATE AND FEDERAL GRANTS. ALL OF THESE SERVICES HELP US MEET THE IDENTIFIED NEEDS OF THE COMMUNITIES WE SERVE.PARTICIPATION IN THE BELOW COMMUNITY ORGANIZATIONS IS PART OF THE HOSPITAL'S INDIANA STATE DEPARTMENT OF HEALTH COMMUNITY BENEFIT PLAN AND GOALS.OVERVIEW OF 2011 COMMUNITY BENEFIT ACTIVITIES1. HEALTH SCREENS16 COMMUNITY HEALTH SCREENS 110 CORPORATE HEALTH SCREENS59 SKIN CANCER SCREENS PERFORMED AT 1 EVENT30 BREAST CANCER SCREENS PERFORMED AT 1 EVENT55 COLON CANCER SCREENS PERFORMED180 CORPORATE FLU SHOTS GIVEN120 FLU SHOTS SOLD TO IVY TECH FOR SELF ADMINISTRATION2. HEALTH FAIRSHEARTBEATS HEALTH FAIR IN VERSAILLESRIPLEY COUNTY 4H FAIRJEFFERSON COUNTY 4H FAIR: HOSPITAL AND CASA BOOTHSREMC HEALTH FAIR IN VERSAILLESECO15 DAY AT IVY TECHCULTURAL AWARENESS DAYWAL MART CANCER AWARENESS EVENT3. COMMUNITY EDUCATIONSPEAKERS BUREAU - 27 SPEAKING ENGAGEMENTS IN 2010SAFE SITTER CLASSES - 2 CLASSES AND 27 GRADUATESACE FIT KIDS PROGRAM - 400 STUDENTS IN 8 SCHOOLS AND 18 CLASSROOMSSMOKING CESSATION CLASSES - 16 GRADUATES IN ADULT PROGRAM, 45 YOUTH IN TAP/TEG PROGRAM COURSE CPR AND FIRST AID CLASSES - 600 GRADUATES CREATING POSITIVE RELATIONSHIPS/ABSTINENCE EDUCATION PROGRAM - 1,400 PARTICIPANTS FROM 4 SCHOOLSPRENATAL, LAMAZE, AND CHULDBIRTH EDUCATION CLASSES (HELD QUARTERLY BY OB DEPARTMENT) - SERVED APPROXIMATELY 310 COUPLES AND 20 SIBLINGS; LAMAZE CLASS SERVED 14 COUPLES; MOMS GROUP AT WIC SERVED 6 COUPLES; AND GENETICS CLINIC SERVED 27 COUPLES GIRLS ON THE RUN PROGRAM - 43 PARTICIPANTS FROM LOCAL SCHOOLS (GRADES 3-5) AND 126 PARTICIPANTS IN A 5K RUNWELLNESS CLASSES - 8 TYPES OF CLASSES PLUS YOGA OFFERED IN 5-6 WEEKLY CLASS SESSIONSLIFESKILLS CURRICULUM (DRUG AND ALCOHOL AWARENESS PROGRAM FOR YOUTH) - OFFERED AT 4 SCHOOLS FOR 6TH THROUGH 8TH GRADERSSIX WEEK COMMUNITY PEP WALK SERIES - 200 WALKERS 4. EMPLOYEE HEALTH EMPLOYEE HEALTH NEWSLETTER - ON-LINE PUBLICATION THROUGHOUT THE YEAREMPLOYEE WEIGHT WATCHERS - OFFERED THROUGH SEPTEMBER 2011SPECIAL EMPLOYEE WELLNESS PROGRAMS - WELLNESS COLUMN IN THE MONITOR, WELLNESS CALENDAR DISTRIBUTION,EMPLOYEE HEALTH SCREEN AND EMPLOYEE RISK ASSESSMENT CONTINUED IN 2011 WITH INSURANCE PREMIUM REDUCTION INCENTIVE PROGRAM, 1 WELLNESS CHALLENGE WITH 161 PARTICIPANTS5. COMMUNITY SERVICE ACTIVITIESCANCER SURVIVORS DAY (IN CONJUNCTION WITH RELAY FOR LIFE) - SERVED AROUND 300 PEOPLESUPPORT GROUPS - BREAST CANCER, DIABETES, SURVIVING SPOUSE, NEW MOMSACTIVE ATTENDANCE AND PARTICIPATION IN: CASA (COALITION AGAINST SUBSTANCE ABUSE, JEFFERSON COUNTY) SCAT (SWITZERLAND COUNTY AWARENESS TEAM) ITPC (INDIANA TOBACCO PREVENTION CESSATION) JEFFERSON AND SWITZERLAND SCHOOL WELLNESS COMMITTEE AND POLICY DEVELOPMENT - SERVERAL MEETINGSKDH CLIFTY WALK/RUN - 150 PARTICPANTSJEFFERESON COUNTY PUBLIC HEALTH NEEDS ASSESSMENT AND SIX SIGMA PROJECTSUPPORT TO VARIOUS AREA SCHOOLS WITH INTERNSHIPS6. SUCCESSFUL GRANT ACTIVITYISDH PROJECT RESPECT GRANT - FUNDS THE CPR (CREATING POSITIVE RELATIONSHIPS) PROGRAM COORDINATOR FROM OCTOBER OF 1999 UNTIL SEPTEMBER 2002. EXTENDED ONE MORE YEAR (SEPT 2003). PROGRAM LOST FUNDING IN SEPTEMBER 2003. TAUGHT BY VOLUNTEERS FROM OCTOBER 2003 UNTIL DECEMBER 2005. REAPPLIED AND FUNDED IN NOVEMBER 2005 THROUGH SEPTEMBER 2007. NEW COORDINATOR HIRED. REAPPLIED IN FEBRUARY 2007 FOR FUNDING IN OCTOBER 2007. FUNDING PULLED AT THE FEDERAL LEVEL, THEN LOST STATE FUNDING. HAVE FOUND ALTERNATIVE FUNDING FOR THE 2007-2008 SCHOOL YEAR. SEEKING ALTERNATIVE FUNDING FOR THE 2008-2009 SCHOOL YEAR. WE WERE REFUNDED AT THE STATE LEVEL FOR ONE MONTH. WE HAVE BEEN OPERATING SINCE THAT TIME FROM PRIVATE SOLICITED FUNDS. PROGRAM GIFTED TO CHOICES FOR WOMEN IN THE FALL OF 2011. ITPC: INDIANA TOBACCO PREVENTION AND CESSATION:FUNDING RECEIVED FROM THE STATE FOR JEFFERSON AND SWITZERLAND COUNTIES. FULL TIME COORDINATOR IN PLACE THROUGH JUNE 2013CASA/SCAT GRANTS:TO FUND NICOTINE REPLACEMENT THERAPY FOR INDIVIDUALS WISHING TO QUIT SMOKING.7. PUBLIC RELATIONS ACTIVITIESEMS STAND-BY AT ALL COMMUNITY EVENTS:EMS PROVIDES STAND-BY COVERAGE AT ALL JEFFERSON COUNTY ACTIVITIES.WEBSITEADDED FACEBOOK AND TWITTER FOR KDH AND KDH WELLNESS
PART VI, LINE 6: NA
INREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient202148950EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant52608AmountOfCashGrant
Purpose Of GrantSUPPORT ORGANIZATION'S MISSION.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: FUNDS ARE NOT GRANTED TO ORGANIZATIONS BUT ARE DONATED. DONATIONS ARE DETERMINED ON A DISCRETIONARY BASIS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PAT STACK MD
BOARD MEMBER/PHYSICIAN171810051171010320115590245750260147000
HOLLY ROBINSON
CHIEF MEDICAL OFFICER18441305157002400121200259490274292000
JONATHAN HANSON MD
BOARD MEMBER/PHYSICIAN38193704560202400125000245900464869000
ROGER ALLMAN
PRESIDENT/CEO3154880515401125401146040247840471284000
STEVE MEACHAM
VP FINANCE1814710233001584094320185670213384000
LISA MORGAN
VP PATIENT SERVICES124705026240552066080161770150666000
THOMAS ECKERT MD
EMPLOYED PHYSICIAN4212190321980010320125000230610779792000
PAUL ROSENBURG MD
EMPLOYED PHYSICIAN490906017019010320125000257150547172000
WILLIAM SKILES MD
EMPLOYED PHYSICIAN4239030311121010320125000123670760923000
MICHAEL SCHMIDT MD
EMPLOYED PHYSICIAN41880803064970157270125000250940778626000
SCOTT FREDE
EMPLOYED PHYSICIAN18198301575490836700125000246560460358000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationBOARD MEMBERS PAT STACK, MD AND HOLLY ROBINSON, MD AND JONATHAN HANSON, MD LISTED ABOVE ARE EMPLOYED PHYSICIANS OF THE HOSPITAL. DR. STACK, DR ROBINSON, NOR DR. HANSON RECEIVE COMPENSATION FOR SERVICES PROVIDED AS A BOARD MEMBER. THE COMPENSATION LISTED ABOVE IS COMPENSATION RECEIVED FOR SERVICES PROVIDED AS EMPLOYED PHYSICIANS.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1INDIANA FINANCE AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN351602316IssuerEIN
CUSIP Number45471ACW0CUSIPNumber
Date Issued2010-11-03DateIssued
Issue Price97847058IssuePrice
Description Of PurposeSEE SCHEDULE ODescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds97847058TotalProceeds
Amount In Reserve Fund6756300AmountInReserveFund
Issuance Costs From Proceeds1749243IssuanceCostsFromProceeds
Capital Expenditures83863252CapitalExpenditures
Other Spent Proceeds366857OtherSpentProceeds
Amount Unspent5111406AmountUnspent
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonDR MICHAEL SCHMIDTNamePerson
Purpose Of LoanPRATICE COMMENCEMENT ASSISTANCEPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$75,000OriginalPrincipalAmount
Balance Due39808BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due39808TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
A DATTILO FRUIT COMPANY
VICE PRESIDENT OF PATIENT SERVICES OF KDHHS HAS 51% OWNERSHIP INTEREST43648LISA 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 PRES AND CEO OF RIVER VALLEY FINANCIAL BANK.ANDREA FORRESTER, BOARD ASST TRESURER, IS MARRIED TO THE PRES 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 INVESTMENT INCOME OF $48,612 AND INVESTMENT EXPENSE OF $10,409 FROM ACTIVITY WITH THE BANK.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DOING BUSINESS ASFORM 990, PART I, ITEM CDBA: THE KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 6PER 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 7ATHE 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 7BONLY 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 11THE 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 12CBOARD 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 15ATHE 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 19THE 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.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:CHANGE IN INVESTMENT IN CAPTIVE INSURANCE COMPANY 621,691.
AUDIT OVERSIGHTFORM 990, PART XI, LINE 2CTHE 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.
DESCRIPTION OF PURPOSESCHEDULE K, PART I, LINE ATHE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE KING'S DAUGHTERS' HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode
FieldValueIRS element (for citing)
EIN202148950EIN
Primary ActivitiesFUNDRAISING TO SUPPORT THE PROVISION OF HEALTHCARE SERVICESPrimaryActivities
Legal Domicile StateINLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 7PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MADISON CATHETERIZATION SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KINGS DAUGHTERS DRIVEAddressLine1
CityMADISONCity
StateINState
ZIP Code47250ZIPCode
FieldValueIRS element (for citing)
EIN203391301EIN
Primary ActivityCATHETERIZATION SERVICESPrimaryActivity
Legal Domicile StateINLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income63539ShareOfTotalIncome
Share Of EOY Assets26907ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner1GeneralOrManagingPartner
Percentage Ownership0.51000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg