2026-05-14T14:57:47-05:00 2025-06-30 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2024-07-01 843196350 UOFL HEALTH-SHELBYVILLE INC UOFL 5025617213 530 S JACKSON STREET LOUISVILLE KY 40202 KIRK STRACK CFO 5025623621 2026-05-14 1 0 EMILIE M KNIERIEM CPA P01330194 5029923500 2026-05-14 2024 2025-03-06 01:10:19Z KIRK STRACK 530 S JACKSON STREET LOUISVILLE KY 40202 37964850 0 X WWW.UOFLHEALTHNETWORK.ORG/SHELBYVILLE-HOSPITAL X 2019 KY TO OPERATE AND MAINTAIN A HOSPITAL AFFILIATED WITH THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND TO PROVIDE CARE FOR THE PEOPLE WHO ARE IN NEED OF THOSE, OR RELATED, MEDICAL SERVICES. 12 6 0 6 0 0 0 0 36738602 37840226 0 0 194450 124624 36933052 37964850 43758 36913 0 0 18545514 20509073 0 0 0 23967344 23803453 42556616 44349439 -5623564 -6384589 14790348 15435339 6997578 7306455 7792770 8128884 X TO OPERATE AND MAINTAIN A HOSPITAL AFFILIATED WITH THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND TO PROVIDE CARE FOR THE PEOPLE WHO ARE IN NEED OF THOSE, OR RELATED, MEDICAL SERVICES. 0 0 38872016 36913 37861126 U OF L HEALTH - SHELBYVILLE, INC. OWNS AND OPERATES A 70-BED HOSPITAL LOCATED AT 727 HOSPITAL DRIVE IN SHELBYVILLE, KENTUCKY. FOR MORE THAN A CENTURY, SHELBYVILLE HOSPITAL HAS SERVED THE PEOPLE OF SHELBY AND SURROUNDING COUNTIES WITH HIGH-QUALITY HEALTH CARE. THE HOSPITAL SERVES RESIDENTS OF SHELBY, HENRY, AND SPENCER COUNTIES. THE HOSPITAL OFFERS A FULL COMPLEMENT OF INPATIENT AND OUTPATIENT CARE, INCLUDING: 24/7 EMERGENCY CARE, INTENSIVE CARE UNIT, INPATIENT CARE (MEDICAL/SURGICAL), DIAGNOSTIC IMAGING: MRI, CT, PET/CT, NUCLEAR CARDIOLOGY, ULTRASOUND, 3D MAMMOGRAPHY, BONE DENSITY, GENERAL AND SPECIALIZED SURGERY: ENDOSCOPY, ENT, GASTROENTEROLOGY, ORTHOPEDICS, PODIATRY, UROLOGY, VASCULAR SURGERY, PAIN MANAGEMENT, CARDIOLOGY, CARDIAC REHAB/HEALTHY LIFESTYLE CENTER, SLEEP MEDICINE, FRAZIER REHAB INSTITUTE - PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, DIABETES AND NUTRITION COUNSELING, OUTPATIENT INFUSION SERVICES, CLINICAL LABORATORY AND PHARMACY. 38872016 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 88 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 KY X THE ORGANIZATION 5025617213 530 S JACKSON STREET LOUISVILLE KY 40202 X THOMAS D MILLER CEO UOFL HEALTH/SECRETARY 2.00 44.00 X X 63640 1400073 42566 ANDREW DUFFEE MD VICE CHAIR/ORTHOPEDIC SURGEON 40.00 0.00 X X 804293 0 58032 VALERIE BRIONES-PRYOR MD MEMBER/HOSPITALIST 40.00 0.00 X 401367 0 60909 GREGORY PFISTER MD MEMBER/PULOMONOLOGIST 1.00 40.00 X 339734 0 37036 KENNETH GARDNER MD VICE CHAIR/ORTHOPEDIC SURGEON 1.00 40.00 X X 0 195895 38637 PAT HARGADON CHAIR 1.00 0.00 X X 0 0 0 RON CAUGHRON MEMBER 1.00 0.00 X 0 0 0 RAY LEATHERS MEMBER 1.00 0.00 X 0 0 0 GARY WALLS MEMBER 1.00 0.00 X 0 0 0 JAMICE HARRIS MEMBER 1.00 20.00 X 0 49224 18481 STEVE MEADOR MEMBER 1.00 0.00 X 0 0 0 TROY RAWLINS MEMBER 1.00 0.00 X 0 0 0 KEN MARSHALL COO UOFL HEALTH 2.00 44.00 X 30292 666437 22266 KIRK STRACK CFO UOFL HEALTH 2.00 44.00 X 23961 527135 39132 JAMES SMITH MD CMO-UOFL HEALTH/UOFL ASSOC. PROFESSOR 2.00 64.00 X 13095 718767 54930 TIMOTHY AARON GAROFOLA CEO SHELBYVILLE HOSPITAL 40.00 0.00 X 325035 0 49549 ANNESSA BAKER CAO/NURSE EXECUTIVE 40.00 0.00 X 184082 0 36341 JAMES BOSE DIRECTOR - IMAGING SERVICE 40.00 0.00 X 141107 0 41619 KELLY NOLAN DIRECTOR - NURSING 40.00 0.00 X 143402 0 24927 RICKY PRUITT RN FLOAT CRITICAL CARE 40.00 0.00 X 168428 0 40331 KAREN CONWAY MANAGER PHARMACY SERVICES 40.00 0.00 X 174659 0 22933 NATHAN MOORE DIRECTOR - LABORATORY 40.00 0.00 X 129807 0 14400 2942902 3557531 602089 10 0 1 0 METZ CULINARY MANAGEMENT TWO WOODLANDS DRIVE DALLAS PA 18612 FOOD/ENVIRONMENTAL SERVICES 1240768 TRIMEDX 5451 LAKEVIEW PKWY DR S INDIANAPOLIS IN 46268 INFORMATION TECHNOLOGY SERVICES 702988 RESTORIX HEALTH INC 3445 N CAUSEWAY BLVD STE 600 METAIRIE LA 70002 PROFESSIONAL SERVICES 356704 BRIGHTVIEW LANDSCAPE SERVICES INC 4510 POPLAR LEVEL ROAD LOUISVILLE KY 40213 LANDSCAPE SERVICES 228786 FOUNDATION RADIOLOGY GROUP PC 401 LIBERTY AVE 20TH FLOOR STE 200 PITTSBURGH PA 15222 PROFESSIONAL SERVICES 181505 8 NET PATIENT REVENUE 622110 37840226 37840226 37840226 91049 0 91049 91049 91049 12634 0 12634 12634 MISCELLANEOUS REVENUE 900099 17869 17869 GENERAL PRODUCT SAFETY REG REVENU 900099 3031 3031 EARNINGS IN KMRRRG 900099 41 41 20941 37964850 37861126 0 103724 X 36913 36913 679880 595866 84014 15645244 13711933 1933311 693347 614298 79049 2322339 2057568 264771 1168263 1035069 133194 1513 1513 9276781 7879566 1397215 6073 125 5948 370231 369745 486 488246 399941 88305 6264 129 6135 6129 126 6003 1664899 1034759 630140 440825 9055 431770 MEDICAL SUPPLIES 6052521 6052521 CORPORATE ALLOCATION EX 3736559 3736559 PROVIDER TAX 1038923 1038923 REPAIRS & MAINTENANCE 645131 297495 347636 69358 1425 67933 44349439 38872016 5477423 0 5399130 6971389 793436 812240 47652 101206 13291266 6662384 7400283 6628882 1149847 921622 14790348 15435339 4257793 4525710 2505908 2505908 233877 274837 6997578 7306455 X 7792770 8128884 7792770 8128884 14790348 15435339 X -6384589 6720703 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 1513 1513 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO KENTUCKY HOSPITAL ASSOCIATION (KHA), OF WHICH 17.4% IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 1000000 1000000 2313412 1400097 913315 9765817 5144284 4621533 212037 118003 94034 6628882 HRIP RECEIVABLE 921622 921622 THIRD PARTY SETTLEMENTS 265418 RELATED PARTY PAYABLE 9419 274837 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN 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 CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2025 AND 2024, 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 CORPORATION HAS FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR THE PERIODS THROUGH JUNE 30, 2024 AND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). 1 1 X 1 X 300.000000000000 1 X 1 1 0 0 1021267 1021267 0.02300 9748227 11634292 0 0.00000 10769494 11634292 1021267 0.02300 6 292 37238 37238 0.00080 2 27 81143 81143 0.00180 1 12374 12374 0.00030 9 319 130755 130755 0.00290 9 319 10900249 11634292 1152022 0.02590 29414 29414 0.00070 5439 5439 0.00010 2068 2068 0.00000 36921 36921 0.00080 1 3377370 6063819 6925377 -861558 X 1 1 1 1 U OF L HEALTH - SHELBYVILLE INC 727 HOSPITAL DRIVE SHELBYVILLE KY 40065 100385 X X X U OF L HEALTH - SHELBYVILLE INC 1 0 0 1 X X X X X X X X X 25 1 1 1 1 X HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/ X 1 25 1 HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/ 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTPS://UOFLHEALTH.ORG/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/ X HTTPS://UOFLHEALTH.ORG/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/ X HTTPS://UOFLHEALTH.ORG/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 U OF L HEALTH - SHELBYVILLE INC. PART V, SECTION B, LINE 5: THE UOFL HEALTH COMMUNITY ENGAGEMENT TEAM COMPLETED THE CHNA OVER THE COURSE OF THE 2024 CALENDAR YEAR. COMMUNITY ENGAGEMENT STAFF COLLABORATED WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD) ON SURVEY ADMINISTRATION. UOFL HEALTH AND NCDHD ADMINISTERED THE SURVEY AS ITS JOINT CHNA SURVEY. THIS SURVEY WAS RELEASED IN THE NCDHD COUNTIES OF SHELBY, SPENCER, HENRY, AND TRIMBLE AND IN NEIGHBORING BULLITT COUNTY. THE SURVEY WAS DISTRIBUTED TO THE COMMUNITY THROUGH COMMUNITY PARTNERS SUCH AS THE HEALTH DEPARTMENT AND LIBRARIES, AND WAS LINKED TO MYCHART FOR UOFL HEALTH PATIENTS OF ULP PRACTICES. THE COMMUNITY ENGAGEMENT TEAM UTILIZED LARGE COMMUNITY-WIDE EVENTS, PUBLIC QUESTIONS THAT WERE PLACED AT LOCAL LIBRARIES IN THE FOUR NCDHD COUNTIES, LISTENING SESSIONS WITH COMMUNITY MEMBERS, FOCUS GROUPS WITH PEOPLE LIVING WITH DISABILITIES, AND LGBTQIA+ LISTENING SESSIONS.FOR GENERAL FEEDBACK ON PREVIOUS CHNAS, AN ONLINE FEEDBACK FORM WAS MADE AVAILABLE ON THE UOFL HEALTH WEBSITE AT HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/. ANY COMMENTS COLLECTED THROUGH THE FORM WERE INCLUDED IN THE CHNA PROCESS. U OF L HEALTH - SHELBYVILLE INC. PART V, SECTION B, LINE 6A: UOFL HEALTH AS A HEALTHCARE SYSTEM CONDUCTED THE MOST RECENT CHNA DURING THE 2024 CALENDAR YEAR. ALL HOSPITALS IN THE SYSTEM FELL INTO THE SAME CHNA TIMELINE. PRIMARY AND SECONDARY DATA FOR ALL SEVEN HOSPITALS WAS COLLECTED AT THE SAME TIME. THREE CHNA REPORTS WERE CREATED BASED ON COUNTY LOCATION, WHICH RESULTED IN SEPARATE REPORTS FOR JEFFERSON, SHELBY, AND BULLITT COUNTIES. SOUTH HOSPITAL AND SHELBYVILLE HOSPITALS UTILIZED THE SAME SURVEY TOOL THAT WAS ADMINISTERED IN COORDINATION WITH NORTH CENTRAL DISTRICT HEALTH DEPARTMENT AND BULLITT COUNTY HEALTH DEPARTMENT. THE SAME DATA FROM PATIENTS LIVING WITH DISABILITIES, DATA COLLECTED AT EVENTS, DATA COLLECTED AT LIBRARIES, COMMUNITY LISTENING SESSIONS WAS UTILIZED FOR BOTH SHELBYVILLE AND SOUTH HOSPITAL. U OF L HEALTH - SHELBYVILLE INC. PART V, SECTION B, LINE 6B: THE UOFL HEALTH COMMUNITY ENGAGEMENT TEAM COLLABORATED ON DATA COLLECTION WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD). THE SURVEY WAS DISTRIBUTED BY BOTH THE PUBLIC HEALTH DEPARTMENT AND SHELBYVILLE HOSPITAL. BOTH ENTITIES ALSO WORKED TOGETHER TO PLACE SURVEY QUESTIONS AT PUBLIC LIBRARIES AND PUBLIC HEALTH CLINICS THROUGHOUT EACH OF THE COUNTIES THAT NCDHD SERVES AND HOST LISTENING SESSIONS IN EACH OF THE COUNTIES. U OF L HEALTH - SHELBYVILLE INC. PART V, SECTION B, LINE 11: THE CHNA IDENTIFIED THE FOLLOWING OVERALL NEEDS FOR SHELBYVILLE HOSPITAL: OVERALL HEALTH AND WELLBEING, PROJECTED WORKFORCE GAPS, BEHAVIORAL HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, AND ACCESS TO CARE. ONCE PRIORITIES WERE SET BY HOSPITAL LEADERS, A TRANSITION IN LEADERSHIP NECESSITATED A CHANGE IN PRIORITIES. PREVIOUSLY CHOSEN PRIORITIES WERE STREAMLINED INTO SYSTEM LEVEL PRIORITIES OF ACCESS TO CARE, WORKFORCE PIPELINES, AND COMMUNITY PARTNERSHIPS. EACH HOSPITAL THEN TAILORED THESE PRIORITIES TO MEET THE NEEDS OF THEIR PATIENT POPULATIONS, COMMUNITY NEEDS, AND SERVICES. SHELBYVILLE HOSPITAL PRIORITIES INCLUDE: DECREASE BARRIERS TO ACCESSING CARE FOR FARMERS AND FARMWORKERS, ENHANCE WORKFORCE PIPELINES, AND INCREASE RESOURCES THROUGH COMMUNITY PARTNERSHIPS. ACCESS TO CARE, WORKFORCE PIPELINES, AND COMMUNITY PARTNERSHIPS ARE BEING ADDRESSED AS SYSTEM-WIDE PRIORITIES ACROSS ALL HOSPITALS IN THE UOFL HEALTH SYSTEM. THE FOLLOWING LISTS THE PRIORITIES AND STRATEGIES SPECIFIC TO THE HOSPITAL. ***SYSTEM LEVEL STRATEGIESPRIORITY: DECREASE BARRIERS TO ACCESSING CARE FOR FARMERS AND FARMWORKERSTARGET OUTCOME(S): INCREASE SCREENING AND RESOURCES AVAILABLE TO FARMERS AND FARMWORKERSACTION STEPS CREATE A COMMUNITY COLLABORATIVE TO TIE INTO EXISTING EFFORTS AND COMMUNICATION CHANNELS FOR OUTREACH AND HEALTH EDUCATION WITH FARMERS PRIORITIZE IDUSTRY APPROPRIATE TRAININGS AND RESOURCES FOR OUTREACH AS RESOURCES ARE AVAILABLE (E.G. FALLS PREVENTION, BURN, STOP THE BLEED) EXPLORE PARTNERSHIP WITH KENTUCKY HOSPITAL ASSOCIATION AND DEPT OF AGRICULTURE FOR FOOD AS MEDICINE OPPORTUNITIESPRIORITY: ENHANCE WORKFORCE PIPELINESTARGET OUTCOME(S): TRANSLATE STUDENT ENGAGEMENT TO PERMANENT POSITIONS THAT FILL WORKFORCE NEEDS; FILL PROJECTED WORKFORCE GAPS FOR NURSING AND ALLIED HEALTH FIELDSACTION STEPS CONTINUE TO STRENGTHEN PARTNERSHIP WITH LOCAL SCHOOLS FOR STUDENT LEARNING EXPERIENCES AND INTRODUCTIONS TO HEALTH CARE CAREERS ***STREAMLINE PROCESS FROM NURSE EXTERN TO OPEN PERMANENT POSITIONSPRIORITY: INCREASE ACCESS TO RESOURCES THROUGH COMMUNITY PARTNERSHIPSTARGET OUTCOME(S): INCREASE COLLABORATIVE PARTNERSHIPS TO MEET PATIENT NEEDSACTION STEPS CREATE A COMMUNITY COLLABORTIVE TO TIE INTO EXISTING EFFORTS AND COMMUNICATION CHANNELS FOR OUTREACH AND HEALTH EDUCATION WITH FARMERS IMPLEMENT VETERANS' PROGRAM TO ENHANCE SCREENING AND SERVICES FOR VETERAN PATIENTS, CONNECTING THEM TO THE VA AND COMMUNITY RESOURCES EARLIERHEALTH NEEDS CHOSEN AS PRIORITIES FOR EACH UOFL HEALTH HOSPITAL WERE CHOSEN BASED ON PATIENT POPULATION, MAJOR SERVICE LINES WITHIN THE HOPITALS, AND CURRENT OPERATIONAL PRIORITIES FOR THE HOSPITALS. PRIORITIES WERE CHOSEN TO ENSURE ALIGNMENT WITH THE CAPACITY OF THE HOSPITAL OF ADDRESSING THE HEALTH NEEDS AND AVOIDING MISALIGNMENT. MANY OF THE MAJOR THEMES FROM THE CHNA WERE ALSO COMBINED WHERE APPROPRIATE. FOR INSTANCE, ACCESS TO CARE FOR FARMWORKERS WAS SELECTED AS A PRIORITY THAT WILL ADDRESS OVERALL HEALTH AND CHRONIC CONDITIONS AND BEHAVIORAL HEALTH NEEDS. COMMUNITY PARTNERSHIPS WILL ADDRESS SDOH NEEDS AND WORKFORCE GAPS. PART V, SECTION B, LINE 7A HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/ PART V, SECTION B, LINE 10A HTTPS://UOFLHEALTH.ORG/ABOUT/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/ PART I, LINE 3C: UOFL HEALTH-SHELBYVILLE'S FINANCIAL ASSISTANCE POLICY APPLIES TO PATIENTS WHO COME TO OUR FACILITIES AND ARE UNINSURED/UNDERINSURED, INELIGIBLE FOR GOVERNMENT HEALTH PROGRAMS, OR OTHERWISE WITHOUT ADEQUATE FINANCIAL RESOURCES TO PAY FOR HEALTH CARE SERVICES. THIS POLICY PROVIDES FINANCIAL RELIEF TO PATIENTS WHO QUALIFY BASED ON A COMPARISON OF THEIR FINANCIAL RESOURCES AND/OR INCOME TO FEDERAL POVERTY GUIDELINES. THE PROGRAM IS DESIGNED SPECIFICALLY FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE AND PATIENTS WHOSE HOUSEHOLD FINANCIAL RESOURCES AND/OR INCOME ARE AT OR BELOW 300 PERCENT OF THE FEDERAL POVERTY LEVEL. TO QUALIFY FOR ANY ASSISTANCE, PATIENTS WILL BE ASKED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION WHICH INCLUDES INFORMATION RELATING TO HOUSEHOLD INCOME. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE 6/30/2025 COST REPORT COST-TO-CHARGE RATIO WAS USED. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET NUMBER 3 WAS USED TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE ORGANIZATION'S COST ACCOUNTING PROGRAM WAS UTILIZED FOR CALCULATING PORTIONS OF THE SUBSIDIZED HEALTH SERVICES. THE ORGANIZATION'S COST ACCOUNTING PROGRAM ENCOMPASSES ALL PATIENT TYPES, SERVICES AND PAYORS. THE COST ASSOCIATED WITH A SERVICE ARE REVIEWED AND UPDATED ANNUALLY TO PROVIDE THE MOST ACCURATE COST POSSIBLE. BOTH DIRECT AND INDIRECT COSTS ARE UTILIZED IN CALCULATING COST. ACTUAL COST OF HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS AND HEALTH PROFESSIONS EDUCATION ARE STATED AT ACTUAL COST. THE COST OF THESE ITEMS ARE TRACKED THROUGHOUT THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE. THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED WAS A COST-TO-CHARGE RATIO DERIVED FROM THE 6/30/2025 COST REPORT FOR LINES 7A AND 7B. LINES 7E AND 7F ARE BASED ON ACTUAL COSTS. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING: ECONOMIC DEVELOPMENTTHIS INCLUDES IN-KIND DONATION OF TIME FROM HOSPITAL LEADER IN SERVICE TO NONPROFIT ORGANIZATIONS. THE NONPROFITS ARE FOCUSED ON BUSINESS DEVELOPMENT INITIATIVES TO SUPPORT A THRIVING ECONOMY AND ACCESS TO MEANINGFUL WORK AND WEALTH FOR RESIDENTS OF SHELBY COUNTY. NONPROFIT ORGANIZATIONS INCLUDE CHAMBER OF COMMERCE, INDUSTRIAL INDUSTRIES FOUNDATION, AND A FARMERS ADVISORY GROUP. SHELBY COUNTY IS COMPRISED OF 1350 FARMS WITH A TOTAL PAYROLL OF OVER $11 MILLION. FARMERS AND EMPLOYED FARMWORKERS OFTEN FACE BARRIERS TO ACCESSING CARE SUCH AS HEALTH CARE COSTS, LACK OF INSURANCE, AND HEALTH SEEKING BEHAVIORS (UOFL HEALTH CHNA REPORT). THE COOPERATIVE EXTENSION STATEWIDE COMMUNITY NEEDS ASSESSMENT FOUND A NEED ACROSS THE STATE OF KY FOR EFFORTS THAT SUPPORT LOCAL AND SMALL BUSINESSES. SHELBY COUNTY, SPECIFICALLY, FACES A POVERTY RATE OF ALMOST 10% WITH DECREASING EMPLOYMENT (DATA USA, 2024). COMMUNITY BUILDING: WORKFORCE DEVELOPMENTPORTION OF WORKFORCE DEVELOPMENT MANAGER TIME WHOSE RESPONSIBILITY IS TO CONNECT SCHOOLS AND STUDENTS TO HEALTH CARE CAREERS TO MEET EXPECTED HEALTH CARE WORKFORCE SHORTAGES AND DECREASE THE NUMBER OF YOUTH DISCONNECTED FROM EMPLOYMENT AND/OR SCHOOL. THE FEDERAL RESERVE ESTIMATES A SHARP INCREASE IN DISCONNECTED YOUTH IN SHELBY COUNTY BETWEEN 2023 AND 2024. COMMUNITY BUILDING: COMMUNITY SUPPORTIN-KIND DONATION OF TIME FROM HOSPITAL LEADER IN SERVICE TO NONPROFIT ORGANIZATIONS. THIS INCLUDES A VETERANS RESOURCE ORGANIZATION AND YOUTH SERVING ORGANIZATIONS. THE VETERANS ORGANIZATION FOCUSES ON PROVIDING SAFE AND STABLE HOUSING, FOOD, COUNSELING, AND OTHER BASIC NEEDS TO VETERANS WHO REPRESENT 7% OF THE SHELBY COUNTY POPULATIONS. SHELBY COUNTY EXPERIENCES MANY BARRIERS TO HOUSING, FOOD, AND MENTAL HEALTH SUPPORT FOR VETERANS AND THE WIDER POPULATION AS INDICATED IN THE CHNAS. THE YOUTH SERVICE ORGANIZATIONS PROVIDE MENTORSHIP, EDUCATION, AND HEALTH CARE ACCESS. OVER 22% OF THE SHELBY COUNTY POPULATION ARE UNDER THE AGE OF 18 (CENSUS BUREAU) AND THE FEDERAL RESERVE ESTIMATES A SHARP INCREASE IN DISCONNECTED YOUTH IN SHELBY COUNTY BETWEEN 2023 AND 2024. PART III, LINE 2: THE ORGANIZATION HAS REPORTED BAD DEBT EXPENSE AT GROSS CHARGES WRITTEN OFF. THE ORGANIZATION'S BAD DEBT EXPENSE REPRESENTS AMOUNTS BILLED TO PATIENTS THAT WERE DEEMED UNCOLLECTIBLE AND DOES NOT INCLUDE ANY CHARGES THAT WERE ULTIMATELY REIMBURSED OR DISCOUNTED. PATIENT DISCOUNTS ARE RECORDED IN CONTRACTUAL ALLOWANCE OR FINANCIAL ASSISTANCE, AS APPROPRIATE, AS AN OFFSET TO GROSS REVENUE AND ARE NOT INCLUDED IN BAD DEBT EXPENSE. PART III, LINE 3: U OF L HEALTH - SHELBYVILLE, INC. HAS TAKEN REASONABLE AND PRUDENT STEPS TO ENSURE NO PORTION OF BAD DEBT COULD BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. PART III, LINE 4: SEE AUDITED FINANCIAL STATEMENTS PAGES 13-16. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE TAKEN DIRECTLY OFF MEDICARE COST REPORT FILED WITH THE 6/30/25 YEAR END. ANY SHORTFALL SHALL BE TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B: U OF L HEALTH - SHELBYVILLE INC.'S DEBT COLLECTION POLICY PROVIDES THAT THE HOSPITAL WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ALL UNINSURED PATIENTS/GUARANTORS ARE BILLED DIRECTLY AND TIMELY AND WILL RECEIVE A STATEMENT AS PART OF THE NORMAL BILLING PROCESS. ALL PATIENTS/GUARANTORS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNTS AT ANY TIME. AT LEAST THREE SEPARATE POST-DISCHARGE BILLING STATEMENTS ARE SENT. AN ORAL ATTEMPT TO REACH THE PATIENT IS ALSO MADE BEFORE INITIATION OF ANY ECA.AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO THE HOSPITAL FOR APPROPRIATE FOLLOW-UP. U OF L HEALTH - SHELBYVILLE INC. REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL'S CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS:- NEITHER U OF L HEALTH - SHELBYVILLE INC. NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT,- NEITHER U OF L HEALTH - SHELBYVILLE INC. NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE, AND - U OF L HEALTH - SHELBYVILLE INC.'S COLLECTION AGENCY MAY NOT SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. PART VI, LINE 2: THE CHNAS ARE THE PRIMARY METHOD USED BY THIS FACILITY FOR ASSESSING THE NEEDS OF THE COMMUNITY. A FURTHER UNDERSTANDING OF THE NEEDS OF THE COMMUNITY IS GARNERED FROM PARTICIPATION IN COMMUNITY COLLABORATIVES AND COALITIONS WHERE COMMUNITY-BASED ORGANIZATIONS SHARE BARRIERS TO HEALTH AND WELL-BEING, ANALYSIS OF SOCIAL DETERMINANTS OF HEALTH DATA FROM PATIENTS ADMITTED TO THE HOSPITALS AND ACCESSING SERVICES IN PHYSICIAN CLINICS, AND DATA COLLECTION PROJECTS TIED TO STRATEGIC PLANNING. THE COMMUNITY ENGAGEMENT TEAM ALSO CONSISTENTLY ATTENDS COMMUNITY HEALTH FOCUSED EVENTS, WEBINARS, AND MEETINGS, WHERE INFORMATION IS SHARED TO RELEVANT STAKEHOLDERS WITHIN THE HEALTH CARE SYSTEM. THROUGH HOSPITAL BOARD MEMBERS AND THE INVOLVEMENT OF HOSPITAL LEADERSHIP IN THE COMMUNITY, OTHER NEEDS CAN COME TO LIGHT THAT MAY HAVE ARISEN AFTER THE CHNA WAS COMPLETED. PART VI, LINE 3: NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM UOFL HEALTH ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO:- CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS;- NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND- PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE, <WWW.UOFLHEALTH.ORG> AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT.SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE UOFL HEALTH ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.UOFL HEALTH ORGANIZATIONS WILL PROVIDE FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR BILLS AND WILL MAKE THE AVAILABILITY OF SUCH COUNSELING KNOWN. IT IS THE RESPONSIBILITY OF THE PATIENT OR THE PATIENT'S GUARANTOR TO SCHEDULE CONSULTATIONS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH A FINANCIAL COUNSELOR. PART VI, LINE 4: SHELBYVILLE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES SHELBY COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 49,515 RESIDENTS AND COVERS ROUGHLY 386 SQUARE MILES, WITH THE LOCAL ECONOMY AND SURROUNDING AREAS FOCUSED ON MANUFACTURING, HEALTH CARE AND SOCIAL ASSISTANCE, AND RETAIL TRADE. THE MEDIAN AGE IN SHELBY COUNTY IS 40.9. THE MEDIAN AGE FOR THE UNITED STATES IS 39.2 YEARS. THE NUMBER OF PERSONS PER HOUSEHOLD IN SHELBY COUNTY IS 2.64. THE U.S. AVERAGE NUMBER OF PERSONS PER HOUSEHOLD IS 2.64. RACE IN SHELBY COUNTY IS AS FOLLOWS: 88.5% NON-HISPANIC WHITE, 1.0% BLACK OR AFRICAN AMERICAN, 1.0% ASIAN, 0.2% NATIVE HAWAIIAN OR PACIFIC ISLANDER, 0.6% NATIVE AMERICAN, AND 2.7% FROM TWO OR MORE RACES. 10.9% OF THE POPULATION WERE HISPANIC OR LATINO OF ANY RACE. THE RATIO OF PATIENTS TO PRIMARY CARE PHYSICIANS IN SHELBY COUNTY IS 2,850 PATIENTS TO 1. THE KENTUCKY AVERAGE IS 1,600 TO 1. THE OVERALL HEALTH RANKING FOR SHELBY COUNTY IS 9 OUT OF 120 WITH THE OVERALL STATE RANKING BEING 41ST OUT OF 50 STATES. PART VI, LINE 5: UOFL HEALTH SHELBYVILLE, INC. WORKS TO ENHANCE THE HEALTH OF THE COMMUNITY. MOST COMMUNITY OUTREACH IS OPEN TO THE PUBLIC AND SERVES THE BROADER COMMUNITY. THE FOLLOWING PROVIDES A SNAPSHOT OF THE HOSPITAL'S ENGAGEMENT WITH THE COMMUNITY. - FACILITATION OF HEALTH FAIRS IN THE LOCAL COMMUNITY- FACILITATION OF SMOKING CESSATION CLASSES- PARTNERSHIP WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT- MONITORING HOSPITAL PROVIDER OPIATE PRESCRIBING PRACTICES- INVOLVEMENT OF HOSPITAL LEADERSHIP ON HEALTH-RELATED AND SOCIAL SERVICE BOARDS, COMMITTEES, AND ADVISORY GROUPS- FACILITATING CONVERSATIONS RELATED PATIENTS' EXPERIENCES WITH THE SOCIAL DETERMINANTS OF HEALTH SUCH AS TRANSPORTATION- INVOLVEMENT IN THE EDUCATION OF HEALTH PROFESSIONALS THROUGH CLINICAL ROTATIONS AND CAPSTONES- ASSISTING PATIENTS WITH INSURANCE ENROLLMENT- DISCHARGE PLANNING THAT INCLUDES STREAMLINED PRIMARY CARE ACCESS- PARTNER WITH PEACE HOSPITAL TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES- AVAILABILITY OF REGISTERED DIETICIAN AND DIABETES EDUCATORS- PARTNERING WITH NURSING HOMES, ASSISTED LIVING FACILITIES, AND HOME HEALTH ORGANIZATIONS TO BETTER UNDERSTAND THE NEEDS AND RESOURCES AVAILABLE-SCREENING FOR SOCIAL DETERMINANTS OF HEALTH AND REFERRAL OF PATIENTS TO COMMUNITY RESOURCES PART VI, LINE 6: UOFL HEALTH, INC. IS THE PARENT ORGANIZATION FOR A NUMBER OF TAX-EXEMPT HOSPITALS AND HEALTH CARE ORGANIZATIONS. ITS GENERAL PURPOSE IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF EACH ENTITY DIRECTLY OR INDIRECTLY CONTROLLED BY IT AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)3. UOFL HEALTH, INC. IS SUPERVISED OR CONTROLLED IN CONNECTION WITH ITS SUPPORTED ORGANIZATIONS BECAUSE THE SAME PEOPLE MANAGE UOFL HEALTH, INC. AND THE SUPPORTED ORGANIZATIONS. THE SUPPORTED ORGANIZATIONS INCLUDE UNIVERSITY MEDICAL CENTER, INC., UNIVERSITY OF LOUISVILLE PHYSICIANS, INC, UOFL HEALTH-SHELBYVILLE, INC, AND UOFL HEALTH-LOUISVILLE, INC., ALL OF WHICH ARE KENTUCKY, NONPROFIT CORPORATIONS RECOGNIZED BY THE IRS AS BEING TAX-EXEMPT UNDER SECTION 501(C)3 OF THE CODE. UOFL HEALTH-LOUISVILLE, INC. INCLUDES FIVE HOSPITALS IN THE LOUISVILLE METRO AREA INCLUDING JEWISH HOSPITAL, MARY AND ELIZABETH HOSPITAL, PEACE HOSPITAL, SOUTH HOSPITAL AND FRAZIER REHABILITATION INSTITUTE, AND SHELBYVILLE HOSPITAL LOCATED IN SHELBY COUNTY. UOFL HEALTH IS DEDICATED TO COMMUNITY HEALTH PROMOTION AND IMPROVEMENT, WHICH IS PRESENT THROUGHOUT EACH OF ITS HOSPITALS AND SERVICE LINES. EACH OF THE SUPPORTED ORGANIZATIONS CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND THE CORRESPONDING HOSPITALS DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THOSE NEEDS. BEYOND THE CHNA PROCESS, MANY SERVICE LINES, PROGRAMS, AND FACILITIES THROUGHOUT THE UOFL HEALTH SYSTEM HAVE A COMMUNITY HEALTH COMPONENTS SUCH THAT THEY PROVIDE OUTREACH, HEALTH LITERACY, ACCESS TO CARE FOR UNDERSERVED POPULATIONS, AND CHRONIC DISEASE MANAGEMENT AND PREVENTION. FORM 990, SCHEDULE H, PART VI, LINE 7 A COMMUNITY BENEFIT REPORT IS NOT REQUIRED IN THE STATE OF KENTUCKY. COMMUNITY BENEFIT TOTALS WERE POSTED TO THE ORGANIZATION'S WEBSITE. 1 SUPPLIES OVER SEAS 1500 ARLINGTON AVE LOUISVILLE KY 40206 272624272 501(C)(3) 0 12374 FMV MEDICAL SUPPLIES AND EQUIPMENT TO SUPPORT THE MISSION OF SOS 1 0 PART I, LINE 2: GRANT RECORDS ARE PROCESSED AND RECORDED IN OUR ACCOUNTING/ERP SYSTEM AS PAYMENTS ARE MADE. THE CRITERIA FOR RECIPIENT SELECTION IS BASED ON REVIEWS WITH EXECUTIVE LEADERSHIP AND MARKETING DEPARTMENTS. ORGANIZATIONAL CAUSES AS WELL AS HISTORICAL ALIGNMENT WITH THE MISSION OF ULH ARE THE MAJOR DETERMINING FACTORS IN SELECTING RECIPIENTS. 0 0 0 0 0 0 0 1 0 THOMAS D MILLER CEO UOFL HEALTH/SECRETARY 63073 1387598 0 0 567 12475 525 11550 1326 29165 65491 1440788 0 0 ANDREW DUFFEE MD VICE CHAIR/ORTHOPEDIC SURGEON 751394 0 51601 0 1298 0 17250 0 40782 0 862325 0 0 0 JAMES SMITH MD CMO-UOFL HEALTH/UOFL ASSOC. PROFESSO 13063 717791 0 0 32 976 0 34500 46 20384 13141 773651 0 0 KEN MARSHALL COO UOFL HEALTH 28964 637212 0 0 1328 29225 525 11550 443 9748 31260 687735 0 0 KIRK STRACK CFO UOFL HEALTH 22695 499289 0 0 1266 27846 525 11550 1176 25881 25662 564566 0 0 VALERIE BRIONES-PRYOR MD MEMBER/HOSPITALIST 400368 0 0 0 999 0 17250 0 43659 0 462276 0 0 0 GREGORY PFISTER MD MEMBER/PULOMONOLOGIST 338927 0 0 0 807 0 17078 0 19958 0 376770 0 0 0 TIMOTHY AARON GAROFOLA CEO SHELBYVILLE HOSPITAL 323765 0 0 0 1270 0 11629 0 37920 0 374584 0 0 0 KENNETH GARDNER MD VICE CHAIR/ORTHOPEDIC SURGEON 0 173846 0 17157 0 4892 0 9880 0 28757 0 234532 0 0 ANNESSA BAKER CAO/NURSE EXECUTIVE 181924 0 0 0 2158 0 5957 0 30384 0 220423 0 0 0 RICKY PRUITT RN FLOAT CRITICAL CARE 149259 0 7500 0 11669 0 5356 0 34975 0 208759 0 0 0 KAREN CONWAY MANAGER PHARMACY SERVICES 171774 0 0 0 2885 0 5463 0 17470 0 197592 0 0 0 JAMES BOSE DIRECTOR - IMAGING SERVICE 137972 0 0 0 3135 0 4804 0 36815 0 182726 0 0 0 KELLY NOLAN DIRECTOR - NURSING 129616 0 0 0 13786 0 4673 0 20254 0 168329 0 0 0 PART I, LINE 7 THERE IS A SHORT TERM INCENTIVE PLAN THAT ELIGIBLE UOFL HEALTH - SHELBYVILLE INC. EMPLOYEES MAY RECEIVE BASED ON MEETING CERTAIN BENCHMARKS. THE PLAN IS BASED ON MEETING FINANCIAL GOALS, DESIRED PATIENT QUALITY OUTCOMES, PATIENT SATISFACTION SCORES AND IS CONSISTENT WITH MARKET PRACTICES AND THE ORGANIZATION'S COMPENSATION PHILOSOPHY. FORM 990, PART VI, SECTION A, LINE 6 U OF L HEALTH, INC., A KENTUCKY NONPROFIT CORPORATION, SHALL BE THE HOSPITAL'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A U OF L HEALTH-SHELBYVILLE, INC.'S SOLE CORPORATE MEMBER, U OF L HEALTH, INC., APPOINTS THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING MATTERS SHALL REQUIRE THE APPOVAL OF THE MEMBER, U OF L HEALTH, INC.: (A) ANY CHANGE IN THE MISSION OR PURPOSE OF THE CORPORATION (B) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION (C) ANY ADDITION OF NEW MEMBERS (D) APPOINTMENT OF DIRECTORS OF THE CORPORATION (E) EXCEPT AS OTHERWISE COVERDED, ANY SUCH PURCHASE OR ACQUISITION, SALE, GIFT, LEASE, DISPOSITION OF, MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED BY THE CORPORATION, EXCLUDING ROUTINE OR BUDGETED EXPENDITURES, THE VALUE OF WHICH IN THE AGGREGATE EXCEEDS $250,000 (F) SELLING, EXCHANGING, OR OTHERWISE DISPOSING OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS (G) EXCEPT AS OTHERWISE COVERED, ANY UNBUDGETED INCURRENCE OR GUARANTEE OF INDEBTEDNESS BY THE CORPORATION THAT IN THE AGGREGATE EXCEEDS $250,000 (H) ANY MERGER, ACQUISITION, OR CONSOLIDATION OF THE CORPORATION OR ENTERING INTO ANY JOINT BUSINESS VENTURE WITH ANY OTHER PERSON, CORPORATION OR OTHER LEGAL ENTITY (I) ANY DISSOLUTION OF THE CORPORATION (J) CREATION, ACQUISITION, OR DISPOSITION OF ANY SUBSIDIARY OR AFFILIATED ENTITY OF THE CORPORATION (K) APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS FOR THE CORPORATION, AND (L) EXERCISING ANY OTHER POWER OR AUTHORITY SPECIFICALLY RESERVED TO THE MEMBER OR THE BOARD OF DIRECTORS OF THE MEMBER (THE "CORPORATE BOARD"), PURSUANT TO THE BYLAWS OR THE MEMBER'S BYLAWS, AS AMENDED FROM TIME TO TIME. FORM 990, PART VI, SECTION B, LINE 11B AFTER REVIEW AND APPROVAL BY THE ORGANIZATION'S CEO AND CFO, THE CONTRACTED TAX PROFESSIONAL FILES A COPY OF THE FORM 990 WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO AFFECT E-FILING. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF THE HOSPITAL THAT AN INTERESTED PERSON WHO KNOWS THAT HE OR SHE HAS AN ACTUAL OR APPARENT CONFLICT OF INTEREST SHALL DISCLOSE IT PROMPTLY AND FULLY TO ALL NECESSARY PARTIES WHENEVER IT OCCURS. INTERESTED PERSONS ARE (A) VOTING MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS AND VOTING MEMBERS OF COMMITTEES THAT EXERCISE BOARD-DELEGATED AUTHORITY, (B) OFFICERS OF THE HOSPITAL ELECTED OR APPROVED BY THE BOARD OF DIRECTORS OR (C) A "CONTROLLED ENTITY" IN WHICH AT LEAST 35% OF THE CONTROL OR BENEFICIAL INTEREST IS HELD BY ANY ONE OR COMBINATION OF INDVIDUALS DESCRIBED IN A AND B. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER KNOWN INTEREST IN A PROPOSED TRANSACTION TO THE DIRECTORS AND MEMBERS OF COMMITTE WITH BOARD DELEGATED POWERS CONSIDERING THE TRANSATION OR ARRANGEMENT WHEN A CONFLICT OF INTEREST IS DECLARED. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE PROPOSED TRANSACTION. THE INTERESTED PERSON SHALL LEAVE THE MEETING AND THE VOTE ON ANY TRANSACTIONS INVOLVING THE CONFLICT OF INTEREST THE MINUTES OF THE BOARD WILL CONTAIN THE NAMES OF THE PERSONS WHO DISCLOSE OR OTHERWISE WERE FOUND TO HAVE INTEREST IN CONNECTION WITH A CONFLICT OF INTEREST, THE NATURE OF THE INTEREST AND ANY ACTION TAKEN TO DETERMINE THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. THE HOSPITAL USES THE MERCER GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE MERCER GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO THE HOSPITAL'S COMPENSATION PHILOSOPHY AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY MERCER GROUP TO THE COMPENSATION COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS ANNUALLY. LINE 15B: FOR ALL EXECUTIVE DIRECTORS, TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES, THE FOLLOWING PROCESS IS USED. 1) HUMAN RESOURCES (HR) HAS INDEPENDENT COMPANY DO A COMPARISON OF LIKE POSITIONS WITHIN THE COMMUNITY AND COME UP WITH A RANGE. THEY PREPARE A PROPOSAL THAT IS SUBMITTED TO HR FOR REVIEW 2) A SALARY IS DETERMINED WITHIN THAT RANGE BASED ON YEARS OF SERVICE EDUCATION AND OTHER FACTORS, SUCH AS ADDITIONAL RESPONSIBILITIES. HR PREPARES A PROPOSAL TO SUBMIT TO THE CEO 3)THE PROPOSAL, CONTAINING THE POSITION, RANGE AND FINAL COMPENSATION IS TURNED OVER TO THE CEO FOR REVIEW 4) AFTER REVIEW, THE CEO TAKES THE PROPOSAL INFORMATION AND PRESENTS IT TO THE FINANCE COMMTTEE. 5) THE FINANCE COMMITTEE DECIDES AND VOTES ON THE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION B U OF L HEALTH - SHELBYVILLE, INC. DOES NOT ISSUE ANY 1099S UNDER ITS EIN. ALL INDEPENDENT CONTRACTORS ARE PAID BY RELATED ORGANIZATION UNIVERSITY MEDICAL CENTER UNDER A COMMON PAYMASTER ARRANGEMENT. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,947,418. MANAGEMENT AND GENERAL EXPENSES 1,223,498. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,170,916. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,932,148. MANAGEMENT AND GENERAL EXPENSES 173,717. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,105,865. FORM 990, PART XI, LINE 9: TRANSFERS TO/FROM AFFILIATES 6,720,703. UNIVERSITY MEDICAL CENTER INC 530 S JACKSON STREET LOUISVILLE KY 40202 611293786 HOSPITAL KY 501(C)(3) LINE 3 U OF L HEALTH INC 0 U OF L HEALTH INC 530 S JACKSON STREET LOUISVILLE KY 40202 843125292 SUPPORTING ORG KY 501(C)(3) LINE 12B, II N/A 0 U OF L HEALTH - LOUISVILLE INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 843178470 HOSPITAL KY 501(C)(3) LINE 3 U OF L HEALTH INC 0 UNIVERSITY OF LOUISVILLE PHYSICIANS LLC 300 EAST MARKET ST 400 LOUISVILLE KY 40202 273645560 MEDICAL SERVICES KY 501(C)(3) LINE 10 U OF L HEALTH INC 0 UNIVERSITY OF LOUISVILLE INC 2301 S 3RD STREET LOUISVILLE KY 40292 611014882 EDUCATION KY 501(C)(3) N/A 0 U OF L HEALTH FOUNDATION INC 530 S JACKSON STREET LOUISVILLE KY 40202 863084814 SUPPORTING ORG KY 501(C)(3) LINE 7 UNIVERSITY MEDICAL CENTER 0 KENTUCKIANA MEDICAL RECIPROCAL RISK RETENTION GROUP 10200 FOREST GREEN BLVD SUITE 605 LOUISVILLE KY 40223 920184981 LIABILITY COVERAGE KY UOFL HEALTH C -7047 126677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1