2025-05-15T11:13:48-05:00 2024-06-30 390859910 BAKER TILLY ADVISORY GROUP LP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2023-07-01 453215312 PORTSMOUTH HOSPITAL CORPORATION PORT 7409914000 1901 ARGONNE AVENUE PORTSMOUTH OH 45662 AUTUMN MCFANN TREASURER 7409914000 2025-05-14 1 1 KERRI N BOGDA CPA P00760402 7177404863 2025-05-14 2023 2025-03-06 01:10:19Z KING'S DAUGHTERS MEDICAL CENTER OHIO SARA MARKS 2201 LEXINGTON AVENUE ASHLAND KY 41101 30239902 0 X WWW.KINGSDAUGHTERSHEALTH.COM/LOCATIONS X 2010 OH TO CARE. TO SERVE. TO HEAL. 10 9 240 11 0 0 5376 2959 28183898 30214263 2105 20010 512493 0 28703872 30237232 2590 12320 0 0 10644210 15202530 0 0 0 10272563 14254212 20919363 29469062 7784509 768170 28835305 28891175 2718778 3119868 26116527 25771307 X KING'S DAUGHTERS MEDICAL CENTER OHIO IS LOCATED IN THE HISTORIC TOWN OF PORTSMOUTH, OH AT THE CONFLUENCE OF THE OHIO, SCIOTO, AND LITTLE SCIOTO RIVERS. WE HAVE BEEN SPECIFICALLY DESIGNED TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. CONTINUED ON SCHEDULE O.OUR PRIMARY SERVICE AREA IS THE COUNTY OF SCIOTO. ADDITIONAL COUNTIES WE SERVE ARE LAWRENCE, ADAMS, AND JACKSON IN OHIO AND GREENUP AND LEWIS IN KENTUCKY. 0 0 25725560 12320 30214263 LOCATED IN PORTSMOUTH, OHIO, KING'S DAUGHTERS MEDICAL CENTER OHIO (PORTSMOUTH HOSPITAL CORPORATION) PROVIDES A COMFORTABLE, SMALL-HOSPITAL ENVIRONMENT WITH ACCESS TO TECHNOLOGY AND SPECIALISTS NORMALLY FOUND ONLY AT LARGER INSTITUTIONS.SERVING AS A HEALTHCARE CHOICE FOR RESIDENTS OF PORTSMOUTH, SCIOTO COUNTY AND SURROUNDING AREAS, KING'S DAUGHTERS MEDICAL CENTER OHIO (KDOH) PROVIDES SERVICES RANGING FROM PRIMARY CARE TO SURGICAL SERVICES; INPATIENT CARE TO OUTPATIENT DIAGNOSTICS; FROM SPECIALTY CARE TO URGENT CARE. KING'S DAUGHTERS MEDICAL CENTER OHIO PROVIDES ACCESS TO THE FOLLOWING HEALTHCARE SERVICES: - PRIMARY CARE- URGENT CARE SERVICES AVAILABLE 24/7/365- SPECIALIST PHYSICIANS IN HEART AND VASCULAR; ORTHOPEDICS; DIGESTIVE HEALTH; GENERAL SURGERY; NEUROLOGY (EPILEPTOLOGIST); SURGICAL BREAST ONCOLOGY; PLASTIC & RECONSTRUCTIVE SURGERY; UROLOGY; ENT, GENERAL SURGERY, GYNECOLOGY, PSYCHIATRY, PAIN AND SPINE- INPATIENT SERVICES - SURGICAL CARE UROLOGY, ORTHOPEDICS, GI, ENT, GYNECOLOGY, GENERAL SURGERY, PAIN AND SPINE- IMAGING SERVICES, INCLUDING MRI, CT, NUCLEAR MEDICINE, 3D MAMMOGRAPHY, X-RAY, AND GENERAL AND VASCULAR ULTRASOUND - CARDIAC DIAGNOSTIC SERVICES, INCLUDING EKG, STRESS TESTING AND NUCLEAR MEDICINE - PULMONARY DIAGNOSTICS- NUTRITION COUNSELING- DIABETIC CONSULTS- SOCIAL WORK- LAB SERVICES- SLEEP LAB - IMAGING- MRI, NUCLEAR MEDICINE, ULTRASOUND, CT, X-RAY- RESPIRATORY PFT- EMG, EMU- ADDICTION TREATMENT OUTPATIENT AND INPATIENTKDOH OFFERS A VARIETY OF COMMUNITY HEALTH SERVICES, INCLUDING FREE SCREENINGS IN HEART AND VASCULAR HEALTH, SKIN CANCER, PROSTATE CANCER, AND ORTHOPEDICS. THEY ALSO PROVIDE A LOW-COST BLOOD PROFILE PROGRAM. THE ORGANIZATION IS ACTIVELY INVOLVED IN COMMUNITY EVENTS AND SUPPORTS LOCAL ORGANIZATIONS SUCH AS ROTARY, KIWANIS, SHAWNEE STATE UNIVERSITY, AND THE HEALTH DEPARTMENT. ADDITIONALLY, KDOH CONTRIBUTES TO SCHOOLS BY PROVIDING ORTHOPEDIC TRAINERS AND OFFERS A KIDS MOBILE FARMERS MARKET AT LOCAL SCHOOLS AND CIVIC ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS. 25725560 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 240 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 OH X LAURIE STEWART CONTROLLER 6064089640 2201 LEXINGTON AVENUE ASHLAND KY 41101 DAVID JONES CHAIRMAN, BOARD OF DIRECTORS 0.25 4.50 X X 0 0 0 CRAIG COLLINS BOARD OF DIRECTORS 0.25 2.25 X 0 0 0 ERIC MONDAY BOARD OF DIRECTORS 0.25 2.25 X 0 0 0 GINA DUGAS BOARD OF DIRECTORS 0.25 2.25 X 0 0 0 JOHN STEWART BOARD OF DIRECTORS 0.25 2.50 X 0 0 0 MARK BIRDWHISTELL BOARD OF DIRECTORS 0.25 2.25 X 0 0 0 PENNY COX BOARD OF DIRECTORS 0.25 2.25 X 0 0 0 ROBERT DIPAOLA BAORD OF DIRECTORS 0.25 2.25 X 0 0 0 STEPHEN ADDINGTON BOARD OF DIRECTORS 0.25 2.50 X 0 0 0 TOM BURNETTE BOARD OF DIRECTORS 0.25 2.50 X 0 0 0 STEVEN CLIFTON SECRETARY 0.25 4.00 X 0 0 0 AMY SAUNDERS ASSISTANT SECRETARY 0.25 44.00 X 0 250853 20545 AUTUMN MCFANN TREASURER 1.25 60.25 X 0 881584 136203 SARA MARKS PRESIDENT/CEO 1.25 60.25 X 0 979730 136985 ROY ADAMS PHC MEDICAL DIRECTOR, PHYSICIAN 0.25 40.00 X 1250 162852 25917 CHARLES L CONLEY PHYSICIAN 10.00 42.00 X 105780 484068 38968 CRAIG HAZELBAKER PHARMACIST / PHARMACY SUPERVISOR 40.00 0.00 X 169927 0 23822 JAMES NEAL CNO PHC 45.00 0.00 X 147045 0 15567 MELISSA WATSON PHARMACIST 40.00 0.00 X 169689 202 23305 TONY VIRGIN PHYSICIAN 19.50 40.00 X 207685 529922 37986 801376 3289211 459298 13 0 1 0 BAYMARK MANAGEMENT SERVICES DEPT D8126 PO BOX 650002 DALLAS TX 75265 ADDICTION RECOVERY SERVICES 325465 1 2959 2959 NET PATIENT REVENUE 621110 29975015 29975015 PHARMACY REVENUE 621110 239248 239248 30214263 22680 2670 20010 20010 20010 30237232 30214263 0 20010 12320 12320 185848 185848 11285121 9917364 1367757 314820 276664 38156 2651169 2329847 321322 765572 665206 100366 241740 241740 3355 3355 2420030 2238300 181730 420436 420436 361563 279501 82062 607247 607247 8348 8348 9402 9402 1812765 1812765 18979 18979 MEDICAL SUPPLIES 4624899 4569997 54902 BAD DEBT EXPENSE 2490342 2490342 REPAIRS AND MAINTENANCE 1084693 992241 92452 MINOR EQUIPMENT 74417 63976 10441 75996 65334 10662 29469062 25725560 3743502 0 429341 431845 3152694 3287744 1593912 1134843 200179 161996 26526475 2651728 23397963 23874747 61216 0 28835305 28891175 1694251 1865253 1024527 1254615 2718778 3119868 X 26116527 25771307 26116527 25771307 28835305 28891175 X 768170 -1113390 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 3355 3355 0 PART II-B, LINE 1: $1005: A PORTION OF THE DUES PAID TO THE OHIO HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING EXPENSES. $ 2350: A PORTION OF DUES PAID TO THE COLLEGE OF AMERICAN PATHOLOGISTS ATTRIBUTABLE TO LOBBYING EXPENSES 605910 605910 19033420 780948 18252472 5250 4150 1100 6281895 1825391 4456504 600000 41239 558761 23874747 DUE TO MEDICARE 1254615 1254615 1 1 X 1 X 1 X 1 1 0 1 1 95503 95503 0.00350 7927090 8808649 0 0.00000 8022593 8808649 95503 0.00350 56247 56247 0.00210 25975 25975 0.00100 82222 82222 0.00310 8104815 8808649 177725 0.00660 1 724478 34071 3581534 4339670 -758136 X 1 1 1 1 PORTSMOUTH HOSPITAL CORPORATION 1901 ARGONNE RD PORTSMOUTH OH 45662 WWW.KDMCOHIO.COM X X X URGENT CARE - 24 HOURS PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://WWW.KINGSDAUGHTERSHEALTH.COM/DOCUMENTS/COMMUNITY/KDOH-2022-COMMUNIT X 1 22 1 HTTPS://WWW.KINGSDAUGHTERSHEALTH.COM/DOCUMENTS/COMMUNITY/KD-OHIO-CHNA-IMPLE 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X KINGSDAUGHTERSHEALTH.COM/PATIENT-VISITORS/FINANCIAL-SERVICES-RESOURCES X KINGSDAUGHTERSHEALTH.COM/PATIENT-VISITORS/FINANCIAL-SERVICES-RESOURCES X KINGSDAUGHTERSHEALTH.COM/PATIENT-VISITORS/FINANCIAL-SERVICES-RESOURCES X X X X X X 1 X 0 X X X X 1 X 0 1 PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO PART V, SECTION B, LINE 5: THE PRC PROCESS WORKED TO ASSURE THAT THERE WAS A BROAD INVOLVEMENT FROM THE COMMUNITY IN THE ASSESSMENT PROCESS THROUGH THE USE OF THE KEY INFORMANT AND COMMUNITY SURVEYS. THE KEY INFORMANT SURVEY INCLUDED INDIVIDUALS FROM PUBLIC HEALTH, BUSINESS, NON-PROFITS, HEALTHCARE AND OTHERS INTERESTED IN THE HEALTH OF THEIR COMMUNITY. PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO PART V, SECTION B, LINE 6A: SOUTHERN OHIO MEDICAL CENTER (SOMC) PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO PART V, SECTION B, LINE 6B: SCIOTO COUNTY HEALTH DEPARTMENTPORTSMOUTH CITY HEALTH DEPARTMENT PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO PART V, SECTION B, LINE 11: THE 2021-22 COMMUNITY HEALTH NEED ASSESSMENT IDENTIFIED THE FOLLOWING NEEDS THAT THE MEDICAL CENTER WILL BE ADDRESSING:- CHRONIC CONDITIONS: BREAST AND COLON CANCERS- PREVENTIVE CARE: PHYSICAL ACTIVITY/WELLNESS, MENTAL HEALTH, NUTRITIONCHRONIC CONDITIONS:BREAST CANCER: KDOH WILL BE ADDRESSING BREAST CANCER THROUGH INCREASING SCREENING MAMMOGRAMS TO HELP IN EARLY IDENTIFICATION AND DIAGNOSIS OF BREAST CANCER. EARLY IDENTIFICATION AND TREATMENT REDUCE THE BURDEN OF BREAST CANCER AND IMPROVE PATIENT OUTCOMES.COLON CANCER: COLON CANCER WILL BE ADDRESSED BY INCREASING EDUCATION ABOUT COLON CANCER AND THE NEED FOR SCREENING AMONG THOSE 45 YEARS OF AGE AND OLDER. THE EARLIER COLON CANCER IS DETECTED THE BETTER THE PATIENT OUTCOMES.PREVENTIVE CARE: PHYSICAL ACTIVITY/WELLNESS: KDOH WILL PROVIDE COMMUNITY EDUCATION FOCUSED ON HEALTHY LIFESTYLES AND WELLNESS. AS PART OF THIS PRIORITY, KDOH PLANS TO HOST OR SPONSOR AT LEAST FOUR EVENTS PROMOTING PHYSICAL ACTIVITY, ESPECIALLY FOR CHILDREN. IN ADDITION, KDOH WILL HOST AT LEAST SIX HEALTH SCREENING ACTIVITIES RELATED TO BLOOD PRESSURE, CHOLESTEROL, BLOOD SUGAR, NUTRITION AND NICOTINE EDUCATION.MENTAL HEALTH: KDOH PLANS TO PROVIDE COMMUNITY EDUCATION REGARDING THE SUICIDE PREVENTION HOTLINE AND MENTAL HEALTH AWARENESS. IN ADDITION, KDOH WILL PARTNER WITH KDMC TO PUBLISH SOCIAL MEDIA POSTS FOCUSED ON MENTAL HEALTH ON KDOH'S SOCIAL MEDIA PAGES. NUTRITION: KDOH WILL PROVIDE COMMUNITY EDUCATION ON HEALTHY EATING AND EDUCATIONAL PROGRAMS FOCUSED ON NUTRITION. THIS WILL BE DONE THROUGH THE MOBILE MARKET AND OTHER OPPORTUNITIES. KDOH WILL PARTICIPATE IN AT LEAST FOUR EVENTS, OF WHICH TWO WILL FOCUS ON SENIOR CITIZENS. THE IDENTIFIED NEEDS OF OVERWEIGHT/OBESITY, DIABETES, AND HEART DISEASE ARE BEING ADDRESS WITHIN THE PREVENTIVE CARE INITIATIVES. THE IDENTIFIED NEEDS OF SUBSTANCE USE DISORDER, RESPIRATORY ILLNESSES, INFANT HEALTH AND FAMILY PLANNING, INJURY AND VIOLENCE, KIDNEY DISEASE, ORAL HEALTH, POTENTIALLY DISABLING CONDITIONS, RESPIRATORY DISEASE, AND TOBACCO USE ARE OUTSIDE THE SCOPE OF SERVICES PROVIDED BY KDOH. THERE ARE ALSO OTHER ORGANIZATIONS IN THE KDOH SERVICE AREA THAT PROVIDE SERVICES TO ADDRESS THESE NEEDS. PORTSMOUTH HOSPITAL CORP DBA KDMC OHIO PART V, SECTION B, LINE 24: FAP ELIGIBLE PATIENTS ARE CHARGED THE GROSS CHARGE FOR ANY SERVICES EXCLUDED FROM ELIGIBILITY AS DEFINED WITHIN THE FAP, WHICH ARE DEFINED AS ELECTIVE SERVICES AND THEREFORE NOT MEDICALLY NECESSARY. PART I, LINE 7: KDOH USED WORKSHEET 2 PROVIDED IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST TO CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE CHARITY CARE AT COST (A. ABOVE). TO CALCULATE THE UNPAID COSTS OF MEDICAID (B), THE HOSPITAL'S COST ACCOUNTING SYSTEM WAS USED. REMAINING ITEMS WERE REPORTED AT NET EXPENSE. PART I, LN 7 COL(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 $2,490,342 PART III, LINE 2: BAD DEBT EXPENSE IS RECORDED AFTER ANY DISCOUNTS AND PAYMENTS ARE MADE ON PATIENT ACCOUNTS.KDOH USED WORKSHEET 2 PROVIDED IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST OF CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE BAD DEBT EXPENSE AT COST. PART III, LINE 3: THE PATIENT ACCOUNTING TEAM QUERIED THE EPIC SYSTEM TO PULL ANY BAD DEBT ACCOUNT THAT WAS FLAGGED AS HAVING AN INCOMPLETE FA APPLICATION. THE BAD DEBT BALANCE WAS THEN NETTED DOWN TO COST, USING THE COST TO CHARGE RATIO. THE SERVICE WAS STILL PROVIDED, REGARDLESS OF PAYMENT AND THEREFORE THIS SHOULD BE COUNTED AS A PART OF COMMUNITY BENEFIT. PART III, LINE 4: SEE PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS FOR FOOTNOTE. PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOPSITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES ALLOWABLE COSTS PER THE MEDICARE COST REPORT. PART III, LINE 9B: THE HOSPITAL HAS A WRITTEN POLICY FOR BAD DEBT. UNINSURED PATIENTS ARE SCREENED FOR ELIGIBILITY FOR MEDICARE, MEDICAID AND OTHER SUCH PROGRAMS BY A CONTRACTED VENDOR. ALL PATIENTS, INSURED AND UNINSURED, WITH VALID MAILING ADDRESSES RECEIVE POST-DISCHARGE BILLING STATEMENTS OVER THE COURSE OF A 120 DAY PERIOD. IF THERE ARE NO ACTIVE DISPUTES OR OTHER PAYMENT SOURCES AVAILABLE, AND THE BALANCE IS UNPAID AT THE END OF THE STATEMENT PERIOD, THE ACCOUNT WILL BE PLACED WITH A COLLECTION AGENCY TO REPORT AS A BAD DEBT. EACH STATEMENT INCLUDES INFORMATION REGARDING THE AVAILABILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM ALONG WITH A NUMBER WHERE REPRESENTATIVES CAN BE REACHED FOR ASSISTANCE. PART VI, LINE 2: IN ADDITION TO THE TRIANNUAL CHNA, KDOH CONTINUOUSLY MONITORS HOSPITAL DATA AND COMMUNITY SPREAD DISEASES LIKE SEASONAL FLU AND COVID-19. DEPENDING ON THE ISSUE, KDOH RESPONDS WITH STRATEGIES TO HELP MITIGATE THE ISSUE. PART VI, LINE 3: THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY PROVIDES DIRECTION FOR FREE OR DISCOUNTED SERVICES TO RESIDENTS OF THE COMMUNITY WHO HAVE INADEQUATE FINANCIAL RESOURCES TO PAY FOR NECESSARY HEALTHCARE SERVICES PROVIDED BY KING'S DAUGHTERS. THE POLICY STATES THAT THE MEDICAL CENTER WILL NOT DENY CARE TO ANY PATIENT REQUIRING CARE DUE TO THEIR INABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY PROVIDES GUIDANCE TO PROVIDING ASSISTANCE BASED ON SLIDING SCALE METHODOLOGY AND THE FEDERAL POVERTY GUIDELINES ESTABLISHED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS REQUIRING CARE WITH INCOME BELOW 300% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR FREE OR REDUCED COST SERVICES. KING'S DAUGHTERS ALSO CONTRACTS WITH OUTSIDE VENDORS TO ASSIST PATIENTS IN GOVERNMENT ENROLLMENT PROGRAMS. THERE ARE SIGNS POSTED IN VARIOUS REGISTRATION AREAS INFORMING PATIENTS OF THE PHONE NUMBER TO CALL IF THEY NEED FINANCIAL ASSISTANCE. ON EACH PATIENT STATEMENT THE INFORMATION IS ALSO PRINTED WITH THE PHONE NUMBER. ALL SELF-PAY PATIENTS RECEIVE CORRESPONDENCE AND PHONES CALLS AND INPATIENTS RECEIVE VISITS FROM OUR MEDICAID ELIGIBILITY VENDOR IN REFERENCE TO GOVERNMENT PROGRAMS. PART VI, LINE 4: SCIOTO COUNTY COVERS MORE THAN 610 SQUARE MILES, WITH A POPULATION DENSITY OF 130.3 PEOPLE PER SQUARE MILE. THE POPULATION IS NEARLY EVENLY DIVIDED BETWEEN URBAN AND RURAL, WITH 54.28% RURAL AND 45.72% URBAN. THE LARGEST CITY IN SCIOTO COUNTY IS PORTSMOUTH WITH A POPULATION OF 18,252 (US CENSUS 2019-2023) 5 YEAR ESTIMATES. OTHER NOTABLE CITIES IN SCIOTO COUNTY ARE WHEELERSBURG, LUCASVILLE, AND NEW BOSTON. ACCORDING TO THE US CENSUS BUREAU AMERICAN COMMUNITY SURVEY, SCIOTO COUNTY HAS 73,118 RESIDENTS. OF THE RESIDENTS, 91.6% ARE WHITE, 2.4% ARE NON-HISPANIC BLACK, 1.5% ARE HISPANIC OR LATINO; AND 3.5% NON-HISPANIC MULTIPLE RACES AND 1% NON HISPANIC SOME OTHER RACE. 49.6% OF THE POPULATION IS MALE AND 50.4% FEMALE. AMONG HOUSEHOLDS IN SCIOTO COUNTY, 1.3% SPEAK A LANGUAGE OTHER THAN ENGLISH. 82% OF HOUSEHOLDS HAVE A COMPUTER, WITH 73.9% HAVING A BROADBAND SERVICE. OF RESIDENTS AGED 25 AND OLDER, 11.3% HAVE NO HIGH SCHOOL DIPLOMA, COMPARED TO 8.4% IN OHIO AND 10.6% NATIONALLY. ONLY 18.0% OF SCIOTO COUNTY RESIDENTS HAVE A BACHELOR'S DEGREE OR HIGHER COMPARED TO OHIO (31.0%) AND THE UNITED STATES (35.0%). THE POPULATION OF SCIOTO COUNTY IS MADE UP OF 5.8% CHILDREN UNDER 5; 21.7% CHILDREN/YOUTH UNDER AGE 17; AGE OF 18-24 8.6%; AGE 25-34 12.8%; AGE 35-44 12.1%; AGE 45-54 12.8%; AGE 55-64 13.4%; OVER THE AGE OF 65 IS 18.5% THESE STATISTICS ARE IN LINE WITH OHIO AND UNITED STATES. 22% OF THE POPULATION REPORTS HAVING SOME TYPE OF DISABILITY WHICH IS SIGNIFICANTLY HIGHER THAN OHIO (14.2%) AND THE UNITED STATES (13.0%). MORE THAN 18% OF THE POPULATION UNDER AGE 65 REPORTS HAVING SOME TYPE OF DISABILITY WHICH IS SIGNIFICANTLY HIGHER THAN OHIO (10%) AND THE UNITED STATES (8.6%). SCIOTO COUNTY'S POVERTY RATE OF 23.37% IS HIGHER THAN OHIO (13.24%) AND THE NATION (12.44%). THE MEDIAN INCOME FOR THE COUNTY IS $81,789, WHICH IS WELL BELOW THE STATE ($115,826) AND NATION ($130,215). PER-CAPITA INCOME IN THE COUNTY IS $23,719, COMPARED TO $31,552 FOR OHIO AND $34,103 FOR THE UNITED STATES. THE US CENSUS BUREAU 2020 AMERICAN COMMUNITY SURVEY 2019-2023 5 YEAR ESTIMATES DATA SHOWS THAT AMONG THOSE UNDER AGE 65, 8.4% HAVE NO HEALTH INSURANCE, COMPARED TO 8.4% IN OHIO AND 11.2% NATIONWIDE. PART VI, LINE 5: KDOH PROVIDES FREE EDUCATIONAL AND SCREENING SERVICES IN SCIOTO COUNTY, THE PRIMARY MARKET. KDOH WORKS WITH LOCAL HEALTH DEPARTMENTS, CHURCHES, SCHOOLS, BUSINESSES, AND COMMUNITY GROUPS TO HELP IMPROVE HEALTH THROUGHOUT THE COUNTY. THE FOLLOWING ACTIVITIES, WHICH CONTRIBUTE TO COMMUNITY HEALTH WERE PROVIDED:SCREENING AND HEALTH EDUCATION ACTIVITIES:SCREENINGS, IMMUNIZATIONS AND PHYSICALS:- FLU SHOTS - 60 PROVIDED- HEALTHY HEART SCREENING - 162 SERVED- MOBILE MAMMOGRAPHY - 152 SERVED- SPORTS PHYSICALS - 480 SERVEDHEALTH EDUCATION:- 988 SUICIDE HELP LINE - 1,590- BONE HEALTH - 67 SERVED- CHF - 128 ADULTS SERVED - BREAST CANCER - 1,009 SERVED - COLON CANCER - 165 SERVED- DIABETES - 1,181 SERVED- HEART SIGNS AND SYMPTOMS - 562 SERVED- HEART DISEASE EDUCATION - 248 SERVED - HYDRATION - 643 SERVED - HYPERTENSION - 69 ADULTS SERVED- IMMUNIZATION EDUCATION - 107 SERVED - MENTAL HEALTH - 189 SERVED - LUNG CANCER - 18 ADULTS SERVED- NUTRITION - 1,923 SERVED- PEDIATRIC IMMUNIZATIONS EDUCATION - 162 SERVED - PHYSICAL ACTIVITY - 224 SERVED- PROSTATE EDUCATION - 149 SERVED -SAFETY - 50 SERVED - STROKE EDUCATION - 504 SERVED - SKIN CANCER - 67 SERVED- TOBACCO, SMOKELESS TOBACCO/VAPING - 251 SERVED - SUBSTANCE USE DISORDER - 50 SERVED -SUMMER SAFETY - 50 SERVEDOTHER COMMUNITY ACTIVITIES:BLOOD DRIVES- KDOH PARTNERED WITH THE RED CROSS TO INCREASE BLOOD DONATIONS BY ENCOURAGING TEAM MEMBERS TO PARTICIPATE IN LOCAL BLOOD DRIVES DURING WORK HOURS. 85 DONATIONS WERE PROVIDED.BACKPACK PROGRAM-TEAM MEMBERS DONATED OVER 200 ITEMS OF SCHOOL AND DISINFECTING SUPPLIES TO PORTSMOUTH ELEMENTARY SCHOOL CHILDREN TO ENSURE STUDENTS START THE YEAR WITH THE NECESSARY SCHOOL SUPPLIES.ADOPT-A-FAMILY-TEAM MEMBERS ADOPTED TWO FAMILIES WITH A TOTAL OF 8 FAMILY MEMBERS AT CHRISTMAS PROVIDING GIFTS AND FOOD.SALVATION ARMY- KDOH TEAM MEMBERS DONATED TIME, GIFTS AND FOOD TO THE SALVATION ARMY CHRISTMAS EVENT. PART VI, LINE 6: KING'S DAUGHTERS MEDICAL CENTER OHIO IS PART OF AN AFFILIATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM OPERATES ANOTHER HOSPITAL, KING'S DAUGHTERS MEDICAL CENTER (KDMC) IN ASHLAND, KY. KDOH HAS BEEN SPECIFICALLY DESIGNED TO MEETING THE HEALTHCARE NEEDS OF PORTSMOUTH AND ITS SURROUNDING AREAS. KDOH OFFERS SURGICAL AND URGENT CARE SERVICES. KDOH PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. THE SYSTEM PROVIDES PHYSICIAN SERVICES THROUGH KING'S DAUGHTERS MEDICAL SPECIALTIES, INC. ("KDMS"). KDMS PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. KING'S DAUGHTERS ALSO INCLUDES TWO OTHER AFFILIATES - KING'S DAUGHTERS MEDICAL TRANSPORT, WHICH SEEKS TO CONTINUOUSLY IMPROVE THE PRE- AND POST-HOSPITAL HEALTHCARE PROVIDED IN ALL OF ITS SERVICES AREAS WHILE ENSURING THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED; AND KINGSBROOK NURSING HOME, WHICH PROVIDES QUALITY CARE TO PATIENTS, MEETING THE NEEDS AND DESIRES OF RESIDENTS AT VARIOUS LEVELS OF CARE, INCLUDING SHORT-TERM AND LONG-TERM CARE 0 1 0 0 0 0 0 1 0 SARA MARKS PRESIDENT/CEO 0 661283 0 294512 0 23935 0 114850 0 22135 0 1116715 0 0 AUTUMN MCFANN TREASURER 0 596476 0 260000 0 25108 0 114850 0 21353 0 1017787 0 0 TONY VIRGIN PHYSICIAN 207685 518468 0 150 0 11304 0 18600 0 19386 207685 567908 0 0 CHARLES L CONLEY PHYSICIAN 105780 482701 0 150 0 1217 9900 0 29068 0 144748 484068 0 0 AMY SAUNDERS ASSISTANT SECRETARY 0 226715 0 23062 0 1076 0 11403 0 9142 0 271398 0 0 CRAIG HAZELBAKER PHARMACIST / PHARMACY SUPERVISOR 160973 0 8228 0 726 0 7674 0 16148 0 193749 0 0 0 MELISSA WATSON PHARMACIST 166872 202 2695 0 122 0 7689 0 15616 0 192994 202 0 0 ROY ADAMS PHC MEDICAL DIRECTOR, PHYSICIAN 1250 162314 0 150 0 388 7449 0 18468 0 27167 162852 0 0 JAMES NEAL CNO PHC 132862 0 13382 0 801 0 6615 0 8952 0 162612 0 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS DETERMINED BY ASHLAND HOSPITAL CORPORATION (RELATED ORGANIZATION) USING THE FOLLOWING METHODS: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD. PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: - AUTUMN MCFANN: $23,848 - SARA MARKS $22,381 THE CEO AND CERTAIN VICE PRESIDENTS, WHOSE BENEFIT IN THE QUALIFIED TAX SHELTERED ANNUITY PLAN IS LIMITED DUE TO THE IRS COMPENSATION AND BENEFIT LIMITS, RECEIVE A BENEFIT RESTORATION CONTRIBUTION UNDER THE DEFERRED ANNUITY PLAN THAT IS PAID AS A TAXABLE DISTRIBUTION TO THE PARTICIPANT ANNUALLY. 1 EMPLOYEE PARTICIPATED IN A CAPITAL ACCUMULATION PLAN: - SARA MARKS: PREMIUM PAYMENT $34,615 THE ORGANIZATION SPONSORS SPECIFIC WELFARE BENEFIT PLANS FOR EACH OF THE INTERESTED PERSONS LISTED ABOVE, THAT AUTHORIZE THE PURCHASE OF LIFE INSURANCE POLICIES AS A MEANS OF PROVIDING POST-EMPLOYMENT BENEFITS. EACH PREMIUM CONTRIBUTION PAID ON BEHALF OF THE INTERESTED PERSON IS TREATED FOR TAX, LEGAL AND FINANCIAL PURPOSES AS A LONG-TERM LOAN RECEIVABLE. AS SUCH THE ORGANIZATION RETAINS A PERMANENT AND PRIMARY IRREVOCABLE INTEREST IN THE DEATH BENEFIT OF THE LIFE INSURANCE POLICIES THAT WILL PROVIDE FULL REPAYMENT OF THE ACCUMULATED LOAN RECEIVABLE AT THE DEATH OF THE INTERESTED PERSON. PART I, LINE 7 NONFIXED PAYMENTS ARE MADE AS A PART OF THE MEDICAL CENTER'S TEAM INCENTIVE AWARD (TIA) PLAN. ALL TEAM MEMBERS ARE ELIGIBLE FOR THE TIA. THE TIA IS PAID OUT BASED UPON SUCCESSFUL COMPLETION OF BOTH QUANTITATIVE AND QUALITATIVE STRATEGIC GOALS, SET ANNUALLY BY THE MEDICAL CENTER LEADERSHIP TEAM AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART V, LINE 1A: THERE IS NO SEPARATE FORM 1096 FILED BY PORTSMOUTH HOSPITAL CORPORATION. ALL THE PAYMENTS ARE MADE BY ASHLAND HOSPITAL CORPORATION AN AFFILIATE ENTITY, UNDER ITS EIN 61-0444716. FORM 990, PART VI, SECTION A, LINE 6 ROYAL BLUE HEALTH, LLC (RBH) IS THE SOLE CORPORATE MEMBER OF PORTSMOUTH HOSPITAL CORPORATION (PHC). FORM 990, PART VI, SECTION A, LINE 7A THE PHC BOARD IS FOLDED INTO THE MAIN BOARD OF TRUSTEES OF THE HEALTH SYSTEM. THE BUSINESS OF PHC IS INCORPORATED INTO THE BUSINESS OF THE FULL BOARD INDEPENDENTLY, OR THROUGH ITS COMMITTEES. FORM 990, PART VI, SECTION A, LINE 7B AS THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM, AS WELL AS THE SOLE MEMBER OF PHC, RBH HAS ALL GOVERNING AUTHORITY. ANY LOCAL BOARD OF DIRECTORS IS ADVISORY ONLY. AT THIS TIME THERE IS NOT AN ADVISORY BOARD FOR PHC. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE CFO AND CONTROLLER BEFORE IT IS FILED WITH THE IRS. THE 990 WILL BE KEPT ON FILE AND AVAILABLE FOR REVIEW BY BOARD MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C PORTSMOUTH HOSPITAL CORPORATION DBA KING'S DAUGHTERS MEDICAL CENTER OHIO (KDOH), THROUGH ITS SOLE MEMBER, REQUIRES ALL DIRECTORS AND OFFICERS TO COMPLY WITH ITS CONFLICTS OF INTEREST POLICY, WHICH TRACKS THE IRS'S RECOMMENDED POLICY WITH RESPECT TO SUCH OFFICERS AND DIRECTORS. MEMBERS OF THE KDOH'S BOARD OF DIRECTORS MUST ANNUALLY IDENTIFY, IN WRITING, ANY INTEREST THAT COULD GIVE RISE TO A CONFLICT, SUCH AS A LEADERSHIP POSITION IN A CONFLICTING ORGANIZATION; DISCLOSURE IS NOT LIMITED TO FINANCIAL CONFLICTS. IN ADDITION, EMPLOYEES OF KDOH CERTIFY THAT NO CONFLICTS OF INTEREST EXIST OR OBTAIN AN ADVANCE WAIVER OF ANY CONFLICTS. KDOH'S GENERAL COUNSEL OBTAINS ALL RELEVANT DISCLOSURES AND SIGNATURES. IF A CONFLICT OF INTEREST IS REPORTED, THE VICE PRESIDENT TO WHOM THE REPORTING EMPLOYEE DIRECTLY OR INDIRECTLY REPORTS, TOGETHER WITH THE CEO, DETERMINES IF A CONFLICT EXISTS. IF THE REPORTING EMPLOYEE IS A VICE PRESIDENT, THE CEO, IN CONSULTATION WITH THE GENERAL COUNSEL, DETERMINES IF A CONFLICT EXISTS. BOARD MEMBERS COMPLETE ANNUAL ATTESTATIONS IDENTIFYING POTENTIAL CONFLICTS OF INTEREST. IF A CONFLICT EXISTS, IT IS REPORTED TO THE CHAIRMAN OF THE BOARD, THE CEO, AND/OR GENERAL COUNSEL AS APPROPRIATE. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE EMPLOYEE OR BOARD MEMBER IS REMOVED FROM ANY PART OF THE DECISION-MAKING PROCESS, AND HAS NO ROLE IN THE INSTANCE IN WHICH THE CONFLICT EXISTS. A BOARD MEMBER WHO REPORTS A POTENTIAL OR ACTUAL CONFLICT OF INTEREST MUST ABSTAIN FROM ANY RELEVANT DISCUSSION OR VOTE. IF A CONFLICT OF INTEREST IS DISCOVERED AFTER THE FACT, THE CEO AND VICE PRESIDENT, TOGETHER WITH THE GENERAL COUNSEL, IF APPROPRIATE, REVIEWS THE INSTANCE IN WHICH THE CONFLICT OCCURRED. THOSE LEADERS ENSURE THAT THE CONFLICTED INDIVIDUAL DID NOT INFLUENCE DECISION MAKING OR PROFIT FROM THE CONFLICT. THE CONFLICTED INDIVIDUAL IS REMOVED FROM ANY FURTHER INVOLVEMENT. IN ADDITION, ANY FAILURE TO REPORT CONFLICTS OF INTEREST VIOLATES THE POLICY AND COULD RESULT IN DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR REMOVAL FROM THE MEDICAL CENTER'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 AT THE DIRECTION OF THE BOARD OF DIRECTORS, KDMC SET COMPENSATION FOR THE TEAM MEMBERS AND LEADERS USING LOCAL, REGIONAL AND NATIONAL SALARY INFORMATION PROVIDED THROUGH SURVEY DATA. THE PRIMARY OBJECTIVE OF KING'S DAUGHTERS COMPENSATION PHILOSOPHY IS TO HAVE COMPENSATION AND BENEFITS SET THAT REFLECT OTHER SIMILAR INDEPENDENT NOT FOR PROFIT HEALTHCARE SERVICES AS WELL AS THE WORK PERFORMANCE OF THE ORGANIZATION. MERCER, AN INDEPENDENT COMPENSATION EXPERT, PERIODICALLY PERFORMS A REVIEW OF EXECUTIVE COMPENSATION AND BENEFITS. SULLIVAN COTTER, AN INDEPENDENT COMPENSATION EXPERT, PROVIDES ANNUAL MARKET SURVEY DATA FOR PHYSICIAN COMPENSATION AND BENEFITS WHICH IS USED FOR DETERMINATION OF FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 ON A QUARTERLY BASIS, THE FINANCIAL STATEMENTS ARE REPORTED TO EMMA (ELECTRONIC MUNICIPAL MARKET ACCESS) AND MADE AVAILABLE ON THEIR WEBSITE. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: FORGIVENESS OF INTERCOMPANY RECEIVABLE -1,113,390. ASHLAND NURSING HOME CORPORATION 2500 STATE ROUTE 5 ASHLAND KY 41102 611386016 NURSING HOME KY 501(C)(3) LINE 10 ASHLAND HOSPITAL COPORATION 0 CHILD DEVELOPMENT CENTER CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 010560598 CHILD CARE KY 501(C)(3) LINE 10 ASHLAND HOSPITAL COPORATION 0 KENTUCKY HEART INSTITUTE INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611255904 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL COPORATION 0 KENTUCKY HEART FOUNDATION INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 260791997 MEDICAL RESEARCH KY 501(C)(3) LINE 7 ASHLAND HOSPITAL COPORATION 0 KENTUCKY MEDICAL LOGISTICS INC 425 22ND STREET ASHLAND KY 41101 264736971 MEDICAL TRANSPORT KY 501(C)(3) LINE 10 ASHLAND HOSPITAL COPORATION 0 KING'S DAUGHTERS MEDICAL SPECIALTIES INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 264183569 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL COPORATION 0 ASHLAND HOSPITAL CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 610444716 HEALTHCARE KY 501(C)(3) LINE 3 ROYAL BLUE HEALTH LLC 0 ROYAL BLUE HEALTH LLC 2201 LEXINGTON AVENUE ASHLAND KY 41101 862993817 HEALTHCARE KY 501(C)(3) LINE 12B, II N/A 0 KING'S DAUGHTERS HEALTH SYSTEM 2201 LEXINGTON AVENUE ASHLAND KY 41101 274553836 HEALTHCARE KY 501(C)(3) LINE 12B, II N/A 0 ASHLAND MEDICAL PROPERTIES INC 2201 LEXINGTON AVE ASHLAND KY 41101 611079090 RENTALS KY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1