2022-08-15T14:57:37-05:00 2021-09-30 FORVIS LLP 3102 WEST END AVENUE SUITE 800 NASHVILLE TN 372031382 990 2020-10-01 611388556 EMHFL INC % AMANDA KINMAN EMHF 8592392424 217 SOUTH THIRD STREET DANVILLE KY 40422 AMANDA KINMAN CFO 8592392424 2022-08-15 true AMANDA KINMAN 999009999 JEFF SMITH P00289876 6159883600 3 2020 2022-09-23 18:48:47Z DANIEL MCKAY 217 SOUTH THIRD STREET DANVILLE KY 40422 34466015 false X WWW.EMHEALTH.ORG X 2002 KY TO PROVIDE ACUTE AND SPECIALTY CARE SERVICES TO INDIVIDUALS RESIDING WITHIN A PRIMARY SERVICE AREA OF CASEY, GARRARD AND LINCOLN COUNTIES. 11 9 187 25 24600 0 20628 4279708 25146124 30054347 25502 37154 97190 94806 25289444 34466015 0 0 0 0 13297700 14626019 0 0 0 9391050 12538554 22688750 27164573 2600694 7301442 13444203 13068384 20339554 12662293 -6895351 406091 X TO PROVIDE ACUTE AND SPECIALTY CARE SERVICES TO INDIVIDUALS RESIDING WITHIN A PRIMARY SERVICE AREA OF CASEY, GARRARD AND LINCOLN COUNTIES. false false 24370729 30054347 EPHRAIM MCDOWELL FORT LOGAN HOSPITAL (EMHFL), OFFERS A FULL ARRAY OF HEALTH CARE SERVICES RANGING FROM SURGERY TO LABOR AND DELIVERY, DIAGNOSTIC IMAGING, ALONG WITH TRANSITIONAL CARE TO SPAN THE GAP BETWEEN THE HOSPITAL AND HOME. RECOGNIZED FOR ITS EMERGENCY CARE, THE HOSPITAL IS ALSO A LEVEL IV TRAUMA CENTER. THE FACILITY IS JOINT COMMISSION ACCREDITED. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 24370729 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 8 0 true 187 true true true false false false false false false false false false false false X 11 9 false false false false true true true true true false false true true true true true true false false false KY X AMANDA KINMAN 8592392424 217 SOUTH THIRD STREET DANVILLE KY 40422 DANIEL MCKAY PRESIDENT & CEO 2.5 57.5 X X 0 725467 62220 WILLIAM SNAPP III PART-YEAR EXECUTIVE VP & CFO 2.5 57.5 X 0 418540 47142 INA GLASS VP OF CLINICAL CARE 40.0 0.0 X X 252451 0 38593 ERIC GOSSER CRNA 40.0 0.0 X 199237 0 55084 AMANDA KINMAN PART-YEAR CFO 2.5 57.5 X 0 174202 46308 SUSAN ADAMS CRNA 40.0 0.0 X 198238 0 17874 GARY BUNCH CHIEF MEDICAL OFFICER 40.0 0.0 X 173263 0 19063 JAIME KENNEY PHARMACIST 40.0 0.0 X 167602 0 22855 BURT PIPER FORMER EXEC VP & COO 0.0 0.0 X 0 167700 0 KARIN DUNN PHARMACIST 40.0 0.0 X 128027 0 22539 JODY WELLS DIRECTOR OF SURGERY 40.0 0.0 X 111961 0 34170 JULIAN GANDER BOARD MEMBER 4.5 7.5 X 4650 0 0 CHRIS WHITWORTH CHAIR 10.0 7.5 X X 3900 0 0 ERIC CALDWELL VICE CHAIR 10.0 0.0 X X 1200 0 0 MARILYN HAFLEY-BARLOW SECRETARY 4.5 0.0 X X 1200 0 0 SHAY PENDYGRAFT BOARD MEMBER 4.5 0.0 X 1050 0 0 DONNA J WARDRIP BOARD MEMBER 4.5 0.0 X 900 0 0 DR WILLIAM STAFFORD BOARD MEM/FORMER MED STAFF VP 4.5 0.0 X 150 0 0 JEROME FLYNN BOARD MEMBER 4.5 0.0 X 0 0 0 DR JAY MILLER PART-YEAR MED STAFF PRES / VP 10.0 0.0 X X 0 0 0 1243829 1485909 365848 7 true true false AIT LABORATORIES 5700 OLD BRIM ROAD MIDLAND GA 31820 LAB SERVICES 235685 QUALIVIS DEPT 3847 PO BOX 12387 DALLAS TX 75312 TEMP AGENCY 504567 KENTUCKY BLOOD CENTER 330 WALLER AVE LEXINGTON KY 40504 BLOOD SERVICES 126660 3 4279708 4279708 PATIENT SERVICES 621110 28704862 28704862 REFERENCE LAB 621500 24600 24600 RETAIL PHARMACY 446110 1324885 1324885 30054347 22854 22854 0 0 37087 37087 0 37087 37087 14300 14300 14300 14300 0 0 0 0 0 0 0 0 0 DIETARY SALES 722514 56059 56059 MEDICAL RECORDS 900099 860 860 MISCELLANEOUS 900099 800 800 57719 34466015 30029747 24600 131960 0 0 0 0 292378 292378 0 11895632 10921586 974046 0 1561780 1399538 162242 876229 787490 88739 0 0 24913 24913 0 0 0 2957993 2590774 367219 2693 1733 960 793989 641427 152562 99588 44789 54799 0 459259 163905 295354 17249 17087 162 0 44338 42962 1376 293988 293988 0 1080394 1080394 207784 207784 MEDICAL SUPPLIES 2671092 2671092 SHARED RESOURCE ALLOCATION 2405697 2405697 PROVIDER TAXES 200280 200280 REPAIRS & MAINTENANCE 644365 541359 103006 634932 566628 68304 27164573 24370729 2793844 0 270215 0 1335160 1190546 0 0 3400595 3502232 0 0 0 0 0 0 495847 519609 153797 132253 29330413 21606669 7788589 7723744 0 0 0 0 0 0 0 0 0 0 13444203 13068384 1798323 2537109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18541231 10125184 20339554 12662293 X -6895351 406091 0 0 -6895351 406091 13444203 13068384 7301442 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1139 1139 false SCH. C, PART II-B, LINE 1I LOBBYING EXPENDITURES --------------------- A PORTION OF DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION (KHA) ARE USED FOR LOBBYING. 1140614 1140614 16094519 11325415 4769104 63957 63957 11664657 9850631 1814026 366666 366666 7723744 0 DUE TO RELATED PARTY 3851312 DUE TO THIRD PARTY 6273872 10125184 SCH D, PART X, LINE 2 INCOME TAXES ------------ The organization's audited financial statements did not include a footnote that addressed the organization's liability for uncertain tax positions under FIN48 (ASC 740). Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. true true X true X 125. true X true true false true true 257529 257529 0.00970 8263056 8279144 8520585 8279144 257529 0.00970 8520585 8279144 257529 0.00970 true 1614336 565017 5224449 4592847 631602 X true true 1 1 EMHFL INC 110 METKER TRAIL STANFORD KY 40484 WWW.EMHEALTH.ORG 600066 X X X X EMHFL INC 1 false false true X X X X X X X X X 20 true false false true X SEE PART V SECTION C X true 20 true SEE PART V SECTION C false true X 125. 300. X X X X X true true X X X X true X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X X true X false X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT ---------------- THROUGH THE FOCUS GROUP AND ONLINE SURVEY, PARTICIPATION AND INPUT WAS GATHERED FROM REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY (INCLUDING HISPANIC, AFRICAN AMERICAN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (SPECIFICALLY, THE ELDERLY, DISABLED, YOUNG ADULTS, LGBT COMMUNITY, THE MENTALLY ILL, INMATES, HEARING IMPAIRED, MEDICAID RECIPIENTS, AND THE UNINSURED). SCHEDULE H, PART V, SECTION B, LINE 7 AND 10 CHNA REPORT / IMPLEMENTATION STRATEGY ------------------------------------ THE CHNA REPORT AND THE IMPLENTATION STRATEGY CAN BE OBTAINED AT: HTTPS://WWW.EMHEALTH.ORG/SERVICES/COMMUNITY-HEALTH SCHEDULE H, PART V, SECTION B, LINE 11 ASSESSING THE NEEDS OF THE COMMUNITY -------------------------------- THE INTERNAL STAKEHOLDERS OF EMHFL DETERMINED THE FOLLOWING TO BE THE TOP HEALTH PRIORITIES FOR THE HOSPITAL TO ADDRESS IN THE COMMUNITY FOR THE COMING YEARS: - CARDIOVASCULAR DISEASE (CVD) RELATED RISK FACTORS (E.G., HYPERTENSION, BMI, GLUCOSE, TOBACCO USE, PHYSICAL ACTIVITY, NUTRITION) - CANCER EARLY DETECTION AND PREVENTION - CHILDHOOD OBESITY - ACCESS TO HEALTH SERVICES - DEMENTIAS, INCLUDING ALZHEIMER'S DISEASE - MENTAL HEALTH AND MENTAL DISORDERS - INJURY AND VIOLENCE PREVENTION THESE PRIORITY AREAS, AND PLANS TO ADDRESS THESE, WILL BE INTEGRATED INTO THE HOSPITAL'S IMPLEMENTATION STRATEGY. THE RATIONALE FOR SELECTING THESE AREAS IS AN UNDERSTANDING THAT IMPACTING THESE WOULD ALSO IMPACT MANY OTHER AREAS OF NEED IDENTIFIED IN THE ASSESSMENT, SUCH AS DIABETES, DEMENTIA, MENTAL HEALTH, SENSORY IMPAIRMENT, KIDNEY DISEASE, RESPIRATORY DISEASE, AND DISABILITY. THESE AREAS ALSO REPRESENT A CONTINUATION OF EXISTING WORK AND ALLOW THE HOSPITAL TO BUILD ON PAST SUCCESSES. THERE ARE ADDITIONAL NEEDS IDENTIFIED WITHIN THE CHNA REPORT THAT ARE NOT SPECIFICALLY ADDRESSED BY EMHFL, DUE TO NO EXPERTISE OR LIMITED RESOURCES, BUT ARE BEING ADDRESSED BY OTHER AGENCIES WITHIN THE COMMUNITY. DEFERRED NEEDS FROM THE CHNA OF BOYLE AND THE SURROUNDING COUNTIES BASED UPON RESOURCES AND/OR EXPERTISE INCLUDED THE FOLLOWING: SUBSTANCE ABUSE IS AN ISSUE IN THE STATE AND REGION. ADDICTION SERVICES ARE OFFERED BY PRIVATE PROVIDERS, COMPREHENSIVE CARE, AND SELF-REFINED IN THE REGION. EMRMC BEHAVIORAL MEDICINE UNIT DOES TREAT DUAL DIAGNOSIS PATIENTS AND THE PSYCHIATRISTS AND COUNSELORS TREAT OUT PATIENTS. THERE IS AN ACTIVE ALCOHOLICS ANONYMOUS CHAPTER. CELEBRATE RECOVERY IS OFFERED AT VARIOUS SITES IN THE SERVICE AREA. SUBSTANCE ABUSE TASK FORCE RESOURCES AND COMMITTEES ARE IN THE SURROUNDING SERVICE AREA, AND COLLABORATION OCCURS AS NEEDED. DUE TO LACK OF EXPERTISE AND RESOURCES, ADDICTION WILL BE DEFERRED AS PART OF THE WORK PLAN BY EMHFL. CHRONIC KIDNEY DISEASE AND END STAGE RENAL FAILURE LINKS TO DIABETES. FREE SCREENINGS WILL PROVIDE EARLY DETECTION AND POSSIBLY PREVENTION WHEN ADDRESSING NUTRITION, BODY MASS INDEX AND EXERCISE. SOME FAITH COMMUNITY NURSES IN CONGREGATIONS ASSESS BLOOD PRESSURES AND MEDICATION ADHERENCE AS WELL AS PROVIDE EDUCATION. RENAL SPECIALISTS AND DIALYSIS CENTERS SERVE THIS POPULATION AS WELL. DEMENTIA LINKS TO CV HEALTH AND STROKE INCIDENCE AND VASCULAR ISSUES. IT ALSO LINKS TO THE AGING OF THE POPULATION IN THE REGION. THERE IS AN ALZHEIMER'S SUPPORT GROUP IN BOYLE AND MERCER COUNTIES. ALSO, MENTAL EVALUATION AND MEDICATION MANAGEMENT IS AVAILABLE BY A PSYCHIATRIST AT THE MEDICAL CENTER. DANVILLE HEALTH & REHABILITATION CENTER AS WELL AS MORNING POINT HAS AN ALZEIMER'S LONG TERM CARE UNIT. THE SANDERS BROWN CENTER AT THE UNIVERSITY OF KENTUCKY HAS ON-GOING ALZHEIMER'S RELATED RESERACH AND SERVES AS A REFERRAL CENTER FOR THE REGION. BIRTHS TO TEENAGERS AND UNWED MOTHERS, AND LOW BIRTH-WEIGHT BIRTHS ARE BEING ADDRESSED BY THE HEALTH DEPARTMENTS AND THE SCHOOL HEALTH COALITIONS. THE HAVEN CARE CENTER PROVIDES PREGNANCY RESOURCES AND SUPPORTS ALL SIX COUNTIES. CHRONIC LUNG/RESPIRATORY DISEASE IS BEING ADDRESSED WITH TOBACCO EDUCATION, STOP SMOKING CLASSES AT THE HEALTH DEPARTMENTS, PULMONARY REHAB AT EPHRAIM MCDOWELL SPECIALTY CENTER AND THROUGH PUBLIC POLICY. THE COMMUNITY SERVICE DEPARTMENT SCREENS FOR TOBACCO USE AT ALL VENUES AND REFERS CLIENTS TO THE HEALTH DEPARTMENTS. THE HEALTH DEPARTMENT OFFERS FREEDOM FROM SMOKING CLASSES TO HELP RESIDENTS STOP SMOKING. THE HEALTH DEPARTMENTS ALSO CONDUCT TOBACCO EDUCATION IN THE SCHOOL SYSTEMS. IN THE AREAS OF INFECTIOUS DISEASE THE COUNTY HEALTH DEPARTMENTS WILL CONTINUE THE ADDRESS HIV EDUCATION AND TESTING. HEPATITIS C VACCINE IS AVAILABLE AT THE HEALTH DEPARTMENTS. EMHFL WILL DEFER DUE TO RESOURCE ALLOCATION - BOTH PERSONNEL AND TIME. INJURY AND VIOLENCE EDUCATION IS IN THE HEALTH DEPARTMENTS, COUNTY EXTENSION OFFICES, SCHOOL RESOURCE CENTERS, FAMILY COURT, AND LAW ENFORCEMENT IN ALL COUNTIES. EMRMC AND EMHFL OFFER THE SERVICES OF A SANE NURSE FOR RAPE VICTIMS. THE RAPE CRISIS CENTER SERVES THE REGION. EMHFL WILL DEFER FOCUS ON INJURY AND VIOLENCE AT THIS TIME DUE TO OTHER AGENCIES COVERING ALL ASPECTS, HAVING GREATER EXPERTISE AND DEPARTMENTAL RESOURCE LIMITATIONS. ORAL HEALTH INCLUDING REGULAR DENTAL CARE AND DENTAL INSURANCE IS A REGIONAL ISSUE. EPHRAIM MCDOWELL HEALTH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. SCHEDULE H, PART V, SECTION B, LINE 16 PUBLICATION OF FAP --------------- THE HOSPITAL'S FAP CAN BE FOUND AT HTTPS://EMHEALTH.ORG/FOR-PATIENTS/GOING-HOME/BILLING-INSURANCE/ 5 EPHRAIM MCDOWELL GARRARD CLINIC 405 DANVILLE STREET LANCASTER KY 40444 RURAL HEALTH CLINIC LIBERTY FAMILY MEDICAL CENTER 511 MIDDLEBURG ST LIBERTY KY 42539 RURAL HEALTH CLINIC NORTH GARRARD FAMILY MEDICAL CENTER 510 N CAMP DICK ROAD LANCASTER KY 40444 RURAL HEALTH CLINIC STANFORD MEDICAL PARK 110 METKER TRAIL STANFORD KY 40484 RURAL HEALTH CLINIC DANVILLE FAMILY PHYSICIANS MD 109 DANIEL DR DANVILLE KY 40422 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY -------------------- THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. COST COMPUTED ON IRS WORKSHEET 3 WAS COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT STEP-DOWN PROCESS. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE ----------------------- TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE ------------- THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2020. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. THIS AMOUNT IS DIRECTLY FROM THE FINANCIAL STATEMENTS AND INCLUDES ESTIMATES AND ACCRUALS OF BAD DEBT EXPENSE AND DOES NOT NECESSARILY REFLECT ACTUAL WRITE-OFFS DURING THE PERIOD. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE ----------------------------------------------- BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS REPORTED PER THE MEDICARE COST REPORT WORKSHEET S-10. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE ---------- THE CORPORATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE CORPORATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CORPORATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. SCHEDULE H, PART III, LINE 8 MEDICARE SURPLUS/SHORTFALL -------------------------- THE AMOUNTS REPORTED ON PART III, LINE 5 AND 6 WERE CALCULATED BASED ON THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 9B WRITTEN DEBT COLLECTION POLICY AND FINANCIAL ASSISTANCE ------------------------------------------------------- IF IT IS DETERMINED THAT A PATIENT OR RESPONSIBLE PARTY IS ELIGIBLE FOR FINANCIAL ASSISTANCE, EMH WILL: - SEND WRITTEN NOTIFICATIONS TO THE RESPONSIBLE INDIVIDUAL OF THE ASSISTANCE DETRMINATION, AND - IF THE DISCOUNT IS LESS THAN 100%, EMH WILL: * PROVIDE THE RESPONSIBLE INDIVIDUAL WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED, HOW THE AMOUNT WAS DETERMINED, AND DESCRIBE HOW THE INDIVIDUAL CAN LEARN MORE ABOUT HOW THE HOSPITAL CALCULATES AGB; * ISSUE REFUNDS TO THE RESPONSIBLE INDIVIDUAL IF HE OR SHE PREVIOUSLY PAID AN AMOUNT TO EMH EXCEEDING WHAT HE OR SHE IS PERSONALLY RESPONSIBLE TO PAY; AND * TAKE ALL REASONABLE MEASURES TO REVERSE ANY ECAS (WITH THE EXCEPTION OF A SALE OF A DEBT OR DEFERRING OR DENYING CARE FOR NON-PAYMENT OF AMOUNTS FOR PREVIOUS CARE) TAKEN AGAINST THE RESPONSIBLE INDIVIDUAL TO THE EXTENT POSSIBLE. IF A PATIENT CANNOT SATISFY STANDARD PAYMENT EXPECTATIONS, A FINANCIAL ASSISTANCE SCREENING PROCESS FOR ALTERNATIVE SOURCES OF BALANCE RESOLUTION IS COMPLETED. THOSE RESOLUTIONS MAY INCLUDE A DISCOUNT ON CHARGES, MEDICAID ENROLLMENT OR APPLICATION FOR CHARITY CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT -------------- IN 2020, PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS ENGAGED TO CONDUCT A NEEDS ASSESSMENT OF EMHFL'S COMMUNITY, WHICH IS DEFINED AS THE PRINCIPAL RESIDENTIAL ZIP CODES IN CASEY, GARRARD, AND LINCOLN COUNTIES IN KENTUCKY. A SURVEY AND A COMMUNITY FOCUS GROUP WERE COMPLETED TO OBTAIN A PRIMARY DATA FROM INDIVIDUALS WITHIN THE COMMUNITY. THE FOCUS GROUP WAS COMPRISED OF REPRESENTATIVES FROM PUBLIC HEALTH, SOCIAL SERVICE PROVIDERS, EMPLOYERS, AND OTHER COMMUNITY LEADERS. SELF REPORT DATA, MORTALITY, MORIDITY, LIFESTYLE, INCIDENCE OF CHRONIC DISEASE, INJURY DATA AND DISABILITY DATA ARE PART OF THE ASSESSMENT PROCESS. THE BENCH MARK IS ESTABLISHED USING HEALTHY PEOPLE 2020 DATA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ------------------------------------------------ EMHFL'S CHARITY CARE POLICY IS POSTED ON THE WWW.EMHEALTH.ORG WEBSITE. AT REGISTRATION OF SELF-PAY CLIENTS, INFORMATION IS GIVEN ON A REDUCED FEE, CHARITY APPLICATION, AND A REFERRAL TO A FINANCIAL COUNSELOR. THE FREE COMMUNITY SCREENINGS ARE POSTED ON THE WEBSITE AND IN AREA NEWSPAPERS IF THE HOSTING ORGANIZATION INVITES COMMUNITY PARTICIPATION. SOME EVENTS ARE DISCUSSED ON LOCAL RADIO. INFORMATION REGARDING THE FREE CLINIC IS ALSO GIVEN BY THE HEALTHCARE PROVIDERS, FAITH COMMUNITY NURSES, CASE WORKERS AND OTHER MEDICAL PROFESSIONALS. SCHEDULE H, PART VI, LINE 4 SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION -------------------- THE COMMUNITY DEFINED FOR THE CHNA REPORT INCLUDES THE PRINCIPAL RESIDENTIAL ZIP CODES IN CASEY, GARRARD, AND LINCOLN COUNTIES IN KENTUCKY, COMPRISING THE SERVICE AREA OF EPHRAIM MCDOWELL, FORT LOGAN HOSPITAL. THE HEALTH SYSTEM SERVES BOYLE, MERCER, CASEY, LINCOLN, GARRARD, AND WASHINGTON COUNTIES, WHICH HAVE A RURAL POPULATION OF APPROXIMATELY 113,000. ACCESS IS AN ISSUE, DUE TO TRAVEL BARRIERS SUCH AS OUT-OF-DATE HIGHWAYS AND LACK OF PUBLIC TRANSPORTATION. THESE ACCESS ISSUES INFLUENCED THE DECISION TO SERVE WITH FREE SCREENINGS AT KEY GATHERING PLACES SUCH AS CHURCHES AND SCHOOLS, ETC. INSURANCE COVERAGE IS ANOTHER ISSUE. THE NUMBERS OF UNINSURED CONTINUES TO EXCEED THE NATIONAL AVERAGE AND THE UNDERINSURED IN THIS SERVICE AREA CONTINUES TO INCREASE POST ACA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH ------------------------------- EMHFL LEADERS HOLD BOTH MEMBERSHIP AND LEADERSHIP POSITIONS WITHIN VARIOUS SERVICE ORGANIZATIONS IN THE COMMUNITY, ROLE MODELING GOOD CITIZENSHIP. EMHFL LEADERS SERVE ON THE LINCOLN COUNTY CANCER COALITION WHICH MEETS MONTHLY TO ADDRESS HEALTH RISK AND NEEDS RELATED TO CANCER. THE COALITION STRIVES TO PROVIDE ACCESS TO CARE/TREATMENT/SCREENINGS, MAKING PUBLIC POLICY RECOMMENDATIONS, AND PROVIDING CLIENT EDUCATION. SENIOR LEADERSHIP SERVES AS A MEMBER OF THE LINCOLN COUNTY HEALTH DEPARTMENT BOARD THAT MEETS BI-MONTHLY. THE LINCOLN COUNTY BOARD OF HEALTH IS FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITY. A HOSPITAL REPRESENTATIVE ON THIS BOARD IMPROVES AWARENESS OF POPULATION HEALTH ISSUES, COMMUNICATION, COLLABORATION, AND REDUCES DUPLICATION OF SERVICES. EMHFL LEADERS SERVED AS TEAM CAPTAINS FOR THE AMERICAN CANCER SOCIETY RELAY FOR LIFE IN LINCOLN COUNTY. SENIOR LEADERSHIP SERVES ON THE CHAMBER OF COMMERCE IN BOTH LINCOLN AND GARRARD COUNTIES ADDRESSING ECONOMIC AND QUALITY OF LIFE ISSUES IN THE COMMUNITY. EMHFL ASSOCIATES PARTICIPATE IN THE SALVATION ARMY (TSA) KETTLE DRIVE TO PROVIDE FOOD AND NECESSITIES FOR THSOE IN NEED IN THE COMMUNITY. STAFF SERVES ON THE LINCOLN COUNTY YOUTH SERVICE CENTER ADVISORY BOARDS (YSC) ALONG WITH PARENTS, STUDENTS, SCHOOL PERSONNEL, AND OTHER COMMUNITY REPRESENTATIVES. THE PURPOSE OF THIS COMMUNITY ADVISORY BOARD IS TO REMOVE BARRIERS TO RECEIVING A QUALITY EDUCATION. ADDITIONAL COMMUNITY INVOLVEMENT THAT ENHANCED THE LIVES OF THE CITIZENS OF LINCOLN COUNTY AND THE SURROUNDING COUNTIES INCLUDED INVOLVEMENT IN LAY HEALTH/FAITH COMMUNITY NURSING MINISTRIES WITHIN THE CONGREGATIONS. FULL CONGREGATIONAL IMPACT WAS GENERATED BY LEADERSHIP POSITIONS WITHIN THE VARIOUS CHURCH COMMITTEES. SERVICES PROVIDED INCLUDED, BUT WERE NOT LIMITED TO, SERVING ON BOARDS/COMMITTEES, TEACHING, MEAL PREPARATION, MUSIC AND WORSHIP LEADERSHIP, CHOIR PARTICIPATION AND HOME VISITS/CALLS. THE JOURNAL OF CHRISTIAN NURSING REPORTS THAT CHRISTIAN FAITH AND PRACTICE SUPPORTS BETTER MENTAL, PHYSICAL, AND SPIRITUAL HEALTH (MARCH 2013). COMMUNITY INVOLVEMENT IN CHILDREN'S PROGRAMS THROUGH THE AREA CHURCHES RESULTED IN OVER 1,000 CHILDREN BEING SERVED. STAFF HAS ALSO GIVEN TESTIMONY AT LOCAL, STATE, AND FEDERAL LEVELS RELATED TO OUR SERVICE AREA'S HEALTH, EDUCATION AND ECONOMIC ISSUES. ** DURING FY 2021, SOME ACTIVITIES MAY HAVE BEEN CANCELLED DUE TO COVID-19. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM ---------------------------- EPHRAIM MCDOWELL HEALTH (EMH) IS A COMPREHENSIVE, INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT SERVES 113,000 RESIDENTS FROM SIX COUNTIES IN SOUTH CENTRAL KENTUCKY. THE EMH BOARD IS COMPRISED OF COMMUNITY MEMBERS AND REPRESENTATION FROM FT LOGAN HOSPITAL, MEDICAL STAFF, AND EMRMC LEADERSHIP. FT LOGAN HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN LINCOLN COUNTY. HEALTH RESOURCE IS COMPRISED OF CLINICS, AN EARLY CHILDHOOD DEVELOPMENT CENTER, ASSISTED LIVING FACILITY, AND DURABLE MEDICAL EQUIPMENT OUTLETS. THERE ARE REPRESENTATIVES FROM OUR SIX COUNTIES, MEDICAL STAFF, AND LEADERSHIP ON THE COMMUNITY BOARD THAT OVERSEES AND COORDINATES THE SERVICES OF EPHRAIM MCDOWELL HEALTH. ON DECEMBER 1, 2017, EMH ACQUIRED JAMES B. HAGGIN HOSPITAL, A CRITICAL ACCESS HOSPITAL LOCATED IN MERCER COUNTY. true false false false false true true false false DANIEL MCKAY PRESIDENT & CEO 0 568451 0 142359 0 14657 0 22800 0 39418 0 787685 0 0 WILLIAM SNAPP III PART-YEAR EXECUTIVE VP & CFO 0 327633 0 71838 0 19069 0 22800 0 24342 0 465682 0 0 BURT PIPER FORMER EXEC VP & COO 0 167700 0 0 0 0 0 0 0 0 0 167700 0 0 GARY BUNCH CHIEF MEDICAL OFFICER 161358 0 10000 0 1905 0 13107 0 5956 0 192326 0 0 0 INA GLASS VP OF CLINICAL CARE 206004 0 35013 0 11434 0 14317 0 24276 0 291044 0 0 0 ERIC GOSSER CRNA 197164 0 500 0 1573 0 16579 0 38505 0 254321 0 0 0 JAIME KENNEY PHARMACIST 158564 0 500 0 8538 0 0 0 22855 0 190457 0 0 0 SUSAN ADAMS CRNA 157733 0 500 0 40005 0 16310 0 1564 0 216112 0 0 0 KARIN DUNN PHARMACIST 123627 0 500 0 3900 0 10305 0 12234 0 150566 0 0 0 AMANDA KINMAN PART-YEAR CFO 0 152496 0 15429 0 6277 0 14839 0 31469 0 220510 0 0 SCHEDULE J, PART I, QUESTION 3 ESTABLISHING CEO COMPENSATION -------------------------- THE CEO IS COMPENSATED BY EPHRAIM MCDOWELL HEALTH, INC. (EMH), A RELATED ORGANIZATION. EMH USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, QUESTION 4A SEVERANCE PAYMENTS ------------------ BURT PIPER LEFT EPHRAIM MCDOWELL IN JULY 2019. HIS SEVERANCE OF $167,700 WAS INCLUDED IN HIS 2020 W-2. WILLIAM SNAPP LEFT EPHRAIM MCDOWELL IN JULY 2021. HIS SEVERANCE OF $80,228 WAS INCLUDED IN HIS 2020 W-2. SCHEDULE J, PART I, LINE 6A AND 6B MANAGEMENT INCENTIVE PLAN --------------------------- EPHRAIM MCDOWELL HEALTH, INC. AND ITS AFFILIATES HAVE MANAGEMENT INCENTIVE PLANS FOR CORPORATE OFFICERS, SENIOR VICE-PRESIDENTS, VICE-PRESIDENTS, AND DIRECTORS. ANNUAL PAYOUTS RELATED TO THESE INCENTIVE PLANS HAVE TWO COMPONENTS. 30% OF THE ANNUAL PAYOUT IS BASED ON THE NET OPERATING INCOME GOALS COMPARED TO BUDGET. THE OTHER 70% IS BASED ON QUALITY MEASURES, PATIENT SATISFACTION GOALS, ASSOCIATE SATISFACTION GOALS, AND SAFETY MEASURES. FORM 990, PART III, LINE 4 PROGRAM SERVICE ACCOMPLISHMENTS --------------------------------- THIS MODERN HOSPITAL, WITH CONSIDERABLE STATE-OF-THE-ART TECHNOLOGY, SERVES THE CITIZENS OF LINCOLN COUNTY, WHILE PATIENTS FROM SURROUNDING COUNTIES ALSO RELY ON EMHFL FOR THEIR HEALTH CARE NEEDS. ALTHOUGH SMALL, EMHFL MAINTAINS THE SAME STANDARDS OF EXCELLENCE IN CARE AND CUSTOMER SERVICE THAT PATIENTS WILL FIND AT ALL EPHRAIM MCDOWELL HEALTH FACILITIES. EMHFL OFFERS A VARIETY OF EPHRAIM MCDOWELL HEALTH SYSTEM SERVICES LOCALLY THROUGH THE FACILITY, INCLUDING CARDIOPULMONARY, DIAGNOSTIC, DIETARY, AND FAMILY-CENTERED MATERNITY CARE WITH A BIRTHING SPA, SWING BEDS, LABORATORY, REHABILITATION, SURGICAL SERVICES, 24-HOUR EMERGENCY CARE, AND DURABLE MEDICAL EQUIPMENT. IN FISCAL YEAR 2021, OUTPATIENT REGISTRATIONS, INCLUDING EMERGENCY SERVICES WERE 37,158; THERE WERE 721 SURGICAL PROCEDURES, 1,295 ADMISSIONS (INCLUDING NURSERY AND SWING), AND THE FACILITY RECORDED 6,287 TOTAL PATIENT DAYS (INCLUDING OBSERVATION AND SWING). IN FY 2021, EMHFL PROVIDED $157,966.24 IN FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. THE FINANCIAL INVESTMENT WAS ABOVE AND BEYOND THE HOURS OF VOLUNTEER TIME IN LEADERSHIP ROLES BY EMHFL STAFF TO IMPROVE HEALTH, EDUCATION, ECONOMIC DEVELOPMENT, AND LEGISLATIVE ENDEAVORS WITHIN THE COMMUNITY, STATE AND NATIONAL LEVELS. FORM 990, PART V, LINE 2A COMMON PAYMASTER ------------------- THE EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR EMHFL, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356. FORM 990, PART VI, SECTION A, LINE 6, 7A, AND 7B MEMBERS OF THE ORGANIZATION --------------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EMHFL, INC. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EMHFL, INC. ON AN ANNUAL BASIS. THE BYLAWS OF EMHFL, INC. REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY ITS SOLE CORPORATE MEMBER, EPHRAIM MCDOWELL HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11 PROCESS TO REVIEW FORM 990 ------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12B AND 12C MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------- ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXIST, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT. FORM 990, PART VI, SECTION B, LINE 15A AND 15B PROCESS FOR DETERMINING COMPENSATION ------------------------------ EMHFL, INC. IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM. THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 MAKING FORMS AVAILABLE TO THE PUBLIC -------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:2957993 EPHRAIM MCDOWELL HEALTH RESOURCE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 311545520 HEALTHCARE KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEATH CARE FOUNDATION 217 SOUTH THIRD STREET DANVILLE KY 40422 611229333 FUNDRAISING KY 501(C)(3) 12B-II EM HEALTH false EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER 217 SOUTH THIRD STREET DANVILLE KY 40422 610492356 ACUTE HOSP KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEALTH INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611324736 MGT SERVICES KY 501(C)(3) 12B-II NA false MCDOWELL HOME HEALTH AGENCY INC 217 SOUTH THIRD STREET DANVILLE KY 40422 610715227 HOME HEALTH KY 501(C)(3) 3 EM HEALTH false JAMES B HAGGIN MEMORIAL HOSPITAL 464 LINDEN AVENUE HARRODSBURG KY 40330 610510934 CRITICAL HOSP KY 501(C)(3) 3 EM HEALTH false COOPERATIVECARE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611265715 CONTRACTING SRVS KY NA C 0 0 0.00000 false false false true false false false false false false false false false false false false false false true true