2022-11-10T12:06:29-06:00 2021-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2021-01-01 310929576 KNOX COMMUNITY HOSPITAL KNOX 7403939623 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 MICHAEL AMBROSIANI CFO 7403939623 2022-11-10 1 MICHAEL AMBROSIANI 999009999 NATHAN A RODGERS CPA P01568275 3176334705 2022-11-10 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z BRUCE D WHITE 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 265759448 0 X WWW.KCH.ORG X 1977 OH TO PROVIDE COMPASSIONATE HEALTHCARE SERVICE THAT EXCEEDS THE EXPECTATIONS OF OUR COMMUNITY 15 9 1611 99 34768 21973 18478948 14628859 172559457 207003150 2932421 8528460 3602427 3742988 197573253 233903457 5717 0 0 0 109658593 121472352 0 0 0 78413705 96230444 188078015 217702796 9495238 16200661 292790253 310076124 100892017 97420647 191898236 212655477 X THE MISSION OF KNOX COMMUNITY HOSPITAL IS TO PROVIDE COMPASSIONATE HEALTHCARE SERVICE THAT EXCEEDS THE EXPECTATIONS OF OUR COMMUNITY. AS THE ONLY HOSPITAL IN KNOX COUNTY, WE OFFER A WIDE SPECTRUM OF HEALTHCARE SERVICES TO EVERY PERSON WHO NEEDS US, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 162605884 0 209714893 OUR ASSISTANCE TO OUR COMMUNITY GOES BEYOND OFFERING PRIMARY SERVICES AND IMPACTS OUR COMMUNITY'S HEALTH AND QUALITY OF LIFE. KNOX COMMUNITY HOSPITAL IS AN ACUTE CARE HOSPITAL SERVING KNOX COUNTY IN OHIO AND SURROUNDING AREAS. THE HOSPITAL OFFERS A WIDE SPECTRUM OF HEALTHCARE SERVICES INCLUDING: INPATIENT AND OUTPATIENT HEALTH CARE. FOR 2021 THE HOSPITAL HAD 3,392 INPATIENT ADMISSIONS, 23,176 ER VISITS, 165,053 OUTPATIENT VISITS, 78,069 RADIOLOGY PROCEDURES, AND 5,531 INPATIENT & OUTPATIENT SURGERIES (INCLUDING ENDOSCOPIES). AT THE END OF 2021, THE HOSPITAL HAD 57 EMPLOYED PHYSICIANS WITH 171,826 OFFICE CLINIC VISITS.IN 2021, KNOX COMMUNITY HOSPITAL PROVIDED A RANGE OF HEALTH AWARENESS AND PREVENTION PROGRAMS, AS WELL AS SERVICES FREE OF CHARGE TO SUPPORT THE HEALTH AND WELLBEING OF THE KNOX AREA COMMUNITY. ALTHOUGH IN-PERSON EVENTS WERE MINIMAL AT TIMES AND SOME ACTIVITIES WERE CANCELLED DUE TO THE COVID-19 PANDEMIC, KCH WAS ABLE TO PROVIDE PROGRAMS AND SERVICES FOR COMMUNITY BENEFIT IN A NUMBER OF METHODS. VOLUNTEERS REMAINED ACTIVE IN SPECIFIC AREAS OF THE HOSPITAL, PROVIDING NEEDED SERVICES SUCH AS TOYS FOR PATIENTS WAITING WITH YOUNG CHILDREN, ASSISTING THE MARKETING DEPARTMENT WITH VARIOUS PROJECTS, AND STAFFING THE GIFT SHOP WHICH HELPS TO PROVIDE FUNDS FOR NURSING SCHOLARSHIPS. A TOTAL OF 99 VOLUNTEERS SERVED OVER 721 HOURS DURING THE YEAR. KCH HAS STRONG PARTNERSHIPS WITH THE NURSING SCHOOLS IN AREA COLLEGES/UNIVERSITIES, AND TOWARD THAT END, PROVIDED CLINICAL SUPERVISION AND PRECEPTING FOR STUDENTS. THE TOTAL NUMBER OF STUDENTS' CLINICAL HOURS IN 2021 WAS OVER 9800, WITH AN ADDITIONAL 1528 HOURS OF JOB SHADOWING, AS WELL. SINCE KCH IS THE ONLY HOSPITAL IN THE COUNTY, THIS IS CRITICAL TO HELP SUPPORT THESE STUDENTS' GOALS AND TO HELP MEET THE SHORTAGE OF NURSING STAFF THAT IS EVIDENT BOTH LOCALLY AND ACROSS THE COUNTRY. ACCORDING TO THE COMMUNITY HEALTH ASSESSMENT CONDUCTED IN 2021, THE PREVALENCE OF DIABETES AMONG OUR SERVICE POPULATION CONTINUES TO INCREASE AND HAS REACHED 10%. KNOX COMMUNITY HOSPITAL RECOGNIZED THE NEED TO EXPAND OUR DIABETES EDUCATION PROGRAM AND HAS INCREASED THE NUMBER OF DIABETES EDUCATORS. IN ADDITION, IN 2021 WE PROVIDED 672 GLUCOSE SCREENINGS AND SHARED INFORMATION ABOUT PREVENTING AND DEALING WITH DIABETES DURING THE CITY OF MOUNT VERNON'S "FIRST FRIDAY" EVENTS (HELD DURING MAY THROUGH AUGUST, MONTHLY). THAT SAME COMMUNITY HEALTH ASSESSMENT IS CONDUCTED EVERY 3 YEARS THROUGH A PARTNERSHIP BETWEEN KCH AND KNOX PUBLIC HEALTH DEPARTMENT. NOT ONLY DOES KCH PROVIDE 50% OF THE COST OF IMPLEMENTING THIS SURVEY AND DATA COLLECTION TOTALING $15,000 BUT WE ALSO PARTNER WITH THE HEALTH DEPARTMENT AND OTHER SERVICE ORGANIZATIONS TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WHICH WILL ADDRESS THE NEEDS IDENTIFIED WITHIN THE CHA. FOR EXAMPLE, ONE OF THE WORK GROUPS DEVELOPED IS THE ACCESS TO (HEALTH) CARE WORK GROUP, WHICH IS REVIEWING THE BARRIERS FACED BY MANY LOCAL RESIDENTS SUCH AS LACK OF INSURANCE, INADEQUATE TRANSPORTATION, OR SIMPLY LACK OF KNOWLEDGE ABOUT HOW TO ESTABLISH A PRIMARY CARE PROVIDER. BOTH THE CHA AND THE CHIP DOCUMENTS ARE LINKED FROM THE HOSPITAL'S WEBSITE. ONE EFFORT THAT IS STARTING IN APRIL 2022 IS THE DEVELOPMENT OF A COMMUNICATIONS TEAM COMPRISED OF STAFF FROM KCH ALONG WITH PARTNER ORGANIZATIONS, TO DEVELOP AN AWARENESS CAMPAIGN TO COMBAT PART OF THE ACCESS TO CARE BARRIERS (LACK OF KNOWLEDGE, INFORMATION). MENTAL HEALTH CONTINUES TO BE A TOP PRIORITY CONCERN IDENTIFIED THROUGH THE COMMUNITY HEALTH ASSESSMENT IN THE COUNTY. WHILE KCH DOES SEE PATIENTS WITH A MENTAL HEALTH OR BEHAVIORAL HEALTH CONDITION AND/OR DIAGNOSIS, WE COLLABORATE WITH APPROPRIATE AGENCIES TO SERVE THIS POPULATION. FOR EXAMPLE, THROUGH OUR EMERGENCY DEPARTMENT, ONCE A PATIENT HAS COMPLETED THE NECESSARY MEDICAL SCREENINGS, CRISIS ASSESSMENT MAY BE HANDLED BY A PARTNERING ORGANIZATION, BEHAVIORAL HEALTH PARTNERS, TO DETERMINE THE NEXT STEPS FOR THAT PATIENT. IN ADDITION, SUBSTANCE ABUSE IS SOMETIMES FOUND ALONG WITH MENTAL HEALTH CONCERNS, AND IN THOSE CASES, KCH MAY REFER TO NEW VISION OR THE FREEDOM CENTER FOR ADDITIONAL TREATMENT, IF APPROPRIATE. IN SHORT, KCH TAKES A COLLABORATIVE APPROACH WITH BEHAVIORAL HEALTH PATIENTS BY WORKING CLOSELY WITH LOCAL AGENCIES. CLASSES WERE HELD TO SUPPORT THE NEED FOR PATIENTS AND THEIR FAMILIES TO BE INVOLVED IN THEIR CARE AND UNDERSTAND THE NUANCES OF CERTAIN CONDITIONS. SOME OF THOSE CLASSES INCLUDED BARIATRICS (WEIGHT MANAGEMENT), CHILDBIRTH EDUCATION CLASSES, AND DIABETES EDUCATION, TO NAME A FEW.THE AMERICAN RED CROSS RELIES UPON KNOX COMMUNITY HOSPITAL TO HOST BLOOD DRIVES REGULARLY TO SUPPORT ITS EFFORTS TO MAINTAIN ADEQUATE BLOOD SUPPLIES. DURING 2021, THROUGH BLOOD DRIVES HOSTED IN THE EDUCATION RESOURCE ROOM AT KCH, A TOTAL OF 305 UNITS OF BLOOD WAS COLLECTED. THE KNOX COUNTY FAIR WAS HELD AND OPEN TO THE PUBLIC JULY 24 THROUGH 31, 2021, AND KCH HAD A BOOTH IN THE MERCHANT'S BUILDING WITH HEALTH EDUCATION INFORMATION PROVIDED ALONG WITH FREE BLOOD PRESSURE CHECKS. KCH STAFF WERE ON HAND AT THE EVENT FOR A TOTAL OF 92 EVENT HOURS. THE AVERAGE GATE ATTENDANCE EACH DAY OF THE FAIR IS 10,000 MEMBERS OF THE COMMUNITY. OBESITY IS AN ONGOING PROBLEM FOR 37 PERCENT OF OUR COUNTY'S POPULATION AND IT STARTS WITH YOUNG CHILDREN. IN AN EFFORT TO REDUCE THIS NUMBER AND SUPPORT THE LOCAL SCHOOLS ATHLETIC PROGRAMS, KCH PROVIDED ATHLETIC TRAINING DURING THE SCHOOL YEAR IN 2021 FOR A FEE OF X PER MONTH. SCHOOLS PARTICIPATING WERE DANVILLE, NORTH FORK, AND CENTERBURG. IN THE FALL OF 2021, KCH ALSO DONATED $7,500 TOWARD THE PURCHASE OF EXERCISE BALLS FOR THE "CRUNCH OUT OBESITY" PROGRAM BENEFITING 590 ELEMENTARY SCHOOL STUDENTS, IN PARTNERSHIP WITH UNITED WAY OF KNOX COUNTY.BEGINNING IN MARCH OF 2021, A WEEKLY HEALTH AND WELLNESS ARTICLE IS PUBLISHED IN THE MOUNT VERNON NEWS PRINT AND DIGITAL VERSIONS, COVERING INFORMATIVE TOPICS SUCH AS DIABETES AWARENESS AND SYMPTOMS, CANCER PREVENTION, IMPORTANCE OF SEEING YOUR PRIMARY CARE PHYSICIAN, PREVENTIVE SCREENINGS, AND OTHERS. MOST OF THESE ARTICLES INVOLVE AN INTERVIEW WITH ONE OF KCH PROVIDERS. THE AVERAGE WEEKLY READERSHIP PER PRINT EDITION IS 5,000, WITH THOUSANDS MORE READING VIA DIGITAL SUBSCRIPTION. IN A SIMILAR EFFORT, THE LOCAL RADIO STATION (WQIO/93.7 FM) AIRS A "MEDICAL MINUTE" FEATURING A DIFFERENT MEDICAL EXPERT EACH MONTH FROM KCH, PROVIDING HEALTH RELATED INFORMATION TO THE COMMUNITY THROUGH A ONE MINUTE RECORDED RADIO SPOT. THE STATION HAS A WIDE LISTENING AREA AMONG ADULTS OVER AGE 35, AND TOPICS HAVE RANGED FROM WEIGHT MANAGEMENT TO FITNESS ROUTINES TO THE IMPORTANCE OF COLONOSCOPY SCREENINGS. 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PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN 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 THESE ENTITIES AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, 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 ENTITIES ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 1 X 1 1 0 1 1 2309629 430121 1879508 0.00860 33003849 30119952 2883897 0.01320 35313478 30550073 4763405 0.02180 1624186 24600 1599586 0.00730 510373 100 510273 0.00230 3847 3847 0.00000 2138406 24700 2113706 0.00960 37451884 30574773 6877111 0.03140 9833 9833 0.00000 7500 7500 0.00000 17333 17333 0.00000 0 10380164 37724540 43557024 -5832484 X 1 1 1 KNOX DIAGNOSTIC IMAGING LLC MEDICAL SERVICES/ECHOCARDIOLOGY SERVICES 0.50000 0.04670 0.28670 1 1 KNOX COMMUNITY HOSPITAL 1330 COSHOCTON RD MOUNT VERNON OH 43050 WWW.KCH.ORG 1030 X X X DSH HOSPITAL; SOLE COMMUNITY HOSPITAL KNOX COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X HTTP://WWW.KCH.ORG/RESOURCES/HEALTH-NEEDS-ASSESSMENT X 1 21 1 HTTP://WWW.KCH.ORG/RESOURCES/HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 350.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.KCH.ORG/FINANCIAL-ASSISTANCE-APPLICATION X HTTPS://WWW.KCH.ORG/FINANCIAL-ASSISTANCE-APPLICATION X HTTPS://WWW.KCH.ORG/FINANCIAL-ASSISTANCE-APPLICATION X X X X X 1 X 0 X X X X 1 X 0 0 KNOX COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED AS A COLLABORATIVE ENDEAVOR COMMISSIONED BY THE KNOX HEALTH PLANNING PARTNERSHIP. BOTH KNOX COMMUNITY HOSPITAL AND THE KNOX COUNTY HEALTH DEPARTMENT ARE MEMBERS OF KHPP, AND SHARED THE PRIMARY FINANCIAL RESPONSIBILITY FOR THE 2021 CHNA.THE KHPP SECURED THE SERVICES OF THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO FACILITATE THE SURVEY, ASSESSMENT AND IMPROVEMENT PLAN TO ENSURE THE FINISHED REPORT MEETS THE NEEDS OF BOTH THE KNOX COUNTY HEALTH DEPARTMENT AND KCH, AND IS IN ALIGNMENT WITH THE OHIO DEPARTMENT OF HEALTH'S STATE HEALTH IMPROVEMENT PLAN, AND OTHER STATE AND FEDERAL REQUIREMENTS. THE FINAL REPORT WAS COMPLETED AND AVAILABLE IN THE FALL OF 2021.WE SOLICITED COMMENTS ABOUT THE EXISTING CHNA REPORT FROM A GROUP OF INDIVIDUALS SELECTED TO REPRESENT EACH OF THE UNIQUE POPULATION GROUPS AS DELINEATED IN THE REGULATIONS. THIS RESULTED IN WRITTEN COMMENTS THAT WERE TAKEN INTO CONSIDERATION DURING THIS PROCESS.WE DEPLOYED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITAL'S DESIRE TO REPRESENT THE REGION'S GEOGRAPHICALLY- AND ETHNICALLY-DIVERSE POPULATION. WE RECEIVED COMMUNITY INPUT FROM LOCAL EXPERT ADVISORS.INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW KNOX COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS.WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED, AND NEW NEEDS DID EMERGE FROM THIS EXCHANGE.HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS.IN THE HOSPITAL PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, THE VAST MAJORITY OF COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A SUMMARY OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA SETS. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE POTENTIAL SIGNIFICANT NEED CANDIDATES, INCLUDING THE OPPORTUNITY TO AGAIN PRESENT ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. A RANK ORDER OF PRIORITIES EMERGED, WITH SOME NEEDS RECEIVING NONE OR VIRTUALLY NO SUPPORT, AND OTHER NEEDS RECEIVING IDENTICAL POINT ALLOCATIONS.WE DICHOTOMIZED THE RANK ORDER OF PRIORITIZED NEEDS INTO TWO GROUPS: "SIGNIFICANT AND "OTHER IDENTIFIED NEEDS." OUR CRITERIA FOR IDENTIFYING AND PRIORITIZING SIGNIFICANT NEEDS WAS BASED ON A DESCENDING FREQUENCY RANK ORDER OF THE NEEDS BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS, FURTHER RANKED BY A DESCENDING FREQUENCY COUNT OF THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY OUR DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST FIFTY PERCENT (50%) OF ALL POINTS WERE INCLUDED AND TO THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT "SIGNIFICANT" AS OPPOSED TO "OTHER" WAS A QUALITATIVE INTERPRETATION BY QHR AND THE KCH EXECUTIVE TEAM WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED. KNOX COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: THE CREATION OF THE 2021 COMMUNITY HEALTH ASSESSMENT (CHA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WAS A COLLABORATIVE COMMUNITY-WIDE EFFORT BETWEEN KNOX COMMUNITY HOSPITAL, THE KNOX COUNTY HEALTH DEPARTMENT, AND THE KNOX HEALTH PLANNING PARTNERSHIP. KNOX COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: IN 2021, KCH CONTINUED TO ADDRESS THE SPECIFIC HEALTH NEEDS IDENTIFIED BY THE CHNA:1. CHRONIC DISEASE:A. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO IMPLEMENT HEALTHY FOOD INITIATIVES.B. CONTINUE TO OFFER EMPLOYERS/BUSINESSES/ORGANIZATIONS WELLNESS PROGRAM OPTIONS AND WELLNESS INCENTIVE PROGRAMS FOR EMPLOYEES. I. KCH OFFERS WELLNESS PROGRAMS TO LOCAL EMPLOYERS THROUGH WELLNESS WORKS, INCLUDING A VARIETY OF HEALTH SCREENING AND EDUCATION PROGRAMS IN THE WORKPLACE. II. KCH ALSO PROVIDES A TELEHEALTH PROGRAM THROUGH A COLLABORATION WITH SWIFTMD TO SEVERAL EMPLOYERS IN THE COMMUNITY, OFFERING LOW-COST ACCESSIBLE CARE FOR BASIC HEALTH NEEDS, REDUCING EMPLOYER HEALTHCARE COSTS AND MISSED WORK TIME FOR APPOINTMENTS, ETC.C. SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO IMPLEMENT A COMMUNITY-WIDE PHYSICAL ACTIVITY CAMPAIGN.D. KNOX COMMUNITY HOSPITAL HAS RECOGNIZED THE NEED TO EXPAND OUR DIABETES EDUCATION PROGRAM AND HAS INCREASED THE NUMBER OF DIABETES EDUCATORS ACCORDINGLY.E. IN 2021, WE PROVIDED GLUCOSE SCREENINGS AND SHARED INFORMATION ABOUT PREVENTING AND DEALING WITH DIABETES DURING THE CITY OF MOUNT VERNON'S "FIRST FRIDAY" EVENTS AND AT THE TOMATO SHOW IN FREDERICKTOWN.2. MENTAL HEALTH:A. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO EXPAND MENTAL HEALTH FIRST AID TRAININGS.B. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE COMMUNITY AWARENESS OF SUBSTANCE ABUSE AND PREVENTION. SPECIFICALLY, KCH FINANCIALLY SUPPORTED THE CREATION AND DISTRIBUTION OF THE KNOX SUBSTANCE ABUSE ACTION TEAMS' RESOURCE TOOLKITS, WHICH PROVIDE SPECIFIC INFORMATION FOR A BROAD RANGE OF SERVICES AND RESOURCES AVAILABLE IN OUR COMMUNITY RELATED TO MENTAL HEALTH AND ADDICTION ISSUES.C. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE CONTINUING EDUCATION FOR PRIMARY CARE AND SUBSTANCE ABUSE DISORDER PROVIDERS.D. KCH'S WORKS WITH THE APPROPRIATE PARTNERING ORGANIZATIONS IF A PATIENT SHOWS THAT THEY NEED CRISIS ASSESSMENT AFTER OUR MEDICAL SCREENING(S); IN ORDER TO, DETERMINE THE NEXT STEPS FOR THAT PATIENT.E. SOME PATIENTS WITH SUBSTANCE ABUSE WHO SHOW SIGNS OF MENTAL HEALTH CONCERNS NEED TO BE REFERRED TO NEW VISION OR THE FREEDOM CENTER FOR ADDITIONAL TREATMENT.3. ACCESS TO CAREA. KCH HAS LED AN EFFORT TO INCREASE AWARENESS AND ACCESS TO EXISTING HEALTHCARE SERVICES ON PREVENTIVE CARE FOR THE KNOX HEALTH PLANNING PARTNERSHIP. KCH HAS COMPILED A LIST OF ALL KNOWN PREVENTIVE CARE ACTIVITIES COUNTY-WIDE AND HAS BEGUN TO EVALUATE THEIR PROMOTION AND EFFECTIVENESS. IN THE FOLLOWING MONTHS, WE WILL IDENTIFY 2-3 SPECIFIC STRATEGIES TO INCREASE AWARENESS OF THESE OPPORTUNITIES, AND MEASURE THEIR EFFECTIVENESS AGAINST THIS YEAR'S BASELINE DATA.B. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE AWARENESS AND AVAILABILITY OF BIRTH CONTROL.C. CONTINUE TO SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE SEXUAL HEALTH EDUCATION AND PREVENTION.THE CREATION OF THE 2021 COMMUNITY HEALTH ASSESSMENT (CHA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WAS A COLLABORATIVE COMMUNITY-WIDE EFFORT BETWEEN KNOX COMMUNITY HOSPITAL, THE KNOX COUNTY HEALTH DEPARTMENT, AND THE KNOX HEALTH PLANNING PARTNERSHIP. THESE PARTNERS ASSIST WITH THE BURDEN OF ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENTLY CONDUCTED CHNA. THIS PARTNERSHIP ALLOWS THE HOSPITAL TO FOCUS ON 'WHAT WE DO BEST' WHILE OUR OTHER PARTNERS CONTINUE TO INVEST IN THE COMMUNITY BY ADDRESSING SIGNIFICANT NEEDS THAT FIT IN THEIR WHEELHOUSE. ABOVE, WE DESCRIBED THE ACTIONS THAT WE ARE TAKING TO ADDRESS THE NEEDS THAT WERE IDENTIFIED AND THE AREAS WHERE WE CONTINUE TO SUPPORT OUR PARTNERS IN THEIR EFFORTS TO PROVIDE NEEDED ASSISTANCE TO THE COMMUNITY. A FEW OF THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT (SOCIAL DETERMINANTS OF HEALTH, PARENTING, AND CANCER) ARE NOT SPECIFICALLY ADDRESSED BY THE COLLABORATION'S COMMUNITY HEALTH IMPROVEMENT PLAN. WHILE KCH OFFERS CHARITABLE CARE AND FINANCIAL ASSISTANCE TO ADDRESS POVERTY AND LACK OF RESOURCES AS A SOCIAL DETERMINANT OF HEALTH, KCH IS CHOOSING NOT TO RESPOND TO THE ISSUE OF PARENTING AT THIS TIME, AS IT FALLS OUTSIDE THE SCOPE OF OUR CORE MISSION AS A HOSPITAL. ADDITIONALLY, KCH IS CHOOSING NOT TO RESPOND TO CANCER AT THIS TIME, AS IT IS A CORE ELEMENT OF OUR OVERALL ORGANIZATIONAL BUSINESS AND STRATEGIC PLANNING. WE ARE NOT ANTICIPATING ANY NEW PROJECTS OR INITIATIVES IN THIS AREA, AND WE BELIEVE WE ALREADY PROVIDE OUTSTANDING HEALTHCARE SERVICES IN THIS AREA. WE FEEL WE CAN HAVE A GREATER IMPACT FOR THE COMMUNITY BY PUTTING NEW ATTENTION AND RESOURCES TOWARD THE OTHER NEEDS. PART I, LINE 3C: IN ADDITION TO FPG, THE ORGANIZATION USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY: MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY. PART I, LINE 7: A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART 1, LINE 7. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 OF THE 2021 IRS INSTRUCTIONS FOR SCHEDULE H. PART II, COMMUNITY BUILDING ACTIVITIES: A CANCER PATIENT NURSE NAVIGATOR AND A BREAST CANCER NURSE NAVIGATOR PROVIDE SERVICE AT NO COST TO CANCER PATIENTS. KCH ALSO HAS A CARDIOLOGY PATIENT NAVIGATOR TO ASSIST PATIENTS WITH SERVICES OR ASSISTANCE WITH RESOURCES AND APPOINTMENTS. DIRECTIVE/LIVING WILL ASSISTANCE AND FREE NOTARY SERVICE WAS PROVIDED TO APPROXIMATELY 5 PEOPLE DUE TO A STAFFING CHANGE THAT RESULTED IN NOT HAVING A NOTARY IN THE DEPARTMENT THE ENTIRE YEAR. THE NEW STAFF MEMBER HAS SINCE OBTAINED HER NOTARY IN ORDER TO CONTINUE TO SERVE IN THE FUTURE.MANY OF OUR FREE MONTHLY SCREENINGS HAD TO BE CANCELLED DUE TO THE COVID PANDEMIC BUT WILL RETURN AS SOON AS FEASIBLE. THE SCREENINGS THAT WE PLAN TO CONTINUE IN THE FUTURE ARE: BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS, COLORECTAL CANCER SCREENINGS AND GLUCOSE SCREENINGS. KCH DID CONTINUE WITH THE 20 MINUTE HEART CHECKS WHICH INCLUDED LIPID AND GLUCOSE TESTING. WE CONTINUED TO OFFER A SUPPORT GROUP FOR BARIATRIC PATIENTS.THE EDUCATION DEPARTMENT CONTINUES TO OFFER FAMILY & FRIENDS CPR CLASSES.AS PARTNERS WITH AREA NURSING SCHOOLS, WE PROVIDED CLINICAL SUPERVISION AND PRECEPTING TO STUDENTS FOR OVER 9,800 HOURS. A QUARTERLY HEALTH EDUCATION PUBLICATION CONTINUED TO PROVIDE HEALTH INFORMATION TO ALL 26,000 HOMES IN KNOX COUNTY. THIS PUBLICATION ALSO PROVIDED A CALENDAR OF COMMUNITY HEALTH EDUCATION EVENTS AND FREE SCREENINGS.THE BREAST HEALTH NAVIGATOR AT KCH ASSISTED IN REQUESTING AND RECEIVING FUNDS FROM THE SUSAN G. KOMEN FOUNDATION TO PROVIDE SCREENING MAMMOGRAMS AND FOLLOW UP CARE AS NEEDED FOR WOMEN WHO ARE UNINSURED OR UNDERINSURED. KCH PROVIDES THE COMMUNITY AT LARGE THE SERVICES OF BOTH A BREAST HEALTH NAVIGATOR AND A PATIENT NAVIGATOR AT NO CHARGE.THE ESTIMATED PREVALENCE OF DIABETES AMONG KNOX COUNTY ADULT RESIDENTS IS APPROXIMATELY 10 PERCENT ACCORDING TO WWW.COUNTYHEALTHRANKINGS.ORG 2022 HEALTH RANKINGS (BASED ON 2019 DATA). KNOX COMMUNITY HOSPITAL RECOGNIZES THE NEED FOR EDUCATION AND SCREENINGS TO SERVE THIS POPULATION. IN 2021, WE OFFERED INFORMATION PRESENTATION AT VARIOUS COMMUNITY EVENTS. THE OBVIOUS NEED TO SERVE THE POPULATION WITH DIABETES HAS LED TO A RESTRUCTURING OF OUR DIABETES PROGRAMS WITH IMPLEMENTATION THAT HAD BEGUN IN 2018 BUT CONTINUES TO EVOLVE. VIRTUAL GROCERY STORE TOURS HAS BEEN THE NEWEST CHANGE INSPIRED IN 2021 TO ASSIST THIS POPULATION WHILE STILL BEING COVID AWARE. COMMUNITY MEMBERS UTILIZE THE HOSPITAL AS A VEHICLE TO CONNECT WITH AND CONTRIBUTE TO THE OVERALL WELL-BEING OF THE COMMUNITY THROUGH PHILANTHROPY AND VOLUNTEERING. A VOLUNTEER FORCE OF 99 CONTRIBUTED 721 HOURS IN 2021. PART III, LINE 2: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE HOSPITAL'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: KNOX COMMUNITY HOSPITAL PROVIDES DETAILED INFORMATION ABOUT THE POVERTY GUIDELINES ON POSTED SIGNS THROUGHOUT THE FACILITY AS WELL AS THE HOSPITAL WEBSITE. THE HOSPITAL REGISTRARS ALSO EDUCATE ALL PATIENTS THAT ARE SELF-PAY OR EXPRESS A NEED FOR FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE HOSPITAL'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 72% AND 71% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY. IN ADDITION, THE HOSPITAL'S PROVISION FOR BAD DEBTS INCREASED APPROXIMATELY $550,000 FROM $9,830,000 FOR FISCAL YEAR 2020 TO $10,380,000 FOR FISCAL YEAR 2021. THE HOSPITAL HAS NOT SIGNIFICANTLY CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2021 AND 2020.THE HOSPITAL DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD PARTY PAYORS RELATING TO DOUBTFUL ACCOUNTS. PART III, LINE 8: MEDICARE IS THE LARGEST PAYOR OF KNOX COMMUNITY HOSPITAL AND THE HOSPITAL ACCEPTS THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE AVAILABILITY, WHICH IS A COMMUNITY BENEFIT. ALONG THE SAME LINES, THE IRS REVENUE RULING 69-545 ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS. ACCORDING TO THIS RULING, IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN IT IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS ALSO IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. PART III, LINE 9B: KNOX COMMUNITY HOSPITAL HAS THE SAME COLLECTION POLICY AND PROCEDURES THAT APPLY EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE AND NON-CHARITY CARE PATIENTS. IF A PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE PROCEDURES OUTLINED IN THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE POLICY WILL BE FOLLOWED. THE DEBT COLLECTION POLICY DOES NOT APPLY TO PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE. PART VI, LINE 2: IN 2021, KNOX COMMUNITY HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT. AS IN THE PAST, KCH WORKED WITH A NUMBER OF HEALTH PARTNERS AND AGENCIES TO DEVELOP THIS ASSESSMENT. KNOX COMMUNITY HOSPITAL USED A COMPREHENSIVE APPROACH TO DEVELOP THE COMMUNITY HEALTH NEEDS ASSESSMENT.THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT WAS PREPARED AS A COLLABORATIVE ENDEAVOR COMMISSIONED BY THE KNOX HEALTH PLANNING PARTNERSHIP. BOTH KNOX COMMUNITY HOSPITAL AND THE KNOX COUNTY HEALTH DEPARTMENT ARE MEMBERS OF KHPP, AND SHARED THE PRIMARY FINANCIAL RESPONSIBILITY FOR THE 2021 CHNA.THE KHPP SECURED THE SERVICES OF THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO FACILITATE THE SURVEY, ASSESSMENT AND IMPROVEMENT PLAN TO ENSURE THE FINISHED REPORT MEETS THE NEEDS OF BOTH THE KNOX COUNTY HEALTH DEPARTMENT AND KCH, AND IS IN ALIGNMENT WITH THE OHIO DEPARTMENT OF HEALTH'S STATE HEALTH IMPROVEMENT PLAN, AND OTHER STATE AND FEDERAL REQUIREMENTS. THE FINAL REPORT WAS COMPLETED AND AVAILABLE IN THE FALL OF 2021. PART VI, LINE 3: DETAILED INFORMATION ABOUT THE POVERTY GUIDELINES IS POSTED ON SIGNS THROUGHOUT THE FACILITY AND THAT INFORMATION IS REPEATED ON THE HOSPITAL WEBSITE. EVERY PATIENT STATEMENT INCLUDES INFORMATION ABOUT FINANCIAL ASSISTANCE AND AN APPLICATION FOR THAT ASSISTANCE.AT REGISTRATION, THOSE WHO ARE SELF-PAY OR EXPRESS A NEED FOR ASSISTANCE ARE EDUCATED BY THE REGISTRARS ABOUT RESOURCES AVAILABLE. THIS INCLUDES PATIENT FINANCIAL COUNSELORS.KNOX COMMUNITY HOSPITAL IMPLEMENTED A SLIDING SCALE FOR UP TO 350% OF THE FEDERAL POVERTY LEVEL TO ASSIST PATIENTS WITH THEIR PORTION OF CHARGES. CASE MANAGERS ADVOCATE FOR ASSISTANCE BY REFERRING PATIENTS TO KNOX COMMUNITY HOSPITAL FINANCIAL COUNSELORS, TOO. IN ADDITION, THE EMPLOYED PHYSICIANS IN THE DEPARTMENTS OF PRIMARY AND SPECIALTY CARE PARTICIPATE IN THE KCH FINANCIAL ASSISTANCE PROGRAM.WE OFFER A 20% DISCOUNT OFF GROSS CHARGES TO THE UNINSURED FOR HOSPITAL SERVICES AND A 40% DISCOUNT OFF PHYSICIAN SERVICES TO THE UNINSURED, AND A 10% PROMPT PAY DISCOUNT ON CO-INSURANCE AMOUNTS TO THOSE WITH INSURANCE IF THEY PAY THEIR PORTION WITHIN 30 DAYS OF THEIR FIRST STATEMENT. PART VI, LINE 4: KNOX COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA IS KNOX COUNTY, OHIO. THE 2021 ESTIMATE OF THE POPULATION OF KNOX COUNTY IS 61,481. KNOX COUNTY IS PREDOMINANTLY WHITE, CAUCASIANS COMPRISING 96.4% OF THE POPULATION. CONSIDERED A RURAL AREA OF OHIO, KCH IS THE ONLY HOSPITAL IN KNOX COUNTY. (MOST RECENT STATISTICS AVAILABLE)THE MEDIAN HOUSEHOLD INCOME IN 2021 WAS ESTIMATED TO BE $57,749. THE 2021 UNEMPLOYMENT RATE WAS 3.6%, WHICH IS SLIGHTLY LOWER THAN THE US RATE FOR THAT PERIOD OF TIME. 19.8% OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY LEVEL. THE PERCENTAGE OF THE POPULATION UNDER 65 WITHOUT INSURANCE IS 11.5%. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 HAS DECLINED TO 17.7%. OUR ELDERLY POPULATION IS SLIGHTLY HIGHER THAN THE STATE OR NATIONAL AVERAGE. KNOX COMMUNITY HOSPITAL RECOGNIZES THE UNIQUE HEALTH CHALLENGES THESE VULNERABLE POPULATIONS ENCOUNTER AND OFFERS PROGRAMS AND FREE SCREENINGS TO ASSIST THEM. (MOST RECENT STATISTICS AVAILABLE) PART VI, LINE 5: HEART DISEASE CONTINUES TO BE THE LEADING CAUSE OF DEATH FOR KNOX COUNTY RESIDENTS. HEART DISEASE RATES PLACE KNOX COUNTY IN THE LOWER QUARTILE OF OHIO COUNTIES. KNOX COMMUNITY HOSPITAL HAS ORGANIZED EDUCATIONAL EVENTS AND LOW COST SCREENINGS FOR OUR SERVICE AREA.KCH CONTINUES TO OFFER LOW COST 20-MINUTE HEART CHECKS EVERY FEBRUARY. THIS ENCOURAGES THE COMMUNITY TO PLAN FOR THESE SCREENINGS ON A YEARLY BASIS. PROVIDING FREE EDUCATIONAL EVENTS BRINGS AWARENESS OF THESE SCREENINGS AND WHAT OUR COMMUNITY CAN DO TO IMPROVE THEIR HEART HEALTH. ALL RESIDENTS IN KNOX COUNTY RECEIVE A QUARTERLY HEALTH MAGAZINE THAT OFTEN FEATURES EASY-TO-UNDERSTAND TIPS FOR BETTER HEART HEALTH.COMMUNITY EDUCATION CLASSES ARE PROVIDED TO LOCAL COMMUNITY GROUPS IN THE FOLLOWING AREAS: BLS, PALS, HSAEDFA, FRIENDS & FAMILY CPR AND FIRST AID.KCH HAS A CARDIOLOGY PATIENT NAVIGATOR TO ASSIST PATIENTS WITH SERVICES OR ASSISTANCE WITH RESOURCES AND APPOINTMENTS.ISSUES OF ALCOHOL ABUSE AND SMOKING/TOBACCO IN KNOX COUNTY WERE IDENTIFIED, AND RECOGNIZED AS MAJOR FACTORS FOR ORAL, HEAD AND NECK CANCER. OUR CANCER RESOURCE LIBRARY IN THE KNOX MEDICAL PAVILION PROVIDES EDUCATIONAL MATERIAL TO THE COMMUNITY. KCH HAS A BREAST HEALTH NAVIGATOR AND A CANCER NAVIGATOR TO COORDINATE PATIENT CARE ACTIVITIES TO SUPPORT THE TRANSITION FROM DIAGNOSIS TO TREATMENT; TO PROVIDE EDUCATIONAL RESOURCES FOR THE PATIENT AND THE FAMILY, AND ASSIST PATIENTS THROUGHOUT THEIR CARE. THIS SERVICE IS AVAILABLE TO ALL CANCER PATIENTS, REGARDLESS OF WHERE THEY RECEIVE CARE, AT NO CHARGE.THE ESTIMATED PREVALENCE OF DIABETES AMONG KNOX COUNTY ADULT RESIDENTS INCREASED TO 10 PERCENT. KNOX COMMUNITY HOSPITAL RECOGNIZES THE NEED FOR EDUCATION AND SCREENINGS TO SERVE THIS POPULATION. NEW EDUCATIONAL PROGRAMS ARE IN THE DEVELOPMENT PHASE TO ASSIST THIS SEGMENT OF OUR COMMUNITY.MONTHLY SUPPORT GROUPS WERE PROVIDED FOR BARIATRIC SUPPORT.OUR COMMITMENT TO OUR COMMUNITY IS DEMONSTRATED IN HOW WE USE OUR RESOURCES. FUNDS REMAINING AFTER EXPENSES ARE USED SOLELY TO INVEST IN THE HOSPITAL'S MISSION OF IMPROVED PATIENT SERVICES, TECHNOLOGY AND FACILITIES.OUR GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN OUR PRIMARY SERVICE AREA AND NONE ARE CONTRACTORS OF KCH.KNOX COMMUNITY HOSPITAL ENHANCES THE OVERALL WELL-BEING OF THE COMMUNITY IN MANY WAYS. EACH YEAR WE SEARCH FOR NEW WAYS TO PROVIDE INFORMATION, CARE, SUPPORT AND SERVICE THAT IMPROVES THE WELL-BEING AND HEALTH OF OUR COMMUNITY.NEW TO THE MEDICAL STAFF IN 2021 WAS DR. REED, INTERNAL MED; DR. CRAWFORD, FAMILY MED; DR. THURMAN, FAMILY MED; DR. BASIL, PEDS; DR. BABBITT, GENERAL SURGERY; DR. WOODS, WOMEN'S HEALTH; DR. DURBIN, OPHTHALMOLOGY; DR. WOODRUFF, NEUROLOGY.WE CONTINUE TO ADD PROVIDERS AND GROW SERVICES IDENTIFIED AS NEEDED WITHIN OUR COMMUNITY.FREE NOTARY SERVICE IS AVAILABLE EVERY WEEKDAY FROM 8 AM TO 4 PM TO ASSIST MEMBERS OF THE COMMUNITY WITH COMPLETING ADVANCE DIRECTIVES.SOME OF KCH'S PARTNERSHIPS WITH OTHERS IN THE COMMUNITY ALLOW CLINICAL STAFF TO MENTOR AND PRECEPT NURSING, RADIOLOGY, PHARMACY AND PHYSICAL THERAPY STUDENTS. KNOX COMMUNITY HOSPITAL IS INVOLVED WITH HEALTH PROFESSIONS EDUCATION WITH STUDENTS FROM MANY AREA NURSING AND HEALTHCARE PROGRAMS.THE HOSPITAL WORKS IN PARTNERSHIP WITH THE LOCAL HEALTH DEPARTMENT AND THE UNITED WAY OF KNOX COUNTY TO ADDRESS AND IDENTIFY CURRENT HEALTH NEEDS OF THE COMMUNITY. COLLABORATION WITH THESE AGENCIES ALLOWS US TO AVOID DUPLICATION OF NEEDED SERVICES AND OFFER WHAT MOST BENEFITS OUR COMMUNITY.AS THE ONLY HOSPITAL IN OUR SERVICE AREA, KNOX COMMUNITY HOSPITAL PROVIDES CARE FOR THE MAJORITY OF MEDICARE AND MEDICAID RECIPIENTS IN KNOX COUNTY. OUR URGENT CARE CENTER AND OUR EMERGENCY DEPARTMENT CONTINUE TO BE SOURCES OF PRIMARY CARE FOR THE UNINSURED OR THOSE WITHOUT A FAMILY PHYSICIAN.COMMUNITY MEMBERS UTILIZE THE HOSPITAL AS A VEHICLE TO CONNECT WITH AND CONTRIBUTE TO THE OVERALL WELL-BEING OF THE COMMUNITY THROUGH PHILANTHROPY AND VOLUNTEERING. A VOLUNTEER FORCE OF 99 CONTRIBUTED APPROXIMATELY 721 HOURS IN 2021. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 GREGORY CUSH ORTHOPAEDIC SURGEON 1105814 0 40362 0 0 0 19500 0 40760 0 1206436 0 0 0 JARRETT B HELMING ORTHOPAEDIC SURGEON 746941 0 341531 0 0 0 19500 0 40760 0 1148732 0 0 0 MICHAEL HEUMAN GENERAL SURGEON 628688 0 234420 0 0 0 19500 0 40760 0 923368 0 0 0 BARRY S GEORGE MD TRUSTEE/CARDIOLOGIST 843324 0 0 0 0 0 19500 0 40558 0 903382 0 0 0 KENNETH H DOOLITTLE II ORTHOPAEDIC SURGEON 791082 0 40217 0 0 0 19500 0 21231 0 872030 0 0 0 GANGARAM RASA CARDIOLOGIST 768312 0 0 0 0 0 19500 0 21030 0 808842 0 0 0 BRUCE WHITE CEO 430972 0 42634 0 7260 0 0 0 113064 0 593930 0 0 0 MICHAEL SULLIVAN MD TRUSTEE/OBGYN 513071 0 0 0 0 0 19500 0 14094 0 546665 0 0 0 MICHAEL AMBROSIANI CFO 284248 0 21463 0 0 0 0 0 73336 0 379047 0 0 0 BRUCE BEHNER COO 284248 0 21463 0 0 0 0 0 73336 0 379047 0 0 0 AMY D MURNEN MD TRUSTEE/FAMILY MEDICINE 230210 0 0 0 0 0 19500 0 12771 0 262481 0 0 0 CAROL N EMERY CHIEF NURSING OFFICER 190491 0 1250 0 0 0 9014 0 39797 0 240552 0 0 0 JEFFERY C NORTHUP CMO- TERM ENDED JUNE '21 192770 0 0 0 0 0 8298 0 11445 0 212513 0 0 0 PART I, LINE 1A HOSPITAL PURCHASES AN ANNUAL MEMBERSHIP TO LOCAL COUNTRY CLUB FOR RECRUITING AND FUNDRAISING ACTIVITIES FOR THE CEO, CFO, AND COO. THIS BENEFIT IS NOT INCLUDED IN THE INDIVIDUALS' COMPENSATION. PART I, LINE 7 SCHEDULE J, PART II: THE CEO, COO, AND CFO OF THE HOSPITAL ARE PAID BY AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE ORGANIZATION THROUGH A MANAGEMENT AGREEMENT WITH QUORUM HEALTH RESOURCES, LLC. DR. GREGORY CUSH IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR A GENERAL ORTHOPEDIC SURGEON. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. KENNETH DOOLITTLE IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR A GENERAL ORTHOPAEDIC SURGEON. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED SEMIANNUALLY. AT THE END OF EACH SIX MONTH PERIOD, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. MICHAEL HEUMAN IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR GENERAL SURGERY. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. BARRY GEORGE IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR AN INVASIVE-INTERVENTIONAL CARDIOLOGIST. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. AMY MURNEN IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HER SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S SHE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR A FAMILY MEDICINE PHYSICIAN. SHE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HER WRVU'S ARE REVIEWED SEMIANNUALLY. AT THE END OF EACH SIX MONTH PERIOD, IF HER EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HER ESTIMATED SALARY, PAYMENT IS MADE TO HER FOR THE EXCESS AMOUNT. DR. JARRETT B. HELMING IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR AN ORTHOPAEDIC SURGEON. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. MICHAEL SULLIVAN, IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR AN OBGYN. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. DR. GANGARAM RASA IS PAID BASED ON WORK RVU ("WRVU" - RELATIVE VALUE UNIT) PROGRAM. HIS SALARY IS BASED ON THE AGGREGATE NUMBER OF WRVU'S HE PRODUCES MULTIPLIED BY THE COMPENSATION/WORK RVU CONVERSION FACTOR AS PUBLISHED IN THE MGMA PHYSICIAN COMPENSATION FOR AN INVASIVE-INTERVENTIONAL CARDIOLOGIST. HE IS PAID AN ESTIMATED SALARY IN EQUAL BIWEEKLY INSTALLMENTS AND HIS WRVU'S ARE REVIEWED QUARTERLY. AT THE END OF EACH QUARTER, IF HIS EARNED INCOME (WRVU'S X CONVERSION FACTOR) EXCEEDS HIS ESTIMATED SALARY, PAYMENT IS MADE TO HIM FOR THE EXCESS AMOUNT. VICKIE SANT SEE PART V BELOW 0 SEE PART V BELOW 0 MARK RAMSER SEE PART V BELOW 0 SEE PART V BELOW 0 KOREY KIDWELL SEE PART V BELOW 0 SEE PART V BELOW 0 SCHEDULE L, PART IV: VICKIE SANT IS A MEMBER OF THE GOVERNING BODY AND A TRUSTEE OF THE FINANCIAL INSTITUTION THAT IS USED BY KNOX COMMUNITY HOSPITAL. DURING THE YEAR, THE HOSPITAL PAID $546,603 TO PARK NATIONAL BANK FOR ASSET MANAGEMENT FEES. TO AVOID A CONFLICT OF INTEREST, MS. SANT ABSTAINS FROM VOTING ON ANY ISSUES RELATED TO THE BANKING ARRANGEMENT. SCHEDULE L, PART IV: MARK RAMSER IS A MEMBER OF THE GOVERNING BODY AND A TRUSTEE OF THE FINANCIAL INSTITUTION THAT IS USED BY KNOX COMMUNITY HOSPITAL. DURING THE YEAR, THE HOSPITAL PAID $546,603 TO PARK NATIONAL BANK FOR ASSET MANAGEMENT FEES. TO AVOID A CONFLICT OF INTEREST, MR. RAMSER ABSTAINS FROM VOTING ON ANY ISSUES RELATED TO THE BANKING ARRANGEMENT. SCHEDULE L, PART IV: KOREY KIDWELL IS A MEMBER OF THE GOVERNING BODY AND A TRUSTEE OF THE FINANCIAL INSTITUTION THAT IS USED BY KNOX COMMUNITY HOSPITAL. DURING THE YEAR, THE HOSPITAL PAID $546,603 TO PARK NATIONAL BANK FOR ASSET MANAGEMENT FEES. TO AVOID A CONFLICT OF INTEREST, MR. KIDWELL ABSTAINS FROM VOTING ON ANY ISSUES RELATED TO THE BANKING ARRANGEMENT. FORM 990, PART VI, SECTION A, LINE 3 KNOX COMMUNITY HOSPITAL HAS ENTERED INTO AN INDEPENDENT CONTRACT AGREEMENT WITH QUORUM HEALTH RESOURCES, LLC TO PROVIDE MANAGEMENT SERVICES UNDER THE DIRECTION, CONTROL AND AUTHORITY OF THE HOSPITAL'S BOARD OF TRUSTEES. IN 2021, QUORUM HEALTH RESOURCES, LLC WAS PAID $1,903,204. OF THIS AMOUNT $1,085,028 RELATES TO COMPENSATION LISTED IN 990 PART PART VII AND SCHEDULE J, PART II FOR THE CEO, CFO, AND COO'S COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT AND AUDIT AND COMPLIANCE COMMITTEE. THE FULL GOVERNING BODY IS PRESENTED A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS ARE REQUIRED TO READ AND SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT WHICH EDUCATES THEM ON THEIR RESPONSIBILITY TO DECLARE POTENTIAL AND SEEMING CONFLICTS OF INTEREST. THE STATEMENTS ARE PRESENTED TO AND REVIEWED BY THE BOARD EXECUTIVE COMMITTEE. THIS IS IMPORTANT BECAUSE THE MEMBERSHIP COMPOSITION OF THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF EACH COMMITTEE OF THE BOARD. THAT WAY, EACH COMMITTEE CHAIR IS AWARE OF THE DISCLOSED CONFLICTS AND POTENTIAL CONFLICTS OF INTEREST FOR THE MEMBERS WHO SERVE ON THEIR COMMITTEE. CHAIRS ARE AWARE THAT ANY AND ALL POTENTIAL CONFLICTS OF INTEREST WHICH MAY COME INTO PLAY DURING ANY BOARD ACTIVITY AND ANY BOARD COMMITTEE WORK SHOULD BE IDENTIFIED AND DECLARED TO THE GROUP. THE MEMBER WITH THE CONFLICT MAY BE ASKED TO RECUSE THEMSELVES FROM ANY VOTE, DISCUSSION, OR ATTENDANCE AT A MEETING REGARDING THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF KNOX COMMUNITY HOSPITAL IS THE COMPENSATION COMMITTEE/ARM OF THE GOVERNING BODY. QUORUM HEALTH RESOURCES, LLC PROVIDES THE NATIONAL PERSPECTIVE; USING THEIR SURVEYS, RANGES ARE ESTABLISHED FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE MAKES THE PROPOSAL FOR THE FULL BOARD TO APPROVE. THE EXECUTIVE COMMITTEE IS COMPRISED OF TRUSTEES DETERMINED TO BE INDEPENDENT ACCORDING TO THE BOARD POLICY. PAID PHYSICIAN BOARD MEMBERS ARE NOT INDEPENDENT DIRECTORS AND ARE EXCLUDED FROM THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 17,378,728. MANAGEMENT AND GENERAL EXPENSES 7,448,026. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,826,754. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN KNOX COMMUNITY HOSPITAL FOUNDATION -2,175,112. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. 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