2021-05-06T11:28:21-05:00 2020-06-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2019-07-01 550477361 BOONE MEMORIAL HOSPITAL INC BOON 3043691230 701 MADISON AVENUE MADISON WV 25130 CHAD HOVIS CFO 3043691230 2021-05-04 1 AMY BIBBY P00445891 8282542254 2021-05-04 2019 2022-09-23 18:48:47Z VIRGIL UNDERWOOD 701 MADISON AVENUE MADISON WV 25130 49928852 0 X WWW.BMH.ORG X 2010 WV BOONE MEMORIAL HOSPITAL STRIVES TO SUPPLY A COMPREHENSIVE RANGE OF INPATIENT AND OUTPATIENT SERVICES 8 8 403 45 0 0 185586 2364556 43714094 46958798 160783 392992 81612 176213 44142075 49892559 0 0 0 0 18178177 24333532 0 0 6262 23376596 22933509 41554773 47267041 2587302 2625518 51231888 61065632 40536879 47745105 10695009 13320527 X THE MISSION OF BOONE MEMORIAL HOSPITAL IS TO CREATE AN ENVIRONMENT IN WHICH QUALIFIED PHYSICIANS AND OTHER HEALTH CARE PERSONNEL CAN WORK TOGETHER TO PROVIDE HIGH QUALITY HEALTH CARE SERVICE, IN AN ATMOSPHERE OF BROTHERLY LOVE AND CONCERN, TO THE RESIDENTS OF BOONE COUNTY AND SURROUNDING AREAS.BOONE MEMORIAL HOSPITAL STRIVES TO SUPPLY A COMPREHENSIVE RANGE OF INPATIENT AND OUTPATIENT SERVICES, INCLUDING PREVENTION, GUIDANCE, DIAGNOSIS, TREATMENT, RESTORATION, REHABILITATION AND OTHER EFFORTS TO ENABLE PATIENTS TO LEAD HEALTHY, PRODUCTIVE LIVES, AS MAY BE NEEDED BY ITS COMMUNITY, AND AS ITS RESOURCES WILL PERMIT. IN CARRYING OUT ITS PROGRAMS, BOONE MEMORIAL HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO MAKE SERVICES AVAILABLE TO ALL PERSONS WHO CAN BENEFIT FROM THEM AND TO PROVIDE THESE IN AN ECONOMICAL MANNER IN COMPLIANCE WITH HIGH PROFESSIONAL STANDARDS. THE HOSPITAL FURTHER RECOGNIZES RESPONSIBILITY TO DEVELOP AN ORGANIZATIONAL ENVIRONMENT IN WHICH PHYSICIANS, EMPLOYEES, VOLUNTEERS 0 0 40788039 46958798 IN PERFORMING ITS MISSION, BOONE MEMORIAL HOSPITAL HAD 614 ACUTE CARE ADMISSIONS AND 152 SKILLED NURSING CARE ADMISSIONS. THE HOSPITAL ALSO HAD 6 RESPITE CARE PATIENTS, 13,610 EMERGENCY ROOM VISITS, 29,057 OUT-PATIENT VISITS AND 33,554 VISITS IN ITS TWO RURAL HEALTH CLINICS.BOONE MEMORIAL HOSPITAL CONDUCTS AN ANNUAL HEALTH FAIR. THE HOSPITAL USES THE LOCAL MADISON CIVIC CENTER AND OFFERS VERY LOW COST BLOOD WORK TO THE COMMUNITY. APPROXIMATELY 450 COMMUNITY MEMBERS ATTENDED THE HEALTH FAIR AND APPROXIMATELY 194 RECEIVED LOW COST BLOOD WORK.BMH RESPITE CARE PROGRAM. THE HOSPITAL HAD 6 RESPITE CARE ADMISSIONS AND 22 RESPITE DAYS FOR ITS 6/30/20 FISCAL YEAR. THE RESPITE CARE PROGRAM IS A CASH ONLY PROGRAM. IT IS NOT BILLED TO INSURANCE, BUT THE RATE IS ONLY $221 PER DAY. WE OFFER THIS AS A COMMUNITY BENEFIT. 40788039 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 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 0 0 0 0 1 55 0 1 403 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WV X CHAD HOVIS 3043691230 701 MADISON AVENUE MADISON WV 25130 ROBERT BROWN PRESIDENT 1.30 X X 0 0 0 SUSAN MCCORY BOARD MEMBER 1.30 X 0 0 0 JOHN REGER BOARD MEMBER 1.30 X 0 0 0 SHAWN MILLER BOARD MEMBER 1.30 X 0 0 0 NADA WOODIE BOARD MEMBER 1.30 X 0 0 0 JAMES GORE BOARD MEMBER 1.30 X 0 0 0 THOMAS BIAS BOARD MEMBER 1.30 X 0 0 0 JAMES HENSLEY VICE PRESIDENT 1.30 X X 0 0 0 MARK LINVILLE COO 40.00 X 110972 0 5884 CHAD HOVIS CFO 40.00 X 162538 0 6584 TERRI CASTLE CNO 40.00 X 105611 0 4031 DAVID GRESHAM CDO 40.00 X 132296 0 6147 VIRGIL UNDERWOOD CEO 40.00 X 229381 0 8404 ZIAD CHANAA DOCTOR 40.00 X 160160 0 3084 SHANE EDWARD COOK DOCTOR 40.00 X 201021 0 7233 ANGELIA DAWN SLACK CERTIFIED REGISTERED NURSE ANESTHETIST 40.00 X 181533 0 3084 AMY P SAYRE DOCTOR 40.00 X 191745 0 3084 KEVIN HILL PHYSICIAN EXTENDER DIRECTOR 40.00 X 201311 0 6407 SHAWN D REINERT DOCTOR 40.00 X 261989 0 9023 KENNETH CHADWIC ADKINS DOCTOR 40.00 X 300576 0 9307 MICHAEL VB BLEDSOE DOCTOR 40.00 X 334731 0 10384 PHILIP TODD BERRY DOCTOR 40.00 X 363255 0 5834 CASEY SHAUN HAGER DOCTOR 40.00 X 544577 0 9646 MELISSA ANN PRICE ADVANCE PRACTICE REGISTERED NURSE 40.00 X 129509 0 5514 KATHY HILL DIRECTOR OF EMPLOYEE HEALTH, WELLNESS AND EDU 40.00 X 140476 0 5767 JOSEPH WRIGHT PHARMACIST 40.00 X 148101 0 6834 HEATHER KAYE ROBINSON PHYSICIAN ASSISTANT 40.00 X 126649 0 0 KELLI D CANTERBURY ADVANCE PRACTICE REGISTERED NURSE 40.00 X 122727 0 1495 4149158 0 117746 24 0 1 0 CARDINAL HEALTH LLC 7000 CARDINAL PLACE DUBLIN OH 43017 HEALTHCARE 2449363 CPSI PO BOX 850309 MOBILE AL 36685 SYSTEM SOFTWARE VENDOR 1635938 THE EMPLOYEE BENEFIT SERVICE COMPANY 4430 KANAWHA TURNPIKE SOUTH CHARLESTON WV 25309 EMPLOYEE BENEFIT SERVICE 1497593 REHAB ONE LTD 1834 PARK AVE BELLE WV 25015 PHYSICAL THERAPY SERVICES 1137158 THE HEALTH PLAN 1110 MAIN ST WHEELING WV 26003 BENEFITS ADMINISTRATOR 944948 36 2302516 62040 2364556 PATIENT SERVICE REVENUE 622110 44802552 44802552 340B PROGRAM REVENUE 900099 1909559 1909559 DIETARY SALES 900099 171683 171683 PHARMACY 446110 67801 67801 EHR INCENTIVE 900099 7203 7203 46958798 281889 281889 9530 0 9530 9530 9530 147396 36293 111103 111103 111103 OTHER REVENUE 900099 166683 166683 166683 49892559 46958798 0 569205 X 3481696 3481696 17023510 17023510 2316472 2060131 256341 295464 266433 29031 1216390 1058806 157584 247619 247619 6109002 4314092 1794910 142176 142176 892789 730436 162353 164638 153846 10792 759117 640813 118304 225272 153338 71934 1176917 1176917 2723791 2723791 585628 585628 MEDICAL SUPPLIES 7338065 7338065 BAD DEBT EXPENSE 1033706 1033706 PROVIDER TAX 962274 962274 CHARITY CARE EXPENSE 285162 285162 287353 281091 6262 47267041 40788039 6472740 6262 2293815 14643881 9390587 8901957 3984505 3616770 168774 76248 709501 914384 185824 96718 44672982 12695056 33719026 31977926 779856 837748 51231888 61065632 3852204 9551373 70000 2542247 33362020 32845157 2017339 3252655 788989 40536879 47745105 X 10695009 13320527 10695009 13320527 51231888 61065632 2625518 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1066373 570191 1636564 404472 661901 1066373 308927 308927 32173555 6798042 25375513 8077842 5192089 2885753 4112658 704925 3407733 31977926 OTHER LIABILITIES 788989 788989 X 48573691 0 48573691 1318868 1318868 49892559 45948173 0 45948173 1318868 1318868 47267041 PART X, LINE 2: THE HOSPITAL IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THEREFORE IS NOT SUBJECT TO FEDERAL INCOME TAX UNDER CURRENT INCOME TAX REGULATIONS. CURRENT ACCOUNTING STANDARDS DEFINE THE THRESHOLD FOR RECOGNIZING UNCERTAIN INCOME TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS, AND ALSO PROVIDE GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES THERE IS NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS RELATED TO UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,033,706. CHARITY CARE EXPENSE NETTED AGAINST REVENUE 285,162. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,033,706. CHARITY CARE EXPENSE NETTED AGAINST REVENUE 285,162. 1 1 X 1 X 1 X 240.000000000000 1 0 0 32735 32735 0.00070 19618912 12078707 7540205 0.15950 19651647 12078707 7572940 0.16020 19651647 12078707 7572940 0.16020 1 1033706 537527 6407313 8894072 -2486759 X 1 1 1 1 BOONE MEMORIAL HOSPITAL INC 701 MADISON AVENUE MADISON WV 25130 WWW.BMH.ORG X X X X TWO RURAL HEALTH CLINICS, SNF/NF BEDS BOONE MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X 19 1 0 0 1 X WWW.BMH.ORG X 1 19 1 WWW.BMH.ORG 0 1 X 100.000000000000 240.000000000000 X X X X 1 1 X X X 1 X HTTP://MEDIA.WIX.COM/UGD/3F447F_7F16F4D8221B4AEB80861E83ADF1F875.PDF X HTTP://MEDIA.WIX.COM/UGD/3F447F_F78C6D10EE0D43D8915549467626C606.PDF X HTTP://MEDIA.WIX.COM/UGD/3F447F_D54B7CF9599D4B35B28620AA527B698F.PDF X X X X X 1 X 0 X X X X 1 X 0 0 BOONE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: THE BMH PROJECT TEAM COMPLETED THE COMMUNITY NEEDS ASSESSMENT USING THE FOLLOWING STRATEGIES:-ASSEMBLED AN ADVISORY PANEL COMPRISED OF REPRESENTATIVES FROM COMMUNITY LEADERS, HEALTH CARE PROVIDERS, AND LOCAL CITIZENS TO ASSIST WITH THE ASSESSMENT PROCESS.-CONDUCTED PRIMARY DATA COLLECTION THROUGH SURVEYS OF PROVIDERS, KEY INFORMANTS, AND THE GENERAL POPULATION. PHONE INTERVIEWS WERE ALSO CONDUCTED.-COLLECTED SECONDARY DATA SOURCES SUCH AS INFORMATION FROM THE BOONE COUNTY HEALTH DEPARTMENT COMMUNITY NEEDS ASSESSMENT, STATE HEALTH STATISTICS AND BEHAVIORAL RISK ASSESSMENTS, US CENSUS DATA, CENTERS FOR DISEASE CONTROL STATISTICS AND DATA, ETC.-CREATED A COMPREHENSIVE DATABASE INCLUDING ANSWERS TO EACH SURVEY QUESTION WHICH WAS USED TO TRACK AND CALCULATE THE DATA.-HELD FOCUS GROUPS, SOME OF WHICH INCLUDED YOUTH REPRESENTATION IN ORDER TO OBTAIN A DIVERSE RANGE OF RESPONSES IN AN OPEN DISCUSSION FORMAT. BOONE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: BOONE MEMORIAL HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN THAT ADDRESSED THE MAJORITY OF THE SIGNIFICANT COMMUNITY NEEDS IDENTIFIED IN THE CHNA. THE AREAS ADDRESSED INCLUDED ALCOHOL AND DRUG ABUSE, DRUNK DRIVING AND LACK OF RECREATIONAL PROGRAMS. THE HOSPITAL SPONSORED MULTIPLE COMMUNITY EVENTS/EDUCATIONAL SEMINARS THAT INCLUDED HEALTH FAIRS, MONTHLY DIABETIC EDUCATIONAL CLASSES, DRUG AND ALCOHOL ABUSE PREVENTION FORUMS AND A LOW COST FITNESS CENTER PROGRAM FOR THE COMMUNITY. AS WITH MOST HEALTH CARE FACILITIES, WE HAVE LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES. BOONE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16J: THE FOLLOWING MEASURES ARE USED TO PUBLICIZE THE FINANCIAL ASSISTANCE AVAILABLE FROM BMH TO THE COMMUNITY AND PATIENTS IN ACCORDANCE WITH FEDERAL AND STATE LAW:A. PROVIDING INFORMATION WHEN A PATIENT CALLS BMH AT (304) 369-1230;B. ANNUALLY POSTING AN ARTICLE IN A NEWSPAPER OF LOCAL CIRCULATION AND/OR OTHER MEANS AS DEEMED REASONABLY NECESSARY;D. POSTING OF A NOTICE IN THE EMERGENCY DEPARTMENT ADMITTING AREAS AND BUSINESS OFFICES AT BMH; AND/ORE. FINANCIAL COUNSELORS VISITING WITH BMH INPATIENTS. PART I, LINE 3C: PATIENTS MUST PROVIDE THEIR "TOTAL YEARLY INCOME" IN ORDER TO BE CONSIDERED FOR FINANCIAL ASSISTANCE.A. ADULTS: IF THE PATIENT IS AN ADULT, THE TERM "TOTAL YEARLY INCOME" MEANS THE SUM OF THE TOTAL YEARLY GROSS INCOME OF THE PATIENT AND THE PATIENT'S SPOUSE.B. MINORS: IF THE PATIENT IS A MINOR, THE TERM "TOTAL YEARLY INCOME" MEANS THE SUM OF THE TOTAL YEARLY GROSS INCOME OF THE PATIENT, THE PATIENT'S MOTHER AND THE PATIENT'S FATHER. THE PATIENT, IMMEDIATE FAMILY MEMBER OR PATIENT REPRESENTATIVE SHALL VERIFY THE PATIENT'S REPORTED TOTAL YEARLY INCOME, AS PROVIDED ON THE APPLICATION. THE TOTAL YEARLY INCOME MAY BE VERIFIED THROUGH ANY OF THE FOLLOWING MECHANISMS:A. INCOME INDICATORS. BY THE PROVISION OF THIRD PARTY FINANCIAL DOCUMENTATION INCLUDING IRS FORM W-2, WAGES AND TAX STATEMENT; PAY CHECK REMITTANCE; INDIVIDUAL TAX RETURN; TELEPHONE VERIFICATION BY EMPLOYER; BANK STATEMENTS; SOCIAL SECURITY PAYMENT REMITTANCE; WORKER'S COMPENSATION PAYMENT REMITTANCE; UNEMPLOYMENT INSURANCE PAYMENT NOTICE; UNEMPLOYMENT COMPENSATION DETERMINATION LETTERS; OR OTHER APPROPRIATE INDICATORS OF THE PATIENT'S TOTAL YEARLY INCOME. B. PARTICIPATION IN A BENEFIT PROGRAM. BY THE PROVISION OF DOCUMENTATION SHOWING CURRENT PARTICIPATION IN A PUBLIC BENEFIT PROGRAM SUCH AS MEDICAID; FOOD STAMPS; WIC; OR OTHER SIMILAR MEANS TESTED PROGRAMS. PROOF OF PARTICIPATION IN ANY OF THE ABOVE PROGRAMS INDICATES THAT THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENT AND THEREFORE, IS NOT REQUIRED TO PROVIDE HIS OR HER INCOME ON THE ASSISTANCE APPLICATION.C. IN CASES WHERE THE PATIENT OR RESPONSIBLE PARTY IS UNABLE TO PROVIDE THIRD PARTY VERIFICATION OF PATIENT'S TOTAL YEARLY INCOME, VERIFICATION OF THE PATIENT'S TOTAL YEARLY INCOME CAN BE DONE IN EITHER OF THE FOLLOWING WAYS:1. OBTAINING THE PATIENT'S OR RESPONSIBLE PARTY'S WRITTEN ATTESTATION. BY OBTAINING AN APPLICATION SIGNED BY THE PATIENT OR RESPONSIBLE PARTY ATTESTING TO THE VERACITY OF THE PATIENT'S TOTAL YEARLY INCOME INFORMATION PROVIDED: OR 2. OBTAINING THE PATIENT'S OR RESPONSIBLE PARTY'S VERBAL ATTESTATION. THROUGH THE WRITTEN ATTESTATION OF THE BMH EMPLOYEE COMPLETING THE ASSISTANCE APPLICATION THAT THE PATIENT OR RESPONSIBLE PARTY VERBALLY VERIFIED THE PATIENT'S TOTAL YEARLY INCOME INFORMATION PROVIDED. 3. IN INSTANCES WHERE THE PATIENT OR RESPONSIBLE PARTY IS UNABLE TO PROVIDE THE REQUESTED THIRD PARTY VERIFICATION OF PATIENT'S TOTAL YEARLY INCOME, THE PATIENT OR RESPONSIBLE PARTY IS REQUIRED TO PROVIDE A REASONABLE EXPLANATION OF WHY THE PATIENT OR RESPONSIBLE PARTY IS UNABLE TO PROVIDE THE REQUIRED THIRD PARTY VERIFICATION. SOUND BUSINESS PRACTICES WILL BE EMPLOYED TO VERIFY PATIENT'S ATTESTATION AND SUPPORTING INFORMATION. UNMARRIED EXPIRED PATIENTS MAY BE DEEMED TO HAVE NO INCOME FOR PURPOSES OF CALCULATION OF TOTAL YEARLY INCOME. DOCUMENTATION OF TOTAL YEARLY INCOME IS NOT REQUIRED FOR EXPIRED PATIENTS; HOWEVER, DOCUMENTATION OF ESTATE ASSETS MAY BE REQUIRED. IF AN EXPIRED PATIENT IS MARRIED, THE SURVIVING SPOUSE MAY APPLY FOR FINANCIAL ASSISTANCE. PATIENTS, IMMEDIATE FAMILY MEMBERS OR PATIENT REPRESENTATIVES APPLYING FOR FINANCIAL ASSISTANCE MUST VERIFY THE NUMBER OF PEOPLE IN THE PATIENT'S HOUSEHOLD "NUMBER IN HOUSEHOLD").A. ADULTS: IN CALCULATING THE NUMBER IN HOUSEHOLD, INCLUDE THE PATIENT, THE PATIENT'S SPOUSE, AND ANY DEPENDENTS (AS DEFINED BY THE INTERNAL REVENUE CODE). B. MINORS: IN CALCULATING THE NUMBER IN HOUSEHOLD, INCLUDE THE PATIENT, THE PATIENT'S MOTHER, THE PATIENT'S FATHER, DEPENDENTS OF THE PATIENT'S MOTHER, AND DEPENDENTS OF THE PATIENT'S FATHER. DURING THE VERIFICATION PROCESS, WHILE INFORMATION TO DETERMINE A PATIENT'S TOTAL YEARLY INCOME IS BEING COLLECTED, THE PATIENT MAY BE TREATED AS A PRIVATE PAY PATIENT. PART III, LINE 2: COST OF BAD DEBT AS REPORTED ON AUDITED FINANCIAL STATEMENTS. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTIBILITY. MANAGEMENT ALSO REVIEWS TROUBLED, AGED ACCOUNTS TO DETERMINE COLLECTION POTENTIAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE MEDICARE CARE COST REPORT FOR THE PERIOD ENDED 6/30/20. PART III, LINE 9B: AFTER THE PATIENT'S ACCOUNT IS REDUCED BY THE DISCOUNTS BASED ON THE FINANCIAL ASSISTANCE ELIGIBILITY DISCOUNT GUIDELINES, THE PATIENT IS RESPONSIBLE FOR THE REMAINDER OF THEIR OUTSTANDING ACCOUNT. PATIENTS WILL BE INVOICED FOR ANY REMAINING AMOUNTS IN ACCORDANCE WITH OTHER BMH DEBT COLLECTION POLICIES REGARDING THIS MATTER. PART VI, LINE 2: THE BMH PROJECT TEAM COMPLETED THE COMMUNITY NEEDS ASSESSMENT USING THE FOLLOWING STRATEGIES:-ASSEMBLED AN ADVISORY PANEL COMPRISED OF REPRESENTATIVES FROM COMMUNITY LEADERS, HEALTH CARE PROVIDERS, AND LOCAL CITIZENS TO ASSIST WITH THE ASSESSMENT PROCESS.-CONDUCTED PRIMARY DATA COLLECTION THROUGH SURVEYS OF PROVIDERS, KEY INFORMANTS, AND THE GENERAL POPULATION. PHONE INTERVIEWS WERE ALSO CONDUCTED.-COLLECTED SECONDARY DATA SOURCES SUCH AS INFORMATION FROM THE BOONE COUNTY HEALTH DEPARTMENT COMMUNITY NEEDS ASSESSMENT, STATE HEALTH STATISTICS AND BEHAVIORAL RISK ASSESSMENTS, US CENSUS DATA, CENTERS FOR DISEASE CONTROL STATISTICS AND DATA, ETC.-CREATED A COMPREHENSIVE DATABASE INCLUDING ANSWERS TO EACH SURVEY QUESTION WHICH WAS USED TO TRACK AND CALCULATE THE DATA.-HELD FOCUS GROUPS, SOME OF WHICH INCLUDED YOUTH REPRESENTATION IN ORDER TO OBTAIN A DIVERSE RANGE OF RESPONSES IN AN OPEN DISCUSSION FORMAT. PART VI, LINE 3: MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY:THE FOLLOWING MEASURES ARE USED TO PUBLICIZE THE FINANCIAL ASSISTANCE AVAILABLE FROM BMH TO THE COMMUNITY AND PATIENTS IN ACCORDANCE WITH FEDERAL AND STATE LAW: A. POSTING ON THE BMH WEBSITE AT THE FOLLOWING LOCATION: WWW.BMH.ORG; B. PROVIDING INFORMATION WHEN A PATIENT CALLS BMH AT (304) 369-1230; C. ANNUALLY POSTING AN ARTICLE IN A NEWSPAPER OF LOCAL CIRCULATION AND/OR OTHER MEANS AS DEEMED REASONABLY NECESSARY; D. POSTING OF A NOTICE IN THE EMERGENCY DEPARTMENT ADMITTING AREAS AND BUSINESS OFFICES AT BMH; AND/OR E. FINANCIAL COUNSELORS VISITING WITH BMH INPATIENTS. PART VI, LINE 4: BMH SERVES PRIMARILY BOONE COUNTY, WV AND PORTIONS OF LOGAN AND LINCOLN COUNTIES IN WV.BOONE COUNTY HAD AN ESTIMATED POPULATION OF 24,224 IN 2013. THE MEDIAN HOUSEHOLD INCOME WAS $41,359 WITH 18.9% BELOW THE FEDERAL POVERTY GUIDELINE. 15% OF THE POPULATION IS OVER 65 AND 28.9% IS UNDER 18 WITH 40.7 YEARS AS THE MEDIAN AGE. 79% OF THE HOSPITAL'S PATIENTS WERE FROM BOONE COUNTY IN FY 13. PART VI, LINE 5: EACH MEMBER OF THE BOARD OF TRUSTEES IS A LOCAL, LIFELONG BOONE COUNTY RESIDENT. THE ER IS ALWAYS AVAILABLE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. BOONE MEMORIAL HAS MADE THE MOST RECENT COMMUNITY NEEDS ASSESSMENT REPORT AVAILABLE ON ITS WEBSITE FOR ALL PATIENTS TO HAVE EASY ACCESS TO READ. BMH OFFERS PATIENTS ACCESS TO OUR OWN MRI SEVEN DAYS A WEEK INSTEAD OF HAVING TO TRAVEL TO OTHER LARGER HOSPITALS IN CHARLESTON OR LOGAN. MOST OTHER CRITICAL ACCESS HOSPITALS IN WV ONLY OFFER A MOBILE MRI SERVICE ONE OR TWO DAYS A WEEK. WE HAVE A FULLY DIGITAL RADIOLOGY DEPARTMENT WITH A PACS SYSTEM. OUR LAB HAS JUST RECENTLY EXPANDED TO INCORPORATE ADDITIONAL TESTING EQUIPMENT. WE ALSO OPERATE TWO RHCS WITH EXTENDED HOURS (ONE HAS SATURDAY HOURS) TO HELP SERVE THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES WV X 0 0 0 0 0 0 0 0 0 CHAD HOVIS CFO 162538 0 0 0 0 0 3500 0 3084 0 169122 0 0 0 VIRGIL UNDERWOOD CEO 229381 0 0 0 0 0 5320 0 3084 0 237785 0 0 0 ZIAD CHANAA DOCTOR 160160 0 0 0 0 0 0 0 3084 0 163244 0 0 0 SHANE EDWARD COOK DOCTOR 201021 0 0 0 0 0 4149 0 3084 0 208254 0 0 0 ANGELIA DAWN SLACK CERTIFIED REGISTERED NURSE ANESTHETI 181533 0 0 0 0 0 0 0 3084 0 184617 0 0 0 AMY P SAYRE DOCTOR 191745 0 0 0 0 0 0 0 3084 0 194829 0 0 0 KEVIN HILL PHYSICIAN EXTENDER DIRECTOR 201311 0 0 0 0 0 3323 0 3084 0 207718 0 0 0 SHAWN D REINERT DOCTOR 261989 0 0 0 0 0 5939 0 3084 0 271012 0 0 0 KENNETH CHADWIC ADKINS DOCTOR 300576 0 0 0 0 0 6223 0 3084 0 309883 0 0 0 MICHAEL VB BLEDSOE DOCTOR 334731 0 0 0 0 0 7300 0 3084 0 345115 0 0 0 PHILIP TODD BERRY DOCTOR 363255 0 0 0 0 0 2750 0 3084 0 369089 0 0 0 CASEY SHAUN HAGER DOCTOR 544577 0 0 0 0 0 6562 0 3084 0 554223 0 0 0 JOSEPH WRIGHT PHARMACIST 148101 0 0 0 0 0 3750 0 3084 0 154935 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO WILL REVIEW THE FORM 990 FOR ACCURACY PRIOR TO FILING WITH THE IRS. A COPY OF THE FINAL FORM 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE IS ENFORCED AND MONITORED WHEN TRUSTEES RECUSE THEMSELVES ON CONFLICT OF INTEREST ISSUES FORM 990, PART VI, SECTION B, LINE 15A AN OUTSIDE FIRM IS CONSULTED. THE CEO PRESENTS RECOMMENDATIONS TO THE BOARD. THE BOARD WILL HOLD AN EXECUTIVE SESSION AND DECIDE THE CEO'S COMPENSATION FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,160,868. MANAGEMENT AND GENERAL EXPENSES 1,765,195. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,926,063. CONTRACT FEES: PROGRAM SERVICE EXPENSES 2,558. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,558. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 150,666. MANAGEMENT AND GENERAL EXPENSES 29,715. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,381. FORM 990, PART XII, LINE 2C: THE OVERSIGHT PROCESS FOR THE AUDIT OF THE FINANCIAL STATEMENTS HAS NOT CHANGED DURING THE TAX YEAR.