2020-10-20T11:53:57-05:00 2019-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2019-01-01 310929576 KNOX COMMUNITY HOSPITAL KNOX 7403939623 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 MICHAEL AMBROSIANI CFO 7403939623 2020-10-20 1 NATHAN A RODGERS CPA P01568275 3176334705 2020-10-20 47.227.233.166 2020-10-20 10:59:34 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CF253C16AA79457DBB141110F0942FA5491417DB 2019 2021-01-29 14:40:06Z BRUCE D WHITE 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 212264368 0 X WWW.KCH.ORG X 1977 OH TO PROVIDE COMPASSIONATE HEALTHCARE SERVICE THAT EXCEEDS THE EXPECTATIONS OF OUR COMMUNITY 15 10 1384 80 24437 4495 2259958 3121380 165660171 174714294 2692431 3136196 5842649 8318882 176455209 189290752 17084 19100 0 0 92650432 102716393 0 0 0 71236485 71653281 163904001 174388774 12551208 14901978 197998617 241963902 42652708 64695954 155345909 177267948 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 131610340 19100 182332903 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 2019 THE HOSPITAL HAD 3,123 INPATIENT ADMISSIONS, 24,701 ER VISITS, 149,482 OUTPATIENT VISITS, 77,930 RADIOLOGY PROCEDURES, AND 6,538 INPATIENT & OUTPATIENT SURGERIES (INCLUDING ENDOSCOPIES). AT THE END OF 2019, THE HOSPITAL HAD 57 EMPLOYED PHYSICIANS WITH 161,419 OFFICE CLINIC VISITS.IN 2019, KNOX COMMUNITY HOSPITAL PRESENTED A VARIETY OF EDUCATION EVENTS ATTENDED BY MEMBERS OF OUR COMMUNITY. FREE MONTHLY SCREENINGS CONTINUED AT NO COST AND WERE UTILIZED AS FOLLOWS:652 BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS AND GLUCOSE SCREENINGS. 650 COLORECTAL CANCER SCREENING KITS WERE DISTRIBUTED WITH 127 KITS RETURNED FOR PROCESSING. WE CONTINUE TO OFFER SUPPORT GROUPS FOR PARKINSON'S DISEASE, BREAST CANCER, YOUNG BREAST CANCER SURVIVORS, CANCER AND DIABETES. THE EDUCATION DEPARTMENT CONTINUES TO OFFER FAMILY & FRIENDS CPR CLASSES. ACTIVE SHOOTER (ALICE) TRAINING WAS PROVIDED TO 12 LOCAL INDIVIDUALS AT NO CHARGE. ADVANCE DIRECTIVE/LIVING WILL ASSISTANCE AND FREE NOTARY SERVICE WAS PROVIDED TO APPROXIMATELY 115 PEOPLE. EDUCATIONAL COLUMNS ARE SUPPLIED TO THE LOCAL NEWSPAPER COVERING TIMELY TOPICS OF INTEREST SUCH AS FLU, ANTIMICROBIAL STEWARDSHIP AND CONCUSSION THERAPY, TO NAME A FEW.AS PARTNERS WITH AREA NURSING SCHOOLS, WE PROVIDED CLINICAL SUPERVISION AND PRECEPTING TO STUDENTS FOR OVER 10,194.5 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 APPLIED FOR AND RECEIVED FUNDS FROM THE SUSAN G. KOMEN FOUNDATION TO PROVIDE SCREENING MAMMOGRAMS AND FOLLOW UP CARE AS NEEDED FOR 250 WOMEN WHO ARE UNINSURED OR UNDERINSURED. KCH PROVIDES THE COMMUNITY AT LARGE WITH 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 STEADY AT 11 PERCENT. KNOX COMMUNITY HOSPITAL RECOGNIZES THE NEED FOR EDUCATION AND SCREENINGS TO SERVE THIS POPULATION. IN 2019, WE OFFERED WELL-PUBLICIZED FREE MONTHLY GLUCOSE SCREENINGS. THE OBVIOUS NEED TO SERVE THE POPULATION WITH DIABETES HAS LED TO A RESTRUCTURING OF OUR DIABETES PROGRAMS WITH IMPLEMENTATION BEGINNING IN 2018 WITH INFORMATION PRESENTED AT: BELLVILLE LION'S HEALTH FAIR, TOPS MONTHLY PROGRAM, ARIEL HEALTH FAIR, EDUCATIONAL PROGRAMS AT THE YMCA, SENIOR TASK FORCE HEALTH FAIR AND GROCERY TOURS AS WELL AS COUNSELLING 202 IN-PATIENTS AND 85 OUT-PATIENTS.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 80 CONTRIBUTED 15,686 HOURS IN 2019.OUR COMMUNITY CARE NETWORK COORDINATOR ASSISTED WITH A VARIETY OF COMMUNITY EDUCATION EVENTS, SUCH AS: YMCA YOUTH ENRICHMENT PROGRAM, GARDENING FOR BETTER HEALTH, KIDS TO THE PARK DAY, YOUTH FISHING DERBY, HIAWATHA PARK PROGRAM, HUMAN TRAFFICKING, SWARM THE CITY COMMUNITY SERVICE FOR MIDDLE SCHOOL STUDENTS, MANY MORE. 131610340 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 206 0 1 1384 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X MICHAEL AMBROSIANI 7403939623 1330 COSHOCTON RD MT VERNON OH 43050 IAN WATSON PRESIDENT 5.00 0.00 X X 0 0 0 SAM BARONE VICE PRESIDENT 2.00 0.00 X X 0 0 0 CHARLES BRENNEMAN SECRETARY 2.00 0.00 X X 0 0 0 THOMAS R FOSNAUGHT TREASURER 2.00 0.00 X X 0 0 0 JEFFERY BOUCHER TRUSTEE 1.50 0.00 X 0 0 0 CAROL DOROUGH TRUSTEE 1.50 0.00 X 0 0 0 JOAN JONES TRUSTEE 1.50 0.00 X 0 0 0 KOREY KIDWELL TRUSTEE 1.50 0.00 X 0 0 0 THOMAS D MCKINLEY MD TRUSTEE 40.00 0.00 X 339092 0 54605 AMY D MURNEN MD TRUSTEE 40.00 0.00 X 242470 0 28993 MARC ODENWELLER TRUSTEE 1.50 0.00 X 0 0 0 MARK RAMSER TRUSTEE 1.50 0.00 X 0 0 0 VICKIE SANT TRUSTEE 1.50 0.00 X 0 0 0 MICHAEL SULLIVAN MD TRUSTEE 40.00 0.00 X 511067 0 55574 JAN THOMAS TRUSTEE 1.50 0.00 X 0 0 0 BRUCE WHITE CEO 40.00 0.00 X 346500 0 89397 MICHAEL AMBROSIANI CFO 40.00 0.00 X 236093 0 60912 BRUCE BEHNER COO 40.00 0.00 X 236093 0 60912 JEFFREY C NORTHUP CHIEF MEDICAL OFFICER 40.00 0.00 X 364136 0 24506 CAROL N EMERY CHIEF NURSING OFFICER 40.00 0.00 X 150224 0 26672 GREGORY CUSH ORTHOPAEDIC SURGEON 40.00 0.00 X 1174715 0 53831 JARRETT B HELMING ORTHOPAEDIC SURGEON 40.00 0.00 X 898169 0 55574 CHRISTOPHER HETRICK ENT-OTOLARYNGOLOGIST 40.00 0.00 X 872615 0 32825 KENNETH H DOOLITTLE II ORTHOPAEDIC SURGEON 40.00 0.00 X 852756 0 38069 BARRY S GEORGE INVASIVE-INTERVENTIONAL CARDIOLOGIST 40.00 0.00 X 845167 0 55549 7069097 0 637419 108 0 1 0 ORIGIN INC PO BOX 70870 ST PAUL MN 551709705 STAFFING AGENCY 1718022 ALLSCRIPTS LLC 24630 NETWORK PLACE CHICAGO IL 606731246 SOFTWARE COMPANY 1535301 PREMIER UROLOGY CORP PO BOX 677 LEWIS CENTER OH 43035 UROLOGY SERVICES 1181233 ROSSMAN & COPCB PO BOX 2051 NEW ALBANY OH 43054 COLLECTION SERVICES FOR SELF-PAY PATIENT 1116823 NATIONAL WOUND CARE & HYPERBARIC SERVICE 28525 NETWORK PLACE CHICAGO IL 60673 MANAGEMENT SERVICES FOR WOUND TREATMENT 815399 49 3121380 9652 3121380 PATIENT SERVICE REVENU 621110 174714294 174714294 174714294 2076447 2076447 43853 0 43853 43853 43853 23945629 22721776 164104 1223853 -164104 1059749 1059749 10302 0 10302 10302 96066 87736 8330 8330 340B PHARMACY REVENUE 900099 4388281 4388281 FOOD AND NUTRITION 900099 482006 482006 JOINT VENTURES 900099 417967 417967 2968143 2812361 24437 131345 8256397 189290752 182332903 24437 3812032 X 19100 19100 2827247 2827247 77476650 63228694 14247956 5212637 4254033 958604 17199859 14036805 3163054 328914 328914 54447 54447 19961126 11986656 7974470 332323 332323 1856965 1703765 153200 3010829 3010829 2834082 182515 2651567 231322 111312 120010 161783 77850 83933 925075 925075 7746138 3363373 4382765 936314 171626 764688 DRUGS AND SUPPLIES 26791941 26791941 MEDICAL PROFESSIONAL FE 4133748 4133748 BOOKS & SUBSCRIPTIONS 467569 308409 159160 DUES AND LICENSES 183656 121139 62517 1697049 1119374 577675 174388774 131610340 42778434 0 21578 23660 6987752 19595079 23880900 27932894 1854698 1826716 3397705 3506512 170998020 82387856 63921435 88610164 85037415 91228833 380452 324413 12516682 8915631 197998617 241963902 13200274 14497919 29273569 50019170 178865 178865 42652708 64695954 X 145734572 165346226 9611337 11921722 155345909 177267948 197998617 241963902 X 14901978 9871730 -2851669 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5149 5149 0 PART II-B, LINE 1: PORTION OF ANNUAL MEMBERSHIP DUES TO OHA AND AHA PAID TO TRADE ASSOCIATIONS WITH A PORTION OF DUES ALLOCATED TO LOBBYING EXPENDITURES. 11744367 3053809 -2851669 24785 11921722 10993805 2198503 -1386486 61455 11744367 808451 49147 10199771 63564 10993805 1154167 100926 -355414 91228 808451 222929 86764 911462 66988 1154167 1.00000 0 0 773930 773930 62594688 32877133 29717555 767511 727870 39641 72848784 48782853 24065931 34013107 34013107 88610164 LEASEHOLD DEPOSITS 178865 178865 X PART V, LINE 4: THE HOSPITAL'S RESTRICTED FUNDS ARE USED FOR MINOR EXPENSES RELATING TO CARE FOR INDIGENT PATIENTS AND KOMEN AND HRSA GRANT FUNDS USED FOR THE HOSPITAL. 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, 2019 AND 2018, 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 2319230 665644 1653586 0.00950 21796714 13679499 8117215 0.04650 24115944 14345143 9770801 0.05600 110344 583540 900 582640 0.00330 110 1224518 1224518 0.00700 67263 67263 0.00040 47312 47312 0.00030 110454 1922633 900 1921733 0.01100 110454 26038577 14346043 11692534 0.06700 1924 1924 0.00000 2886 2886 0.00000 4810 4810 0.00000 1 10738059 38842593 42393612 -3551019 X 1 1 1 KNOX DIAGNOSTIC IMAGING LLC MEDICAL SERVICES/ECHOCARDIOLOGY SERVICES 0.50000 0.03610 0.35570 1 1 KNOX COMMUNITY HOSPITAL 1330 COSHOCTON RD MOUNT VERNON OH 43050 WWW.KNOXCOMMHOSP.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 18 1 0 1 1 X HTTPS://WWW.KCH.ORG/HEALTH-NEEDS-ASSESSMENT X 1 18 1 HTTPS://WWW.KCH.ORG/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 2018 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 2018 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 2018.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 SIXTEEN 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 18 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 2018 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 2019, KCH CONTINUED TO ADDRESS THE SPECIFIC HEALTH NEEDS IDENTIFIED BY THE CHNA:1. CHRONIC DISEASE:A. 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.2. MENTAL HEALTH:A. SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO EXPAND MENTAL HEALTH FIRST AID TRAININGS.B. 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. SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE CONTINUING EDUCATION FOR PRIMARY CARE AND SUBSTANCE ABUSE DISORDER PROVIDERS.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. SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE AWARENESS AND AVAILABILITY OF BIRTH CONTROL.C. SUPPORT KNOX HEALTH PLANNING PARTNERSHIP EFFORTS TO INCREASE SEXUAL HEALTH EDUCATION AND PREVENTION.THE CREATION OF THE 2018 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 2019 IRS INSTRUCTIONS FOR SCHEDULE H. PART II, COMMUNITY BUILDING ACTIVITIES: 652 BP, CHOLESTEROL AND GLUCOSE SCREENINGS AT FREE MONTHLY SCREENINGS 2 CANCER NURSE NAVIGATORS PROVIDE SERVICE AT NO COST TO CANCER PATIENTS PROGRAMS AND EDUCATION PROVIDED BY THE BREAST HEALTH NAVIGATOR TO 250 WOMEN650 COLORECTAL CANCER KITS DISTRIBUTED, 127 RETURNED FOR ANALYSIS COMMUNITY EDUCATION CLASSES CONTINUED FOR FAMILY AND FRIENDS CPR ADVANCE DIRECTIVE/LIVING WILL ASSISTANCE AND FREE NOTARY SERVICE WAS PROVIDED TO APPROXIMATELY 115 PEOPLE10,194.5 HOURS CLINICAL SUPERVISION AND PRECEPTING TO STUDENTSIN 2019, KNOX COMMUNITY HOSPITAL PRESENTED A VARIETY OF EDUCATION EVENTS ATTENDED BY MEMBERS OF OUR COMMUNITY. 652 BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE FREE MONTHLY SCREENINGS CONTINUED TO BE UTILIZED BY THE COMMUNITY. 650 COLORECTAL CANCER SCREENING KITS WERE DISTRIBUTED WITH 127 KITS RETURNED FOR PROCESSING. WE CONTINUE TO OFFER SUPPORT GROUPS FOR PARKINSON'S DISEASE, BREAST CANCER, YOUNG BREAST CANCER SURVIVORS, CANCER AND DIABETES.THE EDUCATION DEPARTMENT CONTINUES TO OFFER FAMILY & FRIENDS CPR CLASSES, AND PROVIDED ACTIVE SHOOTER (ALICE) TRAINING TO SOME COMMUNITY GROUPS. ADVANCE DIRECTIVE/LIVING WILL ASSISTANCE AND FREE NOTARY SERVICE WAS PROVIDED TO APPROXIMATELY 115 PERSONS. AS PARTNERS WITH AREA NURSING SCHOOLS, WE PROVIDED CLINICAL SUPERVISION AND PRECEPTING TO STUDENTS FOR OVER 10,194.5 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 STEADY AT 11 PERCENT. KNOX COMMUNITY HOSPITAL RECOGNIZES THE NEED FOR EDUCATION AND SCREENINGS TO SERVE THIS POPULATION. IN 2019 WE OFFERED WELL-PUBLICIZED FREE MONTHLY GLUCOSE SCREENINGS. THE OBVIOUS NEED TO SERVE THE POPULATION WITH DIABETES HAS LED TO A RESTRUCTURING OF OUR DIABETES PROGRAMS WITH IMPLEMENTATION BEGINNING IN 2018. 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 80 CONTRIBUTED 15,686 HOURS IN 2019. 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 80% AND 80% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2019 AND 2018, RESPECTIVELY. IN ADDITION, THE HOSPITAL'S PROVISION FOR BAD DEBTS INCREASED APPROXIMATELY $1,358,000 FROM $8,695,000 FOR FISCAL YEAR 2018 TO $10,053,000 FOR FISCAL YEAR 2019. THE HOSPITAL HAS NOT SIGNIFICANTLY CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2019 AND 2018.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 2018, 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 2018 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 2018 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 2018. 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 2019 ESTIMATE OF THE POPULATION OF KNOX COUNTY IS 62,322. THERE ARE APPROXIMATELY 116 PEOPLE PER SQUARE MILE. KNOX COUNTY IS PREDOMINANTLY WHITE, CAUCASIANS COMPRISING 96.6% OF THE POPULATION. CONSIDERED A RURAL AREA OF OHIO, KCH IS THE ONLY HOSPITAL IN KNOX COUNTY.THE MEDIAN HOUSEHOLD INCOME IN 2019 WAS ESTIMATED TO BE $55,131. THE 2019 UNEMPLOYMENT RATE WAS 3.6%, WHICH IS ON PAR WITH THE US RATE FOR THAT PERIOD OF TIME. 13.8% OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY LEVEL. THE PERCENTAGE OF THE POPULATION UNDER 65 WITHOUT INSURANCE IS 8.7%. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 HAS RISEN TO 18.6%. 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.A HEART HEALTHY NURTRITION EVENT WAS HELD WITH 32 INDIVIDUALS IN ATTENDENCE.THE SECOND LEADING CAUSE OF DEATH IN KNOX COUNTY IS CANCER. THE AMERICAN CANCER SOCIETY HAS IDENTIFIED COLORECTAL CANCER AS ONE OF THE 5 MOST COMMON IN KNOX COUNTY. WE OFFER FREE COLORECTAL CANCER SCREENING KITS EACH MARCH. IN 2019, 650 KITS WERE DISTRIBUTED THROUGHOUT THE COUNTY. 127 SAMPLES WERE RETURNED.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 REMAINS AT 11 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 ARE PROVIDED FOR PARKINSON'S DISEASE, CANCER SUPPORT, BREAST CANCER SUPPORT AND DIABETIC 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 2019 WAS ERIC HANSEN, MD, FAMILY MEDICINE; TAMARA HOLZER, DO, SURGERY; KATHLEEN ROGERS, MD, DERMATOLOGY; KAMAL TALUKDER, MD, PEDIATRICS; CHANDRAVADAN PATEL, MD, PSYCHIATRY.WE CONTINUE TO ADD PROVIDERS AND GROW SERVICES IDENTIFIED AS NEEDED WITHIN OUR COMMUNITY.AT A REGULAR TIME EACH MONTH FREE BLOOD PRESSURE CHECKS, GLUCOSE, CHOLESTEROL SCREENINGS ARE OFFERED AT THE URGENT CARE CENTER.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.IN ADDITION, THE NURSING STAFF OF THE HOSPITAL CONTINUES TO OFFER THE FUTURE NURSES CLUB OF KNOX COUNTY, A HIGH SCHOOL CLUB THAT PROVIDES STUDENTS INTERESTED IN CAREERS IN NURSING, GREAT HANDS-ON EXPERIENCE AND INFORMATION ON SELECTING NURSING AS A LIFE CALLING. THE FUTURE NURSES CLUB BEGAN ITS 14TH YEAR IN THE FALL OF 2019.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 93 CONTRIBUTED APPROXIMATELY 16,000 HOURS IN 2019. 1 SCHOLARSHIPS 19 19000 HEALTH CAREER SCHOLARSHIPS PROVIDED TO AREA HIGH SCHOOL GRADUATES PART I, LINE 2: THE KNOX COMMUNITY HOSPITAL AUXILIARY AWARDS HEALTH CAREER SCHOLARSHIPS TO AREA HIGH SCHOOL GRADUATES. ALL APPLICATIONS ARE REVIEWED BY THE AUXILIARY SCHOLARSHIP COMMITTEE; AND RECIPIENTS ARE SELECTED BASED ON THEIR SCHOLASTIC STANDING, COMMUNITY INVOLVEMENT, AND FINANCIAL NEED. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 THOMAS D MCKINLEY MD TRUSTEE 304189 0 34903 0 0 0 19000 0 35605 0 393697 0 0 0 AMY D MURNEN MD TRUSTEE 242470 0 0 0 0 0 19000 0 9993 0 271463 0 0 0 MICHAEL SULLIVAN MD TRUSTEE 511067 0 0 0 0 0 19000 0 36574 0 566641 0 0 0 BRUCE WHITE CEO 339240 0 0 0 7260 0 0 0 89397 0 435897 0 0 0 MICHAEL AMBROSIANI CFO 236093 0 0 0 0 0 0 0 60912 0 297005 0 0 0 BRUCE BEHNER COO 236093 0 0 0 0 0 0 0 60912 0 297005 0 0 0 JEFFREY C NORTHUP CHIEF MEDICAL OFFICER 352059 0 0 0 12077 0 5701 0 18805 0 388642 0 0 0 CAROL N EMERY CHIEF NURSING OFFICER 135680 0 0 0 14544 0 0 0 26672 0 176896 0 0 0 GREGORY CUSH ORTHOPAEDIC SURGEON 500000 0 674715 0 0 0 19000 0 34831 0 1228546 0 0 0 JARRETT B HELMING ORTHOPAEDIC SURGEON 605386 0 292783 0 0 0 19000 0 36574 0 953743 0 0 0 CHRISTOPHER HETRICK ENT-OTOLARYNGOLOGIST 636980 0 235635 0 0 0 19000 0 13825 0 905440 0 0 0 KENNETH H DOOLITTLE II ORTHOPAEDIC SURGEON 787087 0 65669 0 0 0 19000 0 19069 0 890825 0 0 0 BARRY S GEORGE INVASIVE-INTERVENTIONAL CARDIOLOGIST 845167 0 0 0 0 0 19000 0 36549 0 900716 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. CHRISTOPHER HETRICK 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 OTORHINOLARYNGOLOGY. 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. 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. THOMAS MCKINLEY 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 INTERNIST. 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 A 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. 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 $479,169 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 $479,169 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 $479,169 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. QUORUM HEALTH RESOURCES, LLC IS ONE OF THE HOSPITAL'S TOP FIVE INDEPENDENT CONTRACTORS OF WHICH $1,537,784 WAS PAID. OF THIS AMOUNT $818,687 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 INDEPENDENT DIRECTORS PER 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 11,986,656. MANAGEMENT AND GENERAL EXPENSES 7,974,470. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,961,126. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN KNOX COMMUNITY HOSPITAL FOUNDATION -2,851,669. 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. KNOX COMMUNITY PAIN MANAGEMENT LLC 1330 COSHOCTON RD MOUNT VERNON OH 43050 452919911 PAIN MANAGEMENT SERVICES OH N/A RELATED 186110 162429 0 1 0.51000 KNOX DIAGNOSTIC IMAGING CENTER LLC 1330 COSHOCTON RD MOUNT VERNON OH 43050 920179889 MEDICAL SERVICES/ ECHOCARDIOLOGY SERVICES OH N/A RELATED 260218 346915 0 1 0.50000 KCH DEVELOPMENT 1330 COSHOCTON ROAD MOUNT VERNON OH 43050 311193847 MEDICAL BUILDING OH N/A C 158072 1.00000 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 KNOX DIAGNOSTIC IMAGING CENTER LLC J 85866 ACTUAL KNOX DIAGNOSTIC IMAGING CENTER LLC O 429635 ACTUAL KNOX DIAGNOSTIC IMAGING CENTER LLC Q 61108 ACTUAL KNOX COMMUNITY PAIN MANAGEMENT LLC O 490335 ACTUAL KNOX COMMUNITY PAIN MANAGEMENT LLC Q 128120 ACTUAL