2019-05-15T14:57:09-05:00 2018-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2017-07-01 610605336 ST CLAIRE MEDICAL CENTER INC STCL 6067836500 222 MEDICAL CIRCLE MOREHEAD KY 40351 CHRIS MCCLURG VICE PRESIDENT FINANCE/ CFO 6067836500 2019-05-15 1 CARRIE A MERRILL CPA P00832283 3176334705 2019-05-15 165.225.0.63 2019-05-15 14:57:06 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 695A88C1AC8205601D3FA4E9E904369603D6739A 2017 2019-02-21 02:37:17Z ST CLAIRE REGIONAL MEDICAL CENTER MARK J NEFF 222 MEDICAL CIRCLE MOREHEAD KY 40351 149162359 0 X WWW.ST-CLAIRE.ORG X 1963 KY THE MISSION IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KY. 14 11 1733 89 26271 29858 2388875 2401356 135552785 137404264 1196194 1715571 6735096 7071176 145872950 148592367 48767 94120 0 0 86316286 91029824 0 0 0 57104921 57143500 143469974 148267444 2402976 324923 123568615 125648258 66139056 67572699 57429559 58075559 X THE MISSION OF ST. CLAIRE REGIONAL MEDICAL CENTER IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KENTUCKY. 0 0 104306310 111553034 ST. CLAIRE REGIONAL MEDICAL CENTER SERVES AS A 159-BED REGIONAL REFERRAL CENTER AND IS THE LARGEST RURAL HOSPITAL IN NORTHEASTERN KENTUCKY. SPONSORED BY THE SISTERS OF NOTRE DAME IN COVINGTON, KENTUCKY, ST. CLAIRE REGIONAL SERVES AS A NOT-FOR-PROFIT HOSPITAL. WITH NEARLY 1,500 EMPLOYEES, ST. CLAIRE REGIONAL IS THE SECOND-LARGEST EMPLOYER IN THE REGION. THE MEDICAL CENTER IS AN ESTABLISHED TRAINING SITE FOR THE UNIVERSITY OF KENTUCKY SCHOOL OF MEDICINES PHYSICIAN RESIDENCY PROGRAMS. ST. CLAIRE REGIONAL'S MEDICAL STAFF IS COMPRISED OF OVER 100 PHYSICIANS AND SURGEONS, REPRESENTING 31 MEDICAL AND SURGICAL SPECIALTIES.CONTINUE ON SCHEDULE O.IN ADDITION TO PROVIDING SERVICES AT THE MEDICAL CENTER'S MAIN CAMPUS IN MOREHEAD, ST. CLAIRE REGIONAL'S OPERATIONS CONSIST OF A ST. CLAIRE REGIONAL OUTPATIENT CENTER, CAVE RUN SURGICAL SPECIALISTS, MOREHEAD MEDICAL SPECIALISTS, FIVE COMPREHENSIVE FAMILY MEDICINE CLINICS AS WELL AS A FAMILY MEDICINE EXPRESS, A REGIONAL TELEMEDICINE SYSTEM, AND AN EIGHT-COUNTY HOME CARE SERVICE REGION COMPRISED OF HOME HEALTH, HOSPICE & PALLIATIVE CARE, AND HOME MEDICAL EQUIPMENT. ADDITIONALLY, ST. CLAIRE REGIONAL PARTNERS WITH THE UNIVERSITY OF KENTUCKY MEDICAL CENTER TO OFFER SERVICES THROUGH THE KENTUCKY CLINIC MOREHEAD CANCER TREATMENT CENTER.ST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. 13755737 94120 14711423 HOME CAREST. CLAIRE HOMECARE IS A SERVICE PROVIDED BY ST. CLAIRE REGIONAL MEDICAL CENTER OFFERING A FULL RANGE OF HOME CARE SERVICES FOR PATIENTS TO RECOVER IN THEIR OWN HOMES. AS ONE OF THE LARGEST PROGRAMS IN THE STATE, ST. CLAIRE HOMECARE IS A COMPREHENSIVE IN-HOME SERVICE SYSTEM COMPRISED OF HOME HEALTH, HOSPICE, AND HOME MEDICAL EQUIPMENT. OUR COMMITTED STAFF INCLUDES NURSES, THERAPISTS AND AIDES WORKING AS A TEAM TO HELP MEET VIRTUALLY EVERY HOME CARE NEED. THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) ACCREDITS BOTH ST. CLAIRE REGIONAL MEDICAL CENTER AND ST. CLAIRE HOMECARE. ST. CLAIRE HOMECARE IS MEDICARE-CERTIFIED AND LICENSED IN THE STATE OF KENTUCKY. 10509004 11239122 FAMILY MEDICINEST. CLAIRE REGIONAL FAMILY MEDICINE IS A SYSTEM OF FIVE FAMILY MEDICINE CLINICS THAT PROVIDE A FULL RANGE OF PREVENTIVE AND THERAPEUTIC HEALTHCARE SERVICES, FROM NEWBORN TO GERIATRICS, INCLUDING OBSTETRICAL SERVICES. THE ST. CLAIRE REGIONAL FAMILY MEDICINE MEDICAL STAFF INCLUDES BOARD CERTIFIED FAMILY AND INTERNAL MEDICINE PHYSICIANS AS WELL AS ADVANCED REGISTERED NURSE PRACTITIONERS, CERTIFIED PHYSICIAN ASSISTANTS, CERTIFIED NURSE MIDWIVES, AND FAMILY MEDICINE RESIDENTS AFFILIATED WITH THE UNIVERSITY OF KENTUCKY. ST. CLAIRE REGIONAL FAMILY MEDICINE EXPRESS PROVIDES FAST, CONVENIENT WALK-IN TREATMENT FOR A VARIETY OF ROUTINE NON-URGENT MEDICAL SERVICES INCLUDING TREATMENT OF COMMON ILLNESSES, PHYSICAL EXAMS, AND FLU SHOTS. 128571051 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 72 0 1 1733 1 1 1 0 0 0 0 0 0 0 X 14 11 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X CHRIS MCCLURG VP OF FINANCIAL SERVICES 6067836500 222 MEDICAL CIRCLE MOREHEAD KY 40351 SISTER MARLA MONAHAN SND CHAIR 2.00 0.00 X 0 0 0 DAN MARKWELL VICE CHAIR 2.00 0.00 X 0 0 0 ROBERT G STEVENS PAST CHAIRMAN 2.00 0.00 X 0 0 0 JOHN NORTHCUTT MEMBER 2.00 0.50 X 0 0 0 SISTER MARY MARGARET DROEGE SND MEMBER 2.00 0.00 X 0 0 0 JEFFREY L ELLIS MD MEMBER 2.00 0.00 X 0 0 0 ANTHONY E HELTON MEMBER 2.00 0.00 X 0 0 0 GARY J ERMERS MEMBER 2.00 0.00 X 0 0 0 O THOMAS NEWCOMB III MD UROLOGIST 40.00 0.00 X 349999 0 25250 WILLIAM REDWINE MEMBER 2.00 0.00 X 0 0 0 NICHOLE SMITH MEMBER 2.00 0.00 X 0 0 0 GLEN TEAGER MEMBER 2.00 0.50 X 0 0 0 MANSHA KAHLOON MD MEMBER 40.00 0.00 X 946999 0 28261 MARK NEFF CEO 40.00 0.50 X X 322228 0 22304 CHRIS MCCLURG CFO 50.00 0.50 X 169650 0 23867 S SUE PERRY SECRETARY -NON VOTING 40.00 0.00 X 44143 0 13293 TRAVIS BAILEY VP ADMINISTRATION 50.00 0.50 X 212011 0 18486 KATHLEEN WILSON VP VP NURSING SERVICES 50.00 0.00 X 161778 0 18120 GREG BAUSCH VP REGIONAL SERVICES 50.00 0.00 X 194978 0 14548 WILL MELAHN MD VP MEDICAL STAFF 50.00 0.00 X 311389 0 27576 CHARLES CROUSE MD ORTHOPEDIC SURGEON 40.00 0.00 X 1551216 0 20503 CRAIG BUTLER MD RADIOLOGIST 40.00 0.00 X 669525 0 21110 STEPHEN A WILLIAMS MD RADIOLOGIST 40.00 0.00 X 671701 0 17501 MOHAMMAD M MARASHDEH MD CARDIOLOGY 40.00 0.00 X 688315 0 28261 WILLIAM D LEWIS RADIOLOGIST 40.00 0.00 X 666831 0 28261 6960763 0 307341 100 0 1 0 ARAMARK ONE SERVICE MASTER WAY DOWNERS GROVE IL 60515 CONTRACT SERVICE 2137142 APOGEE MEDICAL MANAGEMENT 2525 E CAMELBACK RD STE 1100 DOWNERS GROVE IL 60515 PHYSICIAN SERVICES 1594387 TRUSTAFF TRAVEL NURSES 4675 CORNELL RD SUITE 100 CINCINNATI OH 45241 CONTRACT NURSING SERVICE 924112 HORIZON HEALTH PO BOX 840839 DALLAS TX 75284 PHYSICIAN SERVICES 893326 JACOBUS CONSULTING 15375 BARRANCA PARKWAY SUITE B-202 IRVINE CA 92618 CONSULTING 622669 21 62436 2034413 304507 2401356 NET PATIENT SERVICE REVENUE 621110 122692841 122692841 HOME CARE REVENUE 621610 14711423 14711423 137404264 814277 814277 329307 229992 99315 99315 99315 878885 22409 0 0 878885 22409 901294 901294 17070 62436 26081 -9011 -9011 349903 313919 35984 22095 13889 340B REVENUE 900099 2672554 2672554 CAFETERIA INCOME 900099 878260 878260 EHR INCENTIVE REVENUE 900099 34000 34000 3360074 4176 3355898 6944888 148592367 137503579 26271 8661161 94120 94120 2904880 2675841 229039 72153879 66691069 5462810 1137475 918395 219080 9993541 9063344 930197 4840049 4480743 359306 619250 619250 75300 75300 11479167 9296778 2182389 216583 215630 953 4328276 3372767 955509 5900823 5710793 190030 330391 232560 97831 430877 394775 36102 753798 63670 690128 9356043 5136888 4219155 814137 250891 563246 MEDICAL SUPPLIES 18589079 18589079 PROVIDER TAX 1531205 153459 1377746 RECRUITMENT 806150 144579 661571 LICENSES & FEES 636609 191753 444856 1275812 893917 381895 148267444 128571051 19696393 0 11620537 6366091 16078518 17181284 4421489 5276051 3022241 3442425 1426920 1691583 120913368 83492468 33541077 37420900 30010116 30366728 23447717 23903196 123568615 125648258 17463820 19836415 996423 37414730 36099778 11260506 10640083 66139056 67572699 X 56869159 57545427 560400 530132 57429559 58075559 123568615 125648258 324923 321077 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 14700 14700 0 PART II-B, LINE 1: MEMBERSHIP DUES TO KHA AND CHA OF WHICH A PORTION OF THE DUES ARE USED FOR LOBBY EXPENSES BY THE TRADE ORGANIZATIONS. 560400 30268 530132 579226 18826 560400 595035 15809 579226 613249 18214 595035 625780 12531 613249 1.00000 0 0 3582186 3582186 52010694 35029385 16981309 3186203 1889458 1296745 57850759 46573625 11277134 4283526 4283526 37420900 OTHER ASSETS 2762517 INVESTMENT IN CLAIRE FRANCIS VENTURE 390927 PHYSICIAN RECEIVABLE 95606 INCOME TAX CREDIT NOTES RECEIVABLE 19996495 INTERCOMPANY RECEIVABLE 127519 DONOR RESTRICTED FUNDS 530132 23903196 ESTIMATED SETTLEMENTS PAYABLE 1659846 PROF. LIAB CLAIMS RESERVE 3937984 DEFERRED COMPENSATION 5042253 10640083 X 149457601 321077 229992 551069 148906532 -314165 -314165 148592367 148811601 544157 544157 148267444 0 148267444 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE OR BY THE PASSAGE OF TIME. INCOME EARNED FROM THE PRINCIPLE AMOUNT IS UNRESTRICTED. THE DONOR-RESTRICTED NET ASSETS ARE TO BE USED FOR CURATIVE TREATMENT AND REHABILITATIVE THERAPY OF PEDIATRIC ILLNESS, DISEASE, OR DEFORMITY. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE MEDICAL CENTER AND RECOGNIZE A TAX LIABILITY IF THE MEDICAL CENTER HAS TAKEN AN UNCERTAIN POSITION 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 THE MEDICAL CENTER, AND HAS CONCLUDED THAT AS OF JUNE 30, 2018 AND 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 229,992. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOOD SOLD -313,919. INVENTORY ADJUSTMENT -246. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 313,919. RENTAL EXPENSES 229,992. INVENTORY ADJUSTMENT 246. 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CLAIRE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: SCRMC PARTNERED WITH MOREHEAD STATE UNIVERSITY AND THE GATEWAY DISTRICT HEALTH DEPARTMENT (COLLECTIVELY AS THE GATEWAY WELLNESS COALITION) TO CONDUCT/COMPLETE THE UPDATED CHNA. THEY RELIED HEAVILY ON THE COUNTY-LEVEL STEERING COMMITTEES, WITH BROAD COMMUNITY REPRESENTATION, THAT HAD REMAINED ACTIVE SINCE THE ESTABLISHMENT OF THE COALITION IN 2012 TO GATHER THE NECESSARY INPUT AND DATA. SOURCES OF INPUT INCLUDED:ST. CLAIRE REGIONAL MEDICAL CENTER- CAVE RUN SURGICAL SPECIALISTS - MOREHEAD MEDICAL SPECIALISTS - ST. CLAIRE REGIONAL OUTPATIENT CENTER - ST. CLAIRE REGIONAL FAMILY MEDICINE - ST. CLAIRE REGIONAL HOMECARE, HOSPICE AND PALLIATIVE CARE - ST. CLAIRE REGIONAL FAMILY MEDICAL SUPPLY MOREHEAD STATE UNIVERSITYGATEWAY DISTRICT HEALTH DEPARTMENTMOREHEAD-ROWAN COUNTY CHAMBER OF COMMERCEELECTED OFFICIALS IN ROWAN, BATH AND MENIFEE COUNTIESSTUDENTS AND SCHOOL PERSONNEL IN ROWAN, BATH AND MENIFEE COUNTIESMAYSVILLE COMMUNITY AND TECHNICAL COLLEGEMOREHEAD/ROWAN COUNTY ECONOMIC DEVELOPMENT COUNCILPHYSICIANSPHARMACISTSOPTOMETRISTSDENTISTSUNIVERSITY OF KENTUCKYUK EXTENSION SERVICE IN ROWAN, BATH AND MENIFEE COUNTIESPATHWAYS COMMUNITY MENTAL HEALTH CENTERPEOPLE'S CLINIC (FREE CLINIC IN MOREHEAD)HOPE CLINIC (FREE CLINIC IN OWINGSVILLE)AREA LAW ENFORCEMENTAREA EMERGENCY MEDICAL SERVICESFAITH-BASED ORGANIZATIONSAREA EMPLOYERSURBAN PLANNERSPARKS AND RECREATION LEADERSKENTUCKY CANCER PROGRAMNORTHEAST KENTUCKY AREA HEALTH EDUCATION CENTERTHEY ALSO GATHERED INFORMATION AND INPUT THROUGH FOCUS GROUPS AND COMMUNITY SURVEYS. ST. CLAIRE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THROUGHOUT THIS COMPREHENSIVE PROCESS, MANY HEALTH NEEDS WERE IDENTIFIED, BUT SOME HAVE NOT BEEN ADDRESSED IN THIS SPECIFIC PLAN. SOME GATEWAY WELLNESS COALITION EXECUTIVE COMMITTEE MEETINGS FOCUSED ON NEEDS THAT WERE ALREADY BEING ADDRESSED IN VARIOUS WAYS. ONE OF THE MOST CRITICAL AREAS OF NEED IS CARE FOR THE UNINSURED/UNDERINSURED, AS ST. CLAIRE REGIONAL PROVIDES CARE AND SERVICES FOR A SIGNIFICANT NUMBER OF UNINSURED AND MEDICAID PATIENTS. WHILE GOVERNMENT REIMBURSEMENT FOR MEDICAID SERVICES PROVIDED BY SCRMC IN FISCAL 2016 COVERED COSTS, SCRMC DID PROVIDE $220,908 IN CHARITY CARE (AT COST) IN FISCAL 2016. UNCOMPENSATED CARE, WHICH TOTALED NEARLY $3.3 MILLION IN FISCAL 2016, WAS THE COST OF SCRMC SERVICES TO INDIVIDUALS WHO WERE UNABLE OR UNWILLING TO PAY AND DID NOT OFFICIALLY MEET GUIDELINES FOR TRADITIONAL CHARITY CARE. THUS, MORE FUNDING, EXPERTISE AND ACCESS ARE NECESSARY TO ENSURE THAT THE SUBSTANTIAL IMPACT THAT ST. CLAIRE REGIONAL HAS ON THE UNINSURED/UNDERINSURED POPULATION IN ITS PRIMARY SERVICE AREA IS SUSTAINABLE FOR YEARS TO COME, PARTICULARLY GIVEN THE REQUIREMENTS AND IMPACT OF THE AFFORDABLE CARE ACT.SINCE OUR FOUNDING IN 1963, ST. CLAIRE REGIONAL MEDICAL CENTER HAS CONTINUALLY SOUGHT TO EXPAND OUR REACH AND POSITIVE IMPACT IN THE REGION. SCRMC OPERATES SEVERAL FAMILY MEDICINE CLINICS IN FIVE SERVICE REGION COUNTIES. THE FIRST OPENED IN 1973 IN MENIFEE COUNTY, WHILE THE SECOND OPENED THREE YEARS LATER IN BATH COUNTY. OTHERS FOLLOWED IN ROWAN, CARTER AND ELLIOTT COUNTIES. SCRMC'S HOMECARE, HOSPICE AND PALLIATIVE CARE PROGRAMS SERVE AN EIGHT-COUNTY AREA.SCRMC ALSO FORGES STRATEGIC PARTNERSHIPS TO OFFER MORE EXTENSIVE AND EFFICIENT SERVICES IN THE SERVICE AREA, INCLUDING RELATIONSHIPS WITH THE UNIVERSITY OF KENTUCKY FOR WOMEN'S HEALTH, STROKE AND CANCER CARE SERVICES. SCRMC IS ALSO A FOUNDING MEMBER OF THE KENTUCKY HEALTH COLLABORATIVE, A GROUP OF 10 HOSPITALS AND HEALTH SYSTEMS SEEKING TO DEVELOP MORE EFFICIENT WAYS TO ADDRESS THE HEALTHCARE NEEDS OF KENTUCKIANS.EVIDENCE OF OUR EFFORTS TO ADDRESS AN ANTICIPATED NEED FOR MORE PRIMARY CARE PHYSICIANS AND SPECIALISTS IN THE REGION IS A UNIQUE JOINT INITIATIVE FEATURING A REGIONAL UNIVERSITY (MOREHEAD STATE UNIVERSITY), A LAND GRANT UNIVERSITY (THE UNIVERSITY OF KENTUCKY), AND A PRIVATE NON-PROFIT HOSPITAL (ST. CLAIRE REGIONAL MEDICAL CENTER) THAT LED TO THE CONSTRUCTION OF THE CENTER FOR HEALTH, EDUCATION AND RESEARCH IN MOREHEAD. IN THIS FACILITY, THE NEXT GENERATION OF MEDICAL STUDENTS AND OTHER HEALTHCARE PROFESSIONALS FOR THE REGION ARE BEING TRAINED. THIS FACILITY PROVIDES TRAINING OPPORTUNITIES FOR THE STATE'S TOP-RANKED NURSING PROGRAM AT MOREHEAD STATE UNIVERSITY. ADDITIONALLY, IT HOUSES A REGIONAL SATELLITE CAMPUS FOR THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE'S RURAL PHYSICIAN LEADERSHIP PROGRAM.ANOTHER EFFORT TO IMPROVE ACCESS AND EFFICIENCY IN SERVICES IS THE ONGOING CONSTRUCTION OF A NEW MEDICAL SERVICES PAVILION ADJACENT TO ST. CLAIRE REGIONAL MEDICAL CENTER. THIS NEW STATE-OF-THE-ART FACILITY WILL BRING CAVE RUN SURGICAL SPECIALISTS, MOREHEAD MEDICAL SPECIALISTS, THE UNIVERSITY OF KENTUCKY WOMEN'S CENTER AND ST. CLARE REGIONAL'S ONCOLOGY SERVICES UNDER ONE ROOF, WITH EASY ACCESS TO SCRMC'S ACUTE-CARE SERVICES. THIS NEW PAVILION IS SLATED TO OPEN IN EARLY 2018. 12 1 - ST CLAIRE FAMILY MEDICINE-MOREHEAD 316 WEST SECOND ST MOREHEAD KY 40351 OUTPATIENT FAMILY MEDICINE 2 - ST CLAIRE FAMILY MEDICINE-OLIVE HILL 155 BRICKLAYER ST OLIVE HILL KY 41164 OUTPATIENT FAMILY MEDICINE 3 - ST CLAIRE FAMILY MEDICINE- OWINGSVILLE 632 SLATE AVE OWINGSVILLE KY 40360 OUTPATIENT FAMILY MEDICINE 4 - ST CLAIRE FAMILY MEDICINE- SANDY HOOK 390 KY HWY 75 SANDY HOOK KY 41171 OUTPATIENT FAMILY MEDICINE 5 - ST CLAIRE FAMILY MEDICINE- FRENCHBURG 732 HWY 36 FRENCHBURG KY 40322 OUTPATIENT FAMILY MEDICINE 6 - ST CLAIRE MEDICAL PAVILION 245 FLEMINGSBURG RD MOREHEAD KY 40351 MULTI SPECIALTY GROUP 7 - ST CLAIRE OUTPATIENT CENTER 1028 EAST MAIN ST MOREHEAD KY 40351 OUTPATIENT LAB, PHYSICAL, OCCUPATIONAL THERAPY & SLEEP CENTER 8 - ST CLAIRE PEDIATRICS 716 W MAIN ST MOREHEAD KY 40351 PEDIATRIC CARE 9 - ST CLAIRE FAMILY MEDICAL SUPPLY 244 KROGER CENTER DR MOREHEAD KY 40351 HOME MEDICAL SUPPLY AND EQUIPMENT 10 - ST CLAIRE COUNSELING 445 CLINIC DR MOREHEAD KY 40351 OUTPATIENT COUNSELING 11 - ST CLAIRE MEDICINE EXPRESS 1028 EAST MAIN ST MOREHEAD KY 40351 OUTPATIENT CLINIC 12 - ST CLAIRE FAMILY MEDICINE-MOREHEAD NORT 255 OLD VIKING DR MOREHEAD KY 40351 OUTPATIENT FAMILY MEDICINE PART I, LN 7 COL(F): TOTAL BAD DEBT EXPENSE HAS BEEN EXCLUDED FROM THE DENOMINATOR FOR THE PERCENTAGE CALCULATION PER IRS INSTRUCTIONS. PART II, COMMUNITY BUILDING ACTIVITIES: OUR MISSION AND VALUES HAVE BEEN ENHANCED THROUGH COMMUNITY BENEFIT PROGRAMS, AND THOSE ACTIVITIES HAVE CENTERED ON EDUCATION, COLLABORATION AND IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES THAT WE SERVE. THE EDUCATION AND DEVELOPMENT OF HEALTH PROFESSIONALS HAS BEEN ONE OF OUR PRIMARY FOCUS AREAS FOR COMMUNITY BENEFIT, BECAUSE WE BELIEVE THAT THEIR TRAINING IS VITAL TO IMPROVING COMMUNITY HEALTH. ANOTHER TARGET AREA IS OUR ENGAGEMENT IN COMMUNITY SUPPORT AND PARTNERSHIPS. THIS ENGAGEMENT IS REALIZED THROUGH PARTICIPATION IN HEALTH FAIRS AND SCREENINGS, PROVIDING SUPPORT GROUPS, AS WELL AS COALITION BUILDING INITIATIVES. PART III, LINE 2: THE BAD DEBT AMOUNT IS FROM THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. SEE PAGES 8 & 9 ON THE ATTACHED FINANCIAL STATEMENTS FOR AN EXPLANATION OF BAD DEBT EXPENSES. SECTION A. BAD DEBT EXPENSE. LINE 3 EXPLANATION FOR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: BAD DEBT EXPENSE IS RECORDED AS A GROSS AMOUNT ON THE FINANACIAL STATEMENTS. COSTS ASSOCIATED WITH THIS EXPENSE ARE CALCULATED BY USING THE COST TO CHARGE RATIO WITHIN EACH RESPECTIVE DIVISION OF THE MEDICAL CENTER. THE MEDICAL CENTER HAS A FINANCIAL ASSISTANCE POLICY THAT STATES PARTICIPATION IN CHARITY PROGRAM REQUIRES THAT CANDIDATES FULLY COOPERATE. THE MEDICAL CENTER EDUCATES PATIENTS WILL LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE AND PROVIDES ACCESS TO DEDICATED FINANCIAL COUNSELORS DAILY. FOR THIS REASON THE MEDICAL CENTER BELIEVES THAT IT IS ACCURATELY CAPTURING ALL CHARITY CARE DEDUCTIONS ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE UNDER THE ORGANIZATION CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2018 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: THE MEDICAL CENTER WILL ASSIST ALL PATIENTS AND THEIR RESPONSIBLE PARTY WITH METHODS OF PAYING ACCOUNTS GENERATED AS A RESULT OF NO THIRD PARTY COVERAGE OR BALANCES AFTER INSURANCE PAYMENTS. ACCEPTABLE PAYMENT ARRANGEMENTS ARE REQUESTED IF FULL PAYMENT CANNOT BE MADE. COMPUTER GENERATED STATEMENTS ARE MAILED TO THE RESPONSIBLE PARTY ON A REGULAR SCHEDULE. LETTERS ARE ALSO SENT AS SUPPLEMENT TO THE DATA STATEMENTS TO KEEP THE PATIENT/GUARANTOR INFORMED OF THE STATUS OF THE ACCOUNT. HEALTHCARE FINANCIAL ASSISTANCE WILL BE GRANTED IF THERE ARE NO OTHER RESOURCES AVAILABLE TO THE PATIENT AND THEY HAVE MET THE GUIDELINES AND FURNISHED REQUESTED VERIFICATION. PART VI, LINE 2: THE ORGANIZATION ASSESSES COMMUNITY NEEDS THROUGH VOLUNTEER BOARDS, COMMUNITY INVOLVEMENT, VOLUNTEERING, AND BOARD SERVICE. PART VI, LINE 3: PATIENT FINANCIAL SERVICES' PATIENT ACCESS/REGISTRATION STAFF AND CASHIER ASSIST PATIENTS WITH INFORMING AND EDUCATING PATIENTS ABOUT THEIR ACCOUNTS AND CHARGES. PART VI, LINE 4: ST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THESE VOLUNTEERS ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ANY SURPLUS FUNDS ARE APPLIED DIRECTLY OR INDIRECTLY TO IMPROVE SERVICES. PART VI, LINE 6: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES KY 1 SCHOLARSHIPS 11 50437 PART I, LINE 2: HOSPITAL MAKES SCHOLARSHIPS AVAILABLE TO ELIGIBLE PERSONS TO FURTHER HEALTHCARE IN THE COMMUNITY. X X X X X 0 0 0 0 0 0 0 0 0 O THOMAS NEWCOMB III MD UROLOGIST 349999 0 0 0 0 0 9275 0 15975 0 375249 0 0 0 MANSHA KAHLOON MD MEMBER 946999 0 0 0 0 0 9275 0 18986 0 975260 0 0 0 MARK NEFF CEO 322228 0 0 0 0 0 9275 0 13029 0 344532 0 0 0 CHRIS MCCLURG CFO 169650 0 0 0 0 0 5923 0 17944 0 193517 0 0 0 TRAVIS BAILEY VP ADMINISTRATION 212011 0 0 0 0 0 6897 0 11589 0 230497 0 0 0 KATHLEEN WILSON VP VP NURSING SERVICES 161778 0 0 0 0 0 5597 0 12523 0 179898 0 0 0 GREG BAUSCH VP REGIONAL SERVICES 194978 0 0 0 0 0 6460 0 8088 0 209526 0 0 0 WILL MELAHN MD VP MEDICAL STAFF 311389 0 0 0 0 0 9275 0 18301 0 338965 0 0 0 CHARLES CROUSE MD ORTHOPEDIC SURGEON 1551216 0 0 0 0 0 9275 0 11228 0 1571719 0 0 0 CRAIG BUTLER MD RADIOLOGIST 669525 0 0 0 0 0 9275 0 11835 0 690635 0 0 0 STEPHEN A WILLIAMS MD RADIOLOGIST 671701 0 0 0 0 0 9275 0 8226 0 689202 0 0 0 MOHAMMAD M MARASHDEH MD CARDIOLOGY 688315 0 0 0 0 0 9275 0 18986 0 716576 0 0 0 WILLIAM D LEWIS RADIOLOGIST 666831 0 0 0 0 0 9275 0 18986 0 695092 0 0 0 DR THOMAS NEWCOMB BOARD MEMBER 424538 DR. THOMAS NEWCOMB IS AN INVESTOR IN KY MOBILE LITHOTRIPSY WHICH PROVIDES ESWL SERVICES USED IN SURGERY. ST. CLAIRE PAID KY MOBILE LITHOTRIPSY $193,400 DURING FY 2018. HE IS ALSO A PARTIAL OWNER OF CAVE RUN REAL ESTATE WHICH PROVIDES OFFICE SPACE TO ST. CLAIRE. DURING FY 2018, $231,138 WAS PAID FOR RENTAL. 0 DR JEFFREY ELLIS BOARD MEMBER 411385 DR. JEFFREY ELLIS IS EMPLOYED BY THE UNIVERSITY OF KENTUCKY, WHICH PROVIDES CONTRACTED PATHOLOGY FACULTY SERVICES TO ST. CLAIRE. DR. ELLIS IS A PATHOLOGIST IN THIS CONTRACT. DURING FY 2018, ST. CLAIRE PAID THE UNIVERSITY OF KENTUCKY $411,385 FOR THESE SERVICES. 0 ROBERT STEVENS BOARD MEMBER 156468 ROBERT STEVENS IS THE PRESIDENT OF BOTTOM LINE SYSTEMS, A COLLECTION COMPANY. DURING FY 2018, $156,468 WAS PAID FOR SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 7A THE PRESIDENT OF THE SISTERS OF NOTRE DAME OF COVINGTON, KY IS THE PERSON WHO APPOINTS ALL THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE CFO AND BY THE ACCOUNTING DEPARTMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS, BOARD COMMITTEES, AND MEDICAL CENTER LEADERSHIP SIGN A CONFLICT OF INTEREST STATEMENT ON INITIAL APPOINTMENT OR EMPLOYMENT AND ANNUALLY THEREAFTER. THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE DEPARTMENT HEAD OF BOARD/ADMINISTRATION. THE SCOPE OF THIS POLICY INCLUDES BOARD OF DIRECTORS, BOARD COMMITTEES, ADMINISTRATIVE STAFF, EMPLOYEES, AND MEDICAL STAFF. THE POLICY IS IN PLACE TO AVOID CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS BETWEEN PERSONAL INTERESTS AND ONE'S OFFICIAL RESPONSIBILITIES AND PERFORMANCE OF DUTIES ON BEHALF OF THE MEDICAL CENTER. THE COVERED PERSONS ARE TO AVOID BEING PLACED IN A POSITION FOR PERSONAL PROFIT, EITHER THROUGH MONEY, GOODS, OR INFLUENCE FROM THE CONDUCTING OF MEDICAL CENTER RESPONSIBILITIES. A SELF DISCLOSURE FROM COVERED PERSONS TO THE INTEGRITY OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFUSE FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS ESTABLISHED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND IS BASED ON PERFORMANCE CRITERIA AND ON PUBLISHED MARKET SURVEY COMPARISONS FOR HEALTHCARE INSTITUTIONS SIMILAR IN SIZE AND SCOPE OF OPERATIONS. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO, BASED ON PERFORMANCE CRITERIA, AND PUBLISHED MARKET SURVEY COMPARISONS, AND IS REVIEWED AND BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. MOREHEAD PROFESSIONAL SERVICES BUILDING LLC 222 MEDICAL CIRCLE MOREHEAD KY 40351 610890222 MEDICAL OFFICE BUILDING KY 0 2831250 SCRMC SISTERS OF NOTRE DAME OF COVINGTON KENTUCKY INC 1601 DIXIE HIGHWAY COVINGTON KY 41011 610485643 RELIGIOUS ORDER KY 501(C)(3) LINE 1 N/A 0 ST CLAIRE REAL PROPERTIES 222 MEDICAL CIRCLE MOREHEAD KY 40351 474578938 SUPPORT ST. CLAIRE REGIONAL MEDICAL CENTER KY 501(C)(3) LINE 12A, I N/A 0 CLAIRE-FRANCIS HEALTH SERVICES PLLC DBA INFUSION SOLUTIONS 200 MALL ROAD STE 3 ASHLAND KY 41101 311517507 HOME INFUSION SERVICES KY N/A RELATED 100399 576713 0 0 0.25000 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1