2019-08-15T08:40:54-05:00 2018-09-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 221 W PHILADELPHIA STREET SUITE 200 YORK PA 17401 990 2017-10-01 610444716 ASHLAND HOSPITAL CORPORATION ASHL 6064084000 2201 LEXINGTON AVENUE ASHLAND KY 41101 AUTUMN MCFANN VICE PRESIDENT/CFO 6064084000 2019-08-14 1 KERRI N BOGDA P00760402 7178467000 96.89.178.154 2019-08-14 09:32:02 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9D0D8DD59390B7764A3ECE0F40BBFE3618018605 2017 2019-02-21 02:37:17Z KING'S DAUGHTERS MEDICAL CENTER KRISTIE WHITLATCH 2201 LEXINGTON AVENUE ASHLAND KY 41101 474274887 0 X WWW.KINGSDAUGHTERSHEALTH.COM X 1941 KY TO PROVIDE COMMUNITY HEALTHCARE SERVICES. TO CARE. TO SERVE. TO HEAL. 10 5 3534 145 269640 -215392 2299721 1210887 412729012 417843604 5090242 11178446 4056553 4261391 424175528 434494328 171269 169186 0 0 190135379 185803624 0 0 0 235369721 232096346 425676369 418069156 -1500841 16425172 671315108 676221177 321549910 310679220 349765198 365541957 X TO PROVIDE COMMUNITY HEALTHCARE SERVICES. TO CARE. TO SERVE. TO HEAL. 0 1 349128951 169186 417843604 KING'S DAUGHTERS MEDICAL CENTER IS A LOCALLY CONTROLLED, NOT-FOR-PROFIT, 465-BED REGIONAL REFERRAL CENTER, COVERING A 150-MILE RADIUS THAT INCLUDES EASTERN KENTUCKY AND SOUTHERN OHIO. KDMC OFFERS COMPREHENSIVE CARDIAC, MEDICAL, SURGICAL, MATERNITY, PEDIATRIC, REHABILITATIVE, BARIATRIC, PSYCHIATRIC, CANCER, NEUROLOGICAL, PAIN CARE, WOUND CARE AND HOME CARE SERVICES. KDMC OPERATES MORE THAN 25 OFFICES IN EASTERN KENTUCKY AND SOUTHERN OHIO. KING'S DAUGHTERS MEDICAL CENTER IS THE LARGEST EMPLOYER BETWEEN CHARLESTON, WEST VIRGINIA AND LEXINGTON, KY. OUR VISION: WORLD CLASS CARE IN OUR COMMUNITIES. CONTINUED ON SCHEDULE "O".KING'S DAUGHTERS MEDICAL CENTER IS LOCATED IN EASTERN KENTUCKY, WHERE THE KENTUCKY, OHIO AND WEST VIRGINIA STATE LINES MEET. KDMC'S PRIMARY SERVICE AREA ENCOMPASSES SIX COUNTIES IN TWO STATES, BOYD, CARTER, GREENUP & LAWRENCE COUNTIES IN KENTUCKY AND LAWRENCE & SCIOTO COUNTIES IN OHIO. THE HEALTH AND WELL-BEING OF THE COMMUNITY IS VITALLY IMPORTANT TO US AT KING'S DAUGHTERS. WE OWE OUR VERY EXISTENCE TO FORWARD-THINKING COMMUNITY MEMBERS, TO VOLUNTEERS WHO HELPED SHAPE KING'S DAUGHTERS, AND TO THE PATIENTS AND FAMILIES WHO CHOOSE US FOR THEIR CARE. OUR COMMITMENT TO COMMUNITY DRIVES US TO GIVE BACK. OUR TEAM MEMBERS, PHYSICIANS AND HEALTH PROFESSIONALS PROVIDE FREE SCREENINGS AND EDUCATION, AND PARTICIPATE IN HEALTH FAIRS AND OTHER SPECIAL EVENTS DESIGNED TO HELP PEOPLE AND THE COMMUNITY BE HEALTHIER. 349128951 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 300 0 1 3534 1 1 1 0 0 0 0 0 0 0 0 0 X 10 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X LAURIE STEWART CONTROLLER 6064089640 2201 LEXINGTON AVENUE ASHLAND KY 41101 DAVID JONES CHAIRMAN 2.00 4.00 X X 0 0 0 KRISTIE WHITLATCH PRESIDENT/CEO 51.25 11.25 X X 830553 0 21898 SHERYL MAHANEY NON-VOTING SECRETARY, VP/CHIEF LEGAL 51.25 11.25 X X 415811 0 21756 AUTUMN MCFANN NON-VOTING TREASURER, VP/CFO 51.25 11.25 X X 332527 0 21756 STEPHEN ADDINGTON DIRECTOR 0.25 1.00 X 0 0 0 WILLIAM BOYKIN MD DIRECTOR/MEDICAL STAFF VP 0.25 0.25 X 12000 0 0 TOM BURNETTE DIRECTOR 0.25 1.25 X 0 0 0 JAMES DETHERAGE MD DIRECTOR/PRESIDENT MED STAFF/CMO 0.25 40.25 X 24000 468544 29178 DONALD HAMMONDS DO DIRECTOR 0.25 40.25 X 0 30736 18514 BRADLEY LEVI DIRECTOR 0.25 0.25 X 0 0 0 KIM MCCANN DIRECTOR 0.25 2.25 X 0 0 0 JOHN STEWART DIRECTOR 0.25 1.00 X 0 0 0 JOHN VINCENT DIRECTOR 0.25 1.50 X 0 0 0 KELLY HURT VP PEOPLE SERVICES 45.00 1.25 X 241004 0 19802 SARA MARKS VP/EXECUTIVE DIRECTOR KDIP 51.25 6.25 X 266910 0 33312 RICHARD FORD MD VP/CMO OF INPATIENT/PROC. 40.25 0.25 X 28740 507453 21241 EVAN CONDEE DO PHYSICIAN 40.00 X 386164 0 14731 CHARLES CONLEY DO PHYSICIAN 40.00 10.00 X 374860 0 31884 JANE STRADER MD PHYSICIAN 40.00 X 283474 0 20244 PATRICK BALL DO PHYSICIAN 40.00 X 369861 0 20964 MARIA NASH MD PHYSICIAN 40.00 X 263063 0 29423 MATTHEW EBAUGH UNTIL 51717 FORMER CHIEF STRATEGY OFFICER/CIO 0.00 X 199651 0 26289 4028618 1006733 330992 149 1 1 0 DULEY ENTERPRISES LLC 24203 JACKS FORK ROAD RUSH KY 41168 CONSULTANTS 1308695 OB HOSPITALIST GROUP 777 LOWNDES HILL ROAD-BUILDING 1 GREENVILLE SC 296072131 HOSPITALISTS 1280461 CLEVELAND CLINIC FOUNDATION PO BOX 931760 CLEVELAND OH 441931861 CONSULTANTS 1250000 STITES & HARBISON PLLC 250 WEST MAIN STREET LEXINGTON KY 405071758 LAWYERS 1215812 DLA PIPER LLP 6225 SMITH AVENUE BALTIMORE MD 21209 LAWYERS 1145114 27 806559 241558 162770 1210887 NET PATIENT SVC REV 621110 401501831 401501831 PHARMACY 446110 16253902 16227557 26345 MEANINGFUL USE REVENUE 621110 87871 87871 417843604 6052921 12401 6040520 542 542 973591 3150 658178 3726 315413 -576 314837 -576 315413 44228660 14978 39100548 18107 5128112 -3129 5124983 5124983 CAFETERIA 722210 2262841 2262841 QUALITY INCENTIVE 900099 886505 886505 MANAGEMENT FEES 900099 271740 271740 525468 231470 293998 3946554 434494328 417817259 269640 15196542 169186 169186 2286739 2286739 140176846 123082225 17094621 2477332 2212419 264913 30519106 26795775 3723331 10343601 8936871 1406730 2703586 14083 2689503 166525 16525 150000 54996 54996 497932 497932 30025671 24592732 5432939 2196927 11431 2185496 2387491 1246236 1141255 2983493 2977084 6409 7183822 1681064 5502758 197916 140394 57522 15415 13555 1860 12335849 47193 12288656 20915329 19655038 1260291 7051902 7051902 MEDICAL SUPPLIES 89864443 86840151 3024292 BAD DEBT EXPENSE 23124129 23124129 REPAIRS & MAINTENANCE 15920939 14706826 1214113 TAX (INC. PROVIDER TAX) 7679544 7631889 47655 6790437 5179149 1611288 418069156 349128951 68940205 0 4746824 10045692 3150280 12380469 60626831 56582731 1350251 1195231 12891663 7577837 4464722 4627275 733202477 493815272 246035924 239387205 174483389 165156607 5125617 5575663 788715 788715 157650892 172903752 671315108 676221177 37351975 36716167 231034548 224864944 25945 0 53137442 49098109 321549910 310679220 X 349765198 365541957 349765198 365541957 671315108 676221177 X 16425172 -3002986 2354573 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 54996 54996 0 PART II-B, LINE 1: $23,378: A PORTION OF THE DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING EXPENSES. $24,159: A PORTION OF DUES PAID TO THE COLLEGE OF AMERICAN PATHOLOGISTS ATTRIBUTABLE TO LOBBYING. $4,629: A PORTION OF THE DUES PAID TO THE AMERICAN MEDICAL ASSOCIATION ATTRIBUTABLE TO LOBBYING EXPENSES. $1,510: A PORTION OF THE DUES PAID TO THE AMERICAN COLLEGE OF CARDIOLOGY ATTRIBUTABLE TO LOBBYING EXPENSES. $696: A PORTION OF DUES PAID TO THE AMERICAN COLLEGE OF SURGEONS ATTRIBUTABLE TO LOBBYING. $624: A PORTION OF DUES PAID TO THE OHIO HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING. 28415203 28415203 389575090 229528225 160046865 306535965 257965694 48570271 8676219 6321353 2354866 239387205 SELF INSURANCE FUNDS 182994 TRUSTEED FUNDS 546 DUE FROM RELATED PARTIES 168290029 OTHER RECEIVABLES 4430183 172903752 MALPRACTICE COSTS 19494197 ACCRUED PENSION 11345000 LONG-TERM RETENTION PLAN 404686 INTEREST RATE SWAP AGREEMENTS 10440075 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 1375000 LEASES PAYABLE 6039151 49098109 X PART X, LINE 2: THE MEDICAL CENTER, KHF, KBNH, CDC, KHI, KDMT, KDMS, KDHF AND PHC HAVE BEEN RECOGNIZED BY THE IRS AS SECTION 501(C)(3) CHARITABLE ORGANIZATIONS. SECTION 501(C)(3) ORGANIZATIONS ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. 1 1 X 1 X 1 X 1 1 1 0 1 1 2117298 2117298 0.00540 95013598 65225982 29787616 0.07540 97130896 65225982 31904914 0.08080 2215971 2215971 0.00560 209571 209571 0.00050 2425542 2425542 0.00610 99556438 65225982 34330456 0.08690 692363 692363 0.00180 692363 692363 0.00180 1 7606247 124891311 133742578 -8851267 X 1 1 1 1 ASHLAND HOSPITAL CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 WWW.KINGSDAUGHTERSHEALTH.COM 100958 X X X ASHLAND HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X HTTPS://WWW.KINGSDAUGHTERSHEALTH.COM/ABOUT-US/COMMUNITY X 1 15 1 HTTPS://WWW.KINGSDAUGHTERSHEALTH.COM/ABOUT-US/COMMUNITY 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.KINGSDAUGHTERSHEALTH.COM/PATIENTS-VISITORS/PATIENTS X WWW.KINGSDAUGHTERSHEALTH.COM/PATIENTS-VISITORS/PATIENTS X WWW.KINGSDAUGHTERSHEALTH.COM/PATIENTS-VISITORS/PATIENTS X X X X X X 1 X 0 X X X 1 X 0 1 ASHLAND HOSPITAL CORPORATION PART V, SECTION B, LINE 5: KING'S DAUGHTERS CONDUCTED A CHNA WITH BON SECOURS KENTUCKY, OUR LADY OF BELLEFONTE HOSPITAL BETWEEN SEPTEMBER 2015 AND MARCH 2016. THE CHNA INCLUDED BOTH PRIMARY AND SECONDARY DATA ANALYSIS. THE PRIMARY DATA ENCOMPASSED SURVEYS AND FOCUS GROUPS WITH KEY INDIVIDUALS IN THE COMMUNITY INCLUDING THOSE WITH KNOWLEDGE OF PUBLIC HEALTH, THE BROAD INTERESTS OF THE COMMUNITIES WE SERVE, AS WELL AS INDIVIDUALS WITH SPECIAL KNOWLEDGE OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND VULNERABLE POPULATIONS AND PEOPLE WITH CHRONIC DISEASES. WE WORKED CLOSELY WITH THE HEALTHY CHOICES, HEALTHY COMMUNITIES COALITION AND THE UNIVERSITY OF KY COLLEGE OF PUBLIC HEALTH. ASHLAND HOSPITAL CORPORATION PART V, SECTION B, LINE 6A: BON SECOURS KENTUCKY A.K.A. OUR LADY OF BELLEFONTE HOSPITAL & PORTSMOUTH HOSPITAL CORPORATION. ASHLAND HOSPITAL CORPORATION PART V, SECTION B, LINE 11: IN 2016, KDMC CONDUCTED A CHNA, THROUGH WHICH SIX PRIMARY NEEDS WERE IDENTIFIED - SUBSTANCE ABUSE, OBESITY, ACCESS TO CARE, POVERTY/UNEMPLOYMENT, DIABETES, AND HYPERTENSION. THE MEDICAL CENTER DEVELOPED AN IMPLEMENTATION PLAN, WHICH COVERS THREE YEARS, TO ADDRESS THESE NEEDS. EACH NEED WAS ADDRESSED USING MULTIPLE APPROACHES, AS FOLLOWS:SUBSTANCE ABUSE: SEVERAL PROGRAMS WERE OFFERED TO TACKLE SUBSTANCE ABUSE, INCLUDING TOBACCO EDUCATION IN LOCAL SCHOOLS AND OFFERING TOBACCO CESSATION FOR PATIENTS AND COMMUNITY MEMBERS. THROUGH PARTNERSHIPS, THE MEDICAL CENTER HELD THREE PROGRAMS TO DIRECTLY IMPACT ABUSE OF ILLICIT SUBSTANCES. TWO OF THESE EDUCATIONAL PROGRAMS PROVIDED TRAINING FOR SOCIAL WORKERS, CASE MANAGERS, AND OTHERS WHO WORK WITH INDIVIDUALS ABUSING DRUGS TO HELP IMPROVE THEIR KNOWLEDGE AND CREATE A BETTER REFERRAL SYSTEM. IN ADDITION, A YOUTH SUMMIT WAS HELD TO EDUCATE YOUNG PEOPLE ABOUT SUBSTANCE ABUSE. THE MEDICAL CENTER ALSO RECLASSIFIED FOUR BEDS IN THE BEHAVIORAL MEDICINE NURSING UNIT FOR DETOX PATIENTS. SAFE MEDICATION TAKE-BACK PROGRAMS WERE ALSO IMPLEMENTED THROUGH COMMUNITY EVENTS AND FIXED SITE DROP-OFFS AT KDMC FAMILY PHARMACIES.OBESITY: AS PART OF TACKLING THE ISSUE OF OBESITY, THE MEDICAL CENTER CHOSE TO ADDRESS NUTRITION, PHYSICAL ACTIVITY, AND BMI. WITH A FOCUS ON HEALTHY EATING, KDMC PROVIDED NUTRITION EDUCATION FOR STUDENTS IN AREA SCHOOLS. WELLNESS PROGRAMS WERE PROVIDED FOR SCHOOL STAFF WHICH INCLUDED A HEALTHY LIVING CHALLENGE. AT COMMUNITY EVENTS, KDMC STAFF PROVIDED NUTRITION EDUCATION. SPECIAL EVENTS HELD INCLUDED NUTRITION EDUCATION AND HEALTHY COOKING DEMONSTRATIONS. IN ADDITION, KDMC HELPED MEET THE NEEDS OF VULNERABLE POPULATIONS THROUGH SPONSORSHIP OF THE MEALS-ON-WHEELS PROGRAM, HELPING COLLECT FOOD FOR THE LOCAL FOOD PANTRY THROUGH THE FOOD FEUD AND SPONSORING A FARMER'S MARKET ON CAMPUS WHICH IS LOCATED IN A HEALTHY FOOD DESERT. TO ADDRESS PHYSICAL ACTIVITY, KDMC SPONSORED FOUR EVENTS THAT INCLUDED PHYSICAL ACTIVITY AND EDUCATION ENCOURAGING PEOPLE TO BE PHYSICALLY ACTIVE. THROUGH THE ELECTRONIC MEDICAL RECORD, PRIMARY CARE PROVIDERS NOW INCLUDE BMI AS PART OF THE PATIENT ASSESSMENT. WELLNESS PROGRAMS ALSO INCLUDE BMI ASSESSMENT AS PART OF THEIR PROGRAMMING.ACCESS TO CARE: TO IMPROVE ACCESS TO CARE, KDMC ESTABLISHED SCHOOL-BASED CLINICS IN FOUR SCHOOL DISTRICTS IN THE SERVICE AREA. A 24/7 CARE LINE WAS CREATED TO HELP COMMUNITY MEMBERS REACH A NURSE TO ANSWER QUESTIONS ABOUT THEIR HEALTH OR AID THEM IN GETTING AN APPOINTMENT OR WITH PRESCRIPTION MEDICATIONS. KDMC ALSO EXPANDED ACCESS TO PRIMARY CARE, PEDIATRIC CARE, URGENT CARE, AND WALK-IN CLINICS, WHICH HAS IMPROVED HOW QUICKLY APPOINTMENTS CAN BE PROVIDED. THROUGH MOBILE SERVICES, KDMC TAKES MAMMOGRAPHY AND CARDIAC SCREENINGS INTO AREAS OF THE REGION THAT HAVE LIMITED HEALTHCARE SERVICES. IN ADDITION, KDMC OFFERS LOW-COST BLOOD PROFILES AND VASCULAR SCREENINGS THROUGHOUT THE REGION TO OFFER AFFORDABLE OPTIONS IN CONVENIENT LOCATIONS. POVERTY/UNEMPLOYMENT: POVERTY AND UNEMPLOYMENT ARE TOUGH ISSUES TO TACKLE FOR A SINGLE ORGANIZATION. KDMC CHOSE TO WORK WITH AREA PARTNERS AND PROVIDE STAFF AT CAREER FAIRS AND AS SPEAKERS ON HEALTHCARE CAREERS AT LOCAL COLLEGES/UNIVERSITIES, TECHNICAL SCHOOLS, AND HIGH SCHOOLS. IN ADDITION, THROUGH DONATIONS FROM KDMC, ASHLAND INDEPENDENT SCHOOL WAS ABLE TO EXPAND ITS HEALTH CAREERS CLASSES FROM ONE TO FOUR CAREER PATHS. DIABETES: DURING THE FISCAL YEAR, KDMC STAFF CONDUCTED AN EVALUATION FOR THE NEED TO DO DIABETES EDUCATION AND TESTING IN AREA SCHOOLS. A PLAN IS UNDER DEVELOPMENT TO ADDRESS THESE NEEDS. KDMC ALSO CONDUCTED FREE SCREENING EVENTS AND OFFERED LOW-COST A1C BLOOD PROFILES THROUGHOUT THE REGION TO HELP IDENTIFY PEOPLE WHO MAY HAVE PRE-DIABETES OR DIABETES AND TO EDUCATE THEM ABOUT SEEKING CARE AND ASSISTING INDIVIDUALS WHO ARE MANAGING THEIR CONDITION. HYPERTENSION: KDMC PROVIDED MULTIPLE SCREENING AND EDUCATION EVENTS FOCUSED ON HYPERTENSION IN THE SERVICE AREA AND BEYOND. MATERIALS WERE PROVIDED TO PARTICIPANTS ON HOW TO LOWER OR MAINTAIN A HEALTHY BLOOD PRESSURE.IN ADDITION TO THE PROGRAMMING FOCUSED SPECIFICALLY ON THE SIX PRIMARY NEEDS FROM THE CHNA, KDMC PROVIDED ADDITIONAL PROGRAMMING IN THE PRIMARY, SECONDARY AND TERTIARY MARKET, INCLUDING HEALTH SCREENINGS, HEALTH EDUCATION PROGRAMS, SUPPORT GROUPS, CLINICAL RESEARCH OPPORTUNITIES, BLOOD DRIVES, MOBILE SERVICES, AND OTHERS.KDMC ADDRESSED ALL OF THE SIGNIFICANT NEEDS IDENTIFIED THROUGH THE CHNA. ALL GOALS AND OBJECTIVES FOR THE THREE-YEAR PLAN ARE CURRENTLY BEING MET. ASHLAND HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: DOES NOT COVER SERVICES DEEMED NOT MEDICALLY NECESSARY. ASHLAND HOSPITAL CORPORATION PART V, SECTION B, LINE 24: ONLY FOR SERVICES EXCLUDED FROM ELIGIBILITY AS DEFINED WITHIN THE FAP, WHICH ARE DEFINED AS ELECTIVE SERVICES AND THEREFORE NOT MEDICALLY NECESSARY. 23 1 - CENTER FOR ADVANCED IMAGING 2225 CENTRAL AVENUE ASHLAND KY 41101 OUTPATIENT IMAGING CENTER 2 - ASHLAND URGENT CARE 2245 WINCHESTER AVENUE ASHLAND KY 41101 URGENT CARE 3 - GRAYSON URGENT CARE I-64 INTERCHANGE GRAYSON KY 41143 URGENT CARE 4 - IRONTON URGENT CARE 912 PARK AVENUE IRONTON OH 45638 URGENT CARE 5 - OUTPATIENT SERVICES CENTER 480 23RD STREET ASHLAND KY 41101 PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY 6 - CATLETTSBURG FAMILY CARE CENTER 4004 LOUIS RD CATLETTSBURG KY 41129 FAMILY CARE CENTER 7 - CEDAR KNOLL FAMILY CARE CENTERPEDIATRIC 10650 US ROUTE 60 ASHLAND KY 41102 FAMILY CARE CENTER/PEDIATRICS 8 - FLATWOODS FAMILY CARE 1107 BELLEFONTE RD FLATWOODS KY 41139 FAMILY CARE CENTER 9 - GRAYSON MEDICAL SPECIALTIES 609 N CAROL MALONE BLVD GRAYSON KY 41143 FAMILY CARE CENTER 10 - FLATWOODS MEDICAL SPECIALTIES 1109 BELLEFONTE RD FLATWOODS KY 41139 FAMILY CARE CENTER 11 - OLIVE HILL FAMILY CARE CENTER 391 WEST TOM T HALL BOULEVARD OLIVE HILL KY 41164 FAMILY CARE CENTER 12 - BURLINGTON FAMILY CARE CENTER 384 COUNTRY ROAD 120 SOUTH SOUTH POINT OH 45680 FAMILY CARE CENTER 13 - IRONTON FAMILY CARE CENTER 912 PARK AVENUE IRONTON OH 45638 FAMILY CARE CENTER 14 - JACKSON MEDICAL SPECIALTIES 14395 STATE ROUTE 93 JACKSON OH 45640 FAMILY CARE CENTER 15 - PORTSMOUTH MEDICAL SPECIALTIES 2001 SCIOTO TRAIL PORTSMOUTH OH 45662 FAMILY CARE CENTER 16 - WHEELERSBURG FAMILY CARE 8750 OHIO RIVER ROAD WHEELERSBURG OH 45694 FAMILY CARE CENTER 17 - SANDY HOOK FAMILY CARE CENTER STATE ROUTES 7 AND 32 SANDY HOOK KY 41171 FAMILY CARE CENTER 18 - KDMC OCCUPATIONAL MEDICINE 2301 LEXINGTON AVE STE 215 ASHLAND KY 41101 OCCUPATIONAL MEDICINE 19 - KDMC HOME HEALTH 2301 LEXINGTON AVE STE 305 ASHLAND KY 41101 HOME HEALTH SERVICES 20 - PRESTONSBURG FAMILY CARE 1279 OLD ABBOT MOUNTAIN RD PRESTONBURG KY 41653 FAMILY CARE CENTER 21 - RUSSELL WALK-IN CAREHALL FAMILY CARE 399 DIEDERICH BLVD RUSSELL KY 41169 WALK-IN CLINIC AND FAMILY CARE CENTER 22 - BURLINGTON URGENT CARE 384 COUNTRY ROAD 120 SOUTH SOUTH POINT OH 45680 URGENT CARE 23 - KDMC SKILLED NURSING FACILITY 2201 LEXINGTON AVENUE ASHLAND KY 41101 SKILLED NURSING PART I, LINE 7: KDMC USED WORKSHEET 2 PROVIDED IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST TO CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE CHARITY CARE AT COST. TO CALCULATE UNPAID COSTS OF MEDICAID, THE HOSPITAL'S COST ACCOUNTING SYSTEM WAS USED, ALONG WITH DATA FROM THE KY MEDICAID COST REPORT. ALL OTHER ITEMS WERE REPORTED AS NET EXPENSE. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $23,124,129. PART II, COMMUNITY BUILDING ACTIVITIES: THE EXPENSES REPORTED IN PART II FOR COMMUNITY BUILDING ACTIVITIES ARE THE EXPENSES ASSOCIATED WITH RECRUITING PHYSICIANS TO MEDICALLY UNDER-SERVED AREAS (MURS). THESE EXPENSES ARE NECESSARY TO ENSURE OUR COMMUNITY IS STAFFED WITH THE PHYSICIANS TO MEET THE NEEDS OF THE PEOPLE LIVING HERE. PART III, LINE 2: KDMC USED WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST TO CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE BAD DEBT EXPENSE AT COST. PART III, LINE 3: BAD DEBT EXPENSE IS RECORDED AFTER ANY DISCOUNTS AND PAYMENTS ARE MADE ON PATIENT ACCOUNTS. HOWEVER, THE BUSINESS OFFICE DOES NOT KEEP TRACK OF "NO-RESPONSE" APPLICATIONS AND DOES NOT FEEL THAT THE PORTION CONSIDERED TO BE A COMMUNITY BENEFIT IS MATERIAL. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUAL AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND INSURED PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES), THE MEDICAL CENTER 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 BILLED RATES 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 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES THE ALLOWABLE COSTS PER THE MEDICARE COST REPORT, THE MOST RECENT COST REPORT DATA, AND PROVIDER STATISTICAL AND REIMBURSEMENT REPORT WAS USED TO COMPUTE THE INFORMATION. PART III, LINE 9B: THE HOSPITAL HAS A WRITTEN POLICY FOR BAD DEBT. UNINSURED PATIENTS ARE SCREENED FOR ELIGIBILITY FOR MEDICARE, MEDICAID AND OTHER SUCH PROGRAMS BY A CONTRACTED VENDOR. ALL PATIENTS, INSURED AND UNINSURED, WITH VALID MAILING ADDRESSES RECEIVE POST-DISCHARGE BILLING STATEMENTS OVER THE COURSE OF A 120 DAY PERIOD. IF THERE ARE NO ACTIVE DISPUTES OR OTHER PAYMENT SOURCES AVAILABLE, AND THE BALANCE IS UNPAID AT THE END OF THE STATEMENT PERIOD, THE ACCOUNT WILL BE PLACED WITH A COLLECTION AGENCY TO REPORT AS A BAD DEBT. EACH STATEMENT INCLUDES INFORMATION REGARDING THE AVAILABILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM ALONG WITH A NUMBER WHERE REPRESENTATIVES CAN BE REACHED FOR ASSISTANCE. PART VI, LINE 2: WE USE A VARIETY OF RESOURCES TO HELP MAKE DECISIONS ON HOW TO BEST TARGET OUR ACTIVITIES, INCLUDING INFORMATION FROM OUR COMMUNITY HEALTH NEEDS ASSESSMENT, STATE AND COUNTY MORTALITY DATA AND HOSPITAL DATA. WE HAVE AN ACTIVE PATIENT ADVISORY COUNCIL THAT GIVES INPUT ON NEEDS, ACTIVITIES, AND PROCESSES FOR THE MEDICAL CENTER. WE HAVE CHAPLAINS, PATIENT REPRESENTATIVES AND SOCIAL WORKERS WHO ALSO HELP IDENTIFY AND MEET NEEDS. WE ARE ACTIVELY INVOLVED IN THE COMMUNITY PARTICIPATING ON A HEALTH COALITION, NON-PROFITS BOARDS, ATTENDING COMMUNITY PROGRAMS/MEETINGS AND OTHER ACTIVITIES TO HELP KEEP US INFORMED OF NEEDS, CONCERNS AND ISSUES. ONCE WE KNOW WHAT ISSUES WE WANT TO TARGET, OUR COMMUNITY HEALTH INITIATIVES ARE BUILT INTO THE MEDICAL CENTER'S STRATEGIC PLAN. PART VI, LINE 3: THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY PROVIDES DIRECTION FOR FREE OR DISCOUNTED SERVICES TO RESIDENTS OF THE COMMUNITY WHO HAVE INADEQUATE FINANCIAL RESOURCES TO PAY FOR NECESSARY HEALTHCARE SERVICES PROVIDED BY KING'S DAUGHTERS. THE POLICY STATES THAT THE MEDICAL CENTER WILL NOT DENY CARE TO ANY PATIENT REQUIRING CARE DUE TO THEIR INABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY PROVIDES GUIDANCE TO PROVIDING ASSISTANCE BASED ON SLIDING SCALE METHODOLOGY AND THE FEDERAL POVERTY GUIDELINES ESTABLISHED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS REQUIRING CARE WITH INCOME BELOW 300% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR FREE OR REDUCED COST SERVICES. KING'S DAUGHTERS ALSO CONTRACTS WITH OUTSIDE VENDORS TO ASSIST PATIENTS IN GOVERNMENT ENROLLMENT PROGRAMS. THERE ARE VARIOUS WAYS THE FINANCIAL ASSISTANCE PROGRAM IS CONVEYED TO THE COMMUNITY: KDMC WEBSITE, SIGNS IN VARIOUS PATIENT REGISTRATION AREAS, OUTBOUND/INBOUND CUSTOMER SERVICES CALLS, STATEMENT LANGUAGE, AND CERTAIN COMMUNITY EVENTS ( "IN THE KNOW" NIGHT FOR BOYD CO. SCHOOLS). PART VI, LINE 4: KING'S DAUGHTERS MEDICAL CENTER IS LOCATED IN EASTERN KENTUCKY, WHERE THE KENTUCKY, OHIO AND WEST VIRGINIA LINE MEET. KDMC'S PRIMARY SERVICE AREA ENCOMPASSSES SIX COUNTIES IN TWO STATES: BOYD, CARTER, GREENUP AND LAWRENCE IN KY AND LAWRENCE AND SCIOTO IN OHIO. ABOUT 260,000 PEOPLE LIVE IN THE SIX-COUNTY SERVICE REGION. THE REGION COVERS 2,392 SQUARE MILES. THE POPULATION DENSITY IS APPROXIMATELY 190 PERSONS PER SQUARE MILE. THE AREA IS PREDOMINANTLY RURAL (47.19%), WITH AN URBAN POPULATION AT 35.3% AND SUBURBAN (17.5%). OF THE POPULATION, 96.2% ARE WHITE, 1.6% ARE BLACK AND 2.2% MAKE UP ALL OTHER RACES. THERE ARE MORE FEMALES (50.8%) THAN MALES (49.2%) IN THE AREA. PER CAPITA INCOME IS $22,432, COMPARED TO KENTUCKY ($25,888) AND OHIO ($29,011). APPROXIMATELY 23% OF THE POPULATION LIVES IN POVERTY. OVER SIX-PERCENT OF THE POPULATION UNDER THE AGE OF 65 IS WITHOUT ANY FORM OF HEALTHCARE COVERAGE. PART VI, LINE 5: TO REACH OUR COMMUNITIES AND TO PROVIDE THE BEST OUTREACH SERVICES POSSIBLE, WE PARTNER WITH A DIVERSE GROUP OF BOTH PUBLIC AND PRIVATE ENTITIES. WE HAVE ESTABLISHED PARTNERSHIPS WITH AREA RETAILERS, HEALTH DEPARTMENTS, FACTORIES, CITY OF ASHLAND, LOCAL EMS SERVICES, AMERICAN RED CROSS, SUSAN G. KOMEN, CARES, COMMUNITY KITCHEN, SAFE HARBOR, 16 SCHOOL DISTRICTS AND NEARBY COLLEGES AND UNIVERSITIES, SHELTER OF HOPE, ASHLAND AREA YMCA, AREA SENIOR CITIZENS CENTERS AND MORE THAN 150 CHURCHES. WE SEND OUR OUTREACH TEAMS OUT INTO THE COMMUNITY TO MEET PEOPLE ON THEIR TIME AND IN THE PLACES THAT ARE COMFORTABLE FOR THEM - SCHOOLS, MALLS, CHURCHES, LIBRARIES, WORKSITES, GROCERY STORES AND MORE. SERVICES PROVIDED INCLUDE MORE THAN 50 SCREENING AND EDUCATIONAL EVENTS EACH MONTH, MOBILE HEALTH SERVICES, COORDINATION OF A REGIONAL CPR TRAINING CENTER AND A MEALS ON WHEELS PROGRAM.ADDITIONAL COMMUNITY HEALTH ACTIVITIES:THE MEDICAL CENTER PROVIDES FREE EDUCATIONAL AND SCREENING SERVICES IN AN AREA BROADER THAN THE PRIMARY MARKET. THIS AREA INCLUDES MULTIPLE COUNTIES IN EASTERN KENTUCKY, SOUTHERN OHIO AND WESTERN WEST VIRGINIA. KDMC WORKS WITH CHURCHES, SCHOOLS, BUSINESSES AND COMMUNITY GROUPS TO HELP IMPROVE HEALTH THROUGHOUT THE TRI-STATE AREA. AS A LEADER IN HEALTHCARE IN THE AREA, KDMC IS OFTEN CALLED UPON TO PROVIDE SCREENINGS AND HEALTH EDUCATION IN MORE REMOTE REGIONS WHERE THERE ARE NO PROVIDERS TO OFFER THESE SERVICES. THE FOLLOWING ACTIVITIES, WHICH CONTRIBUTE TO COMMUNITY HEALTH, BUT ARE NOT SPECIFIC TO THE IMPLEMENTATION PLAN GOALS AND OBJECTIVES WERE PROVIDED (COVERED AREAS INCLUDE PRIMARY, SECONDARY AND TERTIARY COUNTIES UNLESS OTHERWISE STATED):SCREENINGS, IMMUNIZATIONS AND PHYSICALS:- CARPAL TUNNEL SCREENING 7 ADULTS SCREENED- DERMA SCAN FOR SKIN DAMAGE 30 ADULTS SERVED- GENERAL HEALTH SCREENING (TOTAL CHOLESTEROL, BLOOD PRESSURE AND BLOOD SUGAR TESTS) 561 ADULTS SCREENED, TOTAL TESTS PROVIDED 2,119 - HEALTHY HEART SCREENING (TOTAL CHOLESTEROL, BLOOD PRESSURE, BLOOD SUGAR AND EKG) 538 ADULTS SCREENED, TOTAL TESTS PROVIDED 2,767 SCREENED - JOINT PAIN 81 ADULTS SCREENED- MOBILE MAMMOGRAPHY 1,529 WOMEN SERVED- PROSTATE CANCER 30 ADULTS SCREENED- SKIN CANCER 63 ADULTS- SPORTS PHYSICALS- 125 ADULTS (COLLEGE), 1,260 YOUTH- FLU SHOTS 1,887- VASCULAR SCREENINGS (LOW COST) 16 ADULTS SERVEDHEALTH EDUCATION:- AUTOMATED EXTERNAL DEFIBRILLATOR 15 ADULTS SERVED- BONE HEALTH 330 ADULTS AND 250 CHILDREN SERVED- BRAIN HEALTH 225 ADULTS SERVED- BREAST CANCER 2,584 ADULTS, 84 CHILDREN SERVED- CONCUSSION 150 ADULTS SERVED- CONGESTIVE HEART FAILURE 541 ADULTS- COLON CANCER 330 ADULTS- DENTAL HEALTH 200 ADULTS AND 250 CHILDREN- DIABETES 1,717 ADULTS, 586 CHILDREN SERVED- FAMILY AND FRIENDS CPR 14 ADULTS AND 2 CHILDREN- FIRE SAFETY 10 ADULTS- FIRST AID 28 ADULTS, 8 CHILDREN SERVED- FLU PREVENTION 192 ADULTS AND 55 CHILDREN SERVED- HAND WASHING 1,257 ADULTS, 888 CHILDREN SERVED- HEALTHY HEART EDUCATION 1,282 ADULT, 358 CHILDREN SERVED- HEPATITIS A EDUCATION IN RESPONSE TO A COMMUNITY OUTBREAK OF HEP A, KDMC PROVIDED EDUCATION THROUGHOUT THE AFFECTED AREA 848 INDIVIDUAL WERE SERVED- HEPATITIS C EDUCATION 42 SERVED- HYPERTENSION 234 ADULTS SERVED- IMMUNIZATIONS 25 ADULTS, 5 CHILDREN SERVED- LUNG CANCER 445 ADULTS AND 122 CHILDREN SERVED- MEDICATION SAFETY 130 ADULTS, 1,194 CHILDREN SERVED- NUTRITION EDUCATION 1,592 ADULTS, 2,442 CHILDREN/YOUTH SERVED - POISON PREVENTION 57 ADULTS, 115 CHILDREN SERVED- PREGNANCY/PARENTING EDUCATION 121 ADULTS AND 62 CHILDREN SERVED- PROSTATE CANCER 171 ADULTS SERVED- SANE FOR NURSING STUDENTS 60 SERVED- SCHOOL BUS SAFETY 326 ADULTS SERVED- SKIN CANCER 430 ADULTS, 56 CHILDREN SERVED- STRESS 129 SERVED- STROKE 1,751 ADULTS SERVED, 544 CHILDREN SERVED - STOP THE BLEED OR FIRST RESPONDERS 48 SERVED- STUFFEE 50 ADULTS AND 50 CHILDREN SERVED- SUMMER SAFETY 447 ADULTS, 71 CHILDREN/YOUTH SERVED- THYROID HEALTH 225 ADULTS SERVED- TOBACCO 861 ADULTS, 680 CHILDREN/YOUTH - VEHICLE SAFETY 250 ADULTS, 100 CHILDREN SERVEDSUPPORT GROUPS: KDMC PROVIDES VARIOUS SUPPORT GROUPS FOR INDIVIDUALS WITH DISEASE AND/OR THEIR CAREGIVERS. DURING FY18, THE FOLLOWING GROUPS WERE OFFERED.- ADULT DIABETES MELLITUS 42 ATTENDED- CHOOSE TO LOSE 3 ATTENDED- DIABETES 49 ATTENDED- LOOK GOOD, FEEL BETTER 24 ATTENDED- PARKINSON'S DISEASE 72 ATTENDED- SURGICAL WEIGHT LOSS 47 ATTENDEDCLINICAL RESEARCH: KDMC SUPPORTS CLINICAL RESEARCH IN BOTH CARDIOLOGY AND ONCOLOGY. ONCOLOGY COMMUNITY NEEDS ASSESSMENT: THE ONCOLOGY SERVICE LINE CONDUCTED A COMMUNITY NEEDS ASSESSMENT IN FY 2018 TO HELP DRIVE THE PATIENT NAVIGATION PROCESS TO ADDRESS HEALTHCARE DISPARITIES AND BARRIERS TO CANCER CARE. THE CHNA WAS USED TO IDENTIFY THE COMMUNITY, FACTORS CONTRIBUTING TO DISPARITIES, BARRIERS TO CARE AND AVAILABILITY OF RESOURCES. THE RESULTS SERVE AS THE BUILDING BLOCKS TO FUTURE NAVIGATIONAL NEEDS AND THE DEVELOPMENT OF PATIENT RESOURCES NEEDED ON-SITE OR BY REFERRAL. OTHER COMMUNITY ACTIVITIES:BLOOD DRIVES - KDMC HOSTED 13 BLOOD DRIVES ON KDMC CAMPUSES. A TOTAL OF 508 COMMUNITY AND TEAM MEMBERS DONATED BLOOD.LOW COST BLOOD TESTS - AS PART OF KDMC'S LOW COST BLOOD PROFILES, INDIVIDUALS RECEIVE A FASTING GLUCOSE TEST. THIS TEST CAN TELL THE INDIVIDUAL IS THEY HAVE ABNORMAL BLOOD SUGAR READINGS. KDMC HOSTED 13 EVENTS, WITH 921 PEOPLE TESTED. IN ADDITION, FOR AN EXTRA $5 AN A1C TEST CAN BE ADDED TO THE PROFILE. DURING 2017, 738 PEOPLE ADDED THE A1C TEST TO CHECK THEIR THREE-MONTH AVERAGE BLOOD SUGAR READING.FIRST AID STATION-KDMC OFFERS FIRST AID STATION SUPPORT FOR AREA EVENTS. DURING THE FISCAL YEAR, 237 ADULTS AND 557 CHILDREN WERE SERVED.FOOD FEUD THE FOOD FEUD IS A FOOD DRIVE COMPETITION BETWEEN KDMC AND OUR LADY OF BELLEFONTE HOSPITAL TO SEE WHICH HOSPITAL CAN COLLECT THE MOST NON-PERISHABLE FOOD FOR DONATION TO RIVER CITIES HARVEST. KDMC WON WITH A DONATION OF 27,137 POUNDS OF FOOD.BACKPACK PROGRAM- THIS IS A PARTNERSHIP WITH THE ASHLAND ALLIANCE. TEAM MEMBERS FILLED BACKPACKS WITH SCHOOL SUPPLIES FOR 116 ELEMENTARY, MIDDLE AND HIGH SCHOOL AGED CHILDREN TO ENSURE STUDENTS START THE SCHOOL YEAR WITH THE NECESSARY SCHOOL SUPPLIES AND AT LEAST ONE NEW OUTFIT OF CLOTHES.FARMER'S MARKET KDMC, WORKING WITH THE BOYD COUNTY COOPERATIVE EXTENSION SERVICE, HOSTS A FARMER'S MARKET ON SITE OF ITS 24TH STREET PARKING LOT. THE FARMER'S MARKET BRINGS FRESH PRODUCE AT A REASONABLE PRICE TO ONE OF ASHLAND'S LOWER INCOME NEIGHBORHOODS, WHICH ALSO IS A FOOD DESSERT AREA. THE MARKET IS OPEN ONE DAY PER WEEK, JUNE THROUGH SEPTEMBER.RIVER CITIES HARVEST KDMC PROVIDED RIVER CITIES HARVEST (RCH) WITH A USED CARGO VAN TO HELP WITH FOOD COLLECTION. IN ADDITION, KDMC DONATED 9,890 POUNDS OF FOOD FROM THE HOSPITAL CAFETERIA. THE FOOD IS COLLECTED EACH WEEKLY AND DELIVERED TO RCH BY VOLUNTEERS. KDMC ALSO PURCHASED $2,000 WORTH OF LIVESTOCK FROM THE BOYD COUNTY FAIR, WHICH WAS DONATED TO RCH FOR PROCESSING AND DISTRIBUTION TO THOSE IN NEED. IN ADDITION, KDMC DONATED A CARGO VAN TO RCH FOR USE PICKING UP AND DELIVERING FOOD.MEDICATION TAKE BACK PROGRAM: KING'S DAUGHTERS FAMILY PHARMACY IN ASHLAND ACCEPTS UNUSED MEDICATIONS AT ANY TIME, REGARDLESS OF WHEN A PRESCRIPTION WAS FILLED. THIS PROGRAM GIVES THE PUBLIC THE OPPORTUNITY TO PREVENT MEDICATION ABUSE AND THEFT BY RIDDING THEIR HOMES OF POTENTIALLY DANGEROUS EXPIRED, UNUSED AND UNWANTED PRESCRIPTION DRUGS. AN EASY-TO-USE CONTAINER INSIDE THE FAMILY PHARMACY AT MEDICAL PLAZA B IN ASHLAND MAKES IT CONVENIENT TO PROPERLY DISPOSE OF ALL TYPES OF MEDICATIONS. ADOPT-A-FAMILY- TEAM MEMBERS ADOPTED 30 FAMILIES, 26 NURSING HOME RESIDENTS AND 90 INDIVIDUAL CHILDREN, PROVIDING GIFTS AND FOOD TO THOSE IN NEED AT CHRISTMAS TIME. IN ADDITION, A CHRISTMAS PARTY WAS PROVIDED FOR THE SHELTER OF HOPE RESIDENTS AND RESIDENTS WERE PROVIDED STOCKINGS.BUILD-A-BED- BUILD-A-BED IS AN EFFORT OF MOREHEAD STATE UNIVERSITY THAT PUTS TOGETHER BEDS FOR UNDERPRIVILEGED CHILDREN IN THE REGION. THESE BEDS COME INTO KDMC'S PRIMARY SERVICE AREA THROUGH AN APPLICATION PROCESS WHERE PARENTS/GUARDIANS CAN APPLY FOR BEDS FOR THEIR CHILDREN. THE APPLICANTS MUST MEET INCOME ELIGIBILITY GUIDELINES. KDMC SUPPLIED 40 BED KITS (COMFORTER, SHEETS, PILLOW) FOR THE BEDS. IN ADDITION, HYGIENE ITEMS AND A STUFFED TOY WERE PROVIDED WITH EACH BED KIT FOR THE CHILDREN RECEIVING BEDS.JOE STEVENS COAT DRIVE IN HONOR OF A TEAM MEMBER THAT DIED OF CANCER AND HAD DONATED HIS COAT TO A HOMELESS PATIENT SEEKING CARE IN THE EMERGENCY ROOM, KDMC COLLECTS COATS EACH YEAR AND DONATES THEM TO LOCAL CHARITIES THAT SERVE THE HOMELESS AND OTHERS. IN FY18, KDMC COLLECTED AND DONATED 997 COATS AND 60 HYGIENE PACKS FOR THE HOMELESS.CPR TRAINING CENTER: KDMC'S CPR TRAINING CENTER PROVIDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT AND/OR PEDIATRIC ADVANCED LIFE SUPPORT TRAINING TO 3,820 INDIVIDUALS. OTHER ACTIVITIES: EASTER BASKETS KDMC COLLECTED EASTER BASKETS FOR RESIDENTS OF SHELTER OF HOPE. THERE WERE 29 BASKETS PROVIDED TO CHILDREN IN THE SHELTER.CRABBE ELEMENTARY KDMC COLLECTED FOOD AND CLOTHING TO HELP REPLACE ITEMS STOLEN FROM THE CRABBE ELEMENTARY FAMILY RESOURCE CENTER'S PANTRY AND CLOTHING CLOSET.CHILDBIRTH CLASSES CHILDBIRTH CLASSES HELP MOTHERS-TO-BE AND THEIR PARTNERS BECOME MORE COMFORTABLE WITH THE BIRTH EXPERIENCE, LEARN BIRTHING OPTIONS, NUTRITION, THE LABOR PROCESS, AND PAIN MANAGEMENT, TO HELP THEM MAKE THE BEST DECISIONS ABOUT HOW THEY WISH TO GIVE BIRTH. PARENTS-TO-BE ALSO LEARN ABOUT THE BENEFITS OF BREAST FEEDING. DURING FY18, KDMC WANTED TO MAKE CHILDBIRTH EDUCATION MORE ACCESSIBLE. THE WOMEN'S HEALTH TEAM, IN PARTNERSHIP WITH LOCAL OB/GYN PHYSICIANS, CREATED A CHILDBIRTH CLASSROOM IN THE DOCTOR'S PRACTICE AND PROVIDED A NURSE CHILDBIRTH EDUCATOR/LACTATION CONSULTANT ON MONDAY AND WEDNESDAY DURING THE OFFICE'S BUSIEST APPOINTMENT DAYS. BY ABANDONING THE TRADITIONAL ALL-DAY CHILDBIRTH CLASS AND PROVIDING MORE ONE-ON-ONE OR SMALL GROUP EDUCATION SESSIONS IN THE DOCTOR'S OFFICE, KDMC HAS BEEN ABLE TO REACH 10 TIMES AS MANY MOTHERS-TO-BE, SERVING 274 MOTHERS AND 465 (WHEN INCLUDING SIGNIFICANT OTHERS) TOTAL IN THESE SESSIONS. PART VI, LINE 6: KING'S DAUGHTERS MEDICAL CENTER IS PART OF AN AFFILIATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM OPERATES ANOTHER HOSPITAL, KING'S DAUGHTERS MEDICAL CENTER OHIO ("KDOH") IN PORTSMOUTH, OH. KDOH HAS BEEN SPECIFICALLY DESINGED TO MEETING THE HEALTHCARE NEEDS OF PORTSMOUTH AND ITS SURROUNDING AREAS. KDOH OFFERS SURGICAL AND URGENT CARE SERVICES. KDOH PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. THE SYSTEM PROVIDES PHYSICIAN SERVICES THROUGH KING'S DAUGHTERS MEDICAL SPECIALITIES, INC. ("KDMS"). KDMS PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. KING'S DAUGHTERS ALSO INCLUDES TWO OTHER AFFILIATES - KING'S DAUGHTERS MEDICAL TRANSPORT, WHICH SEEKS TO CONTINUOUSLY IMPROVE THE PRE- AND POST-HOSPITAL HEALTHCARE PROVIDED IN ALL OF IT'S SERVCIES AREAS WHILE ENSURING THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED; AND KINGSBROOK NURSING HOME, WHICH PROVIDES QUALITY CARE TO PATIENTS, MEETING THE NEEDS AND DESIRES OF RESIDENTS AT VARIOUS LEVELS OF CARE, INCLUDING SHORT-TERM AND LONG-TERM CARE. 1 AMERICAN RED CROSS 510 E CHESTNUT STREET LOUISVILLE KY 40202 530196605 501(C)(3) 3000 4450 INVOICES FOOD CONTRIBUTION TO DANCING WITH OUR STARS & FOOD FOR MONTHLY BLOOD DRIVES ASHLAND COMMUNITY KITCHEN PO BOX 1743 ASHLAND KY 411051743 611100724 501(C)(3) 44565 3118 INVOICES FOOD AND MISC. SUPPLIES PROVIDE FOOD TO SENIOR CITIZENS IN OUR COMMUNITY THROUGH MEALS ON WHEELS HIGHLANDS MUSEUM AND DISCOVERY CENTER 1620 WINCHESTER AVENUE ASHLAND KY 41101 311061542 501(C)(3) 10500 0 N/A N/A SPONSORHIP OF FUNDRAISING EVENT AND MUSEUM EXHIBIT NEIGHBORS HELPING NEIGHBORS 2516 CARTER AVENUE ASHLAND KY 41101 611450110 501(C)(3) 5600 0 N/A N/A SPONSORHIP OF 2 FUNDRAISING EVENTS PARAMOUNT ARTS CENTER 1300 WINCHESTER AVENUE ASHLAND KY 41101 611181883 501(C)(3) 17000 180 INVOICES LEAF BLOWER SPONSORSHIP OF ANNUAL SPRING GALA FUNDRAISER, POSTCARD FUNDRAISING EVENT, AND ARTS & MUSIC FESTIVAL RIVER CITIES HARVEST PO BOX 2136 ASHLAND KY 411052136 611208113 501(C)(3) 8650 0 N/A N/A FOODBANK SUPPORT & SPONSORSHIP OF FUNDRAISING EVENT SAFE HARBOR OF NORTHEAST KENTUCKY PO BOX 2163 ASHLAND KY 411052163 611155742 501(C)(3) 7750 0 N/A N/A SPONSORSHIP OF ANNUAL LOBSTER FEST FUNDRAISER AND AWARDS CEREMONY SUMMER MOTION PO BOX 1643 ASHLAND KY 41105 311695435 501(C)(4) 5000 840 INVOICES FOOD SUPPORT OF ANNUAL COMMUNITY FESTIVAL & VOLUNTEERS UNITED WAY OF NORTHEAST KENTUCKY 2000 CARTER AVENUE SUITE D ASHLAND KY 41101 616000060 501(C)(3) 13718 11584 INVOICES MARKETING MATERIALS CONTRIBUTION TO ANNUAL FUNDRAISING CAMPAIGN ASHLAND ALLIANCE 1730 WINCHESTER AVENUE ASHLAND KY 41101 611347516 501(C)(6) 6045 1943 INVOICES FOOD SPONSORSHIP OF ANNUAL AWARDS CEREMONY, YOUTH LEADERSHIP BANQUET, AND 2 FUNDRAISING EVENTS BOYD COUNTY COOPERATIVE EXTENSION AGENCY 2420 CENTER STREET CATLETTSBURG KY 41129 900992379 501(C)(3) 0 12000 INVOICES TENT SUPPORT OF LOCAL FARMERS MARKET 9 2 PART I, LINE 2: KING'S DAUGHTERS MEDICAL CENTER MAKES GRANTS/CONTRIBUTIONS TO ORGANIZATIONS BASED ON THE NEED OF THE ORGANIZATION AND THE TYPE OF EVENT IT SUPPORTS. MOST CONTRIBUTIONS ARE TO NON-PROFIT ORGANIZATIONS THAT FULFILL A NEED IN THE COMMUNITY, PROMOTE HEALTHY LIVING AND/OR ARE ECONOMIC-DEVELOPMENT BASED. ALL REQUESTS MUST BE MADE IN WRITING TO KDMC OUTLINING WHAT IS NEEDED AND HOW IT WILL BE USED. CONTRIBUTIONS ARE TRACKED AND DOCUMENTED. X X X 1 1 0 0 0 0 0 0 0 KRISTIE WHITLATCH PRESIDENT/CEO 602774 0 90554 0 137225 0 5400 0 16498 0 852451 0 115099 0 SHERYL MAHANEY NON-VOTING SECRETARY, VP/CHIEF LEGAL 281378 0 42345 0 92088 0 5400 0 16356 0 437567 0 90156 0 AUTUMN MCFANN NON-VOTING TREASURER, VP/CFO 284978 0 42885 0 4664 0 5400 0 16356 0 354283 0 0 0 JAMES DETHERAGE MD DIRECTOR/PRESIDENT MED STAFF/CMO 24000 468454 0 0 0 90 0 5400 0 23778 24000 497722 0 0 KELLY HURT VP PEOPLE SERVICES 208878 0 31500 0 626 0 2730 0 17072 0 260806 0 0 0 SARA MARKS VP/EXECUTIVE DIRECTOR KDIP 218477 0 33435 0 14998 0 5400 0 27912 0 300222 0 0 0 RICHARD FORD MD VP/CMO OF INPATIENT/PROC. 28740 507453 0 0 0 0 0 5400 106 15735 28846 528588 0 0 EVAN CONDEE DO PHYSICIAN 386110 0 0 0 54 0 5400 0 9331 0 400895 0 0 0 CHARLES CONLEY DO PHYSICIAN 374770 0 0 0 90 0 5400 0 26484 0 406744 0 0 0 JANE STRADER MD PHYSICIAN 251192 0 12222 0 20060 0 5400 0 14844 0 303718 0 0 0 PATRICK BALL DO PHYSICIAN 369465 0 0 0 396 0 5400 0 15564 0 390825 0 0 0 MARIA NASH MD PHYSICIAN 251153 0 6667 0 5243 0 5083 0 24340 0 292486 0 0 0 MATTHEW EBAUGH UNTIL 51717 FORMER CHIEF STRATEGY OFFICER/CIO 106517 0 0 0 93134 0 0 0 26289 0 225940 0 0 0 PART I, LINES 4A-B SEVERANCE PAYMENT: A FORMER KEY EMPLOYEE, MATTHEW EBAUGH, RECEIVED SEVERANCE PAYMENT IN THE AMOUNT OF $83,077 IN 2017. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: KRISTIE WHITLATCH - $115,099 SHERYL MAHANEY - $90,156 THERE WERE NO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS/DEFERRALS IN 2017. THE CEO AND VICE PRESIDENTS ARE ELIGIBLE TO RECEIVE DISCRETIONARY INCENTIVES BASED ON CERTAIN METRICS (QUALITY MEASURES, INDIVIDUAL GOALS, ETC.). THESE AWARDS ARE DETERMINED BY THE BOARD AND VESTED OVER A 5-10 YEAR PERIOD IF THE INDIVIDUAL REMAINS WITH THE ORGANIZATION. THE CEO AND CERTAIN VICE PRESIDENTS, WHOSE BENEFIT IN THE QUALIFIED TAX SHELTERED ANNUITY PLAN IS LIMITED DUE TO THE IRS COMPENSATION AND BENEFIT LIMITS, RECEIVE A BENEFIT RESTORATION CONTRIBUTION UNDER THE DEFERRED ANNUITY PLAN THAT IS PAID AS A TAXABLE DISTRIBUTION TO THE PARTICIPANT ANNUALLY. A KENTUCKY ECONOMIC DEVELOPMENT AUTHORITY (KEDFA) 610600439 491269CG9 2008-09-24 146580000 REFUND PRIOR BOND ISSUES 0 0 0 B KENTUCKY ECONOMIC DEVELOPMENT AUTHORITY (KEDFA) 610600439 491269CY0 2010-04-01 75000000 HEALTHCARE FACILITIES, BUILDING AND EQUIPMENT 0 0 0 C CITY OF ASHLAND KENTUCKY 616001775 044293AA6 2010-04-01 32615000 REFUND SERIES 1998 BOND 0 0 0 D CITY OF ASHLAND KENTUCKY 616001775 044293AN8 2016-09-23 73445000 REFUND PRIOR BOND ISSUES 0 0 0 A 119125000 145708338 1423351 12574982 131710005 2010 1 0 1 1 B 18290000 73889274 1170837 72718420 17 2015 0 0 1 1 C 13390000 33986558 507546 33479012 2010 1 0 1 1 D 4120000 81984559 1200341 80784218 2016 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: KENTUCKY ECONOMIC DEVELOPMENT AUTHORITY (KEDFA) DATE THE REBATE COMPUTATION WAS PERFORMED: 10/21/2018 ISSUER NAME: KENTUCKY ECONOMIC DEVELOPMENT AUTHORITY (KEDFA) DATE THE REBATE COMPUTATION WAS PERFORMED: 03/24/2015 ISSUER NAME: CITY OF ASHLAND, KENTUCKY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/24/2015 PART II, LINE 3, ISSUE A SERIES 2008C BOND DISCOUNT $871,662. ALSO, THE BOND ISSUES LISTED ON SCHEDULE K, PART I, LINE A CONSISTED OF THREE SERIES: SERIES 2008A, CUSIP 49126CG9, ISSUE PRICE 50,000,000 VARIABLE RATE ISSUE; SERIES 2008B, CUSIP 401269CH7, ISSUE PRICE 50,000,000, VARIABLE RATE ISSUE; SERIES 2008C, CUSIP 491269CJ3, ISSUE PRICE $46,580,000, FIXED RATE ISSUE. PART II, LINE 3, ISSUE B SERIES 2010A DIFFERENCE FROM PART I DUE TO BOND DISCOUNT $1,318,161.05, OFFSET BY $207,435 INTEREST EARNED. PART II, LINE 3, ISSUE C SERIES 2010B - DIFFERENCE FROM PART I DUE TO BOND PREMIUM $1,371,558.05 PART II, LINE 3, ISSUE D SERIES 2016A - DIFFERENCE FROM PART I DUE TO BOND PREMIUM OF $8,539,559 A CITY OF ASHLAND KENTUCKY 616001775 2016-09-23 50000000 REFUND PRIOR BOND ISSUES 0 0 0 A 2375097 50000000 254000 49746000 2016 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 ANNE SLOAN SEE PART V 50411 SEE PART V 0 ASHLAND OFFICE SUPPLY SEE PART V 771954 SEE PART V 0 ASHLAND RADIOLOGY ASSOCIATES PSC SEE PART V 718398 SEE PART V 0 CAROLE EBAUGH SEE PART V 19726 SEE PART V 0 CINDY GILLUM SEE PART V 23514 SEE PART V 0 FRESENIUS MEDICAL CARE SEE PART V 974882 SEE PART V 0 OFFICE FUNITURE USA SEE PART V 484450 SEE PART V 0 VAN ART PROPERTIES SEE PART V 370260 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: ANNE SLOAN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SISTER-IN-LAW OF JOHN STEWART (BOARD MEMBER)(D) DESCRIPTION OF TRANSACTION: EMPLOYEE PAYROLL COMPENSATION. THERE IS NO MANAGEMENT RELATIONSHIP OR CONTROL OVER COMPENSATION BY JOHN STEWART.(A) NAME OF PERSON: ASHLAND OFFICE SUPPLY(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TOM BURNETTE (BOARD MEMBER) IS THE OWNER(D) DESCRIPTION OF TRANSACTION: PURCHASE OF OFFICE SUPPLIES & EQUIPMENT. ALL TRANSACTIONS ARE DONE AT ARM'S LENGTH.(A) NAME OF PERSON: ASHLAND RADIOLOGY ASSOCIATES, PSC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: WIFE OF WILLIAM BOYKIN (BOARD MEMBER) IS A PHYSICIAN OF THIS PRACTICE(D) DESCRIPTION OF TRANSACTION: PAYMENTS FOR RADIOLOGY SERVICES. ALL TRANSACTIONS ARE DONE AT ARM'S LENGTH.(A) NAME OF PERSON: CAROLE EBAUGH(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: WIFE OF MATTHEW EBAUGH (FORMER CHIEF STRATEGY OFFICER/CIO)(D) DESCRIPTION OF TRANSACTION: EMPLOYEE PAYROLL COMPENSATION. THERE IS NO MANAGEMENT RELATIONSHIP OR CONTROL OVER COMPENSATION BY MATTHEW EBAUGH.(A) NAME OF PERSON: CINDY GILLUM(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SISTER OF KRISTIE WHITLATCH (PRESIDENT/CEO)(D) DESCRIPTION OF TRANSACTION: EMPLOYEE PAYROLL COMPENSATION. THERE IS NO MANAGEMENT RELATIONSHIP OR CONTROL OVER COMPENSATION BY KRISTIE WHITLATCH.(A) NAME OF PERSON: FRESENIUS MEDICAL CARE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DON HAMMONDS (BOARD MEMBER) IS AN INDEPENDENT CONTRACTOR/CONSULTANT FOR FRESENIUS(D) DESCRIPTION OF TRANSACTION: INPATIENT DIALYSIS TREATMENT. ALL TRANSACTIONS ARE DONE AT ARM'S LENGTH.(A) NAME OF PERSON: OFFICE FUNITURE USA(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TOM BURNETTE (BOARD MEMBER) IS THE OWNER(D) DESCRIPTION OF TRANSACTION: PURCHASE OF OFFICE FURNITURE. ALL TRANSACTIONS ARE DONE AT ARM'S LENGTH.(A) NAME OF PERSON: VAN ART PROPERTIES(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SON OF JOHN STEWART (BOARD MEMBER) IS THE OWNER(D) DESCRIPTION OF TRANSACTION: OFFICE SPACE RENT. ALL TRANSACTIONS ARE DONE AT ARM'S LENGTH. FORM 990, PART III, LINE 3 THE HOSPITAL CLOSED "HOME MEDICAL EQUIPMENT", A NON-MEDICAL FACILITY, IN MARCH 2018. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE OF THE AHC BOARD IS MADE UP OF THE FOLLOWING MEMBERS: DAVID JONES, CHAIR; STEPHEN ADDINGTON, VICE CHAIR; KRISTIE WHITLATCH, CHIEF EXECUTIVE OFFICER; JOHN STEWART, TRUSTEE; TOM BURNETTE, TRUSTEE; AND BRADLEY LEVI, TRUSTEE. ELECTION AND COMPOSITION: THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE TRUSTEES CHAIR, ANY VICE-CHAIRS, THE CHIEF EXECUTIVE OFFICER, AND ANY OTHER TRUSTEE RECOMMENDED BY THE CHAIR AND APPROVED BY THE TRUSTEES. THE TRUSTEES CHAIR SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. THE CHIEF EXECUTIVE OFFICER SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. POWERS AND FUNCTIONS: THE EXECUTIVE COMMITTEE SHALL HAVE ALL POWERS AND AUTHORITY OF THE TRUSTEES TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY LIMITATIONS IMPOSED BY THE TRUSTEES, THE BYLAWS OR BY APPLICABLE LAW. MEETINGS OF THE EXECUTIVE COMMITTEE SHALL BE HELD AS NEEDED. THE EXECUTIVE COMMITTEE SHALL FROM TIME TO TIME, AS IT DETERMINES APPROPRIATE, REVIEW AND RECOMMEND REVISIONS TO THE BYLAWS FOR CONSIDERATION AND APPROVAL BY THE TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ALSO RECEIVE SUCH REPORTS AS THE COMMITTEE MAY DIRECT FROM THE EXECUTIVE OR ANY SIMILAR COMMITTEE OF THE BOARD OF DIRECTORS OF EACH AFFILIATED ORGANIZATION CONCERNING THE ACTIVITIES OF SUCH COMMITTEE AND PROVIDE PERIODIC REPORTS ON SUCH ACTIVITIES TO THE TRUSTEES. FORM 990, PART VI, SECTION A, LINE 6 KING'S DAUGHTERS HEALTH SYSTEM IS THE CORPORATE MEMBER OF ASHLAND HOSPITAL CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM, KDHS HAS CERTAIN GOVERNANCE RIGHTS WITH RESPECT TO AHC. THOSE RIGHTS INCLUDE ELECTING OR REMOVING AHC'S DIRECTORS AND OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B AS THE PARENT ORGANIZATION OF THE HEALTH CARE SYSTEM, KDHS HAS CERTAIN GOVERNANCE RIGHTS WITH RESPECT TO AHC. THOSE RIGHTS REQUIRE CERTAIN SIGNIFICANT AHC ACTIONS TO NOW ALSO BE APPROVED BY KDHS, INCLUDING, AMONG OTHERS, A CHANGE OF MEMBERSHIP OR SALE OF AHC, ELECTING OR REMOVING AHC'S DIRECTORS AND OFFICERS, AMENDING AHC'S ARTICLES AND BYLAWS, OR ANY BANKRUPTCY, LIQUIDATION OR DISSOLUTION OF AHC, INCLUDING THE TAX-EXEMPT ORGANIZATION TO WHOM AHC'S ASSETS ARE DISTRIBUTED UPON ITS DISSOLUTION. KDHS' BOARD OF TRUSTEES MAY IDENTIFY ADDITIONAL AHC ACTIONS THAT MUST BE APPROVED BY KDHS IN ADDITION TO THOSE SPECIFICALLY LISTED IN AHC'S ARTICLES AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE CFO AND CONTROLLER. AFTER THIS REVIEW, BUT BEFORE IT IS FILED WITH THE IRS, THE FINAL 990 WILL BE PROVIDED TO THE FULL BOARD OF DIRECTORS USING BOARD EFFECTS SOFTWARE. AN E-MAIL WITH A LINK TO THE POSTING WILL BE SENT TO EACH BOARD MEMBER ONCE THE REPORT HAS BEEN POSTED. FORM 990, PART VI, SECTION B, LINE 12C ASHLAND HOSPITAL CORPORATION DBA KING'S DAUGHTERS MEDICAL CENTER REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO COMPLY WITH ITS CONFLICTS OF INTEREST POLICY, WHICH TRACKS THE IRS' RECOMMENDED POLICY WITH RESPECT TO SUCH OFFICERS AND DIRECTORS. MEMBERS OF THE MEDICAL CENTER'S BOARD OF DIRECTORS MUST ANNUALLY IDENTIFY, IN WRITING, ANY INTEREST THAT COULD GIVE RISE TO A CONFLICT, SUCH AS A LEADERSHIP POSITION IN A CONFLICTING ORGANIZATION; DISCLOSURE IS NOT LIMITED TO FINANCIAL CONFLICTS. LEADERSHIP EMPLOYEES MUST ANNUALLY CERTIFY, IN WRITING, THAT THEY KNOW OUR CONFLICTS OF INTEREST POLICY AND PROCEDURE AND HAVE NO CONFLICTS OF INTEREST. IN ADDITION, EMPLOYEES OF THE MEDICAL CENTER CERTIFY THAT NO CONFLICTS OF INTEREST EXIST OR OBTAIN AN ADVANCE WAIVER OF ANY CONFLICTS. THE MEDICAL CENTER'S HUMAN RESOURCES DEPARTMENT MAINTAINS ALL RELEVANT DISCLOSURES AND SIGNATURES. ALL EMPLOYEES PROVIDE ANNUAL CONFLICT CHECKS. IF A CONFLICT OF INTEREST IS REPORTED, THE VICE PRESIDENT TO WHOM THE REPORTING EMPLOYEE DIRECTLY OR INDIRECTLY REPORTS, TOGETHER WITH THE CEO, CHIEF CORPORATE COMPLIANCE OFFICER AND GENERAL COUNSEL, DETERMINES IF A CONFLICT EXISTS. IF THE REPORTING EMPLOYEE IS A VICE PRESIDENT, THE CEO, IN CONSULTATION WITH THE GENERAL COUNSEL, DETERMINES IF A CONFLICT EXISTS. ANNUALLY, BOARD MEMBERS DISCLOSE PERSONAL AND PROFESSIONAL RELATIONSHIPS TO THE SECRETARY OF THE BOARD. IF A POTENTIAL CONFLICT EXISTS, THE BOARD SECRETARY OR A BOARD MEMBER WILL IDENTIFY THE CONFLICT, OR POTENTIAL CONFLICT, AND THE BOARD MEMBER WILL BE REMOVED FROM ANY PART OF THE DECISION-MAKING PROCESS, AND HAS NO ROLE IN THE INSTANCE IN WHICH THE CONFLICT EXISTS. A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST MUST ABSTAIN FROM ANY RELEVANT DISCUSSION OR VOTE. IF A CONFLICT OF INTEREST IS DISCOVERED AFTER THE FACT, THE CEO AND VICE PRESIDENT, TOGETHER WITH THE GENERAL COUNSEL, IF APPROPRIATE, REVIEW THE INSTANCE IN WHICH THE CONFLICT OCCURRED. THOSE LEADERS DETERMINE WHETHER THE CONFLICTED INDIVIDUAL INFLUENCED THE DECISION-MAKING OR PROFITED FROM THE CONFLICT. THE CONFLICTED INDIVIDUAL IS REMOVED FROM ANY FURTHER INVOLVEMENT. IN ADDITION, ANY FAILURE TO REPORT CONFLICTS OF INTEREST VIOLATES THE MEDICAL CENTER'S POLICY AND COULD RESULT IN DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR REMOVAL FROM THE MEDICAL CENTER'S BOARD OF DIRECTORS. MEDICAL STAFF MEMBERS ARE REQUIRED BY THE MEDICAL STAFF BYLAWS TO DISCLOSE CONFLICTS OF INTEREST. ONCE DISCLOSED, THE MEDICAL STAFF MEMBER IS REMOVED FROM ANY DISCUSSION, DECISION-MAKING, AND/OR VOTE ON ANY RELATED ISSUE. FORM 990, PART VI, SECTION B, LINE 15 AT THE DIRECTION OF THE HUMAN RESOURCES & COMPENSATION COMMITTEE OF THE BOARD OF KING'S DAUGHTERS HEALTH SYSTEM (KDHS), KDHS ENGAGED SULLIVAN COTTER AND ASSOCIATES, INC., A LEADING INDEPENDENT COMPENSATION CONSULTING COMPANY SPECIALIZING IN EXECUTIVE, EMPLOYEE AND PHYSICIAN COMPENSATION AND BENEFITS FOR THE HEALTH CARE AND NOT-FOR-PROFIT INDUSTRY, TO ASSIST IN DETERMINING COMPENSATION OF THE CEO, VICE PRESIDENTS, AND CHIEF MEDICAL OFFICERS. SULLIVAN COTTER'S MOST RECENT EXECUTIVE COMPENSATION REVIEW WAS PERFORMED IN 2016. THE PRINCIPLE OBJECTIVE OF THIS STUDY WAS TO ASSEMBLE A DETAILED PROFILE OF THE CURRENT COMPENSATION LEVELS AVAILABLE TO EXECUTIVES MANAGING SIMILAR TASKS AND RESPONSIBILITIES AS MEMBERS OF THE KDHS EXECUTIVE TEAM. MOREOVER, THE OBJECTIVE WAS TO COMPILE MARKET DATA FOR EACH POSITION THAT WAS REFLECTIVE OF THE PAY LEVELS OFFERED BY INDEPENDENT, NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS OF COMPARABLE SIZE WITH OPERATIONS IN THE UNITED STATES. THE SULLIVAN COTTER DATA COUPLED WITH THE PERFORMANCE OF THE ORGANIZATION AS WELL AS THE PERSONAL PERFORMANCE OF EACH EXECUTIVE IS THE BASIS FOR KDHS'S HUMAN RESOURCE & COMPENSATION COMMITTEE'S REVIEW AND RECOMMENDATIONS, AND THE BOARD'S REVIEW AND APPROVAL OF COMPENSATION INCREASES. THE PROCESS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THIS PROCESS WAS USED TO DETERMINE COMPENSATION FOR THE FOLLOWING POSITIONS: - PRESIDENT/CEO - VP, CHIEF COMPLIANCE OFFICER - VP, CHIEF FINANCIAL OFFICER - VP, CHIEF LEGAL & REGULATORY OFFICER/GENERAL COUNSEL - CHIEF MEDICAL OFFICERS - VP, PEOPLE SERVICES - VP, PATIENT SERVICES/CHIEF NURSING OFFICER - VP, CHIEF OPERATING OFFICER FORM 990, PART VI, SECTION C, LINE 19 ON A QUARTERLY BASIS, THE FINANCIAL STATEMENTS ARE REPORTED TO EMMA (ELECTRONIC MUNICIPAL MARKET ACCESS) AND MADE AVAILABLE ON THEIR WEBSITE. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN MARKET VALUE INTEREST RATE SWAP 3,721,707. CHANGE IN MARKET VALUE SELF INSURANCE FUNDS -53. PENSION LIABILITY ADJUSTMENT 3,727,912. WRITE OFF OF DUE TO AFFILIATE 102,333. ADJUSTMENT FOR ACCUMULATED LOSS ON SWAP 79,556. LOSS ON DISCONTINUED OPERATIONS -5,293,208. OTHER TRANSFERS FROM AFFILIATES 16,326. ASHLAND NURSING HOME CORPORATION 2500 STATE ROUTE 5 ASHLAND KY 41102 611386016 NURSING HOME KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 1 CHILD DEVELOPMENT CENTER CORPORATION 2201 LEXINGTON AVENUE ASHLAND KY 41101 010560598 DAYCARE KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 1 KENTUCKY HEART INSTITUTE INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611255904 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 1 KENTUCKY HEART FOUNDATION INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 260791997 MEDICAL RESEARCH KY 501(C)(3) LINE 7 ASHLAND HOSPITAL CORPORATION 1 KENTUCKY MEDICAL LOGISTICS INC 425 22ND STREET ASHLAND KY 41101 264736971 MEDICAL TRANSPORT KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 1 KING'S DAUGHTERS HEALTH FOUNDATION INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611035701 FUNDRAISING KY 501(C)(3) LINE 12B, II ASHLAND HOSPITAL CORPORATION 1 KING'S DAUGHTERS HEALTH SYSTEM 2201 LEXINGTON AVENUE ASHLAND KY 41101 274553836 HEALTHCARE KY 501(C)(3) LINE 12B, II N/A 0 KING'S DAUGHTERS MEDICAL SPECIALTIES INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 264183569 PHYSICIANS KY 501(C)(3) LINE 10 ASHLAND HOSPITAL CORPORATION 1 PORTSMOUTH HOSPITAL CORPORATION 1901 ARGONNE AVENUE PORTSMOUTH OH 45662 453215312 HEALTHCARE OH 501(C)(3) LINE 3 KING'S DAUGHTERS HEALTH SYSTEM 0 ASHLAND MEDICAL PROPERTIES INC 2201 LEXINGTON AVENUE ASHLAND KY 41101 611079090 RENTALS KY ASHLAND HOSPITAL CORPORATION C -4015 35402 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 ASHLAND NURSING HOME CORPORATION C 800000 ALL TRANSACTIONS BETWEEN KENTUCKY HEART FOUNDATION INC O 94641 COMPANIES ARE CAPTURED AT COST KENTUCKY MEDICAL LOGISTICS INC O 1006579 IN THE DUE TO/FROM KING'S DAUGHTERS MEDICAL SPECIALTIES INC O 819245 ACCOUNTS. TRANSACTIONS ASHLAND NURSING HOME CORPORATION R 2234416 THAT HIT THESE ACCOUNTS ARE KENTUCKY HEART FOUNDATION INC R 55423 TRACKED MONTHLY. KENTUCKY MEDICAL LOGISTICS INC R 1003130 KING'S DAUGHTERS MEDICAL SPECIALTIES INC R 23175059 ASHLAND NURSING HOME CORPORATION S 2267546 KENTUCKY MEDICAL LOGISTICS INC S 831665 KING'S DAUGHTERS MEDICAL SPECIALTIES INC S 5372591