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      <Form990PartVIISectionAGrp>
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      <Form990PartVIISectionAGrp>
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      <Form990PartVIISectionAGrp>
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      <ContractorCompensationGrp>
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        <ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
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        <ContractorAddress>
          <USAddress>
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      <ContractorCompensationGrp>
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          <USAddress>
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        <ExplanationTxt>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.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6a: Bon Secours Kentucky a.k.a. Our Lady of Bellefonte Hospital &amp; Portsmouth Hospital Corporation.</ExplanationTxt>
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        <ExplanationTxt>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.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 13b: Does not cover services deemed not medically necessary.</ExplanationTxt>
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        <ExplanationTxt>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.</ExplanationTxt>
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            <AddressLine1Txt>2225 CENTRAL AVENUE</AddressLine1Txt>
            <CityNm>ASHLAND</CityNm>
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            <CityNm>ASHLAND</CityNm>
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            <ZIPCd>41101</ZIPCd>
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            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45638</ZIPCd>
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            <AddressLine1Txt>480 23RD STREET</AddressLine1Txt>
            <CityNm>ASHLAND</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41101</ZIPCd>
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            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41129</ZIPCd>
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            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41139</ZIPCd>
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          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
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            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41143</ZIPCd>
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            <AddressLine1Txt>1109 BELLEFONTE RD</AddressLine1Txt>
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            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41139</ZIPCd>
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            <BusinessNameLine1Txt>11 - OLIVE HILL FAMILY CARE CENTER</BusinessNameLine1Txt>
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            <AddressLine1Txt>391 WEST TOM T HALL BOULEVARD</AddressLine1Txt>
            <CityNm>OLIVE HILL</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41164</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>12 - BURLINGTON FAMILY CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>384 COUNTRY ROAD 120 SOUTH</AddressLine1Txt>
            <CityNm>SOUTH POINT</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45680</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>13 - IRONTON FAMILY CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>912 PARK AVENUE</AddressLine1Txt>
            <CityNm>IRONTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45638</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>14 - JACKSON MEDICAL SPECIALTIES</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>14395 STATE ROUTE 93</AddressLine1Txt>
            <CityNm>JACKSON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45640</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>15 - PORTSMOUTH MEDICAL SPECIALTIES</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2001 SCIOTO TRAIL</AddressLine1Txt>
            <CityNm>PORTSMOUTH</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45662</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>16 - WHEELERSBURG FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8750 OHIO RIVER ROAD</AddressLine1Txt>
            <CityNm>WHEELERSBURG</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45694</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>17 - SANDY HOOK FAMILY CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>STATE ROUTES 7 AND 32</AddressLine1Txt>
            <CityNm>SANDY HOOK</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41171</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>19 - KDMC HOME HEALTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2045 Carter Avenue</AddressLine1Txt>
            <CityNm>AshLAND</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41101</ZIPCd>
          </USAddress>
          <FacilityTxt>HOME HEALTH SERVICES</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>20 - KDMC HOME MEDICAL EQUIPMENT</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1700 WINCHESTER AVE</AddressLine1Txt>
            <CityNm>ASHLAND</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41101</ZIPCd>
          </USAddress>
          <FacilityTxt>DURABLE MEDICAL EQUIPMENT</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>21 - PRESTONSBURG FAMILY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1279 OLD ABBOT MOUNTAIN RD</AddressLine1Txt>
            <CityNm>PRESTONBURG</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41653</ZIPCd>
          </USAddress>
          <FacilityTxt>famILY CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>22 - russell walk-in careHall Family Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>399 DIEDERICH BLVD</AddressLine1Txt>
            <CityNm>rusSELL</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41169</ZIPCd>
          </USAddress>
          <FacilityTxt>walk-in clinic and family care center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>23 - BUrlington urgent care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>384 COUNTRY ROAD 120 SOUTH</AddressLine1Txt>
            <CityNm>souTH POINT</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45680</ZIPCd>
          </USAddress>
          <FacilityTxt>urGENT CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>24 - KDMC SKILLED NURSING FACILITY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2201 LEXINGTON AVENUE</AddressLine1Txt>
            <CityNm>ASHLAND</CityNm>
            <StateAbbreviationCd>KY</StateAbbreviationCd>
            <ZIPCd>41101</ZIPCd>
          </USAddress>
          <FacilityTxt>SKILLED NURSING</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Ln 7 Col(f):</FormAndLineReferenceDesc>
        <ExplanationTxt>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 $25,933,895.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Community Building Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>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. We also received a prescription education grant this year for local elementary children based on an identified community need.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 Cardon Outreach to assist patients in government enrollment programs. The Financial Assistance Program is on the KDMC website and the phone number to access information is provided upon admittance to the hospital. There are also signs posted in various registration areas informing patients of the phone number to call if financial assistance is needed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>King's Daughters Medical Center is located in Eastern Kentucky, where the Kentucky, Ohio and West Virginia state line meet. KDMC's primary service area encompasses six counties in two states: Boyd, Carter, Greenup and Lawrence in KY and Lawrence and Scioto in Ohio. More than 260,000 people live in the six-county primary service area. With the exception of two cities of a population around 20,000, the area is very rural, covering nearly 2,000 square miles with a population density of 114 people per square mile. Nearly 21% of the population lives in poverty. The population is 94.54% white, 4.09% black, and all other races 1.37%. The average per capita income is $21,877, well below the levels for Kentucky ($24,802) and Ohio ($27,800). In KDMC's primary market area, 5.52% of persons under 65 years lack any form of healthcare coverage.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>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:- Derma scan for skin damage 40 adults served- General health screening (total cholesterol, blood pressure and blood sugar tests) 189 adults screened, total tests provided 551 (secondary, tertiary counties)- Healthy Heart screening (total cholesterol, blood pressure, blood sugar and EKG) 148 adults screened, total tests provided 671 screened (secondary, tertiary counties)- Hearing 58 adults tested- Prostate cancer 14 adults screened- Skin cancer 110 adults, 6 children/youth screened- Sleep apnea 8 adults screened- Sports physicals- 1 adults, 633 youth- Flu shots 2,638Health education:- Bone health 20 adults served- Brain health- 36 adults served- Breast cancer 928 adults, 49 children served- Congestive heart failure 448 adults, 217 children served- Colon cancer 544 adults- Diabetes 284 adults, 50 children served (secondary, tertiary counties)- Fire safety 50 adults, 50 children served- First aid- 4 adults, 82 children served- Flu prevention 477 adults served- Hand washing- 660 adults, 152 children served- Healthy habits 50 children served- Healthy Heart Education 694 adults (secondary/tertiary counties)- Heart attack signs and symptoms 14 adults served- Heart challenge course 24 adults and 12 children served- Immunizations- 50 adults, 50 children served- Lung cancer 150 adults served- Nutrition education - 728 adults, 1,420 children/youth served (secondary/tertiary counties)- Physical Activity 50 adults, 200 youth (secondary service county)- Poison prevention 188 adults, 195 children served- Prostate cancer 435 adults served- School bus safety- 129 adults, 112 children served- Skin cancer 490 adults, 976 children served- Stroke 313 adults, 1,137 children served- Summer safety- 260 adults, 86 children/youth served- Tobacco - 656 adults, 1,278 children/youth (secondary and tertiary counties) KDMC's CPR Training Center provided basic life support, advanced life support and/or pediatric advanced life support training to 4,874 individuals.Support groups KDMC provides various support groups for individuals with disease and/or their caregivers. During FY17, the following groups were offered.- Celiac Disease 20 attended- Adult Diabetes Mellitus 79 attended- Look Good, Feel Better 6 attended- Dementia/Alzheimer's 65 attended- Breast Cancer 2 attended- Pregnancy and Infant Loss 8 attended- Parkinson's Disease 81 attended- Surgical Weight Loss 4 attended- Pulmonary Hypertension 7 attendedClinical Research: KDMC supports clinical research in both cardiology and oncology. Hospitality House: KDMC's Hospitality House provides a safe, comfortable place for adult family members to stay while their loved ones are hospitalized. The house is located a block from the main campus and features 13 private sleeping rooms as well as a communal kitchen and living area. The facility is staffed 24 hours a day and is available to family members of hospitalized patients who live 30 miles or more from Ashland. Referrals to the house are made by a King's Daughters social worker upon patient admission. During FY17 1,118 guests, from 560 families were served by the Hospitality House.Other Community Activities:Blood Drives- KDMC partnered with the American Red Cross to host 10 blood drives. A total of 487 community members and team members donated blood.First Aid Station KDMC offers first aid station support for area events. During the fiscal year, 250 adults and 220 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 11,684 pounds of food.Backpack Program- This is a partnership with the Ashland Alliance. Team members filled backpacks with school supplies for 124 elementary aged children to ensure students start the school year with the necessary school supplies and at least one new outfit of clothes.Adopt-a-family- team members adopted 32 families, 20 nursing home residents and 95 individual children, providing gifts and food to those in need at Christmas time. In addition, winter food pantries were filled for 20 elderly in the community.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 30 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 More than 1,000 coats were collected and distributed to the homeless and others in need.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 designed to meet the healthcare needs of Portsmouth and its surrounding areas. KDOH offers services ranging from surgery, cardiac care and urgent care. KDOH provides charity care and participates in Government programs.The system provides physician services through King's Daughters Medical Specialties, 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 its service 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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>AMERICAN RED CROSS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>510 E CHESTNUT STREET</AddressLine1Txt>
          <CityNm>LOUISVILLE</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>40202</ZIPCd>
        </USAddress>
        <RecipientEIN>530196605</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1500</CashGrantAmt>
        <NonCashAssistanceAmt>6242</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>FOOD</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>CONTRIBUTION TO DANCING WITH OUR STARS &amp; FOOD FOR MONTHLY BLOOD DRIVES</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASHLAND COMMUNITY KITCHEN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1743</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>411051743</ZIPCd>
        </USAddress>
        <RecipientEIN>611100724</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>56830</CashGrantAmt>
        <NonCashAssistanceAmt>2310</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>FOOD AND MISC SUPPLIES</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>PROVIDE FOOD TO SENIOR CITIZENS IN OUR COMMUNITY THROUGH MEALS ON WHEELS &amp; SUPPORT ANNUAL HUNGER AWARENESS &amp; FUNDRAISING EVENTS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HIGHLANDS MUSEUM AND DISCOVERY CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1620 WINCHESTER AVENUE</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>41101</ZIPCd>
        </USAddress>
        <RecipientEIN>311061542</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>14540</CashGrantAmt>
        <PurposeOfGrantTxt>SPONSORHIP OF 2 FUNDRAISING EVENTS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NEIGHBORS HELPING NEIGHBORS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2516 Carter Avenue</AddressLine1Txt>
          <CityNm>AshLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>41101</ZIPCd>
        </USAddress>
        <RecipientEIN>611450110</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>5600</CashGrantAmt>
        <PurposeOfGrantTxt>SPONSORHIP OF 2 FUNDRAISING EVENTS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PARAMOUNT ARTS CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1300 Winchester Avenue</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>41101</ZIPCd>
        </USAddress>
        <RecipientEIN>611181883</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>12500</CashGrantAmt>
        <NonCashAssistanceAmt>240</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>ITEM FOR SILENT AUCTION</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SPONSORSHIP OF ANNUAL SPRING GALA FUNDRAISER AND THE KENTUCKY MUSIC TRAIL AND DONATION OF ITEM FOR SILENT AUCTION FUNDRAISER</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>RIVER CITIES HARVEST</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 2136</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>411052136</ZIPCd>
        </USAddress>
        <RecipientEIN>611208113</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1000</CashGrantAmt>
        <NonCashAssistanceAmt>19764</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>FOOD</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>FOODBANK SUPPORT &amp; SPONSORSHIP OF FUNDRAISING EVENT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SAFE HARBOR OF NORTHEAST KENTUCKY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 2163</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>411052163</ZIPCd>
        </USAddress>
        <RecipientEIN>611155742</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>7200</CashGrantAmt>
        <PurposeOfGrantTxt>SPONSORSHIP OF ANNUAL LOBSTER FEST FUNDRAISER AND PROGRAM TO ERADICATE DOMESTIC VIOLENCE</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SUMMER MOTION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1643</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>41105</ZIPCd>
        </USAddress>
        <RecipientEIN>311695435</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>5000</CashGrantAmt>
        <NonCashAssistanceAmt>900</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>FOOD</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>SUPPORT OF ANNUAL COMMUNITY FESTIVAL &amp; VOLUNTEERS</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNITED WAY OF NORTHEAST KENTUCKY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2000 CARTER AVENUE SUITE D</AddressLine1Txt>
          <CityNm>ASHLAND</CityNm>
          <StateAbbreviationCd>KY</StateAbbreviationCd>
          <ZIPCd>41101</ZIPCd>
        </USAddress>
        <RecipientEIN>616000060</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <NonCashAssistanceAmt>15707</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>INVOICES</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>MARKETING MATERIALS</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>CONTRIBUTION TO ANNUAL FUNDRAISING CAMPAIGN</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>8</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
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      <WrittenPolicyRefTAndEExpnssInd>0</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
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        <PersonNm>Kristie Whitlatch</PersonNm>
        <TitleTxt>PRESIDENT/CEO</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7211</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>699206</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>117310</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES DETHERAGE MD</PersonNm>
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        <NontaxableBenefitsRltdOrgsAmt>10119</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>22000</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>501775</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AUTUMN MCFANN</PersonNm>
        <TitleTxt>TReasurer, VP/CFO</TitleTxt>
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        <BonusFilingOrganizationAmount>48871</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>7866</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10734</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>297823</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHERYL Mahaney</PersonNm>
        <TitleTxt>Secretary, VP/Chief Legal Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>289847</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>42345</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>90561</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>5136</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>431864</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>88629</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW EBAUGH</PersonNm>
        <TitleTxt>CHIEF STRATEGY OFFICER/CIO</TitleTxt>
        <BaseCompensationFilingOrgAmt>284844</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>42000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1260</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9409</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>341488</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SARA MARKS</PersonNm>
        <TitleTxt>VP/EXECUTIVE DIRECTOR KDIP</TitleTxt>
        <BaseCompensationFilingOrgAmt>196815</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>45134</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6834</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3761</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8275</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260819</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD FORD MD</PersonNm>
        <TitleTxt>VP/CMO of Inpatient/Proc. Svcs.</TitleTxt>
        <BaseCompensationFilingOrgAmt>247163</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3750</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9657</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260570</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PATRICK BALL DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>396</OtherCompensationFilingOrgAmt>
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        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>486648</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EVAN CONDEE DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6721</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3773</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>342310</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLES CONLEY DO</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10923</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7140</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>389013</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GEORGE ESHAM MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>762</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7831</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>357549</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>FRANKLIN FANNIN MD</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>10060</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1076</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>347874</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>GROSS UP PAYMENTS: AUTUMN MCFANN $7,236 (100% TAXABLE), SARA MARKS $6,199 (100% TAXABLE).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1b</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GROSS UPS ARE APPROVED BY THE CEO FOR THE VICE PRESIDENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: SHERYL MAHANEY - $88,629 KRISTIE WHITLATCH - $117,310 THERE WERE NO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS/DEFERRALS IN 2016. 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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
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        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Kentucky Economic Development Authority (KEDFA)</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>610600439</BondIssuerEIN>
        <CUSIPNum>491269CG9</CUSIPNum>
        <BondIssuedDt>2008-09-24</BondIssuedDt>
        <IssuePriceAmt>146580000</IssuePriceAmt>
        <PurposeDesc>Refund Prior Bond Issues</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Kentucky Economic Development Authority (KEDFA)</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>610600439</BondIssuerEIN>
        <CUSIPNum>491269CY0</CUSIPNum>
        <BondIssuedDt>2010-04-01</BondIssuedDt>
        <IssuePriceAmt>75000000</IssuePriceAmt>
        <PurposeDesc>Healthcare Facilities, Building and Equipment</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>City of Ashland Kentucky</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616001775</BondIssuerEIN>
        <CUSIPNum>044293AA6</CUSIPNum>
        <BondIssuedDt>2010-04-01</BondIssuedDt>
        <IssuePriceAmt>32615000</IssuePriceAmt>
        <PurposeDesc>Refund Series 1998 Bonds</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>city of Ashland Kentucky</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616001775</BondIssuerEIN>
        <CUSIPNum>044293an8</CUSIPNum>
        <BondIssuedDt>2016-09-23</BondIssuedDt>
        <IssuePriceAmt>73445000</IssuePriceAmt>
        <PurposeDesc>refund of prior bond issue</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>119125000</RetiredAmt>
        <TotalProceedsAmt>145708338</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1423351</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>12574982</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>131710005</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2010</SubstantialCompletionYr>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>18290000</RetiredAmt>
        <TotalProceedsAmt>73889274</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1170837</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>72718420</CapitalExpendituresAmt>
        <UnspentAmt>17</UnspentAmt>
        <SubstantialCompletionYr>2015</SubstantialCompletionYr>
        <CurrentRefundingInd>0</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>10550000</RetiredAmt>
        <TotalProceedsAmt>33986558</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>507546</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>33479012</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2010</SubstantialCompletionYr>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <RetiredAmt>2335000</RetiredAmt>
        <TotalProceedsAmt>81984559</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1200341</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>80784218</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
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      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Date Rebate Computation Performed</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer Name: Kentucky Economic Development Authority (KEDFA) Date the Rebate Computation was Performed: 11/06/2013 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</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Line 3, Issue A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, line 3, Issue B</FormAndLineReferenceDesc>
        <ExplanationTxt>Series 2010A DIFFERENCE FROM PART I DUE TO Bond Discount $1,318,161.05, offset by $207,592 interest earned through September 30, 2017.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, line 3, Issue C</FormAndLineReferenceDesc>
        <ExplanationTxt>Series 2010B - DIFFERENCE FROM PART I DUE TO Bond Premium $1,371,558.05</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, LINE 3, Issue D</FormAndLineReferenceDesc>
        <ExplanationTxt>SERIES 2016A - DIFFERENCE FROM PART I DUE TO BOND PREMIUM OF $8,305,846</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleK documentId="RetDoc1053100002">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>city of Ashland Kentucky</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>616001775</BondIssuerEIN>
        <BondIssuedDt>2016-09-23</BondIssuedDt>
        <IssuePriceAmt>50000000</IssuePriceAmt>
        <PurposeDesc>refund of prior bond issue</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>1155849</RetiredAmt>
        <TotalProceedsAmt>50000000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>254000</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>49746000</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2016</SubstantialCompletionYr>
        <CurrentRefundingInd>1</CurrentRefundingInd>
        <AdvanceRefundingInd>0</AdvanceRefundingInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ANNE SLOAN</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SISTER-IN-LAW OF JOHN STEWART</RelationshipDescriptionTxt>
        <TransactionAmt>51858</TransactionAmt>
        <TransactionDesc>EMPLOYEE PAYROLL COMPENSATION. There is no management relationship or control over compensation by John Stewart.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>ASHLAND OFFICE SUPPLY</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>TOM BURNETTE IS OWNER</RelationshipDescriptionTxt>
        <TransactionAmt>988170</TransactionAmt>
        <TransactionDesc>PURCHASE OF OFFICE SUPPLIES &amp; EQUIPMENT. All transactions are done at arm's length.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>CINDY GILLUM</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SISTER OF KRISTIE WHITLATCH</RelationshipDescriptionTxt>
        <TransactionAmt>21029</TransactionAmt>
        <TransactionDesc>EMPLOYEE PAYROLL COMPENSATION. There is no management relationship or control over compensation by Kristie Whitlatch.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>FRESENIUS MEDICAL CARE</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>DON HAMMONDS IS INDEPENDENT CONTRACTOR/CONSULTANT FOR FRESENIUS</RelationshipDescriptionTxt>
        <TransactionAmt>1053975</TransactionAmt>
        <TransactionDesc>INPATIENT DIALYSIS TREATMENT. All transactions are done at arm's length.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>VAN ART PROPERTIES</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SON OF JOHN STEWART IS OWNER</RelationshipDescriptionTxt>
        <TransactionAmt>285619</TransactionAmt>
        <TransactionDesc>OFFICE SPACE RENT. All transactions are done at arm's length.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Carole Ebaugh</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Wife of Matthew Ebaugh</RelationshipDescriptionTxt>
        <TransactionAmt>24488</TransactionAmt>
        <TransactionDesc>EMPLOYEE PAYROLL COMPENSATION. There is no management relationship or control over compensation by Matthew Ebaugh.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Office Funiture USA</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>TOM BURNETTE IS OWNER</RelationshipDescriptionTxt>
        <TransactionAmt>207143</TransactionAmt>
        <TransactionDesc>Purchase of office furniture. All transactions are done at arm's length.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Ashland Radiology Associates PSC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Wife of William Boykin is a physician of this practice</RelationshipDescriptionTxt>
        <TransactionAmt>661003</TransactionAmt>
        <TransactionDesc>Payments for radiology services. All transactions are done at arm's length.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>PHYSICIAN OFFICE SUITE AND EQUIPMENT</Desc>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>228900</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>APPRAISAL</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>1</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Column (b):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NUMBER IN COLUMN (B) REFERS TO THE NUMBER OF CONTRIBUTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>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; Bradley Levi, Trustee; AND Raymond Mecca, Trustee (retired Jan. 2017). 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>KING'S DAUGHTERS HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ASHLAND HOSPITAL CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>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. 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. A member of the Medical Center's Board of Directors reports any conflict or potential conflict to the Chairman of the Board, the CEO and/or the General Counsel of the Medical Center, as appropriate. If it is determined that a conflict exists, the employee or Board member is 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 ensure that the conflicted individual did not influence decision-making or profit 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.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>At the direction of the Human Resources &amp; 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 &amp; 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 &amp; Regulatory Officer/General Counsel Chief Medical Officers VP, People Services VP, Executive Director King's Daughters Integrated Physicians VP, Patient Services/Chief Nursing Officer</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN MARKET VALUE INTEREST RATE SWAP 4,958,679. CHANGE IN MARKET VALUE SELF INSURANCE FUNDS -61. PENSION LIABILITY ADJUSTMENT 4,910,593. write off of due from affiliate -25,669. ADJUSTMENT FOR ACCUMULATED LOSS ON SWAP 79,556. MISCELLANEOUS ADJUSTMENT -161.</ExplanationTxt>
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