2016-05-13T13:57:25-05:00 2015-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2014-07-01 610605336 ST CLAIRE REGIONAL MEDICAL CENTER STCL 6067836500 222 MEDICAL CIRCLE MOREHEAD KY 40351 CHRIS MCCLURG VICE PRESIDENT FINANCE/ CFO 6067836500 2016-05-11 1 CARRIE A MERRILL CPA P00832283 3176334705 2016-05-11 2014 2016-08-17 19:52:53Z ST CLAIRE REGIONAL MEDICAL CENTER MARK J NEFF 222 MEDICAL CIRCLE MOREHEAD KY 40351 135315266 0 X WWW.ST-CLAIRE.ORG X 1963 KY THE MISSION IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KY. 14 13 1537 67 0 0 1334226 1655476 114394017 122311226 1482548 3446406 6823081 7391223 124033872 134804331 39499 93545 0 0 74788044 77800692 0 0 0 49369837 49804682 124197380 127698919 -163508 7105412 83285589 90170528 37557977 39785706 45727612 50384822 X THE MISSION OF ST. CLAIRE REGIONAL MEDICAL CENTER IS TO PROCLAIM GOD'S GOODNESS THROUGH A HEALING MINISTRY TO THE PEOPLE OF EASTERN KENTUCKY. 0 0 111128685 93545 122577718 ST. CLAIRE REGIONAL MEDICAL CENTER SERVES AS A 159-BED REGIONAL REFERRAL CENTER AND IS THE LARGEST RURAL HOSPITAL IN NORTHEASTERN KENTUCKY. SPONSORED BY THE SISTERS OF NOTRE DAME IN COVINGTON, KENTUCKY, ST. CLAIRE REGIONAL SERVES AS A NOT-FOR-PROFIT HOSPITAL. WITH NEARLY 1,500 EMPLOYEES, ST. CLAIRE REGIONAL IS THE SECOND-LARGEST EMPLOYER IN THE REGION. THE MEDICAL CENTER IS AN ESTABLISHED TRAINING SITE FOR THE UNIVERSITY OF KENTUCKY SCHOOL OF MEDICINES PHYSICIAN RESIDENCY PROGRAMS. ST. CLAIRE REGIONAL'S MEDICAL STAFF IS COMPRISED OF OVER 100 PHYSICIANS AND SURGEONS, REPRESENTING 31 MEDICAL AND SURGICAL SPECIALTIES.CONTINUE ON SCHEDULE O.IN ADDITION TO PROVIDING SERVICES AT THE MEDICAL CENTER'S MAIN CAMPUS IN MOREHEAD, ST. CLAIRE REGIONAL'S OPERATIONS CONSIST OF A ST. CLAIRE REGIONAL OUTPATIENT CENTER, CAVE RUN SURGICAL SPECIALISTS, MOREHEAD MEDICAL SPECIALISTS, FIVE COMPREHENSIVE FAMILY MEDICINE CLINICS AS WELL AS A FAMILY MEDICINE EXPRESS, A REGIONAL TELEMEDICINE SYSTEM, AND AN EIGHT-COUNTY HOME CARE SERVICE REGION COMPRISED OF HOME HEALTH, HOSPICE & PALLIATIVE CARE, AND HOME MEDICAL EQUIPMENT. ADDITIONALLY, ST. CLAIRE REGIONAL PARTNERS WITH THE UNIVERSITY OF KENTUCKY MEDICAL CENTER TO OFFER SERVICES THROUGH THE KENTUCKY CLINIC MOREHEAD CANCER TREATMENT CENTER.ST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. HOME CAREST. CLAIRE HOMECARE IS A SERVICE PROVIDED BY ST. CLAIRE REGIONAL MEDICAL CENTER OFFERING A FULL RANGE OF HOME CARE SERVICES FOR PATIENTS TO RECOVER IN THEIR OWN HOMES. AS ONE OF THE LARGEST PROGRAMS IN THE STATE, ST. CLAIRE HOMECARE IS A COMPREHENSIVE IN-HOME SERVICE SYSTEM COMPRISED OF HOME HEALTH, HOSPICE, AND HOME MEDICAL EQUIPMENT. OUR COMMITTED STAFF INCLUDES NURSES, THERAPISTS AND AIDES WORKING AS A TEAM TO HELP MEET VIRTUALLY EVERY HOME CARE NEED. CONTINUE ON SCHEDULE O.THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) ACCREDITS BOTH ST. CLAIRE REGIONAL MEDICAL CENTER AND ST. CLAIRE HOMECARE. ST. CLAIRE HOMECARE IS MEDICARE-CERTIFIED AND LICENSED IN THE STATE OF KENTUCKY. FAMILY MEDICINEST. CLAIRE REGIONAL FAMILY MEDICINE IS A SYSTEM OF FIVE FAMILY MEDICINE CLINICS THAT PROVIDE A FULL RANGE OF PREVENTIVE AND THERAPEUTIC HEALTHCARE SERVICES, FROM NEWBORN TO GERIATRICS, INCLUDING OBSTETRICAL SERVICES. THE ST. CLAIRE REGIONAL FAMILY MEDICINE MEDICAL STAFF INCLUDES BOARD CERTIFIED FAMILY AND INTERNAL MEDICINE PHYSICIANS AS WELL AS ADVANCED REGISTERED NURSE PRACTITIONERS, CERTIFIED PHYSICIAN ASSISTANTS, CERTIFIED NURSE MIDWIVES, AND FAMILY MEDICINE RESIDENTS AFFILIATED WITH THE UNIVERSITY OF KENTUCKY. 111128685 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 85 0 1 1537 1 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X CHRIS MCCLURG VP OF FINANCIAL SERVICES 6067836500 222 MEDICAL CIRCLE MOREHEAD KY 40351 ROBERT G STEVENS BOARD CHAIR 2.00 X 0 0 0 SISTER MARLA MONAHAN VICE CHAIR 2.00 X 0 0 0 GARREN COLVIN BOARD TREASURER 2.00 X 0 0 0 JOHN NORTHCUT SECRETARY 2.00 X 0 0 0 SISTER MARY MARGARET DROEGE MEMBER 2.00 X 0 0 0 JEFFREY L ELLIS MD MEMBER 2.00 X 0 0 0 STEVE LEWIS MEMBER 2.00 X 0 0 0 SAMUEL MATHENY MD MEMBER 2.00 X 0 0 0 O THOMAS NEWCOMB MD MEMBER 2.00 X 0 0 0 BETH PATRICK MEMBER 2.00 X 0 0 0 WILLIAM D LEWIS MD RADIOLOGIST 40.00 X 663333 0 23052 NICHOLE SMITH MEMBER 2.00 X 0 0 0 GLEN TEAGER MEMBER 2.00 X 0 0 0 MARK NEFF CEO 40.00 X X 322544 0 21261 GR JONES JR CFO 50.00 X 200577 0 14504 TRAVIS BAILEY VP ADMINISTRATION 50.00 X 165439 0 20659 GREG BAUSCH COO 50.00 X 175437 0 16170 WILL MELAHN MD VP MEDICAL STAFF 50.00 X 245719 0 22947 MANSHA KAHLOON MD CARDIOLOGY 40.00 X 751312 0 23142 CHARLES CROUSE MD ORTHOPEDIC SURGEON 40.00 X 1099434 0 23052 CRAIG BUTLER MD RADIOLOGIST 40.00 X 635333 0 23142 STEPHEN A WILLIAMS MD RADIOLOGIST 40.00 X 663333 0 23052 THADIS COX MD GASTROENTEROLOGIST 40.00 X 550966 0 22879 5473427 0 233860 80 0 1 0 APOGEE MEDICAL MANAGEMENT 2525 E CAMELBACK RD STE 1100 DOWNERS GROVE IL 60515 CONTRACT SERVICE 1570863 HORIZON HEALTH PO BOX 840839 DALLAS TX 75284 CONTRACT SERVICE 808396 ARAMARK ONE SERVICE MASTER WAY DOWNERS GROVE IL 60515 CONTRACT SERVICE 613933 KMSF-PATH FAC SERVICES 2333 ALUMNI PARK PLAZA LEXINGTON KY 40517 PHYSICIAN SERVICES 524609 PROFESSIONAL MEDICAL BILLING 7619 W JEFFERSON BLVD FORT WAYNE IN 46804 BILLING SERVICE 510211 17 51015 1148348 456113 20000 1655476 NET PATIENT SERVICE REVENUE 621110 108494494 108494494 HOME CARE REVENUE 621610 13816732 13816732 122311226 575398 575398 339747 73255 266492 266492 266492 2817492 76024 0 22508 2817492 53516 2871008 2871008 84871 51015 28866 56005 56005 294890 386306 -91416 -91416 MISC. INCOME 900099 5265662 5265662 EHR INCENTIVE REVENUE 900099 1068039 1068039 CAFETERIA INCOME 900099 657827 657827 168614 168614 7160142 134804331 122577718 0 10571137 93545 93545 1109716 988635 121081 62905913 56163333 6742580 1626310 1385995 240315 8136125 7317860 818265 4022628 3634764 387864 602364 81732 520632 177250 177250 12041030 10114465 1926565 183345 179857 3488 19383179 19017305 365874 5898897 3834283 2064614 198120 148590 49530 387203 367843 19360 551931 48950 502981 5514156 5514156 1232422 848155 384267 PROVIDER TAX 1519966 151997 1367969 RECRUITMENT 610003 213501 396502 LICENSES & FEES 419172 146710 272462 DUES & SUB 227029 79460 147569 858615 797549 61066 127698919 111128685 16570234 0 10689829 15804312 13199596 13788330 1462218 1661930 2293072 2531461 938673 1005740 103641176 72468915 32055543 31172261 20283523 21951204 2363135 2255290 83285589 90170528 13882008 13681056 13590651 11681041 2420258 3887429 7665060 10536180 37557977 39785706 X 45114363 49789787 613249 595035 45727612 50384822 83285589 90170528 X 7105412 -2504455 56253 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14293 14293 0 PART II-B, LINE 1: MEMBERSHIP DUES TO KHA, AHA AND CHA OF WHICH A PORTION OF THE DUES ARE USED FOR LOBBY EXPENSES BY THE TRADE ORGANIZATIONS. 613249 18214 595035 625780 12531 613249 661898 36118 625780 661898 661898 1.00000 0 0 2135520 2135520 47484282 31424935 16059347 2516116 1384539 1131577 51245244 39659441 11585803 260014 260014 31172261 ESTIMATED SETTLEMENTS PAYABLE 3400000 PROF. LIAB CLAIMS RESERVE 3553544 DEFERRED COMPENSATION 3188320 SWAP AGREEMENT 394316 10536180 X 132844449 -2504455 56253 -2448202 135292651 -488320 -488320 134804331 128187239 488320 488320 127698919 0 127698919 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE DONOR-RESTRICTED FOR A SPECIFIC USE OR BY THE PASSAGE OF TIME. INCOME EARNED FROM THE PRINCIPLE AMOUNT IS UNRESTRICTED. THE DONOR-RESTRICTED NET ASSETS ARE TO BE USED FOR CURATIVE TREATMENT AND REHABILITATIVE THERAPY OF PEDIATRIC ILLNESS, DISEASE, OR DEFORMITY. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE MEDICAL CENTER AND RECOGNIZE A TAX LIABILITY IF THE MEDICAL CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE MEDICAL CENTER, AND HAS CONCLUDED THAT AS OF JUNE 30, 2015 AND 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FMV OF INTEREST RATE SWAP 56,253. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOOD SOLD -386,306. SPECIAL EVENT EXPENSES -28,759. RENTAL EXPENSES -73,255. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 386,306. SPECIAL EVENT EXPENSES 28,759. RENTAL EXPENSES 73,255. CHARITY GOLF OUTING 117836 33440 84396 5811 7750 3211 2547 SIGNATURE EVENT 18050 17575 475 7683 1864 135886 51015 84871 5811 7750 10894 4411 28866 56005 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 1502345 2045463 -543118 0.00000 29947778 23789016 6158762 0.04820 31450123 25834479 5615644 0.04820 4407683 4407683 0.03450 2758560 326203 2432357 0.01900 7166243 326203 6840040 0.05350 38616366 26160682 12455684 0.10170 1 7888156 32819884 34266126 -1446242 X 1 1 1 1 ST CLAIRE REGIONAL MEDICAL CENTER 222 MEDICAL CIRCLE DRIVE MOREHEAD KY 40351 WWW.ST-CLAIRE.ORG X X ST CLAIRE REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X HTTPS://WWW.ST-CLAIRE.ORG/SITES/WWW/UPLOADS/COMMUNITY%20NEEDS%20ASSESSMENT/ X 1 13 0 0 0 1 X 125.000000000000 200.000000000000 X X X X X 1 1 1 X 1 0 X X 1 X 0 0 ST. CLAIRE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: SCRMC PARTNERED WITH MOREHEAD STATE UNIVERSITY AND THE GATEWAY DISTRICT HEALTH DEPARTMENT IN ORDER TO COMPILE THE INFORMATION FOR THE CHNA. THEY GATHERED INPUT FROM THE FOLLOWING: ST. CLAIRE REGIONAL MEDICAL CENTER- CAVE RUN SURGICAL SPECIALISTS - MOREHEAD MEDICAL SPECIALISTS - ST. CLAIRE REGIONAL OUTPATIENT CENTER - ST. CLAIRE REGIONAL FAMILY MEDICINE - ST. CLAIRE REGIONAL HOMECARE, HOSPICE AND PALLIATIVE CARE - ST. CLAIRE REGIONAL FAMILY MEDICAL SUPPLY MOREHEAD-ROWAN COUNTY CHAMBER OF COMMERCEELECTED OFFICIALSROWAN COUNTY SCHOOL DISTRICTMAYSVILLE COMMUNITY AND TECHNICAL COLLEGEMOREHEAD & ROWAN COUNTY ECONOMIC DEVELOPMENT COUNCIL (EDC)PHYSICIANSPHARMACISTSOPTOMETRISTS DENTISTSPATHWAYS COMMUNITY MENTAL HEALTH CENTERVETERANS CLINICPEOPLE'S CLINIC (FREE CLINIC)MOREHEAD STATE UNIVERSITY ROWAN UNITE UNIVERSITY OF KENTUCKYMOREHEAD POLICE DEPARTMENT EMERGENCY MEDICAL SERVICES FAITH-BASED ORGANIZATIONS EMPLOYERS URBAN PLANNERSPARKS AND RECREATION MOREHEAD FIRE/ RESCUE GATEWAY DISTRICT HEALTH DEPARTMENTNEW HOPE FREE CLINICCOUNTY LEVEL STEERING COMMITTEESTHEY ALSO GATHERED INFORMATION AND INPUT THROUGH FOCUS GROUPS AND COMMUNITY SURVEYS. ST. CLAIRE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THROUGHOUT THIS COMPREHENSIVE PROCESS, MANY HEALTH NEEDS WERE IDENTIFIED, BUT SOME HAVE NOT BEEN ADDRESSED IN THIS SPECIFIC PLAN. SEVERAL GATEWAY WELLNESS COALITION EXECUTIVE COMMITTEE MEETINGS FOCUSED ON THE NEEDS THAT WERE ALREADY BEING ADDRESSED IN DIFFERENT WAYS. ONE OF THE MOST CRITICAL AREAS OF NEED IS CARE FOR UNINSURED/UNDERINSURED, AS ST. CLAIRE REGIONAL MEDICAL CENTER PROVIDES CARE AND SERVICES FOR UNINSURED AND MEDICAID PATIENTS. SCRMC ROUTINELY TREATS PATIENTS WHO RECEIVE MEDICAID BENEFITS, AND SCRMC'S FISCAL 2012 REIMBURSEMENT FELL $2.7 MILLION SHORT OF THE ACTUAL COST OF CARE FOR MEDICAID PATIENTS. SCRMC ALSO PROVIDED APPROXIMATELY $6 MILLION IN CHARITY CARE (AT COST) IN FISCAL 2012. UNCOMPENSATED CARE, WHICH TOTALED $6.9 MILLION, WAS THE COST OF SCRMC SERVICES TO INDIVIDUALS WHO WERE UNABLE OR UNWILLING TO PAY AND DID NOT OFFICIALLY MEET GUIDELINES FOR TRADITIONAL CHARITY CARE. THUS, MORE FUNDING, EXPERTISE AND ACCESS ARE NECESSARY TO ENSURE THAT THE SUBSTANTIAL IMPACT THAT ST. CLAIRE REGIONAL HAS ON THE UNINSURED/UNDERINSURED POPULATION IN ITS PRIMARY SERVICE AREA IS SUSTAINABLE FOR YEARS TO COME, PARTICULARLY GIVEN THE REQUIREMENTS AND IMPACT OF THE AFFORDABLE CARE ACT. SINCE OUR FOUNDING IN 1963, ST. CLAIRE REGIONAL MEDICAL CENTER HAS CONTINUALLY SOUGHT TO EXPAND OUR REACH IN THE REGION. EVIDENCE OF THIS OUTREACH AND GROWTH INCLUDES THE COMPLETE TRANSFORMATION OF OUR FAMILY MEDICINE CLINIC IN MOREHEAD, AS WE HAVE TRIPLED OUR EXAM ROOM SPACE OVER THE PAST FIVE YEARS. ADDITIONALLY, ST. CLAIRE REGIONAL MEDICAL CENTER HAS EXPANDED INTO THE REGION, OPERATING SEVERAL PRIMACY CARE AND FAMILY CLINICS IN FIVE SERVICE AREA COUNTIES. OUR FIRST PRIMARY CARE CLINIC OPENED IN 1973 IN MENIFEE COUNTY, WHILE OUR SECOND OPENED THREE YEARS LATER IN BATH COUNTY. OTHER PRIMARY CARE/FAMILY MEDICINE CLINICS FOLLOWED IN ROWAN, CARTER AND ELLIOTT COUNTIES. IN 2010, ST. CLAIRE REGIONAL MEDICAL CENTER AND THE UNIVERSITY OF KENTUCKY FORGED A COMPREHENSIVE STROKE AFFILIATION, WHICH ENHANCED PATIENT SERVICES FOR THE REGION. EVIDENCE OF OUR EFFORTS TO ADDRESS AN ANTICIPATED NEED FOR MORE PRIMARY CARE PHYSICIANS AND SPECIALISTS IN THE REGION IS A UNIQUE JOINT INITIATIVE FEATURING A REGIONAL UNIVERSITY (MOREHEAD STATE UNIVERSITY), A LAND GRANT UNIVERSITY (THE UNIVERSITY OF KENTUCKY), AND A PRIVATE NONPROFIT HOSPITAL (ST. CLAIRE REGIONAL MEDICAL CENTER) THAT LED TO THE CREATION OF THE CENTER FOR HEALTH, EDUCATION AND RESEARCH (CHER) IN MOREHEAD TO TRAIN THE NEXT GENERATION OF MEDICAL STUDENTS AND HEALTHCARE PROFESSIONALS FOR THE REGION. THIS FACILITY PROVIDES EXCEPTIONAL TRAINING OPPORTUNITIES FOR THE STATE'S TOP RANKED NURSING PROGRAM AT MOREHEAD STATE UNIVERSITY. ADDITIONALLY, THE FACILITY SERVES AS A REGIONAL CAMPUS FOR THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE'S RURAL PHYSICIAN LEADERSHIP PROGRAM. IT IS ALSO A TRAINING GROUND FOR THE FAMILY PRACTICE RESIDENCY PROGRAMS FOR ST. CLAIRE REGIONAL AND UK. THE OFFICE OF RESEARCH AND ENGAGEMENT FOR ADVANCING COMMUNITY HEALTH (REACH), A UNIVERSITY OF KENTUCKY VENTURE, WILL ALSO ADVANCE ITS EFFORTS AT THE CHER FACILITY. THROUGH THE CREATION AND IMPLEMENTATION OF THE SERVICES THAT THE CHER BUILDING HAS TO OFFER, THIS FACILITY ALLOWS FOR EXCEPTIONAL GRADUATE MEDICAL EDUCATION AND RESEARCH. ANOTHER ADDED BENEFIT TO THE REGION IS THAT CITIZEN ACCESS TO PRIMARY CARE SERVICES WILL BE GREATLY ENHANCED WITH THE EXPANSION OF SCRMC'S FAMILY MEDICINE CLINIC. PART I, LN 7 COL(F): TOTAL BAD DEBT EXPENSE HAS BEEN EXCLUDED FROM THE DENOMINATOR FOR THE PERCENTAGE CALCULATION PER IRS INSTRUCTIONS. HOWEVER, THE BAD DEBT EXPENSE OF $7,888,156 WAS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), DUE TO NEW ACCOUNTING PRONOUNCEMENT, ACCOUNTING STANDARD UPDATE 2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISIONS FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE STATEMENT OF OPERATIONS RATHER THAN AS AN OPERATING EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: OUR MISSION AND VALUES HAVE BEEN ENHANCED THROUGH COMMUNITY BENEFIT PROGRAMS, AND THOSE ACTIVITIES HAVE CENTERED ON EDUCATION, COLLABORATION AND IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES THAT WE SERVE. THE EDUCATION AND DEVELOPMENT OF HEALTH PROFESSIONALS HAS BEEN ONE OF OUR PRIMARY FOCUS AREAS FOR COMMUNITY BENEFIT, BECAUSE WE BELIEVE THAT THEIR TRAINING IS VITAL TO IMPROVING COMMUNITY HEALTH. ANOTHER TARGET AREA IS OUR ENGAGEMENT IN COMMUNITY SUPPORT AND PARTNERSHIPS. THIS ENGAGEMENT IS REALIZED THROUGH PARTICIPATION IN HEALTH FAIRS AND SCREENINGS, PROVIDING SUPPORT GROUPS, AS WELL AS COALITION BUILDING INITIATIVES. PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 2 FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE MEDICAL CENTER'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTY THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE 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 STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE MEDICAL CENTER'S CURRENT ALLOWANCE FOR DOUBTFUL ACCOUNTS POLICY IS TO RESERVE 90 PERCENT OF ALL SELF-PAY ACCOUNTS LESS THAN 150 DAYS OLD AND INCLUDE ALL ACCOUNTS 150 DAYS OLD AND OLDER, NET OF CONTRACTUAL ALLOWANCES ALREADY TAKEN. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS BALANCE WAS IMPACTED IN 2014 BY A SUBSTANTIAL WRITE OFF OF OLD AND FULLY RESERVED PATIENT ACCOUNTS TOTALING APPROXIMATELY $15,700,000.THE JUNE 30, 2015 AND 2014 ALLOWANCE FOR DOUBTFUL ACCOUNTS BALANCES CONSIST OF THE FOLLOWING: RESERVE FOR THIRD-PARTY PAYOR BALANCES IS $2,214,672 FOR 2015 AND $1,844,816 FOR 2014. RESERVE FOR SELF-PAY BALANCES IS $5,693,329 FOR 2015 AND $6,571,022 FOR 2014. THE TOTAL ALLOWANCE FOR DOUBTFUL ACCOUNTS IS $7,908,001 FOR 2015 AND $8,415,838 FOR 2014. SECTION A. BAD DEBT EXPENSE. LINE 3 EXPLANATION FOR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: BAD DEBT EXPENSE IS RECORDED AS A GROSS AMOUNT ON THE FINANACIAL STATEMENTS. COSTS ASSOCIATED WITH THIS EXPENSE ARE CALCULATED BY USING THE COST TO CHARGE RATIO WITHIN EACH RESPECTIVE DIVISION OF THE MEDICAL CENTER. THE MEDICAL CENTER HAS A FINANCIAL ASSISTANCE POLICY THAT STATES PARTICIPATION IN CHARITY PROGRAM REQUIRES THAT CANDIDATES FULLY COOPERATE. THE MEDICAL CENTER EDUCATES PATIENTS WILL LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE AND PROVIDES ACCESS TO DEDICATED FINANCIAL COUNSELORS DAILY. FOR THIS REASON THE MEDICAL CENTER BELIEVES THAT IT IS ACCURATELY CAPTURING ALL CHARITY CARE DEDUCTIONS ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE UNDER THE ORGANIZATION CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2015 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: THE MEDICAL CENTER WILL ASSIST ALL PATIENTS AND THEIR RESPONSIBLE PARTY WITH METHODS OF PAYING ACCOUNTS GENERATED AS A RESULT OF NO THIRD PARTY COVERAGE OR BALANCES AFTER INSURANCE PAYMENTS. ACCEPTABLE PAYMENT ARRANGEMENTS ARE REQUESTED IF FULL PAYMENT CANNOT BE MADE. COMPUTER GENERATED STATEMENTS ARE MAILED TO THE RESPONSIBLE PARTY ON A REGULAR SCHEDULE. LETTERS ARE ALSO SENT AS SUPPLEMENT TO THE DATA STATEMENTS TO KEEP THE PATIENT/GUARANTOR INFORMED OF THE STATUS OF THE ACCOUNT. HEALTHCARE FINANCIAL ASSISTANCE WILL BE GRANTED IF THERE ARE NO OTHER RESOURCES AVAILABLE TO THE PATIENT AND THEY HAVE MET THE GUIDELINES AND FURNISHED REQUESTED VERIFICATION. PART VI, LINE 2: THE ORGANIZATION ASSESS COMMUNITY NEEDS THROUGH VOLUNTEER BOARDS, COMMUNITY INVOLVEMENT, VOLUNTEERING, AND BOARD SERVICE. PART VI, LINE 3: PATIENT FINANCIAL SERVICES' PATIENT ACCESS/REGISTRATION STAFF AND CASHIER ASSIST PATIENTS WITH INFORMING AND EDUCATING PATIENTS ABOUT THEIR ACCOUNTS AND CHARGES. PART VI, LINE 4: ST. CLAIRE REGIONAL MEDICAL CENTER'S SERVICE REGION SERVES A POPULATION OF OVER 160,000 IN BATH, CARTER, ELLIOTT, FLEMING, LEWIS, MAGOFFIN, MENIFEE, MONTGOMERY, MORGAN, ROWAN AND WOLFE COUNTIES. ST. CLAIRE REGIONAL'S FIVE FAMILY MEDICINE CLINICS ARE LOCATED IN FRENCHBURG, MOREHEAD, OLIVE HILL, OWINGSVILLE, AND SANDY HOOK. PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THESE VOLUNTEERS ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ANY SURPLUS FUNDS ARE APPLIED DIRECTLY OR INDIRECTLY TO IMPROVE SERVICES. PART VI, LINE 6: NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES KY 1 SCHOLARSHIPS 18 26988 PART I, LINE 2: HOSPITAL MAKES SCHOLARSHIPS AVAILABLE TO ELIGIBLE PERSONS TO FURTHER HEALTHCARE IN THE COMMUNITY. X X X X X X 0 0 0 0 0 0 0 0 0 WILLIAM D LEWIS MD RADIOLOGIST 663333 0 0 0 0 0 6375 0 16677 0 686385 0 0 0 MARK NEFF CEO 322544 0 0 0 0 0 6375 0 14886 0 343805 0 0 0 GR JONES JR CFO 200577 0 0 0 0 0 4742 0 9762 0 215081 0 0 0 TRAVIS BAILEY VP ADMINISTRATION 165439 0 0 0 0 0 4370 0 16289 0 186098 0 0 0 GREG BAUSCH COO 175437 0 0 0 0 0 4005 0 12165 0 191607 0 0 0 WILL MELAHN MD VP MEDICAL STAFF 245719 0 0 0 0 0 5483 0 17464 0 268666 0 0 0 MANSHA KAHLOON MD CARDIOLOGY 751312 0 0 0 0 0 6375 0 16767 0 774454 0 0 0 CHARLES CROUSE MD ORTHOPEDIC SURGEON 1099434 0 0 0 0 0 6375 0 16677 0 1122486 0 0 0 CRAIG BUTLER MD RADIOLOGIST 635333 0 0 0 0 0 6375 0 16767 0 658475 0 0 0 STEPHEN A WILLIAMS MD RADIOLOGIST 663333 0 0 0 0 0 6375 0 16677 0 686385 0 0 0 THADIS COX MD GASTROENTEROLOGIST 550966 0 0 0 0 0 6375 0 16504 0 573845 0 0 0 A ROWAN COUNTY KENTUCKY 616000882 2010-03-22 6000000 PURCHASE AND INSTALL MEDICAL EQUIPMENT 0 0 0 B ROWAN COUNTY KENTUCKY 616000882 2010-12-22 14000000 AQUIRE, CONSTRUCT, EQUIP FACILITIES/ RETIRE 1994 ISSUANCE 0 0 0 A 6000000 6000000 2010 0 0 1 1 B 14000000 115000 2334385 11550615 2011 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 1 0 1 FIFTH THIRD BANK 10.000000000000 0 0 0 0 1 B 0 0 0 0 1 0 0 0 1 A 0 B 0 FORM 990, PART VI, SECTION A, LINE 7A THE PRESIDENT OF THE SISTERS OF NOTRE DAME OF COVINGTON, KY IS THE PERSON WHO APPOINTS ALL THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE CFO AND BY THE ACCOUNTING DEPARTMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS, BOARD COMMITTEES, AND MEDICAL CENTER LEADERSHIP SIGN A CONFLICT OF INTEREST STATEMENT ON INITIAL APPOINTMENT OR EMPLOYMENT AND ANNUALLY THEREAFTER. THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE DEPARTMENT HEAD OF BOARD/ADMINISTRATION. THE SCOPE OF THIS POLICY INCLUDES BOARD OF DIRECTORS, BOARD COMMITTEES, ADMINISTRATIVE STAFF, EMPLOYEES, AND MEDICAL STAFF. THE POLICY IS IN PLACE TO AVOID CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS BETWEEN PERSONAL INTERESTS AND ONE'S OFFICIAL RESPONSIBILITIES AND PERFORMANCE OF DUTIES ON BEHALF OF THE MEDICAL CENTER. THE COVERED PERSONS ARE TO AVOID BEING PLACED IN A POSITION FOR PERSONAL PROFIT, EITHER THROUGH MONEY, GOODS, OR INFLUENCE FROM THE CONDUCTING OF MEDICAL CENTER RESPONSIBILITIES. A SELF DISCLOSURE FROM COVERED PERSONS TO THE INTEGRITY OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFUSE FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS ESTABLISHED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND IS BASED ON PERFORMANCE CRITERIA AND ON PUBLISHED MARKET SURVEY COMPARISONS FOR HEALTHCARE INSTITUTIONS SIMILAR IN SIZE AND SCOPE OF OPERATIONS. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO, BASED ON PERFORMANCE CRITERIA, AND PUBLISHED MARKET SURVEY COMPARISONS, AND IS REVIEWED AND BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN FMV OF INTEREST RATE SWAP 56,253. FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. SISTERS OF NOTRE DAME OF COVINGTON KENTUCKY INC 1601 DIXIE HIGHWAY COVINGTON KY 41011 RELIGIOUS ORDER KY 501(C)(3) LINE 1 N/A 0 CLAIRE-FRANCIS HEALTH SERVICES PLLC DBA INFUSION SOLUTIONS 200 MALL ROAD STE 3 ASHLAND KY 41101 311517507 HOME INFUSION SERVICES KY N/A RELATED 37449 299415 0 0 0.20040 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0