2015-11-13T13:33:09-06:00 2014-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2014-01-01 314379443 ADENA HEALTH SYSTEM ADEN 7407794478 272 HOSPITAL RD CHILLICOTHE OH 45601 ROBERT M ROSENBERGER CFO 7407794478 2015-11-11 1 BERNIE OSTROWSKI P00366367 6148493000 2014 2016-03-07 17:11:31Z ADENA REGIONAL MEDICAL CENTER MARK SHUTER 272 HOSPITAL RD CHILLICOTHE OH 45601 535616317 0 X WWW.ADENA.ORG X 1895 OH "TO HEAL, TO EDUCATE, TO CARE." THE REPORTING ORGANIZATION IS A REGIONAL HEALTHCARE SYSTEM WITH ONE HOSPITAL AND SEVERAL AMBULATORY CENTERS, IN ADDITION TO MULTIPLE PHYSICIAN PRACTICES. AHS OFFERS A WIDE SCOPE OF DIAGNOSTIC AND REHABILITATIVE SERVICES BOTH FOR INPATIENTS AND OUTPATIENTS, INCLUDING COMPREHENSIVE CARDIOLOGY AND CANCER CARE. FURTHERMORE, AHS IS THE SOLE MEMBER OF TWO CRITICAL ACCESS HOSPITALS, ADENA PIKE MEDICAL CENTER AND ADENA GREENFIELD MEDICAL CENTER, THAT FILE SEPARATELY. 15 9 2959 271 0 0 1444837 2245889 394211412 403577339 11247301 11769623 14001227 11514516 420904777 429107367 1036812 743625 0 0 212275721 234033941 0 0 0 182266631 172493780 395579164 407271346 25325613 21836021 437413995 454365729 221591606 223567717 215822389 230798012 TO HEAL, TO EDUCATE, TO CARE. 0 0 364598495 743625 408953541 HEALTH CARE PROGRAMS, GENERAL/OTHER: ROUTINE HOSPITAL SERVICES. THERE WERE 11,361 INPATIENTS AND 1,012,452 OUTPATIENTS IN 2014. EMERGENCY SERVICES - TREATMENT OF EMERGENCY ACCIDENT AND ILLNESS AS WELL AS LESS URGENT CONDITIONS IN THE ABSENCE OF A FAMILY PHYSICIAN. THERE WERE 46,065 EMERGENCY VISITS IN 2014. THE HOSPICE AND HOME HEALTH DEPARTMENTS PROVIDE MEDICAL CARE, MEDICATIONS, HOME HEALTH NEEDS, BEREAVEMENT COUNSELING PRESCRIPTIONS, FOOD AND SHELTER TO PATIENTS. THERE WERE 17,384 HOSPICE DAYS IN 2014. PHYSICIAN OFFICES: THERE WERE 387,548 PHYSICIAN OFFICE VISITS IN 2014. 364598495 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 1 1 0 0 0 1 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 172 0 1 2959 1 0 0 0 0 0 0 0 0 0 0 X 15 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ROBERT M ROSENBERGER CFO 7407797582 272 HOSPITAL ROAD CHILLICOTHE OH 456019031 STEVEN BURKHARDT TRUSTEE/TREASURER 2.00 0.00 X X 0 0 0 MIKE LILLY TRUSTEE/SECRETARY 2.00 2.00 X X 0 0 0 DAVE STRICKLAND TRUSTEE/CHAIRMAN 2.00 0.00 X X 0 0 0 TOM WHITE TRUSTEE/VICE CHAIR 2.00 0.00 X X 0 0 0 JACK BERNO TRUSTEE/EMPLOYED M.D. 50.00 0.00 X 296541 0 14620 WAYNE COATS TRUSTEE/EMPLOYED M.D. 50.00 0.00 X 413302 0 23312 RALPH D'ANTONI TRUSTEE 2.00 0.00 X 0 0 0 JAMES GROVE TRUSTEE 2.00 0.00 X 0 0 0 JERRY PHILLIPS TRUSTEE 2.00 0.00 X 0 0 0 WILBUR SEVER TRUSTEE/EMPLOYED M.D. 50.00 0.00 X 618177 0 24552 JOSEPH SULZER TRUSTEE 2.00 0.00 X 0 0 0 GAIL TAYLOR TRUSTEE 2.00 0.00 X 0 0 0 JOE WATSON TRUSTEE 2.00 0.00 X 0 0 0 VIRGINIA WETTERSTEN TRUSTEE 2.00 0.00 X 0 0 0 NOBLE YOSHIDA TRUSTEE 2.00 0.00 X 0 0 0 DAWN BENNETT JOHNSON INTERIM CFO (JAN-JULY) 46.00 4.00 X 258798 0 35477 ROBERT ROSENBERGER CHIEF FINANCIAL OFFICER (JULY-DEC) 46.00 4.00 X 203252 0 33052 MARK SHUTER CHIEF EXECUTIVE OFFICER 46.00 4.00 X 733696 0 43716 NICHOLAS ALEXANDER PRESIDENT OF SOHCN 50.00 0.00 X 179237 0 34857 ERIC CECAVA MASTER BLACK BELT 45.00 0.00 X 191800 0 38853 JOHN FORTNEY CHIEF MEDICAL OFFICER 50.00 0.00 X 386039 0 46242 ANTHONY FREEMAN EMPLOYED M.D. 50.00 0.00 X 783473 0 24862 GAIL GAMES VP EDUCATION AND DEVELOPMENT 45.00 0.00 X 164746 0 39077 MICHAEL GLANZMAN EXECUTIVE DIRECTOR PHYS. SERVICES 45.00 0.00 X 185355 0 41882 JUDITH HENSON CHIEF NURSING OFFICER 45.00 0.00 X 219299 0 40869 MARTHA LIVINGSTON CHIEF BUSINESS DEVLOPMENT OFFICER 45.00 0.00 X 242347 0 33296 ERIC PERDUE CHIEF HUMAN RESOURCES 45.00 0.00 X 198764 0 18282 PATRICIA ROAM CHIEF COMPLIANCE OFFICER 45.00 0.00 X 164197 0 22368 LINDA WEIMER KEY EMPLOYEE 50.00 0.00 X 255230 0 33291 JOHN YOUNG EMPLOYED M.D. 50.00 0.00 X 661591 0 24571 SATISH JETTY EMPLOYED M.D. (JAN-MAR) 49.00 1.00 X 418220 0 33395 BRIAN COHEN EMPLOYED M.D. 50.00 0.00 X 3511428 0 24328 MATHEW COSENA EMPLOYED M.D. 50.00 0.00 X 1093783 0 11770 DAVID JONES EMPLOYED M.D. 50.00 0.00 X 877946 0 11404 THOMAS LEWIS EMPLOYED M.D. 50.00 0.00 X 920132 0 24862 HAVAL SAADLLA EMPLOYED M.D. 50.00 0.00 X 1078932 0 24862 ETHELBERT BAKER FORMER KEY EMPLOYEE, EMPLOYED M.D. 50.00 0.00 X 599478 0 24862 NATALIE DI IONNO FORMER ASST. GENERAL COUNSEL 45.00 5.00 X 226631 0 0 FAITHA SHELTON FORMER KEY EMPLOYEE, EMPLOYED M.D. 45.00 0.00 X 144472 0 32344 KIRK TUCKER FORMER KEY EMPLOYEE, EMPLOYED M.D. 50.00 0.00 X 271566 0 24862 15298432 0 785868 260 1 1 0 CAPTIVE RADIOLOGY 6273 FRANK AVENUE NW NORTH CANTON OH 44720 MRI SERVICES 3366050 PRECYSE SOLUTIONS LLC PO BOX 11407 BIRMINGHAM AL 35246 TRANSCRIPTION & CODING 2981863 ECONOMY LINEN & TOWEL SERVICE 508 HOWARD ST ZANESVILLE OH 43701 LINEN SERVICE 1164361 BRICKER AND ECKLER 100 SOUTH THIRD STREET COLUMBUS OH 43215 ATTORNEY FEES 1124140 ROSS EMERGENCY GROUP PC PO BOX 82368 LAFAYETTE LA 705982368 MEDICAL STAFFING SERVICE 1073977 42 852463 55000 1338426 655799 2245889 NET PATIENT SVC REV 622110 403577339 403577339 403577339 1776653 1776653 156312 0 156312 156312 156312 116444671 15311 106458031 8981 9986640 6330 9992970 9992970 38617 41938 -3321 -3321 EHR IMPLEMENTATION 622110 2567944 2567944 FOOD & NUTRITION 722514 1714328 1714328 CONSULTING FEES 900099 1259212 1259212 5820041 1549046 4270995 11361525 429107367 408953541 0 17907937 743625 743625 6724863 4814797 1910066 177472602 160099686 17372916 9744309 8790432 953877 40092167 34817553 5274614 373278 373278 1786687 1786687 88232 88232 35192776 29391596 5801180 1413364 1360089 53275 19942504 11769231 8173273 6170323 6046917 123406 10154307 8852525 1301782 1154082 676216 477866 8596995 7494860 1102135 20144115 17561639 2582476 2040765 2040765 MEDICAL SUPPLIES 57313726 57313726 BAD DEBT EXPENSE 16242930 16242930 OVERHEAD ALLOCATION -8120304 -3791370 -4328934 407271346 364598495 42672851 0 10833 11258 80148561 37995836 8306431 10733895 46093123 54907645 40242 51410 5336782 6724423 10280125 4505669 378873395 236839894 147862420 142033501 125793671 179720729 13541807 17681363 437413995 454365729 41713521 45718894 171764259 167866779 8113826 9982044 221591606 223567717 X 214840183 229503054 982206 1294958 215822389 230798012 437413995 454365729 X 21836021 -4903436 -1956962 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 3925 3925 0 PART II-B, LINE 1: THE OHIO HOSPITAL ASSOCIATION DOES LOBBYING ON BEHALF OF HOSPITAL RELATED CAUSES. THIS ACTIVITY IS PAID FOR THROUGH DUES PAID TO THE OHIO HOSPITAL ASSOCIATION. 2462106 246957 106442 166365 2649140 2168959 358513 156716 222082 2462106 1050463 1142201 169101 192806 2168959 979299 48900 30021 7757 1050463 859540 50593 101333 32167 979299 1.00000 0 0 2648975 2648975 170376502 74071953 96304549 194953728 157346771 37606957 10894190 5421170 5473020 142033501 ACCRUED MALPRACTICE INSURANCE - LT 8198539 DEFINED BENEFIT PLAN LIABILITY 1783505 9982044 X PART V, LINE 4: ADENA HEALTH FOUNDATION ENDOWMENT FUNDS ARE USED TO PROVIDE SCHOLARSHIPS AND PURCHASE CAPITAL FOR PACCAR MEDICAL EDUCATION CENTER. THESE FUNDS ARE HELD BY ADENA HEALTH SYSTEM AND ARE ADMINISTERED BY ADENA HEALTH FOUNDATION. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED AS OF DECEMBER 31, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES THAT IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2011. CHARITY BALL 11101 11101 339 788 13148 PLANT SALE 27516 27516 150 27513 38617 38617 489 788 40661 41938 -3321 1 1 X 1 X 1 X 1 1 1 0 1 1 10657988 3795410 6862578 0.01760 88397793 51235105 37162688 0.09500 99055781 55030515 44025266 0.11260 284254 284254 0.00070 376809 376809 0.00100 661063 661063 0.00170 99716844 55030515 44686329 0.11430 0 16242930 812146 71764353 64170135 7594218 X 1 1 1 1 ADENA REGIONAL MEDICAL CENTER 272 HOSPITAL RD CHILLICOTHE OH 45601 WWW.ADENA.ORG ST. REG. NUM. 1029 X X X ADENA REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.ADENA.ORG/INSIDE/PAGE.DT/CHNA X X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X X X 1 X 0 X X X 1 X 0 0 ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: ADENA REGIONAL MEDICAL CENTER CAPTURED THE BROAD INTERESTS OF THE COMMUNITY FOR THE CHNA THROUGH TWO METHODS: SURVEY AND INTERVIEWS. A HEALTH NEEDS SURVEY WAS WIDELY DISTRIBUTED TO THE ROSS COUNTY COMMUNITY THROUGH PAPER AND WEB FORM. IN ADDITION TO THE SURVEYS, INTERVIEWS WITH LOCAL COMMUNITY LEADERS, INCLUDING CIVIC, PUBLIC HEALTH AND EMERGENCY RESPONSE WERE REQUESTED AND/OR CONDUCTED TO GAIN FURTHER KNOWLEDGE OF SURVEY TOPICS. ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: THE CHNA FOR ADENA REGIONAL MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH WITH TWO OTHER HOSPITAL FACILITIES THAT ARE PART OF THE ADENA HEALTH SYSTEM: ADENA GREENFIELD MEDICAL CENTER AND ADENA PIKE MEDICAL CENTER. ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7D: HARD COPIES OF THE CHNA REPORT WERE PRINTED AND SENT TO COMMUNITY LEADERS AND AGENCIES. ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: OBESITY-EMPLOYEE HEALTH INITIATIVES: IN 2014, ADENA HEALTH SYSTEM RESTRUCTURED ITS INTERNAL HEALTH & WELLNESS TEAM TO CREATE AN EVIDENCE-BASED HEALTH AND WELLNESS PLATFORM BY DEVELOPING AND REFINING PROGRAMS FOR HEALTH SYSTEM EMPLOYEES (RESIDENTS OF THE SERVICE REGION) THAT COULD BE IMPLEMENTED ON A LARGER SCALE IN THE COMMUNITY.THE TEAM SUCCESSFULLY CREATED A MODEL BUILT AROUND THREE COMPONENTS PROVEN TO DRIVE IMPROVED INDIVIDUAL HEALTH AND WELLNESS: MOVEMENT; NUTRITION AND WELLBEING. THE TEAM COORDINATED PROGRAMMING WITHIN THESE THREE AREAS - CAMPUS BASED WALKING PROGRAM, WEIGHT WATCHERS AT WORK, AND STRESS MANAGEMENT CLASSES - IN ADDITION TO ESTABLISHED OFFERINGS INCLUDING FAMILY FIT AND ADENA FIT. A COMMUNICATION PLAN WAS BUILT AROUND THE PROGRAMMING TO ENSURE EFFECTIVE COMMUNICATION TO EMPLOYEES. IN ADDITION, A COMPETITIVE CHALLENGE FOR EMPLOYEES, MOVE MORE ADENA, WAS ALSO COORDINATED TO ENCOURAGE 90 MINUTES OF ACTIVITY PER WEEK, AS WELL AS A VENUE TO MARKET OTHER EMPLOYEE HEALTH AND WELLNESS OFFERINGS. THE TEAM SUCCESSFULLY ENGAGED MORE THAN 35% OF THE TOTAL EMPLOYEE POPULATION THROUGH THESE INITIATIVES IN 2014.OBESITY-COMMUNITY PROGRAMMING:AHS COMMUNITY HEALTH ADVANCEMENT COLLABORATED WITH A VARIETY OF COMMUNITY PARTNERS TO COORDINATE AND DELIVER COMMUNITY PROGRAM AIMED AT PROMOTING MOVEMENT AND NUTRITION. PROGRAMS INCLUDED:SPONSORSHIP AND PARTICIPATION IN THE HEALTHY KIDS EVENT AT THE ROSS COUNTY FAIR WITH CHILLICOTHE GAZETTE, HEALTHY START FOR KIDS, YMCA AND ROSS COUNTY PUBLIC LIBRARY. WITH MORE THAN 200 IN ATTENDANCE, THIS EVENT PROVIDED ENTERTAINMENT INFUSED EDUCATION ON REDUCING SUGAR IN YOUR DIET, REDUCING SCREEN TIME AND WAYS TO GET MORE ACTIVESPONSORSHIP OF THE ROSS COUNTY PUBLIC LIBRARY'S HEALTHY KIDS PORTION OF THE BOOKWORM PROGRAM. AHS PROVIDES SMALL INCENTIVES TO KIDS AS THEY COMPLETE CERTAIN HEALTHY ACTIVITIES DURING THE PROGRAM SUCH AS REDUCING SCREEN TIME, EATING HEALTHIER AND GETTING ACTIVE. MORE THAN 2,000 CHILDREN PARTICIPATED IN THE PROGRAM.OBESITY-REGIONAL INITIATIVES:THE COMMUNITY HEALTH ADVANCEMENT OFFICE WAS RESTRUCTURED IN 2014. THE DIRECTOR FOR THE OFFICE IMMEDIATELY STARTED WITH COORDINATION OF THE EMPLOYEE HEALTH & WELLNESS COMMITTEE WHICH COMPLETED AND BEGAN EXECUTION OF ITS PLAN IN AUGUST. IN ADDITION, A CORPORATE EVENTS COORDINATOR WAS ADDED TO SUPPORT THE DIRECTOR FACILITATE EVENT SET-UP AND DELIVERY, AS WELL AS ALIGN HEALTH AND WELLNESS PROGRAMMING WITH COMMUNITY EVENTS. A COMMUNITY HEALTH FOCUS AND MESSAGE, "MOVE MORE, EAT BETTER" WAS FINALIZED AND SET FOR IMPLEMENTATION IN 2015.MENTAL & BEHAVIORAL HEALTH-ADVOCACY:AHS SUPPORTED MULTIPLE COMMUNITY PARTNERS IN 2014 TO ADVOCATE FOR EXPANDED ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES. TWO PHYSICIANS FROM AHS ARE MEMBERS OF THE ROSS COUNTY DART FORCE, CURRENTLY EXECUTING A COMMUNITY PLAN TO ADDRESS THE GROWING HEROIN EPIDEMIC IN THE REGION.AS ONE OF THREE HEALTH SYSTEM PARTICIPANTS IN THE STRONG START OHIO PROJECT (FROM THE GOVERNOR'S OFFICE OF HEALTH TRANSFORMATION) AHS BEGAN DELIVERING PRENATAL CARE TO PREGNANT WOMEN WITH ADDICTION ISSUES USING A CENTERINGPREGNANCY MODEL. THIS PROJECT PROVIDED A MONTHLY OPPORTUNITY TO INFORM THE STATE OF OHIO ABOUT BARRIERS TO ACHIEVING POSITIVE BIRTH OUTCOMES, INCLUDING ACCESS TO LONGER-TERM ADDICTION TREATMENT IN SOUTHERN OHIO.THE AHS DIRECTOR OF COMMUNITY HEALTH ADVANCEMENT ALSO SERVED ON THE SOUTHEAST OHIO MEDICAID EXPANSION COMMITTEE, TO PARTICIPATE IN EFFORTS TO EXPAND MEDICAID COVERAGE TO THE REGION'S RESIDENTS. THIS GROUP ALSO INFORMS STATE GOVERNMENT ON THE NEED AND BENEFIT OF AFFORDABLE HEALTH CARE IN SOUTHERN OHIO.MENTAL & BEHAVIORAL HEALTH-REFERRAL RESOURCES:AHS CONTINUED TO OPERATE THE REGION'S ONLY ACUTE INPATIENT, PSYCHIATRIC UNIT FOR INSURED, UNINSURED AND UNDER INSURED PATIENTS IN 2014 AT THE ADENA REGIONAL MEDICAL CENTER.AHS WOMEN'S & CHILDREN'S, PRIMARY CARE AND PAIN MANAGEMENT SERVICE LINES MADE REFERRALS FOR PATIENTS NEEDING MENTAL AND BEHAVIORAL HEALTH SERVICES IN ROSS COUNTY TO THE ADENA COUNSELING CENTER, PAINT VALLEY MENTAL HEALTH CENTER, ADENA WOMEN'S AND CHILDREN'S CENTERINGPREGNANCY PROGRAM, THE ROSS COUNTY HEALTH DEPARTMENT'S VIVITROL PROGRAM.AHS PROVIDED COPYING AND PROMOTION RESOURCES FOR THE LOCAL 2-1-1 NETWORK, INCLUDING PRINT COPIES OF THE BROCHURE AND REFERRALS TO THE NETWORKS THROUGH THE HEALTH SYSTEM SERVICE LINES.MENTAL & BEHAVIORAL HEALTH-CESSATION RESOURCES:AHS SERVED A TOTAL OF 25 WOMEN ADDICTED TO OPIATES AS PART OF ITS CENTERINGPREGNANCY PROGRAM IN 2014. IN ADDITION, A WORK TEAM WAS CONVENED TO REVIEW COMMUNITY NEED, DEMAND AND OPPORTUNITIES FOR EXPANSION OF CURRENT AHS MENTAL AND BEHAVIORAL HEALTH OPPORTUNITIES.MENTAL & BEHAVIORAL HEALTH-SCREENING:IN 2014, EACH AHS IMPLEMENTED A SCREENING POLICY TO IDENTIFY POSSIBLE MENTAL AND BEHAVIORAL ISSUES WITH PATIENTS PRESENTING IN THE EMERGENCY ROOMS OF ADENA HEALTH SYSTEM HOSPITALS.SMOKING-CESSATION RESOURCES:ALONG WITH PROVIDER SMOKING CESSATION COUNSELING PROVIDED TO PATIENTS SELF-IDENTIFIED AS SMOKERS, AHS HAS CONVENED A WORK TEAM TO IDENTIFY ADDITIONAL OPPORTUNITIES TO IDENTIFY AND PROVIDE INTERVENTION TO CURRENT SMOKERS.SMOKING-SCREENING:AHS CANCER CENTER PROVIDED 194 PATIENTS WITH FREE LUNG SCREENINGS IN 2014, WITH 13 PATIENTS WHO WERE IDENTIFIED WITH EARLY STAGE LUNG CANCER.NEEDS THAT CANNOT BE ADDRESSED:UNINTENTIONAL INJURIES, IN GENERAL, WERE NOT ADDRESSED AS PART OF THE IMPLEMENTATION PLAN. THE PRIMARY CAUSE OF UNINTENTIONAL INJURIES IN ROSS COUNTY IS AUTOMOTIVE ACCIDENTS. AHS/ARMC DOES NOT HAVE THE CAPABILITIES OR RESOURCES AT THIS TIME TO DELIVER A DRIVER SAFETY CAMPAIGN. A PROGRAM IS CURRENTLY WELL COORDINATED BY THE OHIO STATE HIGHWAY PATROL AND LOCAL LAW ENFORCEMENT.A SECOND CAUSE OF UNINTENTIONAL INJURY DEATHS ARE RELATED TO DRUG OVERDOSES. AHS HAS IDENTIFIED STRATEGIES TO ADVOCATE AND SUPPORT BEHAVIORAL HEALTH EFFORTS AS PART OF ITS IMPLEMENTATION STRATEGY LISTED ABOVE. COORDINATION OF CESSATION RESOURCES AND REGIONAL PARTNERSHIPS TO ADVOCATE FOR EXPANDED ADDICTION SERVICES IN THE PLAN SHOULD BE NOTED, AS DRUG RELATED DEATHS WILL BE INDIRECTLY BE IMPACTED AS PART OF THESE EFFORTS.ADDITIONAL INITIATIVES AND RESOURCES:ADENA FAMILY MEDICINE-RESIDENCY CLINIC:THE ADENA FAMILY MEDICINE - RESIDENCY CLINIC OPERATED A HOSPITAL CLINIC IN 2014 PROVIDING AFFORDABLE, QUALITY HEALTH CARE. THE CLINIC PAIRED ACCESSIBLE PRIMARY CARE MEDICAL SERVICES PROVIDED BY PHYSICIAN INTERNS AND RESIDENTS OF ADENA'S GRADUATE MEDICAL EDUCATION PROGRAM, FAMILY AND INTERNAL MEDICINE PRECEPTORS AND A CERTIFIED NURSE PRACTITIONER ALSO PROVIDING SERVICES TO PATIENTS IN THE CLINIC. FOR MORE INFORMATION, GO TO: HTTP://WWW.ADENA.ORG/LOCATIONS/DEPARTMENT.DT/RESIDENCY-CLINICTHE CLINIC AT WALMART-CHILLICOTHE AND WASHINGTON COURT HOUSE:AHS HAS OPERATED A HEALTHCARE CLINIC WITH WALMART IN WASHINGTON COURT HOUSE, OHIO SINCE 2012. THIS CLINIC HAS INCREASED ACCESS TO HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES FOR CHILLICOTHE PATIENTS. THIS CLINIC PROVIDES A WALK-IN, RETAIL HEALTHCARE ACCESS WITH EXTENDED EVENING AND WEEKEND HOURS. THE CLINIC AND ITS TEAM SPECIALIZE IN QUICK, WALK-IN APPOINTMENTS FOR COLD, FLU, SINUS INFECTIONS, IMMUNIZATIONS, SPORTS AND SCHOOL PHYSICALS.ADENA SPORTS MEDICINE-ATHLETIC TRAINING PROGRAMTHE ADENA HEALTH SYSTEM PROVIDED 10 LOCAL PUBLIC HIGH SCHOOLS WITHIN THE SERVICE REGION WITH ATHLETIC INJURY PREVENTION, DIAGNOSIS, AND EVALUATION SERVICES. A TOTAL OF 8 ATHLETIC TRAINERS WORK WITHIN THE SCHOOL'S ATHLETIC DEPARTMENTS AND FOCUS ON EDUCATING STUDENTS, PARENTS AND COACHES ON SPORTS MEDICINE TOPICS, INCLUDING CONCUSSION IDENTIFICATION AND TREATMENT. THE STAFF IS ALSO READILY AVAILABLE AT ATHLETIC EVENTS AND PROVIDES YEARLY SPORTS PHYSICALS TO MORE THAN 1,200 STUDENTS IN PIKE, ROSS, AND JACKSON COUNTIES IN 2014. COMMUNITY HEALTH PROGRAMS AHS/ARMC OFFERED INFORMATION AT 5 COMMUNITY HEALTH PROGRAMS AND EVENTS IN LOCATIONS THROUGHOUT THE YEAR TO HELP THE COMMUNITY LEAD HEALTHIER LIVES THROUGH WELLNESS EDUCATION AND THE PREVENTION OF ILLNESS AND INJURY. TOPICS INCLUDED, BUT WERE NOT LIMITED TO THE FOLLOWING: HIV; CANCER; DIABETES; HEART DISEASE; BONE AND JOINT CARE; CHILDBIRTH; MULTIPLE SCLEROSIS; STROKE; AND WELLNESS.COMMUNITY EVENTS AHS/ARMC ALSO PARTICIPATED IN 10 HEALTH FAIRS/COMMUNITY EVENTS AND SENIOR HEALTH FAIRS IN 7 COUNTIES, ORGANIZED BY OTHER COMMUNITY ORGANIZATIONS IN 2014, INCLUDING THE LOCAL COMMUNITY COLLEGES, LOCAL PUBLIC SCHOOLS, SENIOR ASSOCIATIONS AND COMMUNITY ORGANIZATIONS. AT THE GENERAL HEALTH FAIRS/COMMUNITY EVENTS, ADENA PROVIDED BLOOD PRESSURE CHECKS, DIABETES INFORMATION, BONE DENSITY SCREENINGS, AND PEDIATRIC CONNECTIONS/INFORMATION. THERE IS NO INVASIVE TESTING - E.G., BLOOD SUGAR, CHOLESTEROL, HIV TESTING, ETC. - AT ANY OF THESE EVENTS. ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 20E: PATIENTS HAVE 120 DAYS FROM THE TIME THEIR ACCOUNT GOES TO "SELF-PAY" TO PAY IN FULL OR MAKE PAYMENT ARRANGEMENTS. ON THE 121ST DAY, THEY ARE SENT TO A COLLECTION AGENCY WHO WILL DO CREDIT REPORTING. COLLECTION AGENCIES REQUIRE ADENA MANAGEMENT APPROVAL TO PURSUE LEGAL ACTION. ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 22D: THE PATIENT IS INITIALLY CHARGED REGULAR HOSPITAL RATES FOR SERVICES PERFORMED. THE PATIENT THEN COMPLETES AN APPLICATION FOR FINANCIAL AID FORM AND RETURNS IT TO THE FINANCIAL COUNSELORS, EMPLOYED BY AN OUTSIDE AGENCY. HCAP/CHARITY ADJUSTMENTS ARE ADMINISTERED BASED ON PROOF OF INCOME AND THE TABLES OF THE FEDERAL POVERTY LIMITS (FPL) AND THE MAXIMUM AMOUNT CHARGED IS CALCULATED IN THE FOLLOWING MANNER: 1. 100% WRITE-OFF AND HCAP ELIGIBLE - LESS THAN OR EQUAL TO 200% FPL 2. 60% WRITE-OFF - BETWEEN 201% - 400% OF FPL. MANAGEMENT DECIDED TO LIMIT THE DISCOUNT TO THOSE UNDER THE 400% FPL, BASED ON MANAGEMENT'S EXPERIENCE AT OTHER INSTITUTIONS ALONG WITH A CURSORY REVIEW OF HOSPITALS IN THE LOCAL MARKET. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ADENA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.ADENA.ORG/FILES/RESOURCES/ADENAFINAIDFORMFINAL.PDF 15 ADENA HEALTH PAVILION 4437 STATE ROUTE 159 CHILLICOTHE OH 45601 PHYSICIAN OFFICES, OUTPATIENT SURGERY CENTER ADENA MEDICAL OFFICE BUILDING 4439 STATE ROUTE 159 CHILLICOTHE OH 45601 PHYSICIAN OFFICES ADENA HEALTH CENTER - WAVERLY 12340 STATE ROUTE 104 WAVERLY OH 45690 AMBULATORY CARE CENTER ADENA URGENT CARE 55 CENTENNIAL BLVD CHILLICOTHE OH 45601 AMBULATORY CARE CENTER ADENA HOME CARE SERVICES 111 W WATER STREET CHILLICOTHE OH 45601 HOME HEALTH CARE AND HOSPICE ADENA HEALTH CENTER - JACKSON 1000 VETERANS DRIVE JACKSON OH 45640 AMBULATORY CARE CENTER ADENA REHABILITATION AND WELLNESS CENTER 445 SHAWNEE LANE CHILLICOTHE OH 45601 OUTPATIENT REHABILITATION CENTER ADENA FAMILY MEDICINE - OAK HILL 315 WASHINGTON STREET OAK HILL OH 45656 PHYSICIAN OFFICES ADENA PICKAWAY-ROSS FAMILY PHYSICIANS 100 N WALNUT STREET CHILLICOTHE OH 45601 PHYSICIAN OFFICES ADENA FAMILY MEDICINE - CIRCLEVILLE 798 N COURT STREET CIRCLEVILLE OH 43113 PHYSICIAN OFFICES ADENA COUNSELING CENTER 445 SHAWNEE LANE CHILLICOTHE OH 45601 MENTAL HEALTH COUNSELING ADENA FAMILY MEDICINE OF CHILLICOTHE 626 CENTRAL CENTER CHILLICOTHE OH 45601 PHYSICIAN OFFICES ADENA ROSS UROLOGY 8 MEDICAL DRIVE CHILLICOTHE OH 45601 PHYSICIAN OFFICES ADENA FAMILY MEDICINE - GREENFIELD 536 MIRABEAU STREET GREENFIELD OH 45123 PHYSICIAN OFFICES ADENA FAMILY MEDICINE - WASHINGTON CH 308 HIGHLAND AVENUE SUITE C WASHINGTON COURT HOU OH 43160 PHYSICIAN OFFICES PART I, LINE 7: THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. ACTUAL COSTS WERE USED IN LINE 7E & 7F. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $16,242,930 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES PROMOTE ECONOMIC DEVELOPMENT IN DOWNTOWN CHILLICOTHE. THE HOSPITAL IS HELPING FUND A HISTORIC BUILDING REHABILITATION PROJECT WHICH WILL IN TURN HELP REVITALIZE THE DOWNTOWN CHILLICOTHE BUSINESS DISTRICT AS WELL AS PROMOTE JOB GROWTH. THE BUILDING WILL ALSO PROVIDE HOUSING FOR ADENA PHYSICIAN RESIDENTS AND MEDICAL STUDENTS WHICH ENABLES THE HEALTH SYSTEM TO INCREASE PROVIDER ACCESS WITHIN THE SERVICE AREA. PART III, LINE 2: THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS. PART III, LINE 3: IN DETERMINING THE APPROPRIATE AMOUNT TO BE RECORDED ON PART III, LINE 3, ALL SELF PAY CLAIMS ARE TURNED OVER TO A COLLECTION VENDOR. THE VENDOR DETERMINES IF THE CLAIM IS CHARITY AFTER THE PATIENT SUPPLIES APPROPRIATE DOCUMENTATION. HOWEVER, THE HOSPITAL HAD AN OUTSIDE CREDIT AGENCY REVIEW TWO MONTHS OF BAD DEBT TRANSACTIONS AND DETERMINED THAT 27% OF THE AMOUNT BOOKED AS BAD DEBT EXPENSE RELATED TO UNCOMPENSATED CHARITY CARE. THE HOSPITAL RECLASSED $10,549,367 FROM BAD DEBT EXPENSE TO CHARITY CARE. BAD DEBT EXPENSE BEFORE THIS RECLASS WAS $26,792,297 LEAVING $16,242,930 AS BAD DEBT EXPENSE. BASED ON THIS ANALYSIS AND RECLASS, THE HOSPITAL ESTIMATES THAT 5% OF THE BAD DEBT EXPENSE REPORTED IN PART III LINE 2 ARE AMOUNTS THAT WOULD BE ATTRIBUTABLE TO PATIENTS UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR ADENA REGIONAL MEDICAL CENTER. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS ESTABLISHED BASED ON EXPECTED PAYMENT RATES FROM PAYORS UTILIZING CURRENT REIMBURSEMENT METHODOLOGIES AND PAYMENT RATES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM 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 IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE." PART III, LINE 8: THE HOSPITAL MEDICARE ADVANTAGE PLAN AND THE PHYSICIAN MEDICARE ADVANTAGE PLAN INCURRED A SHORTFALL OF <$18,155,108> IN 2014. THIS SHORTFALL COMBINED WITH THE LONGFALL FROM TRADITIONAL MEDICARE SOURCES OF $7,594,218 RESULTS IN A NET MEDICARE SHORTFALL OF <$10,560,890>.OUR SERVICE AREA IS A RURAL 13 COUNTY AREA IN SOUTHERN OHIO. THE POPULATION IS AN AGING POPULATION WHICH RESULTS IN MEDICARE AS OUR LARGEST PAYOR GROUP. IN ADDITION, THE ECONOMIC CONDITIONS THAT RESULT FROM APPALACHIAN DESIGNATION CREATE A RECRUITING ISSUE. TO COMBAT THE ISSUE, WE ARE FORCED TO NOT ONLY EMPLOY PHYSICIANS BUT MUST PAY A PREMIUM TO GET THEM TO AGREE TO SERVE THE AREA'S RESIDENTS. BASED ON THESE ISSUES, WE BELIEVE SERVICE TO OUR MEDICARE POPULATION IS A COMMUNITY BENEFIT. ALSO, THE HOSPITAL USED THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT WHEN DETERMINING THE AMOUNT ON PART III - LINE 6. PART III, LINE 9B: THERE ARE TWO TIERS: 100% CHARITY FOR UP TO OR EQUAL TO 200% OF FEDERAL POVERTY LEVELS AND 60% FOR 201%-400% OF FEDERAL POVERTY LEVELS. PART VI, LINE 2: IN 2014, AHS'S COMMUNITY BUILDING ACTIVITIES PROMOTED ECONOMIC DEVELOPMENT IN DOWNTOWN CHILLICOTHE. THE HEALTH SYSTEM IS HELPING FUND A HISTORIC BUILDING REHABILITATION PROJECT WHICH WILL IN TURN HELP REVITALIZE THE DOWNTOWN CHILLICOTHE BUSINESS DISTRICT AS WELL AS PROMOTE JOB GROWTH. THE BUILDING WILL ALSO PROVIDE HOUSING FOR ADENA PHYSICIAN RESIDENTS AND MEDICAL STUDENTS WHICH ENABLES THE HEALTH SYSTEM TO INCREASE PROVIDER ACCESS WITHIN THE AREA. PART VI, LINE 3: THE AVAILABILITY OF FINANCIAL ASSISTANCE IS COMMUNICATED IN THE FOLLOWING MANNER: 1. STATEMENTS FROM ADENA AS WELL AS COLLECTION VENDORS EXPLAIN AND LIST THE 100% AND 60% ASSISTANCE GUIDELINES ON THE BACKSIDE OF THE STATEMENT. 2. THERE IS SIGNAGE EXPLAINING THE PROGRAM AT ALL THE REGISTRATION AREAS. 3. STAFF AT THE CASHIER AREA EXPLAIN OPTIONS AVAILABLE TO THE PATIENT. 4. WE SEND AN APPLICATION WITH THE SELF-PAY DISCOUNT LETTERS IN CASE THE PATIENT/GUARANTOR CAN'T SET UP A PAYMENT PLAN. 5. THE CUSTOMER SERVICE STAFF IS EDUCATED ON ALL THE OPTIONS AND CAN EXPLAIN THE PROGRAMS WHEN PATIENTS CALL. 6. OUR PHYSICIAN OFFICES, AS WELL AS COLLECTION VENDORS HAVE FINANCIAL AID APPLICATIONS AVAILABLE. 7. LASTLY, WE DO A CREDIT SCORING IN ORDER TO DETERMINE "PRESUMPTIVE CHARITY." IN 2014, THAT WAS BASED ON A SAMPLE POPULATION AND EXTRAPOLATED. PART VI, LINE 4: ROSS COUNTY, HOME TO ADENA REGIONAL MEDICAL CENTER, IS LOCATED IN SOUTH CENTRAL OHIO. IT IS PART OF 2 CONGRESSIONAL DISTRICTS (2ND AND THE 15TH) AND ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT CONTAINS THE POPULATION PATTERNS AND DISTINCT ECONOMIC CONDITIONS INHERENT OF THIS REGION OF THE U.S AND FACES SIMILAR CHALLENGES TO IMPROVE THE LIVES OF ITS 78,868 RESIDENTS. THESE INCLUDE LOW EDUCATIONAL ATTAINMENT PERCENTAGES AND HIGH RATES OF UNEMPLOYMENT AND POVERTY. THE TOTAL POPULATION OF ROSS COUNTY REPRESENTS 15% OF THE TOTAL ADENA HEALTH SYSTEM SERVICE REGION AND IS THE PRIMARY PLACE OF RESIDENCE FOR 80% OF THE PATIENTS IT SERVES. THE COUNTY, AS WELL AS THE REMAINDER OF THE 12 COUNTY SERVICE REGION, HAS SIMILAR DEMOGRAPHICS AS THE STATE OF OHIO AND U.S. OVER 64% OF THE POPULATION IS BETWEEN THE AGES OF 19 AND 64 AND 13% OF THE POPULATION IS OVER THE AGE OF 65. THE MAJORITY OF THE POPULATION IS WHITE WITH AFRICAN AMERICANS MAKING UP THE MAJORITY OF THE REGION'S MINORITY POPULATION.THE 28,158 HOUSEHOLDS IN ROSS COUNTY REPRESENT 14.7% OF THE HOUSEHOLDS IN ADENA HEALTH SYSTEM'S 12-COUNTY SERVICE REGION. THE AVERAGE HOUSEHOLD SIZE IS 2.54 PEOPLE, COMPARABLE WITH THE REST OF OHIO AND THE U.S. THE AVERAGE FAMILY SIZE IS AS WELL WITH 3.05 PEOPLE. A LITTLE MORE THAN 50% OF THE POPULATION IS NOW MARRIED WHICH IS COMPARABLE WITH OHIO AND NATIONAL AVERAGES. MORE THAN 14% ARE DIVORCED WHICH IS NOTICEABLY HIGHER THAN BOTH THE STATE AND NATIONAL AVERAGES. MORE THAN 16% OF THE ADULTS IN ROSS COUNTY HAVE NOT GRADUATED FROM HIGH SCHOOL. THIS PERCENTAGE IS HIGHER THAN BOTH THE OHIO (12.2%) AND NATIONAL (14.6%) AVERAGES, BUT IS LOWER THAN THE AVERAGE FOR THE 12-COUNTY SERVICE REGION (18.9%). MORE THAN 10% OF THE POPULATION OF ROSS COUNTY IS ESTIMATED TO BE FUNCTIONALLY ILLITERATE, OR LACKING THE READING AND WRITING SKILLS SUFFICIENT FOR ORDINARY PRACTICAL NEEDS.WHILE THE UNEMPLOYMENT RATE IN ROSS COUNTY (7.9%) IS COMPARABLE TO THE U.S. AVERAGE, IT CONTINUES TO BE HIGHER THAN BOTH THE REGIONAL (6.8%) AND STATE (6%) AVERAGES. IN ADDITION, MORE THAN 43.4% OF THE POPULATION IS NOT IN THE WORKFORCE. THIS IS HIGHER THAN THE STATE (35.4%) AND NATIONAL AVERAGES (35.2%). THE TOP FIVE EMPLOYMENT INDUSTRIES IN ROSS COUNTY ARE MANAGEMENT/PROFESSIONAL OCCUPATIONS (28%), EDUCATION/HEALTHCARE SERVICES (24.6%), SALES (23%), PRODUCTION/TRANSPORTATION SERVICES (19.7%), AND SERVICE OCCUPATIONS (18.9%). ROSS COUNTY HAS MORE PEOPLE EMPLOYED IN PRODUCTION, TRANSPORTATION AND MATERIAL MOVING OCCUPATIONS (19.7%) THAN THE REGIONAL, STATE AND NATIONAL AVERAGES. THE COUNTY HAS ABOUT HALF AS MANY (5.4%) PROFESSIONAL, SCIENTIFIC AND MANAGEMENT SERVICES PROFESSIONALS AS OHIO (9.1%) AND THE U.S. (10.5%).THE PER CAPITA, MEDIAN AND MEAN HOUSEHOLD INCOMES IN ROSS COUNTY OHIO ARE MUCH LOWER THAN THE STATE AND U.S. AVERAGES, BUT HIGHER THAN REGIONAL AVERAGE. POVERTY RATES ARE ALSO HIGHER THAN STATE AND NATIONAL AVERAGES BUT LOWER THAN THE REST OF THE REGION. ACCESS TO EMPLOYMENT IN ROSS COUNTY IS HIGHER THAN OTHER COUNTIES IN THE REGION.THERE ARE 7,697 CIVILIAN VETERANS LIVING IN ROSS COUNTY, ACCOUNTING FOR ALMOST 10% OF THE REGION'S POPULATION. THE TOTAL CIVILIAN VETERANS WITHIN THE ADENA HEALTH SYSTEM 12-COUNTY SERVICE REGION REPRESENT 5% OF OHIO'S TOTAL CIVILIAN VETERAN POPULATION. ROSS COUNTY ALSO HAS A VETERAN'S ADMINISTRATION HOSPITAL LOCATED 4.5 MILES FROM ADENA REGIONAL MEDICAL CENTER.ROSS COUNTY AND ITS ENTIRE SURROUNDING SERVICE REGION HAVE A HIGHER PREVALENCE OF DISABILITY THAN THE REST OF OHIO. SEVEN OF THE 12 COUNTIES IN THE SERVICE REGION HAVE DISABILITY PREVALENCE RATES OF 16.7% - 22%. ROSS COUNTY'S PREVALENCE RATE IS BETTER (14.8% - 16.6%) BUT STILL WORSE THAN THE REST OF OHIO (13.4% - 14.7%). PART VI, LINE 5: ADENA REGIONAL MEDICAL CENTER WORKS TO PROMOTE THE HEALTH OF ITS COMMUNITY THROUGH A VARIETY OF MEANS, INCLUDING BOARD MEMBERS, ADMINISTRATION, EMPLOYEES, AND VOLUNTEERS. THE 2014 BOARD OF TRUSTEES OF ADENA HEALTH SYSTEM WAS COMPRISED OF 16 MEMBERS. TWENTY FIVE PERCENT OF THE BOARD MEMBERS ARE EMPLOYEES OF ADENA HEALTH SYSTEM. ALL BUT 1 (6%) OF THE BOARD MEMBERS RESIDE IN ROSS COUNTY OHIO PART VI, LINE 6: FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES THREE HOSPITALS AND SIX REGIONAL CLINICS, WITH A TOTAL OF 311 BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. GREENFIELD AREA MEDICAL CENTER AND PIKE HEALTH SERVICES, INC.: BOTH ARE CRITICAL ACCESS HOSPITALS, EACH WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (GREENFIELD AREA MEDICAL CENTER) AND PIKE COUNTY (PIKE HEALTH SERVICES, INC.) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WASHINGTON COURT HOUSE AND WAVERLY, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE AND WAVERLY. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN), A PARTNERSHIP OF THE REGION'S THREE LARGEST HEALTHCARE PROVIDERS -- ADENA, O'BLENESS HEALTH SYSTEM AND HOLZER CONSOLIDATED HEALTH SYSTEMS. THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS. 1 ADENA HEALTH FOUNDATION 272 HOSPITAL ROAD CHILLICOTHE OH 45601 753008742 501(C)(3) 618935 PAYMENT OF ORGANIZATION EXPENSES CHILLICOTHE CIVIC THEATER PO BOX 356 CHILLICOTHE OH 45601 311266119 501(C)(3) 50000 THEATER MARQUEE CHILLICOTHE CAVALIER CLUB 2710 S BRIDGE ST CHILLICOTHE OH 45601 311324783 501(C)(3) 15000 SCOREBOARD INSTALLMENT ECONOMIC DEVELOPMENT ALLIANCE OF ROSS COUNTY 45 E MAIN ST CHILLICOTHE OH 45601 203786756 501(C)(3) 15000 PLEDGE INSTALLMENT UNITED WAY 53 E 2ND ST CHILLICOTHE OH 45601 314389671 501(C)(3) 15000 DONATION CAMPAIGN UNIOTO SCHOOLS 14193 PLEASANT VALLEY RD CHILLICOTHE OH 45601 316401035 170(C)(1) 13190 S.C.O.P.E.S. PROJECT WAVERLY HIGH SCHOOL 1 TIGER DR WAVERLY OH 45690 316401098 170(C)(1) 10000 FIELD HOUSE PROJECT ROSS COUNTY AGRICULTURAL SOCIETY PO BOX 614 CHILLICOTHE OH 45601 316050864 501(C)(3) 6500 FREE RIDE DAY AT THE ROSS COUNTY FAIR AND STAGE FOR HEALTHY KIDS EVENT 6 2 PART I, LINE 2: DECISIONS TO DONATE TO COMMUNITY PROJECTS ARE BROUGHT TO CEO FOR APPROVAL FROM MEMBERS OF SENIOR LEADERSHIP AND/OR THE STRATEGY DEPARTMENT. FOR EACH GRANT THERE IS AN AGREEMENT SIGNED BY ADENA AND THE ORGANIZATION RECEIVING THE DONATION THAT CONFIRMS FUNDS ARE BEING USED FOR THE INTENDED PURPOSE. A BLANKET AMOUNT IS BUDGETED FOR THE FISCAL YEAR AND CONSIDERED AS EACH REQUEST IS MADE. X X 1 1 X X X X 1 0 0 0 0 0 0 0 0 JACK BERNO TRUSTEE/EMPLOYED M.D. 292193 0 150 0 4198 0 0 0 17049 0 313590 0 0 0 WAYNE COATS TRUSTEE/EMPLOYED M.D. 396874 0 150 0 16278 0 0 0 26487 0 439789 0 0 0 WILBUR SEVER TRUSTEE/EMPLOYED M.D. 599370 0 0 0 18807 0 0 0 28736 0 646913 0 0 0 DAWN BENNETT JOHNSON INTERIM CFO (JAN-JULY) 196252 0 0 0 62546 0 18124 0 18574 0 295496 0 0 0 ROBERT ROSENBERGER CHIEF FINANCIAL OFFICER (JULY-DEC) 200659 0 0 0 2593 0 12715 0 21115 0 237082 0 0 0 MARK SHUTER CHIEF EXECUTIVE OFFICER 709377 0 150 0 24169 0 26600 0 20034 0 780330 0 0 0 NICHOLAS ALEXANDER PRESIDENT OF SOHCN 170109 0 150 0 8978 0 9587 0 26580 0 215404 0 0 0 ERIC CECAVA MASTER BLACK BELT 188382 0 150 0 3268 0 13583 0 26680 0 232063 0 0 0 JOHN FORTNEY CHIEF MEDICAL OFFICER 324265 0 0 0 61774 0 26071 0 22425 0 434535 0 0 0 ANTHONY FREEMAN EMPLOYED M.D. 771314 0 0 0 12159 0 0 0 29130 0 812603 0 0 0 GAIL GAMES VP EDUCATION AND DEVELOPMENT 157988 0 226 0 6532 0 15107 0 25299 0 205152 0 0 0 MICHAEL GLANZMAN EXECUTIVE DIRECTOR PHYS. SERVICES 177341 0 0 0 8014 0 13042 0 30216 0 228613 0 0 0 JUDITH HENSON CHIEF NURSING OFFICER 198456 0 150 0 20693 0 16250 0 26306 0 261855 0 0 0 MARTHA LIVINGSTON CHIEF BUSINESS DEVLOPMENT OFFICER 217211 0 250 0 24886 0 20154 0 14983 0 277484 0 0 0 ERIC PERDUE CHIEF HUMAN RESOURCES 180597 0 0 0 18167 0 16332 0 3479 0 218575 0 0 0 PATRICIA ROAM CHIEF COMPLIANCE OFFICER 137274 0 200 0 26723 0 12772 0 10654 0 187623 0 0 0 LINDA WEIMER KEY EMPLOYEE 253260 0 0 0 1970 0 22796 0 11745 0 289771 0 0 0 JOHN YOUNG EMPLOYED M.D. 640047 0 50 0 21494 0 0 0 29253 0 690844 0 0 0 SATISH JETTY EMPLOYED M.D. (JAN-MAR) 409237 0 191 0 8792 0 8533 0 27142 0 453895 0 0 0 BRIAN COHEN EMPLOYED M.D. 3491168 0 150 0 20110 0 0 0 29011 0 3540439 0 0 0 MATHEW COSENA EMPLOYED M.D. 1089781 0 0 0 4002 0 0 0 16452 0 1110235 0 0 0 DAVID JONES EMPLOYED M.D. 875064 0 0 0 2882 0 0 0 16086 0 894032 0 0 0 THOMAS LEWIS EMPLOYED M.D. 918387 0 200 0 1545 0 0 0 29545 0 949677 0 0 0 HAVAL SAADLLA EMPLOYED M.D. 1063137 0 200 0 15595 0 0 0 29545 0 1108477 0 0 0 ETHELBERT BAKER FORMER KEY EMPLOYEE, EMPLOYED M.D. 596293 0 0 0 3185 0 0 0 29140 0 628618 0 0 0 NATALIE DI IONNO FORMER ASST. GENERAL COUNSEL 0 0 0 0 226631 0 0 0 0 0 226631 0 0 0 FAITHA SHELTON FORMER KEY EMPLOYEE, EMPLOYED M.D. 143954 0 250 0 268 0 13376 0 19985 0 177833 0 0 0 KIRK TUCKER FORMER KEY EMPLOYEE, EMPLOYED M.D. 270943 0 0 0 623 0 0 0 27247 0 298813 0 0 0 PART I, LINE 1A ADENA HEALTH SYSTEM PROVIDES FOR A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR ALL OFFICERS AND KEY EMPLOYEES. THIS BENEFIT IS GROSSED UP AND TAXED AND RECEIVED BY SEVEN OF THE OFFICERS AND KEY EMPLOYEES. PART I, LINE 4A LINE 4A: ONE EMPLOYEE THAT WAS PREVIOUSLY LISTED IN PART VII, SECTION A, LINE 1A RECEIVED SEVERANCE DURING 2014. - NATALIE DI IONNO REPORTED SEVERANCE COMPENSATION OF $199,502 IN 2014. SHE IS RECEIVING 12 MONTHS OF SEVERANCE AND THEN A 6 MONTH BRIDGE IF NOT EMPLOYED. AT ANY TIME AFTER THE INTIAL 12 MONTHS, AHS WOULD REDUCE PAY IF EMPLOYED AT A LESSER RATE. A COUNTY OF ROSS OHIO 316400085 778260EX3 2008-09-17 141346983 CURRENT REFUNDING OF 2001 AND 2006 ISSUES 0 0 0 B COUNTY OF ROSS OHIO 316400085 2010-09-15 29985000 INFUSION CENTER AND INTERVENTIONAL RADIOLOGY 0 0 0 A 7520000 196860219 10920538 1366439 487668 184085584 2010 1 0 1 1 B 2322777 30087491 411604 29675887 2012 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 1 BAYERISCHE LANDESBANK 3.000000000000 1 0 0 B 0 0 0 0 0 0 0 0 0 A 1 B 1 SCHEDULE K, PART II, LINE 6 2001 AND 2006 ISSUES WERE REFUNDED ON OCTOBER 29, 2008. INCLUDED $116,560,000 OF PRINCIPAL AND $149,427 OF INTEREST. THIS IS FOR THE 2008 ISSUE. SCHEDULE K, PART II, LINE 11 $11,750,000 OF ISSUE WAS USED TO PAY OFF QUALIFIED HEDGED RELATED TO THE 2001 AND 2006 BONDS. THIS IS FOR THE 2008 ISSUE. SCHEDULE K, PART III, LINE 2 ADENA HEALTH SYSTEM LEASES APPROXIMATELY 300 SQUARE FEET TO A FOR PROFIT COMPANY THAT OPERATES A COFFEE KIOSK. THIS IS CONSIDERED DEMINIMUS SPACE AND SO 0% WAS PUT IN LINE 4 OF PART III. THIS IS FOR THE 2008 ISSUE. THE LEASE CEASED IN FALL OF 2012. SCHEDULE K, PART IV, LINE 4A PROCEEDS INVESTED IN GIC FROM 2006 ISSUE - UNUSED PORTION TRANSFERS TO 2008 ISSUE. THE GIC MATURED IN JULY 2009; THIS WAS 36 MONTHS AFTER THE DATE OF ISSUE. THIS IS FOR THE 2008 ISSUE. SCHEDULE K, PART IV, LINE 2C THE DATE THE LAST REBATE COMPUTATION WAS PERFORMED IS OCTOBER 31, 2013. DOUGLAS FOLZENLOGEN PHYSICIAN RETENTION X 15000 15000 0 1 1 BRITTON YOUNG PHYSICIAN RECRUITMENT X 80000 31538 0 1 1 DAVID JONES PHYSICIAN RECRUITMENT X 20000 4872 0 1 1 51410 HORIZON TELCOM INC BUSINESS VENDOR OF AHS 918934 PHONE SERVICE 0 ROBIN BERNO SPOUSE OF DIRECTOR JACK BERNO 94387 EMPLOYEE COMPENSATION 0 JENNIFER WHITE DAUGHTER-IN-LAW OF BOARD DIRECTOR TOM WHITE 126646 EMPLOYEE COMPENSATION 0 BRITTEN YOUNG SPOUSE OF KEY EMPLOYEE JOHN YOUNG 470580 EMPLOYEE COMPENSATION 0 JENNIFER STRICKLAND RELATIVE OF CHAIR DAVID STRICKLAND 28579 EMPLOYEE COMPENSATION 0 MICHELLE PERDUE SPOUSE OF KEY EMPLOYEE ERIC PERDUE 69234 EMPLOYEE COMPENSATION 0 SCHEDULE L, PART IV STEVE BURKHARDT THE TREASURER OF HORIZON TELCOM, INC. REGULARLY ABSTAINS FROM VOTING AND REMOVES HIMSELF FROM DISCUSSIONS CONCERNING HORIZON TELCOM, INC. X EQUIPMENT 1 655799 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS COMPOSED OF 9 MEMBER CHURCHES. ALL OF THE CHURCHES ARE IN THE CHILLICOTHE, OHIO AREA. 1.FIRST PRESBYTERIAN CHURCH 2.SALEM COMMUNITY CHURCH 3.ORCHARD HILL UNITED CHURCH OF CHRIST 4.TABERNACLE BAPTIST CHURCH 5.ST. MARY'S CATHOLIC CHURCH 6.TRINITY UNITED METHODIST CHURCH 7.ST. PAUL'S EPISCOPAL CHURCH 8.WALNUT STREET UNITED METHODIST CHURCH 9.ST. PETER'S CATHOLIC CHURCH FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER CHURCHES MAY ONLY ELECT ONE PERSON PER CHURCH TO ACT AS THEIR TRUSTEE. THE TRUSTEES AT LARGE GET APPOINTED AS FOLLOWS. SECTION 3.03 OF THE CODE OF REGULATIONS OF AHS - "THE BOARD SHALL ELECT SIX (6) AT-LARGE TRUSTEE POSITIONS. TWO OF THESE POSITIONS SHALL BE FILLED WITH PHYSICIANS WHO ARE MEMBERS OF THE ACTIVE MEDICAL STAFF RECOMMENDED BY THE MEDICAL STAFF IN ACCORDANCE WITH THE MEDICAL STAFF BYLAWS. WHEN A VACANCY OCCURS AMONG THE FOUR (4) AT LARGE TRUSTEES, WITH THE EXCEPTION OF MEMBERS ELIGIBLE FOR REAPPOINTMENT, THE TRUSTEE COMMITTEE SHALL NOMINATE TO THE BOARD A CANDIDATE FOR THE VACANT POSITION." FORM 990, PART VI, SECTION A, LINE 7B SECTION 2.04 RIGHTS OF THE CORPORATE MEMBERS: (A) THE RIGHT TO ELECT NINE TRUSTEES OF THE CORPORATION AS SPECIFIED IN THESE BYLAWS. (B) THE RIGHT TO APPROVE ANY LEASE, SALE EXCHANGE, TRANSFER, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION. (C) THE RIGHT TO APPROVE ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION. (D) THE RIGHT TO APPROVE ANY PROPOSED DISSOLUTION OF THE CORPORATION. (E) THE RIGHT TO APPROVE ANY PROPOSED CHANGE TO THE FUNDAMENTAL PURPOSE OF THE CORPORATION AS STATED IN SECTION 1.01. (F) THE RIGHT TO APPROVE ANY PROPOSED AMENDMENTS TO THE CODE OF REGULATIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED AT A BOARD MEETING, AND COPIES OF THE FORM 990 WERE PROVIDED TO THE BOD MEMBERS. ADDITIONALLY, COPIES OF THE 990 WERE MADE AVAILABLE ON THE HOSPITAL'S BOARD PORTAL AND IN ADMINISTRATION OFFICE UNTIL THE NOVEMBER 16 FILING DATE. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE OFFICE OF ADENA HEALTH SYSTEM ANNUALLY COORDINATES THE DISTRIBUTION AND RETURN OF THE CONFLICT OF INTEREST STATEMENTS. THE CORPORATE COMPLIANCE OFFICE IS RESPONSIBLE FOR REVIEWING THE RESPONSES AND COMMUNICATING ANY EXTRA STEPS THAT NEED TO TAKE PLACE REGARDING ANY OF THE RESPONSES. AT EVERY BOARD MEETING AND COMMITTEE OF THE BOARD, THE AGENDA ITEM OF CONFLICT OF INTEREST IS INCLUDED AND CALLED OUT. CONFLICTED BOARD MEMBERS ABSTAIN FROM VOTING ON THE PARTICULAR ITEMS. ANY MEMBER ABSTAINING FROM VOTING IS DOCUMENTED IN THE MINUTES. ALL ADENA HEALTH SYSTEM WORKFORCE MEMBERS AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE TOP MANAGEMENT OFFICIAL AT ADENA HEALTH SYSTEM, ALONG WITH OFFICERS/KEY EMPLOYEES, HAVE THEIR COMPENSATION REVIEWED ON AN ANNUAL BASIS THROUGH THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES THROUGH THE USE OF AN INDEPENDENT THIRD PARTY EXECUTIVE COMPENSATION COMPANY. THE INDEPENDENT THIRD PARTY COMPENSATION COMPANY UTILIZES MULTIPLE INDEPENDENT COMPENSATION SURVEYS TO EVALUATE BOTH BASE COMPENSATION AND TOTAL CASH COMPENSATION AGAINST LIKE ORGANIZATIONS. RECOMMENDATIONS FOR CHANGE ARE MADE BY THE INDEPENDENT THIRD PARTY EXECUTIVE COMPENSATION COMPANY AND PRESENTED TO THE EXECUTIVE COMPENSATION COMMITTEE FOR CONSIDERATION. FINAL DECISIONS, WHETHER THEY BE APPROVAL OR DENIAL, ARE MADE BY THE COMMITTEE. THE PROCESS WAS LAST UNDERTAKEN IN MAY OF 2014. SPECIFIC MERIT INCREASES FOR INDIVIDUALS ARE BASED UPON THE EMPLOYEE MEETING AGREED UPON DEVELOPMENTAL GOALS, PERFORMANCE-BASED GOALS, BEHAVIORS AND ESSENTIAL FUNCTIONS OF THEIR JOB FOR THE FISCAL YEAR. THE MERIT PROCESS WAS LAST UNDERTAKEN IN APRIL OF 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PREPARES AN ANNUAL REPORT TO THE PUBLIC WHICH INCLUDES ITS STATEMENT OF REVENUES AND EXPENSES. ADDITIONALLY, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON GUIDESTAR.ORG AS PART OF THE ANNUAL FORM 990 FILING. FORM 990, PART XI, LINE 9: TRANSFERS TO AFFILIATED ORGANIZATION -3,042,115. PENSION RELATED CHANGES OTHER THAN NET PERIODIC COSTS 851,647. INTERCOMPANY RECEIPTS ELIMINATED IN CONSOLIDATION 397,129. ADENA VAC INCOME NOT INCLUDED IN AUDITED NET ASSETS 3,321. COURT DIALYSIS K-1 ACTIVITY - BOOK TO TAX DIFFERENCE -80,131. TEMPORARILY RESTRICTED EXPENDITURES -86,813. FORM 990, PART XII, LINE 2C: ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. 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