Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
217 SOUTH THIRD STREET
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DANVILLE, KY40422
D Employer identification number

61-0492356
E Telephone number

G Gross receipts $ 167,328,283
F Name and address of principal officer:
VICKI A DARNELL
217 SOUTH THIRD STREET
DANVILLE,KY40422
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.EMHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1972
M State of legal domicile: KY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION'S PRIMARY MISSION IS TO PRIVIDE HEALTH CARE AND RELATED SERVICES TO THE 140,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 15
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 1,181
6 Total number of volunteers (estimate if necessary) ............. 6 250
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,270,502
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 56,267
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 255,183 109,523
9 Program service revenue (Part VIII, line 2g) ......... 154,301,638 165,479,655
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,468 53,842
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,002,013 1,640,710
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 156,562,302 167,283,730
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 60,798,555 62,401,009
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 83,448,867 90,272,953
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 144,247,422 152,673,962
19 Revenue less expenses. Subtract line 18 from line 12....... 12,314,880 14,609,768
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 201,364,111 216,585,521
21 Total liabilities (Part X, line 26)............. 10,658,400 11,270,042
22 Net assets or fund balances. Subtract line 21 from line 20..... 190,705,711 205,315,479
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO THE 140,000 INDIVIDUALS RESIDING WITHIN ITS SERVICE REGION IN SOUTH CENTRAL KENTUCKY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 136,660,243 including grants of $   ) (Revenue $ 162,209,153 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet136,660,243
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
107
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,181
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
17
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
KY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletWILLIAM SNAPP III217 SOUTH THIRD STREETDANVILLEKY40422 (859) 239-2424
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Kryder E VanBuskirk III MD........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 0 0
(2) JUDY HAMMONS........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 2,400 0
(3) DAVID HOPPER MD........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 2,400 0
(4) CLIFF ED IRVIN........................................................................
BOARD MEMEBER
 3.0
.......................4.0 		X           0 0 0
(5) MARK MORGAN........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 2,700 0
(6) SUSIE ROUSH........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 0 0
(7) AARON ROWLAND........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 0 0
(8) WILLIAM RUTH III........................................................................
PAST CHAIR
 3.0
.......................4.0 		X           0 2,700 0
(9) REV QUENTIN SCHOLTZ III........................................................................
TREASURER
 3.0
.......................4.0 		X   X       0 2,550 0
(10) DALE KIHLMAN........................................................................
CHAIR
 3.0
.......................4.0 		X   X       0 2,250 0
(11) DONALD HAMNER MD........................................................................
BOARD MEMBER
 3.0
.......................37.0 		X           0 171,295 10,950
(12) ERIC GUERRANT MD........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           10,500 2,700 0
(13) RODNEY BATES MD........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 2,550 0
(14) JOHN D TRISLER........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 0 0
(15) SCOTT BOTTOMS........................................................................
BOARD MEMBER
 3.0
.......................4.0 		X           0 2,400 0
(16) BILL DEMROW........................................................................
VICE CHAIR
 3.0
.......................4.0 		X   X       0 3,000 0
(17) ALLEN WHITE........................................................................
SECRETARY
 3.0
.......................4.0 		X   X       0 900 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) WILLIAM SNAPP........................................................................
VP & CFO
 30.0
.......................29.0 		    X       0 329,220 98,765
(19) VICKI DARNELL........................................................................
CEO
 30.0
.......................29.0 		    X       0 610,609 209,585
(20) CARL METZ........................................................................
VP HUMAN RESOURCES
 40.0
.......................   		      X     232,942 0 56,165
(21) STEPHANIE STONE........................................................................
PHARMACIST
 40.0
.......................   		        X   152,892 0 12,773
(22) JOAN HALTOM........................................................................
PHARMACY DIRECTOR
 40.0
.......................   		        X   180,314 0 40,055
(23) RONALD BARBATO........................................................................
REHAB DIRECTOR
 40.0
.......................   		        X   155,661 0 37,111
(24) ANDREW LOSCH........................................................................
PHARMACIST
 40.0
.......................   		        X   145,751 0 19,048
(25) TINA COOLEY........................................................................
PHARMACIST
 40.0
.......................   		        X   148,329 0 12,822










1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,026,389 1,137,674 497,274
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet38
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
MARSHALL MEDICAL MANAGEMENT LLC, 1792 ALYSHEBA WAY STE 150LEXINGTONKY40509 PHYSICIAN SERVICES 2,251,230
KENTUCKY BLOOD CENTER, 3121 BEAUMONT CENTER CIRCLELEXINGTONKY40512 BLOOD SERVICES 705,367
LOGAN HEALTHCARE LINEN DIVISION, PO BOX 643958CINCINNATIOH45264 LINEN SERVICES 463,357
COMPUTER INFORMATION SERVICES, 513 S MAIN ST SUITE ACORBINKY40508 COMPUTER SERVICES 1,369,167
MESSER CONSTRUCTION, 854 W MAIN STREETLEXINGTONKY40508 CONSTRUCTION SERVICE 727,754
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet17
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 102,444
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		7,079
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 109,523
Program Service RevenueAmt Business Code
2a PATIENT REVENUE 621110 160,553,929 157,538,826 3,015,103  
b PHARMACY REVENUE 446110 2,352,658 2,301,608 51,050  
c JOINT VENTURE INCOME 621110 2,064,968 2,064,968    
d OTHER OPERATING 621110 303,751 303,751    
e REFERENCE LAB 621400 204,349   204,349  
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 165,479,655
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 40,331     40,331
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 84,028  
b Less: rental expenses    
c Rental income or (loss) 84,028 0
d Net rental income or (loss).......MediumBullet 84,028     84,028
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   58,064
b Less: cost or other basis and sales expenses   44,553
c Gain or (loss)   13,511
d Net gain or (loss)..........MediumBullet 13,511     13,511
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a VENDING COMMISSION 722210 14,664     14,664
b CAFETERIA 722210 702,388     702,388
c All Other Misc Revenue 900099 839,630     839,630
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,556,682
12 Total revenue. See Instructions......MediumBullet 167,283,730 162,209,153 3,270,502 1,694,552
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 453,565   453,565  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 46,385,779 41,535,384 4,850,395  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,558,258 2,269,479 288,779  
9 Other employee benefits ....... 9,549,913 8,471,907 1,078,006  
10 Payroll taxes ........... 3,453,494 3,063,659 389,835  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 73,395   73,395  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 19,711,632 16,342,331 3,369,301  
12 Advertising and promotion .... 4,043 3,969 74  
13 Office expenses ....... 5,206,921 3,990,173 1,216,748  
14 Information technology ...... 1,488,629 334,618 1,154,011  
15 Royalties .. 0      
16 Occupancy ........... 2,392,926 2,267,178 125,748  
17 Travel ............ 73,338 46,828 26,510  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 52,868 36,363 16,505  
20 Interest ........... 1,155,472 1,150,487 4,985  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 7,432,078 7,432,078    
23 Insurance .............. 390,907   390,907  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 32,241,851 32,241,851    
b BAD DEBTS 12,304,229 12,304,229    
c TAXES & LICENSES 2,331,823 2,309,853 21,970  
d REPAIRS & MAINTENANCE 3,382,751 2,742,264 640,487  
e All other expenses 2,030,090 117,592 1,912,498  
25 Total functional expenses. Add lines 1 through 24e 152,673,962 136,660,243 16,013,719 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 5,286 1 5,610
2 Savings and temporary cash investments ......... 115,431 2 184,313
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 17,844,686 4 19,069,010
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 3,530,232 8 4,139,108
9 Prepaid expenses and deferred charges .......... 1,286,579 9 1,370,907
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 171,608,256
b Less: accumulated depreciation ..... 10b 113,307,942 60,623,935 10c 58,300,314
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 1,489,977 13 1,402,350
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 116,467,985 15 132,113,909
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 201,364,111 16 216,585,521
Liabilities 17 Accounts payable and accrued expenses ......... 10,658,400 17 11,270,042
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 0 25 0
26 Total liabilities. Add lines 17 through 25......... 10,658,400 26 11,270,042
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 190,688,421 27 205,298,689
28 Temporarily restricted net assets ........... 17,290 28 16,790
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 190,705,711 33 205,315,479
34 Total liabilities and net assets/fund balances ........ 201,364,111 34 216,585,521
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
167,283,730
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
152,673,962
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
14,609,768
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
190,705,711
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
205,315,479
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
  		Employer identification number

61-0492356
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
  		Employer identification number

61-0492356
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
  		Employer identification number

61-0492356
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
13,727
j
Total. Add lines 1c through 1i ...............................
13,727
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCH. C, PART III-B, LINE 1I --------------------- A PORTION OF DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION (KHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) ARE USED FOR LOBBYING.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   2,353,765 2,353,765
b Buildings ................   70,316,896 35,587,507 34,729,389
c Leasehold improvements ............   2,992,190 2,231,220 760,970
d Equipment ................   89,856,788 73,423,260 16,433,528
e Other .................   6,088,617 2,065,955 4,022,662
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 58,300,314
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) Scholarship Account 17,515
(2) Physician Income Guarantee 176,270
(3) Due from Related Parties 130,230,537
(4) DUE FROM THIRD PARTIES 1,689,587





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 132,113,909
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 154,856,467
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -12,304,229
e Add lines 2a through 2d ..................... 2e -12,304,229
3 Subtract line 2e from line 1..................... 3 167,160,696
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 123,034
c Add lines 4a and 4b....................... 4c 123,034
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 167,283,730
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 140,246,699
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d -123,034
e Add lines 2a through 2d...................... 2e -123,034
3 Subtract line 2e from line 1..................... 3 140,369,733
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 12,304,229
c Add lines 4a and 4b....................... 4c 12,304,229
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 152,673,962
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCH D, PART XI & XII RECONCILIATION TO AUDIT REPORT ------------------------------ PART XI LINE 2D OTHER ITEMS INCLUDED ON LINE 1 BUT NOT ON 990 PART VIII: -------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT (12,304,229) PART XI LINE 4B AMOUNTS INCLUDED IN 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 109,523 GAIN ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT 13,511 -------- 123,034 PART XII LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON 990 PART IX: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 109,523 GAIN ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT 13,511 -------- 123,034 PART XII LINE 4B AMOUNTS INCLUDED ON 990 PART IX BUT NOT ON LINE 1: --------------- BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDIT 12,304,229
SCH D, PART X, LINE 2 INCOME TAXES ------------ The organization's audited financial statements did not include a footnote that addressed the organization's liability for uncertain tax positions under FIN48 (ASC 740). Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		1   1,578,935   1,578,935 1.140 %
b Medicaid (from Worksheet 3,
column a) .... 		1   22,571,341 19,305,648 3,265,693 2.350 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		2   24,150,276 19,305,648 4,844,628 3.490 %
Other Benefits
 280 8,741 653 1,000 -347  
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		18 240 2,126,335   2,126,335 1.530 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits .. 302 9,056 2,126,988 1,000 2,125,988 1.530 %
k Total. Add lines 7d and 7j . 304 9,056 26,277,264 19,306,648 6,970,616 5.020 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
12,304,229
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
10,797,643
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
50,575,856
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
56,356,256
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,780,400
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1CNTL KY SURGERY CTR
  		ASC 60.000 %   40.000 %
2BLUEGRASS IMM CARE
  		URGENT TREATMENT CLINIC 73.000 %   27.000 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 EPHRAIM MCDOWELL REGIONAL MEDICAL CEN
217 SOUTH THIRD STREET
DANVILLE,KY40422 		X X         X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
EPHRAIM MCDOWELL REGIONAL MEDICAL CEN
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 11
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 125.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B COMMUNITY HEALTH NEEDS ASSESSMENT --------------------------------- LINE 1J: THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO DESCRIBES THE ASSESSMENT OF MODIFIABLE HEALTH RISKS, ASSESSMENT OF HEALTH EDUCATION AND OUTREACH AND PERCEPTIONS OF HEALTHCARE. LINE 3: THE HOSPITAL CONSULTED WITH EMS DIRECTORS, JUDGE EXECUTIVES, HEALTH DEPARTMENT DIRECTORS, SCHOOL NURSES, SCHOOL SUPERINTENDENTS, FAITH COMMUNITY NURSES, SALVATION ARMY COMMANDER, HEART OF KY UNITED WAY, COUNTY EXTENSION OFFICES, SOCIAL WORKERS, LEGISLATORS, CLERGY, PHYSICIANS AND FREE CLINIC STAFF. LINE 4: THE NEEDS ASSESSMENT WAS CONDUCTED WITH EPHRAIM MCDOWELL FORT LOGAN HOSPITAL DUE TO OVERLAP OF POPULATION SERVED. LINE 5: THE NEEDS ASSESSMENT WAS ALSO PROVIDED TO VARIOUS EDUCATION FACILITIES - CENTRE COLLEGE, EASTERN KENTUCKY UNIVERSITY SCHOOL OF NURSING, UNIVERSITY OF KENTUCKY SCHOOL OF NURSING AND SCHOOL OF PUBLIC HEALTH. LINE 7: Deferred needs from the Health Risk Assessment of Boyle and the surrounding Counties based upon resources and/or expertise included the following: Arthritis/rheumatism is an issue. This links to the high obesity rate and the lack of a built environment that facilities mobility. This issue is deferred by EMRMC due to resources but the factors to decrease cardiovascular (CV) risks will assist with mobility, i.e. weight reduction, improved nutrition, decreased inflammatory markers, etc. Both Lincoln and Garrard County Health Departments offer a self-help program for managing arthritis. Lincoln County has plans to expand the offering. The McDowell Wellness Center offers pool exercises for those with arthritis and silver snickers as options to assist in managing both mobility and pain. There is a rheumatologist at the specialty clinic in Boyle County. The closest arthritis support group is in Lexington, Kentucky. Osteoporosis is addressed as a nutritional issue. This links with the high consumption of carbonated beverages and poor nutrition in the region. This is being deferred due to resources but is part of the farm to school dialogue in the school coalitions. Migraine headaches are treated by primary care physicians and referred as needed. A neurologist is on the physician recruitment plan to make access for evaluation and specialty care easier to access and closer to home. Twenty-five percent of the population suffers from chronic back pain or sciatica. There are pain centers in Boyle County. Chiropractic and physical therapy services are available in all six counties. Obesity, inactivity, and a diet high in fat and calories compound the issues related to arthritis, back and sciatica pain. Addiction to pain-killers and other drugs is an issue in the state and region. Addiction services are offered by private providers, Comprehensive Care, and Self-Refined in the region. EMRMC behavioral medicine unit does treat dual diagnosis patients and the psychiatrists and counselors treat out patients. There is an active Alcoholics Anonymous chapter. Due to lack of expertise and resources, addiction will be deferred as part of the work plan by EMRMC. Chronic kidney disease and end stage renal failure links to diabetes. Moderate exercise, a healthier diet, and weigh reduction can prevent the development of type 2 diabetes in persons at risk (Diabetes Prevention Program funded by NIH). The free screenings will provide early detection and possibly prevention when addressing nutrition, body mass index and exercise. The health departments collaborate with the kidney foundation to conduct screening and education related to kidney health. Disabilities and activity limitations correlates with the poverty of resources. Those with a disability report not getting preventative care, i.e., annual dental visit, mammogram, pap smear, additional findings include lifestyle issues, such as use of tobacco and inactive; health issues such as obesity, high blood pressure, high stress and poor mental health, lower employment rates, lower income, and less social support. This area will be deferred, but the work with school age children related to diet, activity, and self-esteem has preventative value (DPP). The screening for obesity, diabetes, high blood pressure, tobacco use, high cholesterol and the risk factor reduction education for adults provides early detection and can be preventative. For those individuals with one of the chronic diseases the RN consult can improve self-care health management. Dementia links to CV health and stroke incidence and vascular issues. It also links to the aging of the population in the region. There is an Alzheimer's support group in Danville. Also there is mental evaluation and medication management available by a psychiatrist at the medical center. James B. Haggin Hospital offers adult day care that serves some clients. Danville Health & Rehabilitation Center has an Alzheimer long term care unit. The Sanders Brown Center at the University of Kentucky has on-going Alzheimer's related research and serves as a referral center for the region. Births to teenagers and unwed mothers, and low birth-weight births are being addressed by the health departments and the school health collations. The Lincoln County Health Department has a 5-year grant to address self-esteem and character building in 6th grade through middle school. The Lincoln and Boyle County school nurses and Community Service staff conduct the Perkins Assessment in middle school through high school as part of the effort to help youth make fewer high risk behavior choices. Both school systems have contracts with the University of Kentucky for the services of an adolescent medicine specialist for on-site services. The Pregnancy Resource Center supports all six counties. Fair/poor mental health and major depression was cited by the county residents as a major issue. The health system does have mental health providers on their recruitment plan. Community Service does conduct depression screening for adults and refer if needed. For children in middle school and high school the Community Service department works with the school nurses to conduct the Perkins Assessment. High school students have the option to participate in the High School Artist project annually. No leisure time physical activity, not meeting physical activity guidelines, links to the lack of built environment - bike & walking paths/trails in a large rural environment. Boyle County has ongoing dialogue about the need for a biking/walking path to connect the county both for health and economic reasons. There is no public transportation system to make it easy to access a central gym/wellness faculty for families living in the counties. The Stanford Rotary Club talked about the need for a Wellness Center in Stanford for access by the community and the youth after school. The Lincoln County Fiscal Court is funding a walking track in Lincoln County. One of the Lincoln County elementary schools uses jump ropes from Community Service as an opportunity for brief activity breaks for students. Boyle County School System will be implementing the SPARK curriculum. Camp Dick Robinson Elementary has created an exercise room for students that is highly utilized. Chronic lung/respiratory disease is being addressed with tobacco education, stop smoking classes at the health departments, pulmonary rehab at the Wellness Center in Danville and public policy. The Community Service department screens for tobacco use in all venues and refers to the health departments. The health departments offer Cooper Clayton classes to help residents stop smoking. The health departments also conduct tobacco education in the school systems. Respiratory disease has a genetic, environmental and a cultural component in the six county region. The exposure to tobacco smoke, agrichemicals, dust and pollen all contribute to asthma and chronic lower respiratory disease. The health departments address smoking cessation. The extension offices address safe handling of agrichemicals. The school health nurses are addressing childhood asthma. Community Service provided peek flow meters for children with asthma in the Lincoln County School System so the nurses can assist the children in self-management of their asthma symptoms. The goal was to reduce lost days from school for the children with asthma and fewer emergency room visits for the child and their family related to respiratory distress. Asthma care was a high priority in the Lincoln County School Health Index. Community Service also provided the competency education for the Lincoln County School Nurses related to childhood asthma. The 2014 report from Lincoln County School System reflects improved attendance. Community Service screens for tobacco use and refers at all screening events. Community Service screens for obesity using a calculated BMI for both children and adults. Starting in middle school, Community Services staff and volunteers help map student BMI and chart against the norms. Upon request education is provide
Schedule H,Part V, Line 19d Individuals Eligible for Financial Assistance --------------------------------------------- The maximum amount that can be charged to FAP-Eligible individuals for emergency or other medically necessary care is based upon income guidelines stated in the Hospital's Financial Assistance Policy.
SCHEDULE H, PART V, SECTION B IMPLEMENTATION STRATEGY ----------------------- THE IMPLEMENTATION STRATEGY MAY BE OBTAINED AT http://www.emhealth.org/index.php/services/community-services
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?8
Name and address Type of Facility (describe)
1 CENTRAL KY SURGERY CENTER
230 WEST MAIN STREET
DANVILLE,KY40422 		OUTPATIENT SURGERY CENTER
2 EPHRAIM MCDOWELL DIAGNOSTIC CENTER
101 DANIEL DRIVE
DANVILLE,KY40422 		DIAGNOSTIC IMAGING & TEST/LAB
3 MEDSOURCE HOME MEDICAL
150 SOUTH THIRD STREET
DANVILLE,KY40422 		DUREABLE MEDICAL EQUIPMENT
4 EPHRAIM MCDOWELL SLEEP DISORDERS
440 WHIRL-A-WAY DR
DANVILLE,KY40422 		SLEEP DISORDER CENTER
5 EPHRAIM MCDOWELL SPINE PHYSICAL THERAPY
236 WEST MAIN ST
DANVILLE,KY40422 		OUTPATIENT REHAB FACILITY
6 EPHRAIM MCDOWELL CANCER SUPPORT CENTER
520 TECHWOOD DR
DANVILLE,KY40422 		OUTPATIENT SERVICES
7 EM DIABETES & ENDOCRINOLOGY CENTER
440 WHIRL-A-WAY DR
DANVILLE,KY40422 		DIABETES CENTER
8 CASEY COUNTY REHABILITATION
513 MIDDLEBURG ST
LIBERTY,KY42539 		OUTPATIENT REHAB FACILITY
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B COMMUNITY HEALTH NEEDS ASSESSMENT --------------------------------- LINE 1J: THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO DESCRIBES THE ASSESSMENT OF MODIFIABLE HEALTH RISKS, ASSESSMENT OF HEALTH EDUCATION AND OUTREACH AND PERCEPTIONS OF HEALTHCARE. LINE 3: THE HOSPITAL CONSULTED WITH EMS DIRECTORS, JUDGE EXECUTIVES, HEALTH DEPARTMENT DIRECTORS, SCHOOL NURSES, SCHOOL SUPERINTENDENTS, FAITH COMMUNITY NURSES, SALVATION ARMY COMMANDER, HEART OF KY UNITED WAY, COUNTY EXTENSION OFFICES, SOCIAL WORKERS, LEGISLATORS, CLERGY, PHYSICIANS AND FREE CLINIC STAFF. LINE 4: THE NEEDS ASSESSMENT WAS CONDUCTED WITH EPHRAIM MCDOWELL FORT LOGAN HOSPITAL DUE TO OVERLAP OF POPULATION SERVED. LINE 5: THE NEEDS ASSESSMENT WAS ALSO PROVIDED TO VARIOUS EDUCATION FACILITIES - CENTRE COLLEGE, EASTERN KENTUCKY UNIVERSITY SCHOOL OF NURSING, UNIVERSITY OF KENTUCKY SCHOOL OF NURSING AND SCHOOL OF PUBLIC HEALTH. LINE 7: Deferred needs from the Health Risk Assessment of Boyle and the surrounding Counties based upon resources and/or expertise included the following: Arthritis/rheumatism is an issue. This links to the high obesity rate and the lack of a built environment that facilities mobility. This issue is deferred by EMRMC due to resources but the factors to decrease cardiovascular (CV) risks will assist with mobility, i.e. weight reduction, improved nutrition, decreased inflammatory markers, etc. Both Lincoln and Garrard County Health Departments offer a self-help program for managing arthritis. Lincoln County has plans to expand the offering. The McDowell Wellness Center offers pool exercises for those with arthritis and silver snickers as options to assist in managing both mobility and pain. There is a rheumatologist at the specialty clinic in Boyle County. The closest arthritis support group is in Lexington, Kentucky. Osteoporosis is addressed as a nutritional issue. This links with the high consumption of carbonated beverages and poor nutrition in the region. This is being deferred due to resources but is part of the farm to school dialogue in the school coalitions. Migraine headaches are treated by primary care physicians and referred as needed. A neurologist is on the physician recruitment plan to make access for evaluation and specialty care easier to access and closer to home. Twenty-five percent of the population suffers from chronic back pain or sciatica. There are pain centers in Boyle County. Chiropractic and physical therapy services are available in all six counties. Obesity, inactivity, and a diet high in fat and calories compound the issues related to arthritis, back and sciatica pain. Addiction to pain-killers and other drugs is an issue in the state and region. Addiction services are offered by private providers, Comprehensive Care, and Self-Refined in the region. EMRMC behavioral medicine unit does treat dual diagnosis patients and the psychiatrists and counselors treat out patients. There is an active Alcoholics Anonymous chapter. Due to lack of expertise and resources, addiction will be deferred as part of the work plan by EMRMC. Chronic kidney disease and end stage renal failure links to diabetes. Moderate exercise, a healthier diet, and weigh reduction can prevent the development of type 2 diabetes in persons at risk (Diabetes Prevention Program funded by NIH). The free screenings will provide early detection and possibly prevention when addressing nutrition, body mass index and exercise. The health departments collaborate with the kidney foundation to conduct screening and education related to kidney health. Disabilities and activity limitations correlates with the poverty of resources. Those with a disability report not getting preventative care, i.e., annual dental visit, mammogram, pap smear, additional findings include lifestyle issues, such as use of tobacco and inactive; health issues such as obesity, high blood pressure, high stress and poor mental health, lower employment rates, lower income, and less social support. This area will be deferred, but the work with school age children related to diet, activity, and self-esteem has preventative value (DPP). The screening for obesity, diabetes, high blood pressure, tobacco use, high cholesterol and the risk factor reduction education for adults provides early detection and can be preventative. For those individuals with one of the chronic diseases the RN consult can improve self-care health management. Dementia links to CV health and stroke incidence and vascular issues. It also links to the aging of the population in the region. There is an Alzheimer's support group in Danville. Also there is mental evaluation and medication management available by a psychiatrist at the medical center. James B. Haggin Hospital offers adult day care that serves some clients. Danville Health & Rehabilitation Center has an Alzheimer long term care unit. The Sanders Brown Center at the University of Kentucky has on-going Alzheimer's related research and serves as a referral center for the region. Births to teenagers and unwed mothers, and low birth-weight births are being addressed by the health departments and the school health collations. The Lincoln County Health Department has a 5-year grant to address self-esteem and character building in 6th grade through middle school. The Lincoln and Boyle County school nurses and Community Service staff conduct the Perkins Assessment in middle school through high school as part of the effort to help youth make fewer high risk behavior choices. Both school systems have contracts with the University of Kentucky for the services of an adolescent medicine specialist for on-site services. The Pregnancy Resource Center supports all six counties. Fair/poor mental health and major depression was cited by the county residents as a major issue. The health system does have mental health providers on their recruitment plan. Community Service does conduct depression screening for adults and refer if needed. For children in middle school and high school the Community Service department works with the school nurses to conduct the Perkins Assessment. High school students have the option to participate in the High School Artist project annually. No leisure time physical activity, not meeting physical activity guidelines, links to the lack of built environment - bike & walking paths/trails in a large rural environment. Boyle County has ongoing dialogue about the need for a biking/walking path to connect the county both for health and economic reasons. There is no public transportation system to make it easy to access a central gym/wellness faculty for families living in the counties. The Stanford Rotary Club talked about the need for a Wellness Center in Stanford for access by the community and the youth after school. The Lincoln County Fiscal Court is funding a walking track in Lincoln County. One of the Lincoln County elementary schools uses jump ropes from Community Service as an opportunity for brief activity breaks for students. Boyle County School System will be implementing the SPARK curriculum. Camp Dick Robinson Elementary has created an exercise room for students that is highly utilized. Chronic lung/respiratory disease is being addressed with tobacco education, stop smoking classes at the health departments, pulmonary rehab at the Wellness Center in Danville and public policy. The Community Service department screens for tobacco use in all venues and refers to the health departments. The health departments offer Cooper Clayton classes to help residents stop smoking. The health departments also conduct tobacco education in the school systems. Respiratory disease has a genetic, environmental and a cultural component in the six county region. The exposure to tobacco smoke, agrichemicals, dust and pollen all contribute to asthma and chronic lower respiratory disease. The health departments address smoking cessation. The extension offices address safe handling of agrichemicals. The school health nurses are addressing childhood asthma. Community Service provided peek flow meters for children with asthma in the Lincoln County School System so the nurses can assist the children in self-management of their asthma symptoms. The goal was to reduce lost days from school for the children with asthma and fewer emergency room visits for the child and their family related to respiratory distress. Asthma care was a high priority in the Lincoln County School Health Index. Community Service also provided the competency education for the Lincoln County School Nurses related to childhood asthma. The 2014 report from Lincoln County School System reflects improved attendance. Community Service screens for tobacco use and refers at all screening events. Community Service screens for obesity using a calculated BMI for both children and adults. Starting in middle school, Community Services staff and volunteers help map student BMI and chart against the norms. Upon request education is provide
Schedule H,Part V, Line 19d Individuals Eligible for Financial Assistance --------------------------------------------- The maximum amount that can be charged to FAP-Eligible individuals for emergency or other medically necessary care is based upon income guidelines stated in the Hospital's Financial Assistance Policy.
SCHEDULE H, PART V, SECTION B IMPLEMENTATION STRATEGY ----------------------- THE IMPLEMENTATION STRATEGY MAY BE OBTAINED AT http://www.emhealth.org/index.php/services/community-services
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)DONALD HAMNER MDBOARD MEMBER (i)
(ii)		 0
90,510 		0
77,962 		0
2,823 		0
10,835 		0
115 		0
182,245 		0
0
(2)WILLIAM SNAPPVP & CFO (i)
(ii)		 0
277,420 		0
45,179 		0
6,621 		0
74,016 		0
24,749 		0
427,985 		0
45,179
(3)VICKI DARNELLCEO (i)
(ii)		 0
495,833 		0
80,104 		0
34,672 		0
176,655 		0
32,930 		0
820,194 		0
80,104
(4)CARL METZVP HUMAN RESOURCES (i)
(ii)		 193,241
0 		21,105
0 		18,596
0 		40,353
0 		15,812
0 		289,107
0 		21,105
0
(5)STEPHANIE STONEPHARMACIST (i)
(ii)		 152,316
0 		 
0 		576
0 		12,185
0 		588
0 		165,665
0 		0
0
(6)JOAN HALTOMPHARMACY DIRECTOR (i)
(ii)		 170,146
0 		8,206
0 		1,962
0 		24,585
0 		15,470
0 		220,369
0 		8,206
0
(7)RONALD BARBATOREHAB DIRECTOR (i)
(ii)		 139,660
0 		7,601
0 		8,400
0 		21,160
0 		15,951
0 		192,772
0 		7,601
0
(8)ANDREW LOSCHPHARMACIST (i)
(ii)		 138,796
0 		0
0 		6,955
0 		11,532
0 		7,516
0 		164,799
0 		0
0
(9)TINA COOLEYPHARMACIST (i)
(ii)		 147,880
0 		0
0 		449
0 		11,892
0 		930
0 		161,151
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Question 6a MANAGEMENT INCENTIVE PLANS -------------------------- Ephraim McDowell Health, Inc. and its affiliates have management incentive plans for corporate officers, senior vice-presidents, vice-presidents and directors. Annual payouts related to these incentive plans have two components. 30% of the annual payout is based on net operating income goals compared to budget. The other 70% is based on quality measures, patient satisfaction goals, associate satisfaction goals, and safety measures.
SCH J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ----------------------------------------- VICKI DARNELL PARTICIPATED IN A 457(F) PLAN DURING THE YEAR. THE INCREASE IN THE ACTUARIAL VALUE OF HER NONQUALIFIED RETIREMENT PLAN WAS $48,288. NOTE: THIS AMOUNT REPRESENTS THE ACCRUED BENEFIT AMOUNT AND IS SUBJECT TO RISK OF FORFEITURE.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11 PROCESS TO REVIEW FORM 990 -------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12B AND 12C MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------------ ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXISTS, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OF VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT.
FORM 990, PART VI, SECTION B, LINE 15A AND 15B PROCESS FOR DETERMINING COMPENSATION ------------------------------------ EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS PART OF AN INTERGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEeN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW IN 2012 FOR ESTABLISHING REASONABLE COMPENSATION OF OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM. THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19 MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------ THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART V, LINE 2A COMMON PAYMASTER ---------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR THE FOLLOWING RELATED ORGANIZATIONS: EPHRAIM MCDOWELL HEALTH, INC. EPHRAIM MCDOWELL HEALTH RESOURCE, INC. EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC. EMHFL, INC. COOPERATIVECARE, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356.
FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B MEMBERS OF THE ORGANIZATION --------------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC.
FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------- Ephraim McDowell Regional Medical Center (EMRMC) is a not-for-profit, 222-bed licensed level III trauma center dedicated to serving the health and wellness needs of the populations of Boyle, Lincoln, Mercer, Garrard, Casey and Washington Counties. EMRMC scope of services include: behavioral health, cancer care center, outpatient cancer care, cardiac care services, critical care, diabetes and endocrinology, diagnostic services, level III trauma/emergency care center, Kids Can Do pediatric therapy center, laboratory services, medical-surgical services, orthopedic/spine care, pastoral care, pain management center, pulmonology, rehabilitation, respiratory therapy, surgical services, vascular services, orthopedic/neuro, volunteer/auxiliary, women's health services and wound healing center. Ephraim McDowell Regional Medical Center for Fiscal Year 2014 experienced 7,713 admissions including nursery, and 38,753 patient days for all services including nursery and observation days. Observation patient days for FY 2014 totaled 3,022 verses 3,303 for a -9% percent decrease over FY 2013 volume. Outpatient registrations (including ER visits) increased by four percent to 139,064 as compared to 133,428 in FY 2013. Surgical procedures at EMRMC fell six percent in FY 2014 to 4,537 as compared to 4,830 in FY 2013. The ambulatory surgical center volume decreased in FY 2014 by one percent to 6,510 procedures verses 6,569 in FY 2013. Community Health Education -------------------------- Cancer Eduction - Over 1,000 individuals participated in skin cancer awareness events at InterCounty Energy; 250 each at Lincoln and Boyle County Relay for Life events, 500 at Casey County Apple Festival, and 150 at the Garrard County Tobacco Cutting Contest. Approximately 900 regional 4-H campers received sun screen, lip balm and sun safety education. Additionally various sports groups received sun safety products and education. EPA sun safety literature, sun screen and lip balm with sun screen was distributed to re-enforce the message of sun safety. Over three thousand sun safety items were distributed at twenty sites. All funded by Ephraim McDowell Health Care Foundation (EMHCF). CPR/First Aid - CPR/first aid training was also provided to teen leaders as part of their leadership training at Camp Feltner, at no charge. Another event provided CPR/first aid for 4-H leaders. CPR/first aid training was provided at Mercer County 9th Grade Academy for 155 students. A total of 225 community members from the service area, spanning in age from teens to senior citizens, were trained in CPR/first aid at no cost to the individuals or host organization. This service was funded by the EMHCF. Education Website/Community Publication - Eleven editions of the Health Ministry/Faith Community Nursing newsletter were produced, and distributed in Kentucky, Indiana, Ohio, Virginia, and North Carolina. The intent is to provide relevant and current information to the congregations. All information can be reproduced and used for congregation information/education. Exercise/Fitness - In collaboration with the regional 4-H chapter, Wilderness Trace YMCA, The Salvation Army, Boyle, Lincoln, and Danville school systems and McDowell Wellness Center 5,173 children school age through teens were served. Venues included, but were not limited to: Mercer County horse camp, Healthy Kids Day Bunny Davis Center, The Salvation Army day camp and Feltner 4H camp. The focus was developing leadership skills, promoting physical activity, and encouraging healthy life style habits. Health Fairs - Services were offered at 112 events at 87 sites in Boyle, Lincoln, Garrard, Mercer, Casey, Washington, and Madison Counties with focus on reaching at risk and vulnerable populations. Including all programs, 28,131 community contacts occurred (screenings, education, support groups, etc.). Thirty-four percent of participants were male (an 11 percent decrease from the prior year); 66 percent were female. Ninety percent of clients served were Caucasian, six percent were African America, four percent Hispanic, and less than one percent were other; this reflects the population of the region. Forty-three percent of participants served by community benefit programs had a household income below $35,000. Twelve percent of participants served were unemployed; a six percent decrease in unemployment from FY 2013. Twenty-six percent in the population served were retired; compared to 36 percent in 2013. The uninsured served decreased by fifty percent: 11 percent in FY 2014 compared 22 percent in 2013. Those reporting a primary care provider (PCP) increased by 14 percent in FY 2014; to sixty-eight percent with a PCP. A registered nurse (RN) met with each client to develop a written plan to decrease their life style associated health risk behaviors. At each screening referral options were provided including Hope Clinic, reduced fee program and primary care provider (PCP) listing for the region for the uninsured participant or those without a PCP. Forty-four percent of screening tests were abnormal with 11 percent requiring a referral for follow-up. One explanation for the decrease in referrals for follow-up relates to the decrease in high risk values seen, i.e. reduction in stage two hypertension, uncontrolled blood sugar or lipid ranges in the high risk category. Parish Nursing Program - Grant funding from Ephraim McDowell Health Care Foundation and Margaret T. Stoeckinger Foundation made possible the Faith Community Nursing educational programs. The Faith Community Nursing Foundation Course in the spring of 2014 produced eight graduates. A partnership with University of Kentucky (UK) College of Nursing made possible both KBN and ANCC credits for the course participants. Faith Community Nursing (FCN) faculty provided consultation to the Manchester Hospital chaplaincy group regarding health ministry/faith community nursing within congregations to bridge care for at risk individuals. There were 16 volunteer chaplains representing multiple denominations in Clay County. Consultation was also provided to Centennial Baptist Church in Mercer County regarding establishing a health ministry. FCN faculty also served as faculty for the Tri-State Foundation Course in Southern Indiana in collaboration with the University of Southern Indiana. Eighty-seven participants have completed the faith community nursing foundations course since its inception at EMRMC in 2008 and serve as volunteers within their congregations. These community partners serve in 23 counties within the Commonwealth of Kentucky and support persons of all denominations. Eleven health ministry newsletters were created and disseminated to health ministry partners in Kentucky, Ohio, Illinois, Indiana, Virginia and North Carolina. Volunteer Faith Community Nursing services were active at Lexington Avenue Baptist Church, St. Andrews Catholic Church, Saints Peter & Paul Catholic Church, Gethsemane Baptist Church, Indian Hills Christian Church, and Centenary United Methodist Church-Danville. Actives include but are not limited to home visits, nursing home visits, blood pressure checks, health and wellness educational programs, support groups referrals for follow care and emergency assistance (seizures, chest pain, fainting, hypertensive crisis, etc). School-Based Programs - High school aged students were involved in the building of a canvas, selection of a famous painting, reproducing a painting, and an opening night at the Community Art Center culminating in the auction of their painting. This is both a skill building project and a self-esteem enhancing project (Rosenbum). Students from Boyle County, Danville, and Bruce Hall Day Treatment Center participated in the program, producing 94 paintings. The exhibit was viewed by 1,036 community visitors during the showing at the Community Art Center in month of May, 2014. Staff served as a leader at 4H camp sessions, Kentucky State Issues Conference, State Teen Conference and Teen Leadership Retreat at Jabez. The Children's Program Coordinator also completed year two of a longitudinal BMI project with 4-H District IV. Other children's activities included working summer groups in coordination with Bunny Davis Day Camp, YMCA, The Salvation Army and other area agencies to provide physical activity, and educational programming for kids as part of one hour a day out-of-doors play. Summer student interns from area colleges assisted with this project. Community Service Department staff worked with Danville School System to implement the PEP Grant requirement for body mass index on 1,200 students in the school system and staff. A total of 5,173 youth from Mercer, Boyle, Casey, Garrard, Lincoln, Powell, Estill, Jessamine Counties were served through these venues. Speakers Bureau (Health Topics) - The speakers' bureau reached 3,352 individuals, through venues including service clubs, churche
PROGRAM SERVICE ACCOMPLISHMENTS (CONT) This was the sixth year to be part of the Centre Expo to recruit student volunteers to work in the community to decrease stroke risk. This is an excellent event for meeting students and introducing them to the concept of population health. Community Health Education -Self Help ------------------------------------- Fitness/Exercise - One hundred and fifty jump ropes donated by the Ephraim McDowell Regional Medical Center Auxiliary were provided to The Salvation Army - Day Camp and A Children's Place for a summer fitness project with school aged children. Four hundred twenty Nerf footballs were also provided for the Boyle County Healthy Kids Day as part of the student fitness project. Tobacco/Smoking Cessation - There was a 64 percent decrease in the number for individuals referred to the area health departments for smoking cessation assistance: 90 in FY 2014 verses 144 the prior year. The continued decline in adults reporting tobacco use is believed to be attributed to the passage of no smoking ordinance in some of the communities served and massive public awareness campaign. A statewide ordinance has been drafted by some of the agencies (FHK, SoAHEC, etc.) for consideration by the legislature during the 2015 session. Stress Management - Ninety nine individuals were screened using the perceived stress scale: a 45 percent decrease. Community Health Education - Support Groups ------------------------------------------- Alzheimer's - Ten Alzheimer's Support Group meetings were facilitated by an advanced practice mental health nurse practitioner. The group serves both patients and care-givers/family. Given the incidence rate of stroke and the aging of the population it is anticipated the need for this service will continue to grow in this region. Community-Based Clinical Services-Health Screenings --------------------------------------------------- Blood Pressure Screening - Blood pressure screenings were offered at 37 sites, serving 1,451 individuals an 8 percent increase. There was a five percent decrease of clients with a blood pressure reading that exceeded the recommended range by the American Heart Association (AHA): 77 percent versus 82 percent in FY 2013. Those classified as pre-hypertension received instructions for monitoring and recording as well as dietary instructions related to low sodium diet. Those that were on medications but exceed the recommend range were instructed to share the finding with their primary care provider (PCP). Those at stroke level were transported for immediate follow-up by a physician. Blood pressure control is a major factor in cardiovascular risk reduction. The intense focus on blood pressure monitoring, self-care education, and follow-up may be a contributing factor in the improved blood pressure readings given a significant number of clients have been followed for an extended period of time. Cancer -Colorectal Screening - The Ephraim McDowell Health Care Foundation (EMHCF) funded colorectal screening at 21 sites for a total distribution 171 kits with a 43 percent return rate. Kits were distributed in six counties. Sites included churches, senior citizen centers, wellness center, assisted living facilities, health departments, clinics, hospital lobbies, and the county extension service offices. There was a five percent referral rate for follow-up. Cancer- Skin Screening - The Ephraim McDowell Health Care Foundation (EMHCF) funded skin cancer screening by a licensed independent practitioner May thru July. Forty-eight individuals were seen. Fifty-eight percent were female; 42 percent male (an 11 percent increase in males seen from FY 2013). Sixty-three percent had never been screened for skin cancer. Fifty- five percent stated on an exit survey that they would not have seen their doctor for a skin cancer screen; a five percent increase from FY 2013. Ninety-four percent had a primary care provider; compared to 82 percent the prior year. Forty-six percent were referred to a specialist for follow-up care compared to 36 percent in FY school-age children and continues across the life span and has been a consistent message and focus of the community service work plan since inception in 2008. Cholesterol Testing - Total cholesterol was measured for 1,438 clients in seven counties at 37 sites within health ministries and community settings with 30-36 percent of participants exceeding the recommend range as set by AHA. Thirty six percent was seen in the Healthy People: Healthy Community study group that seeks to reduce cardiovascular disease risk by client education and life-style changes compared to 30 percent seen in the general population. We attribute the change to the focus on cardiovascular risk reduction work being done with the HRSA Outreach Grant to help clients track and improve their cardiovascular (CV) risk profile. Within the lipid panel 49 percent of participants had one or more measure outside the recommended range; this is down from 60 percent in FY 2013 and includes all clients. Effective FY 2013, with support for area pediatricians, the department began offering lipid screening for children age 12 and above, if accompanied by a parent. We have not seen a statistically significant number of participants in the pediatric age range. Derma Scan for Sun Damage - EMHCF funded the purchase of the DermaView equipment for screening for sun damage in the region due to the increase in skin cancer and the agrarian lifestyle in the region. Fifty individuals were screened with 38 percent of participants being referred to their primary care provider for follow-up care; a 12 percent increase in referrals for FY 2013. Diabetes Screening - Blood glucose testing conducted on 1,438 participants. Eleven percent exceeded the recommended range as set by the American Diabetes Association (ADA) compared to 28 percent in FY 2012 prior to the focus on cardiovascular risk reduction. No one was below the recommended range. This represents a 15 percent increase in the number of individuals screened diabetes between FY 2013 and FY 2014. Glucose testing was offered to children age 12-18, if accompanied by a custodial parent. Again the number of pediatric participants was not statistically significant. Nutrition/Obesity Screening - Height, weight, percent body fat, calculated body mass index (BMI) was offered at 37 sites in seven counties with 1,447 adult participants. Seventy-one percent of the participants exceeded the recommend range; compared to 75 percent in 2013. Body Mass Index is a major contributor to CVD risk factors and diabetes this is the first year we have seen a decline in BMI. We attribute the change to the CVD risk reduction focus in FY 2013 and 2014. Eighty percent of life style change is implementation of the change; twenty percent is the knowledge. The HRSA Outreach Grant is focusing on providing the knowledge and for those that choose also encouragement/feedback in the implementation of the change. Stroke Screening - The American Stroke Association Stroke Risk Scorecard became the standard tool for screening for stroke risk within the department in fiscal year 2012. Stroke risk screening was conducted at 20 events in seven counties involving 899 participants with a 18 percent referral rate; which reflects a five percent decrease in referrals. This is one of three screening tests that has resulted in direct referral and transport to emergency care: the others being blood pressure in stroke range, extreme elevation of lab values.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT) Community-Based Clinical Services-Immunizations ----------------------------------------------- Flu Shots - Flu shots were administered at 15 sites in Mercer, Lincoln, Boyle, Garrard, and Washington Counties to 279 individuals age 12 and above. Primary sites were churches and the stockyards. Community-Based Clinical Services-Nonbilled/Reduced -fee Clinic (Hospital Based) ---------------------------------------------------------------- Hope Clinic & Pharmacy - Hope Clinic and Pharmacy provided 282 client visits compared to 1,001 clients visits in FY 2013 for chronic disease management. To qualify for Hope Clinic & Pharmacy an individual must have one or more of the following diagnoses: hypertension, diabetes, obesity, hyperlipidemia, and/or gastro esophageal reflux disease, be uninsured and with a household income below 150% of the federal poverty level. All staff members are volunteers except the part-time LIP and part-time office manager. The clinic is managed by a community advisory board with members from the Boyle County Health Department, Danville Presbyterian Church, Ephraim McDowell Health Care Foundation, Ephraim McDowell Regional Medical Center, Heart of Kentucky United Way, and the Salvation Army. The clinic was started due to community need by a collaboration of the key board members and is a department of EMRMC. The Affordable Care Act has made possible access to expanded Medicaid in Kentucky, resulting in many former Hope clients having insurance and access to both chronic and acute care. Blood Drive - Ninety-eight persons signed up to donate blood. Eighty-eight units of blood were donated through blood drives at the health system in FY 2014 compared to 119 units in FY 2013. Staff that are on duty are paid during the time they are involved in the donation process with an estimated salary value of $3,080. Health Professions Education ---------------------------- Continuing Health Professions Education - The Director for Rehabilitation Services Department serves on Physical Therapy Health Professions Board Meeting for the Commonwealth of Kentucky. Issues of the profession were addressed including educational requirements, licensure, reimbursement, scope of service and professional practice standards. Interns, Residents and Fellows - EMRMC had seven Emergency Medicine Residents in FY 2014; compared to 2 ER Residents in FY 2013. Medical Students - Twenty-three medical students rotated through emergency services, anesthesia, OB, pediatrics, family medicine and/or surgical services with EMRMC medical staff mentors. Students were from University of Kentucky or University of Pikeville Nine physician assistant (PA) students rotated though emergency, orthopedics, surgery, and/or internal medicine services with a mentor. Affiliated programs included: University of Louisville, University of Kentucky, and University of the Cumberland's Three advanced practice nurses (APRNs) rotated through emergency services or primary care clinics in FY 2014 with a LIP mentor. Schools included: Frontier Nursing, Eastern Kentucky University, and Indiana Wesleyan University. Nursing - Four hundred fifty one nursing students completed their clinical experience and/or practicum at EMRMC in FY 2014. Educational partners included Campbellsville University, University of Kentucky, Eastern Kentucky University, Midway College, Bluegrass Community & Technical College, Beckfield College, and Somerset College. Other Allied Health Professions - The Certified Nursing Assistant Course had 43 students enrolled, five no show and 38 individuals completed the course. The pass rate was 97 percent on the state Medicare CNA exam. EMRMC served as a clinical site for students from multiple disciplines from the following institutions: Bluegrass Community & Technical College - Lexington, St. Catharine's College - Springfield, Utah State, Spaulding University, Bellarmine University, Jefferson Community College, Eastern Kentucky University, University of Kentucky, Midway College, Lindsey Wilson College, Kentucky State University, Indiana Wesleyan, Campbellsville University, Marietta College, Murray State, Somerset Community College, Centre College, University of Cincinnati, Union College, Cumberland University, Spaulding and University of Louisville Health Sciences. One hundred sixty nine area students had a job shadowing experience in 43 different areas of EMRMC in FY 2014. This reflects over a two hundred percent increase in the number of students job shadowing within the organization. Research -------- Community Health Research - HRSA Outreach Grant: Healthy People: Healthy Communities targeted cardiovascular disease (CVD) risk factor reduction in a rural population. Lincoln, Garrard, Mercer and Boyle County Health Departments and Boyle County Extension Office collaborate with EMRMC on this grant. In 2014 there were 631 participants compared to 419 in FY 2013 screened by this grant funded project. Screening included cholesterol (either total or lipid panel), glucose (either fasting or non-fasting), body mass index, blood pressure, pulse check for atrial fibrillation, family history of stroke, tobacco use, and activity level. Results of testing are recorded on the Stroke Risk Scorecard. The Healthy People: Healthy Communities study has institutional review board approval. Enrollment for the study opened in September 1, 2012. One hundred fourteen individuals (18%) were referred for follow-up. Two hundred thirty-seven individuals (46%) consented to participate in the study with follow-up by an RN; this is down from 52 percent in the study in FY 2013. These services were funded by HRSA at a cost of $165.436. In FY 2014 there were 3,221 contacts made with those enrolled in the Healthy People:Healthy Communities research program by the RN case managers. The monthly contacts were designed to assist in removing barrier to making the necessary life style changes to reduce cardiovascular risk factor related behaviors. The program was evaluated by client feedback at each screening and an outside reviewer for the biometrics/outcomes component of the study. Good Samaritan Foundation- Group Visits for Management of Chronic Disease in a Rural Free Clinic - The extended pilot to assess the effectiveness of shared health care visits for low-income, uninsured individuals who have uncontrolled chronic Type II Diabetes Mellitus or Hypertension early. due to the impact of ACA implementation and uncertainty about eligibility for Hope Clinic services verses expanded Medicaid coverage. There was not sufficient data to report findings and conclusions. UCLA -RNs Referring Quitlines (RNRQ) ------------------------------------ All nurses at EMRMC were offered the opportunity to participate in the RNRQ study sponsored by UCLA School of Nursing. There was a $1,000 contribution to cover time and cost of communications with staff. The intent was to a base line study then a web based educational intervention to then re-assess the nurse to client education related to tobacco use during acute care stay. Thirty one nurses completed the baseline survey, 17 completed the 3-month, and 18 completed the 6-month follow-up survey. Fourteen nurses viewed the educational webcast and received CE certificates. Financial Donations for the Community - In Kind ---------------------------------------------- Personnel/Administrative Support - A staff member serves on the Boyle County 4-H Counsel. Community Service staff participate in both the Boyle and Lincoln Counties Integrated School Health Committees. This all volunteer group works to improve the School Health Index issues that have community impact. Staff also served on the Danville PEP grant implementation team. An advanced practice nurse serves on the Mercer County Health Department Board. A staff member serves on the Foundation for Healthy Kentucky Board and subcommittees. A staff member serves on the governing board for Christian Care Communities, addressing affordable, safe housing for the elderly in the commonwealth. A staff member serves on the Foundation for Healthy Kentucky governing board. The rehabilitation services director serves on the Physical Therapy Board. A staff member from marketing serves on The Salvation Army Board.
PROGRAM SERVICE ACCOMPLISHMENTS (CONT) Community Building Activities ----------------------------- Coalition Building - Heroin overdose and deaths in the service area have increased at an alarming rate. A mental health professional from the Centre College has put together a broad community coalition to address the many faucets of this public health issue. The emergency department nursing and medical directors have worked with this group. An Ephraim McDowell administrative assistant services as the recording secretary for the task force. A case manager also serves on the task force. Community Service staff served in two statewide planning sessions with District 4-H leaders related to the annual Kentucky youth leadership conference. There were a total of 75 community members involved in the conference planning process. Community Health Improvement Advocacy - Community Service staff served on the board of the Foundation for Healthy Kentucky(FHK) and served on the executive, finance and ambassador committees in addition to their board membership advocating for improved access to care, better built environment and improved nutrition. FHK endowed chairs at the University of Kentucky and University of Louisville to focus on public health issues in rural Kentucky. Community Service staff served on the governance, and workforce committees for Christian Care Communities Board advocating for safe housing and care for the elderly. Community Service staff supported the education of health care professionals by serving on the board of the Southern Area Health Education Council. Community Service staff served as community faculty for University of Kentucky with participation in community research, education and performance improvement. Community Service staff served on the board of the Mercer County Health Department. Rehabilitation Services staff served on the Physical Therapy Board and participated at the Legislative Day in Frankfort to address rehabilitation needs in the Commonwealth. Leadership Development/Training for Community Members - Community Service staff collaborated with 4-H staff related to three events to provide leadership and skill development for a total of 40 students within the district. Workforce Development - The Southern Area Health Education Council is involved in the education of healthcare professionals in rural South-Central Kentucky and health policy. Community Benefit Operations ---------------------------- Community Health Needs Assessment- Professional Research Consultants of Omaha, Nebraska was engaged to conduct a scientifically valid six county CHNA for the system, including EMRMC, at a cost of $84,537. The confidence level is 95 percent for a sample of 1,000 area residents. A community focus group was convened for input from key informants from the six counties, with finding included in the report. The results were made available to the governing board in hard copy along with a summary presentation and implementation plan for 2015-2018. Once reviewed by the board, the report and implementation plan were posted on the website for public access. Findings were shared with community partners and speaking engagements were set up to share the findings throughout the service area during the FY 2015. Dedicated Staff - There was a dedicated staff of two full time, two part time individuals and flex RNs and Technicians that work as needed within the community service department and are funded by the health system. The staff was comprised of children's program coordinator, faith community nursing coordinator, a part-time community benefit coordinator and part time project coordinator all reporting to System Director, Nursing Administration, Regulatory Compliance, Associate Education, and Community Services. Total salary expense for dedicated community benefit staff was $2754,143 for FY 2014; with the decrease reflecting the reduction in hours within the department. Community Services total expense was $373,437. There was a part-time RN project director dedicated to the Healthy People: Health Community research and outreach program funded by the HRSA outreach grant. The cardiovascular risk reduction grant expended $165,436 in HRSA funds during FY 2014. There was a part time nurse practitioner and office manager for the Hope Clinic. Salary expenses were $12,526 for FY 2014. The reporting structure is that all department functions report to the system director and share space and resources. The system director then reports to the Ephraim McDowell Health System CNO/COO who reports to the governing board with annual work plan and budget approved by the governing board. In FY 2014, the new Community Health Needs Assessment and implementation plan were presented to the governing board for approval.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
 
Employer identification number

61-0492356
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) JOHN HILL BAILEY CHILDREN'S LEARNING CTR

217 SOUTH THIRD STREET

DANVILLE,KY40422
61-1186005 		DAYCARE CTR KY 501(C)(3) 2 EM HEALTH
 
 
No
(2) EMHFL INC

217 SOUTH THIRD STREET

DANVILLE,KY40422
61-1388556 		CRITICAL HOSP KY 501(C)(3) 3 EM HEALTH
 
 
No
(3) EPHRAIM MCDOWELL HEALTH RESOURCE INC

217 SOUTH THIRD STREET

DANVILLE,KY40422
31-1545520 		HEALTHCARE KY 501(C)(3) 3 EM HEALTH
 
 
No
(4) EPHRAIM MCDOWELL HEALTH CARE FOUNDATION

217 SOUTH THIRD STREET

DANVILLE,KY40422
61-1229333 		FUNDRAISING KY 501(C)(3) 11-II EM HEALTH
 
 
No
(5) EPHRAIM MCDOWELL HEALTH INC

217 SOUTH THIRD STREET

DANVILLE,KY40422
61-1324736 		MGT SERVICES KY 501(C)(3) 11-II NA
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) CKSC

217 S 3RD
DANVILLE,KY40422
37-1509373 		MEDICAL SERVICES KY NA
  		RELATED 2,364,498 2,466,692   No 0   No 60.000 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) COOPERATIVECARE INC

217 SOUTH THIRD STREET
DANVILLE,KY40422
61-1265715 		CONTRACTING SERV KY NA
  		C 0 0     No
(2) EPHRAIM MCDOWELL SERVICES INC

217 SOUTH THIRD STREET
DANVILLE,KY40422
61-1339437 		MGT SERVICES KY NA
  		C 0 0     No










Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) CENTRAL KENTUCKY SURGERY CENTER LLC

 P 10,578,254 fmv





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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