Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER |
610492356 | 3 | Yes | 0 | 0 | |
| (B)
EMHFL |
611388556 | 3 | Yes | 0 | 0 | |
| (C)
EMCP |
611186005 | 2 | Yes | 0 | 0 | |
| (D)
EMHR |
311545520 | 3 | Yes | 0 | 0 | |
| (E)
MCDOWELL HOME HEALTH AGENCY INC |
610715227 | 3 | Yes | 0 | 0 | |
| Total 5 | 0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCH A, PART VI, SECTION C | BOARD MEMBERS ------------- EPHRAIM MCDOWELL HEALTH'S DIRECTORS AND TRUSTEES ARE THE SAME DIRECTORS AND TRUSTEES THAT SIT ON THE BOARD OF ITS SUPPORTED ORGANIZATIONS, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, EMHR, EMCP AND MCDOWELL HOME HEALTH. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| 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 EXIST, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT. |
| FORM 990, PART VI, SECTION B, LINE 15A AND 15B | PROCESS FOR DETERMINING COMPENSATION ------------------------------------ THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW IN 2015 FOR ESTABLISHING REASONABLE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE 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 EPHRAIM MCDOWELL HEALTH, 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 III, LINE 4 | PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------- The top community health priorities for Ephraim McDowell Health (EMH) have been based on the 2014 Community Health Needs Assessment (CHNA) conducted by Professional Research Consultants (PRC) of Omaha, Nebraska. The top priorities are: 1. Cardiovascular disease and related risk factors 2. Cancer early detection and prevention 3. Childhood obesity and related risk factors 4. Access to health services 5. Dementias, including Alzheimers disease 6. Mental health and mental disorders 7. Injury and violence prevention Other identified needs were deferred due to resource limitations and the fact that addressing health behaviors and risks associated with the top issues would improve overall health and well-being. Targeted populations were the uninsured, underinsured and at-risk groups based on age, gender, ethnicity or socio-economic factors. All screenings were free of charge to the client. A logic chain model was used to plan events with our community partners and to evaluate the effectiveness of each event. Senior Leadership serves in many capacities within the larger community to improve the lives of those we serve. Not reported are the many hours spent as a volunteer manning the booths at the Annual Kentucky BBQ Festival to increase tourism in Danville/Boyle County. This does not reflect the time and efforts in advocacy and giving testimony at the local, state and national level to improve access to care or environmental impact and/or economic improvement. Community Health Education -------------------------- CPR/First Aid - Bookmarks with signs and symptoms of heart attack for men and women have been distributed to primary care providers, OB/gyn, orthopaedic and general surgery offices for public distribution. Early Heart Attack Care) EHAC trifold educational materials are provided for the public. Community CPR was provided to health ministries upon request. The February Happy Heart Luncheon focused on women and heart disease due to the higher cardiovascular risk profile of women in the six county area compared to the general population, state, national, and Healthy People 2020. All the aforementioned were components of the Chest Pain Center Accreditation work within the health system to further improve CV care based upon the health needs of the population served. The Happy Heart Luncheon in February provided a public awareness of risk related to women and heart disease. The spine and orthopaedic symposiums in September provided general information regarding self-care related to joint and muscle function and normal changes of aging. There was also information regarding medical options for care when injuries or over use occur. Sixty-eight people participated with a cost of $2,686.87. Parish Nurse Program - Twelve newsletters were sent to the associated churches and FCNs in FY 2016. The Faith Community Nursing Foundation Course was provided in the early fall of FY 2016 with six local graduates. School Based Program - Safe Swim Program for elementary school students served 210 children in FY 2016. Speakers Bureau - In January there was a presentation of the CHNA to the Centre College econ class as part of the Community Based Learning project. February presentations included: Charlies Chatter re: upcoming health screenings in the area. Indian Hills Christian Church hosted a presentation on Using the Glycemic Index. Charlies Chatter in June was devoted to the risk of skin cancer: prevention and early detection. August there was a presentation in Memphis, Tennessee at the International Parish Nurse Resource Meeting on How to Teach Behavior Health Module by the author. Poster presentations presenting the Healthy People: Healthy Communities Outreach Grant findings were shared at the annual meetings of Kentucky Organization of Rural Health, Bowling Green, Kentucky and Kentucky Organization of Nursing Leaders, Louisville, Kentucky. Book marks with signs and symptoms of heart attack for men and women have been distributed to primary care providers, OB/GYN, orthopaedic, and general surgery offices for public distribution. The Early Heart Attack Care (EHAC) information is also posted on the website and trifold educational brochures are provided for the public. The February Happy Heart luncheon focused on women and heart disease since this region of Appalachia is the epicentere for cardiovascular disease (CVD). These efforts were part of the Chest Pain Accreditation work that supported addressing the CVD within the service area. Financial Donations for the Community ------------------------------------- Cash or In Kind Donations to the Community - One hundred and twenty turkeys were donated toward providing a holiday dinner for those served by the food baskets from The Salvation Army. The turkeys were an average of 13.5 pounds, a total value of $2,235.60. Personnel/Administrative Support - Leadership and administrative support included board membership of the YMCA, Heart of Danville, Heart of Kentucky United Way, Midway College Nursing Advisory Board, Chamber of Commerce, McDowell House, Kentucky Hospital Association, American Hospital Association, Danville/Boyle County Senior Citizen Center, Danville/Boyle County Economic Development Board, Kentucky Organization of Nurse Leaders, American Organization of Nurse Executives, Centre College, Farmers National Bank and Premier. Community Building Activities ----------------------------- Senior leaders and associates assisted in the Salvation Army Kettle drive fund raiser for those in need. Coalition Building - Agencies served included the Heart of Danville Board, Chamber of Commerce, Economic Development Council, board member of Kentucky Organization of Nurse Leaders, member of Rotary with committee responsibilities, board member of The Salvation Army, Heart of Kentucky United Way Investment committee member, board member of YMCA and board member of McDowell House. The marketing department also helped with the logistics of the United Way Day of Action, and The Salvation Army Annual Banquet. Senior leaders of the organization also participate in the Annual EMRMC Auxiliary Membership Event and annual volunteer recognition dinner. Community Health Improvement Advocacy - Senior leaders gave testimony at the City Commissioners meeting, served on the KHA legislative committee, and conducted forums with Congressional members related to healthcare issues in rural south central Kentucky. Based upon community needs feedback from town hall meetings, medical staff and governing board, the following providers were recruited for the service area in FY 2016: EMH recruiting secured six providers to our service area. Jennifer Merrick, APRN - Urgent Care Crystal Brown, APRN - Womens Health Summer Blair, APRN - Family Practice Eva Stone, APRN - Family Practice Fred Hamlin, APRN - Cardiology Donald Jeffrey Covell, MD - Orthopedics Leadership Development/Training for Community Members - Mentoring by the senior leaders included resume building, interview practice, shadowing and individual coaching sessions for young professionals. Community Benefit Operation --------------------------- A 2014 Community Health Need Assessment (CHNA) was conducted by Professional Research Consultants (PRC) of Omaha, Nebraska for the EMH six county service area at a cost of $84,537 and a 95 per cent confidence level. A community focus group from the six counties was convened by PRC. The group included health department, governmental, first responders, educators and social agency leaders from each of the counties. Senior leadership reviews and approves both the community health assessment and the implementation plan to address the priority health risks for the population served and presents to the governing board for approval. They also allocate resources, both financially and personnel to address the implementation plan. Annually there is a budget approved by senior leadership and presented for governing board approval for community benefit. The senior leadership receives an annual update related to the work plan objectives and outcomes. The 2014 health risk assessment showed improvement trends related to cardiovascular risk in Boyle County from the 2008 assessment. The focused community benefit efforts began in Boyle County in FY 2008. The 2014 six county service area needs assessment shows improvement in the trend lines related to cardiovascular disease, but has not yet achieved a statically significant level of improvement from the initial six county survey in 2011. The Ephraim McDowell Health System provided $14,221,446 in financial assistance and means-tested programs within the two hospitals to improve the health of the community we serve in FY 2016. |
| FORM 990, PART VII, SECTION A | PART-YEAR OFFICERS ------------------ VICKI DARNELL RESIGNED AS CEO ON 1/30/2016 AND WAS REPLACED AS CEO BY SALLY DAVENPORT. |
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