TY 2017 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) ALLEN WHITE...................................................................... CHAIR	2.0 ................. 6.0	X	X	3,300	0	0
(2) SCOTT BOTTOMS...................................................................... VICE CHAIR	2.0 ................. 6.0	X	X	3,900	0	0
(3) JOHN D TRISLER...................................................................... TREASURER	2.0 ................. 6.0	X	X	3,000	0	0
(4) JULIAN GANDER...................................................................... SECRETARY	2.0 ................. 6.0	X	X	4,650	0	0
(5) HUSSAM HAMDALLA MD...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		0	884,754	54,117
(6) JAMES TURPIN MD...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,150	0	0
(7) REBECCA CHATHAM MD...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,150	0	0
(8) BRIAN ELLIS MD...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		0	246,146	50,726
(9) SHEREE GILLIAM...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,150	0	0
(10) CLIFF ED IRVIN...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,300	0	0
(11) SUSIE ROUSH...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,150	0	0
(12) AARON ROWLAND...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,150	0	0
(13) MIKE W TAYLOR...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,600	0	0
(14) JAMES W DUNN...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,300	0	0
(15) THOMAS HAGER...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		3,300	0	0
(16) DOUGLAS GREENBURG...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		0	0	0
(17) ERIC GUERRANT MD...................................................................... BOARD MEMBER	2.0 ................. 6.0	X		0	0	0

- TIN:

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

EPHRAIM MCDOWELL HEALTH INC

Employer identification number

61-1324736

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................6

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 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)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(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
(F) JAMES B HAGGIN MEMORIAL HOSPITAL	610510934	3	Yes		0	0
Total 6

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Yes

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
SCH A, PART IV, 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. EPHRAIM MCDOWELL HEALTH ALSO SUPPORT EMHFL AND JAMES B HAGGIN MEMORIAL HOSPITAL. THESE ENTITIES HAVE SEPARATE BOARDS OF DIRECTORS, BUT EACH OF THOSE INCLUDES REPRESENTATION FROM EPHRAIM MCDOWELL HEALTH'S BOARD OF DIRECTORS.

Return Reference

Explanation

SCH A, PART IV, 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. EPHRAIM MCDOWELL HEALTH ALSO SUPPORT EMHFL AND JAMES B HAGGIN MEMORIAL HOSPITAL. THESE ENTITIES HAVE SEPARATE BOARDS OF DIRECTORS, BUT EACH OF THOSE INCLUDES REPRESENTATION FROM EPHRAIM MCDOWELL HEALTH'S BOARD OF DIRECTORS.

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

EPHRAIM MCDOWELL HEALTH INC

Employer identification number

61-1324736

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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" on 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 .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....	1,079,713	359,904	719,809
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				719,809

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	86,613,146
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	7,056,813
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	1,194,725
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	30,712
e	Add lines 2a through 2d .....................			2e	1,225,437
3	Subtract line 2e from line 1..................			3	5,831,376
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	4,569
c	Add lines 4a and 4b....................			4c	4,569
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	5,835,945

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	5,992,603
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	4,569
e	Add lines 2a through 2d....................			2e	4,569
3	Subtract line 2e from line 1...................			3	5,988,034
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	-30,317
c	Add lines 4a and 4b.....................			4c	-30,317
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	5,957,717

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 AND PART XII	RECONCILIATION TO AUDIT REPORT - REVENUE & EXPENSES --------------------------------------------------- PART XI LINE 2D OTHER AMOUNTS INCLUDED ON LINE 1 BUT NOT FORM 990 PART VIII: -------------- REVENUE REPORTED ON COOPERATIVECARE, INC. FORM 1120 $30,712 PART XI LINE 4B OTHER AMOUNTS INCLUDED ON FORM 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REVENUE INCLUDED IN EXPENSE PER AUDIT $ 4,569 PART XII LINE 2D OTHER AMOUNTS INCLUDED ON LINE 1 BUT ON FORM 990 PART IX: ---------------- CONTRIBUTION REVENUE INCLUDED IN EXPENSE PER AUDIT $ 4,569 PART XII LINE 4B OTHER AMOUNTS INCLUDED ON FORM 990 BUT NOT ON LINE 1: ---------------- EXPENSES REPORTED ON COOPERATIVECARE INC. FORM 1120 ($30,317)
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.

Return Reference

Explanation

SCH D, PART XI AND PART XII

RECONCILIATION TO AUDIT REPORT - REVENUE & EXPENSES --------------------------------------------------- PART XI LINE 2D OTHER AMOUNTS INCLUDED ON LINE 1 BUT NOT FORM 990 PART VIII: -------------- REVENUE REPORTED ON COOPERATIVECARE, INC. FORM 1120 $30,712 PART XI LINE 4B OTHER AMOUNTS INCLUDED ON FORM 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REVENUE INCLUDED IN EXPENSE PER AUDIT $ 4,569 PART XII LINE 2D OTHER AMOUNTS INCLUDED ON LINE 1 BUT ON FORM 990 PART IX: ---------------- CONTRIBUTION REVENUE INCLUDED IN EXPENSE PER AUDIT $ 4,569 PART XII LINE 4B OTHER AMOUNTS INCLUDED ON FORM 990 BUT NOT ON LINE 1: ---------------- EXPENSES REPORTED ON COOPERATIVECARE INC. FORM 1120 ($30,317)

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) 2019

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
EPHRAIM MCDOWELL HEALTH INC

Employer identification number
61-1324736

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) SCHOLARSHIPS	10	12,000
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
SCH I, PART I, LINE 2	MONITORING THE USE OF GRANT FUNDS ---------------------------------- IN ORDER TO QUALIFY FOR A SCHOLARSHIP, STUDENTS MUST FIRST MEET CERTAIN CRITERIA ESTABLISHED BY THE ORGANIZATION. IF A STUDENT MEETS ALL CRITERIA, THEY ARE BROUGHT IN TO INTERVIEW WITH THE SCHOLARSHIP COMMITTEE AND SELECTIONS ARE MADE FROM THE INTERVIEWS. THE SCHOLARSHIPS ARE PAID TO THE UNIVERSITIES THAT THE RECIPIENTS ATTEND.

Schedule I (Form 990) 2019

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

EPHRAIM MCDOWELL HEALTH INC

Employer identification number

61-1324736

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

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 on Line 1a? ..

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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 on 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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1HUSSAM HAMDALLA MD BOARD MEMBER	(i) (ii)	0 ------------- 518,456	0 ------------- 347,272	0 ------------- 19,026	0 ------------- 18,000	0 ------------- 36,117	0 ------------- 938,871	0 ------------- 0
2BRIAN ELLIS MD BOARD MEMBER	(i) (ii)	0 ------------- 107,856	0 ------------- 102,271	0 ------------- 36,019	0 ------------- 19,754	0 ------------- 30,972	0 ------------- 296,872	0 ------------- 0
3WILLIAM SNAPP III VP & CFO	(i) (ii)	306,299 ------------- 0	0 ------------- 0	7,917 ------------- 0	21,200 ------------- 0	34,759 ------------- 0	370,175 ------------- 0	0 ------------- 0
4BURT PIPER VP & COO	(i) (ii)	259,070 ------------- 0	0 ------------- 0	7,137 ------------- 0	21,200 ------------- 0	34,319 ------------- 0	321,726 ------------- 0	0 ------------- 0
5MARK MILNER VP & CNO	(i) (ii)	193,164 ------------- 0	0 ------------- 0	9,934 ------------- 0	16,364 ------------- 0	34,069 ------------- 0	253,531 ------------- 0	0 ------------- 0
6SALLY DAVENPORT PART YEAR CEO	(i) (ii)	385,515 ------------- 0	0 ------------- 0	23,740 ------------- 0	21,200 ------------- 0	24,299 ------------- 0	454,754 ------------- 0	0 ------------- 0
7VICKIE DARNELL FORMER CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	512,346 ------------- 0	0 ------------- 0	38,001 ------------- 0	550,347 ------------- 0	0 ------------- 0
8TAMMY ENSSLIN LEGAL COUNSEL	(i) (ii)	213,252 ------------- 0	0 ------------- 0	5,480 ------------- 0	17,991 ------------- 0	32,408 ------------- 0	269,131 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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

SCH J, PART I, LINE 6A

MANAGEMENT INCENTIVE PLAN ------------------------- 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 4A

SEVERANCE PAYMENTS ------------------ VICKI DARNELL RESIGNED FROM CEO IN JANUARY 2016. SEVERANCE PAID OF $550,347 WAS INCLUDED IN HER W-2.

Schedule J (Form 990) 2019

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
EPHRAIM MCDOWELL HEALTH INC

Employer identification number
61-1324736

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	COUNTY OF BOYLE KENTUCKY	61-6000752		06-04-2014	61,751,934	REFUNDING SERIES 2014A & 2014B		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	61,751,934
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	55,626,702
7 Issuance costs from proceeds ...............	85,000
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	0
11 Other spent proceeds .............	0
12 Other unspent proceeds .............	6,040,232
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........	0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

EPHRAIM MCDOWELL HEALTH INC

Employer identification number

61-1324736

Return Reference	Explanation
FORM 990, PART III, LINE 4	PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------- THE TOP COMMUNITY HEALTH PRIORITIES FOR EPHRAIM MCDOWELL HEALTH (EMH) HAVE BEEN BASED ON THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC) OF OMAHA, NEBRASKA. THE TOP PRIORITIES ARE: 1. DIABETES 2. ACCESS TO HEALTH SERVICES 3. CANCER - EARLY DETECTION & PREVENTION 4. CARDIOVASCULAR DISEASE & RELATED RISK FACTORS 5. NUTRITION, PHYSICAL ACTIVITY, & WEIGHT 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 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 EVLUATE 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, ORTHOPEDIC 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 MARCH 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. IN FY 2018 THE SPINE AND ORTHOPEDIC SYMPOSIUM WAS NOT HELD IN SEPTEMBER DUE TO RESOURCE LIMITATIONS. THE SYMPOSIUM PROVIDES GENERAL INFORMATION REGARDING SELF-CARE RELATED TO JOINT AND MUSCLE FUNCTION AND NORMAL CHANGES OF AGING. IN FY 2017 EIGHTY-FIVE PEOPLE PARTICIPATED WITH A COST OF $3,400. INFORMATION REGARDING MEDICAL OPTIONS FOR CARE WHEN INJURIES OR OVER USE OCCUR IS ALSO PROVIDED. THE SYMPOSIUM WILL BE HELD IN FY 2019 AND EVERY OTHER YEAR MOVING FORWARD. PARISH NURSE PROGRAM - TWELVE MONTHLY NEWSLETTERS WERE SENT TO 192 ASSOCIATED CHURCHES AND EIGHTY-TWO FCNS IN FY 2018. THE FAITH COMMUNITY NURSING FOUNDATION COURSE WAS PROVIDED IN MARCH OF FY 2018 WITH FIVE LOCAL GRADUATES. A FAITH COMMUNITY NURSING SYMPOSIUM WAS PRESENTED IN THE FALL OF 2016; THEREFORE ONE DID NOT TAKE PLACE IN 2017 BUT WILL AGAIN IN 2018 AS IT IS HOSTED EVERY OTHER YEAR. SCHOOL BASED PROGRAM - THE SCHOOL BASED PROGRAM WAS TERMINATED DUE TO THE ELIMINATION OF THE PROGRAM AND A SIGNIFICANT REDUCTION IN PERSONNEL WITHIN THE COMMUNITY SERVICE DEPARTMENT. SPEAKERS BUREAU - BOOK MARKS WITH SIGNS AND SYMPTOMS OF HEART ATTACK FOR MEN AND WOMEN HAVE BEEN DISTRIBUTED TO PRIMARY CARE PROVIDERS, OB/GYN, ORTHOPEDIC AND GENERAL SURGERY OFFICES FOR PUBLIC DISTRIBUTION. THE EARLY HEART ATTACH CARE (EHAC) INFORMATION IS ALSO POSTED ON THE WEBSITE AND TRIFOLD EDUCATIONAL BROCHURES ARE PROVIDED FOR THE PUBLIC. A MARCH HAPPY HEART LUNCHEON FOCUSED ON WOMEN AND HEART DISEASE SINCE THIS REGION OF APPALACHIA IS THE EPICENTER 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 - IN KIND ------------------------------------------------ CASH OR IN-KIND DONATIONS TO THE COMMUNITY - ONE HUNDRED AND SIXTEEN 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 POUNDS, A TOTAL VALUE OF $1,523.08. PERSONNEL/ADMINISTRATIVE SUPPORT - LEADERSHIP AND ADMINISTRATIVE SUPPORT INCLUDED BOARD MEMBERSHIP OF THE HEART OF DANVILLE, HEART OF KENTUCKY UNITED WAY, 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 EXECUTIVESM FARMERS NATIONAL BANK AND PREMIER. EMH LEADERS AND STAFF ALSO PARTICIPATE IN THE DAY OF CARING AND DAY OF ACTION TO IMPROVE OUR COMMUNITY THROUGH SERVICE PROJECTS THROUGH THE HEART OF KENTUCKY UNITED WAY. COMMUNITY BUILDING ACTIVITIES ------------------------------ SENIOR LEADERS AND ASSOCIATES ASSISTED IN THE SALVATION ARMY KETTLE DRIVE FUNDRAISER FOR THOSE IN NEED. COALITION BUILDING - AGENCIES SERVED INCLUDED THE HEART OF DANVILLE BOARD, CHAMBER OF COMMERCE, AND ECONOMIC DEVELOPMENT COUNCIL, BOARD MEMBER OF KENTUCKY ORGANIZATION OF NURSE LEADERS, MEMBER OF ROTARY WITH COMMITTEE RESPONSIBILITIES, BOARD MEMBER OF DANVILLE/BOYLE COUNTY SENIOR CITIZENS CENTER, HEART OF KENTUCKY UNITED WAY INVESTMENT COMMITTEE MEMBER, AND BOARD MEMBER OF MCDOWELL HOUSE. THE MARKETING DEPARTMENT ALSO HELPED WITH THE LOGISTICS OF THE UNITED WAY DAY OF ACTION. 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 ON COMMUNITY NEEDS FEEDBACK FROM TOWN HALL MEETINGS, MEDICAL STAFF AND GOVERNING BOARD, THE FOLLOWING PROVIDERS WERE RECRUITED FOR THE SERVICE ARE IN FY 2018: EMH RECRUITING SECURED NINE PROVIDERS TO OUR SERVICE AREA. JENNIFER DANIEL, A.P.R.N. - FAMILY PRACTICE BETH BURCHETT, A.P.R.N. - PRN, WALK-IN CLINIC JENNIFER OWENS, A.P.R.N. - PRM, WALK-IN CLINIC MARY NANCY FULLER, A.P.R.N. - PRM, WALK-IN CLINIC SABRINA WELLMAN, A.P.R.N. - FAMILY PRACTICE DIANA KING, A.P.R.N. - WALK-IN, BLUEGRASS IMMEDIATE CARE MIRA DAUGHTERY, A.P.R.N. - FAMILY PRACTICE DR. JUSTIN LANDE, D.O. - INTERNAL MEDICINE DR. COURTNEY MAIDEN, D.O. - FAMILY PRACTICE 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 ---------------------------- IN 2017 A NEW COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS OF OMAHA, NEBRASKA FOR THE EMH SIX COUNTY SERVICE AREA AT A COST OF $83,000 AND A 95 PERCENT 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. MEMBERS OF THESE GROUPS AS WELL AS ADDITIONAL COMMUNITY AND SOCIAL AGENCIES FROM THE SIX COUNTY SERVICE AREA, AS WELL AS THE EPHRAIM MCDOWELL HEALTH SYSTEM LEADERSHIP RECEIVED COPIES OF THE ASSESSMENT. A COPY IS ALSO POSTED ON OUR WEBSITE. 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. SENIOR LEADERSHIP RECEIVES AN ANNUAL UPDATE RELATED TO THE WORK PLAN OBJECTIVES AND OUTCOMES. THE 2017 SIX COUNTY SERVICE AREA CHNA SHOWS NO STATISTICAL CHANGE IN THE TREND LINES RELATED TO THE PREVALENCE OF HEART DISEASE SINCE 2008 DESPITE FREE COMMUNITY SCREENINGS AND EDUCATION. HOWEVER, THIS MAY REFLECT THE AGING OF THE POPULATION. IT SHOULD BE NOTED THAT AGE-ADJUSTED MORTALITY TRENDS HAVE CONTINUED TO DECREASE, BEING LOWER THAN THE STATEWIDE RATE BUT HIGHER THAN THE NATIONAL RATE. 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 2018.
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 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 ------------------------------------ EPHRAIM MCDOWELL HEALTH, INC. IS THE PARENT COMPANY OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW AND PROVIDED MARKET DATA IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF THE CEO. FOR OTHER 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 VII	PART-YEAR CEO ------------- SALLY DAVENPORT RETIRED IN JULY 2018, AT WHICH TIME DANIEL MCKAY BECAME THE CEO. MCKAY DID NOT RECEIVE ANY COMPENSATION DURING CALENDAR YEAR 2017, THEREFORE NO COMPENSATION IS REPORTED IN PART VII.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

EPHRAIM MCDOWELL HEALTH INC

Employer identification number

61-1324736

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?
(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	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)	12B-II	EM HEALTH		No
(5)EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER 217 SOUTH THIRD STREET DANVILLE,KY40422 61-0492356	ACUTE HOSP	KY	501(C)(3)	3	EM HEALTH		No
(6)MCDOWELL HOME HEALTH AGENCY INC 217 SOUTH THIRD STREET DANVILLE,KY40422 61-0715227	HOME HEALTH	KY	501(c)(3)	3	EM HEALTH		No
(7)JAMES B HAGGIN MEMORIAL HOSPITAL 464 LINDEN AVENUE HARRODSBURG,KY40330 61-0510934	CRITICAL HOSP	KY	501(C)(3)	3	EM HEALTH		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) CTRL KY SURGERY CTR 217 S 3RD DANVILLE,KY40422 37-1509373	MEDICAL SERVICES	KY	EM REG MED CTR	RELATED	0	0		No	0		No

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?
(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		Yes	No
(1) COOPERATIVECARE INC 217 SOUTH THIRD STREET DANVILLE,KY40422 61-1265715	CONTRACTING SRVS	KY	NA	C	30,712	12,561	100.000 %		No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) Ephraim McDowell Health Care Foundation	C	4,569	FMV
(2) EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER	Q	149,667,200	FMV
(3) EMHFL INC	Q	15,402,440	FMV
(4) EPHRAIM MCDOWELL HEALTH RESOURCE	Q	17,475,964	FMV
(5) A CHILDREN'S PLACE	Q	361,205	FMV
(6) EPHRAIM MCDOWELL HEALTH CARE FOUNDATION	Q	39,695	FMV
(7) COOPERATIVECARE INC	Q	242,939	FMV
(8) MCDOWELL HOME HEALTH AGENCY INC	Q	1,846,506	FMV

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation
SCH R, PART V, LINES 1L, 1N, AND 1O	TRANSACTIONS WITH RELATED ORGANIZATIONS --------------------------------------- TRANSACTIONS OCCURRED BETWEEN EPHRAIM MCDOWELL HEALTH AND ITS AFFILIATED ORGANIZATIONS. AMOUNTS ARE RECORDED IN INTERCOMPANY ACCOUNTS. DUE TO THE QUANTITY OF TRANSACTIONS, CLASSIFICATION OF THESE AMOUNTS TO THE VARIOUS TRANSACTIONS TYPES HAS NOT BEEN PERFORMED.

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: EPHRAIM MCDOWELL HEALTH IS COMMITTED TO PROVIDING A HEALING ENVIRONMENT IN THE COMMUNITIES WE SERVE, BUILT ON BEST PEOPLE, PRACTICES AND PERFORMANCE.
2	Check this box
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 2019 (Part V, line 2a) ......	5	27
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	14,923
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	13,923

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	4,569
9	Program service revenue (Part VIII, line 2g) .........	2,952,476	3,636,126
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,028,287	2,185,038
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	11,334	10,212
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	4,992,097	5,835,945
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	11,000	12,000
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)	2,715,194	3,251,684
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,603,558	2,694,033
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	5,329,752	5,957,717
19	Revenue less expenses. Subtract line 18 from line 12.......	-337,655	-121,772
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	145,933,080	135,926,619
21	Total liabilities (Part X, line 26).............	151,999,173	140,919,759
22	Net assets or fund balances. Subtract line 21 from line 20.....	-6,066,093	-4,993,140

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 5,957,717 including grants of $ 12,000 ) (Revenue $ 3,640,263 )
	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 expenses5,957,717

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(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
(A) Name and title
(18) DANIEL MCKAY........................................................................ PART YEAR CEO	20.0 .......................39.0	X			0	0	0
(19) WILLIAM SNAPP III........................................................................ VP & CFO	20.0 .......................42.0	X			314,216	0	55,959
(20) BURT PIPER........................................................................ VP & COO	20.0 .......................39.0	X			266,207	0	55,519
(21) MARK MILNER........................................................................ VP & CNO	40.0 .......................0.0	X			203,098	0	50,433
(22) SALLY DAVENPORT........................................................................ PART YEAR CEO	20.0 .......................39.0	X			409,255	0	45,499
(23) TAMMY ENSSLIN........................................................................ LEGAL COUNSEL	40.0 .......................0.0		X		218,732	0	50,399
(24) ROBERT KEITH BRIDGES........................................................................ VP MARKETING	24.0 .......................16.0		X		109,585	0	26,292
(25) VICKIE DARNELL........................................................................ FORMER CEO	0.0 .......................0.0			X	512,346	0	38,001

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,077,539	1,130,900	426,945

(A) Name and business address	(B) Description of services	(C) Compensation
WYATT TARRANT COMBS LLP, 500 WEST JEFFERSON STREET SUITE 28 LOUISVILLE,KY40202	LEGAL SERVICES	243,092
BKD LLP, 220 W MAIN STREET STE 1700 LOUISVILLE,KY402011178	ACCOUNTING SERVICES	185,010



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 2

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,569
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,569

		Business Code
2a	SHARED SVCS PROVIDED TO AFFILIATED ORGS	900004	3,636,126	3,636,126
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		3,636,126

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,247,107		14,923	2,232,184
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		6,075	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	6,075	6c
d	Net rental income or (loss).......			6,075			6,075
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		3,443,176	7a
b	Less: cost or other basis and sales expenses	166,667	3,338,578	7b
c	Gain or (loss)	-166,667	104,598	7c
d	Net gain or (loss).........			-62,069			-62,069
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	OTHER INCOME		900099	462	462
b	RCEM, INC. OPERATIONS		621110	3,675	3,675
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			4,137
12	Total revenue. See instructions.....			5,835,945	3,640,263	14,923	2,176,190

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	12,000	12,000
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ...........	2,251,102	2,251,102
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........	391,425	391,425
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	324,662	324,662
9	Other employee benefits .......	143,727	143,727
10	Payroll taxes ...........	140,768	140,768
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	567,908	567,908
c	Accounting ...........	122,109	122,109
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	116,406	116,406
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	92,435	92,435
12	Advertising and promotion ....	310,046	310,046
13	Office expenses .......	294,717	294,717
14	Information technology ......	14,406	14,406
15	Royalties ..	0
16	Occupancy ...........	480,640	480,640
17	Travel ............	13,816	13,816
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	8,958	8,958
20	Interest ...........	26,351	26,351
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	218,364	218,364
23	Insurance ...	77,175	77,175
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	MISCELLANEOUS	309,267	309,267
b	MEALS	16,083	16,083
c	DUES	25,352	25,352
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	5,957,717	5,957,717	0	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			67,689,165	2	55,561,997
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			0	4	0
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			0	8	0
9	Prepaid expenses and deferred charges ......			668,193	9	671,312
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,079,713
b	Less: accumulated depreciation	10b	359,904	935,751	10c	719,809
11	Investments—publicly traded securities .			71,741,532	11	73,069,417
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			2,920,062	13	3,924,452
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			1,978,377	15	1,979,632
16	Total assets. Add lines 1 through 15 (must equal line 33)...			145,933,080	16	135,926,619

17	Accounts payable and accrued expenses .....	11,877,643	17	10,560,757
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	47,745,856	20	43,745,856
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		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	92,375,674	25	86,613,146
26	Total liabilities. Add lines 17 through 25..	151,999,173	26	140,919,759

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-6,066,093	32	-4,993,140
33	Total liabilities and net assets/fund balances ........	145,933,080	33	135,926,619