TY 2021 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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) GREG STRAHAN PRESIDENT AND CEO (THRU 08/21)	2.0 ................. 48.0	X	X			0	1,068,089	46,317
(2) JEFFREY THOMAS BOARD TREASURER, CFO (START 08/21)	2.0 ................. 48.0	X	X			0	163,601	9,496
(3) JOHN HACKBARTH BOARD SECRETARY, CFO (THRU 08/21)	2.0 ................. 48.0	X	X			0	594,153	42,608
(4) MARK MARSH PRESIDENT AND CEO (START 06/21)	2.0 ................. 48.0	X	X			0	578,107	33,647
(5) ROBERT FARMER BOARD CHAIRPERSON	1.0 ................. 5.0	X	X			0	0	0
(6) VICKI STOGSDILL BOARD SECRETARY	1.0 ................. 3.0	X	X			0	0	0
(7) DENNIS FENTRESS BOARD MEMBER	1.0 ................. 0	X				0	0	0
(8) GAVIN ROBERTS BOARD MEMBER	1.0 ................. 6.0	X				0	0	0
(9) GLENNA BLACK BOARD MEMBER	1.0 ................. 0	X				0	0	0
(10) JEFF CARPENTER BOARD MEMBER (THRU 10/21)	1.0 ................. 6.0	X				0	0	0
(11) LARRY BRETT ABNEY OD BOARD MEMBER	1.0 ................. 0	X				0	0	0
(12) RYAN BRATCHER BOARD MEMBER	1.0 ................. 0	X				0	0	0
(13) ASHLEY HERRINGTON CEO - OHTLMC	45.0 ................. 5.0		X			293,734	0	41,499
(14) CATHERINE CLEMONS VP OF OPERATIONS - OHTLMC	45.0 ................. 5.0			X		178,858	0	19,282
(15) CATHY STEWART VP PATIENT CARE SVCS AND CNO - OHTLMC	45.0 ................. 5.0			X		164,698	0	33,617
(16) TRINA DAVES VP PT CARE SVCS AND CNO-TL (THRU 10/21)	45.0 ................. 5.0			X		201,195	0	12,401
(17) AMANDA HARTLAGE CLINICAL PHARMACIST	50.0 ................. 0				X	117,945	0	21,906

(A) Name and business address	(B) Description of services	(C) Compensation
QUALIVIS LLC DEPT 3847 PO BOX 123847 DALLAS,TX753123847	CONTRACT LABOR FOR NURSING	1,070,857
CLINICAL MANAGEMENT SOLUTIONS PO BOX 6890 EVANSVILLE,IN47719	OCC. AND PT SERVICES	741,342
EXCEL ANESTHESIA PSC 1020 NORTH MAIN STREET BEAVER DAM,KY42320	ANESTHESIA SERVICES	648,998
BLEIBEL MD SAMER 34912 BUNKER HILL DR FARMINGTON HILLS,MI48331	PHYSICIAN SERVICES	487,104
JENKINS MD ANDREW 223 BYRTLE GROVE ROAD LEITCHFIELD,KY42754	PHYSICIAN SERVICES	322,656
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 10

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

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).)

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 33 1/3% 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 33 1/3% 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 on 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 ...............................

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

(i) Name of supported organization	(ii) EIN	(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)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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.

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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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).

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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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

Schedule A (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

2021

Open to Public Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

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) 2021

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 .....	2,230,751		2,230,751
b	Buildings ....	21,815,022	1,532,788	20,282,234
c	Leasehold improvements
d	Equipment ....	7,050,789	1,308,803	5,741,986
e	Other .....	953,909		953,909
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				29,208,880

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	44,312,793
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) 2021

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	THE SYSTEM APPLIES FASB ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIALS STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 30000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			84,934	0	84,934	0.19 %
b	Medicaid (from Worksheet 3, column a) . . . . .			12,987,962	27,189,703	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	13,072,896	27,189,703	84,934	0.19 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	50	1,377	15,179	162	15,017	0.03 %
f	Health professions education (from Worksheet 5) . . .	89	8	78,322	0	78,322	0.17 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0	0 %
h	Research (from Worksheet 7) .			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	114	1,463	6,781	0	6,781	0.01 %
j	Total. Other Benefits . .	253	2,848	100,282	162	100,120	0.22 %
k	Total. Add lines 7d and 7j .	253	2,848	13,173,178	27,189,865	185,054	0.40 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense
1	Physical improvements and housing					0
2	Economic development	8		226		226
3	Community support					0
4	Environmental improvements					0
5	Leadership development and training for community members					0
6	Coalition building					0
7	Community health improvement advocacy					0
8	Workforce development					0
9	Other					0
10	Total	8	0	226	0	226

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,710,309

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

216,825

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

8,823,400

Enter Medicare allowable costs of care relating to payments on line 5.....

9,439,808

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-616,408

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER 1201 PLEASANT VALLEY ROAD OWENSBORO,KY42303 WWW.OWENSBOROHEALTH.ORG 100151	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

Yes

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): https://www.owensborohealth.org/sites/default/files/documents/ohtlmc-chna-full-report-2021.pdf

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.owensborohealth.org/sites/default/files/documents/2021_owensboro_health_twin_lakes_medic

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.OWENSBOROHEALTH.ORG

The FAP application form was widely available on a website (list url):

WWW.OWENSBOROHEALTH.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.OWENSBOROHEALTH.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 2	OWENSBORO HEALTH ACQUIRED TWIN LAKES REGIONAL MEDICAL CENTER ON JANUARY 1, 2021 AND IS THE THIRD HOSPITAL IN THE OWENSBORO HEALTH SYSTEM. THE HOSPITAL WAS RENAMED OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER ("OHTLMC"). OHTLMC IS A 75 BED HOSPITAL BASED IN LEITCHFIELD, KY, ABOUT 65 MILES SOUTHEAST OF OWENSBORO. THEIR SERVICE AREA COMPRISES 115,000 PEOPLE FROM SIX COUNTIES: GRAYSON (PRIMARY), BRECKINRIDGE, OHIO, BUTLER, EDMONSON, HART, AND HARDIN. OHTLMC IS NOT A MEMBER OF THE OBLIGATED GROUP.
Schedule H, Part V, Section B, Line 3E	THE PRIORITY HEALTH AREAS FOR OHTLMC IN TAX YEARS 2021 - 2024 ARE: MENTAL HEALTH, SUBSTANCE ABUSE, CHRONIC HEALTH CONDITIONS, AND OBESITY/PHYSICAL INACTIVITY.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER. IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER (OHTLMC) AND ITS POPULATION HEALTH COMMITTEE WITH THE COMMUNITY AND ECONOMIC INITIATIVE OF KENTUCKY (CEDIK) DEVELOPED A SURVEY TO GATHER HEALTH INFORMATION AND -PERCEPTIONS OF GRAYSON COUNTY RESIDENTS 18. THE SURVEY WAS CONDUCTED IN JANUARY AND FEBRUARY OF 2022 USING AN ONLINE TOOL AND DISTRIBUTING PRINTED COPIES IN VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. THE ONLINE SURVEY WAS PROMOTED THROUGH LOCAL MEDIA, EMAILS, AND ITS FACEBOOK PAGE. EMAILS WITH A LINK TO THE SURVEY WERE SENT TO GRAYSON COUNTY CHAMBER OF COMMERCE MEMBERS, LOCAL INDUSTRIES, AND EMPLOYEES OF THE GRAYSON COUNTY SCHOOL SYSTEM AND THE HOSPITAL. PRINTED COPIES WERE DELIVERED TO AN ASSISTED LIVING FACILITY, THE GRAYSON COUNTY ALLIANCE FOOD BANK, THE GRAYSON COUNTY HEALTH DEPARTMENT, BIG CLIFTY MEDICAL COMPLEX, AND THE CANEYVILLE FAMILY PRACTICE. SURVEYS WERE ALSO CONDUCTED AT THE COMMUNITY COVID-19 VACCINE CLINIC. 1109 GRAYSON COUNTY RESIDENTS PARTICIPATED IN THE SURVEY. THE SURVEY QUESTIONS WERE IN THREE PRIMARY CATEGORIES: DEMOGRAPHICS, PERSONAL HEALTH INFORMATION, AND PERCEIVED HEALTH NEEDS OF THE COMMUNITY. CEDIK TABULATED THE RESULTS AND SUPPLEMENTED THEM WITH HEALTH STATISTICS AND DEMOGRAPHIC INFORMATION. OHTLMC THEN INVITED REPRESENTATIVES FROM VARIOUS BACKGROUNDS TO PARTICIPATE IN FOCUS GROUPS. THESE FOCUS GROUPS COMPRISED COMMUNITY CITIZENS, COMMUNITY LEADERS, AND HEALTHCARE GROUPS. ORGANIZATIONS REPRESENTED INCLUDED THE COUNTY EXTENSION OFFICE; GRAYSON COUNTY SCHOOLS; THE GRAYSON COUNTY HEALTH DEPARTMENT; OHTLMC EMPLOYEES; LOCAL INDUSTRY/MANUFACTURING; GRAYSON COUNTY HEALTHCARE FOUNDATION; CATHOLIC OUTREACH; TRI-COUNTY CASA; BANKS AND BUSINESSES; OHRH; UNITED WAY OF CENTRAL KENTUCKY; THE GRAYSON COUNTY ALLIANCE. LASTLY, FOUR KEY INFORMANT INTERVIEWS WERE DONE WITH INVOLVED COMMUNITY MEMBERS. AFTER CAREFULLY CONSIDERING THE RESULTS OF THE COMMUNITY HEALTH SURVEY, THE MOST RECENT HEALTH AND DEMOGRAPHIC INFORMATION AVAILABLE INPUT FROM THE COMMUNITY HEALTH COMMITTEE, AND THE KEY INFORMANT INTERVIEWS, THE FOLLOWING NEEDS WERE IDENTIFIED BY THE OHTLMC POPULATION HEALTH COMMITTEE AND APPROVED BY THE HOSPITAL LEADERSHIP AND THE BOARD OF DIRECTORS. THE PRIORITY HEALTH AREAS FOR OHTLMC IN TAX YEARS 2021 - 2024 ARE: MENTAL HEALTH, SUBSTANCE ABUSE, CHRONIC HEALTH CONDITIONS, AND OBESITY/PHYSICAL INACTIVITY.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER. AS PREVIOUSLY NOTED, THE OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER (OHTLMC) CHNA WAS CONDUCTED WITH COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK). CEDIK ENGAGED MULTIPLE COMMUNITY PARTNERS, INDIVIDUAL CITIZENS, ELECTED OFFICIALS, COALITIONS AND SUBJECT MATTER EXPERTS IN CONDUCTING THE CHNA.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER. OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER CREATED A COMMUNITY HEALTH COMMITTEE. THE GROUP IS GUIDED BY THE IDENTIFIED PRIORITY HEALTH NEEDS NAMED IN ITS MOST RECENT CHNA IDENTIFYING AREAS OF FOCUS TO IMPROVE THE HEALTH OF OUR COMMUNITY AND THE HOSPITAL IMPLEMENTATION STRATEGY. THE COMMUNITY HEALTH COMMITTEE IS MADE UP OF INTERNAL TEAM MEMBERS AND EXTERNAL COMMUNITY MEMBERS. OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER CEO CHAIRS THE COMMITTEE. THE COMMUNITY HEALTH COMMITTEE MEETS MONTHLY TO DISCUSS IMPLEMENTATION OF THE IMPLEMENTATION STRATEGY TO IMPROVE THE COMMUNITY'S HEALTH. OHTLMC INTENDS THAT THE CONTENTS OF THIS REPORT BE USED TO CREATE AWARENESS BY INFORMING GRAYSON COUNTY RESIDENTS OF THE PRIORITIZED HEALTH ISSUES IDENTIFIED BY THE COMMUNITY. ALSO, AS A STRATEGY, OHTLMC USES THE CHNA REPORT AS A FOUNDATION TO BUILD LASTING RELATIONSHIPS BETWEEN OHTLMC, COMMUNITY PARTNERS, AND RESIDENTS OF GRAYSON COUNTY. OHTLMC HAS ENGAGED VITAL INTERNAL AND COMMUNITY PARTNERS TO ADDRESS THE PRIORITIZED NEEDS. THE STRATEGIES USED TO IMPACT THE PRIORITY HEALTH AREAS INCLUDE, BUT ARE NOT LIMITED TO, MODIFYING POLICIES, PUBLIC AND PRIVATE; PROVIDING SUPPORT, INFORMATION, AND INCENTIVES; IMPROVING ACCESS; ENHANCING SKILLS, AND CHANGING CONSEQUENCES. FOLLOW-UP SURVEYS WILL MEASURE EACH INITIATIVE'S SUCCESS AND GIVE THE HOSPITAL'S FOLLOWING AREAS OF FOCUS. PRIORITY NEEDS IN MOST RECENT CHNA: MENTAL HEALTH, SUBSTANCE ABUSE, CHRONIC HEALTH CONDITIONS, OBESITY/PHYSICAL INACTIVITY OHTLMC IS WORKING COLLABORATIVELY WITH COMMUNITY PARTNERS TO ADDRESS THE IDENTIFIED PRIORITY AREAS. NOW A PART OF THE OWENSBORO HEALTH SYSTEM, THE POPULATION HEALTH COMMITTEE IS ACCESSING SUPPLEMENTAL DATA, RESOURCE INFORMATION, AND ADDITIONAL PARTNERS TO BETTER UNDERSTAND THE PRIORITY HEALTH ISSUES AND POSSIBLE STRATEGIES. AS THESE HEALTH ISSUES ARE CORRELATED TO SOCIAL DETERMINANTS OF HEALTH, NAMELY POVERTY, TRANSPORTATION, EDUCATION, AND HOUSING, OHTLMC WILL BE LOOKING TO EXPAND UPON INTERNAL AND EXTERNAL STRATEGIES NOW USED TO ADDRESS COMMUNITY HEALTH. MENTAL HEALTH: IN ADDITION TO PARTNERING WITH THE LOCAL MENTAL HEALTH CENTERS SERVING GRAYSON COUNTY AND OTHER PROVIDERS, OHTLMC IS OPENING A NEW SERVICE LINE FOR GERIATRIC BEHAVIORAL HEALTH, UTILIZING THE OWENSBORO HEALTH REGIONAL HOSPITAL INPATIENT BEHAVIORAL HEALTH SERVICES, TELEHEALTH BEHAVIORAL HEALTH INTERVENTIONS, AND INTENSIVE OUTPATIENT PROGRAMS AND WILL ENGAGE WITH ADDITIONAL MENTAL HEALTH RESOURCES AVAILABLE TO THE COMMUNITY AT LARGE. WE HAVE ALSO HIRED A BEHAVIORAL HEALTH PHYSICIAN TO PROVIDE OUTPATIENT SERVICES TO OUR COMMUNITY. WE WILL PROVIDE EDUCATION AND AWARENESS TO OUR COMMUNITY BY HOSTING A COMMUNITY MENTAL HEALTH AWARENESS FAIR. WE WILL PROVIDE MENTAL HEALTH FIRST AID TO OUR TEAM MEMBERS AND PARTICIPATE IN THE GRAYSON COUNTY POVERTY COALITION'S SUMMER RESOURCE FAIR. MENTAL HEALTH ISSUES AMONG YOUTH AND ADULTS ARE INCREASING AND HAVE BEEN EXACERBATED BY THE WORLDWIDE PANDEMIC. WHILE THIS HAS MADE COMMUNITY EDUCATION A CHALLENGE, OHTLMC WILL CONTINUE WORKING WITH THE POPULATION HEALTH COMMITTEE TO EXPLORE STRATEGIES TO DISCOVER INNOVATIVE SOLUTIONS TO COMBAT THIS ISSUE. SUBSTANCE USE: SINCE APRIL 2019, OHTLMC HAS CONTINUED TO BE A MEMBER OF THE KENTUCKY OPIOID RESPONSE EFFORT'S KENTUCKY STATEWIDE OPIOID STEWARDSHIP PROGRAM (KY-SOS) TO ADDRESS INAPPROPRIATE OR EXCESS OPIOID PRESCRIBING. THE OPIOID STEWARDSHIP TEAM AT OHTLMC MEETS REGULARLY AND PARTICIPATES IN DATA COLLECTION AND REPORTING AS REQUIRED BY KY-SOS. IN ADDITION, OHTLMC HAS AN ESTABLISHED OPIOID STEWARDSHIP COMMITTEE WHOSE CHARGE IS TO ENSURE SAFE OPIOID PRESCRIBING AND DECREASE OPIOID ABUSE AND MISUSE BY PATIENTS IN OUR CARE. OUR PHARMACY TEAM IS RESPONSIBLE FOR TRAINING LOCAL POLICE DEPARTMENTS. TREATMENT: OHTLMC OFFERS MEDICAL DETOX FROM ALCOHOL, OPIOIDS, AND OTHER ADDICTIVE SUBSTANCES. AS THE BODY RIDS ITSELF OF TOXINS, WITHDRAWAL SYMPTOMS AND CRAVINGS ARE SAFELY MANAGED UNDER THE 24-HOUR SUPERVISION OF TRAINED PROFESSIONALS. NON-ADDICTIVE MEDICATIONS MAY BE PRESCRIBED TO LESSEN WITHDRAWAL SYMPTOMS, IN ADDITION TO NUTRITIONAL SUPPLEMENTS AND FLUIDS. PAIN WILL BE MANAGED THROUGH NON-NARCOTIC MEDICATIONS AND OTHER PROVEN THERAPIES. PATIENTS ARE USUALLY STABILIZED WITHIN A WEEK. MATERNAL OPIOID MEDICAL STABILIZATION (MOMS) -ANY EXPECTANT MOTHER SUFFERING FROM OPIOID USE DISORDER MAY BE CONSIDERED FOR THE OHTLMC MOMS PROGRAM. A NON-ADDICTIVE MEDICATION IS PRESCRIBED UNDER THE 24-HOUR SUPERVISION OF CARING AND SPECIALLY TRAINED MEDICAL PROFESSIONALS. STUDIES SHOW THAT, COMPARED TO UNTREATED PREGNANT WOMEN WITH OPIOID ADDICTION, EXPECTANT MOTHERS RECEIVING MEDICATION-ASSISTED TREATMENT GAVE BIRTH TO INFANTS WITH A LOWER RISK OF A CONDITION CALLED NEONATAL ABSTINENCE SYNDROME (NAS). OTHER BENEFITS OF MOMS INCLUDE SHORTER TREATMENT TIME FOR THE BABY, AN INCREASED LIKELIHOOD OF A FULL-TERM PREGNANCY, HEALTHIER BIRTH WEIGHT, AND A DESIRABLE HEAD CIRCUMFERENCE AT BIRTH. THE TYPICAL LENGTH OF STAY FOR THE MOMS PROGRAM IS TWO TO SEVEN DAYS, FOLLOWED BY AN INDIVIDUALIZED TREATMENT PLAN, INCLUDING CONTINUED OUTPATIENT TREATMENT AND COMMUNITY-SUPPORT SERVICES TO MEET THE NEEDS OF THE MOTHER AND HER UNBORN BABY. MEDICATION-ASSISTED TREATMENT: IN RESPONSE TO THE NATIONWIDE OPIOID CRISIS, OHTLMC OFFERS MEDICATION-ASSISTED TREATMENT OPTIONS FOR OPIOID ADDICTION. OHTLMC ADDICTION SERVICES USES FDA-APPROVED MEDICATIONS, SUCH AS SUBUTEX, SUBOXONE, SUBLOCADE, AND VIVITROL, TO RELIEVE OPIOID-WITHDRAWAL SYMPTOMS AND ALCOHOL CRAVINGS TO HELP THE PATIENT QUIT USING ADDICTIVE SUBSTANCES. OHTLMC DIRECTOR OF ADDICTION SERVICES SERVES AS A COMMUNITY CONDUIT TO PROVIDE EDUCATION AND INFORMATION REGARDING THIS PREVALENCE OF SUBSTANCE USE DISORDER AND EDUCATION, WHEN POSSIBLE, TO THE COMMUNITY REGARDING SUBSTANCE USE PREVENTION. THIS PERSON SERVES ON THE GRAYSON COUNTY SUBSTANCE ABUSE FOCUSED EDUCATION (SAFE) COALITION, HOSTS A MONTHLY SUBSTANCE ABUSE PROVIDER'S MEETING, "TAKING BACK KENTUCKY, AND HOSTS AN ANNUAL MENTAL HEALTH AND ADDICTION RESOURCE AWARENESS FAIR AND AN ANNUAL SUMMER RESOURCE FAIR. OBESITY/PHYSICAL INACTIVITY OHTLMC HAS BEGUN HAVING CONVERSATIONS WITH LOCAL OFFICIALS TO DEVELOP A PARTNERSHIP WITH PARKS AND RECREATION TO SPONSOR LOCAL WALKING TRAILS TO ENCOURAGE YOUTH AND YOUNG ADULTS TO GET OUTSIDE AND PHYSICALLY MOVE. WE PLAN TO EXPLORE PARTNERSHIPS WITH LOCAL AGENCIES TO OFFER MONTHLY RECIPES VIA SOCIAL MEDIA, OFFER HEALTH EDUCATION CLASSES, CREATE A GET ACTIVE WELLNESS CAMPAIGN, INCREASE ENGAGEMENT IN EXERCISE IN THE SCHOOL DISTRICT, AND PARTNER WITH THE LOCAL AQUATIC CENTER TO PROVIDE FREE OR LOW-COST WATER EXERCISE CLASSES. IN ADDITION, WE ARE NOW ABLE TO PROVIDE TELEHEALTH APPOINTMENTS FOR LIFESTYLE MEDICINE PHYSICIAN VISITS. CHRONIC DISEASES OHTLMC PARTICIPATED IN THE SUMMER RESOURCE FAIR HOSTED BY THE GRAYSON COUNTY POVERTY COALITION, WHERE WE PROVIDED INFORMATION TO COMMUNITY MEMBERS ON PRIMARY CARE AND PREVENTATIVE SERVICES. WE ARE CURRENTLY WORKING ON HAVING THREE CERTIFIED TOBACCO TREATMENT SPECIALISTS, OFFERING CHRONIC DISEASE EDUCATION DAYS, WELLNESS CAMPAIGNS, HOSTING A COMMUNITY HEALTH FAIR, HOSTING DIABETES SUPPORT GROUPS/CLASSES, AND INCREASING THE NUMBER OF PATIENTS WHO RECEIVE DISCHARGE FOLLOW-UP REFERRALS WITHIN SEVEN DAYS OF DISCHARGE. OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER HAS DEVELOPED STRATEGIES TO ADDRESS EACH OF THE NAMED PRIORITY ISSUES IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THERE ARE NO IDENTIFIED PRIORITY HEALTH NEEDS FOR WHICH WE ARE NOT ADDRESSING.

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part I, Line 7b MEDICAID	DURING THE FISCAL YEAR, OHTLMC RECOGNIZED AN UPPER PAYMENT LIMIT (UPL) REIMBURSEMENT BEFORE TAXES AND ADMIN EXPENSES OF $8.357 MILLION AND $1.552 MILLION IN PREVIOUS YEAR. TWO FISCAL YEAR AGO, THE INPATIENT UPL FOR KENTUCKY HOSPITALS WAS THE MEDICARE PAYMENT RATE. IN FISCAL YEAR 2021, KENTUCKY MEDICAID AND THE KENTUCKY HOSPITAL ASSOCIATION OBTAINED APPROVAL FROM CMS TO MOVE THE UPL TO THE COMMERCIAL PAYMENT LEVEL WHICH PROVIDED ADDITIONAL SUPPLEMENTAL PAYMENTS TO KENTUCKY HOSPITALS. THE NET BENEFIT OF THE UPL FOR OHTLMC WAS $7.305 MILLION FOR FY 2022 AND $1.153 MILLION FOR FY 2021 (AFTER TAXES/ADMIN EXPENSES). OH ACQUIRED OHTLMC IN JANUARY OF 2021 (5 MONTHS OF FY 2021). THE PROGRAM HAS TO BE APPROVED ANNUALLY BY CMS AND THE STATEWIDE UPL NUMBERS WILL FLUCTUATE BASED UPON ACTUAL EXPERIENCE EACH YEAR.
Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT	KENTUCKY DOES NOT REQUIRE A COMMUNITY BENEFIT REPORT.
Schedule H, Part III, Line 8 COSTING METHODOLOGY USED	THE COSTING METHODOLOGY USED IS THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF PART I OF SCHEDULE H OF THIS 990. THE CHARGES AND PAYMENTS ARE FROM THE MEDICARE PAID CLAIMS REPORTS. THE HOSPITAL IS DESIGNATED AS A CMS LOW-VOLUME HOSPITAL (LVH). THIS IS A DESIGNATION FOR HOSPITALS WITH FEWER THAN 3,800 PATIENT DISCHARGES IN THE PREVIOUS YEAR WHICH ARE MORE THAN 15 MILES FROM THE NEAREST IPPS ACUTE CARE HOSPITAL.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	2710309
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR BAD DEBTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES HISTORICAL COLLECTIONS AND WRITE-OFFS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR BAD DEBTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATION OF THE SUFFICIENCY OF THE ALLOWANCE FOR BAD DEBTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FAP OHTLMC DOES NOT HAVE A MECHANISM TO DETERMINE THE PORTION OF BAD DEBT ATTRIBUTABLE TO THOSE PATIENTS POTENTIALLY ELIGIBLE FOR THE FAP BUT DO NOT COMPLETE THE APPLICATION. THE AMOUNT ENTERED IS AN ESTIMATE.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE POLICIES OF THE SYSTEM ATTEMPT TO ENSURE ALL UNINSURED PATIENTS OF THE SYSTEM HAVE OPPORTUNITY TO APPLY AND QUALIFY FOR FINANCIAL ASSISTANCE PROGRAMS. THE HOSPITAL HAS FINANCIAL AID APPLICATIONS AVAILABLE AT REGISTRATION AREAS, VIA THE INTERNET, VIA PHONE, AND ARE SENT ROUTINELY VIA MAIL TO PATIENTS OF THE HOSPITAL. THE HOSPITAL EMPLOYS FINANCIAL COUNSELORS TO ENSURE PATIENTS ARE EVALUATED FOR ELIGIBILITY IN THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE. ALL SELF-PAY AND BALANCE AFTER INSURANCE ACCOUNTS ARE REVIEWED AND WORKED BY HOSPITAL STAFF TO ENSURE THAT THE PATIENT IS GIVEN EVERY OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE. SELF-PAY DISCOUNTS ARE AVAILABLE TO ALL UNINSURED PATIENTS AS LONG AS THEY COMPLETE THE AID APPLICATION. DISCOUNTS GIVEN ARE EQUIVALENT TO THE AVERAGE INSURANCE DISCOUNTS THE HOSPITAL CONTRACTS ALLOW. ADDITIONALLY, PATIENTS WITH BALANCE ARE PERMITTED TO ESTABLISH PAYMENT PLANS. THE HOSPITAL DOES NOT CHARGE INTEREST TO ITS PATIENTS.
Schedule H, Part V, Section B, Line 16a FAP website	- OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER: Line 16a URL: WWW.OWENSBOROHEALTH.ORG;
Schedule H, Part V, Section B, Line 16b FAP Application website	- OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER: Line 16b URL: WWW.OWENSBOROHEALTH.ORG;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER: Line 16c URL: WWW.OWENSBOROHEALTH.ORG;
Schedule H, Part VI, Line 2 Needs assessment	AS DESCRIBED IN FORM 990, SCHEDULE H, PART V, SECTION B LINES 3E, 5, 6B OHTLMC ASSESSES THE HEALTH OF ITS DEFINED COMMUNITY THROUGH ITS CHNA CONDUCTED WITH CEDIK AND MULTIPLE COMMUNITY PARTNERS GUIDED BY THE POPULATION HEALTH COMMITTEE. THIS IS ACCOMPLISHED BY SURVEYING RESIDENTS AND ORGANIZATIONS AND CONDUCTING FOCUS GROUPS BUT NOT LIMITED TO THAT DATA. ADDITIONALLY, SECONDARY DATA ANALYSIS IS REVIEWED, AND OTHER ASSESSMENTS, SUCH AS THE GRAYSON COUNTY EXTENSION COMMUNITY ASSESSMENT AND OTHER DATA POINTS, ARE CONSIDERED. MOVING FORWARD, AS A PART OF OWENSBORO HEALTH, OHTLMC ADDITIONAL RESOURCES WILL BE UTILIZED TO ASSESS THE COMMUNITY'S HEALTH.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	OHTLMC REACHES OUT TO EDUCATE PATIENTS ABOUT THE PATIENT FINANCIAL ASSISTANCE PROGRAM. A BROCHURE IS AVAILABLE AT SEVERAL LOCATIONS THROUGHOUT THE HOSPITAL INCLUDING THE BUSINESS OFFICE AND REGISTRATION AREA. A VERSION OF THE BROCHURE AND ADDITIONAL INFORMATION IS ON THE HOSPITAL WEBSITE. INFORMATION CAN ALSO BE FOUND ON THE HOSPITAL'S FACEBOOK PAGE AND HAS BEEN PUBLISHED IN LOCAL NEWSPAPERS. WHEN SELF-PAY PATIENTS PRESENT THEMSELVES TO THE HOSPITAL FOR SERVICES, THE REGISTRAR DIRECTS THE PATIENTS TO THE FINANCIAL COUNSELOR FOR ASSISTANCE ON MEDICAID/COMMERCIAL PLANS AVAILABLE THROUGH THE ACA. ALSO AT THAT TIME, THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM IS APPLIED TO THE PATIENT'S PERSONAL SITUATION.
Schedule H, Part VI, Line 4 Community information	THE PRIMARY SERVICE LOCATION FOR OHTLMC IS GRAYSON COUNTY, KY (POPULATION 26,000) LOCATED 75 MILES SOUTHWEST OF LOUISVILLE, KY. THE HOSPITAL'S SECONDARY SERVICE AREA INCLUDES PARTS OF 6 SURROUNDING COUNTIES. THE ESTIMATED PERCENTAGE OF PEOPLE LIVING BELOW THE POVERTY LEVEL, AS DETERMINED BY THE US CENSUS BUREAU, IS 20.3% FOR THE PRIMARY SERVICE AREA. THE AREA IS MOSTLY RURAL WITH A HIGHER PERCENTAGE OF PERSONS OVER THE AGE OF 65 AND A SIGNIFICANTLY LOWER MEDIAN HOUSEHOLD INCOME COMPARED TO THE STATE OF KENTUCKY. THE UNEMPLOYMENT RATE FOR GRAYSON COUNTY IS 4.6%.
Schedule H, Part VI, Line 5 Promotion of community health	IN ADDITION TO THE HEALTH PROMOTION STRATEGIES AND CONCEPTS PREVIOUSLY DESCRIBED, OHTLMC WORKS CLOSELY WITH ITS LOCAL CHAMBERS OF COMMERCE, THE LOCAL DEPARTMENT OF PUBLIC HEALTH, LOCAL AND STATE ELECTED OFFICIALS, AND COMMUNITY LEADERS TO EDUCATE ON THE PRIORITY HEALTH ISSUES, DISCUSS OTHER EXISTING RELATED NEEDS AND WORK TOGETHER TO DEVELOP SOLUTIONS AND TACTICS TO ADDRESS THEM. OHTLMC PROVES TO BE A DRIVING FORCE IN CHANGE BY EDUCATING THE COMMUNITY ON HEALTH AND WELLNESS ISSUES, RECOGNIZING COMMUNITY NEEDS, AND WORKING TO FULFILL THOSE NEEDS.
Schedule H, Part VI, Line 6 Affiliated health care system	AS AN AFFILIATE HOSPITAL AND IN SUPPORT OF OWENSBORO HEALTH INC., OHTLMC WILL BE ONE OF THREE NOT-FOR-PROFIT HOSPITALS IN THE SYSTEM WHOSE MISSION IS TO HEAL THE SICK AND IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. UTILIZING THE RICH ACCESS TO RESOURCES, PROGRAMS, AND SERVICES WILL BENEFIT THIS WESTERN KENTUCKY REGION AND EXPAND THE ABILITY TO ADDRESS THE PRIORITY HEALTH AREAS OF OUR COMMUNITIES AND DIRECTLY ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, THE NATURAL BARRIERS TO POSITIVE HEALTH OUTCOMES THAT PLAGUE OUR COMMONWEALTH. REPLICATION OF EVIDENCE-BASED PROGRAMS WILL ALLOW GREATER SHARING OF KNOWLEDGE, EXPERTISE, AND PROGRAMMING FOR TARGETED IMPACT ON THE POPULATIONS WHICH NEED THEM THE MOST. WE WILL USE INVESTMENT DOLLARS IN A POPULATION HEALTH APPROACH TO ENGAGE IN INNOVATIVE STRATEGIES THE AFFILIATED HOSPITALS AND THEIR DIFFERENT ENTITIES MAY EMPLOY WITH A GUIDING POPULATION HEALTH STRATEGY AND APPROACH TO HAVE THE MOST SIGNIFICANT IMPACT ON THE HOSPITALS' INDIVIDUAL AND COLLECTIVE IDENTIFIED AND PRIORITIZED HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTH.
Schedule H, Part VI, Line 7 State filing of community benefit report	KY

Schedule H (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

2021

Open to Public Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

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 .....

Yes

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? ....

Yes

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? .........

Yes

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

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

Yes

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1JOHN HACKBARTH BOARD SECRETARY, CFO (THRU 08/21)	(i) (ii)	0 ------------- 317,162	0 ------------- 152,568	0 ------------- 124,423	0 ------------- 28,420	0 ------------- 14,188	0 ------------- 636,761	0 ------------- 0
2MARK MARSH PRESIDENT AND CEO (START 06/21)	(i) (ii)	0 ------------- 386,671	0 ------------- 90,000	0 ------------- 101,436	0 ------------- 13,659	0 ------------- 19,988	0 ------------- 611,754	0 ------------- 0
3GREG STRAHAN PRESIDENT AND CEO (THRU 08/21)	(i) (ii)	0 ------------- 552,130	0 ------------- 322,348	0 ------------- 193,611	0 ------------- 28,420	0 ------------- 17,897	0 ------------- 1,114,406	0 ------------- 0
4JEFFREY THOMAS BOARD TREASURER, CFO (START 08/21)	(i) (ii)	0 ------------- 140,146	0 ------------- 10,000	0 ------------- 13,455	0 ------------- 3,959	0 ------------- 5,537	0 ------------- 173,097	0 ------------- 0
5ASHLEY HERRINGTON CEO - OHTLMC	(i) (ii)	233,988 ------------- 0	46,104 ------------- 0	13,642 ------------- 0	11,965 ------------- 0	29,534 ------------- 0	335,233 ------------- 0	0 ------------- 0
6CATHERINE CLEMONS VP OF OPERATIONS - OHTLMC	(i) (ii)	146,000 ------------- 0	16,451 ------------- 0	16,407 ------------- 0	7,448 ------------- 0	11,834 ------------- 0	198,140 ------------- 0	0 ------------- 0
7TRINA DAVES VP PT CARE SVCS AND CNO-TL (THRU 10/21)	(i) (ii)	100,927 ------------- 0	14,527 ------------- 0	85,741 ------------- 0	3,950 ------------- 0	8,451 ------------- 0	213,596 ------------- 0	67,538 ------------- 0
8CATHY STEWART VP PATIENT CARE SVCS AND CNO - OHTLMC	(i) (ii)	142,164 ------------- 0	21,821 ------------- 0	713 ------------- 0	15,136 ------------- 0	18,481 ------------- 0	198,315 ------------- 0	0 ------------- 0
9ANGELA M GIBSON DIRECTOR OF PHARMACY	(i) (ii)	148,306 ------------- 0	8,313 ------------- 0	329 ------------- 0	5,961 ------------- 0	26,216 ------------- 0	189,125 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	THE ORGANIZATION PROVIDES A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVE EMPLOYEES. BECAUSE BENEFITS UNDER THE SUPPLEMENTAL PLAN MUST BE INCLUDED IN TAXABLE INCOME WHEN THEY BECOME VESTED, AND AS REQUIRED BY THE SUPPLEMENTAL PLAN'S TERMS, THE ORGANIZATION PROVIDES AN ADDITIONAL BENEFIT THAT COVERS THE TAX LIABILITY WHEN IT IS INCURRED. THE TAX LIABILITY PAYMENTS ARE THEMSELVES INCLUDED IN W-2 INCOME IN THE YEAR MADE TO THE EXECUTIVES, AND ARE INCLUDED IN THE FIGURES DISCLOSED ON SCHEDULE J, PART II.
Schedule J, Part I, Line 1a Housing allowance or residence for personal use	THE ORGANIZATION PROVIDED HOUSING ALLOWANCE TO THE SYSTEM CEO. THIS BENEFIT WAS INCLUDED AS A TAXABLE INCOME IN THE YEAR RECEIVED AND FULLY INCLUDED ON THE RECIPIENT'S FORM W-2.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	DURING THE REPORTING PERIOD, THE ORGANIZATION PAID THE SYSTEM CEO MEMBERSHIP DUES IN A SOCIAL CLUB. THE CLUB MEMBERSHIP WAS USED FOR BUSINESS PURPOSES. ANY PERSONAL RELATED EXPENSES ARE TREATED AS TAXABLE WAGE INCOME AND FULLY INCLUDED ON THE RECIPIENT'S FORM W-2.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	OWENSBORO HEALTH TWIN LAKE MEDICAL CENTER, INC. RELIES ON THE COMPENSATION PRACTICES OF A RELATED ORGANIZATION OWENSBORO HEALTH, INC. TO DETERMINE THE COMPENSATION OF TOP MANAGEMENT OFFICIALS.
Schedule J, Part I, Line 4a Severance or change-of-control payment	TRINA DAVES, OHTLMC PT CARE SVCS AND CNO, HAD $67,538 OF SEVERANCE PAYMENT IN FY 2022.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	THE ORGANIZATION PROVIDES A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVE EMPLOYEES. THE TAX LIABILITY PAYMENTS WILL BE INCLUDED IN W-2 INCOME IN THE YEAR MADE TO THE EXECUTIVES, AND WILL BE INCLUDED IN THE FIGURES DISCLOSED ON SCHEDULE J, PART II. 457F PLAN TO EXECUTIVES JOHN HACKBARTH $60,851; GREG STRAHAN $102,719
Schedule J, Part I, Line 7 Non-fixed payments	SUCCESS SHARING PLAN THE SUCCESS SHARING PLAN IS A PROGRAM DESIGNED TO FOCUS ON THE ACCOUNTABILITY OF ALL EMPLOYEES TO INFLUENCE THE FINANCIAL, QUALITY, PATIENT SATISFACTION AND EMPLOYEE DEVELOPMENT GOALS, AND TO REINFORCE THE OH CORE COMMITMENTS (RESPECT, INTEGRITY, INNOVATION, SERVICE, EXCELLENCE AND TEAMWORK) WHILE WORKING TO ACHIEVE THESE GOALS. THE PLAN ACHIEVES THIS BY PROVIDING A DIRECT LINK BETWEEN ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES AND THE TOTAL COMPENSATION OF THOSE WHO'S DECISIONS AND ACTIONS ARE ACCOUNTABLE FOR THE OUTCOMES WHICH DRIVE THE ORGANIZATION'S SUCCESS. ELIGIBILITY IS BASED ON HOURS WORKED IN THE YEAR; STAFF EMPLOYEES ARE PAID A PRO-RATED AMOUNT OF A DOLLAR MAXIMUM AND MANAGEMENT IS PAID A FIXED PERCENTAGE OF ANNUAL SALARY BASED ON LEVEL OF MANAGEMENT. PAYMENT IS PREDICATED ON BOARD APPROVAL.

Schedule J (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

Return Reference	Explanation
Form 990, Part I, Line 6 Volunteers	VOLUNTEERS SUPPORT THE MISSION AND GOALS OF OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER ("OHTLMC"). VOLUNTEERS STAFF THE VISITOR INFORMATION DESK, PROVIDE DIRECTION TO VISITORS, AND OPERATE THE HOSPITAL GIFT SHOP. VOLUNTEERS ARE AN ESSENTIAL PART OF THE CARE AND COMFORT OHTLMC PROVIDES. OHTLMC HAD 28 VOLUNTEERS.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SOLE MEMBER IS OWENSBORO HEALTH, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE SOLE MEMBER OWENSBORO HEALTH, INC. APPOINTS THE MEMBERS OF THE BOARD. THE BOARD IS COMPOSED OF 9 MEMBERS DIVIDED INTO THREE CLASSES SERVING THREE YEAR TERMS (OTHER THAN THE INITIAL BOARD MEMBERS WHO HAVE TERMS EXPIRING IN OCTOBER 2021, 2022 AND 2023 RESPECTIVELY FOR EACH CLASS OF THREE DIRECTORS SO THAT THE TERMS ARE STAGGERED). TERM LIMIT OF THREE FULL THREE YEAR CONSECUTIVE TERMS WITH AT LEAST ONE YEAR OFF BEFORE ELIGIBLE TO SERVE AGAIN. AT LEAST FOUR OF THE BOARD MEMBERS MUST BE RESIDENTS OF GRAYSON COUNTY, KENTUCKY.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE FOLLOWING MATTERS SHALL REQUIRE THE APPROVAL OF THE SOLE MEMBER OF THE CORPORATION, OWENSBORO HEALTH, INC.: (A) ANY CHANGE IN THE MISSION OR PURPOSE OF THE CORPORATION; (B) ANY AMENDMENT TO THE ARTICLES OR BYLAWS OF THE CORPORATION; (C) ANY ADDITION OF NEW MEMBERS; (D) APPOINTMENT OR REMOVAL OF DIRECTORS OF THE CORPORATION IN ACCORDANCE WITH THE BOARD OF DIRECTORS; (E) ANY PURCHASE OR ACQUISITION, SALE, GIFT, LEASE, DISPOSITION OF, MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED BY THE CORPORATION, EXCLUDING ROUTINE OR BUDGETED EXPENDITURES, THE VALUE OF WHICH IN THE AGGREGATE EXCEEDS $200,000; (F) SELLING, EXCHANGING, OR OTHERWISE DISPOSING OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (G) ANY UNBUDGETED INCURRENCE OR GUARANTEE OF INDEBTEDNESS BY THE CORPORATION THAT IN THE AGGREGATE EXCEEDS $200,000; (H) ANY MERGER, ACQUISITION, OR CONSOLIDATION OF THE CORPORATION OR ENTERING INTO ANY JOINT BUSINESS VENTURE WITH ANY OTHER PERSON, CORPORATION OR OTHER LEGAL ENTITY; (I) ANY DISSOLUTION OF THE CORPORATION; (J) CREATION, ACQUISITION, OR DISPOSITION OF ANY SUBSIDIARY OR AFFILIATED ENTITY OF THE CORPORATION; AND (K) APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS FOR THE CORPORATION.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 IS REVIEWED BY THE INTERNAL FINANCE TEAM AND FORWARDED TO THE CFO FOR FINAL REVIEW AND APPROVAL BEFORE FILING.
Form 990, Part VI, Line 12c Conflict of interest policy	MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY UNDER OUR CONFLICT OF INTEREST POLICY (#100-214), EACH BOARD DIRECTOR, OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWER, AND KEY EMPLOYEE IS REQUIRED ANNUALLY TO COMPLETE THE FOLLOWING: (1) CONFIDENTIALITY STATEMENT, (2) DISCLOSURE CERTIFICATE, AND (3) INDEPENDENCE AND RELATED PARTY QUESTIONNAIRE. THESE DISCLOSURES ARE REVIEWED AND RETAINED BY THE CHIEF LEGAL OFFICER, WHO IS ALSO IN THE APPROVAL CHAIN FOR ALL OH CONTRACTS. ALL COMPLETED CONTRACTS ARE MAINTAINED BY THE LEGAL OFFICE IN A SEARCHABLE DATABASE (THROUGH ICONTRACT). THESE WILL BE REVIEWED AND MAINTAINED BY THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER ALSO HAS ACCESS TO THE CONTRACT'S DATABASE AND COMPLETES AN OIG SANCTION CHECK FOR NEW CONTRACTS. ONCE THE CONFLICT OF INTEREST DATA HAS BEEN COLLECTED, NEW CONTRACTS WILL BE SCREENED FOR POTENTIAL CONFLICTS OF INTEREST. IN ADDITION, OH MAINTAINS A COMPLIANCE HOTLINE THROUGH WHICH ANYONE WITH KNOWLEDGE OF A CONFLICT OF INTEREST OR IMPROPER VENDOR RELATIONSHIP CAN ANONYMOUSLY REPORT SUSPECTED VIOLATIONS OF THE OH POLICY. OF THOSE INDIVIDUALS FOUND TO HAVE A CONFLICT OF INTEREST, EMPHASIS IS MADE THAT THEY MAINTAIN IN CONFIDENCE ANY INFORMATION, KNOWLEDGE, OR DOCUMENTS ACQUIRED AS THE RESULT OF THEIR POSITION OR ATTENDANCE.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	OHTLMC FOLLOWS OH'S COMPENSATION PROCESS THAT COMPLIES WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS. OH'S COMPENSATION PROCESS IS AS FOLLOWS: - TOTAL COMPENSATION IS THE SUM OF EACH EXECUTIVE'S BASE SALARY, INCENTIVE OPPORTUNITY, BENEFITS, AND PERQUISITES. - OUR TOTAL COMPENSATION PHILOSOPHY WILL APPLY TO ALL EXECUTIVES OF THE ORGANIZATION. - CASH COMPENSATION AND BENEFITS PLANS PROVISIONS WILL BE, ON AVERAGE, COMPETITIVE WITH THOSE HEALTHCARE ORGANIZATIONS WITHIN WHICH WE COMPETE FOR EXECUTIVE TALENT. OUR LABOR MARKET IS DEFINED AS SUCCESSFUL AND COMPARABLY SIZED HEALTHCARE ORGANIZATIONS ON A NATIONAL LEVEL. SUCCESS IS MEASURED IN TERMS OF FINANCIAL AND OPERATIONAL PERFORMANCE AND MARKET LEADERSHIP. - COMPETITIVE POSITIONING OF BASE SALARIES, AS REFLECTED BY THE SALARY RANGE MIDPOINTS, WILL BE AT THE 50TH PERCENTILE. EXECUTIVES MAY BE PLACED ABOVE OR BELOW THE SALARY RANGE BASED ON THE: EXECUTIVE'S KNOWLEDGE, COMPETENCIES, AND EXPERIENCE; PERFORMANCE OF THE EXECUTIVE'S AREA OF RESPONSIBILITY; THE EXECUTIVE'S CONTRIBUTION TO THE ORGANIZATION'S OVERALL PERFORMANCE; INTERNAL EQUITY CONSIDERATIONS; THE FINANCIAL RESOURCES AVAILABLE; AND, EXECUTIVE BASE SALARY INCREASES PROVIDED IN THE COMPETITIVE MARKET. - ANNUAL INCENTIVE OPPORTUNITIES WILL BE POSITIONED BETWEEN THE 50TH AND 75TH PERCENTILE DEPENDING ON THE DEGREE TO WHICH PERFORMANCE GOALS ARE MET OR EXCEEDED. TOTAL CASH COMPENSATION, AS REFLECTED BY BASE SALARIES AND ANNUAL INCENTIVES, WILL ALSO BE POSITIONED BETWEEN THE 50TH AND 75TH PERCENTILES AND WILL BE INFLUENCED BY PERFORMANCE RESULTS AS MEASURED AGAINST ESTABLISHED GOALS. - THE ORGANIZATION WILL PROVIDE APPROPRIATE AND COMPETITIVE SUPPLEMENTAL BENEFITS AND PERQUISITES DELIVERED IN A FLEXIBLE STRUCTURE TO ALLOW FOR INDIVIDUAL CHOICE AND BASED ON THE ORGANIZATION'S MISSION AND BUSINESS NEEDS. - OUR EXECUTIVE COMPENSATION PLAN WILL BE DESIGNED, MANAGED AND MAINTAINED IN A MANNER THAT WILL: SUPPORT AND COMPLEMENT OUR MISSION, MANAGEMENT PHILOSOPHY, SHORT- AND LONG-TERM BUSINESS STRATEGIES, AND EMPLOYEE RELATION'S GOALS; ATTRACT AND RETAIN EXECUTIVES WITH THE RIGHT SKILLS, ABILITIES AND MOTIVATION TO ACHIEVE OUR BUSINESS OBJECTIVE; AND ENSURE THE EXECUTIVE TOTAL COMPENSATION IS REASONABLE AND COMPETITIVE. OUR CASH COMPENSATION AND BENEFITS PLANS WILL BE REVIEWED AND ADJUSTED PERIODICALLY TO MEET THE CHANGING BUSINESS AND ORGANIZATIONAL CHARACTERISTICS OF OUR ORGANIZATION AND ITS EXECUTIVE STAFF. THE COMPENSATION OF EACH INDIVIDUAL EXECUTIVE WILL BE REVIEWED AND APPROVED IN A MANNER CONSISTENT WITH THE INTERMEDIATE SANCTION TAX REGULATIONS. THE LAST COMPENSATION REVIEW PROCESS WAS COMPLETED IN 2022 BY SULLIVAN COTTER.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	OHTLMC FOLLOWS OH'S COMPENSATION PROCESS THAT COMPLIES WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS. OH'S COMPENSATION PROCESS IS AS FOLLOWS: - TOTAL COMPENSATION IS THE SUM OF EACH EXECUTIVE'S BASE SALARY, INCENTIVE OPPORTUNITY, BENEFITS, AND PERQUISITES. - OUR TOTAL COMPENSATION PHILOSOPHY WILL APPLY TO ALL EXECUTIVES OF THE ORGANIZATION. - CASH COMPENSATION AND BENEFITS PLANS PROVISIONS WILL BE, ON AVERAGE, COMPETITIVE WITH THOSE HEALTHCARE ORGANIZATIONS WITHIN WHICH WE COMPETE FOR EXECUTIVE TALENT. OUR LABOR MARKET IS DEFINED AS SUCCESSFUL AND COMPARABLY SIZED HEALTHCARE ORGANIZATIONS ON A NATIONAL LEVEL. SUCCESS IS MEASURED IN TERMS OF FINANCIAL AND OPERATIONAL PERFORMANCE AND MARKET LEADERSHIP. - COMPETITIVE POSITIONING OF BASE SALARIES, AS REFLECTED BY THE SALARY RANGE MIDPOINTS, WILL BE AT THE 50TH PERCENTILE. EXECUTIVES MAY BE PLACED ABOVE OR BELOW THE SALARY RANGE BASED ON THE: EXECUTIVE'S KNOWLEDGE, COMPETENCIES, AND EXPERIENCE; PERFORMANCE OF THE EXECUTIVE'S AREA OF RESPONSIBILITY; THE EXECUTIVE'S CONTRIBUTION TO THE ORGANIZATION'S OVERALL PERFORMANCE; INTERNAL EQUITY CONSIDERATIONS; THE FINANCIAL RESOURCES AVAILABLE; AND, EXECUTIVE BASE SALARY INCREASES PROVIDED IN THE COMPETITIVE MARKET. - ANNUAL INCENTIVE OPPORTUNITIES WILL BE POSITIONED BETWEEN THE 50TH AND 75TH PERCENTILE DEPENDING ON THE DEGREE TO WHICH PERFORMANCE GOALS ARE MET OR EXCEEDED. TOTAL CASH COMPENSATION, AS REFLECTED BY BASE SALARIES AND ANNUAL INCENTIVES, WILL ALSO BE POSITIONED BETWEEN THE 50TH AND 75TH PERCENTILES AND WILL BE INFLUENCED BY PERFORMANCE RESULTS AS MEASURED AGAINST ESTABLISHED GOALS. - THE ORGANIZATION WILL PROVIDE APPROPRIATE AND COMPETITIVE SUPPLEMENTAL BENEFITS AND PERQUISITES DELIVERED IN A FLEXIBLE STRUCTURE TO ALLOW FOR INDIVIDUAL CHOICE AND BASED ON THE ORGANIZATION'S MISSION AND BUSINESS NEEDS. - OUR EXECUTIVE COMPENSATION PLAN WILL BE DESIGNED, MANAGED AND MAINTAINED IN A MANNER THAT WILL: SUPPORT AND COMPLEMENT OUR MISSION, MANAGEMENT PHILOSOPHY, SHORT- AND LONG-TERM BUSINESS STRATEGIES, AND EMPLOYEE RELATION'S GOALS; ATTRACT AND RETAIN EXECUTIVES WITH THE RIGHT SKILLS, ABILITIES AND MOTIVATION TO ACHIEVE OUR BUSINESS OBJECTIVE; AND ENSURE THE EXECUTIVE TOTAL COMPENSATION IS REASONABLE AND COMPETITIVE. OUR CASH COMPENSATION AND BENEFITS PLANS WILL BE REVIEWED AND ADJUSTED PERIODICALLY TO MEET THE CHANGING BUSINESS AND ORGANIZATIONAL CHARACTERISTICS OF OUR ORGANIZATION AND ITS EXECUTIVE STAFF. THE COMPENSATION OF EACH INDIVIDUAL EXECUTIVE WILL BE REVIEWED AND APPROVED IN A MANNER CONSISTENT WITH THE INTERMEDIATE SANCTION TAX REGULATIONS. THE LAST COMPENSATION REVIEW PROCESS WAS COMPLETED IN 2022 BY SULLIVAN COTTER.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE ON GUIDESTAR'S DATABASE AVAILABLE AT WWW.GUIDESTAR.ORG. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE KENTUCKY SECRETARY OF STATE'S WEBSITE AT HTTPS://APP.SOS.KY.GOV/FTSEARCH/. OTHERWISE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. A COPY OF THE ORGANIZATION'S FINANCIAL STATEMENTS IS ATTACHED TO ITS 990 IN COMPLIANCE WITH THE REQUIREMENTS OF THE AFFORDABLE CARE ACT.
Form 990, Part IX, Line 11g Other Fees	COLLECTION SERVICES - Total Expense: 160044, Program Service Expense: , Management and General Expenses: 160044, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 2445520, Program Service Expense: 2395666, Management and General Expenses: 49854, Fundraising Expenses: ; MISC PROFESSIONAL FEES - Total Expense: 8908, Program Service Expense: 4523, Management and General Expenses: 4385, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 3668641, Program Service Expense: 3668641, Management and General Expenses: , Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 843058, Program Service Expense: 744243, Management and General Expenses: 98815, Fundraising Expenses: ; RM SERVICE CONTRACTS - Total Expense: 1115762, Program Service Expense: 1007473, Management and General Expenses: 108289, Fundraising Expenses: ;

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- 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

2021

Open to Public Inspection

Name of the organization

Owensboro Health Twin Lakes Regional Medical Center Inc

Employer identification number

85-3033915

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)OWENSBORO HEALTH INC 1201 PLEASANT VALLEY ROAD OWENSBORO,KY42303 61-1286361	HEALTHCARE	KY	501(c)(3)	3	NA		No
(2)OWENSBORO HEALTH FOUNDATION INC 1201 PLEASANT VALLEY ROAD OWENSBORO,KY42303 61-1251763	HEALTHCARE	KY	501(c)(3)	7	OH	Yes
(3)OWENSBORO HEALTH MEDICAL GROUP 1201 PLEASANT VALLEY ROAD OWENSBORO,KY42303 61-1197638	HEALTHCARE	KY	501(c)(3)	10	OH	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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	(k) Percentage ownership
(1) OWENSBORO AM SR FAC 1000 BRKRG OWENSBORO,KY42303 75-2184992	SURGERY CENTER	KY	NA	Unrelated	1,813,192	5,840,070		No			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	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

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) ............................

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) .......................

Yes

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) .....................

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) ...................

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

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) ............................

Yes

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

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

1	Briefly describe the organization’s mission or most significant activities: OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER EXISTS TO HEAL THE SICK AND TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	484
6	Total number of volunteers (estimate if necessary) .............	6	34
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	115,000
9	Program service revenue (Part VIII, line 2g) .........	21,127,728	54,769,840
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	0	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	241,838	1,394,092
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	21,369,566	56,278,932
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	9,190,838	23,100,962
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	11,813,643	25,329,388
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	21,004,481	48,430,350
19	Revenue less expenses. Subtract line 18 from line 12.......	365,085	7,848,582
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	49,384,321	55,501,629
21	Total liabilities (Part X, line 26).............	49,019,236	47,287,962
22	Net assets or fund balances. Subtract line 21 from line 20.....	365,085	8,213,667

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 42,581,305 including grants of $ 0 ) (Revenue $ 55,987,273 )
	OHTLMC IS A 75 BED HOSPITAL BASED IN LEITCHFIELD, KY, ABOUT 65 MILES SOUTHEAST OF OWENSBORO. THE SERVICE AREA COMPRISES 115,000 PEOPLE FROM SIX COUNTIES: GRAYSON (PRIMARY), BRECKINRIDGE, OHIO, BUTLER, EDMONSON, HART, AND HARDIN. OH WHOLLY OWNS AND CONTROLS OHTLMC AND IS NOT A MEMBER OF THE OBLIGATED GROUP. OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER ("OHTLMC") PRIMARY ACTIVITY CONSISTS OF PROVIDING MEDICAL AND PATIENT CARE SERVICES IN ITS MAIN HOSPITAL, SERVING SIX COUNTIES, IN SUPPORT OF OWENSBORO HEALTH, INC. ("OH"). THE SOLE MEMBER OF OWENSBORO HEALTH TWIN LAKES MEDICAL CENTER (OHTLMC) IS OWENSBORO HEALTH, INC. (OH). OUR MEDICAL SERVICES ARE DELIVERED BY HIGHLY SKILLED PHYSICIANS ALONG WITH A CARING AND COMPASSIONATE NURSING STAFF. FOR THE FISCAL YEAR 2022, OHTLMC HAD TOTAL ADMISSIONS OF 1,897, PATIENT DAYS OF 7,470 AND TOTAL ER VISITS OF 17,868. COST OF PARTICIPATING IN GOVERNMENT PROGRAMS: OHTLMC IS COMMITTED TO SERVING ALL PERSONS IN NEED, REGARDLESS OF RACE, CREED, SEX, NATIONALITY, RELIGION, DISABILITY, AGE OR ABILITY TO PAY. TO PROMOTE ACCESS TO CARE, OHTLMC PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH PROGRAMS: MEDICAID, MEDICARE, TRICARE AND LOCAL HEALTH DEPARTMENTS. IN GENERAL, PAYMENTS FROM THESE PROGRAMS FREQUENTLY DO NOT COVER THE COSTS OHTLMC INCURS TO SERVE PROGRAM BENEFICIARIES. UNCOMPENSATED CARE AND FINANCIAL ASSISTANCE: OHTLMC PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COST TO RESIDENTS OF THE COMMUNITIES THAT IT SERVES. OHTLMC'S FINANCIAL ASSISTANCE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE PROGRAMS, LIKE MEDICAID, AND WHOSE ANNUAL INCOMES ARE AT OR BELOW CERTAIN PERCENTAGES OF THE FEDERAL POVERTY GUIDELINES. OHTLMC IS COMMITTED TO EXPANDING ITS PROGRAMS TO IMPROVE ACCESS TO HEALTH CARE IN THE AREAS IT SERVES, WHICH INCLUDE RURAL AND ECONOMICALLY DEPRESSED AREAS AND AREAS THAT LACK ADEQUATE NUMBERS OF PRIMARY CARE AND SPECIALTY PROVIDERS.

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 expenses42,581,305

(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/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) ANGELA M GIBSON DIRECTOR OF PHARMACY	50.0 .......................0	X	156,948	0	32,177
(19) BRITTANY N CLEMONS DIR OF NURSG AND QLTY-PT SFTY	50.0 .......................0	X	106,913	0	14,739
(20) CHLOE ADAMS CLINICAL PHARMACIST	50.0 .......................0	X	118,684	0	14,185
(21) TODD E BULLOCK NURSE PRACTITIONER	50.0 .......................0	X	117,056	0	13,674

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,456,031	2,403,950	335,548

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	100,000

f	All other contributions, gifts, grants, and similar amounts not included above		1f	15,000

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

h Total. Add lines 1a-1f.......		115,000

		Business Code
2a	MEDICARE/MEDICAID PAYMENT	622110	36,830,135	36,830,135
b	PATIENT REVENUE - OTHER INCOME	622110	9,557,195	9,557,195
c	UPPER PAYMENT LIMIT	622110	8,357,236	8,357,236
d	REVENUE - HOME HEALTH LHC	621493	25,274	25,274
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		54,769,840

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		183,699	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	183,699	6c
d	Net rental income or (loss).......			183,699	183,699
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	0	0	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA AND VENDING		722514	176,659			176,659
b	ALL OTHER REVENUE		900099	1,033,734	1,033,734
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			1,210,393
12	Total revenue. See instructions.....			56,278,932	55,987,273	0	176,659

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	777,196		777,196
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	17,126,221	16,040,801	1,085,420
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	426,527	298,310	128,217
9	Other employee benefits .......	3,501,135	2,447,745	1,053,390
10	Payroll taxes ...........	1,269,883	1,150,982	118,901
11	Fees for services (non-employees):
a	Management ......	45,722	41,597	4,125
b	Legal .........
c	Accounting ...........	30,000		30,000
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	8,241,933	7,820,546	421,387	0
12	Advertising and promotion ....	88,579	1,549	87,030
13	Office expenses .......	3,050,221	2,695,738	354,483
14	Information technology ......	349,624	240,803	108,821
15	Royalties ..	35,358	20,570	14,788
16	Occupancy ...........	1,128,605	743,127	385,478
17	Travel ............	24,593	20,728	3,865
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,362	1,997	365
20	Interest ...........	917	917
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,121,073		1,121,073
23	Insurance ...	3,798	3,798
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	6,358,403	6,358,403
b	BAD DEBT	2,710,309	2,710,309
c	PROVIDER TAX	1,748,978	1,748,978
d	DIETARY PATIENT SUPPLIES	218,312	216,004	2,308
e	All other expenses	170,601	18,403	152,198	0
25	Total functional expenses. Add lines 1 through 24e	48,430,350	42,581,305	5,849,045	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 ........			6,658,943	1	14,697,316
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,406,057	4	6,573,204
5	Loans and other receivables from 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 ...........				7
8	Inventories for sale or use ............			1,816,686	8	2,258,816
9	Prepaid expenses and deferred charges ......			1,803,541	9	2,414,450
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	32,050,471
b	Less: accumulated depreciation	10b	2,841,591	28,351,117	10c	29,208,880
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			347,977	13	348,963
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...			49,384,321	16	55,501,629

17	Accounts payable and accrued expenses .....	5,604,470	17	2,893,523
18	Grants payable ...		18
19	Deferred revenue .........	230,604	19	81,646
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	43,184,162	25	44,312,793
26	Total liabilities. Add lines 17 through 25..	49,019,236	26	47,287,962

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	365,085	27	8,213,667
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 ...........	365,085	32	8,213,667
33	Total liabilities and net assets/fund balances ........	49,384,321	33	55,501,629