Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER |
610492356 | 3 | Yes | 0 | 0 | |
| (B)
EMHFL |
611388556 | 3 | Yes | 0 | 0 | |
| (C)
EPHRAIM MCDOWELL HEALTH RESOURCE |
311545520 | 3 | Yes | 0 | 0 | |
| (D)
MCDOWELL HOME HEALTH AGENCY INC |
610715227 | 3 | Yes | 0 | 0 | |
| (E)
JAMES B HAGGIN MEMORIAL HOSPITAL |
610510934 | 3 | Yes | 0 | 0 | |
|
Total 5
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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.).. | ||||||
| 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 | ||||
| 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 2022 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-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section C, Line 1 BOARD MEMBERS | EPHRAIM MCDOWELL HEALTH'S DIRECTORS AND TRUSTEES ARE THE SAME DIRECTORS AND TRUSTEES THAT SIT ON THE BOARD OF ITS SUPPORTED ORGANIZATIONS, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, EMHR, AND MCDOWELL HOME HEALTH. EPHRAIM MCDOWELL HEALTH ALSO SUPPORTS EMHFL AND JAMES B. HAGGIN MEMORIAL HOSPITAL. THESE ENTITIES HAVE SEPARATE BOARDS OF DIRECTORS, BUT EACH OF THOSE INCLUDES REPRESENTATION FROM EPHRAIM MCDOWELL HEALTH'S BOARD OF DIRECTORS. |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS | WE PROVIDE A NUMBER OF SPECIALTY SERVICES FOR PATIENTS WHO SEEK THEIR CARE FROM OUR HEALTH CARE SYSTEM. OUR SYSTEM ALSO INCLUDES AN ASSISTED LIVING COMMUNITY FOR OUR SENIOR POPULATION AND A WELLNESS FACILITY. AT THE CORE OF THE SYSTEM IS EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, A NON-PROFIT, 222-BED LICENSED HOSPITAL. OUR OTHER HOSPITALS ARE EPHRAIM MCDOWELL FORT LOGAN HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN NEIGHBORING LINCOLN COUNTY (STANFORD) AND EPHRAIM MCDOWELL JAMES B. HAGGIN HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN NEIGHBORING MERCER COUNTY (HARRODSBURG). THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION PROVIDES PHILANTHROPIC SUPPORT TO OUR SYSTEM, ALLOWING EPHRAIM MCDOWELL HEALTH TO PROVIDE THE MOST ADVANCED COMPREHENSIVE AND COMPASSIONATE CARE TO OUR PATIENTS. THE FOUNDATION HAS BEEN INSTRUMENTAL IN PROVIDING RESOURCES FOR CARDIOLOGY, CANCER, NEWBORN CARE AND INFECTION REDUCTION, AMONG OTHERS. ALL MONIES RAISED THROUGH THE FOUNDATION'S FUNDRAISING EFFORTS ARE RETURNED TO THE COMMUNITIES WE SERVE. OUR COMMUNITY SERVICE DEPARTMENT HAS A MISSION TO MAKE A MEASURABLE DIFFERENCE IN THE HEALTH AND WELLNESS OF THE INDIVIDUALS WHO LIVE IN OUR SIX-COUNTY SERVICE AREA. TO ACCOMPLISH THAT MISSION, REGULAR HEALTH SCREENINGS ARE OFFERED IN THE COMMUNITIES WE SERVE TO DETECT FOR THE RISKS OF HEART DISEASE AND STROKE AS WELL AS DIABETES, CANCER AND OBESITY. MANY TIMES, THESE SCREENINGS SAVE LIVES. WE ALSO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS TO IDENTIFY THE PRIMARY HEALTH RISK FACTORS IN THE COMMUNITIES WE SERVE. YOU CAN VIEW THE RESULTS OF THOSE ASSESSMENTS ON OUR WEBSITE AT HTTPS://WWW.EMHEALTH.ORG/SERVICES/COMMUNITY-HEALTH/. SENIOR LEADERSHIP SERVES IN MANY CAPACITIES WITHIN THE LARGER COMMUNITY TO IMPROVE THE LIVES OF THOSE WE SERVE. NOT REPORTED ARE THE MANY HOURS SPENT AS A VOLUNTEER AT LOCAL EVENTS AND THE EFFORTS IN ADVOCACY AND GIVING TESTIMONY AT THE LOCAL, STATE AND NATIONAL LEVEL TO IMPROVE ACCESS TO CARE OR ENVIRONMENTAL IMPACT AND/OR ECONOMIC IMPROVEMENT. DURING FY2023, THE EPHRAIM MCDOWELL HEALTH SYSTEM PROVIDED $6,753,292 IN FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS WITHIN THE THREE HOSPITALS TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. |
| Form 990, Part V, Line 2a COMMON PAYMASTER | EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR EPHRAIM MCDOWELL HEALTH, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356. |
| Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION | EPHRIAM MCDOWELL HEALTH, INC. IS THE PARENT COMPANY OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW AND PROVIDED MARKET DATA IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF THE CEO. FOR OTHER OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM, THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE ORGANIZATION ALSO PARTICIPATES IN AND RECEIVES ANNUAL KHA SALARY SURVEY DATA WHICH IS REVIEWED TO DETERMINE REASONABLE COMPENSATION LEVELS. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE. |
| Form 990, Part VI, Line 19 MAKING FORMS AVAILABLE TO THE PUBLIC | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXIST, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT. |
| Form 990, Part VI, Line 19 Required documents available to the public | MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |