2025-08-15T13:03:01-05:00 2024-09-30 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2023-10-01 610420440 HARRISON MEMORIAL HOSPITAL INC HARR 8592353502 1210 KY HWY 36 EAST CYNTHIANA KY 41031 HEATHER HUTCHISON CFO 8592353502 2025-08-15 1 1 EMILIE M KNIERIEM CPA P01330194 5029923500 2025-08-15 2023 2025-03-06 01:10:19Z KATHY TUSSEY 1210 KY HWY 36 EAST CYNTHIANA KY 41031 104410767 0 X HARRISONMEMHOSP.COM X 1906 KY HARRISON MEMORIAL HOSPITAL EXISTS FOR THE PURPOSE OF PROVIDING HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES OF OUT REGION WITHIN THE CAPABILITIES OF OUR RESOURCES. IN FULFILLING THIS MISSION, WE STRIVE FOR EXCELLENCE IN: THE CARE WE DELIVER; IN PATIENT SAFETY; IN THE FACILITIES WE PROVIDE; IN THE RECRUITMENT, RETENTION, AND DEVELOPMENT OF DEDICATED PHYSICIANS AND PERSONNEL; IN FACILITATING, COORDINATING AND PROVIDING ACCESS TO GENERAL AND SPECIALIZED HEALTH SERVICES THROUGH OUR OWN RESOURCES AND IN COLLABORATION WITH THE RESOURCES OF OTHERS. 11 11 762 10 0 70896 574837 952862 84028168 90639607 81810 54239 2863316 10781893 87548131 102428601 87040 111310 0 0 41623755 50114581 0 0 0 41577707 51656864 83288502 101882755 4259629 545846 81037572 82712482 47437387 47644697 33600185 35067785 X HARRISON MEMORIAL HOSPITAL EXISTS FOR THE PURPOSE OF PROVIDING HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE PEOPLE OF HARRISON AND SURROUNDING COUNTIES OF OUT REGION WITHIN THE CAPABILITIES OF OUR RESOURCES. IN FULFILLING THIS MISSION, WE STRIVE FOR EXCELLENCE IN: THE CARE WE DELIVER; IN PATIENT SAFETY; IN THE FACILITIES WE PROVIDE; IN THE RECRUITMENT, RETENTION, AND DEVELOPMENT OF DEDICATED PHYSICIANS AND PERSONNEL; IN FACILITATING, COORDINATING AND PROVIDING ACCESS TO GENERAL AND SPECIALIZED HEALTH SERVICES THROUGH OUR OWN RESOURCES AND IN COLLABORATION WITH THE RESOURCES OF OTHERS. 0 0 91260036 111310 101878969 THE HOSPITAL PROVIDED HEALTHCARE TO 1,230 IN-PATIENTS, 226 NURSERY PATIENTS, AND 177,643 OUT-PATIENTS. THE HOSPITAL HAS A HIGH VOLUME OF MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL TREATS ALL PATIENTS REGARDLESS OF ABILITY TO PAY. HARRISON MEMORIAL HOSPITAL PROVIDED APPROXIMATELY $616,741 OF CHARITY CARE AT COST. 91260036 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 142 0 1 762 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X THE ORGANIZATION 8592353502 1210 KY HWY 36 EAST CYNTHIANA KY 41031 TODD BRADEN REID MD CHIEF OF STAFF (END 12/2023) 40.00 X 305011 0 26555 HARLAND HATTER CHAIRMAN 1.00 X 0 0 0 WAYNE CONNOR CHAIRMAN-ELECT 1.00 X 0 0 0 JACQUELINE BURRELL DIRECTOR 1.00 X 0 0 0 JAMES CALDER MD DIRECTOR/CHIEF OF STAFF (BEG 01/2024) 40.00 X 0 0 0 GREGORY WILLS DIRECTOR (END 12/2023) 1.00 X 0 0 0 PATRICK DARNELL DIRECTOR 1.00 0.50 X 0 0 0 MARIBETH MIDDEN DIRECTOR 1.00 X 0 0 0 JANELLE GARDENER-COX DIRECTOR 1.00 X 0 0 0 ANGELA GRAY DIRECTOR 1.00 X 0 0 0 DAVID CASE DIRECTOR (BEG 01/2024) 1.00 X 0 0 0 DOUGLAS DARBO DIRECTOR (BEG 01/2024) 1.00 X 0 0 0 BRETT HINES OD DIRECTOR (BEG 01/2024) 1.00 X 0 0 0 DR STEPHEN TOADVINE CEO/SECRETARY (END 06/2024) 40.00 0.50 X 358758 0 50195 PEGGY LAIR CFO/TREASURER 40.00 0.50 X 179205 0 23118 NICK WILEY COO (BEG 09/2024) 40.00 X 0 0 0 KATHY TUSSEY CEO (BEG 06/2024) 40.00 X 182277 0 41174 DR MATTHEW K SHOTWELL CARDIOLOGY PHYSICIAN 40.00 X 2096774 0 31114 DR SRINADH ANNANGI PULMONOLOGY PHYSICIAN 40.00 X 545018 0 29241 DR MARIA ALEJAN PAVEZ NEUROLOGY PHYSICIAN 40.00 X 456230 0 80195 DR JENNIFER CANAN OB/GYN PHYSICIAN 40.00 X 457007 0 47714 DR DEREK CLARKE OB/GYN PHYSICIAN 40.00 X 431495 0 47731 5011775 0 377037 49 0 1 0 MEDYCUS STAFFING PLLC 102 REDDING ROAD GEORGETOWN KY 40324 ER PHYSICIAN STAFFING 1724525 COMMUNITY ANESTHESIA OF THE BLUEGRASS 1210 KY HIGHWAY 36 EAST CYNTHIANA KY 41031 NURSE ANESTHESIA SERVICES 1505250 BLUE & CO LLC 12800 N MERIDIAN ST STE 400 CARMEL IN 46032 CONSULTING SERVICES 1330336 QUALIVIS 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 NURSE STAFFING SERVICES 1199189 COGENT HEALTHCARE PO BOX 742936 LOS ANGELES CA 90074 HOSPITALISTS 981981 18 170495 200095 582272 952862 NET PATIENT REVENUE 621999 90099655 90099655 340B PHARMACY REVENUE 621399 539952 539952 90639607 61739 61739 440600 876987 -436387 -436387 -436387 2000 9500 -7500 -7500 -7500 29600 170495 50682 -21082 -21082 10035217 1044997 8990220 8990220 KIDTOWN CHILD CARE FEES 624410 908400 908400 CAFETERIA REVENUE 722310 492772 492772 PURCHASE DISCOUNTS/SUBSIDY 900099 397046 397046 450924 450924 2249142 102428601 101878969 0 -403230 X 100000 100000 11310 11310 1154839 1044359 110480 40269840 36417345 3852495 1037528 938271 99257 4868279 4402545 465734 2784095 2517749 266346 27360 27360 1457379 1457379 14793027 13377822 1415205 227982 206172 21810 998583 903052 95531 125804 113769 12035 1104873 999173 105700 70255 63534 6721 88258 79815 8443 857175 857175 3855401 3486566 368835 1271691 1150032 121659 MEDICAL SUPPLIES AND DR 20652515 18676751 1975764 PROVIDER TAXES 3907338 3907338 FOOD EXPENSE 755472 683198 72274 REPAIRS AND MAINTENANCE 558479 505051 53428 905272 819009 86263 101882755 91260036 10622719 0 219008 1312543 11973684 13927887 7625251 12322131 342649 427755 2066457 2181797 1251463 1231507 93257807 53735833 42516467 39521974 5769458 4190766 806170 1100057 1150907 1033810 7316058 5462255 81037572 82712482 7058901 8387395 199837 152693 29130374 29783073 8926758 7045572 2121517 2275964 47437387 47644697 X 33517994 34985594 82191 82191 33600185 35067785 81037572 82712482 X 545846 441679 480075 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4747 4747 0 PART II-B, LINE 1: HMH PAID KHA AND AHA DURING FYE 2024 FOR MEMBERSHIP DUES, OF WHICH A PORTION OF EACH IS ATTRIBUTABLE TOWARDS LOBBYING ACTIVITIES. 2139179 2139179 43229218 19489656 23739562 5316024 2873298 2442726 39443846 28359624 11084222 3129540 3013255 116285 39521974 INTERCOMPANY RECEIVABLES 1252195 PHYSICIAN RECRUITMENT 122571 DEPOSITS 52000 ROU ASSET - FINANCE LEASE 193621 ROU ASSET - OPERATING LEASE 668195 ESTIMATED THIRD PARTY SETTLEMENTS 3173673 5462255 PHYSICIAN COMMITTMENTS 49394 DUE FROM PHARMACY 1237122 ROU LIABILITY - FINANCE LEASE 321253 ROU LIABILITY - OPERATING LEASE 668195 2275964 X PART X, LINE 2: HMH, THE FOUNDATION, EMS, AND THE PHARMACY ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS SUCH, THESE ENTITIES ARE GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THESE ENTITIES ARE REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SPRING GALA 200095 170495 29600 5906 34825 625 9326 200095 170495 29600 5906 34825 625 9326 50682 -21082 1 1 1 X 1 X 150.000000000000 1 1 0 1 1 394319 394319 0.00390 20901107 31346880 0 0.00000 21295426 31346880 394319 0.00390 12190 12190 0.00010 5 4708960 93042 4615918 0.04530 111310 111310 0.00110 5 4832460 93042 4739418 0.04650 5 26127886 31439922 5133737 0.05040 52 7114 42760 42760 0.00040 26 2766 60695 60695 0.00060 2 22 43040 43040 0.00040 80 9902 146495 146495 0.00140 1 7977953 9144257 12584874 -3440617 X 1 1 1 1 HARRISON MEMORIAL HOSPITAL INC 1210 KY HWY 36 EAST CYNTHIANA KY 41031 100167 X X X HARRISON MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X WWW.HARRISONMEMHOSP.COM X 1 24 1 WWW.HARRISONMEMHOSP.COM 0 1 X 150.000000000000 150.000000000000 X X X X 1 1 X X X 1 X WWW.HARRISONMEMHOSP.COM/VISITOR-INFO/BILLING-QUESTIONS X WWW.HARRISONMEMHOSP.COM/VISITOR-INFO/BILLING-QUESTIONS X WWW.HARRISONMEMHOSP.COM/VISITOR-INFO/BILLING-QUESTIONS X 1 0 X X X X 1 0 0 HARRISON MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: HMH ENGAGED BLUE TO ASSIST THE HOSPITAL IN CONDUCTING A CHNA AND ANALYZE THE DATA FOR THE CHNA REQUIREMENTS OUTLINED IN SECTION 9007 OF THE PPACA OF 2010. BLUE IS A CERTIFIED PUBLIC ACCOUNTING FIRM THAT PROVIDES TAX CONSULTING AND COMPLIANCE TO THE HEALTHCARE INDUSTRY, AMONG OTHER SERVICES. HMH PROVIDED ALL THE FINANCIAL SUPPORT FOR THE ASSESSMENT PROCESS.BLUE AND HMH DEVELOPED INTERVIEW QUESTIONS AND A SURVEY THAT WOULD BE THE TOOLS USED TO GATHER INFORMATION FROM KEY STAKEHOLDERS IN THE COMMUNITY. HMH THEN CONDUCTED CONVERSATIONS WITH COMMUNITY LEADERS AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF AND SENT SURVEYS THAT COULD BE COMPLETED ONLINE. THE COMMUNITY OUTREACH DATA COLLECTION STRATEGY WAS TARGETED AT ENGAGING A CROSSSECTION OF RESIDENTS FROM THE COMMUNITY. ONCE DATA HAD BEEN COLLECTED AND ANALYZED, MEETINGS WITH HOSPITAL LEADERSHIP WERE HELD TO DISCUSS KEY FINDINGS AND REFINE THE COMPREHENSIVE LIST OF COMMUNITY NEEDS, SERVICES, AND POTENTIAL GAPS. A SURVEY WAS DEVELOPED BY BLUE AND HMH TO SOLICIT PERCEPTIONS, INSIGHTS, AND GENERAL UNDERSTANDING FROM COMMUNITY MEMBERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THESE INDIVIDUALS ALSO REPRESENTED THE INTERESTS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS OF THE COMMUNITY SERVED. PERSONAL INTERVIEWS WERE CONDUCTED BY HMH WITH A TOTAL OF TWENTY (20) PARTICIPANTS DURING MARCH - APRIL 2024, WITH EACH SESSION LASTING APPROXIMATELY 15 MINUTES. THESE SESSIONS WERE CONDUCTED WITH COMMUNITY MEMBERS SERVED BY HMH, INCLUDING PUBLIC SERVICE LEADERS, HEALTH EXPERTS, PUBLIC OFFICIALS, PHYSICIANS, HOSPITAL EMPLOYEES, AND OTHER HEALTH PROFESSIONALS AND PROVIDERS, INCLUDING THOSE ASSOCIATED WITH HMH. THE PRIMARY OBJECTIVE WAS TO SOLICIT PERCEPTIONS REGARDING HEALTH NEEDS AND SERVICES OFFERED IN THE COMMUNITY AND ANY OPPORTUNITIES OR BARRIERS TO SATISFY THE REQUIREMENTS. HARRISON MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THIS COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED FOUR VITAL AREAS OF FOCUS, WHICH WILL GUIDE HMH'S STRATEGIC PLANNING AND COMMUNITY HEALTH INITIATIVES. THESE ARE OUTLINED BELOW:- OBESITY AND CHRONIC CONDITIONS- DRUG, ALCOHOL, AND TOBACCO USE AND ABUSE- ACCESS TO CARE- HEALTH AND WELL-BEING OF OLDER ADULTSFOCUS AREA 1:OBESITY AND CHRONIC CONDITIONS- GOAL: PROMOTE WELLNESS AND FOOD INSECURITY- STRATEGIES: RECRUIT AN ENDOCRINOLOGIST AND ESTABLISH A CLINIC TO ASSIST WITH DIABETIC AND PRE-DIABETIC PATIENTS, IMPROVE OUTPATIENT DIETICIAN CONSULTS TO HELP WITH HEALTHY EATING HABITS AND TREATMENTS, INCREASE HEART DISEASE AWARENESS, DECREASE HYPERTENSION, HOST HEALTH AND WELLNESS FAIRS, PROVIDE INDUSTRY SCREENINGS, CONTINUE TO SUPPORT LOCAL EVENTS INVOLVING EXERCISE, PROMOTE HMH WELLNESS CENTER AND CLASSES, PROVIDE A FULL-SERVICE DIABETICS CLINIC, CREATE A RESOURCE GUIDE FOR EACH COMMUNITY HMH SERVES, AND PROMOTE FOOD PANTRIES, FOOD DROP-OFFS AND COMMUNITY GARDENS IN EACH AREA.FOCUS AREA 2: ALCOHOL, SUBSTANCE AND TOBACCO USE- GOAL: INCREASE COMMUNITY CAPACITY TO RESPOND TO INCREASED SUBSTANCE USE NEEDS, INCLUDING PREVENTION, TREATMENT AND RECOVER. - STRATEGIES: PARTERNSHIPS WITH LOCAL MENTAL HEALTH PROGRAMS, PROMOTION OF AA AND NA GROUPS IN COMMUNITIES, EDUCATION TO THE COMMUNITY, ADDING A FULL-TIME PEER SUPPORT SPECIALIST TO THE EMERGENCY DEPARTMENT, HAVING MORE MENTAL HEALTH PROVIDERS AT HMH, CREATING AN HMH SMOKING CESSATION PROGRAM, PARTNERING WITH UNIVERSITY OF KENTUCKY #ICANTRENTPROGRAM FOR EDUCATION ON THE RISKS OF VAPING AND E-CIGARETTES, AND PROMOTION OF HMH LUNG CANCER SCREENING PROGRAM. FOCUS AREA 3: ACCESS TO CARE- GOAL: SPECIALTY CARE, PRIMARY CARE, COST OF CARE, AND TRANSPORTATION- STRATEGIES: ADD A FULL-TIME GASTROENTEROLOGY AND ENDOCRINOLOGY SERVICE AT HMH, EVALUATE APPOINTMENT AVAILABILITY, ADD MORE PRIMARY CARE PROVIDERS TO HMH PRIMARY CARE OFFICES, INCREASE UTILIZATION OF PATIENT PORTAL, INCREASE HOURS PRMARY CARE IS AVAILABLE INCLUDING EVENING AND WEEKEND HOURS, PROMOTE ABLEPAY PROGRAM, INCREASE AWARENESS OF COMMUNITY PROGRAMS TO ASSIST WITH COST OF LIVING ISSUES, CREATE TRANSPORTATION SERVICE FOR THE LOCAL COMMUNITY, AND PROMOTE TRANSPORTATION ASSISTANCE. FOCUS AREA 4: HEALTH AND WELL-BEING OF OLDER ADULTS- GOAL: PROVIDING ACCES AND EDUCATION - STRATEGIES: ADD ADDITIONAL PRIMARY CARE AND SPECIALISTS TO MEDICAL STAFF, INCREASE ACCESS OF CARE FOR AGING POPULATION, ADD MORE HEALTH-RELATED FOCUSED SEMINARS AND EDUCATION, AND ADD MORE HEALTH-RELATED EDUCATION VIA SOCIAL, RADIO, AND EMAIL BLASTS. OTHER GOALS OF THE ASSESSMENT WERE:- STRENGTHEN RELATIONSHIPS WITH LOCAL COMMUNITY LEADERS, HEALTH CARE LEADERS/PROVIDERS, OTHER HEALTH SERVICE ORGANIZATIONS, AND THE COMMUNITY AT LARGE- PROVIDE QUANTITATIVE AND QUALITATIVE DATA TO HELP GUIDE FUTURE STRATEGIC POLICY, BUSINESS, AND CLINICAL PROGRAMMING DECISIONS 9 1 - PRIMARY CARE PLEASANT 439 EAST PLEASANT STREET CYNTHIANA KY 41031 RURAL HEALTH CLINIC 2 - PRIMARY CARE CARLISLE 254 EAST MAIN STREET CARLISLE KY 40311 RURAL HEALTH CLINIC 3 - PRIMARY CARE FALMOUTH 1120 WEST SHELBY STREET FALMOUTH KY 41040 RURAL HEALTH CLINIC 4 - PRIMARY CARE SOUTH 809 US HWY 27 S CYNTHIANA KY 41031 RURAL HEALTH CLINIC 5 - PRIMARY CARE MAIN 1210 KY HWY 36 EAST CARLISLE KY 41031 RURAL HEALTH CLINIC 6 - PT CLINIC 2300 CONCRETE DRIVE CARLISLE KY 40311 PT SATELLITE OFFICE 7 - HARRISON COUNTY EMS 101 RODGERS PARK CYNTHIANA KY 41031 AMBULANCE SERVICE 8 - CLINIC PHARMACY 1210 KY HWY 36 EAST CYNTHIANA KY 41031 RETAIL PHARMACY 9 - COTTAGES AT FLAT RUN KY HWY 36 EAST CYNTHIANA KY 41031 SENIOR RENTAL COTTAGES PART I, LINE 7: AMOUNTS WERE DETERMINED USING A COST-TO-CHARGE RATIO DERIVED FROM THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H. PART II, COMMUNITY BUILDING ACTIVITIES: HARRISON MEMORIAL HOSPITAL IS VERY ACTIVE IN THE COMMUNITY WITH PROMOTING HEALTH EDUCATION. HMH PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS TO REACH THE LARGEST AUDIENCE. IN MOST RECENT YEARS, HMH HAS PROVIDED HEALTH FAIRS AND SEMINARS IN SEVERAL COUNTIES LIKE PENDLETON, BRACKEN AND ROBERTSON. BY PROVIDING THESE EVENTS, HMH IS ABLE TO PROVIDE EDUCATION AND SCREENINGS MORE LOCALLY FOR THE RESIDENTS. IN ADDITION, THE EVENTS AID IN BUILDING RELATIONSHIPS WITH COMMUNITY LEADERS AND RESIDENTS. THE EVENTS LIKE HEALTH FAIRS PROVIDE FREE TESTS AND SCREENINGS, WHICH WOULD NORMALLY COST $1,200 PER PERSON. THE HEALTH FAIRS PROVIDE AN OPPORTUNITY FOR THE UNDERINSURED AND UNINSURED TO RECEIVE MEDICAL CARE. THE EVENTS ALSO HAVE SEVERAL OPPORTUNITIES TO MEET WITH HEALTH CARE PROFESSIONALS TO DISCUSS HEALTH ISSUES. THE HMH SPONSORED EDUCATIONAL SEMINARS PROVIDE AN OPPORTUNITY FOR INDIVIDUALS TO MEET HEALTH CARE PROFESSIONALS AND DISCUSS MAJOR HEALTH TOPICS. COMMUNITY EVENTS WERE LIMITED DURING THE FISCAL YEAR DUE TO COVID. PART III, LINE 2: BAD DEBT COST REPRESENTS THE EXPENSE THE HOSPITAL INCURRED DUE TO NONPAYMENT OF HOSPITAL CHARGES INCLUDING, BUT NOT LIMITED TO, NONPAYMENT OF MEDICARE COINSURANCE AND DEDUCTIBLE AMOUNTS. THIS EXPENSE IS LISTED AS CONTRA-REVENUE IN THE FINANCIAL STATEMENTS. BAD DEBT COST IS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE LISTED ON THE FINANCIAL STATEMENTS BY THE COST TO CHARGE RATIO COMPUTED ON WORKSHEET 2. PART III, LINE 4: SEE AUDITED FINANCIAL STATEMENTS PAGES 10 AND 11. PART III, LINE 8: THE SHORTFALL REPORTED ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. LINE 6 WAS COMPUTED USING REVENUE AMOUNTS LISTED ON THE SETTLEMENT WORKSHEETS ON THE AS-FILED MEDICARE COST REPORT FOR FYE 2024. PART III, LINE 9B: THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE BASED ON FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AND DISCOUNTED CARE. FOR PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WITH DISCOUNTED CARE, COLLECTION PURSUITS FOR THE DISCOUNTED CHARGES ARE FOLLOWED AS STATED IN OUR PROMPT PAYMENT ON SELF-PAY ACCOUNTS POLICY. PART VI, LINE 2: THE HOSPITAL COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. IN ADDITION, HARRISON MEMORIAL HOSPITAL ASSESSES THE COMMUNITY THROUGH SEVERAL METHODS. THE HMH COMMUNITY CONSISTS OF A SEVEN-COUNTY AREA. HMH HAS TWO BOARD LEVEL COMMITTEES WHO PROVIDE RECOMMENDATIONS TO THE HMH BOARD OF DIRECTORS. PLANNING: MARKET SHARE ENHANCEMENT COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS AND HMH PHYSICIAN STAFF MEMBERS. THE COMMITTEE IS PRESENTED WITH MARKET SHARE DATA OF THE INPATIENT ACTIVITY OF THE HOSPITAL AND OF MAJOR SERVICE LINES LIKE CARDIOLOGY, ORTHOPEDICS. THE DATA INFORMS THE COMMITTEE WHERE PATIENTS IN THE HMH SERVICE AREA CHOOSE TO RECEIVE HEALTHCARE. THE DATA IS EXTRACTED FROM KENTUCKY INFOSUITE EACH QUARTER. THE REPORTS AID THE COMMITTEE IN MAKING DECISIONS IN REGARDS TO THE NEEDS OF THE COMMUNITY. EACH YEAR THE PMSE COMMITTEE HOSTS A STRATEGIC RETREAT INVITING HMH BOARD MEMBERS, PHYSICIAN STAFF MEMBERS AND SENIOR MANAGEMENT TO DISCUSS COMMUNITY NEEDS AND PLANS FOR THE FUTURE. ANOTHER BOARD LEVEL COMMITTEE IS CALLED MEDICAL STAFF DEVELOPMENT. THE COMMITTEE IS COMPRISED OF HMH BOARD MEMBERS, HMH PHYSICIAN STAFF MEMBERS AND COMMUNITY VOLUNTEERS. EACH YEAR THE MEDICAL STAFF DEVELOPMENT COMMITTEE COMPLETES A PHYSICIAN NEEDS ASSESSMENT. THE ASSESSMENT DEMONSTRATES THE PHYSICIAN NEED IN THE AREA BASED ON POPULATION. THE ASSESSMENT IS USED TO FORM A PHYSICIAN RECRUITING PLAN FOR THE FUTURE AND IS RECOMMENDED TO THE BOARD FOR APPROVAL. FINALLY, THE HMH MEDICAL STAFF MEETINGS ARE HELD ONCE A MONTH WHERE MEMBERS OF THE HMH SENIOR MANAGEMENT ALSO ATTEND. WITHIN THESE MEETINGS, THE STAFF MEMBERS DISCUSS PATIENT NEEDS. THE INFORMATION GATHERED AT THESE MEETINGS AID IN THE DECISIONS OF SERVICE LINE ENHANCEMENT. PART VI, LINE 3: NOTIFICATION ABOUT CHARITY AVAILABLE FROM HARRISON MEMORIAL HOSPITAL, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY HARRISON MEMORIAL HOSPITAL BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, SPECIALTY PHYSICIAN CLINICS, ADMITTING AND REGISTRATIONDEPARTMENTS, HOSPITAL BUSINESS OFFICES, AND PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES AS HARRISON MEMORIAL HOSPITAL MAY ELECT. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY HARRISON MEMORIAL HOSPITAL. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE HARRISON MEMORIAL HOSPITAL STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: HARRISON MEMORIAL HOSPITAL SERVES SEVEN COUNTIES IN THE CENTRAL KENTUCKY AREA MAKING IT A REGIONAL FACILITY. THOSE COUNTIES ARE HARRISON, PENDLETON, ROBERTSON, BRACKEN, NICHOLAS, BOURBON AND SCOTT. HMH'S COMMUNITY IS CONSIDERED IN MOST PARTS RURAL WITH CYNTHIANA BEING ITS LARGEST TOWN IT SERVES WITH A POPULATION AROUND 7,000. THE AREA IS ALSO DESCRIBED AS A BEDROOM COMMUNITY OF LEXINGTON. THE AREA IS A FARMING COMMUNITY WITH SEVERAL STRONG INDUSTRIES BASED IN THE AREA. HMH CONSIDERS ITS SERVICE AREA POPULATION TO BE 35,000. THE DEMOGRAPHIC OF THE COMMUNITIES IS PREDOMINANTLY CAUCASIAN WITH AN AGING POPULATION. PART VI, LINE 5: THE ORGANIZATION'S HOSPITAL FACILITY FURTHERS ITS EXEMPT PURPOSE BY ACTIVELY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH SEVERAL KEY INITIATIVES. THE HOSPITAL MAINTAINS A MEDICAL STAFF WHO PROVIDES SPECIALIZED CARE TO ALL THE PATIENT POPULATION, ENSURING ACCESS TO A BROAD RANGE OF MEDICAL EXPERTISE. THE HOSPITAL PROVIDES SEVERAL RURAL HEALTH CLINICS OFFERING PRIMARY CARE SERVICES TO OUR PATIENTS. A VOLUNTEER COMMUNITY BOARD, COMPRISING LOCAL LEADERS AND STAKEHOLDERS, GUIDES HOSPITAL POLICIES AND PROGRAMS TO ADDRESS SPECIFIC HEALTH NEEDS AND PRIORITIES OF THE AREA. THE HOSPITAL HAS A SIGNIFICANT PRESENCE IN THE COMMUNITY OFFERING FREE HEALTH SCREENINGS, EDUCATIONAL SEMINARS, AND WELLNESS INITIATIVES, AIMED AT PREVENTING DISEASE AND FOSTERING A HEALTHIER POPULATION. THESE EFFORTS UNDERSCORE THE HOSPITAL'S COMMITMENT TO ENHANCING COMMUNITY HEALTH AND WELLBEING, ALIGNING WITH ITS MISSION TO SERVE AND SUPPORT THE LOCAL POPULATION. 0 UNIVERSITY OF LOUISVILLE FOUNDATION 215 CENTRAL AVENUE STE 212 LOUISVILLE KY 40208 237078461 SECTION 115 100000 0 CARDIOLOGY RESEARCH SUPPORT 1 HUMAN RESOURCE SCHOLARSHIPS 4 11310 X X X 0 0 0 0 0 0 0 0 0 DR MATTHEW K SHOTWELL CARDIOLOGY PHYSICIAN 2096774 0 0 0 0 0 13200 0 17914 0 2127888 0 0 0 DR SRINADH ANNANGI PULMONOLOGY PHYSICIAN 523796 0 0 0 21222 0 13200 0 16041 0 574259 0 0 0 DR MARIA ALEJAN PAVEZ NEUROLOGY PHYSICIAN 456230 0 0 0 0 0 13200 0 66995 0 536425 0 0 0 DR JENNIFER CANAN OB/GYN PHYSICIAN 434507 0 0 0 22500 0 13200 0 34514 0 504721 0 0 0 DR DEREK CLARKE OB/GYN PHYSICIAN 408995 0 0 0 22500 0 13200 0 34531 0 479226 0 0 0 DR STEPHEN TOADVINE CEO/SECRETARY (END 06/2024) 352659 0 0 0 6099 0 13200 0 36995 0 408953 0 0 0 TODD BRADEN REID MD CHIEF OF STAFF (END 12/2023) 305011 0 0 0 0 0 12200 0 14355 0 331566 0 0 0 KATHY TUSSEY CEO (BEG 06/2024) 181927 0 350 0 0 0 7291 0 33883 0 223451 0 0 0 PEGGY LAIR CFO/TREASURER 156705 0 0 0 22500 0 6860 0 16258 0 202323 0 0 0 A COUNTY OF HARRISON KENTUCKY 616000746 415005AA5 2015-12-03 32065000 FINANCE CAPITAL EXPENDITURES AND REFUND PREVIOUS BONDS 0 0 0 A 2281927 32065000 15299328 557081 16208591 2015 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE BOARD CHAIRMAN, BOARD CHAIRMAN-ELECT, FINANCE COMMITTEE CHAIRMAN, BOARD MEMBER AND CEO (WHEN APPROPRIATE AND AS AN EX-OFFICIO MEMBER WITHOUT VOTE). IT SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION WHICH IT MAY TAKE SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS, AND IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. SHOULD ANY MATTERS OF EXTREME URGENCY ARISE BETWEEN THE REGULAR MEETINGS OF THE BOARD OF DIRECTORS, IT SHALL BE THE DUTY OF THE EXECUTIVE COMMITTEE TO REQUEST THE BOARD CHAIRMAN TO CALL A SPECIAL MEETING OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE BOARD THROUGH THE HMH BOARD PORTAL PRIOR TO FILING. THE 990 IS REVIEWED IN DETAIL AT THE FINANCE COMMITTEE MEETING WITH BOARD MEMBERS PRESENT. THEY ARE ENCOURAGED TO PERSONALLY VISIT WITH THE CFO TO COVER ANY TOPICS NECESSARY. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL APPLICABLE PERSONNEL SIGN A CONFLICT OF INTEREST STATEMENT AND WHEN NEEDED, IT IS INCORPORATED INTO POLICIES. IF THE CEO OR HIS/HER DESIGNEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICT OF INTEREST, HE/SHE SHALL INFORM THE MANAGER/DIRECTOR OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MANAGER/DIRECTOR AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. WHEN IT IS DEEMED THAT A CONFLICT HAS IN FACT ARISEN, THE INDIVIDUAL SHALL ABSTAIN FROM ANY VOTING MATTERS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: THE BYLAWS OF THE HARRISON MEMORIAL BOARD OF DIRECTORS SET OUT THE REQUIREMENTS FOR CEO EVALUATION AND COMPENSATION. THE BOARD EXECUTIVE COMMITTEE HAS THE SPECIFIC RESPONSIBILITY TO ANNUALLY EVALUATE THE CEO AND RECOMMEND TO THE BOARD OF DIRECTORS THE SALARY AND BENEFITS OF THE CEO. THE BOARD OF DIRECTORS DISCUSSES THE RESULTS AND RECOMMENDATIONS OF THE EXECUTIVE COMMITTEE AND APPROVE ANY SALARY ADJUSTMENT. LINE 15B: THE BOARD CHAIR AND EXECUTIVE COMMITTEE REVIEW AND THE BOARD APPROVES COMPENSATION ANNUALLY DURING THE BUDGET PROCESS. MANAGEMENT USES THE AHA SALARY SURVEY AND THE BOARD APPROVES ANY INCREASES IN COMPENSATION. THIS PROCESS IS DOCUMENTED AND COMPLETED BY INDEPENDENT INDIVIDUALS FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,935,610. MANAGEMENT AND GENERAL EXPENSES 627,913. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,563,523. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,548,963. MANAGEMENT AND GENERAL EXPENSES 692,797. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,241,760. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 893,249. MANAGEMENT AND GENERAL EXPENSES 94,495. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 987,744. FORM 990, PART XI, LINE 9: BUSINESS ACQUISITION OF HMH PHARMACY 480,075. HARRISON MEMORIAL HOSPITAL FOUNDATION 1210 KY HWY 36 EAST CYNTHIANA KY 41031 610420440 HOLD REAL ESTATE KY -221110 9002100 HARRISON MEMORIAL HOSPITAL INC CLINIC PHARMACY LLC 1210 KY HWY 36 EAST CYNTHIANA KY 41031 611395931 PHARMACY SERVICES KY HARRISON MEMORIAL HOSPITAL INC HARRISON COUNTY EMS LLC 1210 KY HWY 36 EAST CYNTHIANA KY 41031 884390894 AMBULANCE SERVICES KY HARRISON MEMORIAL HOSPITAL INC HARRISON MEMORIAL PAIN MANAGEMENT LLC 1210 KY HWY 36 EAST CYNTHIANA KY 41031 472547452 PAIN MANAGEMENT SERVICES KY HARRISON MEMORIAL HOSPITAL INC RELATED 298702 288975 0 0 0.51000 COMMUNITY HEALTH PARTNERSHIP LLC 1210 KY HWY 36 EAST CYNTHIANA KY 41031 611348611 HEALTH CARE PROMOTION KY HARRISON MEMORIAL HOSPITAL INC C -202 500 0.80000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0