2023-11-14T13:53:22-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 852985806 ADENA FAYETTE MEDICAL CENTER ADEN 7403351210 272 HOSPITAL ROAD CHILLICOTHE OH 45601 JAMES P MCMANUS CFO 7403351210 2023-11-13 1 JAMES MCMANUS 999009999 0 AMY CIMINELLO P00796388 6148493000 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JEFF GRAHAM 272 HOSPITAL ROAD CHILLICOTHE OH 45601 67690963 0 X HTTPS://WWW.ADENA.ORG X 2021 OH ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL THAT HAS SERVES THE HEALTH NEEDS OF FAYETTE COUNTY. 5 5 388 17 0 0 4259829 1638693 43875316 65558125 22121 81558 565552 163957 48722818 67442333 0 0 0 0 16547929 19424077 0 0 0 23637290 45992460 40185219 65416537 8537599 2025796 42268764 30488041 10264051 8832542 32004713 21655499 X CALLED TO SERVE OUR COMMUNITIES 0 0 56770334 65558125 ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL THAT HAS SERVED THE HEALTH NEEDS OF FAYETTE COUNTY FOR 70 YEARS.SINCE 1950, ADENA FAYETTE MEDICAL CENTER, FORMERLY KNOWN AS FAYETTE COUNTY MEMORIAL HOSPITAL, HAS SERVED THE HEALTHCARE NEEDS OF OUR COMMUNITY. OUR TRADITION OF PROVIDING COMPASSIONATE CARE CONTINUES TO HELP THOUSANDS OF PEOPLE EACH YEAR. WHILE AFMC HAS GROWN IN SIZE AND SERVICES, WE HAVE RETAINED THE PERSONAL TOUCH THAT IS OUR TRADEMARK. OUR TEAM CONSISTS OF MORE THAN 300 HIGHLY SKILLED, COMPASSIONATE HEALTHCARE PROFESSIONALS DEDICATED TO DELIVERING PERSONAL CARE.PHYSICIANS AFFILIATED WITH OUR HOSPITAL ARE TRAINED IN A NUMBER OF SPECIALTIES, AND THEY, ALONG WITH OUR NURSE PRACTITIONERS, LOOK FORWARD TO ESTABLISHING LONG-TERM RELATIONSHIPS WITH OUR PATIENTS AND THEIR FAMILIES.COMPREHENSIVE CARE AND SERVICESPATIENTS AND VISITORS TO ADENA FAYETTE MEDICAL CENTER CAN EXPECT A FULL RANGE OF MEDICAL SERVICES AS WELL AS PERSONAL CARE FROM OUR DEDICATED PROVIDERS AND CAREGIVERS.SERVICES AT ADENA FAYETTE MEDICAL CENTERCANCERCARDIOPULMONARYDIAGNOSTIC TESTINGEMERGENCY SERVICESFOOD SERVICESGASTROENTEROLOGYLAB SERVICESNEPHROLOGYOCCUPATIONAL HEALTHOPHTHALMOLOGYORTHOPEDICSOUTPATIENT SERVICESPRIMARY CAREPULMONOLOGYREHABILITATION SERVICESSENIOR LIFE SOLUTIONSSLEEPSTROKESURGICAL SERVICESURGENT CARE AND WALK-IN CLINICWOMEN'S HEALTH 56770334 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 388 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X JEFF CRAFT VP SYSTEM FINANCE 7407794481 272 HOSPITAL ROAD CHILLICOTHE OH 456019031 JENNY BREEDLOVE SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 MYRON PRIEST TRUSTEE 2.00 0.00 X 0 0 0 BRIAN REAM CHAIR 2.00 0.00 X X 0 0 0 MARK RICHARDS VICE CHAIR 2.00 0.00 X X 0 0 0 RALPH STEGBAUER TRUSTEE 2.00 0.00 X 0 0 0 JEFF GRAHAM AHS CEO 1.00 54.00 X 0 1178750 88919 KATHERINE EDRINGTON AHS COO 1.00 54.00 X 0 696085 41744 LISA CARLSON AHS CFO-PART YEAR 1.00 54.00 X 0 619618 50481 JAMES MCMANUS AHS CFO 1.00 54.00 X 0 314210 19615 DONALD DIENER ADMINISTRATOR 50.00 0.00 X 304128 0 44091 CAROLYN WALLIN DIRECTOR OF OPERATIONS 50.00 0.00 X 174254 0 16442 TAMMY WILSON DIRECTOR OF NURSING 50.00 0.00 X 176795 0 7067 MELISSA LEMLE PHARMACIST 50.00 0.00 X 176351 0 10600 DOROTHY SOWDERS NURSE STAFF RN 50.00 0.00 X 140092 0 33048 971620 2808663 312007 5 0 1 0 COMMUNITY EMERGENCY MEDICINE PARTNERS L 1430 COLUMBUS AVE WASHINGTON COURT HOUSE OH 43160 PHYSICIAN SERVICES 980000 RURAL PHYSICIANS GROUP 5575 DTC PKWY 225 GREENWOOD VILLAGE CO 80111 PHYSICIAN SERVICES 820857 CAPTIVE RADIOLOGY LLC 6273 FRANK AVE NW NORTH CANTON OH 44720 MRI SERVICES 522650 ALLSCRIPTS LLC 222 MERCHANDISE MART PLZ 2024 CHICAGO IL 60654 IT SERVICES 464844 TRUSTAFF TRAVEL NURSES LLC 4270 GLENDALE MILFORD ROAD CINCINNATI OH 45241 NURSING SERVICES 461576 12 1637234 1459 1638693 NET PATIENT SVC REV 622110 65558125 65558125 65558125 81558 81558 36282 248630 -212348 -212348 -212348 PHARMACY 456110 208578 208578 CAFETERIA 722514 133242 133242 INCENTIVE PAYMENTS 621400 34485 34485 376305 67442333 65558125 0 245515 14315654 11595680 2719974 530484 429162 101322 3527161 2853473 673688 1050778 850079 200699 6457703 2813242 3644461 3637 1580 2057 419236 395052 24184 664858 626505 38353 2608320 2071135 537185 2254 1173 1081 78469 40845 37624 18784 15291 3493 2049177 1494269 554908 274646 206694 67952 MEDICAL EQUIPMENT & SUP 24375054 24375054 PROVISION FOR BAD DEBTS 6382744 6382744 HCAP ASSESSMENT 2028812 2028812 CAFETERIA/CATERING 219295 203694 15601 409471 385850 23621 65416537 56770334 8646203 0 15526598 4009757 14041651 14831714 1565343 1666102 24677 0 12868729 3688875 9793183 9179854 1317312 800614 42268764 30488041 6194852 6606233 966634 591344 3102565 1634965 10264051 8832542 X 31568264 21222800 436449 432699 32004713 21655499 42268764 30488041 X 2025796 -12375011 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 1478 1478 0 PART II-B, LINE 1: THE OHIO HOSPITAL ASSOCIATION DOES LOBBYING ON BEHALF OF HOSPITAL RELATED CAUSES. THIS ACTIVITY IS PAID FOR THROUGH DUES PAID TO THE OHIO HOSPITAL ASSOCIATION. 860000 860000 7887319 1321574 6565745 3743473 2209315 1534158 377937 157986 219951 9179854 RIGHT OF USE LIABILITY 800614 COST REPORT SETTLEMENT PAYABLE 834351 1634965 1 1 X 1 X 1 X 1 1 1 0 1 1 184026 184026 0.00310 14070644 7397212 6673432 0.11300 14254670 7397212 6857458 0.11610 14254670 7397212 6857458 0.11610 0 6382744 26284728 27854398 -1569670 X 1 1 1 1 ADENA FAYETTE MEDICAL CENTER 272 HOSPITAL ROAD CHILLICOTHE OH 45601 HTTPS://WWW.ADENA.ORG 1168 X X X X ADENA FAYETTE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, PAGE 8 X X 1 22 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X X 1 X 0 0 ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 5: THE ADENA FAYETTE MEDICAL CENTER CAPTURED THE BROAD INTERESTS OF THE COMMUNITY FOR THE CHNA THROUGH THREE PRIMARY METHODS: PUBLIC SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS. A HEALTH NEEDS SURVEY WAS WIDELY DISTRIBUTED IN BOTH ELECTRONIC AND PAPER FORM ACROSS THE ROSS COUNTY COMMUNITY AND RECEIVED 539 RESPONSES. IN ADDITION TO THE SURVEYS, INTERVIEWS WITH LOCAL COMMUNITY LEADERS, INCLUDING CIVIC, PUBLIC HEALTH AND EMERGENCY RESPONSE WERE REQUESTED AND/OR CONDUCTED TO GAIN FURTHER KNOWLEDGE OF SURVEY TOPICS. ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 6A: THE CHNA FOR ADENA FAYETTE MEDICAL CENTER WAS COMPLETED WITH ITS PARENT ENTITY, ADENA HEALTH SYSTEM. ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA FOR ADENA FAYETTE MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS: ADAMH BOARD, FAYETTE COUNTY COMMUNITY ACTION, AMERICAN RED CROSS, COMMUNITY ACTION-TRANSPORTATION, FAYETTE COUNTY COMMISSION, DIALYSIS CENTER, DOMESTIC VIOLENCE SHELTER, EMERGENCY MANAGEMENT AGENCY, FAYETTE COUNTY JOB AND FAMILY SERVICES, FAYETTE COUNTY DEPARTMENT OF DD, FAYETTE COUNTY HEALTH DEPARTMENT, FAYETTE COUNTY EMS, JEFFERSON TOWNSHIP EMS, FAYETTE COUNTY MEMORIAL HOSPITAL, FAYETTE COUNTY CORONER, FAYETTE COUNTY SHERRIFF'S DEPARTMENT, FAYETTE COUNTY FARMER'S MARKET, FAYETTE COUNTY PARKS AND RECREATION DISTRICT, FAYETTE COUNTY YMCA, FAYETTE COUNTY HOMELESS SHELTER, OHIO HOSPICE OF FAYETTE COUNTY, MEDICAL RESERVE CORP, MIAMI TRACE LOCAL SCHOOLS- SUPERINTENDENT, FAYETTE COUNTY COMMISSION ON AGING, PUBLIC HEALTH, EPI-UNION COUNTY (CONTRACTED), ROSE AVENUE COMMUNITY CENTER, ST. CATHERINE'S AND COURT HOUSE MANOR LTC, WASHINGTON CITY SCHOOLS-SUPERINTENDENT, AND SCIOTO PAINT VALLEY MENTAL HEALTH. ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 7D: THE CHNA WAS MADE AVAILABLE IN ELECTRONIC FORM THROUGH SOCIAL MEDIA, NEWSPAPER AND RADIO WEBSITES. PRESENTATIONS OF ITS CONTENT WERE MADE TO GOVERNMENT, COMMUNITY AND CIVIC ORGANIZATIONS. HARD COPIES OF THE CHNA REPORT WERE ALSO PRINTED AND SENT TO COMMUNITY LEADERS AND AGENCIES. ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 11: THE FOLLOWING DETAILS THE SPECIFIC IMPLEMENTATION STRATEGIES USED FOR HEALTH PRIORITIES IDENTIFIED FOR THE ADENA FAYETTE MEDICAL CENTER. THE FOLLOWING OUTLINES THE EFFORTS THAT WERE INITIATED IN 2022. SUBSTANCE USE DISORDER ADVOCACYADENA HEALTH SYSTEM HAD 3 EMPLOYEE WHO DEDICATED A MINIMUM TOTAL OF TWO HOURS A MONTH TO PARTICIPATING IN FAYETTE COUNTY I-TEAM MEETINGS AND CONTRIBUTING TO SUBSTANCE USE DISORDER PREVENTION, TREATMENT AND RECOVERY PROJECTS FOR THE GROUP IN 2022. PROGRAMMING & INITIATIVESTHE BABY CENTERED RECOVERY PROGRAM PROVIDED A TOTAL OF 5 WOMEN (FROM MULTIPLE COUNTIES INCLUDING FAYETTE) WITH PREGNANCY EDUCATION AND ADDICTION COUNSELING IN 2022. IN ADDITION, PARTICIPANTS WERE PROVIDED RESOURCE REFERRALS, AS WELL AS FOOD AND BABY SUPPLIES AT NO CHARGE TO PARTICIPANTS. A TOTAL OF 5 COMPLETED THE PROGRAM. A TOTAL OF 289 MOTHERS HAVE BEEN SUPPORTED BY THE PROGRAM SINCE 2014. THE PROGRAM HAS BEEN RECOGNIZED WITH MULTIPLE AWARDS, INCLUDING:NATIONAL AWARDS "PROGRAM OF PROMISE" BY NATIONAL HOSPITAL CHARITABLE SERVICES "A BEST PRACTICE SITE" BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' CENTERS FOR MEDICARE AND MEDICAID SERVICE (CMS) MEDICATION MANAGEMENT AND OPIOID SUPPORT TEAM (1 OF ONLY 3 IN OHIO) RECOGNIZED BY CONGRESSMAN STEVE STIVERS ON THE FLOOR OF THE US. HOUSE OF REPRESENTATIVES, "AS A MODEL THAT OTHER COMMUNITIES SHOULD REPLICATE". FEATURED IN THE EMMY NOMINATED DOCUMENTARY SHORT BY "FAULT LINES": HEROIN'S CHILDREN: INSIDE THE US OPIOID CRISIS. STATE AWARDS THE OHIO SENATE HAS RECOGNIZED THE PROGRAM TWICE FOR THE CREATION OF THE ADENA BABY-CENTERED CLOSET. THE OHIO STATE SENATE ALSO RECOGNIZED THE PROGRAM FOR ITS WORK WITH MEDICAID PATIENTS. THE OHIO LACTATION ASSOCIATION RECOGNIZED ONE OF THE PROGRAM'S FACILITATORS "AS MOST BREASTFEEDING SUPPORTIVE HEALTH PROFESSIONAL IN OHIO".COMMUNITY AWARDS THE PROGRAM RECEIVED A COMMUNITY AWARD FROM OHIO CAN-ROSS COUNTY-2019 STEPS OF CHANGE FOR THE IMPACT THE PROGRAM MADE IN A YOUNG WOMAN'S LIFE. PAINT VALLEY ADAMH BOARD NAMED ONE OF THE PROGRAM'S FACILITATOR A ROSS COUNTY RECOVERY CHAMPION. THE HOPE PARTNERSHIP PROJECT NAMED OF THE PROGRAM'S FACILITATORS PROVIDER OF THE YEAR IN 2021.FINANCIAL SUPPORT AND CLINICAL ALIGNMENTTHE ADENA HEALTH SYSTEM PROVIDED $5,000 TO SUPPORT THE ADAMH ANNUAL RECOVERY CELEBRATION DINNER, HONORING THOSE WHO WORK TO PREVENT, TREAT AND SUPPORT RECOVERY FOR THOSE IN ROSS, HIGHLAND, FAYETTE, PIKE AND PICKAWAY COUNTIES.OBESITY AND DIABETESPROGRAMMINGIN 2022, ADENA BEGAN ITS JUST WALK PROGRAM IN PARTNERSHIP WITH THE FAYETTE COUNTY YMCA AND COURT HOUSE MANOR OF FAYETTE COUNTY. THE HOUR LONG PROGRAM HELD ONCE PER MONTH ENGAGES 10-15 LOCAL RESIDENTS ON A HEALTH TOPIC DISCUSSED BY A LOCAL MEDICAL PROVIDER AND A ONE MILE WALK FOR HEALTH AND FITNESS. A TOTAL OF 13 ADENA EMPLOYEES SPEND A TOTAL OF 36 HOURS EACH YEAR COORDINATING AND DELIVERING THE PROGRAM. A TOTAL OF $193 WAS PROVIDED IN SUPPLIES FOR THE PROGRAM. FINANCIAL SUPPORT & CLINICAL ALIGNMENTADENA HEALTH SYSTEM WORKS TO ALIGN ITS SERVICE LINES AND CLINICS WITH COMMUNITY RESOURCES THAT WILL ADDRESS THE SOCIAL FACTORS AND BARRIERS FACED BY MANY OF ITS RURAL PATIENTS. THIS OFTEN INVOLVES COMMUNITY PARTNERING AND MONETARY SUPPORT FROM ADENA COMMUNITY HEALTH AND DEVELOPMENT. THESE TWO STRATEGIES ARE CONNECTED AND REPORTED TOGETHER. ADENA HEALTH SYSTEM PARTNERED AGAIN IN 2022 WITH THE FAYETTE COUNTY FARMER'S MARKET TO FUND THE "FOOD RX AND FRUIT & VEGGIE PERKS PROGRAM. THIS PROGRAM PROVIDED 13 INDIVIDUAL ADENA PATIENTS REFERRED BY THEIR PRIMARY CARE PROVIDER FOR A TOTAL OF $195 IN FRESH FRUITS AND VEGETABLES. IN 2022, ADENA HEALTH SYSTEM BEGAN ITS PARTNERSHIP WITH THE YMCA OF FAYETTE COUNTY TO COORDINATE THE "FIRST STEP" PROGRAM. THIS PROGRAM UTILIZES A YMCA TRAINER TO OPTIMIZE (REDUCE BMI) ADENA BONE & JOINT PATIENTS PRIOR TO SURGERY TO IMPROVE SURGICAL OUTCOMES OF JOINT REPLACEMENT. A TOTAL OF 2 PATIENTS WERE SERVED IN 2022 AND A TOTAL OF $1,237 IN SUPPORT WAS PROVIDED THROUGH THIS PARTNERSHIP. RESPIRATORY ISSUESPROGRAMMINGTHE ADENA CANCER CENTER PROVIDED A TOTAL OF 1,440 PATIENTS FROM THE REGION INCLUDING PIKE, FAYETTE, HIGHLAND AND ROSS COUNTIES WITH FREE LUNG CANCER SCREENINGS IN 2022 WHICH RESULTED IN 36 POSITIVE CANCER FINDINGS. DATA FROM 2013 THROUGH 2021 DEMONSTRATES A HIGHLY INCREASED RATE OF FINDING LUNG CANCERS AT STAGE 1, WITH RATES OF DEATH DECLINING DUE TO EARLY INTERVENTION AND TREATMENT. MENTAL HEALTHPROGRAMMINGTHE ADENA HEALTH SYSTEM HOUSES A VICTIM'S ADVOCATE TEAM IN THE ARMC EMERGENCY DEPARTMENT WHICH PROVIDED A TOTAL OF 472 VICTIMS OF SEXUAL ASSAULT (ADULT AND PEDIATRIC), DOMESTIC VIOLENCE, CHILD ABUSE, ELDER ABUSE, HUMAN TRAFFICKING AND HATE CRIMES WITH MENTAL HEALTH REFERRAL, SAFETY NET AND SUPPORT SERVICES FREE OF CHARGE, VALUED AT $231,061 IN 2022. PATIENTS ARE SERVED 24 HOURS A DAY, SEVEN DAYS PER WEEK IN ROSS COUNTY, PIKE COUNTY, FAYETTE COUNTY AND HIGHLAND COUNTY. IN ADDITION TO THIS SUPPORT, THE ADVOCACY TEAM ALSO RESPONDED TO 67 CASES ACROSS THE HEALTH SYSTEM TO PROVIDE SUPPORT AND RESOURCES FOR INDIVIDUALS EXPERIENCING HOMELESSNESS AND OTHER SOCIAL NEEDS. CHILD SAFETY & WELLNESSPROGRAMMING AND INITIATIVESTHE ADENA HEALTH SYSTEM PROVIDED OVER $800,000 IN ATHLETIC INJURY PREVENTION, DIAGNOSIS, AND EVALUATION SERVICES TO 14 LOCAL PUBLIC HIGH SCHOOLS WITHIN SIX COUNTIES, ROSS, PIKE, FAYETTE, HIGHLAND, JACKSON, PICKAWAY, SERVICE REGION IN 2022. AN ADDITIONAL $40,000 IN MEDICAL SUPPLIES WAS PROVIDED AS PART OF THESE SERVICES. A TOTAL OF 13 ATHLETIC TRAINERS WORKED WITHIN THE SCHOOL'S ATHLETIC DEPARTMENTS AND FOCUSED ON EDUCATING STUDENTS, PARENTS AND COACHES ON SPORTS MEDICINE TOPICS, INCLUDING CONCUSSION IDENTIFICATION AND TREATMENT. THE STAFF IS ALSO READILY AVAILABLE AT ATHLETIC EVENTS AND PROVIDES YEARLY SPORTS PHYSICALS TO 1,235 STUDENTS IN HIGHLAND, FAYETTE, JACKSON, PICKAWAY, PIKE, AND ROSS COUNTIES. IN 2021, ADENA HEALTH SYSTEM PARTNERED WITH NATIONWIDE CHILDREN'S HOSPITAL TO DEVELOP THE APPALACHIAN WHOLE CHILD INITIATIVE. IN 2022, ADENA HEALTH SYSTEM COMMUNITY HEALTH AND DEVELOPMENT EXPANDED THE PROGRAM AND PROVIDED A 1.0 FTE VALUED AT $101,608 TO WORK WITH FOUR ROSS COUNTY SCHOOL DISTRICTS, ONE PIKE COUNTY SCHOOL DISTRICT, ONE FAYETTE COUNTY SCHOOL DISTRICT AND ONE HIGHLAND COUNTY SCHOOL DISTRICT TO COMPLETE SCHOOL NEEDS ASSESSMENTS AND DEVELOP SCHOOL WELLNESS STRATEGIC PLANS. IN ADDITION, THE COORDINATOR IS ASSISTING THE DISTRICTS IN DEVELOPING PRIMARY CARE AND TELEHEALTH RESOURCES FOR THE DISTRICT, AS WELL AS BRING IN ADDITIONAL COMMUNITY PARTNERS TO ADDRESS MENTAL HEALTH AND SOCIAL NEEDS OF STUDENTS. ADENA HEALTH SYSTEM PARTNERED WITH THE CARNEGIE PUBLIC LIBRARY TO COORDINATE THE HEALTHY KIDS SUMMER FUN CHALLENGE, PART OF THE BOOKWORM SUMMER READING PROGRAM. A TOTAL OF 455 FAYETTE COUNTY RESIDENTS - 325 CHILDREN, 22 TEENS, AND 108 ADULTS- WERE ENGAGED IN THE PROGRAM THAT REWARDED THEM FOR COMPLETING WEEKLY HEALTH CHALLENGES. PARTICIPANTS ARE OFFERED THE OPPORTUNITY TO EARN PRIZES AS THEY COMPLETE CHALLENGES AND THOSE WHO COMPLETE ALL CHALLENGES ARE ENTERED INTO A DRAWING FOR A NEW BICYCLE AND ADULTS GOT THE OPPORTUNITY FOR A FITBIT. A TOTAL OF $7,394 WAS SPENT ON REWARD PRIZES FOR PARTICIPANTS IN ROSS, FAYETTE, HIGHLAND AND PIKE COUNTIES. FINANCIAL SUPPORTADENA HEALTH SYSTEM PROVIDED SLEEP SACKS FOR THE 1,279 BABIES BORN AT THE ADENA WOMEN'S AND CHILDREN'S CENTER IN 2022, VALUED AT $12,777. PATIENTS COME FROM A NUMBER OF COUNTIES INCLUDING FAYETTE, ROSS, PIKE AND HIGHLAND. IN ADDITION, A TOTAL OF 1 PORTABLE CRIB, VALUED AT $75 WAS PROVIDED FOR A FAMILY WITHOUT A BED FOR THEIR BABY PRIOR TO LEAVING THE HOSPITAL.SCHOOL DISTRICTS: A TOTAL OF 2 HIGHLAND COUNTY SCHOOL DISTRICTS WASHINGTON COURT HOUSE CITY SCHOOLS AND MIAMI TRACE LOCAL SCHOOLS - EACH RECEIVED $25,000 OR A TOTAL OF $50,000 TO SUPPORT THE HEALTH AND WELLNESS OF THEIR DISTRICT'S ATHLETES, ALIGNED WITH THE SUPPORT OF ATHLETIC TRAINERS PROVIDED BY ADENA HEALTH SYSTEM. RONALD MCDONALD HOUSE: ADENA PROVIDED $3,000 TO SUPPORT THE RONALD MCDONALD HOUSE CHARITIES. THE RONALD MCDONALD HOUSE AT NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS, OHIO PROVIDED OVER 500 NIGHTS OF STAY FREE OF CHARGE TO PARENTS OF CHILDREN FROM ROSS, PIKE, HIGHLAND AND FAYETTE COUNTIES WHO NEEDED SPECIALTY CARE NOT AVAILABLE IN THEIR HOME COUNTY. COMMUNITY HEALTH OUTCOMES AND HEALTH FACTORS SUMMARY FAYETTE COUNTY HEALTH OUTCOMES MOVED FROM AT 81 IN 2021 TO 74 IN 2022 (COUNTY HEALTH RANKINGS). FAYETTE COUNTY HEALTH FACTORS REMAINED AT 68 IN 2022 (COUNTY HEALTH RANKINGS). ADENA FAYETTE MEDICAL CENTER PART V, SECTION B, LINE 20E: PATIENTS HAVE 120 DAYS FROM THE TIME THEIR ACCOUNT GOES TO "SELF-PAY" TO PAY IN FULL OR MAKE PAYMENT ARRANGEMENTS. ON THE 121ST DAY, THEY ARE SENT TO A COLLECTION AGENCY. COLLECTION AGENCIES REQUIRE ADENA MANAGEMENT APPROVAL TO PURSUE LEGAL ACTION. IF AVAILABLE, SELFPAY PATIENTS ARE SCREENED FOR GOVERNMENT ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE DURING THE INPATIENT STAY. FAP APPLICATIONS ARE PROVIDED TO THE PATIENT AS PART OF THE SCREENING. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE ONLINE AND THROUGHOUT THE HOSPITAL. PART V, SECTION B, LINE 11 CONTINUED ADDITIONAL INITIATIVES AND RESOURCESTHE ADENA FAMILY MEDICINE - RESIDENCY CLINIC AND THE ADENA RESIDENCY CLINIC INTERNAL MEDICINE CONTINUED OPERATIONS OF ITS CLINIC IN 2022 PROVIDING AFFORDABLE, QUALITY HEALTH CARE. THE CLINICS PAIRED ACCESSIBLE PRIMARY CARE MEDICAL SERVICES PROVIDED BY PHYSICIAN INTERNS AND RESIDENTS OF ADENA'S GRADUATE MEDICAL EDUCATION PROGRAM, FAMILY AND INTERNAL MEDICINE PRECEPTORS PROVIDING SERVICES TO PATIENTS IN THE CLINIC. A TOTAL OF 4,356 UNIQUE PATIENTS, MOSTLY FROM SEVEN COUNTIES (ROSS, PICKAWAY, PIKE, JACKSON, HIGHLAND, FAYETTE, VINTON), MADE A TOTAL OF 11,984 VISITS TO THE TWO CLINICS IN 2022. APPROXIMATELY 5% OF PATIENTS SERVED BY THE CLINICS ARE UNINSURED. ADENA ALSO PROVIDES SUPPORT TO THE FAYETTE COUNTY COMMUNITY THROUGH A VARIETY OF ENGAGEMENT ACTIVITIES, INCLUDING FINANCIAL SUPPORT AND PARTICIPATION IN LOCAL COMMUNITY EVENTS AND INITIATIVES. A TOTAL OF 18 CAREGIVERS FROM AFMC PROVIDED MORE THAN 75 HOURS OF COMMUNITY SERVICE AND VOLUNTEER TIME PARTICIPATING IN COMMUNITY PROGRAMMING, NON-PROFIT BOARD PARTICIPATION AND LEADERSHIP, AND OTHER INITIATIVES. THESE INCLUDED: OVER $3,360 IN COORDINATED TRANSPORTATION SERVICES FOR PATIENTS IN FAYETTE, ROSS, HIGHLAND AND PIKE COUNTIES WITHOUT TRANSPORT TO MEDICAL APPOINTS AND NO INSURANCE COVERAGE. A TOTAL OF $2,000 IN SUPPORT FOR THE FAYETTE COUNTY CHAMBER OF COMMERCE, INCLUDING SUPPORT OF THEIR ANNUAL TOAST TO SUMMER. $10,000 TO THE FAYETTE COUNTY UNITED WAY TO SUPPORT COMMUNITY IMPACT PROGRAMS RELATED TO HEALTH. A TOTAL OF $1,000 IN SUPPORT TO THE FAYETTE COUNTY CANCER SUPPORT FOUNDATION. IN ADDITION, ANOTHER $1,500 WAS PROVIDED TO SUPPORT LOCAL PELOTONIA TEAMS SUPPORTING CANCER TREATMENT AND RESEARCH. A TOTAL OF $250 TO SUPPORT THE ALZHEIMER'S ASSOCIATION OF CENTRAL OHIO. A TOTAL OF $12, 590 TO SUPPORT THE FAYETTE COUNTY AGRICULTURE ASSOCIATION'S FAIR AND 4H PROGRAMMING. A TOTAL OF $1,025 TO SUPPORT LOCAL COMMUNITY EVENTS INCLUDING THE WASHINGTON COURT HOUSE 4TH OF JULY CELEBRATION AND TRICK OR TREAT COMMUNITY NIGHT. ADDITIONAL COMMUNITY COLLABORATIONSROSS COUNTY CHILD PROTECTION CENTER: ADENA HEALTH SYSTEM CONTINUED IT'S MORE THAN 25 YEAR RELATIONSHIP WITH AND SUPPORT OF THE ROSS COUNTY CHILD PROTECTION CENTER IN 2022 WHICH PROVIDES RESOURCES AND COUNSELING TO YOUNG VICTIMS OF INTERPERSONAL VIOLENCE AND SEXUAL ASSAULT IN A NINE COUNTY SERVICE REGION THAT INCLUDES FAYETTE, ROSS, PIKE AND HIGHLAND COUNTIES. ADENA PROVIDED A TOTAL OF $63,374 IN FINANCIAL SUPPORT FOR THE CPC'S FACILITY COSTS AND INFORMATION TECHNOLOGY NEEDS. MEDICAL AND NURSING STAFF ALSO PROVIDE SUPPORT TO THE CENTER. AN ADDITIONAL $2,000 IN SUPPORT WAS PROVIDED TO SUPPORT THE FUNDRAISING EFFORTS OF THE ORGANIZATION. HOPE CLINIC: ADENA PROVIDER, JAMI EASTERDAY, CNP, CONTINUED VOLUNTEER EFFORTS AS THE DIRECTOR OF THE HOPE CLINIC OF ROSS COUNTY IN 2022. A TOTAL OF 10 PROVIDERS FROM ADENA HEALTH SYSTEM VOLUNTEERED 215 HOURS OF CARE AT HOPE CLINIC IN 2022. A TOTAL OF 283 PATIENTS WERE SERVED WITH DENTAL AND MEDICAL CARE AND VALUED AT $1,055,751. THIS CLINIC PROVIDES FREE MEDICAL CARE TO THOSE WITHOUT HEALTH INSURANCE COVERAGE, INCLUDING MEDICAL, DENTAL AND VISION CARE. THE CLINIC IS LOCATED IN CHILLICOTHE, OH AND SERVES PATIENTS FROM AROUND THE REGION INCLUDING ROSS, PIKE FAYETTE, AND HIGHLAND COUNTIES. IT IS OPEN ONE DAY PER WEEK. AHS PROVIDES AN ADDITIONAL $29,616 IN MONETARY SUPPORT FROM ITS COMMUNITY HEALTH BUDGET TO THE HOPE CLINIC FOR THE CLINIC'S COMMUNITY CHARITABLE PHARMACY (SERVING 1,284 PATIENTS IN 2022) AND MEDICAL RESOURCE SYSTEM ELSEVIER. AN ADDITIONAL $3,250 WAS ALSO PROVIDED TO SUPPORT GENERAL FUNDRAISING CAMPAIGN FOR SERVICES. FOR MORE INFORMATION, GO TO HTTP://WWW.HOPECLINICFREE.ORG/FAYETTE COUNTY HEALTH COALITION: IN 2022, ADENA HEALTH SYSTEM COLLABORATED WITH THE FAYETTE COUNTY HEALTH DEPARTMENT TO CONTINUE COLLABORATION ON DEVELOPING A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR FAYETTE COUNTY, UTILIZING THE COMMUNITY HEALTH ASSESSMENT (CHA) COMPLETED IN 2022. A TOTAL OF 15 LOCAL GOVERNMENT, CIVIC AND BUSINESS LEADERS PARTICIPATE TO IDENTIFY STRATEGIC HEALTH PRIORITIES FOR THE COMMUNITY AND ASSIST IN ALLOCATING RESOURCES TO SUPPORT INITIATIVES BUILT AROUND THESE STRATEGIC PRIORITIES. ADENA HEALTH SYSTEM HAD A TOTAL OF TWO ADENA EMPLOYEES THAT VOLUNTEERED OVER 60 HOURS IN 2022 TO CONTRIBUTING TO THE FAYETTE COUNTY HEALTH COALITION STEERING COMMITTEE ASSISTING IN THE COORDINATION AND COMPILATION OF THE 2022 COMMUNITY HEALTH IMPROVEMENT PLAN. PART V, LINE 7A HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW PART V, LINE 10A HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW PARY V, LINE 16A, FAP HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE PART V, LINE 16B, FAP APPLICATION HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE PART I, LINE 7: THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $6,382,744 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN. PART III, LINE 2: THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS. PART III, LINE 4: WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR ADENA FAYETTE MEDICAL CENTER. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE SYSTEM'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE, ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE." PART III, LINE 8: MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.ADENA FAYETTE MEDICAL CENTER USED THE MEDICARE ALLOWABLE COSTS PER ITS 2022 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: IF THE RESPONSIBLE INDIVIDUAL HAS NOT SUBMITTED A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE OR HAS NOT PAID-IN-FULL, FOUR SEPARATE STATEMENTS ARE SENT OUT FOR THE COLLECTION OF SELF-PAY ACCOUNTS. THE FINAL STATEMENT SENT WILL INFORM THE INDIVIDUAL OF POSSIBLE EXTRAORDINARY COLLECTION ACTIONS (ECA) TO BE TAKEN IF FINANCIAL ASSISTANCE IS NOT APPLIED FOR OR THE ACCOUNT IS NOT PAID IN FULL. AFTER THE FINAL STATEMENT AND BEFORE ECAS ARE TAKEN, REASONABLE EFFORTS ARE MADE TO ORALLY CONTACT THE INDIVIDUAL AS A FINAL NOTICE. PATIENTS WHO CANNOT PAY CHARGES IN FULL MAY ALSO BE OFFERED A PAYMENT PLAN THAT IS CONSISTENT WITH ADENA FAYETTE MEDICAL CENTER'S CUSTOMER SERVICE PROCEDURES. PART VI, LINE 3: THE AVAILABILITY OF FINANCIAL ASSISTANCE IS COMMUNICATED IN THE FOLLOWING MANNER: 1. STATEMENTS FROM ADENA AS WELL AS COLLECTION VENDORS EXPLAIN AND LIST THE 100% AND 60% ASSISTANCE GUIDELINES ON THE BACKSIDE OF THE STATEMENT. 2. THERE IS SIGNAGE EXPLAINING THE PROGRAM AT ALL THE REGISTRATION AREAS. 3. A CONTRACTED VENDOR SUPPLIES STAFF AT THE CASHIER AREA TO EXPLAIN OPTIONS AVAILABLE TO THE PATIENT. 4. WE SEND AN APPLICATION WITH THE SELF-PAY DISCOUNT LETTERS IN CASE THE PATIENT/GUARANTOR CAN'T SET UP A PAYMENT PLAN. 5. THE CUSTOMER SERVICE STAFF IS EDUCATED ON ALL THE OPTIONS AND CAN EXPLAIN THE PROGRAMS WHEN PATIENTS CALL. 6. OUR PHYSICIAN OFFICES, AS WELL AS COLLECTION VENDORS HAVE FINANCIAL AID APPLICATIONS AVAILABLE. 7. LASTLY, WE UTILIZE A "HINDSIGHT" VENDOR THAT SCREENS ALL BAD DEBT ACCOUNTS, AFTER THE YEAR-END, AGAINST THE STATE MEDICAID ELIGIBILITY AND FEDERAL POVERTY GUIDELINES TO ATTEMPT ONE LAST EFFORT TO OBTAIN FINANCIAL ASSISTANCE FOR INDIVIDUALS. PART VI, LINE 5: ADENA FAYETTE MEDICAL CENTER WORKS TO PROMOTE THE HEALTH OF ITS COMMUNITY THROUGH A VARIETY OF MEANS, INCLUDING BOARD MEMBERS, ADMINISTRATIONS, EMPLOYEES AND VOLUNTEERS. THE 2022 BOARD OF TRUSTEES OF ADENA FAYETTE MEDICAL CENTER WAS COMPRISED OF 5 MEMBERS WHO ALL RESIDE IN THE HOSPITAL'S SERVICE AREA. PART VI, LINE 6: FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES FOUR HOSPITALS AND EIGHT REGIONAL CLINICS, WITH A TOTAL OF 311 REGISTERED BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. FAYETTE MEDICAL GROUP, NOW KNOWN AS ADENA FAYETTE MEDICAL CENTER, WAS A GOVERNMENTAL HOSPITAL PRIOR TO 2021 AND BECAME A PART OF THE ADENA HEALTH SYSTEM DURING THE TAX YEAR. ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL IN CHILLICOTHE, OH, BENEFITTING THE FAYETTE COUNTY. ADENA GREENFIELD MEDICAL CENTER AND ADENA PIKE MEDICAL CENTER: BOTH ARE CRITICAL ACCESS HOSPITALS EACH, WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (ADENA GREENFIELD MEDICAL CENTER) AND PIKE COUNTY (ADENA PIKE MEDICAL CENTER) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WELLSTON, HILLSBORO, WASHINGTON COURT HOUSE AND WAVERLY, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE AND WAVERLY. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN). THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS. 0 1 0 0 0 0 0 1 0 JEFF GRAHAM AHS CEO 0 925582 0 250303 0 2865 0 24920 0 63999 0 1267669 0 250203 KATHERINE EDRINGTON AHS COO 0 561061 0 132159 0 2865 0 15921 0 25823 0 737829 0 132059 LISA CARLSON AHS CFO-PART YEAR 0 415123 0 136007 0 68488 0 18980 0 31501 0 670099 0 202646 DONALD DIENER ADMINISTRATOR 258843 0 40761 0 4524 0 14253 0 29838 0 348219 0 35457 0 JAMES MCMANUS AHS CFO 0 291710 0 22500 0 0 0 7246 0 12369 0 333825 0 0 CAROLYN WALLIN DIRECTOR OF OPERATIONS 149632 0 24622 0 0 0 0 0 16442 0 190696 0 22788 0 MELISSA LEMLE PHARMACIST 176351 0 0 0 0 0 0 0 10600 0 186951 0 0 0 TAMMY WILSON DIRECTOR OF NURSING 160979 0 15816 0 0 0 4920 0 2147 0 183862 0 15816 0 DOROTHY SOWDERS NURSE STAFF RN 129732 0 10000 0 360 0 7111 0 25937 0 173140 0 0 0 PART I, LINE 3 EXECUTIVE LEADERSHIP AT ADENA FAYETTE MEDICAL CENTER HAS THEIR COMPENSATION REVIEWED EVERY YEAR BY ADENA HEALTH SYSTEM, A RELATED PARTY. THE SYSTEM UTILIZES A SEPARATE COMPENSATION CONSULTING FIRM THAT USES SEVERAL AVAILABLE MARKET STUDIES FOR APPLICABLE POSITIONS IN COMPARABLE MARKETS. OTHER ADENA FAYETTE MEDICAL CENTER MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. PART I, LINE 4B ADENA HEALTH SYSTEM HAS A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENT FROM THE SERP IN 2022: LISA CARLSON $259,980 SERP ACCRUAL JAMES MCMANUS $32,295 SERP ACCRUAL THE SERP ACCRUALS, INCLUDED IN PART II, COLUMN (C), ARE AMOUNTS CREDITED TO THE EXECUTIVE UNDER THE SECTION 457(F) DEFERRED COMPENSATION PLAN. PART I, LINE 7 MANAGEMENT OF ADENA HEALTH SYSTEM HAVE A PORTION OF THEIR ANNUAL SALARY AT RISK UNDER A VARIABLE COMPENSATION PLAN. IF THE OPERATING RESULTS OF AHS MEET A MARGIN TARGET IN ANY FISCAL YEAR, ADDITIONAL COMPENSATION IS PAID THAT IS CALCULATED USING THE OPERATING MARGIN ALONG WITH RESULTS IN EMPLOYEE ENGAGEMENT, PATIENT QUALITY, AND SATISFACTION USING A BALANCED SCORECARD FORMULA. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ADENA FAYETTE MEDICAL CENTER IS ADENA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF THE ORGANIZATION NOMINATES TRUSTEES, AND ADENA HEALTH SYSTEM, AS THE SOLE MEMBER OF THE ORGANIZATION, ELECTS THE TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN GOVERNANCE DECISIONS ARE RESERVED FOR ADENA HEALTH SYSTEM AS THE SOLE MEMBER OF THE ORGANIZATION, SUCH AS THE ELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE ORGANIZATION, APPROVAL OF STRATEGIC PLANS OF THE ORGANIZATION, AND APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND CODE OF REGULATIONS. ADENA HEALTH SYSTEM CAN ACT ON THESE RIGHTS BY A VOTE AT ANY MEETING, AN ACTION WITHOUT A MEETING, OR THROUGH OTHER AUTHORIZED MEANS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PROVIDED TO THE ADENA HEALTH SYSTEM BOARD MEMBERS FOR REVIEW AND APPROVAL BEFORE FILING. ADENA HEALTH SYSTEM IS THE SOLE MEMBER AND THE RETURN IS AVAILABILE VIA THE BOARD PORTAL. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE OFFICE OF ADENA HEALTH SYSTEM ANNUALLY COORDINATES THE DISTRIBUTION AND RETURN OF THE CONFLICT OF INTEREST STATEMENTS. ALL CONFLICTS ARE REVIEWED, AND THE CORPORATE COMPLIANCE OFFICE IS RESPONSIBLE FOR REVIEWING THE RESPONSES AND COMMUNICATING ANY EXTRA STEPS THAT NEED TO TAKE PLACE REGARDING ANY OF THE RESPONSES. AT EVERY BOARD MEETING AND COMMITTEE OF THE BOARD, THE AGENDA ITEM OF CONFLICT OF INTEREST IS INCLUDED AND CALLED OUT. CONFLICTED BOARD MEMBERS ABSTAIN FROM VOTING ON THE PARTICULAR ITEMS. ANY MEMBER ABSTAINING FROM VOTING IS DOCUMENTED IN THE MINUTES. FRONT LINE SUPERVISORS UP THROUGH THE CEO AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE LEADERSHIP WILL HAVE COMPENSATION REVIEWED ANNUALLY BY ADENA HEALTH SYSTEM, THE SOLE MEMBER OF THE FILING ENTITY. THE SYSTEM UTILIZES A SEPARATE COMPENSATION CONSULTING FIRM THAT USES SEVERAL AVAILABLE MARKET STUDIES FOR APPLICABLE POSITIONS IN COMPARABLE MARKETS. OTHER MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER (TO) FROM RELATED ORGANIZATION -12,375,011. FORM 990, PART XII, LINE 2C: THE ADENA HEALTH SYSTEM'S AUDIT COMMITTEE ENGAGES THE INDEPENDENT AUDIT FIRM FOR THE AUDIT, REVIEWS RESULTS, AND REPORTS TO THE BOARD. ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. FAYETTE MEDICAL CENTER IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. FORM 990, PART V, LINE 1 A RELATED ORGANIZATION, ADENA HEALTH SYSTEM, ISSUES THE 1099S. ADENA HEALTH FOUNDATION 272 HOSPITAL ROAD CHILLICOTHE OH 45601 753008742 FUNDRAISING OH 501(C)(3) 12A ADENA HEALTH SYSTEM 1 ADENA HEALTH SYSTEM 272 HOSPITAL ROAD CHILLICOTHE OH 45601 314379443 HOSPITAL OH 501(C)(3) 3 N/A 0 GREENFIELD AREA MEDICAL CENTER 550 MIRABEAU ST GREENFIELD OH 45123 310993422 HOSPITAL OH 501(C)(3) 3 ADENA HEALTH SYSTEM 1 PIKE HEALTH SERVICES 100 DAWN LANE WAVERLY OH 45690 311072406 HOSPITAL OH 501(C)(3) 3 ADENA HEALTH SYSTEM 1 SOUTHERN OHIO HEALTHCARE NETWORK 272 HOSPITAL ROAD CHILLICOTHE OH 45601 261566590 FIBEROPTIC NETWORK GRANTS OH 501(C)(3) 12A ADENA HEALTH SYSTEM 1 ADENA CARE 272 HOSPITAL ROAD CHILLICOTHE OH 45601 453980850 SEE SCHEDULE R, PART VII OH N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 SCHEDULE R, PART IV, COLUMN (B) THE PRIMARY ACTIVITY OF ADENA CARE IS TO DEVELOP STRATEGIC RELATIONSHIPS TO THE SERVICE AREAS MAJOR EMPLOYERS THROUGH HEALTH MANAGEMENT AND WELLNESS SERVICES.