2023-11-14T14:39:40-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 310993422 GREENFIELD AREA MEDICAL CENTER GREE 7407794478 550 MIRABEAU ST GREENFIELD OH 45123 JAMES P MCMANUS CFO 7407794478 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 ADENA GREENFIELD MEDICAL CENTER JEFF GRAHAM 550 MIRABEAU ST GREENFIELD OH 45123 24435580 0 X WWW.ADENA.ORG X 1918 OH ADENA GREENFIELD MEDICAL CENTER IS A PART OF THE ADENA HEALTH SYSTEM AND IS A CRITICAL ACCESS HOSPITAL PROVIDING HEALTHCARE TO CITIZENS IN HIGHLAND, FAYETTE, AND ROSS COUNTIES. 9 8 218 8 0 0 214051 471109 25627071 23870673 280788 0 141844 93798 26263754 24435580 0 0 0 0 11343415 12453201 0 0 0 12021423 13022803 23364838 25476004 2898916 -1040424 12172716 15597696 2420812 3363713 9751904 12233983 X CALLED TO SERVE OUR COMMUNITIES 0 0 20638191 23870673 ADENA GREENFIELD MEDICAL CENTER IS A 25-BED INPATIENT FACILITY IN RURAL GREENFIELD, OH. THE HOSPITAL HAS AN EMERGENCY DEPARTMENT, INPATIENT REHABILITATION AND MEDICAL/SURGICAL UNITS, DIAGNOSTIC AND SURGICAL TREATMENT SERVICES, AS WELL AS SPECIALTY PHYSICIANS. EMERGENCY, INPATIENT MEDICAL AND SURGICAL, AND REHABILITATION SERVICES ARE THE LARGEST PROGRAMS, BY EXPENSES, FOR THE FACILITY. EMERGENCY SERVICES ARE PROVIDED 24 HOURS A DAY, SEVEN DAYS A WEEK AT THE ADENA GREENFIELD MEDICAL CENTER. IT IS EQUIPPED TO HANDLE MOST EMERGENCIES AND THE AFFILIATION WITH ADENA REGIONAL MEDICAL CENTER MEANS THAT ACCESS TO SPECIALISTS AND REGIONAL-LEVEL CARE IS READILY AVAILABLE TO THE RURAL COMMUNITY. IN 2022, THERE WERE 8,403 VISITS PAID TO THE EMERGENCY ROOM IN GREENFIELD.THE INPATIENT UNIT OF ADENA GREENFIELD MEDICAL CENTER SERVES GENERAL ADULT ACUTE AND SKILLED CARE WITH AN AVERAGE LENGTH OF STAY OF 8.0 DAYS. IN 2022, THERE WERE 502 INPATIENT DISCHARGES AND 63 SURGICAL PROCEDURES. CARE IS ADMINISTERED PRIMARILY FOR THOSE INDIVIDUALS SUFFERING FROM PNEUMONIA, CONGESTIVE HEART FAILURE, DIABETES, STROKE, AND COPD. THROUGH THE AFFILIATION WITH ADENA HEALTH SYSTEM, THE HOSPITAL IS ABLE TO OFFER RESIDENTS OF THE GREENFIELD AREA ACCESS TO HIGHER-INTENSITY SERVICES SUCH AS THE INTENSIVE/CARDIAC CARE UNIT AND CARDIAC TELEMETRY UNIT, AS WELL AS SPECIALIZED SERVICES SUCH AS MATERNITY AND PEDIATRICS.THE ADENA GREENFIELD MEDICAL CENTER OFFERS ACCESS TO HIGH-QUALITY INPATIENT AND OUTPATIENT REHABILITATION SERVICES TO THE RURAL COMMUNITY. THE REHAB TEAM FOCUSES ON RETURNING PATIENTS TO A NORMAL ROUTINE AS SOON AS POSSIBLE. EACH MEMBER HAS ADVANCED TRAINING SPECIFIC TO THE TYPE OF TREATMENT BEING PROVIDED, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH, AND RECREATIONAL THERAPY. THE THERAPISTS USE THE LATEST TECHNIQUES AND EQUIPMENT TO HELP EACH PATIENT. 20638191 1 0 0 1 0 0 0 0 0 1 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 0 218 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 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 45601 RICHARD MIZER TRUSTEE/PRESIDENT OF AMG 2.00 50.00 X 0 428751 47984 RON COFFEY TRUSTEE/BOARD CHAIRMAN 2.00 2.00 X X 0 0 0 STEVE PEARCE TRUSTEE/VICE CHAIR 2.00 0.00 X X 0 0 0 TERRENCE FOUCH TRUSTEE 2.00 0.00 X 0 0 0 QUINCY GRAY TRUSTEE 2.00 0.00 X 0 0 0 HEATH FETTRO TRUSTEE 2.00 0.00 X 0 0 0 DESTINY BRYSON TRUSTEE 2.00 0.00 X 0 0 0 DANNY LONG TRUSTEE 2.00 0.00 X 0 0 0 BLAIN BERGSTROM TRUSTEE 2.00 0.00 X 0 0 0 TARA CAMPBELL TRUSTEE 2.00 0.00 X 0 0 0 JEFF GRAHAM AHS CEO 1.00 53.00 X 0 1178750 88919 LISA CARLSON AHS CFO-PART YEAR 1.00 53.00 X 0 619618 50481 KATHERINE EDRINGTON AHS COO 1.00 53.00 X 0 696085 41744 JOSH MCCOY WEST MARKET VP/SENIOR OPS EXECUTIVE 50.00 0.00 X 259834 0 32788 JAMES MCMANUS AHS CFO 1.00 53.00 X 0 314210 19615 ANITA HARRIS DIRECTOR OPERATIONS CRITICAL ACCESS 50.00 0.00 X 154167 0 25230 LAUREN KING DIRECTOR OF NURSING 50.00 0.00 X 117335 0 29207 CHERYL BECKMAN REHAB OPERATIONS MGR 50.00 0.00 X 117391 0 6637 DAWN PAGE NURSE STAFF RN/COORD PT CARE 50.00 0.00 X 115263 0 14496 LISA CASE MEDICAL LAB SCIENTIST 50.00 0.00 X 125383 0 6963 889373 3237414 364064 6 0 1 0 PREMIER PHYSICIAN SERVICES 332 CONGRESS PARK DR DAYTON OH 45459 PHYSICIAN SERVICES 1453300 APOGEE MEDICAL MANAGEMENT 15059 N SCOTTSDALE RD 600 SCOTTSDALE AZ 85254 PHYSICIAN SERVICES 823354 CAPTIVE RADIOLOGY 6273 FRANK AVENUE NW NORTH CANTON OH 44720 MRI SERVICES 255433 MEDCARE AMBULANCE 3699 PARAGON DRIVE COLUMBUS OH 43228 AMBULANCE 181677 4 471109 471109 NET PATIENT SVC REV 622110 23870673 23870673 23870673 FOOD & NUTRITION 722514 90872 90872 AUX INCOME 900099 2926 2926 93798 24435580 23870673 0 93798 X 292633 236892 55741 9566991 7744666 1822325 1947556 1574896 372660 646021 522407 123614 3248763 1411445 1837318 218823 173756 45067 30851 16059 14792 2543 1324 1219 711736 519001 192735 89947 73223 16724 OVERHEAD ALLOCATION 3416851 3219747 197104 BAD DEBT EXPENSE 1989365 1989365 MEDICAL SUPPLIES 1888692 1779741 108951 HCAP ASSESSMENT 728529 728529 696703 647140 49563 25476004 20638191 4837813 0 959820 1059158 3327470 3964007 419209 2529 17709120 8784245 5558358 8924875 1907859 1647122 5 12172716 15597696 655640 1267539 1112322 652850 2096174 2420812 3363713 X 7897909 10573460 1853995 1660523 9751904 12233983 12172716 15597696 X -1040424 -260405 3782908 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 782 782 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. 179200 29920 29916 179204 179200 55959 55959 179200 179200 55955 55955 179200 179200 65836 65836 179200 179200 9427 9427 179200 0.00000 1.00000 0.00000 0 0 669553 669553 9465998 4340808 5125190 7124457 4202276 2922181 449112 241161 207951 8924875 COST REPORT SETTLEMENT PAYABLE 1303600 CAPITAL LEASE OBLIGATION 11260 ROU LIABILITY 132478 ADVANCED MEDICARE PAYMENTS 648836 2096174 PART V, LINE 4: EARNINGS FROM ENDOWMENT FUNDS ARE USED FOR PURCHASE OF CAPITAL EQUIPMENT AND OPERATIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 483742 751846 0 0.00000 5624185 3480338 2143847 0.09130 6107927 4232184 2143847 0.09130 5880 5880 0.00030 1287080 1287080 0.05480 1292960 1292960 0.05510 7400887 4232184 3436807 0.14640 0 1989365 0 9200356 10651905 -1451549 X 1 1 1 1 GREENFIELD AREA MEDICAL CENTER 550 MIRABEAU ST GREENFIELD OH 451231617 WWW.ADENA.ORG ST. REG. NUM. 1200 X X X X CAH WITH ACUTE & SKILLED NURSING GREENFIELD AREA 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 GREENFIELD AREA MEDICAL CENTER PART V, SECTION B, LINE 5: THE ADENA GREENFIELD MEDICAL CENTER CAPTURED THE BROAD INTERESTS OF THE COMMUNITY FOR THE CHNA THROUGH THREE PRIMARY METHODS: PUBLIC SURVEYS, KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS. A HEALTH NEEDS SURVEY WAS WIDELY DISTRIBUTED IN BOTH ELECTRONIC AND PAPER FORM ACROSS THE HIGHLAND COUNTY COMMUNITY AND RECEIVED APPROXIMATELY 600 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. GREENFIELD AREA MEDICAL CENTER PART V, SECTION B, LINE 6A: THE CHNA FOR ADENA FAYETTE MEDICAL CENTER WAS COMPLETED WITH ITS PARENT ENTITY, ADENA HEALTH SYSTEM. GREENFIELD AREA MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA FOR ADENA GREENFIELD MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS: HIGHLAND COUNTY COMMUNITY ACTION, PAINT VALLEY ADAMH BOARD, HIGHLAND COUNTY EMS, HIGHLAND COUNTY HEALTH DEPARTMENT, ADENA HEALTH SYSTEM, ADENA GREENFIELD MEDICAL CENTER, HIGHLAND COUNTY CORONER'S OFFICE, HILLSBORO CITY POLICE, HIGHLAND COUNTY SHERIFF, HIGHLAND COUNTY JOB AND FAMILY SERVICES, FAMILY AND CHILDREN FIRST COUNCIL-HIGHLAND, HIGHLAND DISTRICT HOSPITAL, PAINT CREEK FIRE AND EMS, HILLSBORO CITY SCHOOLS, SAMARITAN OUTREACH SERVICES, CITY OF HILLSBORO, CITY OF GREENFIELD, HIGHLAND COUNTY SENIOR CENTER, HIGHLAND COUNTY COMMISSIONERS, HIGHLAND COUNTY PROBATION DEPARTMENT, TURNING POINT ALC REENTRY SERVICES, FRS TRANSPORTATION, FAMILY RECOVERY SERVICES, HIGHLAND COUNTY CHAMBER OF COMMERCE, MEMBERS OF THE GENERAL PUBLIC, VILLAGE OF HIGHLAND, AREA AGENCY ON AGING, HIGHLAND COUNTY PROSECUTOR, GREENFIELD POLICE DEPARTMENT, SOUTHERN OHIO EDUCATION CENTER, HIGHLAND COUNTY MEDICAL RESERVE CORPS. GREENFIELD AREA 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. GREENFIELD AREA MEDICAL CENTER PART V, SECTION B, LINE 11: THE FOLLOWING DETAILS THE SPECIFIC IMPLEMENTATION STRATEGIES USED FOR HEALTH PRIORITIES IDENTIFIED FOR THE ADENA GREENFIELD MEDICAL CENTER DURING 2022.SUBSTANCE USE DISORDER PROGRAMMING & INITIATIVESTHE BABY CENTERED RECOVERY PROGRAM PROVIDED A TOTAL OF 5 WOMEN (FROM MULTIPLE COUNTIES INCLUDING HIGHLAND) 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 OF 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 DIABETESFINANCIAL SUPPORT AND 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. 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 HEALTHPROGRAMMING & INITIATIVESTHE 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 AND 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 HIGHLAND COUNTY DISTRICT LIBRARIY-GREENFIELD BRANCH TO COORDINATE THE HEALTHY KIDS SUMMER FUN CHALLENGE, PART OF THE BOOKWORM SUMMER READING PROGRAM. A TOTAL OF 259 GREENFIELD RESIDENTS - 173 CHILDREN, 28 TEENS, AND 58 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 WOMEN'S & CHILDREN'S CENTER: ADENA 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: THE GREENFIELD MCCLAIN IN HIGHLAND COUNTY RECEIVED $25,000 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 HIGHLAND COUNTY HEALTH OUTCOMES WERE RANKED 66 IN 2022 (COUNTY HEALTH RANKINGS). HIGHLAND COUNTY HEALTH FACTORS MOVED FROM 76 TO 82 IN 2022 (COUNTY HEALTH RANKINGS). GREENFIELD AREA 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, LINE 7A HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW PART V, LINE 10A HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW 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 HIGHLAND COUNTY COMMUNITY THROUGH A VARIETY OF ENGAGEMENT ACTIVITIES, INCLUDING FINANCIAL SUPPORT AND PARTICIPATION IN LOCAL COMMUNITY EVENTS AND INITIATIVES. APPROXIMATELY 10 CAREGIVERS FROM AGMC PROVIDED MORE THAN 30 HOURS OF COMMUNITY SERVICE AND VOLUNTEER TIME PARTICIPATING IN COMMUNITY OUTREACH, NON-PROFIT BOARD PARTICIPATION AND LEADERSHIP, AND OTHER INITIATIVES. 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. OVER $3,700 TO PIKE COUNTY FARM BUREAU TO SUPPORT PIKE COUNTY 4H AND FARM EDUCATION PROGRAMS. ADENA HEALTH SYSTEM PROVIDED $1,500 IN SUPPORT FOR THE ANNUAL ERNIE BLANKENSHIP TELETHON WHICH PROVIDES MEDICAL RELATED SUPPORT TO LOCAL RESIDENTS OF HIGHLAND COUNTY INCLUDING MEDICATIONS LIKE INSULIN. A TOTAL OF $1,000 WAS PROVIDED TO SUPPORT THE HIGHLAND COUNTY ALZHEIMER'S ASSOCIATION. A TOTAL OF $6,750 WAS PROVIDED TO SUPPORT THE HIGHLAND COUNTY AGRICULTURAL SOCIETY, INCLUDING THE COUNTY FAIR AND THE COUNTY'S 4H MARKET PROGRAM. A TOTAL OF $1,000 WAS SPENT TO SUPPORT COMMUNITY ACTIVITIES IN HIGHLAND COUNTY, INCLUDING GREENFIELD'S OUTDOOR MOVIE NIGHT AND GROW GREATER HIGHLAND. A TOTAL OF $500 WAS PROVIDED TO SUPPORT GREENFIELD'S BLESSINGS IN A BAG PROGRAM, LED BY THE FIRST PRESBYTERIAN CHURCH OF GREENFIELD.ADDITIONAL COMMUNITY COLLABORATIONROSS 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/HIGHLAND COUNTY HEALTH COALITION STEERING COMMITTEE: IN 2019, ADENA HEALTH SYSTEM COLLABORATED WITH THE HIGHLAND COUNTY HEALTH DEPARTMENT TO COORDINATE AND CONVENE A COMMUNITY STEERING COMMITTEE FOCUSED ON COMPLETING REGULAR COMMUNITY HEALTH ASSESSMENTS (CHA) AND A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR HIGHLAND COUNTY. A TOTAL OF 17 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 THREE ADENA EMPLOYEES THAT VOLUNTEERED 12 HOURS IN 2022 TO CONTRIBUTING TO THE HIGHLAND COUNTY HEALTH COLLABORATIVE COMMITTEE IN ADDITION TO OTHER SUB-COMMITTEES MENTIONED THROUGHOUT THIS REPORT. IN ADDITION, ADENA HEALTH SYSTEM PROVIDED $6,000 IN FINANCIAL SUPPORT TO CONTRACT THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO COLLECT AND VALIDATE PUBLIC HEALTH DATA THAT WAS UTILIZED TO DEVELOP COMMUNITY HEALTH NEEDS ASSESSMENTS IN HIGHLAND, PIKE AND ROSS COUNTIES IN 2022. THESE WERE COMPLETED IN PARTNERSHIP WITH PUBLIC HEALTH DEPARTMENTS IN EACH OF THESE COUNTIES. 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 $1,989,365 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 GREENFIELD 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.GREENFIELD AREA 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.PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES THAT WERE BOOKED IN THE CURRENT TAX YEAR ARE ALSO INCLUDED IN THE CURRENT TAX YEAR CALCULATION. 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 GREENFIELD AREA 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 GREENFIELD MEDICAL CENTER 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 4: HIGHLAND COUNTY, HOME OF THE ADENA GREENFIELD MEDICAL CENTER, IS LOCATED IN SOUTHWESTERN OHIO. IT IS PART OF THE 2ND CONGRESSIONAL DISTRICT AND ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT CONTAINS THE POPULATION PATTERNS AND DISTINCT ECONOMIC CONDITIONS INHERENT OF THIS REGION OF THE U.S AND FACES SIMILAR CHALLENGES IN DIVERSIFYING ITS ECONOMY TO IMPROVE THE LIVES OF ITS RESIDENTS.A RURAL COUNTY SITUATED IN SOUTHWESTERN OHIO, HIGHLAND COUNTY IS ONE OF THE STATE'S 32 COUNTIES LOCATED WITHIN THE DESIGNATED APPALACHIAN REGION. IN GENERAL, THE APPALACHIAN REGION'S ECONOMY, ONCE CHARACTERIZED BY ITS DEPENDENCE ON HEAVY INDUSTRY, AGRICULTURE, AND MINING, IS GRADUALLY DIVERSIFYING, WITH A GREATER FOCUS ON SERVICE INDUSTRIES, RETAILING, GOVERNMENT, AND TOURISM (OHIO DEPARTMENT OF JOBS AND FAMILY SERVICES, 2013).THE COUNTY'S ONLY CITY, HILLSBORO, POPULATION 6,550 (U.S. CENSUS, 2015), SERVES AS THE COUNTY SEAT. VILLAGES WITHIN THE COUNTY INCLUDE GREENFIELD, HIGHLAND, LEESBURG, LYNCHBURG, MOWRYSTOWN, AND SINKING SPRING. ACCORDING TO 2015 U.S. CENSUS DATA, THE POPULATION IN HIGHLAND COUNTY IS 43,026. THE COUNTY IS BORDERED BY SEVEN RURAL COUNTIES OF SIMILAR SIZE, INCLUDING ADAMS, BROWN, CLINTON, FAYETTE, PIKE, ROSS, AND SCIOTO. IN THE LAST 40 YEARS, HIGHLAND COUNTY HAS EXPERIENCED A POPULATION GROWTH OF NEARLY 37 PERCENT.THERE ARE 16,841 HOUSEHOLDS IN HIGHLAND COUNTY. THE AVERAGE HOUSEHOLD SIZE IS 2.57 PEOPLE, COMPARABLE WITH THE REST OF THE 12 COUNTY SERVICE REGION AND OHIO. THE AVERAGE FAMILY SIZE IS AS WELL WITH 3.01 PEOPLE. MORE THAN 50% OF THE POPULATION IS NOW MARRIED WHICH IS COMPARABLE WITH OHIO AND NATIONAL AVERAGES. APPROXIMATELY 12% ARE DIVORCED WHICH IS ALSO COMPARABLE WITH THE REGION AND THE STATE.EDUCATIONAL ATTAINMENT IN HIGHLAND COUNTY IS NOT AS PREVALENT AS THE REST OF THE SERVICE REGION, OHIO OR THE U.S. APPROXIMATELY 12.1% OF THE ADULTS IN HIGHLAND COUNTY HOLD A BACHELOR'S DEGREE OR HIGHER, AS COMPARED WITH 11.4% IN THE REGION, 24.5% IN OHIO, AND 28.2% IN THE U.S. ABOUT 11% OF THE POPULATION OF HIGHLAND COUNTY IS ESTIMATED TO BE FUNCTIONALLY ILLITERATE OR LACKING READING AND WRITING SKILLS SUFFICIENT FOR PRACTICAL NEEDS.THE TOP FIVE EMPLOYMENT INDUSTRIES IN HIGHLAND COUNTY ARE PRODUCTION/TRANSPORTATION SERVICES (25.5%), MANAGEMENT/BUSINESS/SCIENCE (22.7%), SALES (22.3%), SERVICE (17.3%), AND NATURAL RESOURCES/CONSTRUCTION/MAINTENANCE (12.3%). HIGHLAND COUNTY HAS CONSIDERABLY MORE PEOPLE EMPLOYED IN PRODUCTION, TRANSPORTATION AND MATERIAL MOVING OCCUPATIONS (25.5%) THAN THE REGIONAL, STATE AND NATIONAL AVERAGES.THE PER CAPITA MEDIAN AND MEAN HOUSEHOLD INCOMES IN HIGHLAND COUNTY OHIO ARE MUCH LOWER THAN THE STATE AND U.S. AVERAGES. POVERTY RATES ARE LOWER THAN THE REGIONAL AVERAGE BUT STILL HIGHER THAN THE STATE AND NATIONAL AVERAGES.THERE ARE 3,849 CIVILIAN VETERANS LIVING IN HIGHLAND COUNTY. THE TOTAL CIVILIAN VETERANS WITHIN THE ADENA HEALTH SYSTEM 12 COUNTY SERVICE REGION REPRESENT 5% OF OHIO'S TOTAL CIVILIAN VETERAN POPULATION.HIGHLAND COUNTY AND ITS ENTIRE SURROUNDING SERVICE REGION HAVE A HIGHER PREVALENCE OF DISABILITY THAN THE REST OF OHIO. SEVEN OF THE 12 COUNTIES IN THE SERVICE REGION, INCLUDING HIGHLAND COUNTY, HAVE DISABILITY PREVALENCE RATES OF 16.7% - 22%. PART VI, LINE 5: ADENA GREENFIELD MEDICAL CENTER WORKS TO PROMOTE THE HEALTH OF ITS COMMUNITY THROUGH LOCAL BOARD REPRESENTATION. THE 2021 BOARD OF TRUSTEES OF ADENA GREENFIELD MEDICAL CENTER WAS COMPRISED OF 9 MEMBERS. ONE BOARD MEMBER IS AN EMPLOYEE OF ADENA HEALTH SYSTEM. ALL BOARD MEMBERS RESIDE 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 THREE 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. 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. 1 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 RICHARD MIZER TRUSTEE/PRESIDENT OF AMG 0 348092 0 54119 0 26540 0 13146 0 34838 0 476735 0 80459 JAMES MCMANUS AHS CFO 0 291710 0 22500 0 0 0 7246 0 12369 0 333825 0 0 JOSH MCCOY WEST MARKET VP/SENIOR OPS EXECUTIVE 217127 0 42707 0 0 0 9607 0 23181 0 292622 0 42707 0 ANITA HARRIS DIRECTOR OPERATIONS CRITICAL ACCESS 133369 0 20798 0 0 0 6376 0 18854 0 179397 0 20798 0 PART I, LINE 3 EXECUTIVE LEADERSHIP AT ADENA GREENFIELD MEDICAL CENTER HAS THEIR 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 ADENA GREENFIELD MEDICAL CENTER MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. PART I, LINE 4B THE ORGANIZATION 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 GREENFIELD AREA 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, ADVANCED PRACTICE CLINICIANS, AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE LEADERSHIP HAVE COMPENSATION REVIEWED EVERY OTHER 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 MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. THIS PROCESS WAS LAST UNDERTAKEN IN 2022. FORM 990, PART VI, SECTION C, LINE 19 AS PART OF ADENA HEALTH SYSTEM, ITS CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AS WELL AS THE AUDITED FINANCIAL STATEMENTS. FORM 990, PART IX, LINE 11G CONTRACT STAFFING: PROGRAM SERVICE EXPENSES 1,411,445. MANAGEMENT AND GENERAL EXPENSES 1,837,318. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,248,763. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE 3,782,908. 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. GREENFIELD AREA MEDICAL CENTER IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. FORM 990, PART V, LINE 1 A RELATED ORGANIZATION, ADENA HEALTH SYSTEM, ISSUES THE 1099S. ADENA HEALTH SYSTEM 272 HOSPITAL ROAD CHILLICOTHE OH 45601 314379443 HOSPITAL OH 501(C)(3) 3 N/A 0 ADENA HEALTH FOUNDATION 272 HOSPITAL ROAD CHILLICOTHE OH 45601 753008742 FUNDRAISING OH 501(C)(3) 12A 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 PIKE HEALTH SERVICES INC 100 DAWN LANE WAVERLY OH 45690 311072406 HOSPITAL OH 501(C)(3) 3 ADENA HEALTH SYSTEM 1 ADENA FAYETTE MEDICAL CENTER 272 HOSPITAL ROAD CHILLICOTHE OH 45601 852985806 HOSPITAL OH 501(C)(3) 3 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 1 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.