Contents. Message from the President 3. Board of Directors & Senior Leadership Team Updates 5 6. Financial Report 7.

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Contents Message from the President 3 Board of Directors & Senior Leadership Team 4 2017 Updates 5 6 Financial Report 7 Service Lines 2017 All Service Line Totals 8 2017 Hospice Care Admissions by Site 9 2017 Palliative Care Location of Service 10 2017 By the Numbers 11 Our Services 12 2

Message from the President For Bluegrass Care Navigators, previously Hospice of the Bluegrass, 2017 was a spectacular year as we cared for a record number of hospice patients, expanded our services and received numerous awards. We continued in our mission to provide patientcentered care to the seriously ill and their families, with excellence and compassion. Many of you have experienced the meaningful care that hospice provides to individuals and their families at the end of life. In 2017, 5,645 hospice patients and their families across 32 Kentucky counties received our unique, compassionate and individualized care that only a hospice team can provide. For those not in need of hospice care, our other services combined reached an additional 6,677 patients and families. We could not have provided these services from hospice and palliative care to personal care and transitional care without the support of our donors, volunteers, team members and health care and community partners. We thrive because we receive generous support from so many. We have always been proud of our ability to provide award-winning care. This year we are able to show off a bit, yet are humbled by three national awards. The American Hospital Association presented a 2017 Circle of Life Award to Bluegrass Care Navigators for innovation in palliative care and for improving the care of patients near the end of life. In June, we were named a 2017 Hospice Honors Elite recipient, placing us among the best in the nation. The award recognizes hospices providing the highest level of quality as measured from the caregiver s point of view. Only one month earlier, Modern Healthcare named Bluegrass Care Navigators one of its prestigious Best Places to Work. We are especially proud that these three national honors reflect praise from consumers, our staff and the health care community. Bluegrass Home Primary Care joined our lines of service, providing ongoing expert care for people in Fayette and Jessamine counties who are home limited. Our new Bluegrass Adult Day Health Care facility will open in Frankfort in April 2018 for adults who have physical or mental conditions resulting from age or illness. Both of these new services help fulfil our mission to provide patient-centered care to the seriously ill and their families. As our service lines expanded beyond hospice and palliative, 2017 marked the first full year of providing care under our new name and brand and we continue to receive compliments about the new look. Our media campaign serves to remind patients and families that we are still the same great provider with the same compassionate experts. With a growing, expert staff and newly expanded services, teams from Bluegrass Care Navigators surround patients with unsurpassed experience, expertise and access to the right care at the right time in the right place. Stay tuned we are celebrating our 40th anniversary in 2018, as we continue to provide expert, compassionate care to the seriously ill and their families. Thank you! Liz Fowler, President & CEO Bluegrass Care Navigators 3

Board of Directors Nana Mensah, Chair Shannon Bishop Arvin, Vice Chair Jen Shah, Treasurer David Fogg, Secretary Eric Frankl, Past Chair Liz Fowler, President & CEO Jim Blancet J.D. Miller Anne Bolton Greg Milward David Brennen Zachary Moore Jenna Canning Zachary Murray Laura Feltner Mark Nabity Steve Fryman Jeff Raines Joan Palmore Key Robert Rosenstein Katie LaMonica George Wallace Ellen Miller Leadership Team Liz Fowler, MPH, President & CEO Todd Coté, MD, FAAFP, FAAHPM, Chief Medical Officer Deede Byrne, CHPCA, Chief Operating Officer (Retired Aug. 2017) Croswell Chambers, Chief Information Officer Stephanie Greene, MHA, Vice President & Chief Hospice Officer Holly Hodge, CPA, MBA, Chief Financial Officer & Vice President of Finance Cassie Mitchell, MSN, MBA, RN, Vice President of Marketing & Business Development Danita Ross, SPHR, Vice President of Human Resources Susan Swinford, MSW, Vice President of Administration Eugenia Smither, BS, RN, CHP, CHE, CHC, Corporate Compliance Officer & Vice President for Compliance & Quality Improvement (CQI) Susan Ware, CFRM, Vice President of Philanthropy Monica Couch, RN, CHPN, AVP of Eastern Kentucky Operations Denise Burton, RN, BSN, CHPN, CHPCA, Executive Director, Northern KY (From Dec. 2017) Amy Cox, RN, BSN, CHPN, CHPCA, Executive Director, Cynthiana Carla Foster, RN, BSN, MA, Executive Director, Northern KY (Through Dec. 2017) Brian Hensley, RN, BSN, CHPN, Executive Director, Barbourville Gwen Johnson, RN, CHPN, Executive Director, Lexington Lindsay Kampfer, LCSW, ACHP, Executive Director, Frankfort 4

2017 Updates National recognition We were humbled to receive three national awards in 2017: Our social media outreach campaign continues to spread the word about our services to a growing audience. The number of likes for our Facebook page rose by 8 percent in 2017, to 11,263. The American Hospital Association presented a Circle of Life Award to Bluegrass Care Navigators for innovation in palliative care and for improving the care of patients near the end of life. In June, we were named a Hospice Honors Elite recipient, placing us among the best in the nation. The award recognizes hospices providing the highest level of quality as measured from the caregiver s point of view. Only one month earlier, Modern Healthcare named Bluegrass Care Navigators one of its prestigious Best Places to Work. These three national honors reflect praise from consumers, our staff and the health care community. Our new name Bluegrass Care Navigators saw the first full year under its new name and brand in 2017. Our media campaign continues to remind patients and families that we made the change to guide and provide care to more people in more ways at earlier stages of serious illness. The new brand simply reflects the growing range of services that we provide. Home Primary Care launched Bluegrass Home Primary Care joined our other lines of service in 2017, providing ongoing physician/medical care for people in Fayette and Jessamine counties who are home limited with complex health care needs. It is often difficult for these patients to travel to a doctor s office or clinic. Bluegrass Home Primary Care uses a highly trained team of nurses and nurse practitioners to deliver care in the home under the supervision of a board-certified physician. Patients are seen on a regular basis and given care focused on the patient and prevention of more serious health issues. Our team can also help to improve communication and coordination between the patient and other health care providers. With our new name came a new online presence a fresh, redesigned website that s gaining attention. Nearly 43,000 people visited bgcarenav.org in 2017, an average of more than 3,500 a month. 5

2017 Updates Neonatal Abstinence Syndrome (NAS) and Low-Birth Weight Project Bluegrass Transitional Care began working with UK Children s Hospital in 2017 to develop and implement a transition intervention for Neonatal Abstinence Syndrome babies and their mothers. NAS babies are born drug addicted due to drug abuse by their mother during pregnancy and are very sensitive to stimuli, inconsolable, irritable, feed poorly and have tremors and seizures, as well as other serious symptoms. Low birth weight (LBW) babies are born weighing less than 5 pounds, 8 ounces. In contrast, the average newborn weighs about 8 pounds. A baby with low birthweight may be at increased risk for complications. The team has already enrolled and successfully treated babies, and is working with foster parents as well as biological parents. The program utilizes a transition nurse who establishes a trusting relationship with the mother, ensures that medications are being taken on time, and assesses the baby s home environment for appropriate referral to additional helpful resources. Stephanie Greene Coming and going Stephanie Greene joined us in November as our new Vice President & Chief of Hospice Services. She came to us from Caretenders / Almost Family, a provider of home health nursing, rehabilitation and personal care services, where she was the regional executive director. Stephanie has extensive experience in developing strategic relationships with corporations, community organizations and health care providers. Denise Burton Deede Byrne Carla Foster Staff awards Denise Burton, RN, BSN, CHPN, was promoted, leaving her position as nurse supervisor to become the new executive director for northern Kentucky. Deede Byrne retired as chief operating officer in August for the warmer climate in Florida, capping 27 years of hard work, commitment and leadership. Carla Foster retired in December as executive director of our northern Kentucky operations after 12 years with the agency. As a leader, she gained respect and confidence by consistently being an available resource of knowledge, encouragement and support for her staff, colleagues and peers, said President and CEO Liz Fowler. We welcome Stephanie aboard as we thank Carla and Deede for their years of service and dedication to our mission. A number of our experts were singled out for praise in 2017. The Kentucky Association of Hospice and Palliative Care presented its Distinguished Leader award to Sue Snider, our Associate Clinical Officer of Nursing and a committed leader, educator and innovator. The group s Award of Excellence was given to Eugenia Smither, a nationally recognized expert who oversees our compliance, quality, accreditation, infection control and patient safety. Congratulations to our talented staff! 6

Financial Report 2017 Total Income = $62,379,798 2017 Total Expenses = $56,301,301 Investment Philanthropy $6,647,083 $1,404,985 Other Income $160,131 Admin & Program $7,456,789 Fundraising $586,120 Patient Revenue $54,167,599 Patient Services $48,258,392 7

Service Lines 2017 All Service Line Totals 12,322 Total Patients Served Grief Care 1,773 (14%) Palliative Care 2,455 (20%) Hospice Care 5,645 (46%) Home Primary Care 30 (<1%) Transitional Care 2,351 (19%) Extra Care 68 (<1%) 8

Service Lines 2017 Hospice Care Admissions by Location 5,249 Total Hospice Care Admissions Northern Kentucky 580 (11%) Hazard & Pikeville 983 (19%) Cynthiana 428 (8%) Barbourville 580 (11%) Frankfort 464 (9%) Lexington 2,214 (42%) 9

Service Lines 2017 Palliative Care Location of Service 8,732 Total Palliative Care Visits Nursing Facility 952 (11%) Palliative Clinic 605 (7%) Palliative Home 493 (6%) Primary Care 82 (1%) Hospital 6,600 (76%) 10

2017 By the Numbers Social Media January 2017: 10,832 Likes December 2017: 11,661 Likes December 2017: 1,793 Followers Miles Driven Bluegrass Hospice Care Bluegrass Palliative Care Bluegrass Extra Care Bluegrass Transitional Care Total miles 2,470,013 20,517 24,205 12,396 2,527,131 That s equal to driving across America over 900 times! Our Durable Medical Equipment staff completed more than 14,000 deliveries and pickups in 2017. Our pharmacy filled more than 63,000 prescriptions in 2017. July 2017: 1,767 Followers July 2017: 1,013 Followers December 2017: 1,060 Followers 513 Employees 69 part-time 444 full-time Volunteers provided 26,050 hours of their time, which equals a cost savings to the agency of $624,313.27. 817 Veterans Served Barbourville: 82 Cynthiana: 73 Fayette County: 303 Lexington HCC: 59 Frankfort: 84 Hazard & Hazard HCC: 119 Northern Kentucky: 97 182 Children, Adults, Staff & Volunteers Participated in our Camp Programs 11

Our Services Bluegrass Extra Care: a private pay, personalized service for clients in their home, nursing home, or assisted living facility. Service can include homemakers, certified nursing assistants, sitters and skilled nursing, and service can range from one time to intermittent to 24-hour care. Bluegrass Home Primary Care: comprehensive, ongoing expert care for chronic medical conditions in those who are home limited. Bluegrass Adult Day Health Care: an engaging program for adults whose physical or intellectual competency has been compromised by age or illness. Bluegrass Transitional Care: a program provided by the hospital or insurance provider that helps patients after a hospitalization transition to care at home. Bluegrass Palliative Care: a physician consult service providing specialized medical care focused on relief from the symptoms and stresses of a serious illness, with the goal of improving quality of life. Bluegrass Hospice Care: a program providing expert care for the final months of life, including medical, nursing, emotional and spiritual support for the patient and entire family. Bluegrass Grief Care: a unique counseling service for support and guidance through anticipatory grief and bereavement. 12