2021-11-12T10:51:59-06:00 2020-12-31 310800053 Clark Schaefer Hackett & Co 10100 Innovation Drive Suite 400 Dayton OH 45342 990 2020-01-01 270712680 Beavercreek Medical Center BEAV 9377621629 1 Prestige Place No 910 Miamisburg OH 45342 Dann Hotelling Vice President of Finance 9377621629 2021-11-11 1 Dann Hotelling 999009999 Herbert L Lemaster CPA P00039882 9372260070 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z The Indu and Raj Soin Medical Center Richard Haas 1 Prestige Place Suite 910 Miamisburg OH 45342 204531668 0 X www.ketteringhealth.org X 2009 OH To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner. 12 4 0 309 6957 1586 76824 72415 192807560 200616449 343587 3031 0 3839773 193227971 204531668 19882 31252 0 0 75113763 76252018 0 0 0 109489033 102038917 184622678 178322187 8605293 26209481 208510534 241654917 113445155 127658970 95065379 113995947 To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner 0 0 168571889 31252 201551863 Care was provided for 8,775 discharges, adult & ped days of 33,799, and 111,610 outpatient visits.Leading edge response to the COVID-19 pandemic centered around the community. Soin Medical Center established screening and testing sites, created telehealth options for community access, and created surge capacity for treatment and protocols for protecting team members. Soin Medical Center also purchased and stored essential supplies and personal protective equipment and provided training for team members as well as enhanced safety and cleaning protocols for facilities. 168571889 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Dann Hotelling 9377621629 1 Prestige Place Suite 910 Miamisburg OH 45342 Manchur Fred CEO KH 1.00 50.00 X 0 1440192 50725 Burns Terry COO KH 1.00 50.00 X 0 955496 63515 Dodds Rick President GMH/SOIN 26.00 25.00 X X 0 507729 62760 Smith Robert T Physician 1.00 39.00 X 0 405890 35113 Tyner Troy A Physician 1.00 39.00 X 0 255096 34338 Chew Roy Consultant 0.25 5.75 X 0 31250 31386 Weigley David Pres. Columbia Union Conference of SDA 1.00 5.00 X 0 16000 0 Halvorsen Ron Jr Pres. Ohio Conference of SDA 1.00 4.00 X 0 0 0 Peebles Thomas Community Volunteer 1.00 2.00 X 0 0 0 Gordon Delthony Community Volunteer 1.00 1.00 X 0 0 0 Parker Phillip Pres, Dayton Chamber of Commerce 1.00 1.00 X 0 0 0 Soin Amol MD Physician 1.00 1.00 X 0 0 0 Barber Wendi CFO Region #1 Effective 3/30/2020 25.00 25.00 X 0 411997 86090 Schneider Erica VP Patient Care Services GMH/SOIN 25.00 24.00 X 0 275914 68730 Williams Eric A Medical Physicist MS Certified 40.00 X 0 173366 18006 Jones Jeff Manager Human Resources 40.00 X 0 168785 29146 Gruia Ovidiu E Director Business Development 40.00 X 0 164965 31677 Robinson Barbara M Director of Nursing 40.00 X 0 157007 29779 Williams Mendy K Dir Acute & Critical Care Services 20.00 20.00 X 0 170281 11254 Connovich Ron Former Officer 0.00 49.00 X 0 509552 52945 Mallett Belinda A Former Key Employee 0.00 40.00 X 0 179649 26598 0 5823169 632062 0 1 1 0 0 72415 72415 Patient care services 622000 199646274 196748872 2897402 Leasing activities related to mis 531120 963218 963218 Reference lab 621500 6957 6957 200616449 31 31 3000 0 3000 3000 3000 Stimulus & retention credits 900099 3839773 3839773 3839773 204531668 201551863 6957 2900433 X 31252 31252 3133731 2733432 400299 57546090 53113366 4432724 1856127 1713151 142976 9542584 8807527 735057 4173486 3852006 321480 14083 2150 11933 2970 2970 10141797 9777157 364640 1896432 1854266 42166 401296 399774 1522 -1692077 -1689503 -2574 44344 33520 10824 48605 45615 2990 2462403 2458656 3747 12479966 12460978 18988 736528 588956 147572 Medical supplies 30503445 30382908 120537 Network services 20633515 17997815 2635700 Physician services 16523845 16523845 Cost of goods sold 1787343 1787343 6054422 5697675 356747 178322187 168571889 9750298 0 111596 74817 22174363 25259328 2813995 3346709 892363 664188 309571185 97912614 181344068 211658571 1174149 651304 208510534 241654917 13285253 11847517 3099 14533099 96618133 95948718 3538670 5329636 113445155 127658970 X 95065379 113995947 95065379 113995947 208510534 241654917 X 26209481 -7278913 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20671041 20671041 227145434 59585168 167560266 55597203 38327446 17269757 6157507 6157507 211658571 Estimated amounts due to third-party payors 2325545 Operating lease liabilities 210270 Other long-term contracts 280000 Physician income guarantee commitments -131666 Professional self-insurance liability 2645487 5329636 X Part X, Line 2: The Network completed an analysis of its certain and uncertain tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2020 or 2019. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 2779352 609107 2170245 0.01220 36510568 18670359 17840209 0.10000 39289920 19279466 20010454 0.11220 5022030 3567709 1454321 0.00820 2008894 1412849 596045 0.00330 2192614 840113 1352501 0.00760 1365778 1365778 0.00770 10589316 5820671 4768645 0.02680 49879236 25100137 24779099 0.13900 1 13950856 334821 36286275 34241605 2044670 X 1 1 1 1 Beavercreek Medical Center 3535 Pentagon Boulevard Beavercreek OH 45431 ketteringhealth.org/soin/ X X X X Beavercreek Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X https://ketteringhealth.org/about/community-health/ X 1 20 1 https://ketteringhealth.org/about/community-health/ 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X X 1 X https://ketteringhealth.org/billing-insurance/financial-assistance/ X https://ketteringhealth.org/billing-insurance/financial-assistance/ X https://ketteringhealth.org/billing-insurance/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section A: The facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law. Beavercreek Medical Center Part V, Section B, Line 5: Nonprofit hospitals in the Greater Cincinnati and Greater Dayton regions combined their efforts and resources to produce a comprehensive and collaborative Community Health Needs Assessment (CHNA). The CHNA Team involved four entities working closely together: The Health Collaborative (lead agency); the Greater Dayton Area Hospital Association; Gwen Finegan (lead consultant and project manager); and Public Health - Dayton & Montgomery County (secondary data collection for Ohio counties). The Southwest District of the Association of Ohio Health Commissioners also partnered in the effort. They provided representatives who could speak on the behalf of the 17 Ohio counties served by the hospitals. All county-level public health departments completed surveys, plus 5 city health departments. Beavercreek Medical Center Part V, Section B, Line 6a: The Christ Hospital Health NetworkCincinnati Children's Hospital Medical CenterClinton Memorial HospitalHighpoint HealthFort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Behavioral Medicine CenterKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterLindner Center of HopeMercy Health - Anderson HospitalMercy Health - Clermont HospitalMercy Health - Fairfield HospitalMercy Health - West HospitalThe Jewish Hospital - Mercy HealthMercy Health | Springfield Urbana regionMercy Health - Urbana HospitalSpringfield Regional Medical CenterAtrium Medical CenterMiami Valley HospitalMiami Valley Hospital NorthMiami Valley Hospital SouthUpper Valley Medical CenterBethesda Butler HospitalBethesda North HospitalGood Samaritan HospitalMcCullough-Hyde Memorial HospitalTriHealth Evendale Hospital Daniel Drake Center for Post-Acute CareUniversity of Cincinnati Medical Center West Chester HospitalWilson HealthWayne HealthCare Beavercreek Medical Center Part V, Section B, Line 6b: The Health CollaborativeGreater Dayton Area Hospital AssociationGwen FineganPublic Health - Dayton & Montgomery CountySouthwest District of the Association of Ohio Health Commissioners Beavercreek Medical Center Part V, Section B, Line 11: The priorities for Soin Medical Center are the top community health needs identified in the Community Health Needs Assessment (CHNA): 1. Mental health, including substance abuse 2. Access to care and/or services, including infant mortality 3. Chronic disease 4. Healthy behaviorsThese will be addressed through a rural health initiative, congregational health, midwifery care, referrals to prenatal care from ED, a hospital-based tobacco cessation program, and ongoing participation with Drug Free Coalition. 1 1 - Springfield Health Center 2100 Emmanuel Way Springfield OH 45502 Outpatient Clinic & Diagnostic Center Part I, Line 6a: The organization provides an annual community benefit report that is made available to the public. Part I, Line 7: Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid, and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures. Part I, Line 7g: Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers. Part III, Line 2: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Part III, Line 3: An industry average was used to estimate this amount. It was not included as part of community benefit. Part III, Line 4: Bad Debt Footnote extract:Implicit price concessions represent differences between amounts billed and the estimated consideration the Network expects to receive from patients, which are determined based on historical collection experience, current market conditions, and other factors. Part III, Line 8: The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in community benefit in Part I. Part III, Line 9b: Financial counselors work out a payment program for any amount due after the Charity Sliding Scale Discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances. Part VI, Line 3: Soin informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Soin's charity care policy as follows:-Soin has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This data is available for future visits as well.-Soin has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.-Soin contracts with an outside agency for patient assistance in the application process.-The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for Soin's HCAP or Charity Sliding Scale program. -Soin's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs. Part VI, Line 4: Kettering Health serves a population of approximately 1,574,000. The seven-county service area includes Butler, Clark, Greene, Miami, Montgomery, Preble, and Warren counties. Eighteen zip codes within this service area received a Community Need Index score of 3.4 or greater. The Community Need Index identifies the severity of healthcare disparities based upon certain barriers known to limit healthcare access. A score of 1.0 indicates a zip code with the lowest socio-economic barriers (low need), while a score of 5.0 represents a zip code with the most socio-economic barriers (high need). Part VI, Line 5: Soin furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments.-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most advanced medical technology, upgrades of existing hospital structures, and construction of new facilities in order to provide accessible, efficient, quality care. Part VI, Line 6: Soin promotes the health of the communities served as described below:-Soin, a part of Kettering Health, is dedicated to the creation and maintenance of community wellness programs, support groups, and health education programs. Soin provides numerous screenings, family-focused classes, health fairs, conferences, donations, and education programs to ensure the long-term well-being of people living in the community.-Kettering Affiliated Health Services Inc includes Sycamore Glen Retirement Community which provides services to the surrounding communities which complement those services provided by Soin as part of Kettering Health.-Medical research is supported through the Innovation Center, which cultivates new technologies and fosters best practices among partners from industry, academia and health care. Part VI, Line 7, Reports Filed With States OH 1 Assistance to employees for hardship 16 13286 FMV COVID-19 hardship assistance 46 12966 FMV Scholarship 3 5000 FMV Part I, Line 2: Funds are monitored and use is determined by board members. 0 1 0 0 0 0 0 0 0 Manchur Fred CEO KH 0 1412844 0 0 0 27348 0 15787 0 34938 0 1490917 0 0 Burns Terry COO KH 0 830866 0 0 0 124630 0 15787 0 47728 0 1019011 0 0 Dodds Rick President GMH/SOIN 0 417777 0 0 0 89952 0 34297 0 28463 0 570489 0 49820 Smith Robert T Physician 0 401496 0 0 0 4394 0 16087 0 19026 0 441003 0 0 Tyner Troy A Physician 0 255096 0 0 0 0 0 16087 0 18251 0 289434 0 0 Barber Wendi CFO Region #1 Effective 3/30/2020 0 409576 0 0 0 2421 0 56287 0 29803 0 498087 0 0 Schneider Erica VP Patient Care Services GMH/SOIN 0 274085 0 0 0 1829 0 41630 0 27100 0 344644 0 0 Williams Eric A Medical Physicist MS Certified 0 172866 0 500 0 0 0 10831 0 7175 0 191372 0 0 Jones Jeff Manager Human Resources 0 161063 0 5748 0 1974 0 9741 0 19405 0 197931 0 0 Gruia Ovidiu E Director Business Development 0 152171 0 7549 0 5245 0 9353 0 22324 0 196642 0 0 Robinson Barbara M Director of Nursing 0 145606 0 6955 0 4446 0 9084 0 20695 0 186786 0 0 Williams Mendy K Dir Acute & Critical Care Services 0 55582 0 0 0 114699 0 0 0 11254 0 181535 0 0 Connovich Ron Former Officer 0 420291 0 0 0 89261 0 34087 0 18858 0 562497 0 49068 Mallett Belinda A Former Key Employee 0 167494 0 8593 0 3562 0 11389 0 15209 0 206247 0 0 Part I, Line 3 Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid. Part I, Line 4b Kettering Health has a supplemental executive retirement plan available only to a certain class of management. Part II, Col Biii Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets. A County of Greene Ohio 316000271 394650BV6 2009-11-03 97931091 Construct and equip a hospital 0 0 0 B County of Montgomery Ohio 316000271 613520LA1 2016-05-04 12087009 Hospital building improvements and equipment 0 0 0 C County of Miami Ohio 316000055 593328EW3 2019-03-07 85486838 Hospital facilities improvement and refunding 0 0 0 A 100867503 9296792 2633592 1612304 85213731 2111084 2012 0 0 1 1 B 12087009 110713 11976296 2016 0 0 1 1 C 85486838 521348 4790564 80174926 2019 1 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 Form 990, Part VI, Section B, line 11b A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board). Form 990, Part VI, Section B, line 12c Kettering Health regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review Kettering Health's policy, sign a conflict of interest statement, and notify Kettering Health if a conflict should arise. Form 990, Part VI, Section B, line 15 Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Part IX, Lines 5, 7, 8, 9, & 10 Salaries, retirement plan contributions, other benefits, and payroll taxes are paid by and allocated from Kettering Medical Center and Kettering Network Services. Form 990, Part XI, line 9: Net transfers to affiliate -7,278,913. Part XII, Line 2c Neither the oversight process nor the selection process changed during the tax year. Alliance Physicians Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311175717 Physician Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Dayton Osteopathic Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310564121 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Fort Hamilton Hospital Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 452036966 Fundraising OH 501(c)(3) 509(a)(3) The Fort Hamilton Hospital 0 Greene Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 310886949 Fundraising OH 501(c)(3) 509(a)(3) Greene Memorial Hospital 0 Greene Memorial Hospital Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 310809436 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettering Adventist Healthcare 1 Prestige Place Suite 910 Miamisburg OH 45342 311051688 Management OH 501(c)(3) 509(a)(3) N/A 0 Kettering Affiliated Health Services Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311127485 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Independent Medical Group 1 Prestige Place Suite 910 Miamisburg OH 45342 272649285 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Medical Center 1 Prestige Place Suite 910 Miamisburg OH 45342 310621866 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettering Medical Center Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 237419897 Fundraising OH 501(c)(3) 509(a)(3) Kettering Medical Center 0 Kettering Network Services 1 Prestige Place Suite 910 Miamisburg OH 45342 832687866 Administrative Support Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 The Fort Hamilton Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310536662 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettcor 1 Prestige Place Suite 910 Miamisburg OH 45342 311078381 Health Services OH N/A C 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 Greene Foundation C 72415 FMV Alliance Physicians Inc J 448662 FMV Dayton Osteopathic Hospital J 313016 FMV Kettering Network Services J 36710 FMV Kettering Network Services K 188015 FMV Alliance Physicians Inc M 0 FMV Greene Foundation M 0 FMV Kettering Adventist Healthcare M 0 FMV Kettering Medical Center M 0 FMV Kettering Network Services M 0 FMV Kettering Medical Center N 0 FMV Kettering Network Services N 0 FMV Greene Memorial Hospital Inc O 0 FMV Kettering Medical Center O 0 FMV Kettering Network Services O 0 FMV Kettering Medical Center P 0 FMV Kettering Network Services P 0 FMV Kettering Medical Center R 7278913 FMV Part V, Line 2 Kettering Medical Center and Kettering Network Services are conduits through which revenue is received and expenses are paid.