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      <Desc>During the year, REF received funding from the U.S. Department of Health and Human Services ("HHS") - Assistant Secretary for Preparedness and Response ("ASPR") for COVID-19 response activities. The majority of the funding was distributed to member hospitals for special pathogen preparedness and response within their hospitals and jurisdictions. Additionally, REF contracted with OHA for services related to the creation of a Resource Tracker dashboard for the purposes of COVID-19 and/or other pandemic surge and capacity knowledge. The dashboard includes items such as personal protective equipment, mechanical ventilators, bed capacity, and staffing. Disaster Preparedness COVID-19 Initiatives and Funding: -Facilitated Ohio Governor's Executive Advisory Group -Facilitated weekly surgeon/proceduralist forums -Collaborated with Ohio Department of Administrative Services for procurement of viable PPE product options -Facilitated and updated congregate care and hospital pairing list -Member of Vaccine Planning Workgroup -Facilitated bi-weekly forum of infectious disease physicians -Served on monthly Housing and Homelessness forums -Collaborated with ODH/Governor's office on creating a staffing relief resource -As recipient, the Research and Educational Foundation of the Ohio Hospital Association administered two tranches of Hospital Association COVID-19 Preparedness and Response (CFDA No. 93.889) funding per Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR): *April 10, 2020 in the amount of $1,712,902 to 54 OHA member hospital subrecipients *September 9, 2020 in the amount of $4,251,788 to 64 OHA member hospital subrecipients Ebola and Other Special Pathogens Initiatives and Funding: -The work of the Ohio Emerging Pathogens Coalition was supported by a grant from ODH of $120,000 for the 2019-2020 grant year. The work was maintained by assessment, treatment and front-line hospitals along with public health, EMS, and Ohio Department of Health. The following actions were maintained: -Hosted quarterly meetings of the Ohio Emerging Pathogens Coalition -Hosted previously created annual training modules on our webpage to be utilized for all hospitals on Ebola and emerging pathogens -Hosted planning meetings and created documentation in support of a statewide Ebola exercise -Held a modified statewide exercise with participating hospitals, local health departments, and state partners on March 10, 2020. Due to the pandemic, the originally planned statewide exercise was drastically modified from original planning.</Desc>
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        <Desc>Safety &amp; Quality Sepsis Mortality: For the sixth year, the OHA Statewide Sepsis Initiative was facilitated in response to the OHA Board-directed goal of a statewide reduction in sepsis mortality to 14.9%. One hundred twenty-five member hospitals have maintained their commitment to participate in the ongoing initiative which includes data submission regarding compliance to the elements of the 3-hour sepsis bundle, monthly educational/coaching calls, and dissemination of effective practices. A sepsis website was hosted and maintained. Evidence-based, approved, continuing education webcasts were posted to the site along with evidence-based literature and resources. OHA analyzed and provided quarterly sepsis comparator data outcomes reports to participating hospitals. Report enhancements were made to include the addition of live links to web-based sepsis resources. Hospital Improvement Innovation Network (HIIN): OHA was awarded the Hospital Improvement Innovation Network award (HHSM-500-2016-00074C) effective September 28, 2016 and ending September 27, 2018 in the amount of $6,751,123.00. Recruitment was conducted and 104 hospitals submitted commitments to participate. The initiative was designed to reduce all-cause preventable inpatient harm by 20% and readmissions by 12%. Hospital commitments included: -Work with OHA to assess the organization's current improvement projects and areas of need for improvement -Implement OHA's recommendations for the organization's participation in this project whether that will be to sustain current improvements or to implement new initiatives -Form a multi-disciplinary team which include: *Senior health care facility executive champion(s) *Site project team leader *Physician champion(s)/epidemiologist(s) *Quality/process improvement specialists *And others as appropriate such as: -Nursing manager/director/champion(s) -Bedside nurses and pertinent clinical disciplines -Data collector/submitter (if different than someone listed here) -Infection control practitioner(s) -Pharmacy -Laboratory *Submit the required outcome and process measures on a monthly and quarterly basis to the OHA, allowing enough time to provide aggregate data to CMS by the assigned due date *Develop an action plan based on a completed gap analysis *Implement harm reduction strategies to meet or exceed HIIN improvement goals *Incorporate patient centered, person and family engagement and safe care practices into all methodologies *Consider health disparity and health literacy in the development of patient education materials, communications, and care planning *Incorporate antibiotic stewardship into improvement plan *Host the regional coordinator onsite on a quarterly basis *Submit monthly data collection by the established due date *Meet regularly with team to develop strategies for improvement and reporting process *Share internal data with leadership and staff so they can continually work on improvement plan *Conduct educational programming for staff to meet the project goals as appropriate *Identify any problems with project implementation and alert the regional coordinator as soon as possible *Collaboration with other hospitals participating in the OHA HIIN *Share effective practices with regional coordinators *Provide baseline data and metrics *Provide monthly process and outcome measure data either by granting access to NHSN or enter data onto the OHA data entry site *Provide quarterly process and outcome measure data through existing administrative data set *Participation by at least one member of the organization in monthly coaching calls, webinars, conferences, etc. *Participation as a mentor facility, as requested and able, for an area of identified strength *Recognize that in addition to meeting the base 20/12 reduction goals, HIIN continued to place additional emphasis on the following: *Adverse drug events (ADE) to include opioid safety, anticoagulation safety, and glycemic management *Catheter-associated urinary tract infections (CAUTI) to all hospital settings, including avoiding placement of catheters in the ER and in the hospital *Central line-associated bloodstream infections (CLABSI) to all hospital settings *Clostridium difficile (C. diff) infection, including Antibiotic Stewardship *Injury from falls and immobility *Sepsis and septic shock *SSI to include at a minimum, colon, abdominal hysterectomy, total hip replacements and total knee replacements *Venous thromboembolism (VTE), at a minimum to all surgical settings *Ventilator-associated events (VAE) to include Ventilator-associated conditions (VAC), infection-related ventilator-association complications (IVAC) and ventilator-associated pneumonia (VAP) *Readmissions In addition to the required base measures outlined above, each hospital participated in at least one of the selected initiative(s) below: *Multi-drug Resistant Organisms (e.g. MRSA, VRE, CRE, etc.) *Hospital culture of safety that fully integrates patient safety with worker safety *Iatrogenic delirium *Developing a metric to measure and report all-cause harm within the HIIN Network OHA commitments included: *Provide outcomes data using existing data sources *Obtain data from NHSN on behalf of our organization *Provide a web-based data entry site to enable timely data collection and submission *Provide free access to Wayfinder and associated data reports for the duration of HIIN *Provide Hand Hygiene Process Observers to collect up to 150 hand hygiene observations monthly from our organization at no additional cost to hospitals *Provide Educational programming and resources related to the HIIN topics *Provide Regional Coordinators to serve as a reference and support to our organization *Provide engagement awards based on the level of engagement and level of attainment of benchmarks at the end of the contract Effective September 28, 2018, a 6-month extension of the award was granted by the Centers for Medicare and Medicaid Services to continue the efforts listed above through March 2019. A further 3-month extension was followed by two 30-day extensions, and finally another 7-month extension that would ultimately end on March 31, 2020. -Final Results of the hospitals participating in HIIN demonstrated: *Harm areas that exceeded the 20% reduction - INR, Glucose Mgt, Opioid, CAUTI, CLABSI, CDI, SSI - Abd Hyst, Sepsis, PVAP, Iatrogenic delirium. Worker Safety *Making progress but not at target -Readmissions, Falls, SSI: Knees and VTE Continuous Service Readiness (CSR): Access to continuous survey readiness services for hospital accreditation were facilitated for member hospitals via subscription to the CSR consultant service for 85 hospitals. Provided both a Spring and a Fall conference virtually related to accreditation standards. Regional Quality Collaboratives: Regional quality collaboratives were facilitated in the Northeast, Central and Northwest Ohio regions. Each collaborative was facilitated by a chairperson or two co-chairs. Collaborative services included facilitating meetings and providing quarterly data reports including: Patient Safety Indicators (PSI), Readmissions, and Sepsis. *Northeast Ohio - 8 hospitals/health systems and a regional hospital association *Northwest Ohio - 5 hospitals/health systems and a regional hospital association *Central Ohio - 8 hospitals/health systems and a regional hospital association Quality Summit: The 13th Annual Quality Summit scheduled for June 10, 2020 was cancelled due to the COVID-19 pandemic. As an alternative, the following program was provided virtually: *December 16, 2020: Effective Practices in Sepsis Mortality Reduction Hand Hygiene: In 2020, the hand hygiene program contracted hand hygiene observers and reporting continued. Certain hospitals and hospital systems saw the need for continuous hand hygiene monthly monitoring and at higher thresholds of observations than associated with projects typically led by OHA. The hand hygiene program transitioned from supporting the HIIN hospitals to only a subscription service. In 2020, the hand hygiene subscription service expanded from 26 hospitals to 42 hospitals. This program afforded data continuity for dashboard purposes and avoided the loss or lag of data between OHA projects &amp; funding.</Desc>
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        <Desc>Ohio Patient Safety Institute Patient Safety Organization (OPSI PSO) Patient safety data collection and analysis was continued for 49 members voluntarily participating in OPSI Patient Safety Organization (PSO) while securing uniform federal confidentiality and privilege protections. Based on OPSI's 3 objectives, the following will outline 2020 accomplishments. Objective 1: OPSI shall set the Ohio patient safety agenda as the convener or facilitator by: *Identifying, sharing, disseminating best practices, and using those practices to set statewide benchmarks *Acting as the catalyst to provide safe patient-centered care along the continuum Current and Potential Activities/Programs in support of objective: *Best Practice Award (annual) - 2020 Best Practice Awards was presented to University Hospitals Health System received the OPSI Patient Engagement Best Practice Award for "Safe Discharge to Home." -Cleveland Clinic Fairview Hospital received the OPSI Acute Care Best Practice Award for "Bubble CPAP in the NICU." *National Patient Safety Week - "Together in Safety" - March 8-14, 2020 - developed calendar, posters, daily messaging, free teleconferences to support patient safety week at the hospitals. Had high respond to teleconferences and posters *Medication Safety Brochures - continue receiving requests for brochures and cards *Inpatient Brochure: Hospital Patient Safety Checklist - Updated the medication brochure this year to meet current standards *Revised Tips Before Surgery - Updated the medication brochure this year to meet current standards *Brown Bag Event Toolkit - Updated the Brown Bag Toolkit this year to meet current standards Objective 2: As a designated PSO, OPSI will be a conduit to identify opportunities for improvement and effective practices by: *Adopting and developing tools to enhance patient safety *Providing leadership and consulting services to integrate evidence-based safe practices in healthcare settings *Working with local, state, and national partners whenever possible Current and Potential Activities/Programs in support of objective: *Recruit members to PSO - Currently have 43 hospitals enrolled *Recruitment Efforts - Contacted 32 hospitals, quotes sent to 9 hospitals, multiple presentations *Patient safety alerts, etc. from PSO - Currently sharing national alerts *Held quarterly OPSI PSO User Group *Conducted six webinars Objective 3: OPSI shall be a leader in creating a learning culture that emphasizes patient safety through professionalism, collaboration, interpersonal skills, and teamwork by: -Spreading a culture of safety, mitigating risks, facilitating effective communication, and enhancing safe behavior Current and Potential Activities/Programs in support of objective: -2020 Best Practice OPSI Audio Conference Series</Desc>
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        <Desc>Community Health Opioid Response Initiative (ORI): The Opioid Response Initiative began as a targeted initiative aimed at hospitals most disproportionately affected by the opioid epidemic. The goals of the ORI are divided into three focus areas of advocacy, intervention and economic sustainability with clinical interventions grouped into target areas of prevention, harm reduction, and transition to treatment and recovery. In addition to the remarkable clinical initiatives launched by member hospitals and shared among ORI participants, much of the efforts have been concentrated in two areas: Data Support and Grant Development. Data Support: -Continued support for the public data release for opioid overdose with data presented statewide, by market area, and by county, with appropriate HIPAA restrictions -The Opioid Data Collaborative, or ODC, was launched July 2018 to serve as a data-aggregating and benchmarking service for opioid prescribing at participating hospitals with a goal to support hospitals' internal efforts in right-sizing opioid prescribing by peer-to-peer education and large statewide comparison groups -The practice areas include emergency departments, hospital discharge, outpatient surgical centers, and physician offices -Participating hospitals receive free quarterly reports. First reports were delivered in December 2019: 1. Data Integrity Report - this includes data at the hospital level and is intended to provide a view of the data the facility has submitted 2. Use Case Report - this includes data for hospital(s) and health system (if applicable) and is intended to provide information about data compared to the project-wide benchmarks 3. Provider Report - this includes data for each individual hospitals' providers and is intended to provide information about the hospital specific data compared to the health system (if applicable) and the project-wide benchmarks for hospitals who submit this data. -At the time of this submission, there are 103 participating hospitals and/or health systems -In 2020, 164 reports were produced as a part of the ODC for these participating hospitals and health systems. Grant Development: -The Cardinal Health Foundation supported a three-pronged approach to the opioid epidemic including 1) a patient, community, and clinician online resource hub to bring the most up-to-date information around treatment resources and interventions, 2) launch of the Opioid Data Collaborative to benchmark opioid prescribing around the state, and 3) exploration of resources to provide alternatives to opioids in patients with chronic pain and on chronic opioid medications. The opioid resource hub pages have had a total of 9,446 hits since the launch, averaging nearly 500 hits per month. Information regarding the ODC has been provided previously. The work began in 2018, the contract was amended in mid-2019, and was completed in early 2020. Award: $223,252.69 for 18 months -The Coverys Healthcare Foundation approved a grant that began in January 2019 that focuses on clinician education. These efforts include regular opioid-related webinars, provision of an online learning tool called Smart Rx that provides education on guidelines and recommendations as well as Ohio-specific regulations and laws, and lastly ongoing support of the Opioid Data Collaborative. The online learning tool reached over 750 providers across Ohio. An overview of the extended work of the ODC has been provided previously. Award: $288,677.82 and has been extended to February 2022. -OHA was awarded a grant from ACOG and ASAM to host a free Buprenorphine Waiver Training course for Ohio maternal health providers. This was hosted virtually on July 17, 2020. Maternal and Infant Health Infant Mortality: -Presented an annual data analysis of the Ohio Infant Mortality data and rankings for the various OHA clinical and executive boards. -OHA served on executive/steering committees for the Ohio Perinatal Quality Collaborative and Ohio March of Dimes. -OHA has a seat on the state of Ohio Commission on Infant Mortality and Ohio Newborn Advisory Steering Committee Safe Sleep: -OHA continued its "Safe Sleep is Good4Baby" initiative aimed at promoting the ABC's of safe sleep practices in Ohio. In 2017, OHA and the Ohio Department of Health partnered to create a free resource for hospitals around promoting 'safe sleep and breastfeeding'. This resource was further distributed statewide in 2020 at no cost and is available online. -Maintained the statewide interactive map for Ohio Department of Health of the locations of Cribs For Kids sites across the state. -In partnership with member hospitals, ODH, and the leadership of the NAPPSS-INN initiative, OHA helped recruit four member hospitals into the latest cohort of this national initiative to improve breastfeeding and safe sleep outcomes. This cohort began in 2019, but continued into 2020. These hospitals were MetroHealth Medical Center, Mount Carmel St. Ann's, Mercy Health Anderson Hospital, and The Christ Hospital. OHA is also supporting these hospitals with free onesies and breastfeeding education. Breastfeeding: -The First Steps for Healthy Babies, a quarterly recognition program for hospitals implementing the 10 Steps to Successful Breastfeeding, was launched in March of 2015 in partnership with the Ohio Department of Health. In 2020, the program expanded its reach to over 99% of the maternity hospitals in the state. -The First Steps program partnered with the Ohio Lactation Consultants Association (OLCA) and Ohio Breastfeeding Alliance (OBA) to revive a 'Bag Free' recognition program for hospitals. This program launched in early 2016 and was continued in 2020. 79 hospitals were recognized in 2020 for their work in 2019. This reflects over a 50% increase in participation since the first year. -In October 2020, Ohio First Steps hosted a webcast on 'Breastfeeding &amp; COVID-19 - What are We Learning', which was provided at no cost to all hospitals. The recording and slide are posted on our webpage. Maternal Health: In 2019, OHA reached out to members hospitals/health systems and partner organizations to create a Maternal Health Steering Committee. This group includes representatives from rural hospitals, large systems, AWHONN, ACOG, OPQC, and other healthcare partners. In 2020, OHA partnered with the Ohio Department of Health (ODH) to submit an application for Ohio to join the national ACOG program, the Alliance for Innovation on Maternal Health (AIM). This application was accepted in September 2020. Additionally, OHA is on the steering committee of a HRSA funded project that is run through ODH to pilot work around severe maternal hypertension. Lastly, the OHA has been providing quarterly hospital benchmark reports on maternal health outcomes, including 'Severe Maternal Morbidity'. In 2020, OHA provided 405 total reports to member hospitals at no cost. Physician Leadership Council: The Physician Leadership Council, launched in 2017, brought together physician leaders from statewide hospitals and health systems. Three meetings of the Physician Leadership Council were facilitated on: *January 17, 2020 *July 24, 2020 *October 9, 2020 Continuing Education Provider Unit: The Ohio Hospital Association (OLN-0017-P) is approved as a provider unit of continuing education by the Ohio Board of Nursing through the approver unit at the Ohio League for Nursing (OBN-006-92) and provider unit status is valid through June 30, 2023. In 2020: -OHA successfully renewed its nursing continuing education provider unit status. -A total of 55.25 hours of approved continuing nursing education were provided via this unit.</Desc>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>The Internal Revenue Service has ruled that the Foundation is a tax exempt organization as defined under Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for federal income taxes has been made in the financial statements. Additionally, the Foundation has been determined not to be a private foundation under Section 509(a) of the U.S. Internal Revenue Code. Accounting principles generally accepted in the United States of America prescribe recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. Tax benefits will be recognized only if the tax position is more likely-than-not sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized will be the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the more-likely-than-not test, no tax benefit will be recorded. Management has concluded that they are unaware of any tax benefits or liabilities to be recognized at December 31, 2020 and 2019. The Foundation does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Foundation would recognize interest and penalties related to the unrecognized tax benefits in interest and income tax expense, respectively. The Foundation has no amounts accrued for interest or penalties as of December 31, 2020 and 2019.</ExplanationTxt>
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      <SupplementalInformationDetail>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Firelands Regional Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1111 Hayes Avenue</AddressLine1Txt>
          <CityNm>Sandusky</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44870</ZIPCd>
        </USAddress>
        <RecipientEIN>344428218</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Fisher-Titus Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>272 Benedict Avenue</AddressLine1Txt>
          <CityNm>Norwalk</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
        </USAddress>
        <RecipientEIN>344430916</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Fulton County Health Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>725 South Shoop Ave</AddressLine1Txt>
          <CityNm>Wauseon</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43567</ZIPCd>
        </USAddress>
        <RecipientEIN>344428214</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Galion Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>269 Portland Way South</AddressLine1Txt>
          <CityNm>Galion</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44833</ZIPCd>
        </USAddress>
        <RecipientEIN>344451872</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Genesis Healthcare System</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2951 Maple Avenue</AddressLine1Txt>
          <CityNm>Zanesville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43701</ZIPCd>
        </USAddress>
        <RecipientEIN>311480941</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Good Samaritan</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>375 Dixmyth Ave</AddressLine1Txt>
          <CityNm>Cincinnati</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45220</ZIPCd>
        </USAddress>
        <RecipientEIN>310537486</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Grand Lake Health System</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 Saint Clair Avenue</AddressLine1Txt>
          <CityNm>Saint Marys</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45885</ZIPCd>
        </USAddress>
        <RecipientEIN>341623770</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>951 East Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43907</ZIPCd>
        </USAddress>
        <RecipientEIN>341571750</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Henry County Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1600 East Riverview Avenue</AddressLine1Txt>
          <CityNm>Napoleon</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43545</ZIPCd>
        </USAddress>
        <RecipientEIN>344477047</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Highland District Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1275 North High Street</AddressLine1Txt>
          <CityNm>Hillsboro</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45133</ZIPCd>
        </USAddress>
        <RecipientEIN>310653685</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Hocking Valley Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 State Route 664 N</AddressLine1Txt>
          <CityNm>Logan</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43138</ZIPCd>
        </USAddress>
        <RecipientEIN>310733259</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Holzer Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 Jackson Pike</AddressLine1Txt>
          <CityNm>Gallipolis</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45631</ZIPCd>
        </USAddress>
        <RecipientEIN>314379491</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Kettering Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2110 Leiter Road</AddressLine1Txt>
          <CityNm>Miamisburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45342</ZIPCd>
        </USAddress>
        <RecipientEIN>832687866</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Knox Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1330 Coshocton Road</AddressLine1Txt>
          <CityNm>Mount Vernon</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43050</ZIPCd>
        </USAddress>
        <RecipientEIN>310929576</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Licking Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1320 West Main Street</AddressLine1Txt>
          <CityNm>Newark</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43055</ZIPCd>
        </USAddress>
        <RecipientEIN>314379519</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Lima Memorial Health System</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1001 Bellefontaine Ave</AddressLine1Txt>
          <CityNm>Lima</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45804</ZIPCd>
        </USAddress>
        <RecipientEIN>341883284</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Lutheran Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1730 West 25th Street</AddressLine1Txt>
          <CityNm>Cleveland</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44113</ZIPCd>
        </USAddress>
        <RecipientEIN>340714585</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Madison Health</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>210 North Main Street</AddressLine1Txt>
          <CityNm>London</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43140</ZIPCd>
        </USAddress>
        <RecipientEIN>311657206</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Magruder Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>615 Fulton Street</AddressLine1Txt>
          <CityNm>Port Clinton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43452</ZIPCd>
        </USAddress>
        <RecipientEIN>344441792</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Marietta Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 Matthew Street</AddressLine1Txt>
          <CityNm>Marietta</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <RecipientEIN>314379509</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mary Rutan Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>205 Palmer Avenue</AddressLine1Txt>
          <CityNm>Bellefontaine</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43311</ZIPCd>
        </USAddress>
        <RecipientEIN>341407259</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>McLaren St Luke's Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5901 Monclova Rd</AddressLine1Txt>
          <CityNm>Maumee</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43537</ZIPCd>
        </USAddress>
        <RecipientEIN>344428232</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 London Ave</AddressLine1Txt>
          <CityNm>Marysville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43040</ZIPCd>
        </USAddress>
        <RecipientEIN>316402480</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercer Health</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>800 West Main Street</AddressLine1Txt>
          <CityNm>Coldwater</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45828</ZIPCd>
        </USAddress>
        <RecipientEIN>341101385</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercy Health - Defiance Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1404 East Second Street</AddressLine1Txt>
          <CityNm>Defiance</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43512</ZIPCd>
        </USAddress>
        <RecipientEIN>020701635</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercy Health - Tiffin Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>45 St Lawrence Drive</AddressLine1Txt>
          <CityNm>Tiffin</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44883</ZIPCd>
        </USAddress>
        <RecipientEIN>344431174</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercy Health - Urbana Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>904 Scioto Street</AddressLine1Txt>
          <CityNm>Urbana</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43078</ZIPCd>
        </USAddress>
        <RecipientEIN>310785684</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercy Health - West Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3300 Mercy Health Blvd</AddressLine1Txt>
          <CityNm>Cincinnati</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45211</ZIPCd>
        </USAddress>
        <RecipientEIN>311091597</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mercy Health - Willard Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1100 Neal Zick Road</AddressLine1Txt>
          <CityNm>Willard</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44890</ZIPCd>
        </USAddress>
        <RecipientEIN>341577110</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MetroHealth Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2500 MetroHealth Drive</AddressLine1Txt>
          <CityNm>Cleveland</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44109</ZIPCd>
        </USAddress>
        <RecipientEIN>346004382</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Mount Carmel EastGrove City</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6001 East Broad Street</AddressLine1Txt>
          <CityNm>Columbus</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43213</ZIPCd>
        </USAddress>
        <RecipientEIN>311439334</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OhioHealth Hardin Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>921 East Franklin Street</AddressLine1Txt>
          <CityNm>Kenton</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43326</ZIPCd>
        </USAddress>
        <RecipientEIN>316059784</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OhioHealth Marion General Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1000 McKinley Park Drive</AddressLine1Txt>
          <CityNm>Marion</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43302</ZIPCd>
        </USAddress>
        <RecipientEIN>316059784</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OhioHealth O'Bleness Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>55 Hospital Drive</AddressLine1Txt>
          <CityNm>Athens</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45701</ZIPCd>
        </USAddress>
        <RecipientEIN>316059784</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OhioHealth Riverside Methodist Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3535 Olentangy River Road</AddressLine1Txt>
          <CityNm>Columbus</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43214</ZIPCd>
        </USAddress>
        <RecipientEIN>316059784</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OSU Wexner Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>410 West 10th Ave</AddressLine1Txt>
          <CityNm>Columbus</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43210</ZIPCd>
        </USAddress>
        <RecipientEIN>311340739</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Paulding County Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1035 West Wayne Street</AddressLine1Txt>
          <CityNm>Paulding</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45879</ZIPCd>
        </USAddress>
        <RecipientEIN>346405718</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Pomerene Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>981 Wooster Road</AddressLine1Txt>
          <CityNm>Millersburg</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44654</ZIPCd>
        </USAddress>
        <RecipientEIN>311518658</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ProMedica Defiance Regional Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1200 Ralston Avenue</AddressLine1Txt>
          <CityNm>Defiance</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43512</ZIPCd>
        </USAddress>
        <RecipientEIN>344446484</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ProMedica Fostoria Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>501 Van Buren Street</AddressLine1Txt>
          <CityNm>Fostoria</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44830</ZIPCd>
        </USAddress>
        <RecipientEIN>340898745</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ProMedica Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>715 South Taft Avenue</AddressLine1Txt>
          <CityNm>Fremont</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43420</ZIPCd>
        </USAddress>
        <RecipientEIN>344430849</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ProMedica Toledo Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2142 North Cove Blvd</AddressLine1Txt>
          <CityNm>Toledo</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43606</ZIPCd>
        </USAddress>
        <RecipientEIN>344428256</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Salem Regional Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1995 East State Street</AddressLine1Txt>
          <CityNm>Salem</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44460</ZIPCd>
        </USAddress>
        <RecipientEIN>341041385</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Selby General Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1106 Colegate Drive</AddressLine1Txt>
          <CityNm>Marietta</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <RecipientEIN>314413259</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Southeastern Ohio Regional Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1341 Clark Street</AddressLine1Txt>
          <CityNm>Cambridge</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43725</ZIPCd>
        </USAddress>
        <RecipientEIN>314391798</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Southwest General Health Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18697 Bagley Road</AddressLine1Txt>
          <CityNm>Middleburg Heights</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <RecipientEIN>340753531</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>St Vincent Charity Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2351 East 22nd Street</AddressLine1Txt>
          <CityNm>Cleveland</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44115</ZIPCd>
        </USAddress>
        <RecipientEIN>340714736</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Summa Health System</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>525 East Market Street</AddressLine1Txt>
          <CityNm>Akron</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44304</ZIPCd>
        </USAddress>
        <RecipientEIN>341887844</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Summa Western Reserve Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1900 23rd Street</AddressLine1Txt>
          <CityNm>Cuyahoga Falls</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44223</ZIPCd>
        </USAddress>
        <RecipientEIN>263536780</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Sun Behavioral Columbus</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>900 E Dublin-Granville Road</AddressLine1Txt>
          <CityNm>Columbus</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43229</ZIPCd>
        </USAddress>
        <RecipientEIN>383968723</RecipientEIN>
        <CashGrantAmt>12857</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Trinity Hospital Twin City</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>819 North 1st Street</AddressLine1Txt>
          <CityNm>Dennison</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44621</ZIPCd>
        </USAddress>
        <RecipientEIN>275401105</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University Hospitals Conneaut Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>158 West Main Road</AddressLine1Txt>
          <CityNm>Conneaut</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44030</ZIPCd>
        </USAddress>
        <RecipientEIN>340714550</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University Hospitals Geneva Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>870 West Main Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44041</ZIPCd>
        </USAddress>
        <RecipientEIN>340714461</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University Hospitals Rainbow Babies &amp; Children's Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>11100 Euclid Ave</AddressLine1Txt>
          <CityNm>Cleveland</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44106</ZIPCd>
        </USAddress>
        <RecipientEIN>341567805</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University Hospitals Samaritan Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1025 Center Street</AddressLine1Txt>
          <CityNm>Ashland</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44805</ZIPCd>
        </USAddress>
        <RecipientEIN>340714535</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University of Cincinnati Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>234 Goodman Street</AddressLine1Txt>
          <CityNm>Cincinnati</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45219</ZIPCd>
        </USAddress>
        <RecipientEIN>311479038</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>University of Toledo Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3000 Arlington Ave</AddressLine1Txt>
          <CityNm>Toledo</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43614</ZIPCd>
        </USAddress>
        <RecipientEIN>340967014</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Van Wert Health</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1250 South Washington Street</AddressLine1Txt>
          <CityNm>Van Wert</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45891</ZIPCd>
        </USAddress>
        <RecipientEIN>344429514</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>31344</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Wayne HealthCare</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>835 Sweitzer Street</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45331</ZIPCd>
        </USAddress>
        <RecipientEIN>344428598</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Wilson Health</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>915 West Michigan Street</AddressLine1Txt>
          <CityNm>Sidney</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45365</ZIPCd>
        </USAddress>
        <RecipientEIN>344427944</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Wooster Community Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1761 Beall Avenue</AddressLine1Txt>
          <CityNm>Wooster</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44691</ZIPCd>
        </USAddress>
        <RecipientEIN>346003129</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WVU Medicine - Barnesville Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>639 West Main Street</AddressLine1Txt>
          <CityNm>Barnesville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43713</ZIPCd>
        </USAddress>
        <RecipientEIN>340719172</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>64893</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Wyandot Memorial Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>885 North Sandusky Avenue</AddressLine1Txt>
          <CityNm>Upper Sandusky</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43351</ZIPCd>
        </USAddress>
        <RecipientEIN>346408698</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>96237</CashGrantAmt>
        <PurposeOfGrantTxt>COVID-19 preparedness and response activities</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>81</Total501c3OrgCnt>
      <TotalOtherOrgCnt>4</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Trustees and management monitor the use of grants to ensure they are used for their intended purposes. Additionally, an audit of compliance in accordance with Uniform Guidance was performed. Under federal guidelines, the Foundation is responsible for monitoring grant recipients to help assure that federal awards are expended for authorized purposes in compliance with law, regulations and the provisions of contracts or grant agreements, and that performance goals are achieved.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Michael Abrams</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>676605</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>171175</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>36518</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>118363</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>62307</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1064968</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Mary Gallagher</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Executive VP &amp; Chief of Staff</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>348670</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>72058</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>18973</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>32775</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>62305</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>534781</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>Rosalie Weakland</BusinessNameLine1Txt>
        </BusinessName>
        <TitleTxt>Senior Director, Quality Programs</TitleTxt>
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        <OtherCompensationFilingOrgAmt>5818</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>15575</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationFilingOrgAmt>186427</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization relied on Ohio Hospital Association's (OHA), a related tax-exempt organization, process to compensate the Chief Executive Officer (CEO). AN INDEPENDENT COMPENSATION COMMITTEE DELEGATED BY THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE YEARLY COMPENSATION REVIEW OF THE CEO. OUTSIDE CONSULTANTS, SALARY SURVEYS, AND DATA FROM COMPARABLE ORGANIZATIONS ARE USED IN THE PROCESS OF DETERMINING THE CEO'S COMPENSATION. THIS PROCESS WAS LAST PERFORMED IN 2020 AND IS DOCUMENTED WITHIN THE COMPENSATION COMMITTEE MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>Mike Abrams participates in a SERP 457(f) plan maintained by OHA. Amounts includible in income under section 457(f) = $0 Contributions to nonqualified plans (nonvested) = $85,587.50</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="20011424" softwareVersionNum="2020v4.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4b PROGRAM SERVICE DESCRIPTION (Cont.)</FormAndLineReferenceDesc>
        <ExplanationTxt>WayFinder: As OHA was awarded the federal HIIN contract through CMS, OHA continued to work on the usage of the Battelle WayFinder platform. This predictive analytics platform was provided at no cost to HIIN-participating hospitals. OHA worked with participating hospitals to provide user training and platform improvement. In 2018, OHA worked with Battelle to create a supplemental quarterly summary report for the data inclusive of the platform. In 2019, a monthly report for hospitals was developed. These reports were posted on a regular basis to the platform and is of no cost to participating hospitals. This platform was taken down in March 2020, when the federal contract ended. OHA worked with Battelle to archive at OHA the quarterly and monthly final reports for hospitals, totaling 170 reports.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 2 New program services</FormAndLineReferenceDesc>
        <ExplanationTxt>During the year, REF received funding from the U.S. Department of Health and Human Services ("HHS") - Assistant Secretary for Preparedness and Response ("ASPR") for COVID-19 response activities. Please see Form 990, Part III, Line 4a for more information regarding this program</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d Description of other program services</FormAndLineReferenceDesc>
        <ExplanationTxt>(Expenses $ 146,548 including grants of $)(Revenue $ 2,199) Community Health Opioid Response Initiative (ORI): The Opioid Response Initiative began as a targeted initiative aimed at hospitals most disproportionately affected by the opioid epidemic. The goals of the ORI are divided into three focus areas of advocacy, intervention and economic sustainability with clinical interventions grouped into target areas of prevention, harm reduction, and transition to treatment and recovery. In addition to the remarkable clinical initiatives launched by member hospitals and shared among ORI participants, much of the efforts have been concentrated in two areas: Data Support and Grant Development. Data Support: -Continued support for the public data release for opioid overdose with data presented statewide, by market area, and by county, with appropriate HIPAA restrictions -The Opioid Data Collaborative, or ODC, was launched July 2018 to serve as a data-aggregating and benchmarking service for opioid prescribing at participating hospitals with a goal to support hospitals' internal efforts in right-sizing opioid prescribing by peer-to-peer education and large statewide comparison groups -The practice areas include emergency departments, hospital discharge, outpatient surgical centers, and physician offices -Participating hospitals receive free quarterly reports. First reports were delivered in December 2019: 1. Data Integrity Report - this includes data at the hospital level and is intended to provide a view of the data the facility has submitted 2. Use Case Report - this includes data for hospital(s) and health system (if applicable) and is intended to provide information about data compared to the project-wide benchmarks 3. Provider Report - this includes data for each individual hospitals' providers and is intended to provide information about the hospital specific data compared to the health system (if applicable) and the project-wide benchmarks for hospitals who submit this data. -At the time of this submission, there are 103 participating hospitals and/or health systems -In 2020, 164 reports were produced as a part of the ODC for these participating hospitals and health systems. Grant Development: -The Cardinal Health Foundation supported a three-pronged approach to the opioid epidemic including 1) a patient, community, and clinician online resource hub to bring the most up-to-date information around treatment resources and interventions, 2) launch of the Opioid Data Collaborative to benchmark opioid prescribing around the state, and 3) exploration of resources to provide alternatives to opioids in patients with chronic pain and on chronic opioid medications. The opioid resource hub pages have had a total of 9,446 hits since the launch, averaging nearly 500 hits per month. Information regarding the ODC has been provided previously. The work began in 2018, the contract was amended in mid-2019, and was completed in early 2020. Award: $223,252.69 for 18 months -The Coverys Healthcare Foundation approved a grant that began in January 2019 that focuses on clinician education. These efforts include regular opioid-related webinars, provision of an online learning tool called Smart Rx that provides education on guidelines and recommendations as well as Ohio-specific regulations and laws, and lastly ongoing support of the Opioid Data Collaborative. The online learning tool reached over 750 providers across Ohio. An overview of the extended work of the ODC has been provided previously. Award: $288,677.82 and has been extended to February 2022. -OHA was awarded a grant from ACOG and ASAM to host a free Buprenorphine Waiver Training course for Ohio maternal health providers. This was hosted virtually on July 17, 2020. Maternal and Infant Health Infant Mortality: -Presented an annual data analysis of the Ohio Infant Mortality data and rankings for the various OHA clinical and executive boards. -OHA served on executive/steering committees for the Ohio Perinatal Quality Collaborative and Ohio March of Dimes. -OHA has a seat on the state of Ohio Commission on Infant Mortality and Ohio Newborn Advisory Steering Committee Safe Sleep: -OHA continued its "Safe Sleep is Good4Baby" initiative aimed at promoting the ABC's of safe sleep practices in Ohio. In 2017, OHA and the Ohio Department of Health partnered to create a free resource for hospitals around promoting 'safe sleep and breastfeeding'. This resource was further distributed statewide in 2020 at no cost and is available online. -Maintained the statewide interactive map for Ohio Department of Health of the locations of Cribs For Kids sites across the state. -In partnership with member hospitals, ODH, and the leadership of the NAPPSS-INN initiative, OHA helped recruit four member hospitals into the latest cohort of this national initiative to improve breastfeeding and safe sleep outcomes. This cohort began in 2019, but continued into 2020. These hospitals were MetroHealth Medical Center, Mount Carmel St. Ann's, Mercy Health Anderson Hospital, and The Christ Hospital. OHA is also supporting these hospitals with free onesies and breastfeeding education. Breastfeeding: -The First Steps for Healthy Babies, a quarterly recognition program for hospitals implementing the 10 Steps to Successful Breastfeeding, was launched in March of 2015 in partnership with the Ohio Department of Health. In 2020, the program expanded its reach to over 99% of the maternity hospitals in the state. -The First Steps program partnered with the Ohio Lactation Consultants Association (OLCA) and Ohio Breastfeeding Alliance (OBA) to revive a 'Bag Free' recognition program for hospitals. This program launched in early 2016 and was continued in 2020. 79 hospitals were recognized in 2020 for their work in 2019. This reflects over a 50% increase in participation since the first year. -In October 2020, Ohio First Steps hosted a webcast on 'Breastfeeding &amp; COVID-19 - What are We Learning', which was provided at no cost to all hospitals. The recording and slide are posted on our webpage. Maternal Health: In 2019, OHA reached out to members hospitals/health systems and partner organizations to create a Maternal Health Steering Committee. This group includes representatives from rural hospitals, large systems, AWHONN, ACOG, OPQC, and other healthcare partners. In 2020, OHA partnered with the Ohio Department of Health (ODH) to submit an application for Ohio to join the national ACOG program, the Alliance for Innovation on Maternal Health (AIM). This application was accepted in September 2020. Additionally, OHA is on the steering committee of a HRSA funded project that is run through ODH to pilot work around severe maternal hypertension. Lastly, the OHA has been providing quarterly hospital benchmark reports on maternal health outcomes, including 'Severe Maternal Morbidity'. In 2020, OHA provided 405 total reports to member hospitals at no cost. Physician Leadership Council: The Physician Leadership Council, launched in 2017, brought together physician leaders from statewide hospitals and health systems. Three meetings of the Physician Leadership Council were facilitated on: *January 17, 2020 *July 24, 2020 *October 9, 2020 Continuing Education Provider Unit: The Ohio Hospital Association (OLN-0017-P) is approved as a provider unit of continuing education by the Ohio Board of Nursing through the approver unit at the Ohio League for Nursing (OBN-006-92) and provider unit status is valid through June 30, 2023. In 2020: -OHA successfully renewed its nursing continuing education provider unit status. -A total of 55.25 hours of approved continuing nursing education were provided via this unit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a Common Pay Agent</FormAndLineReferenceDesc>
        <ExplanationTxt>OHIO HOSPITAL ASSOCIATION (OHA) EIN 31-4270340 IS THE COMMON PAYING AGENT FOR THE FOLLOWING RELATED ORGANIZATIONS. THEREFORE, ALL APPLICABLE IRS TAX FILINGS ARE REPORTED BY OHA. --OHIO HOSPITALS GROUP RATED WORKERS COMPENSATION PROGRAM, INC. EIN 31-1314404 --THE RESEARCH &amp; EDUCATIONAL FOUNDATION OF THE OHIO HOSPITAL ASSOCIATION EIN 31-6060347 --OHIO HEALTHCARE PURCHASING EIN 20-0414070 THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, OHA, FOR THE YEAR ENDED DECEMBER 31, 2020 WAS 52. FOR PURPOSES OF REPORTING THE NUMBER OF EMPLOYEES ON THE FORM 990, PART V, LINE 2A, THERE WERE THE FOLLOWING FOR EACH RESPECTIVE ORGANIZATION: --OHIO HOSPITAL ASSOCIATION - 49 EMPLOYEES --OHIO HOSPITALS GROUP RATED WORKERS COMPENSATION PROGRAM, INC. - 0 EMPLOYEES --THE RESEARCH &amp; EDUCATIONAL FOUNDATION OF THE OHIO HOSPITAL ASSOCIATION - 3 EMPLOYEES --OHIO HEALTHCARE PURCHASING - 0 EMPLOYEES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT HAVE OTHER OFFICERS OR KEY EMPLOYEES THAT RECEIVE COMPENSATION. THEREFORE, THIS QUESTION IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. THEY ARE COMPENSATED BY THE ORGANIZATION'S COMMON PAY AGENT, OHIO HOSPITAL ASSOCIATION (OHA), A RELATED TAX-EXEMPT ORGANIZATION. OHA CURRENTLY USES AN OUTSIDE CONSULTANT TO PERIODICALLY PROVIDE A BENCHMARK OF COMPARABLE SALARY RANGES FOR ALL OFFICERS AND KEY EMPLOYEES. THIS PROCESS WAS LAST PERFORMED IN 2020. OHIO HOSPITAL ASSOCIATION'S COMPENSATION IS BASED ON THE USE OF THIS DATA FOR SIMILARLY QUALIFIED INDIVIDUALS IN COMPARABLE POSITIONS AT SIMILAR SIZED ASSOCIATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a PROCESS USED TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIAL</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT HAVE OFFICERS THAT RECEIVE COMPENSATION. THEREFORE, THIS QUESTION IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. THE CEO IS COMPENSATED BY THE ORGANIZATION'S COMMON PAY AGENT, OHIO HOSPITAL ASSOCIATION (OHA), A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION PROCESS IS THAT OF OHA'S. AN INDEPENDENT COMPENSATION COMMITTEE DELEGATED BY THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE YEARLY COMPENSATION REVIEW OF THE CHIEF EXECUTIVE OFFICER (CEO). OUTSIDE CONSULTANTS, SALARY SURVEYS, AND DATA FROM COMPARABLE ORGANIZATIONS ARE USED IN THE PROCESS OF DETERMINING THE CEO'S COMPENSATION. THIS PROCESS WAS PERFORMED IN 2020 AND IS DOCUMENTED WITHIN THE COMPENSATION COMMITTEE MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1a Delegate broad authority to a committee</FormAndLineReferenceDesc>
        <ExplanationTxt>The board of trustees may, by resolution, establish an executive committee, which shall consist of at least three (3) trustees, which committee shall have the power to transact all of the business of the corporation during the interim between meetings of the board of trustees and which shall have and exercise the authority of the board of trustees in the management of the corporation subject to any restrictions established by the board of trustees. The designation of the executive committee and the delegation thereto of such authority shall not operate to relieve the board of trustees, or any individual trustee of any responsibility imposed by law. The executive committee shall be subject to the control and direction of the board of trustees. Additionally, as the sole member of filing organization, Ohio Hospital Association, a related tax-exempt organization, has broad authority to act on behalf of the governing body. Please see the narratives for Part VI, Lines 6, 7a and 7b for a description of such authority.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>The sole member of the Corporation shall be the Ohio Hospital Association, an Ohio nonprofit corporation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>As the sole member of the filing organization, OHA has the right to elect, appoint or remove members of the governing body.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>As the sole member of the filing organization, OHA has the right to approve or deny significance governance decisions of the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 and supplemental schedules were reviewed by management and the Audit Committee Chair with the paid tax preparer. A copy of the organization's final form 990 (including required schedules), as ultimately filed with the IRS, was provided to each voting member of the organization's governing body, officers, and management prior to its filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH TRUSTEE, DIRECTOR, PRINCIPAL OFFICER, other officer, key employee, AND MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE DUALITY OF INTEREST AND CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THE ORGANIZATION IS TAX-EXEMPT AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. After a disclosure, and after any discussions with the interested person, the interested person may be asked by the chairperson to leave the board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. If a conflict of interest exists, the interested person may make a presentation to the board or committee and may be asked to leave the meeting during the discussion of, and the vote on, the arrangement that results in the conflict. After exercising due diligence, the board or committee shall determine whether the company can obtain a more advantageous arrangement with reasonable efforts from a person that would not give rise to a conflict of interest. If that is not reasonably attainable, the board or committee shall determine by a majority vote of the disinterested directors whether the arrangement is in the company's best interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial statements, governing documents, and conflict of interest policy are available upon request from the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>Quality/Patient Safety Consulting - Total Expense: 820585, Program Service Expense: 820585, Management and General Expenses: , Fundraising Expenses: ; Hospital Improvement Innovation Network - Total Expense: 374724, Program Service Expense: 374724, Management and General Expenses: , Fundraising Expenses: ; Energy Programs - Total Expense: 29000, Program Service Expense: 29000, Management and General Expenses: , Fundraising Expenses: ; Other - Total Expense: 35292, Program Service Expense: , Management and General Expenses: 35292, Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Repayment of unused grant funds - -130081; Grant unfulfillment due to Covid-19 - -200000;</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>OHIO HOSPITAL ASSOCIATION (OHA)</BusinessNameLine1Txt>
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          <AddressLine1Txt>155 E BROAD ST SUITE 301</AddressLine1Txt>
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          <AddressLine1Txt>155 E BROAD ST SUITE 301</AddressLine1Txt>
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          <BusinessNameLine1Txt>FRIENDS OF OHIO HOSPITALS</BusinessNameLine1Txt>
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          <AddressLine1Txt>155 E BROAD ST</AddressLine1Txt>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Q3 Health Innovation Partners LLC</BusinessNameLine1Txt>
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          <AddressLine1Txt>30 North Third St Suite 600</AddressLine1Txt>
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          <BusinessNameLine1Txt>OHA</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>OHIO HEALTHCARE PURCHASING INC DBA OHA SOLUTIONS</BusinessNameLine1Txt>
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          <AddressLine1Txt>155 E BROAD ST SUITE 301</AddressLine1Txt>
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          <BusinessNameLine1Txt>OHA</BusinessNameLine1Txt>
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      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
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      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
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      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
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      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>Ohio Hospital Association</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>Ohio Hospital Association</BusinessNameLine1Txt>
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        <FormAndLineReferenceDesc>Schedule R, Part II, Column (b) Primary Activity</FormAndLineReferenceDesc>
        <ExplanationTxt>1. OHIO HOSPITAL ASSOCIATION PRIMARY ACTIVITY: A MEMBERSHIP DRIVEN ORGANIZATION THAT PROVIDES PROACTIVE LEADERSHIP TO CREATE AN ENVIRONMENT IN WHICH OHIO HOSPITALS ARE SUCCESSFUL IN SERVING THEIR COMMUNITIES. THIS NON-PROFIT TRADE ASSOCIATION WORKS ON BEHALF OF MEMBER HOSPITALS THROUGH LEADERSHIP IN THE DEVELOPMENT OF PUBLIC POLICY, IN THE REPRESENTATION AND ADVOCACY OF HOSPITAL INTERESTS, AND IN THE PROVISION OF SERVICES WHICH ASSIST HOSPITALS IN MEETING HEALTH CARE NEEDS AND IMPROVING THE HEALTH STATUS OF THEIR COMMUNITIES, WHICH IN TURN IMPROVES THE HEALTH CARE INDUSTRY AS A WHOLE. 2. OHIO HOSPITALS GROUP RATED WORKERS COMP PRIMARY ACTIVITY: THE PRIMARY PURPOSE OF THE OHIO HOSPITALS GROUP RATED WORKERS COMPENSATION PROGRAM, INC. IS TO DEVELOP AND IMPLEMENT PROGRAMS THAT WILL PROMOTE A SAFE WORKING ENVIRONMENT AND REDUCE HEALTH CARE COSTS. 3. OHIO HEALTH COUNCIL PRIMARY ACTIVITY: PROMOTION OF HEALTH BY COORDINATING THE EFFORTS OF ITS MEMBERS AND OTHER ORGANIZATIONS INTERESTED IN THE HEALTH OF COMMUNITIES. THIS PURPOSE INCLUDES FUNDING PROJECTS THAT CONDUCT HEALTH EDUCATION AND HEALTH PROMOTION PROGRAMS REGARDING THE ADVANTAGES TO THE HEALTH OF COMMUNITIES TO BE GAINED THROUGH THE PRACTICE OF MEDICINE AND OTHER HEALTH PROFESSIONS AND THE OPERATION OF HOSPITALS. 4. Friends of Ohio Hospitals Primary Activity: THE ORGANIZATION MAKES CONTRIBUTIONS IN SUPPORT OF POLITICAL CANDIDATES AND PARTIES IN THE INTEREST OF OHIO HOSPITALS.</ExplanationTxt>
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