2020-11-06T09:55:44-06:00 2019-12-31 310800053 Clark Schaefer Hackett & Co 10100 Innovation Drive Suite 400 Dayton OH 45342 990 2019-01-01 270712680 Beavercreek Medical Center BEAV 9377621629 1 Prestige Place No 910 Miamisburg OH 45342 Dann Hotelling Vice President of Finance 9377621629 2020-11-06 1 Herbert L Lemaster CPA P00039882 9372260070 2020-11-06 162.155.224.162 2020-11-06 09:27:11 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 E2C124E6C044DEA460B709D9705FB0CFF27D5D90 2019 2021-01-29 14:40:06Z The Indu and Raj Soin Medical Center Rick Dodds 1 Prestige Place Suite 910 Miamisburg OH 45342 193227971 0 X www.ketteringhealth.org X 2009 OH To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner 11 3 0 447 5706 0 2165319 76824 178023592 192807560 281822 343587 0 0 180470733 193227971 15108 19882 0 0 64070643 75113763 0 0 0 98989679 109489033 163075430 184622678 17395303 8605293 193661008 208510534 122406451 113445155 71254557 95065379 To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner 0 0 176851164 19882 189502759 Care was provided for 8,185 discharges, adult & ped days of 29,139, and 116,411 outpatient visits. 176851164 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Dann Hotelling 9377621629 1 Prestige Place Suite 910 Miamisburg OH 45342 Manchur Fred CEO - KHN 1.00 50.00 X 0 2489655 43898 Burns Terry Exec VP-KHN & President-KMC 3/2019; COO KHN begin 1.00 50.00 X 0 1409719 57197 Chew Roy President of KHN until 7/31/2019 1.00 50.00 X 0 1093457 36078 Dodds Rick President GMH/SOIN 26.00 25.00 X X 0 563679 82756 Smith Robert T Physician 1.00 39.00 X 0 514368 34549 Tyner Troy A Physician 1.00 39.00 X 0 298931 31013 Weigley David Pres. Columbia Union Conference of SDA 1.00 5.00 X 0 24394 0 Halvorsen Ron Jr Pres. Ohio Conference of SDA 1.00 4.00 X 0 0 0 Harting Donald Community Volunteer until 8/19 1.00 1.00 X 0 0 0 Peebles Thomas Community Volunteer 1.00 2.00 X 0 0 0 Parker Phillip Pres, Dayton Chamber of Commerce 1.00 1.00 X 0 0 0 Soin Amol MD Physician 1.00 1.00 X 0 0 0 Barber Wendi VP Operation & Finance GMH/SOIN begin 1/2019 25.00 25.00 X 0 368827 72456 King Peter Interim VP Operations & Finance GMH/SOIN until 1/2 25.00 24.00 X 0 63200 0 Schneider Erica VP Patient Care Services - GMH/SOIN 25.00 24.00 X 0 329381 67755 Jones Jeff Director HR 40.00 X 0 191967 30426 Hope Jill A Pharmacist 40.00 X 0 185974 29649 Gruia Ovidiu E Director Business Development 40.00 X 0 184563 31458 Morrison Brad Director Nursing Admin 48.00 X 0 177842 33494 Robinson Barbara M Director - Transistion 40.00 X 0 163744 27827 Connovich Ron Former Officer 0.00 49.00 X 0 582478 82373 Mallett Belinda A Former (Dec 15) 0.00 40.00 X 0 192761 27109 0 8834940 688038 0 1 1 0 0 76824 76824 Patient care services 622000 191796520 188497425 3299095 Leasing activities related to mis 531120 1005334 1005334 Catering 722320 5441 5441 Reference lab 621500 265 265 192807560 190 190 49320 49320 294077 0 294077 294077 294077 193227971 189502759 5706 3642682 X 19882 19882 2555162 2280060 275102 57163893 55968495 1195398 1569929 1537099 32830 9659085 9457096 201989 4165694 4078582 87112 6215 6215 2460 2460 9375837 9133636 242201 2110218 2027529 82689 325671 316136 9535 2806793 2802340 4453 156012 127896 28116 116303 94952 21351 6521747 6511399 10348 11361923 11343896 18027 529442 381633 147809 Medical supplies 30159527 30157497 2030 Network services 21212084 18928279 2283805 Physician services 15381039 15381039 Cost of goods sold 1717231 1717231 7706531 4586487 3120044 184622678 176851164 7771514 0 84840 111596 21456236 22174363 2611850 2813995 526765 892363 263382154 82038086 158071692 181344068 10858494 51131 1174149 193661008 208510534 11863827 13285253 100 3099 109754433 96618133 32566 755525 3538670 122406451 113445155 X 71254557 95065379 71254557 95065379 193661008 208510534 X 8605293 15205529 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20671041 20671041 160919343 51335308 109584035 46102224 30702778 15399446 35689546 35689546 181344068 Estimated amounts due to third-party payors 383130 Finance lease liabilities 5508 Operating lease liabilities 623138 Other long-term contracts 360000 Physician income guarantee commitments 66667 Professional self-insurance liability 2100227 3538670 X Part X, Line 2: The Network completed an analysis of its certain and uncertain tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2019 or 2018. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 3241939 2415665 826274 0.00450 37250387 16008894 21241493 0.11510 40492326 18424559 22067767 0.11960 1454374 7031 1447343 0.00780 180436 180436 0.00100 2472862 969833 1503029 0.00810 218709 218709 0.00120 4326381 976864 3349517 0.01810 44818707 19401423 25417284 0.13770 1 16704958 400919 35652685 38787178 -3134493 X 1 1 1 1 Beavercreek Medical Center 3535 Pentagon Boulevard Beavercreek OH 45431 ketteringhealth.org/soin/ X X X X Beavercreek Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X https://www.ketteringhealth.org/aboutus/communityhealth.cfm X 1 19 1 https://www.ketteringhealth.org/aboutus/communityhealth.cfm 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X X 1 X https://www.ketteringhealth.org/financial/pdfs/PatientFinancialAssistancePo X https://www.ketteringhealth.org/financial/pdfs/HCAP-2019b.pdf X https://www.ketteringhealth.org/financial/pdfs/PLS3.pdf X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section A: The facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law. Beavercreek Medical Center Part V, Section B, Line 5: Nonprofit hospitals in the Greater Cincinnati and Greater Dayton regions combined their efforts and resources to produce a comprehensive and collaborative Community Health Needs Assessment (CHNA). The CHNA Team involved four entities working closely together: The Health Collaborative (lead agency); the Greater Dayton Area Hospital Association; Gwen Finegan (lead consultant and project manager); and Public Health - Dayton & Montgomery County (secondary data collection for Ohio counties). The Southwest District of the Association of Ohio Health Commissioners also partnered in the effort. They provided representatives who could speak on the behalf of the 17 Ohio counties served by the hospitals. All county-level public health departments completed surveys, plus 5 city health departments. Beavercreek Medical Center Part V, Section B, Line 6a: The Christ Hospital Health NetworkCincinnati Children's Hospital Medical CenterClinton Memorial HospitalHighpoint HealthFort Hamilton HospitalGrandview Medical CenterGreene Memorial HospitalKettering Behavioral Medicine CenterKettering Medical CenterSoin Medical CenterSouthview Medical CenterSycamore Medical CenterLindner Center of HopeMercy Health - Anderson HospitalMercy Health - Clermont HospitalMercy Health - Fairfield HospitalMercy Health - West HospitalThe Jewish Hospital - Mercy HealthMercy Health | Springfield Urbana regionMercy Health - Urbana HospitalSpringfield Regional Medical CenterAtrium Medical CenterMiami Valley HospitalMiami Valley Hospital NorthMiami Valley Hospital SouthUpper Valley Medical CenterBethesda Butler HospitalBethesda North HospitalGood Samaritan HospitalMcCullough-Hyde Memorial HospitalTriHealth Evendale Hospital Daniel Drake Center for Post-Acute CareUniversity of Cincinnati Medical Center West Chester HospitalWilson HealthWayne HealthCare Beavercreek Medical Center Part V, Section B, Line 6b: The Health CollaborativeGreater Dayton Area Hospital AssociationGwen FineganPublic Health - Dayton & Montgomery CountySouthwest District of the Association of Ohio Health Commissioners Beavercreek Medical Center Part V, Section B, Line 11: The priorities for Soin Medical Center are the top community health needs identified in the Community Health Needs Assessment (CHNA): 1. Mental health, including substance abuse 2. Access to care and/or services, including infant mortality 3. Chronic disease 4. Healthy behaviorsThese will be addressed through a rural health initiative, congregational health, midwifery care, referrals to prenatal care from ED, a hospital-based tobacco cessation program, and ongoing participation with Drug Free Coalition. 1 1 - Springfield Health Center 2100 Emmanuel Way Springfield OH 45502 Outpatient Clinic & Diagnostic Center Part I, Line 6a: The organization provides an annual community benefit report that is made available to the public. Part I, Line 7: Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid, and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures. Part I, Line 7g: Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers. Part III, Line 2: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Part III, Line 3: An industry average was used to estimate this amount. It was not included as part of community benefit. Part III, Line 4: Bad Debt Footnote extract:Implicit price concessions represent differences between amounts billed and the estimated consideration the Network expects to receive from patients, which are determined based on historical collection experience, current market conditions, and other factors. Part III, Line 8: The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in community benefit in Part I. Part III, Line 9b: Financial counselors work out a payment program for any amount due after the Charity Sliding Scale Discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances. Part VI, Line 3: Soin informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Soin's charity care policy as follows:-Soin has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This data is available for future visits as well.-Soin has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.-Soin contracts with an outside agency for patient assistance in the application process.-The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for Soin's HCAP or Charity Sliding Scale program. -Soin's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs. Part VI, Line 4: KHN serves a population of approximately 1,574,000. The seven-county service area includes Butler, Clark, Greene, Miami, Montgomery, Preble, and Warren counties. Eighteen zip codes within this service area received a Community Need Index score of 3.4 or greater. The Community Need Index identifies the severity of healthcare disparities based upon certain barriers known to limit healthcare access. A score of 1.0 indicates a zip code with the lowest socio-economic barriers (low need), while a score of 5.0 represents a zip code with the most socio-economic barriers (high need). Part VI, Line 5: Soin furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments.-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most advanced medical technology, upgrades of existing hospital structures, and construction of new facilities in order to provide accessible, efficient, quality care. Part VI, Line 6: Soin promotes the health of the communities served as described below:-Soin, a part of the Kettering Health Network, is dedicated to the creation and maintenance of community wellness programs, support groups, and health education programs. Soin provides numerous screenings, family-focused classes, health fairs, conferences, donations, and education programs to ensure the long-term well-being of people living in the community.-Kettering Affiliated Health Services, Inc includes Sycamore Glen Health Center and Sycamore Glen Retirement Community. These healthcare areas provide services to the surrounding communities which complement those services provided by Soin as part of the Kettering Health Network.-Medical research is supported through the Innovation Center, which cultivates new technologies and fosters best practices among partners from industry, academia and health care. Part VI, Line 7, Reports Filed With States OH 1 Assistance to employees for hardship 16 17340 FMV Scholarship 1 1500 FMV Patient assistance 36 1042 FMV Part I, Line 2: Funds are monitored and use is determined by board members. 0 1 0 0 0 0 0 0 0 Manchur Fred CEO - KHN 0 1508849 0 465325 0 515481 0 15787 0 28111 0 2533553 0 0 Burns Terry Exec VP-KHN & President-KMC 3/2019; 0 862259 0 194400 0 353060 0 15787 0 41410 0 1466916 0 102400 Chew Roy President of KHN until 7/31/2019 0 773908 0 319549 0 0 0 15787 0 20291 0 1129535 0 0 Dodds Rick President GMH/SOIN 0 451322 0 110548 0 1809 0 52807 0 29949 0 646435 0 0 Smith Robert T Physician 0 396572 0 113584 0 4212 0 15787 0 18762 0 548917 0 0 Tyner Troy A Physician 0 298931 0 0 0 0 0 15787 0 15226 0 329944 0 0 Barber Wendi VP Operation & Finance GMH/SOIN begi 0 367548 0 0 0 1279 0 44627 0 27829 0 441283 0 0 Schneider Erica VP Patient Care Services - GMH/SOIN 0 266230 0 61585 0 1566 0 39281 0 28474 0 397136 0 0 Jones Jeff Director HR 0 160918 0 27591 0 3458 0 11131 0 19295 0 222393 0 0 Hope Jill A Pharmacist 0 155247 0 27487 0 3240 0 11169 0 18480 0 215623 0 0 Gruia Ovidiu E Director Business Development 0 154171 0 26206 0 4186 0 9384 0 22074 0 216021 0 0 Morrison Brad Director Nursing Admin 0 146928 0 26728 0 4186 0 10801 0 22693 0 211336 0 0 Robinson Barbara M Director - Transistion 0 137456 0 23002 0 3286 0 9100 0 18727 0 191571 0 0 Connovich Ron Former Officer 0 461877 0 115133 0 5468 0 52388 0 29985 0 664851 0 0 Mallett Belinda A Former (Dec 15) 0 159511 0 29818 0 3432 0 12096 0 15013 0 219870 0 0 Part I, Line 3 Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid. Part I, Line 4b The network has a supplemental executive retirement plan available only to a certain class of management. Part II, Col Biii Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets. A County of Greene Ohio 316000271 394650BV6 2009-11-03 97931091 Construct and equip a hospital 0 0 0 B County of Montgomery Ohio 316000271 613520LA1 2016-05-04 12087009 Hospital building improvements and equipment 0 0 0 C County of Miami Ohio 316000055 593328EW3 2019-03-07 85486838 Hospital facilities improvement and refunding 0 0 0 A 100867503 9296792 2633592 1612304 85213731 2111084 2012 0 0 1 1 B 12087009 110713 11976296 2016 0 0 1 1 C 85486838 521348 4790564 80174926 2019 1 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 Form 990, Part VI, Section B, line 11b A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board). Form 990, Part VI, Section B, line 12c The Network regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review the Network's policy, sign a conflict of interest statement, and notify the Network if a conflict should arise. Form 990, Part VI, Section B, line 15 The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Part IX, Lines 5, 7, 8, 9, & 10 Salaries, retirement plan contributions, other benefits, and payroll taxes are paid by and allocated from Kettering Medical Center and Kettering Network Services. Form 990, Part XI, line 9: Net transfers from affiliate 15,205,529. Part XII, Line 2c Neither the oversight process nor the selection process changed during the tax year. Alliance Physicians Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311175717 Physician Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Dayton Osteopathic Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310564121 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Fort Hamilton Hospital Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 452036966 Fundraising OH 501(c)(3) 509(a)(3) The Fort Hamilton Hospital 0 Greene Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 310886949 Fundraising OH 501(c)(3) 509(a)(3) Greene Memorial Hospital 0 Greene Memorial Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310809436 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Greene Oaks 1 Prestige Place Suite 910 Miamisburg OH 45342 310999724 Senior Healthcare Facilities OH 501(c)(3) 509(a)(2) Kettering Affiliated Health Services Inc 0 Kettering Adventist Healthcare 1 Prestige Place Suite 910 Miamisburg OH 45342 311051688 Management OH 501(c)(3) 509(a)(3) N/A 0 Kettering Affiliated Health Services Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311127485 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Independent Medical Group 1 Prestige Place Suite 910 Miamisburg OH 45342 272649285 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Medical Center 1 Prestige Place Suite 910 Miamisburg OH 45342 310621866 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettering Medical Center Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 237419897 Fundraising OH 501(c)(3) 509(a)(3) Kettering Medical Center 0 Kettering Network Services 1 Prestige Place Suite 910 Miamisburg OH 45342 832687866 Administrative Support Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 The Fort Hamilton Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310536662 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettcor 1 Prestige Place Suite 910 Miamisburg OH 45342 311078381 Health Services OH N/A C 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 1 Greene Foundation C 76824 FMV Alliance Physicians Inc J 490890 FMV Dayton Osteopathic Hospital J 306878 FMV Kettering Network Services J 36026 FMV Kettering Network Services K 94767 FMV Alliance Physicians Inc M 0 FMV Greene Foundation M 0 FMV Kettering Adventist Healthcare M 0 FMV Kettering Medical Center M 0 FMV Kettering Network Services M 0 FMV Kettering Medical Center N 0 FMV Kettering Network Services N 0 FMV Greene Memorial Hospital O 0 FMV Kettering Medical Center O 0 FMV Kettering Network Services O 0 FMV Kettering Medical Center P 0 FMV Kettering Network Services P 0 FMV Kettering Medical Center S 15205529 FMV Part V, Line 2 Kettering Medical Center and Kettering Network Services are conduits through which revenue is received and expenses are paid.