2020-05-08T12:11:47-07:00 2019-06-30 990 2018-07-01 341041385 Salem Community Hospital SALE 3303327214 1995 East State Street Salem OH 44460 Michael Giangardella VP Finance/Administration 3303327214 2020-05-11 12.33.201.68 2018 2020-09-23 17:36:50Z Salem Regional Medical Center Dr Anita Hackstedde MD 1995 E State Street Salem OH 44460 118615637 0 X www.salemregional.com X 1913 OH Salem Regional Medical Center (SRMC) is an 87-bed, not-for-profit rural facility, which provides a continuum of medical services to the residents of Columbiana and southern Mahoning counties, including inpatient and outpatient medical and surgical care, orthopedics and intensive care. The Hospital also operates a full-time 24-hour Emergency Department, and treats all patients requiring medical care, irrespective of their financial means. The Hospital provides its services free of charge or on a sliding scale to uninsured/underinsured patients, regardless of race, creed, origin, handicap, age or ability to pay.; in support of its mission- "To Serve. To Care. To Heal." 18 16 903 94 995464 -20466 154050 115703 99750494 111463788 9574053 6305358 1108969 521303 110587566 118406152 14743 4900 0 0 55141855 48968883 0 0 0 55270580 56960719 110427178 105934502 160388 12471650 238336672 240445095 75448531 73550080 162888141 166895015 "To Serve. To Care. To Heal," encompasses the Hospital's mission of providing high quality care on both an inpatient and outpatient basis; and addresses our patients' health care needs at each life stage, within our available resources. SRMC seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community-based hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. 0 0 91022652 111822165 SRMC's mission and purpose is achieved by providing quality care to the sick and injured on both an inpatient and outpatient basis, while addressing our patients' healthcare needs at each life stage, within our available resources. The Medical Center seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. During fiscal year 2019, SRMC provided comprehensive healthcare services including: 3,722 Admissions; 3,617 Surgeries; and 23,071 Emergency Department visits. In support of this commitment, SRMC operates a full-time, 24-hour Emergency Department, and treats all patients requiring emergency medical care, irrespective of their financial means. The Medical Center also accepts all patients covered by Medicare, Medicaid and General Assistance. For fiscal year 2019, costs incurred by SRMC for unpaid costs of the Medicaid program were $1,235,137, and unreimbursed costs from other governmental programs were $7,963,767. These community benefits, arising from patient care provided by SRMC are documented to help to relieve a governmental financial and programmatic burden as evidenced through the Medical Center's charitable purpose. 0 0 0 91022652 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 63 0 1 903 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Michael Giangardella 3303327214 1995 East State Street Salem OH 44460 Jon Vollnogle Chair 1 2.00 X 6913 0 0 Chris Meta Vice-Chair 1 1 X 0 0 0 Jeffrey Zimmerman Treasurer 1 1 X 0 0 0 Denise Harlan Secretary 1 1 X 0 0 0 Dr Meredith Mcnally Chief of Staff 5 35 X 20000 317562 21374 Todd Olson Director 1.00 0 X 0 0 0 John Biastro Director 1 0 X 0 0 0 Peter Apicella MD Director 1 1 X 8882 0 0 Vicki Hall Director 1 1 X 0 0 0 Dr Lauren Fredrickson MD Director 1 0 X 14600 0 0 Ruth Ann Rinto Director 1 1 X 0 0 0 Lynn Scullion O D Director 1 1 X 0 0 0 Terry Criss Director 1 0 X 0 0 0 Nelson Witmer Director 1 0 X 0 0 0 Vito Abruzzino Director 1 0 X 0 0 0 Dr Lee Simon Director 1 0 X 0 414251 20708 Scott Tuel Director 1 0 X 0 0 0 Bruce Rhodes Jr Director 1 0 X 0 0 0 Anita Hackstedde President/CEO 35 5 X 372200 0 101272 Mike Giangardella VP Finance/Administration 38 2 X 212022 0 123950 Barbara Hirst VP Nursing/Human Resources 40 0 X 182198 0 86483 Keith Meredith VP Clinical Operations 40 0 X 161634 0 61637 Sue Bryarly Director of Pharmacy 40 0 X 139829 0 74290 Mark LItalien Director Information Services 40 0 X 135703 0 107927 Diane Spalding Pharmacist 40.13 0 X 123408 0 3082 Deborah Pietrzak Asst VP Marketing & Planning 40 0 X 121447 0 108273 Kimberly Meek Pharmacist 40 0 X 120292 0 57773 1619128 731813 766769 20 0 1 0 University Hospitals 3605 Warrensville Center Road Mail Stop 9230 -- Cube 2344I Shaker Heights OH 441225203 Medical Services 1131699 Northstar Anesthesia 6225N State Hwy 161 Suite 200 Irving TX 75038 Medical Services 1106629 Laboratory Corporation of America PO box 12140 Burlington NC 27216 Laboratory services 606826 Healogics Wound Care 5220 Belfort Road Suite 130 Jacksonville FL 32256 Healthcare Services 423567 Ohio Security Systems Inc 320 Fulton St SE Warren OH 44483 Security Personnel Services 421599 19 115703 115703 Patient Service Revenue 622000 109502177 109502177 0 0 Outside Lab Revenue 621500 101951 0 101951 0 Durable Medical Equipment Revenue 621610 1859660 966147 893513 0 0 0 0 0 111463788 6258972 0 0 6258972 0 0 0 0 0 0 0 0 369365 206439 162926 0 162926 162926 0 49432 0 3046 0 46386 46386 0 0 46386 Dietary Income 900099 144731 144731 0 0 Gift Shop Income 900099 103117 103117 0 0 Medical Records Fees 900099 15204 15204 0 0 95325 95325 0 0 358377 118406152 110826701 995464 6468284 X 4900 4900 1093734 1093734 32907884 29848783 3059101 4540398 3824495 715903 7948945 6811264 1137681 2477922 2203807 274115 70565 70565 198301 198301 78934 78934 11739453 9340575 2398878 144080 144080 1579738 531754 1047984 2506322 1783539 722783 2032392 1608596 423796 66175 40239 25936 1146786 1146786 9935846 8834198 1101648 347987 347987 Bad Debt 2205170 2205170 0 0 State Assessment 1782527 0 1782527 0 Drugs & Pharmaceuticals 9765701 9765701 0 0 Medical Supplies 12917012 12916525 487 0 443730 156320 287410 0 105934502 91022652 14911850 0 5129956 9249133 11920002 11553809 1445045 1312230 2838386 3069947 170688584 80992829 93804557 89695755 123198726 125564221 238336672 240445095 11140911 11445278 45557542 43897538 310635 216885 18439443 17990379 75448531 73550080 X 162802591 166854770 85550 40245 0 0 162888141 166895015 238336672 240445095 X 12471650 -2241745 0 0 0 -6223031 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2330744 0 2330744 116566414 0 49981475 66584939 2006667 0 477923 1528744 49779452 0 30533431 19246021 5307 0 0 5307 89695755 Deferred Liability 195546 Pension Liability 17794833 17990379 1 1 1 X 1 X 1 1 0 1 1 1466407 2614638 0 0 3050243 1815106 1235137 0.01216 10369370 6233099 4136271 0.04074 0 0 14886020 10662843 5371408 0.05290 137 122223 134881 400 134481 0.00132 381 966 624875 0 624875 0.00615 260462 210414 50048 0.00049 0 0 0 0 9 2179 56949 0 56949 0.00056 527 125368 1077167 210814 866353 0.00852 527 125368 15963187 10873657 6237761 0.06142 2 200 223 0 223 0 18 2959 9957 0 9957 0.0001 191 6530 18383 0 18383 0.00018 4 185 115422 13289 102133 0.00101 4 281 5400 0 5400 0.00005 11 820 8329 0 8329 0.00008 37 2067 18635 0 18635 0.00018 54 652 310275 0 310275 0.00306 0 0 0 0 0 0 321 13694 486624 13289 473335 0.00466 1 800015 164600 24585538 28413034 -3827496 X 1 1 1 1 Salem Community Hospital dba Salem Regional Medical Center 1995 East State Street Salem OH 44460 Salemregional.com X 15 bed skilled nursing facility Salem Community Hospital dba Salem Regional Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X http://www.salemregional.com X X 1 16 1 http://www.salemregional.com 0 0 1 X 150 350 X 1 1 X X X 1 X http://www.salemregional.com X http://www.salemregional.com X X 1 X X 1 X X X X X X 1 0 0 Schedule H, Part V, Section B, Line 5-Salem Community Hospital To take into account input from persons representing the community served, the CHNA primary data collection process included focus group and stakeholder interviews conducted with a total of 115 adult participants, including those from school districts, juvenile justice, community resource centers, senior services, Hispanic community providers, local government officials, health and human service providers, mental health providers and faith-based organizations. Community leaders and key stakeholders were identified as experts in a particular field related to their background experience or professional position; and/or those who understand the needs of a particular community/geographic region or under-represented group, including the medically underserved and vulnerable populations. In addition, a community survey derived from the Behavioral Risk Factor Surveillance System was completed by 382 adults, so that local primary data could be compared with state and national data. Schedule H, Part V, Section B, Line 6a-Salem Community Hospital Along with Salem Regional Medical Center, East Liverpool City Hospital and Akron Children's Hospital also provided financial support for the CHNA process. Schedule H, Part V, Section B, Line 6b-Salem Community Hospital A collaborative workgroup conducted the CHNA, composed of the Akron Children's Hospital, Columbiana County Educational Service Center, Columbiana County General Health District, Columbiana County Mental Health and Recovery Services Board, Community Action Agency of Columbiana County, East Liverpool City Health Department, East Liverpool City Hospital, Family and Children First Council, Salem City Health Department, Salem Regional Medical Center and The Ohio State University- Extension. In addition, this workgroup developed a County Health Improvement Plan to address the CHNA's priorities. Schedule H, Part V, Section B, Line 7d-Salem Community Hospital The CHNA was posted on Salem Regional Medical Center's website at http://www.salemregional.com/about-us/our-publications:Community Health Needs Assessment, along with being posted on many of the collaborative partners' websites. In addition, two news releases were issued regarding the preliminary CHNA findings and publication of the final report, with information about how the general public could access the CHNA via the internet. A summary of the CHNA's findings was also presented to several community groups including social service providers and school health professionals, and posted on social media. Schedule H, Part V, Section B, Line 11-Salem Community Hospital As outlined in the 2019-2022 Implementation Plan, SRMC will focus on the CHNA's top 3 health priorities related to obesity/chronic disease; mental health and addiction/substance abuse and access to health care utilizing a three-year intervention strategy and defined target outcomes for each priority. Note that these priorities align with the priority topics identified in Ohio's 2019 State Health Assessment. To address the significant needs identified in the 2019 CHNA regarding obesity and chronic disease prevention, SRMC is working with existing and/or developing new community partnerships to broaden access to recreational opportunities and promote existing resources for improved physical activity and nutrition to positively impact the rates of physical activity and consumption of healthy foods for residents within SRMC's Service Area. To address the significant needs regarding mental health and substance abuse prevention, SRMC is serving as a community partner in improving access to mental health and substance abuse treatment services through membership on the ADAPT and CASH Coalitions, as well as facilitating the coordination of and access to community-based, post-acute treatment resources. SRMC also operates the Behavioral Medicine and Wellness Center as an intensive outpatient and partial hospitalization program designed to meet individual and group needs for mental health services in Columbiana and other surrounding counties. Data related to barriers in accessing clinical care indicated higher ratios of the population to primary care physicians, mental health providers and dental health providers, reflecting health professional shortages in these categories. To reduce barriers to accessing health care, SRMC is actively recruiting providers to underserved areas; exploring alternate delivery of care models, such as telemedicine; and increasing health literacy interventions to reduce hospital readmissions, strengthen medication education and increase patients' knowledge to decrease disparities among vulnerable populations. Primary data gathered from focus group participants and stakeholders identified multi-faceted socio-economic issues related to the poor economy, generational poverty, increased drug abuse and mental health issues, lack of transportation, Appalachian culture/unhealthy lifestyles, obesity, lack of parenting skills and language/health literacy barriers as key drivers of the health status of the community. Other identified needs related to the environment and social determinants of health included not enough money, lack of access to employment/better jobs, safe water/clean air/fracking/agricultural runoff, poor housing conditions and crime/violence. In addition, focus group participants identified the weather, chemical waste and unemployment as environmental determinants that impact community health. Due to their societal magnitude and SRMC's limited resources and capacity to meaningfully impact the environment and economic foundation of the county, SRMC has chosen to allocate significant resources to the priority health needs which yield the greatest opportunities to affect a positive change as outlined in the 2019-2022 Implementation Plan. Schedule H, Part V, Section B, Line 16j-Salem Community Hospital The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the billing office. Schedule H, Part I, Line 6a Salem Regional Medical Center (SRMC) prepares an Annual Report that is distributed to the community via a paper and electronic format, as well as being posted on the SRMC website at www.salemregional.com. The Annual Report includes a summary of the Medical Center's statement of expenses and uncompensated care, along with highlighting SRMC's major community benefit initiatives and outcomes. This community benefit information is provided in an effort to document its tax exempt purpose and demonstrate the benefits provided for the broader community as determined by community need. Schedule H, Part I, Line 7 Costs are determined by applying the ratio of cost to charges to gross charges and utilizing the format as outlined in the Schedule H instructions. Beyond charity care, "Other Benefits" reported include community health improvement services and community benefit operations, with community building activities listed in Part II. The Medical Center seeks opportunities to further its tax exempt purpose by providing a wide variety of benefits for the broader community, including the development of a county-wide needs assessment to identify regional health needs; and the development and adoption of a related Implementation Plan to address the health needs identified. Examples of other community benefit activities include, but are not limited to: grant-writing activities for improved community health; community health education regarding cancer, diabetes, cardiac disease and other chronic diseases; obesity prevention and women's health; and community health fairs and free and reduced-cost clinical screenings for high blood pressure, blood sugar, colorectal cancer and mammography. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. It is estimated that over 125,000 area residents participated in community health improvement programs and/or events provided and/or sponsored by Salem Regional Medical Center. Schedule H, Part I, Line 7, Column f Bad Debt expense in the amount of $2,205,170 is included in total expenses on Form 990, Part IX, line 25 but was subtracted for purposes of calculating the percentages in Schedule H, Part 1, Line 7. Schedule H, Part I, Line 7g Costs for subsidized health services include those attributable to providing Salem Regional Medical Center's outpatient behavioral health services. There are no health services attributable to a physician clinic. Schedule H, Part II During the taxable year, SRMC participated in 321 different community building activities in an effort to provide programs and activities that respond to demonstrated, unmet community needs; improve the community's health and safety; and promote the well-being of area residents through the Hospital's resources and expertise. SRMC participated in several area activities for the local and regional Chambers of Commerce; was a leading collaborative partner in disaster readiness; assisted in environmental improvements related to community medications' disposal; represented SRMC on diverse community coalitions related to improving community health; assisted with workforce development related to recruiting and retaining physicians and clinical professionals in medically underserved areas; and participated in community workforce boards, partnerships with area universities to address the health care work force shortage and provided many school-based programs on health care careers, including offering teen and college student mentoring opportunities. SRMC continues to serve as a community resource and partner for regional non-profit organizations by providing collaborative programming with agencies such as the American Cancer Society, American Diabetes Association, American Heart Association, American Red Cross, Columbiana County Community Action Agency, Columbiana County and Salem City Departments of Health, Coordinated Action for School Health, Hospice of the Valley, Kent State University- Salem Campus, Northeast Ohio Medical University and the Salem Community Center. In addition, SRMC makes financial and in-kind contributions to many of these and other not-for-profit organizations through event sponsorships and staff support. Schedule H, Part III, Section A, Line 4 Excerpt from footnote. "Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Center analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Center analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Center records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided under the Center's Financial Assistance Policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The cost of bad debt was determined by applying the Medical Center's cost to charge ratio to the charges that were written off to bad debt. The Hospital believes this is a community benefit because the patients who may likely qualify for assistance under the Hospital's Financial Assistance Policy do not or are unwilling to provide documentation of the eligibility for charity care and therefore are classified as bad debt. The hospital is very willing to work out payment arrangements and discounted fees; however those patients unwilling to respond to repeated offers of assistance are categorized as bad debt expense. Had information been made available to make a determination of their eligibility, the Hospital believes that many patients classified as bad debt would qualify for charity care. This judgement is based on the economic conditions and specific knowledge of the patients involved. Schedule H, Part III, Section B, Line 8 The costs were obtained from the Medicare cost report. The Medical Center incurred costs in excess of $28.4 million to care for and treat beneficiaries while receiving reimbursement of $24.6 million, leaving a shortfall of $3.8 million. This is a direct benefit provided by the Medical Center to local beneficiaries who live in the surrounding communities. Schedule H, Part III, Section C, Line 9b Per the Medical Center's collection policy, the Medical Center will not pursue collection for non-payment of bills against individuals who demonstrate that they have neither sufficient income nor assets to meet their financial obligations. Schedule H, Part VI, Line 2 SRMC formally assesses the healthcare needs of the communities that it serves on a minimum of a triennial basis, and does so in collaboration with other community health providers. The most recent comprehensive, county-wide needs assessment was published in May 2019, and was developed by a collaborative of Columbiana County's major health providers, public health entities, and health-focused coalitions including Salem Regional Medical Center; East Liverpool City Hospital and Akron Children's Hospital; the Columbiana County, East Liverpool and Salem City Health Departments; Columbiana County Educational Service Center; Community Action Agency of Columbiana County; the Coordinated Action for School Health (CASH) Coalition; and the Columbiana County Mental Health Services and Recovery Board. The CHNA process began in May 2018, with the development of the project plan and timeline. The above mentioned collaborative convened in June 2018 and continued meeting through May 2019 to evaluate the previous CHNA, collect and analyze primary and secondary data, conduct community asset mapping and identify issues and select priorities to address through the development of the 2019-2022 CHNA. The Hospital Council of Northwest Ohio was retained to facilitate the process and provide data analysis and prioritization support. The geographic area of the needs assessment encompassed Ohio's Columbiana County, most of which is within Salem Regional Medical Center's Service Area; and prioritized the public, primary and specialty health care needs of community members from birth through end-of-life care. The CHNA action plan and report development were presented to and approved by the SRMC Board in May 2019, and distributed to all participating coalition organizations. The SRMC Implementation Plan was approved by the Board in November 2019, and both documents are posted on the SRMC website at: http://www.salemregional.com/about-us/our-publications: Community Health Needs Assessment and SRMC Implementation Plan. The Medical Center will carry forward its implementation strategies by addressing them in its Strategic Plan and annual Organizational Goals. In addition, SRMC is a collaborative partner in other types of needs assessments, such as the school health asset study through the Search Institute, conducted on an annual basis with area school districts; a multi-disciplinary assessment of substance abuse incidence and treatment needs via the county-wide ADAPT coalition; behavioral health needs in collaboration with the Mental Health and Recovery services Board; and minority health access needs in collaboration with faith-based and literacy-based advocacy groups. Schedule H, Part VI, Line 3 The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the Hospital's billing office. Schedule H, Part VI, Line 4 Salem Regional Medical Center's rural service area is officially designated as within one of Ohio's 32 Appalachian counties and includes Columbiana County, excluding Yellow Creek and East Liverpool Townships; and the five lower townships of Mahoning County. Portions of Columbiana County are also designated as Medically Underserved, and as a dental and mental health care Health Professional Shortage Areas. The Robert Wood Johnson 2018 County Health Rankings data also showed that Columbiana County faces a significant barrier to access as indicated by the county's ratio of the population to primary care providers (2,280:1) being higher than Ohio (1,310:1); and the county's ratio of dentists (4,320:1) being considerably higher than Ohio (1,660:1). Columbiana County residents are older than their state and national counterparts, and the Service Area is characterized by a declining social, economic and population base, which impacts the area's health status problems and health service utilization. Generational poverty, lack of transportation and lack of insurance are also barriers to access, with the rate of uninsured Columbiana County adults higher than Ohio. Regional health outcomes and social/economic/environmental rates that were worse than Ohio benchmarks included: higher rates of premature death/years of potential life lost before age 75, higher adult obesity rates combined with lower physical activity rates, higher percentage of people who report their physical health as fair or poor, lower post-secondary education rates, higher teen birth rates, greater number of deaths due to injury and a higher index of air pollution. Health disparities are also more common among vulnerable populations and based on the demographics of Columbiana County's population, the 2019-2022 CHNA identified vulnerable populations as those living in poverty/socioeconomically disadvantaged, the Appalachian culture, children/youth, the elderly and those facing ethnic and literacy barriers. Schedule H, Part VI, Line 5 Salem Regional Medical Center actively seeks opportunities to further the community's health status by providing a wide variety of benefits for the broader community, including grant-writing activities for improved community health; financial and in-kind contributions for community based feeding programs, physical fitness as an obesity and chronic disease prevention tool, blood drives, social services for vulnerable populations (including assistance with medications, transportation, limited English proficiency and referrals to support systems); community health education regarding cancer, diabetes, arthritis, cardiac and other chronic diseases, and women's health; and community health fairs and free and reduced-cost clinical screenings. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. It is estimated that over 125,000 area residents participated in community benefit programs and/or events provided and/or sponsored by SRMC. SRMC also utilizes an active volunteer base, with 61 community members donating over 8433 hours of volunteer service annually. In addition, the SRMC Board of Directors is comprised of 18 community volunteers from the SRMC Service Area, who perform fiduciary responsibilities through monthly committee and Board activities. 0 0 0 0 0 0 0 0 0 Anita Hackstedde President/CEO 368200 0 0 0 4000 0 84889 0 16383 0 473472 0 0 0 Mike Giangardella VP Finance/Administration 212022 0 0 0 0 0 114851 0 9099 0 335972 0 0 0 Barbara Hirst VP Nursing/Human Resources 182198 0 0 0 0 0 77384 0 9099 0 268681 0 0 0 Keith Meredith VP Clinical Operations 161634 0 0 0 0 0 54297 0 7340 0 223271 0 0 0 Sue Bryarly Director of Pharmacy 139829 0 0 0 0 0 46982 0 27308 0 214119 0 0 0 Mark LItalien Director Information Services 135703 0 0 0 0 0 89725 0 18202 0 243630 0 0 0 Diane Spalding Pharmacist 123408 0 0 0 0 0 3082 0 0 0 126490 0 0 0 Deborah Pietrzak Asst VP Marketing & Planning 121447 0 0 0 0 0 80965 0 27308 0 229720 0 0 0 Kimberly Meek Pharmacist 120292 0 0 0 0 0 48674 0 9099 0 178065 0 0 0 A City Of Salem Ohio 346002560 2013-04-04 52000000 Hospital Facility Construction 0 1 0 A 29600292 0 52000000 0 193598 0 168913 0 160493 21883897 6893 0 2014 0 1 1 1 A 0 1 0 0 0.0112 0 0.0112 1 0 1 A 0 0 1 0 1 0 0 0 1 A 1 John Biastro Director 28375 Child of interested person is an employee of org 0 Form 990, Part VI, Section B, Line 11b The 990 is made available for review to the governing board prior to filing. Form 990, Part VI, Section B, Line 12c Each member of the Hospital's governing body, along with the Administrative staff, are required to review and disclose conflicts of interest in accordance with the Hospital's code of Regulations. On an annual basis, Directors and Key Employees disclose potential business or professional relationships they may have with the Organization and/or other Directors/Key Employees. In situations when a Director may have a conflict, they may participate in the discussion, but must leave the room prior to final discussion and vote. Form 990, Part VI, Section B, Line 15 The President's compensation is determined by the Board of Directors of Salem Regional Medical Center, based upon the recommendation of the Board's Executive Committee, both of which are comprised primarily of independent board members. The committee evaluates market data through formal statewide surveys, as well as targeted regional survey data. Form 990, Part VI, Section C, Line 19 As a private, not-for-profit organization, Salem Regional Medical Center does not make its governing documents or financial statements generally available to the public; although, the federal form 990 is available for review upon request. Form 990, Part IX, Line 11g Balance in this category represents the following expenses: 1) Purchased Services total $7,485,288; 2) Professional Health Care Services total $2,199,563; 3) Repair & Maintenance Services total $2,054,602. Form 990, Part XI, Line 9 Change in defined benefit plan losses, prior service costs or credits and curtailment gain-$721,851; transfers to related organizations -$5,049,435; consolidation of wholly-owned subsidiary -$406,440; decrease in restricted net assets -$45,305 SCH Professional Corporation 1995 East State Street Salem OH 44460 341764515 Physician Offices OH 501(c)(3) 11 Salem Community Hospital 0 The Charitable Foundation of Salem Community Hospital 1995 East State Street Salem OH 44460 462902698 Support Salem Community Hospital OH 501(c)(3) 11 Salem Communiy Hospital 0 Salem Medical Arts & Development Corporation 2020 East State Street Salem OH 44460 341049534 Office Rent OH N/A C 1 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 SCH Professional Corporation j 189072 Cost per square foot SCH Professional Corporation b 5049435 Actual Capital Contribution SCH Professional Corporation o 237452 Net of Actual Salaries & Benefits Paid The Charitable Foundation of Salem Community Hospital q 126000 Reimburse actual salary, benefit and accounts payable cost paid. The Charitable Foundation of Salem Community Hospital c 50211 Contribution received from contributing organization.