OHIOHEALTH CORPORATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- OHIOHEALTH CORPORATION (EIN 31-4391798)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201923189349312737
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-14T16:24:22-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341310124 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REA & ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 941 STEUBENVILLE AVE PO BOX 820 | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 437250820 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 314391798 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN OHIO REGIONAL MEDICAL | BusinessNameLine1Txt |
| Business Name Line2 | CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 7404398179 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY R EVANCHO | PersonNm |
| Person Title | V.P. OF FINANCE & CFO | PersonTitleTxt |
| Phone | 7404393651 | PhoneNum |
| Signature | 2019-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY T TUCKER CPA | PreparerPersonNm |
| PTIN | P00537125 | PTIN |
| Phone | 7404325658 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.102.154.154 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-14 | IPDt |
| IP Tm | 13:01:20 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | F153814047753C7F8B68683DDDCC7077EFE953AD | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F153814047753C7F8B68683DDDCC7077EFE953AD | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY R EVANCHO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $109,513,749 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SEORMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | GENERAL COMMUNITY HOSPITAL WITH A MISSION TO PROVIDE HIGH QUALITY, COMPREHENSIVE, AFFORDABLE, PATIENT-CENTERED HEALTHCARE IN A CARING AND SAFE ENVIRONMENT, WHILE ADDRESSING COMMUNITY NEEDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1029 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $148,620 | PYContributionsGrantsAmt |
| CY Contributions Grants | $110,562 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $100,514,229 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $98,481,433 | CYProgramServiceRevenueAmt |
| PY Investment Income | $971,596 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,122,799 | CYInvestmentIncomeAmt |
| PY Other Revenue | $470,000 | PYOtherRevenueAmt |
| CY Other Revenue | $470,757 | CYOtherRevenueAmt |
| PY Total Revenue | $102,104,445 | PYTotalRevenueAmt |
| CY Total Revenue | $100,185,551 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $51,817,958 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $50,466,707 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $165,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $19,119 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $52,268,868 | PYOtherExpensesAmt |
| CY Other Expenses | $52,359,023 | CYOtherExpensesAmt |
| PY Total Expenses | $104,251,826 | PYTotalExpensesAmt |
| CY Total Expenses | $102,825,730 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,147,381 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,640,179 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $65,714,995 | TotalAssetsBOYAmt |
| Total Assets EOY | $57,217,436 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $41,157,792 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,034,974 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,557,203 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,182,462 | NetAssetsOrFundBalancesEOYAmt |
| Mission | GENERAL COMMUNITY HOSPITAL WITH A MISSION TO PROVIDE HIGH QUALITY, COMPREHENSIVE, AFFORDABLE, PATIENT-CENTERED HEALTHCARE IN A CARING AND SAFE ENVIRONMENT, WHILE ADDRESSING COMMUNITY NEEDS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $87,552,559 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $93,444,557 | RevenueAmt |
| Desc | GENERAL HOSPITAL - MEDICAL SERVICES FOR INPATIENTS AND OUTPATIENTS - SEE ATTACHED SCHEDULE H FOR ADDITONAL INFORMATION | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,831,243 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,036,876 | RevenueAmt |
| Desc | OPERATION OF PHYSICIAN OFFICES | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $98,383,802 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 162 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1029 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIMOTHY R EVANCHO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7404398179 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GREG ADAMS | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHAWN RAY | ||||||||
| CHAIR | 8.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BRIAN SHANAHAN | ||||||||
| VICE CHAIR | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PHILIP HEARING | ||||||||
| TREASURER | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MATTHEW P ELLI | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| COLLEEN H HEACOCK | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD J CROCK | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHON GRESS | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARIBETH WRIGHT | ||||||||
| SECRETARY | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MICHAEL D SARAP MD | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $5,125 | $0 | $0 | |||
| MARCIA WINNETT | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK GOGGIN MD | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $11,750 | $0 | $0 | |||
| RAYMOND M CHOREY | ||||||||
| PRESIDENT & CEO | 0.00 | Yes (X) | $0 | $347,489 | $25,318 | Yes (X) | 40.00 | |
| THOMASINA CROCK | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SUELLEN JOHNSON | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CHERYL L HERBERT | ||||||||
| PRESIDENT & CEO | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | 40.00 | |
| TIMOTHY R EVANCHO | ||||||||
| V.P. FINANCE & CFO/ASST TREASURER | 0.00 | $0 | $186,160 | $19,800 | Yes (X) | 40.00 | ||
| ANGELA S LONG | ||||||||
| V.P. NURSING SERVICES | 0.00 | $0 | $182,699 | $16,665 | Yes (X) | 40.00 | ||
| STEVEN M BROOKS | ||||||||
| V.P. HUMAN RESOURCES | 0.00 | $0 | $140,485 | $23,259 | Yes (X) | 40.00 | ||
| BARBARA PURDUM | ||||||||
| ASSISTANT SECRETARY | 40.00 | $55,643 | $0 | $438 | Yes (X) | 0.00 | ||
| E EDWIN CONAWAY | ||||||||
| VP MEDICAL AFFAIRS | 2.00 | $10,000 | $151,051 | $23,452 | Yes (X) | 20.00 | ||
| GINA F WOODS | ||||||||
| CHIEF NURSING OFFICER | 0.00 | $0 | $0 | $0 | Yes (X) | 40.00 | ||
| ELAINE BEED MD | ||||||||
| PHYSICIAN | 40.00 | $555,856 | $0 | $0 | 0.00 | Yes (X) | ||
| KARL W KUMLER MD | ||||||||
| PHYSICIAN | 40.00 | $632,286 | $0 | $21,111 | 0.00 | Yes (X) | ||
| CARL F JUENG MD | ||||||||
| PHYSICIAN | 40.00 | $539,838 | $0 | $26,279 | 0.00 | Yes (X) | ||
| EYAD MAHAYRI MD | ||||||||
| PHYSICIAN | 40.00 | $501,118 | $0 | $26,279 | 0.00 | Yes (X) | ||
| CLIFFORD B MAXIMO MD | ||||||||
| PHYSICIAN | 40.00 | $453,139 | $0 | $26,279 | 0.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,764,755 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,007,884 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $208,880 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SOUTHERN OH EMERGENCY PHYSICIANS | |||||
| PO BOX 674579 | DETROIT | MI | 482674579 | EMERGENCY ROOM PHYSICIANS | $1,473,009 |
| MEDSTAFF SERVICES LLC | |||||
| PO BOX 1895 | POWELL | OH | 43065 | HOSPITALIST PHYSICIAN SERVICES | $1,241,700 |
| SHIFTWISE | |||||
| 200 SW MARKET ST SUITE 700 | PORTLAND | OR | 97201 | MEDICAL STAFFING | $974,480 |
| NORTHSTAR ANESTHESIA OF OHIO LLC | |||||
| 6225 STATE HWY 161 200 | IRVING | TX | 75038 | ANESTHISIA SERVICES | $887,655 |
| LABORATORY CORPORATION | |||||
| 133 E DAVIS ST | BURLINGTON | NC | 272162140 | LABORATORY SERVICES | $578,837 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $110,562 | AllOtherContributionsAmt |
| Total Contributions | $110,562 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE & MEDICAID | 622110 | $51,468,098 | $51,468,098 |
| HEALTH & MEDICAL SERVICES | 622110 | $41,467,731 | $41,467,731 |
| PHYSICIAN OFFICES | 621110 | $5,545,604 | $5,545,604 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $98,481,433 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $424,793 | TotalRevenueColumnAmt |
| Exclusion | $424,793 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,026,204 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,328,198 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $698,006 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $698,006 | TotalRevenueColumnAmt |
| Exclusion | $698,006 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SALES | Desc |
| Business | 722300 | BusinessCd |
| Total Revenue Column | $470,757 | TotalRevenueColumnAmt |
| Exclusion | $470,757 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $470,757 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $100,185,551 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $98,481,433 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,593,556 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,518 | TotalAmt |
| Program Services | $26,875 | ProgramServicesAmt |
| Management And General | $55,643 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,097 | TotalAmt |
| Program Services | $1,053,097 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,129,924 | TotalAmt |
| Program Services | $37,963,732 | ProgramServicesAmt |
| Management And General | $151,344 | ManagementAndGeneralAmt |
| Fundraising | $14,848 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,516 | TotalAmt |
| Program Services | $606,044 | ProgramServicesAmt |
| Management And General | $3,240 | ManagementAndGeneralAmt |
| Fundraising | $232 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,647,854 | TotalAmt |
| Program Services | $7,614,279 | ProgramServicesAmt |
| Management And General | $30,659 | ManagementAndGeneralAmt |
| Fundraising | $2,916 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,943,798 | TotalAmt |
| Program Services | $2,926,082 | ProgramServicesAmt |
| Management And General | $16,593 | ManagementAndGeneralAmt |
| Fundraising | $1,123 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,560,740 | TotalAmt |
| Management And General | $1,560,740 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,388 | TotalAmt |
| Management And General | $143,388 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,775 | TotalAmt |
| Management And General | $62,775 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,347 | TotalAmt |
| Management And General | $98,347 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,345,564 | TotalAmt |
| Program Services | $11,718,381 | ProgramServicesAmt |
| Management And General | $1,627,183 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,753 | TotalAmt |
| Program Services | $329,753 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,148,496 | TotalAmt |
| Program Services | $1,085,389 | ProgramServicesAmt |
| Management And General | $63,107 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,441,774 | TotalAmt |
| Program Services | $1,441,774 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,111,595 | TotalAmt |
| Program Services | $2,048,655 | ProgramServicesAmt |
| Management And General | $62,940 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,634 | TotalAmt |
| Program Services | $38,948 | ProgramServicesAmt |
| Management And General | $3,686 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,904 | TotalAmt |
| Program Services | $23,155 | ProgramServicesAmt |
| Management And General | $1,749 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,709 | TotalAmt |
| Program Services | $281,709 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,939,322 | TotalAmt |
| Program Services | $4,751,632 | ProgramServicesAmt |
| Management And General | $187,690 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750,104 | TotalAmt |
| Program Services | $750,104 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $17,014,879 | $17,014,879 | |
| PROVISION FOR BAD DEBTS | $4,296,507 | $4,296,507 | |
| REPAIRS & MAINTENANCE | $2,115,812 | $2,108,555 | $7,257 |
| FRANCHISE FEE | $1,399,435 | $1,399,435 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,251,285 | TotalAmt |
| Program Services | $904,817 | ProgramServicesAmt |
| Management And General | $346,468 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,825,730 | TotalAmt |
| Program Services | $98,383,802 | ProgramServicesAmt |
| Management And General | $4,422,809 | ManagementAndGeneralAmt |
| Fundraising | $19,119 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,508,286 | BOYAmt |
| EOY | $4,001,647 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,846,508 | BOYAmt |
| EOY | $10,828,097 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,675 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,738 | BOYAmt |
| EOY | $124,381 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,914,079 | BOYAmt |
| EOY | $2,712,353 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,839,957 | BOYAmt |
| EOY | $2,500,533 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $98,219,673 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $80,381,212 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,623,258 | BOYAmt |
| EOY | $17,838,461 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,605,574 | BOYAmt |
| EOY | $12,204,387 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,270 | BOYAmt |
| EOY | $691,670 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,393,650 | BOYAmt |
| EOY | $6,315,907 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,714,995 | BOYAmt |
| EOY | $57,217,436 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,270,209 | BOYAmt |
| EOY | $26,938,022 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,113,129 | BOYAmt |
| EOY | $6,817,536 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,774,454 | BOYAmt |
| EOY | $2,279,416 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,157,792 | BOYAmt |
| EOY | $36,034,974 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,557,203 | BOYAmt |
| EOY | $21,182,462 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,557,203 | BOYAmt |
| EOY | $21,182,462 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,714,995 | BOYAmt |
| EOY | $57,217,436 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,640,179 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,456,277 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $721,715 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,717 | BeginningYearBalanceAmt |
| Contributions | $200 | ContributionsAmt |
| Investment Earnings Or Losses | -$926 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $315 | AdministrativeExpensesAmt |
| End Year Balance | $19,676 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $18,028 | BeginningYearBalanceAmt |
| Contributions | $450 | ContributionsAmt |
| Investment Earnings Or Losses | $2,544 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $305 | AdministrativeExpensesAmt |
| End Year Balance | $20,717 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,871 | BeginningYearBalanceAmt |
| Contributions | $150 | ContributionsAmt |
| Investment Earnings Or Losses | $1,278 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $271 | AdministrativeExpensesAmt |
| End Year Balance | $18,028 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,436 | BeginningYearBalanceAmt |
| Contributions | $150 | ContributionsAmt |
| Investment Earnings Or Losses | -$454 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $261 | AdministrativeExpensesAmt |
| End Year Balance | $16,871 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,959 | BeginningYearBalanceAmt |
| Contributions | $150 | ContributionsAmt |
| Investment Earnings Or Losses | $1,805 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $478 | AdministrativeExpensesAmt |
| End Year Balance | $17,436 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,088,965 | OtherCostOrOtherBasisAmt |
| Book Value | $1,088,965 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,982,824 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,312,333 | DepreciationAmt |
| Book Value | $6,670,491 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,907,944 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,068,879 | DepreciationAmt |
| Book Value | $9,839,065 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $239,940 | OtherCostOrOtherBasisAmt |
| Book Value | $239,940 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,838,461 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESTRICTED CASH BOND FUND | Desc |
| Book Value | $6,315,907 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,315,907 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $100,125,998 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $4,875 | OtherRevenueAmt |
| Revenue Not Reported | $4,875 | RevenueNotReportedAmt |
| Revenue Subtotal | $100,121,123 | RevenueSubtotalAmt |
| Other Revenues Not Included | $64,428 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $64,428 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $100,185,551 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $102,766,177 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $4,875 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $4,875 | ExpensesNotReportedAmt |
| Expenses Subtotal | $102,761,302 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $64,428 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $64,428 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $102,825,730 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUND HELD BY PARENT COMPANY, GUERNSEY HEALTH SYSTEMS. USED FOR SUPPORT OF CHARITABLE HEALTH CARE SERVICES. |
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2018 AND 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SALE OF SCRAP & WASTE REPORTED ON PART IX LINE 24E 4,875. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PHYSICIAN LOAN LOSS REPORTED ON PART IX LINE 11G 64,428. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SALE OF SCRAP & WASTE REPORTED ON PART IX LINE 24E 4,875. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PHYSICIAN LOAN LOSS REPORTED ON PART IX LINE 11G 64,428. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1724 | PersonsServedCnt |
| Total Community Benefit Expns | $944,573 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $944,573 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00960 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 33471 | PersonsServedCnt |
| Total Community Benefit Expns | $21,724,595 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,322,642 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,401,953 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07510 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 35195 | PersonsServedCnt |
| Total Community Benefit Expns | $22,669,168 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,322,642 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,346,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 26 | ActivitiesOrProgramsCnt |
| Persons Served | 5173 | PersonsServedCnt |
| Total Community Benefit Expns | $198,468 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,649 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $179,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 319 | PersonsServedCnt |
| Total Community Benefit Expns | $133,373 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $133,373 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 528 | PersonsServedCnt |
| Total Community Benefit Expns | $59,461 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $59,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 37 | ActivitiesOrProgramsCnt |
| Persons Served | 6020 | PersonsServedCnt |
| Total Community Benefit Expns | $391,302 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,712 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $372,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 37 | ActivitiesOrProgramsCnt |
| Persons Served | 41215 | PersonsServedCnt |
| Total Community Benefit Expns | $23,060,470 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,341,354 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,719,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08850 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $491 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $491 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $7,297 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,297 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 24 | PersonsServedCnt |
| Total Community Benefit Expns | $1,595 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,595 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 6 | PersonsServedCnt |
| Total Community Benefit Expns | $1,063 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,063 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $10,446 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,446 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $3,121,097 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,184,768 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $38,049,797 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,391,099 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,341,302 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | SEORMC.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SEORMC.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEORMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEORMC.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEORMC.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEORMC.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 5: SEE ATTACHED SUPPLEMENTAL INFORMATION |
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 11: SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE | ||||
| 10095 BRICK CHURCH ROAD | CAMBRIDGE | OH | 43725 | OUTPATIENT FACILITY |
| 2 - EYAD MAHAYRI MD | ||||
| 1335 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 3 - CLIFFORD MAXIMO MD | ||||
| 1200 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 4 - MELISSA NAU MD | ||||
| 205 SENECA AVENUE | BYESVILLE | OH | 43725 | PHYSICIAN OFFICE |
| 5 - MARY LILKO DO | ||||
| 1230A CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 6 - SUPERIOR MED ENT | ||||
| 1210 NEAL DRIVE | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 7 - SIVARAM KOLLENGODE MD | ||||
| 1432 CLARK STREET SUITE C | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 8 - RON ROUTH DO | ||||
| 18125 WOODSFIELD ROAD | CALDWELL | OH | 43724 | PHYSICIAN OFFICE |
| 9 - SUPERIOR MED PEDIATRICS & ADOLESCENT MED | ||||
| 1420 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| 10 - SUPERIOR MED ORTHOPEDICS | ||||
| 316 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY USED IS BASED UPON THE SOUTHEASTERN MED'S DETAILED COST-TO-CHARGE RATIO. THE RATIO WAS BASED UPON THE DETAILED CALCULATIONS IN ACCORDANCE WITH THE IRS FORM 990 SCHEDULE H INSTRUCTIONS. THIS CALCULATION ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICARE, MEDICAID, UNINSURED AND SELF-PAY SERVICES. THE COST-TO-CHARGE RATIO WAS USED FOR SCHEDULE H CALCULATIONS IN LIEU OF USING A COST ACCOUNTING SYSTEM, AND WAS DERIVED FROM SCHEDULE H WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,296,507. |
| PART III, LINE 2: | SOUTHEASTERN MED'S COST-TO-CHARGE RATIO IS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H. OTHER BAD DEBT AMOUNTS HAVE NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS REPORTED IN PART I LINE 7 OF SCHEDULE H. THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H HAVE BEEN REDUCED BY BAD DEBT RECOVERIES RECEIVED AND COSTS ARE REPORTED NET OF APPLICABLE DISCOUNTS. AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE HAVE BEEN DETERMINED BASED UPON HISTORICAL AVERAGES RELATING TO THE AMOUNT OF SERVICES PROVIDED TO SUCH PATIENTS. |
| PART III, LINE 3: | SOUTHEASTERN MED'S COST-TO-CHARGE RATIO IS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H. OTHER BAD DEBT AMOUNTS HAVE NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS REPORTED IN PART I LINE 7 OF SCHEDULE H. THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H HAVE BEEN REDUCED BY BAD DEBT RECOVERIES RECEIVED AND COSTS ARE REPORTED NET OF APPLICABLE DISCOUNTS. AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE HAVE BEEN DETERMINED BASED UPON HISTORICAL AVERAGES RELATING TO THE AMOUNT OF SERVICES PROVIDED TO SUCH PATIENTS. |
| PART II: | COSTS ASSOCIATED WITH COMMUNITY HEALTH NEEDS PERFORMED WITH OTHER COMMUNITY BASED ORGANIZATIONS. ITEMS INCLUDE COMMUNITY DISASTER READINESS PLANNING AND PREPARATION, SPONSORSHIP OF MEDICAL EXPLORER POST WITH BOY SCOUTS OF AMERICA, AND HOSPITAL REPRESENTATION ON VARIOUS COMMUNITY COALITIONS. |
| PART III, LINE 4: | FOOTNOTE FROM AUDIT DESCRIBING BAD DEBT EXPENSE: ALLOWANCE FOR DOUBTFUL ACCOUNTS - ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON SOUTHEASTERN MED'S EVALUATION OF ITS MAJOR PAYER SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, SOUTHEASTERN MED RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE DECEMBER 31, 2018 AND 2017 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $8,195,000 AND $6,722,000, RESPECTIVELY, RELATES TO RESERVES FOR SELF-PAY BALANCES AND CERTAIN THIRD-PARTY RECEIVABLES. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON A PERCENTAGE OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2018 AND 2017. SOUTHEASTERN MED'S SELF-PAY WRITE-OFFS INCREASED $539,750 FROM $2,283,962 FOR 2017 TO $2,823,712 FOR 2018. WRITE-OFFS INCREASED PRIMARILY DUE TO A CLEAN-UP OF AGED ACCOUNTS IN THE CURRENT YEAR. SOUTHEASTERN MED ALSO RESERVES A CERTAIN PORTION OF AMOUNTS DUE FROM THIRD-PARTY PAYERS THAT ARE MORE THAN 365 DAYS OUTSTANDING. |
| PART III, LINE 8: | SOUTHEASTERN MED HAS USED ITS COST-TO-CHARGE RATIO AS THE BASIS TO PREPARE ITS MEDICARE COST REPORT. THE AMOUNTS REPORTED ON PART III SECTION B LINE 8 ARE TAKEN DIRECTLY FROM THE MEDICARE AND MEDICAID COST REPORTS. THE SHORTFALL REPORTED ON PART III SECTION B LINE 7 HAS NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS INCLUDED IN PART I LINE 7 OF SCHEDULE H, BUT THEY DO PROVIDE A DIRECT BENEFIT TO THE COMMUNITY IN THAT LOCAL RESIDENTS ARE TREATED IN SPITE OF THIS OUT-OF-POCKET SHORTFALL NOT REIMBURSED TO SOUTHEASTERN MED. |
| PART III, LINE 9B: | SOUTHEASTERN MED'S FINANCIAL ASSISTANCE GUIDELINES ALLOW PATIENTS TO RECEIVE HEALTHCARE AT REDUCED RATES BASED ON FINANCIAL STATUS. THE GOAL IS TO WORK WITH EACH INDIVIDUAL PATIENT TO FULLY EXPLORE PAYMENT OPTIONS, INCLUDING GOVERNMENT ASSISTANCE PROGRAMS AND PAYMENT PLANS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OH |
| SCHEDULE H, PART VI: | COMMUNITY INFORMATION: SOUTHEASTERN MED IS THE SOLE HOSPITAL PROVIDER FOR GUERNSEY COUNTY. THE ORGANIZATION EMPLOYS MORE THAN 700 ASSOCIATES AND INCLUDES A MEDICAL STAFF OF APPROXIMATELY 225 PHYSICIANS AND EXTENDED CARE PROVIDERS. SOUTHEASTERN MED IS LOCATED IN CAMBRIDGE, OHIO WHICH IS IN THE RURAL APPALACHIAN AREA OF EAST CENTRAL AND SOUTHEASTERN OHIO. MORE THAN TWO-THIRDS OF SOUTHEASTERN MED'S PATIENTS ARE RESIDENTS OF THE GUERNSEY COUNTY COMMUNITY, MAKING GUERNSEY COUNTY THE PRIMARY COMMUNITY SERVED BY THE HOSPITAL. SOUTHEASTERN MED ALSO PROVIDES MEDICAL CARE FOR RESIDENTS OF SURROUNDING COMMUNITIES, SUCH AS NOBLE, MUSKINGUM, BELMONT, AND TUSCARAWAS COUNTIES. SOUTHEASTERN MED OFFERS HIGH-QUALITY HEALTH CARE SERVICES AND CONTINUOUSLY REINVESTS TO IMPROVE ITS FACILITIES AND TECHNOLOGY. THE HOSPITAL DEDICATES COUNTLESS RESOURCES TO THE BENEFIT OF THE COMMUNITY IN THE FORM OF HEALTH SCREENINGS, HEALTH FAIRS, EDUCATION, AND FREE OR REDUCED-COST HEALTH SERVICESTHE ACTIVE PROVIDERS ON THE SOUTHEASTERN MED MEDICAL STAFF BRING VAST EXPERIENCE, KNOWLEDGE AND COMPASSION TO PATIENTS THROUGHOUT GUERNSEY AND NOBLE COUNTIES. WITH MORE THAN 25 MEDICAL SPECIALTIES, SOUTHEASTERN MED PHYSICIANS OFFER QUALITY CARE WITH CLOSE-TO-HOME COMFORT. NINETY-THREE PERCENT OF SOUTHEASTERN MED PHYSICIANS HAVE EARNED BOARD CERTIFICATION, WHICH INVOLVES UNDERGOING RIGOROUS TRAINING, PASSING A NATIONAL EXAM AND TAKING STEPS TO MAINTAIN BOARD-CERTIFIED STATUS. BOARD CERTIFICATION DEMONSTRATES SOUTHEASTERN MED'S MEDICAL PROFESSIONALS' EXCEPTIONAL EXPERTISE IN THEIR PARTICULAR SPECIALTY OF MEDICAL PRACTICE.SOUTHEASTERN MED IS PROUD TO BE ACCREDITED BY THE JOINT COMMISSION, WHICH IS THE NATIONAL ACCREDITING BODY FOR HOSPITALS AND OTHER HEALTH CARE DELIVERY ORGANIZATIONS. THE JOINT COMMISSION'S MISSION IS TO CONTINUOUSLY IMPROVE THE SAFETY AND QUALITY OF CARE PROVIDED TO THE PUBLIC THROUGH THE PROVISION OF HEALTH CARE ACCREDITATION AND RELATED SERVICES THAT SUPPORT PERFORMANCE IMPROVEMENT IN HEALTH CARE ORGANIZATIONS.THE HEALTHY OHIO BUSINESS COUNCIL (HOBC) RECOGNIZED 73 OHIO EMPLOYERS FOR HEALTHY WORKSITE PRACTICES DURING THE 15TH ANNUAL HEALTHY OHIO HEALTHY WORKSITE AWARDS CEREMONY. THESE AWARDS RECOGNIZED OHIO EMPLOYERS WHO DEMONSTRATED A COMMITMENT TO EMPLOYEE WELLNESS THROUGH COMPREHENSIVE WORKSITE HEALTH PROMOTION AND WELLNESS PROGRAMS. APPLICANTS WERE SCORED ON THE EXTENT THEIR WELLNESS PROGRAMS FACILITATED AND ENCOURAGED EMPLOYEE HEALTH, ENHANCED PRODUCTIVITY, AND ENSURED A HEALTHY WORK ENVIRONMENT. SOUTHEASTERN MED RECEIVED A BRONZE AWARD.SOUTHEASTERN MED COLLABORATED WITH AREA COLLEGES AND UNIVERSITIES TO SUPPORT EDUCATIONAL AND CAREER OPPORTUNITIES. SOUTHEASTERN MED STRIVES TO BUILD A HEALTHIER COMMUNITY BY CARING FOR COMMUNITY MEMBERS WHO OTHERWISE WOULD HAVE LIMITED ACCESS TO QUALITY HEALTHCARE. IN ADDITION TO PROVIDING HOSPITAL-BASED MEDICAL SERVICES, SOUTHEASTERN MED COMMITS ITSELF TO PROVIDING A DIVERSE ARRAY OF FREE OR REDUCED COST HEALTH SCREENINGS AND WELLNESS EDUCATIONAL CLASSES DESIGNED TO IMPROVE THE HEALTH OF AREA RESIDENTS. WITH 95 BEDS AND A STAFF OF MORE THAN 700 EMPLOYEES, SOUTHEASTERN MED IS GUERNSEY COUNTY'S ONLY ADVANCED GENERAL ACUTE HOSPITAL AND LARGEST EMPLOYER.QUALITY EFFORTS AND ACTIVITIES HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARDS TOP 12% NATIONWIDE - THIS AWARD IS GIVEN TO THE TOP 15% OF HOSPITALS NATIONWIDE, BASED ON THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) PATIENT SURVEY, WHICH EVALUATES A HOSPITAL'S PERFORMANCE ACROSS 10 MEASUREMENTS RELATED TO COMMUNICATION, CLEANLINESS AND NOISE LEVELS, AND MEDICATION AND POST-DISCHARGE CARE INSTRUCTIONS. WHILE THE AWARD RECOGNIZES THE TOP 15%, SOUTHEASTERN MED PERFORMED AMONG THE TOP 12% OF HOSPITALS IN THE UNITED STATES, ACCORDING TO PATIENT SURVEY FEEDBACK. LEAPFROG PATIENT SAFETY "A" RATING THE LEAPFROG GROUP IS A NONPROFIT ORGANIZATION COMMITTED TO DRIVING QUALITY, SAFETY, AND TRANSPARENCY IN THE U.S. HEALTHCARE SYSTEM. THEY ASSIGN A,B,C,D AND F LETTER GRADES TO HOSPITALS NATIONWIDE. HEALTH RESOURCES & SERVICES ADMINISTRATION IS A FEDERAL AGENCY THAT ENCOURAGES HOSPITALS TO PROMOTE ORGAN TISSUE AND EYE DONATION. SOUTHEASTERN MED WAS ONE OF 23 HOSPITALS IN OHIO TO RECEIVE THE PLATINUM AWARD IN 2018. BUILDING A HEALTHY COMMUNITY MYHEALTH PATIENT PORTAL:TECHNOLOGY CONTINUES TO QUICKLY ADVANCE, AND SOUTHEASTERN MED IS COMMITTED TO MEETING THE NEEDS OF OUR COMMUNITY WHILE EMBRACING CHANGES IN TECHNOLOGY. ONE IMPORTANT ADVANCEMENT IN THAT TECHNOLOGY IS THE MYHEALTH PATIENT PORTAL. THE PORTAL ACTIVELY ENGAGES PATIENTS IN THEIR CARE BY GIVING THEM ACCESS TO VALUABLE HEALTH INFORMATION ONLINE. THIS ONLINE TOOL ALLOWS PATIENTS THE ABILITY TO MANAGE A WIDE RANGE OF HEALTH DATA FROM WHEREVER THEY ARE AND AT THEIR CONVENIENCE. PATIENTS CAN ACCESS THEIR ACCOUNT FROM ANYWHERE USING THE INTERNET, INCLUDING THEIR COMPUTER, SMARTPHONE, OR TABLET. IN ADDITION TO HANDLING THEIR OWN CARE, PARENTS AND THOSE WITH AUTHORIZED CONSENT WILL APPRECIATE THE ABILITY TO ACCESS THE RECORDS OF THOSE INDIVIDUALS FOR WHOM THEY MANAGE CARE.THE MYHEALTH PATIENT PORTAL GIVES PATIENTS INSTANT AND SECURE ACCESS TO THE PERSONAL HEALTH INFORMATION THEIR CARE TEAM ENTERED INTO THEIR RECORD. ALL OF THE INFORMATION IN THE PORTAL COMES FROM SOUTHEASTERN MED'S ELECTRONIC HEALTH RECORD. THIS ENSURES THAT PATIENTS HAVE ACCESS TO THE MOST UP-TO-DATE INFORMATION. THE INFORMATION AVAILABLE THROUGH THE PORTAL INCLUDES: ALLERGIES, DISCHARGE INSTRUCTIONS, MEDICATION LISTS, UPCOMING APPOINTMENTS AT SOUTHEASTERN MED, CONDITIONS, LAB RESULTS, DIAGNOSTIC IMAGING RESULTS, AND VISIT HISTORIES. SOUTHEASTERN MED ASSOCIATES PROVIDE EDUCATION TO PATIENTS AND FAMILIES ABOUT THE MYHEALTH PATIENT PORTAL AND ARE AVAILABLE TO ASSIST PATIENTS WITH PORTAL REGISTRATION BEFORE BEING DISCHARGED FROM THE HOSPITAL. THERE ARE MANY RESOURCES AVAILABLE AT SOUTHEASTERN MED TO HELP PATIENTS EASILY SIGN-UP AND VIEW THEIR PORTAL ACCOUNT. PROMOTION OF COMMUNITY HEALTH ADDRESSING THE HEALTH NEEDS OF OUR COMMUNITY IS AN IMPORTANT PART OF OUR NOT-FOR-PROFIT ORGANIZATION'S MISSION. SOUTHEASTERN MED IS COMMITTED TO AND RESPONDS TO THE COMMUNITY'S HEALTH AND WELLNESS NEEDS. IN ADDITION TO PROVIDING HOSPITAL-BASED SERVICES, SOUTHEASTERN MED OFFERS A VARIETY OF HEALTH EDUCATION AND WELLNESS SCREENING OPPORTUNITIES THROUGHOUT THE YEAR. EFFORTS ARE MADE TO ENSURE THAT MEMBERS OF THE COMMUNITY WHO HAVE LIMITED ACCESS TO CARE DUE TO LACK OF FINANCIAL RESOURCES OR AVAILABLE HEALTHCARE COVERAGE ARE ABLE TO RECEIVE REGULAR HEALTH AND WELLNESS SCREENINGS AND/OR EDUCATION. SOUTHEASTERN MED'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND SURROUNDING COMMUNITIES. OTHER THAN THE PHYSICIAN CHIEF OF STAFF AND DR. MICHAEL SARAP, TRUSTEE, THEY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF SOUTHEASTERN MED, BUT ARE SUPPORTIVE OF THE EFFORTS BY SOUTHEASTERN MED TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY. RESOURCES ARE APPROVED AND PROVIDED FOR SUPPORTING IMPROVEMENTS IN PATIENT CARE, EDUCATION, AND HEALTH PROMOTION ACROSS THE BROADER COMMUNITY. THE FOLLOWING ARE EXAMPLES OF PROGRAMS REGULARLY OFFERED BY SOUTHEASTERN MED: HEALTH FAIRS FOR TARGETED POPULATIONS: HEARING SCREENINGS; DIABETES RISK SCREENINGS; BLOOD CHEMISTRY TESTS; SKIN CANCER SCREENINGS; COLORECTAL AND BREAST CANCER AWARENESS EDUCATION. OTHER SIGNIFICANT HEALTH AND WELLNESS COMMITMENTS BY SOUTHEASTERN MED INCLUDE FREE TOBACCO CESSATION CLASSES, FREE DIABETES EDUCATION CONSULTATIONS AND CLASSES, LOW-COST LUNG CANCER SCREENINGS, A VARIETY OF SUPPORT GROUPS, RELAY FOR LIFE AMERICAN CANCER SOCIETY FUNDRAISER PARTICIPATION, MEDICAL EXPLORERS PROGRAM TO INTRODUCE ADOLESCENTS TO HEALTHCARE CAREERS, UNITED WAY FUNDRAISERS, AS WELL AS CPR CLASSES. SCREENINGS/EVENTS- HEART DISEASE & STROKE - TO INCREASE THE SCOPE OF EDUCATIONAL OPPORTUNITIES FOR AWARENESS OF HEART DISEASE AND STROKE RISK FACTORS AND PREVENTIVE STRATEGIES, SOUTHEASTERN MED OFFERS CPR CLASSES AND FIRST AID CLASSES. IN 2018, TWELVE COMMUNITY CPR AND FIRST AID CLASSES WERE HELD WITH 40 PARTICIPANTS. THE CARDIAC HEALTH SCREENING WAS EXPANDED IN 2018 TO INCLUDE OHIOHEALTH CARDIOLOGY AND PROVIDE ONSITE EKG. IN 2018 THERE WERE 58 INDIVIDUALS WHO PARTICIPATED IN THE CARDIAC HEALTH SCREENING. PARTICIPANTS RECEIVED FREE EKG, BLOOD PRESSURE, BODY COMPOSITION, LIPID PANEL AND GLUCOSE LAB SCREENINGS, AS WELL AS ONSITE EDUCATION REGARDING THEIR RESULTS FROM NURSES, DIETITIANS, EXERCISE PHYSIOLOGIST AND CARDIOLOGIST.SOUTHEASTERN MED HOSTED THE BYESVILLE ROTARY'S HEALTH FAIR SEEING CLOSE TO 100 INDIVIDUALS, AND THE NEWCOMERSTOWN ROTARY'S HEALTH FAIR, SEEING CLOSE TO 90 INDIVIDUALS. IT ALSO HOSTED HEALTH SCREENINGS AT THE FOLLOWING LOCAL BUSINESSES: |
| SCHEDULE H, PART VI: CONTINUED | QUANEX BUILDING PRODUCTS, COLGATE-PALMOLIVE, RIDGE TOOL, AND ASCENT RESOURCES. HEALTH SCREENINGS CONSISTED OF BASIC LAB WORK THAT CHECKED A1C, BLOOD PRESSURE, & A LIPID PROFILE. APPROXIMATELY 5% OF THOSE SCREENED HAD ABNORMAL FINDINGS AND WERE REFERRED TO THEIR PRIMARY CARE PROVIDER FOR FOLLOW UP.SOUTHEASTERN MED ALSO HOSTED LUNG CANCER SCREENINGS SIX TIMES THIS YEAR. EACH EVENT IS 5 HOURS IN LENGTH. EVENTS WERE HELD FEBRUARY 22, APRIL 19, JUNE 14, AUGUST 16, SEPTEMBER 20, AND DECEMBER 6 AT THE COMMUNITY HEALTHLINK. 40 PEOPLE WERE SCREENED IN 2018.SKIN AND COLON CANCER SCREENINGS WERE HELD TWO TIMES IN 2018; 21 PEOPLE WERE SCREENED.BREAST CANCER SCREENINGS ARE HELD ONCE A YEAR. SOUTHEASTERN MED ALSO HAD A PUBLIC BREAST CANCER AWARENESS EVENT AT RIESBECKS GROCERY STORE IN 2018. SOUTHEASTERN MED PROVIDED AN INFLATABLE BREAST AND DR. MICHAEL SARAP ANSWERED QUESTIONS AND EDUCATED GUESTS ON BREAST CANCER. OVER 100 PEOPLE STOPPED BY TO ASK QUESTIONS AND TOUR THE INFLATABLES.FUN 2B FIT - IN 2018, SOUTHEASTERN MED CONTINUED ITS "FUN 2B FIT" PROGRAM, A STUDENT FITNESS PROGRAM. THIS PROGRAM FOCUSES ON CHILDREN'S HEALTH, EXERCISE AND EATING HABITS AND IS OPEN TO THE LOCAL COMMUNITY. FUN 2B FIT TEACHES KIDS TO EXPLORE HEALTH-PROMOTING AND FUN ACTIVITIES, BUILDS SELF-ESTEEM AND EDUCATES ON HEALTHY LIFESTYLE CHOICES. FUN 2B FIT PROVIDES A SAFE AND SUPPORTIVE ENVIRONMENT FOR CHILDREN TO EXPLORE EXERCISE THROUGH SPORTS, GAMES, SWIMMING, ARTS, CRAFTS AND MUCH MORE. THEY ALSO LEARN ABOUT HEALTHY EATING AND MAKING THE RIGHT FOOD CHOICES. AT SOUTHEASTERN MED, IT IS OUR GOAL TO BUILD CHILDREN'S SELF-ESTEEM AND CONFIDENCE WHILE IMPROVING MUSCULAR STRENGTH AND INSTILLING A PASSION FOR EXERCISE AND NUTRITION, LEADING TO HEALTHY LIFESTYLE CHOICES. TWENTY-FOUR YOUTHS ATTENDED THE PROGRAM IN 2018.OLDER ADULT HEALTH FAIR - AREA INDIVIDUALS AGE 55 AND OLDER ATTENDED THE 2018 OLDER ADULT HEALTH FAIR AT THE GUERNSEY COUNTY SENIOR CITIZENS' CENTER. THE HEALTH FAIR PROVIDES AREA RESIDENTS THE OPPORTUNITY TO ACCESS LOW-COST HEALTH SCREENINGS, ENJOY A VARIETY OF EXHIBITS, WIN DOOR PRIZES AND ENJOY THEMSELVES IN A SAFE AND SECURE ENVIRONMENT. SOUTHEASTERN MED INVITES LOCAL BUSINESSES, AGENCIES, AND PHYSICIANS TO JOIN WITH SOUTHEASTERN MED DEPARTMENTS TO PARTICIPATE IN THE FAIR TO PROVIDE AREA RESIDENTS WITH A PLETHORA OF INFORMATION. AS A COMMUNITY BENEFIT, FOOT HEALTH, HEARING, BLOOD PRESSURE, VASCULAR, AND SKIN CANCER SCREENINGS ARE OFFERED FREE OF CHARGE. SOUTHEASTERN MED'S LABORATORY SERVICES ALSO PROVIDED BLOOD SCREENINGS AT THE EVENT FOR THE FOLLOWING: GLUCOSE AND LIPID PROFILE, THYROID AND PROSTATE. FLU VACCINES WERE AVAILABLE AT THE EVENT PROVIDED BY THE GUERNSEY COUNTY HEALTH DEPARTMENT. THE GUERNSEY COUNTY SHERIFF'S DEPARTMENT COLLECTED ANY EXPIRED OR UNUSED MEDICATIONS FOR PROPER DISPOSAL DURING THE FAIR. OVER 100 COMMUNITY MEMBERS ATTENDED THE EVENT. APRIL IS NATIONAL DONATE LIFE MONTH. TO PROMOTE ORGAN DONATION AWARENESS, SOUTHEASTERN MED ASSOCIATES PARTICIPATED IN LIFELINE OF OHIO'S NATIONAL BLUE AND GREEN DAY. SOUTHEASTERN MED'S PARTICIPATION INCLUDES VARIOUS DONATION STATIONS THROUGHOUT THE YEAR; FLAG RAISINGS; RADIO SPOTS ENCOURAGING ORGAN DONATION; LOCAL LIFELINE OF OHIO REPRESENTATIVE ATTENDS ALL NURSING ORIENTATION MEETINGS; PROVIDE EDUCATION FOR ALL NEW ASSOCIATES ON ORGAN, TISSUE, AND EYE DONATION; PROVIDE EDUCATION TO CARDIAC REHAB PATIENTS ENCOURAGING DONATION; HOST THE "GREEN" CHAIR AT SOUTHEASTERN MED; DECORATE A SHOWCASE AT SOUTHEASTERN MED; AS WELL AS HOSTING A TREE AT CHRISTMAS TIME HONORING THOSE OHIO RESIDENTS WHO HAVE RECEIVED OR DONATED AN ORGAN. SOUTHEASTERN MED WAS AWARDED THE LIFELINE OF OHIO PLATINUM AWARD IN 2018.DIABETES EDUCATION PRESENTATION - THE DIABETES SUPPORT GROUP MET MONTHLY IN 2018. EACH MONTH A DIFFERENT PRESENTER DISCUSSES A TOPIC CONCERNING DIABETIC HEALTH. THE CLASS IS ATTENDED BY AN AVERAGE OF 14 PARTICIPANTS. DURING DIABETES MONTH IN NOVEMBER 2018, OVER 40 PEOPLE ATTENDED A PRESENTATION BY OUR COMMUNITY DIETITIAN INCLUDING DIET RECOMMENDATIONS AND A COOKING DEMONSTRATION BY THE HOSPITAL CHEF FOR HEALTHY DIABETIC MEALS.BREAST CANCER SCREENINGS - SOUTHEASTERN MED'S POWER ME PINK PROGRAM OFFERED 76 FREE BREAST CANCER SCREENINGS AND MAMMOGRAMS TO THOSE IN OUR COMMUNITY IN 2018. SPECIFICALLY, THIS SCREENING IS GEARED TOWARD THOSE OVER THE AGE OF 40 WITH LIMITED RESOURCES WHO ARE UNDERINSURED OR UNINSURED. SOUTHEASTERN MED'S POWER ME PINK PROGRAM PROVIDES WOMEN AND MEN WHO ARE UNINSURED AND UNDERINSURED WITH BREAST HEALTH EDUCATION, CLINICAL BREAST EXAMS, MAMMOGRAMS AND ADDITIONAL TESTING IF NECESSARY. THE PROGRAM SERVES MEN AND WOMEN 35-64 YEARS' OLD WHO EARN BELOW THE POVERTY LEVEL WITH BREAST HEALTH EDUCATION AND MAMMOGRAMS. THE PROJECT ALSO REACHES WOMEN YOUNGER THAN 35 YEARS OF AGE WHO HAVE A FAMILY HISTORY OF BREAST CANCER.SAFE SITTER COURSES - SOUTHEASTERN MED HOSTED THREE SAFE SITTER COURSES DURING 2018 WITH 30 PARTICIPANTS. SAFE SITTER IS A COURSE DESIGNED TO TEACH SAFE AND NURTURING BABYSITTING SKILLS TO YOUNG ADOLESCENTS BETWEEN THE AGES OF 11 AND 13. INSTRUCTION INCLUDES HOW TO ADMINISTER FIRST AID, HOW TO HANDLE MEDICAL EMERGENCIES AND WHAT TO DO FOR A CHOKING CHILD. SAFE SITTER ALSO TEACHES ORGANIZATIONAL SKILLS, SAFETY HABITS AND THE IMPORTANCE OF KNOWING WHEN TO CALL FOR HELP. AFTER COMPLETING THE SAFE SITTER CLASS, NEW SAFE SITTERS AND THEIR PARENTS WERE INVITED TO PARTICIPATE IN A FREE FAMILY AND FRIENDS CPR CLASS. THE SOUTHEASTERN MED AUXILIARY PROVIDES THE FUNDS FOR THE SAFE SITTER MANUALS AND BACKPACKS. THE REDUCED COST TO ATTEND IS $35.CHILDREN'S HEALTH FAIR - IN 2018, THE ANNUAL CHILDREN'S HEALTH FAIR WAS GIVEN A "FUN IN THE SUN" THEME. HELD AT THE CAMBRIDGE CITY PARK PAVILION, THE CHILDREN'S HEALTH FAIR WAS GEARED TO CHILDREN AGES 3-11 AND THEIR FAMILIES, TO LEARN ABOUT HEALTH AND SAFETY TOPICS, ENJOY DELICIOUS FOOD, PLAY GAMES AND SOCIALIZE. THE CHILDREN'S HEALTH FAIR IS A FREE COMMUNITY EVENT. THE GOAL OF THIS ANNUAL FAIR IS TO ENCOURAGE CHILDREN TO BECOME MORE AWARE OF HEALTHY INTERESTS, SUCH AS EXERCISE AND EATING PROPERLY, AND TO HELP KIDS ESTABLISH A COMFORT LEVEL WITH HEALTHCARE PROVIDERS AND SAFETY OFFICIALS. THE EVENT WAS ATTENDED BY MORE THAN 400 CHILDREN AGES 3-11 WITH THEIR PARENTS. MORE THAN 25 LOCAL ORGANIZATIONS AND BUSINESSES, IN ADDITION TO VARIOUS DEPARTMENTS FROM SOUTHEASTERN MED, DISPLAYED FUN AND INTERACTIVE EXHIBITS TO PROMOTE SAFETY AND HEALTH AT THE FAIR. MEDICAL EXPLORERS - HIGH SCHOOL STUDENTS INTERESTED IN LEARNING ABOUT CAREERS IN THE MEDICAL FIELD WERE INVITED TO ATTEND MEDICAL EXPLORERS AT SOUTHEASTERN MED. MEDICAL EXPLORERS PROVIDES YOUNG ADULTS WITH THE CHANCE TO LEARN ABOUT A VARIETY OF MEDICAL CAREERS FROM HEALTHCARE PROFESSIONALS, AS WELL AS PARTICIPATE IN HANDS-ON ACTIVITIES DESIGNED TO FAMILIARIZE THEM WITH A SPECIFIC ASPECT OF MEDICINE. EXPLORERS MUST BE AT LEAST 14 YEARS OLD IN GRADES 9-12 TO PARTICIPATE. DURING THE 2018 PROGRAM YEAR, THERE WERE APPROXIMATELY 45 PARTICIPANTS.ANNUAL FUNDRAISERS:THE UNITED WAY OF GUERNSEY AND NOBLE COUNTIES USES LOCALLY-RAISED MONEY TO HELP THOSE IN NEED IN GUERNSEY, MONROE AND NOBLE COUNTIES. SOUTHEASTERN MED IS A BIG SUPPORTER OF THE LOCAL UNITED WAY AGENCY. TWO HUNDRED SEVENTY-FIVE HOURS WERE SPENT TO RAISE THE $4,729.00, WHICH WAS DONATED TO THE UNITED WAY BY SOUTHEASTERN MED ASSOCIATES IN 2018. A PORTION OF THIS MONEY WAS RAISED THROUGH VOLUNTARY PAYROLL DEDUCTION FROM SOUTHEASTERN MED ASSOCIATES. ACCESS TO CARE SENIOR MANAGEMENT CONTINUED TO IMPLEMENT THE PHYSICIAN RECRUITMENT PLAN IN 2018. THIS PLAN WAS TO RECRUIT PHYSICIANS TO JOIN THE SUPERIOR MED MULTI-PHYSICIAN SPECIALTY GROUP OWNED BY SOUTHEASTERN MED OR TO JOIN INDEPENDENT LOCAL PHYSICIAN PRACTICES.FINANCIAL COUNSELORS ARE CAC (CERTIFIED APPLICATION COUNSELOR) CERTIFIED BY HEALTHCARE MARKETPLACE AND CONTINUE TO ASSIST PATIENTS WITH APPLICATION FOR MEDICAID ONSITE AT SOUTHEASTERN MED AND TO PROVIDE GUIDANCE REGARDING THEIR MEDICAL INSURANCE. SOUTHEASTERN MED IS A QUALIFIED ENTITY FOR MEDICAID ENROLLMENT.KEEPING CANCER PATIENTS CLOSE TO HOMESOUTHEASTERN MED EXPANDED ITS SUCCESSFUL CANCER SERVICE LINE IN 2012 BY PURCHASING THE CAMBRIDGE REGIONAL CANCER CENTER, LOCATED ACROSS THE STREET FROM SOUTHEASTERN MED.THE CAMBRIDGE REGIONAL CANCER CENTER OFFERS ADVANCED HEMATOLOGY AND MEDICAL ONCOLOGY SERVICES FOR PATIENTS WITH MANY DIFFERENT TYPES OF CANCER, INCLUDING BREAST, LUNG, COLON AND GENITOURINARY CANCERS, AS WELL AS BENIGN AND MALIGNANT BLOOD DISORDERS, SUCH AS ANEMIA, LYMPHOMA, LEUKEMIA AND MYELOMA.CANCER WAS IDENTIFIED AS THE SECOND HEALTH NEED IN THE COMMUNITY THROUGH THE 2016 CHNA. SOUTHEASTERN MED CONTINUES TO PROVIDE SERVICES TO THE COMMUNITY FIVE DAYS A WEEK.SOUTHEASTERN MED'S CANCER REGISTRY, BREAST HEALTH NAVIGATOR, AND DR. MICHAEL SARAP, SURGEON WITH SOUTHEASTERN OHIO PHYSICIANS, INC. AND SOUTHEASTERN MED MEDICAL STAFF MEMBER, CONTINUE THE VIRTUAL BREAST CARE CLINIC. |
| SCHEDULE H, PART VI: CONTINUED | THE IDEAL ARRANGEMENT FOR QUALITY BREAST CARE IS A CENTER OR CLINIC HOUSING MULTIPLE SPECIALISTS THAT ACT AS A TEAM TO CARE FOR BENIGN AND MALIGNANT BREAST DISEASE. THE SPECIALISTS INVOLVED IN SUCH A CLINIC INCLUDE SURGEONS, RADIOLOGISTS, ONCOLOGISTS, GENETICS COUNSELORS AND BREAST NAVIGATORS. AN ALL-ENCOMPASSING BREAST CENTER IS NOT FEASIBLE IN RESOURCE-LIMITED AREAS. IN MOST SMALL TOWNS AND RURAL AREAS, THERE IS NO ORGANIZED TEAM APPROACH TO BREAST CARE. SCREENING AND DIAGNOSTIC MAMMOGRAMS, ULTRASOUNDS AND MRI SCANS, AND EVEN BREAST BIOPSIES MAY BE ORDERED BY PRIMARY CARE PHYSICIANS, GYNECOLOGISTS AND EVEN NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. CERTAINLY, IT IS VITALLY IMPORTANT FOR EVERY WOMAN TO BE INVOLVED IN A SCREENING PROGRAM, BUT IT IS JUST AS IMPORTANT FOR ALL WOMEN TO GET THE BEST RETURN ON INVESTMENT IN TERMS OF PROPER INTERPRETATION OF THE FINDINGS AND APPROPRIATE FOLLOW-UP. IN 2016, SOUTHEASTERN MED PURCHASED AND BEGAN OFFERING 3D MAMMOGRAPHY TO OUR COMMUNITY. ALL PRIMARY CARE PROVIDERS CAN AND DO ORDER BREAST IMAGING AND BREAST BIOPSIES WHEN SUGGESTED BY THE INTERPRETING RADIOLOGIST. MANY PRACTITIONERS WILL IMMEDIATELY REFER THE PATIENT TO A SURGEON AT THE TIME OF THE INITIAL ABNORMAL IMAGING. INDIVIDUAL PRACTITIONERS RECEIVE THE RESULTS OF ALL IMAGING AND BIOPSY RESULTS. IN ADDITION, THE BREAST NAVIGATOR COLLECTS RESULTS OF ALL ABNORMAL MAMMOGRAMS, ULTRASOUND STUDIES AND MRI STUDIES AND ALL BIOPSY REPORTS. THE INFORMATION IS COLLATED IN A NOTEBOOK ALONG WITH OTHER PERTINENT PATIENT INFORMATION REGARDING SYMPTOMS AND PHYSICAL EXAMINATIONS. THE LEADERSHIP OF THE BREAST CARE TEAM (BCT) THEN REVIEWS EVERY BIRADS CATEGORY IV AND V MAMMOGRAM AND EACH BIOPSY PERFORMED BY RADIOLOGY OR OTHER PRACTITIONERS. OUR PROGRAM CARES FOR 20-30 NEW BREAST CANCER PATIENTS PER YEAR. OUR RADIOLOGY DEPARTMENT PERFORMS AN AVERAGE OF 89 BIOPSIES PER YEAR. THE BREAST HEALTH NAVIGATOR AND BCT ACT AS A TEAM TO REVIEW AND TRACK EVERY PATIENT THAT HAS HAD A BIOPSY OR WHO NEEDS RADIOLOGIC FOLLOW-UP FOR ABNORMAL IMAGES. ANY DISCORDANCE OR IRREGULARITY TRIGGERS CONTACT WITH THE PRIMARY CARE PROVIDER, RADIOLOGIST, PATHOLOGIST OR SURGEON TO RESOLVE THE ISSUE. THERE IS NO COST TO THE PATIENT FOR THIS QUALITY ASSURANCE ACTIVITY ORGANIZED BY THE BREAST TEAM LEADERSHIP.THE SOUTHEASTERN MED BREAST HEALTH NAVIGATOR SAW 20 WOMEN IN 2018 AND PROVIDED ONE-ON-ONE EDUCATIONAL TRAINING REGARDING THEIR LUMPECTOMY AND OR MASTECTOMY, RESOURCES NEEDED TO NAVIGATE APPOINTMENTS, FINANCIAL RESOURCES AND EMOTIONAL SUPPORT.SOUTHEASTERN MED SPONSORS THE BREAST CANCER SUPPORT GROUP AND POSITIVELY PINK. POSITIVELY PINK IS A GROUP THAT MEETS MONTHLY AND IS GEARED TOWARD THOSE WHO HAVE OR ARE CURRENTLY BATTLING BREAST CANCER. THE BREAST CANCER SUPPORT GROUP APPROACHES CANCER IN AN ACTIVE, POSITIVE WAY AND HELPS PARTICIPANTS GAIN A SENSE OF CONTROL OVER THEIR DISEASE. FOR OVER 30 YEARS, SOUTHEASTERN MED HAS ALSO SPONSORED A SURVIVOR'S DAY CELEBRATION. CANCER SURVIVORS, CAREGIVERS, FAMILY MEMBERS AND FRIENDS ARE INVITED TO ATTEND THIS FREE EVENT. LUNCH, SPEAKERS, AND ENTERTAINMENT ARE PROVIDED AT NO COST TO PARTICIPANTS. IN 2018, SOUTHEASTERN MED HELD 19 COMMUNITY BREAST SCREENING CLINICS, WHICH WERE OFFERED TO WOMEN IN THE COMMUNITY WHO DO NOT HAVE HEALTH CARE COVERAGE AND DID NOT HAVE ACCESS TO A PHYSICIAN. THE SCREENING IS SPONSORED BY SUSAN G. KOMEN FOR THE CURE AND SOUTHEASTERN MED'S POWER ME PINK PROGRAM. SPECIFICALLY, THIS SCREENING IS GEARED TOWARD THOSE OVER THE AGE OF 40 WITH LIMITED RESOURCES, WHO ARE UNDERINSURED OR UNINSURED. SOUTHEASTERN MED'S POWER ME PINK PROGRAM PROVIDES WOMEN AND MEN WHO ARE UNINSURED AND UNDERINSURED WITH BREAST HEALTH EDUCATION, CLINICAL BREAST EXAMS, MAMMOGRAMS AND ADDITIONAL TESTING IF NECESSARY. THE PROGRAM SERVES MEN AND WOMEN 35-64 YEARS OLD, WHO EARN BELOW THE POVERTY LEVEL, WITH BREAST HEALTH EDUCATION AND MAMMOGRAMS. THE PROJECT ALSO REACHES WOMEN YOUNGER THAN 35 YEARS OF AGE WHO HAVE A FAMILY HISTORY OF BREAST CANCER. THE PROGRAM INCLUDED A MAMMOGRAM AND CLINICAL BREAST EXAM BY A LOCAL PHYSICIAN. IN 2018, 79 WOMEN TOOK PART IN THE PROGRAM. SOUTHEASTERN MED AND PHYSICIANS CONTINUE TO OFFER A FREE OR LOW-COST COLONOSCOPY TO ALL PERSONS WHO NEED THE PROCEDURE BUT DO NOT HAVE HEALTH CARE INSURANCE. IN 2018, 1,607 COLONOSCOPIES WERE PERFORMED AT SOUTHEASTERN MED. DR. MICHAEL SARAP, ALONG WITH HIS PARTNERS, DONATES HIS TIME TO PROVIDE FREE EDUCATION AND COLONOSCOPIES TO THE COMMUNITY ON AN AS-NEEDED BASIS. SOUTHEASTERN MED PHYSICIANS ALSO REGULARLY HOSTS FREE SKIN CANCER SCREENINGS TO COMMUNITY MEMBERS. OBESITY AND FITNESS PHYSICAL ACTIVITYSOUTHEASTERN MED OFFERED GROUP LIFESTYLE BALANCE, A WEIGHT LOSS PROGRAM WHICH MET INITIALLY FOR 12 WEEKS AND PROVIDED 10 FOLLOW-UP SESSIONS THROUGHOUT THE YEAR AND WAS OFFERED AT VERY LOW COST TO THE COMMUNITY AT MULTIPLE LOCATIONS INCLUDING SOUTHEASTERN MED AND THE PUBLIC LIBRARY. IN 2018, THIS PROGRAM WAS HELD 4 TIMES FOR 18 PEOPLE. SOUTHEASTERN MED OFFERS A FREE SMOKING CESSATION PROGRAM TO THE COMMUNITY INSTRUCTED BY AN RN. PROGRAMS ARE DESIGNED FOR BOTH EXPECTANT MOTHERS AS WELL AS THE COMMUNITY AT LARGE. PERSONAL TRAINING "COUPONS" WERE GIVEN AWAY IN 2018 AS GIFTS/PRIZES, AT THE ST. BENEDICT SCHOOL ANNUAL FUNDRAISING EVENT. EACH "COUPON" WAS FOR 4 FREE 30-MINUTE SESSIONS WITH AN ATHLETIC TRAINER FROM THE PHYSICAL THERAPY DEPARTMENT. THE PURPOSE OF EACH SESSION WAS TO PROVIDE INCENTIVE TO EXERCISE AND HELP PEOPLE REALIZE HOW BENEFICIAL EXERCISE IS FOR THEIR PHYSICAL AND MENTAL HEALTH.DISASTER PREPAREDNESS PLAN THE EMERGENCY MANAGEMENT COORDINATOR FOR SOUTHEASTERN MED IS APPOINTED TO THE LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) BY THE COUNTY COMMISSIONERS. IT IS THE JOB OF THE LEPC TO DEVELOP AN EMERGENCY RESPONSE PLAN FOR THE COUNTY AND REVIEW IT EVERY YEAR. THE LEPC IS MADE UP OF: ELECTED STATE AND LOCAL OFFICIALS POLICE, FIRE, CIVIL DEFENSE, AND PUBLIC HEALTH PROFESSIONALS ENVIRONMENTAL, TRANSPORTATION, AND HOSPITAL OFFICIALS FACILITY REPRESENTATIVES REPRESENTATIVES FROM COMMUNITY GROUPS AND THE MEDIASOUTHEASTERN MED SHARES ITS OWN EMERGENCY OPERATIONS PLAN (EOP) AND HAZARD VULNERABILITY ANALYSIS (HVA) WITH OUR COMMUNITY PARTNERS.THE EMERGENCY MANAGEMENT COORDINATOR IS A MEMBER OF THE GUERNSEY AND NOBLE COUNTY LEPC. THE LEPC MEETS AT LEAST QUARTERLY. SOUTHEASTERN MED PARTICIPATES IN BOTH GUERNSEY AND NOBLE COUNTY DISASTER DRILLS.SOUTHEASTERN MED IS A PART OF THE OHIO HOSPITAL ASSOCIATION (OHA) REGIONAL HOSPITAL COALITION. THE REGIONAL COALITION MEETS MONTHLY TO DISCUSS AND SHARE IDEAS FOR DISASTER PREPAREDNESS. HOSPITALS THAT PARTICIPATE IN THE REGIONAL COALITION CAN OBTAIN GRANTS FOR EMERGENCY PREPAREDNESS EQUIPMENT, WHICH REMAIN AVAILABLE TO OTHER HOSPITALS IN THE STATE IN THE EVENT OF A SIGNIFICANT DISASTER IN THEIR SERVICE AREA. PART VI LINE 6 SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. WHICH OPERATES A NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL, IS A SUBSIDIARY OF GUERNSEY HEALTH SYSTEMS, A NOT-FOR-PROFIT OHIO CORPORATION. GUERNSEY HEALTH SYSTEMS IS INVOLVED IN FUNDRAISING, THE OWNERSHIP AND OPERATION OF MEDICAL OFFICE BUILDINGS AND OTHER HEALTHCARE RELATED FACILITIES, AND THE EXECUTIVE-LEVEL MANAGEMENT OF ITS RELATED CORPORATIONS. GUERNSEY HEALTH ENTERPRISES, INC., A SUBSIDIARY OF GUERNSEY HEALTH SYSTEMS, IS A FOR-PROFIT HEALTH SERVICES CORPORATION AND IS THE PARENT COMPANY OF UNITED AMBULANCE SERVICE OF CAMBRIDGE, INC., AN EMERGENCY RESPONSE AND TRANSPORT AMBULANCE SERVICE. SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. IS THE SOLE MEMBER OF SUPERIOR MED, LLC, A DISREGARDED TAX-EXEMPT ORGANIZATION THAT OPERATES PHYSICIAN OFFICES IN THE COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RAYMOND M CHOREY | ||||||||||||||
| PRESIDENT & CEO | $0 | $237,162 | $0 | $54,285 | $0 | $56,042 | $0 | $0 | $0 | $25,318 | $0 | $372,807 | $0 | $0 |
| TIMOTHY R EVANCHO | ||||||||||||||
| V.P. FINANCE & CFO/ASST TREASURER | $0 | $170,240 | $0 | $15,640 | $0 | $280 | $0 | $0 | $0 | $19,800 | $0 | $205,960 | $0 | $0 |
| ANGELA S LONG | ||||||||||||||
| V.P. NURSING SERVICES | $0 | $144,313 | $0 | $14,260 | $0 | $24,126 | $0 | $0 | $0 | $16,665 | $0 | $199,364 | $0 | $0 |
| STEVEN M BROOKS | ||||||||||||||
| V.P. HUMAN RESOURCES | $0 | $123,537 | $0 | $16,948 | $0 | $0 | $0 | $0 | $0 | $23,259 | $0 | $163,744 | $0 | $0 |
| E EDWIN CONAWAY | ||||||||||||||
| VP MEDICAL AFFAIRS | $0 | $138,167 | $0 | $12,604 | $10,000 | $280 | $0 | $0 | $0 | $23,452 | $10,000 | $174,503 | $0 | $0 |
| ELAINE BEED MD | ||||||||||||||
| PHYSICIAN | $515,008 | $0 | $0 | $0 | $40,848 | $0 | $0 | $0 | $0 | $0 | $555,856 | $0 | $0 | $0 |
| KARL W KUMLER MD | ||||||||||||||
| PHYSICIAN | $600,018 | $0 | $0 | $0 | $32,268 | $0 | $0 | $0 | $21,111 | $0 | $653,397 | $0 | $0 | $0 |
| CARL F JUENG MD | ||||||||||||||
| PHYSICIAN | $536,515 | $0 | $0 | $0 | $3,323 | $0 | $0 | $0 | $26,279 | $0 | $566,117 | $0 | $0 | $0 |
| EYAD MAHAYRI MD | ||||||||||||||
| PHYSICIAN | $435,011 | $0 | $23,125 | $0 | $42,982 | $0 | $0 | $0 | $26,279 | $0 | $527,397 | $0 | $0 | $0 |
| CLIFFORD B MAXIMO MD | ||||||||||||||
| PHYSICIAN | $452,632 | $0 | $0 | $0 | $507 | $0 | $0 | $0 | $26,279 | $0 | $479,418 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | RAYMOND CHOREY RECEIVED $55,772 IN SEVERANCE PAY IN 2018 FROM GUERNSEY HEALTH SYSTEMS, A RELATED ORGANIZATION . ANGELA LONG RECEIVED $23,846 IN SEVERANCE PAY IN 2018 FROM GUERNSEY HEALTH SYSTEMS, A RELATED ORGANIZATION. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF CAMBRIDGE OHIO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316400220 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2015-05-15 | BondIssuedDt |
| Issue Price | $15,000,000 | IssuePriceAmt |
| Purpose | SEE PART VI SUPPLEMENTAL INFORMATION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $8,117,627 | RetiredAmt |
| Total Proceeds | $15,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $118,400 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,596,600 | CapitalExpendituresAmt |
| Other Spent Proceeds | $10,285,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PT I-A COL (F): | FormAndLineReferenceDesc |
| Explanation | 10,285,000 FOR CURRENT REFUNDING OF 2001 AND 2002 BOND ISSUES, 118,400 FOR BOND ISSUANCE COSTS, AND 4,596,600 FOR CAPITAL IMPROVEMENTS. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SOUTHEASTERN OHIO PHYSICIANS INC | |||
| PARITAL OWNERSHIP BY TRUSTEE | $260,391 | MEDICAL TRANSACTIONS | 0 |
| AMBER E PAULEY | |||
| FAMILY MEMBER OF OFFICER | $54,474 | EMPLOYMENT | 0 |
| JOSEPH OHANLON DO | |||
| FAMILY MEMBER OF TRUSTEE | $23,250 | PHYSICIAN SERVICES | 0 |
| KENDRA D BROOKS | |||
| SPOUSE OF OFFICER | $49,752 | EMPLOYMENT | 0 |
| KAITLIN MICHELLE CHOREY | |||
| FAMILY MEMBER OF OFFICER | $46,815 | EMPLOYMENT | 0 |
| MARK GOGGIN MD | |||
| FAMILY MEMBER OF TRUSTEE | $19,250 | PHYSICIAN SERVICES | 0 |
| DOMINIC D CROCK | |||
| FAMILY MEMBER OF TRUSTEE | $98,047 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS DONALD J. CROCK AND THOMASINA CROCK ARE BROTHER IN-LAW AND SISTER IN-LAW |
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE OCTOBER 10, 2018 GUERNSEY HEALTH SYSTEMS AND THE SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER ENTERED INTO A MANAGEMENT AGREEMENT WITH OHIO HEALTH CORPORATION TO PROVIDE SENIOR LEVEL MANAGEMENT FOR GUERNSEY HEALTH SYSTEMS AND THE SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER BY PROVIDING THE PRESIDENT & CEO, VICE PRESIDENT OF FINANCE, AND CHIEF NURSING OFFICER OF THE ORGANIZATION. THESE OFFICERS ARE LISTED IN PART VII, SECTION A. THE MANAGEMENT DUTIES PERFORMED INCLUDED HIRING, FIRING, AND SUPERVISING PERSONNEL, PLANNING AND EXECUTING BUDGETS AND FINANCIAL OPERATIONS, AND SUPERVISING EXEMPT AND NON EXEMPT OPERATIONS. NEITHER GUERNSEY HEALTH SYSTMES NOR SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. MADE ANY PAYMENTS TO OHIO HEALTH CORPORATION RELATED TO CHERYL L. HERBERT, PRESIDENT & CEO. ALL AMOUNTS OF REPORTABLE COMPENSATION PAID TO CHERYL L. HERBERT WERE MADE DIRECTLY BY OHIO HEALTH CORPORATION AND WOULD BE REPORTED ON OHIO HEALTH CORPORATION'S FORM 990. 2018 2018 REPORTABLE COMPENSATION AMOUNTS PAID BY OHIO HEALTH THAT WERE REIMBURSED BY GUERNSEY HEALTH SYSTEMS TOTALED APPROXIMATELY $40,705 FOR TIMOTHY R. EVANCHO, VICE PRESIDENT OF FINANCE, AND $20,352 FOR GINA F. WOODS, CHIEF NURSING OFFICER. |
| FORM 990, PART VI, SECTION A, LINE 7A | BOARD MEMBERS ARE ELECTED BY BOARD MEMBERS OF GUERNSEY HEALTH SYSTEMS, THE NOT-FOR-PROFIT PARENT COMPANY OF SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD BEFORE FILING. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS COMPLETE AN ANNUAL STATEMENT DISCLOSING ALL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PERFORMS A COMPENSATION STUDY OF MANAGEMENT POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL SUCH ITEMS ARE AVAILABLE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 6,858,781. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,858,781. OTHER SERVICES: PROGRAM SERVICE EXPENSES 1,861,375. MANAGEMENT AND GENERAL EXPENSES 1,436,644. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,298,019. RADIOLOGY FEES: PROGRAM SERVICE EXPENSES 104,301. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,301. ANETHESIA FEES: PROGRAM SERVICE EXPENSES 1,150,698. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,150,698. LINEN SERVICE FEE: PROGRAM SERVICE EXPENSES 206,929. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 206,929. COLLECTION FEES: PROGRAM SERVICE EXPENSES 312,758. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 312,758. SECURITY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 190,539. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 190,539. PHYSICIAN LOAN LOSSES: PROGRAM SERVICE EXPENSES 190,245. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 190,245. PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 652,347. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 652,347. ANSWERING SERVICES: PROGRAM SERVICE EXPENSES 5,344. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,344. BILLING SERVICES: PROGRAM SERVICE EXPENSES 375,603. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 375,603. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY -631,285. TRANSFERS FROM AFFILIATES 1,353,000. |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUPERIOR MED LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311311881 | EIN |
| Primary Activities | PHYSICIAN OFFICES | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $5,036,876 | TotalIncomeAmt |
| End Of Year Assets | $1,796,684 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GUERNSEY HEALTH SYSTEMS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK STREET | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311148352 | EIN |
| Primary Activities | MANAGEMENT & FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 12 TYPE II | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN HOME CARE LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 EDISON DRIVE | AddressLine1Txt |
| City | MILFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45150 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271219638 | EIN |
| Primary Activities | HOME HEALTH SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,026,312 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $521,362 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.40000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| GUERNSEY HEALTH ENTERPRISES INC | |||||||||
| 1341 CLARK STREET | CAMBRIDGE | OH | 43725 | 311191428 | AMBULANCE SERVICE | OH | GUERNSEY HEALTH SYSTEMS | C | 0 |
| UNITED AMBULANCE SERVICE OF CAMBRIDGE INC | |||||||||
| 1341 CLARK STREET | CAMBRIDGE | OH | 43725 | 311086097 | AMBULANCE SERVICE | OH | GUERNSEY HEALTH SYSTEMS | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| UNITED AMBULANCE SERVICE OF CAMBRIDGE | ||
| D | $6,660 | CASH OWED |
| GUERNSEY HEALTH SYSTEMS | ||
| D | $109,901 | CASH OWED |
| GUERNSEY HEALTH SYSTEMS | ||
| E | $6,817,536 | LOANS GUARANTEED |
| GUERNSEY HEALTH SYSTEMS | ||
| K | $521,319 | CASH PAID |
| GUERNSEY HEALTH ENTERPRISES INC | ||
| L | $42,000 | CASH PAID |
| GUERNSEY HEALTH SYSTEMS | ||
| M | $1,500,000 | CASH PAID |
| GUERNSEY HEALTH SYSTEMS | ||
| N | $100,000 | ESTIMATED |
| GUERNSEY HEALTH SYSTEMS | ||
| O | $1,046,790 | CASH PAID |