2025-11-04T12:18:57-06:00 2024-12-31 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 341407259 MARY RUTAN HOSPITAL MARY 9375924015 205 PALMER AVE BELLEFONTAINE OH 43311 THOMAS DENBOW VP OF FINANCE 9375924015 2025-10-31 1 1 AMY CIMINELLO P00796388 6148493000 2025-10-31 2024 2025-03-06 01:10:19Z CHAD ROSS 205 PALMER AVE BELLEFONTAINE OH 43311 171077459 0 X WWW.MARYRUTAN.ORG X 1919 OH SEE SCHEDULE O 14 13 1052 85 0 0 2817364 0 132628876 136023486 4142442 3506238 0 0 139588682 139529724 0 0 0 0 83278284 83145935 0 0 0 51914607 55283317 135192891 138429252 4395791 1100472 162507936 165388271 38805323 34824106 123702613 130564165 X TO CREATE PHILANTHROPIC RELATIONSHIPS TO SUPPORT PATIENT CARE SERVICES, MEDICAL SCHOLARSHIPS, MEDICAL EQUIPMENT, AND CAPITAL DEVELOPMENT WHILE PROMOTING HEALTH AND WELLNESS THROUGH EDUCATIONAL PROGRAMS AND SERVICES TO THE COMMUNITY IN WHICH WE SERVE. 0 0 3934701 25598491 EMERGENCY DEPARTMENT - THE HOSPITAL MAINTAINS AN EMERGENCY DEPARTMENT, WHICH IS AVAILABLE TO THE PUBLIC REGARDLESS OF THEIR ABILITY TO PAY. IN 2024, 14,802 PATIENTS WERE TREATED. 6496372 14708878 PHARMACY - THE PHARMACY DEPARTMENT DISPENSED 242,961 MEDICATIONS TO PATIENTS. 5863749 67665305 OPERATING ROOM - THE HOSPITAL PERFORMED APPROXIMATELY 2,661 SURGERIES IN 2024. 100426090 28050812 MARY RUTAN HOSPITAL OPERATES A NONPROFIT HOSPITAL IN BELLEFONTAINE, OHIO. THE HOSPITAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. IN ASSESSING A PATIENT'S ABILITY TO PAY, THE HOSPITAL USES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITY IT SERVES. IN 2024, MARY RUTAN HOSPITAL PROVIDED $181,667 IN CHARITY CARE. IN ADDITION, THE HOSPITAL PROVIDES MANY SERVICES AND PROGRAMS THAT BENEFIT ITS PATIENTS AND COMMUNITY MEMBERS. THESE SERVICES INCLUDE PASTORAL CARE, COMMUNITY HEALTH SCREENINGS, HEALTH FAIRS, HEALTH EDUCATION PROGRAMS AND PUBLICATIONS. 100426090 28050812 116720912 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 116 0 1 1052 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 X THOMAS DENBOW 9375924015 205 PALMER AVE BELLEFONTAINE OH 43311 X JOAN HAUSHALTER CHAIR / BOARD MEMBER 1.25 2.00 X X 0 0 0 RICK GILDOW VICE CHAIR / CHAIR 0.75 0.75 X X 0 0 0 SCOTT ABRAHAM BOARD MEMBER / VICE CHAIR 0.75 0.75 X X 0 0 0 SCOTT SHELLHAAS BOARD MEMBER 0.75 0.75 X X 0 0 0 DR MATT VERBSKY BOARD MEMBER (JAN-APRIL) 0.75 0.75 X 0 0 0 THOMAS SIMON BOARD MEMBER 1.25 1.00 X 0 0 0 DAVID WILLOBY BOARD MEMBER 0.75 1.25 X 0 0 0 JOENEE PURCELL BOARD MEMBER 0.75 1.25 X 0 0 0 DARIN OLSON BOARD MEMBER 0.75 0.75 X 0 0 0 DOUG CHAMBERLAIN BOARD MEMBER 0.75 1.25 X 0 0 0 JEFF HOLYCROSS BOARD MEMBER 0.75 0.75 X 0 0 0 KELLY KAUFFMAN BOARD MEMBER 0.75 1.50 X 0 0 0 RICK HATCHER BOARD MEMBER 0.75 0.75 X 0 0 0 PAIGE DUFF BOARD MEMBER (MAY-DEC) 0.75 1.25 X 0 0 0 DR GRANT VARIAN BOARD MEMBER (MAY-DEC) 0.75 0.75 X 0 0 0 JACK RESER BOARD MEMBER (JAN-FEB) 0.75 0.75 X 0 0 0 CHAD ROSS PRESIDENT 44.50 1.50 X 0 475092 101479 CHRISTINA MYERS COO 40.00 0.00 X 268239 0 39182 THOMAS DENBOW VICE PRESIDENT/CFO 44.50 1.50 X 242257 0 36032 TAMARA GUMP COO (LOGAN VIEW INC) 20.00 20.00 X 0 176502 28688 DAVID KELLY VICE PRESIDENT 40.00 0.00 X 266148 0 40731 MARY SEBRING VICE PRESIDENT 40.00 0.00 X 195767 0 31964 LAURA MILLER VICE PRESIDENT 40.00 0.00 X 178625 0 28665 ROGER AMIGO PHYSICIAN 40.00 0.00 X 766870 0 39709 GREGG FULMER PHYSICIAN 40.00 0.00 X 730133 0 36165 KIMBERLY KLAPCHAR PHYSICIAN 40.00 0.00 X 487931 0 35677 JOHN KOVAL PHYSICIAN 40.00 0.00 X 487909 0 35640 LISA GAINES PHYSICIAN 40.00 0.00 X 483687 0 35757 4107566 651594 489689 104 0 1 0 CARDIOSOLUTIONS 4675 CORNELL RD CINCINNATI OH 45241 CONTRACT CARDIO NURSING 3343084 AMERICAN HEALTHCARE STAFFING ASSOCIATION 277 S WASHINGTON ST SUITE 200 ALEXANDRIA VA 22314 CONTRACT NURSING 1468219 MIDOHIO REHABILITATION SPECIALIST LLC 515 HUNTERS RUN BLUFFTON OH 45817 OCCUPATIONAL THERAPY SERVICE 1190521 HAWKE OF OHIO 1134 N MAIN ST STE 2100 BELLEFONTAINE OH 43311 SPEECH THERAPY SERVICES 894421 CLOUDWAVE 100 CROWLEY DRIVE MARLBOROUGH MA 01752 INFO TECH SECURITY SERVICES 761570 28 PATIENT SERVICES 621110 104682078 104682078 PHARMACY 621110 14731124 14731124 PEDIATRICS CLINIC 621110 1964431 1964431 OB/GYN CLINIC 621110 1836911 1836911 ANESTHESIA 621110 1133241 1133241 11675701 11675701 136023486 1812614 1812614 32752109 489250 31169880 377855 1582229 111395 1693624 1693624 139529724 136023486 0 3506238 X 1904179 1596119 308060 63167694 52794397 10373297 3231804 2648983 582821 11019041 9446268 1572773 3823217 3208730 614487 407988 407988 188915 188915 11888 11888 16257776 13942795 2314981 135225 115885 19340 1252714 754772 497942 1852085 1564822 287263 211271 181055 30216 496445 496445 6604122 4922907 1681215 2494232 2137510 356722 MEDICAL SUPPLIES 17038275 14637725 2400550 BAD DEBT EXPENSE 4644740 4644740 OHIO HOSPITAL FRANCHISE 2838149 2838149 HCAP FUNDING EXP 640436 640436 209056 149174 59882 138429252 116720912 21708340 0 4960 4960 11485789 4210394 14690509 15968603 920988 1014568 9189463 8825433 132817891 73067422 58869436 59750469 63063087 71799734 4000000 3600000 283704 214110 162507936 165388271 13120346 11020913 12649123 11501976 2666667 1333333 10369187 10967884 38805323 34824106 X 123702613 130564165 123702613 130564165 162507936 165388271 X 1100472 5752059 9021 X X 0 1 X 1 0 X 1 11888 11888 0 PART II-B, LINE 1: 3.7% PERCENT OF DUES TO THE OHIO HOSPITAL ASSOCIATION AND 39% OF THE AMERICAN HOSPITAL ASSOCIATION DUES WERE ALLOCATED TO LOBBYING ACTIVITIES BY THAT ORGANIZATION. 5454137 5454137 55574500 20943566 34630934 2536663 1330085 1206578 63014078 48171408 14842670 6238513 2622363 3616150 59750469 UNPAID INSURANCE CLAIMS 2767036 COST REPORT SETTLEMENT PAYABLE 331170 INTERCOMPANY PAYABLE 88039 LEASE LIABILITIES 1905322 INSURANCE PLAN PAYABLE 5876317 10967884 X 140641705 5752059 -4640078 1111981 139529724 0 139529724 133784512 0 133784512 4644740 4644740 138429252 PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS OF BAD DEBT EXPENSE -4,644,740. CHANGE IN FMV OF INTEREST RATE SWAP AGREEMENT 4,662. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF BAD DEBT EXPENSE 4,644,740. 1 1 X 1 X 125.000000000000 1 X 1 1 0 1 1 1355883 3284822 0 0.00000 21277884 10795191 10482693 0.07840 22633767 14080013 10482693 0.07840 286 32726 1199343 0 1199343 0.00900 4 208 247303 0 247303 0.00180 2607302 2076774 530528 0.00400 61 44906 255849 0 255849 0.00190 351 77840 4309797 2076774 2233023 0.01670 351 77840 26943564 16156787 12715716 0.09510 3 4933 4933 0.00000 13 6578 12770 12770 0.00010 2 500 3034 3034 0.00000 2 68 1717 1717 0.00000 13 60 3816 3816 0.00000 13 14910 9972 9972 0.00010 14 1715 26539 26539 0.00020 60 23831 62781 62781 0.00040 0 4644740 181667 13902820 17610171 -3707351 X 1 1 1 1 MARY RUTAN HOSPITAL 205 PALMER AVE BELLEFONTAINE OH 43311 X X X MARY RUTAN HOSPITAL 1 0 0 1 X X X X X X X X X 23 1 0 1 1 X HTTP://WWW.MARYRUTAN.ORG/NEEDS-ASSESSMENT.ASPX X WWW.LOGANHEALTH.ORG X X 1 23 1 HTTPS://FOUNDATION.MARYRUTAN.ORG/NEEDS-ASSESSMENT/ 0 1 X 125.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.MARYRUTAN.ORG/PATIENTS-AND-VISITORS/BILLING-INFORMATION/FINANCI X HTTPS://WWW.MARYRUTAN.ORG/PATIENTS-AND-VISITORS/BILLING-INFORMATION/FINANCI X HTTPS://WWW.MARYRUTAN.ORG/PATIENTS-AND-VISITORS/BILLING-INFORMATION/FINANCI X X X X X 1 X 0 X X X X 1 X 0 1 MARY RUTAN HOSPITAL PART V, SECTION B, LINE 5: MARY RUTAN HOSPITAL WAS A LEAD ORGANIZATION IN FACILITATING AND FUNDING THE COMMUNITIES' FIFTH FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT IN 2023; PARTNERING WITH THE LOGAN COUNTY HEALTH DISTRICT, MENTAL HEALTH DRUG AND ALCOHOL BOARD OF LOGAN AND CHAMPAIGN COUNTIES, THE UNITED WAY OF LOGAN COUNTY, LOGAN COUNTY JOB AND FAMILY SERVICES, AND COMMUNITY HEALTH AND WELLNESS PARTNERS OF LOGAN COUNTY. THIS COLLABORATION ALLOWED COMMUNITY PARTNERS TO COME TOGETHER IN A UNIFIED FRONT TO CREATE A COMPREHENSIVE ASSESSMENT AND PLAN TO ASSIST ALL AGENCIES AND ORGANIZATIONS TO IMPACT THE HEALTH, SAFETY AND WELL-BEING OF THE COMMUNITY AND RESIDENTS OF LOGAN COUNTY.A RANDOM SURVEY WAS COMPLETED VIA TELEPHONE AND ELECTRONIC SURVEYS TO NUMEROUS RESIDENTS OF LOGAN COUNTY TO GATHER INFORMATION ABOUT HEALTHCARE, QUALITY OF LIFE, WELLNESS, ENVIRONMENT, SAFETY, PARENTING, AND SOCIAL DEMOGRAPHICS. 400 LOGAN COUNTY RESIDENTS RESPONDED TO THE ANONYMOUS SURVEY. ADDITIONAL QUALITATIVE DATA WAS PROVIDED BY 68 COMMUNITY PARTNERS WITH KNOWLEDGE OF AND EXPERIENCE WITH HEALTH-RELATED ISSUES VIA AN ON-LINE SURVEY. THE GATHERING OF DATA FROM NUMEROUS SECONDARY SOURCES TO FURTHER VALIDATE AND IDENTIFY AREAS OF CONCERN AND NEED WERE A PART OF THIS COMPREHENSIVE NEEDS ASSESSMENT PROCESS. HEALTH AND HUMAN SERVICE PROVIDERS AND PROFESSIONALS FROM ACROSS THE COUNTY CAME TOGETHER FOR THE PURPOSE OF THIS SURVEY. THESE COMMUNITY PARTNERS INCLUDED PROFESSIONALS IN THE AREAS OF HOSPITAL ADMINISTRATION, PUBLIC HEALTH, MENTAL HEALTH, FQHC, HEALTH AND HUMAN SERVICES, INDUSTRY, COUNSELING, EDUCATION, CHILDREN'S DEVELOPMENT, AGING, LAW ENFORCEMENT, AND LOCAL GOVERNMENT. MARY RUTAN HOSPITAL AND EACH PARTICIPATING ORGANIZATION WILL UTILIZE THIS INFORMATION ACCORDING TO COMMUNITY NEEDS AND THEIR OWN UNIQUE STRENGTHS. EFFORTS ARE BEING COORDINATED ACROSS THE COUNTY TO HELP ENSURE ADEQUATE AVAILABILITY OF NEEDED SERVICES AND EFFORTS TO IMPROVE AT RISK FINDINGS. FIVE ACTIVE COALITIONS ARE WORKING COLLABORATIVELY TO ADDRESS THESE ISSUES. THOSE COALITIONS INCLUDE: EMERGING NEEDS AND SOCIAL DETERMINANTS OF HEALTH COALITION, HEALTHY LIVING COALITION, COALITION FOR ONGOING RECOVERY EFFORTS, MENTAL HEALTH & SUICIDE PREVENTION COALITION, HOUSING AND HOMELESSNESS COALITION, SENIOR LIVING COALITION, AND THE LOGAN COUNTY COALITION ADVISORY BOARD THAT PROVIDES OVERSIGHT AND DIRECTION FOR THE COALITIONS. THE COMPLETE ACTION PLAN, INCLUDING NEEDS IDENTIFIED, STRATEGIES FOR ADDRESSING THOSE NEEDS, ACTIVITIES UNDERTAKEN, AND MEASUREMENT OF OUTCOMES, CAN BE VIEWED AND/OR DOWNLOADED FROM THE HOSPITAL WEBSITE AT WWW.MARYRUTAN.ORG. THESE SAME COMMUNITY PARTNERS CAME TOGETHER FOR THE CREATION, FACILITATION, AND IMPLEMENTATION OF THE CURRENT YEAR NEEDS ASSESSMENT. IN ADDITION, A COMMUNITY CALL TO ACTION MEETING WAS HELD ON JUNE 23, 2024, WHERE 80 COMMUNITY MEMBERS CAME TOGETHER TO REVIEW AND PRIORITIZE AREAS OF RISK AND NEED. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 6B: MARY RUTAN FOUNDATION, LOGAN COUNTY HEALTH DISTRICT, UNITED WAY OF LOGAN COUNTY, LOGAN COUNTY JOB AND FAMILY SERVICES, MENTAL HEALTH, DRUG AND ALCOHOL SERVICES BOARD OF LOGAN AND CHAMPAIGN COUNTIES, COMMUNITY HEALTH AND WELLNESS PARTNERS OF LOGAN COUNTY ACTED AS THE LEAD ORGANIZATION AND FUNDING PARTNERS FOR THE ASSESSMENT. OTHERS INVOLVED IN THE PROCESS INCLUDE: LOGAN COUNTY CHILDREN'S SERVICES, LOGAN COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, LOGAN COUNTY COMMISSIONERS, LOGAN COUNTY FAMILY COURT, LOGAN COUNTY SHERIFF'S DEPARTMENT, BELLEFONTAINE CITY POLICE DEPARTMENT, AREA EMS, COUNCIL OF RURAL SERVICES, LOGAN COUNTY EDUCATIONAL SERVICES CENTER, INDIAN LAKE LOCAL SCHOOLS AND THE LOGAN COUNTY FAITH COALITION. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 7D: AREA MEDIA COMMUNICATION IN PRINT AND RADIO, ELECTRONIC COMMUNICATION AND SOCIAL MEDIA. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 11: AN INTERNAL WORKGROUP REVIEWED THE FINDINGS OF THE 2023 LOGAN COUNTY CHNA AND STATE OF OHIO HEALTH IMPROVEMENT PLAN(SHIP) AND SELECTED THE PRIORITY AREAS OF ACCESS TO MENTAL HEALTH SERVICES, ACCESS TO LOCAL HEALTHCARE PROVIDERS, DRUG OVERDOSE AND DEATH, ENCOURAGING HEALTHY BEHAVIORS, CHRONIC DISEASE REDUCTION, AND INFANT AND MATERNAL MORTALITY. AS A PART OF THE CREATION OF THE HEALTH IMPROVEMENT PLAN THE GROUP IDENTIFIED PRIORITY HEALTH OUTCOMES AND PRIORITY FACTORS ALIGNING WITH LOGAN COUNTY AND THE OHIO DEPARTMENT OF HEALTH AND WHENEVER POSSIBLE. WHERE GREATER NEEDS WERE IDENTIFIED- PRIORITY POPULATIONS FOR OBJECTIVES AND SELECT STRATEGIES LIKELY TO REDUCE DISPARITIES AND INEQUITIES WERE INCLUDED. A COPY CAN BE ACCESSED AT WWW.MARYRUTAN.ORG. AN AREA OF NEED THAT WAS IDENTIFIED BY THE 2023 COMMUNITY HEALTH RISK AND NEEDS ASSESSMENT BUT WAS NOT ADDRESSED BY THE HOSPITAL'S HEALTH IMPROVEMENT PLAN AT THIS TIME: HOUSING AND HOMELESSNESS. WHILE WE WILL FOCUS THE MAJORITY OF OUR EFFORTS ON THE IDENTIFIED HEALTH NEEDS, WE WILL SUPPORT COMMUNITY EFFORTS IN THESE AREAS THROUGH PARTICIPATION AND FINANCIAL SUPPORT TO THE LOGAN COUNTY CHAMBER OF COMMERCE, LOCAL ECONOMIC DEVELOPMENT EFFORTS, AND THE HOUSING AND HOMELESSNESS COALITION. THESE TOPICS ARE NOT ADDRESSED IN MARY RUTAN HOSPITAL'S PLAN OF ACTION DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE PRIORITY HEALTH NEEDS SPECIFICALLY IDENTIFIED. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 13H: MARY RUTAN ALSO HAS A CATASTROPHIC CHARITY POLICY IN PLACE FOR PATIENTS WHO DO NOT QUALIFY FOR OTHER PROGRAMS, WHO HAVE AN ACCUMULATED BALANCE ABOVE $50,000, AND WHOSE INCOME IN BETWEEN 200 AND 400% OF THE FPL. THIS IS A PARTIAL DISCOUNT DEPENDENT UPON % OF FPL, RANGING FROM 50% DISCOUNT TO 90% DISCOUNT. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 15E: PATIENTS CAN COMPLETE A DIGITAL VERSION OF THE FAP APPLICATION ONLINE, WHICH IS IDENTICAL TO THE PAPER FORM AND USED FOR PROCESSING, THOUGH THEY STILL WOULD ULTIMATELY HAVE TO SIGN OFF ON A PRINTED COPY. MARY RUTAN HOSPITAL PART V, SECTION B, LINE 24: AS STATED IN THE FAP, THE FAP APPLIES TO ONLY SERVICES THAT ARE URGENT AND MEDICALLY NECESSARY. NON-FAP ELIGIBLE PATIENTS RECEIVING MEDICALLY NECESSARY SERVICES, SUCH AS OUT OF STATE PATIENTS, RECEIVE AT LEAST A NOMINAL DISCOUNT FROM CHARGE. ELECTIVE SERVICES ARE EXCLUDED FROM THE FAP AS THOSE ARE NOT DEEMED URGENT OR MEDICALLY NECESSARY. RETAIL SERVICES, SUCH AS OUR DIRECT ACCESS LAB, ARE EXEMPT FROM OUR ASSISTANCE PROGRAM AS THEY ARE CONSIDERED NEITHER URGENT NOR MEDICALLY NECESSARY BY THE NATURE OF THEIR RETAIL STATUS (RETAIL IN THIS CASE MEANING NOT SUBMITTED TO THIRD PARTY PAYERS AND THAT THEY ALLOW PATIENTS TO SELF-ORDER/SELF-REFER). PRICES FOR THESE SERVICES ARE LOW, FIXED (NON-NEGOTIATED WITH PAYERS), AND ARE STANDARDIZED REGARDLESS OF SETTING OR INSURANCE STATUS. AN INDIVIDUAL WHO MIGHT OTHERWISE QUALIFY FOR FAP COULD THEREFORE RECEIVE THESE ELECTIVE SERVICES AND PAY THE GROSS CHARGE AMOUNT DUE TO THE EXCLUSION OF THESE ELECTIVE SERVICES, DESPITE BEING OTHERWISE ELIGIBLE UNDER THE FAP. PART V, SECTION B, LINE 16I THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY WERE NOT TRANSLATED FOR OTHER FOREIGN SPEAKING POPULATIONS BECAUSE NONE OF THE FOREIGN SPEAKING POPULATIONS IN THE COMMUNITY EXCEEDED FIVE PERCENT OF THE COMMUNITY IN WHICH THE MARY RUTAN HOSPITAL SERVES. PART I, LINE 7: THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO REPORT FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AS COMMUNITY BENEFITS. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE RELATED TO PATIENT CARE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), (BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN) IS $4,644,740. PART II, COMMUNITY BUILDING ACTIVITIES: MARY RUTAN HOSPITAL AND FOUNDATION ARE COMMITTED TO PROVIDING PROFESSIONAL ASSISTANCE TO THE LOGAN COUNTY COMMUNITY THROUGH THE VOLUNTEERING OF TIME AND RESOURCES FOR ECONOMIC DEVELOPMENT TO THE LOGAN COUNTY CHAMBER OF COMMERCE, THE LOGAN COUNTY COMMUNITY IMPROVEMENT CORPORATION, INDIAN LAKE CHAMBER OF COMMERCE AND THE LOGAN COUNTY COLLABORATIVE AND HOUSING AND HOMELESSNESS COALTIONS. IN ADDITION, ADMINISTRATIVE TEAM MEMBERS VOLUNTEER PROFESSIONAL SERVICES AND RESOURCES TO THE UNITED WAY OF LOGAN COUNTY, LOGAN COUNTY MENTAL HEALTH BOARD, LOGAN COUNTY COALITION OF ONGOING RECOVERY EFFORTS, LOGAN COUNTY FAMILY AND CHILDREN FIRST COUNCIL, LOGAN COUNTY HEALTHY LIVING COALITION, LOGAN COUNTY TRANSPORTATION ADVISORY GROUP, LOGAN COUNTY SUICIDE COALITION, LOGAN COUNTY COALITION ADVISORY BOARD (CAB), LOGAN COUNTY CHAMBER OF COMMERCE, SENIOR COALITION, YOUNG PROFESSIONALS, COMMUNITY OUTREACH CENTERS, COLCAS, CRISES INTERVENTION, ONE OHIO REGION 15, AND CENTRAL OHIO TRAUMA SYSTEM PROMOTING AND ESTABLISHING HEALTH, WELLNESS AND NUTRITIONAL SERVICES FOR THOSE IN NEED IN THE COMMUNITY. PART III, LINE 2: BAD DEBT IS PRESENTED AT GROSS CHARGES. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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 COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PART III, LINE 3: THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS BASED ON AN ESTIMATED PERCENTAGE OF BAD DEBT WRITE OFFS. THE PERCENTAGE IS DERIVED FROM A HISTORICAL REVIEW OF PATIENTS THAT QUALIFIED FOR CHARITY AFTER THEY WERE PLACED IN COLLECTIONS. PART III, LINE 4: BAD DEBT FOOTNOTE: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS 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 HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE BALANCE CONSISTS OF AMOUNTS DUE FROM ITS PATIENTS AND THIRD PARTY PAYORS. PATIENT ACCOUNTS RECEIVABLE ARE STATED AT EXPECTED NET REALIZABLE AMOUNTS. AN ALLOWANCE FOR CREDIT LOSSES IS ESTABLISHED FOR AMOUNTS EXPECTED TO BE UNCOLLECTIBLE OVER THE CONTRACTUAL LIFE OF THE RECEIVABLES. THE HOSPITAL COLLECTIVELY EVALUATES PATIENT RECEIVABLES TO DETERMINE THE ALLOWANCE FOR CREDIT LOSSES BASED ON THE EXPECTED PAYMENT TO BE RECEIVED BASED ON EACH INDIVIDUAL PAYOR. THE HOSPITAL CALCULATES THE ALLOWANCE USING AN EXPECTED CREDIT LOSS MODEL THAT CONSIDERS THE HOSPITAL'S ACTUAL HISTORICAL CREDIT LOSSES, ADJUSTED FOR CURRENT ECONOMIC CONDITIONS AND REASONABLE AND SUPPORTABLE FORECASTS. THE HOSPITAL CONSIDERS HISTORICAL WRITE-OFF AMOUNTS AND ADJUST FOR MARKET CONDITIONS AND CREDIT RATINGS OF ITS PAYORS BASED ON REASONABLE AND SUPPORTABLE FORECASTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. RECOVERIES OF AMOUNTS PREVIOUSLY WRITTEN OFF ARE RECOGNIZED WHEN RECEIVED.THE COMPOSITION OF NET RECEIVABLES FROM PATIENTS AND THIRD-PARTY PAYORS WAS AS FOLLOWS IN 2024: 15% MEDICARE, 64% COMMERCIAL INSURANCE AND HMOS, 7% MEDICAID, AND 14% SELF-PAY. PART III, LINE 8: MEDICARE COSTS HAVE BEEN PULLED FROM THE 2024 MEDICARE COST REPORT, UTILIZING A COST TO CHARGE RATIO. BASED ON 2024 US CENSUS BUREAU ESTIMATES, 19.8% OF THE LOGAN COUNTY, OHIO POPULATION IS OVER AGE 65. SERVICES PROVIDED TO MEDICARE PATIENTS ACCOUNTED FOR APPROXIMATELY 24.2% OF NET PATIENT SERVICE REVENUE IN 2024. WE HAVE INCLUDED MEDICARE SHORTFALLS IN OUR 2024 COMMUNITY BENEFIT REPORT. THE ONGOING CARE OF OUR AGING POPULATION CERTAINLY MEETS A SIGNIFICANT NEED OF THE COMMUNITY. EQUIVALENT HOSPITAL-BASED CARE IS NOT AVAILABLE FROM ANY OTHER LOCAL SOURCE. PROVIDING EFFICIENT, COST EFFECTIVE CARE IS ALWAYS A GOAL, BUT SHORTFALLS CAN AND DO OCCUR. THOSE SHORTFALLS ARE ABSORBED BY THE HOSPITAL AND ARE CONSIDERED TO BE A COST OF OUR MISSION TO ACCEPT RESPONSIBILITY FOR MEETING THE HEALTHCARE NEEDS OF OUR COMMUNITY. PART III, LINE 9B: MARY RUTAN HOSPITAL COMPLIES WITH THE FAIR DEBT COLLECTION PRACTICES ACT AT ALL TIMES. A SELF-PAY ACCOUNT IS MANAGED BY A DEDICATED TEAM AT THE TIME PATIENT LIABILITY IS DETERMINED POST-SERVICE. THE TYPICAL PROCESS IS A SERIES OF LETTERS AND PHONE CALLS. THE TIMELINESS AND STEPS ARE OUTLINED IN MARY RUTAN HOSPITAL'S BAD DEBT & COLLECTIONS POLICY (WHICH IS POSTED IN FULL ONLINE FOR PATIENT REVIEW, ALONG WITH A PLAIN LANGUAGE SUMMARY). IF THERE IS NO RESPONSE TO THE TEAM'S STATEMENTS AND CALLS, THEN THE ACCOUNT IS PULLED FOR REVIEW, REVIEWED TO VALIDATE THAT THE BALANCES ARE CORRECT, WRITTEN OFF TO BAD DEBT, AND SENT TO A COLLECTION AGENCY. WHEN A PATIENT HAS INITIATED THE CHARITY APPLICATION PROCESS AND HAS APPLIED FOR ONE OF OUR PROGRAMS, THAT PATIENT REMAINS IN THAT STATUS WITHOUT ANY COLLECTION EFFORTS OF ANY KIND UNTIL FINAL ELIGIBILITY FOR ASSISTANCE CAN BE DETERMINED. APPLICABLE ASSISTANCE/DISCOUNTS ARE APPLIED TO THE ACCOUNT BALANCE IF QUALIFIED. PATIENTS WHO DO NOT QUALIFY ARE NOTIFIED AND NORMAL COLLECTION EFFORTS BEGIN/RESUME AT THAT TIME. PART VI, LINE 2: SECONDARY DATA SOURCES HAVE BEEN IDENTIFIED AND ARE REVIEWED ANNUALLY, ALLOWING MRH AND COMMUNITY COALITIONS TO MONITOR AND ADJUST STRATEGIES IN IDENTIFIED AREAS OF RISK AND NEED AS HIGHLIGHTED IN CHA/CHIP. COLLABORATION WITH LOCAL HUMAN SERVICE ORGANIZATIONS IS KEY IN IDENTIFYING NEEDS ON AN ONGOING BASIS. MARY RUTAN HOSPITAL AND MARY RUTAN FOUNDATION PROGRAMS ARE TARGETED TOWARD SPECIFIC POPULATIONS IN NEED, AS WELL AS DESIGNATED AT-RISK AREAS. GENERAL HEALTH AND WELLNESS PROMOTIONS EDUCATE THE COMMUNITY ABOUT PREVENTATIVE MEASURES AGAINST CHRONIC ILLNESSES. HEALTH AND WELLNESS EDUCATION, AS WELL AS FREE SCREENINGS, ARE PROVIDED MONTHLY AT SUBSIDIZED SENIOR HOUSING UNITS AND AT FOOD PANTRIES. OTHER EXAMPLES INCLUDE "POWER-UP 4 FITNESS", "FIELD TO FORK", AND "BILLY BONES", WHICH ARE PROGRAMS EDUCATING STUDENTS ON THE IMPORTANCE OF EXERCISE AND PROPER NUTRITION IN THE FIGHT AGAINST CHILDHOOD OBESITY, AND "CATCH MY BREATH" ANTI-VAPING PROGRAM. THIS PROGRAM IS DONE IN COLLABORATION WITH ALL AREA SCHOOLS. IN ADDITION, MARY RUTAN HOSPITAL UTILIZES THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS REPORT. MARY RUTAN HOSPITAL FACILITATES" CREATING A HEALTHIER ME AND "MATTER OF BALANCE" COURSES TARGETED FOR THE ADULT POPULATION ADDRESSING PROPER NUTRITION, DIET AND EXERCISE. PARENTING CLASSES WERE IMPLEMENTED IN 2022 TO ADDRESS CONCERNS OF MALTREATMENT OF YOUTH IN LOGAN COUNTY. MARY RUTAN HOSPITAL LEADS OTHER COMMUNITY PARTNERS ON THE HEALTHY LIVING COALITION REVIEWING AT-RISK AREAS IN THE COMMUNITY AND ESTABLISHING EDUCATIONAL PROGRAMS AND RESOURCES TO ADDRESS THOSE NEEDS. MARY RUTAN HOSPITAL ALSO SERVICES AS AN ACTIVE MEMBER OF THE LOGAN COUNTY FAMILY AND CHILDREN FIRST COUNCIL TO PROVIDE ORGANIZATION UPDATES REGARDING ONGOING PROJECTS AND TO DISCUSS AND IDENTIFY COMMUNITY NEEDS. THIS COUNCIL IS COMPRISED OF SENIOR LEADERS OF THE HOSPITAL, HEALTH DEPARTMENT, CHILDREN'S SERVICES, JOB AND FAMILY SERVICES, AND MENTAL HEALTH BOARD AS WELL AS OTHER HEALTH AND HUMAN SERVICE AGENCIES, LAW ENFORCEMENT, AND AREA SCHOOL DISTRICTS. MARY RUTAN HOSPITAL IS ALSO AN ACTIVE MEMBER OF THE LOGAN COUNTY COALITION FOR ONGOING RECOVERY EFFORTS - IMPLEMENTING PROGRAMS AND SERVICES TO COMBAT SUBSTANCE ABUSE ISSUES IN LOGAN COUNTY. IN ADDITION, MARY RUTAN HOSPITAL SENIOR LEADERSHIP SERVES ON THE LOGAN COUNTY COALITION ADVISORY BOARD CREATED TO ASSIST AND BE A RESOURCE FOR AT RISK FINDINGS OF THE NEEDS ASSESSMENT OF OBESITY, CHRONIC DISEASE, DRUG ABUSE, MENTAL HEALTH, ACCESS TO SERVICES, HOUSING AND HOMELESSNESS AND WORKFORCE DEVELOPMENT. PART VI, LINE 3: A VARIETY OF MEANS IS USED TO PROVIDE INFORMATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO ALL PATIENTS. NOTICES ARE POSTED AT ALL POINTS OF REGISTRATION, IN OUR CLINICS, AND IN OUR OFF-SITE BUSINESS OFFICE LOCATION. HANDOUTS AND APPLICATIONS FOR HCAP/CHARITY CARE ARE ALSO AVAILABLE AT REGISTRATION. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN PATIENT BILLING BROCHURES, ON THE MARY RUTAN HOSPITAL WEBSITE, ON BILLING STATEMENTS, AND IN A SEPARATE LETTER INCLUDED WITH ALL SELF-PAY ACCOUNT BILLING STATEMENTS. MARY RUTAN HOSPITAL REPRESENTATIVES ALSO ATTEMPT TO EDUCATE PATIENTS PRIOR TO AND CONCURRENT WITH SERVICE ABOUT OUR ASSISTANCE PROGRAMS. PART VI, LINE 4: MARY RUTAN HOSPITAL'S PRIMARY SERVICE AREA IS RURAL LOGAN COUNTY. ALTHOUGH MARY RUTAN HOSPITAL DOES SERVE SOME INDIVIDUALS FROM ADJOINING COUNTIES (INCLUDING AUGLAIZE, HARDIN, CHAMPAIGN, SHELBY AND UNION), INPATIENT VOLUMES EQUAL 80% AND OUTPATIENT SERVICE VOLUMES EQUAL 83% OF LOGAN COUNTY RESDENTS. THE LOGAN COUNTY POPULATION IS APPROXIMATELY 46,085 AND BASED ON 2024 US CENSUS BUREAU ESTIMATES, MEDIAN HOUSEHOLD INCOME IS $69,183. AN ESTIMATED 11.9% OF THE COUNTY POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. PART VI, LINE 5: THE HOSPITAL FAMILY INCLUDES PARENT CORPORATION, MARY RUTAN HEALTH ASSOCIATION, AND SUBSIDIARIES MARY RUTAN HOSPITAL, MARY RUTAN FOUNDATION, LOGAN VIEW, INC., AND LOGAN COUNTY CANCER SOCIETY. THERE IS A COORDINATED EFFORT TO MEET THE HEALTHCARE NEEDS OF OUR COMMUNITY. DOLLARS ARE BUDGETED ANNUALLY THROUGH MARY RUTAN FOUNDATION TO SUPPORT COMMUNITY HEALTH ACTIVITIES ORGANIZED AND SPONSORED BY MARY RUTAN FOUNDATION. THE GOVERNING BODIES OF EACH CORPORATION ARE MADE UP OF RESIDENTS OF OUR COMMUNITY WHO ARE FAMILIAR WITH THE HEALTH AND WELLNESS ISSUES FACING LOGAN COUNTY AND THE SURROUNDING AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. IN ADDITION, ANNUALLY MARY RUTAN FOUNDATION AWARDS COMMUNITY HEALTH AND WELLNESS GRANTS TO AREA SCHOOLS, SOCIAL SERVICE AND NOT FOR PROFIT ORGANIZATIONS FOCUSED ON THE AREAS OF RISK AND NEED IDENTIFIED IN THE COMMUNITY TO EXPAND OUTREACH EFFORTS PAST THE PROGRAMS AND SERVICES PROVIDED BY THE HOSPITAL AND FOUNDATION. DUE TO LACK OF FUNDING BY AREA SCHOOLS AND INABILITY TO EMPLOYEE ATHLETIC TRAINERS, MARY RUTAN HOSPITAL FUNDS AND PROVIDES ATHLETIC TRAINERS AT AREA HIGH SCHOOLS FOR THE HEALTH, WELLBEING AND SAFETY OF AREA STUDENT ATHLETES. PART VI, LINE 6: MARY RUTAN HEALTH ASSOCIATION IS THE PARENT CORPORATION. THE HEALTH ASSOCIATION PROVIDES MANAGEMENT SERVICES TO THE HOSPITAL, FOUNDATION, LOGAN COUNTY CANCER SOCIETY AND LOGAN VIEW, LLC AND PARTICIPATES IN VARIOUS HEALTH FAIRS AND SCREENINGS THROUGHOUT THE COMMUNITY EACH YEAR. MARY RUTAN FOUNDATION'S MISSION IS TO CREATE PHILANTHROPIC RELATIONSHIPS TO SUPPORT PATIENT CARE SERVICES, AWARD MEDICAL SCHOLARSHIPS, PURCHASE NEEDED MEDICAL EQUIPMENT AND DEVELOP CAPITAL, WHILE PROMOTING HEALTH AND WELLNESS THROUGH EDUCATIONAL PROGRAMS AND SERVICES. LOGAN COUNTY CANCER SOCIETY PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS OF LOGAN COUNTY WHO HAVE CANCER OR CANCER RELATED ILLNESSES, WHILE PROMOTING EDUCATION IN AWARENESS AND THE DETECTION AND TREATMENT OF CANCER. OPERATION AND FACILITATION OF ALL SERVICES PROVIDED BY THE LOGAN COUNTY CANCER SOCIETY ARE PROVIDED BY EMPLOYEES OF MARY RUTAN HOSPITAL AND MARY RUTAN HEALTH ASSOCIATION AND NO SALARIES OR BENEFITS ARE CHARGED TO THE ORGANIZATION FOR THIS SERVICE. PART VI, LINE 7 THE OHIO DEPARTMENT OF HEALTH - FILED LOGAN COUNTY CHA AND MARY RUTAN HEALTH IMPROVEMENT PLAN WITH THE STATE ALIGNING WORK WITH STATE PRIORITY AREAS. 0 0 0 0 0 0 0 1 0 ROGER AMIGO PHYSICIAN 713217 0 52230 0 1423 0 18000 0 21709 0 806579 0 0 0 GREGG FULMER PHYSICIAN 591733 0 137710 0 690 0 18000 0 18165 0 766298 0 0 0 CHAD ROSS PRESIDENT 0 398449 0 75953 0 690 0 83596 0 17883 0 576571 0 0 KIMBERLY KLAPCHAR PHYSICIAN 418458 0 69227 0 246 0 18000 0 17677 0 523608 0 0 0 JOHN KOVAL PHYSICIAN 484099 0 0 0 3810 0 18000 0 17640 0 523549 0 0 0 LISA GAINES PHYSICIAN 482997 0 0 0 690 0 18000 0 17757 0 519444 0 0 0 CHRISTINA MYERS COO 234308 0 33631 0 300 0 24865 0 14317 0 307421 0 0 0 DAVID KELLY VICE PRESIDENT 243602 0 22488 0 58 0 26503 0 14228 0 306879 0 0 0 THOMAS DENBOW VICE PRESIDENT/CFO 208082 0 32885 0 1290 0 22159 0 13873 0 278289 0 0 0 MARY SEBRING VICE PRESIDENT 179238 0 16399 0 130 0 18610 0 13354 0 227731 0 0 0 LAURA MILLER VICE PRESIDENT 154605 0 23260 0 760 0 15722 0 12943 0 207290 0 0 0 TAMARA GUMP COO (LOGAN VIEW INC) 0 153002 0 21674 0 1826 0 15762 0 12926 0 205190 0 0 PART I, LINE 3 THE RELATED ORGANIZATION, MARY RUTAN HEALTH ASSOCIATION, DETERMINES EXECUTIVE COMPENSATION BASED ON USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. PART I, LINE 7 ADDITIONAL NON-FIXED PAYMENTS TO PHYSICIANS ARE AWARDED BY THE COMPENSATION COMMITTEE BASED UPON RELATIVE VALUE UNITS (RVU), ANY EXTRA CALL TIME TAKEN AND OVERALL QUALITY STANDARDS/MERIT. ADDITIONAL NON-FIXED PAYMENTS TO EXECUTIVES AND OTHER STAFF MEMBERS ARE AWARDED BY THE COMPENSATION COMMITTEE BASED UPON MERIT AND INDIVIDUAL DEPARTMENT GOALS COMPARED TO THE OVERALL GOALS OF THE HOSPITAL. A CITY OF BELLEFONTAINE OHIO 346400091 2012-09-13 9125000 SEE SCH K PART IV 0 0 0 B CITY OF BELLEFONTAINE OHIO 346400091 2012-09-13 10000000 SEE SCH K PART IV 0 0 0 C CITY OF BELLEFONTAINE OHIO 346400091 2017-12-20 11000000 SEE SCH K PART IV 0 0 0 A 8405000 9125000 9125000 2009 1 0 1 1 B 8458962 10000000 125322 9874678 2013 0 0 1 1 C 1633739 11000000 11000000 2017 1 0 1 1 A 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 DEUTSCHE BANK 13.200000000000 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, LINE A, COLUMN (F): CURRENTLY REFUND THE CITY OF BELLEFONTAINE, OHIO ADJUSTABLE RATE DEMAND HOSPITAL FACILITIES REVENUE REFUNDING AND IMPROVEMENT BONDS, SERIES 2005 (MARY RUTAN HOSPITAL PROJECT) ISSUED SEPTEMBER 29, 2005. PART I, LINE B, COLUMN (F) FINANCE (I) THE ACQUISITION OF A CANCER TREATMENT CENTER, (II) THE ACQUISITION OF A BUILDING FOR HOSPITAL ADMINISTRATIVE PURPOSES AND (III) THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF OTHER CAPITAL BUDGET ITEMS. PART I, LINE C, COLUMN (F): CONSTRUCTION AND EQUIPPING OF NEW HEALTH CENTER BUILDING PART II, LINE 3, COLUMN B THE $10,000,000 CITY OF BELLEFONTAINE, OHIO HOSPITAL FACILITIES REVENUE BONDS, SERIES 2012B (MARY RUTAN HOSPITAL PROJECT) WERE ISSUED AS DRAW DOWN BONDS, PERMITTING MARY RUTAN HOSPITAL TO DRAW DOWN THE BONDS A MAXIMUM OF TWELVE TIMES, IN MINIMUM AMOUNTS OF $100,000 EACH. AS OF DECEMBER 31, 2014, THE END OF MARY RUTAN HOSPITAL'S FISCAL YEAR, $6,841,987 OF PROCEEDS HAD BEEN DRAWN DOWN. PART III, LINE 9; PART IV, LINE 7 AND PART V (COLUMNS A, B AND C FOR ALL) MARY RUTAN HOSPITAL INTENDS TO ENGAGE BOND COUNSEL TO DRAFT WRITTEN PROCEDURES COVERING POST-ISSUANCE COMPLIANCE. COVERLINK THOMAS SIMON IS 100 OWN THOMAS SIMON, CHAIR MEMBER OF MARY RUTAN HOSPITAL 2347802 PROVIDES BUSINESS AND MAL-PRACTICE INSURANCE POLICIES TO MARY RUTAN HOSPITAL AND MARY RUTAN HEALTH ASSOCIATION. ALL PAYMENTS ARE MADE BY MARY RUTAN HOSPITAL. 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS MARY RUTAN HEALTH ASSOCIATION OF LOGAN COUNTY, AN OHIO NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, MARY RUTAN HEALTH ASSOCIATION OF LOGAN COUNTY MAY PARTICIPATE IN THE ELECTION OF THE ORGANIZATION'S TRUSTEES. THE MEMBER SHALL EXERCISE ITS RIGHT TO VOTE AT ANY MEETING OR TO CONSENT TO ANY ACTION WITHOUT A MEETING THROUGH ITS CHAIRMAN, VICE CHAIRMAN, TREASURER, SECRETARY OR PRESIDENT UNLESS BEFORE SUCH VOTE IS TAKEN OR CONSENT IS GIVEN THE BOARD OF TRUSTEES OF THE MEMBER PROVIDES A CERTIFIED COPY OF A RESOLUTION STATING THAT SUCH AUTHORITY IS VESTED ON SOME OTHER OFFICER OR PERSON. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER SHALL EXERCISE ITS RIGHT TO VOTE AT ANY MEETING OR TO CONSENT TO ANY ACTION WITHOUT A MEETING THROUGH ITS CHAIRMAN, VICE CHAIRMAN, TREASURER, SECRETARY OR PRESIDENT UNLESS BEFORE SUCH VOTE IS TAKEN OR CONSENT IS GIVEN THE BOARD OF TRUSTEES OF THE MEMBER PROVIDES A CERTIFIED COPY OF A RESOLUTION STATING THAT SUCH AUTHORITY IS VESTED ON SOME OTHER OFFICER OF PERSON. AN ANNUAL MEETING OF THE MEMBER IS HELD FOR THE ELECTION OF TRUSTEES, FOR THE CONSIDERATION OF REPORTS AND FOR SUCH OTHER BUSINESS. IN ADDITION, THE FOLLOWING MATTERS ARE AUTHORIZED ONLY AFTER AUTHORIZATION BY THE BOARD OF TRUSTEES AND UPON APPROVAL BY THE MEMBER: 1. REMOVAL OF TRUSTEE; 2. AMENDMENT OF THE CORPORATE REGULATIONS; 3. THE PURCHASE, SALE OR ENCUMBRANCE OF REAL PROPERTY, OR OF SUBSTANTIALLY ALL OF THE PERSONAL PROPERTY, OF THE CORPORATION; 4. MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION OR LEGAL ENTITY; 5. ANY CHANGES TO THE ARTICLES OF INCORPORATION; 6. ADOPTION OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGET; 7. EXPENDITURES FOR (A) NON-BUDGETED ITEMS IN EXCESS OF $250,000; (B) ITEMS WHICH ARE INCUDED IN THE CORPORATION'S ANNUAL BUDGET BUT EXCEED THE BUDGETED AMOUNT BY $250,000 OR MORE, AND (C) EXECUTIVE COMPENSATION; 8. EXECUTION OF ANY CONTRACT WITH A TERM IN EXCESS OF ONE YEAR AND REPRESENTING AN EXPENDITURE OF MORE THAN $500,000; 9. APPROVE THE SELECTION OF THE CEO OF THE CORPORATION; 10. APPOINTMENT OF THE CORPORATION'S AUDITORS; 11. ADOPTION OF THE CORPORATION'S LONG RANGE PLANS AND MANAGEMENT OBJECTIVES; 12. ADOPTION OF THE MEDICAL STAFF BY-LAWS; 13. ANY OTHER MATTERS REQUIRED BY LAW TO BE SUBMITTED TO THE MEMBER OR WHICH THE BOARD DETERMINES BY RESOLUTION TO SUBMIT. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE VP OF FINANCE, CEO, AND MEMBERS OF THE AUDIT COMMITTEE PRIOR TO FILING. THE BOARD RECEIVES A COPY BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS OF THE CORPORATION SHALL DISCLOSE TO THE BOARD ANY SITUATION WHEREIN THE DIRECTOR OR OFFICER HAS A CONFLICTING INTEREST OR DUALITY OF INTEREST THAT COULD POSSIBLY CAUSE THAT PERSON TO ACT IN OTHER THAN THE BEST INTEREST OF THE CORPORATION. OFFICERS AND DIRECTORS MUST COMPLETE AN ANNUAL STATEMENT OF CONFLICTS OF INTEREST. THE RESPONSES TO THE CONFLICT OF INTEREST ARE REVIEWED AND DETERMINED IF ADDITIONAL DISCLOSURE IS NECESSARY OR IF THE ANSWERS NEED TO BE REVIEWED BY LEGAL COUNSEL. ANY MEMBER OF THE BOARD HAVING A KNOWN DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD MAKE A DISCLOSURE OF SUCH CONFLICT TO THE OTHER TRUSTEES. SUCH PERSON SHALL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, BUT SUCH PERSON MAY BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES OF THE MEETING SHOULD REFLECT THE MAKING OF THE DISCLOSURE, AND ABSTENTION FROM VOTING AND THE QUORUM SITUATION. IN ADDITION, ANY OFFICER OF THE CORPORATION HAVING A KNOWN DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER BEFORE SUCH OFFICER FOR ADMINISTRATIVE ACTION SHALL REPORT THE CONFLICT TO THE PRESIDENT OR, IN THE CASE OF THE PRESIDENT, TO THE CHAIR. SUCH OFFICER SHALL ABSTAIN FROM TAKING ANY ADMINISTRATIVE ACTION ON SUCH MATTER. THE CONFLICT OF INTEREST POLICY IS BASED ON THE IRS MODEL. FORM 990, PART VI, SECTION B, LINE 15B MARY RUTAN HOSPITAL'S EXECUTIVE COMPENSATION PHILOSOPHY COVERS THE FOLLOWING GROUPS OF EXECUTIVES: PRESIDENT AND CHIEF EXECUTIVE OFFICER; CHIEF FINANCIAL OFFICER; ASSOCIATION, HOSPITAL, AND SELECT SUBSIDIARY VICE PRESIDENTS AND ADMINISTRATORS. IN DETERMINING THE APPROPRIATE LEVEL OF COMPENSATION WITHIN THE OVERALL STRATEGY, MARY RUTAN WILL CONSIDER SUCH FACTORS AS: TOTAL INCUMBENT RESPONSIBILITIES AND SCOPE OF THE POSITION HELD BY THE INDIVIDUAL; INCUMBENT'S LENGTH OF SERVICE IN THE INDUSTRY, LENGTH OF SERVICE WITH THE HOSPITAL, AND YEARS IN CURRENT POSITION; THE HOSPITAL'S FINANCIAL AND NON-FINANCIAL PERFORMANCE OVER A RELEVANT TIME PERIOD; AND ADDITIONAL ACTIVITIES PERFORMED BY THE INCUMBENT FROM THE POSITION RESPONSIBILITIES IDENTIFIED, BUT HAVING A DIRECT OR INDIRECT IMPACT ON BUSINESS (MULTIPLE JOB RESPONSIBILITIES, SPECIAL PROJECTS, SPECIFIC INDUSTRY EXPERTISE/EXPERIENCE, ETC.). THE REVIEW INCLUDES PERIODIC USE OF AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION STUDIES AND SURVEYS, AND APPROVAL BY THE EXECUTIVE COMMITTEE AND BOARD. VOTING MEMBERS OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE CORPORATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. THE COMPENSATION REVIEW FOR THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES WAS LAST CONDUCTED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE ONLY MADE AVAILABLE AT THE WRITTEN REQUEST OF THE INTERESTED PARTY. PART VII AND PART IX THE SALARIES AND WAGES FOR THE OFFICERS AND HIGHEST COMPENSATED EMPLOYEES ON MARY RUTAN HEALTH ASSOCIATION, A RELATED ORGANIZATION, ARE INITIALLY PAID OUT OF MARY RUTAN HEALTH ASSOCIATION BUT AN ENTRY IS MADE TO ALLOCATE THE SALARY AND WAGE EXPENSES TO MARY RUTAN HOSPITAL (WHERE THE MAJORITY OF THE TIME IS SPENT). THEREFORE, THE OFFICERS TAMARA ALLISION, TAMARA GUMP, SALLY ARMSTRONG, CHAD ROSS AND STEVE BROWN WILL BE SHOWN AS BEING PAID BY A RELATED ORGANIZATION ON PART VII, BUT THEIR OFFICER COMPENSATION WILL BE INCLUDED ON PART IX, LINE 5 OF THE MARY RUTAN HOSPITAL RETURN. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,205,005. MANAGEMENT AND GENERAL EXPENSES 701,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,906,765. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 4,761,353. MANAGEMENT AND GENERAL EXPENSES 794,607. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,555,960. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,976,437. MANAGEMENT AND GENERAL EXPENSES 818,614. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,795,051. FORM 990, PART XI, LINE 9: EQUITY INCOME OF SUBSIDIARIES 4,359. CHANGE IN FMV OF INTEREST RATES 4,662. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART I, LINE 1: THOSE DIRECTING MARY RUTAN HOSPITAL, A NOT-FOR-PROFIT, NON-GOVERNMENTAL HOSPITAL, ACCEPT RESPONSIBILITY FOR MEETING HEALTH CARE NEEDS OF THE COMMUNITY AND INSURING: A. THE DELIVERY OF SAFE, EFFICIENT AND ECONOMICAL HEALTH CARE WITHIN THE BOUNDS OF SOUND FINANCIAL AND DEBT SERVICE MANAGEMENT; B. A STRONG COMPETITIVE POSTURE WITHIN ITS SELECTED AREAS OF HEALTH SERVICES THROUGH EFFECTIVE BUDGETING, FORECASTING, AND MANAGEMENT; C. FIRM ESTABLISHMENT OF MARY RUTAN HOSPITAL AS A LEADER IN HEALTH CARE, SERVING RESIDENTS OF LOGAN COUNTY, OHIO, AND SURROUNDING AREAS WITH HIGH QUALITY ACUTE CARE, EMERGENCY CARE, AMBULATORY CARE AND CONSUMER HEALTH EDUCATION CONSISTENT WITH COMMUNITY NEEDS AND STAFF UTILIZATION; D. THAT THE HOSPITAL'S POSITION IN THE COMMUNITY WILL BE ENHANCED THROUGH STRONG INTERNAL MANAGEMENT, WELL-TRAINED HEALTH PROFESSIONALS WHO MAINTAIN CURRENT STANDARDS OF PRACTICE AND AGGRESSIVE AND CREATIVE EVALUATION OF SERVICES, TRENDS AND COMMUNITY NEEDS. E. THAT PATIENT EDUCATION IS PLANNED AND PROVIDED TO PROMOTE AND MAINTAIN HEALTH. MARY RUTAN HEALTH ASSOCIATION 205 PALMER AVE BELLEFONTAINE OH 43311 346544675 HEALTHCARE OH 501(C)(3) 9 N/A 0 MARY RUTAN FOUNDATION 205 PALMER AVE BELLEFONTAINE OH 43311 341407262 CHARITABLE FOUNDATION OH 501(C)(3) 11B MARY RUTAN HEALTH ASSOCIATION 1 LOGAN COUNTY CANCER SOCIETY INC 205 PALMER AVE BELLEFONTAINE OH 43311 237105514 SUPPORT FOR CANCER PATIENTS OH 501(C)(3) 7 MARY RUTAN FOUNDATION 1 LOGAN VIEW LLC 205 PALMER AVE BELLEFONTAINE OH 43311 311101004 HOME MEDICAL EQUIPMENT OH N/A C 1 1 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 1 0 1 LOGAN VIEW LLC L 774157 AMOUNT PAID TO LV MARY RUTAN HEALTH ASSOCIATION N 1196759 MANAGEMENT AGREEMENT MARY RUTAN HEALTH ASSOCIATION Q 352341 SALARY REIMBURSEMENT MARY RUTAN FOUNDATION Q 102227 SALARY REIMBURSEMENT LOGAN VIEW LLC A 24794 MONTHLY RENT