OHIOHEALTH CORPORATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- OHIOHEALTH CORPORATION (EIN 31-4391798)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-09
- IRS object ID
- 201633149349302833
- Schema version
- 2015v2.1
- 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 | 2016-11-09T15:06:42-08:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TUCKER & TUCKER CPAS LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 409 WHEELING AVE | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | 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 CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 7404393561 | 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. FINANCE & CFO | PersonTitleTxt |
| Phone | 7404393561 | PhoneNum |
| Signature | 2016-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY T TUCKER | PreparerPersonNm |
| Phone | 7404395513 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RAYMOND M CHOREY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1341 CLARK ST | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $106,845,785 | GrossReceiptsAmt |
| Group Return For Affiliates | false | 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 | 12 | VotingMembersIndependentCnt |
| Total Employee | 1020 | TotalEmployeeCnt |
| Total Volunteers | 101 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $113,511 | PYContributionsGrantsAmt |
| CY Contributions Grants | $148,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $100,040,908 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $104,167,827 | CYProgramServiceRevenueAmt |
| PY Investment Income | $414,711 | PYInvestmentIncomeAmt |
| CY Investment Income | $698,040 | CYInvestmentIncomeAmt |
| PY Other Revenue | $479,833 | PYOtherRevenueAmt |
| CY Other Revenue | $495,137 | CYOtherRevenueAmt |
| PY Total Revenue | $101,048,963 | PYTotalRevenueAmt |
| CY Total Revenue | $105,509,004 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,532,683 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,273,954 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,491,079 | PYOtherExpensesAmt |
| CY Other Expenses | $51,453,466 | CYOtherExpensesAmt |
| PY Total Expenses | $95,023,762 | PYTotalExpensesAmt |
| CY Total Expenses | $100,727,420 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,025,201 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,781,584 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $62,349,433 | TotalAssetsBOYAmt |
| Total Assets EOY | $68,242,547 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $48,065,492 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,362,935 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,283,941 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,879,612 | NetAssetsOrFundBalancesEOYAmt |
| Mission | GENERAL COMMUNITY HOSPITAL WITH A MISSION TO PROVIDE HIGH QUALITY, COMPREHENSIVE, | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $85,581,527 | ExpenseAmt |
| Revenue | $97,980,912 | RevenueAmt |
| Desc | GENERAL HOSPITAL - MEDICAL SERVICES FOR INPATIENTS AND OUTPATIENTS - SEE ATTACHED SCHEDULE H FOR ADDITIONAL INFORMATION | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,545,158 | ExpenseAmt |
| Revenue | $6,186,915 | RevenueAmt |
| Desc | OPERATION OF PHYSICIAN OFFICES | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $96,126,685 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | Yes (true) | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 154 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1020 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY R EVANCHO | PersonNm |
| Phone | 7404393561 | 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 (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DANIEL G PADDEN | |||||||
| CHAIR | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| SHON GRESS | |||||||
| VICE CHAIR | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG ADAMS | |||||||
| SECRETARY | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAWN RAY | |||||||
| TREASURER | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN SHANAHAN | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| 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 | ||
| PHILIP HEARING | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIBETH WRIGHT | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL D SARAP MD | |||||||
| TRUSTEE | 2.00 | Yes (X) | $4,625 | $0 | $0 | ||
| MARCIA WINNETT | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| EYAD MAHAYRI MD FCCP | |||||||
| TRUSTEE & PHYSICIAN | 40.00 | Yes (X) | $504,995 | $0 | $18,328 | ||
| BETTY PARRY | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RAYMOND M CHOREY | |||||||
| PRESIDENT & CEO | 0 | Yes (X) | $294,611 | $20,153 | Yes (X) | ||
| TIMOTHY R EVANCHO | |||||||
| V.P. FINANCE & CFO/ASST TREAS | 0 | $130,572 | $20,297 | Yes (X) | |||
| ANGELA SUE LONG | |||||||
| V.P. NURSING SERVICES | 0 | $152,013 | $14,714 | Yes (X) | |||
| STEVEN M BROOKS | |||||||
| V.P. HUMAN RESOURCES | 0 | $119,244 | $18,411 | Yes (X) | |||
| SHARRON LYNN BUXTON | |||||||
| ASSISTANT SECRETARY | 40 | $47,110 | $16,455 | Yes (X) | |||
| EARL EDWIN CONAWAY | |||||||
| VP MEDICAL AFFAIRS | 0 | $125,562 | $18,767 | Yes (X) | |||
| COREY A JACKSON DO | |||||||
| PHYSICIAN | 40 | $980,474 | $12,209 | Yes (X) | |||
| NABIEL ALKHOURI MD | |||||||
| PHYSICIAN | 40 | $651,744 | $18,328 | Yes (X) | |||
| CARL F JUENG MD | |||||||
| PHYSICIAN | 40 | $538,242 | Yes (X) | ||||
| CLIFFORD B MAXIMO MD | |||||||
| PHYSICIAN | 40 | $467,332 | $18,328 | Yes (X) | |||
| JOEL LINK MD | |||||||
| PHYSICIAN | 40 | $384,389 | $18,328 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,578,911 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $822,002 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $194,318 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | 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 | 48267 | EMERGENCY ROOM PHYSICIANS | $1,375,792 |
| SHIFTWISE | |||||
| 1800 SW 1ST AVE STE 510 | PORTLAND | OR | 21279 | MEDICAL STAFFING | $856,276 |
| MEDSTAFF SERVICES LLC | |||||
| PO BOX 1895 | POWELL | OH | 43065 | HOSPITAL PHYSICIANS | $840,000 |
| NORTHSTAR ANESTHESIA OF OHIO | |||||
| 200 E LAMAR BLVD STE 400 | ARLINGTON | TX | 76006 | ANESTHESIA SERVICES | $643,339 |
| THE ADVISORY BOARD | |||||
| PO BOX 79461 | BALTIMORE | MD | 21279 | CONSULTING | $527,398 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 31 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $148,000 | AllOtherContributionsAmt |
| Total Contributions | $148,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt |
|---|---|---|
| DIAGNOSTIC IMAGING | 622110 | $19,651,987 |
| SURGERY | 622110 | $19,396,050 |
| LABORATORY SERVICES | 622110 | $10,660,493 |
| EMERGENCY SERVICES | 622110 | $7,478,384 |
| PHARMACY | 622110 | $6,853,096 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,127,817 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $104,167,827 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $681,973 | TotalRevenueColumnAmt |
| Exclusion | $681,973 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,352,848 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,336,781 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,067 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,067 | TotalRevenueColumnAmt |
| Exclusion | $16,067 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SALES | Desc |
| Business | 722300 | BusinessCd |
| Total Revenue Column | $495,137 | TotalRevenueColumnAmt |
| Exclusion | $495,137 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $495,137 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $105,509,004 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $104,167,827 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,193,177 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,730 | TotalAmt |
| Program Services | $509,620 | ProgramServicesAmt |
| Management And General | $47,110 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,108 | TotalAmt |
| Program Services | $239,108 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,509,145 | TotalAmt |
| Program Services | $37,304,970 | ProgramServicesAmt |
| Management And General | $204,175 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,478,912 | TotalAmt |
| Program Services | $1,467,405 | ProgramServicesAmt |
| Management And General | $11,507 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,808,625 | TotalAmt |
| Program Services | $6,762,820 | ProgramServicesAmt |
| Management And General | $45,805 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,681,434 | TotalAmt |
| Program Services | $2,662,524 | ProgramServicesAmt |
| Management And General | $18,910 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,507,625 | TotalAmt |
| Program Services | $7,625 | ProgramServicesAmt |
| Management And General | $1,500,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,419 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $136,419 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,000 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $57,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,454 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $102,454 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,794,589 | TotalAmt |
| Program Services | $10,959,376 | ProgramServicesAmt |
| Management And General | $1,835,213 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,015 | TotalAmt |
| Program Services | $356,015 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,406,322 | TotalAmt |
| Program Services | $1,341,853 | ProgramServicesAmt |
| Management And General | $64,469 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,981,642 | TotalAmt |
| Program Services | $1,981,642 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,224,442 | TotalAmt |
| Program Services | $2,209,514 | ProgramServicesAmt |
| Management And General | $14,928 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,659 | TotalAmt |
| Program Services | $72,832 | ProgramServicesAmt |
| Management And General | $14,827 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,155 | TotalAmt |
| Program Services | $58,871 | ProgramServicesAmt |
| Management And General | $19,284 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,994 | TotalAmt |
| Program Services | $550,994 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,533,726 | TotalAmt |
| Program Services | $4,302,837 | ProgramServicesAmt |
| Management And General | $230,889 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $911,635 | TotalAmt |
| Program Services | $911,635 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $16,206,052 | $16,206,052 | $0 | $0 |
| PROVISION FOR BAD DEBTS | $4,237,851 | $4,237,851 | $0 | $0 |
| REPAIRS & MAINTENANCE | $2,009,741 | $1,995,120 | $14,621 | $0 |
| FRANCHISE FEE | $1,120,000 | $1,120,000 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,151,145 | TotalAmt |
| Program Services | $868,021 | ProgramServicesAmt |
| Management And General | $283,124 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,727,420 | TotalAmt |
| Program Services | $96,126,685 | ProgramServicesAmt |
| Management And General | $4,600,735 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,268,511 | BOYAmt |
| EOY | $11,561,878 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,333,073 | BOYAmt |
| EOY | $11,729,156 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,145 | BOYAmt |
| EOY | $123,075 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,400 | BOYAmt |
| EOY | $117,056 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,276,342 | BOYAmt |
| EOY | $2,366,607 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,053,211 | BOYAmt |
| EOY | $2,979,371 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $91,697,596 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $71,439,036 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,978,815 | BOYAmt |
| EOY | $20,258,560 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,119,524 | BOYAmt |
| EOY | $14,889,289 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,070 | BOYAmt |
| EOY | $660,780 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,342 | BOYAmt |
| EOY | $3,556,775 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,349,433 | BOYAmt |
| EOY | $68,242,547 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,949,217 | BOYAmt |
| EOY | $32,054,792 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,285,000 | BOYAmt |
| EOY | $13,571,536 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,831,275 | BOYAmt |
| EOY | $2,736,607 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,065,492 | BOYAmt |
| EOY | $48,362,935 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,283,941 | BOYAmt |
| EOY | $19,879,612 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,283,941 | BOYAmt |
| EOY | $19,879,612 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,349,433 | BOYAmt |
| EOY | $68,242,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,781,584 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$392,865 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,206,952 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY170 | 0 | PublicSupportCY170Pct |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $935,800 | OtherCostOrOtherBasisAmt |
| Book Value | $935,800 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,177,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,548,788 | DepreciationAmt |
| Book Value | $7,628,252 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,371,974 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,890,248 | DepreciationAmt |
| Book Value | $11,481,726 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $212,782 | OtherCostOrOtherBasisAmt |
| Book Value | $212,782 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,258,560 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| TRUSTEE HELD BOND FUND ESCROW | $3,480,338 |
| RESTRICTED CASH BOND FUND | $76,437 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,556,775 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $105,158,975 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $16,891 | OtherRevenueAmt |
| Revenue Not Reported | $16,891 | RevenueNotReportedAmt |
| Revenue Subtotal | $105,142,084 | RevenueSubtotalAmt |
| Other Revenues Not Included | $366,920 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $366,920 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $105,509,004 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $100,377,391 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $16,891 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $16,891 | ExpensesNotReportedAmt |
| Expenses Subtotal | $100,360,500 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $366,920 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $366,920 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $100,727,420 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt V, Line 4 | ENDOWMENT HELD BY PARENT COMPANY GUERNSEY HEALTH SYSTEMS. USED FOR SUPPORT OF CHARITABLE HEALTH CARE SERVICES. |
| Pt 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, 2015 AND 2014, 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. |
| Pt XI, Line 2d | REVENUE NETTED AGAINST EXPENSE ON TAX RETURN. SALE OF SCRAP AND WASTE 16,891 |
| Pt XI, Line 4b | EXPENSE ITEMS NETTED AGAINST REVENUE IN AUDIT REPORT. PHYSICIAN LOAN LOSSES 366,920 |
| Pt XII, Line 2d | REVENUE NETTED AGAINST EXPENSE ON TAX RETURN. SALE OF SCRAP AND WASTE 16,891 |
| Pt XII, Line 4b | EXPENSE ITEMS NETTED AGAINST REVENUE IN AUDIT REPORT. PHYSICIAN LOAN LOSSES 366,920 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4117 | PersonsServedCnt |
| Total Community Benefit Expns | $919,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $919,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 37845 | PersonsServedCnt |
| Total Community Benefit Expns | $22,145,704 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,210,421 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,935,283 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05110 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 41962 | PersonsServedCnt |
| Total Community Benefit Expns | $23,065,104 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,210,421 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,854,683 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06060 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 31 | ActivitiesOrProgramsCnt |
| Persons Served | 9957 | PersonsServedCnt |
| Total Community Benefit Expns | $188,416 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,542 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $172,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 251 | PersonsServedCnt |
| Total Community Benefit Expns | $181,106 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $181,106 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 623 | PersonsServedCnt |
| Total Community Benefit Expns | $160,406 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $160,406 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 42 | ActivitiesOrProgramsCnt |
| Persons Served | 10831 | PersonsServedCnt |
| Total Community Benefit Expns | $529,928 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,542 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $514,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 42 | ActivitiesOrProgramsCnt |
| Persons Served | 52793 | PersonsServedCnt |
| Total Community Benefit Expns | $23,595,032 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,225,963 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,369,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06600 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 220 | PersonsServedCnt |
| Total Community Benefit Expns | $25,229 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,229 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $1,040 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 264 | PersonsServedCnt |
| Total Community Benefit Expns | $1,181 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,181 | 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 Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 207 | PersonsServedCnt |
| Total Community Benefit Expns | $2,808 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,808 | 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 Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 711 | PersonsServedCnt |
| Total Community Benefit Expns | $30,564 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,564 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,735,927 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,070,932 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $37,651,641 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $40,150,340 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,498,699 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 CTR | 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 CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | 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 (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEORMC.ORG/ABOUT-SEORMC/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 1.00000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 2.50000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER Pt V Line 5 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER Pt V Line 11 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER Pt V Line 22d | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER | ||||
| 10095 BRICK CHURCH ROAD | CAMBRIDGE | OH | 43725 | OUTPATIENT FACILITY |
| EYAD MAHAYRI MD | ||||
| 1335 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| CLIFFORD MAXIMO MD | ||||
| 1200 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| MELISSA NAU MD | ||||
| 205 SENECA AVENUE | BYESVILLE | OH | 43723 | PHYSICIAN OFFICE |
| SANDRA MASSULLO-SCHUBERT MD | ||||
| 1230A CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| SOUTHEASTERN OHIO ENT | ||||
| 1210 NEAL DRIVE | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| SIVARAM KOLLENGODE MD | ||||
| 1432 CLARK STREET SUITE B | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| TONY STARR DO | ||||
| 18125 WOODSFIELD ROAD | CALDWELL | OH | 43724 | PHYSICIAN OFFICE |
| SOUTHEASTERN OHIO PEDIATRICS | ||||
| 1420 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| SOUTHEASTERN OHIO ORTHOPEDICS | ||||
| 316 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
| GEORGE NAUM III DO | ||||
| 1327 CLARK STREET | CAMBRIDGE | OH | 43725 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI Line 7 | OH |
| Pt I Line 7 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt I Line 7g | NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC HAVE BEEN INCLUDED AS UNSUBSIDIZED HEALTH SERVICES |
| Pt I Line 7 col(f) | BAD DEBTS EXCLUDED FROM COSTS 4,237,851 |
| Pt 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. |
| Pt III Line 2 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt III Line 3 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt III Line 4 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt III Line 8 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt III Line 9b | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt VI Line 2 | SEE PART V SECTION C FOR RESPONSE |
| Pt VI Line 3 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt VI Line 4 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt VI Line 5 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
| Pt VI Line 6 | SEE ATTACHED SUPPLEMENTAL INFORMATION |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EYAD MAHAYRI MD FCCP | |||||||||||
| $435,011 | $24,375 | $45,609 | $2,650 | $15,678 | $523,323 | ||||||
| RAYMOND M CHOREY | |||||||||||
| $241,498 | $52,029 | $1,084 | $2,650 | $17,503 | $314,764 | ||||||
| TIMOTHY R EVANCHO | |||||||||||
| $121,628 | $8,944 | $1,332 | $18,965 | $150,869 | |||||||
| ANGELA SUE LONG | |||||||||||
| $139,400 | $11,513 | $1,100 | $1,548 | $13,166 | $166,727 | ||||||
| COREY A JACKSON DO | |||||||||||
| $639,018 | $198,040 | $143,416 | $2,650 | $9,559 | $992,683 | ||||||
| NABIEL ALKHOURI MD | |||||||||||
| $625,019 | $26,725 | $2,650 | $15,678 | $670,072 | |||||||
| CARL F JUENG MD | |||||||||||
| $536,515 | $1,727 | $538,242 | |||||||||
| CLIFFORD B MAXIMO MD | |||||||||||
| $467,002 | $330 | $2,650 | $15,678 | $485,660 | |||||||
| JOEL LINK MD | |||||||||||
| $360,006 | $24,030 | $353 | $2,650 | $15,678 | $402,717 | ||||||
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 | 000000000 | CUSIPNum |
| Bond Issued | 2015-05-15 | BondIssuedDt |
| Issue Price | $15,000,000 | IssuePriceAmt |
| Purpose | SEE PART VI SUPPLEMENTAL INFO | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,315,000 | RetiredAmt |
| Total Proceeds | $15,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $118,400 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,116,262 | CapitalExpendituresAmt |
| Other Spent Proceeds | $10,285,000 | OtherSpentProceedsAmt |
| Unspent | $3,480,338 | UnspentAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | 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 | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
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
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH OHANLON DO | PersonNm |
| Relationship With Org | FAMILY MBR OF TRUSTE | RelationshipWithOrgTxt |
| Loan Purpose | PHYSICIAN RECRUITMEN | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $139,837 | OriginalPrincipalAmt |
| Balance Due | $123,075 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | Yes (true) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $123,075 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (8 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SOUTHEASTERN OHIO PHYSICIANS INC | |||
| PARTIAL OWNERSHIP BY TRUSTEE | $168,238 | MEDICAL SERVICES | false |
| SOUTHEASTERN OHIO PHYSICIANS INC | |||
| PARTIAL OWNERSHIP BY TRUSTEE | $148,885 | PHYSICIAN RECRUITMENT LOAN | false |
| STEPHANIE R BUXTON | |||
| FAMILY MEMBER OF OFFICER | $64,598 | EMPLOYMENT | false |
| JORDI B HARDING | |||
| FAMILY MEMBER OF OFFICER | $43,478 | EMPLOYMENT | false |
| AMBER E PAULEY | |||
| FAMILY MEMBER OF OFFICER | $47,678 | EMPLOYMENT | false |
| JOSEPH OHANLON DO | |||
| FAMILY MEMBER OF TRUSTEE | $18,750 | PHYSICIAN SERVICES | false |
| KENDRA D BROOKS | |||
| SPOUSE OF OFFICER | $51,490 | EMPLOYMENT | false |
| KAITLIN MICHELLE CHOREY | |||
| FAMILY MEMBER OF OFFICER | $13,114 | EMPLOYMENT | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, 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. |
| Pt VI, Line 11b | FORM 990 REVIEWED BY AUDIT COMMITTEE OF BOARD BEFORE FILING. PROVIDED A COMPLETE COPY OF FORM 990 TO ALL BOARD MEMBERS BEFORE FILING |
| Pt VI, Line 12c | DIRECTORS COMPLETE ANNUAL DISCLOSURE STATEMENT DISCLOSING ALL CONFLICTS |
| Pt VI, Line 15a | EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS PERFORMS COMPENSATION STUDY OF MANAGEMENT POSITIONS |
| Pt VI, Line 15b | EXECUTIVE COMMITTEE OF BOARD OF DIRECTORS PERFORMS COMPENSATION STUDY OF MANAGEMENT POSITIONS |
| Pt VI, Line 19 | ALL SUCH ITEMS AVAILABLE UPON REQUEST |
| Other | PART IX LINE 11G - SEE ATTACHED SUPPLEMENTAL SCHEDULE |
| Pt XI | CHANGE IN PENSION LIABILITY 1,206,952 |
| Form 990, Part IX, Line 24e | LICENSES & FEES 56971. 54278. 2693. 0. |
| Form 990, Part IX, Line 24e | FOOD PURCHASES 566302. 534691. 31611. 0. |
| Form 990, Part IX, Line 24e | SUNDRY 367133. 131995. 235138. 0. |
| Form 990, Part IX, Line 24e | BOOKS & SUBSCRIPTIONS 95152. 91481. 3671. 0. |
| Form 990, Part IX, Line 24e | DUES & MEMBERSHIPS 65587. 55576. 10011. 0. |
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 | $8,050,314 | TotalIncomeAmt |
| End Of Year Assets | $2,542,648 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC | 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 & FUND RAISING | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(C)3 | ExemptCodeSectionTxt |
| Public Charity Status | 11 TYPE II | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | 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 | 1700 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 Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $685,211 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $448,042 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0.33000 | 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 | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GUERNSEY HEALTH ENTERPRISES INC | ||||||||||
| 1341 CLARK STREET | CAMBRIDGE | OH | 43725 | 311191428 | AMBULANCE SERVICE | OH | GUERNSEY HEALTH SYSTEMS | C | 0.00000 | false |
| UNITED AMBULANCE SERVICE OF CAMBRIDGE INC | ||||||||||
| 1341 CLARK STREET | CAMBRIDGE | OH | 43725 | 311086097 | AMBULANCE SERVICE | OH | GUERNSEY HEALTH SYSTEMS | C | 0.00000 | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GUERNSEY HEALTH SYSTEMS | ||
| d | $207,233 | CASH OWED |
| GUERNSEY HEALTH SYSTEMS | ||
| e | $13,685,000 | LOANS GUARANTEED |
| GUERNSEY HEALTH SYSTEMS | ||
| e | $116,460 | CASH LOAN |
| GUERNSEY HEALTH SYSTEMS | ||
| k | $212,412 | CASH PAID |
| GUERNSEY HEALTH ENTERPRISES INC | ||
| l | $42,000 | CASH PAID |
| GUERNSEY HEALTH SYSTEMS | ||
| m | $1,500,000 | |
| GUERNSEY HEALTH SYSTEMS | ||
| n | $100,000 | |
| GUERNSEY HEALTH SYSTEMS | ||
| o | $830,861 | |