BEAVERCREEK MEDICAL CENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
BEAVERCREEK MEDICAL CENTER (EIN 27-0712680)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201503209349308850
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-16T13:37:13-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN310800053PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Clark Schaefer Hackett & CoBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110100 Innovation Drive Suite 400AddressLine1Txt
CityDaytonCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45342ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN270712680EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Beavercreek Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBEAVBusinessNameControlTxt
Phone9377621629PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Prestige Place No 910AddressLine1Txt
CityMiamisburgCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45342ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonClifton PattenPersonNm
Person TitleKHN CFOPersonTitleTxt
Phone9373958992PhoneNum
Signature2015-11-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHerbert L Lemaster CPAPreparerPersonNm
PTINP00039882PTIN
Phone9372260070PhoneNum
Preparation2015-11-13PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1The Indu and Raj Soin Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTerry BurnsPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Prestige PlaceAddressLine1Txt
CityMiamisburgCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45342ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$100,944,395GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.khnetwork.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionProvide quality healthcare to individuals and the community as a whole in a Judeo-Christian mannerActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers317TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$17,107PYContributionsGrantsAmt
CY Contributions Grants$52,521CYContributionsGrantsAmt
PY Program Service Revenue$74,741,484PYProgramServiceRevenueAmt
CY Program Service Revenue$100,635,191CYProgramServiceRevenueAmt
PY Investment Income$334,471PYInvestmentIncomeAmt
CY Investment Income$240,286CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$75,093,062PYTotalRevenueAmt
CY Total Revenue$100,927,998CYTotalRevenueAmt
PY Grants And Similar Paid$9,957PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$8,121CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$35,316,856PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,407,875CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$48,584,835PYOtherExpensesAmt
CY Other Expenses$57,476,525CYOtherExpensesAmt
PY Total Expenses$83,911,648PYTotalExpensesAmt
CY Total Expenses$98,892,521CYTotalExpensesAmt
PY Revenues Less Expenses-$8,818,586PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,035,477CYRevenuesLessExpensesAmt
Total Assets BOY$170,025,883TotalAssetsBOYAmt
Total Assets EOY$167,058,317TotalAssetsEOYAmt
Total Liabilities BOY$107,382,171TotalLiabilitiesBOYAmt
Total Liabilities EOY$108,237,220TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$62,643,712NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$58,821,097NetAssetsOrFundBalancesEOYAmt
MissionProvide quality healthcare to individuals and the community as a whole in a Judeo-Christian mannerMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$85,856,396ExpenseAmt
Grant$8,121GrantAmt
Revenue$100,020,341RevenueAmt
DescCare was provided for 4,913 discharges, adult & ped days of 17,226, and 57,761 outpatient visits.Desc
Total Program Service Expenses$85,856,396TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Clifton PattenBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9373958992PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Prestige Place Suite 910AddressLine1Txt
CityMiamisburgCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45342ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Fred Manchur
KHN CEO1.0050.00Yes (X)$0$3,814,940$1,098,251
Terri Day
KHN President1.0050.00Yes (X)$0$1,301,793$1,012,256
Terry Burns
Senior VP GMH/SOIN24.0027.00Yes (X)$0$549,246$49,840Yes (X)
Michael McCullough MD
Physician1.0039.00Yes (X)$0$392,337$27,582
Troy Tyner DO
Physician1.009.00Yes (X)$0$61,538$0
Ron Halvorsen Jr
Pres. Ohio Conference of SDA1.00Yes (X)$0$0$0
David Weigley
Pres. Columbia Union Confe1.00Yes (X)$0$0$0
Donald Harting
Community Volunteer1.00Yes (X)$0$0$0
Thomas Peebles
Community Volunteer1.00Yes (X)$0$0$0
Phillip Parker
Pres. Dayton Chamber of Co1.00Yes (X)$0$0$0
Amol Soin MD
Physician1.00Yes (X)$0$0$0
Stephen Zimmer
Community Volunteer1.00Yes (X)$0$0$0
Ronald Connovich
GMH/SOIN VP of Finance & O24.0025.00$0$325,242$33,404Yes (X)
Belinda Mallett
GMH/SOIN VP of Patient Car24.0024.00$0$312,966$30,789Yes (X)
Mark Smith
Former Officer0.0048.00$0$516,475$40,262Yes (X)
Steve Chavez
Former Officer0.0048.00$0$330,205$33,357Yes (X)
Tim Ko
Former Officer0.0048.00$0$328,178$32,822Yes (X)
Greg Henderson
Former Director & Officer0.00$0$214,940$13,573Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,147,860TotReportableCompRltdOrgAmt
Total Other Compensation$2,372,136TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$38,681RelatedOrganizationsAmt
Government Grants$13,840GovernmentGrantsAmt
Total Contributions$52,521TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient care servicesDesc
Business622000BusinessCd
Total Revenue Column$100,635,191TotalRevenueColumnAmt
Related Or Exempt Func Income$100,020,341RelatedOrExemptFuncIncomeAmt
Exclusion$614,850ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$100,635,191TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8TotalRevenueColumnAmt
Exclusion$8ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$226,793TotalRevenueColumnAmt
Exclusion$226,793ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,811SecuritiesAmt
Other$20,071OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$16,397OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$9,811SecuritiesAmt
Other$3,674OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,485TotalRevenueColumnAmt
Exclusion$13,485ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,927,998TotalRevenueColumnAmt
Related Or Exempt Func Income$100,020,341RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$855,136ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$8,121TotalAmt
Program Services$8,121ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,271,005TotalAmt
Program Services$1,101,393ProgramServicesAmt
Management And General$169,612ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,486,748TotalAmt
Program Services$27,736,405ProgramServicesAmt
Management And General$4,750,343ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,353,896TotalAmt
Program Services$1,155,924ProgramServicesAmt
Management And General$197,972ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,284,220TotalAmt
Program Services$3,657,764ProgramServicesAmt
Management And General$626,456ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,012,006TotalAmt
Program Services$1,717,802ProgramServicesAmt
Management And General$294,204ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$424,347TotalAmt
Program Services$367,719ProgramServicesAmt
Management And General$56,628ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$39,818TotalAmt
Program Services$10,613ProgramServicesAmt
Management And General$29,205ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,534,620TotalAmt
Program Services$5,161,429ProgramServicesAmt
Management And General$2,373,191ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$308,861TotalAmt
Management And General$308,861ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,517,407TotalAmt
Program Services$1,435,959ProgramServicesAmt
Management And General$81,448ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,310,694TotalAmt
Program Services$131,200ProgramServicesAmt
Management And General$1,179,494ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$228,391TotalAmt
Program Services$206,060ProgramServicesAmt
Management And General$22,331ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$68,088TotalAmt
Program Services$43,043ProgramServicesAmt
Management And General$25,045ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$24,615TotalAmt
Program Services$23,987ProgramServicesAmt
Management And General$628ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$9,235,938TotalAmt
Program Services$8,332,894ProgramServicesAmt
Management And General$903,044ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,579,613TotalAmt
Program Services$12,251,866ProgramServicesAmt
Management And General$1,327,747ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$236,045TotalAmt
Program Services$175,819ProgramServicesAmt
Management And General$60,226ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$16,506,168$16,504,312$1,856
Physician services$4,342,592$4,342,592
Cost of goods sold$723,942$723,942
Hospital assessment$255,921$255,921

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,139,465TotalAmt
Program Services$511,631ProgramServicesAmt
Management And General$627,834ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$98,892,521TotalAmt
Program Services$85,856,396ProgramServicesAmt
Management And General$13,036,125ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$13,840EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,113,463BOYAmt
EOY$12,897,418EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,618,629BOYAmt
EOY$1,725,553EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$210,463BOYAmt
EOY$146,103EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$171,699,524LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$31,595,545LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$146,828,298BOYAmt
EOY$140,103,979EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,937,635BOYAmt
EOY$10,924,950EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,317,395BOYAmt
EOY$1,246,474EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$170,025,883BOYAmt
EOY$167,058,317EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,118,493BOYAmt
EOY$8,732,390EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$98,309,517BOYAmt
EOY$98,400,524EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$954,161BOYAmt
EOY$1,104,306EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$107,382,171BOYAmt
EOY$108,237,220EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$62,068,712BOYAmt
EOY$58,246,097EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$575,000BOYAmt
EOY$575,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$62,643,712BOYAmt
EOY$58,821,097EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$170,025,883BOYAmt
EOY$167,058,317EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,035,477ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$88,986NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,947,078OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,057,342OtherCostOrOtherBasisAmt
Depreciation$16,307,209DepreciationAmt
Book Value$115,750,133BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,729,643OtherCostOrOtherBasisAmt
Depreciation$15,288,336DepreciationAmt
Book Value$21,441,307BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,912,539OtherCostOrOtherBasisAmt
Book Value$2,912,539BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$140,103,979TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescProfessional self-insurance liabilityDesc
Amt$1,104,306Amt
FieldValueIRS element (for citing)
Total Liability$1,104,306TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe Network completed an analysis of its tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2014 or 2013.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,770,221TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,127,597DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,642,624NetCommunityBenefitExpnsAmt
Total Expense0.02670TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,359,934TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,847,687DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,512,247NetCommunityBenefitExpnsAmt
Total Expense0.10630TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,130,155TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,975,284DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,154,871NetCommunityBenefitExpnsAmt
Total Expense0.13300TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,866TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$65,866NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$931,063TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$178,037DirectOffsettingRevenueAmt
Net Community Benefit Expns$753,026NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$121,380TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$121,380NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,118,309TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$178,037DirectOffsettingRevenueAmt
Net Community Benefit Expns$940,272NetCommunityBenefitExpnsAmt
Total Expense0.00950TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,248,464TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,153,321DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,095,143NetCommunityBenefitExpnsAmt
Total Expense0.14250TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,581,122BadDebtExpenseAmt
Bad Debt Expense Attributable$37,947BadDebtExpenseAttributableAmt
Reimbursed By Medicare$20,624,495ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$24,318,137CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,693,642MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Beavercreek Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13535 Pentagon BoulevardAddressLine1Txt
CityBeavercreekCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45431ZIPCd
FieldValueIRS element (for citing)
Website Addressketteringhealth.org/soin/WebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Beavercreek Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.ketteringhealth.org/aboutusOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt14ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.ketteringhealth.org/aboutusStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section A:The facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law.
Beavercreek Medical CenterPart V, Section B, Line 5: Partners in the data review process and in the process for identifying and prioritizing community health needs and services are the Board of Trustees and executive leadership of Soin Medical Center, community health collaboratives featuring community, health, and business stakeholders/advocates organized by both Soin Medical Center, and the Greater Dayton Area Hospital Association with its member hospitals. These partners were consulted through the use of focus groups.To prepare the CHNA, primary and secondary data were collected in order to paint a detailed picture of the Soin Medical Center Service Area. Primary data is collected directly from first-hand experience and secondary data is data that has already been collected and archived by other organizations.For Soin's Community Health Needs Assessment, primary data were collected by surveying 975 Greene County adults using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). Secondary data were collected from sources such as the Ohio Hospital Association via the Greater Dayton Area Hospital Association, the Ohio Department of Health, the Health Resources and Services Administration(HRSA), the Bureau of the Census, and the Robert Wood Johnson Foundation, among others.
Beavercreek Medical CenterPart V, Section B, Line 6a: Soin Medical Center partnered with member hospitals of the Greater Dayton Area Hospital Association to prepare the Community Health Needs Assessment (CHNA) for the hospital's service area.
Beavercreek Medical CenterPart V, Section B, Line 11: Five health priorities were identified for adults in the service area: heart disease, breast cancer, diabetes, chronic lower respiratory disease, and unintentional injury. Two of these, heart disease and diabetes, will be addressed by the Soin Medical Center. Greene Memorial Hospital will address Breast Cancer in its Hospital Implementation Strategy. The remaining health priorities will be addressed by other organizations within the service area.
Beavercreek Medical CenterPart V, Section B, Line 22d: The hospital provided a discount on medically necessary hospital services to uninsured patients who do not qualify under the charity care policy.
Beavercreek Medical CenterPart V, Section B, Line 24: The hospital charged patients an amount equal to gross charges in select circumstances. This includes, for example, claims with insurance denials for non-cooperation.
Part V, Section B, Line 16Financial Assistance Policy Website Availability
Beavercreek Medical Center Part V, Section B, line 16b website:https://secure.ketteringhealth.org/registration

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The organization provides an annual community benefit report that is made available to the public.
Part I, Line 7:Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Subsidized health services is calculated based on the non-Medicare, Medicaid, and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures.
Part I, Line 7g:Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers.
Part III, Line 4:A cost to charge ratio was used to determine the amount reported in Part III, line 2. An industry average was used to compute the amount on line 3. Discounts and payments on patient accounts reduce bad debt expense. Text of footnote describing bad debt expense is as follows:"Based on historical experience, a significant portion of the Network's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Network records a significant provision for bad debts related to uninsured patients in the period the services are provided."
Part III, Line 8:The costing methodology used to determine Medicare costs is the the Medicare cost report. Medicare costs have not been included in Community Benefit in Part I.
Part III, Line 9b:Financial Counselors work out a payment program for any amount due after the charity sliding scale discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances.
Part VI, Line 3:SOIN informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under SOIN's charity care policy as follows:-SOIN has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This is done regardless of insured or uninsured status. This data is available for future visits as well.-SOIN has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.-SOIN contracts with an outside agency for patient assistance in the application process.-The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for SOIN's HCAP or Charity Sliding Scale program. SOIN's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs.
Part VI, Line 4:KHN serves a population of approximately 1,669,000 in its primary and secondary service area. The nine county service area includes Butler, Clark, Clinton, Darke, Greene, Miami, Montgomery, Preble and Warren counties. Out of this service area, approximately 12.6% of area households have income below $15,000. 11.2% have income between $15,000 and $24,999 and 20.1% have income between $25,000 and $49,000. Portions of Clark, Darke and Preble counties have been identified as medically underserved by the Health Resources and Services Administration. This nine county area is served by 15 hospitals, 8 of which are part of Kettering Health Network.
Part VI, Line 5:SOIN furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments.-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades and establishment of new programs.
Part VI, Line 6:SOIN promotes the health of the communities served as described below:-SOIN, a part of the Kettering Health Network, is dedicated to the creation and maintenance of community wellness programs, support groups and health education programs. SOIN provides numerous screenings, family-focused classes, donations and education programs to ensure the long-term well-being of people living in the community.-Kettering Affiliated Health Services, Inc. includes Sycamore Glen Health Center, Sycamore Glen Retirement Community, and Kettering Breast Evaluation Centers. These health care areas provide services to the surrounding communities which complement those services provided by SOIN as part of the Kettering Health Network.-Medical research is supported through the Innovation Center, cultivating new technologies and fostering best practices among partners from industry, academia and health care.
Part VI, Line 7, Reports Filed With StatesOH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeAssistance to employees for hardshipGrantTypeTxt
Recipient14RecipientCnt
Cash Grant$8,121CashGrantAmt
Valuation Method UsedFMVValuationMethodUsedDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationFunds are monitored and use is determined by board members.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Fred Manchur
KHN CEO$0$1,213,136$0$401,410$0$2,200,394$0$1,080,380$0$17,871$0$4,913,191$0$1,823,687
Terri Day
KHN President$0$948,762$0$278,194$0$74,837$0$976,975$0$35,281$0$2,314,049$0$0
Terry Burns
Senior VP GMH/SOIN$0$422,484$0$113,465$0$13,297$0$13,987$0$35,853$0$599,086$0$0
Michael McCullough MD
Physician$0$392,337$0$0$0$0$0$14,287$0$13,295$0$419,919$0$0
Ronald Connovich
GMH/SOIN VP of Finance & O$0$253,887$0$63,036$0$8,319$0$13,987$0$19,417$0$358,646$0$0
Belinda Mallett
GMH/SOIN VP of Patient Car$0$245,080$0$62,332$0$5,554$0$13,987$0$16,802$0$343,755$0$0
Mark Smith
Former Officer$0$406,947$0$107,130$0$2,398$0$13,987$0$26,275$0$556,737$0$0
Steve Chavez
Former Officer$0$265,474$0$63,036$0$1,695$0$13,987$0$19,370$0$363,562$0$0
Tim Ko
Former Officer$0$264,027$0$63,036$0$1,115$0$13,987$0$18,835$0$361,000$0$0
Greg Henderson
Former Director & Officer$0$214,940$0$0$0$0$0$0$0$13,573$0$228,513$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.
Part I, Line 4bThe Network has a Supplemental Executive Retirement Plan available only to a certain class of management.
Part II, Column BiiiColumn Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Oprations and Changes in Net Assets.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1County of Greene OhioBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN316000271BondIssuerEIN
CUSIP394650BV6CUSIPNum
Bond Issued2009-11-03BondIssuedDt
Issue Price$97,931,091IssuePriceAmt
PurposeConstruct and equip a hospitalPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$100,436,148TotalProceedsAmt
In Reserve Fund$10,924,933InReserveFundAmt
Capitalized Interest$2,633,592CapitalizedInterestAmt
Issuance Costs From Proceeds$1,612,304IssuanceCostsFromProceedsAmt
Capital Expenditures$85,213,731CapitalExpendituresAmt
Other Spent Proceeds$51,588OtherSpentProceedsAmt
Substantial Completion2012SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research AgreementsYes (1)AnyResearchAgreementsInd
Engage Bond Counsel ResearchYes (1)EngageBondCounselResearchInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board).
Form 990, Part VI, Section B, line 12cThe Network regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review the Network's policy, sign a conflict of interest statement, and notify the Network if a conflict should arise.
Form 990, Part VI, Section B, line 15The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy, and financial statements are available upon request.
Form 990, Part IX, Lines 7, 8, 9, & 10Salaries, retirement plan contributions, other benefits, and payroll taxes are paid by and allocated from Kettering Medical Center.
Form 990, Part XI, line 9:Net transfers to affiliate -5,947,078.
Form 990, Part XII, Line 2cNeither the oversight process nor the selection process changed during the tax year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Alliance Physicians Inc
1 Prestige Place Suite 910MiamisburgOH45342311175717Physician ServicesOH501(c)(3)509(a)(3)Kettering Adventist Healthcare0
Dayton Osteopathic Hospital
1 Prestige Place Suite 910MiamisburgOH45342310564121HospitalOH501(c)(3)509(a)(1)Kettering Adventist Healthcare0
The Fort Hamilton Hospital
1 Prestige Place Suite 910MiamisburgOH45342310536662HospitalOH501(c)(3)509(a)(1)Kettering Adventist Healthcare0
Fort Hamilton Hospital Foundation
1 Prestige Place Suite 910MiamisburgOH45342452036966FundraisingOH501(c)(3)509(a)(3)The Fort Hamilton Hospital0
Greene Foundation
1 Prestige Place Suite 910MiamisburgOH45342310886949FundraisingOH501(c)(3)509(a)(3)Greene Memorial Hospital0
Greene Memorial Hospital
1 Prestige Place Suite 910MiamisburgOH45342310809436HospitalOH501(c)(3)509(a)(1)Kettering Adventist Healthcare0
Greene Memorial Hospital Services Inc
1 Prestige Place Suite 910MiamisburgOH45342311358549Physician ServicesOH501(c)(3)509(a)(3)Kettering Adventist Healthcare0
Greene Oaks
1 Prestige Place Suite 910MiamisburgOH45342310999724Senior Healthcare FacilitiesOH501(c)(3)509(a)(2)Kettering Affiliated Health Services Inc0
Kettering Adventist Healthcare
1 Prestige Place Suite 910MiamisburgOH45342311051688ManagementOH501(c)(3)509(a)(3)0N/A
Kettering Affiliated Health Services Inc
1 Prestige Place Suite 910MiamisburgOH45342311127485Health ServicesOH501(c)(3)509(a)(3)Kettering Adventist Healthcare0
Kettering Medical Center
1 Prestige Place Suite 910MiamisburgOH45342310621866HospitalOH501(c)(3)509(a)(1)Kettering Adventist Healthcare0
Kettering Medical Center Foundation
1 Prestige Place Suite 910MiamisburgOH45342237419897FundraisingOH501(c)(3)509(a)(3)Kettering Medical Center0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1KettcorBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Prestige Place Suite 910AddressLine1Txt
CityMiamisburgCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45342ZIPCd
FieldValueIRS element (for citing)
EIN311078381EIN
Primary ActivitiesHealth ServicesPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Greene Foundation
C$38,681FMV
Alliance Physicians Inc
JFMV
Alliance Physicians Inc
MFMV
Greene Foundation
MFMV
Kettering Adventist Healthcare
MFMV
Kettering Medical Center
MFMV
Kettering Medical Center
NFMV
Greene Memorial Hospital
OFMV
Kettering Medical Center
OFMV
Kettering Medical Center
PFMV
Kettering Medical Center
R$5,947,078FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 2FormAndLineReferenceDesc
ExplanationKettering Medical Center is a conduit through which revenue is received and expenses are paid.ExplanationTxt

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