SOUTHERN OHIO MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SOUTHERN OHIO MEDICAL CENTER (EIN 31-0678022)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-12
IRS object ID
201431329349301563
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-12T10:06:30-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE STREET SUITE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310678022EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN OHIO MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone7403567622Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11248 KINNEYS LANEAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEAN WRAYName
TitleVP FINANCETitle
Phone7403567622Phone
Date Signed2014-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBERNIE OSTROWSKIName
PTINP00366367PTIN
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonMR RANDAL ARNETTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11805 27TH STREETAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode
FieldValueIRS element (for citing)
Gross Receipts315077402GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SOMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionSOUTHERN OHIO MEDICAL CENTER IS AN ACUTE HEALTH CARE SYSTEM LOCATED IN PORTSMOUTH, OHIO. SOMC'S EXEMPT PURPOSE IS TO SERVE SOUTH CENTRAL OHIO AND NORTHEASTERN KENTUCKY WITH STATE-OF-THE-ART FACILITIES AND HEALTH CARE TECHNOLOGIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees2509TotalNbrEmployees
Total Nbr Volunteers441TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income-35972NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year343101ContributionsGrantsPriorYear
Contributions Grants Current Year882193ContributionsGrantsCurrentYear
Program Service Revenue Prior Year290435825ProgramServiceRevenuePriorYear
Program Service Revenue CY298714796ProgramServiceRevenueCY
Investment Income Prior Year6153248InvestmentIncomePriorYear
Investment Income Current Year7257551InvestmentIncomeCurrentYear
Other Revenue Prior Year4192874OtherRevenuePriorYear
Other Revenue Current Year2370720OtherRevenueCurrentYear
Total Revenue Prior Year301125048TotalRevenuePriorYear
Total Revenue Current Year309225260TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year23768885GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY25028021GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year121980916SalariesEtcPriorYear
Salaries Etc Current Year126558102SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year19775TotalFundrsngExpCurrentYear
Other Expense Prior Year139513243OtherExpensePriorYear
Other Expenses Current Year145123678OtherExpensesCurrentYear
Total Expenses Prior Year285263044TotalExpensesPriorYear
Total Expenses Current Year296709801TotalExpensesCurrentYear
Revenues Less Expenses Prior Year15862004RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12515459RevenuesLessExpensesCY
Total Assets BOY430168195TotalAssetsBOY
Total Assets EOY446664331TotalAssetsEOY
Total Liabilities BOY202051367TotalLiabilitiesBOY
Total Liabilities EOY192863648TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY228116828NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY253800683NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE WILL MAKE A DIFFERENCE. AT SOMC, OUR MISSION IS TO MAKE A DIFFERENCE. WE STRIVE TO LIVE OUT THAT MISSION BY PROVIDING OUR REGION WITH THE HIGHEST QUALITY OF CARE, DELIVERED BY PROFESSIONALS WHO ARE AMONG THE BEST IN THEIR FIELDS. WE EXTEND THAT CARE AND PASSION TO MAKE A DIFFERENCE IN THE COMMUNITY BY BEING A VERY GOOD NEIGHBOR, EMPLOYER, AND COMMUNITY SUPPORTER.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense242521833Expense
Grants25028021Grants
Revenue298804877Revenue
DescriptionSOUTHERN OHIO MEDICAL CENTER TAKES PRIDE IN PARTNERING WITH THE LOCAL COMMUNITY TO PROVIDE THE BEST POSSIBLE HEALTH CARE TO THE RESIDENTS OF OUR AREA. WHETHER IT'S THROUGH ANNUAL COLLABORATIVE BLOOD DRIVES, PARTICIPATION DURING COUNTY FAIRS, OR ATTENDANCE AT MONTHLY SCHOOL BOARD MEETINGS, OUR EMPLOYEES GO ABOVE AND BEYOND TO CREATE LASTING RELATIONSHIPS IN AND OUTSIDE OUR HOSPITAL WALLS, HELPING US TRULY MAKE A DIFFERENCE IN THE LIVES OF THOSE AROUND US. IT'S THROUGH THESE RELATIONSHIPS THAT SOMC HAS BEEN RECOGNIZED FOR MANY OUTSTANDING ACCOMPLISHMENTS, RECEIVING SUCH NOTABLE HONORS OVER THE YEARS AS ANCC'S MAGNET RECOGNITION, OSHA'S VPP STAR STATUS, PRESS GANEY'S DISTINCTIVE WORKPLACE AWARD, AS WELL AS BEING NAMED ONE OF FORTUNE'S 100 BEST COMPANIES TO WORK FOR, A BEST EMPLOYER IN OHIO, AND ONE OF MODERN HEALTHCARE'S 100 BEST PLACES TO WORK.IT'S ALSO THROUGH THESE RELATIONSHIPS THAT MANY KEY DECISIONS ARE MADE AT SOMC. AS ONE OF OUR FIVE STRATEGIC VALUES, RELATIONSHIPS (PARTICULARLY THOSE BETWEEN CO-WORKERS, PHYSICIANS, VOLUNTEERS AND THE COMMUNITY) SHAPE MANY FACETS OF CUSTOMER SERVICE AND THE CARE THAT IS PROVIDED WITHIN THE HOSPITAL. IT IS OUR GOAL TO LISTEN AND PARTNER WITH CUSTOMERS TO MAKE A DIFFERENCE TO THOSE WE SERVE. PATIENTS AND FAMILY MEMBERS CAN PARTICIPATE IN THE HOSPITAL'S INPATIENT AND OUTPATIENT SATISFACTION SURVEY PROCESS, CONDUCTED BY A THIRD-PARTY VENDOR TO PROVIDE BENCHMARKED DATA THAT COMPARES SOMC AGAINST MANY HEALTHCARE FACILITIES ACROSS THE NATION. ADDITIONAL FEEDBACK IS ALSO OBTAINED THROUGH FOCUS GROUPS CONDUCTED BY THE SOMC COMMUNITY RELATIONS DEPARTMENT, AS WELL AS THE SOMC EXECUTIVE TEAM'S "OPEN DOOR POLICY," WHICH BOTH PROVIDE THE OPPORTUNITY TO GATHER SUGGESTIONS TO IMPROVE HOSPITAL SERVICES AND UNDERSTAND TECHNOLOGICAL NEEDS. IN ADDITION TO PERSONAL RELATIONSHIPS, SOMC ESTABLISHES WORKING RELATIONSHIPS WITH OTHER ORGANIZATIONS THROUGHOUT THE TRI-STATE TO FOCUS ON THE HEALTH AND WELLNESS OF THE COMMUNITY. SOMC AND ITS EMPLOYEES PARTICIPATE IN A VARIETY OF COMMUNITY-BASED ORGANIZATIONS INCLUDING THE OHIO RIVER VALLEY CHAPTER RED CROSS BOARD, THE CHAMBER OF COMMERCE, ROTARY CLUB, UNITED WAY, SOUTHERN OHIO PERFORMING ARTS ASSOCIATION, MAIN STREET PORTSMOUTH, THE PORTSMOUTH AREA ARTS COUNCIL, AS WELL AS AREA SCHOOL BOARDS, COMMITTEES AND CHURCHES. OTHER PARTICIPATORY PROGRAMS INCLUDE LEADERSHIP PORTSMOUTH, OHIO PARTNERSHIP FOR EXCELLENCE, TASK FORCE ON DOMESTIC VIOLENCE, PORTSMOUTH KIWANIS SERVICE CLUB, SCIOTO RESIDENTIAL SERVICES BOARD, PARAMEDIC ADVISORY BOARD, SALVATION ARMY, RIVER SWEEP, HABITAT FOR HUMANITY, SOUTHERN OHIO CORRECTIONAL FACILITY MINISTRIES, ARTHRITIS FOUNDATION, MEDICAL RESERVE CORP, PARISH NURSE NETWORK, SOUTHERN OHIO DIABETES COALITION, PORTSMOUTH BICENTENNIAL BOARD AND THE SOUTHERN OHIO CORRECTIONAL FACILITY COMMUNITY ADVISORY BOARD. MANY BENEFITS ARE CREATED THROUGH THESE PARTNERSHIPS INCLUDING SPONSORSHIPS FOR CULTURAL AFFAIRS, COMMUNITY HEALTH AND WELLNESS PROGRAMS, HEALTH SCREENINGS, EDUCATION, CHILDREN'S PROGRAMS AND YOUTH ACTIVITIES. ONE SUCH COLLABORATIVE EFFORT ALLOWS SOMC TO PROVIDE ADULT IMMUNIZATIONS FOR INFLUENZA TO HUNDREDS OF COMMUNITY MEMBERS EACH YEAR. NURSES AND PHYSICIANS VOLUNTEER THEIR TIME AND EFFORT TO TRAVEL AROUND THE AREA AND PROVIDE THIS SERVICE FREE OF CHARGE OR AT A REDUCED RATE TO THE MANY POPULATIONS WHO GREATLY BENEFIT FROM THIS ANNUAL PREVENTIVE MEASURE. ANOTHER SUCH PROGRAM, KNOWN AS "LOVE YOUR HEART," REACHES MORE THAN 1,200 KINDERGARTEN STUDENTS EACH YEAR. DEVELOPED IN 2000 BY THE SOMC INTENSIVE CARE UNIT TO SPECIFICALLY PROMOTE EARLY CHILDHOOD HEALTHY HABITS, "LOVE YOUR HEART" USES CHARACTERS FROM THE WIZARD OF OZ TO TEACH CHILDREN HOW TO TAKE CARE OF THEIR HEARTS THROUGH HEALTHY EATING, EXERCISE AND FIVE OTHER HANDS-ON STATIONS. HOSPITAL EMPLOYEES, LOCAL NURSING STUDENTS, AND VOLUNTEERS FROM ALL OVER THE COMMUNITY PARTICIPATE IN PROVIDING EDUCATION DURING THIS ANNUAL BELOVED PROGRAM. THROUGH ITS CREATIVE MESSAGE AND INVENTIVE APPROACH, PARTICIPANTS TRULY FEEL THEY ARE MAKING A DIFFERENCE AND SERVING AS ROLE MODELS FOR HEALTHY LIVING. THE ICU STAFF WAS EVEN AWARDED THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES SEABURY AND SMITH NATIONAL COMMUNITY SERVICE AWARD FOR THIS EXTRAORDINARY PROGRAM.MANY OTHER WELLNESS-RELATED PROGRAMS AND SCREENINGS ARE ALSO CONDUCTED EACH YEAR BY MEMBERS OF THE SOMC COMMUNITY HEALTH AND WELLNESS DEPARTMENT, HELPING THOUSANDS OF COMMUNITY MEMBERS LEARN MORE ABOUT THEIR HEALTH. FOR THE PAST TWO YEARS, THE HOSPITAL HAS DEDICATED EACH MONTH TO A DIFFERENT HEALTH MESSAGE AND WORKS TO PROVIDE EVENTS THAT FOCUS INFORMATION ON THAT PARTICULAR AREA. FOR EXAMPLE, FEBRUARY IS ANNUALLY KNOWN AS HEART HEALTH MONTH, AND OFTEN FEATURES MANY PROGRAMS, SCREENINGS, COMMERCIALS, FLYERS, AND CHILDREN'S ACTIVITIES THAT FOCUS SPECIFICALLY ON THAT TOPIC AND ITS EDUCATION. CONDUCTING PROGRAMS IN THIS FASHION ALLOWS THE HOSPITAL TO DELIVER A CONSISTENT MESSAGE TO THE COMMUNITY, HELPING TO SUCCESSFULLY EDUCATE THOSE WE SERVE. AS ANOTHER MEANS OF PROMOTING HEALTHY EDUCATION, THE COMMUNITY HEALTH AND WELLNESS DEPARTMENT ACTIVELY SEEKS GRANTS THAT CAN BE USED TOWARD SPECIFIC COMMUNITY-WIDE PROGRAMS. A DIABETES GRANT EARNED THROUGH THE OHIO DEPARTMENT OF HEALTH IN 2010 HAS SINCE GROWN TO PROVIDE HUNDREDS OF COMMUNITY MEMBERS WITH A SOLID UNDERSTANDING OF THEIR DISEASE, AND HAS ALSO BEEN USED TO PROVIDE TIPS AND TOOLS TO MANAGE THEIR HEALTH FOR THE LONG-TERM. BOTH THE INPATIENT AND OUTPATIENT DIABETES DEPARTMENTS AT SOMC HAVE GREATLY BENEFITTED FROM THIS INCREASED AWARENESS AND HAVE SEEN A DRAMATIC POSITIVE TURN IN PATIENTS' GLUCOSE, WEIGHT AND A1C RESULTS SINCE THE PROGRAMMING'S IMPLEMENTATION. ADDITIONAL EDUCATION EFFORTS AND COMMUNITY SUPPORT IS ALSO PROVIDED BY THE PHYSICIANS, MEDICAL STUDENTS AND EMPLOYEES OF SOMC DURING MANY VOLUNTEER OPPORTUNITIES THAT ARE AVAILABLE THROUGHOUT THE YEAR, SUCH AS SPORTS PHYSICALS, AND SKIN, BREAST AND PROSTATE SCREENINGS. IN 2012 ALONE, THE COMMUNITY HEALTH AND WELLNESS DEPARTMENT AND OUR VOLUNTEERS WERE ABLE TO PROVIDE HEALTH AND SCREENING EVENTS, THUS TOUCHING THE LIVES OF MORE THAN 7,900 COMMUNITY MEMBERS. SOMC AND ITS EMPLOYEES ALSO GIVE BACK TO THE COMMUNITY THROUGH INTERNAL DONATION CAMPAIGNS AIMED AT RAISING FUNDS OR ITEMS FOR A SPECIFIC CAUSE. EACH YEAR, SOMC SELECTS CHAIRMEN TO LEAD THE ORGANIZATION'S UNITED WAY CAMPAIGN, WHICH DIRECTLY BENEFITS THE MORE THAN 15 LOCAL ORGANIZATIONS THAT MAKE UP THE SCIOTO COUNTY UNITED WAY PROGRAM. MORE THAN 98 PERCENT OF SOMC EMPLOYEES PARTICIPATE IN THE EVENT, CHOOSING TO MAKE DIRECT OR PAYROLL-DEDUCTED MONETARY CONTRIBUTIONS. LAST YEAR'S CAMPAIGN WAS THE HOSPITAL'S MOST SUCCESSFUL EVENT TO DATE. IN ADDITION TO THIS MONETARY CONTRIBUTION, SOMC ALSO SUPPORTS THE UNITED WAY THROUGH AN ANNUAL SCHOOL SUPPLY DRIVE. THROUGH THIS PROGRAM, SOMC EMPLOYEES HELP TO PROVIDE BASIC AND NECESSARY SUPPLIES TO THE STUDENTS OF 11 COUNTY SCHOOLS. ANYWHERE FROM 1,800 TO 3,500 ITEMS HAVE ANNUALLY BEEN COLLECTED IN THE PAST, TRULY SHOWING THAT SOMC INVESTS IN THE EDUCATION OF OUR COMMUNITY'S FUTURE GENERATIONS. THE VOLUNTEERS AND GUILDS OF THE SOMC FRIENDS COMMUNITY CENTER ALSO GIVE BACK TO THE COMMUNITY BY RAISING FUNDS TO PURCHASE MEDICAL EQUIPMENT, ASSISTING WITH PATIENT NEEDS AND PROVIDING VARIOUS COMMUNITY SERVICES TO AID IN MAKING A DIFFERENCE. TOGETHER, THESE IMPORTANT TEAMS ARE TRULY PROVING THAT SOMC CAN MAKE A DIFFERENCE.Description
Total Program Service Expense242521833TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096202NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2509NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD GILCHERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7403567622TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11248 KINNEYS LANEAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROBERT E DEVER
CHAIRMAN1.004.00X000
RANDAL ARNETT
PRESIDENT & CEO40.005.00X7477960314382X
STEVEN A CONLEY
DIRECTOR1.004.00X000
GARY DUZAN
TREASURER1.004.00X000
GEORGE LAWSON
SECRETARY1.004.00X000
RITA RICE-MORRIS PHD
DIRECTOR1.004.00X000
IBRAHIM ZAYNEH MD
CHIEF OF STAFF - JAN-JUNE1.004.00X000
DARREN ADAMS DO
CHIEF OF STAFF - JULY-DEC1.004.00X8475200
DAVID FOWLER
DIRECTOR1.004.00X000
GEORGE V JOHNSON MD
DIRECTOR1.004.00X000
JAMES W STAKER
DIRECTOR1.004.00X000
ELIE SAAB MD
SMD CRITICAL CARE1.005.00X070057753959
AARON ADAMS DO
DIRECTOR JULY-FEB1.004.00X2019300
DEAN WRAY
VP FINANCE40.000.003729970126461X
KENDALL L STEWART
VP MEDICAL AFFAIRS40.001.00519813049704X
CLAUDIA L BURCHETT
VP PATIENT SERVICES40.001.002868220116137X
VICKI A NOEL
VP HR & ORGANIZATIONAL DEV40.001.00255728081691X
LEEANN L SAMMONS
VP HEALTH & SAFETY40.001.00208564068634X
BENJAMIN L GILL
VP OF SUPPORT SERVICES40.001.00188043054031X
RORY E PHILLIPS
ADM DIR OF PHARMACY40.000.00197895041035X
BRENT A RICHARD
ADM DIRECTOR INFORMATION SYSTEMS40.000.00160220031014X
CRAIG E GILLILAND
ADM DIR FINANCIAL SERVICES40.000.00158368035251X
VALERIE DECAMP
ADM DIR OF NURSING (I/P &40.000.00134154029497X
LEONARD T GREENE
ADM DIRECTOR OF SURGICAL SERVICES40.000.00150618030150X
JOHN TURJOMAN
FORMER CHIEF OF STAFF0.000.001966200X
ERNESTO BANALAGAY
FORMER CHIEF OF STAFF0.000.0014801000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3653635TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs700577TotalReportableCompFrmRltdOrgs
Total Other Compensation1031946TotalOtherCompensation
Number Individuals GT100 K57NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHABCARE GROUP INC
7733 FORSYTH BLVD SUITE 1200ST LOUISMO63105MANAGEMENT SERVICES6124764
DKM CONSTRUCTION INC
584 SMOKEY HOLLOW RDPIKETONOH45661CONSTRUCTION4115781
UNITED COLLECTION BUREAU INC
4100 HORIZONS DR SUITE 101COLUMBUSOH43220PATIENT ACCOUNT BILLING1468704
MAYO COLLABORATIVE SERVICES
200 SW FIRST STROCHESTERMN55905LABORATORY TESTING1086365
HILL VIEW RETIREMENT
1610 28TH STPORTSMOUTHOH45662HOSPICE PURCHASE SERVICES769017
FieldValueIRS element (for citing)
Number Of Contractors GT100 K28NumberOfContractorsGT100K
Fundraising Events54142FundraisingEvents
Related Organizations59768RelatedOrganizations
Government Grants112123GovernmentGrants
All Other Contributions656160AllOtherContributions
Noncash Contributions17203NoncashContributions
Total Contributions882193TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICES622110287508971287508971
PHARMACY INCOME44611091785569178556
LIFE CENTER62211015881621588162
LAB SERVICES621500439107439107
FieldValueIRS element (for citing)
Total Program Service Revenue298714796TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5002370TotalRevenueColumn
Exclusion$5,002,370ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real24491Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real24491Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column24491TotalRevenueColumn
Exclusion$24,491ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7943633Securities
Other21764Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5252366Securities
Other457850Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2691267Securities
Other-436086Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2255181TotalRevenueColumn
Exclusion$2,255,181ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events130725GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events54142CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses141926FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-11201TotalRevenueColumn
Exclusion-$11,201ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA SALES6221101739182$1,739,182
GIFT SHOP REVENUE900099192720$192,720
NURSING CONTRACT REVENUE6221105894258942

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column366586TotalRevenueColumn
Related Or Exempt Function Income31139RelatedOrExemptFunctionIncome
Exclusion$335,447ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2357430TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column309225260TotalRevenueColumn
Related Or Exempt Function Income298804877RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$9,538,190ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total25016741Total
Program Services25016741ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total11280Total
Program Services11280ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3453898Total
Management And General3453898ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total87182949Total
Program Services66500264ProgramServices
Management And General20682685ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6239981Total
Program Services4759655ProgramServices
Management And General1480326ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23062621Total
Program Services17660847ProgramServices
Management And General5401774ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6618653Total
Program Services5048494ProgramServices
Management And General1570159ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total29561Total
Management And General29561ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total313710Total
Management And General313710ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total204470Total
Management And General204470ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total21468787Total
Program Services16743718ProgramServices
Management And General4725069ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2266643Total
Program Services2266643ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22151418Total
Program Services16896368ProgramServices
Management And General5255050ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1689806Total
Program Services726559ProgramServices
Management And General963247ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total10334011Total
Program Services7882441ProgramServices
Management And General2451570ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total472944Total
Program Services316764ProgramServices
Management And General156180ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total427765Total
Program Services150046ProgramServices
Management And General277719ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8165006Total
Program Services7039052ProgramServices
Management And General1125954ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18076560Total
Program Services15584551ProgramServices
Management And General2492009ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1282413Total
Program Services1282413ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXEPENSE2542172025421720
MEDICAL SUPPLIES1615321216153212
PHARMACY SUPPLIES/DRUGS1201456912014569
OHIO FRANCHISE TAX32207703220770

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1430313Total
Program Services1046496ProgramServices
Management And General364042ManagementAndGeneral
Fundraising19775Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total296709801Total
Program Services242521833ProgramServices
Management And General54168193ManagementAndGeneral
Fundraising19775Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7215BOY
EOY6240EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15510009BOY
EOY19273276EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY32960807BOY
EOY31574974EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY116196BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3956145BOY
EOY4594172EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2790395BOY
EOY2021559EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis325242479LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec169241745LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY167735747BOY
EOY156000734EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY188609907BOY
EOY210072563EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3800202BOY
EOY3489698EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2000436BOY
EOY2287471EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12681136BOY
EOY17343644EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY430168195BOY
EOY446664331EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY24727809BOY
EOY26258618EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY150174639BOY
EOY147349584EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1801617BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY25347302BOY
EOY19255446EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY202051367BOY
EOY192863648EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY228116828BOY
EOY253800683EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY228116828BOY
EOY253800683EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY430168195BOY
EOY446664331EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses12515459ReconcilationRevenueExpenses
Reconciliation Unrealized Invest5542676ReconciliationUnrealizedInvest
Reconcilation Other Changes7625720ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$5,704OtherActivitiesAmount
Total Lobbying Expenditures IIB5704TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationMEMBERSHIP DUES IN THE AMOUNT OF $44,865 AND $62,761 WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION, RESPECTIVELY. OF THESE DUES, $2,378 AND $3,326 WERE RELATED TO LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1819486BeginningOfYearBalance
Contributions58179Contributions
Investment Earnings Or Losses169435InvestmentEarningsOrLosses
Other Expenditures9645OtherExpenditures
Administrative Expenses43049AdministrativeExpenses
End Of Year Balance1994406EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1751554BeginningOfYearBalance
Contributions48512Contributions
Investment Earnings Or Losses58318InvestmentEarningsOrLosses
Administrative Expenses38898AdministrativeExpenses
End Of Year Balance1819486EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1618097BeginningOfYearBalance
Contributions72131Contributions
Investment Earnings Or Losses104428InvestmentEarningsOrLosses
Administrative Expenses43103AdministrativeExpenses
End Of Year Balance1751553EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1640677BeginningOfYearBalance
Contributions75282Contributions
Investment Earnings Or Losses-62236InvestmentEarningsOrLosses
Administrative Expenses35626AdministrativeExpenses
End Of Year Balance1618097EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1555536BeginningOfYearBalance
Contributions65883Contributions
Investment Earnings Or Losses51298InvestmentEarningsOrLosses
Administrative Expenses32039AdministrativeExpenses
End Of Year Balance1640678EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4666227OtherCostOrOtherBasis
Book Value4666227BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis91075177OtherCostOrOtherBasis
Depreciation29107912Depreciation
Book Value61967265BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis108358OtherCostOrOtherBasis
Depreciation77705Depreciation
Book Value30653BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis217188498OtherCostOrOtherBasis
Depreciation134859068Depreciation
Book Value82329430BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12204219OtherCostOrOtherBasis
Depreciation5197060Depreciation
Book Value7007159BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings156000734TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
COST REPORT SETTLEMENT$5,825,202
PENSION LIABILITY$8,109,907
ACCRUED SELF-INSURED LIABILITY$4,004,098
CERP DEFERRED COMP LIABILITY$1,316,239
FieldValueIRS element (for citing)
Total Of Amounts19255446TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUNDS ARE TO BE SPENT AT THE BOARD'S DISCRETION, AND ARE INTENDED TO BE RETAINED FOR FUTURE NEEDS OF THE ORGANIZATION. THE ENDOWMENT FUNDS ARE HELD AND ADMINISTERED BY THE SCIOTO FOUNDATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:SOUTHERN OHIO MEDICAL CENTER AND ITS SUBSIDIARIES ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS AND, ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCECPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2010.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1HIKE FOR HOSPICENameOfEvent1
Gross Receipts Event168899GrossReceiptsEvent1
Charitable Contributions Event140319CharitableContributionsEvent1
Gross Revenue Event128580GrossRevenueEvent1
Non Cash Prizes Event110189NonCashPrizesEvent1
Food And Beverage Event12087FoodAndBeverageEvent1
Other Direct Expenses Event130128OtherDirectExpensesEvent1
Name Of Event2PAINT IT PINKNameOfEvent2
Gross Receipts Event248571GrossReceiptsEvent2
Gross Revenue Event248571GrossRevenueEvent2
Other Direct Expenses Event226500OtherDirectExpensesEvent2
Total Number Of Other Events5TotalNumberOfOtherEvents
Gross Receipts Other Events62652GrossReceiptsOtherEvents
Charitable Contrib Other Events13823CharitableContribOtherEvents
Gross Revenue Other Events48829GrossRevenueOtherEvents
Non Cash Prizes Other Events3027NonCashPrizesOtherEvents
Food And Beverage Other Events694FoodAndBeverageOtherEvents
Other Direct Expenses Other Events59953OtherDirectExpensesOtherEvents
Gross Receipts Total180122GrossReceiptsTotal
Charitable Contributions Total54142CharitableContributionsTotal
Gross Revenue Total Events125980GrossRevenueTotalEvents
Non Cash Prizes Total Events13216NonCashPrizesTotalEvents
Food And Beverage Total Events2781FoodAndBeverageTotalEvents
Other Direct Expenses Total Events116581OtherDirectExpensesTotalEvents
Direct Expense Summary Events132578DirectExpenseSummaryEvents
Net Income Summary-6598NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served4627PersonsServed
Total Community Benefit Expense8634026TotalCommunityBenefitExpense
Direct Offsetting Revenue1188908DirectOffsettingRevenue
Net Community Benefit Expense7445118NetCommunityBenefitExpense
Percent Of Total Expense0.02740PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served76318PersonsServed
Total Community Benefit Expense40172399TotalCommunityBenefitExpense
Direct Offsetting Revenue30037458DirectOffsettingRevenue
Net Community Benefit Expense10134941NetCommunityBenefitExpense
Percent Of Total Expense0.03740PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served80945PersonsServed
Total Community Benefit Expense48806425TotalCommunityBenefitExpense
Direct Offsetting Revenue31226366DirectOffsettingRevenue
Net Community Benefit Expense17580059NetCommunityBenefitExpense
Percent Of Total Expense0.06480PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense105930TotalCommunityBenefitExpense
Net Community Benefit Expense105930NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2439418TotalCommunityBenefitExpense
Direct Offsetting Revenue1034031DirectOffsettingRevenue
Net Community Benefit Expense1405387NetCommunityBenefitExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2545348TotalCommunityBenefitExpense
Direct Offsetting Revenue1034031DirectOffsettingRevenue
Net Community Benefit Expense1511317NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served80945PersonsServed
Total Community Benefit Expense51351773TotalCommunityBenefitExpense
Direct Offsetting Revenue32260397DirectOffsettingRevenue
Net Community Benefit Expense19091376NetCommunityBenefitExpense
Percent Of Total Expense0.07040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$25,421,720BadDebtExpenseAmount
Amount Attributable To2377666AmountAttributableTo
Amount Reimbursed By Medicare75913421AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare82018077CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6104656MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN OHIO MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11805 27TH STREETAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours
Er OtherXErOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN OHIO MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent125.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SOMC CANCER CENTER
1121 KINNEYS LANEPORTSMOUTHOH45662CANCER TREATMENT & CARE
WOUND HEALING & SLEEP LAB
1745 27TH STREETPORTSMOUTHOH45662SLEEP LAB
URGENT CARE
8770 OHIO RIVER ROADWHEELERSBURGOH45694URGENT CARE
HEALTH CARE CENTER
1212 18TH STREETPORTSMOUTHOH45662HEALTH CARE CENTER
SOMC WAVERLY URGENT CARE
835 WEST EMMITT AVENUEWAVERLYOH45690URGENT CARE
HOSPICE IN-PATIENT
2201 25TH STREETPORTSMOUTHOH45662HOSPICE IN-PATIENT

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: COSTS FOR LINES 7A AND 7B WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, AND THE COSTS ON LINES 7E AND 7F WERE BASED ON ACTUAL COSTS.
PART I, L7 COL(F): THE TOTAL PERCENTAGE CALCULATED ON LINE 7 IS BASED ON TOTAL EXPENSES FROM FORM 990, PART IX, LESS BAD DEBT EXPENSE FROM PART IX OF $25,421,720.
PART III, LINE 4: TOTAL BAD DEBT EXPENSE REPORTED ON THE FINANCIAL STATEMENTS EXCLUDES AMOUNTS KNOWN TO QUALIFY FOR CHARITY DISCOUNTS. ANY PARTIAL PAYMENTS THAT ARE SUBSEQUENTLY RECEIVED ARE APPLIED AS AN OFFSET TO BAD DEBT EXPENSE. NONE OF THE BAD DEBT EXPENSE REPORTED ON THE FINANCIAL STATEMENTS IS TREATED AS A COMMUNITY BENEFIT. THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE REPORTED ON THE FINANCIAL STATEMENTS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY REPRESENTS ACCOUNTS THAT WERE DEEMED TO BE BAD DEBT WHICH SUBSEQUENTLY APPLIED FOR FINANCIAL ASSISTANCE. THE ACCOUNTS BELIEVED TO QUALIFY FOR CHARITY CARE HOWEVER WERE NOT MOVED FROM BAD DEBTS.FOOTNOTE TO FINANCIAL STATEMENTS: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE ORGANIZATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
PART III, LINE 8: MEDICARE COSTS WERE TAKEN FROM THE MEDICARE COST REPORT, WHICH USES A COST TO CHARGE RATIO ALLOWED UNDER MEDICARE COST REPORT METHODOLOGY. NONE OF THE SHORTFALL IS TREATED AS COMMUNITY BENEFIT.
PART III, LINE 9B: WE TREAT ALL PATIENTS THE SAME. IF THERE IS INSURANCE COVERAGE, WE BILL THE CLAIMS FOR PAYMENT. IF THERE IS NO INSURANCE - OR IF THERE IS A BALANCE REMAINING AFTER INSURANCE PAYS - THE PATIENT IS SENT THE SAME AMOUNT OF STATEMENTS OVER A PERIOD OF TIME, PHONE ATTEMPTS ARE MADE AND, IF THERE IS NO RESPONSE TO OUR EFFORTS, THE ACCOUNTS ARE PLACED WITH OUTSIDE AGENCIES FOR COLLECTION.
PART V, SECTION B, LINE 3: TWO FOCUS GROUPS WERE HELD ON JANUARY 17, 2013. ONE GROUP WAS DESIGNATED FOR AN INTERNAL STEERING COMMITTEE MADE OF REPRESENTATIVES FROM SOUTHERN OHIO MEDICAL CENTER; THE OTHER GROUP WAS MADE UP OF KEY INFORMANTS FROM THROUGHOUT THE COMMUNITY. FOCUS GROUP PARTICIPANTS INCLUDED 28 KEY INFORMANTS: REPRESENTATIVES FROM PUBLIC HEALTH; PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUPS WAS PROVIDED BY SOMC. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. FOCUS GROUP CANDIDATES WERE FIRST CONTACTED BY LETTER TO REQUEST THEIR PARTICIPATION. FOLLOW-UP PHONE CALLS WERE THEN MADE TO ASCERTAIN WHETHER OR NOT THEY WOULD BE ABLE TO ATTEND. CONFIRMATION CALLS WERE PLACED THE DAY BEFORE THE GROUPS WERE SCHEDULED TO INSURE A REASONABLE TURNOUT. THE FOLLOWING TABLE LISTS THOSE WHO ATTENDED ONE OF THE TWO FOCUS GROUPS.EXTERNAL FOCUS GROUPS WERE HELD THURSDAY, JANUARY 17TH AT 12PM WHICH INCLUDED THE FOLLOWING ORGANIZATIONS: -WIC-PORTSMOUTH CITY HEALTH DEPARTMENT-COMMUNITY ACTION ORGANIZATION-MAIN STREET PORTSMOUTH-ADVANTAGE HOME CARE-SCIOTO FOUNDATION-PORTSMOUTH CITY POLICE DEPARTMENT-COMMUNITY CHOICE HOME CARE-CHAMBER OF COMMERCE, PORTSMOUTH-SCIOTO COUNTY COURTS-PORTSMOUTH INNER CITY DEVELOPMENT CORPORATION-PORTSMOUTH CITY HEALTH DEPARTMENT-PORTSMOUTH CITY SCHOOLSPOPULATIONS THAT WERE SERVED INCLUDE THE FOLLOWING:-MEDICALLY UNDERSERVED-LOW-INCOME RESIDENTS-MINORITY POPULATION-POPULATION WITH CHRONIC ILLNESSINTERNAL FOCUS GROUPS WERE HELD THURSDAY, JANUARY 17TH AT 9AM WHICH INCLUDED THE FOLLOWING ORGANIZATIONS:-SOUTHERN OHIO MEDICAL CENTER-SOUTHERN OHIO MEDICAL CENTER/INDUSTRIAL REHABPOPULATIONS THAT WERE SERVED INCLUDE THE FOLLOWING:-MEDICALLY UNDERSERVED-LOW-INCOME RESIDENTS-MINORITY POPULATION-POPULATION WITH CHRONIC ILLNESSSOUTHERN OHIO MEDICAL CENTER
PART V, SECTION B, LINE 5C: SOMC IS PART OF A COMMUNITY HEALTH COALITION WITH MULTIPLE AREA AGENCIES, COMMUNITY AND CIVIC GROUPS REPRESENTED. AFTER THE 2013 SOMC CHNA WAS COMPLETED, THE FINAL RESULTS WERE SHARED WITH THE COALITION AND ACCESS WAS GIVEN TO ALL ITS AFFILIATES TO HELP WITH THEIR OWN DATA COLLECTION MEASURES.SOUTHERN OHIO MEDICAL CENTER
PART V, SECTION B, LINE 7: HTTP://WWW.SOMC.ORG/PROGRAMS/COMMUNITYHEALTH/DOCUMENTS/CHNAOVERVIEW.PDFSOUTHERN OHIO MEDICAL CENTER
PART V, SECTION B, LINE 20D: SOMC'S PATIENT PRICING IS BUILT ON CHARGE SPECIFIC COSTS FROM OUR INTERNAL COSTING SYSTEM WHICH THEN IS EVALUATED AGAINST MEDICARE, MEDICAID AND/OR OTHER FEE SCHEDULE IN EFFECT THEN ALSO WITH OTHER HOSPITALS PRICES BOTH LOCALLY AND REGIONALLY WHERE OBTAINABLE. SOMC CHARGES FAP ELIGIBLE INDIVIDUALS THE SAME INITIALLY AS THEY CHARGE INDIVIDUALS WITH INSURANCE COVERING SUCH MEDICAL CARE. IT IS ONLY AFTER THE FAP ELIGIBLE PATIENTS APPLY FOR FINANCIAL ASSISTANCE THAT THE CHARGED AMOUNT MAY BE ADJUSTED. IF THE FAP ELIGIBLE PATIENTS' APPLICATION QUALIFIES FOR FINANCIAL ASSISTANCE THEN THEY ARE ABLE TO RECEIVE UP TO A 100% REDUCTION TO THE CHARGED AMOUNT.SOUTHERN OHIO MEDICAL CENTER
THE POLICY FOR THE FAP IS NOT POSTED ONLINE. HOWEVER, THE FINANCIAL ASSISTANCE APPLICATION DESCRIBES THE QUALIFICATIONS FOR ASSISTANCE AND ALERTS THE PATIENT TO THE AVAILABILITY OF ASSISTANCE THROUGH THE FAP.PART V, SECTION B, LINE 14(A):
PART VI, LINE 2: IN JULY OF 2012, THE COMMUNITY HEALTH LEADERSHIP TEAM CONVENED TO DISCUSS THE CHNA. AN INTERNAL STEERING COMMITTEE WAS ASSEMBLED AND THE SCIOTO COUNTY HEALTH COALITION (SCHC) WAS SELECTED AS THE EXTERNAL STEERING COMMITTEE. A TIMELINE FOR THE CHNA WAS ESTABLISHED AND THE MEETING SCHEDULE WAS SET. SOMC SIGNED WITH PRC IN SEPTEMBER 2012 AND PRC BEGAN SURVEYING THE COMMUNITY IN NOVEMBER 2012. THE FINAL SURVEYS WERE COMPLETED IN JANUARY 2013. PRC COMPLETED DATA COMPILATION AND DELIVERED THE FINAL REPORT TO SOMC IN FEBRUARY 2013. UPON REVIEW OF DATA, A PRELIMINARY PLAN WAS DEVELOPED BY KEY STAKEHOLDERS WITH INPUT FROM THE EXTERNAL STEERING COMMITTEE (SCHC) ON MARCH 8, 2013, SOMC COMMUNITY HEALTH, AND SOMC COMMUNITY HEALTH AND WELLNESS TEAM. FURTHER REFINEMENT OF THE PLAN WAS SOLICITED FROM THE INTERNAL STEERING COMMITTEE ON MAY 15, 2013.THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (THE PRC CHNA) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR TRENDING AND COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH A SET OF KEY INFORMANT FOCUS GROUPS.TWO FOCUS GROUPS WERE HELD ON JANUARY 17, 2013. ONE GROUP WAS DESIGNATED FOR AN INTERNAL STEERING COMMITTEE MADE OF REPRESENTATIVES FROM SOUTHERN OHIO MEDICAL CENTER; THE OTHER GROUP WAS MADE UP OF KEY INFORMANTS FROM THROUGHOUT THE COMMUNITY. FOCUS GROUP PARTICIPANTS INCLUDED 28 KEY INFORMANTS: REPRESENTATIVES FROM PUBLIC HEALTH; PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUPS WAS PROVIDED BY SOMC. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS.
PART VI, LINE 3: SOMC CONTRACTS WITH ELIGIBILITY ASSISTANCE PROGRAM (EAP) WHOSE STAFF IS LOCATED ON-SITE TO SEE PATIENTS INHOUSE, OFFER ASSISTANCE WITH APPLICATIONS FOR OHIO MEDICAID, HCAP AND/OR CHARITY FUNDING. THEY ALSO CONTACT OUTPATIENTS WITH LARGE BALANCES TO OFFER THE SAME ASSISTANCE. EACH BILLING STATEMENT MAILED TO PATIENTS ALSO OFFERS THE FINANCIAL ASSISTANCE APPLICATION (FOR HCAP AND CHARITY FUNDING) FOR THE PATIENT TO COMPLETE AND RETURN TO THE BUSINESS OFFICE.
PART VI, LINE 4: SOMC IS LOCATED IN PORTSMOUTH, OHIO, A RURAL COMMUNITY WITH A POPULATION OF 20,226 SITUATED ALONG THE WINDING OHIO AND SCIOTO RIVERS. PORTSMOUTH IS SEATED AT THE SOUTHERN TIP OF THE STATE, ACROSS THE RIVER FROM KENTUCKY, AND NEARLY TWO HOURS AWAY FROM THE NEAREST MAJOR CITIES OF COLUMBUS AND CINCINNATI IN OHIO, CHARLESTON IN WEST VIRGINIA AND LEXINGTON IN KENTUCKY. PORTSMOUTH IS A PART OF SCIOTO COUNTY AND IS HOME TO 9,120 HOUSEHOLDS AND 5,216 FAMILIES. THE CITY IS DIVERSE IN TERMS OF RACE, AGE AND EDUCATION, WITH THE MEDIAN INCOME FOR A HOUSEHOLD FALLING BELOW $23,000. SOMC'S PRIMARY MARKET IS SCIOTO COUNTY AND MORE THAN HALF OF THE PATIENTS SERVED RESIDE IN SCIOTO COUNTY. SOMC RECEIVES PATIENTS FROM SIX SURROUNDING COUNTIES INCLUDING PIKE, JACKSON, ADAMS, LAWRENCE, GREENUP AND LEWIS. THESE COUNTIES MAKE UP THE SECONDARY SERVICE AREA. SOUTHERN OHIO MEDICAL CENTER (SOMC) IS A NON-PROFIT HOSPITAL LOCATED IN PORTSMOUTH, OHIO. SOMC HAS 433 LICENSED BEDS, 210 STAFFED BEDS, AND 20 OPERATING ROOMS. SOMC IS COMPRISED OF THREE CAMPUSES IN PORTSMOUTH, AS WELL AS MULTIPLE SATELLITE FACILITIES THROUGHOUT THE CITIES OF LUCASVILLE, MINFORD, PORTSMOUTH, SCIOTOVILLE, WAVERLY AND WHEELERSBURG IN OHIO, AND VANCEBURG IN KENTUCKY.
PART VI, LINE 5: BEING ACTIVELY INVOLVED IN THE COMMUNITY IS WHAT DRIVES SOUTHERN OHIO MEDICAL CENTER TO ACHIEVE EXCELLENCE IN HEALTHCARE AND TO PROVIDE FOR THE NEEDS OF THE COMMUNITY. SOUTHERN OHIO MEDICAL CENTER'S GOAL IS TO PROVIDE HEALTHCARE AND SERVICES TO THE MEMBERS OF THE COMMUNITY. THE ECONOMIC, EDUCATIONAL, RECREATIONAL AND CULTURAL ACTIVITIES OF THE COMMUNITY SHOW THE WIDE SWEEP OF SOUTHERN OHIO MEDICAL CENTER'S INVOLVEMENT IN COMMUNITY ACTIVITIES. IT'S THROUGH THESE RELATIONSHIPS THAT SOMC HAS BEEN RECOGNIZED FOR MANY OUTSTANDING ACCOMPLISHMENTS, RECEIVING SUCH NOTABLE HONORS OVER THE YEARS AS ANCC'S MAGNET RECOGNITION, OSHA'S VPP STAR STATUS, PRESS GANEY'S DISTINCTIVE WORKPLACE AWARD, AS WELL AS BEING NAMED ONE OF FORTUNE'S 100 BEST COMPANIES TO WORK FOR AND ONE OF MODERN HEALTHCARE'S 100 BEST PLACES TO WORK.KEY DECISIONS MADE AT SOMC ARE GUIDED BY ITS FIVE STRATEGIC VALUES, WHICH INCLUDE THE FOLLOWING RELATIONSHIPS, SERVICE, PERFORMANCE, SAFETY, AND QUALITY. RELATIONSHIPS SHAPE MANY FACETS OF CUSTOMER SERVICE AND THE CARE THAT IS PROVIDED WITHIN THE HOSPITAL. IT IS THE HOSPITALS GOAL TO LISTEN AND PARTNER WITH CUSTOMERS TO MAKE A DIFFERENCE TO THOSE WE SERVE. ADDITIONAL FEEDBACK IS ALSO GATHERED THROUGH FOCUS GROUPS CONDUCTED BY THE SOMC COMMUNITY RELATIONS DEPARTMENT, AS WELL AS THE SOMC EXECUTIVE TEAM'S "OPEN DOOR POLICY", WHICH BOTH PROVIDE THE OPPORTUNITY TO GATHER INFORMATION AND SUGGESTIONS TO IMPROVE HOSPITAL SERVICES AND UNDERSTAND TECHNOLOGICAL NEEDS. SOMC ESTABLISHES WORKING RELATIONSHIPS WITH ORGANIZATIONS THROUGHOUT THE TRI-STATE AREA TO FOCUS ON THE HEALTH AND WELLNESS OF THE COMMUNITY. SOMC AND ITS EMPLOYEES PARTICIPATE IN A VARIETY OF COMMUNITY-BASED ORGANIZATIONS INCLUDING THE OHIO RIVER VALLEY CHAPTER RED CROSS BOARD, SCIOTO COUNTY HEALTH COALITION THE CHAMBER OF COMMERCE, ROTARY CLUB, UNITED WAY, SOUTHERN OHIO PERFORMING ARTS ASSOCIATION, MAIN STREET PORTSMOUTH, THE PORTSMOUTH AREA ARTS COUNCIL, MORE LITERACY PROGRAMS AS WELL AS AREA SCHOOL BOARDS, COMMITTEES AND CHURCHES. OTHER PARTICIPATORY PROGRAMS INCLUDE LEADERSHIP PORTSMOUTH, OHIO PARTNERSHIP FOR EXCELLENCE, TASK FORCE ON DOMESTIC VIOLENCE, PORTSMOUTH KIWANIS SERVICE CLUB, SCIOTO RESIDENTIAL SERVICES BOARD, PARAMEDIC ADVISORY BOARD, SALVATION ARMY, RIVER SWEEP, HABITAT FOR HUMANITY, AND CHOICE HOUSING FOR THE DEVELOPMENTALLY DISABLED. SOUTHERN OHIO CORRECTIONAL FACILITY MINISTRIES, ARTHRITIS FOUNDATION, MEDICAL RESERVE CORP, PARISH NURSE NETWORK, SOUTHERN OHIO DIABETES COALITION, PORTSMOUTH BICENTENNIAL BOARD AND THE SOUTHERN OHIO CORRECTIONAL FACILITY COMMUNITY ADVISORY BOARD. MANY BENEFITS ARE CREATED THROUGH THESE PARTNERSHIPS INCLUDING SPONSORSHIPS FOR CULTURAL AFFAIRS, COMMUNITY HEALTH AND WELLNESS PROGRAMS, HEALTH SCREENINGS, EDUCATION, CHILDREN'S PROGRAMS AND YOUTH ACTIVITIES. ONE SUCH COLLABORATIVE EFFORT ALLOWS SOMC TO PROVIDE ADULT IMMUNIZATIONS FOR INFLUENZA, PNEUMONIA AND HEPATITIS B TO HUNDREDS OF COMMUNITY MEMBERS EACH YEAR. THE HOSPITAL OFTEN DONATES USED EQUIPMENT TO LOCAL SCHOOLS. NURSES AND PHYSICIANS VOLUNTEER THEIR TIME AND EFFORT TO TRAVEL AROUND THE SOMC REGION AND TO THIRD-WORLD COUNTRIES TO PROVIDE SERVICES FREE OF CHARGE OR AT A REDUCED RATE TO POPULATIONS WHO GREATLY BENEFIT FROM THEIR ANNUAL VISITS. ANOTHER PROGRAM, TITLED "LOVE YOUR HEART", REACHES MORE THAN 1,200 KINDERGARTEN STUDENTS EACH YEAR. DEVELOPED IN 2000 BY THE SOMC INTENSIVE CARE UNIT TO PROMOTE EARLY CHILDHOOD HEALTHY HABITS, "LOVE YOUR HEART" USES CHARACTERS FROM THE WIZARD OF OZ TO TEACH CHILDREN HOW TO TAKE CARE OF THEIR HEARTS THROUGH HEALTHY EATING, EXERCISE AND THREE OTHER HANDS-ON STATIONS. HOSPITAL EMPLOYEES, LOCAL NURSING STUDENTS, AND VOLUNTEERS FROM ALL OVER THE COMMUNITY PARTICIPATE IN PROVIDING EDUCATION DURING THIS ANNUAL BELOVED PROGRAM. THROUGH ITS CREATIVE MESSAGE AND INVENTIVE APPROACH, PARTICIPANTS FEEL THEY ARE MAKING A DIFFERENCE AND SERVING AS ROLE MODELS FOR HEALTHY LIVING. THE ICU STAFF WAS AWARDED THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES SEABURY AND SMITH NATIONAL COMMUNITY SERVICE AWARD FOR THIS EXTRAORDINARY PROGRAM.THE COMMUNITY HEALTH AND WELLNESS DEPARTMENT ALSO ACTIVELY SEEKS GRANTS THAT CAN BE USED TOWARD SPECIFIC COMMUNITY-WIDE PROGRAMS. THE SUSAN G. KOMEN GRANT FOR THE HANDS OF HOPE PROGRAM PROVIDES FREE OR REDUCED FEE EDUCATION, SCREENINGS AND MAMMOGRAMS TO PROMOTE EARLY DETECTION OF BREAST DISEASE. IT LINKS BREAST CANCER PATIENTS TO RESOURCES AFTER BREAST CANCER TREATMENT. SOMC IS DEDICATED TO EDUCATING ITS APPALACHIAN COMMUNITY ON SELF-BREAST EXAMS PROVIDING CLINICAL BREAST SERVICES AND DIAGNOSTIC TESTING, WITH A FOCUS ON YEARLY MAMMOGRAMS. FOR EXAMPLE, OCTOBER IS ANNUALLY KNOWN AS BREAST CANCER AWARENESS MONTH, AND OFTEN FEATURES MANY PROGRAMS, SCREENINGS, COMMERCIALS, FLYERS, AND ACTIVITIES THAT FOCUS SPECIFICALLY ON THAT TOPIC AND ITS EDUCATION. ADDITIONAL EDUCATION EFFORTS AND COMMUNITY SUPPORT IS PROVIDED BY THE PHYSICIANS, MEDICAL STUDENTS AND EMPLOYEES OF SOMC DURING MANY VOLUNTEER OPPORTUNITIES THROUGHOUT THE YEAR, SUCH AS SPORTS PHYSICALS, DIABETES, HIGH BLOOD PRESSURE AND CANCER SCREENINGS. SOMC AND ITS EMPLOYEES ALSO GIVE BACK TO THE COMMUNITY THROUGH INTERNAL DONATION CAMPAIGNS AIMED AT RAISING FUNDS OR ITEMS FOR A SPECIFIC CAUSE. EACH YEAR, SOMC SELECTS CHAIRMEN TO LEAD THE ORGANIZATION'S UNITED WAY CAMPAIGN, WHICH DIRECTLY BENEFITS THE MORE THAN 15 LOCAL ORGANIZATIONS THAT MAKE UP THE SCIOTO COUNTY UNITED WAY PROGRAM. MORE THAN 98 PERCENT OF SOMC EMPLOYEES PARTICIPATE IN THE EVENT, CHOOSING TO MAKE DIRECT OR PAYROLL-DEDUCTED MONETARY CONTRIBUTIONS. IN ADDITION TO THIS MONETARY CONTRIBUTION, SOMC ALSO SUPPORTS THE UNITED WAY THROUGH AN ANNUAL SCHOOL SUPPLY DRIVE. THROUGH THIS PROGRAM, SOMC EMPLOYEES HELP TO PROVIDE BASIC AND NECESSARY SUPPLIES TO THE STUDENTS OF 11 COUNTY SCHOOLS. ANYWHERE FROM 1,800 TO 3,500 ITEMS HAVE ANNUALLY BEEN COLLECTED IN THE PAST, SHOWING THAT SOMC INVESTS IN THE EDUCATION OF OUR COMMUNITY'S FUTURE GENERATIONS. MANY MEMBERS OF THE COMMUNITY VOLUNTEER AT SOMC, SERVING AS COMMUNITY AMBASSADORS. THEY OFFER A FRIENDLY SMILE AND COMFORTING WORDS TO PATIENTS AND FAMILY MEMBERS, WHILE ALSO ASSISTING IN MORE THAN 40 AREAS WITHIN THE HOSPITAL. THEY GIVE BACK TO THE COMMUNITY BY RAISING FUNDS TO PURCHASE MEDICAL EQUIPMENT, ASSISTING WITH PATIENT NEEDS AND PROVIDING VARIOUS COMMUNITY SERVICES TO AID IN MAKING A DIFFERENCE. THESE 445 VOLUNTEERS PROVIDED MORE THAN 38,673 UN-PAID HOURS IN 2013. WITH THE COMMUNITIES AND SOMC WORKING SO CLOSELY TOGETHER, SOMC CAN PROUDLY SAY IT IS ABLE TO OBTAIN ITS GOAL OF "MAKING A DIFFERENCE."
PART VI, LINE 6: SOUTHERN OHIO MEDICAL CENTER IS A SINGLE ACUTE CARE PROVIDER OF HEALTH SERVICES AT TWO FACILITIES IN THE PORTSMOUTH, OHIO AREA. SOMC IS THE PARENT ORGANIZATION OF FRIENDS OF SOMC, SOMC MEDICAL CARE FOUNDATION, INC., SOMC TITLE HOLDING COMPANY, AND THE SOLE BENEFICIARY OF SOMC FOUNDATION.THE FRIENDS OF SOMC RENDER SERVICE TO SOUTHERN OHIO MEDICAL CENTER OF PORTSMOUTH, OHIO AND ITS PATIENTS AND ASSIST THE HOSPITAL IN PROMOTING HEALTH AND WELFARE OF THE COMMUNITY IN ACCORDANCE WITH THE OBJECTIVES ESTABLISHED BY THE GOVERNING BOARD OF TRUSTEES OF SOUTHERN OHIO MEDICAL CENTER. IN ADDITION, THE FRIENDS OF SOMC CREATE, RECEIVE AND MAINTAIN A FUND OR FUNDS OF REAL OR PERSONAL PROPERTY OR BOTH, TO USE AND APPLY THE WHOLE OR ANY PART OF THE INCOME THEREFROM AND THE PRINCIPAL THEREOF EXCLUSIVELY FOR THE USE AND BENEFIT OF SOUTHERN OHIO MEDICAL CENTER.SOMC MEDICAL CARE FOUNDATION IS ORGANIZED AND OPERATES EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES FOR THE BENEFIT OF SOMC, AN OHIO NON-PROFIT CORPORATION INCLUDING (A) PROVIDING MEDICAL, SURGICAL AND OTHER HEALTH CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED, REGARDLESS OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, AGE, HANDICAP, SEX, OR THE ABILITY TO PAY FOR SERVICES; (B) CONDUCTING EDUCATIONAL ACTIVITIES RELATED TO HEALTHCARE AND TREATMENT OF THE SICK, DISABLED, INJURED AND TO PROMOTE AND CARRY ON MEDICAL, SCIENTIFIC AND CLINICAL RESEARCH RELATED TO HEALTH CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED; AND (C) ENGAGING IN ANY LAWFUL ACTIVITIES FOR WHICH CORPORATIONS MAY BE FORMED UNDER CHAPTER 1785 OF THE OHIO REVISED CODE THAT ARE NOT CONSISTNET WITH THE FOREGOING.SOMC TITLE HOLDING COMPANY OWNS AND MANAGES REAL ESTATE ON BEHALF OF SOUTHERN OHIO MEDICAL CENTER.SOMC FOUNDATION SUPPORTS SOUTHERN OHIO MEDICAL CENTER WITH FINANCIAL TRANSFERS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (24 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
AMERICAN RED CROSS
614 GLOVER STPORTSMOUTHOH45662314414096501(C)(3)245004752FOOD AND PRINTINGYEARLY PLEDGE AND SPONSORSHIP DINNER.
NOTRE DAME SCHOOLS
2220 SUNRISE AVEPORTSMOUTHOH45662314395524501(C)(3)8500DEVELOPMENT FUND, GOLF TEAM SPONSOR, BID YOUR HEART OUT DONATION.
PORTSMOUTH RIVER DAYS INC
PO BOX 132PORTSMOUTHOH45662311068766501(C)(3)15000SPONSORSHIP OF RIVER DAYS COMMUNITY FESTIVAL.
(no name)
VARIOUS SPONSORSHIPS AND DONATIONS.
(no name)
PROGRAM DONATION.
(no name)
MATCHING DONATION - PROGRAM SERVICES.
PORTSMOUTH AREA ARTS COUNCIL
PO BOX 1258PORTSMOUTHOH45662237073017501(C)(3)10000SPONSORSHIP OF "DICKENS OF A CHRISTMAS" AND "RESPECT IS A MAGIC WORD."
SCIOTO COUNTY JUNIOR FAIR
602 7TH STREET COURTHOUSE ROOM 7PORTSMOUTHOH45662311262987501(C)(3)7500SPONSORSHIP OF CIRCUS AND BUYER'S RECOGNITION DINNER.
SOMC MEDICAL CARE FOUNDATION INC
1248 KINNEYS LANEPORTSMOUTHOH45662311374523501(C)(3)24517089INTERCOMPANY SUPPORT.
SOUTHERN OHIO PERFORMING ARTS
PO BOX 1122PORTSMOUTHOH45662311346687501(C)(3)300001681PRINTINGSPONSORSHIP OF "BROADWAY SERIES."
CIVIC FORUM
5466 STATE RT 139PORTSMOUTHOH45662352339573501(C)(3)5000SPELLING BEE AND FIREWORKS ON JULY 4TH.
SOUTHERN OHIO MUSEUM
PO BOX 990PORTSMOUTHOH45662310914613501(C)(3)5000SPONSORSHIP OF "CREAM OF THE CROP" AND DONATIONS.
(no name)
RELATIONSHIPS AND DONATIONS.
PORTSMOUTH ROTARY CLUB
7438 CANTERBURY RDSCIOTOVILLEOH45662316038791501(C)(3)6000CIVIC SIGN
STEVEN HUNTER HOPE FUND
PO BOX 802PORTSMOUTHOH45662262211905501(C)(3)6000PROGRAM DONATION
CIRQUE D'ART THEATRE
412-414 CHILLOCOTHE STPORTSMOUTHOH45662262867950501(C)(3)72001662SPONSOR OF THE NUTCRACKER
CLAY TOWNSHIP ROSEMOUNT SQUAD 12
1129 ORM AVEPORTSMOUTHOH45662310891634501(C)(3)5595EMS EQUIPMENT
CLAY TOWNSHIP SQUAD 11
6000 STATE ROUTE 139LUCASVILLEOH45653310891634501(C)(3)5195EMS EQUIPMENT
MINFORD SQUAD
PO BOX 117MCDERMONTOH45652310904494501(C)(3)17484EMS EQUIPMENT
SOUTH WEBSTER SQUAD
81 MARKET STREETSOUTH WEBSTEROH45682900979093501(C)(3)24431EMS EQUIPMENT
UNION TOWNSHIP SQUAD
13055 STATE ROUTE 73MCDERMOTTOH45652310835348501(C)(3)32760EMS EQUIPMENT
VALLEY TOWNSHIP SQUAD
PO BOX 595LUCASVILLEOH45648316401054501(C)(3)10890EMS EQUIPMENT
PIKE COUNTY AGRICULTURE
311 MILL STREETPIKETONOH45661316101189501(C)(3)5000SPONSOR OF APPRECIATION DINNER
TIME OUT FOR ME
PO BOX 765PORTSMOUTHOH45662314409973501(C)(3)7200SPONSOR YOUTH PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants20TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEMPLOYEE RELIEF FUNDTypeOfGrant
Number Of Recipients12NumberOfRecipients
Amount Of Cash Grant11239AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: SOUTHERN OHIO MEDICAL CENTER MAY MAKE CONTRIBUTIONS IN SUPPORT OF ORGANIZATIONS IN THE COMMUNITY. THE FOLLOWING PROCEDURES ARE IN PLACE TO MONITOR THESE FUNDS: ORGANIZATIONS ARE REQUIRED TO FILL OUT A REQUEST FOR DONATION AND ATTACH ADDITIONAL DOCUMENTATION EXPLAINING WHAT THE FUNDS WILL BE USED FOR. DEPENDING ON THE REQUEST, SOMC WILL FOLLOW UP DIRECTLY WITH GRANTEE TO VARIFY THE FUNDS WERE USED FOR ITS INTENDED PURPOSE. SOMC ALSO PROVIDES FUNDING TO SOMC MEDICAL CARE FOUNDATION. THE FOLLOWING PROCEDURES OUTLINE SOMC'S POLICIES AS IT RELATES TO PROVIDING GRANTS: REQUESTS ARE FIRST CONSIDERED AT THE FINANCE AND ALLOCATIONS SUBCOMMITTEE MEETINGS ON A MONTHLY BASIS. IF THE COMMITTEE APPROVES THE FUNDING REQUEST, THE REQUEST WILL BE PRESENTED AT THE DEVELOPMENT FOUNDATION'S BOARD OF DIRECTORS BIMONTHLY MEETING. THEREFORE, REQUESTS MUST BE RECEIVED IN THE DEVELOPMENT FOUNDATION OFFICE NO LATER THAN THE END OF THE MONTH PRECEDING THE MEETING AT WHICH THE APPLICANT DESIRES FOR THE REQUEST TO BE CONSIDERED. THE FOLLOWING INFORMATION MUST BE INCLUDED IN THE REQUEST: I. TITLE OF PROJECT II. NAME, DEPARTMENT AND CONTACT INFORMATION FOR THE PROJECT MANAGER III. AMOUNT REQUESTED IV. TIME PERIOD FOR THE PROJECT V. PURPOSE OF THE PROJECT VI. STATEMENT THAT DESCRIBES HOW THE PROJECT IS CONSISTENT WITH THE MISSION OF SOMC VII. STATEMENT THAT EXPLAINS WHY FUNDS ARE NOT AVAILABLE FROM SOMC'S OPERATING BUDGET VIII. SIGNATURES OF THE PROJECT MANAGER AND HIS/HER DEPARTMENT DIRECTOR MONITORING USE OF FUNDS: A QUARTERLY REPORT SHALL BE SUBMITTED BY THE PROJECT MANAGER TO THE DEVELOPMENT FOUNDATION OUTLINING THE RESULTS OF THE PROJECT OR AN UPDATE ON THE OUTCOME OF THE FUNDING EXPENDITURE. A FINAL PROJECT REPORT WILL BE DUE WITHIN TWO MONTHS AFTER COMPLETION OF THE PROJECT. FOR GRANTS TO INDIVIDUALS LISTED IN PART III, FUNDS ARE DONATED BY EMPLOYEES AND MATCHED BY SOUTHERN OHIO MEDICAL CENTER. IN THE EVENT THAT AN EMPLOYEE EXPERIENCES AN EMERGENCY WHERE THEY ARE IN SERIOUS FINANCIAL NEED, A COMMITTEE MAY APPROVE GRANTS FROM THE EMPLOYEE RELIEF FUND. THE FOLLOWING PROCEDURES ARE IN PLACE TO MONITOR THE USE OF THESE FUNDS: EMPLOYEES REQUESTING ASSISTANCE MUST COMPLETE A REQUEST FORM IN ORDER TO DETERMINE ELIGIBILITY. YOUR NAME WILL NOT BE SHARED IN THE DETERMINATION, ONLY THE INFORMATION SPECIFIC TO YOUR REQUEST WILL BE DISCUSSED. THE MAXIMUM SINGLE DONATION IS $1,000. DONATIONS ARE SUBJECT TO THE AVAILABILITY OF FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required0SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RANDAL ARNETT
PRESIDENT & CEO5205370197483029776029601601836601062178000
ELIE SAAB MD
SMD CRITICAL CARE0615467000851100284640254950754536067972
DEAN WRAY
VP FINANCE27162608310001827101064150200460499458000
KENDALL L STEWART
VP MEDICAL AFFAIRS319978092779010705603133801836605695170862000
CLAUDIA L BURCHETT
VP PATIENT SERVICES226905058913010040930180231190402959000
VICKI A NOEL
VP HR & ORGANIZATIONAL DEV19810505720204210570970245940337419000
LEEANN L SAMMONS
VP HEALTH & SAFETY16155404667703330449390236950277198000
BENJAMIN L GILL
VP OF SUPPORT SERVICES14628604149702600382340157970242074000
RORY E PHILLIPS
ADM DIR OF PHARMACY16415503360201380161400248950238930000
BRENT A RICHARD
ADM DIRECTOR INFORMATION SYSTEMS13912502083702580145530164610191234000
CRAIG E GILLILAND
ADM DIR FINANCIAL SERVICES1314420265660360097560254950193619000
VALERIE DECAMP
ADM DIR OF NURSING (I/P &122895011205054075210219760163651000
LEONARD T GREENE
ADM DIRECTOR OF SURGICAL SERVICES12794702241302580136890164610180768000
JOHN TURJOMAN
FORMER CHIEF OF STAFF2501000171610000019662000
ERNESTO BANALAGAY
FORMER CHIEF OF STAFF00001480100000014801001480100

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE ORGANIZATION PAYS A COUNTRY CLUB MEMBERSHIP ON THE CEO'S BEHALF AS A MEANS FOR THE CEO TO NETWORK WITH PHYSICIANS. ALL OF THE COUNTRY CLUB MEMBERSHIP DUES WERE TREATED AS TAXABLE COMPENSATION TO THE CEO.
PART I, LINE 4BTHE ORGANIZATION MADE CONTRIBUTIONS TO A SERP FOR THE FOLLOWING INDIVIDUALS: RANDAL ARNETT: 276,016 KENDALL STEWART: 13,838 DEAN WRAY: 91,415 CLAUDIA BURCHETT: 71,618 VICKI NOEL: 42,097 LEEANN SAMMONS: 34,428 BENJAMIN GILL: 28,722 THE SERP PLAN IS AVAILABLE ONLY TO INDIVIDUALS WHO HAVE HELD AN EXECUTIVE POSITION FOR ONE YEAR. THE SERP WILL VEST UPON THE EXECUTIVE REACHING A SPECIFIED AGE. IF AN EXECUTIVE SEVERS EMPLOYMENT OR IS TERMINATED, A NONCOMPETE AGREEMENT IS IN PLACE FOR 2 YEARS. THE EXECUTIVE FORFEITS ANY SERP PAYMENTS IF HE/SHE DOES NOT CONFORM TO THE NONCOMPETE AGREEMENT. THE AMOUNTS LISTED ABOVE ARE INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN C. KENDALL STEWART'S SERP WAS PAID OUT DURING THE CALENDAR YEAR IN THE AMOUNT OF $86,200. THE PAY OUT IS INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN B(III). THE CERP PROGRAM IS AN INCENTIVE PROGRAM FOR PHYSICIANS TO BE AVAILABLE ON CALL IN THE EVENT OF AN EMERGENCY. A PHYSICIAN MUST PARTICIPATE IN THE PROGRAM FOR 5 YEARS BEFORE BECOMING VESTED AND THE PHYSICIAN ALSO MUST REACH A SPECIFIED AGE. A NONCOMPETE AGREEMENT IS IN PLACE, AND THE PHYSICIAN FORFEITS ANY CERP PAYMENTS IF HE/SHE DOES NOT CONFORM TO THE NONCOMPETE AGREEMENT. SOUTHERN OHIO MEDICAL CENTER MADE CONTRIBUTIONS TO A CERP (COMMUNITY EMERGENCY RESPONSE PLAN) FOR THE FOLLOWING INDIVIDUAL: DR. ELIE SAAB $ 150 THE AMOUNT LISTED ABOVE IS INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN C. ELIE SAAB, DARREN ADAMS, FORMER CHIEF OF STAFF ERNESTO BANALAGAY AND JOHN TURJOMAN'S CERP WAS PAID OUT DURING THE CALENDAR YEAR IN THE FOLLOWING AMOUNTS: ELIE SAAB $ 67,972 DARREN ADAMS $ 58,550 ERNESTO BANALAGAY $148,010 JOHN TURJOMAN $ 17,161 THE PAY OUT IS INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN B(III).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF SCIOTO OHIOBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN316400086IssuerEIN
CUSIP Number808878FN7CUSIPNumber
Date Issued2008-07-23DateIssued
Issue Price150783464IssuePrice
Description Of PurposeHOSPITAL ADDITION & RENOVATIONS AND CURRENT REFUNDING OF 2006 BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired10265000AmountRetired
Total Proceeds178921832TotalProceeds
Amount In Reserve Fund10956542AmountInReserveFund
Capitalized Interest2835003CapitalizedInterest
Refunding Escrow127600000RefundingEscrow
Issuance Costs From Proceeds1619626IssuanceCostsFromProceeds
Working Capital Expenditures7850000WorkingCapitalExpenditures
Capital Expenditures27628899CapitalExpenditures
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs1NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due1NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE K PART IV, ARBITRAGE, LINE 2CDATE REBATE COMPUTATION PERFORMEDISSUER NAME: COUNTY OF SCIOTO, OHIO DATE THE REBATE COMPUTATION WAS PERFORMED: 05/13/2013
PART II, LINE 1: RETIRED CUSIP 808878FL1 ($2,380,000) AND CUSIP 808878FM9 ($2,500,000) AND CUSIP 808878FN7. PART II, LINE 3: INCLUDES ISSUE PRICE PLUS UNSPENT PROCEEDS FROM 2006 BONDS. INTEREST EARNINGS ON CONSTRUCTION FUND AFTER 7/23/08, INTEREST EARNINGS ON EXPENSE FUND, INTEREST EARNINGS ON CAPITALIZED INTEREST FUND AND INTEREST EARNINGS ON DSFR. PART II, LINE 5: INCLUDES INTEREST EARNINGS ON THE CAPITALIZED INTEREST FUND, WHICH WERE USED TO PAY CAPITALIZED INTEREST ON THE 2008 BONDS. PART II, LINE 6: $127,600,000 OF PROCEEDS WERE USED TO CURRENTLY REFUND THE 2006 BONDS. THE ESCROW FUND WAS EXPENDED ON THE DATE OF ISSUANCE OF THE SERIES 2008 BONDS (7/23/08). PART II, LINE 7: INCLUDES UNDERWRITER'S DISCOUNT PLUS SERIES 2008 PROCEEDS DEPOSITED IN 2008 EXPENSE FUND. PART II, LINE 9: INCLUDES QUALIFIED HEDGE TERMINATION PAYMENT PLUS NON-QUALIFIED HEDGE TERMINATION PAYMENT RELATED TO THE 2006 SERIES BONDS. PART II, LINE 10: INCLUDES UNSPENT PROCEEDS FOR 2006 BONDS PLUS INTEREST EARNINGS ON THE CONSTRUCTION FUND. PART III, LINE 3: ALL MANAGEMENT CONTRACTS COMPLY WITH SAFE HARBOR REVENUE PROCEDURE 97-13. PART V: SOMC PLANS TO WORK WITH BOND COUNSEL TO DEVELOP WRITTEN PROCEDURES.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
BANNON HOWLAND & DEVER
BOARD CHAIR ROBERT DEVER IS SENIOR PARTNER OF BANNON, HOWLAND, & DEVER240000$20,000 PER MONTH RETAINER AS GENERAL COUNSEL TO SOUTHERN OHIO MEDICAL CENTER AND ITS RELATED ENTITIES.0
PORTSMOUTH INSURANCE AGENCY
BOARD MEMBER GARY DUZAN IS A PARTNER OF PORTSMOUTH INSURANCE AGENCY273233INSURANCE PROVIDER0
US BANK
BOARD MEMBER DAVID FOWLER IS AN OFFICER AT US BANK'S PORTSMOUTH BRANCH265066SERVICE CHARGES, INTEREST, AND FEES ASSOCIATED WITH SEVERAL DIFFERENT BANK ACCOUNTS.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11FORM 990 INFORMATION IS COMPILED IN THE ACCOUNTING DEPARTMENT THEN SENT TO THE INDEPENDENT TAX ACCOUNTANTS TO ANALYZE THE INFORMATION AND COMPLETE THE TAX RETURN. THE FORM IS THEN REVIEWED BY FINANCIAL STAFF, TIED OUT TO THE TRIAL BALANCE, AND E-MAILED TO THE BOARD. IN ADDITION, THE CFO PRESENTS FORM 990 TO THE BOARD EXECUTIVE COMPENSATION COMMITTEE BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE FILLED OUT ANNUALLY IN JANUARY FOR OFFICERS AND FOR NEW AND RETURNING BOARD MEMBERS. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE. ANY CONFLICTS ARE DOCUMENTED IN THE MINUTES AND ADDRESSED. CONFLICTS OF INTEREST ARE RAISED BY OFFICERS OR BOARD MEMBERS ONCE THEY ARE KNOWN BY THE INDIVIDUAL. BOARD MEMBERS ABSTAIN FROM VOTING IF A CONFLICT IS IDENTIFIED THAT THE BOARD MEMBER IS INVOLVED WITH.
FORM 990, PART VI, SECTION B, LINE 15ON AN ANNUAL BASIS, AN INDEPENDENT CONSULTANT PROVIDES THE BOARD COMPENSATION COMMITTEE WITH COMPARABLE DATA AND OTHER FACTS WHICH ARE USED BY THE COMMITTEE TO DETERMINE EXECUTIVE PAY PHILOSOPHY. THE DECISIONS REGARDING OFFICER COMPENSATION ARE DOCUMENTED IN THE BOARD COMPENSATION COMMITTEE MINUTES, AS WELL AS THE BOARD MEETING MINUTES. THIS COMMITTEE DETERMINES THE CEO'S PAY AND SETS PAY RANGES FOR THE OTHER EXECUTIVES. THE PROCESS WAS LAST UNDERTAKEN DURING 2012.
FORM 990, PART VI, SECTION C, LINE 19SOUTHERN OHIO MEDICAL CENTER PROVIDES ITS FINANCIAL STATEMENTS TO THE PUBLIC THROUGH THE FILING OF ITS FORM 990 AS WELL AS ITS BOND DISCLOSURE. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC ON SOUTHERN OHIO MEDICAL CENTER'S WEBSITE.
FORM 990, PART XI, LINE 9:CHANGE IN ACTUARIAL VALUE OF PENSION 86,800. GAIN FROM DISCONTINUED OPERATIONS (RRC) 261,699. CHANGE IN ACTUARIAL COST 7,552,800. TRANSFER TO SOMC TITLE HOLDING COMPANY -275,579.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C:THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PAGE 1, LINE C:DOING BUSINESS AS: SOMC CANCER CENTER, SOMC HOME HEALTH SERVICES, SOMC L.I.F.E. CENTER, SOMC URGENT CARE CENTER, SOMC HOSPICE CENTER, SOMC WOUND HEALING CENTER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SOMC FOUNDATION INC
1805 27TH STREETPORTSMOUTHOH45662311564440HOLD INVESTMENTS FOR BENEFIT OF SOUTHERN OHIO MEDICAL CENTEROH501(C)(3)LINE 11A, ISOUTHERN OHIO MEDICAL CENTER1
THE FRIENDS OF SOUTHERN OHIO MEDICAL CENTER
1805 27TH STREETPORTSMOUTHOH45662310677520FUNDRAISINGOH501(C)(3)LINE 11A, ISOUTHERN OHIO MEDICAL CENTER1
SOMC MEDICAL CARE FOUNDATION INC
1248 KINNEYS LANEPORTSMOUTHOH45662311374523MEDICINE AND SURGERYOH501(C)(3)LINE 11A, ISOUTHERN OHIO MEDICAL CENTER1
SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY
1805 27TH STREETPORTSMOUTHOH45662311417566MANAGE REAL ESTATEOH501(C)(2)N/ASOUTHERN OHIO MEDICAL CENTER1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SOMC MEDICAL CARE FOUNDATION
B24517089ACCRUAL TRANSACTIONS
SOMC MEDICAL CARE FOUNDATION
K152514RENTAL CHARGES PER CONTRACT
SOMC MEDICAL CARE FOUNDATION
L62393COST PER CONTRACT
SOMC MEDICAL CARE FOUNDATION
M949510COST PER CONTRACT
SOMC MEDICAL CARE FOUNDATION
O35414614ALLOCATION OF COSTS
SOMC MEDICAL CARE FOUNDATION
P37737707ALLOCATION OF COSTS
SOMC MEDICAL CARE FOUNDATION
Q7322678ALLOCATION OF COSTS
SOMC TITLE HOLDING COMPANY
K1540262RENTAL CHARGES PER CONTRACT
SOMC TITLE HOLDING COMPANY
Q1260456ALLOCATION OF COSTS
THE FRIENDS OF SOUTHERN OHIO MEDICAL CENTER
O145424ALLOCATION OF COSTS
SOMC TITLE HOLDING COMPANY
H87139ALLOCATION OF COSTS
THE FRIENDS OF SOUTHERN OHIO MEDICAL CENTER
C59768CASH AND FMV
SOMC TITLE HOLDING COMPANY
R275579TRANSFER OF CASH

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