2014-05-15T13:18:54-05:00 2013-06-30 351178661 BLUE & CO LLC 8800 LYRA DRIVE SUITE 450 COLUMBUS OH 43240 990 2012-07-01 344440884 WOOD COUNTY HOSPITAL ASSOCIATION WOOD 4193548900 950 W WOOSTER STREET BOWLING GREEN OH 43402 KAROL D BORTEL 4193548900 2014-05-15 1 STEPHEN A SHERIDAN P00028551 6148852583 2014-05-15 2012 2015-11-30 17:44:51Z KAROL D BORTEL 950 W WOOSTER STREET BOWLING GREEN OH 43402 102976068 0 X WWW.WOODCOUNTYHOSPITAL.ORG X 1951 OH INPATIENT ACUTE CARE AND ANCILLARY SERVICES ARE AVAILABLE TO SERVE BOTH TRADITIONAL INPATIENTS AND AMBULATORY PATIENTS. EMERGENCY SERVICES ARE PROVIDED 24 HOURS A DAY, SEVEN DAYS A WEEK. DURING FISCAL YEAR 2013, 24,749 INDIVIDUALS RECEIVED TREATMENT IN THE EMERGENCY DEPARTMENT. MEDICAL CARE IS PROVIDED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DURING THE FISCAL YEAR, $80,372,542 WAS THE VALUE OF SERVICES PROVIDED WHERE THE HOSPITAL DID NOT RECEIVE FULL PAYMENT. OF THIS, $4,001,292 WAS CHARITY CARE. 11 10 819 300 4251 0 1287105 1690772 87599330 92924700 913517 4616412 2402308 3744184 92202260 102976068 0 0 0 0 47214883 49049475 0 0 0 44604762 50143610 91819645 99193085 382615 3782983 180469324 195885942 67631592 71279549 112837732 124606393 X WOOD COUNTY HOSPITAL'S MISSION IS TO PROVIDE THE HIGHEST QUALITY PREVENTATIVE, RESTORATIVE, EDUCATIONAL AND REHABILITATION HEALTH CARE SERVICES TO ALL. 0 0 4001292 WOOD COUNTY HOSPITAL PROVIDED HEALTH CARE SERVICES TO 3,238 INPATIENTS, 325 NEWBORNS, AND 99,561 OUTPATIENTS DURING FISCAL YEAR ENDING 6/30/13. WOOD COUNTY HOSPITAL PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF OUR HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS ARE FINANCIALLY ABLE TO PURCHASE NECESSARY MEDICAL CARE. THEREFORE, IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, WOOD COUNTY HOSPITAL PROVIDED CHARITY CARE VALUED AT $4,001,292. 587040 185041 THE HOSPITAL PROVIDED COMMUNITY EDUCATION AND ASSISTANCE IN THE FOLLOWING WAYS:- COMMUNITY HEALTH IMPROVEMENT SVCS AT AN EXPENSE OF $341,901 WITH AN OFFSET OF $113,541 FOR A BENEFIT OF $228,360 HELPING 20,106 PERSONS. - HEALTH PROFESSIONS EDUCATION AT AN EXPENSE OF $54,986 WITH AN OFFSET OF $0 FOR A BENEFIT OF $54,986 HELPING 119 PERSONS. - SUBSIDIZED HEALTH SERVICES AT AN EXPENSE OF $4,663 WITH AN OFFSET OF $0 FOR A BENEFIT OF $4,663 HELPING 122 PERSONS. - FINANCIAL AND IN-KIND CONTRIBUTIONS AT AN EXPENSE OF $132,468 WITH AN OFFSET OF $71,500 FOR A BENEFIT OF $60,968 HELPING 99,782 PERSONS. - COMMUNITY BUILDING ACTIVITIES AT AN EXPENSE OF $31,125 WITH AN OFFSET OF $0 FOR A BENEFIT OF $31,125 HELPING 287,937 PERSONS - COMMUNITY BENEFIT OPERATIONS AT AN EXPENSE OF $21,897 WITH AN OFFSET OF $0 FOR A BENEFIT OF $21,897 HELPING 450,000 PERSONS. 50273320 93283864 IN FULFILLING OUR MISSION, WOOD COUNTY HOSPITAL SHALL STRIVE TO:-PROVIDE THE HIGHEST QUALITY PATIENT CARE, RESPECTING THE UNIQUENESS OF EACH PATIENT, AND PROVIDING SERVICE WITH COMPASSION AND COURTESY.-MAINTAIN AN ENVIRONMENT ATTRACTIVE TO WELL-TRAINED, EFFECTIVE HEALTH CARE PROFESSIONALS IN ALL APPROPRIATE SPECIALTIES.-IDENTIFY, INITIATE, AND PROVIDE INNOVATIVE SERVICES RESPONSIVE TO CHANGING HEALTHCARE NEEDS.-CULTIVATE A PROACTIVE APPROACH TO ASSURE THE PROVISION OF SAFE CARE AND SERVICE TO PATIENTS, VISITORS, AND STAFF.-PROVIDE AND UTILIZE FACILITIES AND TECHNICAL RESOURCES APPROPRIATE FOR THE DELIVERY OF HIGH QUALITY, COST EFFECTIVE CARE.-IDENTIFY, PLAN AND IMPLEMENT FINANCIAL AND BUSINESS PRACTICES THAT ENSURE THE FUTURE STABILITY, VITALITY, AND INDEPENDENCE OF WOOD COUNTY HOSPITAL.-FOSTER A SPIRIT OF COOPERATION WITHIN THE HOSPITAL, AS WELL AS WITH OTHER PROVIDERS IN THE HEALTH CARE DELIVERY SYSTEM. 54861652 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 94 0 819 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 1 1 0 OH X KAROL D BORTEL 4193548900 950 W WOOSTER ST BOWLING GREEN OH 434022699 KAREN APPLE 1.50 1.00 X 0 0 0 DR THOMAS WOJCIECHOWSKI 1.50 X 0 0 0 DIANE HUFFMAN 1.50 X 0 0 0 DR RICHARD BARKER 1.50 X X 0 0 0 DANELDA DREWES 1.50 1.00 X X 0 0 0 JAMES F CARTER 1.50 0.30 X 0 0 0 WILLIAM CULBERTSON 1.50 0.30 X 0 0 0 MICHAEL MARSH 1.50 X 0 0 0 STEVEN PATTON 1.50 X 0 0 0 GAYLYN FINN 1.50 X X 0 0 0 STANLEY KORDUCKI 40.00 0.30 X X 244582 0 39074 KAROL BORTEL 40.00 0.30 X 114670 0 18917 WILLIAM KIDD 40.00 0.30 X 115663 0 2665 GEORGE MASSAR 40.00 X 121044 0 19057 CAROLE MATTHEWS 40.00 X 136568 0 9439 JOANNE WHITE 40.00 X 117558 0 7455 TODD M LEOPOLD 40.00 X 111628 0 18859 961713 0 115466 10 0 1 0 TECHNICORE CLINICAL ENGINEERING PO BOX 1210 FINDLAY OH 45839 SERVICE AGREEMENTS 429086 SHUMAKER LOOP & KENDRICK NORTH COURTHOUSE SQUARE TOLEDO OH 43624 LEGAL SERVICES 225354 BILLING MANAGEMENT LLC PO BOX 634850 CINCINNATI OH 452634850 CONSULTANTS 165337 BLUE & CO LLC PO BOX 66568 INDIANAPOLIS IN 46266 AUDITORS 157404 CJ OSTRANDER 6846 HEATHER COVE MAUMEE OH 43537 CONSTRUCTION MANAGEMENT 105884 5 1517685 173087 1690772 PATIENT SERVICE REVENUE - RELATED 900099 92924700 92924700 92924700 967905 967905 744415 0 744415 744415 744415 3648255 252 0 0 3648255 252 3648507 3648507 MEANINGFUL USE - STATE AND FED 900099 988465 988465 MISCELLANEOUS 900099 769118 544205 4251 220662 MEALS 900099 420263 420263 821923 821923 2999769 102976068 93468905 4251 7812140 417243 262254 154989 36810384 26871580 9938804 3121452 2278660 842792 6103018 6103018 2597378 1896086 701292 291558 291558 114481 114481 4630254 4167229 463025 792262 792262 515861 515861 1984154 1785739 198415 4584544 4584544 79023 22126 56897 109104 27276 81828 1696493 1696493 8511344 8511344 692976 692976 MEDICAL AND OTHER SUPPL 14357657 9332477 5025180 BAD DEBT 6508926 6508926 MISCELLANEOUS 2741368 2741368 FRANCHISE TAX 1339721 1339721 1193884 917037 276847 99193085 54861652 44331433 0 1325150 1631909 20052995 22317344 14054557 14021149 234068 73519 1702283 1979962 1168585 1020857 140249009 69522296 70100689 70726713 40689161 49334914 1950295 2004339 29191541 32775236 180469324 195885942 5654954 6677898 42719282 57045735 2071680 1856528 17185676 5699388 67631592 71279549 X 83698394 93305569 27189043 29296485 1950295 2004339 112837732 124606393 180469324 195885942 X 3782983 -471788 8457466 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1305499 1305499 20464984 10062345 10402639 113591222 59459951 54131271 4887304 4887304 70726713 INTEREST IN WOOD COUNTY HOSPITAL FOUNDATION 29296485 INVESTMENT IN JOINT VENTURES 1992354 OTHER ASSETS 131159 ESTIMATED THIRD PARTY SETTLEMENTS 594529 BOND ISSUANCE COSTS, NET 760709 32775236 PENSION LIABILITY 5699388 5699388 ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ASSOCIATION AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES AND HAS CONCLUDED THAT AS OF JUNE 30, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ASSOCIATION HAS FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH JUNE 30, 2013 AND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). 1 1 1 X 1 X 1 1 1 0 1 1 3593459 1002451 2591008 0.02800 9443722 4974140 4469582 0.04820 13037181 5976591 7060590 0.07620 60770 60770 0.00070 60770 60770 0.00070 13097951 5976591 7121360 0.07690 1 5784057 11880866 16346325 -4465459 X 1 1 1 WOOD CARE NET MESSENGER MODEL PHO 0.50000 0.00000 0.50000 1 1 WOOD COUNTY HOSPITAL ASSOCIATION

1037 CONNEAUT AVE BOWLING GREEN OH 43402

HTTP://WWW.WOODCOUNTYHOSPITAL.ORG/ X WOOD COUNTY HOSPITAL ASSOCIATION 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 100.000000000000 1 200.000000000000 1 X X 1 1 X X X X X 1 X X X 1 X X X X X X 1 X 0 1 3 WOOD COUNTY HOSPITAL REHABILITATION CENT

1037 CONNEAUT AVE BOWLING GREEN OH 43402

PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY WOOD COUNTY WOUND HEALING CENTER

1037 CONNEAUT AVE BOWLING GREEN OH 43402

WOUND HEALING TREATMENT CENTER WOOD COUNTY HOSPITAL BLOOD DRAW STATION

1039 HASKINS ROAD BOWLING GREEN OH 43402

LAB PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6508926. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE ASSOCIATION'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE JUNE 30, 2013 AND 2012 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $4,366,642 AND $3,620,590, RESPECTIVELY, RELATES TO RESERVES FOR SELF-PAY BALANCES. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON A PERCENTAGE OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2013 AND 2012. THE ASSOCIATION'S SELF-PAY WRITE-OFFS INCREASED $613,952 FROM $5,148,922 FOR 2012 TO $5,762,874 FOR 2013. THE INCREASE IN WRITE-OFFS IS THE RESULT OF INCREASES IN ENDING SELF-PAY ACCOUNTS RECEIVABLE. THE ASSOCIATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. PART III, LINE 9B: IT IS OUR POLICY TO PROCESS CHARITY APPLICATIONS WHEN WE KNOW THE PATIENT IS ELIGIBLE, AND NOT TO PURSUE A FORM OF PAYMENT ONCE WE HAVE THE ELIGIBILTIY CONFIRMED. WOOD COUNTY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 3: DESIGNTHIS COMMUNITY HEALTH ASSESSMENT WAS CROSS-SECTIONAL IN NATURE AND INCLUDED A WRITTEN SURVEY OF ADULTS, ADOLESCENTS, AND PARENTS WITHIN WOOD COUNTY. FROM THE BEGINNING, COMMUNITY LEADERS WERE ACTIVELY ENGAGED IN THE PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE STUDY. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID NEEDS ASSESSMENT.INSTRUMENT DEVELOPMENTFOUR SURVEY INSTRUMENTS WERE DESIGNED AND PILOT TESTED FOR THIS STUDY: ONE FOR ADULTS, ONE FOR ADOLESCENTS, ONE FOR PARENTS OF CHILDREN AGES 0-5, AND ONE FOR PARENTS OF CHILDREN AGES 6-11. AS A FIRST STEP IN THE DESIGN PROCESS, HEALTH EDUCATION RESEARCHERS FROM THE UNIVERSITY OF TOLEDO AND STAFF MEMBERS FROM THE HOSPITAL COUNCIL OF NW OHIO MET TO DISCUSS POTENTIAL SOURCES OF VALID AND RELIABLE SURVEY ITEMS THAT WOULD BE APPROPRIATE FOR ASSESSING THE HEALTH STATUS AND HEALTH NEEDS OF ADULTS AND ADOLESCENTS. THE INVESTIGATORS DECIDED TO DERIVE THE MAJORITY OF THE ADULT SURVEY ITEMS FROM THE BRFSS. THE MAJORITY OF THE SURVEY ITEMS FOR THE ADOLESCENT SURVEY WERE DERIVED FROM THE YRBSS. THE MAJORITY OF THE SURVEY ITEMS FOR THE PARENTS OF CHILDREN 0-11 WERE DERIVED FROM THE NSCH. THIS DECISION WAS BASED ON BEING ABLE TO COMPARE LOCAL DATA WITH STATE AND NATIONAL DATA.THE PROJECT COORDINATOR FROM THE HOSPITAL COUNCIL OF NW OHIO CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM WOOD COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS, YRBSS, AND NSCH SURVEYS WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE WOOD COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED DRAFTS OF SURVEYS CONTAINING 112 ITEMS FOR THE ADULT SURVEY, 73 ITEMS FOR THE ADOLESCENT SURVEY, 71 ITEMS FOR THE 0-5 SURVEY, AND 79 ITEMS FOR THE 6-11 SURVEY. THE DRAFTS WERE REVIEWED AND APPROVED BY HEALTH EDUCATION RESEARCHERS AT THE UNIVERSITY OF TOLEDO.DESIGNTHIS COMMUNITY HEALTH ASSESSMENT WAS CROSS-SECTIONAL IN NATURE AND INCLUDED A WRITTEN SURVEY OF ADULTS, ADOLESCENTS, AND PARENTS WITHIN WOOD COUNTY. FROM THE BEGINNING, COMMUNITY LEADERS WERE ACTIVELY ENGAGED IN THE PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE STUDY. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID NEEDS ASSESSMENT.INSTRUMENT DEVELOPMENTFOUR SURVEY INSTRUMENTS WERE DESIGNED AND PILOT TESTED FOR THIS STUDY: ONE FOR ADULTS, ONE FOR ADOLESCENTS, ONE FOR PARENTS OF CHILDREN AGES 0-5, AND ONE FOR PARENTS OF CHILDREN AGES 6-11. AS A FIRST STEP IN THE DESIGN PROCESS, HEALTH EDUCATION RESEARCHERS FROM THE UNIVERSITY OF TOLEDO AND STAFF MEMBERS FROM THE HOSPITAL COUNCIL OF NW OHIO MET TO DISCUSS POTENTIAL SOURCES OF VALID AND RELIABLE SURVEY ITEMS THAT WOULD BE APPROPRIATE FOR ASSESSING THE HEALTH STATUS AND HEALTH NEEDS OF ADULTS AND ADOLESCENTS. THE INVESTIGATORS DECIDED TO DERIVE THE MAJORITY OF THE ADULT SURVEY ITEMS FROM THE BRFSS. THE MAJORITY OF THE SURVEY ITEMS FOR THE ADOLESCENT SURVEY WERE DERIVED FROM THE YRBSS. THE MAJORITY OF THE SURVEY ITEMS FOR THE PARENTS OF CHILDREN 0-11 WERE DERIVED FROM THE NSCH. THIS DECISION WAS BASED ON BEING ABLE TO COMPARE LOCAL DATA WITH STATE AND NATIONAL DATA.THE PROJECT COORDINATOR FROM THE HOSPITAL COUNCIL OF NW OHIO CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM WOOD COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS, YRBSS, AND NSCH SURVEYS WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE WOOD COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED DRAFTS OF SURVEYS CONTAINING 112 ITEMS FOR THE ADULT SURVEY, 73 ITEMS FOR THE ADOLESCENT SURVEY, 71 ITEMS FOR THE 0-5 SURVEY, AND 79 ITEMS FOR THE 6-11 SURVEY. THE DRAFTS WERE REVIEWED AND APPROVED BY HEALTH EDUCATION RESEARCHERS AT THE UNIVERSITY OF TOLEDO.THE RESPONSE RATE FOR THE MAILING WAS 37% (N=360: CI=5.16). THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSES IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY.ADOLESCENT SURVEYTHE SURVEY WAS APPROVED BY ALL SUPERINTENDENTS. SCHOOLS AND GRADES WERE RANDOMLY SELECTED. EACH STUDENT IN THAT GRADE HAD TO HAVE AN EQUAL CHANCE OF BEING IN THE CLASS THAT WAS SELECTED, SUCH AS A GENERAL ENGLISH OR HEALTH CLASS. CLASSROOMS WERE CHOSEN BY THE SCHOOL PRINCIPAL. PASSIVE PERMISSION SLIPS WERE MAILED HOME TO PARENTS OF ANY STUDENT WHOSE CLASS WAS SELECTED TO PARTICIPATE. THE RESPONSE RATE WAS 97% (N=452). THE SURVEY CONTAINED 73 QUESTIONS AND HAD A MULTIPLE CHOICE RESPONSE FORMAT.CHILDREN 0-5 AND 6-11PRIOR TO MAILING THE SURVEY TO PARENTS OF 0-11 YEAR OLDS, AN ADVANCE LETTER WAS MAILED TO 1,600 PARENTS IN WOOD COUNTY. THIS ADVANCE LETTER WAS PERSONALIZED, PRINTED ON WOOD COUNTY HEALTH PARTNERS STATIONERY AND WAS SIGNED BY PAMELA BUTLER, HEALTH COMMISSIONER, WOOD COUNTY HEALTH DEPARTMENT, AND STAN KORDUCKI, CEO, WOOD COUNTY HOSPITAL. THE LETTER INTRODUCED THE COUNTY HEALTH ASSESSMENT PROJECT AND INFORMED THE READERS THAT THEY MAY BE RANDOMLY SELECTED TO RECEIVE THE SURVEY. THE LETTER ALSO EXPLAINED THAT THE RESPONDENTS' CONFIDENTIALITY WOULD BE PROTECTED AND ENCOURAGED THE READERS TO COMPLETE AND RETURN THE SURVEY PROMPTLY IF THEY WERE SELECTED.TWO WEEKS FOLLOWING THE ADVANCE LETTER, A THREE-WAVE MAILING PROCEDURE WAS IMPLEMENTED TO MAXIMIZE THE SURVEY RETURN RATE. THE INITIAL MAILING INCLUDED A PERSONALIZED HAND SIGNED COVER LETTER (ON HEALTHY WOOD COUNTY STATIONERY) DESCRIBING THE PURPOSE OF THE STUDY; A QUESTIONNAIRE PRINTED ON COLORED PAPER; A SELF-ADDRESSED STAMPED RETURN ENVELOPE; AND A $2 INCENTIVE. APPROXIMATELY TWO WEEKS AFTER THE FIRST MAILING, A SECOND WAVE MAILING INCLUDED ANOTHER PERSONALIZED COVER LETTER ENCOURAGING THEM TO REPLY, ANOTHER COPY OF THE QUESTIONNAIRE ON COLORED PAPER, AND ANOTHER REPLY ENVELOPE. A THIRD WAVE POSTCARD WAS SENT TWO WEEKS AFTER THE SECOND WAVE MAILING. SURVEYS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT.BECAUSE MUCH OF THE OUTPUT COMBINES IDENTICAL ITEMS FROM THE 0-5 AND THE 6-11 SURVEYS, THE NUMBER OF RETURNED SURVEYS NEEDED FOR POWER OF THE COMBINED POPULATION (N=17,437) WAS 370 AND THIS WAS EXCEEDED BY HAVING A COMBINED 515 SURVEYS.DATA ANALYSISINDIVIDUAL RESPONSES WERE ANONYMOUS AND CONFIDENTIAL. ONLY GROUP DATA ARE AVAILABLE. ALL DATA WAS ANALYZED BY HEALTH EDUCATION RESEARCHERS AT THE UNIVERSITY OF TOLEDO USING SPSS 17.0. CROSSTABS WERE USED TO CALCULATE DESCRIPTIVE STATISTICS FOR THE DATA PRESENTED IN THIS REPORT. TO BE REPRESENTATIVE OF WOOD COUNTY, THE ADULT DATA COLLECTED WAS WEIGHTED BY AGE, GENDER, RACE, AND INCOME USING 2010 CENSUS DATA. MULTIPLE WEIGHTINGS WERE CREATED BASED ON THIS INFORMATION TO ACCOUNT FOR DIFFERENT TYPES OF ANALYSES.LIMITATIONSAS WITH ALL COUNTY ASSESSMENTS, IT IS IMPORTANT TO CONSIDER THE FINDINGS IN LIGHT OF ALL POSSIBLE LIMITATIONS. FIRST, THE WOOD COUNTY ADULT ASSESSMENT HAD A HIGH RESPONSE RATE. HOWEVER, IF ANY IMPORTANT DIFFERENCES EXISTED BETWEEN THE RESPONDENTS AND THE NON-RESPONDENTS REGARDING THE QUESTIONS ASKED, THIS WOULD REPRESENT A THREAT TO THE EXTERNAL VALIDITY OF THE RESULTS (THE GENERALIZABILITY OF THE RESULTS TO THE POPULATION OF WOOD COUNTY). IF THERE WERE LITTLE TO NO DIFFERENCES BETWEEN RESPONDENTS AND NON-RESPONDENTS, THEN THIS WOULD NOT BE A LIMITATION.SECOND, IT IS IMPORTANT TO NOTE THAT, ALTHOUGH SEVERAL QUESTIONS WERE ASKED USING THE SAME WORDING AS THE CDC QUESTIONNAIRES AND THE NSCH QUESTIONNAIRE, THE ADULT AND PARENT DATA COLLECTION METHOD DIFFERED. CDC ADULT DATA AND NSCH CHILD DATA WERE COLLECTED USING A SET OF QUESTIONS FROM THE TOTAL QUESTION BANK AND ADULTS WERE ASKED THE QUESTIONS OVER THE TELEPHONE RATHER THAN AS A MAIL SURVEY. THE YOUTH CDC SURVEY WAS ADMINISTERED IN SCHOOLS IN A SIMILAR FASHION AS THIS COUNTY HEALTH ASSESSMENT.THIRD, THIS WAS THE FIRST TIME THAT PARENTS OF CHILDREN AGES 0-11 WERE SURVEYED IN WOOD COUNTY. BEING A NEW INSTRUMENT, THERE MAY HAVE BEEN QUESTIONS THAT WOULD BE WORDED DIFFERENTLY OR ADDITIONAL ITEMS THAT WOULD BE ASKED THE NEXT TIME THIS ASSESSMENT IS COMPLETED.FINALLY, THIS SURVEY ASKED PARENTS QUESTIONS REGARDING THEIR YOUNG CHILDREN. SHOULD ENOUGH PARENTS FEEL COMPELLED TO RESPOND IN A SOCIALLY DESIRABLE MANNER WHICH IS NOT CONSISTENT WITH REALITY, THIS WOULD REPRESENT A THREAT TO THE INTERNAL VALIDITY OF THE RESULTS. WOOD COUNTY HOSPITAL ASSOCIATION PART V, SECTION B, LINE 22: SELF PAY PATIENTS ARE BILLED ACCORDING TO THE FEE SCHEDULE HOWEVER, BASED ON INCOME THE SLIDING FEE SCHEDULE IS APPLIED. SELF PAY PATIENTS GENERALLY RECEIVE A DISCOUNT OF NOT LESS THAN 20%. PART V, SECTION B, LINE 21 SELF PAY PATIENTS ARE BILLED ACCORDING TO THE FEE SCHEDULE HOWEVER, BASED ON INCOME THE SLIDING FEE SCHEDULE IS APPLIED. SELF PAY PATIENTS GENERALLY RECEIVE A DISCOUNT OF NOT LESS THAN 20%. PART VI, LINE 2: NEEDS ASSESSMENT PREPARED BY THE WOOD COUNTY HEALTH PARTNERS. THIS HEALTH NEEDS ASSESSMENT CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT:HTTP://WWW.WOODCOUNTYHOSPITAL.ORG/ABOUT/COMMUNITY-RESOURCES/WOOD-COUNTY-2012-COMMUNITY-HEALTH-ASSESSMENT PART VI, LINE 3: THROUGH FINANCIAL COUNSELOR AND WEBSITE - ALSO, THE BACKSIDE OF PATIENT STATEMENTS INCLUDES A CHARITY APPLICATION TO WHICH THE PATIENTS ARE DIRECTED FROM THE FRONT OF THE STATEMENT. PART VI, LINE 4: THE COMMUNITY THAT IS SERVED BY WOOD COUNTY HOSPITAL IS DEFINED AS WOOD COUNTY SOUTH OF STATE ROUTE 582 AND CONTIGUOUS AREAS TO THE EAST, SOUTH AND WEST OF THE COUNTY LINES. THE ESTIMATED POPULATION OF THE HOSPITAL'S PRIMARY SERVICE AREA CENTERS ON 22 ZIP CODES. THIS CONSTITUTES APPROXIMATELY 80% OF THE INPATIENT DISCHARGES FROM THE HOSPITAL; WITH 20% FALLING OUTSIDE THE DEFINED SERVICE AREA. THE POPULATION IS ESTIMATED TO BE 76,615, BASED ON THE 2010 CENSUS. IT IS EXPECTED TO EXPERIENCE A VERY MODEST GROWTH RATE OF 0.5% OVER THE NEXT FIVE YEARS. PART VI, LINE 5: COMMUNITY PARTNERS: WOOD COUNTY HEALTH PARTNERSWOOD COUNTY HOSPITAL IS COMMITTED TO THE COMMUNITY IT SERVES BY PROVIDING EXCELLENT HEALTHCARE SERVICES INCLUDING MEDICAL CARE, EDUCATION, COMMUNITY SUPPORT, AND WORKING WITH LIKE-MINDED ORGANIZATIONS, AGENCIES, AND INSTITUTIONS TO MAKE A DIFFERENCE. THIS GROUP, WOOD COUNTY HEALTH PARTNERS, HAVE WORKED TOGETHER OVER THE PAST TWELVE YEARS TO COMPLETE THREE COMMUNITY HEALTH ASSESSMENTS. THE CURRENT ASSESSMENT, COMPLETED IN SEPTEMBER 2012, WAS JOINTLY FUNDED BY WOOD COUNTY HOSPITAL AND WOOD COUNTY HEALTH DISTRICT AND ALSO INCLUDED IN-KIND SUPPORT FROM THE REMAINING PARTNERS.THIS HEALTH NEEDS ASSESSMENT CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT:HTTP://WWW.WOODCOUNTYHOSPITAL.ORG/ABOUT/COMMUNITY-RESOURCES/WOOD-COUNTY-2012-COMMUNITY-HEALTH-ASSESSMENT REPORTS FILED WITH STATES PART VI, LINE 7 OH X 0 0 X X X X 0 0 0 0 0 0 0 0 0 STANLEY KORDUCKI 241867 0 0 0 2715 0 18960 0 20114 0 283656 0 0 0 PART I, LINE 1A FITNESS FACILITY BENEFIT: ACCORDING TO THE ECONOMIC BENEFITS OF REGULAR EXERCISE, RESEARCHERS HAVE FOUND THAT THE RETURN ON INVESTMENT AMONG COMPANIES THAT OFFER WELLNESS BENEFITS RANGES FROM $1.49 TO $13 FOR EVERY DOLLAR INVESTED. WELLNESS-ORIENTED SERVICES IN BOTH A FITNESS FACILITY AND THE WORKPLACE PROGRAMS WE OFFER THROUGH WELLNESS ARE PROVEN TO HELP ADDRESS OUR HEALTH GOALS, REDUCE THE IMPACT OF OBESITY RATES, AND IMPROVE BUSINESS PROFITABILITY. WOOD COUNTY HOSPITAL INVESTS IN EMPLOYEE HEALTH BY PAYING A FIXED AMOUNT OF $62.50 TO ALL EMPLOYEES, INCLUDING EXECUTIVES, WHO JOIN A FITNESS FACILITY WHERE THEY CAN WORK OUT. WOOD COUNTY HOSPITAL, LIKE OTHER EMPLOYERS, ARE AWARE THAT A FITNESS BENEFIT REDUCES EMPLOYEE HEALTH CARE EXPENSES, LOWERS RATES OF ABSENTEEISM, REDUCES DISABILITY AND WORKERS' COMPENSATION CLAIMS AND HELPS TO ATTRACT AND RETAIN TALENTED EMPLOYEES. STUDIES SHOW THAT EMPLOYEES WHO EXERCISE AT LEAST ONCE A WEEK, REGARDLESS OF THEIR WEIGHT, HAVE LOWER HEALTH CARE COSTS THAN THEIR SEDENTARY CO-WORKERS. ONE STUDY, IN FACT, SHOWED THAT ACTIVE EMPLOYEES TAKE 27 PERCENT FEWER SICK DAYS AND REPORT 14 TO 25 PERCENT FEWER DISABILITY DAYS THAN INACTIVE EMPLOYEES. WHILE ONLY 16% OF THE AMERICAN POPULATION CURRENTLY BELONGS TO A HEALTH CLUB, MEMBERSHIP HAS INCREASED MORE THAN 10% OVER THE PAST THREE YEARS TO OVER 50.2 MILLION MEMBERS, DESPITE THE POOR ECONOMY. WITH AN IMPROVED ECONOMIC OUTLOOK, CLUBS ACROSS THE COUNTRY ARE GEARING UP FOR MORE DEMAND THAN THEY'VE SEEN IN YEARS. SO THAT IS THE REASON WHY WE SUBSIDIZE EMPLOYEES JOINING A FITNESS FACILITY. SUPPLEMENTAL INFORMATION PART III 2011 W2 COMPENSATION FOR STANLEY KORDUCKI WAS REPORTED IN 2010 DUE TO FISCAL YEAR VS CALENDAR YEAR REPORTING. A WOOD COUNTY 344601607 978303AV7 2008-02-28 45525000 NEW BED TOWER, SURGERY, ETC. 1 0 0 B WOOD COUNTY 344601607 978303BH7 2012-12-06 57172853 0 0 0 A 45525000 45525000 1091332 206890 25000 44201778 2011 0 0 1 1 B 57172853 4316000 42746051 775794 9335008 2014 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 1 1 JP MORGAN CHASE 10.000000000000 0 0 0 0 0 A 1 B 1 DR VEGA PHYSICIAN RECRUITMENT X 20438 19410 0 1 1 DR T JANTZ PHYSICIAN RECRUITMENT X 33142 26514 0 1 1 DR LANE PHYSICIAN RECRUITMENT X 459306 0 1 1 1 DR BELL HOME DOWNPAYMENT LOAN X 44541 27595 0 1 1 73519 PART II - LOANS TO AND/ OR FROM INTERETED PERSONS DR. LANE PHYSICIAN LOAN DURING THE 2012 TAX YEAR END, THE REMAING BALANCE OF THE LOAN TO DR. LANEWAS WRITTED OFF AS BAD DEBT. LEGAL COUNSEL HAS EXHAUSTED ALL ATTEMPTS TO COLLECT ON THIS DEBT. LIST OF STATES WITH QUALIFIED HEALTH PLANS FORM 990, PART V, LINE 13A OH FORM 990, PART VI, SECTION B, LINE 11 THE DRAFT 990 IS PREPARED AND MEMBERS NOTIFIED THAT IT IS AVAILABLE FOR REVIEW & COMMENT. ANY QUESTIONS ARE DISCUSSED AND HANDLED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 12C EVERY 2 YEARS ALL BOARD MEMBERS AND VICE PRESIDENTS ARE ASKED TO SIGN A CONFLICT OF INTEREST DISCLOSURE. THESE DOCUMENTS ARE RETAINED IN ADMINISTRATION. ANY IDENTIFIED CONFLICTS ARE ADDRESSED BY THE BOARD OR CEO AS APPROPRIATE. ACTION TAKEN WOULD BE CONTINGENT UPON THE TYPE OF CONFLICT RANGING FROM DISCLOSURE ONLY TO ABSTAINING FROM VOTES OR DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, AN EVALUATION IS SENT TO BOARD MEMBERS AND KEY EMPLOYEES. THE BOARD COMPENSATION COMMITTEE MEETS TO REVIEW INPUT FROM THOSE QUERIED. COMPARATIVE WAGE DATA IS OBTAINED FROM OHA AND OTHER INDUSTRY REPORTING SERVICES. THE COMPENSATION COMMITTEE MAKES A RECOMMENDATION TO THE BOARD AND A VOTE IS TAKEN. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION RELATED CHANGE OTHER THAN NET PERIODIC BENEFIT COST 5,836,416. POST RETIREMENT RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST 459,564. TEMP RESTRICTED - CHANGE IN INTEREST IN NET ASSETS OF RELATED ORGANIZATION 2,107,442. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 54,044. FOIRM 990, PART XII, LINE 2C NO CHANGES WERE MADE IN THE CURRENT YEAR WOOD HEALTH COMPANY 950 W WOOSTER STREET BOWLING GREEN OH 43402 810616720 FAMILY HEALTH AND SPECIALIZED CARE OH -439609 2080272 WOOD COUNTY HOSPITAL WHC MEDICAL SERVICES 950 W WOOSTER STREET BOWLING GREEN OH 43402 050623391 FAMILY HEALTH AND SPECIALIZED CARE OH -25279 823859 WOOD COUNTY HOSPITAL WOOD COUNTY WOMEN'S CARE 755 HASKING ROAD BOWLING GREEN OH 43402 810565899 WOMEN'S HEALTH CARE OH -236972 122371 WOOD COUNTY HOSPITAL FALCON HEALTH CENTER 830 E WOOSTER ST BOWLING GREEN OH 43402 462101028 PHYSICIAN OFFICES OH 0 985750 WOOD COUNTY HOSPITAL WOOD COUNTY HOSPITAL FOUNDATION 950 W WOOSTER ST BOWLING GREEN OH 43402 341546464 TO OBTAIN CHARITABLE CONTRIBUTIONS, MANAGE THOSE GIFTS & DISBURSE THEM OH 501(C)(3) LINE 11A, I WOOD COUNTY HOSPITAL 0 WOOD COUNTY HOSPITAL MEDICAL BUILDING 950 W WOOSTER ST BOWLING GREEN OH 43402 341114700 MEDICAL OFFICE BUILDING OH 501(C)(3) LINE 3 WOOD COUNTY HOSPITAL 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WOOD COUNTY HOSPITAL FOUNDATION C 1517685 CASH