2014-09-29T08:36:29-07:00 2013-12-31 990 2013-01-01 340714581 ALLIANCE COMMUNITY HOSPITAL ALLI 3305966000 200 E State Street Alliance OH 44601 Dale Wells Chief Financial & Operating Officer 3305967066 2014-09-29 2013 2015-11-30 17:44:51Z Dale W Wells 200 E State Street Alliance OH 44601 103310161 0 X www.achosp.org X 1901 OH Alliance Community Hospital is an acute care hospital providing care to all, regardless of ability to pay. The most significant activities include inpatient and outpatient care, surgical procedures, radiology, skilled nursing facility, lab and emergency treatment. 14 10 1197 325 43513 -1695 377208 173166 94533735 99434554 -43384 6555 986941 3677487 95854500 103291762 42000 39750 0 0 53094417 55420803 0 0 46315 40457559 44075125 93593976 99535678 2260524 3756084 107498046 101405339 65050955 60429203 42447091 40976136 Alliance Community Hospital's (ACH) mission is to provide our patients and guests with a safe, comforting, and healing environment. This mission is accomplished through our Planetree philosophy of caring and provides for all patients to receive the appropriate care - physical, spiritual and social - regardless of their ability to pay. 0 0 15874338 0 7366494 Inpatient health care programs account for ACH's largest program service, providing medical services to patients from Alliance and surrounding communities. ACH admitted 3,733 patients (which includes 418 births) totaling 18,862 days of care from our staff. Various services include care from our Senior Care/Psychiatric Department, Medical Surgical Departments, Obstetrics, Intensive Care Unit, Dialysis, and Inpatient Rehabilitation Unit. Total expenses for inpatient health care in 2013 was $15.9 million. 10707872 0 16496953 Surgical procedures account for our second largest program service. In addition to Inpatient surgical procedures, ACH provides Same Day Surgery and Endoscopy services. Our surgical services departments performed 22,700 surgical procedures costing $10.7 million. 7386155 0 13036332 Radiology is ACH's third largest program service which includes Imaging, Womens Wellness, Ultrasound, MRI, Nuclear Medicine, and CT Scan. ACH provides a full service Radiology Department for Alliance and the surrounding communities that is used not only for the routine daily images, but also to service our Emergency Room 24 hours a day, 7 days per week. ACH is also providing women's wellness services to promote women's health in our service area. In 2013 ACH provided 60,357 tests costing $7.4 million. 51087307 39750 64776588 All other program services 51087307 39750 64776588 85055672 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 140 0 1197 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 10 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X X Dale Wells 3305967066 200 E State Street Alliance OH 44601 Don McAlister President 1 3 X X 0 0 0 David Lundgren Vice President 1 2 X X 0 0 0 William McCallum Secretary 1 2 X X 0 0 0 Ron Lyons Treasurer 1 3 X X 0 0 0 Dan Davia Trustee 1 1 X 0 0 0 Dr Paul Garfinkle Trustee 1 0 X 7500 0 0 Teresa Golden-McClelland Trustee 1 1 X 0 0 0 John Gross Trustee 1 1 X 0 0 0 Mike Hoover Trustee 1 3 X 0 0 0 Scott Ingledue Trustee 1 1 X 0 0 0 Stan Jonas Trustee, Chief Executive Officer 41 6 X X 402416 0 23634 Dr Duane Kuentz Trustee, Physician 41 1 X 221579 0 17145 Dr Debra Lehrer Trustee 1 1 X 106941 15000 0 Gary Wagner Trustee 1 1 X 0 0 0 Dale Wells Chief Financial & Operating Officer 40 6 X 215831 0 26982 Amy Antonacci VP, Patient Care Services 40 0 X 159448 0 17904 Dr David Mungo Physician 40 0 X 651659 0 29495 Dr Steven Deutch Physician 40 0 X 528287 0 29495 Dr Michael Necci Physician 40 0 X 499760 0 29403 Dr David Kanagy Physician 40 0 X 447856 0 27445 Dr Karamjit Bhullar Physician 40 0 X 492139 0 30443 3733416 15000 231946 30 0 1 0 Anesthesia Associates of Alliance LLC 200 E State Street Alliance OH 44601 Anesthesiologists 685100 Salem Surgical Services LLC 944 Greenbriar Parkway Suite B Kent OH 44240 Lithotripsy Services 592720 S S & G Healthcare Services PO Box 39453 Cleveland OH 44139 Phys. practice billing & consulting 523236 ARUP Laboratories PO Box 27964 Salt Lake City UT 84127 Lab Services 422179 Transtech Medical Solutions 730 N Post Oak Rd Suite 120 Houston TX 77024 Transcription Services 223280 14 0 0 29480 121527 0 22159 0 173166 Patient Revenue 622110 98467632 98467632 0 0 Cafeteria 722212 712399 0 0 712399 Other Hospital Services 900099 152398 0 0 152398 Program Related Investment Income 900099 61835 61835 0 0 Patient Education 900099 40290 40290 0 0 0 0 0 0 99434554 6942 0 0 6942 0 0 0 0 0 0 0 0 510194 0 0 0 510194 0 510194 0 0 510194 0 0 0 387 0 -387 -387 0 0 -387 28282 29480 18012 10270 0 10270 Change in Fair Value of Interest Rate 900099 2618059 2618059 0 0 Deferred Revenue Earned 900099 360000 360000 0 0 EHR Incentive Payments 900099 128551 128551 0 0 50413 0 43513 6900 3157023 103291762 101676367 43513 1398716 39750 39750 0 0 0 0 0 0 850539 178273 672266 0 0 0 0 0 44070329 37876746 6156544 37039 938910 806957 131164 789 6447437 5541323 900695 5419 3113588 2641827 469140 2621 445056 186803 258253 0 396027 0 396027 0 70900 0 70900 0 0 0 0 0 0 0 0 0 0 0 1101490 859495 241995 0 294828 287587 7241 0 20912394 19844224 1067949 221 2008519 1807016 201503 0 0 0 0 0 1685640 1530611 155029 0 381596 316958 64638 0 0 0 0 0 0 0 0 0 2146843 1829089 317754 0 0 0 0 0 5623097 4790822 832275 0 945671 869562 76109 0 Purchased Services 7734493 5416955 2317312 226 Dues & Subscriptions 161667 91659 70008 0 Minor Equipment 166904 140015 26889 0 99535678 85055672 14433691 46315 5662611 4740298 0 0 0 0 12526678 11791428 25000 0 0 0 1721822 1177634 877021 955802 1825103 1676059 118208319 42286266 79240864 75922053 0 134100 134100 250534 250052 5234313 4757913 107498046 101405339 10958409 12328371 0 0 2160000 1800000 51932546 46300832 0 0 0 0 0 0 0 0 65050955 60429203 X 42213847 40743341 233244 232795 0 0 42447091 40976136 107498046 101405339 X 3756084 0 0 0 0 -5227039 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 15607377 15607377 0 64979709 13683429 51296280 0 36691 15900 20791 0 33011514 25470480 7541034 0 4573028 3116457 1456571 75922053 Schedule D, Part V, Line 4 The endowment funds are held by Alliance Community Hospital Foundation, a related 501(c)(3) organization. The intended use of the organization's endowment funds is to hold the principal in perpetuity and use the interest for the general operations of the organization. Charity Golf Classic 57762 29480 28282 2685 66 6830 6681 0 1750 0 0 57762 29480 28282 2685 66 6830 6681 0 1750 18012 10270 Schedule G, Part II, Line 1 Proceeds from the Charity Golf Classic were donated to: the Alliance Family YMCA, Alliance for Children and Families, the Stark County Regional Planning Commission and the Alliance Area Development Foundation. See Schedule I. 1 1 X 1 X 1 X 1 1 1 0 1 1 3562290 1727698 1834592 0.0184 11488410 7601400 3887010 0.0391 0 0 0 0.00 0 0 15050700 9329098 5721602 0.0575 284397 0 284397 0.0029 649294 393861 255433 0.0026 43133960 28789574 14344386 0.1441 0 0 0 0 136518 101352 35166 0.0004 0 0 44204169 29284787 14919382 0.1500 0 0 59254869 38613885 20640984 0.2075 0 0 0 0 0 0 0 0 58990 0 58990 0.00059 0 0 0 583 0 583 0.00001 21135 0 21135 0.00021 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80708 0 80708 0.00081 1 2493801 977507 11084377 11562214 -477837 X 1 1 1 1 Alliance Community Hospital 200 E State Street Alliance OH 44601 www.achosp.org X X X Visiting Nurse Assn, Skilled Nursing Facility, Hospice, Senior Care/Psych Unit, Rehab Unit Alliance Community Hospital 1 1 X X X X X X X X X 13 1 0 1 X www.achosp.org X X X X 1 0 1 1 100 1 300 1 X X X X X 1 1 X X X X X 1 X X X 1 X X X X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 3-Alliance Community Hospital As part of the ACH CHNA, The Center for Marketing and Opinion Research conducted a focus group of 12 area community leaders and physicians to explore community health needs and opportunities to better meet those needs in the future. The agencies represented in the group included local government, Alliance Community Hospital, Alliance City Schools, Alliance YMCA, Alliance Health Department, Alliance for Children and Families, Louisville Food Pantry and Dr. Eichners General Practitioner Office. 1 Alliance Community Medical Foundation 200 E State Street Alliance OH 44601 Physician Practices Schedule H, Part I, Line 6a Alliance Community Hospital's (ACH) community benefit report is contained in a report prepared by Alliance Community Hospital Foundation (EIN 34-1531817), a related organization. Schedule H, Part I, Line 7 ACH's cost accounting system was used to calculate the amounts reported in the table for line 7. The cost accounting system addresses all patient segments specific to ACH. Where applicable, a cost to charge ratio was used and the ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Schedule H, Part I, Line 7g Subsidized health services data on line 7g does not include any costs attributable to a physician clinic; thus there are no costs to report in Part VI. Schedule H, Part II ACH's Inhouse Hospitalilty Program is a 16 week program offered annually during the spring school semester. It is geared to teach handicapped high school students job, life, and personal skills. Students are mentored by an ACH colleague. ACH colleagues also reach out to the community to protect and improve community health and safety. ACH offers reading programs to special-needs children and therapeutic programs to local nursing home residents. ACH colleagues provide leadership development and training through programs such as Safe Kids of Stark County. Numerous colleagues participate in collaborative events including blood drives, local YMCA health challenges, and local health-related boards such as the Prescription Assistance Network of Stark County, The Stark County Health Needs Advisory Committee, The Alzheimer Association, Domestic Violence, Alliance for Children and Families, and the Stark County Minority Health Coaltion. Schedule H, Part III, Section A, Line 2 Bad debt expense at cost was calculated by multiplying bad debt expense per the audited financial statements times the cost to charge ratio derived from Worksheet 2. Schedule H, Part III, Section A, Line 3 Estimated bad debt expense attributable to patients eligible under ACH's charity care policy, was calculated based on the estimated percentage determined by reviewing patient demographics, historical collection rates, current economic conditions, and employee experience in our patient accounts and credit department. Schedule H, Part III, Section A, Line 4 See page 8 of the AFS for footnote text re: bad debt exp included under Patient Accounts Receivable. Schedule H, Part III, Section B, Line 8 Part III lines 5 & 6 data was derived based on Worksheet B from Medicare Cost Reports excluding subsidized programs included on Part I line 7g. Reimbursement was less than allowable cost creating a shortfall in 2013. The shortfall calculated on Part III should be considered community benefit since ACH provided benefit greater than the reimbursement received for services. Schedule H, Part III, Section C, Line 9b ACH's collection practices for patients identified as qualifying for financial assistance is based on the account balance net of the charity write-off. As long as the patient makes a minimal monthly payment, the account is considered current. If payment is not received monthly, a call from our credit department is made along with receiving a monthly statement. If payment is then received, the account returns to "current". If there are six consecutive months without payment, the account is turned over to our collection agency to attempt to collect the balance due. ACH does not charge interest on outstanding balances. Schedule H, Part VI, Line 2 ACH has also played an active role in a county-wide health needs assessment group that is evaluating the health care needs of the community from a local perspective. Members of the group include other health care and health-related nonprofit organizations. In 2013, ACH contracted with CMOR (Center for Marketing and Opinion Research) to update the data collected in the original CHNA work as well as to integrate additional data from ACH's primary and secondary markets. A second community survey of residents in ACH's service area was conducted to ensure that there were enough residents from the service area for a statistically valid sample. A focus group of community health leaders was also conducted in July 2013. As an additional step to gain an understanding of the hospitals primary and secondary markets, secondary data with health statistics and demographics were gathered and analyzed. From ACH's own community health needs assessment, the top five community health needs are identified as 1)need for patient education and resources, 2)access to health care, 3)obesity and lack of healthy lifestyles, 4)chronic disease management and 5)childhood injuries. ACH is analyzing the data collected and has created an action plan based on the results. Implementation of the action plan is underway in 2014. Schedule H, Part VI, Line 3 During the registration process, the patient's initial financial responsibility is determined based on insurance coverage, deductibles, etc. supplied by the patient. If it is determined that the patient will be partially or fully responsible for their medical charges, then the patient will receive personal credit counseling from ACH credit personnel. ACH follows EMTALA standards for emergency room and labor visits. A Patient Billing brochure is available in the admissions and emergency room areas to all patients. The brochure provides information on financial assistance along with phone numbers so that an individual can speak to a member of the patient billing team and/or set up a personal appointment for financial assistance. In addition, monthly billing statements include a financial assistance application on the back plus phone numbers for assistance. We refer patients who we believe are eligible for Medicaid to RevCare which is an agency specializing in Medicaid eligibility and application so the patient receives the financial expertise needed for financial assistance. Schedule H, Part VI, Line 4 Alliance Community Hospital is located in Alliance, Ohio and serves Stark, Mahoning, Columbiana and other surrounding counties. The geographic service area is made up of urban, suburban, and rural areas. In 2013, our patient charges consisted of the following financial classes: 18% from individuals on Means-tested government programs or uninsured; 30% from commercial insurance, health maintenance and preferred provider organizations; and 52% from Medicare programs. Persons below the poverty level was 15.8% per the latest census data available at www.census.gov. For the surrounding area, the average household size was 2.43 and the average household income was $42,950. Persons under the age of 18 accounted for 21.4% of the population, and 18.2% of the population was 65 years and older. Schedule H, Part VI, Line 5 ACH in conjunction with its Foundation promote the health of the community by giving back both time and dollars to charitable organizations such as the local YMCA, Alliance for Children and Families, the Stark County Homeless Council, the Alliance Area Development Foundation and others. Carnation Days in the Park allowed volunteers to offer free blood pressure screenings, and health information/handouts. The Hospitals Health Caring Resources Library offers free blood pressure screenings to the community each week as well as a reference library for medical questions. A mock disaster drill gave our community emergency and police departments a chance to test and enhance its response efforts. Several community health fairs were offered by renting booth space at the local mall where shoppers could pick up information about services and free seminars offered by ACH. Some of the presentations offered to the community in 2013 included childrens safety, community CPR classes, monthly luncheon presentations on various health topics, memory screening, and general health and nutrition. ACH's Cardiopulmonary Rehab department sponsors the Heart and Sole walking program which encourages senior citizens to walk the mall for good heart health. In conjunction with the Alliance Family YMCAs city wide health challenge, ACH provided baseline for screenings such as weight, BMI. body measurements, cholesterol and glucose testing and also healthy eating, smoking cessation, women's health and stress management classes. Sports symposiums provided education to local healthcare professionals such as athletic directors, trainers and coaches. Other Health Fairs are offered free to the community at local grocery stores, farmers markets, libraries, YMCAs, and assisted living locations. Services include free osteoporosis screenings, blood pressure screens, and BMI checks. ACH sponsored a Rehab car show again in 2013. Blood Pressure Screenings were offered during the event and canned goods were collected and distributed to a local food pantry. Our Foundation staff served on the Stark County Minority Health coalition committee which was established to improve and protect the health of racial and ethnic minority populations through the development of health programs and activities that will reduce and eliminate health disparities. ACH promoted colleague support teams for The American Cancer Society, Relay for Life, and The American Heart Association. Our volunteer department coordinates ACHs participation in a local high school health sciences technology program, a Hospitality program which offers mentoring to handicapped high school students, Federal Work study programs with the local university, volunteer training to local high school students, therapeutic services to local nursing homes, and community reading programs for students and senior citizens. . As ACH supports its mission to provide a safe, comforting, healing environment, it also is committed to promoting community health. Throughout the year, managers, directors and executives are encouraged to support the community through participation in various civic groups and organizations. Each colleague is encouraged by the organization to share their unique gifts with the community in a way that furthers the purpose of the charitable organization. 1 Alliance Family YMCA 205 S Union St Alliance OH 44601 340714792 501(c)(3) 13250 0 General support payment as a result of the Charity Golf Classic held on behalf of these entities. Alliance Area Development Fdn 2490 W State St Alliance OH 44601 341652174 501(c)(3) 13250 0 General support payment as a result of the Charity Golf Classic held on behalf of these entities. Alliance for Children and Families 624 Scranton Ave Alliance OH 44601 341590276 501(c)(3) 6625 0 General support payment as a result of the Charity Golf Classic held on behalf of these entities. Stark County Regional Planning Commission 201 3rd St NE Canton OH 44702 341878856 501(c)(3) 6625 0 General support payment as a result of the Charity Golf Classic held on behalf of these entities. 4 0 Schedule I, Part I, Line 2 Alliance Community Hospital (ACH) has not provided grants to organizations outside its control. It worked in conjunction with other community, non-profit organizations to raise funds on their behalf. As such, these organizations such as the local YMCA, Stark County Regional Planning Commission, Alliance for Children and Families and Alliance Area Development Foundation are fully engaged and a participant in the fund raising process. As such, ACH relies on their participation and funding reports to verify use of the funds. Should ACH provide grants outside those listed above, then ACH will rely on the policy of lump sum funding preceeded by a grant application, approval from the Board, and then followed by a 6-month and annual evaluation of the project if needed and/or grant application funding based on reimbursement of actual expenses along with Board approval. X X X X X X 0 0 0 0 0 0 0 0 0 Stan Jonas Trustee, Chief Executive Officer 384416 0 500 0 17500 0 6375 0 19421 0 428212 0 0 0 Dale Wells Chief Financial & Operating Officer 195131 0 20700 0 0 0 5568 0 22655 0 244054 0 0 0 Dr Duane Kuentz Trustee, Physician 221579 0 0 0 0 0 8877 0 13515 0 243971 0 0 0 Amy Antonacci VP, Patient Care Services 148948 0 10500 0 0 0 4008 0 14817 0 178273 0 0 0 Dr David Mungo Physician 634159 0 0 0 17500 0 10200 0 24838 0 686697 0 0 0 Dr Steven Deutch Physician 528287 0 0 0 0 0 10200 0 25194 0 563681 0 0 0 Dr Michael Necci Physician 473947 0 0 0 25813 0 10200 0 23499 0 533459 0 0 0 Dr David Kanagy Physician 430356 0 0 0 17500 0 10200 0 21216 0 479272 0 0 0 Dr Karamjit Bhullar Physician 474639 0 0 0 17500 0 10200 0 26243 0 528582 0 0 0 A City of Alliance Ohio 346000043 018744AA0 2008-01-25 51150000 Refund the 2003 bond issue 0 0 0 B City of Alliance Ohio 346000043 2010-12-28 16350000 Refund a portion of the refunded 2003 bond issue 0 0 0 A 17120000 0 51150000 2259788 0 0 0 0 0 0 48890212 0 2005 1 0 1 1 B 0 0 16350000 0 0 0 200000 0 0 0 16150000 0 2005 1 0 1 1 A 0 0 0 0 0 0.001 0.001 0 0 1 B 0 0 0 0 0 0.001 0.001 0 0 1 A 0 0 0 1 1 1 JP Morgan Chase 24.8 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part IV, Line 2c-01/25/2008 51,150,000 City of Alliance Ohio Arbitrage Rebate Computation performed 2/21/2013. Form 990, Part VI, Section A, Line 1a The governing body of Alliance Community Hospital has delegated authority to the Executive Committee, as follows: (excerpts from the Code of Regulations) Composition of the Executive Committee: The Executive Committee shall meet at least four (4) times each year and shall be authorized to exercise all the powers of the Board of Trustees and perform all of its duties, except as otherwise provided by the Member (Alliance Citizens' Health Association), the Code of Regulations, Articles of Incorporation, or by law. The Executive Committee shall be composed of the President, the Vice President, the Secretary, Treasurer, Chief Executive Officer, President of the Medical Staff, and up to four (4) other members of the Board of Trustees. The governing body of Alliance Community Hospital (per its Code of Regulations) has delegated authority to the Board of Alliance Citizens' Health Association (the Member), a related organization, as follows: 1.) Power to elect and remove members of the Board of Trustees and/or Officers of the corporation; 2.) Approve the annual operating budgets; capital expenditures budgets; capital expenditures or dispositions of capital assets with a value in excess of such limits as shall be set from time to time by the Member; any action which requires Certificate of Need approval from the State Health Planning Development Agency; and any purchase, sale, lease, disposition, or hypothecation of real property; 3.) The incurrence of any obligation(s), liability(ies), and/or debt(s) requiring a mortgage on or security interest in any part of the assets of the corporation; 4.) Power to determine, upon dissolution of the corporation, the organization or organizations to which its remaining assets will be distributed. Form 990, Part VI, Section A, Line 4 ACH added the following duty to its Code of Regulations under, Powers Reserved to Member: "The Member (ACHA), through a committee appointed by its President, shall periodically review and update the strategic plan of the corporation." Form 990, Part VI, Section A, Line 6 See Schedule O comment for Part VI question 1a above. Form 990, Part VI, Section A, Line 7a See Schedule O comment for Part VI question 1a above. Form 990, Part VI, Section A, Line 7b See Schedule O comment for Part VI question 1a above. Form 990, Part VI, Section B, Line 11b The Form 990 is reviewed by the CFO of Alliance Community Hospital and the Hospital hires an independent accouting firm to review the Form 990 and schedules. Prior to filing, the 990 is also distributed to the Board of Trustees for their review and comments. It is then discussed as part of the financial report at the next Board meeting where any questions/concerns can be addressed. Form 990, Part VI, Section B, Line 12c Members of the Board of Trustees are required to annually review and sign a conflict of interest policy. Under that policy, the Board member (i) has a duty to disclose any conflict, and (ii) must recuse themselves from a vote and or decision when such conflict arises. If this policy is violated, then the Board shall take appropriate action which may include an investigation and disciplinary action. Form 990, Part VI, Section B, Line 15 Compensation of officers is determined by an independent (noncompensated) committee from the Board of Trustees. This committee annually reviews compensation by obtaining market surveys of the positions. Form 990, Part VI, Section C, Line 17 Ohio does not require the Form 990 to be filed with the Ohio Attorney General's Office. Instead, a "Verification of Filing with the Internal Revenue Service" form is completed stating that we did file Form 990 by the required due date. Form 990, Part VI, Section C, Line 19 The organization makes its governing documents available to the public via the Ohio Secretary of State's website. Financial statements are available in the NRMSIR filing database at www.emma.msrb.org. The conflict of interest policy is available upon request. Form 990, Part XI, Line 9 The total reduction in Net Assets at 12-31-2013 of $5,227,039 consists of net transfers to/from Section 501(c)(3) related organizations of $5,220,000 plus amortization of interest rate swap agreement of $6,590 and decrease in temporarily Restricted Net Assets of $449. Alliance Community Medical Foundation 200 E State Street Alliance OH 44601 263646817 Physician Offices OH 6976919 1642473 Alliance Comm Hosp Alliance Citizens' Health Association 200 E State St Alliance OH 44601 341531815 Manage Health Facil OH 501(C)(3) Sch A, 11b, II N/A 0 Alliance Community Hospital Foundation 200 E State St Alliance OH 44601 341531817 Fundraising OH 501(C)(3) Sch A, 11a, I Alliance Citizens' Health Assn 0 Alliance Comm Hospital Auxiliary 200 E State St Alliance OH 44601 340777659 Volunteer Services OH 501(C)(3) Sch A, 11c, III-FI N/A 0 Alliance Health Institute 200 E State St Alliance OH 44601 341932972 Support ACH OH 501(C)(3) Sch A, 11a, I Alliance Citizens' Health Assn 0 Caring Hands 885 Sawburg Rd Alliance OH 44601 341505340 Private Duty Nursing OH 501(C)(3) Sch A, 11c, III-FI Alliance Citizens' Health Assn 0 Alliance Health Partners 200 E State St Alliance OH 44601 341884059 PHO OH N/A C 0 0 0 0 Alliance Hospitalist Group 200 E State St Alliance OH 44601 203188585 Dr Offices OH Alliance Comm Hospital C 0 0 1 1 Alliance Community Radiologists Inc 200 E State St Alliance OH 44601 205698786 Dr Offices OH Alliance Comm Hospital C 0 0 1 1 Alliance Medical Associates Inc 200 E State St Alliance OH 44601 911889215 Dr Offices OH Alliance Comm Hospital C 0 0 1 1 Alliance Pulmonary Associates Inc 200 E State St Alliance OH 44601 204083441 Dr Offices OH Alliance Comm Hospital C 0 0 1 1 Health Alliance Inc 200 E State St Alliance OH 44601 341531993 Dr Offices OH All Citizens' Hlth Assn C 0 0 0 0 1 0 1 1 0 0 0 1 0 1 0 0 1 1 1 1 1 1 0 Alliance Community Radiologists Inc a-i 32611 Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. Alliance Pulmonary Associates Inc a-i 26064 Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. Alliance Pulmonary Associates Inc a-iv 8844 Fair vaule based on area rentals of similar square footage and type of facility. Alliance Community Radiologists Inc d 522000 Current year loan advances. Alliance Pulmonary Associates Inc d 132000 Current year loan advances. Alliance Hospitalist Group p 313623 Current year subsidy to cover entity's expenses. Alliance Medical Associates Inc p 526000 Current year subsidy to cover entity's expenses. Schedule R, Part IV The 100% ownership in column (h) of Part IV is based on voting power, not total value of all outstanding shares; thus, colums (f) and (g) are 0.