2014-10-28T17:00:08-05:00 2013-12-31 CROWE HORWATH LLP 10 WEST BROAD STREET SUITE 1700 COLUMBUS OH 432153713 990 2013-01-01 344428598 WAYNE HOSPITAL COMPANY WAYN 9375481141 835 Sweitzer Street Greenville OH 45331 WAYNE DESCHAMBEAU PRES & CEO 2014-10-15 true Rachel Spurlock P00520729 6144690001 2013 2015-11-30 17:44:51Z WAYNE HEALTHCARE WAYNE DESCHAMBEAU PRES & CEO 835 Sweitzer Street Greenville OH 45331 85168452 false X WWW.WAYNEHEALTHCARE.ORG X 1922 OH THE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE QUALITY CARE AND PROMOTE WELLNESS, REGARDLESS OF ABILITY TO PAY. 12 11 576 128 0 0 43232 60902 58611292 58792168 2542961 4940719 357920 489010 61555405 64282799 29055 12925 0 0 28458180 28210745 0 0 0 31792965 32937409 60280200 61161079 1275205 3121720 116453107 123387583 40865393 37129014 75587714 86258569 X THE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES AT A LEVEL TO RANK PROMINENTLY ON A REGIONAL AND NATIONAL BASIS FOR QUALITY OF CARE, PATIENT SATISFACTION AND SPIRITUALITY SUPPORT. THE HOSPITAL COLLABORATES WITH OTHER HEALTH CARE PROVIDERS TO DEVELOP NEW AND/OR IMPROVED SERVICES FOR RESIDENTS OF DARKE COUNTY, OHIO. false false 50864965 12925 59094001 AS A FULL-SERVICE PRIMARY CARE FACILITY, WAYNE HOSPITAL OFFERS PHYSICIANS AND THEIR PATIENTS ACCESS TO A VARIETY OF INPATIENT AND OUTPATIENT SERVICES INCLUDING: EMERGENCY, RADIOLOGY, MATERNITY/SPECIAL BEGINNINGS, SURGERY, HEART HEALTH, CANCER CARE, REHABILITATION SERVICES, LABORATORY, CHRONIC DIALYSIS CENTER, AMBULATORY CARE, OUTPATIENT REHABILITATION, DIABETES EDUCATION PROGRAM, SLEEP CARE SERVICES, AND ENTEROSTOMAL THERAPY. THE HOSPITAL HAD APPROXIMATELY 2,392 ADMISSIONS AND 78,886 OUTPATIENT VISITS IN 2013. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. IN ADDITION TO THE FINANCIAL ASSISTANCE PROVIDED, WAYNE HOSPITAL ALSO IS PROACTIVE IN SUPPORTING COMMUNITY WELLNESS THROUGH HEALTH SCREENINGS, EDUCATION, AND HEALTH MANAGEMENT. 156493 0 13100 WAYNE HOSPITAL HAS MANY ADDITIONAL PROGRAMS. ADDITIONAL PROGRAMS INCLUDE THE COUNTY AND CORPORATE HEALTH FAIRS IN WHICH EMPLOYEES FROM THE HOSPITAL PROVIDE OVER 155 HOURS OF TIME TO HELP WITH HEALTH SCREENINGS AND PROVIDE EDUCATIONAL INFORMATION TO THE COMMUNITY. IN ADDITION TO THE COUNTY AND CORPORATE HEALTH FAIRS, WAYNE HOSPITAL ALSO CONTRIBUTES 213 HOURS TO THE YOUTH HEALTH FAIR, WHICH IS A HEALTH FAIR GEARED TO ALL THE FIFTH GRADERS IN DARKE COUNTY. OVER 410 STUDENTS WERE IN ATTENDANCE. (CONTINUED ON SCHEDULE O) 51021458 true true false true false false false false true true false false false true true true true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 59 0 true 576 true false false false false false false false false false false X 12 11 false false false false true true true true true false false true true true true true true true false true true X WAYNE DESCHAMBEAU 9375475722 835 SWEITZER STREET Greenville OH 45331 JOHN SWALLOW PAST CHAIRMAN 1.00 X X 0 0 0 LARRY ROLL VICE CHAIRMAN 1.00 X X 0 0 0 LUCILLE HOSFELD SECRETARY/TREASURER 1.00 X X 0 0 0 PHILIP DUBBS CHAIRMAN 1.00 X X 0 0 0 BRAD BIXLER BOARD MEMBER 1.00 X 0 0 0 CINDY SCOTT BOARD MEMBER 1.00 X 0 0 0 DAN FRANZ BOARD MEMBER 1.00 X 0 0 0 JENNIFER RAWLINS MD BOARD MEMBER 1.00 X 0 0 0 JOHN DUTRO MD BOARD MEMBER / SURGEON 40.00 X 356455 0 32884 JOHN WARNER BOARD MEMBER 1.00 X 0 0 0 MIKE GRAY BOARD MEMBER 1.00 X 0 0 0 PHILLIP GARBIG BOARD MEMBER 1.00 X 0 0 0 WILLIAM JOHNSTON BOARD MEMBER 1.00 X 0 0 0 DENNIS LOCKARD CFO 40.00 X 172396 0 28782 WAYNE DESCHAMBEAU CEO 40.00 X 271808 0 32122 DANIEL MCKELLAR SURGEON 40.00 X 509466 0 33335 DAVID M WARE SURGEON 40.00 X 483147 0 32904 GUILLERMO G TREVINO PHYSICIAN 40.00 X 270537 0 30276 PATRICK KARR OB/GYN 40.00 X 450385 0 33164 PETER LACHIEWICZ OB/GYN 40.00 X 429858 0 33404 2944052 0 256871 18 false true false KETTERING ANESTHESIA ASSOC 3500 PENTAGON BLVD SUITE 200 BEAVERCREEK OH 45431 ANESTHESIA SERVICES 1068110 MESSER CONSTRUCTION CO 4801 HEMPSTEAD DR DAYTON OH 454295156 CONTRACTOR SERVICES 650662 FERGUSON CONSTRUCTION CO PO BOX 726 SIDNEY OH 45365 CONTRACTOR SERVICES 509831 PHELAN INSURANCE AGENCY PO BOX 1 VERSAILLES OH 45380 INSURANCE SERVICES 459265 CHRIST HOSPITAL PO BOX 635899 CINCINNATI OH 452635899 ULTRASOUND SERVICES 404693 19 60902 60902 NET PATIENT SERVICE REVENUE 621110 57959070 57959070 MEANINGFUL USE INCENTIVE PAYMENTS 621110 833098 833098 0 0 0 0 0 0 0 58792168 1318948 1318948 0 0 362361 1500 336013 26348 1500 27848 27848 24169927 1484 20478911 70729 3691016 -69245 3621771 3621771 0 0 8917 8917 8917 FOOD SALES 722210 137312 137312 HOUSEKEEPING 812900 81019 81019 REBATE REVENUE 900099 156214 156214 77700 77700 0 0 452245 64282799 59107101 0 5114796 X 10925 10925 2000 2000 0 0 498804 498804 0 19507857 17320694 2187163 562000 498990 63010 6166092 5474768 691324 1475992 1277835 198157 0 174470 174470 52300 52300 0 0 363911 363911 7170833 4940035 2230798 0 161558 132582 28976 138930 92074 46856 183356 72819 110537 0 1904427 1858101 46326 55403 32647 22756 0 36985 27789 9196 1268863 1268863 0 5767328 4729209 1038119 391157 334779 56378 BAD DEBT 7104226 7104226 MEDICAL SUPPLIES 5538181 5532876 5305 MAINTENANCE AGREEMENTS 1356983 775181 581802 DIETARY 323943 290140 33803 944555 513788 430767 0 61161079 51021458 10139621 0 0 8503989 5345751 5906551 4872847 13799 9302 5372746 6525636 0 0 0 0 1299912 1370675 536193 723926 100532816 50621589 51333852 49911227 39759042 50991510 1170977 1898325 0 0 2556046 1738384 116453107 123387583 6030468 5466948 28774165 28217083 0 0 6060760 3444983 40865393 37129014 X 75414072 86074102 160722 171547 12920 12920 75587714 86258569 116453107 123387583 X 3121720 5293711 2255424 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4648 4648 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i WAYNE HOSPITAL COMPANY PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES, $4,648, WAS SPENT ON LOBBYING. 194461 9303 77 2000 0 201841 197906 555 4000 194461 196365 1541 197906 195314 0 3051 2000 0 0 196365 236705 0 6844 2000 46235 0 195314 0.09550 0.06400 0.84050 false false 1981661 1981661 67476616 30739736 36736880 3632923 1681783 1951140 27183475 18200070 8983405 258141 258141 49911227 0 INTEREST RATE SWAP LIABILITY 2805983 ESTIMATED THIRD PARTY SETTLEMENTS 639000 3444983 X 62904265 5293711 431981 5725692 57178573 7104226 7104226 64282799 52231410 405418 405418 51825992 2000 9333087 9335087 61161079 Schedule D, Part V, Line 4, Intended uses of endowment funds ENDOWMENT FUNDS ARE SPECIFICALLY SET ASIDE FOR CLINICALLY RELATED SCHOLARSHIPS GRANTED TO STUDENTS GOING INTO A HEALTH RELATED FIELD OF STUDY AND FOR INDIGENT CARE. Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A). U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE HOSPITAL IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE HOSPITAL'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF OHIO FOR THE LAST THREE YEARS. THE HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE HOSPITAL RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL DID NOT HAVE ANY AMOUNTS RECORDED FOR INTEREST AND PENALTIES AT DECEMBER 31, 2013 AND 2012. Schedule D, Part XI, Line 2d, Other revenues in audited financial statements not in form 990 LOSS OF DISPOSAL OF ASSETS - 69405; RENTAL EXPENSE - 336013; CHANGE IN INTEREST OF RELATED PARTIES - 26563; Schedule D, Part XI, Line 4b, Other revenues in form 990 not in audited financial statements BAD DEBTS - 7104226; Schedule D, Part XII, Line 2d, Other expenses in audited financial statements not in form 990 LOSS OF DISPOSAL OF ASSETS - 69405; RENTAL EXPENSES INCLUDED IN REVENUE - 336013; Schedule D, Part XII, Line 4b, Other expenses in form 990 not in audited financial statements CHANGE IN VALUE OF INTEREST RATE SWAP - 2228861; BAD DEBTS - 7104226; true true X true X false true true false true true 1087259 0 1087259 0.02010 7047877 3280327 3767550 0.06970 1685380 0 1685380 0.03120 0 0 9820516 3280327 6540189 0.12100 104131 13100 91031 0.00170 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 48612 0 48612 0.00090 0 0 152743 13100 139643 0.00260 0 0 9973259 3293427 6679832 0.12360 0 0.00000 0 0.00000 3 0 3750 0 3750 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 3 0 3750 0 3750 0.00000 false 7104226 0 17891262 22335226 -4443964 X true false 1 1 WAYNE HOSPITAL COMPANY 835 Sweitzer Street GREENVILLE OH 45331 WWW.WAYNEHEALTHCARE.ORG OHIO DEPARTMENT OF HEALTH 1159AHR X X X WAYNE HOSPITAL COMPANY 1 true X X X X X X X X X 12 true false true X www.waynehealthcare.org X www.darkecountyhealth.org X X X X X X X X false false true true 200 false true X X X X X X true true X X X X X true false X X X X true X false false Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) - WAYNE HOSPITAL COMPANY: THE HOSPITAL WORKED IN CONJUCTION WITH THE CENTER FOR URBAN AND PUBLIC AFFAIRS AT WRIGHT STATE UNIVERSITY TO CONDUCT A TELEPHONE SURVEY OF 600 DARKE COUNTY ADULTS AND A YOUTH SURVEY ADMINISTERED IN DARKE COUNTY SCHOOLS. THE ASSESSMENT WAS BASED ON QUESTIONS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY CONDUCTED ANNUALLY BY THE CENTERS FOR DISEASE CONTROL. ; Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment (1) - WAYNE HOSPITAL COMPANY: THE HOSPITAL FOCUSED ON ADDRESSING THE SPECIFIC HEALTH NEED OF CHANGING RESIDENTS' MINDSETS TOWARDS PHYSICAL ACTIVITY AND NUTRITION. THE OTHER HEALTH NEEDS IDENTIFIED IN THE CHNA ARE BEING ADDRESSED BY OTHER ORGANIZATIONS THAT ARE BETTER EQUIPPED TO PROVIDE THE NECESSARY SERVICES.; Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care (1) - WAYNE HOSPITAL COMPANY: THE HOSPITAL OFFERS A GENEROUS SELF-PAY DISCOUNT. UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FREE CARE (E.G., DUE TO THEIR HOUSEHOLD INCOME) RECEIVE A DISCOUNT OF 55% ON GROSS CHARGES FOR MEDICALLY NECESSARY SERVICES.; 1 WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC 835 SWEITZER STREET GREENVILLE OH 45331 PHYSICIAN PROFESSIONAL SERVICES ORGANIZATION Schedule H, Part I, Line 3c, Eligibility criteria for free or discounted care THE HOSPITAL OFFERS A GENEROUS SELF-PAY DISCOUNT. UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FREE CARE (E.G., DUE TO THEIR HOUSEHOLD INCOME) RECEIVE A DISCOUNT OF 55% ON GROSS CHARGES FOR MEDICALLY NECESSARY SERVICES. Schedule H, Part I, Line 7, Costing Methodology used to calculate financial assistance A COST-TO-CHARGE RATIO WAS USED FOR THE FIGURES REPORTED IN THE TABLE AND WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 7,104,226 Schedule H, Part II, Community Building Activities WAYNE HEALTHCARE CONTRIBUTED $2,500 TO EDISON COMMUNITY COLLEGE FOUNDATION TO SUPPORT THE NURSING STUDENTS GOING THROUGH THE PROGRAM TO EARN AN RN DEGREE. WAYNE HEALTHCARE ALLOWS THOSE STUDENTS TO COMPLETE THE REQUIRED CLINICAL EDUCATION ONSITE WITH THE INTENT THAT SOME OF THE STUDENTS WILL BE INTERESTED IN WORKING FOR WAYNE HEALTHCARE UPON GRADUATION. WAYNE HEALTHCARE DONATED $250 TO THE AMERICAN RED CROSS DARKE COUNTY CHAPTER FOR CPR AND LIFE-SAVING TRAINING TO COMMUNITY MEMBERS. WAYNE HEALTHCARE DONATED $1,000 TO THE STATE OF THE HEART HOSPICE FOR COMMUNITY HOSPICE. Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote THE HOSPITAL EVALUATES THE COLLECTIBILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYOR CLASS, HISTORICAL EXPERIENCE, AN ASSESSMENT OF BUSINESS AND ECONOMIC CONDITIONS, AND TRENDS IN HEALTHCARE COVERAGE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. THESE ACCOUNTS ARE WRITTEN OFF ONLY AFTER ALL COLLECTION ATTEMPTS HAVE BEEN EXHAUSTED AND INCLUDES A FINAL VERIFICATION OF ELIGIBILITY FOR OTHER PAYOR TYPES. Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs THE MEDICARE ALLOWABLE COSTS ARE DETERMINED USING THE INTERNAL COST ACCOUNTING SYSTEM. Schedule H, Part VI, Line 2, Needs assessment. THE ORGANIZATION ASSESES THE NEEDS OF THE COMMUNITY BY REACHING OUT TO LOCAL ORGANIZATIONS TO SURVEY THE HEALTH NEEDS OF THEIR EMPLOYEES. ADDITIONALLY THE HOSPITAL ASSESSES THE TRENDS OF INPATIENT ADMISSIONS TO DETERMINE WHAT THE CURRENT NEEDS ARE AND WHAT ADDITIONAL PROGRAMMING MAY BENEFIT THE NEEDS OF THE COMMUNITY. WAYNE HOSPITAL COMPANY WORKED IN CONJUNCTION WITH THE CENTER FOR URBAN AND PUBLIC AFFAIRS AT WRIGHT STATE UNIVERSITY FOR THE DARKE COUNTY HEALTH DEPARTMENT TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT. Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. WAYNE HOSPITAL PROVIDES PAMPHLETS TO PATIENTS THAT DESCRIBE THE FINANCIAL ASSISTANCE POLICIES. THERE IS SIGNAGE UP THROUGHOUT THE KEY PATIENT AREAS IN THE HOSPITAL ALONG WITH FINANCIAL ASSISTANCE APPLICATIONS. THE HOSPITAL'S WEBSITE HAS THE FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PATIENTS. WAYNE HOSPITAL SENDS A FINANCIAL COUNSELOR TO SPEAK WITH OUR INPATIENTS AS WELL AS EMERGENCY DEPARTMENT PATIENTS THAT MAY BE ELIGIBLE FOR ASSISTANCE. FINALLY, WAYNE HOSPITAL PUTS THE FINANCIAL ASSISTANCE APPLICATION DIRECTLY ON THE BACK OF ALL PATIENT STATEMENTS SO THAT THE PATIENT HAS IMMEDIATE ACCESS TO THE APPLICATION. Schedule H, Part VI, Line 4, Community information. WAYNE HOSPITAL SERVES THE DARKE COUNTY COMMUNITY. DARKE COUNTY IS MAINLY A RURAL FARMING COMMUNITY WITH A POPULATION OF OVER 52,000. APPROXIMATELY 12.0% OF THE COUNTY INCOME LEVEL IS UNDER THE FEDERAL POVERTY GUIDELINES AND 12.9% OF THE REVENUES FOR THE HOSPITAL WERE MEDICAID PATIENTS IN 2013. THE COUNTY UNEMPLOYMENT RATE IN 2013 WAS 6.63%. WAYNE HOSPITAL IS THE ONLY HOSPITAL WITHIN THE COUNTY AND THERE IS A FEDERALLY QUALIFIED HEALTH CENTER THAT SERVES THE COUNTY AND THEREFORE PROVIDES A SIGNIFICANT AMOUNT OF REFERRALS TO THE FACILITY. Schedule H, Part VI, Line 5, Promotion of community health WAYNE HOSPITAL'S GOVERNING BODY IS COMPRISED OF LOCAL COMMUNITY AND COUNTY RESIDENTS WHO HAVE A VESTED INTEREST IN THE VIABILITY OF THE FACILITY. THE MEMBERS ARE ATTORNEYS, BANK EXECUTIVES, SCHOOL OFFICIALS, RETIRED BUSINESS OWNERS, AND OTHER LOCAL MEDICAL PROFESSIONALS. WAYNE HOSPITAL EXTENDS STAFF PRIVILEGES NOT ONLY TO OUR EMPLOYED PHYSICIANS, BUT TO THE COMMUNITY'S MEDICAL PROFESSIONALS AS WELL IN ORDER TO KEEP AS MUCH OF OUR PATIENT POTENTIAL AT THE FACILITY AS POSSIBLE. Schedule H, Part VI, Line 7, State filing of community benefit report OH true Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds SPONSORSHIPS PAID TO ORGANIZATIONS ARE SENT TO THEM TO USE WITHIN THEIR EXEMPT PURPOSES. X true true X X X false false false true false false false false false WAYNE DESCHAMBEAU CEO 244472 0 27336 0 0 0 7511 0 24611 0 303930 0 0 0 DAVID M WARE SURGEON 419631 0 63516 0 0 0 7580 0 25324 0 516051 0 0 0 PETER LACHIEWICZ OB/GYN 395812 0 34046 0 0 0 7580 0 25824 0 463262 0 0 0 PATRICK KARR OB/GYN 380409 0 69976 0 0 0 7580 0 25584 0 483549 0 0 0 JOHN DUTRO MD BOARD MEMBER / SURGEON 349753 0 6702 0 0 0 7580 0 25304 0 389339 0 0 0 GUILLERMO G TREVINO PHYSICIAN 268437 0 2100 0 0 0 6080 0 24196 0 300813 0 0 0 DANIEL MCKELLAR SURGEON 490308 0 19158 0 0 0 7580 0 25755 0 542801 0 0 0 DENNIS LOCKARD CFO 155714 0 9221 0 7461 0 4921 0 23861 0 201178 0 0 0 Schedule J, Part I, Line 1a, Housing allowance or residence for personal use WAYNE HOSPITAL PROVIDES A HOUSE THAT IS OWNED BY THE HOSPITAL FOR USE BY THE CFO. THE HOUSE IS LOCATED RIGHT NEXT TO THE HOSPITAL AND WILL EVENTUALLY BE TORN DOWN AND TURNED INTO PARKING SPACE. THIS WAS TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUAL. Schedule J, Part I, Line 5a, Compensation contingent on revenues of the organization THE ORGANIZATION PAYS THE PHYSICIAN STAFF BONUSES BASED ON THE REVENUES OF THE ORGANIZATION. BONUS AMOUNTS ARE DEPENDENT UPON THE REVENUE GENERATED BY THE LLC ATTRIBUTED TO THE PHYSICIANS. A COUNTY OF DARKE OHIO 346400036 2010-11-01 30000000 REFUND PORTION OF 11/1/2007 BONDS false false false A 0 0 30000000 0 0 0 0 0 0 0 30000000 0 2010 true false true true A false false false false 0.00000 0.00000 0.00000 false false true A false false false true true false false false true A false Sch K, Part IV, Line 2c, ISSUER NAME: County Of Darke, Ohio: No Rebate Due. THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON REBATE NOT REQUIRED DUE TO PROCEEDS NOT BEING INVESTED.. SCHEDULE K, PART V, SCHEDULE K, PART V THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES WHICH DICTATE HOW MANAGEMENT TIMELY IDENTIFIES AND CORRECTS VIOLATIONS OF FEDERAL TAX REQUIREMENTS USING THE VOLUNTARY CLOSING AGREEMENT PROGRAM PROVIDED BY THE IRS WHEN SELF-REMEDIATION IS NOT AVAILABLE TO THE ORGANIZATION. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. IN THE EVENT A VIOLATION IS IDENTIFIED THE ORGANIZATION'S POLICY IS TO CORRECT THE VIOLATION AS SOON AS POSSIBLE, WHILE WORKING WITH THE FEDERAL AUTHORITIES AS NECESSARY TO ENSURE THAT SUFFICIENT CONTROLS ARE PRESENT WHICH WILL GUARD AGAINST FUTURE VIOLATIONS. FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION (CONTINUED FROM PART III) THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SCHEDULE H PROVIDES INFORMATION ABOUT WAYNE HOSPITAL CORPORATION PROVIDING CARE REGARDLESS OF PATIENT'S ABILITY TO PAY. FORM 990, PART III, LINE 4B, PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III, LINE 4B) ANOTHER PROGRAM INVOLVES CONDUCTING VARIOUS DIABETES SEMINARS AND CLASSES HELD AT WAYNE HOSPITAL WHICH PROVIDE INFORMATION TO THE PUBLIC ON DIABETES AWARENESS, OFFER THE COMMUNITY HEALTH SCREENINGS FOR DIABETES, AND EDUCATE THOSE WITH DIABETES ABOUT MANAGING THE DISEASE. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT OVER 262 HOURS OF TIME ON THE DIABETES SEMINARS AND CLASSES AND THE HOSPITAL HAS CONTRIBUTED $457 OF SUPPLIES TO THE PROGRAM. AN ADDITIONAL PROGRAM OF WAYNE HOSPITAL IS THE CANCER AWARENESS, PREVENTION, SCREENING AND TREATMENT PROGRAM IN WHICH THE HOSPITAL OFFERS DIAGNOSTIC AND THERAPEUTIC SERVICES IN ADDITION TO SEMINARS AND CLASSES TO THE COMMUNITY IN ORDER TO PROMOTE AWARENESS, TEACH WAYS OF PREVENTION, AND OFFER HEALTH SCREENINGS TO THE COMMUNITY. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT OVER 58 HOURS OF TIME ON THE CANCER AWARENESS SEMINARS. WAYNE HOSPITAL ALSO PROVIDED AWARENESS, PREVENTION, SCREENING OF BLOOD PRESSURE CLINIC. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT 52 HOURS OF TIME ON THE CLINIC. CHILD BIRTHING CLASSES, BREASTFEEDING CLASSES AND CHILD SIBLING CLASSES WERE OFFERED TO THE COMMUNITY. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT 218 HOURS OF TIME ON THE CHILD BIRTHING CLASSES. Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee SECTION 2. EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY/TREASURER AND TWO ADDITIONAL MEMBERS OF THE BOARD OF TRUSTEES. DUTIES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF TRUSTEES AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE SHALL BE REFERRED TO THE BOARD OF TRUSTEES. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS SHALL BE SUBMITTED TO THE BOARD AND ITS ACTIONS SHALL BE SUBJECT TO APPROVAL OR DISAPPROVAL AT THE NEXT REGULAR BOARD MEETING. Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders WAYNE HOSPITAL COMPANY HAS MEMBERS OF THE CORPORATION AND CONSISTS OF ONLY ONE CLASS OF MEMBERS. ANY NATURAL PERSON OF LEGAL AGE OR ANY ORGANIZATION, INCLUDING CORPORATIONS, PARTNERSHIPS, ASSOCIATIONS OR SIMILAR ENTITIES ("ORGANIZATION") MAY BECOME A MEMBER OF THE CORPORATION PROVIDED, IN THE CASE OF A NATURAL PERSON, SUCH PERSON MAINTAINS A PERSONAL RESIDENCE IN DARKE COUNTY, OHIO OR IS AN EMPLOYEE OF WAYNE HOSPITAL AT THE TIME HE BECOMES A MEMBER AND, IN THE CASE OF AN ORGANIZATION, THE ORGANIZATION MAINTAINS AN OFFICE OR OTHER FACILITY IN DARKE COUNTY. THE MEMBERSHIP OF AN ORGANIZATION SHALL TERMINATE IF IT CEASES TO HAVE AN OFFICE OR OTHER FACILITY IN DARKE COUNTY. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body ANY PERSON DESIRING TO BECOME A MEMBER MAY DO SO BY CONTRIBUTING AT LEAST ONE HUNDRED DOLLARS TO THE CORPORATION IN ONE LUMP SUM PAYMENT FOR THE GENERAL UNRESTRICTED USE OF THE CORPORATION AND SHALL BE ADMITTED AS A MEMBER UNLESS IT IS DETERMINED BY THE BOARD OF TRUSTEES THAT SUCH PERSON DOES NOT MEET CERTAIN QUALIFICATIONS SET FORTH BY THE ARTICLES OF INCORPORATION. NO PERSON SHALL BE ISSUED MORE THAN ONE MEMBERSHIP, OR ENTITLED TO DIRECT THAT A MEMBERSHIP SHALL BE ISSUED TO ANOTHER PERSON OR PERSONS, REGARDLESS OF THE AMOUNT OR NUMBER OF CONTRIBUTIONS MADE BY SUCH PERSON, EXCEPT THAT IN THE EVENT A HUSBAND AND WIFE JOINTLY CONTRIBUTE AT ONE TIME TWO HUNDRED DOLLARS OR MORE, THEN EACH OF THEM SHALL BE ADMITTED AS MEMBERS. NO MEMBERSHIP MAY BE TRANSFERRED TO ANOTHER PERSON OR ORGANIZATION, EXCEPT IN THE CASE OF AN ORGANIZATION, A MEMBERSHIP MAY BE TRANSFERRED TO A SUCCESSOR ORGANIZATION THAT HAS AN OFFICE OR OTHER FACILITY IN DARKE COUNTY. EACH MEMBER WHICH IS NOT A NATURAL PERSON SHALL FROM TIME TO TIME APPOINT AN INDIVIDUAL (A "PRIMARY REPRESENTATIVE") TO REPRESENT SUCH MEMBER IN THE CORPORATION, TO CAST VOTES ON BEHALF OF SUCH MEMBER AND TO RECEIVE CORRESPONDENCE FROM THE CORPORATION. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders EACH MEMBER OF RECORD IN THE MEMBERSHIP BOOK OF THE CORPORATION ON THE RECORD DATE FOR A MEETING OF MEMBERS SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER PROPERLY SUBMITTED TO THE MEMBERS FOR THEIR VOTE. MEMBERS MAY VOTE AT MEETING EITHER IN PERSON OR BY PROXY. THE MEMBERSHIP BOOK OF THE CORPORATION SHALL BE REVIEWED ON AN ANNUAL BASIS TO ASSURE THAT THE NAMES OF MEMBERS WHO HAVE CEASED TO BE MEMBERS ARE DELETED AND THE NAMES OF PERSONS WHO HAVE BECOME MEMBERS SINCE THE LAST ANNUAL REVIEW WERE PROPERLY RECORDED. THE MAJOR ITEM FOR VOTE BY THE MEMBERS EACH YEAR IS THE BOARD OF TRUSTEE ELECTIONS. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body A COPY OF THE DRAFT OF THE FORM 990 IS SENT TO EACH VOTING MEMBER OF THE GOVERNING BODY PRIOR TO THE BOARD MEETING IN WHICH THE CONTROLLER PRESENTS THE MAJOR ITEMS RELATING TO THE FORM 990. AFTER THE PRESENTATION, THE BOARD HAS THE OPPORTUNITY TO ASK QUESTIONS AND THEN VOTES TO APPROVE THE FILING OF THE FORM 990. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy THE CONFLICT OF INTEREST POLICY IS SIGNED ANNUALLY BY ALL MANAGEMENT, SENIOR MANAGEMENT, OFFICERS, DIRECTORS, AND KEY EMPLOYEES. AFTER THE SIGNED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED, THEY ARE REVIEWED BY THE CONTROLLER. ANY CONFLICTS OF INTEREST THAT ARE DISCLOSED ARE DISCUSSED WITH THE BOARD CHAIR, WHICH ENSURES THAT THE INTERESTED PERSON ABSTAINS FROM VOTING ON MATTERS RELATED TO THE CONFLICT OF INTEREST. Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official THE EXECUTIVE BOARD REVIEWS AND DETERMINES THE COMPENSATION FOR THE CEO. THEY USE COMPENSATION SURVEYS CONDUCTED BY INDEPENDENT CONSULTING COMPANIES IN THEIR DECISION MAKING PROCESS. THE VP OF HUMAN RESOURCES COMPILES THE SURVEY INFORMATION AND PROVIDES TO THE CHAIRMAN OF THE BOARD INDEPENDENTLY OF THE CEO'S INFLUENCE. THIS PROCESS IS COMPLETED FOR WAYNE DESCHAMBEAU, CEO AND WAS LAST UNDERTAKEN IN 2013. FORM 990, PART VI, LINE 15B, PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS THE COMPENSATION FOR OTHER OFFICERS IS DETERMINED BY THE CEO USING MARKET STUDIES PROVIDED BY HUMAN RESOURCES, EVALUATIONS, AND PERFORMANCE. THE CEO DETERMINES THE APPROPRIATE COMPENSATION. THIS PROCESS WAS COMPLETED FOR THE CFO AND WAS LAST UNDERTAKEN IN 2013. Form 990, Part VI, Sec C, Line 19, Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, Line 11g, Other Expenses AGENCY EMPLOYEES - TOTAL EXPENSE: 2758424, PROGRAM SERVICE EXPENSE: 2572486, MANAGEMENT AND GENERAL EXPENSES: 185938, FUNDRAISING EXPENSES: ; DATA PROCESSING - TOTAL EXPENSE: 388069, PROGRAM SERVICE EXPENSE: 285220, MANAGEMENT AND GENERAL EXPENSES: 102849, FUNDRAISING EXPENSES: ; CONSULTING - TOTAL EXPENSE: 2255637, PROGRAM SERVICE EXPENSE: 2082329, MANAGEMENT AND GENERAL EXPENSES: 173308, FUNDRAISING EXPENSES: ; COLLECTION FEES - TOTAL EXPENSE: 777812, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 777812, FUNDRAISING EXPENSES: ; PURCHASED SERVICES - TOTAL EXPENSE: 974651, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 974651, FUNDRAISING EXPENSES: ; RECRUITMENT - TOTAL EXPENSE: 16240, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 16240, FUNDRAISING EXPENSES: ; Form 990 , Part XI, Line 9, Other changes in net assets or fund balances CHANGE IN VALUE OF INTEREST IN RELATED ENTITIES - 26563; CHANGE IN VALUE OF INTEREST RATE SWAP - 2228861; WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC 835 SWEITZER STREET GREENVILLE OH 45331 270581440 PROFESSIONAL MEDICAL SERVICES OH -2448116 790797 WAYNE HEALTHCARE THE WAYNE HOSPITAL FOUNDATION INC 835 SWEITZER STREET GREENVILLE OH 45331 260380696 FUNDRAISING OH 501(C)(3) Type I WAYNE HEALTHCARE true HEALTHWAY INC 835 SWEITZER STREET GREENVILLE OH 45331 311497938 PROVIDER NETWORK OH WAYNE HEALTHCARE C CORPORATION 0 28001 1 true false false true false false false false false false false false true true true true false true false false