FURP.ORG / PUBLIC DATA EXPLORER

WAYNE HOSPITAL COMPANY: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WAYNE HOSPITAL COMPANY (EIN 34-4428598)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349308357
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)
Timestamp2013-11-15T14:42:17-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110 West Broad StreetAddressLine1
Address Line2Suite 1700AddressLine2
CityColumbusCity
StateOHState
ZIP Code432153713ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN344428598EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAYNNameControl
Phone9375481141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Sweitzer StreetAddressLine1
CityGreenvilleCity
StateOHState
ZIP Code45331ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE DESCHAMBEAUName
TitleCEOTitle
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRachel SpurlockName
PTINP00520729PTIN
Phone6144690001Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1WAYNE HEALTHCAREBusinessNameLine1

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1WAYNE DESCHAMBEAU PRES & CEOBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1835 Sweitzer StreetAddressLine1
CityGreenvilleCity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Gross Receipts81209829GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WAYNEHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1922YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITIY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees616TotalNbrEmployees
Total Nbr Volunteers116TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year53529ContributionsGrantsPriorYear
Contributions Grants Current Year43232ContributionsGrantsCurrentYear
Program Service Revenue Prior Year57466412ProgramServiceRevenuePriorYear
Program Service Revenue CY58611292ProgramServiceRevenueCY
Investment Income Prior Year2009432InvestmentIncomePriorYear
Investment Income Current Year2542961InvestmentIncomeCurrentYear
Other Revenue Prior Year344373OtherRevenuePriorYear
Other Revenue Current Year357920OtherRevenueCurrentYear
Total Revenue Prior Year59873746TotalRevenuePriorYear
Total Revenue Current Year61555405TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year140383GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY29055GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29167805SalariesEtcPriorYear
Salaries Etc Current Year28458180SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year31397127OtherExpensePriorYear
Other Expenses Current Year31792965OtherExpensesCurrentYear
Total Expenses Prior Year60705315TotalExpensesPriorYear
Total Expenses Current Year60280200TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-831569RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1275205RevenuesLessExpensesCY
Total Assets BOY110735246TotalAssetsBOY
Total Assets EOY116453107TotalAssetsEOY
Total Liabilities BOY39162286TotalLiabilitiesBOY
Total Liabilities EOY40865393TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY71572960NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY75587714NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense50633194Expense
Grants29055Grants
Revenue58836858Revenue
DescriptionAS 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 2,026 ADMISSIONS AND 82,412 OUTPATIENT VISITS IN 2012. 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.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense154682Expense
Grants0Grants
Revenue14186Revenue
DescriptionWAYNE 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 180 HOURS TO THE YOUTH HEALTH FAIR, WHICH IS A HEALTH FAIR GEARED TO ALL THE FIFTH GRADERS IN DARKE COUNTY. OVER 350 STUDENTS WERE IN ATTENDANCE. (CONTINUED ON SCHEDULE O)Description
FieldValueIRS element (for citing)
Total Program Service Expense50787876TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109652NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees616NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WAYNE DESCHAMBEAUBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9375475722TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGreenvilleCity
StateOHState
ZIP Code45331ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
JOHN SWALLOW
CHAIRMAN1.00XX000
LARRY ROLL
SECRETARY/TREASURER1.00XX000
PHILIP DUBBS
VICE CHAIRMAN1.00XX000
PHILLIP GARBIG
PAST CHAIRMAN1.00XX000
BRAD BIXLER
BOARD MEMBER1.00X000
CINDY SCOTT
BOARD MEMBER1.00X000
DAN FRANZ
BOARD MEMBER1.00X000
JENNIFER RAWLINS MD
BOARD MEMBER1.00X000
JOHN DUTRO MD
BOARD MEMBER / SURGEON1.00X35345302833140.00
LUCILLE HOSFELD
BOARD MEMBER1.00X000
MIKE GRAY
BOARD MEMBER1.00X000
ROXANNE CECH MD
BOARD MEMBER1.00X000
WILLIAM JOHNSTON
BOARD MEMBER1.00X000
DENNIS LOCKARD
CFO40.00X166115024021
WAYNE DESCHAMBEAU
CEO40.00X255026027195
DANIEL MCKELLAR
SURGEON40.00519244018049X
DAVID M WARE
SURGEON40.00477166028397X
GUILLERMO G TREVINO
PHYSICIAN40.00270300027312X
PATRICK KARR
OB/GYN40.00483653028602X
PETER LACHIEWICZ
OB/GYN40.00453119028835X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2978076TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation210742TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
KETTERING ANESTHESIA ASSOC
3500 PENTAGON BLVD STE 200BEAVERCREEKOH45431ANESTHESIA SERVICES1129110
MESSER CONSTRUCTION CO
4801 HEMPSTEAD DRDAYTONOH45429CONTRACTOR SERVICES639381
WEST CENTRAL OHIO HOSPITAL CONS
PO BOX 35381CANTONOH44735MRI SERVICES502992
PHELAN INSURANCE AGENCY
PO BOX 1VERSAILLESOH45380INSURANCE SERVICES465257
CHRIST HOSPITAL
PO BOX 635899CINCINNATIOH452635899ULTRASOUND SERVICES428126
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
All Other Contributions43232AllOtherContributions
Total Contributions43232TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6211105724602757246027
MEANINGFUL USE INCENTIVE PAYMENTS62111013652651365265
0
0
0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue58611292TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1315664TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,315,664ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real321629Real
Personal1500Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real297751Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real23878Real
Personal1500Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column25378TotalRevenueColumn
Exclusion$25,378ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities20529969Securities
Other10826Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities19273859Securities
Other39639Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1256110Securities
Other-28813Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1227297TotalRevenueColumn
Exclusion$1,227,297ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory20703GrossSalesOfInventory
Cost Of Goods Sold43175CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-22472TotalRevenueColumn
Exclusion-$22,472ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
FOOD SALES722210115262$115,262
HOUSEKEEPING8129008101981019
REBATE REVENUE9000996207162071

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column96662TotalRevenueColumn
Related Or Exempt Function Income96662RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue355014TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column61555405TotalRevenueColumn
Related Or Exempt Function Income58851044RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,661,129ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total25055Total
Program Services25055ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total4000Total
Program Services4000ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total482357Total
Management And General482357ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19742704Total
Program Services17667562ProgramServices
Management And General2075142ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total604280Total
Program Services540765ProgramServices
Management And General63515ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6150067Total
Program Services5503638ProgramServices
Management And General646429ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1478772Total
Program Services1291778ProgramServices
Management And General186994ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total454184Total
Management And General454184ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total63900Total
Management And General63900ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total327286Total
Management And General327286ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6475665Total
Program Services5014152ProgramServices
Management And General1461513ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total124214Total
Program Services101161ProgramServices
Management And General23053ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total159604Total
Program Services105506ProgramServices
Management And General54098ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total194573Total
Program Services45285ProgramServices
Management And General149288ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2239056Total
Program Services1957158ProgramServices
Management And General281898ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total67585Total
Program Services34917ProgramServices
Management And General32668ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total43847Total
Program Services32953ProgramServices
Management And General10894ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1302455Total
Management And General1302455ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5537443Total
Program Services4762201ProgramServices
Management And General775242ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total483597Total
Program Services348504ProgramServices
Management And General135093ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT670989567036836212
MEDICAL SUPPLIES514072451345126212
MAINTENANCE AGREEMENTS1317734761858555876
DIETARY28566327056015103

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total865540Total
Program Services482628ProgramServices
Management And General382912ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total60280200Total
Program Services50787876ProgramServices
Management And General9492324ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6739196BOY
EOY8503989EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4364274BOY
EOY5906551EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY13799EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6334602BOY
EOY5372746EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1308778BOY
EOY1299912EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY539895BOY
EOY536193EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis97314474LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec45980622LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY54457765BOY
EOY51333852EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY36203959BOY
EOY39759042EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY141408BOY
EOY1170977EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY645369BOY
EOY2556046EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY110735246BOY
EOY116453107EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4079762BOY
EOY6030468EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY29402083BOY
EOY28774165EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5680441BOY
EOY6060760EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY39162286BOY
EOY40865393EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY71394332BOY
EOY75414072EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY165708BOY
EOY160722EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12920BOY
EOY12920EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY71572960BOY
EOY75587714EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY110735246BOY
EOY116453107EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1275205ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2625297ReconciliationUnrealizedInvest
Reconcilation Other Changes114252ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$5,116OtherActivitiesAmount
Total Lobbying Expenditures IIB5116TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of the activities reported on Lines 1a through 1iIdentifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationWAYNE HOSPITAL COMPANY PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES, $5,116, WAS SPENT ON LOBBYING.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance197906BeginningOfYearBalance
Investment Earnings Or Losses555InvestmentEarningsOrLosses
Grants Or Scholarships4000GrantsOrScholarships
End Of Year Balance194461EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance196365BeginningOfYearBalance
Investment Earnings Or Losses1541InvestmentEarningsOrLosses
End Of Year Balance197906EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance195314BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses3051InvestmentEarningsOrLosses
Grants Or Scholarships2000GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance196365EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance236705BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses6844InvestmentEarningsOrLosses
Grants Or Scholarships2000GrantsOrScholarships
Other Expenditures46235OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance195314EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance236705BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance236705EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.09900BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.06600PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.83500TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1998335OtherCostOrOtherBasis
Book Value1998335BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis66909548OtherCostOrOtherBasis
Depreciation28408353Depreciation
Book Value38501195BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3415160OtherCostOrOtherBasis
Depreciation1503304Depreciation
Book Value1911856BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis24836148OtherCostOrOtherBasis
Depreciation16068965Depreciation
Book Value8767183BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis155283OtherCostOrOtherBasis
Book Value155283BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51333852TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY SETTLEMENTS$1,025,916
INTEREST RATE SWAP LIABILITY$5,034,844
FieldValueIRS element (for citing)
Total Of Amounts6060760TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt57860722TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2625297NetUnrealizedGainsInvestments
Other Revenues386558OtherRevenues
Revenue Not Rptd F9903011855RevenueNotRptdF990
Revenue Subtotal54848867RevenueSubtotal
Investment Expenses Not Included2855InvestmentExpensesNotIncluded
Other Revenues Not Included6703683OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt6706538RevenueNotRptdOnFinStmt
Total Revenue Per Form99061555405TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt53845968TotExpensesEtcAuditedFinclStmt
Other Expenses Included326564OtherExpensesIncluded
Expenses Not Rptd F990326564ExpensesNotRptdF990
Expenses Subtotal53519404ExpensesSubtotal
Investment Expenses Not Included22855InvestmentExpensesNotIncluded2
Other Expenses Not Included6757941OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt6760796ExpensesNotRptdOnFinStmt
Total Expenses Per Form99060280200TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Intended uses of endowment fundsSchedule D, Part V, Line 4ENDOWMENT FUNDS ARE SPECIFICALLY SET ASIDE FOR CLINICALLY RELATED SCHOLARSHIPS GRANTED TO STUDENTS GOING INTO A HEALTH RELATED FIELD OF STUDY AND FOR INDIGENT CARE.
FIN 48 (ASC 740) footnoteSchedule D, Part X, Line 2THE 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, 2012 AND 2011.
Other revenues in audited financial statements not in form 990Schedule D, Part XI, Line 2dLOSS ON DISPOSAL OF ASSET - 28813; RENTAL EXPENSES - 297751; CHANGE IN INTEREST OF RELATED PARTIES - 59994;
Other revenues in form 990 not in audited financial statementsSchedule D, Part XI, Line 4bBAD DEBTS - 6703683;
Other expenses in audited financial statements not in form 990Schedule D, Part XII, Line 2dLOSS ON DISPOSAL OF ASSETS - 28813; RENTAL EXPENSES INCLUDED IN REVENUE - 297751;
Other expenses in form 990 not in audited financial statementsSchedule D, Part XII, Line 4bCHANGE IN VALUE OF INTEREST RATE SWAP - 54258; BAD DEBTS - 6703683;

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense853298TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense853298NetCommunityBenefitExpense
Percent Of Total Expense0.01420PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7844599TotalCommunityBenefitExpense
Direct Offsetting Revenue3360556DirectOffsettingRevenue
Net Community Benefit Expense4484043NetCommunityBenefitExpense
Percent Of Total Expense0.07440PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1788864TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1788864NetCommunityBenefitExpense
Percent Of Total Expense0.02970PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense10486761TotalCommunityBenefitExpense
Direct Offsetting Revenue3360556DirectOffsettingRevenue
Net Community Benefit Expense7126205NetCommunityBenefitExpense
Percent Of Total Expense0.11830PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense126829TotalCommunityBenefitExpense
Direct Offsetting Revenue14186DirectOffsettingRevenue
Net Community Benefit Expense112643NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense23477TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense23477NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense150306TotalCommunityBenefitExpense
Direct Offsetting Revenue14186DirectOffsettingRevenue
Net Community Benefit Expense136120NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense10637067TotalCommunityBenefitExpense
Direct Offsetting Revenue3374742DirectOffsettingRevenue
Net Community Benefit Expense7262325NetCommunityBenefitExpense
Percent Of Total Expense0.12060PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense4376TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense4376NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense4376TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense4376NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$6,703,683BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare52426328AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare20208804CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall32217524MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
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 Line1WAYNE HOSPITAL COMPANYBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.WAYNEHEALTHCARE.ORGWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Facility TypePHYSICIAN PROFESSIONAL SERVICES ORGANIZATIONFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Costing Methodology used to calculate financial assistanceSchedule H, Part I, Line 7A 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.
Bad Debt Expense excluded from financial assistance calculationSchedule H, Part I, Line 7, column(f)0
Subsidized Health ServicesSchedule H, Part I, Line 7gN/A
Community Building ActivitiesSchedule H, Part IIWAYNE HEALTHCARE CONTRIBUTED $4,000 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 EXPENSE OF $126 TO MERCER HEALTH UPON A REQUEST FROM THE AMERICAN HEART ASSOCIATION FOR THE COMPLETION OF AN ACLS AUDIT TO ENSURE THAT THE FACILITY WAS WITHIN THE APPROPRIATE GUIDELINES FOR TRAINING COMPLETION OF CLINICAL STAFF.
Bad debt expense - methodology used to estimate amountSchedule H, Part III, Line 2WAYNE HEALTHCARE ACCOUNTS FOR THE ESTIMATED BAD DEBT BY TAKING THE GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE AND APPLYING THE COST TO CHARGE RATIO USED UNIFORMLY THROUGHOUT THE FORM 990 CALCULATIONS.
Bad debt expense - methodology used to estimate amount as community benefitSchedule H, Part III, Line 3N/A.
Bad debt expense - financial statement footnoteSchedule H, Part III, Line 4THE 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.
Community benefit & methodology for determining medicare costsSchedule H, Part III, Line 8THE MEDICARE ALLOWABLE COSTS ARE DETERMINED USING THE INTERNAL COST ACCOUNTING SYSTEM.
Needs assessment.Schedule H, Part VI, Line 2THE 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 ASSESSMENT.
Patient education of eligibility for assistance.Schedule H, Part VI, Line 3WAYNE 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.
Community information.Schedule H, Part VI, Line 4WAYNE HOSPITAL SERVES THE DARKE COUNTY COMMUNITY. DARKE COUNTY IS MAINLY A RURAL FARMING COMMUNITY WITH A POPULATION OF OVER 52,000. APPROXIMATELY 11.5% OF THE COUNTY INCOME LEVEL IS UNDER THE FEDERAL POVERTY GUIDELINES AND 13.5% OF THE REVENUES FOR THE HOSPITAL WERE MEDICAID PATIENTS IN 2012. THE COUNTY UNEMPLOYMENT RATE IN 2012 WAS 6.0%. 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.
Promotion of community healthSchedule H, Part VI, Line 5WAYNE 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.
State filing of community benefit reportSchedule H, Part VI, Line 7OH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedures for monitoring use of grant fundsIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationSPONSORSHPS PAID TO ORGANIZATIONS ARE SENT TO THEM TO USE WITHIN THEIR EXEMPT PURPOSES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 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
WAYNE DESCHAMBEAU
CEO23302602200000071530200420282221000
DENNIS LOCKARD
CFO1496210900007494046910193300190136000
PETER LACHIEWICZ
OB/GYN38591506720400075800212550481954000
PATRICK KARR
OB/GYN361126012252700075800210220512255000
DANIEL MCKELLAR
SURGEON42741509182900075800104690537293000
DAVID M WARE
SURGEON370744010642200075800208170505563000
JOHN DUTRO MD
BOARD MEMBER / SURGEON32944402400900075800207510381784000
GUILLERMO G TREVINO
PHYSICIAN2703000000075800197320297612000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Housing allowance or residence for personal useSchedule J, Part I, Line 1aWAYNE 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.
Compensation contingent on revenues of the organizationSchedule J, Part I, Line 5aTHE 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.

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 DARKE OHIOBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN346400036IssuerEIN
Date Issued2010-11-01DateIssued
Issue Price30000000IssuePrice
Description Of PurposeCURRENTLY REFUND PORTION OF 11/1/2007 BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds30000000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds30000000OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2010YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Prcntge Prvt Business Use By Others0.0000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.0000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.0000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay TestfalseBondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed PropfalseChangeInUseBondFinancedProp
Prcntge Bond Financed Prop0.0000PrcntgeBondFinancedProp
Remedial Action TakenfalseRemedialActionTaken
Non Qualified Bond Remed ProcdrstrueNonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Rebate Not Due YettrueRebateNotDueYet
Exception To RebatefalseExceptionToRebate
No Rebate DuetrueNoRebateDue
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Term Of Hedge0TermOfHedge
Superintegrated HedgefalseSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Term Of GIC0TermOfGIC
Regulatory Safe Harbor SatisfiedfalseRegulatorySafeHarborSatisfied
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1(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.
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4B(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 270 HOURS OF TIME ON THE DIABETES SEMINARS AND CLASSES AND THE HOSPITAL HAS CONTRIBUTED $275 OF SUPPLIES TO THE PROGRAM. AN ADDITIONAL PROGRAM OF WAYNE HOSPITAL IS THE CANCER AWARENESS, PREVENTION, SCREENING AND TREATMENT PROGRAM 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 95 HOURS OF TIME ON THE CANCER AWARENESS SEMINARS.
Delegate broad authority to a committeeForm 990, Part VI, Section A, Line 1aSECTION 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.
Family/business relationships amongst interested personsForm 990, Part VI, Section A, Line 2JOHN SWALLOW AND WAYNE DESCHAMBEAU - BUSINESS RELATIONSHIP
Significant changes to organizational documentsForm 990, Part VI, Section A, Line 4THE ORGANIZATION AMENDED ITS BYLAWS IN ARTICLE VII TO CHANGE THE NAMES AND DUTIES OF TWO OF ITS COMMITTEES: BUILDING/PLANNING COMMITTEE, FINANCE/AUDIT/PENSION COMMITTEE. THE BUILDING/PLANNING COMMITTEE IS TO PROVIDE OVERSIGHT FOR BUILDING AND OTHER CAPITAL PROJECTS.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6WAYNE 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.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aANY 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.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bEACH 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.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bA 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.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cTHE 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, WHO ENSURES THAT THE INTERESTED PERSON ABSTAINS FROM VOTING ON MATTERS RELATED TO THE CONFLICT OF INTEREST.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aTHE EXECUTIVE BOARD REVIEWS AND DETERMINES THE COMPENSATION FOR THE CEO. THEY USE COMPENSATION SURVEYS CONDUCTED BY AN 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. THE DELIBERATION AND DISCUSSION REGARDING THE CEO'S COMPENSATION IS INCLUDED IN THE BOARD MINUTES. THIS PROCESS IS COMPLETED FOR WAYNE DESCHAMBEAU, CEO AND WAS LAST UNDERTAKEN IN 2012.
PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERSFORM 990, PART VI, LINE 15BTHE 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 2012.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
Other ExpensesForm 990, Part IX, Line 11gOTHER EXPENSES - TOTAL EXPENSE: 3678023, PROGRAM SERVICE EXPENSE: 2417969, MANAGEMENT AND GENERAL EXPENSES: 1260054, FUNDRAISING EXPENSES: ; AGENCY EMPLOYEES - TOTAL EXPENSE: 2797642, PROGRAM SERVICE EXPENSE: 2596183, MANAGEMENT AND GENERAL EXPENSES: 201459, FUNDRAISING EXPENSES: ;
Other changes in net assets or fund balancesForm 990 , Part XI, Line 9CHANGE IN VALUE OF INTEREST RATE SWAP - 54258; CHANGE IN VALUE OF INTEREST IN RELATED ENTITIES - 59994;

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
EIN270581440EIN
Primary ActivitiesPROFESSIONAL MEDICAL SERVICESPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Total Income-2728949TotalIncome
EOY Assets449621EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE WAYNE HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusType IPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTHWAY INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
EIN311497938EIN
Primary ActivityPROVIDER NETWORKPrimaryActivity
Legal Domicile StateOHLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPORATIONTypeOfEntity
Share Of Total Income518ShareOfTotalIncome
Share Of EOY Assets28001ShareOfEOYAssets
Percentage Ownership1PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg