WAYNE HOSPITAL COMPANY: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- WAYNE HOSPITAL COMPANY (EIN 34-4428598)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-07-26
- IRS object ID
- 201212089349300131
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-07-26T13:00:02-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3815 River Crossing Parkway | AddressLine1 |
| Address Line2 | Suite 300 | AddressLine2 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 462400977 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344428598 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HOSPITAL COMPANY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WAYN | NameControl |
| Phone | 9375481141 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 Sweitzer Street | AddressLine1 |
| City | Greenville | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WAYNE DESCHAMBEAU | Name |
| Title | CEO | Title |
| Date Signed | 2012-07-23 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rachel Spurlock | Name |
| PTIN | P00520729 | PTIN |
| Phone | 3175698989 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HEALTHCARE | BusinessNameLine1 |
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE DESCHAMBEAU PRES & CEO | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 Sweitzer Street | AddressLine1 |
| City | Greenville | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 82151257 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WAYNEHEALTHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1922 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | THE 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 Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 661 | TotalNbrEmployees |
| Total Nbr Volunteers | 118 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 132889 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 53529 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 58117193 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 57466412 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6110235 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2009432 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 395113 | OtherRevenuePriorYear |
| Other Revenue Current Year | 344373 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 64755430 | TotalRevenuePriorYear |
| Total Revenue Current Year | 59873746 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 136318 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 140383 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 29023602 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29167805 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 29525342 | OtherExpensePriorYear |
| Other Expenses Current Year | 31397127 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 58685262 | TotalExpensesPriorYear |
| Total Expenses Current Year | 60705315 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6070168 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -831569 | RevenuesLessExpensesCY |
| Total Assets BOY | 117124174 | TotalAssetsBOY |
| Total Assets EOY | 110735246 | TotalAssetsEOY |
| Total Liabilities BOY | 39101379 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 39162286 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 78022795 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 71572960 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. (CONTINUED ON SCHEDULE O). | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 39900242 | Expense |
| Grants | 0 | Grants |
| Revenue | 54036412 | Revenue |
| Description | 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 2,264 ADMISSIONS AND 83,804 OUTPATIENT VISITS IN 2011. 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 11295478 | Expense |
| Grants | 140383 | Grants |
| Revenue | 3694031 | Revenue |
| Description | WAYNE HOSPITAL HAS MANY ADDITIONAL PROGRAMS. ONE ADDITIONAL PROGRAM IS THE COUNTY HEALTH FAIR IN WHICH EMPLOYEES FROM THE HOSPITAL PROVIDE OVER 240 HOURS OF TIME TO HELP WITH HEALTH SCREENINGS AND PROVIDE EDUCATIONAL INFORMATION TO THE COMMUNITY. ANOTHER PROGRAM IS THE 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 350 HOURS OF TIME ON THE DIABETES SEMINARS AND CLASSES AND THE HOSPITAL HAS CONTRIBUTED $770 OF SUPPLIES TO THE PROGRAM. AN ADDITIONAL PROGRAM OF WAYNE HOSPITAL IS THE CANCER AWARENESS, PREVENTION, AND SCREENING PROGRAM IN WHICH THE HOSPITAL OFFERS 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 100 HOURS OF TIME ON THE CANCER AWARENESS SEMINARS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 51195720 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 45 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 661 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE DESCHAMBEAU | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9375475722 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | Greenville | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JOHN SWALLOW | |||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| PHILIP DUBBS | |||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| PHILLIP GARBIG | |||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| BRAD BIXLER | |||||||
| PAST CHAIRMAN | 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 | ||
| LARRY ROLL | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LUCILLE HOSFELD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MIKE GRAY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ROXANNE CECH MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM JOHNSTON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DENNIS LOCKARD | |||||||
| CFO | 40.00 | X | 160916 | 0 | 22481 | ||
| WAYNE DESCHAMBEAU | |||||||
| CEO | 40.00 | X | 248110 | 0 | 33578 | ||
| DANIEL MCKELLAR | |||||||
| SURGEON | 40.00 | 528426 | 0 | 16639 | X | ||
| DAVID M WARE | |||||||
| SURGEON | 40.00 | 474650 | 0 | 26785 | X | ||
| JOHN A DUTRO | |||||||
| SURGEON | 40.00 | 372082 | 0 | 37356 | X | ||
| PATRICK KARR | |||||||
| OB/GYN | 40.00 | 508894 | 0 | 43619 | X | ||
| PETER LACHIEWICZ | |||||||
| OB/GYN | 40.00 | 487889 | 0 | 49345 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2780967 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 229803 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| KETTERING ANESTHESIA ASSOC | |||||
| 3500 PENTAGON BLVD STE 200 | BEAVERCREEK | OH | 45431 | ANESTHESIA SERVICES | 1211200 |
| MESSER CONSTRUCTION CO | |||||
| 4801 HEMPSTEAD DR | DAYTON | OH | 45429 | CONTRACTOR SERVICES | 1056712 |
| MIDWEST ULTRASOUND | |||||
| 1373 SOLUTIONS CENTER | CHICAGO | IL | 60677 | ULTRASOUND SERVICES | 425073 |
| WEST CENTRAL OHIO HOSPITAL CONS | |||||
| PO BOX 35381 | CANTON | OH | 44735 | MRI SERVICES | 412631 |
| EDCO GROUP INC | |||||
| PO BOX 7010 | SPRINGFIELD | MO | 65802 | ELECTRONIC MEDICAL RECORD DATABASE SERVICE | 400955 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 24 | NumberOfContractorsGT100K |
| All Other Contributions | 53529 | AllOtherContributions |
| Total Contributions | 53529 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | 55932391 | 55932391 |
| EHR | 621110 | 1534021 | 1534021 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 57466412 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 920307 | TotalRevenueColumn |
| Exclusion | $920,307 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 293712 | Real |
| Personal | 1500 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 350095 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -56383 | Real |
| Personal | 1500 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -54883 | TotalRevenueColumn |
| Exclusion | -$54,883 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 22921193 | Securities |
| Other | 95348 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 21731249 | Securities |
| Other | 196167 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1189944 | Securities |
| Other | -100819 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1089125 | TotalRevenueColumn |
| Exclusion | $1,089,125 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 22521 | GrossSalesOfInventory |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22521 | TotalRevenueColumn |
| Exclusion | $22,521 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| FOOD SALES | 722210 | 112704 | $112,704 | |
| REBATE REVENUE | 900099 | 90871 | 90871 | |
| HOUSEKEEPING | 812900 | 79608 | 79608 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 93552 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93552 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 376735 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59873746 | TotalRevenueColumn |
| Related Or Exempt Function Income | 57730443 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,089,774 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140383 | Total |
| Program Services | 140383 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 465085 | Total |
| Management And General | 465085 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22724813 | Total |
| Program Services | 20038552 | ProgramServices |
| Management And General | 2686261 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 545785 | Total |
| Program Services | 481099 | ProgramServices |
| Management And General | 64686 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3887835 | Total |
| Program Services | 3366364 | ProgramServices |
| Management And General | 521471 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1544287 | Total |
| Program Services | 1334429 | ProgramServices |
| Management And General | 209858 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162463 | Total |
| Management And General | 162463 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110325 | Total |
| Management And General | 110325 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240558 | Total |
| Management And General | 240558 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6242974 | Total |
| Program Services | 4774764 | ProgramServices |
| Management And General | 1468210 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245354 | Total |
| Program Services | 219460 | ProgramServices |
| Management And General | 25894 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194661 | Total |
| Program Services | 130350 | ProgramServices |
| Management And General | 64311 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226827 | Total |
| Program Services | 184299 | ProgramServices |
| Management And General | 42528 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1614070 | Total |
| Program Services | 1305702 | ProgramServices |
| Management And General | 308368 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53988 | Total |
| Program Services | 30674 | ProgramServices |
| Management And General | 23314 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27693 | Total |
| Program Services | 21100 | ProgramServices |
| Management And General | 6593 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1324716 | Total |
| Management And General | 1324716 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5683436 | Total |
| Program Services | 4887755 | ProgramServices |
| Management And General | 795681 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 537015 | Total |
| Program Services | 394251 | ProgramServices |
| Management And General | 142764 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 5457418 | 5450042 | 7376 |
| BAD DEBT | 6899647 | 6899647 | |
| MAINTENANCE AGREEMENTS | 1401148 | 891959 | 509189 |
| DIETARY | 318911 | 312854 | 6057 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 655923 | Total |
| Program Services | 332036 | ProgramServices |
| Management And General | 323887 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60705315 | Total |
| Program Services | 51195720 | ProgramServices |
| Management And General | 9509595 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11965119 | BOY |
| EOY | 6739196 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4344609 | BOY |
| EOY | 4364274 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7144613 | BOY |
| EOY | 6334602 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38115 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1273400 | BOY |
| EOY | 1308778 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 503849 | BOY |
| EOY | 539895 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 95608962 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 41151197 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57644652 | BOY |
| EOY | 54457765 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32343498 | BOY |
| EOY | 36203959 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 133355 | BOY |
| EOY | 141408 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1732964 | BOY |
| EOY | 645369 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117124174 | BOY |
| EOY | 110735246 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5973244 | BOY |
| EOY | 4079762 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30000000 | BOY |
| EOY | 29402083 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3128135 | BOY |
| EOY | 5680441 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39101379 | BOY |
| EOY | 39162286 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77845708 | BOY |
| EOY | 71394332 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164167 | BOY |
| EOY | 165708 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12920 | BOY |
| EOY | 12920 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78022795 | BOY |
| EOY | 71572960 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117124174 | BOY |
| EOY | 110735246 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -831569 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5618266 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $5,191 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5191 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of the activities reported on Lines 1a through 1i | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | WAYNE HOSPITAL COMPANY PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES ($5,191) IS SPENT ON LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 196365 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1541 | InvestmentEarningsOrLosses |
| End Of Year Balance | 197906 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 195314 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 3051 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 196365 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 236705 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 6844 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 46235 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 195314 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 236705 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 0 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 236705 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.09800 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.06500 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.83700 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1962335 | OtherCostOrOtherBasis |
| Book Value | 1962335 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 65359821 | OtherCostOrOtherBasis |
| Depreciation | 25462081 | Depreciation |
| Book Value | 39897740 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3376200 | OtherCostOrOtherBasis |
| Depreciation | 1330258 | Depreciation |
| Book Value | 2045942 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24155595 | OtherCostOrOtherBasis |
| Depreciation | 14358858 | Depreciation |
| Book Value | 9796737 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 755011 | OtherCostOrOtherBasis |
| Book Value | 755011 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 54457765 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $591,339 |
| INTEREST RATE SWAP LIABILITY | $5,089,102 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5680441 | TotalOfAmounts |
| Total Revenue | 59873746 | TotalRevenue |
| Total Expenses | 60705315 | TotalExpenses |
| Excess Or Deficit For Year | -831569 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -3238351 | NetUnrealizedGLOnInvestments |
| Other | -$2,379,915 | OtherAmount |
| Total Adjustments | -5618266 | TotalAdjustments |
| Excess Or Deficit Per FS | -6449835 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 57119902 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -3238351 | NetUnrealizedGainsInvestments |
| Other Revenues | 484507 | OtherRevenues |
| Revenue Not Rptd F990 | -2753844 | RevenueNotRptdF990 |
| Revenue Subtotal | 59873746 | RevenueSubtotal |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 59873746 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 63569737 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 2864422 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 2864422 | ExpensesNotRptdF990 |
| Expenses Subtotal | 60705315 | ExpensesSubtotal |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 60705315 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Intended uses of endowment funds | Schedule D, Part V, Line 4 | 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. |
| FIN 48 (ASC 740) footnote | Schedule D, Part X, Line 2 | 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, 2011 AND 2010. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | false | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1097632 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1097632 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02030 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7802105 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2905673 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4896432 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09040 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1831257 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 776604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1054653 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01950 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 10730994 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3682277 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7048717 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13020 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23263 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11754 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11509 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 190522 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 190522 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 213785 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11754 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 202031 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 10944779 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3694031 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7250748 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13390 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $6,899,647 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 54610199 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 46762850 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 7847349 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST CENTRAL OHIO HOSPITAL CONSORTIUM LTD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | PARTNERSHIP FOR MOBILE MRI UNIT | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.3333 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HOSPITAL COMPANY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HOSPITAL COMPANY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Other Actions | X | OtherActions |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | PHYSICIAN PROFESSIONAL SERVICES ORGANIZATION | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | 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. |
| Bad Debt Expense excluded from financial assistance calculation | Schedule H, Part I, Line 7, column(f) | 6,899,647 |
| Subsidized Health Services | Schedule H, Part I, Line 7g | N/A |
| Bad debt expense - financial statement footnote | Schedule H, Part III, Line 4 | 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. |
| Community benefit & methodology for determining medicare costs | Schedule H, Part III, Line 8 | THE MEDICARE ALLOWABLE COSTS ARE DETERMINED USING THE COST TO CHARGE RATIO. |
| Other collection actions permitted | Schedule H, Part V Section B, Line 15e | (1) WAYNE HOSPITAL COMPANY - WAGE GARNISHMENT; |
| Other collection actions | Schedule H, Part V Section B, Line 16e | (1) WAYNE HOSPITAL COMPANY - WAGE GARNISHMENT; |
| Other actions taken before collection actions | Schedule H, Part V Section B, Line 17e | (1) WAYNE HOSPITAL COMPANY - WAYNE HEALTHCARE SENDS OUT 3 STATEMENTS AND 2 PRECOLLECT LETTERS PRIOR TO TURNING OVER A PATIENT TO AN AGENCY.; |
| Means used to determine amounts billed | Schedule H, Part V Section B, Line 19d | (1) WAYNE HOSPITAL COMPANY - WAYNE HEALTHCARE PROVIDES A 25% DISCOUNT TO PATIENTS WHO DID NOT HAVE INSURANCE COVERAGE DURING CARE. ADDITIONALLY, PATIENTS HAVE THE ABILITY TO APPLY FOR CHARITY CARE, FINANCIAL ASSISTANCE, AND MAKE PAYMENT ARRANGEMENTS.; |
| Gross Charges for Medical Care | Schedule H, Part V Section B, Line 21 | (1) WAYNE HOSPITAL COMPANY - EACH PATIENT IS CHARGED THE SAME RATE OF GROSS CHARGES REGARDLESS OF THE TYPE OF COVERAGE, IF ANY, THAT THE PATIENT HAS.; |
| Needs assessment. | Schedule H, Part VI, Line 2 | 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 ASSESSMENT. |
| Patient education of eligibility for assistance. | Schedule H, Part VI, Line 3 | 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. |
| Community information. | Schedule H, Part VI, Line 4 | WAYNE HOSPITAL SERVES THE DARKE COUNTY COMMUNITY. DARKE COUNTY IS MAINLY A RURAL FARMING COMMUNITY WITH A POPULATION OF OVER 52,000. APPROXIMATELY 10.6% OF THE COUNTY INCOME LEVEL IS UNDER THE FEDERAL POVERTY GUIDELINES AND 14.8% OF THE REVENUES FOR THE HOSPITAL WERE MEDICAID PATIENTS IN 2011. THE COUNTY UNEMPLOYMENT RATE IN 2011 WAS 8.1%. 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 health | Schedule H, Part VI, Line 5 | 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. IN ADDITION, WAYNE HOSPITAL IS OFFERING NEW SERVICES FOR OUR CANCER PATIENTS BY PREPARING A JOINT VENTURE RELATIONSHIP FOR A RADIATION ONCOLOGY CENTER THAT WILL BE ESTABLISHED IN 2012. |
| State filing of community benefit report | Schedule H, Part VI, Line 7 | OH |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH SERVICES OF DARKE COUNTY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5735 MEEKER RD | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 341119524 | EINOfRecipient |
| IRC Section | 501C3 | IRCSection |
| Amount Of Non Cash Assistance | 140383 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK VALUE | MethodOfValuation |
| Description Of Non Cash Assistance | ARCANUM BUILDING AND LAND | DescriptionOfNonCashAssistance |
| Purpose Of Grant | MEDICAL CARE FOR DARKE COUNTY RESIDENTS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures for monitoring use of grant funds | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | THE LAND AND BUILDING WERE GRANTED TO FAMILY HEALTH BY MEANS OF A WARRANTY DEED. IF FAMILY HEALTH DOES NOT USE THE BUILDING AND LAND IN ACCORDANCE WITH MEDICAL NEEDS, WAYNE HOSPITAL HAS THE OPTION OF BUYING BACK THE LAND AND BUILDING FOR THE FAIR MARKET VALUE PURSUANT TO THE DEED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WAYNE DESCHAMBEAU | |||||||||||||
| 230000 | 0 | 18110 | 0 | 0 | 0 | 14980 | 0 | 18598 | 0 | 281688 | 0 | 0 | 0 |
| DENNIS LOCKARD | |||||||||||||
| 143863 | 0 | 10975 | 0 | 6078 | 0 | 4578 | 0 | 17903 | 0 | 183397 | 0 | 0 | 0 |
| PETER LACHIEWICZ | |||||||||||||
| 364465 | 0 | 123424 | 0 | 0 | 0 | 29580 | 0 | 19765 | 0 | 537234 | 0 | 0 | 0 |
| PATRICK KARR | |||||||||||||
| 338432 | 0 | 170462 | 0 | 0 | 0 | 24080 | 0 | 19539 | 0 | 552513 | 0 | 0 | 0 |
| DANIEL MCKELLAR | |||||||||||||
| 350000 | 0 | 178426 | 0 | 0 | 0 | 7580 | 0 | 9059 | 0 | 545065 | 0 | 0 | 0 |
| JOHN A DUTRO | |||||||||||||
| 308153 | 0 | 63929 | 0 | 0 | 0 | 18080 | 0 | 19276 | 0 | 409438 | 0 | 0 | 0 |
| DAVID M WARE | |||||||||||||
| 300000 | 0 | 174650 | 0 | 0 | 0 | 7580 | 0 | 19205 | 0 | 501435 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Housing allowance or residence for personal use | Schedule J, Part I, Line 1a | 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. |
| Compensation contingent on revenues of the organization | Schedule J, Part I, Line 5a | 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. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF DARKE OHIO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 346400036 | IssuerEIN |
| Date Issued | 2010-11-01 | DateIssued |
| Issue Price | 30000000 | IssuePrice |
| Description Of Purpose | CURRENTLY REFUND PORTION OF 11/1/2007 BONDS | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 0 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 30000000 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 0 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 0 | CapitalExpenditures |
| Other Spent Proceeds | 30000000 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2010 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.0000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.0000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.0000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Term Of Hedge | 0.0 | TermOfHedge |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Term Of GIC | 0.0 | TermOfGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures to take corrective action | Identifier |
| Return Reference | Schedule K, Part V | ReturnReference |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 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. |
| Family/business relationships amongst interested persons | Form 990, Part VI, Section A, Line 2 | JOHN SWALLOW - BUSINESS RELATIONSHIP |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | 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. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | 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. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | 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. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | 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. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | 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, 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 official | Form 990, Part VI, Section B, Line 15a | THE 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 2011. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -3238351; CHANGE IN VALUE OF INTEREST RATE SWAP - -2413508; CHANGE IN INTEREST OF RELATED ENTITIES - 33593; |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270581440 | EIN |
| Primary Activities | PROFESSIONAL MEDICAL SERVICES | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Total Income | -2830783 | TotalIncome |
| EOY Assets | 771751 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE WAYNE HOSPITAL FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260380696 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11 - Type I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHWAY INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 SWEITZER STREET | AddressLine1 |
| City | GREENVILLE | City |
| State | OH | State |
| ZIP Code | 45331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311497938 | EIN |
| Primary Activity | PROVIDER NETWORK | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Share Of Total Income | 572 | ShareOfTotalIncome |
| Share Of EOY Assets | 27483 | ShareOfEOYAssets |
| Percentage Ownership | 1 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |