2012-07-26T13:00:02-05:00 2011-12-31 CROWE HORWATH LLP 3815 River Crossing Parkway Suite 300 Indianapolis IN 462400977 990 2011-01-01 344428598 WAYNE HOSPITAL COMPANY WAYN 9375481141 835 Sweitzer Street Greenville OH 45331 WAYNE DESCHAMBEAU 2012-07-23 true Rachel Spurlock P00520729 3175698989 2011 2016-02-24 21:20:13Z WAYNE HEALTHCARE WAYNE DESCHAMBEAU PRES & CEO 835 Sweitzer Street Greenville OH 45331 82151257 false X WWW.WAYNEHEALTHCARE.ORG X 1922 OH THE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITIY TO PAY. 12 10 661 118 0 0 132889 53529 58117193 57466412 6110235 2009432 395113 344373 64755430 59873746 136318 140383 0 0 29023602 29167805 0 0 0 29525342 31397127 58685262 60705315 6070168 -831569 117124174 110735246 39101379 39162286 78022795 71572960 X THE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES AT A LEVEL TO RANK PROMINENTLY ON A REGIONAL AND NATIONAL BASIS FOR QUALITY OF CARE, PATIENT SATISFACTION AND SPIRITUALITY SUPPORT. THE HOSPITAL COLLABORATES WITH OTHER HEALTH CARE PROVIDERS TO DEVELOP NEW AND/OR IMPROVED SERVICES FOR RESIDENTS OF DARKE COUNTY, OHIO. (CONTINUED ON SCHEDULE O). false false 39900242 0 54036412 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. 11295478 140383 3694031 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. 51195720 true true false true false false false false true true false false false true true true true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 45 0 true 661 true false false false false false false false false false false X 12 10 true false false false true true true true true false false true true true true true true true false false X WAYNE DESCHAMBEAU 9375475722 835 SWEITZER STREET Greenville OH 45331 JOHN SWALLOW 1.00 X X 0 0 0 PHILIP DUBBS 1.00 X X 0 0 0 PHILLIP GARBIG 1.00 X X 0 0 0 BRAD BIXLER 1.00 X 0 0 0 CINDY SCOTT 1.00 X 0 0 0 DAN FRANZ 1.00 X 0 0 0 JENNIFER RAWLINS MD 1.00 X 0 0 0 LARRY ROLL 1.00 X 0 0 0 LUCILLE HOSFELD 1.00 X 0 0 0 MIKE GRAY 1.00 X 0 0 0 ROXANNE CECH MD 1.00 X 0 0 0 WILLIAM JOHNSTON 1.00 X 0 0 0 DENNIS LOCKARD 40.00 X 160916 0 22481 WAYNE DESCHAMBEAU 40.00 X 248110 0 33578 DANIEL MCKELLAR 40.00 X 528426 0 16639 DAVID M WARE 40.00 X 474650 0 26785 JOHN A DUTRO 40.00 X 372082 0 37356 PATRICK KARR 40.00 X 508894 0 43619 PETER LACHIEWICZ 40.00 X 487889 0 49345 2780967 0 229803 14 false true false 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 24 53529 53529 PATIENT SERVICE REVENUE 621110 55932391 55932391 EHR 621110 1534021 1534021 0 0 0 0 57466412 920307 920307 0 0 293712 1500 350095 -56383 1500 -54883 -54883 22921193 95348 21731249 196167 1189944 -100819 1089125 1089125 0 0 22521 0 22521 22521 FOOD SALES 722210 112704 112704 REBATE REVENUE 900099 90871 90871 HOUSEKEEPING 812900 79608 79608 93552 93552 0 0 376735 59873746 57730443 0 2089774 140383 140383 0 0 0 465085 465085 0 22724813 20038552 2686261 545785 481099 64686 3887835 3366364 521471 1544287 1334429 209858 0 162463 162463 110325 110325 0 0 240558 240558 6242974 4774764 1468210 245354 219460 25894 194661 130350 64311 226827 184299 42528 0 1614070 1305702 308368 53988 30674 23314 0 27693 21100 6593 1324716 1324716 0 5683436 4887755 795681 537015 394251 142764 MEDICAL SUPPLIES 5457418 5450042 7376 BAD DEBT 6899647 6899647 MAINTENANCE AGREEMENTS 1401148 891959 509189 DIETARY 318911 312854 6057 655923 332036 323887 0 60705315 51195720 9509595 0 0 11965119 6739196 4344609 4364274 7144613 6334602 38115 1273400 1308778 503849 539895 95608962 41151197 57644652 54457765 32343498 36203959 133355 141408 0 0 1732964 645369 117124174 110735246 5973244 4079762 30000000 29402083 3128135 5680441 39101379 39162286 X 77845708 71394332 164167 165708 12920 12920 78022795 71572960 117124174 110735246 X -831569 -5618266 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5191 5191 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 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. 196365 1541 197906 195314 0 3051 2000 0 0 196365 236705 0 6844 2000 46235 0 195314 236705 0 0 0 0 0 236705 0.09800 0.06500 0.83700 false false 1962335 1962335 65359821 25462081 39897740 3376200 1330258 2045942 24155595 14358858 9796737 755011 755011 54457765 0 ESTIMATED THIRD PARTY SETTLEMENTS 591339 INTEREST RATE SWAP LIABILITY 5089102 5680441 59873746 60705315 -831569 -3238351 -2379915 -5618266 -6449835 57119902 -3238351 484507 -2753844 59873746 0 0 59873746 63569737 2864422 2864422 60705315 0 0 60705315 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. true true X true X true X true false false 1097632 0 1097632 0.02030 7802105 2905673 4896432 0.09040 1831257 776604 1054653 0.01950 0 0 10730994 3682277 7048717 0.13020 23263 11754 11509 0.00020 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 190522 0 190522 0.00350 0 0 213785 11754 202031 0.00370 0 0 10944779 3694031 7250748 0.13390 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 false 6899647 0 54610199 46762850 7847349 X true false WEST CENTRAL OHIO HOSPITAL CONSORTIUM LTD PARTNERSHIP FOR MOBILE MRI UNIT 0.3333 0 0 1 1 WAYNE HOSPITAL COMPANY

835 SWEITZER STREET GREENVILLE OH 45331

X X X WAYNE HOSPITAL COMPANY 1 false true true 100 true 200 true X X X X X true true X X X X X true X X X true X X X X X X X X true X false true 1 WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC

835 SWEITZER STREET GREENVILLE OH 45331

PHYSICIAN PROFESSIONAL SERVICES ORGANIZATION 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 true FAMILY HEALTH SERVICES OF DARKE COUNTY 5735 MEEKER RD GREENVILLE OH 45331 341119524 501C3 140383 BOOK VALUE ARCANUM BUILDING AND LAND MEDICAL CARE FOR DARKE COUNTY RESIDENTS 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 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. X true true X X X X false false false true false false false false false 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 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. COUNTY OF DARKE OHIO 346400036 2010-11-01 30000000 CURRENTLY REFUND PORTION OF 11/1/2007 BONDS false false false 0 0 30000000 0 0 0 0 0 0 0 30000000 0 2010 true false true true false false false false 0.0000 0.0000 0.0000 true false true false 0.0 false 0.0 false false Procedures to take corrective action Schedule K, Part V 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; WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLC 835 SWEITZER STREET GREENVILLE OH 45331 270581440 PROFESSIONAL MEDICAL SERVICES OH -2830783 771751 NA THE WAYNE HOSPITAL FOUNDATION INC 835 SWEITZER STREET GREENVILLE OH 45331 260380696 FUNDRAISING OH 501(C)(3) 11 - Type I NA false HEALTHWAY INC 835 SWEITZER STREET GREENVILLE OH 45331 311497938 PROVIDER NETWORK OH NA C CORPORATION 572 27483 1 false false true false false false false false false false true true true true false true false false