DAYTON OSTEOPATHIC HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DAYTON OSTEOPATHIC HOSPITAL (EIN 31-0564121)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201213199349305586
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T20:02:24-08:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT & COBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1KETTERING TOWER SUITE 800AddressLine1
CityDAYTONCity
StateOHState
ZIP Code45423ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310564121EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DAYTON OSTEOPATHIC HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDAYTNameControl
Phone9373844550Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12110 LEITER ROADAddressLine1
CityMIAMISBURGCity
StateOHState
ZIP Code45342ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCLIFTON PATTENName
TitleVP OF FINANCE & DECISION SUPPORTTitle
Phone9373844550Phone
Date Signed2012-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHERBERT L LEMASTER CPAName
Phone9372260070Phone
Date Prepared2012-11-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD HAASNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12110 LEITER ROADAddressLine1
CityMIAMISBURGCity
StateOHState
ZIP Code45342ZIPCode
FieldValueIRS element (for citing)
Gross Receipts285504580GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.khnetwork.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1939YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTo provide quality healthcare to individuals and the community as a whole in a Judeo-Christian mannerActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees2383TotalNbrEmployees
Total Nbr Volunteers187TotalNbrVolunteers
Total Gross UBI145670TotalGrossUBI
Contributions Grants Prior Year1593952ContributionsGrantsPriorYear
Contributions Grants Current Year1385585ContributionsGrantsCurrentYear
Program Service Revenue Prior Year297072065ProgramServiceRevenuePriorYear
Program Service Revenue CY283198777ProgramServiceRevenueCY
Investment Income Prior Year854316InvestmentIncomePriorYear
Investment Income Current Year887686InvestmentIncomeCurrentYear
Other Revenue Prior Year130155OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year299650488TotalRevenuePriorYear
Total Revenue Current Year285472048TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year122320751SalariesEtcPriorYear
Salaries Etc Current Year128519471SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year159419024OtherExpensePriorYear
Other Expenses Current Year154006290OtherExpensesCurrentYear
Total Expenses Prior Year281739775TotalExpensesPriorYear
Total Expenses Current Year282525761TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17910713RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2946287RevenuesLessExpensesCY
Total Assets BOY249894228TotalAssetsBOY
Total Assets EOY248003452TotalAssetsEOY
Total Liabilities BOY203519078TotalLiabilitiesBOY
Total Liabilities EOY207260838TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY46375150NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY40742614NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide quality healthcare toMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense241323893Expense
Revenue283198777Revenue
DescriptionGRANDVIEW MEDICAL CENTER, SOUTHVIEW MEDICAL CENTER, AND OTHER PATIENT CARE RELATED SERVICES. CARE WAS PROVIDED FOR 12,582 DISCHARGES, 58,829 ADULT & PED DAYS AND 313,992 OUT PATIENT VISITS.Description
Total Program Service Expense241323893TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementstrueConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2383NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CLIFTON PATTENBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9373844550TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12110 LEITER ROADAddressLine1
CityMIAMISBURGCity
StateOHState
ZIP Code45342ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
FRED MANCHUR
KHN President1.00X01464243391337
RICHARD HAAS
GVMC President40.00X0641271237608X
KENNETH PUGAR DO
Physician1.00X000
JOHN SEFTON DO
Physician1.00X000
SHEILA BURTON
Exec Dir Assessement & Accountability, Dayton Public Schools1.00X000
GAYLE JOHNSON
President, Day-Mont Behavioral Health Center, Inc.1.00X000
J BRADFORD GAMBLIN
Exec Dir Dayton Masonic Foundation1.00X000
DAVID WEIGLEY
President Columbia Union Conf of SDA1.00X000
RUSS WETHERELL
Interim CFO40.000713980311605X
PETER KING
GVMC CFO40.00047549665569X
TODD ANDERSON
GVMC CFO40.00015638013608X
DR THOMAS HARDY
VP of Medical Affairs40.00046827276342X
DAVE SEIDEL
VP of Clinical Quality40.000245166104263X
RITA PRITCHARD
VP of Patient Care Services40.00018407713736X
MIKE SIEVING
Project Manager - West Wing40199569X
LINDA MCCALL
Director of Pharmacy4018838114929X
ROBERT CAIN DO
Director of Medical Education4018697520621X
REBECCA LEWIS
VP of Patient Care4017121021455X
DOROTHY CLARK
Director of Nutrition Services401501542439X
FRANK PEREZ
Network CEO/Consultant082386021562X
FieldValueIRS element (for citing)
Total Reportable Comp From Org896289TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5172745TotalReportableCompFrmRltdOrgs
Total Other Compensation1295074TotalOtherCompensation
Number Individuals GT100 K42NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations1385585RelatedOrganizations
Total Contributions1385585TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Patient care services900099283053107$1,487,731
Reference lab621500145670145670
FieldValueIRS element (for citing)
Total Program Service Revenue283198777TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column417611TotalRevenueColumn
Exclusion$417,611ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column315TotalRevenueColumn
Exclusion$315ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities329819Securities
Other172473Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other32532Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities329819Securities
Other139941Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column469760TotalRevenueColumn
Exclusion$469,760ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column285472048TotalRevenueColumn
Related Or Exempt Function Income281565376RelatedOrExemptFunctionIncome
Unrelated Business Revenue145670UnrelatedBusinessRevenue
Exclusion$2,375,417ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3310518Total
Program Services0ProgramServices
Management And General3310518ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total97149736Total
Program Services85477009ProgramServices
Management And General11672727ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4291232Total
Program Services3775632ProgramServices
Management And General515600ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16985072Total
Program Services14944283ProgramServices
Management And General2040789ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6782913Total
Program Services5967933ProgramServices
Management And General814980ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total947476Total
Program Services0ProgramServices
Management And General947476ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total422592Total
Program Services0ProgramServices
Management And General422592ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total51880Total
Program Services28150ProgramServices
Management And General23730ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total54492Total
Program Services0ProgramServices
Management And General54492ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total42757422Total
Program Services35757210ProgramServices
Management And General7000212ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total440189Total
Program Services138395ProgramServices
Management And General301794ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total51135060Total
Program Services50881655ProgramServices
Management And General253405ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4283867Total
Program Services339878ProgramServices
Management And General3943989ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5666545Total
Program Services4450572ProgramServices
Management And General1215973ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total295329Total
Program Services250658ProgramServices
Management And General44671ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total196385Total
Program Services188031ProgramServices
Management And General8354ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total7565407Total
Program Services5941961ProgramServices
Management And General1623446ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18988808Total
Program Services14914037ProgramServices
Management And General4074771ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3156467Total
Program Services3133705ProgramServices
Management And General22762ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Cost of goods sold5766544576654400
Hospital assessment2596670259667000
Intercompany allocations21897492167795219540
Minor equipment98994198875211890

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6501467Total
Program Services3615023ProgramServices
Management And General2886444ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total282525761Total
Program Services241323893ProgramServices
Management And General41201868ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1045995BOY
EOY2045378EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY72278BOY
EOY72314EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY44982216BOY
EOY43875983EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY312586BOY
EOY308393EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5241534BOY
EOY4564019EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY715599BOY
EOY891622EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis292650894LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec118525533LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY164632581BOY
EOY174125361EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY26964064BOY
EOY15336145EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2904714BOY
EOY4584148EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3022661BOY
EOY2200089EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY249894228BOY
EOY248003452EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20404586BOY
EOY20728796EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY449048BOY
EOY224524EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY102450995BOY
EOY97882256EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY516402BOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY15645538BOY
EOY16072501EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY64052509BOY
EOY72352761EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY203519078BOY
EOY207260838EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY46164481BOY
EOY40672391EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY210669BOY
EOY70223EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY46375150BOY
EOY40742614EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY249894228BOY
EOY248003452EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2946287ReconcilationRevenueExpenses
Reconcilation Other Changes-8578823ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Protection Of Natural HabitatXProtectionOfNaturalHabitat
Total Number Of Easements1TotalNumberOfEasements
Total Acreage1.5TotalAcreage
Nmbr Easements Modified0NmbrEasementsModified
Nmbr States In Which Easements Held1NmbrStatesInWhichEasementsHeld
Written Policy MonitoringtrueWrittenPolicyMonitoring
Staff Hours Spent On Enforcement20StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement5670ExpensesIncurredForEnforcement
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis14952024OtherCostOrOtherBasis
Book Value14952024BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1600000InvestmentCostOrOtherBasis
Other Cost Or Other Basis162706144OtherCostOrOtherBasis
Depreciation57422427Depreciation
Book Value106883717BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis23519446OtherCostOrOtherBasis
Depreciation6205036Depreciation
Book Value17314410BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis71915735OtherCostOrOtherBasis
Depreciation54898070Depreciation
Book Value17017665BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17957545OtherCostOrOtherBasis
Book Value17957545BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings174125361TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Physician LOC1726858
Unamortized long-term debt issuance costs473231
FieldValueIRS element (for citing)
Total Book Value Other Assets2200089TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
Accrued pension liability$17,462,729
Due to affiliate$129,199
Estimated amounts due to third-party payors$2,422,681
Physician income guarantee commitments$666,540
Professional self-insurance liability$11,408,965
Reserve for payroll tax liability$2,319,430
Synthetic lease obligations$37,768,217
Other long-term liabilities$175,000
FieldValueIRS element (for citing)
Total Of Amounts72352761TotalOfAmounts
Total Revenue285472048TotalRevenue
Total Expenses282525761TotalExpenses
Excess Or Deficit For Year2946287ExcessOrDeficitForYear
Net Unrealized GL On Investments204244NetUnrealizedGLOnInvestments
Other-$8,783,067OtherAmount
Total Adjustments-8578823TotalAdjustments
Excess Or Deficit Per FS-5632536ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt284445574TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments183513NetUnrealizedGainsInvestments
Other Revenues638925OtherRevenues
Revenue Not Rptd F990822438RevenueNotRptdF990
Revenue Subtotal283623136RevenueSubtotal
Other Revenues Not Included1848912OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1848912RevenueNotRptdOnFinStmt
Total Revenue Per Form990285472048TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt290078110TotExpensesEtcAuditedFinclStmt
Other Expenses Included6913424OtherExpensesIncluded
Expenses Not Rptd F9906913424ExpensesNotRptdF990
Expenses Subtotal283164686ExpensesSubtotal
Other Expenses Not Included-638925OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-638925ExpensesNotRptdOnFinStmt
Total Expenses Per Form990282525761TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (9 entries)

IdentifierIdentifierExplanationExplanation
Pt II Line 5KHN does have a policy on conservation easements.
Pt II Line 9The expense to monitor the conservation easement is recorded as incurred to the hospital. There is no income from the easement and no asset is recorded.
Pt XThe Network completed an analysis of its tax positions in accordance with applicable accounting guidance at December 31, 2011 and 2010, and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2011 or 2010.
Pt XI Line 8Net transfers to affiliate (3,233,675)
Pt XI Line 8Change in plan assets and benefit obligation of pension plan (5,549,391) Rounding (1)
Pt XII Line 2dInvestment management fees (26,349) Support allocation 665,274
Pt XII Line 4bContributions 1,385,585 Gain on sales of assets other than inventory 64,018 Investment income 399,309
Pt XIII Line 2dContributions (1,385,585) Gain on sales of assets other than inventory (64,018) Investment income (399,309) Transfers to net assets (140,446) Net unrealized gains on investments (20,731) Net transfers to affiliate 3,233,675 Change in plan assets and benefit obligation of pension plan 5,549,391 Net assets released from restrictions for operations 140,446 Rounding 1
Pt XIII Line 4bInvestment management fees 26,349 Support allocation (665,274)

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense15336530TotalCommunityBenefitExpense
Direct Offsetting Revenue5262445DirectOffsettingRevenue
Net Community Benefit Expense10074085NetCommunityBenefitExpense
Percent Of Total Expense0.03570PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense32258619TotalCommunityBenefitExpense
Direct Offsetting Revenue28554367DirectOffsettingRevenue
Net Community Benefit Expense3704252NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense47595149TotalCommunityBenefitExpense
Direct Offsetting Revenue33816812DirectOffsettingRevenue
Net Community Benefit Expense13778337NetCommunityBenefitExpense
Percent Of Total Expense0.04880PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense709529TotalCommunityBenefitExpense
Net Community Benefit Expense709529NetCommunityBenefitExpense
Percent Of Total Expense0.00250PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense12651591TotalCommunityBenefitExpense
Direct Offsetting Revenue6279613DirectOffsettingRevenue
Net Community Benefit Expense6371978NetCommunityBenefitExpense
Percent Of Total Expense0.02260PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense11330051TotalCommunityBenefitExpense
Direct Offsetting Revenue5564309DirectOffsettingRevenue
Net Community Benefit Expense5765742NetCommunityBenefitExpense
Percent Of Total Expense0.02040PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense141140TotalCommunityBenefitExpense
Net Community Benefit Expense141140NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense24832311TotalCommunityBenefitExpense
Direct Offsetting Revenue11843922DirectOffsettingRevenue
Net Community Benefit Expense12988389NetCommunityBenefitExpense
Percent Of Total Expense0.04600PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense72427460TotalCommunityBenefitExpense
Direct Offsetting Revenue45660734DirectOffsettingRevenue
Net Community Benefit Expense26766726NetCommunityBenefitExpense
Percent Of Total Expense0.09480PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,150,323BadDebtExpenseAmount
Amount Attributable To75608AmountAttributableTo
Amount Reimbursed By Medicare52187724AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare50773827CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1413897MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
GRANDVIEW ASSOCIATES
Medical Office Building0.920000.08000
SOUTHVIEW ORTHOPEDIC CENTER
Medical Service Venture0.510000.49000
FieldValueIRS element (for citing)
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24Hours
GRANDVIEW MEDICAL CENTER
1405 W GRAND AVENUEDAYTONOH45405XXXX
SOUTHVIEW MEDICAL CENTER
21997 MIAMISBURG CENTERVILLE ROADCENTERVILLEOH45459XXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyPermit LawsuitPermitLawsuitCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitNotify Upon AdmissionNotifyUponAdmissionNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
GRANDVIEW MEDICAL CENTER
1truetrue100true300trueXXXXXXtruetrueXXXXXXtrueXXtrueXXXXXtrueXfalsetrue
SOUTHVIEW MEDICAL CENTER
2truetrue100true300trueXXXXXXtruetrueXXXXXXtrueXXtrueXXXXXtrueXfalsetrue

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
YANKEE MEDICAL CENTER
7677 YANKEE STREETCENTERVILLEOH45459Outpatient Clinic & Diag. Ctr
BEAVERCREEK HEALTH CENTER
2510 COMMONS BLVDBEAVERCREEKOH45431Diagnostic Ctr & Rehab Clinic
CORWIN M NIXON HEALTH CENTER
1470 N BROADWAYLEBANONOH45036Circulatory & Wound Ctr
VICTOR J CASSANO HEALTH CTR
165 EDWIN C MOSES BLVDDAYTONOH45402Diagnostic Ctr
PREBLE COUNTY MEDICAL CTR
450-B WASHINGTON JACKSON RDEATONOH45320Outpatient Clinic & Diag. Ctr
CORNERSTONE MEDICAL CTR
7740 WASHINGTON VILLAGE DRCENTERVILLEOH45459Outpatient Clinic & Diag. Ctr
CHARLES H HUBER HEALTH CTR
8701 OLD TROY PIKEHUBER HEIGHTSOH45424Outpatient Clinic & Diag. Ctr
GRANDVIEW CTR FOR CIRCULATORY & WOUND
TALBOTT TOWER 131 N LUDLOW STDAYTONOH45402Outpatient Clinic & Diag. Ctr
SUGARCREEK HEALTH CTR
6438 WILMINGTON PIKEDAYTONOH45459Outpatient Clinic & Diag. Ctr

Form990 Schedule H Part VI Form990ScheduleHPartVI (151 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 3cThe organization used FPG to determine eligibility for
providing free or discounted care to individuals.
Pt I Line 6aThe organization provides an annual community benefit
report that is made available to the public.
Pt I Line 7Charity care is calculated using a cost to charge ratio following the
methodology of Worksheet 2. Medical costs are calculated
using a cost accounting system that addresses all patient
segments. Community health improvement services are
calculated on the basis of direct expenditures. Health
professions education is calculated based on the Medicare
cost report. Subsidized health services is calculated based
on the non-Medicare, Medicaid and charity care proportion
of departmental losses for the specific programs. Cash
and in-kind contributions are calculated on the
basis of direct expenditures.
Pt I Line 7gSubsidized health services represent the non-needs based and
non-Medicare program losses of services the hospital offers.
Pt III Line 4A cost to charge ratio was used to determine the amount
reported in Part III, line 2. An industry average was used
to compute the amount on line 3. Discounts and payments
on patient accounts reduce bad debt expense. Text of
footnote describing debt expense is as follows:
"Based on historical experience, a significant portion
of the Networks uninsured patients will be unable
or unwilling to pay for the services provided.
Thus, the Network records a significant provision
for bad debts related to uninsured patients
in the period the services are provided."
Pt III Line 8The costing methodology used to determine Medicare costs is
the Medicare cost report. Medicare costs
have not been included in Community Benefit in Part I.
A reconciliation between Medicare program amounts
reportable in Section B and the total Medicare
program is below:
Revenues Costs Surplus
Medicare Section B $52,187,724 $50,773,827 $1,413,897
Other Medicare Programs $30,572,998 $30,276,829 $296,169
Total Programs $82,760,722 $81,050,656 $1,710,066
Other Medicare Programs include Medicare
Part C and clinical laboratory and therapy services
not reportable in the Medicare cost report.
These costs exclude medical education expenses.
Pt III Line 9bFinancial Counselors work out a payment program for any amount
due after the Charity Sliding Scale Discounts are applied.
Collection procedures consistent with self-pay accounts
are applied to these balances.
Pt VEach facility listed is required to be licensed, registered, or
recognized as a healthcare facility under state law.
Pt V Sec B 19dThe hospital provided a discount on medically
necessary hospital services to uninsured patients
who do not qualify under the charity care policy.
Pt V Sec B 21The hospital charged patients an amount equal to gross
charges in select circumstances. This includes, for example,
claims with insurance denials for non-cooperation.
Pt VI Line 2Grandview, as a Christian organization,is charged with providing
health education and screenings to look after those who
cannot otherwise afford to do so. Programs and support
groups that helped community members included childbirth
education, infant CPR, stroke support, diabetes education,
first aid, and more. These programs touched people from
various age, gender, and socio-economic groups.
Pt VI Line 3Grandview informs and educates patients or persons
who may be billed for patient care about their
eligibility for assistance under federal, state
or local government programs or under Grandview's
charity care policy as follows:
-Grandview has a financial assistance brochure that
is included in all of the patient information kits
given at the time of intake or registration into
any facility or department.
-There is information posted in all of the admitting
and registration areas about charity care and
financial assistance.
-During the registration process there is specific scripting
to ask patients if they would like to disclose family size
and income to screen them for federal/state/local and
hospital based charity/assistance programs.
This data is available for future visits as well.
-Grandview has the reporting capability to review and screen
any patient who may have been admitted during registration
"off hours" for eligibility and assistance.
-Grandview contracts with an outside agency for
patient assistance in application process.
-The back of the patient statement shows the current and prior
year Federal Poverty Guidelines and has the Financial
Assistance Form to complete and mail in for consideration
for Grandview's HCAP or Charity Sliding Scale program.
-Grandview's patient account representatives in customer
service screen patients that are unable to pay their
bill for the various financial assistance programs.
Pt VI Line 4KHN serves a population of 1,631,000 in its primary
and secondary service area. The nine county service area
includes Butler, Clark, Clinton, Darke, Greene, Miami,
Montgomery,Preble and Warren counties. Out of this
service area, 11.2% of area residents have income
below $15,000, 10.3% have income between $15,000 and
$24,000, and 27.3% have income between $25,000 and
$49,000. Portions of Darke and Montgomery counties have
been identified as medically underserved by the Health
Resources and Services Administration. This nine
county area is served by 15 hospitals, 7 of which
are part of Kettering Health Network.
Pt VI Line 5Grandview furthers its exempt purpose by promoting the
health of the community by:
-Retaining a Board of Directors with a majority
(excluding employees and contractors)living in the
primary service area;
-Extending medical staff privileges to all
qualified physicians in its community for a majority
of its departments;
-Utilizing surplus funds to help support ongoing
improvements in patient care through equipment upgrades,
acquisition of the most-advanced medical technology,
upgrades of existing hospital structures and construction
of new facilities in order to provide accessible,
efficient, quality care. As a nationally-recognized
osteopathic teaching hospital, Grandview partners with
the Ohio University College of Osteopathic Medicine to
enhance state-of-the-art medical education tools and
programs. Medical research is supported through the
Innovation Center, cultivating new technologies and
fostering best practices among partners from industry,
academia and healthcare.
Pt VI Line 6The following describes the respective roles of Grandview and
its affiliates in promoting the health of the communities
served by the system-
-Grandview is dedicated to the creation and maintenance of
community wellness programs, support groups and health
education programs. Grandview provides numerous screenings,
family-focused classes, health fairs, conferences, donations
and education programs to ensure the long-term
well-being of people living in the community.
-Grandview is affiliated with the Ohio University College
of Osteopathic Medicine. The teaching programs have
been an integral part of Grandview's emergence as
one of the nation's leading osteopathic hospitals
for clinical quality.
-The Grandview Foundation is the philanthropic arm
of Grandview Medical Center and supports the
education of future osteopathic physicians.
-Kettering Affiliated Health Services, Inc includes
Sycamore Glen Health Center, Sycamore Glen Retirement
Community, and Kettering Mobile Imaging. These
health care areas provide services to the surrounding
communities which complement those services provided by
Grandview as part of the Kettering Health Network.
-Medical research is supported through the Innovation Center,
cultivating new technologies and fostering
best practices among partners from industry, academia,
and healthcare.
Pt VI Line 7OH

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg
FRED MANCHUR
110040126833595507373845174921855580
RICHARD HAAS
4970901168022737921762119987878879
RUSS WETHERELL
55047514161121894276177354281025585
PETER KING
39636666857122733840827161541065
TODD ANDERSON
15548989113608169988
DR THOMAS HARDY
37700871021202433939836944544614
DAVE SEIDEL
1987723899973958305621207349429
RITA PRITCHARD
145207286621020813736197813
MIKE SIEVING
19948881199569
LINDA MCCALL
146188347952033107398103064623
ROBERT CAIN DO
1841518120759627431034410277
REBECCA LEWIS
146069159931926649148930912145
DOROTHY CLARK
-4391525931505932439
FRANK PEREZ
57528223819710381136877875845422

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 4bThe Network has a Supplemental Executive Retirement Plan available only to a certain class of management.
Part II BiiiColumn Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
RICHARD MANCHUR
Family of Fred Manchur105105Compensationfalse
ARGO LLC
Director John Sefton is 20% owner143296Property rentalfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (62 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11aA tax specialist is engaged to review the 990. The 990 is reviewed
and accepted by the audit committee which reports this to the
governing body (board).
Pt VI, Line 12cThe Network regularly and consistently monitors and enforces compliance
with the conflict of interest policy by making it part of the employees'
annual reviews. Employees must certify that they have read the
conflict of interest policy and have disclosed any potential conflicts
and agree to immediately notify Corporate Integrity if one should arise.
Board members are required to annually review the Network's policy,
sign a conflict of interest statement, and notify the Network if a conflict
should arise.
Pt VI, Line 15The process of determining compensation of CEO's, executive directors,
officers, and key employees is to have an independent board approve
the compensation. The compensation is determined to be reasonable
compared to independent comparability data. The approval of the
amounts is documented in the Board minutes within the appropriate
time frame. At year end the organization reviews executive compensation
by comparing the amounts approved to the amounts paid.
Pt VI, Line 19The KHN Conflict of Interest policy is available on the KHN intranet. The
organization's governing documents and financial statements
are available upon request.
Pt XILine 5: Net unrealized gains on investments 204,244
Pt XILine 5: Net transfers to affiliate (3,233,675)
Pt XILine 5: Change in plan assets and benefit obligation of pension plan (5,549,391)
Pt XILine 5: Rounding (1)
Pt XII, Line 2cKHN has an audit committee that meets regularly throughout the year
Form 990, Part IX, Line 24fMINOR MISCELLANEOUS EXPENSES 6501467. 3615023. 2886444. 0.
to review issues that are brought to it by the internal auditor. This
committee is also responsible for the financial audit.
Part IV, Line 24Line 24a should be "Yes" and b,c,d should be "No"
The organization does have tax-exempt bonds but the
software converts Schedule K with errors. This caused the
return to be rejected by the agency.
Schedule K has been attached as a .pdf file as a workaround.
We've also attached the rejection notice.
Schedule K, Part II, Line 1Bond Issue A: Includes transferred proceeds from the
1999 Bonds that were partially advance refunded
by the 2006 Bonds.
Schedule K, Part II, Line 5Bond Issue A: Of the $2,457,569 issuance costs from
proceeds, $685,029 related to issuance costs and
$1,782,540 related to credit enhancement fees.
Bond Issue B: of the $5,900,788 issuance costs from
proceeds, $1,431,723 related to issuance costs and
$4,469,065 related to credit enhancement fees.
Schedule K, Part II, Line 7Bond Issue A: Listed $0 for capital expenditures
because 2006 Bonds were solely for advance refunding
purposes.
Bond Issue B: Capital expenditures from proceeds reflects
only the new portion of the 2008 Bonds and excludes
the current refunding.
Schedule K, Part II Line 8Bond Issue B: As of December 31, 2009, the bond-financed
project financed by the new money portion of the 2008
Bonds was approximately 70% completed. It is expected
to be substantially completed by December 31, 2010.
Bond Issue C: The bond-financed project is expected
to be substantially completed by December 31, 2010.
Schedule K, Part IV, Line 5Bond Issue B: The available 3-year temporary period
for the portion of the proceeds spent on capital
projects has not expired.
Bond Issue C: The available 3-year temporary period
for the portion of the proceeds spent on capital
projects has not expired.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ALLIANCE PHYSICIANS INC
2110 LEITER ROADMIAMISBURGOH45342311175717PHYSICIAN SERVICESOH501(c)(3)509(a)(3)KETTERING ADVENTIST HEALTHCAREfalse
BEAVERCREEK MEDICAL CENTER
2110 LEITER ROADMIAMISBURGOH45342270712680HOSPITALOH501(c)(3)509(a)(1)KETTERING ADVENTIST HEALTHCAREfalse
THE FORT HAMILTON HOSPITAL
2110 LEITER ROADMIAMISBURGOH45342310536662HOSPITALOH501(c)(3)509(a)(1)KETTERING ADVENTIST HEALTHCAREfalse
GRANDVIEW FOUNDATION
405 W GRAND AVEDAYTONOH45405311649591FUNDRAISINGOH501(c)(3)509(a)(3)NAfalse
GREENE MEMORIAL HOSPITAL
2110 LEITER ROADMIAMISBURGOH45342310809436HOSPITALOH501(c)(3)509(a)(1)KETTERING ADVENTIST HEALTHCAREfalse
GREENE MEMORIAL HOSPITAL SERVICES INC
2110 LEITER ROADMIAMISBURGOH45342311358549PHYSICIAN SERVICESOH501(c)(3)509(a)(3)KETTERING ADVENTIST HEALTHCAREfalse
KETTERING ADVENTIST HEALTHCARE
2110 LEITER ROADMIAMISBURGOH45342311051688MANAGEMENTOH501(c)(3)509(a)(3)NAfalse
KETTERING AFFILIATED HEALTH SERVICES INC
2110 LEITER ROADMIAMISBURGOH45342311127485HEALTH SERVICESOH501(c)(3)509(a)(3)KETTERING ADVENTIST HEALTHCAREfalse
KETTERING MEDICAL CENTER
2110 LEITER ROADMIAMISBURGOH45342310621866HOSPITALOH501(c)(3)509(a)(1)KETTERING ADVENTIST HEALTHCAREfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipCode VCodeVAmount
GRANDVIEW ASSOCIATES
405 GRAND AVEDAYTONOH45405311427280BUILDING MANAGEMENTOHDAYTON OSTEOPATHIC HOSPITALRelated5281442255falsefalse0.92000
SOUTHVIEW ORTHOPEDIC CENTER MANAGEMENT
1997 MIAMISBURG-CENTERVILLE RDDAYTONOH45459262040203MEDICAL SERVICESOHDAYTON OSTEOPATHIC HOSPITALRelated34471881393672falsefalse0.51000$18

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1KETTCORBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12110 LEITER ROADAddressLine1
CityMIAMISBURGCity
StateOHState
ZIP Code45342ZIPCode
FieldValueIRS element (for citing)
EIN311078381EIN
Primary ActivityHEALTH SERVICESPrimaryActivity
Legal Domicile StateOHLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1KETTERING ADVENTIST HEALTHCAREBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeMethod Of Amt DeterminationMethodOfAmtDeterminationAmount InvolvedAmountInvolved
KETTERING MEDICAL CENTER IS A CONDUIT THROUGH WHICH
lmnorFMV
REVENUE IS RECEIVED AND EXPENSES ARE PAID
GRANDVIEW FOUNDATION
cFMV1385585

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