OHIOHEALTH CORPORATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: OHIOHEALTH CORPORATION (EIN 31-1045101)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-05-14
IRS object ID: 201221359349305812
Schema version: 2010v3.4
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 D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-14T16:05:39-05:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PLANTE & MORAN PLLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	65 EAST STATE ST STE 600	AddressLine1
City	COLUMBUS	City
State	OH	State
ZIP Code	43215	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	311045101	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	APPALACHIAN COMMUNITY VISITING NURSE	BusinessNameLine1
Business Name Line2	ASSOCIATION HOSPICE AND HEALTH SERVICES	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	APPA	NameControl
Phone	7405935551	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	30 HERROLD AVENUE	AddressLine1
City	ATHENS	City
State	OH	State
ZIP Code	457012326	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DEBORAH SECHKAR	Name
Title	CFO SHELTERING ARMS	Title
Phone	7405935551	Phone
Date Signed	2012-05-11	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BERNIE OSTROWSKI	Name
Phone	6148493000	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DEBORAH SECHKAR	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	30 HERROLD AVENUE	AddressLine1
City	ATHENS	City
State	OH	State
ZIP Code	457012326	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	3893822	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.ACVNA.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1982	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	WE ARE DEDICATED TO PROVIDING COST EFFECTIVE, HIGH QUALITY HOME HEALTH SERVICES TO THE PEOPLE IN OUR APPALACHIAN COMMUNITY. WE PROVIDE SERVICES TO MEDICAID CLIENTS THROUGH OHIO HOME CARE PROGRAMS AS WELL AS FOR CLIENTS WITH WORKERS' COMPENSATION, VETERAN'S ADMINISTRATION, MEDICARE AND OTHER PAYOR SOURCES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	84	TotalNbrEmployees
Total Nbr Volunteers	68	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	230286	ContributionsGrantsPriorYear
Contributions Grants Current Year	133112	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	3901744	ProgramServiceRevenuePriorYear
Program Service Revenue CY	3758424	ProgramServiceRevenueCY
Investment Income Prior Year	2100	InvestmentIncomePriorYear
Investment Income Current Year	2286	InvestmentIncomeCurrentYear
Other Revenue Prior Year	0	OtherRevenuePriorYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	4134130	TotalRevenuePriorYear
Total Revenue Current Year	3893822	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2347628	SalariesEtcPriorYear
Salaries Etc Current Year	2404202	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1853	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1275923	OtherExpensePriorYear
Other Expenses Current Year	1237158	OtherExpensesCurrentYear
Total Expenses Prior Year	3623551	TotalExpensesPriorYear
Total Expenses Current Year	3641360	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	510579	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	252462	RevenuesLessExpensesCY
Total Assets BOY	872521	TotalAssetsBOY
Total Assets EOY	952589	TotalAssetsEOY
Total Liabilities BOY	555073	TotalLiabilitiesBOY
Total Liabilities EOY	378372	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	317448	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	574217	NetAssetsOrFundBalancesEOY
Mission Description	WE ARE SOUTHEASTERN OHIO'S PRIMARY SOURCE FOR QUALITY HOME CARE, STRIVING TO IDENTIFY AND FULFILL THE HEALTHCARE NEEDS OF OUR APPALACHIAN COMMUNITY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	3274497	Expense
Grants	0	Grants
Revenue	3758424	Revenue
Description	THE ORGANIZATION PROVIDES CARE TO HOME BOUND, INDIGENT, AND TERMNIALLY-ILL PATIENTS IN THE COMMUNITY. TO ACCOMPLISH ITS CHARITABLE PURPOSE, THE ORGANIZATION PROVIDED 9,889 DAYS OF HOSPICE CARE, 21,227 HOURS OF HEALTH SERVICES AND 11,676 HOME HEALTH VISITS. THE ORGANIZATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES.	Description
Total Program Service Expense	3274497	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	8	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	84	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	OH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	KEN DICKEN	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7405929205	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	55 HOSPITAL DRIVE	AddressLine1
City	ATHENS	City
State	OH	State
ZIP Code	45701	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
LARRY CORRIGAN
TRUSTEE	1.00	X	0	0	0
TRACY MARX
TRUSTEE	1.00	X	0	0	0
RON STRICKMAKER
CHAIR	1.00	X	0	0	0	X
DAVID STROH
VICE CHAIR	1.00	X	0	0	0	X
MICHAEL TURNER
TRUSTEE	1.00	X	0	0	0
KATHY TARANTELLI
TRUSTEE	1.00	X	0	0	0
RUTH ANN ALTHAUS
SECRETARY	1.00	X	0	0	0	X
DOREEN IRETON
TRUSTEE	1.00	X	0	0	0
SANDRA SHIREY
TRUSTEE	1.00	X	0	0	0
RAY STEPHENS
TREASURER	1.00	X	0	0	0	X
DEBORAH SECHKAR
PRESIDENT/CEO	40.00		69308	0	705	X
THOMAS CAMPBELL
PHYSICAL THERAPIST	40.00		126903	0	0		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	196211	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	705	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
Government Grants	16388	GovernmentGrants
All Other Contributions	116724	AllOtherContributions
Total Contributions	133112	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT SERVICES	Description
Business Code	621610	BusinessCode
Total Revenue Column	3758424	TotalRevenueColumn
Related Or Exempt Function Income	3758424	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	3758424	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2286	TotalRevenueColumn
Exclusion	$2,286	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	3893822	TotalRevenueColumn
Related Or Exempt Function Income	3758424	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$2,286	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	74485	Total
Program Services	66106	ProgramServices
Management And General	8379	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1963782	Total
Program Services	1742857	ProgramServices
Management And General	220925	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	211540	Total
Program Services	187742	ProgramServices
Management And General	23798	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	154395	Total
Program Services	137026	ProgramServices
Management And General	17369	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1782	Total
Management And General	1782	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	113669	Total
Program Services	100881	ProgramServices
Management And General	12788	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	18357	Total
Program Services	16292	ProgramServices
Management And General	2065	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	385069	Total
Program Services	341749	ProgramServices
Management And General	43320	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1490	Total
Program Services	1322	ProgramServices
Management And General	168	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	84496	Total
Program Services	74990	ProgramServices
Management And General	9506	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	160348	Total
Program Services	142309	ProgramServices
Management And General	18039	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	8555	Total
Program Services	7592	ProgramServices
Management And General	963	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	15	Total
Management And General	15	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	10018	Total
Program Services	8891	ProgramServices
Management And General	1127	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	29245	Total
Program Services	25955	ProgramServices
Management And General	3290	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
HOSPICE ROOM & BOARD	330043	330043
BAD DEBTS	43018	43018
EMERGENCY RESPONSE	34815	34815
DUES & SUBSCRIPTIONS	5749	5195	554
TRAINING & CONT. EDUC.	5516	4896	620

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4973	Total
Program Services	2818	ProgramServices
Management And General	302	ManagementAndGeneral
Fundraising	1853	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	3641360	Total
Program Services	3274497	ProgramServices
Management And General	365010	ManagementAndGeneral
Fundraising	1853	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	238984	BOY
EOY	212702	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	64734	BOY
EOY	70317	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	519337	BOY
EOY	635151	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	11069	BOY
EOY	14048	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	16892	BOY
EOY	13656	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	834548	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	827833	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	16733	BOY
EOY	6715	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	4772	BOY
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	872521	BOY
EOY	952589	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	265845	BOY
EOY	378372	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	289228	BOY
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	555073	BOY
EOY	378372	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	315192	BOY
EOY	571963	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2256	BOY
EOY	2254	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	317448	BOY
EOY	574217	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	872521	BOY
EOY	952589	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	252462	ReconcilationRevenueExpenses
Reconcilation Other Changes	4307	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	259800	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	269104	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	153022	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	230286	CurrentTaxYearMinus1Year
Current Tax Year	133112	CurrentTaxYear
Total	1045324	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3512978	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3468287	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3524933	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3901744	CurrentTaxYearMinus1Year
Current Tax Year	3758424	CurrentTaxYear
Total	18166366	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3772778	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3737391	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3677955	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4132030	CurrentTaxYearMinus1Year
Current Tax Year	3891536	CurrentTaxYear
Total	19211690	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	19211690	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3456	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2180	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2425	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2100	CurrentTaxYearMinus1Year
Current Tax Year	2286	CurrentTaxYear
Total	12447	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3456	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2180	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2425	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2100	CurrentTaxYearMinus1Year
Current Tax Year	2286	CurrentTaxYear
Total	12447	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	15504	CurrentTaxYearMinus2Years
Total	15504	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3776234	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3739571	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3695884	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4134130	CurrentTaxYearMinus1Year
Current Tax Year	3893822	CurrentTaxYear
Total	19239641	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99850	PublicSupportPercentage509
Prior Year Support Percentage	0.99830	PriorYearSupportPercentage
Investment Income Percentage	0.00060	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00060	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509
General Explanation	SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: BAD DEBT RECOVERY	GeneralExplanation

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 D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2259	BeginningOfYearBalance
Investment Earnings Or Losses	2	InvestmentEarningsOrLosses
End Of Year Balance	2261	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2257	BeginningOfYearBalance
Investment Earnings Or Losses	2	InvestmentEarningsOrLosses
End Of Year Balance	2259	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2251	BeginningOfYearBalance
Investment Earnings Or Losses	6	InvestmentEarningsOrLosses
End Of Year Balance	2257	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	834548	OtherCostOrOtherBasis
Depreciation	827833	Depreciation
Book Value	6715	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	6715	TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ENDOWMENTS ARE INTENDED FOR THE SUPPORT OF THE ORGANIZATION'S HEALTHCARE ACTIVITIES.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	O'BLENESS MEMORIAL HOSPITAL AND THE APPALACHIAN COMMUNITY VISITING NURSE ASSOCIATION HOSPICE AND HEALTH SERVICES, INC. ARE EXEMPT FROM FEDERAL TAXES UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ATHENS MEDICAL LABORATORY ASSOCIATES, INC., ATHENS SURGERY CENTER, LTD., AND ATHENS MEDICAL ASSOCIATES, LLC ARE FOR-PROFIT SUBSIDIARIES SUBJECT TO FEDERAL INCOME TAXES. FEDERAL INCOME TAX EXPENSE IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL FILES FEDERAL, STATE, AND APPLICABLE LOCAL TAX RETURNS AND IS NO LONGER SUBJECT TO RELATED EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE FISCAL YEAR 2008.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6	SHELTERING ARMS HOSPITAL FOUNDATION, INC. D/B/A O'BLENESS MEMORIAL HOSPITAL IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B	GOVERANCE DECISIONS OF THE ORGANIZATION, SUCH AS APPROVAL OF THE ELECTION OR REMOVAL OF MEMBERS OF THE GOVERNING BODY AND DECISIONS TO DISSOLVE, ARE RESERVED FOR THE SOLE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11	THE PRESIDENT/CEO REVIEWS THE FORM 990 PRIOR TO SIGNING AND SUBMITTING TO THE IRS.
	WHENEVER A TRUSTEE FEELS THAT A CONFLICT OF INTEREST SITUATION IS OR MAY BE INVOLVED, THE TRUSTEE IS TO PROMPTLY AND FULLY DISCLOSE THE FACTS RELATED TO THE CONFLICT. TRUSTEES ARE REQUIRED TO DISCLOSE POSSIBLE CONFLICTS OF INTEREST TO THE FULL BOARD OF TRUSTEES. WHENEVER CONFLICTS ARE DISCLOSED TO THE FULL BOARD, THE BOARD DISCUSSES THE POSSIBLE CONFLICT AND DECIDES ON A COURSE OF ACTION, SUCH AS RESTRICTIONS ON VOTING AND PARTICIPATION. CONFLICT OF INTEREST STATEMENTS FOR BOARD MEMBERS ARE SIGNED YEARLY. OFFICERS MUST ALSO DISCLOSE CONFLICTS AS THEY ARISE. IF A CONFLICT ARISES, THE BOARD WILL DETERMINE NECESSARY ACTION.	FORM 990, PART VI, SECTION B, LINE 12C
	COMPENSATION FOR THE PRESIDENT/CEO IS REVIEWED BY AN EVALUATION COMMITTEE APPOINTED BY THE BOARD AND IS NEGOTIATED DURING THIS REVIEW. THIS EVALUATION IS PERFORMED ANNUALLY. THE LAST EVALUATION WAS IN 2011.	FORM 990, PART VI, SECTION B, LINE 15A
	FORM 1023 AND 990 ARE AVAILABLE UPON REQUEST.	FORM 990, PART VI, SECTION C, LINE 18
	IF REQUESTS ARE MADE FROM THE PUBLIC TO VIEW THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS, THE ORGANIZATION SEEKS LEGAL COUNSEL TO ENSURE COMPLIANCE WITH ORGANIZATION GUIDELINES. A WRITTEN REQUEST MUST BE SUBMITTED TO THE ORGANIZATION ASKING TO VIEW THESE DOCUMENTS.	FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:	NET UNREALIZED GAINS ON INVESTMENTS: 4,307.	FORM 990, PART XI, LINE 5:
	THE AUDIT IS OVERSEEN BY A COMMITTEE OF THE SHELTERING ARMS HOSPITAL FOUNDATION AND THIS HAS NOT CHANGED SINCE THE PRIOR YEAR.	FORM 990, PART XI, LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	SHELTERING ARMS HOSPITAL FOUNDATION	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	55 HOSPITAL DRIVE	AddressLine1
City	ATHENS	City
State	OH	State
ZIP Code	45701	ZIPCode

Field	Value	IRS element (for citing)
EIN	314446959	EIN
Primary Activities	PATIENT CARE	PrimaryActivities
Legal Domicile State	OH	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	HOSPITAL	PublicCharityStatus
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	0	ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	ATHENS SURGERY CENTER LTD	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	75 HOSPITAL DRIVE	AddressLine1
City	ATHENS	City
State	OH	State
ZIP Code	45701	ZIPCode

Field	Value	IRS element (for citing)
EIN	550840856	EIN
Primary Activity	OUTPATIENT SURGERY	PrimaryActivity
Legal Domicile State	OH	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity
ATHENS MEDICAL LABORATORY ASSOCIATES INC
400 E STATE STREET	ATHENS	OH	45701	311381808	MEDICAL LABORATORY	OH	N/A	S
THE DRUGSTORE AT O'BLENESS LLC
55 HOSPITAL DRIVE	ATHENS	OH	45701	030598042	DRUGSTORE	OH	N/A	S

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	1	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
SHELTERING ARMS HOSPITAL FOUNDATION
J	67200	LEASE AGREEMENT
SHELTERING ARMS HOSPITAL FOUNDATION
E	265000	LOAN AGREEMENT