2011-05-13T14:44:49-05:00 2010-06-30 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2009-07-01 314394942 OhioHealth Corporation OHIO 6145444052 180 East Broad Street 33rd Floor Columbus OH 432153707 MICHAEL W LOUGE 6145444052 2011-05-13 1 5137847100 2009 2016-02-24 21:20:13Z See Schedule O-Grant Medical Center David P Blom 180 East Broad Street 33rd Floor Columbus OH 432153707 1970241281 0 3858 X www.ohiohealth.com X 1891 OH To improve the health of those we serve. 21 11 13278 1713 381374 324167 9489050 10881785 1589457519 1676111885 -30558452 34866395 225983809 245586076 1794371926 1967446141 50000 0 863272250 871362922 0 0 836301446 874521344 1699573696 1745934266 94798230 221511875 2013939378 2349906280 1042978445 1169765395 970960933 1180140885 To improve the health of those we serve. 0 0 1442137009 50000 1675730511 In fiscal year 2010 (July 1, 2009, through June 30, 2010), OhioHealth and its member hospitals and home care organizations provided charity care and community benefit programs to a greater degree than ever before. The hospitals of OhioHealth provided more than $191 million in charity care and community benefit programs and services reaching hundreds of thousands of people in the communities we serve.Together-we are united in our mission to provide quality, compassionate healthcare and to be responsible stewards of our community's health. For more than 100 years it has been that way. Even as the face of healthcare continues to change, the commitment of OhioHealth endures: ensuring quality care for everyone, regardless of their faith, race, age or ability to pay. We never lose sight of our mission "to improve the health of those we serve" and our core values-compassion, excellence, stewardship, and integrity. They continue to guide us in our work today. OhioHealth touches thousands of people, saving lives, improving their health and making their futures a little brighter. Through our shared mission, vision and values, we touch more lives in central Ohio than any other health system. As a system of faith-based, not-for-profit healthcare providers-together, we are OhioHealth. 1442137009 1 1 0 1 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 1 927 0 1 13278 1 1 1 1 CJ BD LU UK 0 0 0 0 0 0 0 21 11 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 X Craig Bjerke 6145444052 180 East Broad Street 33rd Floor Columbus OH 432153707 Abbott Lawrence C 2.00 X 0 0 0 Anderson Craig MD 2.00 X 141699 0 36723 Auseon John DO 2.00 X 0 0 0 Blom David P 40.00 X X 1446053 0 855784 deVillers Rebecca DO 2.00 X 72000 101061 28074 Dewire Rev Dr Norman 2.00 X 0 0 0 Endres Michael J 2.00 X X 0 0 0 George Peter MD 2.00 X 78906 842104 26391 Hoaglin Thomas E 2.00 X X 0 0 0 Hondros Linda 2.00 X X 0 0 0 Innes Jeffrey T MD 2.00 X 60000 506474 18315 James Donna 2.00 X 0 0 0 McCullough Steve 2.00 X 0 0 0 McConnell John P 2.00 X 0 0 0 Ough Bishop Bruce R 2.00 X 0 0 0 Parrott Rex A 2.00 X 0 0 0 Rasmussen Steve 2.00 X 0 0 0 Scott Bradley N 2.00 X 0 0 0 Stevens Rev Dr Deborah 2.00 X 0 0 0 Walker Kevin 2.00 X 0 0 0 Wilcox Randy 2.00 X X 0 0 0 Louge Michael W 40.00 X 866017 0 349441 Millen Robert P 40.00 X 839190 0 237807 Pandora Frank T II Esq 40.00 X 525226 0 298341 Bernstein Michael S 40.00 X 579109 0 155837 Connors Karen H 40.00 X 526196 0 148783 Hagen Bruce P 40.00 X 632596 0 165793 Herbert-Sinden Cheryl L 40.00 X 334476 0 49200 Reichfield Michael L 40.00 X 457184 0 127937 Gallaher Connie L 40.00 X 238822 0 34760 Hanly Donna L 40.00 X 248786 0 38700 Markovich Stephen 40.00 X 448048 0 56446 Santanello Steven A DO 40.00 X 479925 21850 24621 Tomaszewski James A 40.00 X 348322 0 22774 Vanderhoff Bruce MD 40.00 X 487283 0 141231 Boggs Martha Bruce 40.00 X 242175 0 13499 Jablonski Susan F 40.00 X 371946 0 75075 Yates Vinson M 40.00 X 306314 0 46192 Dono Frank V 40.00 X 412903 0 40423 Gleeson Sean MD 40.00 X 445562 0 34468 Lozada Leonardo J 40.00 X 544993 0 30463 Kontner John G 40.00 X 437306 0 34241 Imm Amy A 40.00 X 410637 0 40851 Bachman Ronald J 40.00 X 559749 0 9314 Garlock Steven J 40.00 X 402276 0 77365 Seckinger Mark R 40.00 X 255720 0 42179 Swart Steven L 40.00 X 312335 0 39931 13511754 1471489 3300959 739 1 1 0 Gilbane Building Company 2 Easton Oval Suite 110 Columbus OH 432196036 Construction Services (Sch O) 11205282 Elford Inc Construction Services 1220 Dublin Road Columbus OH 43215 Construction Services (Sch O) 11186612 Cardinal Health - Valuelink 2320 Mcgaw Road Obetz OH 43207 Logistics Services 9487364 Messer Construction Company 3705 Business Park Drive Columbus OH 43204 Construction Services (Sch O) 6896784 Dawson Personnel Systems PO Box 711503 Cincinnati OH 452711503 Temporary Help Services 5779956 529 10684127 15000 182658 10684127 10881785 Health and Medical Svc 900099 1663688009 1663688009 Investment Income 621990 12423876 12042502 381374 1676111885 30174777 30174777 6220919 212077 6008842 6008842 6008842 5738111 1524859 2571352 5738111 -1046493 4691618 4691618 11711 11711 0 Intercompany Admin 900099 209234184 209234184 Cafeteria/Food Service 722210 8523585 8523585 Parking Revenue 812930 1796155 1796155 20023310 20023310 239577234 1967446141 1675730511 381374 280452471 50000 50000 16585333 7396352 9188981 683915288 560877266 123038022 35811463 29460526 6350937 92698283 76258828 16439455 42352555 34841597 7510958 4567221 3757253 809968 451433 371375 80058 187125 153940 33185 3237951 2663721 574230 168763849 138834647 29929202 8041692 6615549 1426143 336297704 276657431 59640273 17206397 14154951 3051446 52572453 43249061 9323392 2362039 1943147 418892 12520910 10300405 2220505 89570598 73685819 15884779 15377613 12650490 2727123 Bad Debt 77938659 77938659 0 0 Repair & Maintenance 42715228 35139952 7575276 0 Medicaid Tax Expense 18264022 15025013 3239009 0 Intercompany Expense 5335019 4388887 946132 0 UBI Taxes 63844 52522 11322 0 19047587 15669618 3377969 1745934266 1442137009 303797257 0 180168514 93783846 155689814 160625982 5819115 12662949 23852390 25230365 23708494 25225920 1373314043 767107977 607637985 606206066 632184198 988134164 264297954 308178994 27632275 28991198 92948639 100866796 2013939378 2349906280 216326201 243438646 554367 3907913 593446896 584084003 879477 4196815 13352466 13336000 218419038 320802018 1042978445 1169765395 X 970960933 1180140885 970960933 1180140885 2013939378 2349906280 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 218 0 1 138669 1 48238 0 0 187125 0 29183692 29183692 578676230 307880109 270796121 499012868 348252129 150760739 266441253 110975739 155465514 606206066 Investments in Portfolio 308178994 F 308178994 Due to Affiliates - Loans and Notes 75983277 Pension Liability 157553913 Swap Liability 28732659 Deferred Long Term Liabilities 6758737 Other 51773432 320802018 Central America & the Caribbean 1 Program Services Offshore Captive Management 54605 Europe (including Iceland & Greenland) Investments Central America & the Caribbean Investments 0 1 54605 1 1 X 1 X 1 X 1 1 0 1 1 86207341 23085214 63122127 0.03780 207835715 157617163 50218552 0.03010 294043056 180702377 113340679 0.06790 1720487 66075 1654412 0.00100 45586225 10839015 34747210 0.02080 2168968 2168968 0.00130 453958 453958 0.00030 602976 20544 582432 0.00030 50532614 10925634 39606980 0.02370 344575670 191628011 152947659 0.09160 160236 22 160214 0.00010 13179 13179 0.00000 8161 8161 0.00000 181576 22 181554 0.00010 1 24305439 0 445562142 481665993 -36103851 X 1 1 AKSM Genesis Columbus LLC Brachytherapy Services 0.25000 0.50000 Grant Scope Center LLC Ambulatory Surgery Center 0.50500 0.49500 Knightsbridge Surgery Center Ambulatory Surgery Center 0.49100 0.42670 OhioHealth Sleep Services LLC Sleep Lab Services 0.53880 0.24490 Polaris Surgery Center LLC Ambulatory Surgery Center 0.51810 0.48190 The Eye Center Opthamological Surgery Center 0.03200 0.89600 Upper Arlington Medical Limited Parternship Property Management 0.38800 0.29710 Upper Arlington Surgery Center Ltd Ambulatory Surgery Center 0.36000 0.64000 Whitehall Surgery Center Ambulatory Surgery Center 0.42540 0.57460 Greater Columbus Regional Dialysis Dialysis Services 0.25000 0.75000 OhioHealth Ambulatory Care Corp LTD Urgent Care Services 0.50000 0.50000 OhioHealth Group LTD Managed Care Services 0.50000 0.50000 Riverside Methodist Hospital

3535 Olentangy River Road Columbus OH 432143908

X X X X Grant Medical Center

111 South Grant Avenue Columbus OH 432154701

X X X Doctors Hospital

5100 West Broad Street Columbus OH 432281607

X X X Dublin Methodist Hospital

7500 Hospital Drive Dublin OH 430168518

X X Riverside Outpatient Surgery Center

2240 North Bank Drive Columbus OH 432205420

X The Bone & Joint Center

323 East Town Street Columbus OH 432154753

X East Side Surgery Center

4850 East Main Street Columbus OH 432133162

X Knightsbridge Surgery Center

4845 Knightsbridge Blvd Suite 110 Columbus OH 432142463

X Polaris Surgery Center

300 Polaris Parkway Westerville OH 430827989

X OhioHealth Sleep Services

974 Bethel Road Suite C Columbus OH 43214

Sleep Diagnostic Center OhioHealth Sleep Services

6770 Avery-Muirfield Drive Dublin OH 43017

Sleep Diagnostic Center OhioHealth Sleep Services

7811 Flint Road Suite B Columbus OH 43235

Sleep Diagnostic Center OhioHealth Sleep Services

7634 Rivers Edge Drive Columbus OH 43235

Sleep Diagnostic Center OhioHealth Sleep Services

2041 Stringtown Road Grove City OH 43123

Sleep Diagnostic Center OhioHealth Sleep Services

151 Clint Drive Pickerington OH 43147

Sleep Diagnostic Center OhioHealth Sleep Services

300 Polaris Parkway Suite 2450 Westerville OH 43082

Sleep Diagnostic Center Grant Sleep Diagnostic Center

285 East State Street Suite 425 Columbus OH 43215

Sleep Diagnostic Center Downtown Endoscopy Center

700 East Broad Street 1st Floor Columbus OH 43215

Endoscopy Surgery Center Downtown Rehabilitation Center

223 East Town St Columbus OH 43215

Rehabilitation Center Pickerington Rehabilitation Center

1797 Hill Road North Suite 101 Pickerington OH 43147

Rehabilitation Center Powell Rehabilitation Center

10401 Sawmill Parkway Suite B Powell OH 43065

Rehabilitation Center Upper Arlington Rehabilitation Center

4664 Larwell Drive Columbus OH 43220

Rehabilitation Center Hilliard Sports Medicine & Rehab Center

6356 Scioto Darby Road Hilliard OH 43026

Rehabilitation Center Olentangy Sports Medicine & Rehab Center

409 Orangepoint Drive Lewis Center OH 43035

Rehabilitation Center McConnell Heart Health Center

3773 Olentangy River Road Columbus OH 43214

Rehabilitation & Fitness Center Grant Health & Fitness Center

340 East Town Street 9th Floor Columbus OH 43215

Rehabilitation & Fitness Center Advanced Imaging

41 South High Street Columbus OH 43215

Imaging Center Advanced Imaging

810 Jasonway Avenue Columbus OH 43214

Imaging Center Advanced Imaging

500 East Main Street Suite 210 Columbus OH 43215

Imaging Center and Lab Services William W Wilkins Prof Bldg Imaging

285 East State Street Suite 320 Columbus OH 43215

Imaging Center Women's Imaging Ctr at Doctors Hospital

5131 Beacon Hill Road Columbus OH 43228

Imaging Center Hobbs Radiation Oncology Center

5200 West Broad Street Columbus OH 43228

Radiation Oncology Center America's Urgent Care

24 Hidden Ravines Drive Powell OH 43065

Urgent Care Facility America's Urgent Care

5610 North Hamilton Road Columbus OH 43230

Urgent Care Facility America's Urgent Care

2030 Stringtown Road Grove City OH 43123

Urgent Care Facility Dublin Health Center

6955 Hospital Drive Dublin OH 43016

Imaging, Rehab, Urgent Care & Lab Services East Side Health Center

4850 East Main Street Columbus OH 43213

Rehabilitation Center Gahanna Health Center

765 North Hamilton Road Gahanna OH 43230

Imaging, Rehab, Urgent Care & Lab Services Riverside Health Center

500 Thomas Lane Columbus OH 43214

Imaging Center and Lab Services Southwest Health Center

2030 Stringtown Road Grove City OH 43123

Imaging, Rehab, Urgent Care & Lab Services Unity Health Center

3433 Agler Road Suite 1200 Columbus OH 43219

Imaging and Rehabilitation Center Victorian Village Health Center

1132 Hunter Avenue Columbus OH 43201

Imaging and Urgent Care Facility Dublin Methodist Specialty Care Center

7450 Hospital Drive Suite 350 Dublin OH 43016

X Rvrsde Ctr Female ContinencePelvic Surg

3545 Olentangy River Road Suite 501 Columbus OH 43214

Female Continence & Pelvic Surgery WorkHealth

223 East Town St 2nd Floor Columbus OH 43215

WorkHealth Facility WorkHealth

4079 Gantz Road Grove City OH 43123

WorkHealth Facility WorkHealth

4872 Cemetery Road Hilliard OH 43026

WorkHealth Facility WorkHealth

300 Polaris Parkway Westerville OH 43082

WorkHealth Facility WorkHealth

561 W Central Avenue Delaware OH 43015

WorkHealth Facility Eastside Medical Office Building Lab

4882 East Main Street Suite 130 Columbus OH 43213

Lab Services Westerville Medical Campus

300 Polaris Parkway Suite 1350 Westerville OH 43082

Lab Services Bexley Health Services

2222 Welcome Place Columbus OH 43209

Imaging, Lab & Primary Care Services Easton Station Lab

4030 Easton Station Suite 300 Columbus OH 43219

Lab Services Patient Services - North

3705 Olentangy River Road Suite 112 Columbus OH 43214

Lab Services Patient Services - West Broad

5212 West Broad Street Suite M Columbus OH 43228

Lab Services Pickerington Health Center Lab

417 Hill Road Suite 601 Pickerington OH 43147

Lab Services Greater Columbus Regional Dialysis

285 East State Street Suite 150 Columbus OH 43215

Dialysis Eye Center of Columbus

262 Neil Avenue Columbus OH 43215

Eye Care Services Whetstone Gardens & Care Center

3710 Olentangy River Road Columbus OH 43214

Nursing Home Genesis OhioHealth Heart Services

2951 Maple Avenue Zanesville OH 43701

Heart Services AKSMGenesis Columbus LLC

797 Thomas Lane Columbus OH 43214

Cryotherapy and Brachytherapy Services Downtown Laboratory Patient Service Site

500 East Main Street Suite 210 Columbus OH 43215

Lab Services Grant Scope Center LLC

700 E Broad St Second Floor Columbus OH 43215

X Endoscopy Lane Avenue Mammography

1315 West Lane Avenue Suite D Columbus OH 43221

Mammography Part I, Line 6a: Part I, Line 7: For the cost of charity care, a cost-to-charge ratio was used that was derived from Worksheet 2. For unreimbursed Medicaid, a cost accounting system was used for all amounts reported in the table. This cost accounting system includes all patient segments. All other amounts reported on the table are based on actual costs tracked through cost centers. Costs related to the volunteer time of employees were determined using standard wage rates for hours contributed during work hours. Part I, Line 7f: The amount of bad debt expense reported on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentages in Schedule H, Part I, Line 7, column (f) is $77,938,659. Part III, Line 4: Accounts receivable are stated net of contractual allowances and the allowance for doubtful accounts. The allowance for doubtful accounts is determined utilizing a number of factors including account aging and financial class information as well as recent and historical collection activity.OhioHealth applies a discount to self pay patient accounts that are determined to not qualify for charity at the time of billing. If the account is determined to be bad debt, the remaining balance is written off to bad debt expense. OhioHealth makes all reasonable efforts to qualify eligible patients for charity, including periodic retrospective account reviews to determine if patients that were written off to bad debt should have qualified for charity.In accordance with the Catholic Health Association guidelines per "A Guide for Planning and Reporting Community Benefits", OhioHealth does not report bad debt as community benefit. Part III, Line 8: In accordance with the Catholic Health Association guidelines per "A Guide for Planning and Reporting Community Benefits", OhioHealth does not report Medicare shortfall as community benefit. Part III, Line 9b: The organization has a written debt collection policy. The policy provides the following guidelines as it relates to patients who qualify for Charity Care: The patient may apply for financial assistance via Medicaid, Victims of Crime, HCAP/Charity, with an OhioHealth contracted company to help the applicant complete the process when needed. The operational practice, consistent with the intent of the policy, is that once the charity determination is made, collection efforts are suspended. If a patient qualified for a discount, collection efforts on this balance are consistent with all other self pay collections. Part V: All facilites were listed in Part V. Part VI, Line 2: The Mission and Ministry Department and the Mission/Ministry and Community Needs Committee of the OhioHealth Board of Trustees are responsible for corporate oversight and strategic direction for community benefit services. These two entities are responsible for monitoring community health needs and providing oversight of metrics on community benefit and mission effectiveness.OhioHealth has ongoing partnerships with Columbus Public Health, Ohio Department of Health, and Access Health Columbus in identifying health priorities locally and statewide. OhioHealth is active in direct discussions regarding epidemiologic data and what OhioHealth can do to impact public health issues. Access Health Columbus' goal is to improve access to healthcare for all individuals in central Ohio, specifically the most vulnerable. A representative of OhioHealth's leadership is a part of these mentioned organizations and agencies to ensure that our planning and practice are meeting the identified needs of central Ohio.OhioHealth utilizes primary and secondary data sources to compile the community health needs assessment. OhioHealth combines the primary data source and secondary data sources to conduct a statistical analysis regarding community health needs and consequently provides the information to OhioHealth leadership to create the OhioHealth community benefit strategic priorities. Part VI, Line 3: Signs are posted at multiple entry points and patient registration locations stating our intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's Charity Care program. Information materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. OhioHealth facility billing statements also include information regarding HCAP and can be used to apply for financial assistance. Part VI, Line 4: The following demographic information was obtained from Claritas 2010. Columbus is the capital and the largest city in the state of Ohio. The city has a diverse economy based on education, insurance, banking, fashion, defense, aviation, food, logistics, steel, energy, medical research, health care, hospitality, retail, and technology.OhioHealth's Primary Service Area covers Franklin and Delaware Counties as well as a few rural communities in neighboring counties.The current year median age for this population is 35.3.Of this area's current year estimated population: 73.5% are White Alone, 16.4% are Black or African Am. Alone, 3.9% are Asian Alone, 3.7% are Hispanic, and 2.5% are other races.The number of households in this area is estimated to be 582,510 to 609,673. The number of households in the United States is estimated to be 116,136,572.The average household income in the Columbus area is estimated to be $72,300 for the current year, while the average household income for the United States is estimated to be $71,071 for the same time frame.For this area, 67% of the population is estimated to be employed and age 16 and over for the current year. For the United States, 61.5% of the population is estimated to be employed and age 16 and over for the current year. Currently, it is estimated that 36.4% of the population age 25 and over in this area had earned a Bachelor's Degree or greater. In comparison, for the United States, it is estimated that for the population over age 25, 27.5% had earned a Bachelor's Degree or greater. Part VI, Line 5: Together with our associates and physicians who live in the communities we serve, we share aspirations for the community in which we live, work and raise our families. Our Team OhioHealth is comprised of associates who volunteer their time at various community events such as American Heart Association's Heart Walk, Arthritis Foundation Run, and March of Dimes Walk. Community involvement is an important part of our mission of "to improve the health of those we serve". We collaborate with various sectors to ensure that our communities are provided with the best services that will enable them to live a healthy life. OhioHealth associates serve meals at YWCA Family Center, an emergency shelter supporting families experiencing housing crises. We believe that healthy people live in healthy communities. OhioHealth associates and physicians have participated in various community initiatives of the United Way of Central Ohio such as Community Care Day. During Community Care Day, United Way assigns projects to complete such as repair, painting, and construction at various United Way agencies. CARE Columbus involves mentoring and training in order to bridge cultural gap between diverse patient populations and health care providers to potentially reduce health disparities.OhioHealth also participates in Project Mentor, a collaboration between Columbus City Schools and Big Brothers, Big Sisters of Central Ohio. Project Mentor's goal is to empower individual students to focus on their assets to improve academic performance and eventually increase high school graduation rates. Each student mentee is coached on developing skills to build self-confidence, academic competence, and become caring individuals. These skills will eventually serve as strong foundations for productive lives, helping students avoid high-risk behaviors. Project Mentor enables high school students to do their best academically, and adopt positive lifestyle behaviors in the communities they live in. Part VI, Line 6: A majority of the organization's governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization, nor family members thereof.OhioHealth extends medical staff privileges and / or membership to all qualified physicians in the communities it serves to ensure that each community has access to the necessary medical services. OhioHealth reinvests in our community to improve quality of care, increase access to care and enhance service to our patients and their families. Instead of paying dividends to shareholders or owners, OhioHealth uses its earnings to provide a broad array of community benefits. For example:- We provide charity care to those without adequate resources to pay for their care in conjunction with our charity care policies. - We invest in research, innovation and technology, and medical education and training, to advance medical knowledge and provide the highest quality of care and service to our patients.- We subsidize essential community health services - trauma centers, poison control, psychiatric services, and kidney dialysis, as examples that might not otherwise pay for themselves.- We support a wide range of vital community outreach services, targeting in particular, the most vulnerable and historically underserved residents of our community.In total, OhioHealth Corporation provided $190,965,000 of community benefit. The total community benefit represents an appropriate balance of charity care, community health services, subsidized health services, research and net medical education costs, and cash or in-kind community building. Part VI, Line 7: OH 1 Council on Development West Ohio Conference United Methodist Church 32 Wesley Blvd Worthington OH 430853585 50000 Haiti Earthquake Relief Fund 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: OhioHealth Corporation does not regularly issue grants; therefore there is no formal process in place for the monitoring of grants. However, in accordance with OhioHealth Corporation's Authority Matrix for the issuance of payment, the grant was authorized by a Vice President. The grant was contributed to OhioHealth Corporation's sole corporate member, The West Ohio Conference of the United Methodist Church, to assist with their efforts in the Haiti earthquake relief. X 0 1 X X X X X X 1 1 0 0 0 0 0 1 0 Anderson Craig MD 137986 0 3635 0 78 0 13390 0 23333 0 178422 0 0 0 Blom David P 891942 0 524426 0 29685 0 836383 0 19401 0 2301837 0 0 0 deVillers Rebecca DO 72000 93666 0 0 0 7395 0 8573 0 19501 72000 129135 0 0 George Peter MD 78906 644088 0 156392 0 41624 1578 3322 0 21491 80484 866917 0 0 Innes Jeffrey T MD 60000 343326 0 146030 0 17118 0 18275 0 40 60000 524789 0 0 Louge Michael W 594442 0 259070 0 12505 0 331089 0 18352 0 1215458 0 0 0 Millen Robert P 572935 0 246405 0 19850 0 214122 0 23685 0 1076997 0 0 0 Pandora Frank T II Esq 350881 0 146231 0 28114 0 279989 0 18352 0 823567 0 0 0 Bernstein Michael S 415126 0 158326 0 5657 0 134625 0 21212 0 734946 0 0 0 Connors Karen H 365674 0 138534 0 21988 0 126556 0 22227 0 674979 0 0 0 Hagen Bruce P 444114 0 160941 0 27541 0 147940 0 17853 0 798389 0 0 0 Herbert-Sinden Cheryl L 222520 0 90477 0 21479 0 29473 0 19727 0 383676 0 0 0 Reichfield Michael L 325979 0 124769 0 6436 0 104585 0 23352 0 585121 0 0 0 Gallaher Connie L 189561 0 46000 0 3261 0 19705 0 15055 0 273582 0 0 0 Hanly Donna L 191073 0 53650 0 4063 0 24795 0 13905 0 287486 0 0 0 Markovich Stephen 330278 0 95940 0 21830 0 38664 0 17782 0 504494 0 0 0 Santanello Steven A DO 393106 21850 80740 0 6079 0 22446 0 2175 0 504546 21850 0 0 Tomaszewski James A 277814 0 46000 0 24508 0 20359 0 2415 0 371096 0 0 0 Vanderhoff Bruce MD 350603 0 131625 0 5055 0 122676 0 18555 0 628514 0 0 0 Boggs Martha Bruce 147075 0 75000 0 20100 0 0 0 13499 0 255674 0 0 0 Jablonski Susan F 273590 0 93845 0 4511 0 66229 0 8846 0 447021 0 0 0 Yates Vinson M 227433 0 75000 0 3881 0 26367 0 19825 0 352506 0 0 0 Dono Frank V 310147 0 85650 0 17106 0 26587 0 13836 0 453326 0 0 0 Gleeson Sean MD 272192 0 96980 0 76390 0 17719 0 16749 0 480030 0 0 0 Lozada Leonardo J 398877 0 115400 0 30716 0 17150 0 13313 0 575456 0 0 0 Kontner John G 302625 0 129690 0 4991 0 17150 0 17091 0 471547 0 0 0 Imm Amy A 307432 0 82050 0 21155 0 19026 0 21825 0 451488 0 0 0 Bachman Ronald J 13365 0 0 0 546384 0 9284 0 30 0 569063 0 0 0 Garlock Steven J 267678 0 110373 0 24225 0 59063 0 18302 0 479641 0 0 0 Seckinger Mark R 181235 0 54600 0 19885 0 28606 0 13573 0 297899 0 0 0 Swart Steven L 227414 0 60480 0 24441 0 21906 0 18025 0 352266 0 0 0 Part I, Line 1a For key executives, OhioHealth provides a temporary housing allowance, administered by Human Resources, if relocation is required in order to accept employment with OhioHealth. As part of a relocation package, the following individual received a cash payment, including a tax gross-up, to offset the cost of temporary housing. The full amount, including the gross-up, was treated as taxable compensation reported on the individual's W-2. Martha Bruce Boggs $9,601.01 Part I, Line 4a The following individuals listed in Form 990, Part VII received severance payments: Sean Gleeson, M.D. - $58,250.80 Ronald J. Bachman - $533,276.10 Part I, Line 4b: The following individuals listed in Form 990, Part VII participated in a supplemental non-qualified retirement plan: David P. Blom - $804,462 Frank T. Pandora II, Esq. - $241,211 Michael W. Louge - $309,143 Michael S. Bernstein - $117,475 Karen H. Connors - $108,773 Bruce P. Hagen - $126,728 Susan F. Jablonski - $66,229 Robert P. Millen - $193,176 Michael L. Reichfield - $87,435 Bruce Vanderhoff, M.D. - $102,805 Cheryl L. Herbert-Sinden - $6,466 Steven Markovich - $15,233 Steven J. Garlock - $24,791 Mark R. Seckinger - $322 Steven L. Swart - $3,884 Ronald J. Bachman - $0 These arrangements are an industry standard and are unfunded. Due to the substantial risk of forfeiture provision, there is no guarantee that these officers will ever receive these benefits. Amounts for these arrangements are included in the deferred compensation amount. Part I, Line 7 Incentive bonuses are calculated using an objective formula that includes clinical quality, patient, physician and employee satisfaction, and financial items. Minor modifications to increase or decrease incentive payments, within the maximum amount established for each position, may be made based on individual performance and accountabilities. In addition, one time bonuses may be awarded to recognize exemplary performance. All payments are examined for reasonableness and are reviewed and approved by either the Executive Compensation Committee (for disqualified persons) or through management and the company's human resources function (for non-disqualified persons). County of Franklin Ohio 316400067 3531866P9 2009-02-25 165800000 To Refund Series 2006, issued on 5/10/06 0 0 County of Franklin Ohio 316400067 3531866D6 2008-08-01 186700000 To Refund Series 2003 A/B, issued on 2/13/03 and 2/27/03 0 0 County of Franklin Ohio 316400067 3531863P2 2003-11-05 123578533 To Refund Series 1993A, issued on 4/27/93 0 0 County of Franklin Ohio 316400067 3531863Q0 2003-11-05 27755000 To Refund Series 2000A, issued on 1/27/00 0 0 165800000 1195000 2009 1 0 1 1 186700000 2008 1 0 1 1 123578533 3820905 2003 1 0 1 1 27755000 217980 2003 1 0 1 1 0 1 1 0 0 0.01600 0.01600 1 0 1 1 0 0 0.03600 0.03600 1 0 1 1 0 0 0.04400 0.04400 1 0 0 1 0 0 0.02100 0.02100 1 0 1 0 NA 0 No 0 1 0 1 0 NA 0 No 0 1 0 0 0 NA 0 No 0 1 0 1 0 NA 0 No 0 1 Live Technologies Inc Director of Org - Entity more than 35% owned by Director (Lawrence Abbott) 453741 Payments - Goods or services provided to OhioHealth Corporation. 0 Beatrice Mills RN Director of Org - Daughter of Director (Rebecca deVillers, DO) 62045 Comp/Ben - Daughter is employed at Grant Medical Center and receives compensation. 0 Huntington National Bank Director of Org - A Director of OhioHealth (Michael J Endres) is a Director 445497 Banking fees. 0 Biotronics Inc Director of Org - A Director of OhioHealth (Michael J Endres) is a Director 356568 Payments - Goods and services provided to OhioHealth Corporation. 0 Linda Kress Key Employee - Sister of Key Employee (Donna L. Hanly) 26714 Comp/Ben - Sister is employed at OhioHealth Corporation and receives compensation. 0 American Electric Power Director of Org - A Dir/Off of OhioHealth (Hoaglin & Walker) are Dir/Off 9153571 Payments - Electricity provided to OhioHealth Corporation.Continued from relationship between interested person and organization - Thomas E. Hoaglin, a Director and Officer of OhioHealth, is a Director of American Electric Power. Kevin Walker, a Director of OhioHealth, is an employee and officer of American Electric Power. 0 Time Warner Cable Director of Org - A Director of OhioHealth (Donna James) is a Director 223649 Payments - Goods and services provided to OhioHealth Corporation. 0 Mark Vanderhoff Key Employee - Brother of Key Employee (Bruce Vanderhoff, MD) 84052 Comp/Ben - Brother is employed at Grant Medical Center and receives compensation. 0 Central Ohio Newborn Medicine Director of Org - Entity more than 5% owned by Dir (Craig Anderson, MD) 185494 Payments - Goods or services provided to OhioHealth Corporation. 0 Ohio Hospital Association Insurance Solutions An Officer of OhioHealth (Frank T. Pandora, II Esq.) is a Director 196394 Payments - Goods or services provided to OhioHealth Corporation. 0 X Hospital PP&E 40 10473026 Cost or selling price X Ultrasound 2 211100 Cost or selling price 0 1 0 Form 990, Part VI, Section A, line 2 David P. Blom, President/CEO of OhioHealth Corporation, and Randy Wilcox, Vice Chairman of OhioHealth Corporation, have a business relationship. Michael J. Endres, Treasurer of OhioHealth Corporation, and John P. McConnell, Director of OhioHealth Corporation, have a business relationship. Form 990, Part VI, Section A, line 6 Pursuant to Ohio Revised Code Section 1702.13, OhioHealth Corporation has a sole member, The West Ohio Conference of The United Methodist Church. Form 990, Part VI, Section A, line 7a Pursuant to Ohio Revised Code Section 1702.13, The West Ohio Conference of the United Methodist Church is the sole voting member of OhioHealth Corporation. OhioHealth Corporation is the sole voting member of all subsidiary organizations. Form 990, Part VI, Section A, line 7b Revisions of the Code of Regulations that affect the rights of the Member must be approved by the Member. Form 990, Part VI, Section B, line 11 Corporate Finance, using a public accounting tax firm, prepares the Form 990. Multiple levels of internal review occur, as well as a presentation to the OhioHealth Board Finance and Audit Committee, prior to copies being provided to the OhioHealth Corporation Board before filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy has been reviewed by independent tax counsel to assure its compliance with the requirements of the Internal Revenue Service. The policy requires all officers, directors and key employees to complete an annual questionnaire pertaining to conflicts of interest. The questionnaire is administered by the General Counsel of OhioHealth, the parent company of the organization. The responses are recorded and reported to the Board in the format approved by the Chair of the Board (a community member). In the interim between questionnaires, conflicts are to be reported to the General Counsel, who will advise the conflicted officer, director or key employee on the steps required to manage or clear the conflict. Failure to report a conflict, or failure to follow the steps advised to clear the conflict, constitutes grounds for disciplinary action. Members of the governing board with a transactional conflict are required to recuse themselves from any discussion and/or vote pertaining to the conflicted transaction, and this is reflected in the minutes of the organization. Legal counsel attends Board meetings and Board committee meetings with the instruction to assure the conflict of interest policy is followed. Form 990, Part VI, Section B, line 15 The CEO's compensation is set by the Compensation Committee, which is composed of independent and disinterested members of the Board of Directors. The CEO's 2009 base salary fell below the middle of the market and his 2009 total compensation (which includes annual incentive and all benefits) was estimated to approximate the 80th percentile. The organization's performance for FY6/30/2010 was at the 85th percentile as measured by the Balanced Scorecard using Quality, Customer Service, Worklife, and Finance indicators. The Compensation Committee annually receives a report from its independent executive compensation consultant, which includes third-party comparability data for functionally-similar positions in comparable not-for-profit health systems across the United States. The annual report to the Compensation Committee, completed each fall, includes market analyses for base salaries, total cash compensation, benefits and perquisites and aggregate total compensation values for the Chief Executive Officer, Executive Vice Presidents, Senior Vice Presidents and Entity Presidents, to support OhioHealth's qualification for the rebuttable presumption of reasonableness. The Compensation Committee reviews and approves each executive's compensation, based on performance and the compensation philosophy, and rationale for the Committee's decisions is documented in meeting minutes. With respect to non disqualified postions, compensation is determined in the same manner as set forth above, however it is not reviewed by the Executive Compensation Committee and is instead determined by management. Form 990, Part VI, Section C, line 19 Information is made available as required. Form 990, Schedule K, Part II, Line 5: Column A Costs of Issuance - $1,195,000 Credit Enhancement - $0 Total - $1,195,000 Column C Cost of Issuance - $1,139,905 Credit Enhancement - $2,681,000 Total - $3,820,905 Column D Cost of Issuance - $211,270 Credit Enhancement - $6,710 Total - $217,980 Form 990, Part VII, Section A: Rebecca deVillers, D.O., Jeffrey T. Innes, M.D., and Peter George, M.D. each work 40 hours a week for a related organization. Steven A. Santanello, D.O. provided services "on call" and the hours per week varied due to the nature of an "on call" position. Form 990, Part VII, Section B: Amounts reported for Gilbane Building Company, Elford Inc. Construction Services and Messer Construction Company represent amounts paid for both services and materials. These amounts cannot be separated. DH Ventures Ltd 180 East Broad Street 33rd Floor Columbus OH 432153707 311686358 Holding Company OH 3258823 0 OhioHealth Corporation CG Broad Norton LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 261564783 Real Estate Holding Company OH -13213 243155 OhioHealth Corporation OhioHealth Medical Specialty Foundation LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 261210223 Physician Practices OH 0 0 OhioHealth Corporation OhioHealth Hospital Management Services 180 East Broad Street 33rd Floor Columbus OH 432153707 300632745 Hospital Management Services OH 0 0 OhioHealth Corporation Marion General Hospital 1000 Mckinley Park Drive Marion OH 43302 311070877 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation Grady Memorial Hospital 561 West Central Avenue Delaware OH 43015 314379436 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation Hardin Memorial Hospital 921 East Franklin Street Kenton OH 43326 344440479 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation Hardin Physician Foundation Inc 921 East Franklin Street Kenton OH 43326 311414276 Foundation OH Section 501(c)(3) Schedule A, Line 3 Hardin Memorial Hospital Hardin Memorial Hospital Foundation 921 East Franklin Street Kenton OH 43326 341521537 Foundation OH Section 501(c)(3) Schedule A, Line 3 Hardin Memorial Hospital Doctors Health Corporation of Nelsonville 1950 Mount St Mary Drive Nelsonville OH 45764 311620551 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation GrantRiverside Medical Care Foundation (dba OHPMS & dba OHMSF) 180 East Broad Street 33rd Floor Columbus OH 432153707 311351965 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation OhioHealth Foundation 180 East Broad Street 33rd Floor Columbus OH 432153707 237446919 Foundation OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation Grady Memorial Hospital Foundation 561 West Central Avenue Delaware OH 43015 311763100 Foundation OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Foundation HomeReach 180 East Broad Street 33rd Floor Columbus OH 432153707 311372702 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation HomeReach HomeCare 180 East Broad Street 33rd Floor Columbus OH 432153707 311417595 Health Care OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation OhioHealth Research Institute 180 East Broad Street 33rd Floor Columbus OH 432153707 316059784 Research OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation Hospital Properties Inc 180 East Broad Street 33rd Floor Columbus OH 432153707 311206071 Property Management OH Section 501(c)(2) N/A OhioHealth Corporation Grady Memorial Hospital Volunteers 561 West Central Avenue Delaware OH 430151489 310938287 Fund Raising OH Section 501(c)(3) Schedule A, Line 3 Grady Memorial Hospital OhioHealth Sleep Services LLC 6186 Huntley Rd STE B Columbus OH 43229 201547399 Physician Practice OH OhioHealth Corporation Related 1689798 2049772 0 0 Polaris Surgery Center LLC 6200 Cleveland Avenue Columbus OH 43231 208074623 Medical Services OH OhioHealth Corporation Related 2327074 4445719 0 1 Marion Ancillary Services 1040 Delaware Avenue Marion OH 43302 311704991 Outpatient Services OH N/A Upper Arlington Medical Limited Partnership 180 East Broad Street 33rd Floor Columbus OH 43215 311472667 Medical Services OH OhioHealth Star Corporation Related 77804 1166881 0 0 ESWL Real Estate & Equipment Limited Partnership 100 West Third Avenue Suite 350 Columbus OH 43201 311138732 Equipment Rental OH N/A Marion Area Health Center 1040 Delaware Avenue Marion OH 43302 311639538 Outpatient Surgery Center OH N/A OhioHealth Star Corporation 180 East Broad Street 33rd Floor Columbus OH 432153707 311119936 Administrative Services OH N/A C OhioHealth Star Properties 180 East Broad Street 33rd Floor Columbus OH 432153707 311347216 Administrative Services OH N/A C MedStart Inc 180 East Broad Street 33rd Floor Columbus OH 432153707 311482649 Administrative Services OH N/A C GM Health Services 561 West Central Avenue Delaware OH 43015 311094787 Industrial Health, DME Home, Collection Agency OH N/A C HealthWorks 561 West Central Avenue Delaware OH 43015 311435822 Medical Service Phys Practices OH N/A C Grady Anesthesia Services 561 West Central Avenue Delaware OH 43015 203750671 Anesthesia Services OH N/A C Olentangy Ventures 561 West Central Avenue Delaware OH 43015 311124414 Janitorial Services OH N/A C HardinCare Inc 921 East Franklin Street Kenton OH 43326 341492617 Property Management OH N/A C Intel Health Services PO Box 1051 Governors Square Buil Grand Cayman CJ KY1-1102 314394942 Insurance/Reinsurance CJ OhioHealth Corporation C 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 Hospital Properties Inc J 2708517 Hospital Properties Inc R 4377297 Hospital Properties Inc Q 3603407 Hospital Properties Inc P 884388 HealthWorks O 90485 OhioHealth Star Corporation Q 61014 Doctors Hospital of Nelsonville R 291861 OhioHealth Foundation Q 2222191 Grant Riverside Medical Care Foundation R 300000 Grady Hospital Foundation Q 317740 Grady Hospital R 44582365 HomeReach HomeCare Q 104570 HomeReach R 4804172 Marion General Hospital Q 619132 OhioHealth Research Institute Q 1711947 Intel Health Services O 3170223 Healthworks Q 1723536 Grady Anesthesia Services Q 581353