FURP.ORG / PUBLIC DATA EXPLORER

WAYNE HOSPITAL COMPANY: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WAYNE HOSPITAL COMPANY (EIN 34-4428598)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-08-11
IRS object ID
201102239349301805
Schema version
2010v3.2
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)
Timestamp2011-08-11T12:00:15-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13815 River Crossing ParkwayAddressLine1
Address Line2Suite 300AddressLine2
CityIndianapolisCity
StateINState
ZIP Code462400977ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN344428598EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAYNNameControl
Phone9375481141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE DESCHAMBEAUName
TitleCEOTitle
Date Signed2011-08-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3175698989Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1WAYNE HEALTHCAREBusinessNameLine1

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1WAYNE DESCHAMBEAU PRES & CEOBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Gross Receipts157017343GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WAYNEHEALTHCARE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1922YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITIY TO PAY. SCHEDULE H PROVIDES INFORMATION ABOUT WAYNE HOSPITAL CORPORATION PROVIDING CARE REGARDLESS OF PATIENT'S ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees679TotalNbrEmployees
Total Nbr Volunteers118TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year388223ContributionsGrantsPriorYear
Contributions Grants Current Year132889ContributionsGrantsCurrentYear
Program Service Revenue Prior Year55176785ProgramServiceRevenuePriorYear
Program Service Revenue CY58117193ProgramServiceRevenueCY
Investment Income Prior Year1274615InvestmentIncomePriorYear
Investment Income Current Year6110235InvestmentIncomeCurrentYear
Other Revenue Prior Year431411OtherRevenuePriorYear
Other Revenue Current Year395113OtherRevenueCurrentYear
Total Revenue Prior Year57271034TotalRevenuePriorYear
Total Revenue Current Year64755430TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year32000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY136318GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year25904080SalariesEtcPriorYear
Salaries Etc Current Year29023602SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year114512TotalFundrsngExpCurrentYear
Other Expense Prior Year27975776OtherExpensePriorYear
Other Expenses Current Year29525342OtherExpensesCurrentYear
Total Expenses Prior Year53911856TotalExpensesPriorYear
Total Expenses Current Year58685262TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3359178RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6070168RevenuesLessExpensesCY
Total Assets BOY134188715TotalAssetsBOY
Total Assets EOY117124174TotalAssetsEOY
Total Liabilities BOY56178959TotalLiabilitiesBOY
Total Liabilities EOY39101379TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY78009756NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY78022795NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF WAYNE HOSPITAL CORPORATION IS TO PROVIDE OUTPATIENT AND INPATIENT SERVICES AT A LEVEL TO RANK PROMINENTLY ON A REGIONAL AND NATIONAL BASIS FOR QUALITY OF CARE, PATIENT SATISFACTION AND SPIRITUALITY SUPPORT. THE HOSPITAL COLLABORATES WITH OTHER HEALTH CARE PROVIDERS TO DEVELOP NEW AND/OR IMPROVED SERVICES FOR RESIDENTS OF DARKE COUNTY, OHIO. (CONTINUED ON SCHEDULE O).MissionDescription
Significant ChangefalseSignificantChange
Expense48368201Expense
Grants104318Grants
Revenue58000286Revenue
DescriptionAS A FULL-SERVICE PRIMARY CARE FACILITY, WAYNE HOSPITAL OFFERS PHYSICIANS AND THEIR PATIENTS ACCESS TO A VARIETY OF INPATIENT AND OUTPATIENT SERVICES INCLUDING: EMERGENCY, RADIOLOGY, MATERNITY/SPECIAL BEGINNINGS, SURGERY, HEART HEALTH, CANCER CARE, REHABILITATION SERVICES, LABORATORY, CHRONIC DIALYSIS CENTER, AMBULATORY CARE, OUTPATIENT REHABILITATION, DIABETES EDUCATION PROGRAM, SLEEP CARE SERVICES, AND ENTEROSTOMAL THERAPY. THE HOSPITAL HAD APPROXIMATELY 2,545 ADMISSIONS AND 88,798 OUTPATIENT VISITS IN 2010. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. IN ADDITION TO THE FINANCIAL ASSISTANCE PROVIDED, WAYNE HOSPITAL ALSO IS PROACTIVE IN SUPPORTING COMMUNITY WELLNESS THROUGH HEALTH SCREENINGS, EDUCATION, AND HEALTH MANAGEMENT.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense202297Expense
Grants32000Grants
Revenue18364Revenue
DescriptionWAYNE HOSPITAL HAS MANY ADDITIONAL PROGRAMS. ONE ADDITIONAL PROGRAM IS THE COUNTY HEALTH FAIR IN WHICH EMPLOYEES FROM THE HOSPITAL PROVIDE OVER 120 HOURS OF TIME TO HELP WITH HEALTH SCREENINGS AND PROVIDE EDUCATIONAL INFORMATION TO THE COMMUNITY. ANOTHER PROGRAM IS THE VARIOUS DIABETES SEMINARS AND CLASSES HELD AT WAYNE HOSPITAL WHICH PROVIDE INFORMATION TO THE PUBLIC ON DIABETES AWARENESS, OFFER THE COMMUNITY HEALTH SCREENINGS FOR DIABETES, AND EDUCATE THOSE WITH DIABETES ABOUT MANAGING THE DISEASE. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT OVER 285 HOURS OF TIME ON THE DIABETES SEMINARS AND CLASSES AND THE HOSPITAL HAS CONTRIBUTED $730 OF SUPPLIES TO THE PROGRAM. AN ADDITIONAL PROGRAM OF WAYNE HOSPITAL IS THE CANCER AWARENESS, PREVENTION, AND SCREENING PROGRAM IN WHICH THE HOSPITAL OFFERS SEMINARS AND CLASSES TO THE COMMUNITY IN ORDER TO PROMOTE AWARENESS, TEACH WAYS OF PREVENTION, AND OFFER HEALTH SCREENINGS TO THE COMMUNITY. THE EMPLOYEES OF WAYNE HOSPITAL HAVE SPENT OVER 115 HOURS OF TIME ON THE CANCER AWARENESS SEMINARS.Description
FieldValueIRS element (for citing)
Total Program Service Expense48570498TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
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 OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109669NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees679NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
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 Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
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 ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
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 OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WAYNE DESCHAMBEAUBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9375475722TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
DAN FRANZ
BOARD MEMBER1X000
BRAD BIXLER
CHAIRMAN1X000X
PHILLIP GARBIG
VICE CHAIRMAN1X000X
PHILIP DUBBS
BOARD MEMBER1X000
THOMAS BROWN MD
BOARD MEMBER1X000
ROXANNE CECH MD
BOARD MEMBER1X000
CINDY SCOTT
BOARD MEMBER1X000
JOHN SWALLOW
SECRETARY/TREASURER1X000X
LARRY ROLL
BOARD MEMBER1X000
LUCILLE HOSFELD
BOARD MEMBER1X000
WILLIAM JOHNSTON
BOARD MEMBER1X000
MIKE GRAY
BOARD MEMBER1X000
JAMES APPLEMAN MD
BOARD MEMBER1X000
WAYNE DESCHAMBEAU
CEO40232914036043X
DENNIS LOCKARD
CFO40152438025258X
PETER LACHIEWICZ
OB/GYN40519439047007X
PATRICK KARR
OB/GYN40499901046781X
DANIEL MCKELLAR
SURGEON40565058020206X
JOHN A DUTRO
SURGEON40347615029976X
DAVID M WARE
SURGEON40309331028971X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2626696TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation234242TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MESSER CONSTRUCTION CO
4801 HEMPSTEAD DRDAYTONOH45429CONTRACTOR SERVICES4860924
CPSI
PO BOX 850309MOBILEAL366850309SOFTWARE AND CLINICAL PROVIDER552209
NORTH DAYTON PATHOLOGISTS
2222 PHILADELPHIA DRDAYTONOH45406PATHOLOGY CONSULTING SERVICES466263
MANAGECAST TECHNOLOGIES
PO BOX 778BATAVIAOH45103IT CONSULTING SERVICES448520
WEST CENTRAL OHIO HOSPITAL CONS
PO BOX 35381CANTONOH44735MRI SERVICES393283
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations3000RelatedOrganizations
All Other Contributions129889AllOtherContributions
Total Contributions132889TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PATIENT SERVICE REVENUE5778260157782601
RENTAL INCOME334592$334,592

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue58117193TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1209074TotalRevenueColumn
Exclusion$1,209,074ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities97162073Securities
Other1001Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities92207272Securities
Other54641Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4954801Securities
Other-53640Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4901161TotalRevenueColumn
Exclusion$4,901,161ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory27640GrossSalesOfInventory

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column27640TotalRevenueColumn
Exclusion$27,640ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
FOOD SALES131424$131,424
REBATE REVENUE8237182371
HOUSEKEEPING7960879608

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column74070TotalRevenueColumn
Related Or Exempt Function Income74070RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue367473TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column64755430TotalRevenueColumn
Related Or Exempt Function Income58018650RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6,603,891ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total134318Total
Program Services134318ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total2000Total
Program Services2000ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total446654Total
Management And General446654ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22368972Total
Program Services20185790ProgramServices
Management And General2183182ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total517338Total
Program Services466847ProgramServices
Management And General50491ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4043498Total
Program Services3612224ProgramServices
Management And General431274ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1647140Total
Program Services1449483ProgramServices
Management And General197657ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total153694Total
Program Services28370ProgramServices
Management And General125324ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total212040Total
Management And General212040ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1798220Total
Management And General1798220ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5854689Total
Program Services4208329ProgramServices
Management And General1646360ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total127484Total
Program Services1166ProgramServices
Management And General33962ManagementAndGeneral
Fundraising92356Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total507896Total
Program Services323716ProgramServices
Management And General177305ManagementAndGeneral
Fundraising6875Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total216676Total
Program Services59328ProgramServices
Management And General157348ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1836173Total
Program Services1318362ProgramServices
Management And General517811ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total54039Total
Program Services26626ProgramServices
Management And General27413ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total36163Total
Program Services30376ProgramServices
Management And General5787ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total935298Total
Management And General935298ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4686239Total
Program Services4019275ProgramServices
Management And General666964ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total709143Total
Program Services490808ProgramServices
Management And General218335ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES589667058039447757215154
BAD DEBT63719986371998
MISCELLANEOUS1289203753891255127

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total58685262Total
Program Services48570498ProgramServices
Management And General10000252ManagementAndGeneral
Fundraising114512Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2100195BOY
EOY11965119EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12331990BOY
EOY4344609EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5926618BOY
EOY7144613EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY82731BOY
EOY38115EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY886706BOY
EOY1273400EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY867388BOY
EOY503849EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis94243482LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec36598830LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY48058158BOY
EOY57644652EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY61191609BOY
EOY32343498EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY123166BOY
EOY133355EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2620154BOY
EOY1732964EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY134188715BOY
EOY117124174EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5211874BOY
EOY5973244EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY46865000BOY
EOY30000000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4102085BOY
EOY3128135EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY56178959BOY
EOY39101379EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY77833720BOY
EOY77845708EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY163116BOY
EOY164167EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12920BOY
EOY12920EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY78009756BOY
EOY78022795EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY134188715BOY
EOY117124174EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6070168ReconcilationRevenueExpenses
Reconcilation Other Changes-6057129ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Exmpt Function Expenditures0TotalExmptFunctionExpenditures
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$1,141OtherActivitiesAmount
Total Lobbying Expenditures IIB1141TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Non Ded Lobby Political Total0NonDedLobbyPoliticalTotal

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of other lobbying activitiesIdentifier
Return ReferenceSchedule C, Part II-B, Line 1iReturnReference
ExplanationWAYNE HOSPITAL COMPANY PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES ($1,141) IS SPENT ON LOBBYING.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance195314BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses3051InvestmentEarningsOrLosses
Grants Or Scholarships2000GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance196365EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance236705BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses6844InvestmentEarningsOrLosses
Grants Or Scholarships2000GrantsOrScholarships
Other Expenditures46235OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance195314EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance236705BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance236705EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.0982BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.0658PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.836TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1957475OtherCostOrOtherBasis
Book Value1957475BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis65741650OtherCostOrOtherBasis
Depreciation22751428Depreciation
Book Value42990222BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2848221OtherCostOrOtherBasis
Depreciation1202724Depreciation
Book Value1645497BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis23415108OtherCostOrOtherBasis
Depreciation12644678Depreciation
Book Value10770430BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis281028OtherCostOrOtherBasis
Book Value281028BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings57644652TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY SETTLEMENTS$433,970
INTEREST RATE SWAP LIABILITY$2,675,594
ESTIMATED ASSET RETIREMENT OBLIGATION$18,571
FieldValueIRS element (for citing)
Total Of Amounts3128135TotalOfAmounts
Total Revenue64755430TotalRevenue
Total Expenses58685262TotalExpenses
Excess Or Deficit For Year6070168ExcessOrDeficitForYear
Net Unrealized GL On Investments-2990345NetUnrealizedGLOnInvestments
Other-$3,066,784OtherAmount
Total Adjustments-6057129TotalAdjustments
Excess Or Deficit Per FS13039ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt58873263TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2990345NetUnrealizedGainsInvestments
Other Revenues108810OtherRevenues
Revenue Not Rptd F990-2881535RevenueNotRptdF990
Revenue Subtotal61754798RevenueSubtotal
Other Revenues Not Included3000632OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3000632RevenueNotRptdOnFinStmt
Total Revenue Per Form99064755430TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt58860224TotExpensesEtcAuditedFinclStmt
Other Expenses Included174962OtherExpensesIncluded
Expenses Not Rptd F990174962ExpensesNotRptdF990
Expenses Subtotal58685262ExpensesSubtotal
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99058685262TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Intended uses of endowment fundsSchedule D, Part V, Line 4ENDOWMENT FUNDS ARE SPECIFICALLY SET ASIDE FOR CLINICALLY RELATED SCHOLARSHIPS GRANTED TO STUDENTS GOING INTO A HEALTH RELATED FIELD OF STUDY AND FOR INDIGENT CARE.
FIN 48 (ASC 740) footnoteSchedule D, Part X, Line 2THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A). U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE HOSPITAL IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE HOSPITAL'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF OHIO FOR THE LAST THREE YEARS. THE HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE HOSPITAL RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL DID NOT HAVE ANY AMOUNTS RECORDED FOR INTEREST AND PENALTIES AT DECEMBER 31, 2010 AND 2009.
Other changes in net assetsSchedule D, Part XI, Line 8CHANGE IN INTEREST OF RELATED ENTITIES - 55170; CHANGE IN VALUE OF INTEREST RATE SWAP - -121322; LOSS ON DISPOSITION OF DEFERRED FINANCING COSTS - -3000632;
Other revenues in audited financial statements not in form 990Schedule D, Part XII, Line 2dCHANGE IN INTEREST OF RELATED ENTITIES - 55170; LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT - 53640;
Other revenues in form 990 not in audited financial statementsSchedule D, Part XII, Line 4bLOSS ON DISPOSITION OF DEFERRED FINANCING COSTS - 3000632;
Other expenses in audited financial statements not in form 990Schedule D, Part XIII, Line 2dCHANGE IN VALUE OF INTEREST RATE SWAP - 121322; LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT - 53640;

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
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2106046TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2106046NetCommunityBenefitExpense
Percent Of Total Expense0.0403PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1299184TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1299184NetCommunityBenefitExpense
Percent Of Total Expense0.0248PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1612619TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1612619NetCommunityBenefitExpense
Percent Of Total Expense0.0308PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense5017849TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5017849NetCommunityBenefitExpense
Percent Of Total Expense0.0959PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense19708TotalCommunityBenefitExpense
Direct Offsetting Revenue224DirectOffsettingRevenue
Net Community Benefit Expense19484NetCommunityBenefitExpense
Percent Of Total Expense0.0004PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense150589TotalCommunityBenefitExpense
Direct Offsetting Revenue18140DirectOffsettingRevenue
Net Community Benefit Expense132449NetCommunityBenefitExpense
Percent Of Total Expense0.0025PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense170297TotalCommunityBenefitExpense
Direct Offsetting Revenue18364DirectOffsettingRevenue
Net Community Benefit Expense151933NetCommunityBenefitExpense
Percent Of Total Expense0.0029PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense5188146TotalCommunityBenefitExpense
Direct Offsetting Revenue18364DirectOffsettingRevenue
Net Community Benefit Expense5169782NetCommunityBenefitExpense
Percent Of Total Expense0.0988PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense30000TotalCommunityBuildingExpense
Net Community Building Expense30000NetCommunityBuildingExpense
Percent Of Total Expense0.0005PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense30000TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense30000NetCommunityBuildingExpense
Percent Of Total Expense0.0005PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,990,144BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare53059000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare44608398CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall8450602MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1WEST CENTRAL OHIO HOSPITAL CONSORTIUM LTDBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityPARTNERSHIP FOR MOBILE MRI UNITDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.3333OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANYBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Er OtherXErOther

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
Facility TypePHYSICIAN PROFESSIONAL SERVICES ORGANIZATIONFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Bad Debt Expense excluded from financial assistance calculationSchedule H, Part I, Line 7, column(f)6,371,998
Costing Methodology used to calculate financial assistanceSchedule H, Part I, Line 7A COST-TO-CHARGE RATIO WAS USED FOR THE FIGURES REPORTED IN THE TABLE AND WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
Community Building ActivitiesSchedule H, Part IIWAYNE HOSPITAL COMPANY GRANTED $30,000 TO THE EDISON FOUNDATION, WHICH SUPPORTS EDISON COMMUNITY COLLEGE. THE GRANT WAS INTENDED TO BE USED FOR A NEW FACILITY ON THE CAMPUS OF EDISON COMMUNITY COLLEGE FOR HEALTHCARE EDUCATION. IN ADDITION TO THE GRANT TO THE EDISON FOUNDATION, WAYNE HOSPITAL COMPANY ALLOWS CLINICALS TO BE COMPLETED AT THE WAYNE HOSPITAL FACILITY SO THAT STUDENTS OF EDISON COMMUNITY COLLEGE CAN EARN REGISTERED NURSING DEGREES. WAYNE HOSPITAL'S CONTINUOUS SUPPORT OF HEALTHCARE EDUCATION PROMOTES HEALTH WITHIN THE COMMUNITY IT SERVES.
Bad debt expense - financial statement footnoteSchedule H, Part III, Line 4THE BAD DEBT EXPENSE IN SCHEDULE H, PART III, LINE 2 IS DETERMINED USING THE COST TO CHARGE RATIO. THE WAYNE HOSPITAL COMPANY FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING THE BAD DEBT EXPENSE. THE FINANCIAL STATEMENTS ACCOUNT FOR BAD DEBT BY CALCULATING THE CHARGES TO REVENUE THAT WERE WRITTEN OFF AS UNCOLLECTIBLE. THE HOSPITAL HAS AN EFFICIENT AND EFFECTIVE PROCEDURE IN PLACE TO IDENTIFY ALL PATIENTS THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE.
Community benefit & methodology for determining medicare costsSchedule H, Part III, Line 8THE MEDICARE ALLOWABLE COSTS ARE DETERMINED USING THE COST TO CHARGE RATIO.
Other collection actions permittedSchedule H, Part V Section B, Line 15e(1) WAYNE HOSPITAL COMPANY - WAGE GARNISHMENT;
Other collection actionsSchedule H, Part V Section B, Line 16e(1) WAYNE HOSPITAL COMPANY - WAGE GARNISHMENT;
Other actions taken before collection actionsSchedule H, Part V Section B, Line 17e(1) WAYNE HOSPITAL COMPANY - WAYNE HEALTHCARE SENDS OUT 3 STATEMENTS AND 2 PRECOLLECT LETTERS PRIOR TO TURNING OVER A PATIENT TO AN AGENCY.;
Means used to determine amounts billedSchedule H, Part V Section B, Line 19d(1) WAYNE HOSPITAL COMPANY - WAYNE HEALTHCARE PROVIDES A 25% DISCOUNT TO PATIENTS WHO DID NOT HAVE INSURANCE COVERAGE DURING CARE. ADDITIONALLY, PATIENTS HAVE THE ABILITY TO APPLY FOR CHARITY CARE, FINANCIAL ASSISTANCE, AND MAKE PAYMENT ARRANGEMENTS.;
Gross Charges for Medical CareSchedule H, Part V Section B, Line 21(1) WAYNE HOSPITAL COMPANY - EACH PATIENT IS CHARGED THE SAME RATE OF GROSS CHARGES REGARDLESS OF THE TYPE OF COVERAGE, IF ANY, THAT THE PATIENT HAS.;
Needs assessment.Schedule H, Part VI, Line 2THE ORGANIZATION ASSESES THE NEEDS OF THE COMMUNITY BY REACHING OUT TO LOCAL ORGANIZATIONS TO SURVEY THE HEALTH NEEDS OF THEIR EMPLOYEES. ADDITIONALLY THE HOSPITAL ASSESSES THE TRENDS OF INPATIENT ADMISSIONS TO DETERMINE WHAT THE CURRENT NEEDS ARE AND WHAT ADDITIONAL PROGRAMMING MAY BEENFIT THE NEEDS OF THE COMMUNITY. WAYNE HOSPITAL COMPANY IS WORKING WITH DARKE COUNTY HEALTH DEPARTMENT TO COMPLETE A NEEDS ASSESSMENT IN 2011 AND 2012.
Patient education of eligibility for assistance.Schedule H, Part VI, Line 3WAYNE HOSPITAL PROVIDES PAMPHLETS TO PATIENTS THAT DESCRIBE THE FINANCIAL ASSISTANCE POLICIES. THERE IS SIGNAGE UP THROUGHOUT THE KEY PATIENT AREAS IN THE HOSPITAL ALONG WITH FINANCIAL ASSISTANCE APPLICATIONS. THE HOSPITAL'S WEBSITE HAS THE FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PATIENTS. WAYNE HOSPITAL SENDS A FINANCIAL COUNSELOR TO SPEAK WITH OUR INPATIENTS THAT MAY BE ELIGIBLE FOR ASSISTANCE. FINALLY, WAYNE HOSPITAL PUTS THE FINANCIAL ASSISTANCE APPLICATION DIRECTLY ON THE BACK OF ALL PATIENT STATEMENTS SO THAT THE PATIENT HAS IMMEDIATE ACCESS TO THE APPLICATION.
Community information.Schedule H, Part VI, Line 4WAYNE HOSPITAL SERVES THE DARKE COUNTY COMMUNITY. DARKE COUNTY IS MAINLY A RURAL FARMING COMMUNITY WITH A POPULATION OF OVER 50,000. APPROXIMATELY 10% OF THE COUNTY INCOME LEVEL IS UNDER THE FEDERAL POVERTY GUIDELINES AND 12.7% OF THE REVENUES FOR THE HOSPITAL WERE MEDICAID PATIENTS IN 2010. THE COUNTY UNEMPLOYMENT RATE IN 2010 WAS 9.1%. WAYNE HOSPITAL IS THE ONLY HOSPITAL WITHIN THE COUNTY AND THERE IS A FEDERALLY QUALIFIED HEALTH CENTER THAT SERVES THE COUNTY AND THEREFORE PROVIDES A SIGNIFICANT AMOUNT OF REFERRALS TO THE FACILITY.
Promotion of community healthSchedule H, Part VI, Line 5WAYNE HOSPITAL'S GOVERNING BODY IS COMPRISED OF LOCAL COMMUNITY AND COUNTY RESIDENTS WHO HAVE A VESTED INTEREST IN THE VIABILITY OF THE FACILITY. THE MEMBERS ARE ATTORNEYS, BANK EXECUTIVES, SCHOOL OFFICIALS, RETIRED BUSINESS OWNERS, AND OTHER LOCAL MEDICAL PROFESSIONALS. WAYNE HOSPITAL EXTENDS STAFF PRIVILEGES NOT ONLY TO OUR EMPLOYED PHYSICIANS, BUT TO THE COMMUNITY'S MEDICAL PROFESSIONALS AS WELL IN ORDER TO KEEP AS MUCH OF OUR PATIENT POTENTIAL AT THE FACILITY AS POSSIBLE. WAYNE HOSPITAL COMPLETED ITS MAJOR CONSTRUCTION PROJECT IN 2010 TO EXPAND OUR EMERGENCY DEPARTMENT, OPERATING AND PRE/POST CARE AREAS, RADIOLOGY AND CARDIOPULMONARY DEPARTMENTS, AND A NEW STATE OF THE ART ICU. THERE WAS A GREAT NEED TO EXPAND THE SPACE FOR THESE SERVICES TO IMPROVE PATIENT CARE AND PATIENT PRIVACY. IN ADDITION, WAYNE HOSPITAL IS OFFERING NEW SERVICES FOR OUR CANCER PATIENTS AND LOOKING TO EXPAND THESE IN 2010 AND BEYOND.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
THE EDISON FOUNDATION
1973 EDISON DRPIQUAOH45356311379781501(C)(3)300000N/AN/ABUILD NEW FACILITY
VERSAILLES AREA HISTORICAL SOCIETY
PO BOX 54VERSAILLESOH45380270896150501(C)(3)104318BOOK VALUEBUILDING AND LANDUSE OF BUILDING AND LAND
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedures for monitoring use of grant fundsIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationTHE GRANT FUNDS PAID TO THE EDISON FOUNDATION WERE INTENDED TO BE USED FOR A NEW FACILITY FOR HEALTHCARE EDUCATION. THE ORGANIZATION CONFIRMED THAT THE FUNDS WILL BE USED FOR THIS PURPOSE IN A LETTER TO WAYNE HOSPITAL AS A RECEIPT FOR THEIR CONTRIBUTION. THE LAND AND BUILDING WERE GRANTED TO VERSAILLES AREA HISTORICAL SOCIETY BY MEANS OF A WARRANTY DEED. IF THE HISTORICAL SOCIETY DOES NOT USE THE BUILDING AND LAND IN ACCORDANCE WITH THEIR CHARITABLE PURPOSE, WAYNE HOSPITAL HAS THE OPTION OF BUYING BACK THE LAND AND BUILDING FOR $1 PURSUANT TO THE DEED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
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 (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WAYNE DESCHAMBEAU
205414027500000144400216030268957000
DENNIS LOCKARD
1448980007540042800209780177696000
PETER LACHIEWICZ
4037540115685000240800229270566446000
PATRICK KARR
3549600144941000240800227010546682000
DANIEL MCKELLAR
350068021499000075800126260585264000
JOHN A DUTRO
30335704425800075800223960377591000
DAVID M WARE
25001405931700075800213910338302000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Housing allowance or residence for personal useSchedule J, Part I, Line 1aWAYNE HOSPITAL PROVIDES A HOUSE THAT IS OWNED BY THE HOSPITAL FOR USE BY THE CFO. THE HOUSE IS LOCATED RIGHT NEXT TO THE HOSPITAL AND WILL EVENTUALLY BE TORN DOWN AND TURNED INTO PARKING SPACE. THIS WAS TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUAL.
Compensation contingent on revenues of the organizationSchedule J, Part I, Line 5aTHE ORGANIZATION PAYS THE PHYSICIAN STAFF BONUSES BASED ON THE REVENUES OF THE ORGANIZATION. BONUS AMOUNTS ARE DEPENDENT UPON THE REVENUE GENERATED BY THE LLC ATTRIBUTED TO THE PHYSICIANS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF DARKE OHIOBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN346400036IssuerEIN
Date Issued2010-11-01DateIssued
Issue Price30000000IssuePrice
Description Of PurposeCURRENTLY REFUND PORTION OF 11/1/2007 BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds30000000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2010YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Term Of Hedge0.0TermOfHedge
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Term Of GIC0.0TermOfGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1(CONTINUED FROM PART III) THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SCHEDULE H PROVIDES INFORMATION ABOUT WAYNE HOSPITAL CORPORATION PROVIDING CARE REGARDLESS OF PATIENT'S ABILITY TO PAY.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bA COPY OF THE DRAFT OF THE FORM 990 IS SENT TO EACH VOTING MEMBER OF THE GOVERNING BODY PRIOR TO THE BOARD MEETING IN WHICH THE CONTROLLER PRESENTS THE MAJOR ITEMS RELATING TO THE FORM 990. AFTER THE PRESENTATION, THE BOARD HAS THE OPPORTUNITY TO ASK QUESTIONS AND THEN VOTES TO APPROVE THE FILING OF THE FORM 990.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cTHE CONFLICT OF INTEREST POLICY IS SIGNED ANNUALLY BY ALL MANAGEMENT, SENIOR MANAGEMENT, OFFICERS, DIRECTORS, AND KEY EMPLOYEES. AFTER THE SIGNED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED, THEY ARE REVIEWED BY THE CONTROLLER. ANY CONFLICTS OF INTEREST THAT ARE DISCLOSED ARE DISCUSSED WITH THE BOARD CHAIR, WHO ENSURES THAT THE INTERESTED PERSON ABSTAINS FROM VOTING ON MATTERS RELATED TO THE CONFLICT OF INTEREST.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aTHE EXECUTIVE BOARD REVIEWS AND DETERMINES THE COMPENSATION FOR THE CEO. THEY USE COMPENSATION SURVEYS CONDUCTED BY AN INDEPENDENT CONSULTING COMPANY IN THEIR DECISION MAKING PROCESS. THE DELIBERATION AND DISCUSSION REGARDING THE CEO'S COMPENSATION IS INCLUDED IN THE BOARD MINUTES. THIS PROCESS IS COMPLETED FOR WAYNE DESCHAMBEAU, CEO AND WAS LAST UNDERTAKEN IN 2010.
Public DisclosureForm 990, Part VI, Section C, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
Other changes in net assets or fund balancesForm 990, Part XI, Line 5NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -2990345; CHANGE IN VALUE OF INTEREST RATE SWAP - -121322; CHANGE IN INTEREST OF RELATED ENTITIES - 55170; LOSS ON DISPOSITION OF DEFERRED FINANCING COSTS - -3000632;

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1WAYNE HOSPITAL COMPANY PROFESSIONAL SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
EIN270581440EIN
Primary ActivitiesPROFESSIONAL MEDICAL SERVICESPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Total Income-2171023TotalIncome
EOY Assets-1564155EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE WAYNE HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
EIN260380696EIN
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11 - Type IPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTHWAY INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 SWEITZER STREETAddressLine1
CityGREENVILLECity
StateOHState
ZIP Code45331ZIPCode
FieldValueIRS element (for citing)
EIN311497938EIN
Primary ActivityPROVIDER NETWORKPrimaryActivity
Legal Domicile StateOHLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPORATIONTypeOfEntity
Share Of Total Income662ShareOfTotalIncome
Share Of EOY Assets26911ShareOfEOYAssets
Percentage Ownership1PercentageOwnership
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 OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg