2011-11-14T09:28:45-08:00 2010-12-31 CLARK SCHAEFER HACKETT & CO KETTERING TOWER SUITE 800 DAYTON OH 45423 990 2010-01-01 310564121 DAYTON OSTEOPATHIC HOSPITAL DAYT 9373844550 2110 LEITER ROAD MIAMISBURG OH 45342 CLIFTON PATTEN 9373844550 2011-10-10 HERBERT L LEMASTER CPA 9372260070 2010 2016-03-07 17:11:31Z RICHARD HAAS 2110 LEITER ROAD MIAMISBURG OH 45342 301421100 false X www.khnetwork.org X 1939 OH To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner 9 6 2296 300 73539 2593108 1593952 289309135 297072065 178748 854316 948727 130155 293029718 299650488 0 0 117063776 122320751 0 0 163853228 159419024 280917004 281739775 12112714 17910713 240495290 249894228 203201020 203519078 37294270 46375150 To provide quality healthcare to false false 240150452 297072065 GRANDVIEW HOSPITAL, SOUTHVIEW HOSPITAL, AND OTHER PATIENT CARE RELATED SERVICES 240150452 true true false false false true false false false true false false true true true true true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false true false true 0 0 2296 true true true false false false false false false false false false X 9 6 false false false false false false false true true false false true true true true true true true true true true X X CLIFTON PATTEN 9373844550 2110 LEITER ROAD MIAMISBURG OH 45342 FRED MANCHUR 1.00 X 0 1328552 223838 FRANK PEREZ 1.00 X 0 1123298 31192 RICHARD HAAS 40.00 X X 0 525707 108242 DAVE WEIGLEY 1.00 X 0 0 0 KENNETH PUGAR DO 1.00 X 0 0 0 JOHN SEFTON DO 1.00 X 0 0 0 SHEILA BURTON 1.00 X 0 0 0 GAYLE JOHNSON 1.00 X 0 0 0 J BRADFORD GAMBLIN 1.00 X 0 0 0 PETER KING 40.00 X 0 375563 68999 LINDA MCCALL 40.00 X 171272 0 13400 RITA PRICHARD 40.00 X 154120 0 19541 GEORGE HARRITOS 40.00 X 153195 0 19340 DENNIS MITTLEIDER 40.00 X 150087 0 22656 KEVIN GRETH 40.00 X 148916 0 10849 777590 3353120 518057 42 false true false 0 1535014 58938 1593952 Patient care services 900099 297072065 73539 1460178 297072065 385277 385277 344891 344891 295423 1599337 1770612 295423 -171275 124148 124148 INTERCOMPANY INVESTMENT INCOME ALLOCATION 523000 130155 130155 130155 299650488 295538348 73539 2444649 97226712 84377907 12848805 0 4316889 3746399 570490 0 14243967 12361583 1882384 0 6533183 5669803 863380 0 4630888 0 4630888 0 310786 11419 299367 0 5000 5000 0 0 52411 0 52411 0 42449866 32928133 9521733 0 544192 133210 410982 0 52832046 52559952 272094 0 4375848 287340 4088508 0 4033655 3400722 632933 0 310975 273741 37234 0 129766 117041 12725 0 6906444 5822732 1083712 0 15764024 13290442 2473582 0 2820521 2809714 10807 0 Bad debt 9968326 9958217 10109 0 Cost of goods sold 5069911 5069911 0 0 Hospital assessment 2738101 2738101 0 0 Intercompany allocations 1804290 1703410 100880 0 Minor equipment 1590644 1588542 2102 0 3081330 1297133 1784197 0 281739775 240150452 41589323 0 704668 1045995 104151 72278 32847996 44982216 312586 5190910 5241534 2840374 715599 270105906 105473325 164139525 164632581 28772455 26964064 2904714 2904714 2990497 3022661 240495290 249894228 18442278 20404586 673572 449048 106802221 102450995 516402 17538838 15645538 59744111 64052509 203201020 203519078 X 36943156 46164481 351114 210669 37294270 46375150 240495290 249894228 X 17910713 -8829833 X X false true true X false X 0 0 0 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 1.5 0 1 true 20 2390 false 14952024 14952024 1600000 153070603 49706120 104964483 18020615 5000480 13020135 67155411 50766725 16388686 15307253 15307253 164632581 Physician LOC 1297758 Unamortized long-term debt issuance costs 1724903 3022661 Accrued pension liability 12030038 Due to affiliate 132445 Estimated amounts due to third-party payors 4377672 Physician income guarantee commitments 71043 Professional self-insurance liability 9116226 Synthetic lease obligations 38325085 64052509 299650488 281739775 17910713 421999 -9251832 -8829833 9080880 299059000 -19582 1166902 1147320 297911680 1738808 1738808 299650488 289977000 7515757 7515757 282461243 -721468 -721468 281739775 Pt II Line 5 KHN does have a policy on conservation easements. Pt II Line 9 The expense to monitor the conservation easement is recorded as incurred to the hospital. There is no income from the easement and no asset is recorded. Pt X The Network completed an analysis of its tax positions in accordance with applicable accounting guidance at December 31, 2010 and 2009, and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2010 or 2009. Pt XI Line 8 Net transfers to affiliate (7,534,887) Pt XI Line 8 Change in plan assets and benefit obligation of pension plan (1,716,946) Rounding 1 Pt XII Line 2d Investment management fees (38,162) Support allocation 759,970 Net assets released from restrictions for capital 222,547 Contributions and investment income from restricted investments 222,547 Pt XII Line 4b Audit rounding (782) Contributions 1,535,014 Loss on disposal of assets (118,096) Nonoperating allocation 322,671 Rounding 1 Pt XIII Line 2d Contributions (1,535,014) Loss on disposal of assets 118,096 Nonoperating allocation (322,671) Transfers for PP&E 222,547 Transfers to net assets (140,446) Net unrealized (gains)/losses on investments (441,581) Net transfers to affiliate 7,534,887 Change in plan assets and benefit obligation of pension plan 1,716,946 Net assets released from restrictions for capital 222,547 Net assets released from restrictions for operations 140,446 Pt XIII Line 4b Audit rounding 339 Investment management fees 38,162 Support allocation (759,970) Rounding 1 true true X true X true X true true true false true true 13660941 5740080 7920861 0.02910 36349264 30621574 5727690 0.02110 50010205 36361654 13648551 0.05020 566746 89897 476849 0.00180 12919940 6382394 6537546 0.02410 6743346 3740 6739606 0.02480 395058 395058 0.00150 20625090 6476031 14149059 0.05220 70635295 42837685 27797610 0.10240 true 2156845 51764 51156090 51339171 -183081 X true true GRANDVIEW ASSOCIATES Medical Office Building 0.92000 0.08000 SOUTHVIEW ORTHOPEDIC CENTER Medical Service Venture 0.51000 0.49000 2 1 GRANDVIEW MEDICAL CENTER

405 W GRAND AVENUE DAYTON OH 45405

X X X X 2 SOUTHVIEW MEDICAL CENTER

1997 MIAMISBURG CENTERVILLE CENTERVILLE OH 45459

X X X X 9 YANKEE MEDICAL CENTER

7677 YANKEE STREET CENTERVILLE OH 45459

Outpatient Clinic & Diag. Ctr BEAVERCREEK HEALTH CENTER

2510 COMMONS BLVD BEAVERCREEK OH 45431

Diagnostic Ctr & Rehab Clinic VICTOR J CASSANO HEALTH CTR

165 EDWIN C MOSES BLVD DAYTON OH 45402

Diagnostic Ctr CORWIN M NIXON HEALTH CTR

1470 N BROADWAY LEBANON OH 45036

Circulatory & Wound Ctr PREBLE COUNTY MEDICAL CTR

450-B WASHINGTON JACKSON RD EATON OH 45320

Outpatient Clinic & Diag. Ctr CORNERSTONE MEDICAL CTR

7740 WASHINGTON VILLAGE DR CENTERVILLE OH 45459

Outpatient Clinic & Diag. Ctr CHARLES H HUBER HEALTH CTR

8701 OLD TROY PIKE HUBER HEIGHTS OH 45424

Outpatient Clinic & Diag. Ctr GRANDVIEW CTR FOR CIRCULATORY & WOUND

TALBOTT TOWER 131 N LUDLOW ST DAYTON OH 45402

Outpatient Clinic & Diag. Ctr SUGARCREEK HEALTH CTR

6438 WILMINGTON PIKE DAYTON OH 45459

Outpatient Clinic & Diag. Ctr Pt I Line 3c The organization used FPG to determine eligibility for providing free or discounted care to individuals. Pt I Line 6a The organization provides an annual community benefit report that is made available to the public. Pt I Line 7 Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on the Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures. Pt I Line 7g Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers. Pt I Line 7 col (f) Bad Debt Expense included on Form 990, Part IX, line 25, Columns (A), but subtracted for purposes of calculating the percentage in this column is $9,968,326. Pt III Line 4 A cost to charge ratio was used to determine the amount reported in Part III, line 2. An industry average was used to compute the amount on line 3. Discounts and payments on patient accounts reduce bad debt expense. Text of footnote describing debt expense is as follows: "The Network records bad debt expense and the allowance for doubtful receivables based upon the historical experience of each acute-care facility adjusted for current environment risks and trends." Pt III Line 8 The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in Community Benefit in Part I. A reconciliation between Medicare program amounts reportable in Section B and the total Medicare program is below: Revenues Costs Surplus(Shortfall) Medicare Section B $51,156,090 $51,339,171 ($183,080) Other Programs $35,566,655 $33,868,986 $1,697,669 Total Programs $86,722,746 $85,208,157 $1,514,589 Other Medicare Programs include Medicare Part C and clinical laboratory and therapy services not reportable in the Medicare cost report. Pt III Line 9b Financial Counselors work out a payment program for any amount due after the Charity Sliding Scale Discounts are applied. Collection procedures consistent with self-pay accounts are applied to these balances. Pt V Each facility listed is required to be licensed, registered or recognized as a healthcare facility under state law. Pt VI Line 2 Grandview, being a Christian organization,is charged with providing health education and screenings to look after those who cannot otherwise afford to do so. Programs and support groups that helped community members included childbirth education, infant CPR, stroke support, diabetes education, first aid and more. These programs touched people from various age, gender and socio-economic groups. Pt VI Line 3 Grandview informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Grandview's charity care policy as follows: -Grandview has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department. -There is information posted in all of the admitting and registration areas about charity care and financial assistance. -During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This is done regardless of insured or uninsured status. This data is available for future visits as well. -Grandview has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance. -Grandview contracts with an outside agency for patient assistance in application process. -The back of the patient statement shows the current and prior year Federal Poverty Guidelines and has the Financial Assistance Form to complete and mail in for consideration for Grandview's HCAP or Charity Sliding Scale program. -Grandview's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs. Pt VI Line 4 KHN serves a population of 1,631,000 in its primary and secondary service area. The nine county service area includes Butler, Clark, Clinton, Darke, Greene, Miami, Montgomery,Preble and Warren counties. Out of this service area,11.2% of area residents have income below $15,000. 10.3% have income between $15,000 and $24,000 and 27.3% have income between $25,000 and $49,000. Portions of Darke and Montgomery counties have been identified as medically underserved by the Health Resources and Services Administration. This nine county area is served by 15 hospitals,7 of which are part of Kettering Health Network. Pt VI Line 5 Grandview furthers its exempt purpose by promoting the health of the community by: -Retaining a Board of Directors with a majority (excluding employees and contractors)living in the primary service area; -Extending medical staff privileges to all qualified physicians in its community for a majority of its departments; -Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most-advanced medical technology, upgrades of existing hospital structures and construction of new facilities in order to provide accessible, efficient, quality care. As a nationally-recognized osteopathic teaching hospital, Grandview partners with the Ohio University College of Osteopathic Medicine to enhance state-of-the-art medical education tools and programs. Medical research is supported through the Innovation Center, cultivating new technologies and fostering best practices among partners from industry, academia and healthcare. Pt VI Line 6 The following describes the respective roles of Grandview and its affiliates in promoting the health of the communities served by the system- -Grandview is dedicated to the creation and maintenance of community wellness programs, support groups and health education programs. Grandview provides numerous screenings, family-focused classes, health fairs, conferences, donations and education programs to ensure the long-term well-being of people living in the community. -Grandview is affiliated with the Ohio University College of Osteopathic Medicine. The teaching programs have been an integral part of Grandview's emergence as one of the nation's leading osteopathic hospitals for clinical quality. -The Grandview Foundation is the philanthropic arm of Grandview Medical Center and supports the education of future osteopathic physicians. -Kettering Affiliated Health Services, Inc includes Sycamore Glen Health Center, Sycamore Glen Retirement Community, and Kettering Breast Evaluation Centers. These health care areas provide services to the surrounding communities which complement those services provided by Grandview as part of the Kettering Health Network. -Medical research is supported through the Innovation Center, cultivating new technologies and fostering best practices among partners from industry, academia and healthcare. Pt VI Line 7 OH X X X X X X false true false false false false false false false FRED MANCHUR 771183 170029 387340 207055 16783 1552390 FRANK PEREZ 863128 222466 37704 13687 17505 1154490 RICHARD HAAS 412636 90000 23071 90722 17520 633949 PETER KING 307795 55159 12609 43242 25757 444562 LINDA MCCALL 143090 22688 5494 9277 4123 184672 RITA PRICHARD 129391 24729 8385 1115 163620 GEORGE HARRITOS 152687 508 8317 11023 172535 DENNIS MITTLEIDER 127362 17779 4946 8048 14608 172743 KEVIN GRETH 140096 8820 6493 4356 159765 Pt I Line 4b The Network has a Supplemental Executive Retirement Plan available only to a certain class of management. Part II Biii Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year P&L. COUNTY OF MONTGOMERY OHIO 316000172 613520KH7 2006-01-11 65073160 Advance refund 1999 bonds false false false COUNTY OF MONTGOMERY OHIO 316000172 613520KR5 2008-01-17 31630807 Construction of hospital addn false false false 2388343 81152914 63259805 488996 1309943 16094170 2006 33220193 176504 177652 752656 32113381 2010 true false true true false false true true true 0.00000 0.00000 0.00000 true false true false false false false Part I, Line B, Column (c): Also CUSIP # 613521KS3 Part II, Line 3, Column A: Includes transferred proceeds of $4,635,430 from 1999 bonds Part II, Line 3, Column A: Includes investment earnings of $11,444,324 Part II, Line 3, Column B: Includes investment earnings of $1,589,386 RICHARD MANCHUR Family member of Fred Manchur 91950 EMPLOYMENT false Pt VI-B, Line 11a A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board). Pt VI-B, Line 12c The Network regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review the Network's policy, sign a conflict of interest statement, and notify the Network if a conflict should arise. Pt VI-B, Line 15 The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. At year end the organization reviews executive compensation by comparing the amounts approved to the amounts paid. Pt VI-C, Line 19 The KHN Conflict of Interest policy is available on the KHN intranet. The organization's governing documents and financial statements are available upon request. Pt XI Line 5: Net unrealized gains on investments 421,999 Pt XI Line 5: Net transfers to affiliate (7,534,887) Pt XI Line 5: Change in plan assets and benefit obligation of pension plan (1,716,946) Pt XI Line 5: Rounding 1 Pt XII, Line 2c KHN has an audit committee that meets regularly throughout the year Form 990EZ, Part II, Line 24 ACCOUNTS RECEIVABLE - NET INVENTORIES PREPAIDS INVESTMENTS Form 990EZ, Part II, Line 26 ACCOUNTS PAYABLE & ACCRUED EXPENSES DEFERRED REVENUE BONDS, MORTGAGES & OTHER NOTES Form 990, Part IX, Line 24f MINOR MISCELLANEOUS EXPENSES 3081330. 1297133. 1784197. 0. to review issues that are brought to it by the internal auditor. This committee is also responsible for the financial audit. Schedule K, Part II, Line 1 Bond Issue A: Includes transferred proceeds from the 1999 Bonds that were partially advance refunded by the 2006 Bonds. Schedule K, Part II, Line 5 Bond Issue A: Of the $2,457,569 issuance costs from proceeds, $685,029 related to issuance costs and $1,782,540 related to credit enhancement fees. Bond Issue B: of the $5,900,788 issuance costs from proceeds, $1,431,723 related to issuance costs and $4,469,065 related to credit enhancement fees. Schedule K, Part II, Line 7 Bond Issue A: Listed $0 for capital expenditures because 2006 Bonds were solely for advance refunding purposes. Bond Issue B: Capital expenditures from proceeds reflects only the new portion of the 2008 Bonds and excludes the current refunding. Schedule K, Part II Line 8 Bond Issue B: As of December 31, 2009, the bond-financed project financed by the new money portion of the 2008 Bonds was approximately 70% completed. It is expected to be substantially completed by December 31, 2010. Bond Issue C: The bond-financed project is expected to be substantially completed by December 31, 2010. Schedule K, Part IV, Line 5 Bond Issue B: The available 3-year temporary period for the portion of the proceeds spent on capital projects has not expired. Bond Issue C: The available 3-year temporary period for the portion of the proceeds spent on capital projects has not expired. ALLIANCE PHYSICIANS INC 2110 LEITER ROAD MIAMISBURG OH 45342 311175717 PHYSICIAN SERVICES OH 501(c)(3) 509(a)(3) KETTERING ADVENTIST HEALTHCARE false BEAVERCREEK MEDICAL CENTER 2110 LEITER ROAD MIAMISBURG OH 45342 270712680 HOSPITAL OH 501(c)(3) 509(a)(1) KETTERING ADVENTIST HEALTHCARE false THE FORT HAMILTON HOSPITAL 2110 LEITER ROAD MIAMISBURG OH 45342 310536662 HOSPITAL OH 501(c)(3) 509(a)(1) KETTERING ADVENTIST HEALTHCARE false GRANDVIEW FOUNDATION 405 W GRAND AVE DAYTON OH 45405 311649591 FUNDRAISING OH 501(c)(3) 509(a)(3) NA false GREENE MEMORIAL HOSPITAL 2110 LEITER ROAD MIAMISBURG OH 45342 310809436 HOSPITAL OH 501(c)(3) 509(a)(1) KETTERING ADVENTIST HEALTHCARE false GREENE MEMORIAL HOSPITAL SERVICES INC 2110 LEITER ROAD MIAMISBURG OH 45342 311358549 PHYSICIAN SERVICES OH 501(c)(3) 509(a)(3) KETTERING ADVENTIST HEALTHCARE false KETTERING ADVENTIST HEALTHCARE 2110 LEITER ROAD MIAMISBURG OH 45342 311051688 MANAGEMENT OH 501(c)(3) 509(a)(3) NA false KETTERING AFFILIATED HEALTH SERVICES INC 2110 LEITER ROAD MIAMISBURG OH 45342 311127485 HEALTH SERVICES OH 501(c)(3) 509(a)(3) KETTERING ADVENTIST HEALTHCARE false KETTERING MEDICAL CENTER 2110 LEITER ROAD MIAMISBURG OH 45342 310621866 HOSPITAL OH 501(c)(3) 509(a)(1) KETTERING ADVENTIST HEALTHCARE false GRANDVIEW ASSOCIATES 405 GRAND AVE DAYTON OH 45405 311427280 BUILDING MANAGEMENT OH DAYTON OSTEOPATHIC HOSPITAL rel -35698 1441727 false true 0.92000 SOUTHVIEW ORTHOPEDIC CENTER MANAGEMENT 1997 MIAMISBURG-CENTERVILLE RD DAYTON OH 45459 262040203 MEDICAL SERVICES OH DAYTON OSTEOPATHIC HOSPITAL rel 2928024 901934 false true 0.51000 KETTCOR 2110 LEITER ROAD MIAMISBURG OH 45342 311078381 HEALTH SERVICES OH KETTERING ADVENTIST HEALTHCARE C 0.00000 false false true false false false false false false false false true true true true false false true KETTERING MEDICAL CENTER IS A CONDUIT THROUGH WHICH REVENUE l m n FMV IS RECEIVED AND EXPENSES ARE PAID GRANDVIEW FOUNDATION c 1535014 FMV