OHIOHEALTH CORPORATION: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- OHIOHEALTH CORPORATION (EIN 31-4446959)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-02-14
- IRS object ID
- 201140459349302009
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-14T17:28:43-06:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett & Foster PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1 |
| City | Charleston | City |
| State | WV | State |
| ZIP Code | 25329 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 314446959 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sheltering Arms Hospital Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SHEL | NameControl |
| Phone | 7405935551 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Hospital Drive | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kimberly Dettwiller | Name |
| Title | CFO | Title |
| Phone | 7405935551 | Phone |
| Date Signed | 2011-02-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Harry C Harless | Name |
| Phone | 3043460441 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'Bleness Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Larry Thornhill | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Hospital Drive | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 78445372 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.obleness.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1948 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | To operate an acute care hospital facility in Athens, Ohio. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 575 | TotalNbrEmployees |
| Total Nbr Volunteers | 227 | TotalNbrVolunteers |
| Total Gross UBI | 450094 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1340070 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 310757 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 385025 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 63595420 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 73449385 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 385398 | InvestmentIncomePriorYear |
| Investment Income Current Year | 647625 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7772932 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1811881 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 72064507 | TotalRevenuePriorYear |
| Total Revenue Current Year | 76293916 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 175956 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 34103117 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29823353 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 30000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 37584962 | OtherExpensePriorYear |
| Other Expenses Current Year | 41219934 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 71894035 | TotalExpensesPriorYear |
| Total Expenses Current Year | 71043287 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 170472 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5250629 | RevenuesLessExpensesCY |
| Total Assets BOY | 65489605 | TotalAssetsBOY |
| Total Assets EOY | 69420064 | TotalAssetsEOY |
| Total Liabilities BOY | 44033557 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 42951005 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21456048 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 26469059 | NetAssetsOrFundBalancesEOY |
| Mission Description | To operate an acute care hospital facility in Athens, Ohio for the citizens of Athens, Ohio and the surrounding communities and counties. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 63622228 | Expense |
| Revenue | 74288083 | Revenue |
| Description | Patient care provided included 9,601 inpatient days of care to 2,844 acute patients; 26,548 emergency room visits; 112,106 other outpatient visits; 1,504 inpatient and outpatient surgeries; and 603 births. Procedures and tests performed included 822,406 lab tests; 31,230 x-rays; 2,562 ultrasounds; 1,826 nuclear medicine scans; 8,108 CT scans; 179 cardiovascular catheterizations; 17,620 physical therapy modalities; 39,619 cardiopulmonary procedures; 2,072 MRI's and 10,175 EKG's. The hospital also sponsored or participated in various health fairs or health screenings throughout the community and surrounding areas. Charges foregone for charity amounted to $6,805,291. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 306010 | Expense |
| Revenue | 453925 | Revenue |
| Description | The O'Bleness Wound Care Center was opened in March 2010 in response to a growing need for local treatment of difficult wounds, in part due to the very high incidence of diabetes in the area. In certain cases, the center includes hyperbaric oxygen therapy as part of the treatment provided. The center is the only location in Southeastern Ohio offering this specific type of therapy. It therefore serves as a local convenience for those patients requiring daily treatments that would otherwise be forced to commute long distances on a frequent basis. The center served 175 patients during March 2010 - June 2010. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 63928238 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 171 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 575 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kimberly Dettwiller | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7405929298 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Hospital Drive | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Clifford Young | ||||||||
| Interim CEO | 40.00 | X | X | 145297 | 0 | 19226 | ||
| James Riestenberg | ||||||||
| Chair | 2.00 | X | 0 | 0 | 0 | |||
| Bick Weissenrieder | ||||||||
| Vice-Chair | 2.00 | X | 0 | 0 | 0 | |||
| Robert Norris | ||||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | |||
| Susan Quinn | ||||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | |||
| Greg Blower | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Shelley Conrath | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Larry Corrigan | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Ray Karr | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Valarie Kinnard | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Gerald Rubin | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Steven Sloan | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael Sostarich | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Michael Clark | ||||||||
| Director | 2.00 | X | 250179 | 0 | 7350 | |||
| Kimberly Dettwiller | ||||||||
| CFO | 40.00 | X | 96361 | 0 | 29338 | |||
| Amy Beech | ||||||||
| VP Nursing | 40.00 | 109325 | 0 | 10181 | X | |||
| Sandra Leasure | ||||||||
| Sr. VP of HR | 40.00 | 124238 | 0 | 18490 | X | |||
| Herbert Carson | ||||||||
| Pharmacist | 40.00 | 116965 | 0 | 10170 | X | |||
| Richard Castrop | ||||||||
| Former CEO | 0.00 | 257959 | 0 | 26786 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1100324 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 121541 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Radiology Associates | |||||
| PO Box 2608 | Athens | OH | 45701 | Radiology | 1088198 |
| American Healthcare Solutions | |||||
| 1701 Kenneth Ave | Arnold | PA | 15068 | Interim CEO/Management | 678328 |
| Malone Medical Anesthesiology | |||||
| 227 1/2 West Union St | Athens | OH | 45701 | Anesthesiology | 658140 |
| Ohio University | |||||
| HDL Center 280 | Athens | OH | 45701 | Directorships | 606749 |
| Emergency Professionals | |||||
| PO Box 634850 | Cincinnati | OH | 452634850 | Hospitalists | 568193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 32 | NumberOfContractorsGT100K |
| All Other Contributions | 385025 | AllOtherContributions |
| Total Contributions | 385025 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient services | 622110 | 73381778 | 73381778 |
| Rent-Appalachian Commu | 631110 | 67607 | 67607 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 73449385 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 191840 | TotalRevenueColumn |
| Exclusion | $191,840 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1259293 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1173824 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 85469 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 85469 | TotalRevenueColumn |
| Exclusion | $85,469 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1433417 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 977632 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 455785 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 455785 | TotalRevenueColumn |
| Unrelated Business Revenue | 16305 | UnrelatedBusinessRevenue |
| Exclusion | $439,480 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Pharmacy | 561000 | 342101 | 342101 | |
| From K-1: Athens Medi | 621500 | 256132 | 256132 | |
| Cafeteria | 722210 | 243310 | 243310 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 884869 | TotalRevenueColumn |
| Related Or Exempt Function Income | 707212 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 177657 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1726412 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76293916 | TotalRevenueColumn |
| Related Or Exempt Function Income | 74742008 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 450094 | UnrelatedBusinessRevenue |
| Exclusion | $716,789 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 602116 | Total |
| Program Services | 539496 | ProgramServices |
| Management And General | 62620 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21038005 | Total |
| Program Services | 18850052 | ProgramServices |
| Management And General | 2187953 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1154988 | Total |
| Program Services | 1034869 | ProgramServices |
| Management And General | 120119 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5086792 | Total |
| Program Services | 4557766 | ProgramServices |
| Management And General | 529026 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1941452 | Total |
| Program Services | 1739541 | ProgramServices |
| Management And General | 201911 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 403699 | Total |
| Program Services | 361714 | ProgramServices |
| Management And General | 41985 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 387907 | Total |
| Management And General | 387907 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223474 | Total |
| Management And General | 223474 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8246 | Total |
| Management And General | 8246 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9328195 | Total |
| Program Services | 8358063 | ProgramServices |
| Management And General | 970132 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 184953 | Total |
| Program Services | 165718 | ProgramServices |
| Management And General | 19235 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11074832 | Total |
| Program Services | 9923049 | ProgramServices |
| Management And General | 1151783 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155713 | Total |
| Program Services | 139519 | ProgramServices |
| Management And General | 16194 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1235267 | Total |
| Program Services | 1106799 | ProgramServices |
| Management And General | 128468 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112415 | Total |
| Program Services | 100724 | ProgramServices |
| Management And General | 11691 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31364 | Total |
| Program Services | 28102 | ProgramServices |
| Management And General | 3262 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2262300 | Total |
| Program Services | 2027021 | ProgramServices |
| Management And General | 235279 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3869505 | Total |
| Program Services | 3467076 | ProgramServices |
| Management And General | 402429 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1925408 | Total |
| Program Services | 1725166 | ProgramServices |
| Management And General | 200242 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 6698317 | 6698317 | |
| Repairs & Maintenance | 1356472 | 1215399 | 141073 |
| HCAP & State hospital t | 1298718 | 1298718 | |
| Property taxes | 163378 | 146387 | 16991 |
| Dues & subscriptions | 116441 | 104331 | 12110 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 383330 | Total |
| Program Services | 340411 | ProgramServices |
| Management And General | 42919 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71043287 | Total |
| Program Services | 63928238 | ProgramServices |
| Management And General | 7115049 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 244560 | BOY |
| EOY | 780975 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2343585 | BOY |
| EOY | 17756071 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191911 | BOY |
| EOY | 176636 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11508669 | BOY |
| EOY | 9951468 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 776835 | BOY |
| EOY | 818262 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 867208 | BOY |
| EOY | 1023605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 78994571 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 46259998 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35284367 | BOY |
| EOY | 32734573 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2620271 | BOY |
| EOY | 3403323 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9082658 | BOY |
| EOY | 691205 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2569541 | BOY |
| EOY | 2083946 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65489605 | BOY |
| EOY | 69420064 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7800320 | BOY |
| EOY | 7248688 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29345000 | BOY |
| EOY | 28905000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1422596 | BOY |
| EOY | 1893163 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5465641 | BOY |
| EOY | 4904154 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44033557 | BOY |
| EOY | 42951005 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20654269 | BOY |
| EOY | 25682555 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191911 | BOY |
| EOY | 176636 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 609868 | BOY |
| EOY | 609868 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21456048 | BOY |
| EOY | 26469059 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65489605 | BOY |
| EOY | 69420064 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $1,136 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1136 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | Lobbying expenses relate to the portion of dues paid to the Ohio Hospital Association which is used for lobbying. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 801779 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -15275 | InvestmentEarningsOrLosses |
| End Of Year Balance | 786504 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 663242 | BeginningOfYearBalance |
| Contributions | 138537 | Contributions |
| End Of Year Balance | 801779 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.22460 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.77540 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2389777 | OtherCostOrOtherBasis |
| Book Value | 2389777 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27951497 | OtherCostOrOtherBasis |
| Depreciation | 14947779 | Depreciation |
| Book Value | 13003718 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 40622385 | OtherCostOrOtherBasis |
| Depreciation | 29178948 | Depreciation |
| Book Value | 11443437 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8030912 | OtherCostOrOtherBasis |
| Depreciation | 2133271 | Depreciation |
| Book Value | 5897641 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 32734573 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Leased property deposits | $4,335,332 |
| Investment-Athens Surgery Center Ltd.: 58% owned | $404,651 |
| Capital lease | $164,171 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4904154 | TotalOfAmounts |
| Total Revenue | 76293916 | TotalRevenue |
| Total Expenses | 71043287 | TotalExpenses |
| Excess Or Deficit For Year | 5250629 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 185409 | NetUnrealizedGLOnInvestments |
| Other | -$423,027 | OtherAmount |
| Total Adjustments | -237618 | TotalAdjustments |
| Excess Or Deficit Per FS | 5013011 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 76924585 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1252927 | OtherRevenues |
| Revenue Not Rptd F990 | 1252927 | RevenueNotRptdF990 |
| Revenue Subtotal | 75671658 | RevenueSubtotal |
| Other Revenues Not Included | 622258 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 622258 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 76293916 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 72061448 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1173832 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1173832 | ExpensesNotRptdF990 |
| Expenses Subtotal | 70887616 | ExpensesSubtotal |
| Other Expenses Not Included | 155671 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 155671 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 71043287 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | K-1 income/loss from investments: -422369. Changes in pledges receivable: -15275. Equity method income (loss) of subsidiaries: -20268. Income per books - Access Health Athens: 34885. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses: 1173824. From K-1: The Drugstore at O'Bleness LLC-Loss: 44218. From K-1: Access Health Athens LLC: 34885. |
| Part XII, Line 4b - Other Adjustments: | From K-1: Access Health Athens LLC: 16573. Federal Income Tax Refunds: 155671. From K-1: Access Surgery Center, LTD: 193882. From K-1: Athens Medical Laboratory Assoc.: 256132. |
| Part XIII, Line 2d - Other Adjustments: | Rental Expenses: 1173824. Rounding: 8. |
| Part XIII, Line 4b - Other Adjustments: | Income Tax refunds netted against expenses on Form 990: 155671. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3660930 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1995741 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1665189 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02560 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10795459 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6228401 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4567058 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14456389 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8224142 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6232247 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09580 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9888 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 55 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9833 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 675219 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 675219 | DirectOffsettingRevenue |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 685107 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 675274 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9833 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15141496 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8899416 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6242080 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09600 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,748,184 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 14468572 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13869670 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 598902 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'Bleness Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Hospital Dr | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: The hospital has more than one policy concerning free or discounted care.O'Bleness Memorial Hospital will offer and provide free care to any patient who meets the eligibility requirement for free care under the OCAP or HCAP financial assistance policies.The following steps will be used to determine eligibility for free care under OCAP (O'Bleness Care Assurance Program):1. A recipient of the Ohio Medicaid Program is not eligible. (OAC Rule 5 10 1 :3-2-07.17)2. If the patient is covered under a third-party insurer or a governmental program, the third party will be billed and any payment received will be applied to the account first. Any balance on the account will be considered for the OCAP write-off.3. OCAP assistance will be approved only when services are provided by O'Bleness Memorial Hospital. These services also include anesthesia professional fees, physician interpretation fees for cardiopulmonary services, and services provided in the O'Bleness Family Practice Clinic.4. Family income is between 100 to 150% of the federal poverty guidelines.FAMILY: Family shall be defined as the patient, the patient's spouse, and all of the patient's children, natural and adoptive under the age of eighteen who live at home. If the patient is under the age of eighteen the family shall include the patient, the patient's natural or adoptive parent(s) and the parent(s) children, natural or adoptive under the age of eighteen who live in the home. If the patient is a child of a minor parent who still resides in the home of the patient's grandparents, the family shall include only the parent(s) and any of the parent(s) natural or adoptive children who reside in the home. INCOME: Income shall be defined as the total salaries, wages and cash receipts before taxes: receipts that reflect reasonable deduction for business expenses shall be counted for both farm and non-farm self-employment.The following steps will be used to determine eligibility for free care under HCAP (Hospital Care Assurance Program):1. A completed application will be obtained from all patients seeking free care under HCAP.2. A patient must be a resident of the state of Ohio to be eligible for HCAP.3. O'Bleness Memorial Hospital will define income requirements using the Federal Poverty Guidelines as indicated yearly.4. O'Bleness Memorial Hospital will define a family as indicated in Baldwin's Ohio Administrative Code Chapter 5101:3-2-0717.5. The income provided by the applicant will be verified via sworn signature.6. A recipient of the Ohio Medicaid program is not eligible (OAC Rule:5101:3-2-0717)If a patient has insurance coverage, O'Bleness Memorial Hospital will first bill the insurance and receive a payment or a denial before the HCAP application is processed. | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: The cost of charity care, unreimbursed Medicaid and other means-tested government programs was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.Costing Methodology used to determine the cost of community health improvement services and community benefit operations. The Hospital uses the computer software CBISA to track our programs that happen in the community or at the hospital for the community. The computer tracks direct expenses associated with the programs as well as any offsetting revenue that will decrease the community benefit. The system accounts for utilities used if the activity occurs at the facility (hospital). The system also accounts for any supplies used and the wages of any employee that is present at the activity. A hospital wide wage average is used in determining the amount of salary to use in the direct expenses. An attachment of the form available to our employees to account for a benefit has been added also. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Patient accounts receivables are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivables are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.The cost of bad debt expense was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Patients known to qualify for charity care or financial assistance are asked to fill out the paperwork associated with the programs we have available to patients with low income. Policies concerning the two programs has been attached. (OCAP, HCAP) We do not have a collections process for charity care patients and the full amount is written off to the associated program. This does not apply to patients that do not qualify for either of the programs. If it is determined that the patient is capable of paying for their medical care then at that point they are charged for the services. If failure to pay their medical bills occurs, at that point collection practices ensue. After a chance to pay their bill at a reduced price, they are reminded until ultimately debt collections. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: The hospital does not currently have an established assessment of the health needs of the communities it serves. However, in order to be compliant with future healthcare legislation, we are currently exploring options on how to best assess our communities and their health needs. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: The hospital informs patients of their eligibility for assistance in different ways. There is a sign in the admitting area that directs their attention to the fact that there is availiable care at a reduced fee or free of charge. On each data mailer that is sent out to patients, there is a section that informs them of the availability of this care. Any patient that comes in without insurance or proof of insurance is supplied a self-pay packet. In this packet is an outline on how to obtain free or discounted care; the packet also details the parameters of each program. If any of our employees are asked in admissions or during their care if there are any options available for payment of their care, the employees will describe to the patients the programs available or provide them with materials on how to apply and be accepted into the free or discounted care programs. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: O'Bleness Memorial Hospital is a community hospital in a rural area of Appalachia. Our primary service area includes the communities within Athens County, Ohio, which has been identified by the Appalachian Regional Commission as an ARC-Designated Distressed County. According to the United States Census Bureau, the population of Athens County in 2009 was 63,073. The average income of $30,190 is not truly representative of the population, as the community includes a major university. Athens County has the highest poverty level of any county in Ohio, as 32.8% of community residents have incomes at or below the federal poverty guideline. Uninsured individuals in Athens County represent 18.8% of the population. The hospital's patient population includes 8.69% who are uninsured and 22% who are Medicaid recipients. Located within O'Bleness' primary service area of Athens County is one additional hospital, Doctors Hospital of Nelsonville affiliated with OhioHealth based in Columbus, Ohio. Portions of the patient population are also served by eight other hospitals in Washington, Gallia, Jackson, Hocking, Fairfield and Ross counties in Ohio and Wood County in West Virginia, as well as three major health systems with multiple facilities in Franklin County, Ohio. Three townships in Athens County have been designated as Medically Underserved Areas/Populations by the U.S. Department of Health and Human Services: Lodi, Waterloo and Trimble. | CommunityInformation |
| Other Information | Part VI, Line 6: At O'Bleness Memorial Hospital it is our goal to give access to any person in our community to modern day healthcare at a cost effective price. As the only hospital in Athens, we strive to give help where help is needed. To further our commitment to the community and our exempt purpose we engage in many activities. Our board is compiled of people who reside in our community without a conflict of interest with the hospital. We believe the more diverse the board, the better they will be able to identify the needs of the community. They have no connection to the organization nor are contracted with the hospital. They provide their consult and guidance out of the pure desire to see their community be afforded the same quality of care as bigger markets. We extend medical privileges to qualified physicians that have a desire to practice within our facilities. We continue to search for programs and activities that will be new to the community in order to give the population variety and health oriented alternatives. Funds are used to purchase capital equipment that is vital in keeping up with an ever evolving medical world. It is also used to fund activities inside and outside of the hospital that involves the community on various levels whether it be a health fair or an interactive exercise program. We have many volunteers from the community that are instrumental in carrying out various activities. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: The O'Bleness Health System is designed to offer the most comprehensive medical attention in a mainly centralized location to the community in which we live. The affiliates of the system work together in a collaborative effort to increase the efficiency and cost of healthcare to the patient. The O'Bleness Memorial Hospital is the main component of the health system. At the hospital we offer a variety of inpatient and outpatient services. The Emergency Department is operational 24 hours a day 7 days a week. We offer care to anyone regardless of ability to pay. We are the only fully functional hospital in the community. It is our goal not to exclude anyone from our community that is in need of care. The Athens Medical Lab (AML) is an affiliate of the system that is a medical reference lab that offers convenience and cost efficiency for the patient. This allows us to keep patients close to home and speed up result time. The Athens Medical Associates (AMA) is a multi physician practice that offers a variety of services to patients. AMA is comprised of a multifaceted OB/GYN practice, an orthopedic surgeon, and a Family Practice clinic that serves numerous members of the community. There is also the ACVNAHHS (Appalachian Community Visiting Nurses Association, Hospice and Health Services). This affiliate provides hospice services to not only Athens County but surrounding counties. They are also providers of visiting nurses that serve our clients out of the comfort of their own home. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Clifford Young | |||||||||||||
| 145297 | 0 | 0 | 0 | 0 | 0 | 11269 | 0 | 9363 | 0 | 165929 | 0 | 0 | 0 |
| Michael Clark | |||||||||||||
| 250179 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 24 | 0 | 257553 | 0 | 0 | 0 |
| Richard Castrop | |||||||||||||
| 257959 | 0 | 0 | 0 | 0 | 0 | 11250 | 0 | 16941 | 0 | 286150 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4a | ReturnReference |
| Explanation | Richard Castrop received a severance payment for $207,321. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | County of Athens Ohio | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 316400063 | IssuerEIN |
| CUSIP Number | 047075BA3 | CUSIPNumber |
| Date Issued | 2003-08-21 | DateIssued |
| Issue Price | 31263724 | IssuePrice |
| Description Of Purpose | Bond refunding, hospital construction & renovation | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 31263724 | TotalProceeds |
| Amount In Reserve Fund | 2936689 | AmountInReserveFund |
| Issuance Costs From Proceeds | 625274 | IssuanceCostsFromProceeds |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 2 | New Program Services | The O'Bleness Wound Care Center was opened in March 2010 in response to a growing need for local treatment of difficult wounds, in part due to the very high incidence of diabetes in the area. In certain cases, the center includes hyperbaric oxygen therapy as part of the treatment provided. The center is the only location in Southeastern Ohio offering this specific type of therapy. It therefore serves as a local convenience for those patients requiring daily treatments that would otherwise be forced to commute long distances on a frequent basis. The center served 175 patients during March 2010 - June 2010. |
| Form 990, Part VI, Section A, line 3 | Sheltering Arms Hospital Foundation Inc. entered into a management agreement with OhioHealth Hospital Management Services, LLC, an Ohio nonprofit limited liability company, effective August 1, 2010 for a five year term. OhioHealth Hospital Management Services, LLC is a wholly owned subsidiary of OhioHealth Corporation, an Ohio nonprofit corporation that is exempt from federal income tax under Section 501(c)(3) of the IRS. Prior to this agreement, Sheltering Arms Hospital Foundation, Inc. had entered into a management agreement with American Healthcare Solutions for Interim Management Services beginning October 14, 2008 through May 19, 2010. | |
| Form 990, Part VI, Section B, line 11 | Vice President of Finance reviews the Form 990 throughout the preparation process as well as conducting a final review of Form 990 prior to filing. The final version of the Form 990 is presented to the Board of Directors to review. | |
| Form 990, Part VI, Section B, line 12c | All officers and directors annually disclose interests that could give rise to conflicts. | |
| Form 990, Part VI, Section B, line 15a | Compensation of the executive director is determined by a compensation committee with the full board's approval. | |
| Form 990, Part VI, Section C, line 18 | O'Bleness Memorial Hospital makes its Form 1023, Form 990 and Form 990-T available for public inspection upon request. Its Form 990 is also available at the Guidestar.org website. | |
| Form 990, Part VI, Section C, line 19 | O'Bleness Memorial Hospital makes its governing documents, conflict of interest policy, and financial statements available in hardcopy upon request. | |
| Form 990, Part XI, Line 2c | Audit oversight | There was no change in the oversight of the audit versus prior year. |
| Form 990, Line 6 | Volunteers | O'Bleness had 83 community volunteers, 138 college students and 6 junior volunteers during fiscal year 2010. Total wage value according to the Bureau of Labor Statistics- $497,940 (based on non-farm labor plus benefits). |
| Schedule D, Part X, Line 2 | Fin 48 Footnote | There was no Fin 48 footnote included on the financial statements of the organization. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Athens Medical Associates LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Hospital Dr | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020734615 | EIN |
| Primary Activities | Physician services | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Total Income | -1551984 | TotalIncome |
| EOY Assets | 1146560 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Athens Surgery Center Ltd | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 75 Hospital Dr | AddressLine1 |
| City | Athens | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550840856 | EIN |
| Primary Activity | Outpatient surgery | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | Related | PredominantIncomeType |
| Share Of Total Income | 127085 | ShareOfTotalIncome |
| Share Of EOY Assets | 341912 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Athens Medical Laboratory Associates Inc | |||||||||||
| 400 E State Street | Athens | OH | 45701 | 311381808 | Medical laboratory | OH | N/A | S | 256132 | 731094 | 1.00000 |
| The Drugstore at O'Bleness LLC | |||||||||||
| 55 Hospital Dr | Athens | OH | 45701 | 030598042 | Drugstore | OH | N/A | S | -44218 | 1.00000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Comments