2024-10-28T14:45:37-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 1785 INDIAN WOOD CIRCLE MAUMEE OH 43537 990 2023-01-01 341116795 HOSPITAL COUNCIL OF NORTHWEST OHIO HOSP 4198420800 3231 CENTRAL PARK WEST 200 TOLEDO OH 43617 PAM JENSEN PRESIDENT 4198420800 2024-10-24 1 1 CAITLIN BAINTER P01985124 4197942000 2024-10-22 2023 2024-10-15 13:58:12Z PAM JENSEN 3231 CENTRAL PARK WEST 200 TOLEDO OH 43617 7736796 0 X WWW.HCNO.ORG X 1973 OH THE HOSPITAL COUNCIL OF NORTHWEST OHIO IS A MEMBER DRIVEN ORGANIZATION THAT REPRESENTS AND ADVOCATES ON BEHALF OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS AND PROVIDES COLLABORATIVE OPPORTUNITIES TO ENHANCE THE HEALTH STATUS OF THE CITIZENS OF NORTHWEST OHIO. THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 23 22 59 71 0 0 4684751 4607060 2882179 2940436 11674 149324 62981 39976 7641585 7736796 2694501 3487664 0 0 3442681 3528330 0 0 0 1168060 1002107 7305242 8018101 336343 -281305 7102177 7018785 1198075 1395988 5904102 5622797 X THE HOSPITAL COUNCIL OF NORTHWEST OHIO IS A MEMBER DRIVEN ORGANIZATION THAT REPRESENTS AND ADVOCATES ON BEHALF OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS AND PROVIDES COLLABORATIVE OPPORTUNITIES TO ENHANCE THE HEALTH STATUS OF THE CITIZENS OF NORTHWEST OHIO. SEE SCHEDULE O THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 0 0 7338426 3487664 2980412 -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS.-DEVELOPING, IMPLEMENTING, AND SECURING FUNDING FOR CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS.-PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 7338426 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 83 0 1 59 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 22 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X KIM TEMPLE 4198420800 3231 CENTRAL PARK WEST TOLEDO OH 43617 PAM JENSEN PRESIDENT & CEO 40.00 0.00 X X 162748 0 30382 JEFFREY DEMPSEY CHAIRMAN 1.00 0.00 X X 0 0 0 NICK MARSICO SECRETARY 1.00 0.00 X X 0 0 0 BRENT BURKEY CHAIRMAN ELECT 1.00 0.00 X X 0 0 0 PATRICIA FINN IMMEDIATE PAST CHAIR 1.00 0.00 X X 0 0 0 MYRON LEWIS TRUSTEE 1.00 0.00 X 0 0 0 CHAD TINKEL TRUSTEE 1.00 0.00 X 0 0 0 JEREMY NORMINGTON - SLAY DPT TRUSTEE 1.00 0.00 X 0 0 0 KRISTI BARND TRUSTEE 1.00 0.00 X 0 0 0 SONYA SELHORST TRUSTEE 1.00 0.00 X 0 0 0 CRAIG ALBERS TRUSTEE 1.00 0.00 X 0 0 0 RON GOEDDE TRUSTEE 1.00 0.00 X 0 0 0 THADIUS WADSWORTH TRUSTEE 1.00 0.00 X 0 0 0 KEITH BURMEISTER TRUSTEE 1.00 0.00 X 0 0 0 DARRELL WACHOWIAK TRUSTEE 1.00 0.00 X 0 0 0 JODI RUCKER TRUSTEE 1.00 0.00 X 0 0 0 DAWN BUSKEY TRUSTEE, TREASURER - MARCH 2023 1.00 0.00 X X 0 0 0 TIM BUIT TRUSTEE 1.00 0.00 X 0 0 0 RICHARD SWAINE TRUSTEE 1.00 0.00 X 0 0 0 STANLEY KORDUCKI TRUSTEE 1.00 0.00 X 0 0 0 TY SHAULL TRUSTEE 1.00 0.00 X 0 0 0 ANDREA GWYN TRUSTEE 1.00 0.00 X 0 0 0 ANDREW MORGAN TRUSTEE 1.00 0.00 X 0 0 0 KIMBERLY TEMPLE CONTROLLER & FISCAL OFFICER 40.00 0.00 X 154369 0 74970 CHRISTINE RICHMOND DIRECTOR 40.00 0.00 X 119152 0 21735 CAROLYN TRUMBULL NOSS PROGRAM & SERVICES DIRECTOR 40.00 0.00 X 117162 0 47464 JULIE GRASSON DIRECTOR 40.00 0.00 X 104591 0 41806 AMY HURLEY DIRECTOR 40.00 0.00 X 101577 0 42829 759599 0 259186 6 0 1 0 0 79595 3113736 1413729 4607060 CONTRACT INCOME 900099 2718311 2718311 MEMBERSHIP DUES 900099 222125 222125 2940436 149324 149324 39976 39976 39976 7736796 2980412 0 149324 3438157 3438157 49507 49507 422470 377924 44546 2217606 1983778 233828 153706 136526 17180 527278 468227 59051 207270 177417 29853 19135 19135 43210 43210 272139 174682 97457 12177 11766 411 153698 64430 89268 143985 127052 16933 87085 76394 10691 55850 51235 4615 17045 10878 6167 4813 4813 27634 24200 3434 PROGRAM EXPENSE 122692 122692 BAD DEBT EXPENSE 19864 19864 TRAINING 13180 12468 712 ORG DUES AND MEMBERSHIP 6139 5034 1105 3461 1382 2079 8018101 7338426 679675 0 6106599 2338532 245766 642162 970078 187031 233532 10653 7166 93212 56775 41250 36437 3001369 114482 185905 7102177 7018785 481544 738814 348354 233277 89325 42109 278852 381788 1198075 1395988 X 5195191 5345504 708911 277293 5904102 5622797 7102177 7018785 -281305 0 X X 0 1 X 1 1 1 X 3100552 4087393 3796111 4684751 4607060 20275867 3100552 4087393 3796111 4684751 4607060 20275867 20275867 51351 38861 11749 11674 149324 262959 22668 34206 50925 62981 39976 210756 20749582 16862686 0.97720 0.98240 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: REIMBURSEMENT INCOME - 2019 AMOUNT: $ 22,512. 2020 AMOUNT: $ 15,629. 2021 AMOUNT: $ 50,925. 2022 AMOUNT: $ 62,981. 2023 AMOUNT: $ 39,976. REFUNDS REBATES - 2020 AMOUNT: $ 18,577. MISCELLANEOUS - 2019 AMOUNT: $ 156. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 86686 50249 36437 6526 6526 0 36437 CDARS INVESTMENT 3001369 F 3001369 CONTRACT LIABILITIES 30287 OPERATING LEASE 185905 SEVERANCE 165596 381788 X 7763463 26667 26667 7736796 0 7736796 8044768 26667 26667 8018101 0 8018101 PART IV, LINE 2B: DURING NOVEMBER 2019, THE ORGANIZATION BECAME THE COORDINATING ORGANIZATION, FISCAL AGENT, AND COMMUNICATIONS COORDINATOR FOR HEALTHY LUCAS COUNTY. AS FISCAL AGENT, THE ORGANIZATION PROVIDES CASH MANAGEMENT FUNCTIONS AND HOLDS FUNDS ON BEHALF OF HEALTHY LUCAS COUNTY. FUNDS HELD ON BEHALF OF HEALTHY LUCAS COUNTY WERE $42,109 AND $89,325 AT DECEMBER 31, 2023 AND 2022, RESPECTIVELY. PART X, LINE 2: MANAGEMENT OF THE ORGANIZATION IS REQUIRED TO DETERMINE WHETHER A TAX POSITION OF THE ORGANIZATION IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT OF THE ORGANIZATION IS NOT AWARE OF ANY TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY CHANGE IN THE NEXT TWELVE MONTHS. HOWEVER, MANAGEMENT'S CONCLUSIONS MAY BE SUBJECT TO REVIEW AND ADJUSTMENT AT A LATER DATE BASED ON FACTORS INCLUDING, BUT NOT LIMITED TO, NEW TAX LAWS, REGULATIONS, AND ADMINISTRATIVE INTERPRETATIONS (INCLUDING RELEVANT COURT DECISIONS). THE ORGANIZATION'S FEDERAL TAX RETURNS FOR THE PRIOR THREE YEARS REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. NO INTEREST OR PENALTIES WERE INCURRED OR RECOGNIZED IN 2023 OR 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOSTERING TRANSFERS FROM HLC TO HCNO 26,667. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOSTERING TRANSFERS FROM HCNO TO HLC 26,667. 1 BABY UNIVERSITY 860 ORCHARD STREET TOLEDO OH 43609 474336051 501(C)(3) 304282 0 SUPPORT BLANCHARD VALLEY HEALTH SYSTEM 1900 SOUTH MAIN STREET FINDLAY OH 45840 341369963 501(C)(3) 12200 0 SUPPORT CATHOLIC CHARITIES DIOCESE OF TOLEDO 1933 SPIELBUSCH AVENUE TOLEDO OH 43604 344428254 501(C)(3) 61097 0 SUPPORT COMMUNITY HOSPITALS AND WELLNESS CENTERS 433 W HIGH STREET BRYAN OH 43506 341048666 501(C)(3) 12187 0 SUPPORT COMMUNITY MEMORIAL HOSPITAL 208 N COLUMBUS STREET HICKSVILLE OH 43526 346401873 5753 0 SUPPORT COMPASSION HEALTH TOLEDO 1638 BROADWAY TOLEDO OH 436093240 473197108 501(C)(3) 182805 0 SUPPORT CONCORDANCE HEALTHCARE SOLUTIONS 85 SHAFFER PARK DRIVE TIFFIN OH 44883 383986849 21600 0 SUPPORT EAST TOLEDO FAMILY CENTER 1020 VARLAND AVENUE TOLEDO OH 43605 344429426 501(C)(3) 246894 0 SUPPORT ERIE COUNTY GENERAL HEALTH DISTRICT 420 SUPERIOR ST SANDUSKY OH 44870 15804 0 SUPPORT FIRELANDS REGIONAL MEDICAL CENTER 1111 HAYES AVE SANDUSKY OH 44870 344428218 501(C)(3) 6100 0 SUPPORT FISHER - TITUS MEDICAL CENTER 272 BENEDICT AVE NORWALK OH 44857 344430716 501(C)(3) 6100 0 SUPPORT FISHER & PAYKEL HEALTHCARE INC 17400 LAGUAN CANYON RD SUITE 300 IRVINE CA 92618 92450 0 SUPPORT FULTON COUNTY HEALTH CENTER 725 SOUTH SHOOP AVENUE WAUSEON OH 43567 344428214 5317 0 SUPPORT HENRY COUNTY HEALTH DEPARTMENT 1843 OAKWOOD AVE NAPOLEON OH 43545 346400633 37552 0 SUPPORT HENRY COUNTY HOSPITAL 1600 EAST RIVERVIEW AVENUE NAPOLEON OH 43545 344477047 6100 0 SUPPORT LUCAS COUNTY REGIONAL HEALTH DISTRICT 635 N ERIE STREET TOLEDO OH 43604 346400806 215043 0 SUPPORT MAGRUDER HOSPITAL 615 FULTON STREET PORT CLINTON OH 43452 344441792 501(C)(3) 106493 0 SUPPORT MERCER HEALTH 800 W MAIN STREET COLDWATER OH 45828 341101385 501(C)(3) 6100 0 SUPPORT MERCY FOUNDATION 2525 CHERRY STREET TOLEDO OH 43608 201072726 501(C)(3) 514534 0 SUPPORT NORTH CENTRAL EMS 12513 US 295 N MILAN OH 44846 501(C)(3) 155877 0 SUPPORT PATHWAYS COMMUNITY HUB INSTITUTE INC ONE MARION AVE SUITE 306 MANSFIELD OH 44903 813738049 501(C)(3) 54000 0 SUPPORT PAULDING COMMUNITY HOSPITAL 1035 W WAYNE STREET PAULDING OH 45879 346405718 6100 0 SUPPORT PROMEDICA PHYSICIANS 2142 N COVE BLVD 5SW TOLEDO OH 43606 45460 0 SUPPORT PROMEDICA TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO OH 43606 344428256 501(C)(3) 296310 0 SUPPORT PROMEDICA TRANSPORTATION NETWORK 7140 PORT SYLVANIA DRIVE STE 150 TOLEDO OH 43617 344428256 501(C)(3) 10000 0 SUPPORT SALEM LUTHERAN CHURCH 1127 N HURON ST TOLEDO OH 43604 344474606 501(C)(3) 77900 0 SUPPORT THE BELLEVUE HOSPITAL 1400 W MAIN ST BELLEVUE OH 44811 344428205 501(C)(3) 6100 0 SUPPORT THE UNIVERSITY CHURCH 4747 HILL AVENUE TOLEDO OH 43615 352484010 501(C)(3) 62155 0 SUPPORT TOLEDO-LUCAS COUNTY CARENET INC 3231 CENTRAL PARK WEST DR ROOM/SUITE 200 TOLEDO OH 43617 431986672 501(C)(3) 263697 0 SUPPORT UNIVERSITY OF TOLEDO GRANTS ACCOUNTING 2801 W BANCROFT ST TOLEDO OH 43606 346401483 501(C)(3) 25000 0 SUPPORT VAN WERT COUNTY HOSPITAL 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 344429514 501(C)(3) 6069 0 SUPPORT WOOD COUNTY HOSPITAL 950 W WOOSTER STREET BOWLING GREEN OH 43402 344440884 501(C)(3) 136145 0 SUPPORT YWCA OF NORTHWEST OHIO 1018 JEFFERSON AVE TOLEDO OH 43604 344428265 501(C)(3) 33110 0 SUPPORT LIMA MEMORIAL HOSPITAL 1003 BELLEFONTAINE AVE LIMA OH 45804 344434676 501(C)(3) 6100 0 SUPPORT LUCAS METROPOLITAN HOUSING AUTHORITY 435 NEBRASKA AVE TOLEDO OH 43604 272796499 15950 0 SUPPORT LUCAS COUNTY FAMILY COURT CENTER 429 N MICHIGAN ST TOLEDO OH 43604 32543 0 SUPPORT MERCY HEALTH - ST RITA'S MEDICAL CENTER 730 W MARKET ST LIMA OH 45801 341105619 9100 0 SUPPORT MCLAREN ST LUKE'S HOSPITAL 5901 MONCLOVA RD MAUMEE OH 43537 344428232 501(C)(3) 6100 0 SUPPORT 25 13 GIFT CARDS 1030 26197 0 SURVEY INCENTIVES 11655 23310 0 PART I, LINE 2: THE PROGRAM STAFF WORK CLOSELY WITH EACH SUB GRANTEE REGARDING PAPERWORK NEEDED. ALL SUB GRANTEES MUST SUBMIT DOCUMENTATION FOR REIMBURSEMENT OF ALL EXPENDITURES. WHEN NECESSARY, THE ASSISTANT CONTROLLER TRACKS EXPENDITURES TO ENSURE ADHERENCE TO THE BUDGET; IN ADDITION, THE PROGRAM DIRECTOR WORKS WITH FINANCE TO OVERSEE THE GRANT AND MANTAIN COMPLIANCE WITH APPLICABLE MANDATES. EACH SUB-GRANTEE MUST SUBMIT A BUDGET SPENDING PLAN FOR APPROVAL, PRIOR TO RECEIVING THEIR FIRST PAYMENT. THE SPENDING PLANS GIVE AN ESTIMATE "DATE TO BE SPENT" FOR EACH LINE ITEM. SUB GRANTEES TURN IN QUARTERLY REPORTS, AND THE PROGRAM DIRECTOR AND SPECIALIST REVIEW THEIR SPENT FUNDS TO DATE. SUB GRANTEES MUST SUBMIT RECEIPTS FOR EXPENSES, AT WHICH TIME A CHECK FOR REIMBURSEMENT WILL BE DISBURSED. X X X 0 0 0 0 0 0 0 0 0 KIMBERLY TEMPLE CONTROLLER & FISCAL OFFICER 152682 0 0 0 1687 0 19111 0 55859 0 229339 0 0 0 PAM JENSEN PRESIDENT & CEO 162619 0 0 0 129 0 0 0 30382 0 193130 0 0 0 CAROLYN TRUMBULL NOSS PROGRAM & SERVICES DIRECTOR 115924 0 0 0 1238 0 13980 0 33484 0 164626 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 AREA HOSPITALS COMPRISE THE MEMBERSHIP OF HOSPITAL COUNCIL OF NORTHWEST OHIO. FORM 990, PART VI, SECTION A, LINE 7A THESE MEMBER HOSPITALS MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S SIGNING OFFICER SCANS THE FORM 990 FOR COMPLETENESS PRIOR TO SIGNATURE, IN ADDITION TO RELYING UPON THE INDEPENDENT ACCOUNTANT FOR ACCURACY. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT-OF-INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BODY USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO OR TOP MANAGEMENT OFFICIALS WHICH INCLUDES A COMPARISON TO OTHER ORGANIZATIONS, SALARY SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. THE ORGANIZATION USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES WHICH INCLUDES A REVIEW AND APPROVAL BY THE CEO, USE OF MANAGEMENT SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. NORTHWEST OHIO SHARED SERVICES 3231 CENTRAL PARK WEST DR TOLEDO OH 43617 341388279 PURCHASE CORPORATION OH N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0