ADENA FAYETTE MEDICAL CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- ADENA FAYETTE MEDICAL CENTER (EIN 85-2985806)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-15
- IRS object ID
- 202413209349310521
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-15T11:25:39-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S HIGH ST SUITE 100 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 852985806 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADENA FAYETTE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADEN | BusinessNameControlTxt |
| Phone | 7403351210 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1Txt |
| City | CHILLICOTHE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES P MCMANUS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7403351210 | PhoneNum |
| Signature | 2024-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY CIMINELLO | PreparerPersonNm |
| PTIN | P00796388 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Preparation | 2024-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF GRAHAM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1Txt |
| City | CHILLICOTHE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $63,725,836 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.ADENA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL THAT HAS SERVES THE HEALTH NEEDS OF FAYETTE COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 374 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,638,693 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $65,558,125 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $63,412,759 | CYProgramServiceRevenueAmt |
| PY Investment Income | $81,558 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,033 | CYInvestmentIncomeAmt |
| PY Other Revenue | $163,957 | PYOtherRevenueAmt |
| CY Other Revenue | $312,920 | CYOtherRevenueAmt |
| PY Total Revenue | $67,442,333 | PYTotalRevenueAmt |
| CY Total Revenue | $63,728,712 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,424,077 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,775,014 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,992,460 | PYOtherExpensesAmt |
| CY Other Expenses | $36,392,804 | CYOtherExpensesAmt |
| PY Total Expenses | $65,416,537 | PYTotalExpensesAmt |
| CY Total Expenses | $57,167,818 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,025,796 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,560,894 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,488,041 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,699,495 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,832,542 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,989,057 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,655,499 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,710,438 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CALLED TO SERVE OUR COMMUNITIES | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $52,171,885 | ExpenseAmt |
| Revenue | $63,433,169 | RevenueAmt |
| Desc | ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL THAT HAS SERVED THE HEALTH NEEDS OF FAYETTE COUNTY FOR 70 YEARS.SINCE 1950, ADENA FAYETTE MEDICAL CENTER, FORMERLY KNOWN AS FAYETTE COUNTY MEMORIAL HOSPITAL, HAS SERVED THE HEALTHCARE NEEDS OF OUR COMMUNITY. OUR TRADITION OF PROVIDING COMPASSIONATE CARE CONTINUES TO HELP THOUSANDS OF PEOPLE EACH YEAR. WHILE AFMC HAS GROWN IN SIZE AND SERVICES, WE HAVE RETAINED THE PERSONAL TOUCH THAT IS OUR TRADEMARK. OUR TEAM CONSISTS OF MORE THAN 300 HIGHLY SKILLED, COMPASSIONATE HEALTHCARE PROFESSIONALS DEDICATED TO DELIVERING PERSONAL CARE.PHYSICIANS AFFILIATED WITH OUR HOSPITAL ARE TRAINED IN A NUMBER OF SPECIALTIES, AND THEY, ALONG WITH OUR NURSE PRACTITIONERS, LOOK FORWARD TO ESTABLISHING LONG-TERM RELATIONSHIPS WITH OUR PATIENTS AND THEIR FAMILIES.COMPREHENSIVE CARE AND SERVICESPATIENTS AND VISITORS TO ADENA FAYETTE MEDICAL CENTER CAN EXPECT A FULL RANGE OF MEDICAL SERVICES AS WELL AS PERSONAL CARE FROM OUR DEDICATED PROVIDERS AND CAREGIVERS.SERVICES AT ADENA FAYETTE MEDICAL CENTERCANCERCARDIOPULMONARYDIAGNOSTIC TESTINGEMERGENCY SERVICESFOOD SERVICESGASTROENTEROLOGYLAB SERVICESNEPHROLOGYOCCUPATIONAL HEALTHOPHTHALMOLOGYORTHOPEDICSOUTPATIENT SERVICESPRIMARY CAREPULMONOLOGYREHABILITATION SERVICESSENIOR LIFE SOLUTIONSSLEEPSTROKESURGICAL SERVICESURGENT CARE AND WALK-IN CLINICWOMEN'S HEALTH | Desc |
| Total Program Service Expenses | $52,171,885 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 374 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFF CRAFT VP SYSTEM FINANCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7407794481 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1Txt |
| City | CHILLICOTHE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 456019031 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JEFF GRAHAM | |||||||||
| AHS PRESIDENT & CEO | 1.00 | 53.00 | Yes (X) | Yes (X) | $0 | $1,010,366 | $58,200 | ||
| JENNY BREEDLOVE | |||||||||
| SECRETARY/TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRIAN REAM | |||||||||
| TRUSTEE/CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHELSIE BAKER | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG BOEDEKER | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFF FUNARI | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBYN HADDEN | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY E KING | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CARLA MELVIN | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHIQUITA NASH | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KIM PITTSER | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DIANNA WAYNE | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JIM MCMANUS | |||||||||
| AHS CHIEF FINANCIAL OFFICER | 1.00 | 53.00 | Yes (X) | $0 | $621,511 | $125,944 | |||
| KATHERINE EDRINGTON | |||||||||
| AHS COO | 1.00 | 53.00 | Yes (X) | $0 | $621,194 | $32,774 | |||
| JOSH MCCOY | |||||||||
| SENIOR OPERATIONS EXECTUTIVE DIRECTOR | 25.00 | 25.00 | Yes (X) | $0 | $252,673 | $39,592 | |||
| MELISSA LEMLE | |||||||||
| PHARMACIST | 50.00 | 0.00 | $161,814 | $0 | $37,597 | Yes (X) | |||
| CAROYLN WALLIN | |||||||||
| DIR OPERATIONS CRITICAL ACCESS | 50.00 | 0.00 | $154,263 | $0 | $43,974 | Yes (X) | |||
| TAMMIE WILSON | |||||||||
| DIR NURSING | 50.00 | 0.00 | $152,982 | $0 | $29,305 | Yes (X) | |||
| MATTHEW INSLEY | |||||||||
| TL PHARMACY | 50.00 | 0.00 | $146,234 | $0 | $35,827 | Yes (X) | |||
| EMILY STEPHENS | |||||||||
| NURSE PRACTITIONER WRVU | 50.00 | 0.00 | $131,196 | $0 | $20,092 | Yes (X) | |||
| LISA CARLSON | |||||||||
| AHS CFO- FORMER | 0.00 | 0.00 | $0 | $270,056 | $1,020 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $746,489 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,775,800 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $424,325 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMUNITY EMERGENCY MEDICINE PARTNERS L | |||||
| 1430 COLUMBUS AVE | WASHINGTON COURT HOUSE | OH | 43160 | PHYSICIAN SERVICES | $1,078,000 |
| RURAL PHYSICIANS GROUP | |||||
| 5575 DTC PKWY 225 | GREENWOOD VILLAGE | CO | 80111 | PHYSICIAN SERVICES | $666,673 |
| CAPTIVE RADIOLOGY LLC | |||||
| 6273 FRANK AVE NW | NORTH CANTON | OH | 44720 | MRI SERVICES | $624,250 |
| PSYCHIATRIC MEDICAL CARE LLC | |||||
| 8 CADILLAC DRIVE | BRENTWOOD | TN | 37027 | PHYSICIAN SERVICES | $442,438 |
| ALLSCRIPTS LLC | |||||
| 222 MERCHANDISE MART PLZ 2024 | CHICAGO | IL | 60654 | IT SERVICES | $440,701 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SVC REV | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $63,412,759 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63,412,759 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $63,412,759 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,033 | TotalRevenueColumnAmt |
| Exclusion | $3,033 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,534 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,876 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,410 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,410 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,410 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722514 | $144,767 | $144,767 |
| PHARMACY | 456110 | $72,669 | $72,669 |
| EMS INCOME | 621910 | $43,262 | $43,262 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,812 | TotalRevenueColumnAmt |
| Exclusion | $31,812 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $292,510 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,728,712 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63,433,169 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $295,543 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,962,470 | TotalAmt |
| Program Services | $13,299,400 | ProgramServicesAmt |
| Management And General | $2,663,070 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,622 | TotalAmt |
| Program Services | $447,119 | ProgramServicesAmt |
| Management And General | $75,503 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,182,821 | TotalAmt |
| Program Services | $2,723,001 | ProgramServicesAmt |
| Management And General | $459,820 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,107,101 | TotalAmt |
| Program Services | $947,159 | ProgramServicesAmt |
| Management And General | $159,942 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,737,930 | TotalAmt |
| Program Services | $2,224,403 | ProgramServicesAmt |
| Management And General | $513,527 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,813 | TotalAmt |
| Program Services | $2,375 | ProgramServicesAmt |
| Management And General | $3,438 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,164 | TotalAmt |
| Program Services | $243,967 | ProgramServicesAmt |
| Management And General | $41,197 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,800 | TotalAmt |
| Program Services | $641,477 | ProgramServicesAmt |
| Management And General | $108,323 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,979,446 | TotalAmt |
| Program Services | $1,566,508 | ProgramServicesAmt |
| Management And General | $412,938 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,009 | TotalAmt |
| Program Services | $11,268 | ProgramServicesAmt |
| Management And General | $8,741 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,759 | TotalAmt |
| Program Services | $31,964 | ProgramServicesAmt |
| Management And General | $24,795 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,540 | TotalAmt |
| Program Services | $10,208 | ProgramServicesAmt |
| Management And General | $2,332 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,646,921 | TotalAmt |
| Program Services | $1,208,985 | ProgramServicesAmt |
| Management And General | $437,936 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,980 | TotalAmt |
| Program Services | $189,865 | ProgramServicesAmt |
| Management And General | $61,115 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL EQUIPMENT & SUP | $23,029,039 | $23,029,039 | |
| PROVISION FOR BAD DEBTS | $3,058,724 | $3,058,724 | |
| HCAP ASSESSMENT | $2,160,932 | $2,160,932 | |
| CAFETERIA/CATERING | $199,492 | $187,857 | $11,635 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,255 | TotalAmt |
| Program Services | $187,634 | ProgramServicesAmt |
| Management And General | $11,621 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,167,818 | TotalAmt |
| Program Services | $52,171,885 | ProgramServicesAmt |
| Management And General | $4,995,933 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,009,757 | BOYAmt |
| EOY | $1,334,172 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,831,714 | BOYAmt |
| EOY | $14,602,033 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,666,102 | BOYAmt |
| EOY | $1,698,026 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,974,566 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,335,796 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,179,854 | BOYAmt |
| EOY | $8,638,770 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $800,614 | BOYAmt |
| EOY | $426,494 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,488,041 | BOYAmt |
| EOY | $26,699,495 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,606,233 | BOYAmt |
| EOY | $2,747,332 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $591,344 | BOYAmt |
| EOY | $315,230 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,634,965 | BOYAmt |
| EOY | $3,926,495 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,832,542 | BOYAmt |
| EOY | $6,989,057 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,222,800 | BOYAmt |
| EOY | $19,274,706 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $432,699 | BOYAmt |
| EOY | $435,732 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,655,499 | BOYAmt |
| EOY | $19,710,438 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,488,041 | BOYAmt |
| EOY | $26,699,495 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,560,894 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$8,505,955 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,617 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,617 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE OHIO HOSPITAL ASSOCIATION DOES LOBBYING ON BEHALF OF HOSPITAL RELATED CAUSES. THIS ACTIVITY IS PAID FOR THROUGH DUES PAID TO THE OHIO HOSPITAL ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $860,000 | OtherCostOrOtherBasisAmt |
| Book Value | $860,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,977,689 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,131,945 | DepreciationAmt |
| Book Value | $5,845,744 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,786,857 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,951,074 | DepreciationAmt |
| Book Value | $1,835,783 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $350,020 | OtherCostOrOtherBasisAmt |
| Depreciation | $252,777 | DepreciationAmt |
| Book Value | $97,243 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,638,770 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RIGHT OF USE LIABILITY | $426,495 |
| COST REPORT SETTLEMENT PAYABLE | $3,500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,926,495 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $377,986 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $377,986 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00700 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,464,047 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,091,944 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,372,103 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06230 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,842,033 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,091,944 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,750,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,842,033 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,091,944 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,750,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06930 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,058,724 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $24,730,724 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,355,760 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,374,964 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADENA FAYETTE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1Txt |
| City | CHILLICOTHE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.ADENA.ORG | WebsiteAddressTxt |
| State License | 1168 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADENA FAYETTE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 5: THE ADENA FAYETTE MEDICAL CENTER CAPTURED THE BROAD INTERESTS OF THE COMMUNITY FOR THE CHNA THROUGH THREE PRIMARY METHODS: PUBLIC SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS. A HEALTH NEEDS SURVEY WAS WIDELY DISTRIBUTED IN BOTH ELECTRONIC AND PAPER FORM ACROSS THE ROSS COUNTY COMMUNITY AND RECEIVED 539 RESPONSES. IN ADDITION TO THE SURVEYS, INTERVIEWS WITH LOCAL COMMUNITY LEADERS, INCLUDING CIVIC, PUBLIC HEALTH AND EMERGENCY RESPONSE WERE REQUESTED AND/OR CONDUCTED TO GAIN FURTHER KNOWLEDGE OF SURVEY TOPICS. |
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 6A: THE CHNA FOR ADENA FAYETTE MEDICAL CENTER WAS COMPLETED WITH ITS PARENT ENTITY, ADENA HEALTH SYSTEM. |
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 6B: THE CHNA FOR ADENA FAYETTE MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS: ADAMH BOARD, FAYETTE COUNTY COMMUNITY ACTION, AMERICAN RED CROSS, COMMUNITY ACTION-TRANSPORTATION, FAYETTE COUNTY COMMISSION, DIALYSIS CENTER, DOMESTIC VIOLENCE SHELTER, EMERGENCY MANAGEMENT AGENCY, FAYETTE COUNTY JOB AND FAMILY SERVICES, FAYETTE COUNTY DEPARTMENT OF DD, FAYETTE COUNTY HEALTH DEPARTMENT, FAYETTE COUNTY EMS, JEFFERSON TOWNSHIP EMS, FAYETTE COUNTY MEMORIAL HOSPITAL, FAYETTE COUNTY CORONER, FAYETTE COUNTY SHERRIFF'S DEPARTMENT, FAYETTE COUNTY FARMER'S MARKET, FAYETTE COUNTY PARKS AND RECREATION DISTRICT, FAYETTE COUNTY YMCA, FAYETTE COUNTY HOMELESS SHELTER, OHIO HOSPICE OF FAYETTE COUNTY, MEDICAL RESERVE CORP, MIAMI TRACE LOCAL SCHOOLS- SUPERINTENDENT, FAYETTE COUNTY COMMISSION ON AGING, PUBLIC HEALTH, EPI-UNION COUNTY (CONTRACTED), ROSE AVENUE COMMUNITY CENTER, ST. CATHERINE'S AND COURT HOUSE MANOR LTC, WASHINGTON CITY SCHOOLS-SUPERINTENDENT, AND SCIOTO PAINT VALLEY MENTAL HEALTH. |
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 7D: THE CHNA WAS MADE AVAILABLE IN ELECTRONIC FORM THROUGH SOCIAL MEDIA, NEWSPAPER, AND PARTICIPATING AGENCY WEBSITES. PRESENTATIONS OF ITS CONTENT WERE MADE TO GOVERNMENT, COMMUNITY AND CIVIC ORGANIZATIONS. HARD COPIES OF THE CHNA REPORT WERE ALSO PRINTED AND SENT TO COMMUNITY LEADERS AND AGENCIES. |
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 11: THE FOLLOWING DETAILS THE SPECIFIC IMPLEMENTATION STRATEGIES USED FOR HEALTH PRIORITIES IDENTIFIED FOR THE ADENA FAYETTE MEDICAL CENTER DURING THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. SUBSTANCE USE DISORDER COMMUNITY DEVELOPMENTADENA HEALTH ASSISTED IN THE DEVELOPMENT OF A HRSA RURAL COMMUNITIES OPIOID RESPONSE PROGRAM (RCORP) IMPLEMENTATION GRANT IN 2019. IN 2022, ADENA HEALTH AWARDED $1.6 MILLION OVER THREE YEARS. ADENA HEALTH IS THE FISCAL AGENT FOR THE GRANT, OVERSEES ALL OF THE GRANTS MANAGEMENT AND PROVIDES 1FTE PROJECT COORDINATOR TO OVERSEE THE PROJECT. THE GRANT IS FOCUSED ON INCREASING MEDICATION ASSISTED TREATMENT ACCESS FOR THOSE WHO ARE BEING TREATED FOR OPIOID USE DISORDER IN PIKE, ROSS AND FAYETTE COUNTIES. THIS GRANT CONTINUES THROUGH AUGUST 2025. PROGRAMMING & INITIATIVESTHE BABY CENTERED RECOVERY PROGRAM PROVIDED A TOTAL OF 5 WOMEN (FROM MULTIPLE COUNTIES INCLUDING ROSS) WITH PREGNANCY EDUCATION AND ADDICTION COUNSELING IN 2023. IN ADDITION, PARTICIPANTS WERE PROVIDED RESOURCE REFERRALS, AS WELL AS FOOD AND BABY SUPPLIES AT NO CHARGE TO PARTICIPANTS. A TOTAL OF 5 COMPLETED THE PROGRAM. A TOTAL OF 289 MOTHERS HAVE BEEN SUPPORTED BY THE PROGRAM SINCE 2014. THE PROGRAM HAS BEEN RECOGNIZED WITH MULTIPLE AWARDS, INCLUDING:NATIONAL AWARDS "PROGRAM OF PROMISE" BY NATIONAL HOSPITAL CHARITABLE SERVICES "A BEST PRACTICE SITE" BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' CENTERS FOR MEDICARE AND MEDICAID SERVICE (CMS) MEDICATION MANAGEMENT AND OPIOID SUPPORT TEAM (1 OF ONLY 3 IN OHIO) FEATURED IN THE EMMY NOMINATED DOCUMENTARY SHORT BY "FAULT LINES": HEROIN'S CHILDREN: INSIDE THE US OPIOID CRISIS. STATE AWARDS THE OHIO SENATE HAS RECOGNIZED THE PROGRAM TWICE FOR THE CREATION OF THE ADENA BABY-CENTERED CLOSET. THE OHIO STATE SENATE ALSO RECOGNIZED THE PROGRAM FOR ITS WORK WITH MEDICAID PATIENTS. THE OHIO LACTATION ASSOCIATION RECOGNIZED ONE OF THE PROGRAM'S FACILITATORS "AS MOST BREASTFEEDING SUPPORTIVE HEALTH PROFESSIONAL IN OHIO".COMMUNITY AWARDS THE PROGRAM RECEIVED A COMMUNITY AWARD FROM OHIO CAN-ROSS COUNTY-2019 STEPS OF CHANGE FOR THE IMPACT THE PROGRAM MADE IN A YOUNG WOMAN'S LIFE. PAINT VALLEY ADAMH BOARD NAMED ONE OF THE PROGRAM'S FACILITATOR A ROSS COUNTY RECOVERY CHAMPIONTHE HOPE PARTNERSHIP PROJECT NAMED OF THE PROGRAM'S FACILITATORS "PROVIDER OF THE YEAR" IN 2021FINANCIAL SUPPORT AND CLINICAL ALIGNMENTADENA HEALTH PROVIDE $1,000 IN SUPPORT THE ADAMH ANNUAL RECOVERY CELEBRATION DINNER, HONORING THOSE WHO WORK TO PREVENT, TREAT AND SUPPORT RECOVERY FOR THOSE IN ROSS, HIGHLAND, FAYETTE, PIKE AND PICKAWAY COUNTIES.OBESITY AND DIABETESPROGRAMMINGIN 2022, ADENA BEGAN ITS JUST WALK PROGRAM IN PARTNERSHIP WITH THE FAYETTE COUNTY YMCA AND COURT HOUSE MANOR OF FAYETTE COUNTY. THE HOUR LONG PROGRAM HELD ONCE PER MONTH ENGAGES 10-15 LOCAL RESIDENTS ON A HEALTH TOPIC DISCUSSED BY A LOCAL MEDICAL PROVIDER AND AN OPTIONAL WALK FOR HEALTH AND FITNESS. A TOTAL OF 13 ADENA EMPLOYEES SPEND A TOTAL OF 36 HOURS EACH YEAR COORDINATING AND DELIVERING THE PROGRAM. APPROXIMATELY $2500 WAS PROVIDED IN SUPPLIES FOR THE PROGRAM. FINANCIAL SUPPORT & CLINICAL ALIGNMENTADENA HEALTH WORKS TO ALIGN ITS SERVICE LINES AND CLINICS WITH COMMUNITY RESOURCES THAT WILL ADDRESS THE SOCIAL FACTORS AND BARRIERS FACED BY MANY OF ITS RURAL PATIENTS. THIS OFTEN INVOLVES COMMUNITY PARTNERING AND MONETARY SUPPORT FROM ADENA COMMUNITY HEALTH AND DEVELOPMENT. THESE TWO STRATEGIES ARE CONNECTED AND REPORTED TOGETHER. ADENA HEALTH PARTNERED AGAIN IN 2023 WITH THE FAYETTE COUNTY FARMER'S MARKET TO FUND THE "FOOD RX AND FRUIT & VEGGIE PERKS PROGRAM. THIS PROGRAM SERVED ADENA PATIENTS REFERRED BY THEIR PRIMARY CARE PROVIDER FOR A TOTAL OF $680 IN FRESH FRUITS AND VEGETABLES. ADENA HEALTH CONTINUED ITS PARTNERSHIP WITH YMCA OF FAYETTE COUNTY FOR THE FIRST STEP AND LIVESTRONG PROGRAMS. "FIRST STEP" UTILIZES A YMCA TRAINER TO OPTIMIZE (REDUCE BMI) ADENA BONE & JOINT PATIENTS PRIOR TO SURGERY TO IMPROVE SURGICAL OUTCOMES OF JOINT REPLACEMENT. THE PROGRAM SERVED SEVERAL PATIENTS IN 2023 AND A TOTAL OF $2032.50 IN SUPPORT WAS PROVIDED THROUGH THIS PARTNERSHIP. PLANNING ALSO STARTED FOR A CONTINUED ADENA AND OSU EXTENSION FAYETTE COUNTY PARTNERSHIP TO PROVIDE NUTRITION/COOKING EDUCATION PROGRAMMING IN 2024.RESPIRATORY ISSUESPROGRAMMING & INITIATIVESADENA HEALTH CONTINUED ITS COORDINATION OF THE ADENA QUIT CLINIC IN 2023. THE CLINIC PROVIDED A TOTAL OF 19 PATIENTS SERVED IN 5 LOCATIONS: CHILLICOTHE (ROSS COUNTY); WAVERLY (PIKE COUNTY); WASHINGTON COURT HOUSE (FAYETTE COUNTY); GREENFIELD (HIGHLAND COUNTY) AND JACKSON (JACKSON COUNTY). ADENA PHARMACISTS COMPLETED 35 VISITS WITH PATIENT WITH TOBACCO CESSATION COUNSELING SERVICES INCLUDING CESSATION PLANNING, SUPPORT AND NICOTINE REPLACEMENT EDUCATION IS PROVIDED BY ADENA PHARMACISTS. ADENA PROVIDED A TOTAL OF 1,726 PATIENTS FROM THE REGION INCLUDING PIKE, FAYETTE, HIGHLAND AND ROSS COUNTIES WITH FREE LUNG CANCER SCREENINGS IN 2023 WHICH RESULTED IN 32 POSITIVE CANCER FINDINGS. BY PROVIDING CANCER SCREENINGS ADENA HEALTH IS HELPING TO DECREASE RATES OF DEATH DECLINING DUE TO EARLY INTERVENTION AND TREATMENT. MENTAL HEALTHPROGRAMMING & INITIATIVESTHE ADENA HEALTH HOUSES A VICTIM'S ADVOCATE TEAM IN THE ARMC EMERGENCY DEPARTMENT WHICH PROVIDED A TOTAL OF 477 VICTIMS OF SEXUAL ASSAULT (ADULT AND PEDIATRIC), DOMESTIC VIOLENCE, CHILD ABUSE, ELDER ABUSE, HUMAN TRAFFICKING AND HATE CRIMES WITH MENTAL HEALTH REFERRAL, SAFETY AND SUPPORT SERVICES FREE OF CHARGE, VALUED AT $250,000 IN 2023 . PATIENTS ARE SERVED 24 HOURS A DAY, SEVEN DAYS PER WEEK IN ROSS, PIKE, AND HIGHLAND AND FAYETTE COUNTIES. IN ADDITION TO THIS SUPPORT, THE ADVOCACY TEAM ALSO RESPONDED TO CASES ACROSS THE HEALTH SYSTEM TO PROVIDE SUPPORT AND RESOURCES FOR INDIVIDUALS EXPERIENCING HOMELESSNESS AND OTHER SOCIAL NEEDS. CHILD SAFETY & WELLNESSPROGRAMMING AND INITIATIVESADENA HEALTH PROVIDED ATHLETIC TRAINER SERVICES TO 12 LOCAL PUBLIC HIGH SCHOOLS WITHIN A SIX COUNTY (ROSS, PIKE, FAYETTE, HIGHLAND, JACKSON, PICKAWAY) SERVICE REGION IN 2023. A TOTAL OF 13 ATHLETIC TRAINERS WORKED WITHIN THE SCHOOL'S ATHLETIC DEPARTMENTS AND FOCUSED ON EDUCATING STUDENTS, PARENTS AND COACHES ON SPORTS MEDICINE TOPICS, INCLUDING CONCUSSION IDENTIFICATION AND TREATMENT. THE VALUE OF THIS COMMUNITY SUPPORT WAS $662,774. THE STAFF IS ALSO READILY AVAILABLE AT ATHLETIC EVENTS AND PROVIDES YEARLY SPORTS PHYSICALS TO MORE THAN 1200 STUDENTS IN HIGHLAND, FAYETTE, AND JACKSON, PICKAWAY, PIKE, AND ROSS COUNTIES. IN 2021, ADENA HEALTH PARTNERED WITH NATIONWIDE CHILDREN'S HOSPITAL TO DEVELOP THE APPALACHIAN WHOLE CHILD INITIATIVE. IN 2023, ADENA HEALTH EXPANDED THE PROGRAM AND PROVIDED A 1.0 FTE VALUED AT $101,608 TO WORK WITH PARTNERED SCHOOL DISTRICT TO COMPLETE SCHOOL NEEDS ASSESSMENTS, DEVELOP SCHOOL WELLNESS PLANS, AND IMPROVE HEALTHCARE ACCESS TO STUDENTS AND STAFF. ALSO IN SEPTEMBER 2023, ADENA LAUNCHED A MOBILE HEALTH CLINIC TO PROVIDE MEDICAL CARE TO 373 STUDENTS AND STAFF. IN ADDITION, THE COORDINATOR IS ASSISTING THE DISTRICTS IN DEVELOPING PRIMARY CARE AND TELEHEALTH RESOURCES FOR THE DISTRICT, AS WELL AS BRING IN ADDITIONAL COMMUNITY PARTNERS TO ADDRESS MENTAL HEALTH AND SOCIAL NEEDS OF STUDENTS. ADENA HEALTH PARTNERED WITH THE CARNEGIE PUBLIC LIBRARY TO COORDINATE THE HEALTHY KIDS SUMMER FUN CHALLENGE, PART OF THE BOOKWORM SUMMER READING PROGRAM. A TOTAL OF 455 FAYETTE COUNTY RESIDENTS - 325 CHILDREN, 22 TEENS, AND 108 ADULTS- WERE ENGAGED IN THE PROGRAM THAT REWARDED THEM FOR COMPLETING WEEKLY HEALTH CHALLENGES. PARTICIPANTS ARE OFFERED THE OPPORTUNITY TO EARN PRIZES AS THEY COMPLETE CHALLENGES AND THOSE WHO COMPLETE ALL CHALLENGES ARE ENTERED INTO A DRAWING FOR A NEW BICYCLE AND ADULTS GOT THE OPPORTUNITY FOR A FITBIT. A TOTAL OF $2500 WAS SPENT ON REWARD PRIZES FOR PARTICIPANTS IN ROSS, FAYETTE, HIGHLAND AND PIKE COUNTIES. |
| ADENA FAYETTE MEDICAL CENTER | PART V, SECTION B, LINE 20E: PATIENTS HAVE 120 DAYS FROM THE TIME THEIR ACCOUNT GOES TO "SELF-PAY" TO PAY IN FULL OR MAKE PAYMENT ARRANGEMENTS. ON THE 121ST DAY, THEY ARE SENT TO A COLLECTION AGENCY. COLLECTION AGENCIES REQUIRE ADENA MANAGEMENT APPROVAL TO PURSUE LEGAL ACTION. IF AVAILABLE, SELFPAY PATIENTS ARE SCREENED FOR GOVERNMENT ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE DURING THE INPATIENT STAY. FAP APPLICATIONS ARE PROVIDED TO THE PATIENT AS PART OF THE SCREENING. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE ONLINE AND THROUGHOUT THE HOSPITAL. |
| PART V, SECTION B, LINE 11 CONTINUED | FINANCIAL SUPPORT & CLINICAL ALIGNMENTADENA HEALTH WORKS TO ALIGN ITS SERVICE LINES AND CLINICS WITH COMMUNITY RESOURCES THAT WILL ADDRESS THE SOCIAL FACTORS AND BARRIERS FACED BY MANY OF ITS RURAL PATIENTS. THIS OFTEN INVOLVES COMMUNITY PARTNERING AND MONETARY SUPPORT FROM ADENA COMMUNITY HEALTH AND DEVELOPMENT. THESE TWO STRATEGIES ARE CONNECTED AND REPORTED TOGETHER. SCHOOL DISTRICTS: A TOTAL OF 2 HIGHLAND COUNTY SCHOOL DISTRICTS WASHINGTON COURT HOUSE CITY SCHOOLS AND MIAMI TRACE LOCAL SCHOOLS - EACH RECEIVED $25,000 OR A TOTAL OF $50,000 TO SUPPORT THE HEALTH AND WELLNESS OF THEIR DISTRICT'S ATHLETES, ALIGNED WITH THE SUPPORT OF ATHLETIC TRAINERS PROVIDED BY ADENA HEALTH. ADENA WOMEN'S & CHILDREN'S CENTER: ADENA HEALTH PROVIDED SLEEP SACKS FOR THE 1,200 BABIES BORN AT THE ADENA WOMEN'S AND CHILDREN'S CENTER IN 2023, VALUED AT $12,777. PATIENTS COME FROM A NUMBER OF COUNTIES INCLUDING FAYETTE, ROSS, PIKE AND HIGHLAND. ADDITIONAL INITIATIVES AND RESOURCESTHE ADENA FAMILY MEDICINE - RESIDENCY CLINIC AND THE ADENA RESIDENCY CLINIC INTERNAL MEDICINE CONTINUED OPERATIONS OF ITS CLINIC IN 2023 PROVIDING AFFORDABLE, QUALITY HEALTH CARE. THE CLINICS PAIRED ACCESSIBLE PRIMARY CARE MEDICAL SERVICES PROVIDED BY PHYSICIAN INTERNS AND RESIDENTS OF ADENA'S GRADUATE MEDICAL EDUCATION PROGRAM, FAMILY AND INTERNAL MEDICINE PRECEPTORS PROVIDING SERVICES TO PATIENTS IN THE CLINIC. COMBINED THE CLINICS HAD 10,084 VISITS FROM PATIENTS MOSTLY FROM SEVEN COUNTIES (ROSS, PICKAWAY, PIKE, JACKSON, HIGHLAND, FAYETTE, VINTON). APPROXIMATELY 5% OF PATIENTS SERVED BY THE CLINICS ARE UNINSURED. COMMUNITY SERVICE: ADENA ALSO PROVIDES SUPPORT TO THE FAYETTE COUNTY COMMUNITY THROUGH A VARIETY OF ENGAGEMENT ACTIVITIES, INCLUDING FINANCIAL SUPPORT AND PARTICIPATION IN LOCAL COMMUNITY EVENTS AND INITIATIVES. A TOTAL OF 18 CAREGIVERS FROM AFMC PROVIDED MORE THAN 75 HOURS OF COMMUNITY SERVICE AND VOLUNTEER TIME PARTICIPATING IN COMMUNITY PROGRAMMING, NON-PROFIT BOARD PARTICIPATION AND LEADERSHIP, AND OTHER INITIATIVES. COMMUNITY SPONSORSHIPS: ADENA SUPPORT A NUMBER OF INITIATIVES IN THE COMMUNITY AND REGION TO BENEFIT THE WELLBEING OF THOSE IN THE COMMUNITY. THESE INCLUDE: OVER $2,956.42 IN COORDINATED TRANSPORTATION SERVICES FOR PATIENTS IN FAYETTE, ROSS, HIGHLAND AND PIKE COUNTIES WITHOUT TRANSPORT TO MEDICAL APPOINTS AND NO INSURANCE COVERAGE. A TOTAL OF $2,000 IN SUPPORT FOR THE FAYETTE COUNTY CHAMBER OF COMMERCE, INCLUDING SUPPORT OF THEIR ANNUAL TOAST TO SUMMER $35,0000 SPONSORSHIP TO THE FAYETTE COUNTY FAMILY YMCA A TOTAL OF $2,000 IN SUPPORT TO THE FAYETTE COUNTY CANCER SUPPORT FOUNDATION. $750 WAS PROVIDED TO SUPPORT LOCAL PELOTONIA TEAMS SUPPORTING CANCER TREATMENT AND RESEARCH. SUPPORT OF FAYETTE FARM BUREAU FARM TO TABLE EVENT WITH A $650 SPONSORSHIP. A TOTAL OF $12,000 TO SUPPORT THE FAYETTE COUNTY AGRICULTURE ASSOCIATION'S FAIR AND 4H PROGRAMMING. SUPPORT OF THE FAYETTE COUNTY COLOR RUN FOR SUICIDE PREVENTION WITH A $500 SPONSORSHIP. $500 TO THE MIAMI TRACE FFA PROGRAM. A TOTAL OF $1,025 TO SUPPORT LOCAL COMMUNITY EVENTS INCLUDING THE WASHINGTON COURT HOUSE 4TH OF JULY CELEBRATION AND TRICK OR TREAT COMMUNITY NIGHT. ADDITIONAL COMMUNITY COLLABORATIONSROSS COUNTY CHILD PROTECTION CENTER: ADENA HEALTH CONTINUED IT'S MORE THAN 25 YEAR RELATIONSHIP WITH AND SUPPORT OF THE ROSS COUNTY CHILD PROTECTION CENTER IN 2023 WHICH PROVIDES RESOURCES AND COUNSELING TO YOUNG VICTIMS OF INTERPERSONAL VIOLENCE AND SEXUAL ASSAULT IN A NINE COUNTY SERVICE REGION THAT INCLUDES FAYETTE, ROSS, PIKE AND HIGHLAND COUNTIES. ADENA PROVIDED A TOTAL OF $61,374 IN FINANCIAL SUPPORT FOR THE CPC'S FACILITY COSTS AND INFORMATION TECHNOLOGY NEEDS. MEDICAL AND NURSING STAFF ALSO PROVIDE SUPPORT TO THE CENTER. AN ADDITIONAL $2,000 IN SUPPORT WAS PROVIDED TO SUPPORT THE FUNDRAISING EFFORTS OF THE ORGANIZATION. HOPE CLINIC: ADENA PROVIDER, JAMI EASTERDAY, CNP, CONTINUED VOLUNTEER EFFORTS AS THE DIRECTOR OF THE HOPE CLINIC OF ROSS COUNTY IN 2023. THIS CLINIC PROVIDES FREE MEDICAL CARE TO THOSE WITHOUT HEALTH INSURANCE COVERAGE, INCLUDING MEDICAL, DENTAL AND VISION CARE. LOCATED IN CHILLICOTHE, OHIO, THE CLINIC SERVES PATIENTS FROM AROUND THE REGION INCLUDING ROSS, PIKE FAYETTE, AND HIGHLAND COUNTIES. IT IS OPEN ONE DAY PER WEEK. THE CLINIC SAW MORE THAN 1500 PATIENTS FOR MEDICAL, DENTAL AND PHARMACY SERVICES AND DISPENSED MORE THAN 4000 PRESCRIPTIONS THROUGH THE CHARITABLE PHARMACY. TEN PROVIDERS FROM ADENA HEALTH VOLUNTEERED 68 HOURS OF CARE AT HOPE CLINIC IN 2023. ADENA CAREGIVERS ALSO VOLUNTEER AS STAFF IN THE CLINIC AND/OR AT THE MOBILE FOOD CLINIC TO ASSIST THOSE WHO ARE FOOD INSECURE (MORE THAN 7900 RESIDENTS IN 2023). ADENA HEALTH PROVIDES ADDITIONAL MONETARY SUPPORT FROM ITS COMMUNITY HEALTH BUDGET TO THE HOPE CLINIC FOR THE CLINIC'S COMMUNITY CHARITABLE PHARMACY AND MEDICAL RESOURCE SYSTEM ELSEVIER. AN ADDITIONAL $1500 WAS ALSO PROVIDED TO SUPPORT GENERAL FUNDRAISING CAMPAIGN FOR SERVICES. FOR MORE INFORMATION, GO TO HTTP://WWW.HOPECLINICFREE.ORG/. FAYETTE COUNTY HEALTH COALITION: IN 2023, ADENA HEALTH WORKED WITH THE FAYETTE COUNTY HEALTH DEPARTMENT TO CONTINUE COLLABORATION ON THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR FAYETTE COUNTY. THE FAYETTE COUNTY HEALTH COALITION IS A GROUP OF 15 LOCAL GOVERNMENT, CIVIC AND BUSINESS LEADERS WORKING TO IDENTIFY STRATEGIC HEALTH PRIORITIES FOR THE COMMUNITY AND ASSIST IN ALLOCATING RESOURCES TO SUPPORT INITIATIVES BUILT AROUND THESE STRATEGIC PRIORITIES.OTHER LOCATIONS ADENA SERVESADENA HEALTH HAS ALSO SUPPORTED PROGRAMMING AND ADDRESSED COMMUNITY IMPROVEMENT NEEDS BEYOND THE COUNTIES WHERE HOSPITALS ARE LOCATED OR HAVE SOME REGIONAL STRATEGIES THAT AFFECT THE ENTIRE SERVICE AREA. INFORMATION RELATED TO THESE ACTIVITIES IS OUTLINED BELOW.COMMUNITY SPONSORSHIPS: ADENA SUPPORT A NUMBER OF INITIATIVES IN THE COMMUNITY AND REGION TO BENEFIT THE WELLBEING OF THOSE IN THE COMMUNITY. THESE INCLUDE: REGIONAL: COATS FOR KIDS PROJECT PROVIDED 1100 COATS FOR CHILDREN IN 28 SCHOOLS PORTABLE AED EQUIPMENT THAT CAN BE UTILIZED BY COMMUNITY PARTNERS TO HAVE AT EVENTS WHERE SUCH EQUIPMENT MIGHT NOT BE AVAILABLE. ADENA FOUNDATION PROVIDED $70,000 IN SCHOLARSHIPS TO STUDENTS FROM ADENA, CHILLICOTHE, JACKSON, LOGAN ELM, MCCLAIN, PAINT VALLEY, PIKETON, SOUTHEASTERN, TEAYS VALLEY, UNIOTO, VINTON COUNTY AND ZANE TRACE HIGH SCHOOLS BREAST CANCER AWARENESS CAMPAIGN IN REGION ($10,775)JACKSON COUNTY $12,000 SPONSORSHIP FOR JACKSON COUNT APPLE FESTIVAL SPONSORSHIP SPONSORED BOOKS FOR JACKSON COUNTY 600 4-H PARTICIPANTS AT A COST OF $4,800 PRESENTING SPONSOR FOR BIG RED DIAMOND CLUB ($2000) $1400 IN ADD-ONS FOR MARKET FAIR PROJECTS FOR JACKSON COUNTY JUNIOR FAIR PARTICIPANTS $750 SPONSORSHIP FOR THE JACKSON AREA KIWANIS 5K AND GOLF EVENTS $325 JACKSON ROUNDBALL BOOSTERSPICKAWAY COUNTY $16,000 TO SUPPORT OF THE CIRCLEVILLE PUMPKIN SHOW (INCLUDES COST OF BAGS) $15,000 DONATION TO PICKAWAY ADDICTION SERVICES $3000 SPONSORSHIP FOR THE ASHVILLE 4TH OF JULY FESTIVAL $1200 TO PICKAWAY COUNTY CHAMBER OF COMMERCE GOLF SPONSORSHIP $1000 TO PICKAWAY COUNTY AGRICULTURE AND EVENT CENTER (FAIR SPONSORSHIP). AN ADDITIONAL $250 IN ADD ONS FOR MARKET PROJECTS $1000 SPONSORSHIP FOR THE PICKAWAY COUNTY HEALTH FAIR $500 DEER CREEK DAM DAYS SPONSORSHIPVINTON COUNTY $1050 IN ADD-ONS FOR MARKET FAIR PROJECTS FOR VINTON COUNTY JUNIOR FAIR PARTICIPANTS |
| PART V, LINE 7A | HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW |
| PART V, LINE 10A | HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW |
| PARY V, LINE 16A, FAP | HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE |
| PART V, LINE 16B, FAP APPLICATION | HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY | HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $3,058,724 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN. |
| PART III, LINE 2: | THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS. |
| PART III, LINE 4: | WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR ADENA FAYETTE MEDICAL CENTER. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE SYSTEM'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE, ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE." |
| PART III, LINE 8: | MEDICARE SURPLUS, WHICH IS THE EXCESS OF REMIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT OVER COST TO TREAT MEDICARE PATIENTS. ADENA FAYETTE MEDICAL CENTER USED THE MEDICARE ALLOWABLE COSTS PER ITS 2023 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. |
| PART III, LINE 9B: | IF THE RESPONSIBLE INDIVIDUAL HAS NOT SUBMITTED A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE OR HAS NOT PAID-IN-FULL, FOUR SEPARATE STATEMENTS ARE SENT OUT FOR THE COLLECTION OF SELF-PAY ACCOUNTS. THE FINAL STATEMENT SENT WILL INFORM THE INDIVIDUAL OF POSSIBLE EXTRAORDINARY COLLECTION ACTIONS (ECA) TO BE TAKEN IF FINANCIAL ASSISTANCE IS NOT APPLIED FOR OR THE ACCOUNT IS NOT PAID IN FULL. AFTER THE FINAL STATEMENT AND BEFORE ECAS ARE TAKEN, REASONABLE EFFORTS ARE MADE TO ORALLY CONTACT THE INDIVIDUAL AS A FINAL NOTICE. PATIENTS WHO CANNOT PAY CHARGES IN FULL MAY ALSO BE OFFERED A PAYMENT PLAN THAT IS CONSISTENT WITH ADENA FAYETTE MEDICAL CENTER'S CUSTOMER SERVICE PROCEDURES. |
| PART VI, LINE 3: | THE AVAILABILITY OF FINANCIAL ASSISTANCE IS COMMUNICATED IN THE FOLLOWING MANNER: 1. STATEMENTS FROM ADENA AS WELL AS COLLECTION VENDORS EXPLAIN AND LIST THE 100% AND 60% ASSISTANCE GUIDELINES ON THE BACKSIDE OF THE STATEMENT. 2. THERE IS SIGNAGE EXPLAINING THE PROGRAM AT ALL THE REGISTRATION AREAS. 3. A CONTRACTED VENDOR SUPPLIES STAFF AT THE CASHIER AREA TO EXPLAIN OPTIONS AVAILABLE TO THE PATIENT. 4. WE SEND AN APPLICATION WITH THE SELF-PAY DISCOUNT LETTERS IN CASE THE PATIENT/GUARANTOR CAN'T SET UP A PAYMENT PLAN. 5. THE CUSTOMER SERVICE STAFF IS EDUCATED ON ALL THE OPTIONS AND CAN EXPLAIN THE PROGRAMS WHEN PATIENTS CALL. 6. OUR PHYSICIAN OFFICES, AS WELL AS COLLECTION VENDORS HAVE FINANCIAL AID APPLICATIONS AVAILABLE. 7. LASTLY, WE UTILIZE A "HINDSIGHT" VENDOR THAT SCREENS ALL BAD DEBT ACCOUNTS, AFTER THE YEAR-END, AGAINST THE STATE MEDICAID ELIGIBILITY AND FEDERAL POVERTY GUIDELINES TO ATTEMPT ONE LAST EFFORT TO OBTAIN FINANCIAL ASSISTANCE FOR INDIVIDUALS. |
| PART VI, LINE 5: | ADENA FAYETTE MEDICAL CENTER WORKS TO PROMOTE THE HEALTH OF ITS COMMUNITY THROUGH A VARIETY OF MEANS, INCLUDING BOARD MEMBERS, ADMINISTRATIONS, EMPLOYEES AND VOLUNTEERS. THE 2022 BOARD OF TRUSTEES OF ADENA FAYETTE MEDICAL CENTER WAS COMPRISED OF 5 MEMBERS WHO ALL RESIDE IN THE HOSPITAL'S SERVICE AREA. |
| PART VI, LINE 6: | FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES FOUR HOSPITALS AND EIGHT REGIONAL CLINICS, WITH A TOTAL OF 311 REGISTERED BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. FAYETTE MEDICAL GROUP, NOW KNOWN AS ADENA FAYETTE MEDICAL CENTER, WAS A GOVERNMENTAL HOSPITAL PRIOR TO 2021 AND BECAME A PART OF THE ADENA HEALTH SYSTEM DURING THE TAX YEAR. ADENA FAYETTE MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL IN CHILLICOTHE, OH, BENEFITTING THE FAYETTE COUNTY. ADENA GREENFIELD MEDICAL CENTER AND ADENA PIKE MEDICAL CENTER: BOTH ARE CRITICAL ACCESS HOSPITALS EACH, WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (ADENA GREENFIELD MEDICAL CENTER) AND PIKE COUNTY (ADENA PIKE MEDICAL CENTER) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WELLSTON, HILLSBORO, WASHINGTON COURT HOUSE AND WAVERLY, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE AND WAVERLY. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN). THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFF GRAHAM | ||||||||||||||
| AHS PRESIDENT & CEO | $0 | $956,818 | $0 | $39,688 | $0 | $13,860 | $0 | $23,080 | $0 | $35,120 | $0 | $1,068,566 | $0 | $0 |
| JIM MCMANUS | ||||||||||||||
| AHS CHIEF FINANCIAL OFFICER | $0 | $547,954 | $0 | $35,472 | $0 | $38,085 | $0 | $74,012 | $0 | $51,932 | $0 | $747,455 | $0 | $29,615 |
| KATHERINE EDRINGTON | ||||||||||||||
| AHS COO | $0 | $605,161 | $0 | $13,933 | $0 | $2,100 | $0 | $17,691 | $0 | $15,083 | $0 | $653,968 | $0 | $0 |
| JOSH MCCOY | ||||||||||||||
| SENIOR OPERATIONS EXECTUTIVE DIRECTO | $0 | $247,938 | $0 | $0 | $0 | $4,735 | $0 | $11,367 | $0 | $28,225 | $0 | $292,265 | $0 | $0 |
| LISA CARLSON | ||||||||||||||
| AHS CFO- FORMER | $0 | $28,082 | $0 | $291 | $0 | $241,683 | $0 | $931 | $0 | $89 | $0 | $271,076 | $0 | $241,505 |
| MELISSA LEMLE | ||||||||||||||
| PHARMACIST | $148,069 | $0 | $333 | $0 | $13,412 | $0 | $1,300 | $0 | $36,297 | $0 | $199,411 | $0 | $0 | $0 |
| CAROYLN WALLIN | ||||||||||||||
| DIR OPERATIONS CRITICAL ACCESS | $152,568 | $0 | $1,500 | $0 | $195 | $0 | $21,160 | $0 | $22,814 | $0 | $198,237 | $0 | $0 | $0 |
| TAMMIE WILSON | ||||||||||||||
| DIR NURSING | $151,183 | $0 | $1,200 | $0 | $599 | $0 | $27,388 | $0 | $1,917 | $0 | $182,287 | $0 | $0 | $0 |
| MATTHEW INSLEY | ||||||||||||||
| TL PHARMACY | $140,353 | $0 | $0 | $0 | $5,881 | $0 | $7,627 | $0 | $28,200 | $0 | $182,061 | $0 | $0 | $0 |
| EMILY STEPHENS | ||||||||||||||
| NURSE PRACTITIONER WRVU | $115,182 | $0 | $15,455 | $0 | $559 | $0 | $2,470 | $0 | $17,622 | $0 | $151,288 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | EXECUTIVE LEADERSHIP AT ADENA FAYETTE MEDICAL CENTER HAS THEIR COMPENSATION REVIEWED EVERY YEAR BY ADENA HEALTH SYSTEM, A RELATED PARTY. THE SYSTEM UTILIZES A SEPARATE COMPENSATION CONSULTING FIRM THAT USES SEVERAL AVAILABLE MARKET STUDIES FOR APPLICABLE POSITIONS IN COMPARABLE MARKETS. OTHER ADENA FAYETTE MEDICAL CENTER MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. |
| PART I, LINE 4B | ADENA HEALTH SYSTEM HAS A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENT FROM THE SERP IN 2023: LISA CARLSON $241,505 SERP EARNINGS JAMES MCMANUS $29,615 SERP EARNINGS THE SERP ACCRUALS, INCLUDED IN PART II, COLUMN (C), ARE AMOUNTS CREDITED TO THE EXECUTIVE UNDER THE SECTION 457(F) DEFERRED COMPENSATION PLAN. JAMES MCMANUS $60,232 SERP ACCRUAL |
| PART I, LINE 7 | MANAGEMENT OF ADENA HEALTH SYSTEM HAVE A PORTION OF THEIR ANNUAL SALARY AT RISK UNDER A VARIABLE COMPENSATION PLAN. IF THE OPERATING RESULTS OF AHS MEET A MARGIN TARGET IN ANY FISCAL YEAR, ADDITIONAL COMPENSATION IS PAID THAT IS CALCULATED USING THE OPERATING MARGIN ALONG WITH RESULTS IN EMPLOYEE ENGAGEMENT, PATIENT QUALITY, AND SATISFACTION USING A BALANCED SCORECARD FORMULA. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF ADENA FAYETTE MEDICAL CENTER IS ADENA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF THE ORGANIZATION NOMINATES TRUSTEES, AND ADENA HEALTH SYSTEM, AS THE SOLE MEMBER OF THE ORGANIZATION, ELECTS THE TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN GOVERNANCE DECISIONS ARE RESERVED FOR ADENA HEALTH SYSTEM AS THE SOLE MEMBER OF THE ORGANIZATION, SUCH AS THE ELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE ORGANIZATION, APPROVAL OF STRATEGIC PLANS OF THE ORGANIZATION, AND APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND CODE OF REGULATIONS. ADENA HEALTH SYSTEM CAN ACT ON THESE RIGHTS BY A VOTE AT ANY MEETING, AN ACTION WITHOUT A MEETING, OR THROUGH OTHER AUTHORIZED MEANS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PROVIDED TO THE ADENA HEALTH SYSTEM BOARD MEMBERS FOR REVIEW AND APPROVAL BEFORE FILING. ADENA HEALTH SYSTEM IS THE SOLE MEMBER AND THE RETURN IS AVAILABILE VIA THE BOARD PORTAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE OFFICE OF ADENA HEALTH SYSTEM ANNUALLY COORDINATES THE DISTRIBUTION AND RETURN OF THE CONFLICT OF INTEREST STATEMENTS. ALL CONFLICTS ARE REVIEWED, AND THE CORPORATE COMPLIANCE OFFICE IS RESPONSIBLE FOR REVIEWING THE RESPONSES AND COMMUNICATING ANY EXTRA STEPS THAT NEED TO TAKE PLACE REGARDING ANY OF THE RESPONSES. AT EVERY BOARD MEETING AND COMMITTEE OF THE BOARD, THE AGENDA ITEM OF CONFLICT OF INTEREST IS INCLUDED AND CALLED OUT. CONFLICTED BOARD MEMBERS ABSTAIN FROM VOTING ON THE PARTICULAR ITEMS. ANY MEMBER ABSTAINING FROM VOTING IS DOCUMENTED IN THE MINUTES. FRONT LINE SUPERVISORS UP THROUGH THE CEO AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE TOP MANAGEMENT OFFICIAL AT ADENA GREENFIELD MEDICAL CENTER HAS HIS COMPENSATION REVIEWED EVERY OTHER YEAR BY ADENA HEALTH SYSTEM TOTAL REWARDS TEAM. THE LAST REVIEW WAS COMPLETED IN 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | TRANSFER (TO) FROM RELATED ORGANIZATION -8,505,955. |
| FORM 990, PART XII, LINE 2C: | THE ADENA HEALTH SYSTEM'S AUDIT COMMITTEE ENGAGES THE INDEPENDENT AUDIT FIRM FOR THE AUDIT, REVIEWS RESULTS, AND REPORTS TO THE BOARD. ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. FAYETTE MEDICAL CENTER IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. |
| FORM 990, PART V, LINE 1 | A RELATED ORGANIZATION, ADENA HEALTH SYSTEM, ISSUES THE 1099S. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADENA HEALTH FOUNDATION | |||||||||||
| 272 HOSPITAL ROAD | CHILLICOTHE | OH | 45601 | 753008742 | FUNDRAISING | OH | 501(C)(3) | 12A | ADENA HEALTH SYSTEM | Yes (1) | |
| ADENA HEALTH SYSTEM | |||||||||||
| 272 HOSPITAL ROAD | CHILLICOTHE | OH | 45601 | 314379443 | HOSPITAL | OH | 501(C)(3) | 3 | 0 | N/A | |
| GREENFIELD AREA MEDICAL CENTER | |||||||||||
| 550 MIRABEAU ST | GREENFIELD | OH | 45123 | 310993422 | HOSPITAL | OH | 501(C)(3) | 3 | ADENA HEALTH SYSTEM | Yes (1) | |
| PIKE HEALTH SERVICES | |||||||||||
| 100 DAWN LANE | WAVERLY | OH | 45690 | 311072406 | HOSPITAL | OH | 501(C)(3) | 3 | ADENA HEALTH SYSTEM | Yes (1) | |
| SOUTHERN OHIO HEALTHCARE NETWORK | |||||||||||
| 272 HOSPITAL ROAD | CHILLICOTHE | OH | 45601 | 261566590 | FIBEROPTIC NETWORK GRANTS | OH | 501(C)(3) | 12A | ADENA HEALTH SYSTEM | Yes (1) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADENA CARE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1Txt |
| City | CHILLICOTHE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453980850 | EIN |
| Primary Activities | SEE SCHEDULE R, PART VII | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART IV, COLUMN (B) | FormAndLineReferenceDesc |
| Explanation | THE PRIMARY ACTIVITY OF ADENA CARE IS TO DEVELOP STRATEGIC RELATIONSHIPS TO THE SERVICE AREAS MAJOR EMPLOYERS THROUGH HEALTH MANAGEMENT AND WELLNESS SERVICES. | ExplanationTxt |