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JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL (EIN 34-1623770)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-14
IRS object ID
202303189349305440
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-14T10:52:04-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1250 S HIGH ST SUITE 100AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341623770EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOINT TOWNSHIP DISTRICTBusinessNameLine1Txt
Business Name Line2MEMORIAL HOSPITALBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlJOINBusinessNameControlTxt
Phone4193943387PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STREETAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTRICIA A POHLPersonNm
Person TitleCFOPersonTitleTxt
Phone4193943387PhoneNum
Signature2023-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTRICIAPersonFirstNm
Person LastPOHLPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY CIMINELLOPreparerPersonNm
PTINP00796388PTIN
Phone6148493000PhoneNum
Preparation2023-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GRAND LAKE HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerCYNTHIA BERNINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STREETAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$100,878,263GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GRANDLAKEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHE MISSION OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL IS TO OPTIMIZE THE HEALTH STATUS OF THOSE WE SERVE BY PROVIDING THE HIGHEST QUALITY, VALUE AND SERVICE WHILE REMAINING FINANCIALLY STRONG.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee787TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI-$886TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$8,376NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$357,017PYContributionsGrantsAmt
CY Contributions Grants$751,504CYContributionsGrantsAmt
PY Program Service Revenue$99,420,541PYProgramServiceRevenueAmt
CY Program Service Revenue$98,185,957CYProgramServiceRevenueAmt
PY Investment Income$988,164PYInvestmentIncomeAmt
CY Investment Income$391,544CYInvestmentIncomeAmt
PY Other Revenue$941,075PYOtherRevenueAmt
CY Other Revenue$949,625CYOtherRevenueAmt
PY Total Revenue$101,706,797PYTotalRevenueAmt
CY Total Revenue$100,278,630CYTotalRevenueAmt
PY Grants And Similar Paid$79,350PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$95,450CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,650,505PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$33,243,264CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$142,122CYTotalFundraisingExpenseAmt
PY Other Expenses$57,006,556PYOtherExpensesAmt
CY Other Expenses$57,419,123CYOtherExpensesAmt
PY Total Expenses$91,736,411PYTotalExpensesAmt
CY Total Expenses$90,757,837CYTotalExpensesAmt
PY Revenues Less Expenses$9,970,386PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,520,793CYRevenuesLessExpensesAmt
Total Assets BOY$92,663,170TotalAssetsBOYAmt
Total Assets EOY$86,269,366TotalAssetsEOYAmt
Total Liabilities BOY$33,047,816TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,893,218TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$59,615,354NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$57,376,148NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL IS TO OPTIMIZE THE HEALTH STATUS OF THOSE WE SERVE BY PROVIDING THE HIGHEST QUALITY, VALUE AND SERVICE WHILE REMAINING FINANCIALLY STRONG.VISION: TO BE: THE REGION'S LEADER AND PREFERRED CHOICE FOR HEALTHCARE; THE MOST DESIRED PLACE FOR EMPLOYMENT; THE RECOGNIZED SOURCE FOR HEALTH AND WELLNESS; AND THE COORDINATOR OF PATIENT SERVICES THAT EXCEED THE SCOPE OF OUR HEALTH SYSTEM.VALUES:- COMPASSION: TO SERVE WITH DIGNITY, CONCERN, TRUST AND KINDNESS- RESPECT: FOR OUR PATIENTS, FAMILIES, COMMUNITIES AND EACH OTHER- STEWARDSHIP: MAKING THE BEST USE OF OUR HUMAN AND ECONOMIC RESOURCES- SERVICE EXCELLENCE: ANTICIPATING CUSTOMER NEEDS, CONTINUOUSLY IMPROVING AND CONSISTENTLY EXCEEDING EXPECTATIONS- COLLABORATION: TO WORK IN PARTNERSHIP, INTERNALLY AND EXTERNALLY, TO BETTER SERVE OUR COMMUNITIES- WORKFORCE: TO VALUE AND RESPECT THE TALENTED, COMMITTED AND DIVERSE PEOPLE WHO MAKE UP OUR HEALTH SYSTEMMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$74,972,954ExpenseAmt
Grant$95,450GrantAmt
Revenue$98,310,721RevenueAmt
DescGRAND LAKE HEALTH SYSTEM AND AFFILIATED HEALTH CENTERS ARE ORGANIZED AS A CHARITABLE, NON-PROFIT COMMUNITY HOSPITAL OFFERING A WIDE RANGE OF PRIMARY, ACUTE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF THE GRAND LAKE REGION.THE ANCHOR OF GRAND LAKE HEALTH SYSTEM IS JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL (JTDMH) IN ST. MARYS OHIO. JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL OPENED ITS DOORS ON MAY 5, 1953 AND TODAY AS THE GRAND LAKE HEALTH SYSTEM, HAS GROWN TO A STATE-OF-THE-ART COMMUNITY HOSPITAL INCLUDING OVER 800 MEDICAL PROFESSIONALS, 200 + PHYSICIANS AND OVER 20 AFFILIATES.JTDMH IS LOCATED IN ST. MARYS (AUGLAIZE COUNTY), A RURAL SMALL-TOWN ENVIRONMENT DOMINATED BY AGRICULTURE AND MANUFACTURING. JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL'S CORE SERVICE AREA OF ST. MARYS, MINSTER, NEW BREMEN AND NEW KNOXVILLE ZIP CODES INCLUDES A POPULATION OF 24,483 WITH THE ADJACENT COMMUNITIES OF CELINA (ZIP CODE POPULATION OF 20,375) AND WAPAKONETA (POPULATION 18,399) ALSO BEING SERVED BY THE HOSPITAL. THE ABOVE COMMUNITIES ACCOUNT FOR OVER 80% OF JTDMH'S PATIENTS. THOSE ZIP CODES HAVE A TOTAL POPULATION OF 63,257 WITH 17% IN THE MEDICARE AGE GROUP (65+).JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL PROVIDES A FULL RANGE OF ACUTE AND OUTPATIENT SERVICES INCLUDING A 24-HOUR EMERGENCY ROOM AND OBSTETRICAL SERVICE. MAJOR SERVICES INCLUDE SURGICAL; MEDICAL; SKILLED NURSING UNIT; INPATIENT REHABILITATION UNIT; INPATIENT PSYCHIATRIC UNIT; ICU/CCU; DIAGNOSTIC RADIOLOGY INCLUDING CT, MRI AND 3D MAMMOGRAPHY; PHYSICAL THERAPY; OCCUPATIONAL MEDICINE; CARDIAC SERVICES; URGENT CARE; HOME HEALTH SERVICES; HOSPICE; WOUND CARE; HEARTBURN CENTER AND VEIN CLINIC SERVICES.THE GRAND LAKE SYSTEM COMMUNITY OUTREACH DEPARTMENT OFFERS A VARIETY OF OUTREACH PROGRAMS THAT PROMOTE GOOD HEALTH AMONG ALL AREA CITIZENS NOT JUST PATIENTS. THE GOAL IS TO EDUCATE PEOPLE SO THEY GAIN THE SKILLS AND KNOWLEDGE TO KEEP THEMSELVES AND THOSE AROUND THEM HEALTHY. MANY OF THE CLASSES, SERVICES, AND PROGRAMS HAVE EVOLVED FROM A SUGGESTION BY A HEALTHCARE PROVIDER OR LOCAL RESIDENT. THE OUTREACH DEPARTMENT OFFERS HUNDREDS OF PROGRAMS A YEAR RANGING FROM BLOOD PRESSURE SCREENINGS, SUPPORT GROUPS, SCHOOL PROGRAMS, AND COMMUNITY HEALTH FAIRS TO NAME A FEW. DURING 2022, JTDMH PROVIDED SERVICES TO THE FOLLOWING BY CATEGORY:ACUTE PATIENTS ADMITTED: 1,627SNF PATIENTS ADMITTED: 113INPATIENT PSYCH PATIENTS ADMITTED: 186BIRTHS: 313OUTPATIENT VISITS: 79,761 E.R. VISITS: 12,288HOME HEALTH VISITS: 5,357OCCUPATIONAL HEALTH VISITS: 11,265URGENT CARE VISITS: 6,074JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL AND GRAND LAKE HEALTH SYSTEM IS THE HUB OF THE LOCAL HEALTH CARE DELIVERY SYSTEM IN ST. MARYS AND SURROUNDING COMMUNITIES. THE NON-PROFIT COMMUNITY HOSPITAL ALSO HAS A MAJOR ECONOMIC IMPACT ON THE LOCAL COMMUNITY BY PROVIDING EMPLOYMENT TO APPROXIMATELY 700 INDIVIDUALS. THE GRAND LAKE HEALTH SYSTEM INCLUDES PHYSICIAN PRACTICES AND FACILITIES IN CELINA, ST. MARYS, WAPAKONETA, AND MINSTER. IN 2022, THESE PRACTICES HAD 90,347 PATIENT VISITS.GRAND LAKE AFFILIATES INCLUDE: JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL GRAND LAKE FAMILY PRACTICE & PEDIATRICS AT THE CELINA MEDICAL CENTER WAPAKONETA PRIMARY CARE AT THE WAPAKONETA MEDICAL CENTER GRAND LAKE FOOT & ANKLE CENTER GRAND LAKE HOME HEALTH GRAND LAKE HOSPICE GRAND LAKE PRIMARY CARE AT ST. MARYS GRAND LAKE OB/GYN GRAND LAKE OCCUPATIONAL MEDICINE GRAND LAKE REHAB & WELLNESS CENTER GRAND LAKE HEARTBURN CENTER MIAMI & ERIE FAMILY PRACTICE & PEDIATRICS GRAND LAKE SLEEP CENTER NEW DAY PAIN MANAGEMENT CENTER GRAND LAKE NEUROLOGICAL CENTER VANAN ENT & SINUS CENTER JTDMH TRANSITIONAL CARE UNIT JTDMH INPATIENT REHAB UNIT AUGLAIZE + MERCER GENERAL & BARIATRIC SURGERY URGENT CARE AT JTDMH INPATIENT PSYCHIATRIC CENTER CANCER CENTER OF NORTHWEST OHIO GRAND LAKE PEDIATRICS KEMMLER ORTHOPAEDIC MOR REHAB CIAO MED SPAWE HAVE INVESTED SIGNIFICANTLY IN THE BUILDING DURING THE PAST TEN YEARS INCLUDING COMPLETING A NEW WOMEN'S CENTER, LABORATORY, WOUND CARE CENTER WITH TWO HYPERBARIC CHAMBERS, A NEUROLOGY CENTER, SLEEP CENTER AND THE MIAMI & ERIE MEDICAL CENTER IN MINSTER. IN EARLY 2021, GRAND LAKE HEALTH SYSTEM COMPLETED A NEW STATE OF THE ART 31,286 SQ. FT. MEDICAL OFFICE BUILDING THAT PROVIDES SPACE FOR PRIMARY CARE, OB/GYN, LAB, ADMINISTRATIVE PHYSICIANS' OFFICES, AMONG OTHER SERVICES. IN CONJUNCTION WITH PREMIER HEALTH, GRAND LAKE HEALTH SYSTEM ENTERED INTO A TEN YEAR NAMING RIGHTS PARTNERSHIP WITH THE AUGLAIZE MERCER FAMILY YMCA LOCATED IN MINSTER & CELINA. THIS PARTNERSHIP FOCUSES ON MEETING THE NEEDS OF THOSE SERVED BY EXTENDING THE MUTUAL MISSION TO BUILD HEALTHY COMMUNITIES.JTDMH RECEIVED THE FOLLOWING CERTIFICATIONS AND WAS THE RECIPIENT OF THE FOLLOWING AWARDS IN THE PAST THREE YEARS. BIRTHING CENTER 2020 ANTHEM BLUE DISTINCTION 2021 ANTHEM BLUE DISTINCTION 2021 OHIO FIRST STEPS FOR HEALTHY BABIES, THREE STAR AWARD 2022 OHIO FIRST STEPS FOR HEALTHY BABIES, FOUR STAR AWARD 2022 RECERTIFIED AS GOLD SAFE SLEEP CHAMPION 2022 ANTHEM BLUE DISTINCTION CARDIAC REHAB 2020 AACVPR CARDIAC REHAB REACCREDITATION 2021 INTENSIVE CARDIAC REHAB NEW SERVICECOMMUNITY OUTREACH AWARDS 2020 HEALTHY WORKSITE GOLD AWARD LEVEL 2021 HEALTHY WORKSITE GOLD AWARD LEVEL 2022 HEALTHY WORKSITE PLATINUM AWARD LEVELDIABETIC EDUCATION & CLINICAL NUTRITIONOUTPATIENT DIABETES SELF-MANAGEMENT EDUCATION CERTIFICATE OF RECOGNITION FOR MEETING NATIONAL STANDARDS, FROM AMERICAN DIABETES ASSOCIATION 2023-2027CDC FULL RECOGNITION FOR DIABETES PREVENTION PROGRAM 2019-2021CDC FULL RECOGNITION FOR DIABETES PREVENTION PROGRAM 2022-2024EMERGENCY DEPARTMENT 2020 ACUTE STROKE READY CERTIFICATION: DEFICIENCY FREE SURVEY 2021 ACUTE STROKE READY CERTIFICATION: DEFICIENCY FREE SURVEY 2022 ACUTE STROKE READY CERTIFICATION: DEFICIENCY FREE SURVEYINPATIENT PSYCHIATRIC CENTER 2020 CNV SURVEY: NO CITATIONSMEDICAL IMAGING 2021 ACR REACCREDITATION IN 3D MAMMOGRAPHY 2021 ACR REACCREDITATION IN MAMMOGRAPHY 2022-2025 ACR REACCREDITATION IN MRI 2022-2026 ACR REACCREDITATION IN CT NEW VISION MEDICAL LABORATORY 2023-2025 RECERTIFICATION OF HFAPPHARMACY 2020 COMPREHENSIVE PHARMACY SERVICES TOP 10% 2020 COMPREHENSIVE PHARMACY BEST PRACTICE SITE AWARD 2020 COMPREHENSIVE PHARMACY SERVICE GLENN ETOW PRESIDENT AWARD QUALITY 2020 ANNUAL ACCREDITATION: 0 DEFICIENCIES 2020 ISO SURVEY: 5/5 SCORE 2021 5-STAR RATING MEDICARE COMPARE 2022 5-STAR RATING MEDICARE COMPARESLEEP 2021 AASM SLEEP CENTER REACCREDITATION TRANSITIONAL CARE UNIT 2020 5-STAR MEDICARE COMPARE FACILITY 2021 5-STAR MEDICARE COMPARE FACILITY 2022 5-STAR MEDICARE COMPARE FACILITYVOLUNTEERS 2020 CERTIFIED DIRECTOR OF VOLUNTEER SERVICES (CDVS)WOUND CARE CENTER 2020 HEALOGICS CENTER OF DISTINCTION AWARD 2020 ROBERT A WARRINER III CENTER OF EXCELLENCE AWARD 2021 ROBERT A WARRINER III, CLINICAL EXCELLENCE AWARD 2021 CENTER OF DISTINCTION AWARD 2021 PRESIDENTS CIRCLE AWARD 2022 CENTER OF DISTINCTION 2022 ROBERT A WARRINER III CENTER OF EXCELLENCE AWARDWELCOMED THE FOLLOWING PROVIDERS IN 2022:PADMAJA CHALASANI, MDDesc
Total Program Service Expenses$74,972,954TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document152IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee787EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TRICIA A POHLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4193943387PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RAJENDRA KAKARLA MD
DIRECTOR1.000.00Yes (X)$404,553$0$0
KEN FOX
DIRECTOR1.000.00Yes (X)$4,200$0$0
CHRIS SCHROER
CHAIR2.000.00Yes (X)$0$0$0Yes (X)
JEFFREY SQUIRE
VICE CHAIR1.500.00Yes (X)$0$0$0Yes (X)
ANITA GREEN
CHAIR - PART YEAR2.000.00Yes (X)$0$0$0Yes (X)
CLAUDIA COE
DIRECTOR1.000.00Yes (X)$0$0$0
ISAAC HOYING
DIRECTOR1.000.00Yes (X)$0$0$0
RANDALL NIEKAMP
DIRECTOR1.000.00Yes (X)$0$0$0
WALLY WAGNER
DIRECTOR1.000.00Yes (X)$0$0$0
BRIAN SCHLOSSER
DIRECTOR1.000.00Yes (X)$0$0$0
CYNTHIA BERNING
PRESIDENT24.0021.00$333,700$150,208$30,998Yes (X)
TRICIA POHL
TREASURER38.007.00$217,895$0$46,830Yes (X)
LESLIE WOBLER
SECRETARY30.0010.00$64,891$0$23,152Yes (X)
LANA HINDERS
CHIEF CLINICAL OFFICER44.001.00$200,082$0$44,921Yes (X)
TYLER KROEGER
VP OF OPERATIONS45.000.00$156,389$0$26,735Yes (X)
HOLLY JACOMET
VP OF QUALITY AND PHYSICIAN PRACTICES45.000.00$154,045$0$5,433Yes (X)
SHELLY RUPPERT
EXECUTIVE DIRECTOR OF HR40.000.00$157,362$0$40,633Yes (X)
AMY DIRKSEN
ED OF SPECIALTY CARE SERVICES40.000.00$143,065$0$38,604Yes (X)
JILL ENGEL
DIRECTOR OF INPATIENT SERVICES40.000.00$138,861$0$38,158Yes (X)
LORI MILLER
CHIEF OF INFORMATION SERVICES40.000.00$133,349$0$35,628Yes (X)
LESIA ARNETT
EXEC DIRECTOR DEVELOPMENT, MARKETING40.000.00$139,005$0$27,680Yes (X)
KEVIN HARLAN
FORMER PRESIDENT0.000.00$242,771$0$0Yes (X)
JEFF VOSSLER
FORMER CFO0.000.00$107,823$0$11,935Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,597,991TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$150,208TotReportableCompRltdOrgAmt
Total Other Compensation$370,707TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EMERGENCY PHYSICIANS OF NW OHIO
PO BOX 351357TOLEDOOH43635MEDICAL SERVICES$3,923,400
JTDM FAMILY PRACTICE
200 ST CLAIR STST MARYSOH45885MEDICAL SERVICES$3,023,404
THERAPY SOLUTIONS
120 W MAIN STVAN WERTOH45891MEDICAL SERVICES$2,239,541
NEW VISION MEDICAL LABORATORIES INC
680 S FOURTH STREETLOUISVILLEKY63150MEDICAL SERVICES$2,012,166
QUALIVIS LLC
PO BOX 123847DALLASTX75312MEDICAL SERVICES$1,470,461
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Related Organizations$306,991RelatedOrganizationsAmt
Government Grants$444,513GovernmentGrantsAmt
Total Contributions$751,504TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE621400$98,191,372$98,191,372
PASSTHROUGH INCOME621400-$5,415-$5,415
FieldValueIRS element (for citing)
Total Program Service Revenue$98,185,957TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$434,289TotalRevenueColumnAmt
Exclusion$434,289ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$905,675RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$542,424RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$363,251RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$363,251TotalRevenueColumnAmt
Unrelated Business Revenue-$16,289UnrelatedBusinessRevenueAmt
Exclusion$379,540ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$14,464OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$57,209OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$42,745OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$42,745TotalRevenueColumnAmt
Exclusion-$42,745ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA AND VENDING SALES722514$441,436$441,436
HPSA INCENTIVES621400$62,903$62,903
OUTREACH621400$37,203$37,203

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,832TotalRevenueColumnAmt
Related Or Exempt Func Income$24,658RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$15,403UnrelatedBusinessRevenueAmt
Exclusion$4,771ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$586,374OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,278,630TotalRevenueColumnAmt
Related Or Exempt Func Income$98,310,721RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$886UnrelatedBusinessRevenueAmt
Exclusion$1,217,291ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$95,450TotalAmt
Program Services$95,450ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,751,971TotalAmt
Management And General$1,751,971ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,983,807TotalAmt
Program Services$18,837,619ProgramServicesAmt
Management And General$2,060,385ManagementAndGeneralAmt
Fundraising$85,803FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,144,154TotalAmt
Program Services$1,006,153ProgramServicesAmt
Management And General$133,503ManagementAndGeneralAmt
Fundraising$4,498FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,440,085TotalAmt
Program Services$6,324,296ProgramServicesAmt
Management And General$1,087,516ManagementAndGeneralAmt
Fundraising$28,273FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,923,247TotalAmt
Program Services$1,610,122ProgramServicesAmt
Management And General$305,927ManagementAndGeneralAmt
Fundraising$7,198FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$164,184TotalAmt
Management And General$164,184ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$151,957TotalAmt
Management And General$151,957ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$61,682TotalAmt
Management And General$61,682ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$25,097,433TotalAmt
Program Services$22,859,249ProgramServicesAmt
Management And General$2,234,956ManagementAndGeneralAmt
Fundraising$3,228FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$245,886TotalAmt
Program Services$13,912ProgramServicesAmt
Management And General$231,974ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,589,192TotalAmt
Program Services$2,719,446ProgramServicesAmt
Management And General$857,150ManagementAndGeneralAmt
Fundraising$12,596FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,516,317TotalAmt
Program Services$3,936,943ProgramServicesAmt
Management And General$3,579,374ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$173,185TotalAmt
Program Services$161,926ProgramServicesAmt
Management And General$10,733ManagementAndGeneralAmt
Fundraising$526FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$442,139TotalAmt
Program Services$357,953ProgramServicesAmt
Management And General$84,186ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$415,431TotalAmt
Management And General$415,431ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,462,567TotalAmt
Program Services$3,391,551ProgramServicesAmt
Management And General$1,071,016ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,312,300TotalAmt
Management And General$1,312,300ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$9,043,566$9,043,566
BAD DEBT EXPENSE$4,591,347$4,591,347
PHYSICIAN RECRUITMENT$36,446$36,446
AWARDS AND RECOGNITION$16,502$16,502

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$98,989TotalAmt
Program Services$23,421ProgramServicesAmt
Management And General$75,568ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$90,757,837TotalAmt
Program Services$74,972,954ProgramServicesAmt
Management And General$15,642,761ManagementAndGeneralAmt
Fundraising$142,122FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$218,737BOYAmt
EOY$155,614EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$18,072,505BOYAmt
EOY$15,115,291EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$19,295,359BOYAmt
EOY$16,459,827EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,215,450BOYAmt
EOY$1,558,078EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,883,686BOYAmt
EOY$1,648,414EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$101,987,899LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$71,270,041LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$32,927,121BOYAmt
EOY$30,717,858EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$16,233,799BOYAmt
EOY$13,519,708EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,409,830BOYAmt
EOY$2,363,562EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$406,683BOYAmt
EOY$4,731,014EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$92,663,170BOYAmt
EOY$86,269,366EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,160,183BOYAmt
EOY$7,472,597EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,564,103BOYAmt
EOY$2,307,693EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$8,530,411BOYAmt
EOY$6,985,039EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,793,119BOYAmt
EOY$12,127,889EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,047,816BOYAmt
EOY$28,893,218EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$59,615,354BOYAmt
EOY$57,376,148EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,615,354BOYAmt
EOY$57,376,148EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,663,170BOYAmt
EOY$86,269,366EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$9,520,793ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$3,000,286NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$8,759,713OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$1,793OtherActivitiesAmt
Total Lobbying Expenditures$1,793TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationLINE 1(G): EXECUTIVE OFFICERS OF JTD MEMORIAL HOSPITAL PLACED CALLS WITH THEIR LEGISLATORS TO HELP EDUCATE THE LEGISLATORS ON VARIOUS HEALTH CARE RELATED ISSUES. LINE 1(I): THE HOSPITAL PAID DUES TO OHA, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$166,975BeginningYearBalanceAmt
Contributions$41,309ContributionsAmt
Investment Earnings Or Losses-$18,361InvestmentEarningsOrLossesAmt
Other Expenditures$5,292OtherExpendituresAmt
End Year Balance$184,631EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$62,756BeginningYearBalanceAmt
Contributions$100,100ContributionsAmt
Investment Earnings Or Losses$4,119InvestmentEarningsOrLossesAmt
End Year Balance$166,975EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$63,135BeginningYearBalanceAmt
Contributions$100ContributionsAmt
Investment Earnings Or Losses$5,916InvestmentEarningsOrLossesAmt
Other Expenditures$6,395OtherExpendituresAmt
End Year Balance$62,756EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,607BeginningYearBalanceAmt
Investment Earnings Or Losses$8,528InvestmentEarningsOrLossesAmt
End Year Balance$63,135EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$57,509ContributionsAmt
Investment Earnings Or Losses-$2,902InvestmentEarningsOrLossesAmt
End Year Balance$54,607EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,840,845OtherCostOrOtherBasisAmt
Book Value$1,840,845BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,588,730OtherCostOrOtherBasisAmt
Depreciation$44,317,503DepreciationAmt
Book Value$19,271,227BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,484,471OtherCostOrOtherBasisAmt
Depreciation$26,952,538DepreciationAmt
Book Value$9,531,933BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$73,853OtherCostOrOtherBasisAmt
Book Value$73,853BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,717,858TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
MISCELLANEOUS ACCOUNTS RECEIVABLE$368,141
COST REPORT SETTLEMENT RECEIVABLE$1,641,485
RIGHT OF USE ASSET$2,721,388
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,731,014TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
PROFESSIONAL LIABILITY$6,865,085
COST REPORT SETTLEMENT PAYABLE$1,396,210
OTHER LONG TERM LIABILITIES$1,057,935
LEASE LIABILITY$2,808,659
FieldValueIRS element (for citing)
Total Liability$12,127,889TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationJTD HOSPITAL FOUNDATION, A RELATED ORGANIZATION, HOLDS THE NED & FERN JOHNS INPATIENT PSYCHIATRIC ENDOWMENT FUND AND THE HEINRICH FAMILY ENDOWMENT FUND. THE NED & FERN JOHNS INPATIENT PSYCHIATRIC ENDOWMENT FUND THE INTENTION OF THIS FUND IS TO SUPPORT SPECIALIZED SERVICES TO THE INPATIENT PSYCHIATRIC CENTER. THIS ENDOWMENT FUND MAY UTILIZED TO SUPPORT SPECIALIZED SERVICES INCLUDING BUT NOT LIMITED TO MUSIC THERAPY, ART THERAPY, EDUCATION FOR PATIENTS, FAMILIES, AND THE COMMUNITY, ONGOING EDUCATIONAL NEEDS OF THE INPATIENT PSYCHIATRIC STAFF RELATED TO THE TYPE OF CARE, PROVIDED ON THIS UNIT, AND SUPPLIES SPECIFIC FOR INPATIENT PSYCH PATIENTS SUCH AS WEIGHTED BLANKETS, SENSORY BOXES, FIDGET BOARDS, OR OTHER ACTIVITIES THAT PROVIDE A SAFE SUPPORTIVE ENVIRONMENT AIMED AT HELPING PATIENTS ACHIEVE THEIR OPTIMAL LEVEL OF FUNCTIONING. THE HEINRICH FAMILY ENDOWMENT FUND THE HEINRICH FAMILY ENDOWMENT FUND HAS BEEN ESTABLISHED TO PROVIDE FUTURE INCOME TO SUPPORT JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL'S EFFORTS TO MEET THE HEALTH CARE NEEDS OF OUR SURROUNDING COMMUNITIES. THE REQUEST FOR A GRANT MUST BE FOR AN ITEM OR SERVICE THAT WILL BENEFIT THE SAFETY, CARE, AND/OR COMFORT OF PATIENTS BEING CARED FOR BY JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. REQUESTS FOR FUNDS MAY ALSO BE REQUESTED TO SUPPORT A COMMUNITY PARTNERSHIP INITIATIVE THAT RELATES TO A NEED IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other120.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served134PersonsServedCnt
Total Community Benefit Expns$112,875TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$112,875NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served11363PersonsServedCnt
Total Community Benefit Expns$13,660,550TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,016,555DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,643,995NetCommunityBenefitExpnsAmt
Total Expense0.08870TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served11497PersonsServedCnt
Total Community Benefit Expns$13,773,425TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,016,555DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,756,870NetCommunityBenefitExpnsAmt
Total Expense0.09000TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs63ActivitiesOrProgramsCnt
Persons Served14495PersonsServedCnt
Total Community Benefit Expns$718,165TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,938DirectOffsettingRevenueAmt
Net Community Benefit Expns$714,227NetCommunityBenefitExpnsAmt
Total Expense0.00830TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served45PersonsServedCnt
Total Community Benefit Expns$60,088TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$60,088NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served686PersonsServedCnt
Total Community Benefit Expns$61,822TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$61,822NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$62TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$62NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served706PersonsServedCnt
Total Community Benefit Expns$101,860TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$74DirectOffsettingRevenueAmt
Net Community Benefit Expns$101,786NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs71ActivitiesOrProgramsCnt
Persons Served15932PersonsServedCnt
Total Community Benefit Expns$941,997TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,012DirectOffsettingRevenueAmt
Net Community Benefit Expns$937,985NetCommunityBenefitExpnsAmt
Total Expense0.01090TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs71ActivitiesOrProgramsCnt
Persons Served27429PersonsServedCnt
Total Community Benefit Expns$14,715,422TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,020,567DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,694,855NetCommunityBenefitExpnsAmt
Total Expense0.10090TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$999TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$999NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs7ActivitiesOrProgramsCnt
Persons Served1162PersonsServedCnt
Total Community Benefit Expns$37,025TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,565DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,460NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served251PersonsServedCnt
Total Community Benefit Expns$1,091TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,091NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served1PersonsServedCnt
Total Community Benefit Expns$11,977TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,977NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served163PersonsServedCnt
Total Community Benefit Expns$9,172TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,172NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs18ActivitiesOrProgramsCnt
Persons Served1577PersonsServedCnt
Total Community Benefit Expns$60,264TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,565DirectOffsettingRevenueAmt
Net Community Benefit Expns$54,699NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$4,591,347BadDebtExpenseAmt
Bad Debt Expense Attributable$50,046BadDebtExpenseAttributableAmt
Reimbursed By Medicare$12,736,491ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$19,232,469CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,495,978MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JTD MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 SAINT CLAIR STREETAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.GRANDLAKEHEALTH.ORGWebsiteAddressTxt
State LicenseSTATE REG. NO. 1111StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherINPATIENT REHAB UNIT, TRANSITIONAL CARE UNIT, GERIATRIC PSYCH UNITOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JTD MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care120.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, PAGE 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, PAGE 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, PAGE 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
JTD MEMORIAL HOSPITALPART V, SECTION B, LINE 5: JTD MEMORIAL HOSPITAL CREATED A COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE THAT MET ON JUNE 17, 2019. PARTICIPANTS INCLUDED THE AUGLAIZE COUNTY HEALTH DEPARTMENT, THE MERCER COUNTY HEALTH DEPARTMENT, THE AUGLAIZE COUNTY COUNCIL ON AGING, ST. MARY'S CITY SCHOOLS, UNITED WAY, AND THE FOLLOWING GROUPS FROM JTD MEMORIAL HOSPITAL:- PATIENT CARE SERVICES- HOSPITAL FOUNDATION AND GRAND LAKE HOME HEALTH/HOSPICE- EMPLOYED PHYSICIAN PRACTICES- COMMUNITY OUTREACH- ADMINISTRATIONPARTICIPANTS WERE PROVIDED A REPORT COMPILED BY AN INDEPENDENT CONSULTANT, WHICH DREW DATA FROM VARIOUS WEB SOURCES WITH BOTH AUGLAIZE AND MERCER COUNTY HEALTH INDICATORS AND HEALTH STATUS PROFILES FROM 2019. THERE WERE FIVE MAIN SOURCES FOR THIS DATA OHIO DEPARTMENT OF DEVELOPMENT COUNTY PROFILES, OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, COUNTY HEALTH RANKINGS AND ROADMAPS 2019, AUGLAIZE COUNTY COMMUNITY HEALTH ASSESSMENT 2017, AND GRAND LAKE HEALTH SYSTEM/JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL COMMUNITY HEALTH ASSESSMENT 2016. PARTICIPANTS REVIEWED ALL DATA AND INFORMATION IDENTIFIED IN THE CHNA IN ORDER TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. PARTICIPANTS IDENTIFIED THE HEALTH NEEDS OF THE COMMUNITY BY CONSIDERING THOSE REQUISITES FOR THE IMPROVEMENT OR MAINTENANCE OF HEALTH STATUS IN THE COMMUNITY USING ALL FACTS AND CIRCUMSTANCES PRESENTED. PARTICIPANTS CONSIDERED THE SEVERITY OF EACH NEED, EFFECTIVENESS OF INTERVENTION, HEALTH DISPARITIES ASSOCIATED WITH THE NEED, AND IMPORTANCE THE COMMUNITY PLACES ON ADDRESSING THE NEED.
JTD MEMORIAL HOSPITALPART V, SECTION B, LINE 6B: AUGLAIZE COUNTY HEALTH DEPARTMENT, MERCER COUNTY HEALTH DEPARTMENT, AUGLAIZE COUNTY COUNCIL ON AGING, ST. MARY'S CITY SCHOOLS, UNITED WAY
JTD MEMORIAL HOSPITALPART V, SECTION B, LINE 11: JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL, CONDUCTED AND ADOPTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2022 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - SOCIAL DETERMINANTS OF HEALTH- ACCESS TO CARE- HEALTH BEHAVIORS TO ADDRESS OBESITY, HEART DISEASE, AND STROKE- MENTAL HEALTH AND ADDICTIONTHE CHNA DISCUSSED IN THE BELOW DISCLOSURES WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019, AND THESE NEEDS HAVE BEEN ADDRESSED THROUGH 2022. THE LATEST CHNA WAS ADOPTED AT THE END OF 2022, AND WILL BE ADDRESSED IN 2023-2025.THE 2019 CHNA WAS APPROVED BY THE BOARD ON OCTOBER 23, 2019 WITH THE CORRESPONDING IMPLEMENTATION STRATEGY APPROVED BY THE BOARD JANUARY 22, 2020 AND EFFECTIVE 2020 - 2022. THEREFORE, THE FOLLOWING ACTIONS TAKEN DURING THE 2022 TAXABLE YEAR WERE ASSOCIATED WITH THE 2019 CHNA:SIGNIFICANT HEALTH NEED 1: MENTAL HEALTH-COLEMAN BEHAVIORAL HEALTH PARTNERSHIP: ONGOING INTEGRATION OF COLEMAN STAFF INTO THE GRAND LAKE PHYSICIAN PRACTICES THAT BEGAN IN 2014 CONTINUED THROUGH 2022. THE PEER COUNSELOR REFERRALS FOR OPIOID OVERDOSES WAS IMPLEMENTED IN 2018, AS WELL AS PRE-SCREENS FOR CRISIS INTERVENTIONS CONTINUED THROUGH 2022. BEGINNING IN JUNE 2019, COLEMAN EXPANDED TO BOTH CELINA AND MINSTER LOCATION OFFERINGS TO INCREASE ACCESS AND HAS CONTINUED THROUGH 2022.-HORIZON HEALTH PARTNERSHIP: JTDMH'S INPATIENT GERO-PSYCH UNIT IN COLLABORATION WITH HORIZON HEALTH, CONTINUED TO SEE STEADILY INCREASING AVERAGE DAILY CENSUS THROUGHOUT THE YEAR. IN 2022, THE UNIT HAD 186 ADMISSIONS WITH AN ADC OF 6.2.-TELE MENTAL HEALTH PILOT: IN EXPLORATION OF TELEMEDICINE OFFERINGS FOR JTDMH'S POPULATION, THE TELEMEDICINE PROCESS FOR ADDICTION SERVICES VIA BRIGHT HEART HEALTH ESTABLISHED IN AUGUST 2018 IN THE EMERGENCY DEPARTMENT CONTINUED THROUGH 2022. SIGNIFICANT HEALTH NEED 2: OBESITY-HEALTH SMART: CONTINUED TO SPONSOR HEALTH SMART PROGRAM IN CONJUNCTION WITH THE EMPLOYER-SPONSORED HEALTH PLAN WITH IMPROVED BIOMETRICS NOTED DURING 2022 IN MULTIPLE CATEGORIES FOR THOSE JTDMH EMPLOYEES AND THEIR SPOUSES AND DEPENDENTS WHO PARTICIPATE.-GRAND HEALTH CHALLENGE: 16TH ANNUAL GRAND HEALTH CHALLENGE WAS HELD JANUARY THRU MAY 2022 IN WHICH 243 PARTICIPANTS LOST 1,690.7 POUNDS. THE 1ST PLACE FINISHER OF THE 'MASTER MAINTAINER' PROGRAM, LOST 36.68% OF THEIR BODYWEIGHT.SIGNIFICANT HEALTH NEED 3: RISKY BEHAVIORS-SMOKING CESSATION PROGRAM: SMOKING CESSATION PROGRAM FOR JTDMH/GLHS EMPLOYEES, SPOUSES AND DEPENDENTS CONSISTING OF 8-12 ONE-ON-ONE SESSIONS WITH THE EMPLOYER OUTREACH COORDINATOR BEGAN IN EARLY 2019. SIGNIFICANT HEALTH NEED 4: ACCESS TO CARE- JTDMH/GLHS PRIMARY CARE SERVICES EDUCATION: CONTINUE TO COLLABORATE WITH AUGLAIZE COUNTY HEALTH DEPARTMENT IN DISTRIBUTION OF COMPREHENSIVE AUGLAIZE COUNTY PRIMARY CARE PROVIDER LISTINGS, WITH LOCATION, CONTACT INFO, OFFICE HOURS, AND MEDICAID ACCEPTANCE TO PARENTS OF YOUNG CHILDREN AT IMMUNIZATION APPOINTMENTS.-PROMOTION OF JTDMH/GLHS SERVICES VIA WEBSITE AND SOCIAL MEDIA OUTLETS: TRACKING OF PAGE VIEWS AND SOCIAL MEDIA SESSIONS CONTINUED IN COLLABORATION WITH JTDMH'S MARKETING FIRM TO ASSIST IN ASSESSING COMMUNITY REACH OF SERVICES PROMOTION. THE 'URGENT CARE', 'FIND A PHYSICIAN AND 'PEDIATRICS' PAGES REPRESENTED THE LARGEST YEAR-OVER-YEAR INCREASE IN PAGE VIEWS.SIGNIFICANT HEALTH NEED 5: EDUCATION/PREVENTION/HEALTH PROMOTION-HEALTH SCREENINGS AT COMMUNITY FUNCTIONS: COMMUNITY OUTREACH EFFORTS TO INCREASE BLOOD PRESSURE SCREENINGS WITHIN THE COMMUNITY CONTINUED IN 2022.-COLORECTAL SCREENINGS: COMMUNITY OUTREACH CONTINUED EFFORTS IN 2022 TO INCREASE COLORECTAL SCREENING KIT DISTRIBUTION.
PART V, LINE 7AHTTPS://WWW.GRANDLAKEHEALTH.ORG/NEWS-AND-EVENTS/COMMUNITY-HEALTH-ASSESSMENT.HTML
PARY V, LINE 16A, FAPHTTPS://WWW.GRANDLAKEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE.HTML
PART V, LINE 16B, FAP APPLICATIONHTTPS://WWW.GRANDLAKEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE.HTML
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARYHTTPS://WWW.GRANDLAKEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE.HTML
PART V, SECTION B, LINE 20DJTDMH DOES NOT HAVE PRESUMPTIVE ELIGIBILITY DETERMINATIONS, AT THIS POINT IN TIME. AN INDIVIDUAL'S ELIGIBILITY IS ONLY DETERMINED AFTER AN APPLICATION HAS BEEN COMPLETED AND SUBMITTED. FINANCIAL ASSISTANCE COUNSELORS ARE TRAINED TO PROVIDE CANDIDATES IN HOW TO COMPLETE THE APPLICATION, AND WORK WITH CANDIDATES THROUGHOUT THE APPROVAL PROCESS. EVERY EFFORT IS MADE TO IDENTIFY POTENTIAL CANDIDATES AND ASSIST POTENTIAL CANDIDATES IN COMPLETING THE APPLICATION.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - URGENT CARE AT JTDMH
200 ST CLAIR STREETST MARYSOH45885URGENT CARE
2 - GRAND LAKE HOME HEALTH
1122 EAST SPRING STREETST MARYSOH45885HOME HEALTH
3 - GRAND LAKE HOSPICE
1122 EAST SPRING STREETST MARYSOH45885HOSPICE
4 - GRAND LAKE OCCUPATIONAL MEDICINE
200 ST CLAIR STREETST MARYSOH45885OCCUPATIONAL MEDICINE
5 - CELINA PRO HEALTH DIAGNOSTIC CENTER
801 PRO DRIVECELINAOH45822DIAGNOSTIC CENTER

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE HOSPITAL USED THE MEDICARE COST REPORT AS THEIR BASIS FOR CALCULATING THE AMOUNTS REPORTED IN LINE 7A & 7B. ON THE COST REPORT, IT FIRST ALLOCATES OVERHEAD DEPARTMENTS VIA A COST STEP DOWN METHODOLOGY AND THEN CALCULATES A COST TO CHARGE RATIO. FOR LINES 7E, 7F,7G & 7I ACTUAL COSTS WERE USED.
PART I, LN 7 COL(F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $4,591,347
PART II, COMMUNITY BUILDING ACTIVITIES:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL PARTICIPATED IN SEVERAL COMMUNITY BUILDING ACTIVITIES IN 2022 RANGING FROM PARTICIPATION IN COMMUNITY BOARDS, COMMITTEES AND CLUBS THAT WERE ENGAGED IN IMPROVING THE OVERALL COMMUNITY INCLUDING THE COMMUNITY'S HEALTH/MEDICAL NEEDS TO OFFERING BABYSITTING TRAINING CLASSES TO ASSURE THE CHILDREN OF THE COMMUNITY ARE WELL CARED FOR IN THEIR PARENT'S ABSENCE. OTHER EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO PARTICIPATING IN WORKFORCE DEVELOPMENT OF HEALTH CARE CAREERS THROUGH JOB SHADOWING AND SEMINARS AND ACTIVE PARTICIPATION IN THE COMMITTEE THAT IS WORKING TO RESTORE CLEAN AND HEALTHY WATER TO THE COMMUNITIES LARGEST RECREATION RESOURCE, GRAND LAKE ST. MARYS.
PART III, LINE 2:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL RECORDS GROSS BAD DEBT EXPENSE WHEN AN ACCOUNT IS DEEMED UNCOLLECTIBLE AT THE VALUE OF CHARGES. IF IT BECOMES NECESSARY TO ESTIMATE BAD DEBT EXPENSE, ESTIMATES ARE DONE BASED UPON HISTORIC RELATIONSHIPS BETWEEN CHARGES AND BAD DEBT.
PART III, LINE 3:THE HOSPITAL ESTIMATES THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BASED UPON A HISTORIC REVIEW OF THE APPLICABLE BAD DEBT ACCOUNTS. EVERY EFFORT IS MADE TO IDENTIFY THESE ACCOUNTS PRIOR TO BEING WRITTEN OFF AS UNCOLLECTIBLE, INCLUDING MULTIPLE EFFORTS TO CONTACT THE PATIENT. AS SOON AS THESE ACCOUNTS ARE DEEMED UNCOLLECTIBLE, ALL COLLECTION WORK AND ACTIVITY IS IMMEDIATELY CEASED. THESE ACCOUNTS ARE THEN TREATED THE SAME AS ANY OTHER ACCOUNT QUALIFYING FOR FINANCIAL ASSISTANCE.
PART III, LINE 4:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES REMAINING AFTER THIRD-PARTY COVERAGE FOR A PORTION OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
PART III, LINE 8:THE HOSPITAL USED A COST STEP DOWN METHODOLOGY FROM THE MEDICARE COST REPORT TO CALCULATE THE AMOUNTS REPORTED IN LINE 6. THE COST OF PROVIDING CARE TO THE MEDICARE POPULATION IN 2022 WAS $19,232,469 THE PAYMENTS RELATED TO THESE SERVICES WERE $12,736,491. LEAVING A MEDICARE SHORTFALL OF $6,495,978 FOR THE YEAR. THE MEDICARE SHORTFALL IS A COMMUNITY BENEFIT BECAUSE PROVIDING SERVICES TO THE ELDERLY IS A TAX EXEMPT PURPOSE CONSISTENT WITH JTD MEMORIAL HOSPITAL'S OVERALL EXEMPT STATUS, AND THE HOSPITAL ACCEPTS THESE PATIENTS REGARDLESS OF ITS IMPACT ON OVERALL PROFITABILITY.
PART III, LINE 9B:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL FOLLOWS THE SAME COLLECTION PRACTICES NO MATTER THE TYPE OF PATIENT. ALL PATIENTS ARE TREATED EQUALLY. COLLECTION PRACTICES ARE NOT PURSUED FOR PATIENTS THAT THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE/CHARITY CARE.
PART VI, LINE 2:N/A - ALL NEEDS WERE ASSESSED WHILE CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT.
PART VI, LINE 3:PATIENTS ARE INFORMED ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE THROUGH SIGNS POSTED AT REGISTRATION, IN ER/WAITING ROOMS, ON THE WEBSITE, THROUGH INFORMATION INCLUDED IN THE PATIENT HANDBOOK, THROUGH INFORMATION PRINTED ON THE REVERSE SIDE OF THE STATEMENTS THEY RECEIVE FOR SERVICES, AND IS AVAILABLE UPON REQUEST.
PART VI, LINE 4:JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL IS LOCATED IN ST. MARYS (AUGLAIZE COUNTY), A RURAL SMALL TOWN ENVIRONMENT DOMINATED BY AGRICULTURE AND SMALL MANUFACTURING JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL'S CORE SERVICE AREA OF ST. MARYS, MINSTER, NEW BREMEN AND NEW KNOXVILLE ZIP CODES INCLUDES A POPULATION OF 24,483. THE ADJACENT COMMUNITY OF CELINA (ZIP CODE POPULATION OF 20,375) IS ALSO SERVED BY THE HOSPITAL. THE HOSPITAL ALSO PROVIDES SERVICES TO THE WAPAKONETA COMMUNITY (POPULATION 18,399) ALTHOUGH THE TRADITIONAL SERVICE PATTERNS SEND THAT COMMUNITY'S PATIENTS TO LIMA. THE ABOVE COMMUNITIES ACCOUNT FOR OVER 80% OF JTDMH'S PATIENTS. THOSE ZIP CODES HAVE A TOTAL POPULATION OF 63,257 WITH 17% IN THE MEDICARE AGE GROUP (65+).
PART VI, LINE 5:JTD MEMORIAL HOSPITAL/GRAND LAKE HEALTH COMMUNITY OUTREACHPART OF THE HOSPITAL'S PHILOSOPHY HAS BEEN TO PROMOTE THE HEALTH AND WELLNESS OF COMMUNITY MEMBERS. THE HOSPITAL HAS A HISTORY OF REACHING OUT TO THE COMMUNITY TO PROMOTE WELLNESS AND PREVENTIVE MEDICINE AND HAS AN OFFICE THAT IS DEDICATED TO COORDINATING HEALTHCARE, OUTREACH, AND EDUCATION.FOLLOWING IS A LISTING OF THE WIDE VARIETY OF OUTREACH PROGRAMS THAT ARE SPONSORED BY GRAND LAKE HEALTH SYSTEM.- MONTHLY BLOOD PRESSURE CHECKS - BREASTFEEDING CLASSES- CHILDBIRTH CLASSES - CALL A NURSE- CPR CLASSES - DIABETIC SUPPORT GROUP- HEALING MEMORIES SUPPORT GROUP- STROKE SUPPORT GROUP- PARKINSON'S SUPPORT GROUP- COMMUNITY HEALTH FAIRS/ROTARY BLOOD TEST CLINICS- SCHOOL HEALTH FAIRS- MAKE BELIEVE HOSPITAL (KINDERGARTEN PROGRAM TO ALLEVIATE FEARS OF HOSPITAL)- NEW BREMEN SENIOR CITIZEN PROGRAM- FREE PROSTATE SCREENING- SENIOR SUPPER HOUR- SENIORCISE- AMERICAN SIGN LANGUAGE CLASSES (I & II)- SPEAKERS BUREAU- SUPERSITTERS CLASSES- FREE MONTHLY WELLNESS EDUCATION & SCREENING (WRIGHT STATE, AGAPE, WAGNERS IGA)- WOMEN'S WALK FOR WELLNESS- COORDINATION OF THE UNITED WAY CAMPAIGN FOR THE HOSPITAL- ROAD TO FITNESS PROGRAM (12 MONTHS)- MAN TO MAN PROSTATE SUPPORT GROUP- DRUG TAKEBACK PROGRAM- PRE-DIABETES CLASSES (ADVANCED LIFE BALANCED CLASS)IN ADDITION, WE SUPPORT THE WELLNESS OF THE COMMUNITY BY PARTICIPATING IN EVENTS HOSTED AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. FOLLOWING IS A LIST OF TOPICS THAT ARE COVERED:- NUTRITION- HEART EDUCATION- SKIN CANCER- OSTEOPOROSIS SCREEN- BREAST CANCER AWARENESS- CHOLESTEROL AWARENESS- ASSESSMENT OF DIABETES- ALCOHOL EDUCATION- COLORECTAL CANCER EDUCATION- ASTHMA EDUCATION- PERIPHERAL SCREENING- SLEEP APNEA INFORMATION- STROKE EDUCATIONWE ALSO PARTNER WITH ONE LOCAL RADIO STATION PROVIDING MONTHLY INTERVIEWS ON A WIDE VARIETY OF HEALTHCARE TOPICS.SINCE 2007, WE HAVE SPONSORED A WEIGHT LOSS/WELLNESS PROGRAM, ENTITLED, "THE GRAND HEALTH CHALLENGE." IN THE PAST 16 YEARS, THIS PROGRAM HAS SERVED 6,344 RESIDENTS OF BOTH MERCER AND AUGLAIZE COUNTIES, LOSING MORE THAN 50,000 LBS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
AUGLAIZE-MERCER COUNTY YMCA
7590 STATE ROUTE 703CELINAOH45822341371829501(C)(3)$25,000$0YMCA ANNUAL FUND DRIVE DONATION
ST MARYS COMMUNITY FOUNDATION
146 E SPRING STST MARYSOH45885237372270501(C)(3)$35,000$0ST MARYS ATHLETIC COMPLEX
JTD FOUNDATION
200 ST CLAIR STREETST MARYSOH45885341623769501(C)(3)$20,000$0GLHS VOLUNTEERS DONATION TO SUPPORT THE FOUNDATION
AUGLAIZE COUNTY FAIR BOARD
PO BOX 431WAPAKONETAOH45895344427752501(C)(3)$7,500$0GIFT OF LIGHTS SPONSORSHIP
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL MAKES GRANTS TO COMMUNITY ORGANIZATIONS. GRANTS ARE MONITORED THROUGH DIRECT INVOLVEMENT AND CONTACT WITH THE ORGANIZATION OR EVENT IN WHICH THE GRANT WAS GIVEN.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CYNTHIA BERNING
PRESIDENT$304,560$130,208$29,140$20,000$0$0$6,000$0$23,915$1,083$363,615$151,291$0$0
RAJENDRA KAKARLA MD
DIRECTOR$404,553$0$0$0$0$0$0$0$0$0$404,553$0$0$0
TRICIA POHL
TREASURER$217,895$0$0$0$0$0$23,053$0$23,777$0$264,725$0$0$0
LANA HINDERS
CHIEF CLINICAL OFFICER$193,082$0$7,000$0$0$0$21,193$0$23,728$0$245,003$0$0$0
KEVIN HARLAN
FORMER PRESIDENT$0$0$0$0$242,771$0$0$0$0$0$242,771$0$242,771$0
SHELLY RUPPERT
EXECUTIVE DIRECTOR OF HR$154,362$0$3,000$0$0$0$16,976$0$23,657$0$197,995$0$0$0
TYLER KROEGER
VP OF OPERATIONS$153,389$0$3,000$0$0$0$3,046$0$23,689$0$183,124$0$0$0
AMY DIRKSEN
ED OF SPECIALTY CARE SERVICES$143,065$0$0$0$0$0$14,966$0$23,638$0$181,669$0$0$0
JILL ENGEL
DIRECTOR OF INPATIENT SERVICES$138,861$0$0$0$0$0$14,536$0$23,622$0$177,019$0$0$0
LORI MILLER
CHIEF OF INFORMATION SERVICES$133,349$0$0$0$0$0$12,008$0$23,620$0$168,977$0$0$0
LESIA ARNETT
EXEC DIRECTOR DEVELOPMENT, MARKETING$136,005$0$3,000$0$0$0$4,046$0$23,634$0$166,685$0$0$0
HOLLY JACOMET
VP OF QUALITY AND PHYSICIAN PRACTICE$151,045$0$3,000$0$0$0$4,376$0$1,057$0$159,478$0$0$0
JEFF VOSSLER
FORMER CFO$100,823$0$7,000$0$0$0$10,825$0$1,110$0$119,758$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AJOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL PROVIDES A PORTION OF YMCA DUES TO THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES; HOWEVER, THIS IS AN EMPLOYEE BENEFIT AVAILABLE TO ALL ELIGIBLE EMPLOYEES OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL TO PROMOTE COMMUNITY WELLNESS (ONE OF THE PEOPLE LISTED IN PART VII, SECTION A, LINE 1A RECEIVED THIS BENEFIT). THE YMCA DUES WERE NOT INCLUDED IN THE RECIPIENT'S COMPENSATION.
PART I, LINE 4BKEVIN HARLAN, THE FORMER PRESIDENT, HAS RECEIVED A PAYOUT FROM THE NON QUALIFIED RETIREMENT PLAN OF 242,771 IN THE CURRENT YEAR DUE TO HIS DEPARTURE FROM JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. THE PLAN IS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN MAINTAINED BY A RELATED ORGANIZATION FOR KEY EMPLOYEES OF THE RELATED ORGANIZATION. THERE IS AN INCENTIVE BONUS PLAN AND A PRODUCTION COMPENSATION PLAN. VESTING HAPPENS OVER A 3 OR A 5 YEAR TIME FRAME DEPENDING IF THE CONTRIBUTION WAS MADE TO THE INCENTIVE BONUS PLAN OR THE PRODUCTION COMPENSATION PLAN. THERE ARE CERTAIN CIRCUMSTANCES WHERE A PARTICIPANT WILL FORFEIT ANY AND ALL OF THE COMPANY CONTRIBUTIONS MADE INTO THE PLAN INCLUDING ENGAGING IN ACTIVITIES WHICH ARE DEEMED TO BE SIGNIFICANTLY COMPETITIVE WITH THE COMPANY WITHIN A 50 MILE RADIUS OF ANY EXISTING OFFICE, IF IT IS DEEMED THE PARTICIPANT ACTED IN A DISHONEST WAY, BREACHES HIS OR HER FIDUCIARY OBLIGATIONS, CONVICTED OF A FELONY INVOLVING SIGNIFICANT MORAL TURPITUDE, OR OTHER ACTS WHICH WOULD CAUSE THE COMPANY SUBSTANTIAL HARM.
PART I, LINE 7EMPLOYEE'S BONUSES ARE DETERMINED AT THE DISCRETION OF THE PRESIDENT.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL FACILITIES REVENUE IMPROVEMENT BONDS SERIES 2012BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN341623770BondIssuerEIN
Bond Issued2012-12-14BondIssuedDt
Issue Price$8,500,000IssuePriceAmt
PurposeASU BUILDING PROJECT AND CAPITAL EQUIPMENTPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$8,500,000TotalProceedsAmt
Capital Expenditures$8,500,000CapitalExpendituresAmt
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF FORM 990 IS PROVIDED TO THE BOARD-DESIGNATED COMMITTEE FOR THEIR REVIEW PRIOR TO FILING. THE BOARD-DESIGNATED COMMITTEE WILL REPORT THEIR REVIEW AND APPROVAL OF FORM 990 TO THE FULL BOARD OF DIRECTORS. A PAPER COPY OF THE FORM 990 WAS MADE AVAILABLE TO ALL BOARD MEMBERS FOR THEIR INDEPENDENT REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS, OFFICERS, AND MANAGERS OF GRAND LAKE HEALTH SYSTEM. ANNUALLY, THESE INDIVIDUALS, AS WELL AS, NEW BOARD MEMBERS WHEN THEY FIRST JOIN, PROVIDE THE PRESIDENT OF THE CORPORATION AN UPDATED LISTING OF ALL BUSINESSES OR OTHER ORGANIZATIONS OF WHICH HE OR SHE IS A TRUSTEE, OFFICER, DIRECTOR, MEMBER, PARTNER, OWNER, GENERAL MANAGER, SUBSTANTIAL SHAREHOLDER, EMPLOYEE OR FOR WHICH HE OR SHE ACTS AS AN AGENT. WHEN A CONFLICT OF INTEREST IS IDENTIFIED THE DETERMINATION IS MADE AND DISCUSSED OPENLY AT THE BOARD LEVEL. THE INDIVIDUAL IS THEN PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS.
FORM 990, PART VI, SECTION B, LINE 15THE SALARY AMOUNT FOR THE PRESIDENT IS REVIEWED AND APPROVED BY JTDMH'S BOARD EXECUTIVE COMMITTEE. THE EXEC COMMITTEE USES THE OHIO HOSPITAL ASSOCIATION'S ANNUAL CHIEF EXECUTIVE OFFICER COMPENSATION SURVEY, INTEGRATED HEALTHCARE STRATEGIES (AN INDEPENDENT COMPENSATION CONSULTANT), ANNUAL NATIONAL HEALTHCARE LEADERSHIP COMPENSATION SURVEY, AND INPUT FROM THE BOARD OF TRUSTEES AND BOARD EXEC COMMITTEE TO DETERMINE THE PRESIDENT'S SALARY. THE BOARD CHAIR SIGNS THE CHANGE OF PAY FORM AS WELL AS WRITES A MEMO TO THE DIRECTOR OF FINANCIAL SERVICES. DOCUMENTATION REGARDING THE PRESIDENT'S SALARY AND RECORD KEEPING REGARDING DELIBERATIONS IS KEPT BY THE BOARD EXEC COMMITTEE. SALARY AMOUNTS FOR OFFICERS AND OTHER KEY EMPLOYEES ARE REVIEWED AND APPROVED BY THE PRESIDENT. THE PRESIDENT REFERENCES THE OHA COMPENSATION SALARY SURVEY. THE PRESIDENT IS APPROVED BY THE BOARD OF DIRECTORS TO PERFORM THIS PROCESS. FURTHERMORE, THE PRESIDENT IS COMPLETELY INDEPENDENT FROM ALL OFFICERS AND KEY EMPLOYEES. THIS PROCESS WAS LAST COMPLETED IN DECEMBER 2022.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GHOSPITAL CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 12,460,766. MANAGEMENT AND GENERAL EXPENSES 1,979,108. FUNDRAISING EXPENSES 3,228. TOTAL EXPENSES 14,443,102. OTHER CONTRACTED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,404,479. MANAGEMENT AND GENERAL EXPENSES 226,448. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,630,927. FAMILY PRACTICE PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,994,004. MANAGEMENT AND GENERAL EXPENSES 29,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,023,404.
FORM 990, PART XI, LINE 9:CAPITAL CONTRIBUTION IN JTD FAMILY PRACTICE, INC. -8,430,312. DIFFERENCE BETWEEN BOOK AND TAX PASS THROUGH INCOME -329,401.
FORM 990, PART XII, LINE 2C:THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1JTD HOSPITAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STREETAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd
FieldValueIRS element (for citing)
EIN341623769EIN
Primary ActivitiesTO RAISE FUNDS FOR JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL.PrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1JTDMH PAIN MANAGEMENT LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd
FieldValueIRS element (for citing)
EIN465353958EIN
Primary ActivitiesPAIN MANAGEMENT SERVICESPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$41,923ShareOfTotalIncomeAmt
Share Of EOY Assets$178,731ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1JTDM FAMILY PRACTICE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 ST CLAIR STREETAddressLine1Txt
CityST MARYSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45885ZIPCd
FieldValueIRS element (for citing)
EIN341689161EIN
Primary ActivitiesPHYSICIANS PROVIDING MEDICAL SERVICESPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income-$8,719,668ShareOfTotalIncomeAmt
Share Of EOY Assets$7,621,699ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationYes (1)DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
JTD HOSPITAL FOUNDATION
C$306,991CASH TRANSACTION
JTD HOSPITAL FOUNDATION
R$55,367CASH TRANSACTION
JTDM FAMILY PRACTICE LLC
A$773,025CASH TRANSACTION
JTDM FAMILY PRACTICE LLC
B$5,885,000CASH TRANSACTION
JTDM FAMILY PRACTICE LLC
O$3,005,124CASH TRANSACTION
JTDM FAMILY PRACTICE LLC
P$921,447CASH TRANSACTION
JTDM FAMILY PRACTICE LLC
Q$6,375,755CASH TRANSACTION
JTDMH PAIN MANAGEMENT LLC
J$92,300AMOUNT INVOICED
JTDMH PAIN MANAGEMENT LLC
F$90,122CASH TRANSACTION