2022-05-12T11:17:13-07:00 2021-06-30 990 2020-07-01 341041385 SALEM COMMUNITY HOSPITAL SALE 3303327214 1995 East State Street Salem OH 44460 Anita Hackstedde CEO/President 3303327214 2022-05-12 1 11 0 AAL2 X 2020 2022-09-23 18:48:47Z Salem Regional Medical Center Dr Anita Hackstedde MD 1995 East State Street Salem OH 44460 130372348 0 X www.salemregional.com X 1913 OH Salem Regional Medical Center (SRMC) is an 87-bed, not-for-profit rural facility, which provides a continuum of medical services to the residents of Columbiana and southern Mahoning counties, including inpatient and outpatient medical and surgical care, orthopedics and intensive care. The Hospital also operates a full-time 24-hour Emergency Department, and treats all patients requiring medical care, irrespective of their financial means. The Hospital provides its services free of charge or on a sliding scale to uninsured/underinsured patients, regardless of race, creed, origin, handicap, age or ability to pay.; in support of its mission- "To Serve. To Care. To Heal." 15 13 812 50 868339 0 5674993 7625408 106300282 112202916 3645409 10282695 291462 159068 115912146 130270087 0 0 0 0 44006025 41141055 0 0 0 59623121 63450091 103629146 104591146 12283000 25678941 254361671 290042052 85461550 63893260 168900121 226148792 "To Serve. To Care. To Heal," encompasses the Hospital's mission of providing high quality care on both an inpatient and outpatient basis; and addresses our patients' health care needs at each life stage, within our available resources. SRMC seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community-based hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. 0 0 91445079 111470324 SRMC's mission and purpose is achieved by providing quality care to the sick and injured on both an inpatient and outpatient basis, while addressing our patients' healthcare needs at each life stage, within our available resources. The Medical Center seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. During fiscal year 2021, SRMC provided comprehensive healthcare services including: 2,842 Admissions; 2,968 Surgeries; and 18,850 Emergency Department visits. In support of this commitment, SRMC operates a full-time, 24-hour Emergency Department, and treats all patients requiring emergency medical care, irrespective of their financial means. The Medical Center also accepts all patients covered by Medicare, Medicaid and General Assistance. For fiscal year 2021, costs incurred by SRMC for unpaid costs of the Medicaid program were $2,736,150 and unreimbursed costs from other governmental programs were $1,950,397. These community benefits, arising from patient care provided by SRMC are documented to help to relieve a governmental financial and programmatic burden as evidenced through the Medical Center's charitable purpose. The organization also provided charitable support at a cost of $560,708 to patients who qualified. 0 0 0 91445079 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 64 0 1 812 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Michael Giangardella 3303327214 1995 East State Street Salem OH 44460 Anita Hackstedde President/CEO 35 6.00 X 416644 0 50172 Dr Lee Simon Director 1 39 X 0 412746 26281 Dr Richard Beatty Chief of Staff 5 35 X 20000 279724 0 Mike Giangardella VP Finance/Administration 38 2 X 218906 0 50267 Keith Meredith VP Clinical Operations 40 0 X 168596 0 26250 Sue Bryarly Director of Pharmacy 40 0 X 143254 0 45396 Deborah Pietrzak Asst VP Marketing & Planning 40 0 X 127638 0 50234 Robin Weyant Asst VP of Nursing 40 0 X 122227 0 52110 Diane Spalding Pharmacist 40.50 0 X 124047 0 31672 Kimberly Meek Pharmacist 40 0 X 123506 0 19325 Jeffrey Zimmerman Chair 1 1.00 X 0 0 0 Chris Meta Treasurer 1 1 X 0 0 0 Denise Harlan Vice Chair 1 1 X 0 0 0 Nelson Witmer Secretary 1 0.00 X 0 0 0 William Young EdD Director 1 0.00 X 0 0 0 Ruth Ann Rinto Director 1 1 X 0 0 0 Lynn Scullion O D Director 1 1 X 0 0 0 Terry Criss Director 1 0.00 X 0 0 0 Vito Abruzzino Director 1 0.00 X 0 0 0 Scott Tuel Director 1 0.00 X 0 0 0 Bruce Rhodes Jr Director 1 0.00 X 0 0 0 Lawrence Schmetterer MD Director 1 0 X 0 0 0 Dr Michael Sevilla Director 1 0 X 0 0 0 1464818 692470 351707 23 0 1 0 Xanitos 75 Remittance Drive Department 6704 Chicago IL 60675 Housekeeping Services 1752996 Northstar Anesthesia 6225N State Hwy 161 Suite 200 Irving TX 75038 Medical Services 1706895 AVI Food Systems 2590 Elm Road NE Warren OH 44483 Food Services/Vending 1335700 University Hospitals 3605 Warrensville Center Road Mail Stop 9230 -- Cube 2344I Shaker Heights OH 441225203 Medical Services 1061718 Laboratory Corporation of America PO box 12140 Burlington NC 27216 Laboratory services 728854 22 0 0 0 0 7591650 33758 0 7625408 Patient Service Revenue 622000 110109355 110109355 0 0 Outside Lab Revenue 621500 73672 0 73672 0 Durable Medical Equipment Revenue 621610 1762662 967995 794667 0 Affiliated Exempt Organization Rent 531190 257227 257227 0 0 0 0 0 0 112202916 10193406 0 0 10193406 0 0 0 0 0 0 0 0 85671 0 62350 0 23321 0 23321 0 0 23321 0 129200 0 39911 0 89289 89289 0 0 89289 0 Gift Shop Revenue 900099 63403 63403 0 0 Medical Records Fees 900099 6561 6561 0 0 Canteen Revenue 900099 5870 5870 0 0 59913 59913 0 0 135747 130270087 111470324 868339 10306016 X 948044 948044 30766720 27834235 2932485 2507266 2205307 301959 4610088 4089145 520943 2308937 2054170 254767 194516 194516 170134 170134 80842 80842 14246856 12554516 1692340 149404 149404 2827366 2315979 511387 2621206 1756908 864298 2224593 1979653 244940 33864 30408 3456 1043907 1043907 9489241 8211338 1277903 344850 344850 Bad Debt/Implied Price Concessions 2319515 2319515 0 0 State Assessment 2492210 0 2492210 0 Drugs & Pharmaceuticals 12775146 12775146 0 0 Medical Supplies 12271831 12271831 0 0 164610 3021 161589 104591146 91445079 13146067 0 9941841 8519420 13836164 12032805 9077186 10028619 1546090 1878717 2830428 3868883 175744368 99770719 82547783 75973649 134582179 177739959 254361671 290042052 10906388 9923791 140000 100000 42207534 40472530 137396 64956 32070232 13331983 85461550 63893260 X 168900121 226148792 0 0 168900121 226148792 254361671 290042052 X 25678941 30773767 0 0 0 795963 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2304295 0 2304295 117267691 0 58843954 58423737 1555485 0 540352 1015133 53990796 0 40386413 13604383 626101 0 0 626101 75973649 0 Pension Liability 4096353 Medicare Accelerated Payments - Cares Act 9042564 Deferred Liability 193066 13331983 1 1 1 X 1 X 1 1 0 1 1 1123616 1591462 0 0 3589774 853624 2736150 0.0268 10864390 10201878 662512 0.0065 0 0 15577780 12646964 3398662 0.0333 137 11373 383263 1800 381463 0.0037 2487 2535 526235 0 526235 0.0051 163458 134334 29124 0.0003 18 900 426574 0 426574 0.0042 2642 14808 1499530 136134 1363396 0.0133 2642 14808 17077310 12783098 4762058 0.0466 1 0 84 0 84 0 13 1350 6490 0 6490 0.0001 2160 5165 256187 0 256187 0.0025 56 310 70659 7894 62765 0.0006 1 14 235 0 235 0 8 285 1997 0 1997 0 5 1424 23498 0 23498 0.0002 14 2467 183869 0 183869 0.0018 0 0 0 0 0 0 2258 11015 543019 7894 535125 0.0052 1 861000 206081 22187321 23475206 -1287885 X 1 1 1 1 Salem Community Hospital dba Salem Regional Medical Center 1995 East State Street Salem OH 44460 Salemregional.com X Salem Community Hospital dba Salem Regional Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X http://www.salemregional.com X X 1 19 1 http://www.salemregional.com 0 0 1 X 150 400 X 1 1 X X X 1 X http://www.salemregional.com X http://www.salemregional.com X X 1 X X 1 X X X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Salem Community Hospital To take into account input from persons representing the community served, the CHNA primary data collection process included focus group and stakeholder interviews conducted with a total of 115 adult participants, including those from school districts, juvenile justice, community resource centers, senior services, Hispanic community providers, local government officials, health and human service providers, mental health providers and faith-based organizations. Community leaders and key stakeholders were identified as experts in a particular field related to their background experience or professional position; and/or those who understand the needs of a particular community/geographic region or under-represented group, including the medically underserved and vulnerable populations. In addition, a community survey derived from the Behavioral Risk Factor Surveillance System was completed by 382 adults, so that local primary data could be compared with state and national data. Schedule H, Part V, Section B, Line 6a-Salem Community Hospital Along with Salem Regional Medical Center, East Liverpool City Hospital and Akron Children's Hospital also provided financial support for the CHNA process. Schedule H, Part V, Section B, Line 6b-Salem Community Hospital A collaborative workgroup conducted the CHNA, composed of Akron Children's Hospital, Columbiana County Educational Service Center, Columbiana County General Health District, Columbiana County Mental Health and Recovery Services Board, Community Action Agency of Columbiana County, East Liverpool City Health Department, East Liverpool City Hospital, Family and Children First Council, Salem City Health Department, Salem Regional Medical Center and The Ohio State University- Extension. In addition to the CHNA, this same workgroup developed a County Health Improvement Plan to address the CHNA's priorities. Schedule H, Part V, Section B, Line 7d-Salem Community Hospital The CHNA was posted on Salem Regional Medical Center's website at http://www.salemregional.com/about-us/our-publications:Community Health Needs Assessment, along with being posted on many of the collaborative partners' websites. In addition, two news releases were issued regarding the preliminary CHNA findings and publication of the final report, with information about how the general public could access the CHNA via the internet. A summary of the CHNA's findings was also presented to several community groups including social service providers and school health professionals, and posted on social media. Schedule H, Part V, Section B, Line 11-Salem Community Hospital As outlined in the 2019-2022 Implementation Plan, SRMC will focus on the CHNA's top 3 health priorities related to obesity/chronic disease; mental health and addiction/substance abuse; and access to health care utilizing a three-year intervention strategy and defined target outcomes for each priority. Note that these priorities align with the priority topics identified in Ohio's 2019 State Health Assessment. To address the significant needs identified in the 2019 CHNA regarding obesity and chronic disease prevention, SRMC is working with existing and/or developing new community partnerships to broaden access to recreational opportunities and promote existing resources for improved physical activity and nutrition to positively impact the rates of physical activity and consumption of healthy foods for residents within SRMC's Service Area. To address the significant needs regarding mental health and substance abuse prevention, SRMC is serving as a community partner in improving access to mental health and substance abuse treatment services through membership on the ADAPT and CASH Coalitions, as well as facilitating the coordination of and access to community-based, post-acute treatment resources. SRMC also operates the Behavioral Medicine and Wellness Center as an intensive outpatient and partial hospitalization program designed to meet individual and group needs for mental health services in Columbiana and other surrounding counties. Data related to barriers in accessing clinical care indicated higher ratios of the population to primary care physicians, mental health providers and dental health providers, reflecting health professional shortages in these categories. To reduce barriers to accessing health care, SRMC is actively recruiting providers to underserved areas; exploring alternate delivery of care models, such as telemedicine; and increasing health literacy interventions to reduce hospital readmissions, strengthen medication education and increase patients' knowledge to decrease disparities among vulnerable populations. Primary data gathered from focus group participants and stakeholders identified multi-faceted socio-economic issues related to the poor economy, generational poverty, increased drug abuse and mental health issues, lack of transportation, Appalachian culture/unhealthy lifestyles, obesity, lack of parenting skills and language/health literacy barriers as key drivers of the health status of the community. Other identified needs related to the environment and social determinants of health included not enough money, lack of access to employment/better jobs, safe water/clean air/fracking/agricultural runoff, poor housing conditions and crime/violence. In addition, focus group participants identified the weather, chemical waste and unemployment as environmental determinants that impact community health. Due to their societal magnitude and SRMC's limited resources and capacity to meaningfully impact the environment and economic foundation of the county, SRMC has chosen to allocate significant resources to the priority health needs which yield the greatest opportunities to affect a positive change as outlined in the 2019-2022 Implementation Plan. Schedule H, Part V, Section B, Line 16j-Salem Community Hospital The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the billing office. 0 Schedule H, Part I, Line 6a Salem Regional Medical Center (SRMC) prepares an Annual Report that is distributed to the community via a paper and electronic format, as well as being posted on the SRMC website at www.salemregional.com. The Annual Report includes a summary of the Medical Center's statement of expenses and uncompensated care, along with highlighting SRMC's major community benefit initiatives and outcomes. This community benefit information is provided in an effort to document its tax exempt purpose and demonstrate the benefits provided for the broader community as determined by community need. Schedule H, Part I, Line 7 Costs are determined by applying the ratio of cost to charges to gross charges and utilizing the format as outlined in the Schedule H instructions. Beyond charity care, "Other Benefits" reported include community health improvement services and community benefit operations, with community building activities listed in Part II. The Medical Center seeks opportunities to further its tax exempt purpose by providing a wide variety of benefits for the broader community, including the development of a county-wide needs assessment to identify regional health needs, and the development and adoption of a related Implementation Plan to address the health needs identified. Examples of other community benefit activities include, but are not limited to: grant-writing activities for improved community health and emergency preparedness, especially related to COVID activities; community health education regarding cancer, diabetes, cardiac disease, other chronic diseases and COVID prevention; obesity prevention; and community health fairs and free and reduced-cost clinical screenings for high blood pressure, blood sugar, skin cancer and breast cancer. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. Due to the COVID pandemic beginning in March 2020 and continuing throughout 2021, the number of traditional community health improvement programs, outreach activities and community events was severely curtailed. It is estimated that over 25,850 area residents participated in traditional community building and health improvement programs and/or events provided and/or sponsored by Salem Regional Medical Center. However, the Hospital aggressively participated in a multitude of COVID related community health improvement activities, including: the development and implementation of community disaster readiness responses; provided education to increase awareness of COVID risks, prevention and available testing and treatment services, which were established at nominal costs; set up a telephone hotline for vaccination clinics; established emergency food distribution programs; donated personal protective equipment to vulnerable populations; and conducted additional internal staff and external health care provider training to respond quickly to augment COVID care as necessary. Schedule H, Part I, Line 7, Column f Bad debt expense in the amount of $2,319,515 is included in total expenses on Form 990,Part IX ,line 25, but was subtracted for purposes of calculating the percentages in Schedule H, Part 1, line 7. Schedule H, Part I, Line 7g Costs for subsidized health services include those attributable to providing Salem Regional Medical Center's Emergency Department, outpatient services and outpatient behavioral health services. There are no health services attributable to a physician clinic. Subsidized health services related to Covid-19 inpatient and outpatient care are also included, due to the resources and lengths of stay needed to treat these patients. The amounts reported in Part 1, Line 7g of Schedule H are specifically related to the outpatient behavioral health services. Schedule H, Part II During the taxable year, SRMC participated in 2,226 different community building activities in an effort to provide programs and activities that respond to demonstrated, unmet community needs; improve the community's health and safety; and promote the well-being of area residents through the Hospital's resources and expertise. It should be noted that the number of traditional community building activities was significantly reduced from prior years due to curtailed activities beginning in March 2020 and continuing throughout 2021 related to the pandemic. Prior to the pandemic, SRMC participated in several area activities for the local and regional Chambers of Commerce; assisted in environmental improvements related to community medications' disposal; represented SRMC on diverse community coalitions related to improving community health; assisted with workforce development related to recruiting and retaining physicians and clinical professionals in medically underserved areas; and participated in community workforce boards and partnerships with area universities to address the health care work force shortage. In addition, SRMC provided many on-site and off-site school-based programs to foster interest and awareness about health care careers, including offering teen and college student mentoring opportunities. During the pandemic, SRMC served in several leadership roles for the region's disaster readiness and preparedness activities, including coordinating and mobilizing disaster readiness and COVID awareness coalitions and community support. SRMC continued to serve as a community resource and partner for regional non-profit organizations by providing collaborative programming with agencies such as the American Cancer Society, American Diabetes Association, American Heart Association, American Red Cross, Columbiana County Community Action Agency, Columbiana County and Salem City Departments of Health, Coordinated Action for School Health, Community Hospice, Kent State University- Salem Campus, Northeast Ohio Medical University and the Salem Community Center. In addition, SRMC made financial and in-kind contributions to many of these and other not-for-profit organizations through event sponsorships and staff support. Schedule H, Part III, Section A, Line 4 Excerpt from footnote. " On July 1, 2020, the Organization adopted Topic 606, Revenue from Contracts with Customers (Topic 606), using a modified retrospective method of adoption to all contracts with customers (patients) at July 1, 2020. The core guidance in Topic 606 is to recognize revenue to depict the transfer of promised goods or services to patients in amounts that reflect the consideration to which the Organization expects to be entitled in exchange for those goods or services. The amount to which the Organization expects to be entitled is calculated as the transaction price and recorded as revenue in exchange for providing patient services to its patients. Schedule H, Part III, Section B, Line 8 The costs were obtained from the Medicare cost report. The Medical Center incurred costs in excess of $23.5 million to care for and treat beneficiaries while receiving reimbursement of $22.2 million, leaving a shortfall of $1.3 million. This is a direct benefit provided by the Medical Center to local beneficiaries who live in the surrounding communities. Schedule H, Part III, Section C, Line 9b Per the Medical Center's collection policy, the Medical Center will not pursue collection for non-payment of bills against individuals who demonstrate that they have neither sufficient income nor assets to meet their financial obligations. Schedule H, Part VI, Line 2 SRMC formally assesses the health care needs of the communities that it serves on a minimum of a triennial basis, and does so in collaboration with other community health providers. The most recent comprehensive, county-wide needs assessment was published in May 2019, and was developed by a collaborative of Columbiana County's major health providers, public health entities, and health-focused coalitions including Salem Regional Medical Center; East Liverpool City Hospital and Akron Children's Hospital; the Columbiana County, East Liverpool and Salem City Health Departments; Columbiana County Educational Service Center; Community Action Agency of Columbiana County; the Coordinated Action for School Health (CASH) Coalition; and the Columbiana County Mental Health Services and Recovery Board. The CHNA process began in May 2018, with the development of the project plan and timeline. The above mentioned collaborative convened in June 2018 and continued meeting through May 2019 to evaluate the previous CHNA, collect and analyze primary and secondary data, conduct community asset mapping and identify issues and select priorities to address through the development of the 2019-2022 CHNA. The Hospital Council of Northwest Ohio was retained to facilitate the process and provide data analysis and prioritization support. The geographic area of the needs assessment encompassed Ohio's Columbiana County, most of which is within Salem Regional Medical Center's Service Area; and prioritized the public, primary and specialty health care needs of community members from birth through end-of-life care. The CHNA action plan and report development were presented to and approved by the SRMC Board in May 2019, and distributed to all participating coalition organizations. The SRMC Implementation Plan was approved by the Board in November 2019, and both documents are posted on the SRMC website at: http://www.salemregional.com/about-us/our-publications: Community Health Needs Assessment and SRMC Implementation Plan. The Medical Center will carry forward its implementation strategies by addressing them in its Strategic Plan and annual Organizational Goals. In addition, SRMC is a collaborative partner in other types of needs assessments, such as the school health asset study through the Search Institute, conducted on a bi-annual basis with area school districts; a multi-disciplinary assessment of substance abuse incidence and treatment needs via the county-wide ADAPT coalition; behavioral health needs in collaboration with the Mental Health and Recovery Services Board; and minority health access needs in collaboration with faith-based and literacy-based advocacy groups. Schedule H, Part VI, Line 3 The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the Hospital's billing office. Schedule H, Part VI, Line 4 Salem Regional Medical Center's rural service area is officially designated as within one of Ohio's 32 Appalachian counties and includes Columbiana County, excluding Yellow Creek and East Liverpool Townships; and the five lower townships of Mahoning County. Portions of Columbiana County are also designated as Medically Underserved and a dental and mental health care Health Professional Shortage Area. The Robert Wood Johnson 2018 County Health Rankings data also showed that Columbiana County faces a significant barrier to access as indicated by the county's ratio of the population to primary care providers (2,280:1) being higher than Ohio (1,310:1); and the county's ratio of dentists (4,320:1) being considerably higher than Ohio (1,660:1). Columbiana County residents are older than their state and national counterparts, and the Service Area is characterized by a declining social, economic and population base, which impacts the area's health status problems and health service utilization. Generational poverty, lack of transportation and lack of insurance are also barriers to access, with the rate of uninsured Columbiana County adults higher than Ohio. Regional health outcomes and social/economic/environmental rates that were worse than Ohio benchmarks included: higher rates of premature death/years of potential life lost before age 75, higher adult obesity rates combined with lower physical activity rates, higher percentage of people who report their physical health as fair or poor, lower post-secondary education rates, higher teen birth rates, greater number of deaths due to injury and a higher index of air pollution. Health disparities are also more common among vulnerable populations and based on the demographics of Columbiana County's population, the 2019-2022 CHNA identified vulnerable populations as those living in poverty/socioeconomically disadvantaged, the Appalachian culture, children/youth, the elderly and those facing ethnic and literacy barriers. Schedule H, Part VI, Line 5 Salem Regional Medical Center actively seeks opportunities to further the community's health status by providing a wide variety of benefits for the broader community, including grant-writing activities for improved community health; financial and in-kind contributions for community-based feeding programs, physical fitness as an obesity and chronic disease prevention tool, blood drives, social services for vulnerable populations (including assistance with medications, transportation, limited English proficiency, referrals to support systems, and provision of personal protective equipment and COVID prevention education during the pandemic); community health education regarding COVID awareness and prevention, cancer, diabetes, arthritis, cardiac and other chronic diseases; and community health fairs and free and reduced-cost clinical screenings. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. Due to the Covid-19 pandemic beginning in March 2020 and continuing throughout 2021, the number of external outreach activities and community events was significantly curtailed; however the Hospital transitioned to virtual education and awareness campaigns to continue to improve community health and enhance the community's ability to withstand and recover from this public health emergency. It is estimated that over 25,850 area residents participated in community benefit programs and/or events provided and/or sponsored by SRMC. SRMC also utilizes an active volunteer base, with 55 community members donating over 2,050 hours of volunteer service annually. In addition, the SRMC Board of Directors is comprised of 16 community volunteers from the SRMC Service Area, who perform fiduciary responsibilities through monthly committee and Board activities. X X 0 0 0 0 0 0 0 0 0 Anita Hackstedde President/CEO 408644 0 0 0 8000 0 31611 0 18561 0 466816 0 0 0 Mike Giangardella VP Finance/Administration 218906 0 0 0 0 0 39542 0 10725 0 269173 0 0 0 Keith Meredith VP Clinical Operations 168596 0 0 0 0 0 17583 0 8667 0 194846 0 0 0 Sue Bryarly Director of Pharmacy 143254 0 0 0 0 0 14304 0 31092 0 188650 0 0 0 Deborah Pietrzak Asst VP Marketing & Planning 127638 0 0 0 0 0 29381 0 20853 0 177872 0 0 0 Diane Spalding Pharmacist 124047 0 0 0 0 0 5741 0 25931 0 155719 0 0 0 Kimberly Meek Pharmacist 123506 0 0 0 0 0 8600 0 10725 0 142831 0 0 0 Robin Weyant Asst VP of Nursing 122227 0 0 0 0 0 21018 0 31092 0 174337 0 0 0 A City Of Salem Ohio 346002560 2013-04-04 52000000 Hospital Facility Construction 0 1 0 A 29600292 0 52000000 0 193598 0 168913 0 160493 21883897 6893 0 2014 0 1 1 1 A 0 1 0 0 0.0112 0 0.0112 1 0 1 A 0 0 1 0 1 0 0 0 1 Form 990, Part VI, Section B, Line 11b The Form 990 is made available for review to the governing board prior to filing. Form 990, Part VI, Section B, Line 12c Each member of the Hospital's governing body, along with the Administrative staff, are required to review and disclose conflicts of interest in accordance with the Hospital's Code of Regulations. On an annual basis, Directors and Key Employees disclose potential business or professional relationships they may have with the Organization and/or other Directors/Key Employees. In situations when a Director may have a conflict, they may participate in the discussion, but must leave the room prior to final discussion and vote. Form 990, Part VI, Section B, Line 15 The President's compensation is determined by the Board of Directors of Salem Regional Medical Center, based upon the recommendation of the Board's Executive committee, both of which are comprised primarily of independent board members. The committee evaluates market data through formal statewide surveys, as well as targeted regional survey data. Form 990, Part VI, Section C, Line 19 As a private, not-for-profit organization, Salem Regional Medical Center does not make its governing documents or financial statements generally available to the public; although, the federal Form 990 is available for review upon request Form 990, Part IX, Line 11g Balance in this category represents the following expense: 1) Purchased Services total $9,559,550; 2) Repairs and Maintenance Services total $2,425,158; Professional Health Care Services total $2,262,148. Form 990, Part XI, Line 9 Change in defined benefit plan gains, prior service costs or credits and settlements $8,932,585; transfers to related organization -$8,136,622 Form 990, Part XII, Line 3b The audit that SRMC will be required to undergo per Single Audit Act and OMB Circular A-133 guidance is related to the CARES Act Relief Funds that the organization received during Fiscal Year 2020 and 2021 (specifically April, May and July 2020) in direct response to the COVID-19 Pandemic Disaster that was declared March 2020. The due date for the Single Audit related to all funds received in calendar year 2020 through our Fiscal Year Ending June 30, 2021 is not due until September 2022. Please note that this will be a Consolidated Single Audit as the award is considered a single program irrespective of specific entity receipt for the general distributions. Due to the fact that the audit will cover an 18 month period, has delayed the guidance to the auditing community to begin the single audit on this program. SCH Professional Corporation 1995 East State Street Salem OH 44460 341764515 Physician Offices OH 501(c)(3) 11 Salem Community Hospital 0 The Charitable Foundation of Salem Community Hospital 1995 East State Street Salem OH 44460 462902698 Support Salem Community Hospital OH 501(c)(3) 11 Salem Communiy Hospital 0 Salem Medical Arts & Development Corporation 2020 East State Street Salem OH 44460 341049534 Office Rent OH N/A C 1 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 SCH Professional Corporation j 251719 Cost per square foot SCH Professional Corporation b 8136622 Actual capital contribution SCH Professional Corporation o 136251 Net of actual salaries and benefits paid The Charitable Foundation of Salem Community Hospital q 115000 Reimburse actual salary, benefit and accounts payable cost paid Salem Medical Arts & Development Corporation q 218960 Reimburse accounts payable cost paid