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PROMEDICA FOUNDATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
PROMEDICA FOUNDATION (EIN 34-1517672)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-08
IRS object ID
202203129349303050
Schema version
2021v4.2
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)
Return2022-11-08T12:18:05-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341517672EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROMEDICA FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPROMBusinessNameControlTxt
Phone5675853618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1444 N SUMMIT STAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLOUIS ROBICHAUXPersonNm
Person TitleTREASURERPersonTitleTxt
Phone5675853618PhoneNum
Signature2022-11-07SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLOUISPersonFirstNm
Person LastROBICHAUXPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLOUIS ROBICHAUXPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$191,150,743GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROMEDICA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHE PROMEDICA FOUNDATION'S MISSION IS TO GENERATE AND DIRECT THE UTILIZATION OF RESOURCES TO ENRICH EXISTING PROGRAMS AND FUND NEW SERVICES, INSPIRING EXCELLENT IN THE PROVISION OF HEALTH CARE AND ENHANCING QUALITY OF LIFE FOR THE PEOPLE OF OUR COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$14,319,985PYContributionsGrantsAmt
CY Contributions Grants$14,467,690CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$9,958,426PYInvestmentIncomeAmt
CY Investment Income$19,549,963CYInvestmentIncomeAmt
PY Other Revenue-$45,073PYOtherRevenueAmt
CY Other Revenue-$71,522CYOtherRevenueAmt
PY Total Revenue$24,233,338PYTotalRevenueAmt
CY Total Revenue$33,946,131CYTotalRevenueAmt
PY Grants And Similar Paid$16,263,509PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,182,080CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,220,229PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,502,662CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$436,333PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$6,061,195CYTotalFundraisingExpenseAmt
PY Other Expenses$4,217,981PYOtherExpensesAmt
CY Other Expenses$4,115,217CYOtherExpensesAmt
PY Total Expenses$23,138,052PYTotalExpensesAmt
CY Total Expenses$20,799,959CYTotalExpensesAmt
PY Revenues Less Expenses$1,095,286PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,146,172CYRevenuesLessExpensesAmt
Total Assets BOY$386,053,064TotalAssetsBOYAmt
Total Assets EOY$412,976,640TotalAssetsEOYAmt
Total Liabilities BOY$3,759,390TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,470,806TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$382,293,674NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$406,505,834NetAssetsOrFundBalancesEOYAmt
MissionTHE PROMEDICA FOUNDATION'S MISSION IS TO GENERATE AND DIRECT THE UTILIZATION OF RESOURCES TO ENRICH EXISTING PROGRAMS AND FUND NEW SERVICES, INSPIRING EXCELLENCE IN THE PROVISION OF HEALTH CARE AND ENHANCING QUALITY OF LIFE FOR THE PEOPLE OF OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$13,182,080ExpenseAmt
Grant$13,182,080GrantAmt
Revenue$280RevenueAmt
DescPROMOTE HEALTH AND WELL-BEING WITH SUPPORT FOR MEDICAL CARE, MEDICAL EDUCATION, MEDICAL RESEARCH, AND SOCIAL DETERMINANTS OF HEALTH, AND BY SOLICITING CONTRIBUTIONS, PROVIDING GRANTS, AND INVESTING FUNDS TO GENERATE INCOME TO SUPPORT PROMEDICA HEALTH SYSTEM, INC. ENTITIES.Desc
Total Program Service Expenses$13,182,080TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
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 Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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 Members6GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIFER SARPALIUSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5675855652PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
LESLIE A CHAPMAN
CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
RANDALL OOSTRA
EX OFFICIO, PHS PRES. & CEO1.0055.00Yes (X)Yes (X)$0$7,155,772$300,344
STEVEN M CAVANAUGH
TREASURER, CFO1.0055.00Yes (X)Yes (X)$0$3,497,904$60,660
ROBERT W LACLAIR
EX OFFICIO1.004.00Yes (X)$0$0$0
ANGELA BRANDT
TRUSTEE, PRES. SENIOR CARE1.0055.00Yes (X)$0$827,767$26,535
GARY M CATES
TRUSTEE, CHIEF PHILANTHROPIC OFFICER1.0041.00Yes (X)$0$608,294$38,726
DAVID PARKER
TRUSTEE (PARTIAL YEAR), PRES.1.0054.00Yes (X)$0$1,921,499$15,313
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER1.0055.00Yes (X)$0$1,347,615$68,186
CHRISTI L ANSBERG
VP, PHILANTHROPY OPERATIONS1.0051.00$0$213,120$23,900Yes (X)
ALAN M SATTLER
FORMER TREASURER, VP BUSINESS DEV.0.0040.00$0$269,627$37,223Yes (X)
GARY W AKENBERGER
FORMER TREASURER, COO, METRO REGION0.0040.00$0$525,467$38,467Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$16,367,065TotReportableCompRltdOrgAmt
Total Other Compensation$609,354TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$15,640FederatedCampaignsAmt
Fundraising$673,840FundraisingAmt
Related Organizations$202,909RelatedOrganizationsAmt
All Other Contributions$13,575,301AllOtherContributionsAmt
Noncash Contributions$215,517NoncashContributionsAmt
Total Contributions$14,467,690TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,713,762TotalRevenueColumnAmt
Exclusion$9,713,762ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$166,778,668SecuritiesAmt
Other$61,506OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$156,853,973SecuritiesAmt
Other$150,000OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$9,924,695SecuritiesAmt
Other-$88,494OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,836,201TotalRevenueColumnAmt
Exclusion$9,836,201ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$128,837FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$673,840ContriRptFundraisingEventAmt
Fundraising Direct Expenses$200,639FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$71,802TotalRevenueColumnAmt
Exclusion-$71,802ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMEMBERSHIP DUESDesc
Business900099BusinessCd
Total Revenue Column$280TotalRevenueColumnAmt
Related Or Exempt Func Income$280RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$280OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,946,131TotalRevenueColumnAmt
Related Or Exempt Func Income$280RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$19,478,161ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,113,876TotalAmt
Program Services$13,113,876ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$68,204TotalAmt
Program Services$68,204ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,940,157TotalAmt
Management And General$260,337ManagementAndGeneralAmt
Fundraising$2,679,820FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$42,448TotalAmt
Management And General$4,543ManagementAndGeneralAmt
Fundraising$37,905FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$365,081TotalAmt
Management And General$39,069ManagementAndGeneralAmt
Fundraising$326,012FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$154,976TotalAmt
Management And General$16,585ManagementAndGeneralAmt
Fundraising$138,391FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$157TotalAmt
Management And General$157ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$53,072TotalAmt
Management And General$53,072ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,245TotalAmt
Management And General$1,245ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$773,793TotalAmt
Management And General$773,793ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$761,419TotalAmt
Fundraising$761,419FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$17,233TotalAmt
Management And General$17,233ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$66,109TotalAmt
Management And General$66,109ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$93TotalAmt
Management And General$93ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$107,895TotalAmt
Management And General$107,895ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,756TotalAmt
Fundraising$34,756FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$186,091TotalAmt
Management And General$186,091ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,003TotalAmt
Management And General$1,003ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
FUNDRAISING EXPENSE$2,080,692$2,080,692
INTERCOMPANY SERVICES$16,696$16,696
DUES AND SUBSCRIPTIONS$6,940$6,940
MINOR EQUIPMENT$5,823$5,823

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,200TotalAmt
Fundraising$2,200FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,799,959TotalAmt
Program Services$13,182,080ProgramServicesAmt
Management And General$1,556,684ManagementAndGeneralAmt
Fundraising$6,061,195FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,115,825BOYAmt
EOY$1,184,917EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,161,046BOYAmt
EOY$16,838,991EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$30,205EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$2,473,771EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,871,250LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,021,250BOYAmt
EOY$1,871,250EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$328,849,016BOYAmt
EOY$348,922,838EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,821,692BOYAmt
EOY$3,018,339EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$36,084,235BOYAmt
EOY$38,636,329EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$386,053,064BOYAmt
EOY$412,976,640EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$52,686BOYAmt
EOY$142,371EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,706,704BOYAmt
EOY$6,328,435EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,759,390BOYAmt
EOY$6,470,806EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$234,348,515BOYAmt
EOY$249,380,839EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$147,945,159BOYAmt
EOY$157,124,995EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$382,293,674BOYAmt
EOY$406,505,834EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$386,053,064BOYAmt
EOY$412,976,640EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$13,146,172ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$11,513,285NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$447,297OtherChangesInNetAssetsAmt
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 RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations34SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (34 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
BAY PARK COMMUNITY HOSPITAL
3418831323Yes (1)$26,614$0
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
3861081103Yes (1)$681,843$0
DEFIANCE HOSPITAL INC
3444464843Yes (1)$25,286$0
EMMA L BIXBY MEDICAL CENTER
3827960053Yes (1)$441,982$0
FOSTORIA HOSPITAL ASSOCIATION
3408987453Yes (1)$40,565$0
HERRICK MEMORIAL HOSPITAL INC
3830490153Yes (1)$0$0
MEMORIAL HOSPITAL
3444308493Yes (1)$81,910$0
MERCY MEMORIAL HOSPITAL CORPORATION
3819842893Yes (1)$80,314$0
THE TOLEDO HOSPITAL
3444282563Yes (1)$4,455,815$0
HCR MANORCARE INC
825373223100$319,098$0
KAITLYN'S COTTAGE INC
454781053100$234,282$0
LENAWEE LONG TERM CARE
382879330100$0$0
MONROE COMMUNITY HEALTH SERVICES
382934134100$0$0
PROMEDICA CONTINUING CARE SERVICES CORPORATION
344492440100$0$0
PROMEDICA PHYSICIAN GROUP
34189943910Yes (1)$0$0
TOLEDO DISTRICT NURSE ASSOCIATION
344427949100$0$0
VISITING NURSE HOSPICE AND HEALTH CARE
341831624100$20,000$0
PROMEDICA CONTINUUM SERVICES
341880767100$0$0
MANOR CARE OF GIG HARBOR WA ASSOCIATION
260624719100$0$0
MANOR CARE OF LACEY WA ASSOCIATION
260624391100$0$0
MANOR CARE OF LYNNWOOD WA ASSOCIATION
260624675100$0$0
MANOR CARE OF SALMON CREEK WA ASSOCIATION
260624375100$0$0
MANOR CARE OF SPOKANE WA ASSOCIATION
260624687100$0$0
MANOR CARE OF TACOMA WA ASSOCIATION
260624696100$0$0
PROMEDICA CENTRAL PHYSICIANS
341881137100$0$0
PROMEDICA CHILDRENS SPECIALISTS
208734161100$0$0
PROMEDICA GENITO-URINARY SURGEONS
461120436100$0$0
PROMEDICA MONROE CARDIOLOGY
272920342100$0$0
PROMEDICA MONROE PHYSICIANS
461111822100$0$0
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS
263888045100$0$0
PROMEDICA PHYSICIANS AT HOME INC
852181349100$0$0
PROMEDICA PRIMARY CARE PROVIDERS
831731861100$0$0
MEMORIAL PROFESSIONAL SERVICES
273763993100$6,000$0
PROMEDICA MULTI SPECIALTY PHYSICIANS
454976786100$0$0
FieldValueIRS element (for citing)
Supported Organizations Total34SupportedOrganizationsTotalCnt
Support Sum$6,413,709SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationYes (1)SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgYes (1)OrganizationChangeSuprtOrgInd
Supported Org Class Designated0SupportedOrgClassDesignatedInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported Org0MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, SECTION A, LINE 1:PROMEDICA HEALTH SYSTEM, INC. (34-1517671) AFFILIATES DESIGNATED BY CLASS AND PURPOSE LISTED IN SCHEDULE R, PART II THAT ARE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3) THAT ARE NOT PRIVATE FOUNDATIONS BECAUSE THEY ARE DESCRIBED IN CODE SECTION 509(A)(1) OR SECTION 509(A)(2).
PART IV, SECTION C, LINE 1:PROMEDICA FOUNDATION IS AN OHIO NOT-FOR-PROFIT CORPORATION THAT OPERATES TO SUPPORT, BENEFIT, AND, THROUGH ITS ACTIVITIES, CARRY OUT AND FURTHER THE PURPOSE OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AFFILIATES DESIGNATED BY CLASS AND PURPOSE LISTED IN SCHEDULE R, PART II THAT ARE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3) THAT ARE NOT PROVATE FOUUNDATIONS BECAUSE THEY ARE DESCRIBED IN CODE SECTION 509(A)(1) OR SECTION 509(A)(2). PHS IS THE MEMBER OF PROMEDICA FOUNDATION AND THE PARENT OF AN INTEGRATED HEALTH CARE DELIVERY NETWORK MADE UP OF AN AFFILIATED GROUP OF EXEMPT ORGANIZATIONS WHICH INCLUDES HOSPITALS, HEALTH CARE PROVIDERS, CONTINUING CARE SERVICES, SPECIALIZED HEALTH SERVICES, ENTITIES PROVIDING SUPPORT SERVICES, AND FOUNDATIONS. PHS PROVIDES OVERALL DIRECTION, MANAGEMENT, AND CONTROL TO ITS FIRST TIER SUBSIDIARIES, INCLUDING PROMEDICA FOUNDATION, AND INDIRECTLY THROUGH ITS FIRST TIER SUBSIDIARIES, TO ALL AFFILIATED SECOND TIER SUBSIDIARIES OF EACH FIRST TIER SUBSIDIARY. THE ACTIVITIES OF PHS SUPPORT THE EXEMPT PURPOSES OF THE AFFILIATED ORGANIZATIONS IN THE PHS NETWORK AND ENHANCE AND IMPROVE THE DELIVERY OF EFFECTIVE HEALTH CARE SERVICES TO THE COMMUNITIES SERVED BY THE PHS NETWORK. CONTROL AND MANAGEMENT EFFECTIVELY IS VESTED IN THE SAME PERSONS THAT CONTROL AND MANAGE ALL SUBSIDIARY ORGANIZATIONS THROUGH RESERVED POWERS. PHS HAS RESERVED POWERS IN EACH SUBSIDIARY'S CODE OF REGULATIONS OR BYLAWS ALONG WITH THE RIGHT TO APPROVE CERTAIN ACTIONS OF EACH SUBSIDIARY'S BOARD OF TRUSTEES. THE FIRST TIER SUBSIDIARIES HAVE IN TURN RESERVED SIMILAR POWERS OVER THE SECOND TIER SUBSIDIARIES TO INTEGRATE OVERALL DIRECTION, MANAGEMENT, AND CONTROL. PROMEDICA FOUNDATION QUALIFIES AS A TYPE II SUPPORTING ORGANIZATION BECAUSE IT IS SUPERVISED AND CONTROLLED IN CONNECTION WITH ALL ORGANIZATIONS THAT ARE EXEMPT AFFILITIATED MEMBERS OF PHS. COMMON SUPERVISION AND CONTROL ARE SHARED THROUGH THE STRUCTURAL RELATIONSHIP OF PHS. THERE HAS ALSO BEEN A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN PROMEDICA FOUNDATION AND ITS SUPPORTED ORGANIZATIONS AND A SUBSTANTIAL IDENTITY OF INTERESTS BETWEEN THE ORGANIZATIONS AS A RESULT OF THIS RELATIONSHIPS SUPPORTING COMMON CONTROL CONSISTENT WITH TYPE I SUPPORTING ORGANIZATION CLASSIFICATION. PROMEDICA FOUNDATION HAS MAINTAINED, AND WILL CONTINUE TO MAINTAIN, A SIGNIFICIANT INVOLVEMENT IN EACH SUPPORTED ORGANIZATIONS' OPERATIONS.
PART IV, SECTION A, LINE 2PROMEDICA FOUNDATION PROVIDES SUPPORT FOR THE FOLLOWING ENTITIES THAT CURRENTLY HAVE NOT RECEIVED AN IRS DETERMINATION OF STATUS. THE 1023 APPLICATION FORMS FOR THESE ENTITIES ARE EITHER IN THE FINAL STEP OF REVIEW PRIOR TO BEING ELECTRONICALLY FILED OR HAVE NOT YET RECEIVED A DETERMINATION LETTER: - PROMEDICA CHILDREN'S SPECIALISTS FEIN 20-8734161 - PROMEDICA PHYSICIANS AT HOME, INC FEIN 85-2181349 - PROMEDICA MULTI SPECIALTY PHYSCIANS FEIN 45-4976786

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 D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$60,983,875BeginningYearBalanceAmt
Contributions$2,000ContributionsAmt
Investment Earnings Or Losses$5,185,950InvestmentEarningsOrLossesAmt
Other Expenditures$30,747OtherExpendituresAmt
End Year Balance$66,141,078EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$57,669,824BeginningYearBalanceAmt
Contributions$2,000ContributionsAmt
Investment Earnings Or Losses$3,812,051InvestmentEarningsOrLossesAmt
Other Expenditures$500,000OtherExpendituresAmt
End Year Balance$60,983,875EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,971,352BeginningYearBalanceAmt
Contributions$10,450ContributionsAmt
Investment Earnings Or Losses$6,688,022InvestmentEarningsOrLossesAmt
End Year Balance$57,669,824EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,244,034BeginningYearBalanceAmt
Contributions$8,450ContributionsAmt
Investment Earnings Or Losses-$4,741,132InvestmentEarningsOrLossesAmt
Other Expenditures$540,000OtherExpendituresAmt
End Year Balance$50,971,352EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,869,326BeginningYearBalanceAmt
Contributions$376,639ContributionsAmt
Investment Earnings Or Losses$5,188,830InvestmentEarningsOrLossesAmt
Other Expenditures$190,761OtherExpendituresAmt
End Year Balance$56,244,034EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.34960BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.65040PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,871,250InvestmentCostOrOtherBasisAmt
Book Value$1,871,250BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,871,250TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
CASH VALUE OF LIFE INSURANCE$1,546,762
FUNDED PERPETUITIES$37,089,567
FieldValueIRS element (for citing)
Total Book Value Other Assets$38,636,329TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$6,328,435Amt
FieldValueIRS element (for citing)
Total Liability$6,328,435TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationTHE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT PROMEDICA HEALTH SYSTEM, INC. ENTITIES CONSISTENT WITH DONOR INTENT.ExplanationTxt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
ALY STERLING PHILANTHROPY
1847 COLLINGWOOD BLVDTOLEDOOH43604CAMPAIGN CONSULTING0$8,750,000$325,501$8,424,499
GINA REISS
1061 MERIDIAN AVE 2CMIAMI BEACHFL33139CONSULTING0$750,000$107,143$642,857
MAMMOTH TECH
333 FLORENCE STDEFIANCEOH43512PHONE SOLICITATION0$380$40,000-$39,620
FieldValueIRS element (for citing)
Total Gross Receipts$9,500,380TotalGrossReceiptsAmt
Total Retained By Contractors$472,644TotalRetainedByContractorsAmt
Total Net To Organization$9,027,736TotalNetToOrganizationAmt
Licensed StatesFLLicensedStatesCd
Licensed StatesMILicensedStatesCd
Licensed StatesOHLicensedStatesCd
Licensed StatesAKLicensedStatesCd
Licensed StatesCALicensedStatesCd
Licensed StatesCOLicensedStatesCd
Licensed StatesILLicensedStatesCd
Licensed StatesKSLicensedStatesCd
Licensed StatesKYLicensedStatesCd
Licensed StatesMALicensedStatesCd
Licensed StatesMDLicensedStatesCd
Licensed StatesMELicensedStatesCd
Licensed StatesMNLicensedStatesCd
Licensed StatesMSLicensedStatesCd
Licensed StatesNCLicensedStatesCd
Licensed StatesNDLicensedStatesCd
Licensed StatesNHLicensedStatesCd
Licensed StatesNJLicensedStatesCd
Licensed StatesNMLicensedStatesCd
Licensed StatesNVLicensedStatesCd
Licensed StatesNYLicensedStatesCd
Licensed StatesOKLicensedStatesCd
Licensed StatesORLicensedStatesCd
Licensed StatesPALicensedStatesCd
Licensed StatesSCLicensedStatesCd
Licensed StatesTNLicensedStatesCd
Licensed StatesUTLicensedStatesCd
Licensed StatesVALicensedStatesCd
Licensed StatesWALicensedStatesCd
Licensed StatesWILicensedStatesCd
Licensed StatesWVLicensedStatesCd
Licensed StatesALLicensedStatesCd
Licensed StatesARLicensedStatesCd
Licensed StatesCTLicensedStatesCd
Licensed StatesLALicensedStatesCd
Licensed StatesMOLicensedStatesCd
Licensed StatesRILicensedStatesCd
Licensed StatesTXLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1CHILDREN'S HOSPITAL EVENTEvent1Nm
Gross Receipts Event1$179,350GrossReceiptsEvent1Amt
Charitable Contri Event1$164,350CharitableContriEvent1Amt
Gross Revenue Event1$15,000GrossRevenueEvent1Amt
Cash Prizes Event1$0CashPrizesEvent1Amt
Food And Beverage Event1$6,522FoodAndBeverageEvent1Amt
Entertainment Event1$950EntertainmentEvent1Amt
Other Direct Expenses Event1$6,618OtherDirectExpensesEvent1Amt
Event2FLOWER GOLF EVENTEvent2Nm
Gross Receipts Event2$139,570GrossReceiptsEvent2Amt
Charitable Contri Event2$106,385CharitableContriEvent2Amt
Gross Revenue Event2$33,185GrossRevenueEvent2Amt
Cash Prizes Event2$2,230CashPrizesEvent2Amt
Rent Facility Costs Event2$0RentFacilityCostsEvent2Amt
Food And Beverage Event2$13,384FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$33,710OtherDirectExpensesEvent2Amt
Other Events Total8OtherEventsTotalCnt
Gross Receipts Other Events$483,757GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$403,105CharitableContriOtherEventsAmt
Gross Revenue Other Events$80,652GrossRevenueOtherEventsAmt
Cash Prizes Other Events$900CashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$800RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$39,114FoodAndBeverageOtherEventsAmt
Entertainment Other Events$400EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$96,011OthDirectExpnssOtherEventsAmt
Gross Receipts Total$802,677GrossReceiptsTotalAmt
Charitable Contributions Tot$673,840CharitableContributionsTotAmt
Gross Revenue Total Events$128,837GrossRevenueTotalEventsAmt
Cash Prizes Total Events$3,130CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$800RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$59,020FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,350EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$136,339OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$200,639DirectExpenseSummaryEventsAmt
Net Income Summary-$71,802NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2B, COLUMN (V):FormAndLineReferenceDesc
ExplanationAMOUNTS PAID FOR THE REIMBURSEMENT OF EXPENSES TO PROFESSIONAL FUNDRAISING COMPANIES IS $6,260. PAYMENT FOR PROFESSIONAL FUNDRAISING SERVICES IS DISTINGUISHED FROM EXPENSE PAYMENTS ON THE DETAIL OF THE INVOICES.ExplanationTxt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
BAY PARK COMMUNITY HOSPITAL
2801 BAY PARK DRORGEONOH43616341883132501(C)(3)$26,614$0OPERATING GRANT
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
274 E CHICAGO STCOLDWATERMI49036386108110501(C)(3)$681,843$0OPERATING GRANT
DEFIANCE HOSPITAL INC
1200 RALSTON AVEDEFIANCEOH43512344446484501(C)(3)$25,286$0OPERATING GRANT
EMMA L BIXBY MEDICAL CENTER
818 RIVERSIDE AVENUEADRIANMI49221382796005501(C)(3)$441,982$0OPERATING GRANT
FIRST TEE OF LAKE ERIE
4700 HILL AVETOLEDOOH43615455657531501(C)(3)$3,842,561$0OPERATING GRANT
FOSTORIA HOSPITAL ASSOCIATION
PO BOX 907FOSTORIAOH44830340898745501(C)(3)$40,565$0OPERATING GRANT
HCR MANORCARE INC
333 N SUMMIT STTOLEDOOH43604825373223501(C)(3)$319,098$0OPERATING GRANT
HOPE TOLEDO
300 MADISON AVE STE 1400ATOLEDOOH43604852018307501(C)(3)$667,989$0OPERATING GRANT
KAITLYN'S COTTAGE
1260 RALSTON AVEDEFIANCEOH43512454781053501(C)(3)$234,282$0OPERATING GRANT
MEMORIAL HOSPITAL
715 S TAFT AVEFREMONTOH43420344430849501(C)(3)$81,910$0OPERATING GRANT
MEMORIAL PROFESSIONAL SERVICES
715 S TAFT AVEFREMONTOH43420273763993501(C)(3)$6,000$0OPERATING GRANT
MERCY MEMORIAL HOSPITAL CORPORATION
718 N MACOMBMONROEMI48162381984539501(C)(3)$80,314$0OPERATING GRANT
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVETOLEDOOH43604341517671501(C)(3)$2,189,370$0OPERATING GRANT
THE TOLEDO HOSPITAL
2142 NORTH COVE BLVDTOLEDOOH43606344453256501(C)(3)$4,455,815$0OPERATING GRANT
VISITING NURSE HOSPICE & HEALTH CARE
5855 MONROE STREETSYLVANIAOH43560341831624501(C)(3)$20,000$0OPERATING GRANT
FieldValueIRS element (for citing)
Total501c3 Org15Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient60RecipientCnt
Cash Grant$68,204CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS) CORPORATE POLICIES EXIST TO ENSURE THAT THE APPROVAL AND DISTRIBUTION OF FOUNDATION FUNDS ARE CONSISTENT WITH THE APPROVED CORPORATE MISSION, SUPPORTED BUSINESS UNIT STRATEGIC PLAN AND DOCUMENTED DONOR INTENT. ALL REQUESTS FOR FUNDS MUST BE SUBMITTED ON THE "FUND UTILIZATION REQUEST" FORM AND INCLUDE WRITTEN SUPPORTING DOCUMENTATION AND APPROPRIATE APPROVALS, INCLUDING BOARD APPROVALS, DEPENDING ON THE DOLLAR AMOUNT OF THE REQUEST. ON A REGULAR BASIS A REPORT LISTING ALL FUND DISTRIBUTIONS IS DISTRIBUTED TO THE CHIEF PHILANTHROPY OFFICER, CHIEF FINANCIAL OFFICER AND RESPECTIVE FOUNDATION BOARDS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
RANDALL OOSTRA
EX OFFICIO, PHS PRES. & CEO$0$1,956,043$0$5,028,392$0$171,337$0$283,814$0$16,530$0$7,456,116$0$0
STEVEN M CAVANAUGH
TREASURER, CFO$0$1,300,553$0$2,196,109$0$1,242$0$35,041$0$25,619$0$3,558,564$0$0
DAVID PARKER
TRUSTEE (PARTIAL YEAR), PRES.$0$1,116,902$0$534,563$0$270,034$0$0$0$15,313$0$1,936,812$0$0
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER$0$724,534$0$616,992$0$6,089$0$53,463$0$14,723$0$1,415,801$0$0
ANGELA BRANDT
TRUSTEE, PRES. SENIOR CARE$0$505,278$0$315,704$0$6,785$0$12,350$0$14,185$0$854,302$0$0
GARY M CATES
TRUSTEE, CHIEF PHILANTHROPIC OFFICER$0$383,133$0$220,178$0$4,983$0$23,795$0$14,931$0$647,020$0$0
GARY W AKENBERGER
FORMER TREASURER, COO, METRO REGION$0$387,188$0$133,715$0$4,564$0$20,943$0$17,524$0$563,934$0$0
ALAN M SATTLER
FORMER TREASURER, VP BUSINESS DEV.$0$210,556$0$50,619$0$8,452$0$10,550$0$26,673$0$306,850$0$0
CHRISTI L ANSBERG
VP, PHILANTHROPY OPERATIONS$0$174,102$0$37,533$0$1,485$0$4,058$0$19,842$0$237,020$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ACHARTER TRAVEL: 1 OFFICER- NOT INCLUDED IN TAXABLE COMPENSATION
PART I, LINE 3PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF PROMEDICA FOUNDATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-BUNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: DAVID PARKER $268,557.66 ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMTATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII.
SCHEDULE J, SUPPLEMENTAL INFORMATION:IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR.

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution3ContributionCnt
Noncash Contributions Rpt F990$215,517NoncashContributionsRptF990Amt
Method Of Determining RevenuesCOST OR SELLING PRICEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I LINE 9FormAndLineReferenceDesc
ExplanationTHE AMOUNT IN COLUMN B REFERS TO THE NUMBER OF DONORS THAT CONTRIBUTED STOCK.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, 1ATHE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART VI, SECTION A, LINE 6AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7APROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF PROMEDICA FOUNDATION. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF PROMEDICA FOUUNDATION, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7BWHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CPROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE IDENTIFIED PROVIDER BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, WILL PROVIDE THE PROVIDER-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PHS WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE.
FORM 990, PART VI, SECTION B, LINE 15PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
PART VII, SECTION BPROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART XI, LINE 9:TRANSFERS BETWEEN RELATED ENTITIES -75,560. UNCOLLECTIBLE PLEDGES -371,737.
FORM 990, PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MISSION POINTE GOLF COURSE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12142 NORTH COVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43606ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesGOLF COURSEPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PROMEDICA FOUNDATIONBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (43 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
100 MADISON AVETOLEDOOH43604386108110HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTONDEFIANCEOH43512510173779HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)10DEFIANCE HOSPITAL INCYes (1)
DEFIANCE HOSPITAL INC
100 MADISON AVETOLEDOOH43604344446484HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER
100 MADISON AVETOLEDOOH43604382796005HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVEADRIANMI43604382149602HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)12B, IIEMMA L BIXBY MEDICAL CENTERYes (1)
FOSTORIA HOSPITAL ASSOCIATION
100 MADISON AVETOLEDOOH43604340898745HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907FOSTORIAOH44830346517634HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)10FOSTORIA HOSPITAL ASSOCIATIONYes (1)
HCR MANORCARE FOUNDATION INC
444 N SUMMIT STTOLEDOOH43604522031975FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
HCR MANORCARE INC
PO BOX 10086 ATTN TAX-5TOLEDOOH43699825373223SKILLED NURSING FACILITIESOH501(C)(3)10PROMEDICA HEALTH SYSTEM INCYes (1)
HEARTLAND HOSPICE MEMORIAL FUND INC
444 N SUMMIT STTOLEDOOH43604270497199FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE STTECUMSEHMI49286383076105HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)12B, IIHERRICK MEMORIAL HOSPITAL INCYes (1)
HERRICK MEMORIAL HOSPITAL INC
100 MADISON AVETOLEDOOH43604383049015HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
KAITLYN'S COTTAGE INC
100 MADISON AVETOLEDOOH43604454781053RESPITE CAREOH501(C)(3)10DEFIANCE HOSPITAL INCYes (1)
LENAWEE LONG TERM CARE
PO BOX 10086 ATTN TAX-5TOLEDOOH43699382879330LONG TERM CAREMI501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF GIG HARBOR WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624719SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF LACEY WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624391SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF LYNNWOOD WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624675SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF SALMON CREEK WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624375SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF SPOKANE WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624687SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF TACOMA WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624696SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MEMORIAL HOSPITAL
100 MADISON AVETOLEDOOH43604344430849HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
MEMORIAL PROFESSIONAL SERVICES
100 MADISON AVETOLEDOOH43604273763993PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
100 MADISON AVETOLEDOOH43604381984289HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
MONROE COMMUNITY HEALTH SERVICES
PO BOX 10086 ATTN TAX-5TOLEDOOH43699382934134LONG TERM CAREMI501(C)(3)10HCR MANORCARE INCYes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIRMAUMEEOH43537203376102HEALTH INSURANCEOH501(C)(3)10PROMEDICA INSURANCE CORP INC AND SUBSIDIARIESYes (1)
PROMEDICA CENTRAL PHYSICIANS
100 MADISON AVETOLEDOOH43604341881137PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA CHILDRENS SPECIALISTS
100 MADISON AVETOLEDOOH43604208734161PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
100 MADISON AVETOLEDOOH43604344492440LONG TERM AND HOME HEALTH CAREOH501(C)(3)10PROMEDICA CONTINUUM SERVICESYes (1)
PROMEDICA CONTINUUM SERVICES
100 MADISON AVETOLEDOOH43604341880767PHYSICIAN MANAGEMENT SERVICESOH501(C)(3)12B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA COURIER SERVICES INC
100 MADISON AVETOLEDOOH43604260324790COURIER SERVICEOH501(C)(3)12B, IIPROMEDICA CONTINUUM SERVICESYes (1)
PROMEDICA GENITO-URINARY SURGEONS
100 MADISON AVETOLEDOOH43604461120436PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVETOLEDOOH43604341517671PARENT COMPANY OF HEALTH SYSTEMOH501(C)(3)12B, II0N/A
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOORBURLINGTONVT05401341931936PROFESSIONAL & GENERAL LIABILITYVT501(C)(3)12B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA MONROE CARDIOLOGY
100 MADISON AVETOLEDOOH43604272920342PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA MONROE PHYSICIANS
100 MADISON AVETOLEDOOH43604461111822PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
100 MADISON AVETOLEDOOH43604454976786PHYSICIAN HEALTH CARE SERVICESOH501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS
100 MADISON AVETOLEDOOH43604263888045PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA PHYSICIAN GROUP INC
100 MADISON AVETOLEDOOH43604341899439PHYSICIAN HEALTH CARE SERVICESOH501(C)(3)10PROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA PHYSICIANS AT HOME INC
100 MADISON AVETOLEDOOH43604852181349PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA PRIMARY CARE PROVIDERS
100 MADISON AVETOLEDOOH43604831731861PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
THE HUG FUND
444 N SUMMIT STTOLEDOOH43604202272848FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
THE TOLEDO HOSPITAL
100 MADISON AVETOLEDOOH43604344428256HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
100 MADISON AVETOLEDOOH43604341831624HOSPICE HOME CAREOH501(C)(3)10HCR MANORCARE INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
EAST-WEST HOLDINGS LTD
715 SOUTH TAFT AVEFREMONTOH43420204066818REAL ESTATEOHN/A00
AIR DIVERTER SOLUTIONS LLC
100 MADISON AVETOLEDOOH43604853725776DEVELOPMENTOHN/A00
MERCYMANOR PARTNERSHIP
PO BOX 10086 ATTN TAX-5TOLEDOOH43604521931012SKILLED NURSINGPAN/A0Yes (1)
NORMAN SPECIALTY HOSPITAL LLC
PO BOX 10086 ATTN TAX-5TOLEDOOH43604421627672HEALTH CAREDEN/A0Yes (1)
NORTHWEST OHIO DEDICATED BREAST MRI LLC
100 MADISON AVETOLEDOOH43604260679898MEDICAL DIAGNOSTICSOHN/A00
PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC
100 MADISON AVETOLEDOOH43604473163945REAL ESTATEOHN/A0Yes (1)
PROMEDICA MASTER TENANT LLC
100 MADISON AVETOLEDOOH43604475288490REAL ESTATEOHN/A0Yes (1)
PROMEDICA PATHOLOGY LABORATORIES LLC
2130 W CENTRAL AVE STE 300TOLEDOOH43606831022842CLINICAL LABORATORYDEN/A00
PROMEDICA SENIOR CARE OF GEORGIA LLC
100 MADISON AVETOLEDOOH43604871802834SKILLED NURSINGOHN/A0Yes (1)
PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC
100 MADISON AVETOLEDOOH43604461989695PHYSICIAN MANAGEMENT SERVICESOHN/A00
REYNOLDS ROAD SURGICAL CENTER LTD
2865 N REYNOLDS RDTOLEDOOH43615311569454FREESTANDING AMBULATORY SURGICAL CENTEROHN/A00
ROCKET VENTURE FUND II LLC
2865 N REYNOLDS RD STE 220TOLEDOOH43615475603627INVESTMENT FUNDOHN/A00
SENIOR & REHAB CARE AT METROHEALTH LLC
100 MADISON AVE ATTN TAX DEPTTOLEDOOH43604872465544SKILLED NURSINGOHN/A0Yes (1)
THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC
1051 S TELEGRAPH RDMONROEMI48161270843485AMBULATORY SURGICAL CENTERMIN/A00
WEST CENTRAL SURGICAL CENTER LLC
7055 W CENTRALTOLEDOOH43617200088459AMBULATORY SURGICAL CENTEROHN/A0Yes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TRADRIANMI49221383146907FACILITY LEASINGMIN/AC0
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVEADRIANMI49221383639616FACILITY MANAGEMENTMIN/AC0
MONROE HEALTH VENTURES INC
718 N MACOMBMONROEMI48164382704426PHARMACYMIN/AC0
PROMEDICA AT HOME INC
100 MADISON AVETOLEDOOH43604852320857PHYSICAN SUPPORTMIN/AC0
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
100 MADISON AVETOLEDOOH43604383322278PHYSICIAN HEALTH CARE SERVICESOHN/AC0
PROMEDICA HEALTH NETWORK INC
100 MADISON AVETOLEDOOH43604474006496PHYSICIAN MANAGEMENT SERVICESOHN/AC0
PROMEDICA INNOVATIONS LLC
100 MADISON AVETOLEDOOH43604301221601INVESTMENT COMPANYOHN/AC0
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIRMAUMEEOH43537341570675HEALTH CARE INSURANCEOHN/AC0
PROMEDICA MANAGER MEMBER LLC
100 MADISON AVETOLEDOOH43604475168737REAL ESTATEOHN/AC0
PROMEDICA NORTH PHYSICIAN CORPORATION
100 MADISON AVETOLEDOOH43604383482148PHYSICIAN HEALTH CARE SERVICESOHN/AC0
PROMEDICA SENIOR CARE OF PISCATAWAY NJ LLC
PO BOX 10086 ATTN TAX-5TOLEDOOH43699861179270SKILLED NURSINGNJN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
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 Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd