2022-11-15T13:33:50-06:00 2021-12-31 310800053 CLARK SCHAEFER HACKETT & CO 10100 INNOVATION DRIVE DAYTON OH 45342 990 2021-01-01 311438763 GREATER DAYTON AREA HEALTH INFORMATION NETWORK GREA 9372712343 124 E THIRD ST 400 DAYTON OH 45402 MARTIN LARSON CFO 9372281000 2022-11-14 1 MARTIN LARSON 999009999 HERBERT L LEMASTER CPA P00039882 9372260070 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z SARAH HACKENBRACHT 124 E THIRD ST 400 DAYTON OH 45402 2297309 0 X WWW.GDAHA.ORG X 1995 OH IMPROVE ACCESS TO HEALTHCARE SERVICES INFORMATION & SUPPORT DISASTER MEDICAL PLANNING 28 28 0 0 0 0 976290 1041459 1212955 1255777 447 -52 1189 0 2190881 2297184 613407 590055 0 0 0 0 0 0 0 1577398 1703314 2190805 2293369 76 3815 878897 831020 1069706 1018014 -190809 -186994 TO PROMOTE A HEALTHIER COMMUNITY BY IMPROVING ACCESS TO CLINICAL, FINANCIAL AND ADMINISTRATIVE INFORMATION TO FACILITATE DELIVERY OF HEALTHCARE SERVICES IN A TIMELY AND COST-EFFECTIVE MANNER; TO PROVIDE SUPPORT SERVICES FOR DISASTER MEDICAL PLANNING. 0 0 590055 590055 GRANTS AND CONTRACTS THROUGH THE ASPR/ODH TO PROVIDE MULTIPLE HOSPITALS WITH FUNDING FOR DOMESTIC PREPAREDNESS PROGRAMS. 1532983 1255777 TO PROVIDE A COMMUNITY-WIDE MEDICAL INFORMATION NETWORK, SUPPORT THE ACTIVITIES OF THE DISASTER MEDICAL ASSISTANCE TEAM. 2123038 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 28 28 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 1 0 OH X MARTIN LARSON 9372712343 124 E THIRD ST 400 DAYTON OH 45402 MICHAEL UHL CHAIR 1.00 X X 0 0 0 TERRY BURNS VICE CHAIR 1.00 X X 0 0 0 KEVIN HARLAN TRUSTEE 1.00 X X 0 0 0 DEBORAH FELDMAN IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 LYNNE BLINCO TRUSTEE 1.00 X 0 0 0 MARY BOOSALIS TRUSTEE 1.00 X 0 0 0 WAYNE DESCHAMBEAU TRUSTEE (JAN-MAR) 1.00 X 0 0 0 RICK DODDS TRUSTEE 1.00 X 0 0 0 JONATHAN DUCKETT TRUSTEE 1.00 X 0 0 0 ADAM GROSHANS SECRETARY 1.00 X 0 0 0 FRED MANCHUR TRUSTEE 1.00 X 0 0 0 RICHARD MANCHUR TRUSTEE 1.00 X 0 0 0 WALTER SACKETT TRUSTEE 1.00 X 0 0 0 DAVID SMITH MD TRUSTEE 1.00 X 0 0 0 PHILLIP UNDERWOOD TRUSTEE 1.00 X 0 0 0 KENT ANDERSON TRUSTEE 1.00 X 0 0 0 KEITH D BRICKING MD TRUSTEE 1.00 X 0 0 0 RON CONNOVICH TRUSTEE 1.00 X 0 0 0 MARK KLOSTERMAN TREASURER 1.00 X 0 0 0 JOANN RINGER TRUSTEE (JAN-DEC) 1.00 X 0 0 0 MARK MURDOCK TRUSTEE 1.00 X 0 0 0 CINDY BERNING TRUSTEE 1.00 X 0 0 0 LUIS CHANAGA TRUSTEE 1.00 X 0 0 0 CHRISTIAN LYONS TRUSTEE 1.00 X 0 0 0 ANGELA NICKELL TRUSTEE 1.00 X 0 0 0 SHAWN TODD TRUSTEE (JAN) 1.00 X 0 0 0 DANIEL TRYON TRUSTEE 1.00 X 0 0 0 VALERIE WEBER MD TRUSTEE 1.00 X 0 0 0 CHRIS LAFONTSEE TRUSTEE (JAN-DEC) 1.00 X 0 0 0 ERIC LUNDE TRUSTEE 1.00 X 0 0 0 JEFF SUBLER TRUSTEE (APR-DEC) 1.00 X 0 0 0 SARAH HACKENBRACHT PRESIDENT & CEO 10.00 30.00 X 0 272826 20196 MARTIN LARSON EXECUTIVE VICE PRESIDENT 12.00 28.00 X 0 103100 29558 0 375926 49754 0 0 1 0 HEALTH COLLABORATIVE 615 ELSINORE PL SUITE 500 CINCINNATI OH 45202 HEALTH INFORMATION EXCHANGE SERVICES 936956 1 1041459 1041459 PROGRAM SERVICES 624100 1255777 1255777 1255777 73 73 125 -125 -125 -125 2297184 1255777 0 -52 590055 590055 43608 39247 4361 86330 77697 8633 1526 1373 153 666 599 67 6208 5587 621 CONSULTING SERVICES 1216943 1095249 121694 ALLOCATED WAGES & EXP F 334770 301293 33477 DUES & SUBSCRIPTIONS 10902 9813 1089 EQUIPMENT MAINTENANCE A 2061 1855 206 300 270 30 2293369 2123038 170331 0 491339 353513 387558 280669 2418 5198 5198 0 0 194420 878897 831020 174651 15399 441159 250772 453896 751843 1069706 1018014 X -190809 -186994 -190809 -186994 878897 831020 3815 0 X X 0 1 X 1 1 1 X 865687 998826 838030 976290 1041459 4720292 865687 998826 838030 976290 1041459 4720292 4720292 1036 3065 3525 447 -52 8021 410 -1 1189 1598 4729911 6187812 0.99800 0.99430 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5198 5198 0 0 PAYABLE TO THE GREATER DAYTON AREA HOSPITAL ASSOCIATION 314261 PAYABLE TO THE GMVEMS 79153 REFUNDABLE ADVANCES 358429 751843 X 2297184 0 2297184 0 2297184 2293369 0 2293369 0 2293369 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ASSOCIATION AND RECOGNIZE A TAX LIABILITY IF THE ASSOCIATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. AS DISCUSSED ABOVE, GDAHA AND GDAHIN ARE EXEMPT FROM INCOME TAXES AND MANAGEMENT BELIEVES THESE ENTITIES HAVE NOT ENGAGED IN ANY ACTIVITIES THAT WOULD DISQUALIFY THEM FROM TAX-EXEMPT STATUS. THE ASSOCIATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OTHER EXPENSES. 1 MIAMI VALLEY HOSPITAL ONE WYOMING STREET DAYTON OH 45409 310537504 501(C)(3) 28500 0 FOR HEALTH CARE PREPAREDNESS DAYTON CHILDREN'S HOSPITAL ONE CHILDRENS PLAZA DAYTON OH 45404 310672132 501(C)(3) 9500 0 FOR HEALTH CARE PREPAREDNESS WRIGHT STATE RESEARCH INSTITUTE 4035 COLONEL GLENN HIGHWAY DAYTON OH 45431 161704454 501(C)(3) 5600 0 FOR HEALTH CARE PREPAREDNESS UPPER VALLEY MEDICAL CENTER 3130 N DIXIE DRIVE TROY OH 45373 310537095 501(C)(3) 9360 0 FOR HEALTH CARE PREPAREDNESS CITY OF DAYTON 300 NORTH MAIN STREET DAYTON OH 45402 170(C)(1) 65000 0 FOR HEALTH CARE PREPAREDNESS COMMUNITY MERCY HEALTH PARTNERS 100 MEDICAL CENTER DRIVE SPRINGFIELD OH 45504 310785684 501(C)(3) 18992 0 FOR HEALTH CARE PREPAREDNESS DIXIE KIRKLAND 2358 STATE RT 68 SOUTH XENIA OH 45385 287509188 19952 0 FOR HEALTH CARE PREPAREDNESS MOBILE MEDICAL REPAIR AND MAINTENANCE 15027 STATE ROAD 1 LEO IN 46765 37025 0 FOR HEALTH CARE PREPAREDNESS VYAIRE 26125 N RIVERWOODS BLVD METLAWA IL 60045 24419 0 FOR HEALTH CARE PREPAREDNESS VIKING TRUCK AND TRAILER 714 ALBANY ST DAYTON OH 45417 5666 0 FOR HEALTH CARE PREPAREDNESS GRAINGER 2321 NEEDMORE ROAD DAYTON OH 45414 361150280 16204 0 FOR HEALTH CARE PREPAREDNESS 6 5 PART I, LINE 2: THE USE OF GRANT FUNDS IS MONITORED BY THE GRANTING ORGANIZATIONS: THE OHIO DEPARTMENT OF HEALTH & THE OHIO HEALTH INFORMATION PARTNERSHIP. 0 0 0 0 0 0 0 0 0 SARAH HACKENBRACHT PRESIDENT & CEO 0 272826 0 0 0 0 0 10838 0 9358 0 293022 0 0 FORM 990, PART VI, SECTION A, LINE 2 MARY BOOSALIS IS THE PRESIDENT AND CEO OF PREMIER HEALTH; DURING 2021 KEVIN HARLAN SERVED AS THE PRESIDENT OF UPPER VALLEY MEDICAL CENTER, A MEDICAL PROVIDER IN PREMIER'S HEALTH NETWORK. MICHAEL UHL IS THE PRESIDENT AND CEO OF MIAMI VALLEY HOSPITAL, A MEDICAL PROVIDER IN PREMIER HEALTH'S NETWORK. KEITH D. BRICKING, MD IS THE PRESIDENT AND CEO OF ATRIUM MEDICAL CENTER, A MEDICAL PROVIDER IN PREMIER HEALTH'S NETWORK. JOANN RINGER IS THE PRESIDENT AND CEO OF MIAMI VALLEY SOUTH, A MEDICAL PROVIDER IN PREMIER HEALTH'S NETWORK. TERRY BURNS, WALTER SACKETT, RICHARD MANCHUR AND RICK DODDS ARE EMPLOYED BY KETTERING ADVENTIST HEALTHCARE; FRED MANCHUR IS AN EMPLOYEE, OFFICER, AND VOTING TRUSTEE OF THE SAME ORGANIZATION. LUIS CHANAGA WAS THE PRESIDENT OF SYCAMORE MEDICAL CENTER, A MEDICAL PROVIDER IN THE KETTERING HEALTH NETWORK. RON CONNOVICH IS PRESIDENT OF KETTERING HEALTH HAMILTON, A MEDICAL PROVIDER IN THE KETTERING HEALTH NETWORK. DANIEL TRYON IS THE PRESIDENT OF KETTERING HEALTH WASHINGTON TOWNSHIP, A MEDICAL PROVIDER IN THE KETTERING HEALTH NETWORK. ERIC LUNDE IS THE PRESIDENT OF KETTERING HEALTH TROY, A MEDICAL PROVIDER IN THE KETTERING HEALTH NETWORK. DURING 2021, SHAWN TODD, AND CHRIS LAFONTSEE SERVED AS EXECUTIVES WITH PAM SPECIALITY HOSPITAL OF DAYTON. FRED MANCHUR AND RICHARD MANCHUR SHARE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE PRESIDENT AND VICE PRESIDENT OF FINANCE PRIOR TO FILING. THEN THE DRAFT IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS ANY ACTIVITY THAT COULD GIVE RISE TO POTENTIAL CONFLICTS OF INTEREST ON A "AS NEEDED" BASIS. A GENERAL REVIEW FOR CONFLICTS OF INTEREST OCCURS ANNUALLY BY THE PRESIDENT AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD UTILIZES NATIONAL MARKET KNOWLEDGE AND ANNUAL PERFORMANCE EVALUATION TO EVALUATE AND ADJUST COMPENSATION OF THE PRESIDENT AND OTHER KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE INDEPENDENT AUDIT. THIS PROCESS IS CONSISTENT WITH THE PRIOR YEAR. GREATER DAYTON AREA HOSPITAL ASSOCIATION 124 E THIRD ST SUITE 400 DAYTON OH 454021470 311221836 HEALTHCARE OH 501(C)(6) N/A 0 GREATER MIAMI VALLEY EMERGENCY MEDICAL SERVICES COUNCIL 124 E THIRD ST SUITE 400 DAYTON OH 454021470 310909738 HEALTHCARE OH 501(C)(3) LINE 1 N/A 0 QBASE HOLDINGS LLC 3800 PENTAGON BLVD BEAVERCREEK OH 45431 271717852 DATA SERVICES OH N/A EXCLUDED 11 0 0 0.00020 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 GREATER DAYTON AREA HOSPITAL ASSOCIATION E 314261 FAIR MARKET VALUE GREATER DAYTON AREA HOSPITAL ASSOCIATION O 334770 FAIR MARKET VALUE GREATER DAYTON AREA HOSPITAL ASSOCIATION P 279107 FAIR MARKET VALUE