OHIOHEALTH CORPORATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: OHIOHEALTH CORPORATION (EIN 34-4429514)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-15
IRS object ID: 202213199349321501
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-15T14:57:33-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	312 WALNUT STREET SUITE 3000	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45202	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	344429514	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT COUNTY HOSPITAL ASSOCIATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% EDGAR SILALAHI	InCareOfNm
Business Name Control	VANW	BusinessNameControlTxt
Phone	4192388609	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 SOUTH WASHINGTON STREET	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	EDGAR SILALAHI	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4192388870	PhoneNum
Signature	2022-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	EDGAR	PersonFirstNm
Person Last	SILALAHI	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Aaron Hershberger	PreparerPersonNm
PTIN	P00961884	PTIN
Phone	5136218300	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	MIKE KEYSOR	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 SOUTH WASHINGTON STREET	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$80,682,040	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.VANWERTHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1905	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	TO BE THE BEST COMMUNITY HOSPITAL.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	637	TotalEmployeeCnt
Total Volunteers	12	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$10,922,107	PYContributionsGrantsAmt
CY Contributions Grants	$1,931,580	CYContributionsGrantsAmt
PY Program Service Revenue	$56,594,578	PYProgramServiceRevenueAmt
CY Program Service Revenue	$75,077,047	CYProgramServiceRevenueAmt
PY Investment Income	$4,925,071	PYInvestmentIncomeAmt
CY Investment Income	$848,389	CYInvestmentIncomeAmt
PY Other Revenue	$914,572	PYOtherRevenueAmt
CY Other Revenue	$2,190,009	CYOtherRevenueAmt
PY Total Revenue	$73,356,328	PYTotalRevenueAmt
CY Total Revenue	$80,047,025	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$35,260,718	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$36,901,750	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$38,754,535	PYOtherExpensesAmt
CY Other Expenses	$50,445,982	CYOtherExpensesAmt
PY Total Expenses	$74,015,253	PYTotalExpensesAmt
CY Total Expenses	$87,347,732	CYTotalExpensesAmt
PY Revenues Less Expenses	-$658,925	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$7,300,707	CYRevenuesLessExpensesAmt
Total Assets BOY	$132,778,077	TotalAssetsBOYAmt
Total Assets EOY	$120,811,656	TotalAssetsEOYAmt
Total Liabilities BOY	$71,548,731	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$67,085,268	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$61,229,346	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$53,726,388	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MISSION: TO BE THE BEST COMMUNITY HOSPITAL. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTHCARE WITHIN OUR REGION. WE STRIVE TO PROVIDE A CONTINUUM OF HEALTH CARE SERVICES IN INPATIENT AND AMBULATORY SETTINGS AND MAINTAIN OR EXTEND ALL NECESSARY ELEMENTS OF CARE TO ADDRESS THE NEEDS OF EVERY PATIENT IN A COMPASSIONATE MANNER. VAN WERT HEALTH WILL MEET THE COMMUNITY HEALTH CARE NEEDS BY CONTINUALLY ENDEAVORING TO IMPROVE THE QUALITY OF PATIENT CARE WE PROVIDE WITHIN OUR RESOURCE CAPABILITIES. PROGRAMS AND SERVICES SPONSORED BY VAN WERT HEALTH WILL SERVE AS AN ACCESS POINT TO HEALTH CARE WITHIN OUR COMMUNITY. WE ACCEPT RESPONSIBILITY FOR PROVIDING COMMUNITY LEADERSHIP. VAN WERT HEALTH ASSURES THAT HEALTH CARE SERVICES PROVIDED ARE AVAILABLE TO ALL MEMEBER OF THE COMMUNITIES WE SERVE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR ABILITY TO PAY, WHILE AT THE SAME TIME RESPECTING BOTH RIGHTS AND RESPONSIBILITIES OF OUR PATIENTS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$76,150,804	ExpenseAmt
Revenue	$76,693,558	RevenueAmt
Desc	INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES	Desc
Total Program Service Expenses	$76,150,804	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	67	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	637	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	EDGAR SILALAHI	PersonNm
Phone	4192388870	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 SOUTH WASHINGTON STREET	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd
Dr Nicholai Kiehl
Physician	40.0	0.0	Yes (X)	$922,018	$0	$62,427
Dr Scott Shie
Physician	40.0	0.0	Yes (X)	$922,317	$0	$54,162
Eric Jelinger Md
Trustee	2.0	0.0		$698,250	$0	$0	Yes (X)
Dr M Nizar Orfahli
Physician	40.0	0.0	Yes (X)	$541,510	$0	$62,800
James Pope
CEO	40.0	0.0		$467,949	$0	$77,468	Yes (X)	Yes (X)
Dr Jeremy Stoller
Physician	40.0	0.0	Yes (X)	$437,845	$0	$55,403
Dr Jocelyn Wray
Physician	40.0	0.0	Yes (X)	$393,866	$0	$61,265
Thomas Conte MD
Chief of Staff	40.0	0.0		$379,986	$0	$53,982	Yes (X)	Yes (X)
Karen Shadowens
CFO	40.0	0.0		$172,140	$0	$29,220		Yes (X)
Edgar Silalahi
CFO	40.0	0.0		$179,837	$0	$20,161		Yes (X)
Aaron Baker
Secretary	2.0	0.0		$0	$0	$0	Yes (X)	Yes (X)
Ben Faurote
Trustee	2.0	0.0		$0	$0	$0	Yes (X)
Adam Houg MD
Trustee	2.0	0.0		$0	$0	$0	Yes (X)
Tim Jurzyk
Past Chairperson	2.0	0.0		$0	$0	$0	Yes (X)
Mike Keysor
Chairperson	2.0	0.0		$0	$0	$0	Yes (X)	Yes (X)
Barb Kohnen
Trustee	2.0	0.0		$0	$0	$0	Yes (X)
Jeff Snyder
Trustee	2.0	0.0		$0	$0	$0	Yes (X)
Tom Turnwald
Vice-Chairperson	2.0	0.0		$0	$0	$0	Yes (X)	Yes (X)
Todd Wolfrum
Trustee	2.0	0.0		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,115,718	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$476,888	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	49	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
THERAPY SOLUTIONS LLC
120 WEST MAIN STREET	VAN WERT	OH	45891	REHABILITATION	$3,502,982
Cardinal Health
71 MIL Acres Drive	COLUMBUS	OH	43218	PHARMACY SERVICES	$2,004,085
New Vision Medical Labs Inc
750 West High St Suite 400	LIMA	OH	45801	Laboratory Services	$1,636,624
Alteon Health LLC
12420 Milestone Center Drive	GERMANTOWN	MD	20876	ED PHYSICIANS	$1,586,498
Medline Industries
Dept CH 1400	PALATINE	IL	60055	Healthcare Supplies	$1,494,971

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	128	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,880,133	GovernmentGrantsAmt
All Other Contributions	$51,447	AllOtherContributionsAmt
Total Contributions	$1,931,580	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT SERVICE REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$75,077,047	TotalRevenueColumnAmt
Related Or Exempt Func Income	$75,077,047	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$75,077,047	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$813,344	TotalRevenueColumnAmt
Exclusion	$813,344	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,110,702	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$635,015	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$475,687	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$475,687	TotalRevenueColumnAmt
Exclusion	$475,687	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$35,045	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$35,045	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$35,045	TotalRevenueColumnAmt
Exclusion	$35,045	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
RHC INCOME	900099	$839,869	$839,869
Cafeteria/Vending Services	900099	$97,811		$97,811
ALL OTHER MISC REVENUE	900099	$776,642	$776,642

Field	Value	IRS element (for citing)
Other Revenue Total	$1,714,322	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$80,047,025	TotalRevenueColumnAmt
Related Or Exempt Func Income	$76,693,558	RelatedOrExemptFuncIncomeAmt
Exclusion	$1,421,887	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,078,993	TotalAmt
Program Services	$1,766,380	ProgramServicesAmt
Management And General	$312,613	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$28,418,455	TotalAmt
Program Services	$24,145,236	ProgramServicesAmt
Management And General	$4,273,219	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$472,097	TotalAmt
Program Services	$401,109	ProgramServicesAmt
Management And General	$70,988	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,023,771	TotalAmt
Program Services	$3,418,726	ProgramServicesAmt
Management And General	$605,045	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,908,434	TotalAmt
Program Services	$1,621,467	ProgramServicesAmt
Management And General	$286,967	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$128,917	TotalAmt
Program Services	$109,532	ProgramServicesAmt
Management And General	$19,385	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$92,866	TotalAmt
Program Services	$78,902	ProgramServicesAmt
Management And General	$13,964	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$41,092	TotalAmt
Program Services	$34,913	ProgramServicesAmt
Management And General	$6,179	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$18,958,166	TotalAmt
Program Services	$16,107,469	ProgramServicesAmt
Management And General	$2,850,697	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$136,192	TotalAmt
Program Services	$115,713	ProgramServicesAmt
Management And General	$20,479	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,596,341	TotalAmt
Program Services	$1,356,303	ProgramServicesAmt
Management And General	$240,038	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,347,043	TotalAmt
Program Services	$1,144,491	ProgramServicesAmt
Management And General	$202,552	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$915,266	TotalAmt
Program Services	$777,640	ProgramServicesAmt
Management And General	$137,626	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$334,228	TotalAmt
Program Services	$283,971	ProgramServicesAmt
Management And General	$50,257	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,111,670	TotalAmt
Program Services	$3,493,407	ProgramServicesAmt
Management And General	$618,263	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,038,571	TotalAmt
Program Services	$5,980,197	ProgramServicesAmt
Management And General	$1,058,374	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$795,509	TotalAmt
Program Services	$675,890	ProgramServicesAmt
Management And General	$119,619	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Taxes	$1,417,549	$1,204,395	$213,154
Bad Debt	$5,433,353	$5,433,353
MEDICAL SUPPLIES	$7,156,086	$7,156,086
NUTRITIONAL SERVICES	$294,662	$294,662

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$648,471	TotalAmt
Program Services	$550,962	ProgramServicesAmt
Management And General	$97,509	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$87,347,732	TotalAmt
Program Services	$76,150,804	ProgramServicesAmt
Management And General	$11,196,928	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,490,336	BOYAmt
EOY	$527,410	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,624,183	BOYAmt
EOY	$12,716,334	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$727,151	BOYAmt
EOY	$577,828	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$954,689	BOYAmt
EOY	$893,264	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$133,092,402	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$60,108,091	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$76,839,807	BOYAmt
EOY	$72,984,311	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$17,935,578	BOYAmt
EOY	$16,908,420	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$24,206,333	BOYAmt
EOY	$16,204,089	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$132,778,077	BOYAmt
EOY	$120,811,656	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,338,197	BOYAmt
EOY	$5,602,605	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$11,863	BOYAmt
EOY	$11,863	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$57,050,365	BOYAmt
EOY	$59,070,521	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$4,148,306	BOYAmt
EOY	$2,400,279	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$71,548,731	BOYAmt
EOY	$67,085,268	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$57,360,976	BOYAmt
EOY	$49,208,519	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,868,370	BOYAmt
EOY	$4,517,869	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$61,229,346	BOYAmt
EOY	$53,726,388	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$132,778,077	BOYAmt
EOY	$120,811,656	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$7,300,707	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$202,251	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$653	OtherActivitiesAmt
Total Lobbying Expenditures	$653	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	PERCENTAGE OF DUES PAID TO THE OHIO HOSPITAL ASSOCIATION THAT IS USED FOR POLITICAL PURPOSES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,484,658	BeginningYearBalanceAmt
End Year Balance	$4,484,658	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$9,388,032	BeginningYearBalanceAmt
Contributions	$304,675	ContributionsAmt
Investment Earnings Or Losses	$311,613	InvestmentEarningsOrLossesAmt
Other Expenditures	$5,519,662	OtherExpendituresAmt
End Year Balance	$4,484,658	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$9,053,290	BeginningYearBalanceAmt
Investment Earnings Or Losses	$714,479	InvestmentEarningsOrLossesAmt
Other Expenditures	$285,100	OtherExpendituresAmt
Administrative Expenses	$94,637	AdministrativeExpensesAmt
End Year Balance	$9,388,032	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,958,410	BeginningYearBalanceAmt
Investment Earnings Or Losses	$274,201	InvestmentEarningsOrLossesAmt
Other Expenditures	$105,932	OtherExpendituresAmt
Administrative Expenses	$73,389	AdministrativeExpensesAmt
End Year Balance	$9,053,290	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,582,777	BeginningYearBalanceAmt
Contributions	$168	ContributionsAmt
Investment Earnings Or Losses	$489,031	InvestmentEarningsOrLossesAmt
Other Expenditures	$86,875	OtherExpendituresAmt
Administrative Expenses	$26,691	AdministrativeExpensesAmt
End Year Balance	$8,958,410	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,214,476	OtherCostOrOtherBasisAmt
Book Value	$5,214,476	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$71,654,802	OtherCostOrOtherBasisAmt
Depreciation	$59,057,705	DepreciationAmt
Book Value	$12,597,097	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$56,173,809	OtherCostOrOtherBasisAmt
Depreciation	$1,050,386	DepreciationAmt
Book Value	$55,123,423	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$49,315	OtherCostOrOtherBasisAmt
Book Value	$49,315	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$72,984,311	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
INVESTMENT IN JOINT VENTURES	$1,595,832
ASSETS WHOSE USE IS LIMITED	$9,844,349
OTHER ASSETS	$4,763,908

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$16,204,089	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt
Total Liability	$0	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, LINE 4	FormAndLineReferenceDesc
Explanation	THE INVESTMENT INCOME GENERATED BY THE ENDOWMENT FUNDS DISTRIBUTED TO THE HOSPITAL IS ABLE TO BE USED FOR GENERAL OPERATING AND CAPITAL EQUIPMENT NEEDS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,126,653	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,010,375	DirectOffsettingRevenueAmt
Total Expense	0.00000	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,184,074	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,608,202	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,575,872	NetCommunityBenefitExpnsAmt
Total Expense	0.03140	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,310,727	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,618,577	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,575,872	NetCommunityBenefitExpnsAmt
Total Expense	0.03140	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,889	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,240	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,649	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,916	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,916	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,805	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,240	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$34,565	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,347,532	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,620,817	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,610,437	NetCommunityBenefitExpnsAmt
Total Expense	0.03180	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,212,702	BadDebtExpenseAmt
Reimbursed By Medicare	$10,247,958	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$15,160,540	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,912,582	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY CARE SYSTE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	MANAGED CARE CONTRACTING	PrimaryActivitiesTxt
Org Profit Or Ownership	0.5	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.5	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE VAN WERT COUNTY HOSPITAL ASSOC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 WASHINGTON STREET	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Field	Value	IRS element (for citing)
Website Address	VANWERTHEALTH.ORG/1287	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	THE VAN WERT COUNTY HOSPITAL ASSOC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	IN CONDUCTING ITS MOST RECENT CHNA, VAN WERT COUNTY HOSPITAL ASSOCIATION OBTAINED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH VIA INTERVIEWS AND SURVEYS OF COMMUNITY LEADERS, REPRESENTATIVES, AND MEMBERS.
PART V, SECTION B, LINE 6B	VAN WERT COUNTY HOSPITAL ASSOCIATION'S CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: VAN WERT COUNTY GENERAL HEALTH DISTRICT CRESTVIEW LOCAL SCHOOLS LINCOLNVIEW LOCAL SCHOOLS VAN WERT CITY SCHOOLS WESTWOOD BEHAVIORAL HEALTH CENTER VAN WERT HEALTH NORTHWESTERN OHIO COMMUNITY ACTION COMMISSION FAMILY HEALTH CARE OF NORTHWEST OHIO VAN WERT COUNTY FAMILY & CHILDREN FIRST VAN WERT COUNTY COUNCIL ON AGING YWCA OF VAN WERT COUNTY VAN WERT COUNTY DEPARTMENT OF JOB & FAMILY SERVICES UNITED WAY OF VAN WERT COUNTY MAIN STREET VAN WERT VAN WERT COUNTY ECONOMIC DEVELOPMENT TRI COUNTY ADAMHS BOARD
SCHEDULE H, PART V, SECTION B, LINE 11	THE THREE PRIORITY HEALTH NEEDS THAT WILL BE ADDRESSED IN THE 2022-2024 IMPLEMENTATION STRATEGY ARE: - PRIORITY AREA 1: NUTRITION & PHYSICAL ACTIVITY - PRIORITY AREA 2: ACCESS TO CARE - PRIORITY AREA 3: MENTAL HEALTH & ADDICTION PRIORITY AREA 1: NUTRITION & PHYSICAL ACTIVITY STRATEGY 1: INCREASE YOUTH FRUIT CONSUMPTION. (SHIP INDICATOR HB3: YOUTH FRUIT CONSUMPTION). STRATEGY 2: INCREASE YOUTH VEGETABLE CONSUMPTION. (SHIP INDICATOR HB4: YOUTH VEGETABLE CONSUMPTION) STRATEGY 3: INCREASE PHYSICAL ACTIVITY OF CHILDREN. (SHIP INDICATOR HB5: CHILD PHYSICAL ACTIVITY) ACTION STEP(S): - ANNUAL PARTNERSHIP FOR THE MARKET AT THE WASS FARMERS' MARKET TO INCREASE ACCESS TO FRESH PRODUCE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + BACK TO SCHOOL EVENT + PLACE BIKE RACKS AND WATER STATIONS THROUGHOUT THE COMMUNITY WHERE THERE ARE CURRENTLY NONE (EX. DOWNTOWN AREA) + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN. PRIORITY AREA 2: ACCESS TO CARE STRATEGY 1: INCREASE HEALTH INSURANCE COVERAGE FOR UNINSURANCE ADULTS. (SHIP INDICATOR AC1: UNINSURED ADULTS) STRATEGY 2: INCREASE HEALTH INSURANCE COVERAGE FOR UNINSURED CHILDREN. (SHIP INDICATOR AC2: UNINSURED CHILDREN) ACTION STEP(S): - INCREASE AWARENESS OF SOCIAL SERVICES. - IMPLEMENT INITIATIVE TO DRIVE COMMUNITY WIDE NETWORKING AMONG ORGANIZATIONS AND PROVIDERS IN VAN WERT HEALTH SERVICE AREA. - WORK WITH HEALTH COLLABORATIVE TO BUILD CULTURAL COMPETENCY FOR SPANISH SPEAKING POPULATION. - BUILD NETWORK OF PROVIDERS THAT SERVE SPANISH SPEAKING POPULATION. - INCREASE ELIGIBILITY SOCIAL ASSISTANCE PROGRAMS OF THE HISPANIC/SPANISH SPEAKING POPULATION. STRATEGY 3: DECREASE NUMBER OF PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS. (SHIP INDICATOR AC3: PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS) STRATEGY 4: DECREASE NUMBER OF MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS. (SHIP INDICATOR AC4: MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS) ACTION STEP(S): - PROVIDE UP TO 6 RENEWABLE HIGH SCHOOL SCHOLARSHIPS FOR THOSE PURSUING STUDIES IN HEALTH AND HUMAN SERVICES. - PROVIDE MEDICAL SCHOLARSHIPS. - CONDUCT ONGOING PHYSICIAN RECRUITMENT AND PARTNERSHIPS TO PROVIDE LOCAL ACCESS TO SPECIALTIES. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. STRATEGY 5: DECREASE UNMET NEED FOR MENTAL HEALTH CARE FOR YOUTH DEPRESSION. (SHIP INDICATOR AC5: YOUTH DEPRESSION TREATMENT FOR UNMET NEED) STRATEGY 6: DECREASE UNMET NEED FOR MENTAL HEALTH CARE FOR MENTAL HEALTH CARE FOR ADULTS. (SHIP INDICATOR AC6: ADULT MENTAL HEALTH CARE UNMET NEED) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - INCREASE NUMBER OF ADULTS TRAINED IN YOUTH MENTAL HEALTH FIRST AID. PRIORITY AREA 3: MENTAL HEALTH & ADDICTION STRATEGY 1: DECREASE YOUTH DEPRESSION. (SHIP INDICATOR MHA1: YOUTH DEPRESSION) STRATEGY 2: DECREASE ADULT DEPRESSION. (SHIP INDICATOR MHA2: ADULT DEPRESSION) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. STRATEGY 3: DECREASE YOUTH SUICIDE DEATHS. (SHIP INDICATOR MHA3: YOUTH SUICIDE DEATHS) STRATEGY 4: DECREASE ADULT SUICIDE DEATHS. (SHIP INDICATOR MHA4: ADULT SUICIDE DEATHS) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. STRATEGY 5: DECREASE YOUTH ALCOHOL USE. (SHIP INDICATOR MHA5: YOUTH ALCOHOL USE) STRATEGY 6: DECREASE YOUTH MARIJUANA USE. (SHIP INDICATOR MHA6: YOUTH MARIJUANA USE) STRATEGY 7: DECREASE UNINTENTIONAL DRUG OVERDOSE DEATHS. (SHIP INDICATOR MHA7: UNINTENTIONAL DRUG OVERDOSE DEATHS) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. TAKING EXISTING ORGANIZATIONAL AND COMMUNITY-BASED RESOURCES INTO CONSIDERATION, VAN WERT COUNTY HOSPITAL ASSOCIATION IS CHOOSING NOT TO ADDRESS CHRONIC DISEASES, TOBACCO AND NICOTINE USE, AND VARIOUS COMMUNITY CONDITIONS/SOCIAL DETERMINANTS OF HEALTH AS IDENTIFIED IN THE CHNA. HOWEVER, HEALTH NEEDS SUCH AS VARIOUS CHRONIC DISEASES ARE INDIRECTLY ADDRESSED BY ACTION STEPS FOR THE 3 PRIORITY FACTORS FOCUSED ON BY THE HOSPITAL. WE ARE ALSO CHOOSING NOT TO ADDRESS COVID-19, MATERNAL AND INFANT HEALTH ISSUES, PREVENTATIVE PRACTICES, AND HIV/AIDS TESTING BECAUSE THOSE HEALTH NEEDS WERE PRIORITIZED EXTREMELY LOW BY THE COMMUNITY IN ALL PRIMARY DATA COLLECTION METHODS. VAN WERT COUNTY HOSPITAL ASSOCIATION CANNOT ADDRESS ALL THE HEALTH NEEDS IN THE COMMUNITY AND MUST FOCUS ON AREAS WHERE WE HAVE THE GREATEST POTENTIAL FOR IMPACT AND THAT ALSO ALIGN WITH OUR MISSION AND PREVENT DUPLICATION OF EFFORT. COMMUNITY PARTNERSHIPS MAY SUPPORT OTHER INITIATIVES THAT THE HOSPITAL CANNOT INDEPENDENTLY LEAD IN ORDER TO ADDRESS THE OTHER HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA.
PART V, SECTION B, LINE 13H	VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERED BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF-PAY PATIENTS.
PART V, SECTION B, LINE 16J	EVERY PATIENT STATEMENT SENT BY THE ORGANIZATION INCLUDES INFORMATION ABOUT FA / FAP ALONG WITH A FULL APPLICATION FOR THE FAP.
SCHEDULE H, PART V, LINE 7A:	HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T
SCHEDULE H, PART V, LINE 10A	HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T
SCHEDULE H, PART V, LINE 16A, B & C	HTTPS://WWW.VANWERTHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
VAN WERT HEALTH-HEALTH CENTER
140 FOX ROAD	VAN WERT	OH	45891	PHYS. MEDICAL OFFICE BLDG.
VAN WERT HEALTH-ROCKFORD FAMILY MEDICINE
506 S MAIN ST	ROCKFORD	OH	45882	PHYSICIAN OFFICE
VAN WERT HEALTH-OTTOVILLE FAMILY MED
290 E 3RD ST	OTTOVILLE	OH	45876	PHYSICIAN OFFICE
VAN WERT HEALTH PEDIATRIC THERAPY OFFICE
1182 PROFESSIONAL DR	VAN WERT	OH	45891	PEDIATRIC P.T./HB NON-EXEMPT
VAN WERT HEALTH NORTH
214 TOWNE CENTER BLVD	VAN WERT	OH	45891	PHYSICIAN BASED AMBULATORY CEN
VAN WERT HEALTH OBGYN PAULDING
1035 WEST WAYNE ST	PAULDING	OH	45879	PHYSICIAN OFFICE

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C	VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERE BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF-PAY PATIENTS.VAN WERT HEALTH ALSO USES THE FOLLOWING CRITERIA IN ADDITION TO FPG TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS.
PART I, LINE 7	THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. THE ORGANIZATION DOES NOT CLAIM BAD DEBT EXPENSE AS A COMMUNITY BENEFIT.
PART I, LN 7 COL(F)	$5,433,353 IN BAD DEBT EXPENSE WAS EXCLUDED FROM FORM 990, PART IX TOTAL EXPENSES IN COMPUTING THE PERCENTAGES REPORTED IN COLUMN F.
PART III, LINE 2	BAD DEBT IS ACCOUNTED FOR AFTER ALL DISCOUNTS FOR 501R AND FINANCIAL ASSISTANCE ARE APPLIED. VAN WERT HEALTH UTILIZES A RESERVE MODEL FOR ACTIVE A/R TO ESTIMATE BAD DEBT EXPENSE, THIS MODEL IS ADJUSTED MONTHLY TO ACCOUNT FOR FLUCTUATIONS IN THE A/R AGE AND BALANCES. AFTER 4 STATEMENTS CYCLES OVER 120 DAYS ANY REMAINING SELF-PAY BALANCE IS SUBMITTED TO A COLLECTION AGENCY. AT THIS POINT THE WRITE-OFF WOULD BE EXPENSED AND THE RESERVE MODEL ON THE A/R WOULD REFLECT AN OFFSETTING CREDIT TO EXPENSE FOR ANY AMOUNT THAT HAD BEEN PREVIOUSLY RESERVED.
PART III, LINE 3	THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. VAN WERT HEALTH DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT.
PART III, LINE 4	SEE FOOTNOTE 1, PAGE 13 UNDER 'PATIENT SERVICE REVENUE' IN THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8	THE ORGANIZATION DOES NOT CONSIDER THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.
PART III, LINE 9B	FOLLOWING THE GUIDELINES AND PROCESSES AS INDICATED IN QUESTION 3, PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE, THE ORGANIZATION APPROPRIATELY IDENTIFIES ACCOUNTS AS TO THE TYPE OF ASSISTANCE QUALIFIED FOR. THE AMOUNTS ELIGIBLE FOR ASSISTANCE ARE WRITTEN OFF TO THE APPROPRIATE PROGRAM AND COLLECTION ACTIVITY CEASES IN REGARD TO THOSE AMOUN TS. THE GOAL OF THE ORGANIZATION'S POLICIES IS TO INDENTIY ACCOUNTS ELIGIBLE FOR ASSISTANCE AND BRING THE ACCOUNT TO AN APPROPRIATE CONCLUSION AS EARLY IN THE BILLING CYCLE AS POSSIBLE.
PART VI, LINE 2	THE ORGANIZATION USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS. DATA PROVIDED BY THE STATE OF OHIO IS USED TO DETERMINE EPIDEMIOLOGY'S RELATED TO CHRONIC CONDITIONS AND CANCER REGISTRIES PROVIDING PREVALENCE. INTERNAL DATA IS ALSO USED AS WELL AS INPUT FROM OTHER PROVIDERS. THE HOSPITAL ALSO USES PATIENT ORIGIN DATA PROVIDED BY THE OHIO HOSPITAL ASSOCIATION TO DETERMINE CURRENT TREATMENT PATTERNS AND DIAGNOSIS FOR CURRENT RESIDENTS BEING TREATED BY VAN WERT HEALTH AND OTHER SURROUNDING PROVIDERS. THE HOSPITAL ALSO SPONSORS A NUMBER OF HEALTH FAIRS/ASSESSMENTS TO BOTH ADULT AND PEDIATRIC POPULATIONS OF VAN WERT THAT ARE ALSO EXAMINED FOR FREQUENCY AND NEEDS. A NUMBER OF STAFF AS WELL AS BOARD OF TRUSTEES MEMBERS ALSO SERVED ON COMMUNITY HEALTH PROVIDER BOARDS AND PROVIDE INPUT TO THE PLANNING PROCESS. THE HOSPITAL PARTICIPATED IN A COMMUNITY-WIDE HEALTH CARE NEEDS ASSESSMENT PROJECT WITH COLLABORATING AGENCIES WITHIN THE AREA. AS A RESULT OF THIS EFFORT, NUTRITION AND PHYSICAL ACTIVITY, ACCESS TO CARE, MENTAL HEALTH AND ADDICTION ARE THE NEEDS IDENTIFIED BY THE COALITION THAT WILL BE THE FOCUS OF THE HEALTH IMPROVEMENT PLAN DEVELOPED BY THE COALITION. THE HOSPITAL IS ALSO SUBSCRIBED TO A NUMBER OF BENCHMARKING ORGANIZATIONS THAT PROVIDE BEST OF INDUSTRY APPLICATIONS TO ASSESS METHODOLOGIES FOR TREATING OUR RESIDENTS.
PART VI, LINE 3	PATIENT EDUCATION REGARDING THEIR ELIGIBILITY FOR ASSISTANCE BEGINS AT THE PATIENT ACCESS TO CARE AREAS. INFORMATIONAL SIGNAGE IS POSTED IN ALL PATIENT ACCESS AREAS IDENTIFYING FINANCIAL ASSISTANCE PROGRAMS AND INSTRUCTIONS ON HOW TO SEEK OUT THESE PROGRAMS. SIMILAR INFORMATION IS ALSO FOUND IN PATIENT INFORMATIONAL BROCHURES PROVIDED TO PATIENTS PRIOR TO THE RENDERING OF CARE BASED UPON THE TYPE OF CARE BEING PROVIDED. ALSO, AVAILABLE AT ALL PATIENT ACCESS POINTS ARE THE PATIENT FINANCIAL ASSISTANCE BROCHURES. PATIENT REGISTRATION STAFF AT ALL PATIENT ACCESS POINTS ARE TRAINED IN THE PATIENT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT THE HOSPITAL. THEY BECOME A VALUABLE RESOURCE TO PATIENTS DIRECTING THEM TO THE PROGRAMS THEY MAY QUALIFY FOR AND THE PROCESS WITH WHICH TO SEEK THE APPROPRIATE ASSISTANCE. THE HOSPITAL UTILIZES THE HOSPITAL WEBSITE AS AN ON-LINE AND TECHNOLOGICALLY CURRENT SOURCE OF FINANCIAL ASSISTANCE INFORMATION FOR PATIENTS THAT PREFER FINDING EDUCATIONAL INFORMATION IN THIS FORMAT. FINANCIAL ASSISTANCE PROGRAMS, POLICIES, ELIGIBILITY CRITERIA, AND ON-LINE APPLICATIONS FOR THE VARIOUS PROGRAMS ARE AVAILABLE. PATIENT BILLING STATEMENTS PROVIDE ANOTHER AVENUE FOR EDUCATING PATIENTS AS TO FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AND HOW TO CONTACT THE HOSPITAL TO DETERMINE ELIGIBILITY. THIS INFORMATION IS LOCATED ON THE BACK OF EACH BILLING STATEMENT RECEIVED BY THE PATIENT. THE EXISTENCE OF A FINANCIAL COUNSELOR IN THE PATIENT FINANCIAL SERVICES DEPARTMENT IS ANOTHER MECHANISM UTILIZED IN EDUCATING PATIENTS REGARDING FINANCIAL ASSISTANCE AVAILABLE FOR HOSPITAL SERVICES. ALL UNINSURED OR SELF-PAY POTENTIAL ACCOUNTS ARE IDENTIFIED TO THE FINANCIAL COUNSELOR UPON PATIENT REGISTRATION. PATIENTS MAY BE CONTACTED UPON COMPLETION OF SERVICES. ALL PATIENTS THAT WERE NOT CONTACTED UPON COMPLETION OF SERVICES RECEIVE A FINANCIAL ASSISTANCE APPLICATION THROUGH THE MAIL THAT INCLUDES INFORMATION REGARDING ALL FINANCIAL ASSISTANCE PROGRAMS. THE COUNSELOR PROVIDES FOLLOW-UP AND ASSISTANCE TO IDENTIFY THE PATIENT WITH THE APPROPRIATE FINANCIAL ASSISTANCE PROGRAM.
PART VI, LINE 4	VAN WERT COUNTY HOSPITAL ASSOCIATION DBA VAN WERT HEALTH IS LOCATED IN THE RURAL COUNTY OF VAN WERT, OHIO THAT BORDERS THE INDIANA STATE LINE ALONG ALLEN COUNTY INDIANA. OUR PRIMARY SERVICE AREA COMPRISES VAN WERT AND SOME PORTIONS OF PAULDING, PUTNAM AND MERCER COUNTIES. NUMERICALLY THIS BREAKS DOWN TO APPROXIMATELY 50,000 RESIDENTS IN OUR PRIMARY MARKET AREA. THE HOSPITAL IS LOCATED WITHIN THE CITY OF VAN WERT, WHICH POSSESSES A POPULATION OF 10,700. OUR POPULATION IS PREDOMINANTLY WHITE (93.7%) WITH HISPANIC (3.5%). A MIX OF MINORITIES COMPRISE THE REMAINDER. VAN WERT IS RURAL IN NATURE WITH EMPLOYMENT NOT ONLY IN AGRICULTURAL SERVICES BUT ALSO IN THE MANUFACTURING AND SERVICE SECTOR. THE UNEMPLOYMENT RATE IN VAN WERT COUNTY HAS BEEN STEADILY DROPPING FROM A HIGH OF > 15% IN 2008-2010 TO A CURRENT LEVEL AROUND 3%. HOWEVER, 11.4% OF THE POPULATION IS CONSIDERED TO BE LIVING IN POVERTY AND CONTRIBUTES TO INCREASING NUMBERS OF CITIZENS COVERED UNDER THE MEDICAID PROGRAM AND QUALIFYING FOR THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS INCREASING BAD DEBT. LIKE MANY MIDWEST COMMUNITIES THE REGION HAS EXPERIENCED AN AGING POPULATION WITH 19.0% OVER 65 AND 27.8% 45 -64 ESTIMATED FOR 2018 BY THE OHIO OFFICE FOR RESEARCH.
PART VI, LINE 5	THE VAN WERT COUNTY HOSPITAL ASSOCIATION BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS FROM OUR COMMUNITY. THE MAJORITY OF THESE MEMBERS LIVE AND WORK WITHIN THE COMMUNITY AND ARE INVOLVED WITH OTHER NON-PROFIT AGENCIES. SENIOR LEADERSHIP ALSO LIVES IN THE PRIMARY SERVICE AREA. THIS "SPIRIT" OF COMMUNITY BASED HEALTHCARE RESIDES IN OUR BOARD OF TRUSTEES AND IS FURTHER EVIDENCED BY OUR OPEN MEDICAL STAFF. THE ACCOMMODATION OF SPECIALTY SERVICES NOT CURRENTLY PRESENT IN OUR AREA BEING PROVIDED THROUGH A SPECIALTY CLINIC OF THE HOSPITAL WHICH INCLUDE NEUROLOGY, NEUROSURGERY, IMMUNOLOGY, AND ENT SERVICES. THE HOSPITAL ASSOCIATED PERSONNEL ALSO SIT ON OTHER COMMUNITY BASED GOVERNANCE BOARDS (UNITED WAY, AMERICAN RED CROSS, CHAMBER OF COMMERCE, WRIGHT STATE UNIVERSITY REGIONAL CAMPUS, PUBLIC ACCESS TELEVISION, AMERICAN CANCER SOCIETY & VAN WERT ECONOMIC DEVELOPMENT TO NAME A FEW) THROUGH PHYSICIAN RECRUITMENT WE HAVE BROUGHT IN A NUMBER OF NEW SPECIALTIES INCLUDING OBSTETRICS, PULMONOLOGY/CRITICAL CARE AND ADDITIONAL LAPAROSCOPIC SURGICAL PROCEDURES. WE ALSO PROVIDE A LOAN FORGIVENESS PROGRAM FOR RESIDENTS INTERESTED IN BECOMING PHYSICIANS AND RETURNING TO OUR AREA. OUR WELLNESS CENTER PROVIDES HEALTH, EDUCATION, AND SOCIAL PROGRAMS FOR TARGETED POPULATIONS. WE HAVE JOINED A REGIONAL STROKE NETWORK AS WELL AS PARTICIPATING IN A NUMBER OF PATIENT AND EDUCATIONAL SUPPORT GROUPS (BETTER BREATHERS, STROKE SUPPORT GROUP, BETTER PARENTING). THE HOSPITAL ALSO PARTICIPATES IN HEALTH PROFESSIONS EDUCATIONAL PROGRAMS. A NUMBER OF OUR PHYSICIANS PROVIDE TRAINING FOR SENIOR MEDICAL STUDENTS THROUGH THE LIMA AREA HEALTH EDUCATION COMMITTEE. A NUMBER OF NURSING EDUCATIONAL PROGRAM USE OUR HOSPITAL TO DO THEIR CLINICAL ROTATIONS. OUR REHAB SERVICES DEPARTMENT ROUTINELY HOSTS STUDENTS FROM THE UNIVERSITY OF FINDLAY, HUNTINGTON COLLEGE, RHODES STATE COLLEGE, UNIVERSITY OF ST. FRANCIS, THE OHIO STATE UNIVERSITY, THE UNIVERSITY OF CINCINNATI, THE UNIVERSITY OF DAYTON, TRINE UNIVERSITY, UTMC AND WESTERN MICHIGAN WHO ARE PURSUING CAREERS IN THERAPY. THE HOSPITAL ON AVERAGE SPENDS IN EXCESS OF 1 MILLION DOLLARS IN NEW DIAGNOSTIC TECHNOLOGIES AND OTHER HEALTH RELATED EQUIPMENT TO BETTER DIAGNOSE AND TREAT OUR CLIENTS. THE HOSPITAL IS CURRENTLY UNDERGOING A NEARLY FORTY MILLION DOLLAR EXPANSION IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE EXPANSION PROVIDES ALL NEW INPATIENT SPACE FOR ACUTE CARE AND OBSTETRICS. IT WILL ALSO HOUSE A BRAND-NEW SURGICAL SERVICES AREA WITH INCREASED CAPACITY, PRIVATE PRE/POST-OP ROOMS AND CAPACITY FOR ROBOTIC SURGERY. THIS WILL ALLOW PATIENTS WHO ROUTINELY LEAVE THE AREA FOR PORTIONS OF THEIR CARE TO OBTAIN THEIR CARE LOCALLY. VAN WERT HEALTH SUPPORTS NUMEROUS ORGANIZATIONS VIA SPONSORSHIP THROUGHOUT THE COMMUNITY SOME OF THESE INCLUDE THE YWCA SILVER SNEAKERS PROGRAM, THE COMMUNITY FARMER'S MARKET, LIVE HEALTH VAN WERT & THE COUNTY HEALTH COLLABORATIVE, DARE, JUNIOR ACHIEVEMENT, COUNCIL ON AGING, CAMP CLAY, SAFETY COUNCIL WELLNESS AND THE NISWONGER PERFORMING ARTS CONCERT SERIES. VAN WERT HEALTH PROVIDES NUMEROUS SPONSORSHIPS FOR LOCAL SCHOOLS. VAN WERT HEALTH PRESENTS OR PARTICIPATES IN NUMEROUS HEALTH FAIRS THROUGHOUT THE YEAR INCLUDING THE ANNUAL CHILDREN'S HEALTH FAIR, ANNUAL WOMEN'S HEALTH EVENT, ANNUAL CAR SEAT CLINIC AND AN ANNUAL VETERAN'S DAY EVENT. VAN WERT HEALTH STAFF PRESENT AT VARIOUS EVENTS AND SPEAKERS BUREAUS THROUGHOUT THE YEAR INCLUDING THE SILVER SNEAKERS PROGRAM, THE SAFETY COUNCIL AND VARIOUS CAREER FAIRS FOR YOUNG STUDENTS ON THE BENEFITS OF A CAREER IN HEALTH CARE. SUPPORT FOR THE LOCAL BUSINESS DEVELOPMENT COALITION TO PROMOTE GROWTH IN THE OVERALL VAN WERT COMMUNITY.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Housing Allowance Or Residence	Yes (X)	HousingAllowanceOrResidenceInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
Eric Jelinger Md
Trustee	$698,250	$0	$0	$0	$0	$0	$0	$0	$0	$0	$698,250	$0
James Pope
CEO	$389,218	$0	$72,467	$0	$6,264	$0	$52,000	$0	$25,468	$0	$545,417	$0
Edgar Silalahi
CFO	$169,244	$0	$3,089	$0	$7,504	$0	$7,500	$0	$12,661	$0	$199,998	$0
Thomas Conte MD
Chief of Staff	$252,571	$0	$119,805	$0	$7,610	$0	$24,000	$0	$29,982	$0	$433,968	$0
Dr Scott Shie
Physician	$861,026	$0	$59,851	$0	$1,440	$0	$24,000	$0	$30,162	$0	$976,479	$0
Dr Nicholai Kiehl
Physician	$860,815	$0	$59,847	$0	$1,356	$0	$24,000	$0	$38,427	$0	$984,445	$0
Dr M Nizar Orfahli
Physician	$474,524	$0	$55,718	$0	$11,268	$0	$31,094	$0	$31,706	$0	$604,310	$0
Dr Jeremy Stoller
Physician	$431,101	$0	$5,378	$0	$1,366	$0	$24,000	$0	$31,403	$0	$493,248	$0
Dr Jocelyn Wray
Physician	$347,307	$0	$42,502	$0	$4,057	$0	$26,000	$0	$35,265	$0	$455,131	$0
Karen Shadowens
CFO	$121,955	$0	$48,696	$0	$1,489	$0	$13,000	$0	$16,220	$0	$201,360	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	TRAVEL FOR COMPANIONS WAS PROVIDED FOR JAMES POPE. THE AMOUNT PROVIDED WAS NOT TREATED AS TAXABLE COMPENSATION BECAUSE THERE WAS A BUSINESS PURPOSE FOR THE COMPANION TRAVEL. A HOUSING ALLOWANCE IN THE AMOUNT OF $6,000 WAS PROVIDED TO EDGAR SILALAHI. THE AMOUNT PROIVIDED WAS TREATED AS TAXABLE COMPENSATION.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	COUNTY OF VAN WERT OHIO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	310308605	BondIssuerEIN
CUSIP	921297AA5	CUSIPNum
Bond Issued	2020-03-01	BondIssuedDt
Issue Price	$61,290,000	IssuePriceAmt
Purpose	REVENUE REFUNDING AND IMPROVEMMENT	PurposeDesc

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$9,728,003	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$36,376,499	TotalProceedsAmt
In Reserve Fund	$4,741,918	InReserveFundAmt
Capitalized Interest	$5,147,455	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$1,645,468	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$10,389,830	CapitalExpendituresAmt
Other Spent Proceeds	$2,772	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2020	SubstantialCompletionYr
Refunding Tax Exempt Bonds	Yes (true)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	false	RefundingTaxableBondsInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	Yes (true)	Form8038TFiledInd
Rebate Not Due Yet	false	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	OHIO MEDICAL IMAGING ASSOCIATE	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	SEE PART V	RelationshipDescriptionTxt
Transaction	$798,000	TransactionAmt
Transaction	RADIOLOGY SERVICES	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV, COLUMN (B)	FormAndLineReferenceDesc
Explanation	BOARD MEMBER OWNER OF ENTITY (ERIC JELLINGER)	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS ANY PERSON, AGE 18 OR OLDER AND RESIDING IN VAN WERT COUNTY HOSPITAL'S GEOGRAPHIC SERVICE AREA, WHO SHALL HAVE CONTRIBUTED THE SUM OF ONE DOLLAR OR MORE TO THE ASSOCIATION DURING THE CALENDAR YEAR, SHALL BE A MEMBER. A CONTRIBUTION OF TWENTY FIVE DOLLARS AT ANY TIME SHALL CONSTITUTE A LIFE MEMBERSHIP.
FORM 990, PART VI, SECTION A, LINE 7A	PERSONS AND RIGHTS THE BOARD OF TRUSTEES SHALL BE ELECTED BY THE MEMBERS OF THE ASSOCIATION AT THE REGULAR ANNUAL MEETING. ONE SHALL BE APPOINTED BY THE VAN WERT COUNTY BOARD OF COMMISSIONERS.
FORM 990, PART VI, SECTION A, LINE 7B	PERSONS, DECISIONS, AND VOTING RIGHTS SUBJECT TO THE ARTICLES OF INCORPORATION AND THIS CODE OF REGULATIONS, EACH MEMBER OF THE ASSOCIATION IN GOOD STANDING SHALL BE QUALIFIED TO VOTE ON ANY ISSUES THAT MAY PROPERLY COME BEFORE ANY MEETING OF THE MEMBERS OF THE ASSOCIATION.
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS TO REVIEW THE FORM 990 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE FINANCE COMMITTEE REVIEWS AND APPROVES THE 990. IT IS THEN PRESENTED TO THE FULL BOARD DURING A REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	PRACTICE FOR MONITORING COMPLIANCE THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED BY THE CHAIRPERSON OF THE BOARD OF TRUSTEES AND THE PRESIDENT AND CEO. THE SCOPE OF THIS POLICY INCLUDES ALL STAFF AND BOARD OF TRUSTEES MEMBERS. A CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED ON AN ANNUAL BASIS AND REVIEWED BY THE EXECUTIVE COMMITTEE. ANY ISSUES THAT ARISE ARE ADDRESSED WITH THE INDIVIDUAL AT THAT POINT. ANY ISSUES THAT ARISE THOUGHOUT THE YEAR ARE DEALT WITH AS NECESSARY. THIS MAY INVOLVE DECLARING THE CONFLICT OF INTEREST AND ABSTAINING FROM DISCUSSION OR A VOTE ON SPECIFIC TOPICS. THIS COULD ALSO TAKE THE FORM OF RECUSING ONESELF FROM PART OR A WHOLE MEETING AS NECESSARY AND REQUIRED DEPENDING UPON THE TOPIC FOR DISCUSION AND/OR ACTION.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	COMPENSATION REVIEW THE COMPENSATION COMMITTEE CONTRACTS WITH AN OUTSIDE, INDEPENDENT FIRM TO PROVIDE A COMPENSATION STUDY AND EVALUATION. THE COMMITTEE THEN USES THE RESULTS OF THE STUDY IN CONSULTATION WITH THE COMPENSATION FIRM AND THEN COMPENSATION PHILOSOPHY POLICY TO MAKE COMPENSATION DECISIONS. THE LAST COMPENSATION REVIEW WAS PERFORMED IN 2019.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS AN ATTACHMENT TO FORM 990 AT WWW.GUIDESTAR.ORG OR UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST.
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER TOTAL FEES:18958166

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT MEDICAL SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	140 FOX ROAD	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Field	Value	IRS element (for citing)
EIN	202812541	EIN
Primary Activities	MEDICAL SVCS	PrimaryActivitiesTxt
Legal Domicile State	OH	LegalDomicileStateCd
Total Income	$8,097,943	TotalIncomeAmt
End Of Year Assets	$1,674,483	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT	BusinessNameLine1Txt

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT COUNTY HOSP PAIN MGMT	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 S WASHINGTON ST	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Field	Value	IRS element (for citing)
EIN	810822738	EIN
Primary Activities	PAIN MANAGEMENT	PrimaryActivitiesTxt
Legal Domicile State	OH	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	VAN WERT HOSP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	$398,389	ShareOfTotalIncomeAmt
Share Of EOY Assets	$80,601	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
General Or Managing Partner	false	GeneralOrManagingPartnerInd
Ownership	0.51000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY CARE SYSTEMS INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1250 S WASHINGTON ST	AddressLine1Txt
City	VAN WERT	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45891	ZIPCd

Field	Value	IRS element (for citing)
EIN	341783212	EIN
Primary Activities	HEALTHCARE MGMT	PrimaryActivitiesTxt
Legal Domicile State	OH	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C	EntityTypeTxt
Controlled Organization	false	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd