HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION (EIN 31-1674981)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202233189349312993
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T15:50:54-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311674981 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HIGHLAND DISTRICT HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | PROFESSIONAL SERVICES CORP | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HIGH | BusinessNameControlTxt |
| Phone | 3973936100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1275 N HIGH STREET | AddressLine1Txt |
| City | HILLSBORO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45133 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MEGHANN ACKLEY | PersonNm |
| Person Title | VP FINANCE | PersonTitleTxt |
| Phone | 3973936100 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MEGHANN | PersonFirstNm |
| Person Last | ACKLEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RANDAL LENNARTZ | PrincipalOfficerNm |
| Gross Receipts | $2,753,801 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION IS TO SERVCE THE COMMUNITY BY PROVIDING ACCESSIBLE, EFFICIENT, QUALITY HEALTH CARE IN AN ATMOSPERE OF SAFETY, COMPASSION, AND EXCELLENCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 15 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,087,630 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,109,991 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,255,522 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,619,659 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,700 | PYOtherRevenueAmt |
| CY Other Revenue | $7,555 | CYOtherRevenueAmt |
| PY Total Revenue | $3,347,852 | PYTotalRevenueAmt |
| CY Total Revenue | $2,737,205 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,471,073 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,242,483 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $391,300 | PYOtherExpensesAmt |
| CY Other Expenses | $886,780 | CYOtherExpensesAmt |
| PY Total Expenses | $2,862,373 | PYTotalExpensesAmt |
| CY Total Expenses | $3,129,263 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $485,479 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$392,058 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,506,888 | TotalAssetsBOYAmt |
| Total Assets EOY | $862,661 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $553,455 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $301,286 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $953,433 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $561,375 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION IS TO SERVE THE COMMUNITY BY PROVIDING ACCESSIBLE, EFFICIENT, QUALITY HEALTHCARE IN AN ATMOSPHERE OF SAFETY, COMPASSION, AND EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,109,524 | ExpenseAmt |
| Revenue | $1,621,402 | RevenueAmt |
| Desc | HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION ENGAGES IN THE PRACTICE AND PROFESSIONAL SERVICES OF MEDICINE. HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION SAW 9703 VISITS IN 2021. | Desc |
| Total Program Service Expenses | $3,109,524 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 | false | 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 | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 15 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MEGHANN ACKLEY | PersonNm |
| Phone | 9373936100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1275 N HIGH STREET | AddressLine1Txt |
| City | HILLSBORO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45133 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LARRY PARKER | ||||||||
| PRESIDENT | 0.25 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PHILLIP WILSON PHD | ||||||||
| TREASURER | 0.25 | 1.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DWIGHT CREEK | ||||||||
| SECRETARY | 0.25 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WENDEL HAREWOOD | ||||||||
| DIRECTOR | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| STEVE THOMPSON | ||||||||
| DIRECTOR | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| GINA EARLEY | ||||||||
| DIRECTOR | 0.25 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| BILL COUCH | ||||||||
| DIRECTOR | 0.25 | 1.25 | Yes (X) | $0 | $0 | $0 | ||
| LARRY BURNS | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| RINDY MATTHEWS DC | ||||||||
| DIRECTOR | 0.25 | 1.25 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN SETTY | ||||||||
| DIRECTOR | 0.25 | 1.25 | Yes (X) | $0 | $0 | $0 | ||
| RANDAL LENNARTZ | ||||||||
| CEO | Yes (X) | $0 | $0 | $0 | ||||
| MEGHANN ACKLEY | ||||||||
| VP FINANCE | Yes (X) | $0 | $0 | $0 | ||||
| VINAYAK KULKARNI | ||||||||
| PHYSICIAN | 20.00 | 0.00 | $360,201 | $0 | $16,536 | Yes (X) | ||
| CRAIG MCKINNEY | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $297,979 | $0 | $28,858 | Yes (X) | ||
| STEVEN BATTAGLIA | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $180,386 | $0 | $41,313 | Yes (X) | ||
| RANGA BRAHMAMDAM | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $409,313 | $0 | $9,883 | Yes (X) | ||
| ALEX RENSHAW | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $638,408 | $0 | $26,965 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,886,287 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $123,555 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Business Name Line2ContractorName/BusinessName/BusinessNameLine2Txt | Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| DAYTON CENTER FOR NEUROLOGICAL | ||||||
| DISORDERS | 1975 MIAMISBURG-CENTERVILLE RD | CENTERVILLE | OH | 45459 | PHYSICIAN | $266,286 |
| STAFF CARE INC | ||||||
| PO BOX 281923 | ATLANTA | GA | 30384 | PHYSICIAN | $259,095 | |
| NOBILITY LLC | ||||||
| PO BOX 310843 | DES MOINES | IA | 50331 | BILLING | $114,204 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,109,991 | AllOtherContributionsAmt |
| Total Contributions | $1,109,991 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $1,619,659 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,619,659 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,619,659 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,408 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,596 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,812 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,812 | TotalRevenueColumnAmt |
| Exclusion | $5,812 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Total Revenue Column | $1,743 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,743 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,743 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,737,205 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,621,402 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,812 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,033,841 | TotalAmt |
| Program Services | $2,033,841 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,862 | TotalAmt |
| Program Services | $30,862 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,976 | TotalAmt |
| Program Services | $72,976 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,804 | TotalAmt |
| Program Services | $104,804 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,963 | TotalAmt |
| Program Services | $487,963 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,750 | TotalAmt |
| Program Services | $2,750 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,840 | TotalAmt |
| Program Services | $4,101 | ProgramServicesAmt |
| Management And General | $19,739 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,828 | TotalAmt |
| Program Services | $139,828 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,846 | TotalAmt |
| Program Services | $16,846 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,700 | TotalAmt |
| Program Services | $3,700 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,451 | TotalAmt |
| Program Services | $64,451 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $63,304 | $63,304 |
| REPAIRS & MAINTENANCE | $55,777 | $55,777 |
| HOUSEKEEPING | $13,262 | $13,262 |
| COLLECTION FEES | $4,711 | $4,711 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,348 | TotalAmt |
| Program Services | $10,348 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,129,263 | TotalAmt |
| Program Services | $3,109,524 | ProgramServicesAmt |
| Management And General | $19,739 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $793,877 | BOYAmt |
| EOY | $146,844 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,768 | BOYAmt |
| EOY | $284,489 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,689 | BOYAmt |
| EOY | $124,356 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,691 | BOYAmt |
| EOY | $34,415 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $415,368 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $142,811 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,863 | BOYAmt |
| EOY | $272,557 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,506,888 | BOYAmt |
| EOY | $862,661 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,157 | BOYAmt |
| EOY | $245,307 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,298 | BOYAmt |
| EOY | $55,979 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,455 | BOYAmt |
| EOY | $301,286 | 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 | $953,433 | BOYAmt |
| EOY | $561,375 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $953,433 | BOYAmt |
| EOY | $561,375 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,506,888 | BOYAmt |
| EOY | $862,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$392,058 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HIGHLAND DISTRICT HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | HIGHLAND DISTRICT HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310653685 | EIN |
| Organization Type | 6 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $1,619,659 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Other Support Sum | $1,619,659 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,200 | OtherCostOrOtherBasisAmt |
| Book Value | $15,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $329,805 | OtherCostOrOtherBasisAmt |
| Depreciation | $85,040 | DepreciationAmt |
| Book Value | $244,765 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,363 | OtherCostOrOtherBasisAmt |
| Depreciation | $57,771 | DepreciationAmt |
| Book Value | $12,592 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $272,557 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | 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 (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| VINAYAK KULKARNI | |||||
| PHYSICIAN | $261,736 | $98,465 | $11,600 | $4,936 | $376,737 |
| CRAIG MCKINNEY | |||||
| PHYSICIAN | $297,979 | $11,600 | $17,258 | $326,837 | |
| STEVEN BATTAGLIA | |||||
| PHYSICIAN | $180,386 | $7,671 | $33,642 | $221,699 | |
| RANGA BRAHMAMDAM | |||||
| PHYSICIAN | $395,842 | $13,471 | $9,883 | $419,196 | |
| ALEX RENSHAW | |||||
| PHYSICIAN | $638,408 | $11,600 | $15,365 | $665,373 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 2 | RANDAL LENNARTZ MEGHANN ACKLEY OFFICER OFFICER BUSINESS RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 6 | HIGHLAND DISTRICT HOSPITAL FOUNDATION IS THE SOLE MEMBER OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | AS THE SOLE MEMBER OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION, HIGHLAND DISTRICT HOSPITAL FOUNDATION APPOINTS THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 8B | HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION DOES NOT HAVE COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE INITIAL DRAFT OF THE RETURN IS PREPARED DBY THE ACCOUNTING DEPARTMENT AND THEN FORWARDED TO THE VP FINANCE FOR REVIEW AND COMMENT. ONCE A FINAL DRAFT IS COMPLETED, THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE FINAL VERSION. THE BOARD APPROVED FORM 990 IS THEN FILED WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF ITNEREST STATEMENTS COVERS ALL INTERESTED PERSONS OF THE ORGANIZATION. THIS INCLUDES ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS. THESE INDIVIDUALS MUST AFFIRM THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST STATEMENT, HAVE READY AND UNDERSTAND THE POLICY AND AGREE TO COMPLY WITH THE POLICY. IN THE EVEN OF AN ACTUAL OR POSSIBLE CONFLICT OF INTERST, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE ESISTENCE AS SOON AS IT IS KNOWN. UPON DISCLOSURE, THE REMAINING BOARD MEMBERS DISCUSS AND VOTE TO DETERMINE IF A CONFLICT EXISTS. IN THE EVENT OF A CONFLICT, THE INTERESTED PERSON WILL ABSTAIN FROM ANY PART OF ANY BUSINESS DECISION RELATED TO THE CONFLICT. IF IT IS DETERMINED THAT AN INDIVIDUAL HAS VIOLATED THE CONFLICT OF INTEREST POLICY , APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WILL BE TAKEN. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION OF KEY EMPLOYEES IS BASED UPON INFORMATION OBTAINED REGARDING COMPENSATION LEVELS OF INDIVIDUALS IN SIMILAR POSITIONS AT A SIMILARLY SIZED HEALTH CARE FACILITIES COMPARED TO THE NATIONAL AVERAGE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. A NOTICE IS PLACED IN THE NEWSPAPER AFTER THE AUDIT IS COMPLETED AND APPROVED BY THE STATE OF OHIO AUDITOR. |
| FORM 990, PART IX, LINE 11G | 487,963 0 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Exempt Code SectionExemptCodeSectionTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| HIGHLAND DISTRICT HOSPITAL | ||||||||||
| 1275 N HIGH STREET | HILLSBORO | OH | 45133 | 310653685 | HOSPITAL | OH | 6 | NA | false | |
| HIGHLAND DISTRICT HOSPITAL FOUNDATI | ||||||||||
| 1275 N HIGH STREET | HILLSBORO | OH | 45133 | 311666318 | FOUNDATION | OH | 11 | HDH | false | 3 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | 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 | false | 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 | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HIGHLAND DISTRICT HOSPITAL FDN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $900,000 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |