2022-11-08T12:18:04-06:00 2021-12-31 990 2021-01-01 344446484 DEFIANCE HOSPITAL INC DEFI 4192525772 100 MADISON AVE ATTN TAX DEPARTM TOLEDO OH 43604 LOUIS ROBICHAUX TREASURER 4192525772 2022-11-07 0 LOUIS ROBICHAUX 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z PROMEDICA DEFIANCE REGIONAL HOSPITAL LOUIS ROBICHAUX 100 MADISON AVE TOLEDO OH 43604 84195652 0 X WWW.PROMEDICA.ORG X 1953 OH DEFIANCE HOSPITAL, INC. IS A CRITICAL ACCESS HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO THE GENERAL PUBLIC, INCLUDING THE SURROUNDING COMMUNITIES OF DEFIANCE, PAULDING, HENRY, PUTNAM, WILLIAMS, AND FULTON COUNTIES IN OHIO. 17 9 402 95 0 0 6395307 1497151 68763396 82458557 43478 -3461 224842 200072 75427023 84152319 100700 27500 0 0 26948999 27083654 0 0 0 35962744 35454299 63012443 62565453 12414580 21586866 50769416 48415209 47389465 48223362 3379951 191847 X OUR MISSION IS TO BE THE LEADER IN PROVIDING QUALITY HEALTHCARE SERVICES THAT MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF OUR CUSTOMERS. - SEE SCHEDULE O. 0 0 48340407 27500 81811113 DEFIANCE HOSPITAL, INC. IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O. 48340407 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 402 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 9 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 X JENNIFER SARPALIUS 5675855652 100 MADISON AVE TOLEDO OH 43604 X LAURA W KLINE CHAIRMAN 1.00 1.00 X X 0 0 0 DOUGLAS J BUSH PRES., TRUSTEE 1.00 54.00 X X 0 266286 30097 DAWN M BUSKEY EX OFFICIO, PRES. ACUTE CARE 1.00 54.00 X 0 805499 49161 PAMELA M JENSEN EX OFFICIO, VP HIGH RELIABILITY 1.00 54.00 X 0 521951 34076 AMER ARSHAD MD TRUSTEE, PHYSICIAN 1.00 40.00 X 0 788180 23417 KENNETH EDWIN BOROFF TRUSTEE 1.00 0.00 X 0 0 0 JENNIFER A BOYD TRUSTEE 1.00 0.00 X 0 0 0 HOLLY L BRISTOLL TRUSTEE, CHIEF INTEGRATION OFFICER 1.00 50.00 X 0 548101 43223 GARY M CATES TRUSTEE, CHIEF PHILANTHROPIC OFFICER 1.00 41.00 X 0 608294 38726 KATHRYN E GROFF TRUSTEE 1.00 0.00 X 0 0 0 CRYSTAL HORNISH TRUSTEE 1.00 0.00 X 0 0 0 JOSHUA M LUCAS MD TRUSTEE, PHYSICIAN 1.00 40.00 X 0 486935 24320 RICHANNE C MANKEY EDD MSED BA TRUSTEE 1.00 0.00 X 0 0 0 ANDREW D SHINDLER TRUSTEE (PARTIAL YEAR) 1.00 0.00 X 0 0 0 MICHELLE E STAHL CPA TRUSTEE 1.00 0.00 X 0 0 0 SUE A STRAUSBAUGH TRUSTEE 1.00 0.00 X 0 0 0 JORDAN W STUCKEY MD TRUSTEE, PHYSICIAN 1.00 40.00 X 0 594519 27056 AMANDA K KISSNER VICE CHAIRMAN 1.00 0.00 X 0 0 0 RANDALL OOSTRA PHS PRES. & CEO 1.00 55.00 X 0 7155772 300344 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER 1.00 55.00 X 0 1347615 68186 STEVEN M CAVANAUGH TREASURER, CFO 1.00 55.00 X 0 3497904 60660 DEANA SIEVERT SR VP, PAT CARE/CNO, SYSTEM 1.00 54.00 X 0 530514 33176 GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG 0.00 50.00 X 0 525467 38467 TRINA BUETTNER DIRECTOR OF PHARMACY 40.00 0.00 X 155270 0 15159 MICHAEL BAILEY ADMINISTRATIVE SUPERVISOR 40.00 0.00 X 140095 0 31753 SARA SCHUETTE DIRECTOR REHAB 40.00 0.00 X 139383 0 21428 CHRISTINE HOFFMAN PHARMACIST 40.00 0.00 X 135885 0 23821 JACK POLING DIRECTOR, MED SURG/ICU 40.00 0.00 X 137294 0 18395 ALAN M SATTLER FORMER TREASURER, VP BUSINESS DEV. 0.00 40.00 X 0 269627 37223 DARRIN ARQUETTE FORMER PRESIDENT, PRES. ACUTE CARE 0.00 40.00 X 0 481180 38136 707927 18427844 956824 13 1 1 0 0 25286 1471865 1497151 NET PATIENT SERVICES 622110 81608891 81608891 AFFIL. ORG. RENT REV. 531120 849666 849666 82458557 33557 39872 -6315 -6315 -6315 3461 -3461 -3461 -3461 ANCILLARY REVENUE 900099 134763 134763 INTERCOMPANY SERVICES 900099 66000 66000 DRUG SERVICES REVENUE 900099 1459 1459 4165 4165 206387 84152319 81811113 0 844055 X 27500 27500 21458476 17960732 3497744 1195188 1000372 194816 2911812 2437185 474627 1518178 1270714 247464 261782 261782 143837 143837 35084 35084 6044 6044 9306699 9306699 222568 31789 190779 644146 92001 552145 47714 34807 12907 1531513 490738 1040775 41539 5933 35606 1182050 1182050 3968400 3504487 463913 618680 618680 DRUGS 5908832 5908832 INTERCOMPANY SERVICES 5223305 746028 4477277 SUPPLIES - GENERAL 2462463 2324002 138461 PROVIDER TAXES 1711096 1711096 2138547 305442 1833105 62565453 48340407 14225046 0 7201504 5312996 193073 194073 8893468 11254757 670475 839014 123845 135278 96348542 69692013 29815841 26656529 42303 180049 3828907 3842513 50769416 48415209 8771380 6965150 38618085 41258212 47389465 48223362 X 35106 -3215061 3344845 3406908 3379951 191847 50769416 48415209 X 21586866 -24774970 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6044 6044 0 PART II-B, LINE 1: DEFIANCE HOSPITAL, INC. PAYS DUES TO THE AMERICAN HOSPITAL ASSOCATION AND THE OHIO HOSPITAL ASSOCIATION, A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ORGANIZATION. 168227 168227 168227 168227 168227 168227 168227 168227 168227 168227 1.00000 0 1 1 3246675 3246675 68248395 49561008 18687387 328240 327687 553 18809924 15383194 3426730 5715308 4420124 1295184 26656529 DUE FROM AFFILIATES 413026 BENEFICIAL INTEREST IN FOUNDATION 3406908 OTHER RECEIVABLE 22579 3842513 ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE 3259108 ASSET REMEDIATION OBLIGATION 21285 INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL 37809950 OPERATING LEASE LIABILITY 167869 41258212 PART V, LINE 4: THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT DEFIANCE HOSPITAL, INC. CONSISTENT WITH DONOR INTENT. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 326455 326455 0.00520 12345538 7721267 4624271 0.07390 7072 5009 2063 0.00000 12679065 7726276 4952789 0.07910 222760 39976 182784 0.00290 2083260 1794964 288296 0.00460 21384 21384 0.00030 2327404 1834940 492464 0.00780 15006469 9561216 5445253 0.08690 44121 44121 0.00070 17573 17573 0.00030 61694 61694 0.00100 1 4746591 165772 11663757 11723176 -59419 X 1 1 1 1 DEFIANCE HOSPITAL INC 1200 RALSTON AVENUE DEFIANCE OH 43512 WWW.PROMEDICA.ORG 1160 X X X X DEFIANCE HOSPITAL INC 0 0 1 X X X X X X X X X 19 1 0 1 1 X SEE PART V, SECTION C X 1 19 1 SEE PART V, SECTION C 0 1 X 200.000000000000 600.000000000000 X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 DEFIANCE HOSPITAL, INC. PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY ASSESSMENT SURVEY PROCESS, DRMC STAFF JOINED POWER DEFIANCE, COMPRISED OF MULTIPLE COMMUNITY ORGANIZATIONS, TO COLLABORATE, DEVELOP AND IMPLEMENT A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR DEFIANCE COUNTY. A GAP ANALYSIS AND RESOURCE ASSESSMENT WAS CONDUCTED AS PART OF THIS PROCESS.IN 2019, DEFIANCE REGIONAL HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE MOST RECENT DEFIANCE COUNTY CHA AND CHIP, TAKING INTO ACCOUNT GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THE DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE DEFIANCE COUNTY HEALTH DISTRICT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE.THE POWER DEFIANCE COUNTY STRATEGIC CHIP PROCESS INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED:AYERSVILLE LOCAL SCHOOLS, CITY OF DEFIANCE, COMMUNITY MEMORIAL HOSPITAL, CREDIT ADJUSTMENTS INC., DEFIANCE AREA FOUNDATION, DEFIANCE AREA YMCA, DEFIANCE CITY SCHOOLS, DEFIANCE COUNTY COMMISSIONERS, DEFIANCE COUNTY DRUG FREE COALITION, DEFIANCE COUNTY GENERAL HEALTH DISTRICT, DEFIANCE COUNTY JUVENILE COURT, DEFIANCE COUNTY OHIO STATE UNIVERSITY EXTENSION OFFICE, DEFIANCE COUNTY PUBLIC LIBRARY SYSTEM, DEFIANCE DEVELOPMENT AND VISITORS BUREAU, DEFIANCE 2100, FAIRVIEW SCHOOL DISTRICT, FAMILY AND CHILDREN FIRST COUNCIL, FOUR COUNTY ADAMHS BOARD, HICKSVILLE SCHOOLS, HICKSVILLE VILLAGE, MAUMEE VALLEY GUIDANCE CENTER, MERCY HEALTH, DEFIANCE MINISTERIAL ASSOCIATION, NORTHEASTERN LOCAL SCHOOLS, NORTHWESTERN OHIO COMMUNITY ACTION COMMISSION, PROMEDICA DEFIANCE REGIONAL HOSPITAL, RECOVERY SERVICES OF NORTHWEST OHIO, UNITED WAY OF DEFIANCE COUNTY DEFIANCE HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO DEFIANCE HOSPITAL, INC. PART V, SECTION B, LINE 11: DEFIANCE HOSPITAL, INC. CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - CHRONIC DISEASE PHYSICAL ACTIVITY AND NUTRITION- INJURY PREVENTION INFANT SAFE SLEEP AND FALL PREVENTION- CROSS CUTTING STRATEGY HEALTHCARE SYSTEM ACCESSTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019, THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022. DEFIANCE HOSPITAL, INC. DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT HEALTH; PREVENTIVE MEDICINE (ALL EXCEPT FALL PREVENTION), WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, WEIGHT STATUS, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH, CARDIOVASCULAR HEALTH (EXCEPT PHYSICAL ACTIVITY AND NUTRITION), CANCER, ASTHMA, DIABETES (EXCEPT PHYSICAL ACTIVITY AND NUTRITION), QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS, PARENTING; YOUTH HEALTH: WEIGHT STATUS, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, VIOLENCE; AND CHILD HEALTH: HEALTH AND FUNCTIONAL STATUS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEATH.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2022 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. DEFIANCE HOSPITAL, INC. TOOK THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019: HEALTH NEED IDENTIFIED: CHRONIC DISEASE: PHYSICAL ACTIVITY AND NUTRITIONSTRATEGY #1 PHYSICAL ACTIVITY. THROUGH POWER DEFIANCE COUNTY DISCUSS WAYS TO IMPROVE AND PROMOTE PHYSICAL ACTIVITY OPPORTUNITIES. DETERMINE GOALS OF THE COMMITTEE. COMPLETE A GAP ANALYSIS OF CURRENT PHYSICAL ACTIVITY OFFERINGS WITHIN THE COUNTY AND DETERMINE POTENTIAL ACTION STEPS FOCUSED ON COLLABORATION. CREATE BRANDING FOR PARTNERING ORGANIZATIONS TO SHARE UNIFIED MESSAGING REGARDING PHYSICAL ACTIVITY. YEAR TWO (2021), UPDATE CURRENT PHYSICAL ACTIVITY GUIDES AND CALENDARS. MAINTAIN GUIDES AND DEVELOP A PLAN TO UPDATE AND SUSTAIN GUIDES ON A QUARTERLY BASIS. PARTNER WITH LOCAL BUSINESSES, CHURCHES, AND SCHOOLS TO SUPPORT EFFORTS (I.E. SHARED USE AGREEMENTS). DISSEMINATE UNIFIED INFORMATION AND MESSAGING THROUGHOUT DEFIANCE COUNTY. ACTIONS TAKEN: - DISTRIBUTED 21 COUNTY WALKING TRAIL GUIDES IN HOSPITAL WAITING ROOMS (PAPER MATERIALS WERE PROHIBITED IN WAITING ROOMS DURING FIRST TWO QUARTERS OF 2021 DUE TO COVID RESTRICTIONS)- ATTENDED POWER COUNTY HEALTH COALITION MEETINGS, POST COVID RESTRICTIONS, TO CONTINUE TO ADDRESS PHYSICAL ACTIVITY NEEDS IN THE COMMUNITYSTRATEGY #2 IN 2021 DEFIANCE HOSPITAL CONTINUED EFFORTS OF 2020 TO IMPLEMENT THE FOOD INSECURITY SCREENING MODEL IN AT LEAST TWO ADDITIONAL LOCATIONS WITH ACCOMPANYING EVALUATION MEASURES. EDUCATE PARTICIPATING (HOSPITAL) LOCATIONS ON EXISTING COMMUNITY RESOURCES SUCH AS WIC, SNAP, SCHOOL NUTRITION PROGRAMS, FOOD PANTRIES, AND OTHER RESOURCES.ACTIONS TAKEN:- HOSPITAL UTILIZES A TWO QUESTION FOOD INSECURITY SCREENING TOOL FOR ALL INPATIENTS AND ALL EMERGENCY CENTER (EC) PATIENTS. IN 2021, 11, 427 PATIENTS WERE SCREENED FOR FOOD INSECURITY, WITH COMMUNITY FOOD RESOURCE LISTINGS MADE AVAILABLE TO THEM. EMERGENCY CENTER PATIENTS ARE GIVEN A LISTING OF LOCAL FOOD RESOURCES TO UTILIZE TO OBTAIN FOOD AFTER DISCHARGE FROM THE ER. - IF AN INPATIENT SCREENS POSITIVE, THEY ARE GIVEN A TWO (2) DAY SUPPLY OF NONPERISHABLE FOOD ITEMS TO GO HOME WITH AS WELL AS A LIST OF ALL FOOD PANTRIES IN THE SURROUNDING COUNTIES. FIFTEEN (15) PATIENTS ACCEPTED FOOD AT DISCHARGE IN 2021 IN 2022, A NEW PROCESS WILL BE PUT IN PLACE TO INCREASE UTILIZATION OF THIS PROGRAM BASED ON THE PATIENT'S RISK AND ACCEPTANCE OF FOOD AT DISCHARGE.HEALTH NEED IDENTIFIED: INJURY PREVENTION SAFE SLEEP AND FALL PREVENTION STRATEGY #1 - CONTINUE TO WORK WITH HOSPITALS AND OTHER LOCAL ORGANIZATIONS TO INTEGRATE SAFE SLEEP PRACTICES INTO THE COMMUNITY. IMPROVE MEDIA CAMPAIGNS FOR AWARENESS AND CONTINUE TO PROVIDE SAFE SLEEP TOOLS TO HOSPITALS AND NEW FAMILIES. DEVELOP PARTNERSHIPS WITH LOCAL ORGANIZATIONS TO BUILD REFERRALS FOR THOSE WHO ARE NOT RECEIVING PRENATAL CARE. ACTIONS TAKEN:- ALL PARENTS WHO DELIVER BABIES AT THE HOSPITAL ARE EDUCATED ON SAFE SLEEP PRACTICES INCLUDING LOCATION AND POSITION OF INFANT DURING SLEEP. IN 2021, 191 PARENTS WERE EDUCATED ON SAFE SLEEP PRACTICES. - HOSPITAL CONTINUES TO FUND EDUCATIONAL PACKETS FOR ALL SAFE SLEEP EDUCATION.STRATEGY #2 IN 2021, CONTINUED TO IMPLEMENT THE MATTER OF BALANCE PROGRAM WITHIN DEFIANCE COUNTY. DETERMINE NEED WITHIN SPECIFIC GEOGRAPHIC AREAS (I.E. DEFIANCE CITY). TRAIN ADDITIONAL "LAY" VOLUNTEERS TO IMPLEMENT THE MATTER OF BALANCE PROGRAM WITHIN DEFIANCE COUNTY. ACTIONS TAKEN:- IN LIEU OF MATTER OF BALANCE PROGRAM, 1,633 FALL RISK ASSESSMENTS WERE CONDUCTED IN THE EMERGENCY CENTER FOR PATIENTS THAT WERE OVER 65 AND, EITHER ON 12 OR MORE MEDICATIONS OR HAD FALLEN IN THE LAST THREE (3) MONTHS. IF THEY SCREEN POSITIVE, THEY ARE GIVEN A WRITTEN BROCHURE ON FALL PREVENTION TECHNIQUES. - 75 FALL PREVENTION EDUCATIONAL BROCHURES WERE DISTRIBUTED IN VARIOUS HOSPITAL WAITING ROOMS TO INCREASE KNOWLEDGE OF FALL PREVENTION.HEALTH NEED IDENTIFIED: CROSS CUTTING FACTOR: HEALTHCARE SYSTEM ACCESS STRATEGY #1 - YEAR 1 (2020): RESEARCH COMMUNITY PARAMEDICINE PROGRAMS AND COMMUNITY HEALTH WORKERS AND DETERMINE INTEREST WITHIN DEFIANCE COUNTY. IDENTIFY AND ASSEMBLE AGENCIES INTERESTED IN A PARAMEDICINE PROGRAM AND/OR COMMUNITY HEALTH WORKERS. CONDUCT A NEEDS ASSESSMENT AND GAP ANALYSIS. RESEARCH FUNDING OPPORTUNITIES (HOSPITALS, GRANTS, INSURANCE PLANS) AND DETERMINE FEASIBILITY. YEAR 2 (2021): CONTINUE EFFORTS OF YEAR 1. RESEARCH FUNDING OPPORTUNITIES (FOR HOSPITALS, GRANTS, INSURANCE PLANS) AND DETERMINE FEASIBILITY. SEEK FUNDING OPPORTUNITIES TO MARKET PACKETS REGARDING SAFE SLEEP PRACTICES. ENSURE CONSISTENT SAFE SLEEP EDUCATION MESSAGING.ACTIONS TAKEN:- IN LIEU OF PARAMEDICINE PROGRAM RESEARCH BEGUN IN 2020, DEFIANCE HOSPITAL STAFF AND POWER DEFIANCE HEALTH COALITION HAVE REFOCUSED ON PLANNING HOME VISITING PROGRAMS FOR CHILDREN TO PARTNER WITH COMMUNITY ORGANIZATIONS TO INCREASE HEALTHCARE ACCESS. PART V, SECTION B, LINE 7A THE 2019 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-DEFIANCE-REGIONAL-HOSPITAL-2019-CHNA-.PDF PART V, SECTION B, LINE 10A THE 2020-2020 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-DEFIANCE-REGIONAL-HOSPITAL-2019-CHNA-IMPLEMENTATION-PLAN-2020-2022.PDF PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF 4 1 - PROMEDICA DEFIANCE HOSPITAL - REHAB 1252 RALSTON AVE STE 301 DEFIANCE OH 435121396 PHYSICAL THERAPY, CARDIAC REHAB 2 - DMO ANTICOAGULATION SERVICES DIABETES ED 1252 RALSTON AVE STE 401 DEFIANCE OH 43512 ANTICOAGULATION CLINIC, DIABETES EDUCATION 3 - DMI PAIN CLINIC 1250 RALSTON AVE STE 203 DEFIANCE OH 43512 PAIN CLINIC 4 - PROMEDICA DEFIANCE HOSPITAL - AUDIOLOGY 1200 RALSTON AVE DEFIANCE OH 435121338 AUDIOLOGY PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: DEFIANCE HOSPITAL, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: DEFIANCE HOSPITAL, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. PART III, LINE 2: DEFIANCE HOSPITAL, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. PART III, LINE 3: DEFIANCE HOSPITAL, INC. ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. PART III, LINE 4: PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION. PART III, LINE 8: MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM. - THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS. - MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER. - MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.DEFIANCE HOSPITAL, INC. USED THE MEDICARE ALLOWABLE COSTS PER ITS 2021 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. PART VI, LINE 2: PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE. PART VI, LINE 3: THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS. PART VI, LINE 4: DEFIANCE HOSPITAL, INC., LOCATED IN DEFIANCE, OHIO, SERVES AN AREA PRIMARILY AROUND DEFIANCE COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 84,000. APPROXIMATELY, 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 58% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $60,000; 91% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 41% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. DEFIANCE COUNTY HAS A POPULATION OF APPROXIMATELY 38,000 WITH APPROXIMATELY 9% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 23% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 12% OF DEFIANCE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR DEFIANCE COUNTY IN 2021 WAS 3.1%. THE LEADING CAUSES OF DEATH IN DEFIANCE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, UNINTENTIONAL INJURIES/ACCIDENTS, LUNG DISEASE, DIABETES AND ALZHEIMER'S. ACCORDING TO THE 2021 COUNTY HEALTH RANKINGS, DEFIANCE COUNTY RANKED 19 OF 88 COUNTIES FOR HEALTH OUTCOMES, 29 OF 88 FOR LENGTH OF LIFE, AND 16 OF 88 FOR QUALITY OF LIFE. THERE ARE SEVEN HOSPITALS WITHIN A 30-MILE RADIUS OF DEFIANCE HOSPITAL, INC.: MERCY HOSPITAL OF DEFIANCE, COMMUNITY HOSPITALS AND WELLNESS CENTERS (BRYAN), PAULDING COUNTY HOSPITAL, HENRY COUNTY HOSPITAL, COMMUNITY MEMORIAL HOSPITAL, FULTON COUNTY HEALTH CENTER, AND COMMUNITY HOSPITALS, AND WELLNESS CENTERS (MONTPELIER). PART VI, LINE 5: DEFIANCE HOSPITAL, INC. IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2021:- THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERSHIP IS COMPOSED OF 43% FEMALES, 20% PHYSICIANS, 11% UNDER THE AGE OF 40, AND 18% RACIAL OR ETHNIC MINORITIES. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 3,300 LUNG CANCER SCREENINGS, NEARLY 55,000 SCREENING MAMMOGRAMS AND NEARLY 13,000 SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. IN 2021, APPROXIMATELY 8,000 DOSES OF THE TREATMENT WERE PROVIDED. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. IN 2021, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.- IN THE METRO TOLEDO AREA, PROMEDICA WORKED CLOSELY WITH LUCAS COUNTY DEPARTMENT OF HEALTH OFFICIALS TO ASSIST WITH MASS COVID VACCINE CLINICS AS WELL AS CLINICS IN UNDERSERVED AREAS OF THE COMMUNITY WHERE VACCINE HESITANCY WAS AN ONGOING CONCERN. ONE OF THE PROJECTS PROMEDICA HELPED SPEARHEAD WAS THE V PROJECT, WHICH WORKED ACROSS THE NORTHWEST OHIO COMMUNITY TO INCREASE VACCINE PARTICIPATION. THE V PROJECT HELPED TO BRING RESOURCES TO PEOPLE IN ZIP CODES THAT HAD LOWER VACCINATION PARTICIPATION RATES WITH THE GOAL OF EASING ANY BARRIERS THAT MAY HAVE PROHIBITED THEM FROM PREVIOUSLY GETTING THEIR VACCINE. - PROMEDICA ALSO ALLOCATED 20% OF THE VACCINES IT RECEIVED TO UNDERSERVED COMMUNITIES. THIS LED TO OTHER OPPORTUNITIES SUCH AS THE PARTNERSHIP WITH THE FIRST CHURCH OF GOD ON COLLINGWOOD IN TOLEDO. LED BY THE PPG CLINICAL OPERATIONS TEAM, VARIOUS TEAMS FROM ACROSS PROMEDICA CAME TOGETHER AND HELD VACCINATION CLINICS ON SUNDAYS. PROMEDICA ALSO EXPANDED PARTICIPATION IN COMMUNITY MASS COVID VACCINE CLINICS AT AN ARE UAW HALL TO REACH A LARGER PROPORTION OF THE UNDERSERVED COMMUNITIES. PART VI, LINE 6: PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2021 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2021:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA MANAGED APPROXIMATELY 2.28 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 57,200 SURGERIES, 6,000 BIRTHS, AND MORE THAN 262,600 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $259,433,000.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2021, APPROXIMATELY 5,794 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,093 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 44,100 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 132,300 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. IN 2021, 49 PEOPLE WERE SUPPORTED BY THE INITIATIVE. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2021, NEARLY 2,560 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 21 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 4 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION. 1 PROMEDICA FOUNDATION 444 N SUMMIT STREET TOLEDO OH 43604 341517672 501(C)(3) 27500 0 OPERATING GRANT 1 0 PART I, LINE 2: AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. X 1 1 0 1 0 0 0 0 0 0 0 RANDALL OOSTRA PHS PRES. & CEO 0 1956043 0 5028392 0 171337 0 283814 0 16530 0 7456116 0 0 STEVEN M CAVANAUGH TREASURER, CFO 0 1300553 0 2196109 0 1242 0 35041 0 25619 0 3558564 0 0 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER 0 724534 0 616992 0 6089 0 53463 0 14723 0 1415801 0 0 DAWN M BUSKEY EX OFFICIO, PRES. ACUTE CARE 0 545228 0 256990 0 3281 0 32280 0 16881 0 854660 0 0 AMER ARSHAD MD TRUSTEE, PHYSICIAN 0 468082 0 318752 0 1346 0 0 0 23417 0 811597 0 0 GARY M CATES TRUSTEE, CHIEF PHILANTHROPIC OFFICER 0 383133 0 220178 0 4983 0 23795 0 14931 0 647020 0 0 JORDAN W STUCKEY MD TRUSTEE, PHYSICIAN 0 580861 0 12548 0 1110 0 0 0 27056 0 621575 0 0 HOLLY L BRISTOLL TRUSTEE, CHIEF INTEGRATION OFFICER 0 349095 0 195715 0 3291 0 21888 0 21335 0 591324 0 0 GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG 0 387188 0 133715 0 4564 0 20943 0 17524 0 563934 0 0 DEANA SIEVERT SR VP, PAT CARE/CNO, SYSTEM 0 330172 0 190593 0 9749 0 10552 0 22624 0 563690 0 0 PAMELA M JENSEN EX OFFICIO, VP HIGH RELIABILITY 0 333563 0 184607 0 3781 0 15288 0 18788 0 556027 0 0 DARRIN ARQUETTE FORMER PRESIDENT, PRES. ACUTE CARE 0 322925 0 153338 0 4917 0 14385 0 23751 0 519316 0 0 JOSHUA M LUCAS MD TRUSTEE, PHYSICIAN 0 260287 0 226363 0 285 0 0 0 24320 0 511255 0 0 ALAN M SATTLER FORMER TREASURER, VP BUSINESS DEV. 0 210556 0 50619 0 8452 0 10550 0 26673 0 306850 0 0 DOUGLAS J BUSH PRES., TRUSTEE 0 197972 0 62208 0 6106 0 6609 0 23488 0 296383 0 0 MICHAEL BAILEY ADMINISTRATIVE SUPERVISOR 127945 0 6257 0 5893 0 5025 0 26728 0 171848 0 0 0 TRINA BUETTNER DIRECTOR OF PHARMACY 135250 0 20020 0 0 0 6246 0 8913 0 170429 0 0 0 SARA SCHUETTE DIRECTOR REHAB 123227 0 15856 0 300 0 5511 0 15917 0 160811 0 0 0 CHRISTINE HOFFMAN PHARMACIST 135535 0 350 0 0 0 6932 0 16889 0 159706 0 0 0 JACK POLING DIRECTOR, MED SURG/ICU 106900 0 30266 0 128 0 5522 0 12873 0 155689 0 0 0 PART I, LINE 1A CHARTER TRAVEL 1 OFFICER- NOT INCLUDED IN TAXABLE COMPENSATION PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF DEFIANCE HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. SCHEDULE J, SUPPLEMENTAL INFORMATION: IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. FORM 990, PART III, LINE 4: DEFIANCE HOSPITAL, INC. PROGRAM SERVICE ACCOMPLISHMENTS DEFIANCE HOSPITAL, INC. PROGRAM SERVICE ACCOMPLISHMENTS DEFIANCE HOSPITAL, INC. (D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL) IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PROMEDICA DEFIANCE REGIONAL HOSPITAL (DRH) IS A 25-BED, CRITICAL ACCESS, GENERAL ACUTE CARE HOSPITAL IN DEFIANCE, OHIO THAT INCLUDES A 10-BED, DISTINCT BEHAVIORAL HEALTH UNIT. THE 200,000-SQUARE-FOOT FACILITY PROVIDES HEALTHCARE SERVICES TO RESIDENTS IN THE OHIO COUNTIES OF DEFIANCE, PAULDING, HENRY, FULTON, PUTNAM, AND WILLIAMS. IN 2021, DRH RECEIVED RECOGNITION AS A "HIGH PERFORMING" HOSPITAL FOR HIP FRACTURE TREATMENTS. TO HELP PATIENTS DECIDE WHERE TO RECEIVE CARE, U.S. NEWS & WORLD REPORT GENERATES HOSPITAL RANKINGS BY EVALUATING DATA ON NEARLY 5,000 HOSPITALS NATIONWIDE ACROSS 15 SPECIALTIES AND 17 PROCEDURES AND CONDITIONS. DRH OFFERS A BROAD SPECTRUM OF SERVICES TO MEET THE COMMUNITY'S IDENTIFIED HEALTHCARE NEEDS, INCLUDING FULL-SERVICE EMERGENCY CENTER AND LEVEL III TRAUMA CENTER, SURGICAL SERVICES, HEALTH EDUCATION PROGRAMMING, THE COPING CENTER FOR PATIENTS WITH MENTAL HEALTH ISSUES, ADVANCED DIAGNOSTICS, WOMEN'S SERVICES, AND A SLEEP DISORDERS CENTER. AS A TESTAMENT TO OUR COMMITMENT TO PROVIDE HIGH-QUALITY CARE TO AREA RESIDENTS, DRH ALSO OFFERS AN EXPANDED VISITING PHYSICIAN CLINIC INCLUDING UROLOGY AND OTHER SPECIALTIES AND SUBSPECIALTIES. A MEDICAL OFFICE BUILDING ON THE CAMPUS INCLUDES FIVE CLINICAL SUITES FOR SPECIALTIES SUCH AS ORTHOPAEDICS, REHABILITATION SERVICES, OPHTHALMOLOGY, AND BEHAVIORAL HEALTH SERVICES AS WELL AS NUMEROUS PRIMARY CARE PROVIDERS. AS A COMMUNITY-BASED HOSPITAL, DRH HOSTS VARIOUS SUPPORT GROUPS AND COMMUNITY OUTREACH ACTIVITIES TO PROMOTE HEALTH AND WELLNESS, INCLUDING VARIOUS PROGRAMS FOR NEW MOTHERS AND FAMILIES THROUGHOUT THE YEAR. DRH IS ACCREDITED BY THE JOINT COMMISSION AND HAS EARNED LEVEL III TRAUMA CENTER VERIFICATION, SLEEP MEDICINE ACCREDITATION, A LEVEL I OBSTETRICS AND NEWBORN NURSERY UNIT, AND LABORATORY ACCREDITATION BY THE COMMISSION ON LABORATORY ACCREDITATION OF THE COLLEGE OF AMERICAN PATHOLOGISTS. DRH'S CHARGE IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE INDIVIDUALS WHOM WE SERVE THROUGH PREVENTION, EDUCATION AND QUALITY CARE. AS PART OF PROMEDICA'S SOCIAL DETERMINANTS OF HEALTH INITIATIVE, DRH SPONSORED THE DEFIANCE FARMERS' MARKET FOR THE THIRD YEAR TO HELP IMPROVE COMMUNITY ACCESS TO FRESH FRUITS AND VEGETABLES AND ENJOY SOCIAL INTERACTION WITH OTHER COMMUNITY MEMBERS. IN 2021, DRH SERVED 1,852 INPATIENTS AND 72,366 OUTPATIENTS. ADDITIONALLY, 13,757 INDIVIDUALS SOUGHT EMERGENCY CARE AT DRH. THE HOSPITAL CONTRIBUTED $5,445,000 IN COMMUNITY BENEFIT IN 2021 THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH SERVICES, SUBSIDIZED HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFIT OPERATIONS, DRH CONTRIBUTED $493,000 TO THE COMMUNITY DURING 2021. INCLUDED IN THIS AMOUNT ARE PROGRAMS AND SERVICES SUCH AS: COMMUNITY HEALTH EDUCATION THROUGH NUMEROUS HEALTH PROMOTIONS AND WELLNESS PROGRAMS; A DISCOUNTED MAMMOGRAM PROGRAM FOR UNINSURED AND UNDERINSURED WOMEN IN THE DEFIANCE AREA; HEALTH SCREENINGS, INCLUDING BLOOD PRESSURE, HEARING, SKIN CANCER, BONE DENSITY, AND BODY FAT; JOBCARE, DRH'S OCCUPATIONAL HEALTH PROGRAM, WHICH WORKS CLOSELY WITH AREA EMPLOYERS TO PLAN AND COORDINATE HEALTH SERVICES THAT MEET EMPLOYEES' NEEDS.. DRH ALSO PROVIDED FINANCIAL ASSISTANCE TO THE COMMUNITY THROUGHOUT 2021, OF WHICH $326,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT OF PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. DRH'S COST OF BAD DEBT FOR 2021 WAS $1,213,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $5,445,000 NOTED ABOVE. FURTHER, DRH PROVIDED $4,626,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. DURING 2021, DRH EXPENDED $13,447,000 IN NET PAYROLL, PROVIDING 402 FULL-TIME JOBS. A TOTAL OF $797,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, DRH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. FORM 990, PART IV, LINE 24A: DEFIANCE HOSPITAL, INC. IS A HEALTH FACILITY THAT IS A SUBSIDIARY OF PROMEDICA HEALTH SYSTEM, INC. (PHS). DEFIANCE HOSPITAL, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE TO THE TOLEDO HOSPITAL, WHICH IS ALSO A SUBSIDIARY OF PHS. THE NOTE PAYABLE REPRESENTS DEFIANCE HOSPITAL, INC.'S PORTION OF TAXABLE AND TAX-EXEMPT BONDS ISSUED BY PROMEDICA HEALTHCARE OBLIGATED GROUP. PART V, LINE 1A THE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF DEFIANCE HOSPITAL, INC. AS THE MEMBER, PHS HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF DEFIANCE HOSPITAL, INC., AND (B) APPROVE THE NOMINEES TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY DEFIANCE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE IDENTIFIED PROVIDER BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, WILL PROVIDE THE PROVIDER-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PHS WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. FORM 990, PART VI, SECTION B, LINE 15 DEFIANCE HOSPITAL, INC.'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF DEFIANCE HOSPITAL, INC.'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. PART VII, SECTION B PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671. FORM 990, PART IX, LINE 11G PURCHASED SERVICES - PHYSICIANS: PROGRAM SERVICE EXPENSES 5,266,461. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,266,461. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 685,441. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 685,441. PURCHASED SERVICES - OTHER FEES: PROGRAM SERVICE EXPENSES 1,898,270. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,898,270. LAB HOSPITAL FEES: PROGRAM SERVICE EXPENSES 1,208,127. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,208,127. SERVICE CONTRACTOR FEES: PROGRAM SERVICE EXPENSES 226,047. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,047. DISASTER RECOVERY: PROGRAM SERVICE EXPENSES 22,353. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,353. FORM 990, PART XI, LINE 9: TRANSFER BETWEEN RELATED ENTITIES -24,837,033. BENEFICIAL INTEREST IN FOUNDATION 62,063. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BAY PARK COMMUNITY HOSPITAL 100 MADISON AVE TOLEDO OH 43604 341883132 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 COMMUNITY HEALTH CENTER OF BRANCH COUNTY 100 MADISON AVE TOLEDO OH 43604 386108110 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 DEFIANCE HOSPITAL AUXILIARY 1200 RALSTON DEFIANCE OH 43512 510173779 HOSPITAL / FOUNDATION SUPPORT OH 501(C)(3) 10 DEFIANCE HOSPITAL INC 1 EMMA L BIXBY MEDICAL CENTER 100 MADISON AVE TOLEDO OH 43604 382796005 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 EMMA L BIXBY MEDICAL CENTER AUXILIARY 818 RIVERSIDE AVE ADRIAN MI 43604 382149602 HOSPITAL / FOUNDATION SUPPORT MI 501(C)(3) 12B, II EMMA L BIXBY MEDICAL CENTER 1 FOSTORIA HOSPITAL ASSOCIATION 100 MADISON AVE TOLEDO OH 43604 340898745 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 FOSTORIA HOSPITAL AUXILIARY PO BOX 907 FOSTORIA OH 44830 346517634 HOSPITAL / FOUNDATION SUPPORT OH 501(C)(3) 10 FOSTORIA HOSPITAL ASSOCIATION 1 HCR MANORCARE FOUNDATION INC 444 N SUMMIT 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