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FOSTORIA HOSPITAL ASSOCIATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
FOSTORIA HOSPITAL ASSOCIATION (EIN 34-0898745)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-12
IRS object ID
202113169349306366
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-12T15:07:41-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN340898745EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FOSTORIA HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFOSTBusinessNameControlTxt
Phone4192525722PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVE ATTN TAX DEPARTMAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVEN M CAVANAUGHPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4192525722PhoneNum
Signature2021-11-11SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSTEVENPersonFirstNm
Person LastCAVANAUGHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PROMEDICA FOSTORIA COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSTEVEN M CAVANAUGHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$42,264,896GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROMEDICA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1930FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionFOSTORIA HOSPITAL ASSOCIATION IS AN ACUTE CARE HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO ALL.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee218TotalEmployeeCnt
Total Volunteers51TotalVolunteersCnt
Total Gross UBI$2,351,807TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$22,953PYContributionsGrantsAmt
CY Contributions Grants$5,925,249CYContributionsGrantsAmt
PY Program Service Revenue$35,094,956PYProgramServiceRevenueAmt
CY Program Service Revenue$33,762,585CYProgramServiceRevenueAmt
PY Investment Income$1,781,735PYInvestmentIncomeAmt
CY Investment Income$80,568CYInvestmentIncomeAmt
PY Other Revenue$2,781,757PYOtherRevenueAmt
CY Other Revenue$2,478,510CYOtherRevenueAmt
PY Total Revenue$39,681,401PYTotalRevenueAmt
CY Total Revenue$42,246,912CYTotalRevenueAmt
PY Grants And Similar Paid$90,205PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$71,041CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,356,935PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,384,750CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$21,066,277PYOtherExpensesAmt
CY Other Expenses$21,140,107CYOtherExpensesAmt
PY Total Expenses$34,513,417PYTotalExpensesAmt
CY Total Expenses$35,595,898CYTotalExpensesAmt
PY Revenues Less Expenses$5,167,984PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,651,014CYRevenuesLessExpensesAmt
Total Assets BOY$73,918,469TotalAssetsBOYAmt
Total Assets EOY$29,955,900TotalAssetsEOYAmt
Total Liabilities BOY$17,450,218TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,653,467TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$56,468,251NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,302,433NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionFOSTORIA HOSPITAL ASSOCIATION WILL PROVIDE QUALITY, COST-EFFECTIVE HEALTHCARE TO FOSTORIA AND ITS SURROUNDING COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$25,929,108ExpenseAmt
Grant$71,041GrantAmt
Revenue$33,490,955RevenueAmt
DescFOSTORIA HOSPITAL ASSOCIATION IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE GENERAL PUBLIC.Desc
Total Program Service Expenses$25,929,108TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial LiquidationYes (1)PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee218EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROBERT SHARONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5675855652PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
RANDALL OOSTRA
PHS PRES. & CEO1.0055.00Yes (X)$0$3,971,638$136,986
STEVEN M CAVANAUGH
TREASURER1.0055.00Yes (X)$0$2,048,174$105,065
JEFFREY C KUHN
SECRETARY1.0055.00Yes (X)$0$1,123,411$62,157
KEVIN C WEBB PHD
EX OFFICIO1.0042.00$0$1,049,317$51,281Yes (X)
HOLLY L BRISTOLL
FORMER OFFICER0.0041.00$0$523,344$46,484Yes (X)
GARY W AKENBERGER
COO, ACUTE CARE & SVP, DIAG0.0040.00$0$483,424$41,276Yes (X)
ROBIN L WHITNEY
TRUSTEE (PARTIAL YEAR)1.0040.00$0$490,922$23,325Yes (X)
DEANA SIEVERT
SR VP, PAT CARE/CNO, SYSTEM0.0040.00$0$402,381$35,116Yes (X)
PAMELA M JENSEN
PRES., EX OFFICIO1.0042.00Yes (X)$0$391,013$32,951Yes (X)
ALAN M SATTLER
FORMER OFFICER0.0040.00$0$249,480$36,266Yes (X)
ANN M KUJAWA MSN RN OCN
TRUSTEE1.000.00$0$214,459$34,850Yes (X)
AMY PREBLE
ASSOCIATE VP CLINICAL40.000.00$157,309$0$20,912Yes (X)
LISA SALTZMAN
LEAD PHARMACIST40.000.00$139,107$0$21,886Yes (X)
DASA A DZIERWA
TRUSTEE1.0042.00$0$154,128$3,059Yes (X)
DAVID SCHIEFER
MANAGER PHARMACY40.000.00$140,097$0$15,278Yes (X)
SCOTT BEIDELSCHIES
PHARMACIST40.000.00$129,545$0$13,006Yes (X)
AMY BOWSER
FCH DIALYSIS STAFF RN40.000.00$111,094$0$11,429Yes (X)
ANGELA M SHEETS
CHAIRMAN1.001.00Yes (X)$0$0$0Yes (X)
RICHARD D ERNEST
VICE CHAIRMAN1.000.00$0$0$0Yes (X)
ANGELA D SPRANG MOT OTRL
TRUSTEE1.000.00$0$0$0Yes (X)
DARIN D NYE MD
TRUSTEE1.000.00$0$0$0Yes (X)
DEANNA L BRICKNER
TRUSTEE1.000.00$0$0$0Yes (X)
JEANNE MARIE BOHM MD
TRUSTEE1.000.00$0$0$0Yes (X)
KELSEY L STONER BA LSW
TRUSTEE1.000.00$0$0$0Yes (X)
LIBRA K MARTIN
TRUSTEE1.000.00$0$0$0Yes (X)
LINDA S THIEL-PAPENFUS
TRUSTEE1.000.00$0$0$0Yes (X)
MARSHA L CUSHMAN DO FACEP
TRUSTEE1.000.00$0$0$0Yes (X)
RONALD R CRAIG
TRUSTEE1.000.00$0$0$0Yes (X)
SANSANEE J LONGBRAKE
TRUSTEE1.000.00$0$0$0Yes (X)
TIM A BEIDELSCHIES MD
TRUSTEE1.000.00$0$0$0Yes (X)
TY J OLIVER
TRUSTEE1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$677,152TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$11,101,691TotReportableCompRltdOrgAmt
Total Other Compensation$691,327TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EMERGENCY PHYSICIANS OF NORTHWEST OHIO I
PO BOX 638133CINCINNATIOH452638133STAFFING SERVICE$1,333,751
TOLEDO PAIN SERVICES
7053 W CENTRAL AVETOLEDOOH43617STAFFING SERVICE$437,395
AMN HEALTHCARE INC
12400 HIGH BLUFF DRSAN DIEGOCA92130STAFFING SERVICE$214,923
CGS ADMINISTRATORS LLC
1005 CONVENTION PLAZAST LOUISMO63101BILLING SERVICE$210,555
SPIEKER CO
8350 FREMONT PIKEPERRYSBURGOH43551CONSTRUCTION CONTRACTOR$127,229
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$771,400RelatedOrganizationsAmt
Government Grants$5,153,849GovernmentGrantsAmt
Total Contributions$5,925,249TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
NET PATIENT SERVICES622110$33,456,269$33,456,269
AFFILIATED ORG RENT531120$306,316$306,316
FieldValueIRS element (for citing)
Total Program Service Revenue$33,762,585TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$80,568TotalRevenueColumnAmt
Exclusion$80,568ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$28,068RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$17,984RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$10,084RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,084TotalRevenueColumnAmt
Exclusion$10,084ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RETAIL PHARMACY446110$2,351,807$2,351,807
CAFETERIA722514$81,933$81,933
MISCELLANEOUS RECEIPTS900099$297$297

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,389TotalRevenueColumnAmt
Related Or Exempt Func Income$34,389RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,468,426OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,246,912TotalRevenueColumnAmt
Related Or Exempt Func Income$33,490,955RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,351,807UnrelatedBusinessRevenueAmt
Exclusion$478,901ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$71,041TotalAmt
Program Services$71,041ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,878,135TotalAmt
Program Services$9,027,413ProgramServicesAmt
Management And General$2,850,722ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$389,836TotalAmt
Program Services$251,808ProgramServicesAmt
Management And General$138,028ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,235,656TotalAmt
Program Services$795,140ProgramServicesAmt
Management And General$440,516ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$881,123TotalAmt
Program Services$569,147ProgramServicesAmt
Management And General$311,976ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$77,310TotalAmt
Management And General$77,310ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$133,081TotalAmt
Management And General$133,081ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$3,625TotalAmt
Management And General$3,625ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13,896TotalAmt
Management And General$13,896ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,651,587TotalAmt
Program Services$3,994,255ProgramServicesAmt
Management And General$1,657,332ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$159,693TotalAmt
Program Services$95,413ProgramServicesAmt
Management And General$64,280ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$346,318TotalAmt
Program Services$177,582ProgramServicesAmt
Management And General$168,736ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$45,631TotalAmt
Program Services$37,797ProgramServicesAmt
Management And General$7,834ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$952,314TotalAmt
Program Services$108,824ProgramServicesAmt
Management And General$843,490ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$33,791TotalAmt
Program Services$23,363ProgramServicesAmt
Management And General$10,428ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$335,312TotalAmt
Program Services$213,394ProgramServicesAmt
Management And General$121,918ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,992,890TotalAmt
Program Services$1,112,998ProgramServicesAmt
Management And General$879,892ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$764,568TotalAmt
Program Services$493,860ProgramServicesAmt
Management And General$270,708ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS$4,516,805$4,516,805
MEDICAL SUPPLIES$2,303,869$2,303,869
INTERCOMPANY SERVICES$2,002,536$1,346,429$656,107
PROVIDER TAXES$803,746$803,746

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,003,135TotalAmt
Program Services$789,970ProgramServicesAmt
Management And General$213,165ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$35,595,898TotalAmt
Program Services$25,929,108ProgramServicesAmt
Management And General$9,666,790ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,861,064BOYAmt
EOY$4,220,981EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,718,074BOYAmt
EOY$4,827,149EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$75,000BOYAmt
EOY$75,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$801,078BOYAmt
EOY$716,033EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$167,200BOYAmt
EOY$64,845EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$50,857,838LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$34,197,504LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$17,543,820BOYAmt
EOY$16,660,334EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$42,935,642BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$61,827BOYAmt
EOY$15,481EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,754,764BOYAmt
EOY$3,376,077EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$73,918,469BOYAmt
EOY$29,955,900EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,128,699BOYAmt
EOY$5,576,866EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$59,882BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,261,637BOYAmt
EOY$16,076,601EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,450,218BOYAmt
EOY$21,653,467EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$53,357,944BOYAmt
EOY$5,659,716EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,110,307BOYAmt
EOY$2,642,717EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$56,468,251BOYAmt
EOY$8,302,433EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$73,918,469BOYAmt
EOY$29,955,900EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,651,014ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$30,902NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$54,847,734OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit Performed0FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,625OtherActivitiesAmt
Total Lobbying Expenditures$3,625TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationFOSTORIA HOSPITAL ASSOCIATION PAYS ANNUAL DUES TO THE AMERICAN HOSPOTAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$838,895BeginningYearBalanceAmt
End Year Balance$838,895EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$838,895BeginningYearBalanceAmt
End Year Balance$838,895EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$878,895BeginningYearBalanceAmt
Contributions-$40,000ContributionsAmt
End Year Balance$838,895EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$904,390BeginningYearBalanceAmt
Contributions-$25,495ContributionsAmt
End Year Balance$878,895EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$902,734BeginningYearBalanceAmt
Investment Earnings Or Losses$1,656InvestmentEarningsOrLossesAmt
End Year Balance$904,390EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,676,903OtherCostOrOtherBasisAmt
Book Value$1,676,903BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,298,221OtherCostOrOtherBasisAmt
Depreciation$19,273,039DepreciationAmt
Book Value$9,025,182BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,537,229OtherCostOrOtherBasisAmt
Depreciation$11,487,207DepreciationAmt
Book Value$2,050,022BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,345,485OtherCostOrOtherBasisAmt
Depreciation$3,437,258DepreciationAmt
Book Value$3,908,227BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,660,334TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLES$434,515
OTHER RECEIVABLES$298,844
BENEFICIAL INTEREST IN FOUNDATION$2,642,718
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,376,077TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
DUE TO AFFILIATES$2,549,689
ESTIMATED THIRD PARTY SETTLEMENT$1,195,984
ASSET REMEDIATION OBLIGATION$1,289,516
OPERATING LEASE LIABILITY$112,143
OTHER LIABILITIES$10,742,930
DEFERRED ER FICA - CARES ACT$186,339
FieldValueIRS element (for citing)
Total Liability$16,076,601TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$513,788TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$513,788NetCommunityBenefitExpnsAmt
Total Expense0.01440TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,740,635TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,943,866DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,796,769NetCommunityBenefitExpnsAmt
Total Expense0.07860TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$850TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$888DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,255,273TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,944,754DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,310,557NetCommunityBenefitExpnsAmt
Total Expense0.09300TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$400,153TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$58,799DirectOffsettingRevenueAmt
Net Community Benefit Expns$341,354NetCommunityBenefitExpnsAmt
Total Expense0.00960TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$53,110TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$53,110NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,205TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$14,205NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$467,468TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$58,799DirectOffsettingRevenueAmt
Net Community Benefit Expns$408,669NetCommunityBenefitExpnsAmt
Total Expense0.01150TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,722,741TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,003,553DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,719,226NetCommunityBenefitExpnsAmt
Total Expense0.10450TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,339TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,339NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,839TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,839NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,638,726BadDebtExpenseAmt
Bad Debt Expense Attributable$159,436BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,622,664ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,000,827CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$378,163MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FOSTORIA HOSPITAL ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 VAN BUREN STAddressLine1Txt
CityFOSTORIACityNm
State AbbreviationOHStateAbbreviationCd
ZIP44830ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PROMEDICA.ORGWebsiteAddressTxt
State License1195StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FOSTORIA HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FOSTORIA HOSPITAL ASSOCIATIONPART V, SECTION B, LINE 2: FOSTORIA HOSPITAL ASSOCIATION 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:- MENTAL HEALTH AND ADDICTION- CHRONIC DISEASE HEALTHY EATING- SOCIAL DETERMINANTS OF HEALTH FOOD INSECURITYTHIS 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.FOSTORIA HOSPITAL ASSOCIATION DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN IT'S 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 USEOF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHERCOMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT: HEALTH CARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, QUALITY OF LIFE, ADULT SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS, AND PARENTING, YOUTH: WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH DRUG USE, YOUTH MENTAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, YOUTH VIOLENCE, AND YOUTH PERCEPTIONS.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 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. FOSTORIA HOSPITAL ASSOCIATION DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: MENTAL HEALTH AND ADDICTIONSTRATEGY #1 - UPDATE AND DISTRIBUTE COMMUNITY RESOURCE LISTING OF MENTAL HEALTH AND ADDICTION SERVICES IN THE GREATER FOSTORIA COMMUNITY. PLACING IN HOSPITAL AND EMERGENCY DEPARTMENT WAITING AREAS, AND OTHER COMMUNITY PROGRAMS.ACTIONS TAKEN:- 28 UPDATED COMMUNITY RESOURCE LISTINGS WERE TAKEN BY PATIENTS AND/OR COMMUNITY MEMBERS, FROM FIVE MAJOR WAITING AREAS THROUGHOUT FOSTORIA COMMUNITY HOSPITAL AND TOTAL REHAB FACILITIES. STRATEGY #2 - IMPLEMENT A SOCIAL CALLING PROGRAM FOR PATIENTS SCREENING AT HIGH RISK FOR SOCIAL ISOLATION.ACTIONS TAKEN:- 24 FLYERS WITH SOCIAL CALL AND OTHER SOCIAL CONNECTION INFORMATION WERE TAKEN BY PATIENTS AND/OR COMMUNITY MEMBERS, FROM FIVE MAJOR WAITING AREAS THROUGHOUT FOSTORIA COMMUNITY HOSPITAL FACILITIES.STRATEGY #3 - COLLABORATE WITH COMMUNITY ORGANIZATIONS, INCLUDING SCHOOLS AND THE YMCA, TO DETERMINE NEED FOR YOUTH MENTAL HEALTH PROGRAMMING IN THE COMMUNITY ACTIONS TAKEN:- STAFF ATTENDED AND PARTICIPATED IN ALL SENECA COUNTY HEALTH ALLIANCE (SCHA) MEETINGS.HEALTH NEED IDENTIFIED: CHRONIC DISEASE HEALTHY EATINGSTRATEGY #1 - PROVIDE FREE DIABETES SEMINARS QUARTERLY TO PROVIDE BASICS OF DIABETES MANAGEMENT - TARGET PATIENTS WITH PRE-DIABETES AND GESTATIONAL DIABETES, THROUGH PROMOTION AND PHYSICIAN OFFICES.ACTIONS TAKEN: - RESOURCE DISTRIBUTION OF CDC DIABETES EDUCATION INFORMATION BEGAN IN SEPTEMBER 2020. TWELVE (12) DIABETES EDUCATION FLYERS WERE TAKEN BY PATIENTS AND/OR COMMUNITY MEMBERS FROM FIVE (5) WAITING AREAS THROUGHOUT PROMEDICA FOSTORIA COMMUNITY HOSPITAL AND TOTAL REHAB FACILITY.STRATEGY #2 - SUPPORT COMMUNITY COOKING MATTERS PROGRAM TO TEACH INDIVIDUALS HEALTHY COOKING PER STANDARD CURRICULUM.ACTIONS TAKEN: - "COOKING WITH THE CHEF" INTERACTIVE, VIRTUAL COOKING PROGRAM WAS OFFERED NOVEMBER 2020, WITH 35 PARTICIPANTS RECEIVING MEAL INGREDIENTS PRIOR TO PROGRAM. PRE-DIABETES RISK ASSESSMENTS WERE PROVIDED WITH MEAL KITS THAT PARTICIPANTS PICKED UP AT THE HOSPITAL THE DAY OF THE COOKING DEMO. KITS ALSO INCLUDED ALL OF THE MEAL INGREDIENTS SO THAT THEY COULD COOK ALONG WITH CHEF HANNAH, PROVIDING ENOUGH TO FEED A FAMILY OF FOUR. A DIABETIC EDUCATOR ASSISTED CHEF HANNAH DURING THE COOKING DEMO TO PROVIDE DIABETES EDUCATION AND ANSWER QUESTIONS. THIS EVENT HAD APPROXIMATELY 45 TOTAL PARTICIPANTS ATTENDING ONLINE (10 JOINED THE CLASS WITHOUT SIGNING UP FOR GROCERIES).- TEN (10) COOKING MATTERS MENUS, WITH STEP BY STEP HEALTHY RECIPES, WERE TAKEN BY COMMUNITY MEMBERS FROM LOCAL YMCA AND FOSTORIA LIBRARY; NINE (9) COOKING MATTERS MENUS WERE TAKEN FROM FOSTORIA COMMUNITY HOSPITAL FRONT LOBBY WAITING AREA. HEALTH NEED IDENTIFIED: SOCIAL DETERMINANTS OF HEALTH FOOD INSECURITYSTRATEGY #1 - OUTPATIENT SCREENING AND REFERRALS TO FOOD AGENCIES TO IMPROVE FOOD ACCESS.ACTIONS TAKEN:- 22 COUNTY FOOD AGENCY RESOURCE LISTINGS WERE TAKEN BY PATIENTS AND/OR COMMUNITY MEMBERS FROM FIVE WAITING AREAS AT FOSTORIA COMMUNITY HOSPITAL AND TOTAL REHAB OFFICE.STRATEGY #2 - INPATIENT SCREENING AND PROVISION OF FOOD AND FOOD RESOURCES, AT DISCHARGE FOR PATIENTS SCREENING AT HIGH RISK FOR FOOD INSECURITY.ACTIONS TAKEN:- 28 INPATIENTS WHO SCREENED AT RISK FOR FOOD INSECURITY WERE PROVIDED FOOD AT TIME OF DISCHARGE IN 2020.STRATEGY #3 - PROVIDE FOOD PANTRY FOR HOSPITAL EMPLOYEES IN NEED OF ADDITIONAL FOOD FOR THEIR FAMILIES.ACTIONS TAKEN:- INFORMATION ABOUT THE FOOD PANTRY WAS ADDED TO "NEWS YOU CAN USE" NEWSLETTER FOR HOSPITAL EMPLOYEES AND FLYERS WERE DISPLAYED NEAR TIME CLOCKS TO IMPROVE ACCESS TO FREE FOOD, WHEN NEEDED.
FOSTORIA HOSPITAL ASSOCIATIONPART 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 HEALTH ASSESSMENT SURVEY PROCESS PROMEDICA FOSTORIA COMMUNITY HOSPITAL JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE, DEVELOP AND IMPLEMENT A PRIORITIZED, STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR SENECA COUNTY. A GAP ANALYSIS AND RESOURCE ASSESSMENT WAS COMPILED AS PART OF THIS PROCESS.PROMEDICA FOSTORIA COMMUNITY HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE SENECA COUNTY CHA AND OTHER AVAILABLE HEALTH DATA, SELECT AND PRIORITIZE KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFY RESOURCES AND GAPS IN THESE AREAS, AND DEVELOP IMPLEMENTATION PLANS TO ADDRESS THESE HEALTH ISSUES 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 PLAN FROM THE SENECA COUNTY HEALTH DISTRICT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE. COMMUNITY ORGANIZATIONS WHO PARTICIPATED IN THE HEALTH ASSESSMENT AND STRATEGIC PLANNING PROCESS INCLUDE, BUT ARE NOT LIMITED TO: COMMUNITY HOSPICE CARE, FIRELANDS COUNSELING AND RECOVERY SERVICES, MENTAL HEALTH AND RECOVERY SERVICES BOARD OF SENECA, SANDUSKY AND WYANDOT COUNTIES, MERCY TIFFIN HOSPITAL, SENECA COUNTY FAMILY AND CHILDREN FIRST COUNCIL, SENECA COUNTY GENERAL HEALTH DISTRICT, SENECA COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, SENECA COUNTY JUVENILE AND PROBATE COURT, FIRST CALL FOR HELP, ALLEN EIRY CENTER, TIFFIN CITY SCHOOLS, OSU (OHIO STATE UNIVERSITY) EXTENSION, WSOS (WOOD, SANDUSKY, OTTAWA AND SENECA COMMUNITY ACTION COMMISSION), TIFFIN COMMUNITY YMCA, PK MANAGEMENT, AND THE ADVISER TRIBUNE.
FOSTORIA HOSPITAL ASSOCIATIONPART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
PART V, SECTION B, LINE 7ATHE 2019 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-FOSTORIA-COMMUNITY-HOSPITAL-2019-CHNA-.PDF
PART V, SECTION B, LINE 10ATHE 2020-2020 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-FOSTORIA-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
FieldValueIRS element (for citing)
Facility9FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - PROMEDICA FOSTORIA HOSPITAL DIALYSIS
506 VAN BURENFOSTORIAOH448301533DIALYSIS
2 - PROMEDICA TOTAL REHAB FOSTORIA
455 W 4TH ST 010FOSTORIAOH448301849PHYSICAL THERAPY
3 - NORTHWEST OHIO MEDICAL INST
3101 W US HIGHWAY 224FOSTORIAOH448838305LAB
4 - TOTAL REHAB AT BOWLING GREEN
1180 N MAIN ST STE 1 AND 2BOWLING GREENOH434024932PHYSICAL THERAPY
5 - PROMEDICA LABS - NOW MED INST
3101 W US HIGHWAY 224TIFFINOH448838305LAB
6 - FOSTORIA PAIN CLINIC
501 VAN BUREN STE 206FOSTORIAOH448301593PAIN CLINIC
7 - FOSTORIA FOURTH ST RADIOLOGY
455 W 4TH ST STE 30FOSTORIAOH448301849RADIOLOGY
8 - FOSTORIA PAIN CLINIC
501 VAN BUREN ST STE 206FOSTORIAOH448301593PAIN CLINIC
9 - PROMEDICA HEARING CENTER AT PFCH
501 VAN BUREN STE 202FOSTORIAOH448301593AUDIOLOGY

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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:FOSTORIA HOSPITAL ASSOCIATION REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7:FOSTORIA HOSPITAL ASSOCIATION 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 II, COMMUNITY BUILDING ACTIVITIES:FOSTORIA HOSPITAL ASSOCIATION PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.
PART III, LINE 2:FOSTORIA HOSPITAL ASSOCIATION'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:FOSTORIA HOSPITAL ASSOCIATION 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.FOSTORIA HOSPITAL ASSOCIATION USED THE MEDICARE ALLOWABLE COSTS PER ITS 2020 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:FOSTORIA HOSPITAL ASSOCIATION, LOCATED IN FOSTORIA, OHIO, SERVES AN AREA PRIMARILY IN HANCOCK AND SENECA COUNTIES AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 106,000. APPROXIMATELY, 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 37% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $58,000; 77% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 45% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 55,000 WITH 12% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 22% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 7% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2020 WAS 5%. THE LEADING CAUSES OF DEATH IN SENECA COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, AND ALZHEIMER'S. ACCORDING TO THE 2020 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 33 OF 88 COUNTIES FOR HEALTH OUTCOMES, 20 OF 88 FOR LENGTH OF LIFE, AND 48 OF 88 FOR QUALITY OF LIFE. HANCOCK COUNTY HAS A POPULATION OF APPROXIMATELY 76,000 WITH APPROXIMATELY 9% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 18% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 6% OF HANCOCK COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR HANCOCK COUNTY IN 2020 WAS 4.1%. THE LEADING CAUSES OF DEATH IN HANCOCK COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, ALZHEIMER'S, LUNG DISEASE, STROKE, UNINTENTIONAL INJURIES/ACCIDENTS, AND KIDNEY DISEASE. ACCORDING TO 2020 COUNTY HEALTH RANKINGS, HANCOCK COUNTY RANKED 29 OF 88 COUNTIES FOR HEALTH OUTCOMES, 30 OF 88 FOR LENGTH OF LIFE, AND 32 OF 88 FOR QUALITY OF LIFE. THERE ARE SIX HOSPITALS WITHIN A 30-MILE RADIUS OF FOSTORIA HOSPITAL ASSOCIATION: MERCY HOSPITAL TIFFIN, BLANCHARD VALLEY HOSPITAL, WOOD COUNTY HOSPITAL, MEMORIAL HOSPITAL, BELLEVUE HOSPITAL, AND WYANDOT MEMORIAL HOSPITAL.
PART VI, LINE 5:FOSTORIAL HOSPITAL ASSOCIATION IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2020:- THERE WERE APPROXIMATELY 313 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 MEMBERS INCLUDED 63 PHYSICIANS WITH A BALANCE OF 190 MEN AND 140 WOMEN. - 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 2,300 LUNG CANCER SCREENINGS AT ITS LUNG CLINICS, EXPANDED ITS GENETICS COUNSELING PROGRAM TO INCLUDE VIRTUAL OPTIONS DURING THE PANDEMIC, AND ESTABLISHED A NEW SEXUAL HEALTH PROGRAM FOR CANCER PATIENTS BY HOSTING TWO WEBINARS. ADDITIONALLY, PCI WAS INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT.- APPROXIMATELY 700 ATTENDEES PARTICIPATED IN THE ANNUAL PROMEDICA BARBERSHOP INITIATIVE, ART OF THE CUT, WHICH CELEBRATED THE ROLE OF LOCAL BARBERS AS ARTISTS, MEN'S HEALTH ADVOCATES, AND COMMUNITY LEADERS WHILE EXAMINING THE INTERSECTION OF ART AND WELLNESS. AS PART OF THE BARBERSHOP INITIATIVE, MORE THAN 30 METRO TOLEDO BARBERS RECEIVED TRAINING IN THE USE OF AUTOMATED EXTERNAL DEFIBRILLATORS (AED) AND UNITS WERE INSTALLED IN SIX BLACK-OWNED BARBERSHOPS. ADDITIONALLY, MORE THAN 1,200 HEALTH AND WELLNESS BAGS AND MORE THAN 2,000 CANCER SCREENING EDUCATIONAL MATERIALS WERE PROVIDED TO BARBERSHOPS AND SALONS IN LUCAS AND LENAWEE COUNTIES TO SHARE IMPORTANT HEALTH AND SCREENING INFORMATION WITH TRADITIONALLY UNDERSERVED COMMUNITIES.- PROMEDICA'S FOUNDATIONS RAISED FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. THIS INCLUDED A COVID-19 EMERGENCY EMPLOYEE COMPASSION FUND, WHICH PROVIDED $250 EMERGENCY GRANTS TO EMPLOYEES ACROSS THE COUNTRY WHO FOUND THEMSELVES IN IMMEDIATE FINANCIAL STRAIN DUE TO THE PANDEMIC. NEARLY 10,000 GRANTS WERE GIVEN TO HELP WITH FOOD, HOUSING, CHILDCARE, AND OTHER EXPENSES. THE PROMEDICA FOUNDATION ALSO ESTABLISHED THE PROMEDICA IMPACT FUND TO RAISE $1 BILLION IN THE NEXT EIGHT YEARS TO ACCELERATE NATIONWIDE EFFORTS AROUND THE SOCIAL DETERMINANTS OF HEALTH (SDOH). THESE EFFORTS INCLUDE ADDRESSING HUNGER, AFFORDABLE HOUSING, WORKFORCE DEVELOPMENT, AND EDUCATION.
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 2020 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, APPROXIMATELY 1,200 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,100 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 2020:- 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 1.85 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 50,400 SURGERIES, 6,700 BIRTHS, AND MORE THAN 226,500 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $319,240,000 MILLION.- 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 2020, MORE THAN 8,357 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,860 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 67,535 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 202,605 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA OFFERED VEGGIE MOBILE VOUCHERS TO PATIENTS WHO SCREENED POSITIVE FOR FOOD INSECURITY. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2020, NEARLY 1,848 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 44 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 18 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.

Schedule I IRS990ScheduleI

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Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

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Recipient Business Name RecipientBusinessName

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Business Name Line1PROMEDICA FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1444 N SUMMIT STREETAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd
FieldValueIRS element (for citing)
Recipient EIN341517672RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$71,041CashGrantAmt
Purpose Of GrantOPERATING GRANTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RANDALL OOSTRA
PHS PRES. & CEO$0$1,973,076$0$1,805,059$0$193,503$0$117,599$0$19,387$0$4,108,624$0$0
STEVEN M CAVANAUGH
TREASURER$0$1,330,912$0$710,821$0$6,441$0$82,144$0$22,921$0$2,153,239$0$0
JEFFREY C KUHN
SECRETARY$0$716,660$0$391,346$0$15,405$0$44,915$0$17,242$0$1,185,568$0$0
KEVIN C WEBB PHD
EX OFFICIO$0$663,831$0$370,658$0$14,828$0$31,704$0$19,577$0$1,100,598$0$0
HOLLY L BRISTOLL
FORMER OFFICER$0$331,217$0$183,179$0$8,948$0$21,127$0$25,357$0$569,828$0$0
GARY W AKENBERGER
COO, ACUTE CARE & SVP, DIAG$0$390,451$0$88,180$0$4,793$0$19,393$0$21,883$0$524,700$0$0
ROBIN L WHITNEY
TRUSTEE (PARTIAL YEAR)$0$370,291$0$112,410$0$8,221$0$7,378$0$15,947$0$514,247$0$0
DEANA SIEVERT
SR VP, PAT CARE/CNO, SYSTEM$0$327,015$0$72,423$0$2,943$0$8,160$0$26,956$0$437,497$0$0
PAMELA M JENSEN
PRES., EX OFFICIO$0$314,905$0$72,966$0$3,142$0$11,862$0$21,089$0$423,964$0$0
ALAN M SATTLER
FORMER OFFICER$0$210,691$0$35,926$0$2,863$0$10,110$0$26,156$0$285,746$0$0
ANN M KUJAWA MSN RN OCN
TRUSTEE$0$212,999$0$0$0$1,460$0$8,868$0$25,982$0$249,309$0$0
AMY PREBLE
ASSOCIATE VP CLINICAL$127,700$0$12,916$0$16,693$0$0$0$20,912$0$178,221$0$0$0
LISA SALTZMAN
LEAD PHARMACIST$138,707$0$400$0$0$0$0$0$21,886$0$160,993$0$0$0
DASA A DZIERWA
TRUSTEE$0$135,591$0$11,425$0$7,112$0$2,312$0$747$0$157,187$0$0
DAVID SCHIEFER
MANAGER PHARMACY$135,084$0$400$0$4,613$0$0$0$15,278$0$155,375$0$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ACHARTER TRAVEL: 2 OFFICERS- NOT INCLUDED IN TAXABLE COMPENSATION
PART I, LINE 1BDUE TO EXTENUATING CIRCUMSTANCES RELATED TO THE COVID-19 PANDEMIC THAT LIMITED FLIGHT SCHEDULES AND ABILITY TO TRAVEL, CHARTERED FLIGHT SERVICES WERE UTILIZED WHEN NECESSARY AS THE ONLY FEASIBLE TRAVEL SOLUTION DURING TAX YEAR 2020. THIS WAS NECESSARY IN ORDER TO ENABLE EXECUTIVES TO BE ABLE TO CONTINUE TO CONDUCT BUSINESS WHEN COMMERCIAL FLIGHTS WERE NOT AVAILABLE TO MEET SCHEDULED MEETINGS AND DUE TO SCHEDULE CONSTRAINTS. DURING 2020 THERE WAS NOT A POLICY GOVERNING THIS TYPE OF TRAVEL IN PLACE AS IT WAS NOT FORESEEN IT WOULD BE NECESSARY. CURRENTLY A POLICY IS BEING DRAFTED TO ENSURE PROPER COMPLIANCE AND GOVERNANCE OF THESE EXPENDITURES IN THE FUTURE.
PART I, LINE 3PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF FOSTORIA HOSPITAL ASSOCIATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-BPART 1 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.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NW OHIO ORTHOPEDICS & SPORTS MEDICINE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship With OrgGREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE)RelationshipWithOrgTxt
Loan PurposePHYSICIAN RECRUITMENTLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$125,000OriginalPrincipalAmt
Balance Due$75,000BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$75,000TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NW OHIO ORTHOPEDICS & SPORTS MEDICINE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionGREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE)RelationshipDescriptionTxt
Transaction$202,233TransactionAmt
TransactionORTHOPEDIC CO-MGMTTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE L, PART II, LOANS TO AND/OR FROM INTERESTED PERSONS:(B) RELATIONSHIP WITH ORGANIZATION: GREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE) AND FAMILY MEMBERS.
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: GREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE) AND FAMILY MEMBERS.

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail

FieldValueIRS element (for citing)
Assets Distri Or Expnss PaidPUBLICLY TRADED SECURITIESAssetsDistriOrExpnssPaidDesc
Distribution2020-02-22DistributionDt
Fair Market Value Of Asset$43,035,884FairMarketValueOfAssetAmt
Method Of FMV DeterminationACTUAL VALUEMethodOfFMVDeterminationTxt
EIN344428256EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE TOLEDO HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MADISON AVEAddressLine1Txt
CityTOLEDOCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43604ZIPCd
FieldValueIRS element (for citing)
IRC Section501(C)(3)IRCSectionTxt
FieldValueIRS element (for citing)
Director Of Successor20DirectorOfSuccessor2Ind
Employee Of Successor20EmployeeOfSuccessor2Ind
Owner Of Successor20OwnerOfSuccessor2Ind
Receive Compensation20ReceiveCompensation2Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4:FOSTORIA HOSPITAL ASSOCIATION PROGRAM SERVICE ACCOMPLISHMENTS FOSTORIA HOSPITAL ASSOCIATION (D/B/A PROMEDICA FOSTORIA COMMUNITY 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. ACCREDITED BY THE JOINT COMMISSION, PROMEDICA FOSTORIA COMMUNITY HOSPITAL (FCH) IS A 25-BED, ACUTE CARE HOSPITAL IN NORTHWEST OHIO. THE HOSPITAL CELEBRATED 90 YEARS IN THE COMMUNITY IN 2020. IN ADDITION TO OFFERING EMERGENCY CARE, GENERAL SURGERY, AND INPATIENT CARE, FCH HAS A BROAD RANGE OF OUTPATIENT SERVICES THAT INCLUDE CARDIAC AND PULMONARY REHABILITATION; SPECIAL IMAGING; RADIOLOGY AND LABORATORY SERVICES; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES; AND A DIALYSIS CENTER THAT TREATS PATIENTS LOCALLY WITHOUT HAVING TO TRAVEL OUT OF TOWN. AS A CRITICAL ACCESS HOSPITAL, FCH ALSO PROVIDES HEALTH SERVICES THAT OTHER SIMILARLY SIZED, RURAL HOSPITALS DO NOT, INCLUDING A SLEEP DISORDER UNIT, HEMODIALYSIS, HOME HEALTH CARE, WELLNESS PROGRAMS, PAIN MANAGEMENT, AND A RETAIL PHARMACY. ADDITIONALLY, FCH'S CANCER AND INFUSION CENTER IMPROVES PATIENT ACCESS AND ENSURES A COMFORTABLE SETTING FOR CANCER PATIENTS AND THEIR FAMILIES. IN 2020, FCH RECEIVED ITS FIRST NUCLEAR MEDICINE ACCREDITATION FROM THE AMERICAN COLLEGE OF RADIOLOGY (ACR), REPRESENTING THE HIGHEST LEVEL OF IMAGE QUALITY AND PATIENT SAFETY. A DIABETES EDUCATION PROGRAM IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION IN ACCORDANCE WITH THE NATIONAL STANDARDS AND HELPS PATIENTS LEARN TO MANAGE THEIR CARE AND PREVENT COMPLICATIONS FROM THE CHRONIC DISEASE. THE HOSPITAL ALSO IS A NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) DESIGNATED HOSPITAL, A NATIONAL NURSE-DRIVEN PROGRAM DESIGNED TO HELP HOSPITALS IMPROVE THE CARE OF OLDER ADULTS. FCH ALSO PARTNERS WITH PROMEDICA HOSPICE TO PROVIDE INPATIENT HOSPICE CARE SO THAT PATIENTS WHO ARE TOO ILL TO RETURN HOME OR GO TO AN INPATIENT HOSPICE FACILITY MAY CONTINUE RECEIVING EXPERT, COMPASSIONATE CARE IN THEIR LOCAL HOSPITAL NEAR FRIENDS AND FAMILY. IN 2020, FCH RECEIVED A 5-STAR RATING FROM THE CENTERS FOR MEDICAID AND MEDICARE SERVICES (CMS) FOR PATIENT EXPERIENCE. IN 2020, FCH SERVED 506 INPATIENTS AND 59,400 OUTPATIENTS. ADDITIONALLY, 10,409 INDIVIDUALS SOUGHT EMERGENCY CARE AT FCH. THE HOSPITAL CONTRIBUTED $3,719,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFIT OPERATIONS, FCH CONTRIBUTED $409,000 TO THE COMMUNITY DURING 2020. ACTIVITIES INCLUDED: - A VIRTUAL HEALTHY COOKING CLASS WITH 35 PARTICIPANTS AND NEARLY 600 VIEWS OF THE FACEBOOK LIVE VIDEO. THE COURSE WAS OFFERED TO THE COMMUNITY BASED ON NEEDS IDENTIFIED IN THE FCH COMMUNITY HEALTH NEEDS ASSESSMENT. - DONATIONS OF MORE THAN 30 COATS AND SEVERAL HATS, GLOVES AND SCARVES TO THE FIRST CALL FOR HELP COAT DRIVE, AND GIFT DONATIONS OF TOYS AND OTHER HOLIDAY GOODIES FOR CHILDREN THROUGH CHRISTMAS FOR EVERY CHILD AND TOYS FOR TOTS. - THE 16TH ANNUAL RED DRESS LUNCHEON (A WOMEN'S HEART-HEALTH EDUCATION LUNCHEON IN FEBRUARY) TO BENEFIT THE AMERICAN HEART ASSOCIATION. - INPATIENT SCREENINGS FOR FOOD INSECURITY THAT HELP PROVIDE A SHORT SUPPLY OF FOOD ON DISCHARGE TO HELP COMBAT FOOD INSECURITY. FCH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2020, OF WHICH $514,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE 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. FCH COST OF BAD DEBT FOR 2020 WAS $1,072,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,719,000 NOTED ABOVE. FURTHER, FCH PROVIDED $2,797,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO, IN 2020, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $784,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,719,000 NOTED ABOVE. DURING 2020, FCH PROVIDED 218 JOBS THROUGH DIRECT EMPLOYMENT, EXPENDING $7,019,000 IN NET PAYROLL. A TOTAL OF $429,600 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, FCH 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 ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
FORM 990, PART IV, LINE 24A:FOSTORIA HOSPITAL ASSOCIATION IS A HEALTH FACILITY THAT IS A SUBSIDIARY OF PROMEDICA HEALTH SYSTEM, INC. (PHS). FOSTORIA HOSPITAL ASSOCIATION HOLDS AN INTERCOMPANY NOTE PAYABLE TO THE TOLEDO HOSPITAL, WHICH IS ALSO A SUBSIDIARY OF PHS. THE NOTE PAYABLE REPRESENTS FOSTORIA HOSPITAL ASSOCIATION'S PORTION OF TAXABLE AND TAX-EXEMPT BONDS ISSUED BY PROMEDICA HEALTHCARE OBLIGATED GORUP.
FORM 990, PART VI, SECTION A, LINE 6AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7APROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF FOSTORIA HOSPITAL ASSOCIATION. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF FOSTORIA HOSPITAL ASSOCIATION, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY FOSTORIA HOSPITAL ASSOCIATION.
FORM 990, PART VI, SECTION A, LINE 7BWHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CPROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS 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 PHYSICIANS, 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 PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE 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 PHYSICIAN 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 APPROPRIATE PHYSICIAN 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 PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. 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 15FOSTORIA HOSPITAL ASSOCATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER FEES: PROGRAM SERVICE EXPENSES 1,903,155. MANAGEMENT AND GENERAL EXPENSES 789,675. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,692,830. CONTRACTED PHYSICIANS: PROGRAM SERVICE EXPENSES 1,403,280. MANAGEMENT AND GENERAL EXPENSES 582,261. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,985,541. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 154,849. MANAGEMENT AND GENERAL EXPENSES 64,251. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219,100. LAB HOSPITAL FEES: PROGRAM SERVICE EXPENSES 377,932. MANAGEMENT AND GENERAL EXPENSES 156,815. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 534,747. LAUNDRY FEES: PROGRAM SERVICE EXPENSES 58,124. MANAGEMENT AND GENERAL EXPENSES 24,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 82,241. SERVICE CONTRACTOR FEES: PROGRAM SERVICE EXPENSES 96,915. MANAGEMENT AND GENERAL EXPENSES 40,213. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,128.
FORM 990, PART XI, LINE 9:BENEFICIAL INTEREST IN FOUNDATION -450,420. TRANSFERS BETWEEN RELATED ENTITIES -11,361,430. TRANSFER OF PUBLICLY TRADED SECURITIES TO TOLEDO HOSPITAL -43,035,884.
FORM 990, PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR
FORM 990, PART XII, LINE 3BTHE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
BAY PARK COMMUNITY HOSPITAL
100 MADISON AVETOLEDOOH43604341883132HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
100 MADISON AVETOLEDOOH43604386108110HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTONDEFIANCEOH43512510173779HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)10DEFIANCE HOSPITAL INCYes (1)
DEFIANCE HOSPITAL INC
100 MADISON AVETOLEDOOH43604344446484HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER
100 MADISON AVETOLEDOOH43604382796005HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVEADRIANMI43604382149602HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)12B, IIEMMA L BIXBY MEDICAL CENTERYes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907FOSTORIAOH44830346517634HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)10FOSTORIA HOSPITAL ASSOCIATIONYes (1)
HCR MANORCARE FOUNDATION INC
444 N SUMMIT STTOLEDOOH43604522031975FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
HCR MANORCARE INC
PO BOX 10086 ATTN TAX-5TOLEDOOH43699825373223SKILLED NURSING FACILITIESOH501(C)(3)10PROMEDICA HEALTH SYSTEM INCYes (1)
HEARTLAND HOSPICE MEMORIAL FUND INC
444 N SUMMIT STTOLEDOOH43604270497199FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE STTECUMSEHMI49286383076105HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)12B, IIHERRICK MEMORIAL HOSPITAL INCYes (1)
HERRICK MEMORIAL HOSPITAL INC
100 MADISON AVETOLEDOOH43604383049015HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
KAITLYN'S COTTAGE INC
100 MADISON AVETOLEDOOH43604454781053RESPITE CAREOH501(C)(3)10DEFIANCE HOSPITAL INCYes (1)
LENAWEE LONG TERM CARE
PO BOX 10086 ATTN TAX-5TOLEDOOH43699382879330LONG TERM CAREMI501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF GIG HARBOR WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624719SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF LACEY WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624391SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF LYNNWOOD WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624675SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF SALMON CREEK WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624375SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF SPOKANE WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624687SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MANOR CARE OF TACOMA WA ASSOCIATION
PO BOX 10086 ATTN TAX-5TOLEDOOH43699260624696SKILLED NURSING FACILITYDE501(C)(3)10HCR MANORCARE INCYes (1)
MEMORIAL HOSPITAL
100 MADISON AVETOLEDOOH43604344430849HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
MEMORIAL PROFESSIONAL SERVICES
100 MADISON AVETOLEDOOH43604273763993PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
100 MADISON AVETOLEDOOH43604381984289HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
MONROE COMMUNITY HEALTH SERVICES
PO BOX 10086 ATTN TAX-5TOLEDOOH43699382934134LONG TERM CAREMI501(C)(3)10HCR MANORCARE INCYes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIRMAUMEEOH43537203376102HEALTH INSURANCEOH501(C)(3)10PROMEDICA INSURANCE CORP INC AND SUBSIDIARIESYes (1)
PROMEDICA AT HOME INC
100 MADISON AVETOLEDOOH43604852320857PHYSICIAN SUPPORTMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA CENTRAL PHYSICIANS
100 MADISON AVETOLEDOOH43604341881137PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA CHILDRENS SPECIALISTS
100 MADISON AVETOLEDOOH43604208734161PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
100 MADISON AVETOLEDOOH43604344492440LONG TERM AND HOME HEALTH CAREOH501(C)(3)10PROMEDICA CONTINUUM SERVICESYes (1)
PROMEDICA CONTINUUM SERVICES
100 MADISON AVETOLEDOOH43604341880767PHYSICIAN MANAGEMENT SERVICESOH501(C)(3)12B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA COURIER SERVICES INC
100 MADISON AVETOLEDOOH43604260324790COURIER SERVICEOH501(C)(3)12B, IIPROMEDICA CONTINUUM SERVICESYes (1)
PROMEDICA FOUNDATION
444 N SUMMIT STTOLEDOOH43604341517672FOUNDATIONOH501(C)(3)12B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA GENITO-URINARY SURGEONS
100 MADISON AVETOLEDOOH43604461120436PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVETOLEDOOH43604341517671PARENT COMPANY OF HEALTH SYSTEMOH501(C)(3)12B, II0N/A
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOORBURLINGTONVT05401341931936PROFESSIONAL & GENERAL LIABILITYVT501(C)(3)12B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA MONROE CARDIOLOGY
100 MADISON AVETOLEDOOH43604272920342PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA MONROE PHYSICIANS
100 MADISON AVETOLEDOOH43604461111822PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS
100 MADISON AVETOLEDOOH43604263888045PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA PHYSICIAN GROUP INC
100 MADISON AVETOLEDOOH43604341899439PHYSICIAN HEALTH CARE SERVICESOH501(C)(3)10PROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA PHYSICIANS AT HOME INC
100 MADISON AVETOLEDOOH43604852181349PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
PROMEDICA PRIMARY CARE PROVIDERS
100 MADISON AVETOLEDOOH43604831731861PHYSICIAN HEALTH CARE SERVICESMI501(C)(3)10PROMEDICA PHYSICIAN GROUP INCYes (1)
THE HUG FUND
444 N SUMMIT STTOLEDOOH43604202272848FOUNDATIONOH501(C)(3)12B, IIPROMEDICA FOUNDATIONYes (1)
THE TOLEDO HOSPITAL
100 MADISON AVETOLEDOOH43604344428256HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
100 MADISON AVETOLEDOOH43604341831624HOSPICE HOME CAREOH501(C)(3)10HCR MANORCARE INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)

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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TRADRIANMI49221383146907FACILITY LEASINGMIN/AC0
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVEADRIANMI49221383639616FACILITY MANAGEMENTMIN/AC0
MONROE HEALTH VENTURES INC
718 N MACOMBMONROEMI48164382704426PHARMACYMIN/AC0
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
100 MADISON AVETOLEDOOH43604383322278PHYSICIAN HEALTH CARE SERVICESOHN/AC0
PROMEDICA HEALTH NETWORK INC
100 MADISON AVETOLEDOOH43604474006496PHYSICIAN MANAGEMENT SERVICESOHN/AC0
PROMEDICA INNOVATIONS LLC
100 MADISON AVETOLEDOOH43604301221601INVESTMENT COMPANYOHN/AC0
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIRMAUMEEOH43537341570675HEALTH CARE INSURANCEOHN/AC0
PROMEDICA MANAGER MEMBER LLC
100 MADISON AVETOLEDOOH43604475168737REAL ESTATEOHN/AC0
PROMEDICA NORTH PHYSICIAN CORPORATION
100 MADISON AVETOLEDOOH43604383482148PHYSICIAN HEALTH CARE SERVICESOHN/AC0
PROMEDICA RETAIL GROUP INC
3890 MONROE STTOLEDOOH43606341159928FLORISTOHN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd