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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-12T15:07:41-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340898745 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOSTORIA HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOST | BusinessNameControlTxt |
| Phone | 4192525722 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE ATTN TAX DEPARTM | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN M CAVANAUGH | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 4192525722 | PhoneNum |
| Signature | 2021-11-11 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEVEN | PersonFirstNm |
| Person Last | CAVANAUGH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROMEDICA FOSTORIA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN M CAVANAUGH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,264,896 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROMEDICA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1930 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | FOSTORIA HOSPITAL ASSOCIATION IS AN ACUTE CARE HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO ALL. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 218 | TotalEmployeeCnt |
| Total Volunteers | 51 | TotalVolunteersCnt |
| Total Gross UBI | $2,351,807 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $22,953 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,925,249 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,094,956 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,762,585 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,781,735 | PYInvestmentIncomeAmt |
| CY Investment Income | $80,568 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,781,757 | PYOtherRevenueAmt |
| CY Other Revenue | $2,478,510 | CYOtherRevenueAmt |
| PY Total Revenue | $39,681,401 | PYTotalRevenueAmt |
| CY Total Revenue | $42,246,912 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $90,205 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $71,041 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,356,935 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,384,750 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,066,277 | PYOtherExpensesAmt |
| CY Other Expenses | $21,140,107 | CYOtherExpensesAmt |
| PY Total Expenses | $34,513,417 | PYTotalExpensesAmt |
| CY Total Expenses | $35,595,898 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,167,984 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,651,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $73,918,469 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,955,900 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,450,218 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,653,467 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $56,468,251 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,302,433 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | FOSTORIA HOSPITAL ASSOCIATION WILL PROVIDE QUALITY, COST-EFFECTIVE HEALTHCARE TO FOSTORIA AND ITS SURROUNDING COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,929,108 | ExpenseAmt |
| Grant | $71,041 | GrantAmt |
| Revenue | $33,490,955 | RevenueAmt |
| Desc | FOSTORIA HOSPITAL ASSOCIATION IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE GENERAL PUBLIC. | Desc |
| Total Program Service Expenses | $25,929,108 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 33 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 218 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT SHARON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5675855652 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| RANDALL OOSTRA | ||||||||||
| PHS PRES. & CEO | 1.00 | 55.00 | Yes (X) | $0 | $3,971,638 | $136,986 | ||||
| STEVEN M CAVANAUGH | ||||||||||
| TREASURER | 1.00 | 55.00 | Yes (X) | $0 | $2,048,174 | $105,065 | ||||
| JEFFREY C KUHN | ||||||||||
| SECRETARY | 1.00 | 55.00 | Yes (X) | $0 | $1,123,411 | $62,157 | ||||
| KEVIN C WEBB PHD | ||||||||||
| EX OFFICIO | 1.00 | 42.00 | $0 | $1,049,317 | $51,281 | Yes (X) | ||||
| HOLLY L BRISTOLL | ||||||||||
| FORMER OFFICER | 0.00 | 41.00 | $0 | $523,344 | $46,484 | Yes (X) | ||||
| GARY W AKENBERGER | ||||||||||
| COO, ACUTE CARE & SVP, DIAG | 0.00 | 40.00 | $0 | $483,424 | $41,276 | Yes (X) | ||||
| ROBIN L WHITNEY | ||||||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | 40.00 | $0 | $490,922 | $23,325 | Yes (X) | ||||
| DEANA SIEVERT | ||||||||||
| SR VP, PAT CARE/CNO, SYSTEM | 0.00 | 40.00 | $0 | $402,381 | $35,116 | Yes (X) | ||||
| PAMELA M JENSEN | ||||||||||
| PRES., EX OFFICIO | 1.00 | 42.00 | Yes (X) | $0 | $391,013 | $32,951 | Yes (X) | |||
| ALAN M SATTLER | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $249,480 | $36,266 | Yes (X) | ||||
| ANN M KUJAWA MSN RN OCN | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $214,459 | $34,850 | Yes (X) | ||||
| AMY PREBLE | ||||||||||
| ASSOCIATE VP CLINICAL | 40.00 | 0.00 | $157,309 | $0 | $20,912 | Yes (X) | ||||
| LISA SALTZMAN | ||||||||||
| LEAD PHARMACIST | 40.00 | 0.00 | $139,107 | $0 | $21,886 | Yes (X) | ||||
| DASA A DZIERWA | ||||||||||
| TRUSTEE | 1.00 | 42.00 | $0 | $154,128 | $3,059 | Yes (X) | ||||
| DAVID SCHIEFER | ||||||||||
| MANAGER PHARMACY | 40.00 | 0.00 | $140,097 | $0 | $15,278 | Yes (X) | ||||
| SCOTT BEIDELSCHIES | ||||||||||
| PHARMACIST | 40.00 | 0.00 | $129,545 | $0 | $13,006 | Yes (X) | ||||
| AMY BOWSER | ||||||||||
| FCH DIALYSIS STAFF RN | 40.00 | 0.00 | $111,094 | $0 | $11,429 | Yes (X) | ||||
| ANGELA M SHEETS | ||||||||||
| CHAIRMAN | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| RICHARD D ERNEST | ||||||||||
| VICE CHAIRMAN | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| ANGELA D SPRANG MOT OTRL | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| DARIN D NYE MD | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| DEANNA L BRICKNER | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| JEANNE MARIE BOHM MD | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| KELSEY L STONER BA LSW | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| LIBRA K MARTIN | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| LINDA S THIEL-PAPENFUS | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| MARSHA L CUSHMAN DO FACEP | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| RONALD R CRAIG | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| SANSANEE J LONGBRAKE | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| TIM A BEIDELSCHIES MD | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| TY J OLIVER | ||||||||||
| TRUSTEE | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $677,152 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $11,101,691 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $691,327 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMERGENCY PHYSICIANS OF NORTHWEST OHIO I | |||||
| PO BOX 638133 | CINCINNATI | OH | 452638133 | STAFFING SERVICE | $1,333,751 |
| TOLEDO PAIN SERVICES | |||||
| 7053 W CENTRAL AVE | TOLEDO | OH | 43617 | STAFFING SERVICE | $437,395 |
| AMN HEALTHCARE INC | |||||
| 12400 HIGH BLUFF DR | SAN DIEGO | CA | 92130 | STAFFING SERVICE | $214,923 |
| CGS ADMINISTRATORS LLC | |||||
| 1005 CONVENTION PLAZA | ST LOUIS | MO | 63101 | BILLING SERVICE | $210,555 |
| SPIEKER CO | |||||
| 8350 FREMONT PIKE | PERRYSBURG | OH | 43551 | CONSTRUCTION CONTRACTOR | $127,229 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $771,400 | RelatedOrganizationsAmt |
| Government Grants | $5,153,849 | GovernmentGrantsAmt |
| Total Contributions | $5,925,249 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES | 622110 | $33,456,269 | $33,456,269 | |
| AFFILIATED ORG RENT | 531120 | $306,316 | $306,316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,762,585 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,568 | TotalRevenueColumnAmt |
| Exclusion | $80,568 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,068 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,984 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,084 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,084 | TotalRevenueColumnAmt |
| Exclusion | $10,084 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| RETAIL PHARMACY | 446110 | $2,351,807 | $2,351,807 | ||
| CAFETERIA | 722514 | $81,933 | $81,933 | ||
| MISCELLANEOUS RECEIPTS | 900099 | $297 | $297 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,389 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,468,426 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,246,912 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,490,955 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,351,807 | UnrelatedBusinessRevenueAmt |
| Exclusion | $478,901 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,041 | TotalAmt |
| Program Services | $71,041 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,878,135 | TotalAmt |
| Program Services | $9,027,413 | ProgramServicesAmt |
| Management And General | $2,850,722 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,836 | TotalAmt |
| Program Services | $251,808 | ProgramServicesAmt |
| Management And General | $138,028 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,235,656 | TotalAmt |
| Program Services | $795,140 | ProgramServicesAmt |
| Management And General | $440,516 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $881,123 | TotalAmt |
| Program Services | $569,147 | ProgramServicesAmt |
| Management And General | $311,976 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,310 | TotalAmt |
| Management And General | $77,310 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,081 | TotalAmt |
| Management And General | $133,081 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,625 | TotalAmt |
| Management And General | $3,625 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,896 | TotalAmt |
| Management And General | $13,896 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,651,587 | TotalAmt |
| Program Services | $3,994,255 | ProgramServicesAmt |
| Management And General | $1,657,332 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,693 | TotalAmt |
| Program Services | $95,413 | ProgramServicesAmt |
| Management And General | $64,280 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,318 | TotalAmt |
| Program Services | $177,582 | ProgramServicesAmt |
| Management And General | $168,736 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,631 | TotalAmt |
| Program Services | $37,797 | ProgramServicesAmt |
| Management And General | $7,834 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $952,314 | TotalAmt |
| Program Services | $108,824 | ProgramServicesAmt |
| Management And General | $843,490 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,791 | TotalAmt |
| Program Services | $23,363 | ProgramServicesAmt |
| Management And General | $10,428 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,312 | TotalAmt |
| Program Services | $213,394 | ProgramServicesAmt |
| Management And General | $121,918 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,992,890 | TotalAmt |
| Program Services | $1,112,998 | ProgramServicesAmt |
| Management And General | $879,892 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $764,568 | TotalAmt |
| Program Services | $493,860 | ProgramServicesAmt |
| Management And General | $270,708 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,003,135 | TotalAmt |
| Program Services | $789,970 | ProgramServicesAmt |
| Management And General | $213,165 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,595,898 | TotalAmt |
| Program Services | $25,929,108 | ProgramServicesAmt |
| Management And General | $9,666,790 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,861,064 | BOYAmt |
| EOY | $4,220,981 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,718,074 | BOYAmt |
| EOY | $4,827,149 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,000 | BOYAmt |
| EOY | $75,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,078 | BOYAmt |
| EOY | $716,033 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,200 | BOYAmt |
| EOY | $64,845 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,857,838 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $34,197,504 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,543,820 | BOYAmt |
| EOY | $16,660,334 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,935,642 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,827 | BOYAmt |
| EOY | $15,481 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,754,764 | BOYAmt |
| EOY | $3,376,077 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,918,469 | BOYAmt |
| EOY | $29,955,900 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,128,699 | BOYAmt |
| EOY | $5,576,866 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,882 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,261,637 | BOYAmt |
| EOY | $16,076,601 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,450,218 | BOYAmt |
| EOY | $21,653,467 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,357,944 | BOYAmt |
| EOY | $5,659,716 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,110,307 | BOYAmt |
| EOY | $2,642,717 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,468,251 | BOYAmt |
| EOY | $8,302,433 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,918,469 | BOYAmt |
| EOY | $29,955,900 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,651,014 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $30,902 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$54,847,734 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,625 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,625 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FOSTORIA 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $838,895 | BeginningYearBalanceAmt |
| End Year Balance | $838,895 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $838,895 | BeginningYearBalanceAmt |
| End Year Balance | $838,895 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $878,895 | BeginningYearBalanceAmt |
| Contributions | -$40,000 | ContributionsAmt |
| End Year Balance | $838,895 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $904,390 | BeginningYearBalanceAmt |
| Contributions | -$25,495 | ContributionsAmt |
| End Year Balance | $878,895 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $902,734 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,656 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $904,390 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,676,903 | OtherCostOrOtherBasisAmt |
| Book Value | $1,676,903 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,298,221 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,273,039 | DepreciationAmt |
| Book Value | $9,025,182 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,537,229 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,487,207 | DepreciationAmt |
| Book Value | $2,050,022 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,345,485 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,437,258 | DepreciationAmt |
| Book Value | $3,908,227 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,660,334 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY RECEIVABLES | $434,515 |
| OTHER RECEIVABLES | $298,844 |
| BENEFICIAL INTEREST IN FOUNDATION | $2,642,718 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,376,077 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,076,601 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT FOSTORIA HOSPITAL ASSOCATION CONSISTENT WITH DONOR INTENT. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $513,788 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $513,788 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,740,635 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,943,866 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,796,769 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07860 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $850 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $888 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,255,273 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,944,754 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,310,557 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $400,153 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $58,799 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $341,354 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00960 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,110 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $53,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,205 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,205 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $467,468 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $58,799 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $408,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,722,741 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,003,553 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,719,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10450 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,339 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,839 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,839 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,638,726 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $159,436 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,622,664 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,000,827 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$378,163 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOSTORIA HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 VAN BUREN ST | AddressLine1Txt |
| City | FOSTORIA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PROMEDICA.ORG | WebsiteAddressTxt |
| State License | 1195 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOSTORIA HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FOSTORIA HOSPITAL ASSOCIATION | PART 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 ASSOCIATION | PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY 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 ASSOCIATION | PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO |
| PART V, SECTION B, LINE 7A | THE 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 10A | THE 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - PROMEDICA FOSTORIA HOSPITAL DIALYSIS | ||||
| 506 VAN BUREN | FOSTORIA | OH | 448301533 | DIALYSIS |
| 2 - PROMEDICA TOTAL REHAB FOSTORIA | ||||
| 455 W 4TH ST 010 | FOSTORIA | OH | 448301849 | PHYSICAL THERAPY |
| 3 - NORTHWEST OHIO MEDICAL INST | ||||
| 3101 W US HIGHWAY 224 | FOSTORIA | OH | 448838305 | LAB |
| 4 - TOTAL REHAB AT BOWLING GREEN | ||||
| 1180 N MAIN ST STE 1 AND 2 | BOWLING GREEN | OH | 434024932 | PHYSICAL THERAPY |
| 5 - PROMEDICA LABS - NOW MED INST | ||||
| 3101 W US HIGHWAY 224 | TIFFIN | OH | 448838305 | LAB |
| 6 - FOSTORIA PAIN CLINIC | ||||
| 501 VAN BUREN STE 206 | FOSTORIA | OH | 448301593 | PAIN CLINIC |
| 7 - FOSTORIA FOURTH ST RADIOLOGY | ||||
| 455 W 4TH ST STE 30 | FOSTORIA | OH | 448301849 | RADIOLOGY |
| 8 - FOSTORIA PAIN CLINIC | ||||
| 501 VAN BUREN ST STE 206 | FOSTORIA | OH | 448301593 | PAIN CLINIC |
| 9 - PROMEDICA HEARING CENTER AT PFCH | ||||
| 501 VAN BUREN STE 202 | FOSTORIA | OH | 448301593 | AUDIOLOGY |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROMEDICA FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 444 N SUMMIT STREET | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 341517672 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $71,041 | CashGrantAmt |
| Purpose Of Grant | OPERATING GRANT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CHARTER TRAVEL: 2 OFFICERS- NOT INCLUDED IN TAXABLE COMPENSATION |
| PART I, LINE 1B | DUE 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 3 | PROMEDICA 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-B | PART 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NW OHIO ORTHOPEDICS & SPORTS MEDICINE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | GREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE) | RelationshipWithOrgTxt |
| Loan Purpose | PHYSICIAN RECRUITMENT | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $125,000 | OriginalPrincipalAmt |
| Balance Due | $75,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $75,000 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NW OHIO ORTHOPEDICS & SPORTS MEDICINE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | GREATER THAN 35% CONTROLLED ENTITY BY BRUCE E. HECK, MD (FORMER TRUSTEE) | RelationshipDescriptionTxt |
| Transaction | $202,233 | TransactionAmt |
| Transaction | ORTHOPEDIC CO-MGMT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | PUBLICLY TRADED SECURITIES | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2020-02-22 | DistributionDt |
| Fair Market Value Of Asset | $43,035,884 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | ACTUAL VALUE | MethodOfFMVDeterminationTxt |
| EIN | 344428256 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE TOLEDO HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 6 | AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF 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 7B | WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED 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 15 | FOSTORIA 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 19 | PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER 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 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR |
| FORM 990, PART XII, LINE 3B | THE 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/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BAY PARK COMMUNITY HOSPITAL | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341883132 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| COMMUNITY HEALTH CENTER OF BRANCH COUNTY | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 386108110 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| DEFIANCE HOSPITAL AUXILIARY | |||||||||||
| 1200 RALSTON | DEFIANCE | OH | 43512 | 510173779 | HOSPITAL / FOUNDATION SUPPORT | OH | 501(C)(3) | 10 | DEFIANCE HOSPITAL INC | Yes (1) | |
| DEFIANCE HOSPITAL INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 344446484 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| EMMA L BIXBY MEDICAL CENTER | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 382796005 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| EMMA L BIXBY MEDICAL CENTER AUXILIARY | |||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 43604 | 382149602 | HOSPITAL / FOUNDATION SUPPORT | MI | 501(C)(3) | 12B, II | EMMA L BIXBY MEDICAL CENTER | Yes (1) | |
| FOSTORIA HOSPITAL AUXILIARY | |||||||||||
| PO BOX 907 | FOSTORIA | OH | 44830 | 346517634 | HOSPITAL / FOUNDATION SUPPORT | OH | 501(C)(3) | 10 | FOSTORIA HOSPITAL ASSOCIATION | Yes (1) | |
| HCR MANORCARE FOUNDATION INC | |||||||||||
| 444 N SUMMIT ST | TOLEDO | OH | 43604 | 522031975 | FOUNDATION | OH | 501(C)(3) | 12B, II | PROMEDICA FOUNDATION | Yes (1) | |
| HCR MANORCARE INC | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 825373223 | SKILLED NURSING FACILITIES | OH | 501(C)(3) | 10 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| HEARTLAND HOSPICE MEMORIAL FUND INC | |||||||||||
| 444 N SUMMIT ST | TOLEDO | OH | 43604 | 270497199 | FOUNDATION | OH | 501(C)(3) | 12B, II | PROMEDICA FOUNDATION | Yes (1) | |
| HERRICK MEDICAL CENTER AUXILIARY | |||||||||||
| 500 E POTTAWATAMIE ST | TECUMSEH | MI | 49286 | 383076105 | HOSPITAL / FOUNDATION SUPPORT | MI | 501(C)(3) | 12B, II | HERRICK MEMORIAL HOSPITAL INC | Yes (1) | |
| HERRICK MEMORIAL HOSPITAL INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 383049015 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| KAITLYN'S COTTAGE INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 454781053 | RESPITE CARE | OH | 501(C)(3) | 10 | DEFIANCE HOSPITAL INC | Yes (1) | |
| LENAWEE LONG TERM CARE | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 382879330 | LONG TERM CARE | MI | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF GIG HARBOR WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624719 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF LACEY WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624391 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF LYNNWOOD WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624675 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF SALMON CREEK WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624375 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF SPOKANE WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624687 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MANOR CARE OF TACOMA WA ASSOCIATION | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 260624696 | SKILLED NURSING FACILITY | DE | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| MEMORIAL HOSPITAL | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 344430849 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| MEMORIAL PROFESSIONAL SERVICES | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 273763993 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| MERCY MEMORIAL HOSPITAL CORPORATION | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 381984289 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| MONROE COMMUNITY HEALTH SERVICES | |||||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43699 | 382934134 | LONG TERM CARE | MI | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
| PARAMOUNT ADVANTAGE | |||||||||||
| 1901 INDIAN WOOD CIR | MAUMEE | OH | 43537 | 203376102 | HEALTH INSURANCE | OH | 501(C)(3) | 10 | PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES | Yes (1) | |
| PROMEDICA AT HOME INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 852320857 | PHYSICIAN SUPPORT | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA CENTRAL PHYSICIANS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341881137 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA CHILDRENS SPECIALISTS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 208734161 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA CONTINUING CARE SERVICES CORP | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 344492440 | LONG TERM AND HOME HEALTH CARE | OH | 501(C)(3) | 10 | PROMEDICA CONTINUUM SERVICES | Yes (1) | |
| PROMEDICA CONTINUUM SERVICES | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341880767 | PHYSICIAN MANAGEMENT SERVICES | OH | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA COURIER SERVICES INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 260324790 | COURIER SERVICE | OH | 501(C)(3) | 12B, II | PROMEDICA CONTINUUM SERVICES | Yes (1) | |
| PROMEDICA FOUNDATION | |||||||||||
| 444 N SUMMIT ST | TOLEDO | OH | 43604 | 341517672 | FOUNDATION | OH | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA GENITO-URINARY SURGEONS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461120436 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA HEALTH SYSTEM INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341517671 | PARENT COMPANY OF HEALTH SYSTEM | OH | 501(C)(3) | 12B, II | 0 | N/A | |
| PROMEDICA INDEMNITY CORP | |||||||||||
| ONE CHURCH ST 5TH FLOOR | BURLINGTON | VT | 05401 | 341931936 | PROFESSIONAL & GENERAL LIABILITY | VT | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA MONROE CARDIOLOGY | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 272920342 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA MONROE PHYSICIANS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461111822 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 263888045 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA PHYSICIAN GROUP INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341899439 | PHYSICIAN HEALTH CARE SERVICES | OH | 501(C)(3) | 10 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA PHYSICIANS AT HOME INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 852181349 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| PROMEDICA PRIMARY CARE PROVIDERS | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 831731861 | PHYSICIAN HEALTH CARE SERVICES | MI | 501(C)(3) | 10 | PROMEDICA PHYSICIAN GROUP INC | Yes (1) | |
| THE HUG FUND | |||||||||||
| 444 N SUMMIT ST | TOLEDO | OH | 43604 | 202272848 | FOUNDATION | OH | 501(C)(3) | 12B, II | PROMEDICA FOUNDATION | Yes (1) | |
| THE TOLEDO HOSPITAL | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 344428256 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| VISITING NURSE HOSPICE AND HEALTH CARE | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341831624 | HOSPICE HOME CARE | OH | 501(C)(3) | 10 | HCR MANORCARE INC | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| EAST-WEST HOLDINGS LTD | |||||||||
| 715 SOUTH TAFT AVE | FREMONT | OH | 43420 | 204066818 | REAL ESTATE | OH | N/A | 0 | 0 |
| MERCYMANOR PARTNERSHIP | |||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43604 | 521931012 | SKILLED NURSING | PA | N/A | 0 | Yes (1) |
| NORMAN SPECIALTY HOSPITAL LLC | |||||||||
| PO BOX 10086 ATTN TAX-5 | TOLEDO | OH | 43604 | 421627672 | HEALTH CARE | DE | N/A | 0 | Yes (1) |
| NORTHWEST OHIO DEDICATED BREAST MRI LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 260679898 | MEDICAL DIAGNOSTICS | OH | N/A | 0 | 0 |
| PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 473163945 | REAL ESTATE | OH | N/A | 0 | Yes (1) |
| PROMEDICA MASTER TENANT LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 475288490 | REAL ESTATE | OH | N/A | 0 | Yes (1) |
| PROMEDICA PATHOLOGY LABORATORIES LLC | |||||||||
| 2130 W CENTRAL AVE STE 300 | TOLEDO | OH | 43606 | 831022842 | CLINICAL LABORATORY | DE | N/A | 0 | 0 |
| PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461989695 | PHYSICIAN MANAGEMENT SERVICES | OH | N/A | 0 | 0 |
| REYNOLDS ROAD SURGICAL CENTER LTD | |||||||||
| 2865 N REYNOLDS RD | TOLEDO | OH | 43615 | 311569454 | FREESTANDING AMBULATORY SURGICAL CENTER | OH | N/A | 0 | 0 |
| ROCKET VENTURE FUND II LLC | |||||||||
| 2865 N REYNOLDS RD STE 220 | TOLEDO | OH | 43615 | 475603627 | INVESTMENT FUND | OH | N/A | 0 | 0 |
| SENIOR & REHAB CARE AT METROHEALTH LLC | |||||||||
| 100 MADISON AVE ATTN TAX DEPT | TOLEDO | OH | 43604 | 872465544 | SKILLED NURSING | OH | N/A | 0 | Yes (1) |
| THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC | |||||||||
| 1051 S TELEGRAPH RD | MONROE | MI | 48161 | 270843485 | AMBULATORY SURGICAL CENTER | MI | N/A | 0 | 0 |
| WEST CENTRAL SURGICAL CENTER LLC | |||||||||
| 7055 W CENTRAL | TOLEDO | OH | 43617 | 200088459 | AMBULATORY SURGICAL CENTER | OH | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HERRICK MEMORIAL DEVELOPMENT CORP | |||||||||
| 500 E POTTAWATAMIE TR | ADRIAN | MI | 49221 | 383146907 | FACILITY LEASING | MI | N/A | C | 0 |
| HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION | |||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 383639616 | FACILITY MANAGEMENT | MI | N/A | C | 0 |
| MONROE HEALTH VENTURES INC | |||||||||
| 718 N MACOMB | MONROE | MI | 48164 | 382704426 | PHARMACY | MI | N/A | C | 0 |
| PROMEDICA CENTRAL CORPORATION OF MICHIGAN | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 383322278 | PHYSICIAN HEALTH CARE SERVICES | OH | N/A | C | 0 |
| PROMEDICA HEALTH NETWORK INC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 474006496 | PHYSICIAN MANAGEMENT SERVICES | OH | N/A | C | 0 |
| PROMEDICA INNOVATIONS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 301221601 | INVESTMENT COMPANY | OH | N/A | C | 0 |
| PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES | |||||||||
| 1901 INDIAN WOOD CIR | MAUMEE | OH | 43537 | 341570675 | HEALTH CARE INSURANCE | OH | N/A | C | 0 |
| PROMEDICA MANAGER MEMBER LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 475168737 | REAL ESTATE | OH | N/A | C | 0 |
| PROMEDICA NORTH PHYSICIAN CORPORATION | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 383482148 | PHYSICIAN HEALTH CARE SERVICES | OH | N/A | C | 0 |
| PROMEDICA RETAIL GROUP INC | |||||||||
| 3890 MONROE ST | TOLEDO | OH | 43606 | 341159928 | FLORIST | OH | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |