OHIOHEALTH CORPORATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- OHIOHEALTH CORPORATION (EIN 34-4429514)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202113199349327606
- 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 J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T17:20:20-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 312 WALNUT STREET SUITE 3000 | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344429514 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VAN WERT COUNTY HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % EDGAR SILALAHI | InCareOfNm |
| Business Name Control | VANW | BusinessNameControlTxt |
| Phone | 4192388609 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDGAR SILALAHI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4192388870 | PhoneNum |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | EDGAR | PersonFirstNm |
| Person Last | SILALAHI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aaron Hershberger | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 5136218300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| 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 | VAN WERT HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MIKE KEYSOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $74,072,881 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.VANWERTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO BE THE BEST COMMUNITY HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 571 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $247,796 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,922,107 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,088,136 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,594,578 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,886,872 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,925,071 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,126,926 | PYOtherRevenueAmt |
| CY Other Revenue | $914,572 | CYOtherRevenueAmt |
| PY Total Revenue | $54,349,730 | PYTotalRevenueAmt |
| CY Total Revenue | $73,356,328 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,039,132 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $35,260,718 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,612,277 | PYOtherExpensesAmt |
| CY Other Expenses | $38,754,535 | CYOtherExpensesAmt |
| PY Total Expenses | $63,651,409 | PYTotalExpensesAmt |
| CY Total Expenses | $74,015,253 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,301,679 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$658,925 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $86,992,419 | TotalAssetsBOYAmt |
| Total Assets EOY | $132,778,077 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,139,521 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $71,548,731 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $64,852,898 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $61,229,346 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MISSION: TO BE THE BEST COMMUNITY HOSPITAL. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTHCARE WITHIN OUR REGION. WE STRIVE TO PROVIDE A CONTINUUM OF HEALTH CARE SERVICES IN INPATIENT AND AMBULATORY SETTINGS AND MAINTAIN OR EXTEND ALL NECESSARY ELEMENTS OF CARE TO ADDRESS THE NEEDS OF EVERY PATIENT IN A COMPASSIONATE MANNER. VAN WERT HEALTH WILL MEET THE COMMUNITY HEALTH CARE NEEDS BY CONTINUALLY ENDEAVORING TO IMPROVE THE QUALITY OF PATIENT CARE WE PROVIDE WITHIN OUR RESOURCE CAPABILITIES. PROGRAMS AND SERVICES SPONSORED BY VAN WERT HEALTH WILL SERVE AS AN ACCESS POINT TO HEALTH CARE WITHIN OUR COMMUNITY. WE ACCEPT RESPONSIBILITY FOR PROVIDING COMMUNITY LEADERSHIP. VAN WERT HEALTH ASSURES THAT HEALTH CARE SERVICES PROVIDED ARE AVAILABLE TO ALL MEMEBER OF THE COMMUNITIES WE SERVE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR ABILITY TO PAY, WHILE AT THE SAME TIME RESPECTING BOTH RIGHTS AND RESPONSIBILITIES OF OUR PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $63,665,683 | ExpenseAmt |
| Revenue | $56,939,993 | RevenueAmt |
| Desc | INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES | Desc |
| Total Program Service Expenses | $63,665,683 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 571 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 571 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDGAR SILALAHI | PersonNm |
| Phone | 4192388870 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| DR NIZAR ORFAHLI | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $547,903 | $0 | $45,763 | ||
| THOMAS CONTE | ||||||||
| CHIEF OF STAFF | 40.0 | 2.0 | $297,227 | $0 | $266,829 | Yes (X) | Yes (X) | |
| DR SCOTT SHIE | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $509,684 | $0 | $49,873 | ||
| DR JEREMY STOLLER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $500,050 | $0 | $50,284 | ||
| DR NIK KIEHL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $508,962 | $0 | $25,171 | ||
| JAMES POPE | ||||||||
| CEO | 40.0 | 2.0 | $465,136 | $0 | $68,263 | Yes (X) | Yes (X) | |
| DR CHARLES HOEHN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $388,012 | $0 | $52,083 | ||
| KAREN SHADOWENS | ||||||||
| CFO | 40.0 | 0.0 | $318,514 | $0 | $52,861 | Yes (X) | ||
| BARB KHONEN | ||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| TIM JURCZYK | ||||||||
| PAST CHAIRPERSON | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| MIKE KEYSOR | ||||||||
| CHAIRPERSON | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| AARON BAKER | ||||||||
| SECRETARY | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| TODD WOLFRUM | ||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| TOM TURNWALD | ||||||||
| VICE CHAIRPERSON | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| ERIC JELINGER | ||||||||
| TRUSTEE | 40.0 | 2.0 | $0 | $0 | $0 | Yes (X) | ||
| ADAM HOUG | ||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| JEFFREY SNYDER | ||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| BEN FAUROTE | ||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,535,488 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $611,127 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 45 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THERAPY SOLUTIONS LLC | |||||
| 120 WEST MAIN STREET | VAN WERT | OH | 45891 | REHABILITATION | $2,058,700 |
| ALTHEON HEALTH | |||||
| 12420 MILESTONE CENTER DRIVE | GERMANTOWN | MD | 20876 | ED PHYSICIANS | $1,714,987 |
| OHIO STATE WEXNER | |||||
| 640 ACKERMAN RD | COLUMBUS | OH | 43218 | IT SERVICES | $1,422,252 |
| CARDINAL HEALTH | |||||
| 71 MIL ACRES DR | WHEELING | WV | 26003 | PHARMACY SERVICES | $1,446,363 |
| WEIGAND CONSTRUCTION | |||||
| 7808 HONEYWELL DR | FORT WAYNE | IN | 46825 | CONSTRUCTION SERVICE | $6,337,058 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 65 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,412,395 | GovernmentGrantsAmt |
| All Other Contributions | $509,712 | AllOtherContributionsAmt |
| Total Contributions | $10,922,107 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| Patient Service Revenue | $56,594,578 | $56,594,578 |
| All other program service revenue - |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,594,578 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,268,941 | TotalRevenueColumnAmt |
| Exclusion | $1,268,941 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,149,345 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $716,553 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $432,792 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $432,792 | TotalRevenueColumnAmt |
| Exclusion | $432,792 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,656,130 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,656,130 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,656,130 | TotalRevenueColumnAmt |
| Exclusion | $3,656,130 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Wellness Programs | $8,234 | $8,234 | |
| Cafeteria/Vending Services | $136,365 | $136,365 | |
| All Other Misc Revenue | $337,181 | $337,181 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $481,780 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,356,328 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,939,993 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,494,228 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,468,830 | TotalAmt |
| Program Services | $1,234,250 | ProgramServicesAmt |
| Management And General | $234,580 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,555,494 | TotalAmt |
| Program Services | $21,474,153 | ProgramServicesAmt |
| Management And General | $4,081,341 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,651 | TotalAmt |
| Program Services | $277,844 | ProgramServicesAmt |
| Management And General | $52,807 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,100,033 | TotalAmt |
| Program Services | $5,125,827 | ProgramServicesAmt |
| Management And General | $974,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,805,710 | TotalAmt |
| Program Services | $1,517,329 | ProgramServicesAmt |
| Management And General | $288,381 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,421 | TotalAmt |
| Program Services | $81,022 | ProgramServicesAmt |
| Management And General | $15,399 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,825 | TotalAmt |
| Program Services | $145,224 | ProgramServicesAmt |
| Management And General | $27,601 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,464 | TotalAmt |
| Program Services | $71,815 | ProgramServicesAmt |
| Management And General | $13,649 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,116 | TotalAmt |
| Program Services | $32,029 | ProgramServicesAmt |
| Management And General | $6,087 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,809,712 | TotalAmt |
| Program Services | $14,965,412 | ProgramServicesAmt |
| Management And General | $2,844,300 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,042 | TotalAmt |
| Program Services | $128,600 | ProgramServicesAmt |
| Management And General | $24,442 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,866,836 | TotalAmt |
| Program Services | $1,568,693 | ProgramServicesAmt |
| Management And General | $298,143 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,651,895 | TotalAmt |
| Program Services | $1,388,079 | ProgramServicesAmt |
| Management And General | $263,816 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622,580 | TotalAmt |
| Program Services | $523,151 | ProgramServicesAmt |
| Management And General | $99,429 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,104 | TotalAmt |
| Program Services | $162,264 | ProgramServicesAmt |
| Management And General | $30,840 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $549,786 | TotalAmt |
| Program Services | $461,982 | ProgramServicesAmt |
| Management And General | $87,804 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,271,646 | TotalAmt |
| Program Services | $3,589,443 | ProgramServicesAmt |
| Management And General | $682,203 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $612,034 | TotalAmt |
| Program Services | $514,289 | ProgramServicesAmt |
| Management And General | $97,745 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $4,599,040 | $4,599,040 | $0 | $0 |
| Taxes | $1,084,882 | $911,621 | $173,261 | $0 |
| Nutritional Services | $291,325 | $291,325 | $0 | $0 |
| BAD DEBT | $4,320,611 | $4,320,611 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,216 | TotalAmt |
| Program Services | $281,680 | ProgramServicesAmt |
| Management And General | $53,536 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,015,253 | TotalAmt |
| Program Services | $63,665,683 | ProgramServicesAmt |
| Management And General | $10,349,570 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $696,469 | BOYAmt |
| EOY | $3,490,336 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,898,240 | BOYAmt |
| EOY | $8,624,183 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $597,297 | BOYAmt |
| EOY | $727,151 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $607,816 | BOYAmt |
| EOY | $954,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $129,943,597 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $53,103,790 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,927,884 | BOYAmt |
| EOY | $76,839,807 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $17,935,578 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,264,513 | BOYAmt |
| EOY | $24,206,333 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,992,419 | BOYAmt |
| EOY | $132,778,077 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,071,608 | BOYAmt |
| EOY | $10,338,197 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,863 | BOYAmt |
| EOY | $11,863 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $415,200 | BOYAmt |
| EOY | $57,050,365 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,869,381 | BOYAmt |
| EOY | $4,148,306 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,469 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,139,521 | BOYAmt |
| EOY | $71,548,731 | 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 | $60,984,528 | BOYAmt |
| EOY | $57,360,976 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,868,370 | BOYAmt |
| EOY | $3,868,370 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,852,898 | BOYAmt |
| EOY | $61,229,346 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,992,419 | BOYAmt |
| EOY | $132,778,077 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$658,925 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,964,627 | NetUnrlzdGainsLossesInvstAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $563 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $563 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PERCENTAGE OF DUES PAID TO THE OHIO HOSPITAL ASSOCIATION THAT IS USED FOR POLITICAL PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,388,032 | BeginningYearBalanceAmt |
| Contributions | $304,675 | ContributionsAmt |
| Investment Earnings Or Losses | $311,613 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,519,662 | OtherExpendituresAmt |
| End Year Balance | $4,484,658 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,053,290 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $714,479 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $285,100 | OtherExpendituresAmt |
| Administrative Expenses | $94,637 | AdministrativeExpensesAmt |
| End Year Balance | $9,388,032 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,958,410 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $274,201 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $105,932 | OtherExpendituresAmt |
| Administrative Expenses | $73,389 | AdministrativeExpensesAmt |
| End Year Balance | $9,053,290 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,582,777 | BeginningYearBalanceAmt |
| Contributions | $168 | ContributionsAmt |
| Investment Earnings Or Losses | $489,031 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $86,875 | OtherExpendituresAmt |
| Administrative Expenses | $26,691 | AdministrativeExpensesAmt |
| End Year Balance | $8,958,410 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,265,020 | BeginningYearBalanceAmt |
| Contributions | $40,340 | ContributionsAmt |
| Investment Earnings Or Losses | $492,559 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $170,971 | OtherExpendituresAmt |
| Administrative Expenses | $44,171 | AdministrativeExpensesAmt |
| End Year Balance | $8,582,777 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,045,478 | OtherCostOrOtherBasisAmt |
| Book Value | $5,045,478 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,423,378 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,832,010 | DepreciationAmt |
| Book Value | $49,591,368 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,223,398 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,271,780 | DepreciationAmt |
| Book Value | $19,951,618 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,251,343 | OtherCostOrOtherBasisAmt |
| Book Value | $2,251,343 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $76,839,807 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT IN JOINT VENTURES | $1,248,589 |
| OTHER ASSETS | $13,111,892 |
| ASSETS WHOSE USE IS LIMITED | $9,845,852 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $24,206,333 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | THE INVESTMENT INCOME GENERATED BY THE ENDOWMENT FUNDS DISTRIBUTED TO THE HOSPITAL IS ABLE TO BE USED FOR GENERAL OPERATING AND CAPITAL EQUIPMENT NEEDS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,267,597 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,145,614 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,121,983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05910 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,267,597 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,145,614 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,121,983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05910 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,116 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $144 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $144 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,571 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,288,168 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,145,614 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,142,554 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05940 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,284,763 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,242,410 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,407,836 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,165,426 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY CARE SYSTE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MANAGED CARE CONTRACTING | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.5 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.5 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE VAN WERT COUNTY HOSPITAL ASSOC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 WASHINGTON STREET | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | VANWERTHEALTH.ORG/1287 | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE VAN WERT COUNTY HOSPITAL ASSOC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, PAGE 8 | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | 0 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | 0 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| 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 (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 5 | THE PROJECT WAS CONDUCTED AS A JOINT EFFORT INCLUDING VAN WERT HEALTH, THE VAN WERT COUNTY HEALTH COLLABORATIVE, AND THE HOSPITAL COUNCIL OF NORTHWEST OHIO'S WHO PROVIDED PROJECT MANAGEMENT & DATA SERVICES. THERE WERE MANY PARTICIPATING ORGANIZATIONS THROUGHOUT THE PROC ESS INCLUDING: THE VAN WERT COUNTY HEALTH GENERAL HEALTH DISTRICT, VAN WERT COUNTY FAMILY AND CHILDRENS FIRST COUNCIL, FAMILY HEALTHCARE OF NORTHWEST OHIO, MAIN STREET VAN WERT, VAN WERT COUNTY ECONOMIC DEVELOPMENT, WESTWOOD BEHAVIORAL HEALTH CENTER, INC., VANTAGE CAREER CENTER, VAN WERT CITY SCHOOLS, CRESTVIEW LOCAL SCHOOLS, AND LINCOLNVIEW LOCAL SCHOOLS. |
| PART V, SECTION B, LINE 6B | THE HOSPITAL COUNCIL OF NORTH WEST OHIO WITH ASSISTANCE FROM THE SCHOOL OF POPULATION HEALTH, UNIVERSITY OF TOLEDO. |
| PART V, SECTION B, LINE 11 | KEY ISSUES SELECTED FOR THE HIP (HEALTH IMPROVEMENT PLAN) INCLUDE: STRATEGY 1 - OBESITY & CHRONIC DISEASE ACTION PLAN - OVERALL GOAL TO REDUCE OBESITY AND CHRONIC DISEASE RISK THROUGH INCREASED CONSUMPTION OF HEALTHY FOODS AND PHYSICAL ACTIVITY, EXPANSION OF CARE COORDINATION ACTIVITIES, DEVELOPMENT OF A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN, INCREASE PARTICIPATION IN THE VAN WERT COUNTY HEALTH COLLABORATIVE. STRATEGY 2 - DECREASE INCIDENCE OF MENTAL HEALTH SUBSTANCE USE - PARTNER WITH TRI-COUNTY ADAM HS BOARD & THE OSU EXTENSION OFFICE TO DEVELOP A MENTAL HEALTH FIRST AID COMMUNITY INITIATIVE, INVESTIGATE OPPORTUNITIES FOR TELE PSYCHIATRY SERVICES, PARENTING CLASS INITIATIVE, INCREASE DEPRESSION SCREENINGS WITHIN THE OB/GYN PRACTICE, ADVOCATE FOR TOBACCO 21, EXPLORE REFERRAL PATHWAYS FOR MENTAL HEALTH & SUBSTANCE ABUSE, DEVELOP TOBACCO TREATMENT SERVICES AND REPRESENT VAN WERT HEALTH ON THE OVERDOSE PREVENTION COALITION. STRATEGY 3 - ACCESS TO CARE & RESOURCES - FINANCIAL ASSISTANCE PROGRAM EXPANSION, INCREASE ACCESS TO CARE AT VAN WERT HEALTH, DEVELOP STRATEGIES AROUND PHYSICIAN RECRUITMENT / RETENTION / LOCAL STUDENT SCHOLARSHIPS AND PUBLISH A VAN WERT HEALTH HEALTHY LIFESTYLE RESOURCE LISTING . ADULT KEYS ISSUES NOT SELECTED: HOMELESSNESS AND UNEMPLOYMENT - VAN WERT COUNTY AVERAGES LOWER RATES OF POVERTY, HOMELESSNESS AND LACK OF ACCESS TO FOOD THAN MANY COUNTIES IN THE STATE. THE CHNA DATA INDICATES THAT MOST OF THOSE AFFECTED KNEW WHERE TO OBTAIN HELP AND HAD IN FACT OBTAINED HELP. THIS DATA COMBINED WITH LIMITED RESOURCES AND OTHER NEEDS THAT WERE IDENTIFIED AS MORE IMPORTANT WERE REASONS THIS WAS NOT SELECTED. DRUG USE - OTHER RESOURCES EXIST IN THE COMMUNITY AND LIMITED RESOURCES NEEDED TO ADDRESS OTHER ISSUES WITH HIGHER PRIORITY RANKINGS. CARDIOVASCULAR DISEASE - WILL BE IMPACTED BY ACTION PLAN STEPS TOWARDS OBESITY. DOMESTIC VIOLENCE - ADDRESSED BY WESTWOOD BEHAVIORAL HEALTH AND COURTS. YOUTH ISSUES NOT SELECTED: MENTAL HEALTH - COMMUNITY PARTNERSHIPS ALREADY IN PLACE WITH MENTAL HEALTH AGENCY, HEALTH DEPARTMENT, AND SCHOOLS. PARENTING/BROKEN FAMILY - SCHOOLS WORKING ON THIS ISSUE. BULLYING - MANY PROGRAMS IN PLACE LOCALLY TO ADDRESS THROUGH GRANTS, BEHAVIORAL HEALTH AGENCY, AND SCHOOLS. POVERTY/HUNGER - LOCAL PROGRAMS ALREADY EXIST. DRIVING SAFETY - LACK OF DATA TO ACT UPON. BOOSTER SEAT USE - HEALTH DEPARTMENT AND HOSPITAL PROVIDE SAFETY CHECKS AND REDUCED COST CAR SEATS. ACCESS TO DENTAL - CURRENT DENTAL CLINIC HAS ADDRESSED MUCH OF THIS ISSUE AND LIMITED RESOURCES FOCUSED ON HIGHER NEED AREAS. |
| PART V, SECTION B, LINE 13H | VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERED BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF- PAY PATIENTS. |
| PART V, SECTION B, LINE 16J | EVERY PATIENT STATEMENT SENT BY THE ORGANIZATION INCLUDES INFORMATION ABOUT FA / FAP ALONG WITH A FULL APPLICATION FOR THE FAP. |
| SCHEDULE H, PART V, LINE 7A: | HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T |
| SCHEDULE H, PART V, LINE 7B | WWW.HCNO.ORG/COMMUNITY-SERVICES/COMMUNITY-HEALTH-ASSESSMENTS/ |
| SCHEDULE H, PART V, LINE 10 | HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T |
| SCHEDULE H, PART V, LINE 16A, B & C | HTTPS://WWW.VANWERTHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| VAN WERT HEALTH-HEALTH CENTER | ||||
| 140 FOX ROAD | VAN WERT | OH | 45891 | PHYS. MEDICAL OFFICE BLDG. |
| VAN WERT HEALTH-ROCKFORD FAMILY MEDICINE | ||||
| 506 S MAIN ST | ROCKFORD | OH | 45882 | PHYSICIAN OFFICE |
| VAN WERT HEALTH-OTTOVILLE FAMILY MEDICIN | ||||
| 290 E 3RD ST | OTTOVILLE | OH | 45876 | PHYSICIAN OFFICE |
| VAN WERT HEALTH PEDIATRIC THERAPY OFFICE | ||||
| 1182 PROFESSIONAL DR | VAN WERT | OH | 45891 | PEDIATRIC P.T./HB NON-EXEMPT |
| VAN WERT HEALTH NORTH | ||||
| 214 TOWNE CENTER BLVD | VAN WERT | OH | 45891 | PHYSICIAN BASED AMBULATORY CEN |
| VAN WERT HEALTH OBGYN PAULDING | ||||
| 1035 WEST WAYNE ST | PAULDING | OH | 45879 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C | VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERE BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF-PAY PATIENTS.VAN WERT HEALTH ALSO USES THE FOLLOWING CRITERIA IN ADDITION TO FPG TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. THE ORGANIZATION DOES NOT CLAIM BAD DEBT EXPENSE AS A COMMUNITY BENEFIT. |
| PART I, LN 7 COL(F): | VAN WERT HEALTH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE VAN WERT HEALTH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. MANAGEMENT ESTIMATES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON FACTORS UNIQUE TO THE ORGANIZATION'S OPERATIONS. |
| PART III, LINE 2: | BAD DEBT IS ACCOUNTED FOR AFTER ALL DISCOUNTS FOR 501R AND FINANCIAL ASSISTANCE ARE APPLIED. VAN WERT HEALTH UTILIZES A RESERVE MODEL FOR ACTIVE A/R TO ESTIMATE BAD DEBT EXPENSE, THIS MODEL IS ADJUSTED MONTHLY TO ACCOUNT FOR FLUCTUATIONS IN THE A/R AGE AND BALANCES. AFTER 4 STATEMENTS CYCLES OVER 120 DAYS ANY REMAINING SELF-PAY BALANCE IS SUBMITTED TO A COLLECTION AGENCY. AT THIS POINT THE WRITE-OFF WOULD BE EXPENSED AND THE RESERVE MODEL ON THE A/R WOULD REFLECT AN OFFSETTING CREDIT TO EXPENSE FOR ANY AMOUNT THAT HAD BEEN PREVIOUSLY RESERVED. |
| PART III, LINE 3: | THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. VAN WERT HEALTH DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 4: | SEE FOOTNOTE 1, PAGES 11-13 UNDER 'PATIENT CARE SERVICE REVENUE' IN THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ORGANIZATION DOES NOT CONSIDER THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | FOLLOWING THE GUIDELINES AND PROCESSES AS INDICATED IN QUESTION 3, PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE, THE ORGANIZATION APPROPRIATELY IDENTIFIES ACCOUNTS AS TO THE TYPE OF ASSISTANCE QUALIFIED FOR. THE AMOUNTS ELIGIBLE FOR ASSISTANCE ARE WRITTEN OFF TO THE APPROPRIATE PROGRAM AND COLLECTION ACTIVITY CEASES IN REGARD TO THOSE AMOUN TS. THE GOAL OF THE ORGANIZATION'S POLICIES IS TO INDENTIY ACCOUNTS ELIGIBLE FOR ASSISTANCE AND BRING THE ACCOUNT TO AN APPROPRIATE CONCLUSION AS EARLY IN THE BILLING CYCLE AS POSSIBLE. |
| PART VI, LINE 2: | THE ORGANIZATION USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS. DATA PROVIDED BY THE STATE OF OHIO IS USED TO DETERMINE EPIDEMIOLOGY'S RELATED TO CHRONIC CONDITIONS AND CANCER REGISTRIES PROVIDING PREVALENCE. INTERNAL DATA IS ALSO USED AS WELL AS INPUT FROM OTHER PROVIDERS. THE HOSPITAL ALSO USES PATIENT ORIGIN DATA PROVIDED BY THE OHIO HOSPITAL ASSOCIATION TO DETERMINE CURRENT TREATMENT PATTERNS AND DIAGNOSIS FOR CURRENT RESIDENTS BEING TREATED BY VAN WERT HEALTH AND OTHER SURROUNDING PROVIDERS. THE HOSPITAL ALSO SPONSORS A NUMBER OF HEALTH FAIRS/ASSESSMENTS TO BOTH ADULT AND PEDIATRIC POPULATIONS OF VAN WERT THAT ARE ALSO EXAMINED FOR FREQUENCY AND NEEDS. A NUMBER OF STAFF AS WELL AS BOARD OF TRUSTEES MEMBERS ALSO SERVED ON COMMUNITY HEALTH PROVIDER BOARDS AND PROVIDE INPUT TO THE PLANNING PROCESS. THE HOSPITAL PARTICIPATED IN A COMMUNITY-WIDE HEALTH CARE NEEDS ASSESSMENT PROJECT WITH COLLABORATING AGENCIES WITHIN THE AREA. AS A RESULT OF THIS EFFORT, OBESITY, CHRONIC DISEASE, ACCESS TO CARE, MENTAL HEALTH AND SUBSTANCE ABUSE ARE THE NEEDS IDENTIFIED BY THE COALITION THAT WILL BE THE FOCUS OF THE HEALTH IMPROVEMENT PLAN DEVELOPED BY THE COALITION. THE HOSPITAL IS ALSO SUBSCRIBED TO A NUMBER OF BENCHMARKING ORGANIZATIONS THAT PROVIDE BEST OF INDUSTRY APPLICATIONS TO ASSESS METHODOLOGIES FOR TREATING OUR RESIDENTS. |
| PART VI, LINE 3: | PATIENT EDUCATION REGARDING THEIR ELIGIBILITY FOR ASSISTANCE BEGINS AT THE PATIENT ACCESS TO CARE AREAS. INFORMATIONAL SIGNAGE IS POSTED IN ALL PATIENT ACCESS AREAS IDENTIFYING FINANCIAL ASSISTANCE PROGRAMS AND INSTRUCTIONS ON HOW TO SEEK OUT THESE PROGRAMS. SIMILAR INFORMATION IS ALSO FOUND IN PATIENT INFORMATIONAL BROCHURES PROVIDED TO PATIENTS PRIOR TO THE RENDERING OF CARE BASED UPON THE TYPE OF CARE BEING PROVIDED. ALSO, AVAILABLE AT ALL PATIENT ACCESS POINTS ARE THE PATIENT FINANCIAL ASSISTANCE BROCHURES. PATIENT REGISTRATION STAFF AT ALL PATIENT ACCESS POINTS ARE TRAINED IN THE PATIENT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT THE HOSPITAL. THEY BECOME A VALUABLE RESOURCE TO PATIENTS DIRECTING THEM TO THE PROGRAMS THEY MAY QUALIFY FOR AND THE PROCESS WITH WHICH TO SEEK THE APPROPRIATE ASSISTANCE. THE HOSPITAL UTILIZES THE HOSPITAL WEBSITE AS AN ON-LINE AND TECHNO LOGICALLY CURRENT SOURCE OF FINANCIAL ASSISTANCE INFORMATION FOR PATIENTS THAT PREFER FINDING EDUCATIONAL INFORMATION IN THIS FORMAT. FINANCIAL ASSISTANCE PROGRAMS, POLICIES, ELIGIBILITY CRITERIA, AND ON-LINE APPLICATIONS FOR THE VARIOUS PROGRAMS ARE AVAILABLE. PATIENT BILLING STATEMENTS PROVIDE ANOTHER AVENUE FOR EDUCATING PATIENTS AS TO FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AND HOW TO CONTACT THE HOSPITAL TO DETERMINE ELIGIBILITY. THIS INFORMATION IS LOCATED ON THE BACK OF EACH BILLING STATEMENT RECEIVED BY THE PATIENT. THE EXISTENCE OF A FINANCIAL COUNSELOR IN THE PATIENT FINANCIAL SERVICES DEPARTMENT IS ANOTHER MECHANISM UTILIZED IN EDUCATING PATIENTS REGARDING FINANCIAL ASSISTANCE AVAILABLE FOR HOSPITAL SERVICES. ALL UNINSURED OR SELF-PAY POTENTIAL ACCOUNTS ARE IDENTIFIED TO THE FINANCIAL COUNSELOR UPON PATIENT REGISTRATION. PATIENTS MAY BE CONTACTED UPON COMPLETION OF SERVICES. ALL PATIENTS THAT WERE NOT CONTACTED UPON COMPLETION OF SERVICE S RECEIVE A FINANCIAL ASSISTANCE APPLICATION THROUGH THE MAIL THAT INCLUDES INFORMATION REGARDING ALL FINANCIAL ASSISTANCE PROGRAMS. THE COUNSELOR PROVIDES FOLLOW-UP AND ASSISTANCE TO IDENTIFY THE PATIENT WITH THE APPROPRIATE FINANCIAL ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | VAN WERT COUNTY HOSPITAL ASSOCIATION DBA VAN WERT HEALTH IS LOCATED IN THE RURAL COUNTY OF VAN WERT, OHIO THAT BORDERS THE INDIANA STATE LINE ALONG ALLEN COUNTY INDIANA. OUR PRIMARY SERVICE AREA COMPRISES VAN WERT AND SOME PORTIONS OF PAULDING, PUTNAM AND MERCER COUNTIES. OHIO NUMERICALLY THIS BREAKS DOWN TO APPROXIMATELY 50,000 RESIDENTS IN OUR PRIMARY MARKET AREA. THE HOSPITAL IS LOCATED WITHIN THE CITY OF VAN WERT, WHICH POSSESSES A POPULATION OF 10,700. OUR POPULATION IS PREDOMINANTLY WHITE (93.7%) WITH HISPANIC (3.5%). A MIX OF MINORITIES COMPRISE THE REMAINDER. VAN WERT IS RURAL IN NATURE WITH EMPLOYMENT NOT ONLY IN AGRICULTURAL SERVICES BUT ALSO IN THE MANUFACTURING AND SERVICE SECTOR. THE UNEMPLOYMENT RATE IN VAN WERT COUNTY HAS BEEN STEADILY DROPPING FROM A HIGH OF > 15% IN 2008-2010 TO A CURRENT LEVEL AROUND 3%. HOWEVER, 11.4% OF THE POPULATION IS CONSIDERED TO BE LIVING IN POVERTY AND CONTRIBUTES TO INCREASING NUMBERS OF CITIZENS COVERED UNDER THE MEDICAID PROGRAM AND QUALIFYING FOR THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS INCREASING BAD DEBT. LIKE MANY MIDWEST COMMUNITIES THE REGION HAS EXPERIENCED AN AGING POPULATION WITH 19.0% OVER 65 AND 27.8% 45 -64 ESTIMATED FOR 2018 BY THE OHIO OFFICE FOR RESEARCH. |
| PART VI, LINE 5: | THE VAN WERT COUNTY HOSPITAL ASSOCIATION BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS FROM OUR COMMUNITY. THE MAJORITY OF THESE MEMBERS LIVE AND WORK WITHIN THE COMMUNITY AND ARE INVOLVED WITH OTHER NON-PROFIT AGENCIES. SENIOR LEADERSHIP ALSO LIVES IN THE PRIMARY SERVICE AREA. THIS "SPIRIT" OF COMMUNITY BASED HEALTHCARE RESIDES IN OUR BOARD OF TRUSTEES AND IS FURTHER EVIDENCED BY OUR OPEN MEDICAL STAFF. THE ACCOMMODATION OF SPECIALTY SERVICES NOT CURRENTLY PRESENT IN OUR AREA BEING PROVIDED THROUGH A SPECIALTY CLINIC OF THE HOSPITAL WHICH INCLUDE NEUROLOGY, NEUROSURGERY, IMMUNOLOGY, AND ENT SERVICES. THE HOSPITAL ASSOCIATED PERSONNEL ALSO SIT ON OTHER COMMUNITY BASED GOVERNANCE BOARDS (UNITED WAY, AMERICAN RED CROSS, CHAMBER OF COMMERCE, WRIGHT STATE UNIVERSITY REGIONAL CAMPUS, PUBLIC ACCESS TELEVISION, AMERICAN CANCER SOCIETY & VAN WERT ECONOMIC DEVELOPMENT TO NAME A FEW) THROUGH PHYSICIAN RECRUITMENT WE HAVE BROUGHT IN A NUMBER OF NEW SPECIALTIES INCLUDING OBSTETRICS, PULMONOLOGY/CRITICAL CARE AND ADDITIONAL LAPAROSCOPIC SURGICAL PROCEDURES. WE ALSO PROVIDE A LOAN FORGIVENESS PROGRAM FOR RESIDENTS INTERESTED IN BECOMING PHYSICIANS AND RETURNING TO OUR AREA. OUR WELLNESS CENTER PROVIDES HEALTH, EDUCATION, AND SOCIAL PROGRAMS FOR TARGETED POPULATIONS. WE HAVE JOINED A REGIONAL STROKE NETWORK AS WELL AS PARTICIPATING IN A NUMBER OF PATIENT AND EDUCATIONAL SUPPORT GROUPS (BETTER BREATHERS, STROKE SUPPORT GROUP, BETTER PARENTING). THE HOSPITAL ALSO PARTICIPATES IN HEALTH PROFESSIONS EDUCATIONAL PROGRAMS. A NUMBER OF OUR PHYSICIANS PROVIDE TRAINING FOR SENIOR MEDICAL STUDENTS THROUGH THE LIMA AREA HEALTH EDUCATION COMMITTEE. A NUMBER OF NURSING EDUCATIONAL PROGRAM USE OUR HOSPITAL TO DO THEIR CLINICAL ROTATIONS. OUR REHAB SERVICES DEPARTMENT ROUTINELY HOSTS STUDENTS FROM THE UNIVERSITY OF FINDLAY, HUNTINGTON COLLEGE, RHODES STATE COLLEGE, UNIVERSITY OF ST. FRANCIS, THE OHIO STATE UNIVERSITY, THE UNIVERSITY OF CINCINNATI, THE UNIVERSITY OF DAYTON, TRINE UNIVERSITY, UTMC AND WESTERN MICHIGAN WHO ARE PURSUING CAREERS IN THERAPY. THE HOSPITAL ON AVERAGE SPENDS IN EXCESS OF 1 MILLION DOLLARS IN NEW DIAGNOSTIC TECHNOLOGIES AND OTHER HEALTH RELATED EQUIPMENT TO BETTER DIAGNOSE AND TREAT OUR CLIENTS. THE HOSPITAL IS CURRENTLY UNDERGOING A NEARLY FORTY MILLION DOLLAR EXPANSION IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE EXPANSION PROVIDES ALL NEW INPATIENT SPACE FOR ACUTE CARE AND OBSTETRICS. IT WILL ALSO HOUSE A BRAND-NEW SURGICAL SERVICES AREA WITH INCREASED CAPACITY, PRIVATE PRE/POST-OP ROOMS AND CAPACITY FOR ROBOTIC SURGERY. THIS WILL ALLOW PATIENTS WHO ROUTINELY LEAVE THE AREA FOR PORTIONS OF THEIR CARE TO OBTAIN THEIR CARE LOCALLY. VAN WERT HEALTH SUPPORTS NUMEROUS ORGANIZATIONS VIA SPONSORSHIP THROUGHOUT THE COMMUNITY SOME OF THESE INCLUDE THE YWCA SILVER SNEAKERS PROGRAM, THE COMMUNITY FARMER'S MARKET, LIVE HEALTH VAN WERT & THE COUNTY HEALTH COLLABORATIVE, DARE, JUNIOR ACHIEVEMENT, COUNCIL ON AGING, CAMP CLAY, SAFETY COUNCIL WELLNESS AND THE NISWONGER PERFORMING ARTS CONCERT SERIES. VAN WERT HEALTH PROVIDES NUMEROUS SPONSORSHIPS FOR LOCAL SCHOOLS. VAN WERT HEALTH PRESENTS OR PARTICIPATES IN NUMEROUS HEALTH FAIRS THROUGHOUT THE YEAR INCLUDING THE ANNUAL CHILDREN'S HEALTH FAIR, ANNUAL WOMEN'S HEALTH EVENT, ANNUAL CAR SEAT CLINIC AND AN ANNUAL VETERAN'S DAY EVENT. VAN WERT HEALTH STAFF PRESENT AT VARIOUS EVENTS AND SPEAKERS BUREAUS THROUGHOUT THE YEAR INCLUDING THE SILVER SNEAKERS PROGRAM, THE SAFETY COUNCIL AND VARIOUS CAREER FAIRS FOR YOUNG STUDENTS ON THE BENEFITS OF A CAREER IN HEALTH CARE. (TOTAL STAFF HOURS 129) SUPPORT FOR THE LOCAL BUSINESS DEVELOPMENT COALITION TO PROMOTE GROWTH IN THE OVERALL VAN WERT COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES POPE | ||||||||||||
| CEO | $388,254 | $0 | $76,882 | $0 | $0 | $0 | $40,740 | $0 | $27,523 | $0 | $533,399 | $0 |
| KAREN SHADOWENS | ||||||||||||
| CFO | $273,698 | $0 | $44,816 | $0 | $0 | $0 | $31,026 | $0 | $21,835 | $0 | $371,375 | $0 |
| THOMAS CONTE | ||||||||||||
| CHIEF OF STAFF | $269,389 | $0 | $27,838 | $0 | $0 | $0 | $238,192 | $0 | $28,637 | $0 | $564,056 | $0 |
| DR NIZAR ORFAHLI | ||||||||||||
| PHYSICIAN | $483,776 | $54,285 | $9,842 | $29,288 | $16,475 | $593,666 | ||||||
| DR NIK KIEHL | ||||||||||||
| PHYSICIAN | $481,784 | $26,500 | $678 | $0 | $25,171 | $534,133 | ||||||
| DR SCOTT SHIE | ||||||||||||
| PHYSICIAN | $482,464 | $26,500 | $720 | $24,692 | $25,181 | $559,557 | ||||||
| DR JEREMY STOLLER | ||||||||||||
| PHYSICIAN | $416,940 | $81,900 | $1,210 | $19,500 | $30,784 | $550,334 | ||||||
| DR CHARLES HOEHN | ||||||||||||
| PHYSICIAN | $304,111 | $82,869 | $1,032 | $22,923 | $29,160 | $440,095 | ||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | FIRST CLASS TRAVEL WAS PROVIDED FOR THE ORGANIZATION'S CEO UNDER SPECIFIC CIRCUMSTANCES. THIS WAS NOT INCLUDED IN THE CEO'S TAXABLE COMPENSATION. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF VAN WERT OHIO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 310308605 | BondIssuerEIN |
| CUSIP | 921297AA5 | CUSIPNum |
| Bond Issued | 2020-03-01 | BondIssuedDt |
| Issue Price | $61,290,000 | IssuePriceAmt |
| Purpose | REVENUE REFUNDING AND IMPROVEMMENT | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $9,728,003 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $36,376,499 | TotalProceedsAmt |
| In Reserve Fund | $4,741,918 | InReserveFundAmt |
| Capitalized Interest | $5,147,455 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $1,645,468 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $10,389,830 | CapitalExpendituresAmt |
| Other Spent Proceeds | $2,775 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2020 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | false | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Engage Bond Counsel Research | false | EngageBondCounselResearchInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 1.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 1.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Change In Use Bond Financed Prop | 0.00000 | ChangeInUseBondFinancedPropPct |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (true) | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OHIO MEDICAL IMAGING ASSOCIATES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER OWNER OF ENTITY (ERIC JELLINGER) | RelationshipDescriptionTxt |
| Transaction | $798,000 | TransactionAmt |
| Transaction | RADIOLOGY SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ANY PERSON, AGE 18 OR OLDER AND RESIDING IN VAN WERT COUNTY HOSPITAL'S GEOGRAPHIC SERVICE AREA, WHO SHALL HAVE CONTRIBUTED THE SUM OF ONE DOLLAR OR MORE TO THE ASSOCIATION DURING THE CALENDAR YEAR, SHALL BE A MEMBER. A CONTRBUTION OF TWENTY FIVE DOLLARS AT ANY TIME SHALL CONSTITUTE A LIFE MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF TRUSTEES SHALL BE ELECTED BY THE MEMBERS OF THE ASSOCIATION AT THE REGULAR ANNUAL MEETING. ONE SHALL BE APPOINTED BY THE VAN WERT COUNTY BOARD OF COMMISSIONERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | SUBJECT TO THE ARTICLES OF INCORPORATION AND THIS CODE OF REGULATIONS, EACH MEMBER OF THE ASSOCIATION IN GOOD STANDING SHALL BE QUALIFIED TO VOTE ON ANY ISSUES THAT MAY PROPERLY COME BEFORE ANY MEETING OF THE MEMBERS OF THE ASSOCIATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE FINANCE COMMITTEE REVIEWS AND APPROVES THE 990. IT IS THEN PRESENTED TO THE FULL BOARD DURING A REGULARLY SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED BY THE CHAIRPERSON OF THE BOARD OF TRUSTEES AND THE PRESIDENT AND CEO. THE SCOPE OF THIS POLICY INCLUDES ALL STAFF AND BOARD OF TRUSTEES MEMBERS. A CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED ON AN ANNUAL BASIS AND REVIEWED BY THE EXECUTIVE COMMITTEE. ANY ISSUES THAT ARISE ARE ADDRESSED WITH THE INDIVIDUAL AT THAT POINT. ANY ISSUES THAT ARISE THOUGHOUT THE YEAR ARE DEALT WITH AS NECESSARY. THIS MAY INVOLVE DECLARING THE CONFLICT OF INTEREST AND ABSTAINING FROM DISCUSSION OR A VOTE ON SPECIFIC TOPICS. THIS COULD ALSO TAKE THE FORM OF RECUSING ONESELF FROM PART OR A WHOLE MEETING AS NECESSARY AND REQUIRED DEPENDING UPON THE TOPIC FOR DISCUSION AND/OR ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE COMPENSATION COMMITTEE CONTRACTS WITH AN OUTSIDE, INDEPENDENT FIRM TO PROVIDE A COMPENSATION STUDY AND EVALUATION. THE COMMITTEE THEN USES THE RESULTS OF THE STUDY IN CONSULTATION WITH THE COMPENSATION FIRM AND THEN COMPENSATION PHILOSOPHY POLICY TO MAKE COMPENSATION DECISIONS. THE LAST COMPENSATION REVIEW WAS PERFORMED IN 2019. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS AN ATTACHMENT TO FORM 990 AT WWW.GUIDESTAR.ORG OR UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VAN WERT MEDICAL SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 FOX ROAD | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202812541 | EIN |
| Primary Activities | MEDICAL SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $7,659,259 | TotalIncomeAmt |
| End Of Year Assets | $956,594 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VAN WERT | BusinessNameLine1Txt |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VAN WERT COUNTY HOSPITAL PAIN MANAGEMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 S WASHINGTON ST | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810822738 | EIN |
| Primary Activities | PAIN MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VAN WERT HOSP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $359,939 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $157,880 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY CARE SYSTEMS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 S WASHINGTON ST | AddressLine1Txt |
| City | VAN WERT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45891 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341783212 | EIN |
| Primary Activities | HEALTHCARE MGMT | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |