2021-11-15T17:20:20-06:00 2020-12-31 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2020-01-01 344429514 VAN WERT COUNTY HOSPITAL ASSOCIATION % EDGAR SILALAHI VANW 4192388609 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 EDGAR SILALAHI CFO 4192388870 2021-11-15 true EDGAR SILALAHI 999009999 Aaron Hershberger P00961884 5136218300 2020 2022-09-23 18:48:47Z VAN WERT HEALTH MIKE KEYSOR 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 74072881 false X WWW.VANWERTHEALTH.ORG X 1905 OH TO BE THE BEST COMMUNITY HOSPITAL. 12 9 571 120 0 0 247796 10922107 50088136 56594578 2886872 4925071 1126926 914572 54349730 73356328 0 0 0 0 31039132 35260718 0 0 0 32612277 38754535 63651409 74015253 -9301679 -658925 86992419 132778077 22139521 71548731 64852898 61229346 X 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. false false 63665683 56939993 INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES 63665683 true true false true false false false false false true true false false true false true false true false false false false false false false false true true false false true true false false false false false false false true false false false false false false true true true false false false true 571 0 true 571 true false false false false false false false false false false false false X 12 9 false false false false true true true true true false false true true true true true true true true true true X EDGAR SILALAHI 4192388870 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 X DR NIZAR ORFAHLI PHYSICIAN 40.0 0.0 X 547903 0 45763 THOMAS CONTE CHIEF OF STAFF 40.0 2.0 X X 297227 0 266829 DR SCOTT SHIE PHYSICIAN 40.0 0.0 X 509684 0 49873 DR JEREMY STOLLER PHYSICIAN 40.0 0.0 X 500050 0 50284 DR NIK KIEHL PHYSICIAN 40.0 0.0 X 508962 0 25171 JAMES POPE CEO 40.0 2.0 X X 465136 0 68263 DR CHARLES HOEHN PHYSICIAN 40.0 0.0 X 388012 0 52083 KAREN SHADOWENS CFO 40.0 0.0 X 318514 0 52861 BARB KHONEN TRUSTEE 2.0 0.0 X 0 0 0 TIM JURCZYK PAST CHAIRPERSON 2.0 0.0 X 0 0 0 MIKE KEYSOR CHAIRPERSON 2.0 0.0 X X 0 0 0 AARON BAKER SECRETARY 2.0 0.0 X X 0 0 0 TODD WOLFRUM TRUSTEE 2.0 0.0 X 0 0 0 TOM TURNWALD VICE CHAIRPERSON 2.0 0.0 X X 0 0 0 ERIC JELINGER TRUSTEE 40.0 2.0 X 0 0 0 ADAM HOUG TRUSTEE 2.0 0.0 X 0 0 0 JEFFREY SNYDER TRUSTEE 2.0 0.0 X 0 0 0 BEN FAUROTE TRUSTEE 2.0 0.0 X 0 0 0 3535488 0 611127 45 false true false THERAPY SOLUTIONS LLC 120 WEST MAIN STREET VAN WERT OH 45891 REHABILITATION 2058700 ALTHEON HEALTH 12420 MILESTONE CENTER DRIVE GERMANTOWN MD 20876 ED PHYSICIANS 1714987 OHIO STATE WEXNER 640 ACKERMAN RD COLUMBUS OH 43218 IT SERVICES 1422252 CARDINAL HEALTH 71 MIL ACRES DR WHEELING WV 26003 PHARMACY SERVICES 1446363 WEIGAND CONSTRUCTION 7808 HONEYWELL DR FORT WAYNE IN 46825 CONSTRUCTION SERVICE 6337058 65 10412395 509712 10922107 Patient Service Revenue 56594578 56594578 All other program service revenue - 56594578 1268941 1268941 0 0 1149345 716553 432792 0 432792 432792 3656130 3656130 3656130 3656130 0 0 0 0 0 0 0 0 0 Wellness Programs 8234 8234 Cafeteria/Vending Services 136365 136365 All Other Misc Revenue 337181 337181 481780 73356328 56939993 5494228 0 0 0 0 1468830 1234250 234580 0 0 25555494 21474153 4081341 0 330651 277844 52807 0 6100033 5125827 974206 0 1805710 1517329 288381 0 96421 81022 15399 0 172825 145224 27601 0 85464 71815 13649 0 0 0 38116 32029 6087 0 17809712 14965412 2844300 0 153042 128600 24442 0 1866836 1568693 298143 0 1651895 1388079 263816 0 0 622580 523151 99429 0 193104 162264 30840 0 0 0 549786 461982 87804 0 0 4271646 3589443 682203 0 612034 514289 97745 0 Medical Supplies 4599040 4599040 0 0 Taxes 1084882 911621 173261 0 Nutritional Services 291325 291325 0 0 BAD DEBT 4320611 4320611 0 335216 281680 53536 74015253 63665683 10349570 0 696469 3490336 200 0 0 0 10898240 8624183 0 0 0 0 0 0 597297 727151 607816 954689 129943597 53103790 43927884 76839807 0 17935578 0 0 0 0 0 0 30264513 24206333 86992419 132778077 6071608 10338197 11863 11863 0 0 415200 57050365 0 0 0 0 14869381 4148306 0 0 771469 0 22139521 71548731 X 60984528 57360976 3868370 3868370 64852898 61229346 86992419 132778077 -658925 -2964627 X X false true X true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 563 563 false PART II-B, LINE 1: PERCENTAGE OF DUES PAID TO THE OHIO HOSPITAL ASSOCIATION THAT IS USED FOR POLITICAL PURPOSES. 9388032 304675 311613 5519662 4484658 9053290 714479 285100 94637 9388032 8958410 274201 105932 73389 9053290 8582777 168 489031 86875 26691 8958410 8265020 40340 492559 170971 44171 8582777 1.00000 false false 5045478 5045478 70423378 20832010 49591368 52223398 32271780 19951618 2251343 2251343 76839807 INVESTMENT IN JOINT VENTURES 1248589 OTHER ASSETS 13111892 ASSETS WHOSE USE IS LIMITED 9845852 24206333 0 0 PART V, LINE 4 THE INVESTMENT INCOME GENERATED BY THE ENDOWMENT FUNDS DISTRIBUTED TO THE HOSPITAL IS ABLE TO BE USED FOR GENERAL OPERATING AND CAPITAL EQUIPMENT NEEDS. true true X true X true X true true false true true 11267597 7145614 4121983 0.05910 11267597 7145614 4121983 0.05910 6311 6311 0.00010 14116 14116 0.00020 144 144 20571 20571 0.00030 11288168 7145614 4142554 0.05940 true 2284763 8242410 13407836 -5165426 X true true COMMUNITY CARE SYSTE MANAGED CARE CONTRACTING 0.5 0.5 1 1 THE VAN WERT COUNTY HOSPITAL ASSOC 1250 WASHINGTON STREET VAN WERT OH 45891 VANWERTHEALTH.ORG/1287 X X X THE VAN WERT COUNTY HOSPITAL ASSOC false false true X X X X X X X X X 18 true false true true X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X true 18 true SEE PART V, PAGE 8 false true X 100 200. X X X true true X X X true X 0 X 0 X X X X X X X true X false X X X X true X false false 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 6 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 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. X true true X X X X X true false false false false false false false false JAMES POPE CEO 388254 0 76882 0 0 0 40740 0 27523 0 533399 0 KAREN SHADOWENS CFO 273698 0 44816 0 0 0 31026 0 21835 0 371375 0 THOMAS CONTE CHIEF OF STAFF 269389 0 27838 0 0 0 238192 0 28637 0 564056 0 DR NIZAR ORFAHLI PHYSICIAN 483776 54285 9842 29288 16475 593666 DR NIK KIEHL PHYSICIAN 481784 26500 678 0 25171 534133 DR SCOTT SHIE PHYSICIAN 482464 26500 720 24692 25181 559557 DR JEREMY STOLLER PHYSICIAN 416940 81900 1210 19500 30784 550334 DR CHARLES HOEHN PHYSICIAN 304111 82869 1032 22923 29160 440095 PART I, LINE 1A FIRST CLASS TRAVEL WAS PROVIDED FOR THE ORGANIZATION'S CEO UNDER SPECIFIC CIRCUMSTANCES. THIS WAS NOT INCLUDED IN THE CEO'S TAXABLE COMPENSATION. A COUNTY OF VAN WERT OHIO 310308605 921297AA5 2020-03-01 61290000 REVENUE REFUNDING AND IMPROVEMMENT false false false A 9728003 0 36376499 4741918 5147455 0 1645468 0 0 10389830 2775 0 2020 true false true true A false false false false false false 0.00000 1.00000 1.00000 false false 0.00000 false false A true true false false false false 0 false 0 false true A true OHIO MEDICAL IMAGING ASSOCIATES BOARD MEMBER OWNER OF ENTITY (ERIC JELLINGER) 798000 RADIOLOGY SERVICES false 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. VAN WERT MEDICAL SERVICES 140 FOX ROAD VAN WERT OH 45891 202812541 MEDICAL SVCS OH 7659259 956594 VAN WERT VAN WERT COUNTY HOSPITAL PAIN MANAGEMENT 1250 S WASHINGTON ST VAN WERT OH 45891 810822738 PAIN MANAGEMENT OH VAN WERT HOSP RELATED 359939 157880 false false 0.51000 COMMUNITY CARE SYSTEMS INC 1250 S WASHINGTON ST VAN WERT OH 45891 341783212 HEALTHCARE MGMT OH NA C false true true false false false false false false false true false false false false false true false false false