WOOSTER COMMUNITY HOSPITAL FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- WOOSTER COMMUNITY HOSPITAL FOUNDATION (EIN 34-1785051)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-29
- IRS object ID
- 202123029349301102
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-29T07:20:30-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341310124 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REA & ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 941 STEUBENVILLE AVE PO BOX 820 | AddressLine1Txt |
| City | CAMBRIDGE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 437250820 | 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 | 341785051 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOOSTER COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WOOS | BusinessNameControlTxt |
| Phone | 3302638148 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 446912342 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN TRENT | PersonNm |
| Person Title | SECRETARY/TREASURER | PersonTitleTxt |
| Phone | 3302629370 | PhoneNum |
| Signature | 2021-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KEVIN | PersonFirstNm |
| Person Last | TRENT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LANE A MCCARTNEY CPA | PreparerPersonNm |
| PTIN | P02044349 | PTIN |
| Phone | 7404325658 | PhoneNum |
| Preparation | 2021-10-22 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM SHERON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 446912342 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,064,397 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PROGRAMS AND SERVICES IN SUPPORT OF THE OPERATIONS OF WOOSTER COMMUNITY HOSPITAL IN A MANNER THAT PROMOTES THE PUBLIC PURPOSES OF IMPROVING THE DELIVERY OF HEALTHCARE AND WELLNESS SERVICES TO ALL PEOPLE WITHIN THE CITY OF WOOSTER AND SURROUNDING COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 161 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,676,813 | PYContributionsGrantsAmt |
| CY Contributions Grants | $14,809,004 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,331,269 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,075,394 | CYProgramServiceRevenueAmt |
| PY Investment Income | $200,059 | PYInvestmentIncomeAmt |
| CY Investment Income | $162,616 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,500 | PYOtherRevenueAmt |
| CY Other Revenue | $17,383 | CYOtherRevenueAmt |
| PY Total Revenue | $28,215,641 | PYTotalRevenueAmt |
| CY Total Revenue | $29,064,397 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $15,313 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $106,431 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,546,573 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,934,721 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,022,201 | PYOtherExpensesAmt |
| CY Other Expenses | $8,948,269 | CYOtherExpensesAmt |
| PY Total Expenses | $26,584,087 | PYTotalExpensesAmt |
| CY Total Expenses | $27,989,421 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,631,554 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,074,976 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,832,861 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,011,786 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,086,424 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,188,833 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,746,437 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,822,953 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE PROGRAMS AND SERVICES IN SUPPORT OF THE OPERATIONS OF WOOSTER COMMUNITY HOSPITAL IN A MANNER THAT PROMOTES THE PUBLIC PURPOSES OF IMPROVING THE DELIVERY OF HEALTHCARE AND WELLNESS SERVICES TO ALL PEOPLE WITHIN THE CITY OF WOOSTER AND SURROUNDING COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $106,431 | ExpenseAmt |
| Grant | $106,431 | GrantAmt |
| Revenue | $12,400,000 | RevenueAmt |
| Desc | THE RECRUITMENT AND RETENTION OF PHYSICIANS, PHYSICIAN ASSISTANTS AND CERTIFIED NURSE PRACTITIONERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $26,454,588 | ExpenseAmt |
| Revenue | $16,069,084 | RevenueAmt |
| Desc | THE PROVISION OF MEDICAL SERVICES TO THE PUBLIC THROUGH THE OPERATION OF BLOOMINGTON MEDICAL SERVICES, LLC. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $210,000 | ExpenseAmt |
| Desc | THE PROVISION OF COMMUNITY HEALTH SUPPORT. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $26,771,019 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 161 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN TRENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3302638148 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| THOMAS CAPEK | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JERRY PACKARD | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOAN KIPER | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAN WAKEFIELD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN TRENT | ||||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DON NOBLE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM SHERON | ||||||||
| CEO | 40.00 | Yes (X) | $0 | $480,953 | $149,092 | |||
| SCOTT BOYES | ||||||||
| CFO | 40.00 | Yes (X) | $0 | $376,215 | $59,543 | |||
| CYRIL OFORI | ||||||||
| ASSOCIATE | 40.00 | $1,048,208 | $0 | $29,988 | Yes (X) | |||
| ROBERT D CEBUL | ||||||||
| ASSOCIATE | 40.00 | $728,433 | $0 | $13,470 | Yes (X) | |||
| PAUL MOODISPAW | ||||||||
| ASSOCIATE | 40.00 | $668,802 | $0 | $35,410 | Yes (X) | |||
| JOSEPH S BORRUSO | ||||||||
| ASSOCIATE | 40.00 | $591,020 | $0 | $27,669 | Yes (X) | |||
| NAGAPRADEEP NAGAJOTHI | ||||||||
| ASSOCIATE | 40.00 | $619,009 | $0 | $26,074 | Yes (X) | |||
| SHARON E MARCANTHONY | ||||||||
| ASSOCIATE | 40.00 | $863,277 | $0 | $24,636 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,518,749 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $857,168 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $365,882 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| OSU SPECIALTY CARE NETWORK | |||||
| 660 ACKERMAN RD | COLUMBUS | OH | 432183104 | MEDICAL SERVICES | $2,928,554 |
| HEALTHSCOPE BENEFITS INC | |||||
| 12448 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | 3RD PART ADMIN FOR BMS HEALTH PLAN | $657,522 |
| BARTON ASSOCIATES | |||||
| PO BOX 417844 | BOSTON | MA | 022417844 | MEDICAL SERVICES | $423,925 |
| DAVID AKWAINHA KITTOE DBA DAVEN MED | |||||
| 3487 EAST GALLOWAY DRIVE | RICHFIELD | OH | 44286 | MEDICAL SERVICES | $363,179 |
| CHG COMPANIES INC DBA COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | MEDICAL SERVICES | $127,441 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,400,000 | RelatedOrganizationsAmt |
| Government Grants | $1,976,307 | GovernmentGrantsAmt |
| All Other Contributions | $432,697 | AllOtherContributionsAmt |
| Total Contributions | $14,809,004 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $13,603,851 | $13,603,851 |
| MISCELLANEOUS REVENUE | 900099 | $471,543 | $471,543 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,075,394 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $162,616 | TotalRevenueColumnAmt |
| Exclusion | $162,616 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REPAYMENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $17,383 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,383 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $17,383 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,064,397 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,092,777 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $162,616 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,431 | TotalAmt |
| Program Services | $106,431 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,078,196 | TotalAmt |
| Program Services | $1,078,196 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,191,411 | TotalAmt |
| Program Services | $15,191,411 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,665,114 | TotalAmt |
| Program Services | $2,665,114 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,508 | TotalAmt |
| Management And General | $2,508 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $773 | TotalAmt |
| Management And General | $773 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,562,941 | TotalAmt |
| Program Services | $5,562,941 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,484 | TotalAmt |
| Management And General | $582,484 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,077 | TotalAmt |
| Program Services | $191,077 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,417 | TotalAmt |
| Program Services | $528,417 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHYSICIAN ADVANCES AND | $1,067,529 | $1,067,529 | |
| SUPPLIES | $615,055 | $615,055 | |
| COMMUNITY SUPPORT | $210,000 | $210,000 | |
| REPAIRS AND MAINTENANCE | $17,582 | $17,582 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,903 | TotalAmt |
| Program Services | $169,903 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,989,421 | TotalAmt |
| Program Services | $26,771,019 | ProgramServicesAmt |
| Management And General | $1,218,402 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,441 | BOYAmt |
| EOY | $2,973,897 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,259,656 | BOYAmt |
| EOY | $3,091,648 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,115,678 | BOYAmt |
| EOY | $1,452,340 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,724 | BOYAmt |
| EOY | $302,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,065,234 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,310,247 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $716,087 | BOYAmt |
| EOY | $754,987 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,233 | BOYAmt |
| EOY | $10,674 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,686 | BOYAmt |
| EOY | $533,762 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $752,356 | BOYAmt |
| EOY | $891,825 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,832,861 | BOYAmt |
| EOY | $10,011,786 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,086,424 | BOYAmt |
| EOY | $4,188,833 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,086,424 | BOYAmt |
| EOY | $4,188,833 | 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 | $4,692,796 | BOYAmt |
| EOY | $5,807,937 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,641 | BOYAmt |
| EOY | $15,016 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,746,437 | BOYAmt |
| EOY | $5,822,953 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,832,861 | BOYAmt |
| EOY | $10,011,786 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,074,976 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,540 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,519,198 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,482,663 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,812,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,676,813 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,809,004 | CurrentTaxYearAmt |
| Total | $57,299,818 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,519,198 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,482,663 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,812,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,676,813 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,809,004 | CurrentTaxYearAmt |
| Total | $57,299,818 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $417,296 | SubstantialContributorsTotAmt |
| Public Support Total170 | $56,882,522 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $794 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $94,317 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $200,059 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $162,616 | CurrentTaxYearAmt |
| Total | $458,791 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $117,730 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $137,945 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,419 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,500 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,383 | CurrentTaxYearAmt |
| Total | $404,977 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $58,163,586 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $61,676,768 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97800 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97360 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,476 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,540 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $15,016 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,445 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,031 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $13,476 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,048 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,397 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $11,445 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,048 | BeginningYearBalanceAmt |
| End Year Balance | $10,048 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,048 | BeginningYearBalanceAmt |
| End Year Balance | $10,048 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,065,234 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,310,247 | DepreciationAmt |
| Book Value | $754,987 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $754,987 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN WAYNE NETWORK | Desc |
| Book Value | $533,762 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $533,762 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| 457 (F) CONTRIBUTIONS | $786,380 |
| OTHER RECEIVABLES | $105,445 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $891,825 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS WERE ESTABLISHED TO GROW FOR THE PURPOSE OF PROVIDING FINANCIAL RESOURCES FOR THE FOUNDATION IN THE FUTURE. |
| PART X, LINE 2: | FEDERAL INCOME TAX: THE ORGANIZATION IS TAX EXEMPT UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. WITH FEW EXCEPTIONS THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL AUTHORITIES FOR THE YEARS BEFORE 2015. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOOSTER COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 346003129 | RecipientEIN |
| IRC Section | 501C3 | IRCSectionDesc |
| Cash Grant | $106,431 | CashGrantAmt |
| Valuation Method Used | ACTUAL | ValuationMethodUsedDesc |
| Purpose Of Grant | SUPPORT OF NURSING SCHOLARSHIP AND MEDICAL PROFESSIONAL EDUCATION | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CYRIL OFORI | ||||||||||||||
| ASSOCIATE | $1,048,208 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $18,588 | $0 | $1,078,196 | $0 | $0 | $0 |
| SHARON E MARCANTHONY | ||||||||||||||
| ASSOCIATE | $863,277 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $13,236 | $0 | $887,913 | $0 | $0 | $0 |
| ROBERT D CEBUL | ||||||||||||||
| ASSOCIATE | $728,433 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $2,070 | $0 | $741,903 | $0 | $0 | $0 |
| PAUL MOODISPAW | ||||||||||||||
| ASSOCIATE | $668,802 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $24,010 | $0 | $704,212 | $0 | $0 | $0 |
| NAGAPRADEEP NAGAJOTHI | ||||||||||||||
| ASSOCIATE | $619,009 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $14,674 | $0 | $645,083 | $0 | $0 | $0 |
| WILLIAM SHERON | ||||||||||||||
| CEO | $0 | $480,953 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $149,092 | $0 | $630,045 | $0 | $0 |
| JOSEPH S BORRUSO | ||||||||||||||
| ASSOCIATE | $591,020 | $0 | $0 | $0 | $0 | $0 | $11,400 | $0 | $16,269 | $0 | $618,689 | $0 | $0 | $0 |
| SCOTT BOYES | ||||||||||||||
| CFO | $0 | $376,215 | $0 | $0 | $0 | $0 | $0 | $39,900 | $0 | $19,643 | $0 | $435,758 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | THE FOLLOWING EMPLOYEES WERE COVERED UNDER A 457(F) PLAN: CYRIL OFORI $ 58,488 PAUL MOODISPAW $ 39,326 ROBERT CEBUL $ 39,699 DANIEL PEABODY $ 26,764 JAMES SLABY $21,971 |
| PART I, LINE 5 | BASED ON PHYSICIAN RVU'S ABOVE A PREDETERMINED LEVEL. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE COMPLETED RETURN IS PRESENTED TO THE BOARD. THE BOARD REVIEWS THE RETURN, ADDRESSES ANY QUESTIONS, AND PROPOSES NECESSARY REVISIONS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS OF WOOSTER COMMUNITY HOSPITAL FOUNDATION AND THE BLOOMINGTON MEDICAL SERVICES INC. EMPLOYED DOCTORS MUST SIGN ANNUAL DISCLOSURE STATEMENTS, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. DUE TO THE SMALL SIZE OF THE COMMUNITY, THE FOUNDATION'S MANAGEMENT WOULD LIKELY BECOME AWARE OF ANY CONFLICTS OF INTEREST UPON THEIR CREATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR SENIOR MANAGEMENT IS BASED ON OHA COMPARABILITY DATA. COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE HOSPITAL BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION MAINTAINS PERTINENT PUBLIC RECORDS AND RELEASES THEM TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | MEDICAL SERVICE PROVIDERS: PROGRAM SERVICE EXPENSES 5,562,941. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,562,941. |
| FORM 990, PART XI, LINE 9: | NET CHANGE IN ENDOWMENT FUND AT WAYNE COMMUNITY FOUNDATION 1,540. |
| 990, PART XI LINE 2C | A COMMITTEE ASSUMES RESPONSIBILITY OF THE OVERSIGHT OF THE AUDIT AND THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLOOMINGTON MEDICAL SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261803679 | EIN |
| Primary Activities | PROVIDING MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $16,051,701 | TotalIncomeAmt |
| End Of Year Assets | $6,375,205 | EndOfYearAssetsAmt |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOOSTER COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346003129 | EIN |
| Primary Activities | TO OPERATE A HOSPITAL IN ORDER TO PROVIDE MEDICAL SERVICES TO THE COMMUNITY | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | GOVERMENTAL ENTITY | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE NETWORK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1761 BEALL AVENUE | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270014500 | EIN |
| Primary Activities | PROVIDE HEALTHCARE UTILIZATION AND CARE COORDINATION SERVICES TO EMPLOYERS | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $195,263 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $533,762 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WOOSTER COMMUNITY HOSPITAL | ||
| C | $12,400,000 | ACTUAL |
| WOOSTER COMMUNITY HOSPITAL | ||
| K | $559,648 | ACTUAL |
| WOOSTER COMMUNITY HOSPITAL | ||
| O | $5,443,472 | ACTUAL |
| WOOSTER COMMUNITY HOSPITAL | ||
| P | $513,524 | ACTUAL |
| WOOSTER COMMUNITY HOSPITAL | ||
| M | $600,000 | ACTUAL |