2021-11-15T16:09:24-06:00 2020-12-31 341827159 GILMORE JASION MAHLER LTD 1785 INDIAN WOOD CIRCLE MAUMEE OH 43537 990 2020-01-01 341116795 HOSPITAL COUNCIL OF NORTHWEST OHIO HOSP 4198420800 3231 CENTRAL PARK WEST NO 200 TOLEDO OH 43617 W SCOTT FRY PRESIDENT & CEO 4198420800 2021-11-15 1 W SCOTT FRY 999009999 HEIDI FERGUSON P00410007 4197942000 2021-11-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z W SCOTT FRY 3231 CENTRAL PARK WEST NO 200 TOLEDO OH 43617 7554184 0 X WWW.HCNO.ORG X 1973 OH THE HOSPITAL COUNCIL OF NORTHWEST OHIO IS A MEMBER DRIVEN ORGANIZATION THAT REPRESENTS AND ADVOCATES ON BEHALF OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS AND PROVIDES COLLABORATIVE OPPORTUNITIES TO ENHANCE THE HEALTH STATUS OF THE CITIZENS OF NORTHWEST OHIO. THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 23 22 49 42 0 0 3100552 4087393 4159857 3393724 51351 38861 22668 34206 7334428 7554184 2764742 3012416 0 0 3522632 3471166 0 0 0 1296042 1324967 7583416 7808549 -248988 -254365 6988860 7109332 1569918 1994755 5418942 5114577 X THE HOSPITAL COUNCIL OF NORTHWEST OHIO IS A MEMBER DRIVEN ORGANIZATION THAT REPRESENTS AND ADVOCATES ON BEHALF OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS AND PROVIDES COLLABORATIVE OPPORTUNITIES TO ENHANCE THE HEALTH STATUS OF THE CITIZENS OF NORTHWEST OHIO. SEE SCHEDULE O THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 0 0 7563035 3012416 3409353 -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS.-DEVELOPING, IMPLEMENTING, AND SECURING FUNDING FOR CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS.-PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 7563035 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 17 0 1 49 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 22 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X W SCOTT FRY 4198420800 3231 CENTRAL PARK WEST TOLEDO OH 43617 SCOTT C MALANEY TRUSTEE 1.00 X 0 0 0 DAWN BUSKEY SECRETARY 1.00 X X 0 0 0 JEREMY NORMINGTON - SLAY DPT TRUSTEE 1.00 X 0 0 0 BRENT BURKEY TREASURER 1.00 X X 0 0 0 PATRICIA FINN OUTGOING IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 KIM BORDENKIRCHER TRUSTEE 1.00 X 0 0 0 J TODD ALMENDINGER OUTGOING CHAIR-ELECT 1.00 X X 0 0 0 SONYA SELHORST TRUSTEE 1.00 X 0 0 0 LYNN DETTERMAN TRUSTEE 1.00 X 0 0 0 BRADLEY BERTKE TRUSTEE 1.00 X 0 0 0 CRAIG ALBERS TRUSTEE 1.00 X 0 0 0 JEFFREY DEMPSEY CHAIR-ELECT/OUTGOING SECRETARY 1.00 X X 0 0 0 RON GOEDDE TRUSTEE 1.00 X 0 0 0 GARY AKENBERGER TRUSTEE 1.00 X 0 0 0 DOUG BUSH TRUSTEE 1.00 X 0 0 0 PAMELA JENSEN TRUSTEE 1.00 X 0 0 0 CHAD TINKEL TRUSTEE 1.00 X 0 0 0 DANIEL L WAKEMAN TRUSTEE 1.00 X 0 0 0 MICHAEL WINTHROP OUTOING CHAIRPERSON 1.00 X X 0 0 0 DANIEL BARBEE CHAIRPERSON/OUTGOING TREASURER 1.00 X X 0 0 0 STANLEY KORDUCKI TRUSTEE 1.00 X 0 0 0 TY SHAULL TRUSTEE 1.00 X 0 0 0 W SCOTT FRY PRESIDENT & CEO 34.00 6.00 X X 218729 35607 76920 KIMBERLY TEMPLE CONTROLLER 40.00 0.00 X 140558 0 58760 JAN RUMA VICE PRESIDENT 33.00 7.00 X 169978 32377 67418 CAROLYN TRUMBULL EMPLOYEE 0.00 40.00 X 0 104643 53611 529265 172627 256709 3 0 1 0 MAIL IT 380 S ERIE ST TOLEDO OH 43604 PRINTING 158732 JMS REAL ESTATE 3230 CENTRAL PARK W TOLEDO OH 43617 PROPERTY MGMT 113740 2 12758 1927412 2147223 4087393 CONTRACT INCOME 900099 2720263 2720263 MEMBERSHIP DUES 900099 673461 673461 3393724 38861 38861 REFUNDS & REBATES 900099 18577 18577 15629 15629 34206 7554184 3409353 0 57438 2948782 2948782 63634 63634 331255 276275 54980 2161696 2100247 61449 196213 193288 2925 598488 580079 18409 183514 171753 11761 2506 2506 42286 42286 283656 264399 19257 830 830 181211 165657 15554 101785 97702 4083 133301 127352 5949 14401 11930 2471 7688 6731 957 29 29 2848 2364 484 27183 25922 1261 PROGRAM EXPENSE 496209 496209 TRAINING 26660 26607 53 ORG DUES AND MEMBERSHIP 4038 2955 1083 SUBSCRIPTIONS 336 319 17 7808549 7563035 245514 0 4628111 5351500 1019718 0 691403 894766 563617 782339 11407 9000 89710 87967 4591 1743 70013 69984 6988860 7109332 425298 421065 787824 755934 70013 69984 1504 619500 285279 128272 1569918 1994755 X 4500859 4560040 918083 554537 5418942 5114577 6988860 7109332 -254365 -50000 0 X X 0 1 X 1 1 1 X 4288814 4277681 3267063 3100552 4087393 19021503 4288814 4277681 3267063 3100552 4087393 19021503 19021503 4136 10524 21138 51351 38861 126010 26363 34703 34195 22668 34206 152135 19299648 17683106 0.98560 0.98610 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: REIMBURSEMENT INCOME - 2016 AMOUNT: $ 22,244. 2017 AMOUNT: $ 30,584. 2018 AMOUNT: $ 33,077. 2019 AMOUNT: $ 22,512. 2020 AMOUNT: $ 15,629. REFUNDS REBATES - 2020 AMOUNT: $ 18,577. MISCELLANEOUS - 2016 AMOUNT: $ 4,119. 2017 AMOUNT: $ 4,119. 2018 AMOUNT: $ 1,118. 2019 AMOUNT: $ 156. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 66704 64961 1743 23006 23006 0 1743 OTHER CONTRACT LIABILITIES 128272 128272 X 7757184 203000 203000 7554184 0 7554184 8011549 203000 203000 7808549 0 7808549 PART IV, LINE 2B: DURING NOVEMBER 2019, THE ORGANIZATION BECAME THE COORDINATING ORGANIZATION, FISCAL AGENT, AND COMMUNICATIONS COORDINATOR FOR HEALTHY LUCAS COUNTY. AS FISCAL AGENT, THE ORGANIZATION PROVIDES CASH MANAGEMENT FUNCTIONS AND HOLDS FUNDS ON BEHALF OF HEALTHY LUCAS COUNTY. FUNDS HELD ON BEHALF OF HEALTHY LUCAS COUNTY WERE $70,013 AND $69,984 AT DECEMBER 31, 2019 AND 2020, RESPECTIVELY. PART X, LINE 2: MANAGEMENT OF THE ORGANIZATION IS REQUIRED TO DETERMINE WHETHER A TAX POSITION OF THE ORGANIZATION IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT OF THE ORGANIZATION IS NOT AWARE OF ANY TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY CHANGE IN THE NEXT TWELVE MONTHS. HOWEVER, MANAGEMENT'S CONCLUSIONS MAY BE SUBJECT TO REVIEW AND ADJUSTMENT AT A LATER DATE BASED ON FACTORS INCLUDING, BUT NOT LIMITED TO, NEW TAX LAWS, REGULATIONS, AND ADMINISTRATIVE INTERPRETATIONS (INCLUDING RELEVANT COURT DECISIONS). THE ORGANIZATION'S FEDERAL TAX RETURNS FOR THE PRIOR THREE YEARS REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. NO INTEREST OR PENALTIES WERE INCURRED OR RECOGNIZED IN 2020 OR 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY TRANSACTIONS 203,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY TRANSACTIONS 203,000. 1 ADELANTE INC 520 BROADWAY TOLEDO OH 43604 341826214 501(C)(3) 79105 SUPPORT BABY UNIVERSITY 860 ORCHARD STREET TOLEDO OH 43609 474336051 501(C)(3) 304460 SUPPORT BLANCHARD VALLEY HEALTH SYSTEM 1900 SOUTH MAIN STREET FINDLAY OH 45840 341369963 501(C)(3) 12200 SUPPORT CATHOLIC CHARITIES DIOCESE OF TOLEDO 1933 SPIELBUSCH AVENUE TOLEDO OH 43604 344428254 501(C)(3) 43040 SUPPORT CITY OF CANTON 218 CLEVELAND AVENUE SW 8TH FLOOR CANTON OH 44702 134365 SUPPORT COMMUNITY HOSPITALS AND WELLNESS CENTERSBRYAN 433 W HIGH STREET BRYAN OH 43506 341048666 501(C)(3) 12200 SUPPORT COMMUNITY MEMORIAL HOSPTIAL 208 N COLUMBUS STREET HICKSVILLE OH 43526 346401873 6001 SUPPORT COMPASSION HEALTH TOLEDO 1638 BROADWAY TOLEDO OH 436093240 473197108 501(C)(3) 150320 SUPPORT EAST TOLEDO FAMILY CENTER 1020 VARLAND AVENUE TOLEDO OH 43605 344429426 501(C)(3) 233325 SUPPORT ERIE COUNTY GENERAL HEALTH DISTRICT 420 SUPERIOR ST SANDUSKY OH 44870 37917 SUPPORT FIRELANDS REGIONAL MEDICAL CENTER 1111 HAYES AVE SANDUSKY OH 44870 344428218 501(C)(3) 5385 SUPPORT FISHER-TITUS MEDICAL CENTER 272 BENEDICT AVE NORWALK OH 44857 344430716 501(C)(3) 6284 SUPPORT FULTON COUNTY HEALTH CENTER 725 SOUTH SHOOP AVENUE WAUSEON OH 43567 344428214 501(C)(3) 6491 SUPPORT GRACEHAVEN PO BOX 82102 COLUMBUS OH 43220 262471442 501(C)(3) 5000 SUPPORT HEALTHCARE COLLABORATIVE OF GREATER COLUMBUS 855 GRANDVIEW AVE 210 COLUMBUS OH 43215 41415 SUPPORT HENRY COUNTY HEALTH DEPARTMENT 1843 OAKWOOD AVE NAPOLEON OH 43545 346400633 10697 SUPPORT HENRY COUNTY HOSPITAL 1600 EAST RIVERVIEW AVENUE NAPOLEON OH 43545 344477047 501(C)(3) 6885 SUPPORT LIME MEMORIAL HEALTH SYSTEM 1001 BELLEFONTAINE AVE LIMA OH 45804 341883284 6100 SUPPORT LOCAL INITIATIVE SUPPORT CORPORATION 501 SEVENTH AVENUE 7TH FLOOR NEW YORK NY 10018 133030228 501(C)(3) 36915 SUPPORT LUCAS COUNTY REGIONAL HEALTH DISTRICT 635 N ERIE STREET TOLEDO OH 43604 346400806 182406 SUPPORT MAGRUDER HOSPITAL 615 FULTON STREET PORT CLINTON OH 43452 344441792 501(C)(3) 6077 SUPPORT MERCER COUNTY HEALTH DEPARTMENT 220 WEST LIVINGSTON ST B252 CELINA OH 45822 346400877 9660 SUPPORT MERCER HEALTH 800 W MAIN STREET COLDWATER OH 45828 341101385 501(C)(3) 6056 SUPPORT MERCY FOUNDATION 2525 CHERRY STREET TOLEDO OH 43608 201072726 501(C)(3) 415977 SUPPORT NEIGHBORHOOD HEALTH ASSOCIATION 313 JEFFERSON AVENUE TOLEDO OH 43604 237272741 501(C)(3) 33845 SUPPORT PATHWAYS COMMUNITY HUB INSTITUTE INC ONE MARION AVE SUITE 306 MANSFIELD OH 44903 813738049 501(C)(3) 12000 SUPPORT PAULDING COMMUNITY HOSPITAL 1035 W WAYNE STREET PAULDING OH 45879 346405718 6100 SUPPORT PROMEDICA HEALTH SYSTEM 100 MADISON AVE TOLEDO OH 43604 341517671 501(C)(3) 66745 SUPPORT PROMEDICA TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO OH 43606 344428256 501(C)(3) 406807 SUPPORT PROMEDICA TRANSPORTATION NETWORK 7140 PORT SYLVANIA DRIVE STE 150 TOLEDO OH 43617 344428256 501(C)(3) 10000 SUPPORT ST PAULS COMMUNITY CENTER 230 13TH ST TOLEDO OH 43604 341252554 501(C)(3) 7410 SUPPORT ST LUKE'S HOSPITAL 5901 MONCLOVA RD MAUMEE OH 43537 344428232 501(C)(3) 7100 SUPPORT THE BELLEVUE HOSPITAL 1400 WEST MAIN BELLEVUE OH 44811 344428205 501(C)(3) 6424 SUPPORT THE UNIVERSITY CHURCH 4747 HILL AVENUE TOLEDO OH 43615 352484010 52760 SUPPORT TOLEDO AREA REGIONAL TRANSIT AUTHROITY 1127 WEST CENTERAL AVE TOLEDO OH 43610 341082725 6665 SUPPORT TOLEDO FIRE AND RESCUE 545 N HURON STREET TOLEDO OH 43604 13418 SUPPORT TOLEDO LUCAS COUNTY HOMELESSNESS BOARD 1946 N 13TH STREET STE 437 TOLEDO OH 43604 721604255 501(C)(3) 50000 SUPPORT TOLEDO-LUCAS COUNTY CARENET INC 3231 CENTRAL PARK WEST DR ROOM/SUIT 200 TOLEDO OH 43617 431986672 501(C)(3) 188270 SUPPORT UNIVERSITY OF TOLEDO GRANTS ACCOUNTING 2801 W BANCROFT ST TOLEDO OH 43606 346401483 501(C)(3) 45000 SUPPORT VAN WERT COUNTY HOSPITAL 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 344429514 501(C)(3) 5820 SUPPORT WOOD COUNTY HEALTH DISTRICT 1840 EAST GYPSY LANE BOWLING GREEN OH 43402 346401607 5856 SUPPORT WOOD COUNTY HOSPITAL 950 W WOOSTER STREET BOWLING GREEN OH 43402 344440884 501(C)(3) 12748 SUPPORT YWCA OF NORTHWEST OHIO 1018 JEFFERSON AVE TOLEDO OH 43604 344428265 501(C)(3) 78960 SUPPORT 30 13 GIFT CARDS 217 7154 SURVEY INCENTIVES 27850 56480 PART I, LINE 2: THE PROGRAM STAFF WORK CLOSELY WITH EACH SUB GRANTEE REGARDING PAPERWORK NEEDED. ALL SUB GRANTEES MUST SUBMIT DOCUMENTATION FOR REIMBURSEMENT OF ALL EXPENDITURES. WHEN NECESSARY, THE ASSISTANT CONTROLLER TRACKS EXPENDITURES TO ENSURE ADHERENCE TO THE BUDGET; IN ADDITION, THE PROGRAM DIRECTOR WORKS WITH FINANCE TO OVERSEE THE GRANT AND MANTAIN COMPLIANCE WITH APPLICABLE MANDATES. EACH SUB-GRANTEE MUST SUBMIT A BUDGET SPENDING PLAN FOR APPROVAL, PRIOR TO RECEIVING THEIR FIRST PAYMENT. THE SPENDING PLANS GIVE AN ESTIMATE "DATE TO BE SPENT" FOR EACH LINE ITEM. SUB GRANTEES TURN IN QUARTERLY REPORTS, AND THE PROGRAM DIRECTOR AND SPECIALIST REVIEW THEIR SPENT FUNDS TO DATE. SUB GRANTEES MUST SUBMIT RECEIPTS FOR EXPENSES, AT WHICH TIME A CHECK FOR REIMBURSEMENT WILL BE DISBURSED. X X X 0 0 0 0 0 0 0 0 0 W SCOTT FRY PRESIDENT & CEO 204007 34396 0 0 14722 1211 32211 5244 33940 5525 284880 46376 0 0 JAN RUMA VICE PRESIDENT 167201 31848 1260 240 1517 289 21384 4073 35247 6714 226609 43164 0 0 KIMBERLY TEMPLE CONTROLLER 137577 0 1500 0 1481 0 17322 0 41438 0 199318 0 0 0 CAROLYN TRUMBULL EMPLOYEE 0 102065 0 1500 0 1078 0 12673 0 40938 0 158254 0 0 FORM 990, PART VI, SECTION A, LINE 6 AREA HOSPITALS COMPRISE THE MEMBERSHIP OF HOSPITAL COUNCIL OF NORTHWEST OHIO. FORM 990, PART VI, SECTION A, LINE 7A THESE MEMBER HOSPITALS MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S SIGNING OFFICER SCANS THE FORM 990 FOR COMPLETENESS PRIOR TO SIGNATURE, IN ADDITION TO RELYING UPON THE INDEPENDENT ACCOUNTANT FOR ACCURACY. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BODY USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO OR TOP MANAGEMENT OFFICIALS WHICH INCLUDES A COMPARISON TO OTHER ORGANIZATIONS, SALARY SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. THE ORGANIZATION USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES WHICH INCLUDES A REVIEW AND APPROVAL BY THE CEO, USE OF MANAGEMENT SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES REPSONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. NORTHWEST OHIO SHARED SERVICES 3231 CENTRAL PARK WEST DR TOLEDO OH 43617 341388279 PURCHASE CORPORATION OH N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 NORTHWEST OHIO SHARED SERVICES INC L 233239 AUDITED INCOME RECEIVED NORTHWEST OHIO SHARED SERVICES INC O 204630 ACTUAL COST INCURRED