2021-05-06T14:47:26-07:00 2020-06-30 990 2019-07-01 341041385 SALEM COMMUNITY HOSPITAL SALE 3303327214 1995 East State Street Salem OH 44460 Michael Giangardella VP Finance/Administration 3303327214 2021-05-06 2019 2022-09-23 18:48:47Z Salem Regional Medical Center Dr Anita Hackstedde MD 1995 East State Street Salem OH 44460 115960509 0 X www.salemregional.com X 1913 OH Salem Regional Medical Center (SRMC) is an 87-bed, not-for-profit rural facility, which provides a continuum of medical services to the residents of Columbiana and southern Mahoning counties, including inpatient and outpatient medical and surgical care, orthopedics and intensive care. The Hospital also operates a full-time 24-hour Emergency Department, and treats all patients requiring medical care, irrespective of their financial means. The Hospital provides its services free of charge or on a sliding scale to uninsured/underinsured patients, regardless of race, creed, origin, handicap, age or ability to pay.; in support of its mission- "To Serve. To Care. To Heal." 17 14 905 51 1004246 -25896 115703 5674993 111463788 106300282 6305358 3645409 521303 291462 118406152 115912146 4900 0 0 0 48968883 44006025 0 0 0 56960719 59623121 105934502 103629146 12471650 12283000 240445095 254361671 73550080 85461550 166895015 168900121 X "To Serve. To Care. To Heal," encompasses the Hospital's mission of providing high quality care on both an inpatient and outpatient basis; and addresses our patients' health care needs at each life stage, within our available resources. SRMC seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community-based hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. 0 1 89950346 105467078 SRMC's mission and purpose is achieved by providing quality care to the sick and injured on both an inpatient and outpatient basis, while addressing our patients' healthcare needs at each life stage, within our available resources. The Medical Center seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. During fiscal year 2020, SRMC provided comprehensive healthcare services including: 3,176 Admissions; 3,117 Surgeries; and 20,329 Emergency Department visits. In support of this commitment, SRMC operates a full-time, 24-hour Emergency Department, and treats all patients requiring emergency medical care, irrespective of their financial means. The Medical Center also accepts all patients covered by Medicare, Medicaid and General Assistance. For fiscal year 2020, costs incurred by SRMC for unpaid costs of the Medicaid program were $2,253,205 and unreimbursed costs from other governmental programs were $5,311,716. These community benefits, arising from patient care provided by SRMC are documented to help to relieve a governmental financial and programmatic burden as evidenced through the Medical Center's charitable purpose. 0 0 0 89950346 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 73 0 1 905 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Michael Giangardella 3303327214 1995 East State Street Salem OH 44460 Anita Hackstedde President/CEO 35 5 X 396878 0 105124 Dr Lee Simon Director 1 39 X 0 413190 22833 Mike Giangardella VP Finance/Administration 38 2 X 214633 0 119735 Dr Richard Beatty Chief of Staff 5 35 X 7500 274615 12366 Deborah Pietrzak Asst VP Marketing & Planning 40 0 X 124258 0 98170 Keith Meredith VP Clinical Operations 40 0 X 164333 0 57683 Sue Bryarly Director of Pharmacy 40 0 X 140601 0 80869 Kimberly Meek Pharmacist 40.6 0 X 123634 0 59826 Corey Less Pharmacist 41.4 0 X 120788 0 52816 Barbara Hirst VP Nursing/Human Resources 40 0 X 135552 0 11723 Diane Spalding Pharmacist 40.30 0 X 125067 0 5628 Peter Apicella MD Director 1 1 X 12245 0 0 Jon Vollnogle Chair 1 2 X 0 0 0 Chris Meta Vice-Chair 1 1 X 0 0 0 Jeffrey Zimmerman Treasurer 1 1 X 0 0 0 Denise Harlan Secretary 1 1 X 0 0 0 Dr Michael Sevilla Director 1 0 X 0 0 0 Vicki Hall Director 1 1 X 0 0 0 William Young EdD Director 1 1 X 0 0 0 Ruth Ann Rinto Director 1 1 X 0 0 0 Lynn Scullion O D Director 1 1 X 0 0 0 Terry Criss Director 1 0 X 0 0 0 Nelson Witmer Director 1 0 X 0 0 0 Vito Abruzzino Director 1 0 X 0 0 0 Scott Tuel Director 1 0 X 0 0 0 Bruce Rhodes Jr Director 1 0 X 0 0 0 1565489 687805 626773 24 1 1 0 Northstar Anesthesia 6225N State Hwy 161 Suite 200 Irving TX 75038 Medical Services 1207178 University Hospitals 3605 Warrensville Center Road Mail Stop 9230 -- Cube 2344I Shaker Heights OH 441225203 Medical Services 1018509 AVI Food Systems 2590 Elm Road NE Warren OH 44483 Food Services/Vending 854730 Laboratory Corporation of America PO box 12140 Burlington NC 27216 Laboratory services 495904 Xanitos 75 Remittance Drive Department 6704 Chicago IL 60675 Housekeeping Services 489440 23 5564556 110437 5674993 Patient Service Revenue 622000 104104540 104104540 0 0 Outside Lab Revenue 621500 77566 0 77566 0 Durable Medical Equipment Revenue 621610 1898504 971824 926680 0 Affiliated Exempt Organization Rent 531190 219672 219672 0 0 0 0 0 0 106300282 3636918 3636918 165774 0 45354 0 120420 0 120420 120420 11500 3009 0 8491 8491 8491 Gift Shop Revenue 900099 85883 85883 0 0 Medical Records Fees 900099 9534 9534 0 0 Canteen Revenue 900099 6802 6802 0 0 68823 68823 0 0 171042 115912146 105467078 1004246 3765829 X 0 0 0 0 0 0 0 0 896919 0 896919 0 0 0 0 0 31366434 28512537 2853897 0 4186055 3140806 1045249 0 5209788 4653480 556308 0 2346829 2099178 247651 0 198714 0 198714 0 207978 0 207978 0 87000 0 87000 0 0 0 0 0 0 0 0 0 0 0 14152901 12187129 1965772 0 197767 0 197767 0 1612301 1110873 501428 0 2630778 1817025 813753 0 0 0 0 0 2087626 1834226 253400 0 72246 50675 21571 0 0 0 0 0 0 0 0 0 1097069 1097069 0 0 0 0 0 0 9819619 8501382 1318237 0 243654 0 243654 0 Bad Debt 1962373 1962373 0 0 State Assessment 2139724 0 2139724 0 Drugs & Pharmaceuticals 11559076 11559076 0 0 Medical Supplies 11389433 11389433 0 0 164862 35084 129778 0 103629146 89950346 13678800 0 9249133 9941841 13836164 11553809 9077186 1312230 1546090 3069947 2830428 173238922 90691139 89695755 82547783 125564221 134582179 240445095 254361671 11445278 10906388 140000 43897538 42207534 216885 137396 17990379 32070232 73550080 85461550 X 166895015 168900121 0 0 166895015 168900121 240445095 254361671 X 12283000 -1409905 0 0 0 -8867989 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2330744 0 2330744 117379336 0 54690447 62688889 1555485 0 447464 1108021 51745990 0 35553228 16192762 227367 0 0 227367 82547783 0 Pension Liability 20253703 Medicare Accelerated Payments - Cares Act 10170765 Deferred COVID Relief Funds 1452698 Deferred Liability 193066 32070232 1 1 1 X 1 X 1 1 0 1 1 1347695 2312632 0 0 3381887 1128676 2253205 0.02216 10177787 7788472 2389315 0.0235 0 0 14907369 11229780 4642520 0.04566 86 227675 88996 400 88596 0.00087 261 880 500414 0 500414 0.00492 168586 162814 5772 0 0 0 0 0 8 1540 45939 0 45939 0.00045 355 230095 803935 163214 640721 0.00624 355 230095 15711304 11392994 5283241 0.05190 2 200 224 0 224 0 21 1950 7710 0 7710 0.00008 467 6440 89455 0 89455 0.00088 4 185 115717 8590 107127 0.0011 0 0 0 0 0 0 12 860 8492 0 8492 0.00008 40 2344 26326 0 26326 0.00026 49 2710 156724 0 156724 0.00154 0 0 0 0 0 0 595 14689 404648 8590 396058 0.00394 1 736347 238509 23454779 26377180 -2922401 X 1 1 1 1 Salem Community Hospital dba Salem Regional Medical Center 1995 East State Street Salem OH 44460 Salemregional.com X 15 bed skilled nursing facility (ceased operations fall of 2019) Salem Community Hospital dba Salem Regional Medical Center 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X http://www.salemregional.com X X 1 19 1 http://www.salemregional.com 0 0 1 X 150 350 X 1 1 X X X 1 X http://www.salemregional.com X http://www.salemregional.com X X 1 X X 1 X X X X X X 1 0 0 Schedule H, Part V, Section B, Line 5-Salem Community Hospital To take into account input from persons representing the community served, the CHNA primary data collection process included focus group and stakeholder interviews conducted with a total of 115 adult participants, including those from school districts, juvenile justice, community resource centers, senior services, Hispanic community providers, local government officials, health and human service providers, mental health providers and faith-based organizations. Community leaders and key stakeholders were identified as experts in a particular field related to their background experience or professional position; and/or those who understand the needs of a particular community/geographic region or under-represented group, including the medically underserved and vulnerable populations. In addition, a community survey derived from the Behavioral Risk Factor Surveillance System was completed by 382 adults, so that local primary data could be compared with state and national data. Schedule H, Part V, Section B, Line 6a-Salem Community Hospital Along with Salem Regional Medical Center, East Liverpool City Hospital and Akron Children's Hospital also provided financial support for the CHNA process. Schedule H, Part V, Section B, Line 6b-Salem Community Hospital A collaborative workgroup conducted the CHNA, composed of the Akron Children's Hospital, Columbiana County Educational Service Center, Columbiana County General Health District, Columbiana County Mental Health and Recovery Services Board, Community Action Agency of Columbiana County, East Liverpool City Health Department, East Liverpool City Hospital, Family and Children First Council, Salem City Health Department, Salem Regional Medical Center and The Ohio State University- Extension. In addition, this workgroup developed a County Health Improvement Plan to address the CHNA's priorities. Schedule H, Part V, Section B, Line 7d-Salem Community Hospital The CHNA was posted on Salem Regional Medical Center's website at http://www.salemregional.com/about-us/our-publications:Community Health Needs Assessment, along with being posted on many of the collaborative partners' websites. In addition, two news releases were issued regarding the preliminary CHNA findings and publication of the final report, with information about how the general public could access the CHNA via the internet. A Schedule H, Part V, Section B, Line 11-Salem Community Hospital As outlined in the 2019-2022 Implementation Plan, SRMC will focus on the CHNA's top 3 health priorities related to obesity/chronic disease; mental health and addiction/substance abuse and access to health care utilizing a three-year intervention strategy and defined target outcomes for each priority. Note that these priorities align with the priority topics identified in Ohio's 2019 State Health Assessment. To address the significant needs identified in the 2019 CHNA regarding obesity and chronic disease prevention, SRMC is working with existing and/or developing new community partnerships to broaden access to recreational opportunities and promote existing resources for improved physical activity and nutrition to positively impact the rates of physical activity and consumption of healthy foods for residents within SRMC's Service Area. To address the significant needs regarding mental health and substance abuse prevention, SRMC is serving as a community partner in improving access to mental health and substance abuse treatment services through membership on the ADAPT and CASH Coalitions, as well as facilitating the coordination of and access to community-based, post-acute treatment resources. SRMC also operates the Behavioral Medicine and Wellness Center as an intensive outpatient and partial hospitalization program designed to meet individual and group needs for mental health services in Columbiana and other surrounding counties. Data related to barriers in accessing clinical care indicated higher ratios of the population to primary care physicians, mental health providers and dental health providers, reflecting health professional shortages in these categories. To reduce barriers to accessing health care, SRMC is actively recruiting providers to underserved areas; exploring alternate delivery of care models, such as telemedicine; and increasing health literacy interventions to reduce hospital readmissions, strengthen medication education and increase patients' knowledge to decrease disparities among vulnerable populations. Primary data gathered from focus group participants and stakeholders identified multi-faceted socio-economic issues related to the poor economy, generational poverty, increased drug abuse and mental health issues, lack of transportation, Appalachian culture/unhealthy lifestyles, obesity, lack of parenting skills and language/health literacy barriers as key drivers of the health status of the community. Other identified needs related to the environment and social determinants of health included not enough money, lack of access to employment/better jobs, safe water/clean air/fracking/agricultural runoff, poor housing conditions and crime/violence. In addition, focus group participants identified the weather, chemical waste and unemployment as environmental determinants that impact community health. Due to their societal magnitude and SRMC's limited resources and capacity to meaningfully impact the environment and economic foundation of the county, SRMC has chosen to allocate significant resources to the priority health needs which yield the greatest opportunities to affect a positive change as outlined in the 2019-2022 Implementation Plan. Schedule H, Part V, Section B, Line 16j-Salem Community Hospital The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the billing office. 0 Schedule H, Part I, Line 6a Salem Regional Medical Center (SRMC) prepares an Annual Report that is distributed to the community via a paper and electronic format, as well as being posted on the SRMC website at www.salemregional.com. The Annual Report includes a summary of the Medical Center's statement of expenses and uncompensated care, along with highlighting SRMC's major community benefit initiatives and outcomes. This community benefit information is provided in an effort to document its tax exempt purpose and demonstrate the benefits provided for the broader community as determined by community need. Schedule H, Part I, Line 7 Costs are determined by applying the ratio of cost to charges to gross charges and utilizing the format as outlined in the Schedule H instructions. Beyond charity care, "Other Benefits" reported include community health improvement services and community benefit operations, with community building activities listed in Part II. The Medical Center seeks opportunities to further its tax exempt purpose by providing a wide variety of benefits for the broader community, including the development of a county-wide needs assessment to identify regional health needs; and the development and adoption of a related Implementation Plan to address the health needs identified. Examples of other community benefit activities include, but are not limited to: grant-writing activities for improved community health; community health education regarding cancer, diabetes, cardiac disease and other chronic diseases; obesity prevention and women's health; and community health fairs and free and reduced-cost clinical screenings for high blood pressure, blood sugar, colorectal cancer and mammography. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. Due to the Covid-19 pandemic beginning in March 2020, the number of traditional community health improvement programs, outreach activities and community events was severely curtailed. It is estimated that over 230,000 area residents participated in traditional community health improvementprograms and/or events provided and/or sponsored by Salem Regional Medical Center. However, the Hospital aggressively participated in a multitude of Covid-19 related community health improvement activities, including: developed community disaster readiness responses; provided education to increase awareness of Covid-19 risks and available testing and treatment services, which were established at nominal costs; set up a telephone hotline; established emergency food distribution programs; donated personal protective equipment to vulnerable populations; and conducted additional staff training to respond quickly to augment COVID-19 care as necessary. Schedule H, Part I, Line 7, Column f Bad debt expense in the amount of $1,962,373 is included in total expenses on Form 990,Part IX ,line 25, but was subtracted for purposes of calculating the percentages in Schedule H, Part 1, line 7. Schedule H, Part I, Line 7g Costs for subsidized health services include those attributable to providing Salem Regional Medical Center's outpatient behavioral health services. There are no health services attributable to a physician clinic. Schedule H, Part II During the taxable year, SRMC participated in 595 different community building activities in an effort to provide programs and activities that respond to demonstrated, unmet community needs; improve the community's health and safety; and promote the well-being of area residents through the Hospital's resources and expertise. It should be noted that the number of traditional community building activities was significantly reduced from prior years due to curtailed activities beginning in March 2020 related to the pandemic. Prior to the pandemic, SRMC participated in several area activities for the local and regional Chambers of Commerce; assisted in environmental improvements related to community medications' disposal; represented SRMC on diverse community coalitions related to improving community health; assisted with workforce development related to recruiting and retaining physicians and clinical professionals in medically underserved areas; and participated in community workforce boards, partnerships with area universities to address the health care work force shortage and provided many school-based programs on health care careers, including offering teen and college student mentoring opportunities. During the pandemic, SRMC served in a leadership role for the region's disaster readiness and preparedness activities, including coordinating and mobilizing disaster readiness and Covid-19 awareness coalitions and community support. SRMC continues to serve as a community resource and partner for regional non-profit organizations by providing collaborative programming with agencies such as the American Cancer Society, American Diabetes Association, American Heart Association, American Red Cross, Columbiana County Community Action Agency, Columbiana County and Salem City Departments of Health, Coordinated Action for School Health, Community Hospice, Kent State University- Salem Campus, Northeast Ohio Medical University and the Salem Community Center. In addition, SRMC makes financial and in-kind contributions to many of these and other not-for-profit organizations through event sponsorships and staff support. Schedule H, Part III, Section A, Line 4 "Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Organization analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Organization analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely)." The cost of bad debt was determined by applying the Medical Center's cost to charge ratio to the charges that were written off to bad debt. The Hospital believes this is a community benefit because the patients who may likely qualify for assistance under the Hospital's Financial Assistance Policy do not or are unwilling to provide documentation of the eligibility for charity care and therefore are classified as bad debt. The hospital is very willing to work out payment arrangements and discounted fees; however those patients unwilling to respond to repeated offers of assistance are categorized as bad debt expense. Had information been made available to make a determination of their eligibility, the Hospital believes that many patients classified as bad debt would qualify for charity care. This judgement is based on the economic conditions and specific knowledge of the patients involved. Schedule H, Part III, Section B, Line 8 The costs were obtained from the Medicare cost report. The Medical Center incurred costs in excess of $26.4 million to care for and treat beneficiaries while receiving reimbursement of $23.5 million, leaving a shortfall of $2.9 million. This is a direct benefit provided by the Medical Center to local beneficiaries who live in the surrounding communities. Schedule H, Part III, Section C, Line 9b Per the Medical Center's collection policy, the Medical Center will not pursue collection for non-payment of bills against individuals who demonstrate that they have neither sufficient income nor assets to meet their financial obligations. Schedule H, Part VI, Line 2 SRMC formally assesses the healthcare needs of the communities that it serves on a minimum of a triennial basis, and does so in collaboration with other community health providers. The most recent comprehensive, county-wide needs assessment was published in May 2019, and was developed by a collaborative of Columbiana County's major health providers, public health entities, and health-focused coalitions including Salem Regional Medical Center; East Liverpool City Hospital and Akron Children's Hospital; the Columbiana County, East Liverpool and Salem City Health Departments; Columbiana County Educational Service Center; Community Action Agency of Columbiana County; the Coordinated Action for School Health (CASH) Coalition; and the Columbiana County Mental Health Services and Recovery Board. The CHNA process began in May 2018, with the development of the project plan and timeline. The above mentioned collaborative convened in June 2018 and continued meeting through May 2019 to evaluate the previous CHNA, collect and analyze primary and secondary data, conduct community asset mapping and identify issues and select priorities to address through the development of the 2019-2022 CHNA. The Hospital Council of Northwest Ohio was retained to facilitate the process and provide data analysis and prioritization support. The geographic area of the needs assessment encompassed Ohio's Columbiana County, most of which is within Salem Regional Medical Center's Service Area; and prioritized the public, primary and specialty health care needs of community members from birth through end-of-life care. The CHNA action plan and report development were presented to and approved by the SRMC Board in May 2019, and distributed to all participating coalition organizations. The SRMC Implementation Plan was approved by the Board in November 2019, and both documents are posted on the SRMC website at: http://www.salemregional.com/about-us/our-publications: Community Health Needs Assessment and SRMC Implementation Plan. The Medical Center will carry forward its implementation strategies by addressing them in its Strategic Plan and annual Organizational Goals. In addition, SRMC is a collaborative partner in other types of needs assessments, such as the school health asset study through the Search Institute, conducted on a bi-annual basis with area school districts; a multi-disciplinary assessment of substance abuse incidence and treatment needs via the county-wide ADAPT coalition; behavioral health needs in collaboration with the Mental Health and Recovery services Board; and minority health access needs in collaboration with faith-based and literacy-based advocacy groups. Schedule H, Part VI, Line 3 The availability of free or discounted care is provided on billing statements to patients and this information is also posted on a sign at the Hospital's billing office. Schedule H, Part VI, Line 4 Salem Regional Medical Center's rural service area is officially designated as within one of Ohio's 32 Appalachian counties and includes Columbiana County, excluding Yellow Creek and East Liverpool Townships; and the five lower townships of Mahoning County. Portions of Columbiana County are also designated as Medically Underserved, and as a dental and mental health care Health Professional Shortage Areas. The Robert Wood Johnson 2018 County Health Rankings data also showed that Columbiana County faces a significant barrier to access as indicated by the county's ratio of the population to primary care providers (2,280:1) being higher than Ohio (1,310:1); and the county's ratio of dentists (4,320:1) being considerably higher than Ohio (1,660:1). Columbiana County residents are older than their state and national counterparts, and the Service Area is characterized by a declining social, economic and population base, which impacts the area's health status problems and health service utilization. Generational poverty, lack of transportation and lack of insurance are also barriers to access, with the rate of uninsured Columbiana County adults higher than Ohio. Regional health outcomes and social/economic/environmental rates that were worse than Ohio benchmarks included: higher rates of premature death/years of potential life lost before age 75, higher adult obesity rates combined with lower physical activity rates, higher percentage of people who report their physical health as fair or poor, lower post-secondary education rates, higher teen birth rates, greater number of deaths due to injury and a higher index of air pollution. Health disparities are also more common among vulnerable populations and based on the demographics of Columbiana County's population, the 2019-2022 CHNA identified vulnerable populations as those living in poverty/socioeconomically disadvantaged, the Appalachian culture, children/youth, the elderly and those facing ethnic and literacy barriers. Schedule H, Part VI, Line 5 Salem Regional Medical Center actively seeks opportunities to further the community's health status by providing a wide variety of benefits for the broader community, including grant-writing activities for improved community health; financial and in-kind contributions for community based feeding programs, physical fitness as an obesity and chronic disease prevention tool, blood drives, social services for vulnerable populations (including assistance with medications, transportation, limited English proficiency, referrals to support systems and provision of personal protective equipment and Covid-19 prevention education during the pandemic); community health education regarding Covid-19 awareness and prevention, cancer, diabetes, arthritis, cardiac and other chronic diseases, and women's health; and community health fairs and free and reduced-cost clinical screenings. Many of these educational programs, screenings, health fairs and outreach activities are provided in outlying school districts and communities within the Medical Center's defined geographic service area, in an effort to increase regional access to health services and health resources for people of all ages and socioeconomic means. Due to the Covid-19 pandemic beginning in March 2020, the number of external outreach activities and community events was significantly curtailed; however the Hospital transitioned to virtual education and awareness campaigns to continue to improve community health and enhance the community's ability to withstand and recover from this public health emergency. It is estimated that over 230,000 area residents participated in community benefit programs and/or events provided and/or sponsored by SRMC. SRMC also utilizes an active volunteer base, with 51 community members donating over 2512 hours of volunteer service annually. In addition, the SRMC Board of Directors is comprised of 16 community volunteers from the SRMC Service Area, who perform fiduciary responsibilities through monthly committee and Board activities. X X 0 0 0 0 0 0 0 0 0 Anita Hackstedde President/CEO 388878 0 0 0 8000 0 87273 0 17851 0 502002 0 0 0 Mike Giangardella VP Finance/Administration 214633 0 0 0 0 0 109421 0 10314 0 334368 0 0 0 Keith Meredith VP Clinical Operations 164333 0 0 0 0 0 49349 0 8334 0 222016 0 0 0 Sue Bryarly Director of Pharmacy 140601 0 0 0 0 0 50968 0 29901 0 221470 0 0 0 Diane Spalding Pharmacist 125067 0 0 0 0 0 5628 0 0 0 130695 0 0 0 Deborah Pietrzak Asst VP Marketing & Planning 124258 0 0 0 0 0 78116 0 20054 0 222428 0 0 0 Kimberly Meek Pharmacist 123634 0 0 0 0 0 49512 0 10314 0 183460 0 0 0 Corey Less Pharmacist 120788 0 0 0 0 0 22915 0 29901 0 173604 0 0 0 Barbara Hirst VP Nursing/Human Resources 135552 0 0 0 0 0 6136 0 5587 0 147275 0 0 0 A City Of Salem Ohio 346002560 2013-04-04 52000000 Hospital Facility Construction 0 1 0 A 29600292 0 52000000 193598 0 168913 0 160493 21883897 6893 0 2014 0 1 1 1 A 0 1 0 0 0.0112 0 0.0112 1 0 1 A 0 0 1 0 1 0 0 0 1 A 1 Form 990, Part III, Line 3 SRMC transitioned our skilled care services from our Skilled Nursing Facility unit to Swing beds within our medical/surgical units. The result of this change was to close the Skilled Nursing unit and move patient care to a Swing Bed model effective 8-23-2019. This transition was done to expand our ability to care for patients while improving the management of our patients' chronic conditions and reduce unnecessary readmissions. Form 990, Part VI, Section B, Line 11b Form 990, Part VI, Section B, Line 11b - The Form 990 is made available for review to the governing board prior to filing. Form 990, Part VI, Section B, Line 12c Form 990, Part VI, Section B, Line 12c - Each member of the Hospital's governing body, along with the Administrative staff, are required to review and disclose conflicts of interest in accordance with the Hospital's Code of Regulations. On an annual basis, Directors and Key Employees disclose potential business or professional relationships they may have with the Organization and/or other Directors/Key Employees. In situations when a Director may have a conflict, they may participate in the discussion, but must leave the room prior to final discussion and vote. Form 990, Part VI, Section B, Line 15 Form 990, Part VI, Section B, Line 15 - The President's compensation is determined by the Board of Directors of Salem Regional Medical Center, based upon the recommendation of the Board's Executive committee, both of which are comprised primarily of independent board members. The committee evaluates market data through formal statewide surveys, as well as targeted regional survey data. Form 990, Part VI, Section C, Line 19 Form 990, Part VI, Section C, Line 19 - As a private, not-for-profit organization, Salem Regional Medical Center does not make its governing documents or financial statements generally available to the public; although, the federal Form 990 is available for review upon request Form 990, Part IX, Line 11g Form 990, Part IX, Line 11g - Balance in this category represents the following expense: 1) Purchased Services total $9,686,552; 2) Repairs and Maintenance Services total $2,364,136; Professional Health Care Services total $2,104,852. Form 990, Part XI, Line 9 Form 990, Part XI, Line 9 - Change in defined benefit plan losses, prior service costs or credits and settlements -$3,728,291; transfers to related organization -$5,025,958; change in pledge receivable and medical staff cash -$113,740 Form 990, Part XII, Line 3b The audit that SRMC will be required to undergo per Single Audit Act and OMB Circular A-133 guidance is related to the CARES Act Relief Funds that the organization received during Fiscal Year 2020 (specifically in April 2020) in direct response to the COVID-19 Pandemic Disaster that was declared March 2020. The due date for the Single Audit related to all funds received in calendar year 2020 is not due until September 2021. Please note that this will be a consolidated Single Audit as the award is considered a single program irrespective of specific entity receipt. SCH Professional Corporation 1995 East State Street Salem OH 44460 341764515 Physician Offices OH 501(c)(3) 11 Salem Community Hospital 0 The Charitable Foundation of Salem Community Hospital 1995 East State Street Salem OH 44460 462902698 Support Salem Community Hospital OH 501(c)(3) 11 Salem Communiy Hospital 0 Salem Medical Arts & Development Corporation 2020 East State Street Salem OH 44460 341049534 Office Rent OH N/A C 1 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 SCH Professional Corporation j 215884 Cost per square foot SCH Professional Corporation b 5025958 Actual capital contribution SCH Professional Corporation o 278967 Net of actual salaries and benefits paid The Charitable Foundation of Salem Community Hospital q 110000 Reimburse actual salary, benefit and accounts payable cost paid.