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POMERENE HOSPITAL: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
POMERENE HOSPITAL (EIN 31-1518658)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-10-21
IRS object ID
202502949349300240
Schema version
2024v5.2
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

FieldValueIRS element (for citing)
Return2025-10-21T10:28:04-05:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19200 WORTHINGTON RD STE 200AddressLine1Txt
CityWESTERVILLECityNm
State AbbreviationOHStateAbbreviationCd
ZIP43082ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311518658EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POMERENE HOSPITALBusinessNameLine1Txt
Business Name Line2FKA JOEL POMERENE FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPOMEBusinessNameControlTxt
Phone3306741015PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1981 WOOSTER RDAddressLine1Txt
CityMILLERSBURGCityNm
State AbbreviationOHStateAbbreviationCd
ZIP446541094ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIA CERNAVAPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone3306741015PhoneNum
Signature2025-10-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEMILIE M KNIERIEM CPAPreparerPersonNm
PTINP01330194PTIN
Phone6148852583PhoneNum
Preparation2025-10-21PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIA CERNAVAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1981 WOOSTER RDAddressLine1Txt
CityMILLERSBURGCityNm
State AbbreviationOHStateAbbreviationCd
ZIP446541094ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$43,423,887GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.POMERENEHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1937FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionWE WILL BE A LEADER AND PARTNER IN PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE FOR ALL RESIDENTS OF GREATER HOLMES COUNTY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee561TotalEmployeeCnt
Total Volunteers56TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,526,526PYContributionsGrantsAmt
CY Contributions Grants$45,010CYContributionsGrantsAmt
PY Program Service Revenue$40,473,441PYProgramServiceRevenueAmt
CY Program Service Revenue$42,599,867CYProgramServiceRevenueAmt
PY Investment Income$528,145PYInvestmentIncomeAmt
CY Investment Income$580,302CYInvestmentIncomeAmt
PY Other Revenue$191,375PYOtherRevenueAmt
CY Other Revenue$198,708CYOtherRevenueAmt
PY Total Revenue$42,719,487PYTotalRevenueAmt
CY Total Revenue$43,423,887CYTotalRevenueAmt
PY Grants And Similar Paid$70,762PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$59,547CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,145,435PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,640,916CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$20,062,500PYOtherExpensesAmt
CY Other Expenses$21,104,839CYOtherExpensesAmt
PY Total Expenses$38,278,697PYTotalExpensesAmt
CY Total Expenses$41,805,302CYTotalExpensesAmt
PY Revenues Less Expenses$4,440,790PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,618,585CYRevenuesLessExpensesAmt
Total Assets BOY$40,653,925TotalAssetsBOYAmt
Total Assets EOY$33,820,684TotalAssetsEOYAmt
Total Liabilities BOY$4,904,964TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,425,879TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$35,748,961NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$29,394,805NetAssetsOrFundBalancesEOYAmt
MissionWE WILL BE A LEADER AND PARTNER IN PROVIDING HIGH QUALITY, COST EFFECTIVE HEALTH CARE FOR ALL RESIDENTS OF GREATER HOLMES COUNTY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,119,495ExpenseAmt
Grant$59,547GrantAmt
Revenue$42,603,496RevenueAmt
DescNOT-FOR-PROFIT HOSPITAL THAT PROVIDES ACUTE CARE INPATIENT AND OUTPATIENT SERVICES TO THE HOLMES COUNTY AREA. WE PROVIDED THIS THROUGH MEDICAL, SURGICAL, MATERNAL, AND NURSERY INPATIENT SERVICES. OUTPATIENT SERVICES INCLUDE LABORATORY, RADIOLOGY, REHABILITATION, AND RESPIRATORY SERVICES. POMERENE HOSPITAL PROVIDED 10,030 ED VISITS, 2,093 DISCHARGES, AND 46,172 OUTPATIENT REGISTRATIONS IN 2024.Desc
Total Program Service Expenses$29,119,495TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document53IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee561EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTIA CERNAVAPersonNm
Phone3306741015PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1981 WOOSTER RDAddressLine1Txt
CityMILLERSBURGCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44654ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MELVIN YODER
CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
SHEILA KNAPP
VICE CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
JOHN HENRY TROYER
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
JANE GRAVEN
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
DAVE FINDLEY
DIRECTOR1.000.00Yes (X)$0$0$0
ERNEST HERSHBERGER
TRUSTEE1.000.00Yes (X)$0$0$0
CRAIG MULLET
TRUSTEE1.000.00Yes (X)$0$0$0
DANIEL MATHIE
TRUSTEE1.000.00Yes (X)$0$0$0
TODD SOMMER
TRUSTEE1.000.00Yes (X)$0$0$0
JAMIE TIPPETT
TRUSTEE1.000.00Yes (X)$0$0$0
LEROY J YODER
TRUSTEE1.000.00Yes (X)$0$0$0
JASON JUSTUS
CEO40.002.00Yes (X)Yes (X)$358,984$0$44,450
TIA CERNAVA
CFO40.002.00Yes (X)$220,887$0$28,216
DR MICHAEL T SCHELL
GENERAL SURGEON40.000.00$484,735$0$13,800Yes (X)
LEON MILLER
GENERAL SURGEON40.000.00$398,214$0$13,566Yes (X)
EUGENE R KOSER
ANESTHESIOLOGIST40.000.00$450,515$0$13,800Yes (X)
DURRELL R BEACHY
CRNA40.000.00$322,580$0$12,325Yes (X)
BRITTON HOSTETLER
CRNA40.000.00$302,565$0$11,683Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,538,480TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$137,840TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K33IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AULTMAN DEUBLE HEART & VASCULAR HOSPITAL
PO BOX 80690CANTONOH44708CARDIOVASCULAR CONSULTING$205,850
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397LOCUM TENENS STAFFING$173,208
CASSEL BEAR LTD
4884 DRESSLER RD NWCANTONOH44718MARKETING CONSULTING$158,965
ROZUK RADIOLOGY INC PKGS
PO BOX 392MILLERSBURGOH44654RADIOLOGY SERVICES$145,350
SLEEPWORKS LLC
536 OLD HOWELL RDGREENVILLESC29615SLEEP LAB SERVICES$123,300
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
All Other Contributions$45,010AllOtherContributionsAmt
Total Contributions$45,010TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$42,599,867TotalRevenueColumnAmt
Related Or Exempt Func Income$42,599,867RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$42,599,867TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$576,702TotalRevenueColumnAmt
Exclusion$576,702ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$4,800RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,800RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,800TotalRevenueColumnAmt
Exclusion$4,800ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$3,600OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$3,600OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,600TotalRevenueColumnAmt
Exclusion$3,600ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA INCOMEDesc
Business624200BusinessCd
Total Revenue Column$178,915TotalRevenueColumnAmt
Exclusion$178,915ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,993TotalRevenueColumnAmt
Related Or Exempt Func Income$3,629RelatedOrExemptFuncIncomeAmt
Exclusion$11,364ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$193,908OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,423,887TotalRevenueColumnAmt
Related Or Exempt Func Income$42,603,496RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$775,381ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$59,547TotalAmt
Program Services$59,547ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$652,536TotalAmt
Program Services$430,606ProgramServicesAmt
Management And General$221,930ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,374,233TotalAmt
Program Services$9,485,490ProgramServicesAmt
Management And General$4,888,743ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$601,813TotalAmt
Program Services$525,469ProgramServicesAmt
Management And General$76,344ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,139,575TotalAmt
Program Services$3,614,440ProgramServicesAmt
Management And General$525,135ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$872,759TotalAmt
Program Services$762,043ProgramServicesAmt
Management And General$110,716ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$86,293TotalAmt
Program Services$57,254ProgramServicesAmt
Management And General$29,039ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$247,310TotalAmt
Program Services$164,085ProgramServicesAmt
Management And General$83,225ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,518,716TotalAmt
Program Services$5,523,228ProgramServicesAmt
Management And General$2,995,488ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$297,437TotalAmt
Program Services$197,344ProgramServicesAmt
Management And General$100,093ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,375,496TotalAmt
Program Services$1,867,792ProgramServicesAmt
Management And General$507,704ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$496,740TotalAmt
Program Services$329,577ProgramServicesAmt
Management And General$167,163ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$452,496TotalAmt
Program Services$300,222ProgramServicesAmt
Management And General$152,274ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$307,349TotalAmt
Program Services$203,920ProgramServicesAmt
Management And General$103,429ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$25,573TotalAmt
Program Services$16,967ProgramServicesAmt
Management And General$8,606ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$204,858TotalAmt
Program Services$135,919ProgramServicesAmt
Management And General$68,939ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,428,078TotalAmt
Program Services$506,064ProgramServicesAmt
Management And General$922,014ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$256,488TotalAmt
Program Services$170,175ProgramServicesAmt
Management And General$86,313ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES&EQUIP$4,856,713$3,719,553$1,137,160
FRANCHISE FEE$1,042,197$691,477$350,720
DIETARY$200,710$153,715$46,995
DUES, PUBS, & SUBS$135,821$90,115$45,706

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$172,564TotalAmt
Program Services$114,493ProgramServicesAmt
Management And General$58,071ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$41,805,302TotalAmt
Program Services$29,119,495ProgramServicesAmt
Management And General$12,685,807ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,908BOYAmt
EOY$2,208EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,976,648BOYAmt
EOY$3,653,015EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,640,892BOYAmt
EOY$6,798,950EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$833,857BOYAmt
EOY$680,706EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$941,798BOYAmt
EOY$1,025,822EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$40,276,070LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,628,037LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,463,941BOYAmt
EOY$9,648,033EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$13,794,881BOYAmt
EOY$12,011,950EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$40,653,925BOYAmt
EOY$33,820,684EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,454,488BOYAmt
EOY$2,715,858EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$55,916BOYAmt
EOY$49,628EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,019,822BOYAmt
EOY$1,660,393EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$374,738BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,904,964BOYAmt
EOY$4,425,879EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$35,748,961BOYAmt
EOY$29,394,805EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$35,748,961BOYAmt
EOY$29,394,805EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,653,925BOYAmt
EOY$33,820,684EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,618,585ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$84,560NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$7,888,181OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$631,987OtherCostOrOtherBasisAmt
Book Value$631,987BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,230,912OtherCostOrOtherBasisAmt
Depreciation$14,288,906DepreciationAmt
Book Value$3,942,006BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$345,007OtherCostOrOtherBasisAmt
Depreciation$187,911DepreciationAmt
Book Value$157,096BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,999,751OtherCostOrOtherBasisAmt
Depreciation$16,151,220DepreciationAmt
Book Value$3,848,531BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,068,413OtherCostOrOtherBasisAmt
Book Value$1,068,413BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,648,033TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$622,449
INVESTMENT IN JOINT VENTURES$5,144
ASSETS WHOSE USE IS LIMITED$10,358,860
RIGHT OF USE ASSETS$983,169
OTHER ASSETS$42,328
FieldValueIRS element (for citing)
Total Book Value Other Assets$12,011,950TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, WHICH IS AN INFORMATION RETURN ONLY. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). THE ORGANIZATION HAS FILED ITS APPLICABLE FEDERAL INCOME TAX RETURNS FOR PERIODS THROUGH DECEMBER 31, 2023. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS).ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$320,208TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$320,208NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,021,182TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,085,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,935,964NetCommunityBenefitExpnsAmt
Total Expense0.04630TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,341,390TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,085,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,256,172NetCommunityBenefitExpnsAmt
Total Expense0.05400TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$226,758TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$226,758NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$226,758TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$226,758NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,568,148TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,085,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,482,930NetCommunityBenefitExpnsAmt
Total Expense0.05940TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,641,884BadDebtExpenseAmt
Reimbursed By Medicare$3,946,458ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,914,955CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$968,497MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POMERENE HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1981 WOOSTERAddressLine1Txt
CityMILLERSBURGCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44654ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.POMERENE.ORGWebsiteAddressTxt
State License1202StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1POMERENE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted23CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLHTTPS://HOLMESHEALTH.ORG/OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt23ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, PAGE 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.POMERENEHOSPITAL.ORG/FINANCIAL-SERVICESFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.POMERENEHOSPITAL.ORG/FINANCIAL-ASSISTANCE-APPLICATIONFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.POMERENEHOSPITAL.ORG/FINANCIAL-SERVICESFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
POMERENE HOSPITALPART V, SECTION B, LINE 5: THE 2023 HOLMES COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT WAS COORDINATED, REVIEWED, AND ANALYZED BY VVV CONSULTANTS LLC ON BEHALF OF POMERENE HOSPITAL IN COLLABORATION WITH THE HOLMES COUNTY GENERAL HEALTH DISTRICT. THE CHNA CONSISTED OF AN ONLINE SURVEY TO STAKEHOLDERS, AND A TOWN HALL TO DISCUSS HEALTH DATA, SURVEY FEEDBACK, AND RANK UNMET HEALTH NEEDS. THE ONLINE SURVEY WAS EMAILED TO RESIDENTS, COMMUNITY LEADERS, AND PROVIDERS RESULTING IN 216 SURVEYS BEING COMPLETED. HEALTH INFORMATION DATA WAS ALSO COLLECTED FROM THE OHIO DEPARTMENT OF HEALTH AND RELEVANT NATIONAL, STATE, AND LOCAL DATA SOURCES THAT IS PUBLICLY AVAILABLE. THE PARTNERS SOLICITED INPUT AND RESPONSES FROM MEMBERS OF THE COMMUNITY BY CONDUCTING FOCUS GROUPS AND MEETINGS TO DISCUSS THE SURVEY RESULTS IN ORDER TO DEVELOP STRATEGIES TO ADDRESS THE HEALTH AND WELLNESS ISSUES FACING THE HOLMES COUNTY COMMUNITY. COLLECTIVELY, THE PARTNERS CONDUCTED ONGOING AND FREQUENT MEETINGS TO ANALYZE, DISCUSS AND DEVELOP EACH UNDERLYING COMMUNITY HEALTH ASSESSMENT INITIATIVE. AS EACH COMMUNITY INITIATIVE WAS ENACTED, FOLLOW-UP MEETINGS BY THE PARTNERS WERE CONDUCTED TO RECORD AND TRACK RESULTS AND PROGRESS ON EACH PROJECT.
POMERENE HOSPITALPART V, SECTION B, LINE 6B: HOLMES COUNTY HEALTH DISTRICT
POMERENE HOSPITALPART V, SECTION B, LINE 11: THE 2023 HOLMES COUNTY HEALTH ASSESSMENT IDENTIFIED SIX PRIORITY UNMET NEEDS: LACK OF PROVIDERS, MENTAL HEALTH, CHRONIC DISEASE MANAGEMENT & PREVENTION, DELIVERY OF INTEGRATED TRADITIONAL & ALTERNATIVE MEDICINE, WELLNESS EDUCATION, MOBILE HEALTH/TELEHEALTH. POMERENE HOSPITAL IS ADDRESSING ALL SIX OF THE HEALTHCARE ASSESSMENT'S PRIMARY NEED CATEGORIES IN THE 2024-2027 COMMUNITY HEALTH IMPROVEMENT PLAN. THE COLLABORATORS OF THE IMPROVEMENT PLAN ARE POMERENE MEDICAL GROUP, ANAZO, MENTAL HEALTH AND RECOVERY BOARD, HOLMES FAMILY MEDICINE, ONE-EIGHTY, VIOLA STARTZMAN CLINIC, OHIO'S HOSPICE (LIFECARE). THE LACK OF PROVIDERS IS ADDRESSED THROUGH RECRUITING, EXPLORING SHARED WORKPLACE, WORKFORCE, AND EQUIPMENT OPPORTUNITIES, AND USING PROVIDER MANPOWER ANALYSIS. POMERENE HOSPITAL IS IMPROVING ITS PROVIDER RECRUITMENT EFFORTS BY EXPLORING COLLECTIVE RECRUITMENT WITH LOCAL PARTNERS, DISCUSSING FOREIGN CANDIDATES/OPPORTUNITIES, UTILIZING REGIONAL RECRUITERS, AND ENCOURAGING THE DEVELOPMENT OF NEW PROVIDERS WITHIN HOLMES COUNTY. MENTAL HEALTH IS BEING ADDRESSED BY CONTINUING TO DEVELOP REFERRAL RELATIONSHIPS WITH KEY COMMUNITY PARTNERS; EXPLORING POTENTIAL TELEHEALTH OR SATELLITE OFFICE SITES FOR ADDITIONAL MENTAL HEALTH; CONTINUING TO SUPPORT/PROMOTE 24-HOUR CRISIS HOTLINES; PROVIDING EDUCATION REGARDING MENTAL HEALTH DELIVERY ISSUES; WORKING TO CREATE CENTRALIZED FILE TO UPDATE COMMUNITY INVENTORY RESOURCE SOURCES, IMPROVING COMMUNITY AWARENESS AND PROGRAMMING; INVESTIGATING/SEEKING GRANT OPPORTUNITIES. CHRONIC DISEASE PREVENTION AND MANAGEMENT IMPROVEMENT INITIATIVES ARE EXPLORING GRANT OPPORTUNITIES; COMMUNITY EDUCATION, PREVENTATIVE AND REMINDER PROGRAMS; ENCOURAGE USE OF LOCAL RESOURCES (DIABETIC EDUCATION AND DIETETIC SERVICES, CHRONIC CARE MANAGEMENT, REMOTE MONITORING); EDUCATE THE COMMUNITY ON HOW TO MAINTAIN HEALTH (HEALTH TALKS, SOCIAL MEDIA, PARTNERSHIPS FOR EDUCATIONAL SERVICES). DELIVERY OF INTEGRATED TRADITIONAL & ALTERNATIVE MEDICINE IS BEING ADDRESSED WITH TRIAL ALTERNATIVE MEDICINE THERAPEUTIC OFFERINGS, STARTING WITH ESSENTIAL OILS; ACUPUNCTURE SERVICES AT POMERENE PAIN MANAGEMENT (POSSIBLE EXPANSION); CONTINUE AMISH OUTREACH ACTIVITIES TO EDUCATE REGARDING SERVICE OFFERINGS; PROVIDER EDUCATION; ENCOURAGE THE USE OF ALTERNATIVE THERAPIES TO REDUCE OPIOID PRESCRIPTIONS. WELLNESS EDUCATION IS BEING IMPROVED THROUGH INITIATIVES SUCH AS, EXPANDING HEALTH TALKS TO EDUCATE STAFF AND COMMUNITY/HEALTH CLASSES; EXPLORING EXPANSION OF SOCIAL SERVICE PROGRAMS; EXPANDING SCHOOL-AGED PROGRAMMING; CREATING AN INVENTORY OF AVAILABLE COMMUNITY WELLNESS RESOURCES; CONTINUING TO OFFER POMERENE EMPLOYEE WELLNESS PROGRAMMING; PARTNER WITH INTERESTED PROGRAMS TO FACILITATE EDUCATION; PARTNER WITH CITY PARKS AND REC DEPARTMENTS TO ENCOURAGE USE OF COMMUNITY WALKING TRAILS AND PARTICIPATION IN LEAGUES; EXPAND KINETICS TO 24/7 AVAILABILITY. MOBILE HEALTH/TELEHEALTH IS BEING ADDRESSED BY EXPLORING AND EXPANDING TELEMEDICINE AND TELEHEALTH SERVICES WHEN POSSIBLE; EXPLORING/INVESTING IN ALTERNATIVE TECHNOLOGIES SUCH AS FIXED WIRELESS, SATELLITE, OR MOBILE BROADBAND TO DELIVER RURAL HIGH-SPEED INTERNET WITHOUT REQUIRING EXTENSIVE CABLE OR FIBER INSTALLATION; PROMOTING TELEHEALTH SERVICES AS AN ALTERNATIVE TO PATIENT'S TRAVELING FOR CARE; ASKING COUNTY TO IMPROVE WI-FI CONNECTIVITY; ASKING COUNTY TO PROVIDE SUBSIDIES OR GRANTS FOR RURAL COMMUNITY ANCHOR INSTITUTIONS SUCH AS SCHOOLS, LIBRARIES, HEALTH CENTERS, AND PUBLIC SAFETY AGENCIES.
POMERENE HOSPITAL:SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.POMERENEHOSPITAL.ORG/COMMUNITY-CARE9CC3B603
POMERENE HOSPITAL:SCHEDULE H, PART V, LINE 10:HTTPS://WWW.POMERENEHOSPITAL.ORG/COMMUNITY-CARE9CC3B603

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:IN ADDITION TO FPG, POMERENE HOSPITAL USES THE FOLLOWING METHODS TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY.
PART I, LINE 7:POMERENE HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2 AND A COST ACCOUNTING SYSTEM (STRATA). THE ORGANIZATION'S SYSTEM CALCULATES COST BASED ON PATIENT TYPE AND FINANCIAL CLASS.
PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES PROVIDE FREE TRANSPORTATION TO THE HOSPITAL FOR HEALTH SERVICES. THESE ACTIVITIES ALSO PROVIDE EDUCATION TO IMPROVE OUR COMMUNITY'S HEALTH DECISIONS.
PART III, LINE 2:ACCOUNTS RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE ORGANIZATION'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE 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 BAD DEBTS, 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 DIFFICULTY THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE DECEMBER 31, 2024, AND 2023 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF APPROXIMATELY $1,618,000 AND $1,858,000, RESPECTIVELY, RELATES TO RESERVES FOR SELF-PAY BALANCES.THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON A PERCENTAGE OF SELF-PAY ACCOUNTS RECEIVABLE ON DECEMBER 31, 2024 AND 2023. THE ORGANIZATION'S SELF-PAY WRITE-OFFS INCREASED $658,645 FROM $1,983,239 FOR 2023 TO $2,641,884 FOR 2024. THE ORGANIZATION HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2024 OR 2023. THE ORGANIZATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS.
PART III, LINE 3:THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON, THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.
PART III, LINE 4:THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND UNDER THE HEADING 'PATIENT CARE SERVICE REVENUE' STARTING ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED 12/31/24 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. THE ORGANIZATION DOES NOT CONSIDER MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.
PART III, LINE 9B:WHEN A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP BASED UPON A PRIOR FAP ELIGIBILITY DETERMINATION OR DUE TO INFORMATION ACQUIRED FROM A THIRD-PARTY (I.E. SOMEONE OTHER THAN THE PATIENT OR HIS/HER REPRESENTATIVE) AND THE ELIGIBILITY DETERMINATION IS FOR LESS THAN THE MOST GENEROUS ASSISTANCE AVAILABLE UNDER THE FAP, POMERENE WILL DO THE FOLLOWING BEFORE INSTITUTING ANY ECA:- NOTIFY THE PATIENT (VIA A BILLING STATEMENT) OF THE BASIS FOR THE PRESUMPTIVE ELIGIBILITY DETERMINATION AND HOW TO APPLY FOR MORE GENEROUS ASSISTANCE;- PROVIDE THE PATIENT A REASONABLE PERIOD OF TIME (NOT LESS THAN 90 DAYS FROM THE FIRST BILLING STATEMENT) TO APPLY FOR MORE GENEROUS ASSISTANCE BEFORE INSTITUTING AN ECA TO OBTAIN PAYMENT OF THE DISCOUNTED AMOUNT OWED; AND- IF THE PATIENT SUBMITS A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE, MEET THE REQUIREMENTS FOR NOTICE OF ELIGIBILITY DETERMINATIONS OF COMPLETE APPLICATIONS SET FORTH BELOW.
PART VI, LINE 2:POMERENE HOSPITAL CONDUCTS ONGOING, INTERMITTENT, AND ANNUAL RESEARCH, DATA GATHERING, ANALYZING OF LARGE QUANTITIES OF DATA AND METRICS REGARDING LOCAL HOLMES COUNTY AND SURROUNDING COMMUNITIES AS WELL AS EXTERNAL COMPARISON DATA FROM STATE, REGION, AND FEDERAL SOURCES. POMERENE ATTEMPTS TO BUILD A COMPREHENSIVE PERSPECTIVE AND VIEW TOWARDS LOCAL, STATE, AND NATIONAL ECONOMIC, SOCIAL, ENVIRONMENTAL, HEALTHCARE, AND FINANCIAL CONDITIONS AND TRENDS IN ORDER TO POSITIVELY IMPROVE DECISION MAKING AND STRATEGIC PLANNING. EXAMPLES OF INTERNAL AND EXTERNAL DATA SOURCES POMERENE MAY USE ARE CENTERS FOR MEDICARE AND MEDICAID (CMS), OHIO HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, TRUVEN, MOODY'S AND STANDARD AND POOR'S, HOLMES COUNTY HEALTH DISTRICT, OHIO DEPARTMENT OF HEALTH AS WELL AS HEALTHCARE INDUSTRY RESEARCH. AS MEMBERS OF AN ACO AND OTHER COLLECTIVE HEALTHCARE ORGANIZATIONS, POMERENE ALSO RECEIVES POPULATION-BASED DATA AND ACTIVITY. LAST, POMERENE COLLECTS INTERNAL COMMUNITY AND PATIENT DATA FROM SERVICES PROVIDED TO THE COMMUNITY, CONDUCTING COMMUNITY HEALTH TALKS AND EDUCATION, CONDUCTING COMMUNITY-BASED FOCUS GROUPS, REFERRAL-BASED DATA, COLLABORATING WITH LOCAL INDEPENDENT PROVIDERS AND COMMUNITY AGENCIES AS WELL AS THE POMERENE CARE TEAM WHICH IS A MULTI-DISCIPLINE TEAM OF HEALTHCARE PROVIDERS, STAFF AND ORGANIZATION LEADERS WHO ANALYZE DATA TO HELP IMPROVE THE QUALITY, SAFETY AND EFFICIENCY OF PATIENT CARE WITHIN POMERENE.
PART VI, LINE 3:OUR ORGANIZATION VISITS PATIENTS WHO ARE IN THE ED, UNDER OBSERVATION, OR INPATIENT TO DISTRIBUTE PACKETS CONTAINING FINANCIAL ASSISTANCE ELIGIBILITY INFORMATION. ADMISSIONS IS TRAINED TO HAND OUT THESE PACKETS. THE FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE FOR EASY ACCESS. ADDITIONALLY, SIGNS ARE POSTED IN ALL PATIENT AREAS AND BUSINESS OFFICES THAT DETAIL WHO TO CONTACT FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:HOLMES COUNTY IS ONE OF 88 COUNTIES LOCATED WITHIN THE STATE OF OHIO. THE GEOGRAPHIC FOOTPRINT CONSISTS OF 423 SQ MILES OF RURAL LAND WHICH PRIMARILY SUPPORTS AGRICULTURE, MANUFACTURING, TRADE, AND PUBLIC ADMINISTRATION INDUSTRIES. ACCORDING TO THE U.S. CENSUS BUREAU (2020) THE POPULATION OF HOLMES COUNTY IS APPROXIMATELY 44,223. POPULATION AND DEMOGRAPHIC CHARACTERISTICS OF HOLMES COUNTY ARE: FEMALE (50%)/MALE (50%); MEDIAN AGE OF 32.5 (UNDER 18 (30%), 18-64 (56%) AND 65+ (14%)) WHICH IS LESS THAN THE OHIO AVERAGE OF 39.9; CULTURAL DIVERSITY NEARLY 50/50 BETWEEN ENGLISH AND ANABAPTIST/AMISH; RACE AND ETHNICITY PRIMARILY WHITE (98%) FOLLOWED BY BLACK/AFRICAN AMERICAN (0.2%), AMERICAN INDIAN (0.1%), ASIAN (0.2%), HISPANIC (1.1%) AND TWO OR MORE RACES (1.2%); EDUCATION DISTRIBUTION OF NO DEGREE (43%), HIGH SCHOOL (33%), SOME COLLEGE (9%), BACHELORS (7%), POST GRADUATE (4%); MEDIAN HOUSEHOLD INCOME OF $74,774 (PER CAPITA INCOME $29,238) WITH 8.8% OF THE POPULATION LIVING IN POVERTY; PERSONS WITHOUT HEALTH INSURANCE 42.3%; AND, MORE THAN 37.4% OF HOUSEHOLDS ARE WITHOUT A BROADBAND INTERNET SUBSCRIPTION. HOLMES COUNTY, OHIO CONTAINS ONE HOSPITAL, POMERENE HOSPITAL, THAT IS LOCATED IN THE TOWN OF MILLERSBURG AND SERVES THE ENTIRE COUNTY INCLUDING SURROUNDING CONTIGUOUS COMMUNITIES. HOLMES COUNTY IS DESIGNATED BY CMS AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AS WELL AS A MEDICARE LOW VOLUME COMMUNITY. POMERENE CURRENTLY HAS TWO RURAL HEALTHCARE CLINICS (RHC) ONE IN LOUDONVILLE AND ONE IN POMERENE FAMILY CARE LOCATED IN MILLERSBURG, OHIO.
PART VI, LINE 5:POMERENE HOSPITAL'S MISSION IS "CARING FOR OUR COMMUNITIES HEALTH." THE POMERENE BOARD UNDERTAKES AN ACTIVE ROLE IN ITS RESPONSIBILITY TO PROVIDE OVERSIGHT AND APPROVAL OF THE ORGANIZATIONS MISSION AND ITS STRATEGIC DIRECTION AND PLAN. POMERENE ADHERES TO MAINTAINING SEVENTY-FIVE PERCENT (75%) OF ITS GOVERNING BOARD OF DIRECTORS SHOULD RESIDE WITHIN THE BORDERS OF HOLMES COUNTY, OHIO. DURING 2024 ALL 12 MEMBERS OF THE BOARD CONSISTED OF INDIVIDUALS WHO RESIDED WITHIN HOLMES COUNTY. MEMBERSHIP OF THE POMERENE BOARD INCLUDES REPRESENTATION FROM BOTH PRIMARY CULTURAL DEMOGRAPHIC SEGMENTS OF HOLMES COUNTY, ANABAPTIST/AMISH (25%) AND NON-ANABAPTIST/ENGLISH (75%). BOARD MEMBERSHIP CONSISTED OF A DIVERSE LIST OF PERSONAL AND PROFESSIONAL BACKGROUNDS SUCH AS AN ATTORNEY, FORMER EDUCATOR, DIRECTOR OF A POST-ACUTE HEALTHCARE FACILITY, LOCAL BUSINESS OWNERS, NON-PROFIT DIRECTOR, PREVIOUS NURSE, LOCAL COMMUNITY TOURISM DIRECTOR, HUMAN RESOURCES, CORPORATE AND EMPLOYEE SAFETY MANAGER, ETC. ONE OF POMERENE'S SIX STRATEGIC INITIATIVES WAS "DEVELOP POPULATION HEALTH MODEL FOR POMERENE HOSPITAL AND HOLMES COUNTY." KEY OBJECTIVES WERE TO DEFINE AN INTERNAL/EXTERNAL HEALTH RISK PROFILE FOR EMPLOYEES AND DISTINCT POPULATION OF HOLMES COUNTY; DELIVER POPULATION HEALTH CARE MANAGEMENT TO POMERENE EMPLOYEES; EXPAND POPULATION HEALTH INITIATIVES TO COMMUNITY POPULATIONS. INDIVIDUAL PROJECTS CONSISTED OF DEVELOPING AN ANNUAL PLAN FOR EMPLOYEE WELLNESS ACTIVITIES AND SERVICES (SUCH AS DIABETIC EDUCATION) BASED UPON THE EMPLOYEE RISK PROFILE, BIOMETRIC RESULTS AND HEALTH PLAN CLAIM ACTIVITY. PROVIDE CORPORATE WELLNESS/PREVENTION SERVICES TO LOCAL HOLMES COUNTY EMPLOYERS. INTEGRATE AND OPERATE CARDIAC REHABILITATION AND PHYSICAL THERAPY SERVICES WITHIN KINETICS, WHICH IS POMERENE'S MEDICAL FITNESS FACILITY. DEVELOP AND OPERATE OCCUPATIONAL MEDICINE SERVICES TO MEET THE NEEDS OF HOLMES COUNTY EMPLOYERS. PARTICIPATE IN ACO-LIKE ORGANIZATIONS TO COORDINATE PRIMARY AND POST-ACUTE PATIENT CARE DELIVERY. CONDUCT UTILIZATION REVIEW AND CASE MANAGEMENT WITHIN POMERENE FAMILY CARE OFFICE SETTING.THE PROVISION OF PATIENT CARE ASSOCIATED WITH POMERENE HOSPITAL WAS DELIVERED BY ONE HUNDRED (100) PROVIDERS CONSISTING OF HOSPITAL AND NON-HOSPITAL-BASED, EMPLOYED AND INDEPENDENT, PHYSICIANS AND ADVANCED PRACTICE PROVIDERS, AS WELL AS PRIMARY CARE AND SPECIALISTS. THE HOSPITAL REINVESTED NEARLY 66% OF ITS ANNUAL EBITDA OF $3.9 MILLION ($2.6 MILLION) IN CAPITAL IMPROVEMENTS SUCH AS PATIENT CARE (51.5%), INFORMATION TECHNOLOGY (28.3%), FACILITY (20.2%), POMERENE PROVIDED APPROXIMATELY $2.945 MILLION IN UNCOMPENSATED CARE FOR HOLMES COUNTY AND THE SURROUNDING COMMUNITIES IT SERVES. POMERENE DONATED $59,547.41 TO LOCAL COMMUNITY AGENCIES AND CHARITABLE ORGANIZATIONS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1THE HOLMES CO AGRICULTURAL SOCIETY INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 376AddressLine1Txt
CityMILLERSBURGCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44654ZIPCd
FieldValueIRS element (for citing)
Recipient EIN346570421RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$6,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantTO SUPPORT HOLMES COUNTY FAIRPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR MICHAEL T SCHELL
GENERAL SURGEON$464,735$0$0$0$20,000$0$13,800$0$0$0$498,535$0$0$0
EUGENE R KOSER
ANESTHESIOLOGIST$427,823$0$15,000$0$7,692$0$13,800$0$0$0$464,315$0$0$0
LEON MILLER
GENERAL SURGEON$374,464$0$8,750$0$15,000$0$13,566$0$0$0$411,780$0$0$0
JASON JUSTUS
CEO$318,912$0$27,360$0$12,712$0$10,350$0$34,100$0$403,434$0$0$0
DURRELL R BEACHY
CRNA$322,580$0$0$0$0$0$12,325$0$0$0$334,905$0$0$0
BRITTON HOSTETLER
CRNA$302,565$0$0$0$0$0$11,683$0$0$0$314,248$0$0$0
TIA CERNAVA
CFO$200,992$0$12,515$0$7,380$0$6,537$0$21,679$0$249,103$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CUPON APPOINTMENT, AND THEREAFTER ANNUALLY, THROUGH SIGNED ACKNOWLEDGEMENT OF THE CONFLICT OF INTEREST AGREEMENT, OR AT THE TIME WHEN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MAY ARISE, THE COVERED PERSON MUST IDENTIFY AND DISCLOSE AT ANY MEETING ALL MATERIAL FACTS AND DETAILS RELATING TO THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST SO THAT THE DISINTERESTED POMERENE DECISION MAKERS ARE ABLE TO MAKE AN OBJECTIVE BUSINESS DETERMINATION CONSISTENT WITH POMERENE'S MISSION AND PURPOSE. ANY COVERED PERSON WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE WITH RESPECT TO ANY VOTE OR ACTION TAKEN BY POMERENE DECISION MAKERS VOTING ON THE PROPOSED MATTER, CONTRACT, TRANSACTION OR BUSINESS ARRANGEMENT.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF TRUSTEES CONDUCTS A PERIODIC REVIEW OF THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND COMPENSATION DURING AN EXECUTIVE SESSION OF THE BOARD. THE CEO CONDUCTS AN ANNUAL REVIEW OF THE PERFORMANCE AND COMPENSATION FOR EACH OTHER KEY EMPLOYEE (CFO, CNO, OTHER KEY LEADERSHIP PERSONNEL). THE CEO'S SALARY RECOMMENDATIONS ARE PRESENTED INFORMATIONALLY TO THE EXECUTIVE COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GPROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,040,141. MANAGEMENT AND GENERAL EXPENSES 1,235,172. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,275,313. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,483,087. MANAGEMENT AND GENERAL EXPENSES 1,760,316. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,243,403.
FORM 990, PART XI, LINE 9:TRANSFER TO AFFILIATE -7,888,181.
FORM 990, PART XII, LINE 2C:THE FINANCE MANAGER, STAFF ACCOUNTANT, AND FINANCIAL ANALYST PROVIDE REQUESTED DATA TO THE AUDITORS. THE AUDITOR'S FINDINGS ARE REVIEWED AND PRESENTED TO THE CFO FOR APPROVAL. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
POMERENE HEALTH FOUNDATION
981 WOOSTER RDMILLERSBURGOH44654475317369FUNDRAISING FOR HOSPITALOH501(C)(3)LINE 12B, IIPOMERENE HOSPITALYes (1)
HEALTH PROFESSIONALS OF HOLMES COUNTY
981 WOOSTER RDMILLERSBURGOH44654300329769LEASING OF PROFESSIONAL SERVICESOH501(C)(3)LINE 10POMERENE HOSPITALYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
POMERENE HEALTH FOUNDATION
Q$1,282,116BOOK VALUE
HEALTH PROFESSIONALS OF HOLMES COUNTY
R$6,606,303BOOK VALUE
POMERENE HEALTH FOUNDATION
R$1,281,878BOOK VALUE