MIAMI VALLEY HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MIAMI VALLEY HOSPITAL (EIN 31-0537504)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201803199349301985
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T08:02:03-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 Scripps Center 312 Walnut St | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310537504 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Miami Valley Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % J MICHAEL SIMS | InCareOfNm |
| Business Name Control | MIAM | BusinessNameControlTxt |
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST 500 | AddressLine1Txt |
| City | Dayton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT SHELTON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9374999942 | PhoneNum |
| Signature | 2018-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JULIE L SPARKS | PreparerPersonNm |
| PTIN | P01268401 | PTIN |
| Phone | 5136121400 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.206.163.59 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 31499120183195000013 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D5C1BD8F7EF61FFD60A3F9B3A366FE6784F95F83 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 770194AAF055F9EA87E64CA02E08FE540289067F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J MAIBERGER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 WYOMING ST | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45409 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $999,426,404 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PREMIERHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1890 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 8557 | TotalEmployeeCnt |
| Total Volunteers | 829 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $597,521 | PYContributionsGrantsAmt |
| CY Contributions Grants | $619,334 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $839,435,290 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $771,021,646 | CYProgramServiceRevenueAmt |
| PY Investment Income | $23,363,662 | PYInvestmentIncomeAmt |
| CY Investment Income | $38,452,763 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,282,241 | PYOtherRevenueAmt |
| CY Other Revenue | $9,451,694 | CYOtherRevenueAmt |
| PY Total Revenue | $882,678,714 | PYTotalRevenueAmt |
| CY Total Revenue | $819,545,437 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,599,268 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,783,178 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $393,684,584 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $362,285,623 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $466,807,380 | PYOtherExpensesAmt |
| CY Other Expenses | $487,850,672 | CYOtherExpensesAmt |
| PY Total Expenses | $866,091,232 | PYTotalExpensesAmt |
| CY Total Expenses | $854,919,473 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,587,482 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$35,374,036 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,552,767,380 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,504,811,784 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $859,213,036 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $880,694,853 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $693,554,344 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $624,116,931 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $783,085,027 | ExpenseAmt |
| Grant | $4,783,178 | GrantAmt |
| Revenue | $771,021,646 | RevenueAmt |
| Desc | PLEASE REFER TO SCHEDULE H. | Desc |
| Total Program Service Expenses | $783,085,027 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 338 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 8557 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J MICHAEL SIMS | PersonNm |
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST SUITE 500 | AddressLine1Txt |
| City | Dayton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER J DANIS MD | ||||||||||
| BOARD CHAIR | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARK S SHAKER | ||||||||||
| PRESIDENT & CEO (TO JUN) | 40.0 | 0.0 | Yes (X) | Yes (X) | $878,113 | $0 | $31,199 | |||
| MARY M CLANCY | ||||||||||
| COO | 40.0 | 0.0 | Yes (X) | Yes (X) | $580,489 | $0 | $39,031 | |||
| MARY H BOOSALIS | ||||||||||
| TRUSTEE / PREMIER PRES & CEO | 7.5 | 8.5 | Yes (X) | $0 | $1,540,270 | $50,502 | ||||
| KEITH BRICKING MD | ||||||||||
| TRUSTEE & MEDICAL STAFF PRES | 0.5 | 0.5 | Yes (X) | $75,000 | $0 | $0 | ||||
| A PETER EKEH MD | ||||||||||
| TRUSTEE | 0.5 | 0.0 | Yes (X) | $3,040 | $0 | $0 | ||||
| JAMES M PACENTA MD | ||||||||||
| TRUSTEE | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SCOTT A SHELTON | ||||||||||
| BOARD TREASURER & CFO(INTERIM) | 8.0 | 32.0 | Yes (X) | $0 | $380,597 | $29,234 | ||||
| CARA W POWERS | ||||||||||
| BOARD SECRETARY | 39.5 | 0.5 | Yes (X) | $305,434 | $0 | $49,739 | ||||
| MARC R BELCASTRO DO | ||||||||||
| MVH CMO | 40.0 | 0.0 | Yes (X) | $545,217 | $0 | $38,934 | ||||
| ROBERT M BOWMAN | ||||||||||
| VP - HOSPITAL OPERATIONS | 40.0 | 0.0 | $279,374 | $0 | $46,130 | Yes (X) | ||||
| DALE E CREECH JR | ||||||||||
| SYSTEM SR VP - CLO | 7.5 | 30.0 | $0 | $631,976 | $62,931 | Yes (X) | ||||
| THOMAS R CURTIN | ||||||||||
| SYSTEM VP - REVENUE CYCLE | 7.0 | 33.0 | $0 | $306,577 | $58,768 | Yes (X) | ||||
| GARY G GINTER | ||||||||||
| SYSTEM VP - CIO | 8.0 | 32.0 | $0 | $525,006 | $87,150 | Yes (X) | ||||
| JENNIFER J HAULER MD | ||||||||||
| SYSTEM VP - CMO (FROM OCT) | 7.0 | 33.0 | $0 | $366,374 | $1,542 | Yes (X) | ||||
| KIMBERLY A HENSLEY | ||||||||||
| VP - HOSPITAL OPERATIONS | 40.0 | 0.0 | $278,998 | $0 | $40,737 | Yes (X) | ||||
| BARBARA A JOHNSON | ||||||||||
| SYSTEM VP - HR OPERATIONS | 8.0 | 32.0 | $0 | $508,775 | $38,453 | Yes (X) | ||||
| TAMMY S LUNDSTROM MD | ||||||||||
| SYSTEM VP - CMO (TO AUG) / CCO | 8.0 | 32.0 | $0 | $722,423 | $83,950 | Yes (X) | ||||
| MARGARET W MARK | ||||||||||
| SYSTEM VP - CNO (FROM JUN) | 8.0 | 32.0 | $0 | $345,867 | $35,411 | Yes (X) | ||||
| THOMAS R PARKER | ||||||||||
| SYS VP -CHF EXPERIENCE OFFICER | 8.0 | 32.0 | $0 | $526,374 | $67,212 | Yes (X) | ||||
| JOANN R RINGER | ||||||||||
| VP - COO MVH SOUTH | 40.0 | 0.0 | $407,198 | $0 | $41,059 | Yes (X) | ||||
| CRAIG SELF | ||||||||||
| SYS VP -CHIEF STRATEGY OFFICER | 8.0 | 32.0 | $0 | $536,933 | $50,456 | Yes (X) | ||||
| MARK W SHAW | ||||||||||
| SYSTEM VP - MANAGED CARE | 8.0 | 32.0 | $0 | $514,343 | $61,788 | Yes (X) | ||||
| SYLVAIN TREPANIER DNP RN CENP | ||||||||||
| SYSTEM VP - CNO (TO APR) | 7.0 | 33.0 | $0 | $215,751 | $28,526 | Yes (X) | ||||
| ROBERT T MORRISON MD | ||||||||||
| ASSOCIATE CMO | 40.0 | 0.0 | $424,911 | $0 | $32,512 | Yes (X) | ||||
| WALTER REILING JR MD | ||||||||||
| CHIEF MEDICAL INFO OFFICER | 40.0 | 0.0 | $412,387 | $0 | $50,044 | Yes (X) | ||||
| CHRISTOPHER J BUTLER | ||||||||||
| SYS VP-CHIEF CONSUMER OFFICER | 40.0 | 0.0 | $411,930 | $0 | $17,569 | Yes (X) | ||||
| JEFFREY G POULOS MD | ||||||||||
| VP & CHIEF HOSPITALIST OFFICER | 40.0 | 0.0 | $407,482 | $0 | $30,101 | Yes (X) | ||||
| J MICHAEL SIMS | ||||||||||
| VP FINANCE | 39.5 | 0.5 | $361,329 | $0 | $55,984 | Yes (X) | ||||
| LISA A GIBBS | ||||||||||
| FORMER OFFICER | 0.0 | 0.0 | $112,549 | $0 | $11,235 | Yes (X) | ||||
| GEOFFREY P WALKER | ||||||||||
| FORMER OFFICER | 40.0 | 0.0 | $340,332 | $0 | $54,377 | Yes (X) | ||||
| RENEE P GEORGE | ||||||||||
| FORMER KEY EMPLOYEE | 0.0 | 40.0 | $0 | $396,472 | $28,198 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,823,783 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,517,738 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,222,772 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 271 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPUNET CLINICAL LABORATORIES | |||||
| 2308 SANDRIDGE DR | MORAINE | OH | 45349 | CLINICAL LAB | $22,570,676 |
| ANESTHESIOLOGY SERVICES NETWORK | |||||
| 1 WYOMING ST 3SW TOWER | DAYTON | OH | 45409 | MEDICAL SERVICES | $9,991,143 |
| WENCO CONSTRUCTION CO LLC | |||||
| 1807 DALTON DR | NEW CARLISLE | OH | 45344 | CONSTRUCTION | $4,328,658 |
| SOUTH SURGERY MANAGEMENT LLC | |||||
| 1222 S PATTERSON BLVD 120 | DAYTON | OH | 45402 | PHYSICIAN CO MANEGMT | $1,054,500 |
| EVOKES LLC | |||||
| 8118 CORPORATE WAY | MASON | OH | 45040 | SURGICAL MONITORING | $574,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $560,084 | RelatedOrganizationsAmt |
| Government Grants | $59,250 | GovernmentGrantsAmt |
| Total Contributions | $619,334 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $376,011,572 | $376,011,572 |
| MEDICARE/MEDICAID | 900099 | $371,526,345 | $371,526,345 |
| HOSPITAL FRANCHISE TAX RECOVERIES | 900099 | $23,340,213 | $23,340,213 |
| MEDICAL RECORDS | 900099 | $47,314 | $47,314 |
| HEALTH EDUCATION | 900099 | $26,078 | $26,078 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,124 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,124 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $771,021,646 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,498,288 | TotalRevenueColumnAmt |
| Exclusion | $9,498,288 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,236,131 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,164,465 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $71,666 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,666 | TotalRevenueColumnAmt |
| Exclusion | $71,666 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $196,523,197 | SecuritiesAmt |
| Other | $3,209,323 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $167,387,133 | SecuritiesAmt |
| Other | $3,390,912 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,136,064 | SecuritiesAmt |
| Other | -$181,589 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,954,475 | TotalRevenueColumnAmt |
| Exclusion | $28,954,475 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,185,829 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $938,457 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $247,372 | TotalRevenueColumnAmt |
| Exclusion | $247,372 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 812930 | $5,180,301 | $5,180,301 |
| JOINT VENTURES | 900099 | $1,351,366 | $1,351,366 |
| PARKING GARAGE | 900099 | $852,286 | $852,286 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,748,703 | TotalRevenueColumnAmt |
| Exclusion | $1,748,703 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $9,132,656 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $819,545,437 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $771,021,646 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $47,904,457 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,783,178 | TotalAmt |
| Program Services | $4,783,178 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,639,692 | TotalAmt |
| Program Services | $3,261,165 | ProgramServicesAmt |
| Management And General | $378,527 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,022 | TotalAmt |
| Program Services | $106,644 | ProgramServicesAmt |
| Management And General | $12,378 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,776,617 | TotalAmt |
| Program Services | $263,223,849 | ProgramServicesAmt |
| Management And General | $30,552,768 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,862,280 | TotalAmt |
| Program Services | $8,836,603 | ProgramServicesAmt |
| Management And General | $1,025,677 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,675,148 | TotalAmt |
| Program Services | $30,172,933 | ProgramServicesAmt |
| Management And General | $3,502,215 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,212,864 | TotalAmt |
| Program Services | $19,006,726 | ProgramServicesAmt |
| Management And General | $2,206,138 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,377 | TotalAmt |
| Program Services | $144,594 | ProgramServicesAmt |
| Management And General | $16,783 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,693,442 | TotalAmt |
| Program Services | $2,413,324 | ProgramServicesAmt |
| Management And General | $280,118 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $387,381 | TotalAmt |
| Management And General | $387,381 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,447 | TotalAmt |
| Program Services | $52,447 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,406,765 | TotalAmt |
| Management And General | $1,406,765 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,912,849 | TotalAmt |
| Program Services | $73,393,913 | ProgramServicesAmt |
| Management And General | $8,518,936 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,055,462 | TotalAmt |
| Program Services | $7,055,462 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,360,245 | TotalAmt |
| Program Services | $3,906,780 | ProgramServicesAmt |
| Management And General | $453,465 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,547,588 | TotalAmt |
| Program Services | $18,410,639 | ProgramServicesAmt |
| Management And General | $2,136,949 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,250,606 | TotalAmt |
| Program Services | $11,872,543 | ProgramServicesAmt |
| Management And General | $1,378,063 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,862 | TotalAmt |
| Program Services | $477,444 | ProgramServicesAmt |
| Management And General | $55,418 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,161 | TotalAmt |
| Program Services | $1,040 | ProgramServicesAmt |
| Management And General | $121 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,242,540 | TotalAmt |
| Program Services | $19,242,540 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,074,976 | TotalAmt |
| Program Services | $60,099,178 | ProgramServicesAmt |
| Management And General | $6,975,798 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,420,400 | TotalAmt |
| Program Services | $2,168,678 | ProgramServicesAmt |
| Management And General | $251,722 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OPERATING SUPPLIES | $135,020,325 | $135,020,325 | |
| JOINT OPERATING AGREEMENT | $69,434,000 | $62,212,864 | $7,221,136 |
| PURCHASED SERVICES | $35,716,656 | $32,002,124 | $3,714,532 |
| HOSPITAL FRANCHISE TAX | $13,506,937 | $13,506,937 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,072,653 | TotalAmt |
| Program Services | $11,713,097 | ProgramServicesAmt |
| Management And General | $1,359,556 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $854,919,473 | TotalAmt |
| Program Services | $783,085,027 | ProgramServicesAmt |
| Management And General | $71,834,446 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,980 | BOYAmt |
| EOY | $29,855 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,189,712 | BOYAmt |
| EOY | $21,441,071 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,674,148 | BOYAmt |
| EOY | $131,700,559 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,215,587 | BOYAmt |
| EOY | $6,481,183 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,092,212 | BOYAmt |
| EOY | $6,295,877 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,319,236 | BOYAmt |
| EOY | $6,752,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,269,797,293 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $740,122,686 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $548,367,394 | BOYAmt |
| EOY | $529,674,607 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $565,368,192 | BOYAmt |
| EOY | $563,776,343 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,295,584 | BOYAmt |
| EOY | $200,336,431 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,958,790 | BOYAmt |
| EOY | $2,958,790 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,256,545 | BOYAmt |
| EOY | $35,364,675 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,552,767,380 | BOYAmt |
| EOY | $1,504,811,784 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,601,185 | BOYAmt |
| EOY | $65,836,722 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,362,459 | BOYAmt |
| EOY | $2,267,657 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,365,907 | BOYAmt |
| EOY | $979,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $649,626,210 | BOYAmt |
| EOY | $643,608,529 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,943,488 | BOYAmt |
| EOY | $2,246,799 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,313,787 | BOYAmt |
| EOY | $165,756,146 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $859,213,036 | BOYAmt |
| EOY | $880,694,853 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,554,344 | BOYAmt |
| EOY | $624,116,931 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,554,344 | BOYAmt |
| EOY | $624,116,931 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,552,767,380 | BOYAmt |
| EOY | $1,504,811,784 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$35,374,036 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $60,818,518 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$94,881,895 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $38,677 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $13,770 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $52,447 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1F: | FormAndLineReferenceDesc |
| Explanation | PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO GREATER DAYTON AREA HOSPITAL ASSOCIATION, DAYTON DEVELOPMENT COALITION, AMERICAN HOSPITAL ASSOCIATION, AND OHIO HOSPITAL ASSOCIATION. PART II-B, LINE 1I: THE HOSPITAL CONTRACTS WITH A LOBBYIST FOR HEALTHCARE RELATED ISSUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,401,468 | OtherCostOrOtherBasisAmt |
| Book Value | $35,401,468 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $749,156,280 | OtherCostOrOtherBasisAmt |
| Depreciation | $424,388,540 | DepreciationAmt |
| Book Value | $324,767,740 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,320,046 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,228,110 | DepreciationAmt |
| Book Value | $3,091,936 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $422,063,802 | OtherCostOrOtherBasisAmt |
| Depreciation | $311,506,036 | DepreciationAmt |
| Book Value | $110,557,766 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,855,697 | OtherCostOrOtherBasisAmt |
| Book Value | $55,855,697 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $529,674,607 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ALTERNATIVE INVESTMENTS | Desc |
| Book Value | $200,336,431 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $200,336,431 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| JOINT OPERATING AGREEMENT | $69,434,000 |
| PENSION OBLIGATION | $27,623,204 |
| SWAP LIABILITY | $23,124,828 |
| MALPRACTICE INSURANCE | $22,051,000 |
| LEASE COMMITMENT | $7,613,928 |
| LOAN GUARANTEE & OTHER LTL | $6,271,451 |
| NICU COLLABORATIVE | $4,050,000 |
| OTHER | $5,587,735 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $165,756,146 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING FOOTNOTE IS FROM THE AUDITED COMBINED FINANCIAL STATEMENTS FOR PREMIER HEALTH AND AFFILIATES. MEDAMERICA HEALTH SYSTEMS IS THE PARENT ORGANIZATION OF MIAMI VALLEY HOSPITAL. PREMIER HEALTH (PREMIER), MEDAMERICA HEALTH SYSTEMS (MAHS), ATRIUM HEALTH SYSTEM (AHS), SAMARITAN HEALTH PARTNERS (SHP), AND UVMC HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE TAX-EXEMPT NONPROFIT CORPORATIONS AND PUBLIC CHARITIES UNDER SECTIONS 501(C)(3) AND 509(A), RESPECTIVELY, OF THE INTERNAL REVENUE CODE. AS TAX-EXEMPT ORGANIZATIONS, THEIR INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PREMIER, SHP, AND UVMC ALSO OWN OR CONTROL CERTAIN SUBSIDIARIES, WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. TAXES PAYABLE AT DECEMBER 31, 2017 AND 2016, FOR SUCH UNRELATED BUSINESS ACTIVITIES ARE NOT SIGNIFICANT. MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (3 entries)
| RegionRegionTxt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt | Specific Services ProvidedSpecificServicesProvidedTxt |
|---|---|---|---|
| Central America and the Caribbean | Investments | $76,953,000 | |
| Europe (Including Iceland and Greenland) | Investments | $56,091,000 | |
| Central America and the Caribbean | Program Services | $27,000 | INSURANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $133,071,000 | SubtotalSpentAmt |
| Total Spent | $133,071,000 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,021,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,049,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,972,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01990 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $209,474,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $147,566,213 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $61,908,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07240 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,235,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,756,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,479,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $251,730,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $167,371,213 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $84,359,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,291,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,291,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,466,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,315,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,151,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,192,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,192,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02600 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,381,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,381,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,330,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,315,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,015,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03750 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $306,060,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $189,686,213 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $116,374,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13620 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,800 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $91,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $73,137 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $73,137 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,395 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,395 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $180,332 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $180,332 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $12,908,795 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $132,382,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $144,068,000 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$11,686,000 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Teaching HospitalTeachingHospitalInd | Research FacilityResearchFacilityInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI VALLEY HOSPITAL | ||||||||||||
| 1 | ONE WYOMING ST | DAYTON | OH | 45409 | WWW.PREMIERHEALTH.COM | SEE PART V SEC C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A |
| MIAMI VALLEY HOSPITAL SOUTH | ||||||||||||
| 2 | 2400 MIAMI VALLEY DR | CENTERVILLE | OH | 45459 | WWW.PREMIERHEALTH.COM | SEE PART V SEC C | Yes (X) | Yes (X) | Yes (X) | A | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 12 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SEC C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SEC C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SEC C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, SECTION A, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE STATE OF OHIO DOES NOT LICENSE HOSPITALS, BUT THE OHIO DEPARTMENT OF HEALTH DOES REGISTER HOSPITALS. AS PART OF THIS REGISTRATION PROCESS, HOSPITALS IN THE STATE OF OHIO ARE REQUIRED TO COMPLETE AND SUBMIT THE ANNUAL HOSPITAL REGISTRATION AND PLANNING REPORT (AHR) EACH CALENDAR YEAR. MIAMI VALLEY HOSPITAL'S REGISTRATION NUMBER IS 1247. MIAMI VALLEY HOSPITAL SOUTH'S REGISTRATION NUMBER IS 1489. PART V, SECTION B, LINE 5: PARTNERING IN THE DATA REVIEW PROCESS AND IN THE PROCESS FOR IDENTIFYING AND PRIORITIZING COMMUNITY HEALTH NEEDS AND SERVICES WERE THE BOARD OF TRUSTEES AND EXECUTIVE LEADERSHIP OF MIAMI VALLEY HOSPITAL, THE HEALTH COLLABORATIVE IN CINCINNATI, OHIO, DAYTON-MONTGOMERY COUNTY PUBLIC HEALTH DEPARTMENT, GREENE COUNTY COMBINED HEALTH DISTRICT, MIAMI COUNTY PUBLIC HEALTH, SHELBY COUNTY HEALTH DEPARTMENT, WARREN COUNTY COMBINED HEALTH DISTRICT, AND THE GREATER DAYTON AREA HOSPITAL ASSOCIATION WITH ITS MEMBER HOSPITALS. THE PARTICIPATING HOSPITALS INVITED A BROAD RANGE OF NONPROFIT AGENCIES AND ORGANIZATIONS, WHICH ASSIST THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, TO ATTEND COMMUNITY MEETINGS AND COMPLETE SURVEYS. PART V, SECTION B, LINES 6A & 6B: MIAMI VALLEY HOSPITAL PARTNERED WITH MEMBER HOSPITALS OF THE GREATER DAYTON AREA HOSPITAL ASSOCIATION, THE HEALTH COLLABORATIVE IN CINCINNATI, OHIO, DAYTON-MONTGOMERY COUNTY PUBLIC HEALTH DEPARTMENT, GREENE COUNTY COMBINED HEALTH DISTRICT, MIAMI COUNTY PUBLIC HEALTH, SHELBY COUNTY HEALTH DEPARTMENT, WARREN COUNTY COMBINED HEALTH DISTRICT, THE GREATER DAYTON AREA HOSPITAL ASSOCIATION, XAVIER UNIVERSITY AND AN INDEPENDENT CONSULTANT TO PREPARE THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART V, SECTION B, LINES 7A & 10A: THE DIRECT WEBSITE ADDRESS WHERE THE 2016 CHNA AND THE 2017 COMMUNITY HEALTH IMPLEMENTATION PLAN CAN BE ACCESSED IS: HTTP://WWW.PREMIERHEALTH.COM/OUR-COMMUNITY/MAKING-A-DIFFERENCE/ COMMUNITY-HEALTH-IMPROVEMENT/ PART V, SECTION B, LINE 11: MIAMI VALLEY HOSPITAL (MVH) AND MIAMI VALLEY HOSPITAL SOUTH (MVHS), AS MEMBERS OF THE PREMIER HEALTH SYSTEM, WERE PART OF A COLLABORATION IN 2016 WITH MEMBER HOSPITALS OF THE GREATER DAYTON AREA HOSPITAL ASSOCIATION, THE HEALTH COLLABORATIVE IN CINCINNATI, OHIO, DAYTON-MONTGOMERY COUNTY PUBLIC HEALTH DEPARTMENT, GREENE COUNTY COMBINED HEALTH DISTRICT, MIAMI COUNTY PUBLIC HEALTH, SHELBY COUNTY HEALTH DEPARTMENT, WARREN COUNTY COMBINED HEALTH DISTRICT, THE GREATER DAYTON AREA HOSPITAL ASSOCIATION, XAVIER UNIVERSITY AND AN INDEPENDENT CONSULTANT TO PREPARE THE COMMUNITY HEALTH NEEDS ASSESSMENT. BASED ON THE RESULTS OF THIS ASSESSMENT, MIAMI VALLEY HOSPITAL AND MIAMI VALLEY HOSPITAL SOUTH HAVE ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE FOLLOWING PRIORITIZED NEEDS: * BIRTH OUTCOMES * BEHAVIORAL HEALTH/SUBSTANCE ABUSE * CHRONIC DISEASES HEALTH ISSUE: BIRTH OUTCOMES -------------- MVH AND MVHS WILL WORK TOWARD ITS GOAL TO REDUCE INFANT MORTALITY THROUGH THEIR HELP ME GROW AND BRIGHTER FUTURES PROGRAMS WHICH PROVIDE HOME VISITS DURING CRITICAL CHILD DEVELOPMENT YEARS, FROM BIRTH TO AGE 3. THE PROGRAMS INCLUDE EDUCATION ABOUT SAFE SLEEP, ENCOURAGEMENT FOR MOTHERS TO BREASTFEED, AND SCREENINGS FOR DEPRESSIONS FOR ENROLLED MOTHERS. IN ADDITION, MVH AND MVHS WILL SUPPORT THE FIVE RIVERS HEALTH CENTER'S "CENTERINGPREGNANCY" PROGRAM. MVH AND MVHS WILL DEVELOP AND IMPLEMENT A PROCESS TO SCREEN FOR HUNGER AS PART OF THE HOME VISITS. RESULTS OF THE HUNGER SCREENINGS WILL DETERMINE THE FUTURE FOOD PROGRAMMING AND/OR RESOURCES. FURTHER ASSISTANCE WILL BE PROVIDED THROUGH PARTNERSHIPS WITH GREATER DAYTON AREA HOSPITAL ASSOCIATION, KETTERING HEALTH NETWORK, LIFE STAGES CENTERING, FIVE RIVERS HEALTH CENTER, SOUTHVIEW WOMEN'S CENTER, CASSANO'S, PHYSICIAN OFFICES, AND A VARIETY OF COMMUNITY PROGRAMS, SUCH AS THE WESLEY CENTER, ELIZABETH NEW LIFE, MIAMI VALLEY CHILD DEVELOPMENT CENTER, PROMISE TO HOPE, AND FAMILY SERVICE AGENCY. TO REDUCE INFANT MORTALITY BY SUPPORTING SAFE SLEEP AND ENSURING FOOD SECURITY, MIAMI VALLEY HOSPITAL SOUTH WILL OFFER EDUCATION AND RESOURCES THROUGH THE SAFE BEGINNING INITIATIVE. ONCE THE BABY IS BORN, NEW MOTHERS WILL BE ASSESSED FOR FOLLOW-UP HOME VISITS WHICH INCLUDE ADDRESSING DETERMINANTS OF POOR INFANT OUTCOMES. THE HOSPITAL WILL OFFER A 'PACK-N-PLAY' TO MOTHERS WHO CANNOT AFFORD ONE. IN ADDITION, MOTHERS WILL ALSO BE ENCOURAGED TO BREASTFEED AND TO SIGN UP FOR ANY FOOD BENEFITS FOR WHICH THEY ARE ELIGIBLE, SUCH AS THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR WOMEN INFANT CHILDREN (WIC) PROGRAMS. SLEEP-RELATED DEATHS ARE THE LEADING CAUSE OF DEATH FOR INFANTS FROM ONE MONTH TO ONE YEAR OF AGE AND ACCOUNT FOR 15 PERCENT OF INFANT DEATHS, MORE THAN ANY OTHER CAUSE OF DEATH EXCEPT PREMATURE BIRTH. SEVENTY-ONE PERCENT OF THESE DEATHS OCCUR WHEN A BABY IS SLEEPING SOMEWHERE OTHER THAN A CRIB OR BASSINET; 45 PERCENT OCCURRED IN ADULT BEDS. ORGANIZATIONS ASSISTING WITH THIS PROGRAM INCLUDE FIDELITY HEALTH CARE, MIAMI VALLEY HOSPITAL FOUNDATION, SNAP, AND WIC. HEALTH ISSUE: BIRTH OUTCOMES AND SUBSTANCE ABUSE ---------------------------------- IMPROVEMENT OF HEALTH OUTCOMES FOR NEWBORNS EXPOSED TO OPIATE DRUGS DURING THE FETAL PERIOD WILL BE ADDRESSED BY MVH THROUGH THE PROMISE TO HOPE PROGRAM. THE COMPREHENSIVE PROGRAM PROVIDES MEDICATION-ASSISTED TREATMENT FOR MOTHERS AND WITHDRAWAL TREATMENT FOR INFANTS. THE PROGRAM ASSISTS MOTHERS FROM THE INITIAL IDENTIFICATION OF OPIATE ADDICTION TO SEVERAL MONTHS POST-PARTUM - WITH A GOAL OF KEEPING MOTHER AND CHILD TOGETHER IN A STABLE HOME ENVIRONMENT. FRONT-LINE STAFF WILL ALSO RECEIVE CEU TRAINING IN ADDICTION AS A DISEASE TO ENSURE COMPASSIONATE CARE. PARTNERSHIPS WITH ADAMHS BOARD OF MONTGOMERY COUNTY, FIVE RIVERS HEALTH CENTERS, NOVA BEHAVIOR HEALTH, SAMARITAN BEHAVIORAL HEALTH, INC., AND THE WOMEN'S RECOVERY CENTER IN XENIA PROVIDE ADDITIONAL SUPPORT AND PROGRAMMING. MIAMI VALLEY HOSPITAL'S NATIONALLY-RECOGNIZED LEVEL IIIB NEONATAL INTENSIVE CARE UNIT PROVIDES COMPREHENSIVE CARE FOR CRITICALLY ILL NEWBORNS. MIAMI VALLEY HOSPITAL HAS HIGHLY SPECIALIZED EQUIPMENT AND THE EXPERIENCED NEONATAL PHYSICIANS, NURSES, AND RELATED STAFF TO PROVIDE CARE FOR THE LITTLEST VICTIMS OF OPIATE ABUSE. KEY COMPONENTS ARE CARE COORDINATION AND CASE MANAGEMENT TO HELP PARTICIPANTS NAVIGATE THE DRUG ADDICTION SERVICES FOR WHICH THEY ARE ELIGIBLE AND TO HELP THEM OVERCOME BARRIERS TO ATTENDING GROUP MEETINGS AND PARENTING CLASSES. THE PATIENTS ALSO HAVE A SUPPORT GROUP. THE PROGRAM ADDRESSES THE BEHAVIORAL AND MEDICAL HEALTH NEEDS OF THE PATIENT, AS WELL AS THE SOCIAL DETERMINANTS OF HEALTH. IN ADDITION TO PROVIDING PRE- AND POST-NATAL CARE FOR MOMS AND BABIES, FOUR MIAMI VALLEY HOSPITAL PHYSICIANS HAVE BECOME CERTIFIED TO PRESCRIBE MEDICATION-ASSISTED THERAPY. THIS STEP GIVES OPIATE-ADDICTED WOMEN ADDITIONAL TIME TO JOIN A BEHAVIORAL HEALTH PROGRAM - THUS GREATLY INCREASING THE ODDS THAT THE PATIENT WOULD NOT GIVE UP AND DROP OUT BEFORE THEY HAD A CHANCE TO BEGIN THE HOSPITAL-BASED PROGRAM. HEALTH ISSUE: SUBSTANCE ABUSE AND BEHAVIORAL HEALTH ------------------------------------- MVH AND MVHS WILL PROVIDE EDUCATION THAT ADDICTION IS A DISEASE, AND AS A RESULT, CHANGE PERCEPTIONS FIRST OF HOSPITAL PERSONNEL AND MEDICAL PROFESSIONALS, AND THEN OF THE COMMUNITY. THE OBJECTIVES ARE 1) TO PROVIDE CEUS TO FRONT-LINE STAFF AND PHYSICIANS FOR EDUCATION ON THIS TOPIC, WITH CURRICULUM DELIVERED BY ADAMHS, AND 2) TO OFFER THE EDUCATION IN THE COMMUNITY IN CONJUNCTION WITH THE ADAMHS BOARD AND THE LOCAL HEROIN COALITIONS. HEALTH ISSUE: BEHAVIORAL HEALTH ----------------- PROJECT SEARCH IS A TRANSITION PROGRAM AT MIAMI VALLEY HOSPITAL SOUTH FOR STUDENTS WITH MILD DISABILITIES TO GO FROM HIGH SCHOOL TO A COMPETITIVE JOB. THE PROGRAM'S FOCUS IS ON EDUCATION AND EMPLOYMENT. STUDENTS, AGE 18 TO 21, WORK AS INTERNS TO GAIN WORK EXPERIENCE AND AN IMPROVED SENSE OF SELF-ESTEEM AND CONFIDENCE. MVHS COLLABORATES WITH MIAMI VALLEY CAREER TECHNOLOGY CENTER, OPPORTUNITIES FOR OHIOANS WITH DISABILITIES, MONTGOMERY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, AND HIGH SCHOOL TEACHERS IN THIS HIGHLY SUCCESSFUL PROGRAM. HEALTH ISSUE: CHRONIC DISEASES ---------------- MAHOGANYS CHILD, A PROGRAM OPERATED BY MVH AND MVHS, WORKS TO REMOVE BARRIERS, AND EDUCATE AND EMPOWER THE AFRICAN-AMERICAN POPULATION IN THE COMMUNITY TO MAKE POSITIVE HEALTH DECISIONS THROUGH CULTURALLY RELEVANT MEANS. THE RESULT WILL BE HEALTHY AFRICAN-AMERICAN COMMUNITIES. THE PROGRAM OFFERS A VARIETY OF WAYS FOR INDIVIDUALS TO BECOME INVOLVED WITH EDUCATION, EVENTS, AND ACTIVITIES. MAHOGANY'S CHILD WILL ENGAGE WITH COMMUNITY ORGANIZATIONS, SUCH AS SCHOOLS AND CHURCHES WHERE THEY ALREADY HAVE A RELATIONSHIP, IN A NEW FITNESS INITIATIVE TO COMBAT OBESITY. ONE MODEL UNDER CONSIDERATION IS "THE DAILY MILE." PARTICIPANTS MAKE A COMMITMENT TO RUN A MILE EVERY DAY. THE PROGRAM WILL ALSO DEVELOP A MECHANISM FOR SCREENING FOR HUNGER AND DESIGNING FUTURE PROGRAMS TO ADDRESS FOOD INSECURITY AS A HEALTH NEED. OTHER ORGANIZATIONS PARTNERING | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 12 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Dialysis Centers of Dayton LLC | ||||
| 110 N MAIN ST | Dayton | OH | 45402 | Dialysis Treatment |
| MVH Jamestown Emergency Center | ||||
| 4940 Cottonville Rd | Jamestown | OH | 45335 | Emergency Center, cardiac testing & rehab, medical imaging, LABORATORY TESTING |
| OCCUPATIONAL HEALTH AT MVH | ||||
| 409 E MONUMENT AVE 201 | DAYTON | OH | 45402 | OCCUPATIONAL HEALTH |
| OUTPATIENT CARDIAC TESTING & REHAB | ||||
| 1244 MEADOW BRIDGE DR | BEAVERCREEK | OH | 45434 | CARDIAC TESTING & REHAB, DIAGNOSTIC & IMAGING |
| OUTPATIENT CARDIAC TESTING & REHAB | ||||
| 122 WYOMING ST | DAYTON | OH | 45409 | CARDIAC TESTING & REHAB |
| OUTPATIENT PHYSICAL THERAPY & SPORTS MED | ||||
| 90 REMICK BLVD | SPRINGBORO | OH | 45066 | REHABILITATION & SPORTS MEDICINE |
| REHABILITATION AT CLAYBOURNE MED CTR | ||||
| 1525 E STROOP RD | KETTERING | OH | 45429 | REHABILITATION |
| REHABILITATION AT SURECARE MED CENTER | ||||
| 360 W CENTRAL AVE | SPRINGBORO | OH | 45066 | REHABILITATION, DIAGNOSTIC, & IMAGING |
| REHABILITATION AT WRIGHT HEALTH BUILDING | ||||
| 1222 S PATTERSON BLVD | DAYTON | OH | 45402 | REHABILITATION |
| SLEEP CENTER AT CLYO ROAD | ||||
| 6611 CLYO RD | DAYTON | OH | 45459 | SLEEP CENTER |
| DIAGNOSTIC & IMAGING IN SPRINGBORO | ||||
| 630 N MAIN ST | SPRINGBORO | OH | 45066 | DIAGNOSTIC & IMAGING |
| DIAGNOSTIC & IMAGING IN FAIRBORN | ||||
| 725 UNIVERSITY BLVD | FAIRBORN | OH | 45435 | DIAGNOSTIC & IMAGING |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 6A: | FormAndLineReferenceDesc |
| Explanation | THE COMMUNITY BENEFIT REPORT FOR MIAMI VALLEY HOSPITAL IS PART OF THE PREMIER HEALTH REPORT (EIN# 31-1446699). PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO CALCULATE THIS FINANCIAL ASSISTANCE AT COST. THIS CALCULATION TAKES TOTAL OPERATING EXPENSES LESS OTHER OPERATING REVENUES DIVIDED BY TOTAL GROSS REVENUES. UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENTAL PROGRAMS WERE CALCULATED USING A COST ACCOUNTING SYSTEM. THIS SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND INCLUDES FULLY LOADED COSTS. FOR THE REMAINING ITEMS THE ORGANIZATION USED SPECIFIC NUMBERS FOR EXPENSE PAID DIRECTLY FOR THESE SERVICES. PART I, LINE 7G: MIAMI VALLEY HOSPITAL (MVH) PROVIDES SUBSIDIZED EMERGENCY SERVICES BY OPERATING A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR. THIS EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL INCURS EXPENSES RELATED TO CALL TIME AND PHYSICIAN SUBSIDIES DUE TO THE LARGE NUMBER OF INDIGENT PATIENTS COMING THROUGH THE EMERGENCY ROOM. FOR 2017, THE AMOUNT PAID FOR CALL AND SUBSIDIES WAS $22,192,000. PART II: -------- MIAMI VALLEY HOSPITAL (MVH) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A VARIETY OF PREVENTION, HEALTH IMPROVEMENT AND ENGAGEMENT PROGRAMS. AS PART OF ITS OVERALL COMMITMENT TO THE COMMUNITY, MVH FOCUSES ON FOUR AREAS OF SERVICE: --INVESTING IN THE COMMUNITY --PREVENTION AND WELLNESS --COMMITMENT TO THE UNDER-SERVED --COMMUNITY ENGAGEMENT SOME OF THE PROGRAMS SUPPORTED BY MVH DURING 2017 INCLUDE: 1) FUNDING OF $51,000 TO SUPPORT A NON-PROFIT MINORITY-OWNED HEALTH CARE FACILITY THAT ACCOMMODATES RESIDENTS NEEDING SHORT-TERM REHAB, RESPITE CARE FOR A LOVED ONE, OR POST-OPERATIVE CARE. 2) ONGOING EFFORTS TO IMPROVE THE ECONOMIC CONDITION IN DAYTON AND THE MIAMI VALLEY. A TOTAL OF $41,000 WAS CONTRIBUTED TOWARD A CAPITAL CAMPAIGN PROJECT TO SUPPORT THE RENOVATION OF A 100-YEAR-OLD BUILDING OFFERING SINGLE ROOM OCCUPANCY HOUSING UNITS THAT PROVIDES CRISIS INTERVENTION, SUPPORTIVE LISTENING, LINKAGE TO RESOURCES, SUPPORT GROUPS, LIFE COACHING, AND FINANCIAL EMPOWERMENT PROGRAMS TO A DIVERSE POPULATION OF WOMEN FROM ALL DIFFERENT BACKGROUNDS. THE SUPPORT WILL GO TO UPDATE THE COMMUNAL SPACES WITH MODERN DAY AMENITIES; INCREASING ADA ACCESSIBILITY AND BASIC IMPROVEMENTS, INCLUDING NEW WINDOWS AND HVAC SYSTEMS. 3) PARTNERING WITH A LOCAL UNIVERSITY, COMMUNITY DEVELOPMENT COUNCILS, LOCAL FINANCING ORGANIZATIONS AND THE LOCAL GOVERNMENT TO REVITALIZE SURROUNDING NEIGHBORHOODS. EFFORTS INCLUDED REMOVING OR REHABILITATING DETERIORATING STRUCTURES, BUILDING NEW HOMES, DEDICATING A SOCIAL WORKER FOR NEIGHBORHOOD RESIDENTS AND FUNDING ADDITIONAL COMMUNITY-BASED POLICE OFFICERS IN THE NEIGHBORHOOD. THE AMOUNT CONTRIBUTED IN 2017 FOR THIS PROGRAM WAS $66,000. 4) $6,000 WAS DONATED TO PROGRAMS TO ASSIST IN SKILL ENHANCEMENT AND HELPING INDIVIDUALS BECOME READY TO ENTER THE WORKFORCE. 5) $5,100 WAS DONATED TO HELP WITH HURRICANE RELIEF. 6) FUNDING OF $2,550 FOR A CAPITAL IMPROVEMENT PROJECT OF A LOCAL NON-PROFIT ORGANIZATION DEDICATED TO INSPIRING AND ENABLING ALL YOUNG PEOPLE TO REACH THEIR FULL POTENTIAL. PART III, LINES 2 & 3: BAD DEBT EXPENSE IS INCURRED WHEN AN ACCOUNT IS TAKEN OUT OF ACCOUNTS RECEIVABLE AND TURNED OVER TO A COLLECTION AGENCY. THIS ACTION MAY OCCUR IF A PATIENT REFUSES PAYMENT ARRANGEMENTS, REFUSES TO APPLY FOR FINANCIAL ASSISTANCE, AND THERE IS NOT AN INSURANCE BALANCE BEING CONTENDED. AN ACCOUNT IS WRITTEN OFF TO BAD DEBT AFTER 130 DAYS IF AN ATTEMPT TO COLLECT FROM THE PATIENT IS MADE WITHIN OUR COLLECTION POLICY. THE COLLECTION AGENCY ATTEMPTS TO COLLECT THE ACCOUNT IN ACCORDANCE WITH ESTABLISHED GUIDELINES. COLLECTION ATTEMPTS ARE CEASED AND THE ACCOUNT RETURNED TO THE ORGANIZATION IF THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE. ANY AMOUNTS COLLECTED FROM THESE ACCOUNTS ARE CREDITED BACK AGAINST BAD DEBT EXPENSE. THE ORGANIZATION RECOGNIZES THERE ARE ACCOUNTS WRITTEN OFF TO BAD DEBT THAT MAY HAVE QUALIFIED FOR CHARITY CARE IF THE PATIENT HAD PROVIDED THE NECESSARY FINANCIAL INFORMATION. TO RESOLVE THIS, THE ORGANIZATION HAS ENGAGED A THIRD-PARTY VENDOR TO ANALYZE DATA BASED ON CREDIT SCORES TO REALLOCATE SOME OF THIS EXPENSE TO CHARITY CARE. A REPRESENTATIVE SAMPLE OF THESE ACCOUNTS IS THEN SENT TO OUR THIRD-PARTY VENDOR WHO GATHERS EXTERNAL CREDIT DATA THAT PRESENTS THE ACCOUNT AS LESS THAN 100% FEDERAL POVERTY LEVEL OR NOT ENOUGH INFORMATION (TYPICALLY INDICATIVE OF INDIGENT). THESE ACCOUNTS ARE RECLASSED FROM BAD DEBT EXPENSE TO CHARITY EXPENSE ON OUR INCOME STATEMENT. ANY CREDIT SCORE THAT PRESENTS THE ACCOUNTS AS GREATER THAN 100% FEDERAL POVERTY LEVEL REMAINS IN BAD DEBT EXPENSE. DUE TO THIS PROCESS, THE ORGANIZATION HAS USED BEST EFFORTS TO NOT REPORT BAD DEBT EXPENSE FOR PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 4: THE ORGANIZATION DOES NOT HAVE A FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS WHICH DISCUSSES THIS CALCULATION. PART III, SECTION B, LINES 5, 6, AND 7: THE AMOUNTS REPORTED ON LINES 5, 6, AND 7 DO NOT INCLUDE CERTAIN MEDICARE PROGRAM REVENUES AND COSTS, AND THUS DO NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN MEDICARE PROGRAMS. IN ADDITION TO THE AMOUNTS REPORTED ON LINE 5, 6, AND 7, THE ORGANIZATION RECEIVED REVENUE OF $112,896,000 AND INCURRED COST OF $167,104,000, FOR AN ADDITIONAL NET SHORTFALL OF $54,208,000 ASSOCIATED WITH THESE PROGRAMS. BELOW IS A RECONCILIATION OF THE AMOUNTS ASSOCIATED WITH MEDICARE PROGRAMS. ALLOWABLE MEDICARE REVENUE PER MEDICARE COST REPORT (PART III, SECTION B) $132,382,000 MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $112,896,000 TOTAL MEDICARE ASSOCIATED REVENUE $245,278,000 ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT (PART III, SECTION B) $144,068,000 MEDICARE COST NOT REPORTED IN PART III, SECTION B $167,104,000 TOTAL MEDICARE ASSOCIATED COST $311,172,000 MEDICARE SHORTFALL PER PART III, SECTION B $11,686,000 ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $54,208,000 TOTAL MEDICARE SHORTFALL $65,894,000 PART III, LINE 8: THE ORGANIZATION'S SHORTFALL SHOULD BE CONSIDERED CHARITY CARE BECAUSE IT IS PROVIDING HIGH-QUALITY CARE IN EXCESS OF THE COST TO OUR COMMUNITY RESIDENTS THAT NEED CARE. THE MEDICARE POPULATION AT THE ORGANIZATION IS IN EXCESS OF 41% OF NET PATIENT REVENUE. THE ORGANIZATION USED A COST ACCOUNTING SYSTEM TO CALCULATE THE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: THE ORGANIZATION MAKES REASONABLE EFFORTS TO DETERMINE WHETHER OR NOT AN INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE STATE OR HOSPITAL FINANCIAL ASSISTANCE POLICY BEFORE ENGAGING IN EXTRAORDINARY COLLECTIVE ACTIONS AGAINST THAT INDIVIDUAL. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE OFFERED REASONABLE PAYMENT PLAN ARRANGEMENTS FOR ANY REMAINING BALANCES. ANY THIRD-PARTY COLLECTING SELF-PAY RECEIVABLES ON OUR BEHALF IS REQUIRED TO MAKE REASONABLE EFFORTS TO DETERMINE IF THE INDIVIDUAL MEETS THE QUALIFICATIONS OF THE STATE OR OF OUR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS. REASONABLE EFFORTS INCLUDE: A. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL. B. DOCUMENTED THAT THE ORGANIZATION HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE UNDER ITS FINANCIAL ASSISTANCE POLICY. C. DOCUMENTED THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. D. DOCUMENT THAT THE PATIENT HAS BEEN OFFERED AND ACCEPTED TERMS FOR A PAYMENT PLAN, BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE FINANCIAL COUNSELORS MEET WITH INPATIENT, OUTPATIENT, SELF-PAY, AND OTHER PATIENTS UPON REQUEST WHO MAY NEED FINANCIAL ASSISTANCE. IN ADDITION TO ASSISTING PATIENTS WHO WANT TO APPLY FOR ASSISTANCE THROUGH THE MEDICAID PROGRAM, THE FINANCIAL COUNSELOR WILL PROVIDE THE PATIENT WITH A FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 2: THE ORGANIZATION WORKS WITH THE COMMUNITY ON PROGRAMS THAT ADDRESS THE UNDERLYING CAUSES OF PERSISTENT HEALTH PROBLEMS AS PART OF A COMPREHENSIVE STRATEGY TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE FOR IDENTIFIED MEMBERS OF THE COMMUNITY WHO ARE ECONOMICALLY DISADVANTAGED, DISENFRANCHISED AND/OR WHO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE ORGANIZATION STRIVES TO WORK WITH PREMIER HEALTH, THE HOSPITAL BOARD OF TRUSTEES, EXECUTIVE MANAGEMENT, MANAGERS, STAFF MEMBERS, COMMUNITY GROUPS, AND INDIVIDUALS TO PROVIDE A COLLABORATIVE APPROACH TO THE GOVERNANCE AND MANAGEMENT OF COMMUNITY BENEFIT ACTIVITIES. PART VI, LINE 3: THERE ARE SEVERAL WAYS IN WHICH OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS WHO MAY BE BILLED FOR SERVICES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FIRST, NOTIFICATION OF SUCH AVAILABLE ASSISTANCE IS CLEARLY POSTED IN REGISTRATION AREAS, AS WELL AS MATERNITY AND EMERGENCY DEPARTMENTS. NEXT, PATIENT ADVOCATES, PATIENT ACCESS STAF | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (38 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| FIVE RIVERS HEALTH CENTERS | |||||||
| 2261 PHILADELPHIA DR | DAYTON | OH | 45406 | 450914398 | 501(C)(3) | $3,663,836 | SUPPORT |
| DAYTON FOUNDATION DEPOSITORY | |||||||
| 40 N MAIN ST 500 | DAYTON | OH | 45423 | 311044298 | 501(C)(3) | $206,040 | SUPPORT |
| REACH OUT MONTGOMERY COUNTY | |||||||
| 25 E FORAKER ST | DAYTON | OH | 45409 | 311434282 | 501(C)(3) | $77,000 | RX ASSIST FOR INDIGENT |
| CITY OF DAYTON | |||||||
| 335 W THIRD ST | DAYTON | OH | 45402 | 316000175 | GOVERNMENT | $65,572 | POLICE PROGRAM |
| YWCA OF DAYTON | |||||||
| 141 W THIRD ST | DAYTON | OH | 45402 | 310537168 | 501(C)(3) | $56,610 | SUPPORT |
| BRIGIDS PATH INC | |||||||
| 3601 S DIXIE DR | KETTERING | OH | 45439 | 471200761 | 501(C)(3) | $52,760 | SUPPORT |
| MARY SCOTT NURSING CENTER INC | |||||||
| 3109 CAMPUS DR | DAYTON | OH | 45406 | 316010222 | 501(C)(3) | $52,270 | SUPPORT |
| MIAMI VALLEY HOSPITAL FOUNDATION | |||||||
| 110 N MAIN ST 500 | DAYTON | OH | 45402 | 311040231 | 501(C)(3) | $37,259 | SUPPORT |
| ADVOCATES FOR BASIC LEGAL EQUALITY INC | |||||||
| 130 W 2ND ST 700 | DAYTON | OH | 45402 | 237376131 | 501(C)(3) | $17,000 | SUPPORT |
| EQUITAS HEALTH | |||||||
| 15 W FOURTH ST | DAYTON | OH | 45402 | 311126780 | 501(C)(3) | $17,000 | SUPPORT |
| DAYTON ART INSTITUTE | |||||||
| 456 BELMONTE PARK N | DAYTON | OH | 45405 | 310537480 | 501(C)(3) | $16,830 | SUPPORT |
| ATRIUM MEDICAL CENTER FOUNDATION | |||||||
| 110 N MAIN ST 500 | DAYTON | OH | 45402 | 311079213 | 501(C)(3) | $12,878 | SUPPORT |
| HOUSE OF BREAD | |||||||
| 9 NORTH AVE | DAYTON | OH | 45402 | 311076425 | 501(C)(3) | $12,750 | SUPPORT |
| DAYTON CONTEMPORARY DANCE CO | |||||||
| 840 GERMANTOWN ST | DAYTON | OH | 45402 | 237220259 | 501(C)(3) | $12,840 | SUPPORT |
| SOUTHBROOK CHRISTIAN CHURCH - 9095 | |||||||
| WASHINGTON CHURCH RD | MIAMISBURG | OH | 45342 | 311170733 | 501(C)(3) | $11,220 | SUPPORT |
| ST PETER CATHOLIC CHURCH - 6161 | |||||||
| CHAMBERSBURG RD | HUBER HEIGHTS | OH | 45424 | 310626310 | 501(C)(3) | $10,838 | SUPPORT |
| HOSPICE OF DAYTON FOUNDATION | |||||||
| 324 WILMINGTON AVE | DAYTON | OH | 45420 | 310933339 | 501(C)(3) | $9,610 | SUPPORT |
| UVMC FOUNDATION | |||||||
| 110 N MAIN ST 500 | DAYTON | OH | 45402 | 311581859 | 501(C)(3) | $8,517 | SUPPORT |
| DAYBREAK | |||||||
| 605 PATTERSON BLVD | DAYTON | OH | 45402 | 310864474 | 501(C)(3) | $8,483 | SUPPORT |
| SC MINISTRY FOUNDATION | |||||||
| 345 NEEB RD | CINCINNATI | OH | 45233 | 311185570 | 501(C)(3) | $8,415 | SUPPORT |
| HEALTH POLICY INSTITUTE OF OHIO | |||||||
| 10 W BROAD ST 1050 | COLUMBUS | OH | 43215 | 300186863 | 501(C)(3) | $8,160 | SUPPORT |
| THE DAYTON FOUNDATION | |||||||
| 40 N MAIN ST 500 | DAYTON | OH | 45423 | 316027287 | 501(C)(3) | $8,160 | SUPPORT |
| CATHOLIC SOCIAL SERVICES | |||||||
| 922 W RIVERVIEW AVE | DAYTON | OH | 45402 | 310536968 | 501(C)(3) | $7,761 | SUPPORT |
| OMEGA COMMUNITY DEVELOPMENT | |||||||
| 1800 HARVARD BLVD | DAYTON | OH | 45406 | 311561713 | 501(C)(3) | $7,395 | SUPPORT |
| ZIKS FAMILY PHARMACY | |||||||
| 1130 W 3RD ST | DAYTON | OH | 45402 | 141932629 | NONE | $6,800 | SUPPORT |
| MIAMI COUNTY FOUNDATION | |||||||
| 317 N WAYNE ST | PIQUA | OH | 45356 | 311142558 | 501(C)(3) | $6,630 | SUPPORT |
| CLOTHES THAT WORK 1133 S EDWIN C | |||||||
| MOSES BLVD 392 | DAYTON | OH | 45417 | 311575093 | 501(C)(3) | $6,625 | SUPPORT |
| PREMIER COMMUNITY HEALTH CO FIDELITY HEALTH | |||||||
| 3170 KETTERING BLVD | MORAINE | OH | 45439 | 311122883 | 501(C)(3) | $15,736 | COMMUNITY HEALTH |
| GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON | |||||||
| 110 N MAIN ST 500 | DAYTON | OH | 45402 | 237296923 | 501(C)(3) | $6,375 | SUPPORT |
| GINGHAMSBURG UNITED METHODIST CHURCH | |||||||
| 6759 S CO RD 25A | TIPP CITY | OH | 45371 | 310808339 | 501(C)(3) | $6,375 | SUPPORT |
| NORTHERN KENTUCKY UNIVERSITY FND - 100 | |||||||
| NUNN DR AC 221 | HIGHLAND HEIGHTS | KY | 41099 | 237116528 | 501(C)(3) | $6,000 | SUPPORT |
| HEALTH PARTNERS FREE CLINIC | |||||||
| 1300 N CO RD 25A | TROY | OH | 45373 | 311596731 | 501(C)(3) | $5,865 | SUPPORT |
| SALVATION ARMY - DAYTON | |||||||
| 1000 N KEOWEE ST | DAYTON | OH | 45404 | 135562351 | 501(C)(3) | $5,750 | SUPPORT |
| COUNTRYSIDE YMCA | |||||||
| 1699 DEERFIELD RD | LEBANON | OH | 45036 | 510181689 | 501(C)(3) | $5,610 | SUPPORT |
| AMERICAN RED CROSS DAYTON CHAPTER | |||||||
| 370 W FIRST ST | DAYTON | OH | 45404 | 530196605 | 501(C)(3) | $5,100 | SUPPORT |
| FIRST FOUR EVENTS INC | |||||||
| 40 N MAIN ST 900 | DAYTON | OH | 45423 | 454231032 | NONE | $5,100 | SUPPORT |
| OTTERBEIN LEBANON INDEPENDENT LIVING | |||||||
| 585 N ST RT 741 | LEBANON | OH | 45036 | 311743874 | 501(C)(3) | $5,100 | SUPPORT |
| MARCH OF DIMES | |||||||
| 1275 MAMORONECK AVE | WHITE PLAINS | NY | 10605 | 131846366 | 501(C)(3) | $5,100 | SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 36 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 1) DISBURSEMENTS ARE ANALYZED MONTHLY THROUGH VARIOUS REPORTS AND COMMITTEE MEETINGS. 2) INVOICES ARE RECEIVED IN ACCOUNTS PAYABLE AND APPROVED AND DISBURSED PER ORGANIZATIONAL POLICY. 3) GRANT SPENDING IS MONITORED AGAINST BUDGETED AMOUNTS ON AN ONGOING BASIS. SCHEDULE I, PART II, LINE 1(A)(1) PAGE 3, ZIKS FAMILY PHARMACY: MIAMI VALLEY HOSPITAL CONTRIBUTES FUNDS TO SUPPORT THE ZIKS FAMILY PHARMACY/WRIGHT DUNBAR COMMUNITY CELEBRATION & ANNUAL COMMUNITY WELLNESS EVENT. SCHEDULE I, PART II, LINE 1(A)(12) PAGE 3, FIRST FOUR EVENTS INC: MIAMI VALLEY HOSPITAL CONTRIBUTES FUNDS TO SUPPORT THE WRIGHT PATTERSON AIR FORCE BASE APPRECIATION NIGHT AND CONCERT (HOMETOWN HEROES PROGRAM). | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (28 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK S SHAKER | ||||||||||||||
| PRESIDENT & CEO (TO JUN) | $559,677 | $0 | $136,962 | $0 | $181,474 | $0 | $27,206 | $0 | $3,993 | $0 | $909,312 | $0 | $0 | $0 |
| MARY M CLANCY | ||||||||||||||
| COO | $388,283 | $0 | $149,376 | $0 | $42,830 | $0 | $24,970 | $0 | $14,061 | $0 | $619,520 | $0 | $0 | $0 |
| MARY H BOOSALIS | ||||||||||||||
| TRUSTEE / PREMIER PRES & CEO | $0 | $980,548 | $0 | $527,251 | $0 | $32,471 | $0 | $39,833 | $0 | $10,669 | $0 | $1,590,772 | $0 | $0 |
| SCOTT A SHELTON | ||||||||||||||
| BOARD TREASURER & CFO(INTERIM) | $0 | $252,664 | $0 | $116,419 | $0 | $11,514 | $0 | $24,804 | $0 | $4,430 | $0 | $409,831 | $0 | $0 |
| CARA W POWERS | ||||||||||||||
| BOARD SECRETARY | $231,770 | $0 | $72,890 | $0 | $774 | $0 | $24,408 | $0 | $25,331 | $0 | $355,173 | $0 | $0 | $0 |
| MARC R BELCASTRO DO | ||||||||||||||
| MVH CMO | $438,257 | $0 | $98,107 | $0 | $8,853 | $0 | $15,758 | $0 | $23,176 | $0 | $584,151 | $0 | $0 | $0 |
| ROBERT M BOWMAN | ||||||||||||||
| VP - HOSPITAL OPERATIONS | $225,183 | $0 | $46,983 | $0 | $7,208 | $0 | $20,244 | $0 | $25,886 | $0 | $325,504 | $0 | $0 | $0 |
| DALE E CREECH JR | ||||||||||||||
| SYSTEM SR VP - CLO | $0 | $398,677 | $0 | $146,709 | $0 | $86,590 | $0 | $37,157 | $0 | $25,774 | $0 | $694,907 | $0 | $0 |
| THOMAS R CURTIN | ||||||||||||||
| SYSTEM VP - REVENUE CYCLE | $0 | $231,960 | $0 | $68,571 | $0 | $6,046 | $0 | $28,926 | $0 | $29,842 | $0 | $365,345 | $0 | $0 |
| GARY G GINTER | ||||||||||||||
| SYSTEM VP - CIO | $0 | $385,251 | $0 | $135,949 | $0 | $3,806 | $0 | $61,801 | $0 | $25,349 | $0 | $612,156 | $0 | $0 |
| JENNIFER J HAULER MD | ||||||||||||||
| SYSTEM VP - CMO (FROM OCT) | $0 | $337,058 | $0 | $28,191 | $0 | $1,125 | $0 | $0 | $0 | $1,542 | $0 | $367,916 | $0 | $0 |
| KIMBERLY A HENSLEY | ||||||||||||||
| VP - HOSPITAL OPERATIONS | $229,781 | $0 | $48,065 | $0 | $1,152 | $0 | $28,429 | $0 | $12,308 | $0 | $319,735 | $0 | $0 | $0 |
| BARBARA A JOHNSON | ||||||||||||||
| SYSTEM VP - HR OPERATIONS | $0 | $363,394 | $0 | $124,821 | $0 | $20,560 | $0 | $28,293 | $0 | $10,160 | $0 | $547,228 | $0 | $0 |
| TAMMY S LUNDSTROM MD | ||||||||||||||
| SYSTEM VP - CMO (TO AUG) / CCO | $0 | $524,280 | $0 | $192,978 | $0 | $5,165 | $0 | $81,162 | $0 | $2,788 | $0 | $806,373 | $0 | $0 |
| MARGARET W MARK | ||||||||||||||
| SYSTEM VP - CNO (FROM JUN) | $0 | $267,121 | $0 | $70,931 | $0 | $7,815 | $0 | $9,544 | $0 | $25,867 | $0 | $381,278 | $0 | $0 |
| THOMAS R PARKER | ||||||||||||||
| SYS VP -CHF EXPERIENCE OFFICER | $0 | $378,787 | $0 | $121,190 | $0 | $26,397 | $0 | $52,371 | $0 | $14,841 | $0 | $593,586 | $0 | $0 |
| JOANN R RINGER | ||||||||||||||
| VP - COO MVH SOUTH | $277,330 | $0 | $77,687 | $0 | $52,181 | $0 | $29,879 | $0 | $11,180 | $0 | $448,257 | $0 | $0 | $0 |
| CRAIG SELF | ||||||||||||||
| SYS VP -CHIEF STRATEGY OFFICER | $0 | $389,413 | $0 | $144,360 | $0 | $3,160 | $0 | $23,805 | $0 | $26,651 | $0 | $587,389 | $0 | $0 |
| MARK W SHAW | ||||||||||||||
| SYSTEM VP - MANAGED CARE | $0 | $307,295 | $0 | $118,673 | $0 | $88,375 | $0 | $36,068 | $0 | $25,720 | $0 | $576,131 | $0 | $0 |
| SYLVAIN TREPANIER DNP RN CENP | ||||||||||||||
| SYSTEM VP - CNO (TO APR) | $0 | $111,026 | $0 | $103,825 | $0 | $900 | $0 | $19,789 | $0 | $8,737 | $0 | $244,277 | $0 | $0 |
| ROBERT T MORRISON MD | ||||||||||||||
| ASSOCIATE CMO | $381,672 | $0 | $36,793 | $0 | $6,446 | $0 | $8,227 | $0 | $24,285 | $0 | $457,423 | $0 | $0 | $0 |
| WALTER REILING JR MD | ||||||||||||||
| CHIEF MEDICAL INFO OFFICER | $319,319 | $0 | $88,975 | $0 | $4,093 | $0 | $20,717 | $0 | $29,327 | $0 | $462,431 | $0 | $0 | $0 |
| CHRISTOPHER J BUTLER | ||||||||||||||
| SYS VP-CHIEF CONSUMER OFFICER | $300,999 | $0 | $50,000 | $0 | $60,931 | $0 | $0 | $0 | $17,569 | $0 | $429,499 | $0 | $0 | $0 |
| JEFFREY G POULOS MD | ||||||||||||||
| VP & CHIEF HOSPITALIST OFFICER | $381,470 | $0 | $24,958 | $0 | $1,054 | $0 | $5,540 | $0 | $24,561 | $0 | $437,583 | $0 | $0 | $0 |
| J MICHAEL SIMS | ||||||||||||||
| VP FINANCE | $251,121 | $0 | $64,155 | $0 | $46,053 | $0 | $27,089 | $0 | $28,895 | $0 | $417,313 | $0 | $0 | $0 |
| RENEE P GEORGE | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $323,626 | $0 | $71,751 | $0 | $1,095 | $0 | $15,853 | $0 | $12,345 | $0 | $424,670 | $0 | $0 |
| LISA A GIBBS | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $112,549 | $0 | $4,916 | $0 | $6,319 | $0 | $123,784 | $0 | $114,552 | $0 |
| GEOFFREY P WALKER | ||||||||||||||
| FORMER OFFICER | $231,072 | $0 | $75,140 | $0 | $34,120 | $0 | $28,348 | $0 | $26,029 | $0 | $394,709 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I LINE 4A: | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN 2017: LISA GIBBS $114,552. PART I LINE 4B: DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, MIAMI VALLEY HOSPITAL (MVH) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. MVH SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2017. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2017: MARC BELCASTRO, D.O. $2,202; ROBERT BOWMAN $5,195; MARY CLANCY $38,621; DALE CREECH $80,472; BARBARA JOHNSON $15,163; JOANN RINGER $48,089; MARK SHAKER $159,168; MARK SHAW $79,734; SCOTT SHELTON $8,114; J. MICHAEL SIMS $23,961; GEOFFREY WALKER $31,901. THERE WERE NO INDIVIDUALS WHO MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED AN ASSOCIATED PAYMENT IN 2017. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED AND PAID TO THE SERP PARTICIPANTS: MARC BELCASTRO, D.O. $7,544; THOMAS CURTIN $3,311; RENEE GEORGE $4,842; GARY GINTER $35,597; KIMBERLY HENSLEY $1,052; BARBARA JOHNSON $9,636; TAMMY LUNDSTROM, M.D. $71,860; MARGARET MARK $986; THOMAS PARKER $24,658; CARA POWERS $5,361; WALTER REILING, JR, M.D. $11,219; CRAIG SELF $14,135; SYLVAIN TREPANIER $11,028. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| COUNTY OF MONTGOMERY OH | ||||||||
| A | 316000172 | 613549GP3 | 2008-11-13 | $234,895,988 | SEE PART VI - NOTE A | false | false | false |
| COUNTY OF MONTGOMERY OH | ||||||||
| B | 316000172 | 613549GZ1 | 2009-02-24 | $126,463,824 | SEE PART VI - Note B | false | false | false |
| COUNTY OF MONTGOMERY OH | ||||||||
| C | 316000172 | 613549JL9 | 2011-04-12 | $106,431,124 | SEE PART VI - Note C | false | false | false |
| COUNTY OF MONTGOMERY OH | ||||||||
| D | 316000172 | 000000000 | 2012-11-20 | $128,640,000 | SEE PART VI - Note D | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $218,760,000 | $0 | $234,895,988 | $0 | $0 | $0 | $2,119,000 | $0 | $0 | $34,078,936 | $198,698,053 | $0 | 2008 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $115,000,000 | $0 | $126,463,824 | $0 | $0 | $0 | $2,293,824 | $0 | $0 | $0 | $124,170,000 | $0 | 2009 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $3,420,000 | $0 | $106,431,124 | $0 | $0 | $0 | $1,203,000 | $0 | $0 | $105,228,124 | $0 | $0 | 2011 | false | false | Yes (true) | Yes (true) |
| D | $3,000,000 | $0 | $128,640,000 | $0 | $0 | $0 | $375,517 | $0 | $0 | $0 | $128,264,483 | $0 | 2012 | false | Yes (true) | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | false | false | 0.00821 | 0.00000 | 0.00821 | false | false | false | Yes (true) |
| B | false | Yes (true) | false | false | 0.00821 | 0.00000 | 0.00821 | false | false | false | Yes (true) |
| C | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false | false | false | Yes (true) |
| D | false | Yes (true) | false | false | 0.00821 | 0.00000 | 0.00821 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERRILL LYNCH | |||||||||||||
| A | false | false | false | Yes (true) | Yes (true) | Yes (true) | 0. | Yes (true) | Yes (true) | false | 0 | false | Yes (true) |
| 0 | |||||||||||||
| B | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
| BARCLAYSWELLS FARGO | |||||||||||||
| C | false | false | false | Yes (true) | false | Yes (true) | 19. | Yes (true) | false | false | 0 | false | Yes (true) |
| PNCDEUTSCHE BANK | |||||||||||||
| D | false | false | false | Yes (true) | Yes (true) | Yes (true) | 22. | Yes (true) | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
| D | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NOTE A, PART 1, LINE A, COLUMN F | REFUND MIAMI VALLEY HOSPITAL BOND SERIES 1992B, 1998A, 2003A, 2003B, & 2003C, AND TO PROVIDE FUNDS TO CONSTRUCT THE SOUTH EAST TOWER ON THE HOSPITAL'S CAMPUS. |
| NOTE B, PART I, LINE B, COLUMN F | REFUND PORTION OF MIAMI VALLEY HOSPITAL SERIES 2008A AND 2008B BONDS. |
| NOTE C, PART 1, LINE C, COLUMN F | PROVIDE FUNDS TO CONSTRUCT THE SOUTH EAST TOWER ON THE HOSPITAL'S CAMPUS. |
| Note D, PART 1, LINE D, COLUMN F: | REFUND MIAMI VALLEY HOSPITAL SERIES 2009A BONDS. |
| Note E, PART 1, LINE A, COLUMN F: | REFUND MIAMI VALLEY HOSPITAL SERIES 2008BC AND 2011BC BONDS. |
| PART IV, ARBITRAGE, LINE 2C: | COMPUTATION DATE WAS NOVEMBER 13, 2013 FOR THE 2008ABC COMPUTATION DATE WAS NOVEMBER 17, 2014 FOR THE 2009AB COMPUTATION DATE WAS APRIL 12, 2016 FOR THE 2011A COMPUTATION DATE WAS NOVEMBER 20, 2017 FOR THE 2012AB |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF MONTGOMERY OH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316000172 | BondIssuerEIN |
| CUSIP | 613520LE3 | CUSIPNum |
| Bond Issued | 2016-08-31 | BondIssuedDt |
| Issue Price | $114,930,000 | IssuePriceAmt |
| Purpose | SEE PART VI - NOTE E | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $114,930,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $881,031 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $141,738,341 | OtherSpentProceedsAmt |
| Unspent | $2,310,628 | UnspentAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (true) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00821 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00821 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (true) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARCLAYSWELLS FARGO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 28.5 | TermOfHedgePct |
| Superintegrated Hedge | Yes (true) | SuperintegratedHedgeInd |
| Hedge Terminated | false | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARC R BELCASTRO DO | |||
| CHILD | $47,148 | ACCESS CENTER COORDINATOR | false |
| ROBERT BOWMAN | |||
| SPOUSE | $71,874 | INFECTION PREVENT SPEC SALARY | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VI, SECTION A, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MARY M. CLANCY (TRUSTEE & OFFICER) AND THOMAS R. CURTIN (KEY EMPLOYEE) HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3: PREMIER HEALTH (PREMIER) AS THE OPERATOR OF MIAMI VALLEY HOSPITAL (MVH) DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR MVH, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. MVH SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. MVH SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. MVH SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF MVH WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO INSURERS. MVH MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. MVH MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN PREMIER'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6: MIAMI VALLEY HOSPITAL HAS TWO CORPORATE MEMBERS. ONE MEMBER IS MEDAMERICA HEALTH SYSTEMS. THE SECOND MEMBER IS PREMIER HEALTH, AN OHIO NON-PROFIT CORPORATION FORMED PURSUANT TO THE JOINT OPERATING AGREEMENT. MEDAMERICA HEALTH SYSTEMS HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES OF THE CORPORATION. PREMIER HEALTH HAS THE GENERAL AUTHORITY TO OPERATE AND MANAGE THE OPERATIONAL ACTIVITIES OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINES 7A & 7B: MEDAMERICA HEALTH SYSTEMS (MAHS) HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR MIAMI VALLEY HOSPITAL (MVH) FROM AMONG THOSE RECOMMENDED BY THE NOMINATING COMMITTEE SET FORTH IN THE JOINT OPERATING AGREEMENT. MAHS HAS THE AUTHORITY TO REMOVE SUCH TRUSTEES AT ANY REGULAR OR SPECIAL MEETING OR BY WRITTEN CONSENT. FORM 990, PART VI, SECTION B, LINE 11B: THIS 990 TAX RETURN AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER HEALTH (PREMIER), OF WHICH MIAMI VALLEY HOSPITAL IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE TAX MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. THE RETURN IS CONCURRENTLY SENT TO ERNST & YOUNG U.S. LLP FOR THEIR REVIEW. AFTER ALL CHANGES FROM THE ABOVE GROUPS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER AND THE CHIEF FINANCIAL OFFICER OF THIS ENTITY. A FINAL VERSION OF THE RETURN IS SENT TO ERNST & YOUNG U.S. LLP FOR A FINAL REVIEW AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 TAX RETURN IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C: PREMIER HEALTH (PREMIER), WITH WHICH MIAMI VALLEY HOSPITAL IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINES 15A AND 15B: COMPENSATION FOR MIAMI VALLEY HOSPITAL'S (MVH) CEO IS REVIEWED AND APPROVED BY PREMIER HEALTH (PREMIER), WITH WHICH MVH IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH-PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD-PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE IS COMPRISED OF THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CHIEF INTEGRATION OFFICER, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19: THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON WWW.PREMIERHEALTH.COM. FORM 990, PART XI, LINE 9: EQUITY TRANSFER (89,693,339) PENSION FASB 158 ADJUSTMENT (5,207,361) FOUNDATION ADJUSTMENT (500,834) SWAP AMORTIZATION (130,990) TRANSFERS FROM AFFILIATES 650,629 ------------ TOTAL (94,881,895) | ExplanationTxt |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIALYSIS CENTERS OF DAYTON LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST SUITE 500 | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311607686 | EIN |
| Primary Activities | DIALYSIS | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $656,673 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MVH | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PREMIER HEALTH | ||||||||||
| 110 N MAIN ST SUITE 500 | DAYTON | OH | 45402 | 311446699 | SUPPRTG. ORG. | OH | 501(C)(3) | 12A I | NA | false |
| MEDAMERICA HEALTH SYSTEMS CORP (MAHS) | ||||||||||
| 110 N MAIN ST SUITE 500 | DAYTON | OH | 45402 | 311040228 | PARENT | OH | 501(C)(3) | 12C III FI | NA | false |
| MIAMI VALLEY HOSPITAL FOUNDATION | ||||||||||
| 110 N MAIN ST SUITE 500 | DAYTON | OH | 45402 | 311040231 | Foundation | OH | 501(C)(3) | 7 | MAHS | Yes (true) |
| PREMIER COMMUNITY HEALTH | ||||||||||
| C/O FIDELITY 3170 KETTERING BLVD | DAYTON | OH | 45439 | 311122883 | Health Educat | OH | 501(C)(3) | 10 | FHC | Yes (true) |
| FIDELITY HEALTH CARE (FHC) | ||||||||||
| 3170 KETTERING BLVD | DAYTON | OH | 45439 | 311075381 | HOME HEALTH | OH | 501(C)(3) | 10 | MAHS | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Premier Plaza LLC | ||||||||||||||
| 110 N Main St 500 | Dayton | OH | 45402 | 800708185 | HOLDING COMPANY | OH | MAHS | EXCLUDED | -$3,066 | $132,644 | false | $0 | false | 0.01000 |
| SOUTHWEST OHIO NEONATAL COLLABORATIVE | ||||||||||||||
| 110 N MAIN ST 500 | DAYTON | OH | 45402 | 463231330 | NEONATOLOGY | OH | CHILDRENS MEDIC | RELATED | -$2,626 | $6,886 | false | $0 | false | 0.61500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (17 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MEDAMERICA HEALTH SYSTEMS | ||
| C | $2,089,125 | FMV |
| MEDAMERICA HEALTH SYSTEMS | ||
| R | $1,552,500 | FMV |
| MIAMI VALLEY HOSPITAL FOUNDATION | ||
| C | $1,210,713 | FMV |
| MIAMI VALLEY HOSPITAL FOUNDATION | ||
| Q | $125,923 | FMV |
| MIAMI VALLEY HOSPITAL FOUNDATION | ||
| R | $1,538,801 | FMV |
| FIDELITY HEALTH CARE | ||
| J | $230,351 | FMV |
| FIDELITY HEALTH CARE | ||
| M | $707,227 | FMV |
| FIDELITY HEALTH CARE | ||
| O | $3,912,555 | FMV |
| FIDELITY HEALTH CARE | ||
| P | $223,895 | FMV |
| FIDELITY HEALTH CARE | ||
| Q | $455,506 | FMV |
| FIDELITY HEALTH CARE | ||
| R | $81,691 | FMV |
| FIDELITY HEALTH CARE | ||
| S | $127,534 | FMV |
| PREMIER COMMUNITY HEALTH | ||
| M | $161,268 | FMV |
| PREMIER COMMUNITY HEALTH | ||
| O | $81,165 | FMV |
| PREMIER COMMUNITY HEALTH | ||
| Q | $59,671 | FMV |
| PREMIER HEALTH | ||
| B | $262,269 | FMV |
| PREMIER PLAZA LLC | ||
| K | $1,933,113 | FMV |