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ADENA HEALTH SYSTEM: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ADENA HEALTH SYSTEM (EIN 31-4379443)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201833199349312468
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-15T14:50:53-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1250 S HIGH ST SUITE 100AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN314379443EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADENA HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADENBusinessNameControlTxt
Phone7407794478PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1272 HOSPITAL RDAddressLine1Txt
CityCHILLICOTHECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLISA CARLSONPersonNm
Person TitleCFOPersonTitleTxt
Phone7407794478PhoneNum
Signature2018-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBERNIE OSTROWSKIPreparerPersonNm
PTINP00366367PTIN
Phone6148493000PhoneNum
Preparation2018-11-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.59.56.32IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-14IPDt
IP Tm08:08:17IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdDCADD2CDA100FC630949EB2812E82144C693340DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ADENA REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerLISA CARLSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1272 HOSPITAL RDAddressLine1Txt
CityCHILLICOTHECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$469,880,689GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ADENA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1895FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or Mission"TO CARE, TO HEAL, TO EDUCATE." THE REPORTING ORGANIZATION IS A REGIONAL HEALTHCARE SYSTEM WITH ONE HOSPITAL AND SEVERAL AMBULATORY CENTERS, IN ADDITION TO MULTIPLE PHYSICIAN PRACTICES. AHS OFFERS A WIDE SCOPE OF DIAGNOSTIC AND REHABILITATIVE SERVICES BOTH FOR INPATIENTS AND OUTPATIENTS, INCLUDING COMPREHENSIVE CARDIOLOGY AND CANCER CARE. FURTHERMORE, AHS IS THE SOLE MEMBER OF TWO CRITICAL ACCESS HOSPITALS, ADENA PIKE MEDICAL CENTER AND ADENA GREENFIELD MEDICAL CENTER, THAT FILE SEPARATELY.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee3577TotalEmployeeCnt
Total Volunteers213TotalVolunteersCnt
Total Gross UBI$788TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$788,168PYContributionsGrantsAmt
CY Contributions Grants$463,634CYContributionsGrantsAmt
PY Program Service Revenue$408,415,410PYProgramServiceRevenueAmt
CY Program Service Revenue$446,204,420CYProgramServiceRevenueAmt
PY Investment Income$2,180,196PYInvestmentIncomeAmt
CY Investment Income$13,964,554CYInvestmentIncomeAmt
PY Other Revenue$11,554,082PYOtherRevenueAmt
CY Other Revenue$9,248,081CYOtherRevenueAmt
PY Total Revenue$422,937,856PYTotalRevenueAmt
CY Total Revenue$469,880,689CYTotalRevenueAmt
PY Grants And Similar Paid$562,077PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$593,238CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$229,977,764PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$245,758,274CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$183,278,092PYOtherExpensesAmt
CY Other Expenses$197,731,213CYOtherExpensesAmt
PY Total Expenses$413,817,933PYTotalExpensesAmt
CY Total Expenses$444,082,725CYTotalExpensesAmt
PY Revenues Less Expenses$9,119,923PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$25,797,964CYRevenuesLessExpensesAmt
Total Assets BOY$485,156,474TotalAssetsBOYAmt
Total Assets EOY$565,089,403TotalAssetsEOYAmt
Total Liabilities BOY$228,637,469TotalLiabilitiesBOYAmt
Total Liabilities EOY$280,319,022TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$256,519,005NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$284,770,381NetAssetsOrFundBalancesEOYAmt
MissionTO CARE, TO HEAL, TO EDUCATE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$397,885,397ExpenseAmt
Grant$593,238GrantAmt
Revenue$449,191,258RevenueAmt
DescHEALTH CARE PROGRAMS, GENERAL/OTHER: ROUTINE HOSPITAL SERVICES. ADENA REGIONAL MEDICAL CENTER PROVIDED CARE FOR 11,228 INPATIENTS.EMERGENCY SERVICES - TREATMENT OF EMERGENCY ACCIDENT AND ILLNESS AS WELL AS LESS URGENT CONDITIONS IN THE ABSENCE OF A FAMILY PHYSICIAN. THERE WERE 46,934 EMERGENT AND URGENT VISITS IN 2017. PHYSICIAN OFFICES: THERE WERE 408,392 PHYSICIAN OFFICE VISITS IN 2017.Desc
Total Program Service Expenses$397,885,397TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt BondsYes (1)InvestTaxExemptBondsInd
Escrow AccountYes (1)EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document608IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3577EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSHARON WISECUP VP SYSTEM FINANCEPersonNm
Phone7407794478PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1272 HOSPITAL ROADAddressLine1Txt
CityCHILLICOTHECityNm
State AbbreviationOHStateAbbreviationCd
ZIP456019031ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
TOM WHITE
TRUSTEE/SECRETARY2.000.00Yes (X)Yes (X)$0$0$0
JOSEPH SULZER
TRUSTEE/TREASURER2.000.00Yes (X)Yes (X)$0$0$0
VIRGINIA WETTERSTEN
TRUSTEE/VICE CHAIR2.000.00Yes (X)Yes (X)$0$0$0
STEVE BURKHARDT
TRUSTEE/CHAIRMAN2.000.00Yes (X)Yes (X)$0$0$0
JERRY PHILLIPS
TRUSTEE2.000.00Yes (X)$0$0$0
REGGINA YANDILA
TRUSTEE50.000.00Yes (X)$212,288$0$11,525
DAVID STRICKLAND
TRUSTEE2.000.00Yes (X)$0$0$0
JENNIFER MCKELL
TRUSTEE2.000.00Yes (X)$0$0$0
CARVEL SIMMONS
TRUSTEE2.000.00Yes (X)$0$0$0
RALPH D'ANTONI
TRUSTEE2.000.00Yes (X)$0$0$0
JOE WATSON
TRUSTEE2.000.00Yes (X)$0$0$0
BARTOW HENSHAW
TRUSTEE2.000.00Yes (X)$0$0$0
GAIL TAYLOR
TRUSTEE2.000.00Yes (X)$0$0$0
WILLIAM STRAUCH
TRUSTEE50.000.00Yes (X)$520,494$0$32,959
JOHN FORTNEY
CEO (JAN - JULY)50.004.00Yes (X)$620,562$0$159,069
LISA CARLSON
CFO50.000.00Yes (X)$335,986$0$125,663
JEFF GRAHAM
CEO (JULY-DEC)50.000.00Yes (X)$311,630$0$52,015
JACK BERNO
CHIEF MEDICAL OFFICER (JAN-JULY)50.000.00Yes (X)$336,380$0$20,625
ERIC CECAVA
COO (JAN-OCT)50.000.00$471,558$0$45,412Yes (X)
TIM CAHILL
GENERAL COUNSEL50.000.00$321,654$0$114,637Yes (X)
BRIAN COHEN
EMPLOYED M.D.50.000.00$2,769,669$0$33,682Yes (X)
HAVAL SAADLLA
EMPLOYED M.D.50.000.00$1,106,710$0$34,182Yes (X)
THOMAS LEWIS
EMPLOYED M.D.50.000.00$980,204$0$34,283Yes (X)
JAMES MANAZER
EMPLOYED M.D.50.000.00$1,008,799$0$33,882Yes (X)
MARK SHUTER
FORMER CEO0.000.00$648,688$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,644,622TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$697,934TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K13IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
APOGEE MEDICAL MANAGEMENT
15059 N SCOTTSDALE RD 600SCOTTSDALEAZ85254MANAGEMENT SERVICES$5,862,294
CAPTIVE RADIOLOGY
6273 FRANK AVENUE NWNORTH CANTONOH44720MRI SERVICES$2,582,399
NTHRIVE INC
200 NORTH POINT CENTER EALPHARETTAGA30022REVENUE CYCLE MANAGEMENT$2,146,958
TATUM LLC
3715 NORTHSIDE PARKWAY NW 300 NORTATLANTAGA30327CONSULTING SERVICES$1,655,014
ARUP INC
500 CHIPETA WAYSALT LAKE CITYUT84108LABORATORY SERVICES$1,598,374
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K60CntrctRcvdGreaterThan100KCnt
Related Organizations$135,355RelatedOrganizationsAmt
All Other Contributions$328,279AllOtherContributionsAmt
Total Contributions$463,634TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SVC REVDesc
Business622110BusinessCd
Total Revenue Column$446,204,420TotalRevenueColumnAmt
Related Or Exempt Func Income$446,194,297RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$10,123UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$446,204,420TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,952,104TotalRevenueColumnAmt
Exclusion$13,952,104ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$119,157RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$119,157RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$119,157TotalRevenueColumnAmt
Unrelated Business Revenue-$9,335UnrelatedBusinessRevenueAmt
Exclusion$128,492ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$12,450OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$12,450OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,450TotalRevenueColumnAmt
Exclusion$12,450ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
FOOD & NUTRITION722514$1,965,122$1,965,122
EHR IMPLEMENTATION622110$772,392$772,392
CONSULTING FEES900099$100,323$100,323

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,291,087TotalRevenueColumnAmt
Related Or Exempt Func Income$159,124RelatedOrExemptFuncIncomeAmt
Exclusion$6,131,963ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$9,128,924OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$469,880,689TotalRevenueColumnAmt
Related Or Exempt Func Income$449,191,258RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$788UnrelatedBusinessRevenueAmt
Exclusion$20,225,009ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$593,238TotalAmt
Program Services$593,238ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,167,476TotalAmt
Program Services$1,043,681ProgramServicesAmt
Management And General$123,795ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$196,816,568TotalAmt
Program Services$176,687,336ProgramServicesAmt
Management And General$20,129,232ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$40,489,907TotalAmt
Program Services$37,099,052ProgramServicesAmt
Management And General$3,390,855ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,284,323TotalAmt
Program Services$6,511,917ProgramServicesAmt
Management And General$772,406ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$48,233TotalAmt
Management And General$48,233ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$589,382TotalAmt
Management And General$589,382ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$102,000TotalAmt
Management And General$102,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$67,056,405TotalAmt
Program Services$51,607,170ProgramServicesAmt
Management And General$15,449,235ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,169,610TotalAmt
Program Services$4,786,922ProgramServicesAmt
Management And General$382,688ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$8,699,747TotalAmt
Program Services$7,777,444ProgramServicesAmt
Management And General$922,303ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,818,525TotalAmt
Program Services$2,154,609ProgramServicesAmt
Management And General$663,916ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,093,855TotalAmt
Program Services$6,341,646ProgramServicesAmt
Management And General$752,209ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$22,581,889TotalAmt
Program Services$20,188,034ProgramServicesAmt
Management And General$2,393,855ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,788,703TotalAmt
Program Services$1,788,703ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$66,786,842$66,652,536$134,306
BAD DEBT EXPENSE$11,762,109$11,762,109
LOSS ON BOND REFINANCIN$10,413,657$9,309,427$1,104,230
OVERHEAD ALLOCATION-$7,179,744-$6,418,427-$761,317

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$444,082,725TotalAmt
Program Services$397,885,397ProgramServicesAmt
Management And General$46,197,328ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$11,658BOYAmt
EOY$11,958EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$74,914,778BOYAmt
EOY$24,816,980EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,215,234BOYAmt
EOY$7,290,422EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$52,869,504BOYAmt
EOY$59,982,767EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$8,989BOYAmt
EOY$8,389EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,640,546BOYAmt
EOY$6,222,011EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$11,210,480BOYAmt
EOY$3,943,720EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$395,222,728LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$259,905,872LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$135,040,792BOYAmt
EOY$135,316,856EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$188,239,938BOYAmt
EOY$312,557,286EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$12,004,555BOYAmt
EOY$14,939,014EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$485,156,474BOYAmt
EOY$565,089,403EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$51,452,745BOYAmt
EOY$61,467,940EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$158,764,005BOYAmt
EOY$194,594,671EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$500,000BOYAmt
EOY$500,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,920,719BOYAmt
EOY$23,756,411EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$228,637,469BOYAmt
EOY$280,319,022EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$254,709,236BOYAmt
EOY$282,810,528EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,809,769BOYAmt
EOY$1,959,853EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$256,519,005BOYAmt
EOY$284,770,381EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$485,156,474BOYAmt
EOY$565,089,403EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$25,797,964ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$12,677,219NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$10,223,807OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$4,326OtherActivitiesAmt
Total Lobbying Expenditures$4,326TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE OHIO HOSPITAL ASSOCIATION DOES LOBBYING ON BEHALF OF HOSPITAL RELATED CAUSES. THIS ACTIVITY IS PAID FOR THROUGH DUES PAID TO THE OHIO HOSPITAL ASSOCIATION.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,331,708BeginningYearBalanceAmt
Contributions-$3,508ContributionsAmt
Investment Earnings Or Losses$155,784InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
End Year Balance$1,483,984EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,321,696BeginningYearBalanceAmt
Contributions-$43,583ContributionsAmt
Investment Earnings Or Losses$54,095InvestmentEarningsOrLossesAmt
Grants Or Scholarships$500GrantsOrScholarshipsAmt
End Year Balance$1,331,708EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,305,508BeginningYearBalanceAmt
Contributions$44,539ContributionsAmt
Investment Earnings Or Losses-$6,351InvestmentEarningsOrLossesAmt
Grants Or Scholarships$22,000GrantsOrScholarshipsAmt
End Year Balance$1,321,696EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,219,218BeginningYearBalanceAmt
Contributions$34,077ContributionsAmt
Investment Earnings Or Losses$52,213InvestmentEarningsOrLossesAmt
End Year Balance$1,305,508EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,149,935BeginningYearBalanceAmt
Contributions-$2,887ContributionsAmt
Investment Earnings Or Losses$77,350InvestmentEarningsOrLossesAmt
Grants Or Scholarships$5,180GrantsOrScholarshipsAmt
End Year Balance$1,219,218EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,648,975OtherCostOrOtherBasisAmt
Book Value$2,648,975BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$176,802,237OtherCostOrOtherBasisAmt
Depreciation$96,571,242DepreciationAmt
Book Value$80,230,995BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,000OtherCostOrOtherBasisAmt
Depreciation$271DepreciationAmt
Book Value$64,729BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$199,196,087OtherCostOrOtherBasisAmt
Depreciation$157,635,357DepreciationAmt
Book Value$41,560,730BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,510,429OtherCostOrOtherBasisAmt
Depreciation$5,699,002DepreciationAmt
Book Value$10,811,427BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$135,316,856TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED MALPRACTICE INSURANCE - LT$9,580,633
DEFERRED COMPENSATION LIABILITY$10,333,772
INTERCOMPANY PAYABLE$643,576
DEFINED BENEFIT PLAN LIABILITY$3,198,430
FieldValueIRS element (for citing)
Total Liability$23,756,411TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationADENA HEALTH FOUNDATION ENDOWMENT FUNDS ARE USED TO PROVIDE SCHOLARSHIPS AND PURCHASE CAPITAL FOR ADENA HEALTH SYSTEM. THESE FUNDS ARE HELD BY ADENA HEALTH SYSTEM AND ARE ADMINISTERED BY ADENA HEALTH FOUNDATION.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,032,277TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,379,374DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,652,903NetCommunityBenefitExpnsAmt
Total Expense0.02290TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$88,521,141TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$53,662,648DirectOffsettingRevenueAmt
Net Community Benefit Expns$34,858,493NetCommunityBenefitExpnsAmt
Total Expense0.08260TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$99,553,418TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,042,022DirectOffsettingRevenueAmt
Net Community Benefit Expns$44,511,396NetCommunityBenefitExpnsAmt
Total Expense0.10550TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,128,122TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,128,122NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$892,853TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$892,853NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$938,440TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$938,440NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,959,415TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,959,415NetCommunityBenefitExpnsAmt
Total Expense0.00700TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$102,512,833TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,042,022DirectOffsettingRevenueAmt
Net Community Benefit Expns$47,470,811NetCommunityBenefitExpnsAmt
Total Expense0.11250TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$11,762,109BadDebtExpenseAmt
Bad Debt Expense Attributable$2,760,942BadDebtExpenseAttributableAmt
Reimbursed By Medicare$89,839,025ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$86,097,774CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$3,741,251MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADENA REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1272 HOSPITAL RDAddressLine1Txt
CityCHILLICOTHECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.ADENA.ORGWebsiteAddressTxt
State LicenseST. REG. NUM. 1029StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ADENA REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.ADENA.ORG/INSIDE/PAGE.DT/CHNAOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLHTTP://ROSSCOUNTYHEALTH.ORG/HEALTHASSESSMENT.PDFOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.ADENA.ORG/FILES/RESOURCES/ROSS-IS-2016.DOCXStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.ADENA.ORG/INSIDE/PAGE.DT/FINANCIAL-AIDFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.ADENA.ORG/INSIDE/PAGE.DT/FINANCIAL-AIDFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.ADENA.ORG/INSIDE/PAGE.DT/FINANCIAL-AIDFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 5: ADENA REGIONAL MEDICAL CENTER CAPTURED THE BROAD INTERESTS OF THE COMMUNITY FOR THE CHNA THROUGH TWO METHODS: SURVEY AND INTERVIEWS. A HEALTH NEEDS SURVEY WAS WIDELY DISTRIBUTED TO THE ROSS COUNTY COMMUNITY THROUGH PAPER AND WEB FORM. IN ADDITION TO THE SURVEYS, INTERVIEWS WITH LOCAL COMMUNITY LEADERS, INCLUDING CIVIC, PUBLIC HEALTH AND EMERGENCY RESPONSE WERE REQUESTED AND/OR CONDUCTED TO GAIN FURTHER KNOWLEDGE OF SURVEY TOPICS.
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 6B: THE CHNA FOR ADENA REGIONAL MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS: ADENA HEALTH SYSTEM, CHILLICOTHE CITY SCHOOLS, CHILLICOTHE GAZETTE, HOPE CLINIC OF ROSS COUNTY, HOPEWELL HEALTH CENTER, OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, OHIO STATE UNIVERSITY EXTENSION, OHIO UNIVERSITY CHILLCOTHE, PACCAR, PAINT VALLEY ADAMH BOARD, RECOVERY COUNCIL, ROSS COUNTY CHILD PROTECTION CENTER, ROSS COUNTY HEALTH DISTRICT, ROSS COUNTY YMCA, SCIOTO PAINT VALLEY MENTAL HEALTH CENTER, UNION-SCIOTO SCHOOL DISTRICT, UNITED WAY OF ROSS COUNTY, AND VETERANS ADMINISTRATION HOSPITAL.
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 7D: HARD COPIES OF THE CHNA REPORT WERE PRINTED AND SENT TO COMMUNITY LEADERS AND AGENCIES.
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 11: ADDICTION INFRASTRUCTURE BUILDINGADENA, AS PART OF ITS COORDINATION EFFORTS FOR PARTNERS FOR A HEALTHIER ROSS COUNTY (PHRC) BEGAN CROSS REPORTING IN JANUARY OF 2017 WITH THE HEROIN PARTNERSHIP PROJECT (HPP). A TOTAL OF FOUR MEMBERS OF PHRC STEERING TEAM PARTICIPATE AS PART OF THE HPP.ADVOCACYADENA HEALTH SYSTEM CONTRIBUTED .30 FTE COMMUNITY HEALTH DIRECTOR TO CO-CHAIR THE PARTNERS FOR A HEALTHIER ROSS COUNTY. ARMC HAS A TOTAL OF FOUR EMPLOYEES WHO DEDICATED A MINIMUM TOTAL OF SIX HOURS A MONTH TO PARTICIPATING IN COMMITTEE MEETINGS AND COORDINATING PROJECTS FOR THE HPP. PROGRAMMINGTHE BABY CENTERED RECOVERY PROGRAM PROVIDED A TOTAL OF 57 WOMEN (FROM MULTIPLE COUNTIES INCLUDING PIKE) WITH PREGNANCY EDUCATION AND ADDICTION COUNSELING, AS WELL AS FOOD AND BABY SUPPLIES AT NO CHARGE TO PARTICIPANTS. THE PROGRAM WAS RECOGNIZED AS THE 2017 HOSPITAL CHARITABLE SERVICES PROGRAM OF PROMISE.THE ARMC EMERGENCY DEPARTMENT DEPLOYED A POST OVERDOSE RESPONSE TEAM (PORT) IN AUGUST OF 2017.FINANCIAL SUPPORTADENA HEALTH SYSTEM PROVIDED $12,000 IN SUPPORT FOR THE DRUG FREE CLUBS OF AMERICAN PROGRAM MADE DEPLOYED IN ALL SEVEN ROSS COUNTY SCHOOL DISTRICTS WHICH INCENTIVIZES STUDENT PARTICIPATION IN DRUG TESTING. OBESITY ADVOCACYARMC CONTRIBUTED THE TIME OF TWO EMPLOYEES WHO DEDICATED A MINIMUM TOTAL OF 2 HOURS PER MONTH TO PARTICIPATING IN COMMITTEE MEETINGS AND COORDINATING PROJECTS FOR LIVEWELL ROSS.EDUCATIONA HERE FOR LIFE EVENT LED BY DR. JOHN KELLER ON HEART HEALTH AND ATRIAL FIBRILLATION WAS HELD IN APRIL WHERE A TOTAL OF 55 PARTICIPANTS WERE PROVIDED TWO HOURS OF EDUCATION ON GENERAL HEART HEALTH AND MANAGING ATRIAL FIBRILLATION.ARMC COORDINATED A REGIONAL DIABETES AWARENESS EXPO DELIVERED AT THE JACKSON COUNTY YMCA IN MARCH 2017 WHERE A TOTAL OF 75 PARTICIPANTS WERE PROVIDED FOUR HOURS OF EDUCATION ON DIABETES MANAGEMENT, INCLUDING MEDICATION, NUTRITION, COOKING, AND FITNESS.A WALK WITH A DOC EVENT WAS HELD IN OCTOBER AS PART OF DIABETES AWARENESS MONTH WHERE ENDOCRINOLOGIST DR. GIANINA USERA PROVIDED A TOTAL OF 65 COMMUNITY MEMBERS .5 HOURS OF EDUCATION ON DIABETES MANAGEMENT FOLLOWED BY A 30 MINUTE WALK. PROGRAMMINGADENA HEALTH SYSTEM COORDINATED A HEALTHY KIDS EVENT AT THE ROSS COUNTY FAIR WHERE A TOTAL OF 75 CHILDREN WERE PROVIDED 45 MINUTES OF HEALTHY COOKING INSTRUCTION FOLLOWED BY THIRTY MINUTES OF NUTRITION, FITNESS AND WELLBEING EDUCATION. THE ADENA FAMILY FIT PROGRAM PROVIDED SEVEN FAMILIES A TOTAL OF 12 HOURS OF FITNESS AND NUTRITION EDUCATION OVER SIX WEEKS OF AT THE ROSS COUNTY YMCA. FINANCIAL SUPPORTADENA HEALTH SYSTEM PARTNERED WITH THE ROSS COUNTY FARMER'S MARKET TO FUND THE FOOD RX AND FRUIT & VEGGIE PERKS PROGRAM WHICH PROVIDE 161 INDIVIDUAL ADENA PATIENTS AND COMMUNITY SNAP BENEFICIARIES A TOTAL OF $2,891 OF FRESH FRUITS AND VEGETABLES.RESPIRATORYINFRASTRUCTURE BUILDINGADENA CO-CHAIR OF THE PHRC STEERING TEAM COORDINATED AND CONVENED THE BREATHEWELL ROSS COMMITTEE NOW LED BY THE ROSS COUNTY HEALTH DISTRICT WHICH DEVELOPED A PLAN IN 2017 TO ENGAGE LOCAL TOWNS AND VILLAGES IN SMOKE FREE SPACE POLICY AND DEVELOP POLICY DEVELOPMENT AND CESSATION KITS FOR LOCAL BUSINESSES AND AGENCIES.ADVOCACYARMC CONTRIBUTED THE TIME OF ONE EMPLOYEE WHO DEDICATED A MINIMUM TOTAL OF 4 HOURS PER MONTH TO PARTICIPATING IN COMMITTEE MEETINGS AND COORDINATING PROJECTS FOR BREATHEWELL ROSS.ARMC CONTRIBUTES THE TIME OF ONE EMPLOYEE WHO DEDICATES A MINIMUM TOTAL OF 4 HOURS PER MONTH TO PARTICIPATING IN COMMITTEE MEETINGS AND COORDINATING PROJECTS FOR THE ROSS COUNTY AIR QUALITY COMMITTEE.PROGRAMMINGADENA HEALTH SYSTEM COORDINATED THE ADENA QUIT CLINIC WHICH PROVIDED A TOTAL OF 19 PATIENTS RECEIVED TOBACCO CESSATION COUNSELING, SUPPORT AND NICOTINE REPLACEMENT EDUCATION BY ADENA PHARMACISTS. THE ADENA CANCER CENTER PROVIDED A TOTAL OF 787 PATIENTS FROM THE REGION INCLUDING PIKE, HIGHLAND AND ROSS COUNTIES WITH FREE LUNG CANCER SCREENINGS IN 2017 WHICH RESULTED IN 7 POSITIVE CANCER RESULTS.FINANCIAL SUPPORTADENA HEALTH SYSTEM PROVIDED $10,000 IN SUPPORT FOR RELAY FOR LIFE WHICH ENGAGED THE ROSS, PIKE AND HIGHLAND COMMUNITIES IN CANCER AWARENESS.MENTAL HEALTHINFRASTRUCTURE BUILDINGADENA CO-CHAIR OF THE PHRC STEERING TEAM COORDINATED AND CONVENED THE ROSS MENTAL HEALTH FORUM NOW LED BY DR. JIM HAGEN. THIS TEAM INVENTORIED THE NUMBER OF MENTAL HEALTH PROVIDERS IN THE COMMUNITY, INCLUDING INSURANCES TAKEN AND SPECIALTY AND BEGAN PLANNING FOR AN IN-DEPTH MENTAL HEALTH CONTINUUM ASSESSMENT FOR 2018.ADVOCACYARMC CONTRIBUTED THE TIME OF THREE EMPLOYEES WHO DEDICATED A MINIMUM TOTAL OF 2 HOURS PER MONTH TO PARTICIPATING IN COMMITTEE MEETINGS AND COORDINATING PROJECTS FOR THE ROSS MENTAL HEALTH FORUM.ARMC DEPLOYED PUBLIC SERVICE ANNOUNCEMENTS VIA LOCAL RADIO AND SOCIAL MEDIA FOCUSED ON MENTAL HEALTH AWARENESS.EDUCATIONA WALK WITH A DOC EVENT WAS HELD IN NOVEMBER WHERE LOCAL PSYCHIATRIST DR. NATHAN SCHIFLETT PROVIDED A TOTAL OF 55 COMMUNITY MEMBERS .5 HOURS OF EDUCATION ON DEPRESSION AND SEASONAL AFFECTIVE DISORDER FOLLOWED BY A 30 MINUTE WALK. PROGRAMMINGTHE ADENA HEALTH SYSTEM HOUSES A VICTIM'S ADVOCATE TEAM IN THE ARMC EMERGENCY DEPARTMENT WHICH PROVIDED 81 VICTIMS OF SEXUAL ASSAULT (ADULT AND PEDIATRIC), DOMESTIC VIOLENCE, CHILD ABUSE, ELDER ABUSE, HUMAN TRAFFICKING AND HATE CRIMES WITH MENTAL HEALTH REFERRAL, SAFETY NET AND SUPPORT SERVICES FREE OF CHARGE, VALUED AT $175,000. FINANCIAL SUPPORTADENA HEALTH SYSTEM PROVIDED $8,000 IN SUPPORT TO THE SCIOTO PAINT VALLEY MENTAL HEALTH CENTER TO COMPLETE AN ASSESSMENT AND STRATEGIC PLAN FOR THE REGIONAL 211 RESOURCE REFERRAL LINE THAT SUPPORTS SIX COUNTIES INCLUDING ROSS, PIKE AND HIGHLAND.INFANT MORTALITY/CHILD SAFETYADVOCACYARMC CONTRIBUTED THE TIME OF ONE EMPLOYEE WHO DEDICATES A MINIMUM TOTAL OF 2 HOURS PER QUARTER TO PARTICIPATING IN MEETINGS AND COORDINATING PROJECTS FOR THE FAMILY AND CHILDREN FIRST COUNCIL.ARMC DEPLOYED PUBLIC SERVICE ANNOUNCEMENTS ACROSS THE HEALTH SYSTEM AND CLINICS FOCUSED ON SAFE SLEEP AWARENESS.EDUCATIONA WALK WITH A DOC EVENT WAS HELD IN MARCH WHERE PEDIATRICIAN DR. ALESSANDRO MARANZANA PROVIDED A TOTAL OF 35 COMMUNITY MEMBERS .5 HOURS OF EDUCATION ON CHILD BEHAVIOR AND PARENTING STRATEGIES FOLLOWED BY A 30 MINUTE WALK. PROGRAMMINGTHE ADENA CENTERING PREGNANCY PROGRAM PROVIDED A TOTAL OF 25 NUMBER HIGH-RISK PREGNANCY PATIENTS WITH PREGNANCY EDUCATION AND SUPPORT DURING A TOTAL 7 ONGOING MONTHLY CLASSES. FINANCIAL SUPPORTADENA HEALTH SYSTEM PROVIDED A TOTAL OF 8 CRIBS AND 1212 SLEEP SACKS FOR SOME OF THE 947 BABIES BORN AT THE ADENA WOMEN'S AND CHILDREN'S CENTER IN 2017. PATIENTS COME FROM MULTIPLE COUNTIES INCLUDING ROSS, PIKE AND HIGHLAND.COMMUNITY HEALTH OUTCOMES AND HEALTH FACTORS SUMMARY ROSS COUNTY HEALTH OUTCOMES MOVED FROM 74 TO 81 IN 2017 (COUNTY HEALTH RANKINGS). ROSS COUNTY HEALTH FACTORS MOVED FROM 64 TO 60 IN 2017 (COUNTY HEALTH RANKINGS).ADDITIONAL INITIATIVES AND RESOURCESCOMMUNITY ENGAGEMENTADENA HEALTH SYSTEM IS A PARTNER OF THE UNITED WAY PROGRAM MAP YOUR FUTURE, WHICH ENGAGES 6TH THROUGH 8TH GRADE STUDENTS IN EXPLORING CAREER OPPORTUNITIES AND BUILDING A PRODUCTIVE FUTURE. IN 2017, A TOTAL OF 67 EMPLOYEES PROVIDED A TOTAL OF 2,124 HOURS OF CAREER MENTORING THROUGH THE MAP YOUR FUTURE PROGRAM IN 2017, WHICH UNITED WAY VALUED AT $105,152. UNINTENTIONAL INJURIES ADENA HEALTH SYSTEM AT THE ADENA REGIONAL MEDICAL CENTER CONTINUES OPERATIONS OF THE ROSS COUNTY SAFE COMMUNITIES PROGRAM THOUGH ITS GRANT FROM THE OHIO DEPARTMENT OF PUBLIC SAFETY. THIS PROGRAM SAW AN IMPROVEMENT IN THE USE OF SEATBELTS FROM 81% TO 89% FROM 2016 TO 2017 (SURVEY ASSESSMENT CONDUCTED ANNUALLY BY MIAMI UNIVERSITY). ADENA SPORTS MEDICINE ATHLETIC TRAINING PROGRAMTHE ADENA HEALTH SYSTEM PROVIDED MORE THAN $465,878 IN ATHLETIC INJURY PREVENTION, DIAGNOSIS, AND EVALUATION SERVICES TO 10 LOCAL PUBLIC HIGH SCHOOLS WITHIN THE SERVICE REGION IN 2017. A TOTAL OF 8 ATHLETIC TRAINERS WORK WITHIN THE SCHOOL'S ATHLETIC DEPARTMENTS. THE STAFF IS ALSO PROVIDES YEARLY SPORTS PHYSICALS TO MORE THAN 1,200 STUDENTS IN PIKE, ROSS, AND JACKSON COUNTIES. COMMUNITY COLLABORATIONSHOPE CLINICA TOTAL OF 8 ADENA PHYSICIANS PROVIDED 99 HOURS OF CARE AND TWO ADENA NURSE PRACTITIONERS PROVIDED 110 HOURS OF FREE CARE AT HOPE CLINIC IN 2017. A TOTAL OF 415 PATIENTS WERE SERVED WITH $181,130 WORTH OF MEDICAL SERVICES AT NO CHARGE. AHS PROVIDES AN ADDITIONAL $3,589 IN MONETARY SUPPORT FROM ITS COMMUNITY HEALTH BUDGET TO THE HOPE CLINIC FOR MEDICAL SUPPLIES AND RESOURCES.
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 16J: HTTP://WWW.ADENA.ORG/INSIDE/PAGE.DT/FINANCIAL-AID
ADENA REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 20E: PATIENTS HAVE 120 DAYS FROM THE TIME THEIR ACCOUNT GOES TO "SELF-PAY" TO PAY IN FULL OR MAKE PAYMENT ARRANGEMENTS. ON THE 121ST DAY, THEY ARE SENT TO A COLLECTION AGENCY. COLLECTION AGENCIES REQUIRE ADENA MANAGEMENT APPROVAL TO PURSUE LEGAL ACTION. SELF-PAY PATIENTS HAVE TO ASK FOR A QUESTIONNAIRE AT REGISTRATION ASKING IF THEY WOULD LIKE TO BE SCREENED FOR FINANCIAL ASSISTANCE. IF SO, THEY ARE GIVEN A FAP AT THAT TIME. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE ONLINE AND THROUGHOUT THE HOSPITALS AND CLINICS. THIS IS ALSO AVAILABLE AT THE HOPE CLINIC.
FieldValueIRS element (for citing)
Facility21FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - ADENA HEALTH PAVILION
4437 STATE ROUTE 159CHILLICOTHEOH45601PHYSICIAN OFFICES, OUTPATIENT SURGERY CENTER
2 - ADENA MEDICAL OFFICE BUILDING
4439 STATE ROUTE 159CHILLICOTHEOH45601PHYSICIAN OFFICES
3 - ADENA HEALTH CENTER - WAVERLY
12340 STATE ROUTE 104WAVERLYOH45690AMBULATORY CARE CENTER
4 - ADENA URGENT CARE
55 CENTENNIAL BLVDCHILLICOTHEOH45601AMBULATORY CARE CENTER
5 - ADENA HOME CARE SERVICES
111 W WATER STREETCHILLICOTHEOH45601HOME HEALTH CARE AND HOSPICE
6 - ADENA HEALTH CENTER - JACKSON
1000 VETERANS DRIVEJACKSONOH45640AMBULATORY CARE CENTER
7 - ADENA REHABILITATION AND WELLNESS CENTER
445 SHAWNEE LANECHILLICOTHEOH45601OUTPATIENT REHABILITATION CENTER
8 - ADENA FAMILY MEDICINE - OAK HILL
315 WASHINGTON STREETOAK HILLOH45656PHYSICIAN OFFICES
9 - ADENA PICKAWAY-ROSS FAMILY PHYSICIANS
100 N WALNUT STREETCHILLICOTHEOH45601PHYSICIAN OFFICES
10 - ADENA FAMILY MEDICINE - CIRCLEVILLE
798 N COURT STREETCIRCLEVILLEOH43113PHYSICIAN OFFICES
11 - ADENA COUNSELING CENTER
445 SHAWNEE LANECHILLICOTHEOH45601MENTAL HEALTH COUNSELING
12 - ADENA FAMILY MEDICINE OF CHILLICOTHE
626 CENTRAL CENTERCHILLICOTHEOH45601PHYSICIAN OFFICES
13 - ADENA ROSS UROLOGY
8 MEDICAL DRIVECHILLICOTHEOH45601PHYSICIAN OFFICES
14 - ADENA FAMILY MEDICINE - GREENFIELD
536 MIRABEAU STREETGREENFIELDOH45123PHYSICIAN OFFICES
15 - ADENA FAMILY MEDICINE - WASHINGTON CH
308 HIGHLAND AVENUE SUITE CWASHINGTON COURT HOUOH43160PHYSICIAN OFFICES
16 - ADENA FAMILY MEDICINE - WELLSTON
118 SOUTH NEW YORK AVE SUITE AWELLSTONOH45692NURSE PRACTITIONER CLINIC
17 - ADENA FAMILY MEDICINE - HILLSBORO
160 ROBERTS LANEHILLSBOROOH45133URGENT CARE AND FAMILY PRACTICE
18 - ADENA HEALTH & WELLNESS CNTR-MAIN CAMPUS
4457 ST RT 159CHILLICOTHEOH45601PHYSICIAN OFFICE, CARDIAC REHAB, OCCUPATIONAL MEDICINE
19 - ADENA CANCER CENTER
4435 ST RT 159CHILLICOTHEOH45601OUTPATIENT CHEMOTHERAPY AND RADIATION
20 - ADENA WELLNESS CENTER WEST
2077 WESTERN AVENUECHILLICOTHEOH45601HOME HEALTH AND REHABILITATION
21 - CLINIC AT WALMART
85 RIVER TRACE LANECHILLICOTHEOH45601NURSE PRACTITIONER CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. ACTUAL COSTS WERE USED IN LINE 7E & 7F.
PART I, LN 7 COL(F):BAD DEBT EXPENSE OF $11,762,109 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN.
PART II, COMMUNITY BUILDING ACTIVITIES:ADENA HEALTH SYSTEM SUPPORTS COMMUNITY BUILDING ACTIVITIES BY PROVIDING GRANTS TO THE FOLLOWING ORGANIZATIONS:CHILLICOTHE CAVALIER CLUB- GRANT PROVIDED TO INSTALL A SCOREBOARDUNITED WAY OF ROSS COUNTY- GRANT PROVIDED TO SUPPORT RELAY FOR LIFEMIGHTY CHILDREN'S MUSEUM- GRANT PROVIDED TO BUILD A CHILDREN'S MUSEUM TO ENCOURAGE LEARNING AND CREATIVITYROSS COUNTY AGRICULTURAL SOCIETY- GRANT PROVIDED TO SUPPORT FREE RIDE DAY AT THE ROSS COUNTY FAIR AND TO PROVIDE A STAGE FOR THE HEALTHY KIDS EVENTROSS COUNTY CHILD PROTECTION CENTER- GRANT PROVIDED TO SUPPORT ADVOCATES FOR CHILDREN OF ABUSE AND NEGLECT
PART III, LINE 2:THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS WITH THE COST TO CHARGE RATIO APPLIED.
PART III, LINE 3:THE HOSPITAL DEVELOPED, WITH THE HELP OF AN OUTSIDE VENDOR, A NEW PRESUMPTIVE CHARITY POLICY. THE HOSPITAL SENDS A QUARTERLY FILE OF ALL SELF-PAY BALANCES TO THE VENDOR. AFTER THE VENDOR PERFORMS THE CREDIT ANALYSIS, THE VENDOR CATEGORIZES THE CLAIMS INTO THREE CATEGORIES, A CATEGORY THAT WOULD NOT BE ELIGIBLE FOR CHARITY BASED ON THE HOSPITALS CHARITY POLICY, A GROUP THAT WOULD BE ELIGIBLE FOR A 60% CHARITY WRITEOFF, AND A THIRD CATEGORY THAT WOULD BE ELIGIBLE FOR A 100% WRITE OFF. THE HOSPITAL ASSUMES ALL OF THESE AMOUNTS IN THE LAST TWO CATEGORIES TO BE PRESUMPTIVE CHARITY.
PART III, LINE 4:WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR ADENA REGIONAL MEDICAL CENTER. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS ESTABLISHED BASED ON EXPECTED PAYMENT RATES FROM PAYORS UTILIZING CURRENT REIMBURSEMENT METHODOLOGIES AND PAYMENT RATES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE."
PART III, LINE 8:THE HOSPITAL MEDICARE ADVANTAGE PLAN, THE PHYSICIAN MEDICARE ADVANTAGE PLAN, AND THE PHYSICIAN TRADITIONAL MEDICARE PLAN INCURRED A SHORTFALL OF <$27,273,959> IN 2017. THIS SHORTFALL COMBINED WITH THE LONGFALL FROM TRADITIONAL MEDICARE SOURCES OF $3,741,251 RESULTS IN A NET MEDICARE SHORTFALL OF <$23,532,708>.THE ADENA HEALTH SYSTEM SERVICE AREA IS A RURAL 13 COUNTY AREA IN SOUTHERN OHIO. ADENA HEALTH SYSTEM HAS EVALUATED THE COMMUNITY HEALTH NEEDS AND HAS IMPORTANT PROGRAMS AND SERVICES THAT ARE DESIGNED TO MEET THE NEEDS OF ADENA'S BROAD SERVICE AREA. HOWEVER, ONE OF THE MOST SIGNIFICANT HEALTH NEEDS MET BY ADENA IS THE IDENTIFICATION OF PHYSICIAN AND ADVANCED PRACTICE PROVIDERS FOR EACH SPECIALTY OF CARE. ADENA RECRUITS, SUPPORTS, AND PROVIDES THE INFRASTRUCTURE FOR PROVIDERS IN SPECIALTIES RANGING FROM PRIMARY CARE TO INTERVENTIONAL CARDIOLOGY. IN ADENA'S RURAL, APPALACHIAN SERVICE AREA, PHYSICIAN AND OTHER KEY CLINICAL AND SUPPORT STAFF ARE DIFFICULT TO RECRUIT AND RETAIN WHICH ELEVATES THE MARKET SALARY FOR SPECIALIZED STAFF. THE MEDICARE TWO PERCENT SEQUESTRATION IS ALSO A COMPONENT OF THE SHORTFALL CALCULATION. BASED ON THESE ISSUES, WE BELIEVE SERVICE TO OUR MEDICARE POPULATION IS A COMMUNITY BENEFIT. ALSO, THE HOSPITAL USED THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT WHEN DETERMINING THE AMOUNT ON PART III - LINE 6.PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES THAT WERE BOOKED IN THE CURRENT TAX YEAR ARE ALSO INCLUDED IN THE CURRENT TAX YEAR CALCULATION.
PART VI, LINE 3:THE AVAILABILITY OF FINANCIAL ASSISTANCE IS COMMUNICATED IN THE FOLLOWING MANNER: 1. STATEMENTS FROM ADENA AS WELL AS COLLECTION VENDORS EXPLAIN AND LIST THE 100% AND 60% ASSISTANCE GUIDELINES ON THE BACKSIDE OF THE STATEMENT. 2. THERE IS SIGNAGE EXPLAINING THE PROGRAM AT ALL THE REGISTRATION AREAS. 3. STAFF AT THE CASHIER AREA EXPLAIN OPTIONS AVAILABLE TO THE PATIENT. 4. WE SEND AN APPLICATION WITH THE SELF-PAY DISCOUNT LETTERS IN CASE THE PATIENT/GUARANTOR CAN'T SET UP A PAYMENT PLAN. 5. THE CUSTOMER SERVICE STAFF IS EDUCATED ON ALL THE OPTIONS AND CAN EXPLAIN THE PROGRAMS WHEN PATIENTS CALL. 6. OUR PHYSICIAN OFFICES, AS WELL AS COLLECTION VENDORS HAVE FINANCIAL AID APPLICATIONS AVAILABLE.
PART VI, LINE 4:ROSS COUNTY, HOME TO ADENA REGIONAL MEDICAL CENTER, IS LOCATED IN SOUTH CENTRAL OHIO. IT IS PART OF 2 CONGRESSIONAL DISTRICTS (2ND AND THE 15TH) AND ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT CONTAINS THE POPULATION PATTERNS AND DISTINCT ECONOMIC CONDITIONS INHERENT OF THIS REGION OF THE U.S AND FACES SIMILAR CHALLENGES TO IMPROVE THE LIVES OF ITS 77,000 RESIDENTS. THESE INCLUDE LOW EDUCATIONAL ATTAINMENT PERCENTAGES AND HIGH RATES OF UNEMPLOYMENT AND POVERTY. THE TOTAL POPULATION OF ROSS COUNTY REPRESENTS 15% OF THE TOTAL ADENA HEALTH SYSTEM SERVICE REGION AND IS THE PRIMARY PLACE OF RESIDENCE FOR 80% OF THE PATIENTS IT SERVES. THE COUNTY, AS WELL AS THE REMAINDER OF THE 12 COUNTY SERVICE REGION, HAS SIMILAR DEMOGRAPHICS AS THE STATE OF OHIO AND U.S. OVER 64% OF THE POPULATION IS BETWEEN THE AGES OF 19 AND 64 AND 13% OF THE POPULATION IS OVER THE AGE OF 65. THE MAJORITY OF THE POPULATION IS WHITE WITH AFRICAN AMERICANS MAKING UP THE MAJORITY OF THE REGION'S MINORITY POPULATION.THE 28,269 HOUSEHOLDS IN ROSS COUNTY REPRESENT 14.7% OF THE HOUSEHOLDS IN ADENA HEALTH SYSTEM'S 12-COUNTY SERVICE REGION. THE AVERAGE HOUSEHOLD SIZE IS 2.54 PEOPLE, COMPARABLE WITH THE REST OF OHIO AND THE U.S. THE AVERAGE FAMILY SIZE IS AS WELL WITH 3.05 PEOPLE. A LITTLE MORE THAN 50% OF THE POPULATION IS NOW MARRIED WHICH IS COMPARABLE WITH OHIO AND NATIONAL AVERAGES. MORE THAN 14% ARE DIVORCED WHICH IS NOTICEABLY HIGHER THAN BOTH THE STATE AND NATIONAL AVERAGES. MORE THAN 15% OF THE ADULTS IN ROSS COUNTY HAVE NOT GRADUATED FROM HIGH SCHOOL. THIS PERCENTAGE IS HIGHER THAN BOTH THE OHIO (12.2%) AND NATIONAL (14.6%) AVERAGES, BUT IS LOWER THAN THE AVERAGE FOR THE 12-COUNTY SERVICE REGION (18.9%). MORE THAN 10% OF THE POPULATION OF ROSS COUNTY IS ESTIMATED TO BE FUNCTIONALLY ILLITERATE, OR LACKING THE READING AND WRITING SKILLS SUFFICIENT FOR ORDINARY PRACTICAL NEEDS.THE UNEMPLOYMENT RATE IN ROSS COUNTY (4.8%) IS COMPARABLE TO THE U.S. AVERAGE. IN ADDITION, MORE THAN 45% OF THE POPULATION IS NOT IN THE WORKFORCE. THIS IS HIGHER THAN THE STATE AND NATIONAL AVERAGES. THE TOP FIVE EMPLOYMENT INDUSTRIES IN ROSS COUNTY ARE MANAGEMENT/PROFESSIONAL OCCUPATIONS, EDUCATION/HEALTHCARE SERVICES, SALES, PRODUCTION/TRANSPORTATION SERVICES, AND SERVICE OCCUPATIONS. ROSS COUNTY HAS MORE PEOPLE EMPLOYED IN PRODUCTION, TRANSPORTATION AND MATERIAL MOVING OCCUPATIONS THAN THE REGIONAL, STATE AND NATIONAL AVERAGES. THE COUNTY HAS ABOUT HALF AS MANY PROFESSIONAL, SCIENTIFIC AND MANAGEMENT SERVICES PROFESSIONALS AS OHIO AND THE U.S.THE PER CAPITA, MEDIAN AND MEAN HOUSEHOLD INCOMES IN ROSS COUNTY OHIO ARE MUCH LOWER THAN THE STATE AND U.S. AVERAGES, BUT HIGHER THAN REGIONAL AVERAGE. POVERTY RATES ARE ALSO HIGHER THAN STATE AND NATIONAL AVERAGES BUT LOWER THAN THE REST OF THE REGION. ACCESS TO EMPLOYMENT IN ROSS COUNTY IS HIGHER THAN OTHER COUNTIES IN THE REGION.THERE ARE 6,348 CIVILIAN VETERANS LIVING IN ROSS COUNTY, ACCOUNTING FOR ALMOST 8% OF THE REGION'S POPULATION. THE TOTAL CIVILIAN VETERANS WITHIN THE ADENA HEALTH SYSTEM 12-COUNTY SERVICE REGION REPRESENT 5% OF OHIO'S TOTAL CIVILIAN VETERAN POPULATION. ROSS COUNTY ALSO HAS A VETERAN'S ADMINISTRATION HOSPITAL LOCATED 4.5 MILES FROM ADENA REGIONAL MEDICAL CENTER.ROSS COUNTY AND ITS ENTIRE SURROUNDING SERVICE REGION HAVE A HIGHER PREVALENCE OF DISABILITY THAN THE REST OF OHIO. SEVEN OF THE 12 COUNTIES IN THE SERVICE REGION HAVE DISABILITY PREVALENCE RATES OF 16.7% - 22%. ROSS COUNTY'S PREVALENCE RATE IS 13.5%.
PART VI, LINE 5:ADENA REGIONAL MEDICAL CENTER WORKS TO PROMOTE THE HEALTH OF ITS COMMUNITY THROUGH A VARIETY OF MEANS, INCLUDING BOARD MEMBERS, ADMINISTRATIONS, EMPLOYEES AND VOLUNTEERS. THE 2016 BOARD OF TRUSTEES OF ADENA HEALTH SYSTEM WAS COMPRISED OF 15 MEMBERS. ONE OF THE BOARD MEMBERS WAS AN EMPLOYEE OF ADENA HEALTH SYSTEM AT THE END OF THE YEAR. ALL BUT ONE MEMBER OF THE BOARD MEMBERS RESIDE IN ROSS COUNTY OHIO.
PART VI, LINE 6:FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES THREE HOSPITALS AND SIX REGIONAL CLINICS, WITH A TOTAL OF 311 BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. GREENFIELD AREA MEDICAL CENTER AND PIKE HEALTH SERVICES, INC.: BOTH ARE CRITICAL ACCESS HOSPITALS, EACH WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (GREENFIELD AREA MEDICAL CENTER) AND PIKE COUNTY (PIKE HEALTH SERVICES, INC.) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WASHINGTON COURT HOUSE, WAVERLY, HILLSBORO, AND WELLSTON, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE, WAVERLY, AND HILLSBORO. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN), A COLLABORATION OF THE REGION'S THREE LARGEST HEALTHCARE PROVIDERS. THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ADENA HEALTH FOUNDATION
272 HOSPITAL ROADCHILLICOTHEOH45601753008742501(C)(3)$434,775PAYMENT OF ORGANIZATION EXPENSES
CHILLICOTHE CAVALIER CLUB
2710 S BRIDGE STCHILLICOTHEOH45601311324783501(C)(3)$15,000SCOREBOARD INSTALLMENT
MIGHTY CHILDRENS MUSEUM
PO BOX 503CHILLICOTHEOH45601473052995501(C)(3)$21,000RAISING FUNDS TO BUILD A CHILDREN'S MUSEUM TO ENCOURAGE LEARNING AND CREATIV
ROSS COUNTY AGRICULTURAL SOCIETY
207 S QUARRYBAINBRIDGEOH45612316050864501(C)(3)$12,500FREE RIDE DAY AT THE ROSS COUNTY FAIR AND STAGE FOR HEALTHY KIDS EVENT
OSU EXTENSION OFFICE ROSS COUNTY
475 WESTERN AVE FCHILLICOTHEOH45601316025986501(C)(1)$7,500CAPITAL CAMPAIGN FOR OHIO UNIVERSITY- CHILLICOTHE
ROSS COUNTY CHILD PROTECTION CENTER
138 MARIETTA RDCHILLICOTHEOH45601311579825501(C)(3)$63,874ADVOCATES FOR CHILDREN OF ABUSE AND NEGLECT
ECONOMIC DEVELOPMENT ALLIANCE
45 E MAINCHILLICOTHEOH45601203786756501(C)(3)$10,000TO REVITALIZE CHILLICOTHE AND ROSS COUNTY
AMERICAN CANCER SOCIETY
138 MARIETTA RDCHILLICOTHEOH45601131788491501(C)(3)$5,000CAPITAL CAMPAIGN FOR OHIO UNIVERSITY- CHILLICOTHE
CHILLICOTHE ROSS CHAMBER OF COMMERCE
45 E MAINCHILLICOTHEOH45601314147100501(C)(6)$23,589TO REVITALIZE CHILLICOTHE AND ROSS COUNTY
FieldValueIRS element (for citing)
Total501c3 Org7Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationDECISIONS TO DONATE TO COMMUNITY PROJECTS ARE BROUGHT TO CEO FOR APPROVAL FROM MEMBERS OF SENIOR LEADERSHIP AND/OR THE STRATEGY DEPARTMENT. FOR EACH GRANT THERE IS AN AGREEMENT SIGNED BY ADENA AND THE ORGANIZATION RECEIVING THE DONATION THAT CONFIRMS FUNDS ARE BEING USED FOR THE INTENDED PURPOSE. A BLANKET AMOUNT IS BUDGETED FOR THE FISCAL YEAR AND CONSIDERED AS EACH REQUEST IS MADE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
REGGINA YANDILA
TRUSTEE$160,251$0$17,822$0$34,215$0$0$0$31,881$0$244,169$0$0$0
WILLIAM STRAUCH
TRUSTEE$496,977$0$14,743$0$8,774$0$0$0$32,959$0$553,453$0$0$0
JOHN FORTNEY
CEO (JAN - JULY)$491,426$0$0$0$129,136$0$136,363$0$22,706$0$779,631$0$0$0
LISA CARLSON
CFO$231,066$0$100,000$0$4,920$0$115,304$0$10,359$0$461,649$0$0$0
JEFF GRAHAM
CEO (JULY-DEC)$311,630$0$0$0$0$0$50,254$0$1,761$0$363,645$0$0$0
JACK BERNO
CHIEF MEDICAL OFFICER (JAN-JULY)$305,868$0$17,822$0$12,690$0$0$0$20,625$0$357,005$0$2,838$0
ERIC CECAVA
COO (JAN-OCT)$285,129$0$0$0$186,429$0$15,325$0$30,087$0$516,970$0$0$0
TIM CAHILL
GENERAL COUNSEL$258,102$0$0$0$63,552$0$78,001$0$36,636$0$436,291$0$0$0
BRIAN COHEN
EMPLOYED M.D.$2,729,386$0$11,665$0$28,618$0$0$0$33,682$0$2,803,351$0$0$0
HAVAL SAADLLA
EMPLOYED M.D.$1,031,449$0$14,743$0$60,518$0$0$0$34,182$0$1,140,892$0$0$0
THOMAS LEWIS
EMPLOYED M.D.$965,454$0$5,508$0$9,242$0$0$0$34,283$0$1,014,487$0$0$0
JAMES MANAZER
EMPLOYED M.D.$956,594$0$12,290$0$39,915$0$0$0$33,882$0$1,042,681$0$0$0
MARK SHUTER
FORMER CEO$0$0$0$0$648,688$0$0$0$0$0$648,688$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AADENA HEALTH SYSTEM PROVIDES FOR A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR ALL OFFICERS AND KEY EMPLOYEES. THIS BENEFIT IS GROSSED UP AND TAXED AND RECEIVED BY FOUR OF THE OFFICERS AND KEY EMPLOYEES. NEWLY RECRUITED SENIOR LEADERS RECEIVE AN ONBOARDING HOUSING ALLOWANCE THAT IS GROSSED UP AND TAXED. FIVE OFFICERS AND KEY LEADERS RECEIVED THIS REIMBURSEMENT IN 2017.
PART I, LINE 4AMARK SHUTER RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $630,000. ERIC PERDUE RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $111,840.
PART I, LINE 6IF THE NET EARNINGS TARGET WAS ACHIEVED FOR THE ADENA HEALTH SYSTEM, COMPENSATION WAS PAID OUT BASED ON FOUR PILLARS, INCLUDING: A PERCENTAGE OF OPERATING INCOME, PATIENT SATISFACTION, EMPLOYEE SATISFACTION, AND QUALITY MEASURES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
COUNTY OF ROSS OHIO
A316400085778260EX32008-09-17$141,346,983CURRENT REFUNDING OF 2001 AND 2006 ISSUESYes (1)00
COUNTY OF ROSS OHIO
B3164000852010-09-15$29,985,000INFUSION CENTER AND INTERVENTIONAL RADIOLOGY000
CITY OF CHILLICOTHE OHIO
C316400221169203AK22017-06-22$161,095,326ADVANCE REFUNDING OF 2008 ISSUE AND EMERGENCY ROOM000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtCapital ExpendituresCapitalExpendituresAmtUnspentUnspentAmt
A$15,010,000$127,960,000$196,865,226$10,925,535$1,366,439$487,668$184,085,5842010Yes (1)0Yes (1)Yes (1)
B$5,078,641$30,087,491$411,604$29,675,887201200Yes (1)Yes (1)
C$117,249,584$1,777,018$2,615,0000Yes (1)0Yes (1)$161,202,245$5,808,858$33,751,785

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00Yes (1)Yes (1)00.000000.000000.0000000Yes (1)
B00Yes (1)Yes (1)00.000000.000000.0000000Yes (1)
C00Yes (1)Yes (1)00.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line2GICProviderName/BusinessNameLine2TxtTerm Of GICTermOfGICPctRegulatory Safe Harbor StsfdRegulatorySafeHarborStsfdIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
BAYERISCHE
A000Yes (1)00Yes (1)LANDESBANK3.000000000000Yes (1)0Yes (1)
(no name)
B000Yes (1)0000Yes (1)
(no name)
C0Yes (1)00000Yes (1)Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMEDISSUER NAME: COUNTY OF ROSS OHIO DATE THE REBATE COMPUTATION WAS PERFORMED: 10/31/2013 ISSUER NAME: COUNTY OF ROSS OHIO DATE THE REBATE COMPUTATION WAS PERFORMED: 10/09/2015
SCHEDULE K, PART II, LINE 62001 AND 2006 ISSUES WERE REFUNDED ON OCTOBER 29, 2008. INCLUDED $116,560,000 OF PRINCIPAL AND $149,427 OF INTEREST. THIS IS FOR THE 2008 ISSUE.
SCHEDULE K, PART II, LINE 11$11,750,000 OF ISSUE WAS USED TO PAY OFF QUALIFIED HEDGED RELATED TO THE 2001 AND 2006 BONDS. THIS IS FOR THE 2008 ISSUE.
SCHEDULE K, PART III, LINE 2ADENA HEALTH SYSTEM LEASES APPROXIMATELY 300 SQUARE FEET TO A FOR PROFIT COMPANY THAT OPERATES A COFFEE KIOSK. THIS IS CONSIDERED DEMINIMUS SPACE AND SO 0% WAS PUT IN LINE 4 OF PART III. THIS IS FOR THE 2008 ISSUE. THE LEASE CEASED IN FALL OF 2012.
SCHEDULE K, PART IV, LINE 4APROCEEDS INVESTED IN GIC FROM 2006 ISSUE - UNUSED PORTION TRANSFERS TO 2008 ISSUE. THE GIC MATURED IN JULY 2009; THIS WAS 36 MONTHS AFTER THE DATE OF ISSUE. THIS IS FOR THE 2008 ISSUE.
SCHEDULE K, PART IV, LINE 2CTHE DATE THE LAST REBATE COMPUTATION WAS PERFORMED IS OCTOBER 31, 2013.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN FORTNEYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship With OrgPHYSICIANRelationshipWithOrgTxt
Loan PurposeSTUDENT LOANSLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$11,214OriginalPrincipalAmt
Balance Due$8,389BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$8,389TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
ROBIN BERNO
SPOUSE OF KEY EMPLOYEE JACK BERNO$134,600EMPLOYEE COMPENSATION0
JENNIFER STRICKLAND
RELATIVE OF CHAIR DAVID STRICKLAND$34,913EMPLOYEE COMPENSATION0
TARA D'ANTONI
DAUGHTER-IN-LAW OF BOARD DIRECTOR RALPH D'ANTONI$29,063EMPLOYEE COMPENSATION0
MARIA SMITH
SISTER OF BOARD DIRECTOR JOE WATSON$112,790EMPLOYEE COMPENSATION0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3ADENA HEALTH SYSTEM PAID AN EXECUTIVE CONSULTING SERVICES FIRM, TATUM, FOR CFO DUTIES. LISA CARLSON WAS PAID $127,430 FROM TATUM FROM JANUARY TO JUNE FOR HER ROLE AS CHIEF FINANCIAL OFFICER.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS COMPOSED OF 9 MEMBER CHURCHES. ALL OF THE CHURCHES ARE IN THE CHILLICOTHE, OHIO AREA. 1. FIRST PRESBYTERIAN CHURCH 2. FREEDOM HOUSE OF CHILICOTHE 3. ORCHARD HILL UNITED CHURCH OF CHRIST 4. TABERNACLE BAPTIST CHURCH 5. ST. MARY'S CATHOLIC CHURCH 6. TRINITY UNITED METHODIST CHURCH 7. ST. PAUL'S EPISCOPAL CHURCH 8. WALNUT STREET UNITED METHODIST CHURCH 9. ST. PETER'S CATHOLIC CHURCH
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE MEMBER CHURCHES MAY NOMINATE A BOARD MEMBER, BUT THE BOARD OF DIRECTORS OF AHS RESERVES THE FINAL APPROVAL. THE CORPORATE MEMBER CHURCHES MAY ONLY ELECT ONE PERSON PER CHURCH TO ACT AS THEIR TRUSTEE. THE TRUSTEES AT LARGE GET APPOINTED AS FOLLOWS. SECTION 3.03 OF THE CODE OF REGULATIONS OF AHS - "THE BOARD SHALL ELECT SIX (6) AT-LARGE TRUSTEE POSITIONS. TWO OF THESE POSITIONS SHALL BE FILLED WITH PHYSICIANS WHO ARE MEMBERS OF THE ACTIVE MEDICAL STAFF RECOMMENDED BY THE MEDICAL STAFF IN ACCORDANCE WITH THE MEDICAL STAFF BYLAWS. WHEN A VACANCY OCCURS AMONG THE FOUR (4) AT LARGE TRUSTEES, WITH THE EXCEPTION OF MEMBERS ELIGIBLE FOR REAPPOINTMENT, THE TRUSTEE COMMITTEE SHALL NOMINATE TO THE BOARD A CANDIDATE FOR THE VACANT POSITION."
FORM 990, PART VI, SECTION A, LINE 7BSECTION 2.04 RIGHTS OF THE CORPORATE MEMBERS: (A) THE RIGHT TO ELECT NINE TRUSTEES OF THE CORPORATION AS SPECIFIED IN THESE BYLAWS. (B) THE RIGHT TO APPROVE ANY LEASE, SALE EXCHANGE, TRANSFER, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION. (C) THE RIGHT TO APPROVE ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION. (D) THE RIGHT TO APPROVE ANY PROPOSED DISSOLUTION OF THE CORPORATION. (E) THE RIGHT TO APPROVE ANY PROPOSED CHANGE TO THE FUNDAMENTAL PURPOSE OF THE CORPORATION AS STATED IN SECTION 1.01. (F) THE RIGHT TO APPROVE ANY PROPOSED AMENDMENTS TO THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 WAS REVIEWED AT A BOARD MEETING, AND COPIES OF THE FORM 990 WERE PROVIDED TO THE BOD MEMBERS. ADDITIONALLY, COPIES OF THE 990 WERE MADE AVAILABLE ON THE HOSPITAL'S BOARD PORTAL AND IN ADMINISTRATION OFFICE UNTIL THE NOVEMBER 15 FILING DATE.
FORM 990, PART VI, SECTION B, LINE 12CTHE CORPORATE COMPLIANCE OFFICE OF ADENA HEALTH SYSTEM ANNUALLY COORDINATES THE DISTRIBUTION AND RETURN OF THE CONFLICT OF INTEREST STATEMENTS. ALL CONFLICTS ARE REVIEWED, AND THE CORPORATE COMPLIANCE OFFICE IS RESPONSIBLE FOR REVIEWING THE RESPONSES AND COMMUNICATING ANY EXTRA STEPS THAT NEED TO TAKE PLACE REGARDING ANY OF THE RESPONSES. AT EVERY BOARD MEETING AND COMMITTEE OF THE BOARD, THE AGENDA ITEM OF CONFLICT OF INTEREST IS INCLUDED AND CALLED OUT. CONFLICTED BOARD MEMBERS ABSTAIN FROM VOTING ON THE PARTICULAR ITEMS. ANY MEMBER ABSTAINING FROM VOTING IS DOCUMENTED IN THE MINUTES. ADVANCED PRACTICE CLINICIANS, FRONT LINE SUPERVISORS UP THROUGH THE CEO, AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RETAINS MERCER, AN INDEPENDENT COMPENSATION CONSULTANT, TO EVALUATE THE TOTAL COMPENSATION FOR ALL DISQUALIFIED PERSONS. MERCER UTILIZES THE COMPENSATION PHILOSOPHY TO CONDUCT THE EVALUATION. EACH POSITION IS COMPARED TO PEER DATA OF ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY. THE DATA ANALYSIS COVERS CASH COMPENSATION (BASE SALARY), TOTAL CASH COMPENSATION (BASE SALARY AND INCENTIVES, BOTH PAID AND OPPORTUNITY), AND TOTAL COMPENSATION (BASE SALARY, INCENTIVES AND ALL BENEFITS). THE EXECUTIVE COMPENSATION COMMITTEE MEETS WITH MERCER REGULARLY TO REVIEW AND MONITOR ALL TOTAL COMPENSATION FOR THE DISQUALIFIED PERSONS. COMPENSATION WAS LAST REVIEWED IN 2016.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION PREPARES AN ANNUAL REPORT TO THE PUBLIC WHICH INCLUDES ITS STATEMENT OF REVENUES AND EXPENSES. ADDITIONALLY, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE AVAILABLE ON GUIDESTAR.ORG AS PART OF THE ANNUAL FORM 990 FILING.
FORM 990, PART IX, LINE 11GMEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,432,549. MANAGEMENT AND GENERAL EXPENSES -89,963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,342,586. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 30,202,288. MANAGEMENT AND GENERAL EXPENSES 14,008,515. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,210,803. FACILITY MAINTENANCE: PROGRAM SERVICE EXPENSES 17,972,333. MANAGEMENT AND GENERAL EXPENSES 1,530,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,503,016.
FORM 990, PART XI, LINE 9:TRANSFERS (TO) FROM AFFILIATED ORGANIZATION -6,823,046. PENSION RELATED CHANGES OTHER THAN NET PERIODIC COSTS -3,494,248. INTERCOMPANY RECEIPTS ELIMINATED IN CONSOLIDATION 260,016. COURT DIALYSIS K-1 ACTIVITY - BOOK TO TAX DIFFERENCE -81,296. TEMPORARILY RESTRICTED EXPENDITURES -46,130. NET ASSETS RELEASED FROM RESTRICTION FOR PURCHASE OF CAPITAL ASSETS 96,252. CONTRIBUTIONS RECLASSED OUT OF NET ASSETS -135,355.
FORM 990, PART XII, LINE 2C:THE AUDIT COMMITTEE ENGAGES THE INDEPENDENT AUDIT FIRM FOR THE AUDIT, REVIEWS RESULTS, AND REPORTS TO THE BOARD. ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. ADENA HEALTH FOUNDATION IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ADENA MEDICAL GROUP LLC
DEPT L637COLUMBUSOH43260271370967HEALTHCARE PROVIDERSOH$68,625,870$5,863,627ADENA HEALTH SYSTEM
ADENA HOSPICE LLC
272 HOSPITAL ROADCHILLICOTHEOH45601275340755HEALTHCARE PROVIDERSOH$2,147,728$344,301ADENA HEALTH SYSTEM
ADENA HOME HEALTH
272 HOSPITAL ROADCHILLICOTHEOH45601273752730HEALTHCARE PROVIDERSOH$3,316,160$213,289ADENA HEALTH SYSTEM
ADENA HOME INFUSIONHOME RESPIRATORY
272 HOSPITAL ROADCHILLICOTHEOH45601273752854HEALTHCARE PROVIDERSOH$1,567,373$782,989ADENA HEALTH SYSTEM
ADENA PHARMACY
272 HOSPITAL ROADCHILLICOTHEOH45601451138187HEALTHCARE PROVIDERSOH$5,425,929$745,355ADENA HEALTH SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
GREENFIELD AREA MEDICAL CENTER
550 MIRABEAU STGREENFIELDOH45123310993422HOSPITALOH501(C)(3)3ADENA HEALTH SYSTEMYes (1)
ADENA HEALTH FOUNDATION
272 HOSPITAL ROADCHILLICOTHEOH45601753008742FUNDRAISINGOH501(C)(3)12AADENA HEALTH SYSTEMYes (1)
SOUTHERN OHIO HEALTHCARE NETWORK
272 HOSPITAL ROADCHILLICOTHEOH45601261566590FIBEROPTIC NETWORK GRANTSOH501(C)(3)12AADENA HEALTH SYSTEMYes (1)
PIKE HEALTH SERVICES INC
100 DAWN LANEWAVERLYOH45690311072406HOSPITALOH501(C)(3)3ADENA HEALTH SYSTEMYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ADENA CAREBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1272 HOSPITAL ROADAddressLine1Txt
CityCHILLICOTHECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd
FieldValueIRS element (for citing)
EIN453980850EIN
Primary ActivitiesSEE SCHEDULE R, PART VIIPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ADENA HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income-$446,871ShareOfTotalIncomeAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
GREENFIELD AREA MEDICAL CENTER
R$1,524,010BOOK VALUE
PIKE HEALTH SERVICES
S$4,830,544BOOK VALUE
ADENA HEALTH FOUNDATION
C$135,355BOOK VALUE
ADENA HEALTH FOUNDATION
B$434,775BOOK VALUE

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IV, COLUMN (B)FormAndLineReferenceDesc
ExplanationTHE PRIMARY ACTIVITY OF ADENA CARE IS TO DEVELOP STRATEGIC RELATIONSHIPS TO THE SERVICE AREAS MAJOR EMPLOYERS THROUGH HEALTH MANAGEMENT AND WELLNESS SERVICES.ExplanationTxt