MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED (EIN 31-0650283)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-10
- IRS object ID
- 201841309349301114
- Schema version
- 2016v3.0
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-10T12:03:41-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 EAST FIFTH STREET | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310650283 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | INCORPORATED | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MCCU | BusinessNameControlTxt |
| Phone | 5135245310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN KRAUSE | PersonNm |
| Person Title | VP-FINANCE | PersonTitleTxt |
| Phone | 5135245310 | PhoneNum |
| Signature | 2018-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALICIA JANISCH | PreparerPersonNm |
| PTIN | P00741382 | PTIN |
| Phone | 5137847100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK CLEMENT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 619 OAK STREET | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,100,709 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MHMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 371 | TotalEmployeeCnt |
| Total Volunteers | 225 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $410,513 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,354,760 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $46,408,912 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,549 | PYInvestmentIncomeAmt |
| CY Investment Income | $96,212 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,128,287 | PYOtherRevenueAmt |
| CY Other Revenue | $295,262 | CYOtherRevenueAmt |
| PY Total Revenue | $48,923,109 | PYTotalRevenueAmt |
| CY Total Revenue | $46,800,386 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $26,552 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $314,854 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,637,255 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,091,890 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,196,402 | PYOtherExpensesAmt |
| CY Other Expenses | $26,763,812 | CYOtherExpensesAmt |
| PY Total Expenses | $51,860,209 | PYTotalExpensesAmt |
| CY Total Expenses | $50,170,556 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,937,100 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,370,170 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $58,205,117 | TotalAssetsBOYAmt |
| Total Assets EOY | $56,126,707 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,086,025 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,800,093 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,119,092 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $32,326,614 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ACUTE CARE HOSPITAL FACILITY DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $42,933,643 | ExpenseAmt |
| Grant | $314,854 | GrantAmt |
| Revenue | $46,314,877 | RevenueAmt |
| Desc | SURGERY - THIS SERVICE IS COMPRISED OF SURGERY AND MINOR PROCEDURES. TOTAL VOLUME WAS 1,675 CONSISTING OF IP CARE (34%) AND OUTPATIENT CARE (66%).PHARMACY - THIS SERVICE CONSISTS OF CARE PROVIDED TO INPATIENTS (24%) AND OUTPATIENTS (76%). OUTPATIENT CARE INCLUDES A MAJOR PROGRAM FOR ONCOLOGY TREATMENT.INPATIENT CARE - INPATIENT VOLUME CONSISTED OF 1,818 DISCHARGES AND 5,172 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 2.84 DAYS. BIRTHS TOTALED 425 AND A TOTAL OF 717 OBSERVATION DAYS OF SERVICE.FOR ADDITIONAL INFORMATION PLEASE SEE SCHEDULE H. | Desc |
| Total Program Service Expenses | $42,933,643 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 109 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 371 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN KRAUSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5135695126 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 619 OAK STREET-ACCOUNTING 3 WEST | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45206 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| ALAN OAK | ||||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBERT COLLINS MD | ||||||||||
| DIRECTOR | 1.00 | 60.00 | Yes (X) | $0 | $568,916 | $141,265 | ||||
| MICHAEL CROFTON | ||||||||||
| ASSISTANT TREASURER | 1.00 | 60.00 | Yes (X) | Yes (X) | $0 | $533,255 | $130,762 | |||
| HILLARY EVANS MD | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN HARLAN MD | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MYRTIS POWELL | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK CLEMENT | ||||||||||
| SECRETARY | 1.00 | 60.00 | Yes (X) | Yes (X) | $0 | $1,289,284 | $276,073 | |||
| GAIL DONOVAN | ||||||||||
| VICE CHAIR | 1.00 | 60.00 | Yes (X) | Yes (X) | $0 | $895,557 | $133,654 | |||
| JAMES FORMAL | ||||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JASON NIEHAUS | ||||||||||
| DIRECTOR (START 10/16) | 1.00 | 60.00 | Yes (X) | $0 | $152,127 | $12,898 | ||||
| BRETT KIRKPATRICK | ||||||||||
| EXECUTIVE DIRECTOR-MHMH | 60.00 | 0.00 | $0 | $230,423 | $34,382 | Yes (X) | ||||
| GREGORY CALKINS MD | ||||||||||
| PHYSICIAN | 60.00 | 0.00 | $174,383 | $0 | $29,829 | Yes (X) | ||||
| DONALD WATSON | ||||||||||
| DIRECTOR-PHARMACY | 60.00 | 0.00 | $131,690 | $0 | $26,426 | Yes (X) | ||||
| BRYAN SIZELOVE | ||||||||||
| RADIOLOGIC TECHNOLOGIST | 60.00 | 0.00 | $118,396 | $0 | $12,568 | Yes (X) | ||||
| SHARON HANCOCK | ||||||||||
| SITE DIRECTOR - HR | 60.00 | 0.00 | $112,654 | $0 | $22,188 | Yes (X) | ||||
| DENISE MOSTER | ||||||||||
| NURSE | 60.00 | 0.00 | $106,707 | $0 | $1,235 | Yes (X) | ||||
| BRYAN HEHEMANN | ||||||||||
| FORMER OFFICER | 60.00 | 0.00 | $90,257 | $222,879 | $18,904 | Yes (X) | ||||
| JOHN PROUT | ||||||||||
| FORMER OFFICER | 60.00 | 0.00 | $0 | $1,389,908 | $24,109 | Yes (X) | ||||
| DWIGHT ELLINGWOOD | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $432,491 | $70,912 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $734,087 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,714,840 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $935,205 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ARAMARK | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | FOOD SERVICES | $1,146,791 |
| SHIFTWISE INC | |||||
| 1800 SW 1ST AVE SUITE 510 | PORTLAND | OR | 97201 | MEDICAL STAFFING | $395,617 |
| WESTERN OHIO ANESTHESIA ASSOCIATES | |||||
| 110 N POPLAR STREET | OXFORD | OH | 45056 | ANESTHESIA SERVICES | $370,000 |
| CATHOLIC HEALTH INITIATIVES | |||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | CLINICAL ENGINEERING | $291,802 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| 40 LIBERTY BLVD | MALVERN | PA | 19355 | CONSULTING | $227,240 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 900099 | $46,069,630 | $46,069,630 | |
| MANAGEMENT REVENUE | 900099 | $178,582 | $178,582 | |
| AFFILIATED RENTAL REV. | 531120 | $160,700 | $160,700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $46,408,912 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,154 | TotalRevenueColumnAmt |
| Exclusion | $96,154 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $285,508 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $300,323 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$14,815 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$14,815 | TotalRevenueColumnAmt |
| Exclusion | -$14,815 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $58 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $58 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58 | TotalRevenueColumnAmt |
| Exclusion | $58 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA/VENDING | 722210 | $243,412 | $243,412 | |
| WELLNESS CENTER | 900099 | $50,703 | $50,703 | |
| MEDICAL RECORDS | 900099 | $8,988 | $8,988 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,974 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,974 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $310,077 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,800,386 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,314,877 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $485,509 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,854 | TotalAmt |
| Program Services | $314,854 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,070,454 | TotalAmt |
| Program Services | $18,070,454 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,664 | TotalAmt |
| Program Services | $307,664 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,441,755 | TotalAmt |
| Program Services | $3,441,755 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,272,017 | TotalAmt |
| Program Services | $1,272,017 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,166,439 | TotalAmt |
| Management And General | $1,166,439 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,341 | TotalAmt |
| Management And General | $26,341 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,275 | TotalAmt |
| Management And General | $4,275 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,286,454 | TotalAmt |
| Program Services | $4,268,888 | ProgramServicesAmt |
| Management And General | $17,566 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,269 | TotalAmt |
| Program Services | $63,063 | ProgramServicesAmt |
| Management And General | $226,206 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,468 | TotalAmt |
| Program Services | $495,263 | ProgramServicesAmt |
| Management And General | $9,205 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,390,290 | TotalAmt |
| Program Services | $1,388,694 | ProgramServicesAmt |
| Management And General | $1,596 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,958,981 | TotalAmt |
| Program Services | $1,958,685 | ProgramServicesAmt |
| Management And General | $296 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,264 | TotalAmt |
| Program Services | $24,714 | ProgramServicesAmt |
| Management And General | $2,550 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,475 | TotalAmt |
| Program Services | $14,358 | ProgramServicesAmt |
| Management And General | $117 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,991 | TotalAmt |
| Management And General | $463,991 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,275,223 | TotalAmt |
| Program Services | $64,775 | ProgramServicesAmt |
| Management And General | $5,210,448 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,498 | TotalAmt |
| Program Services | $382,498 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL/DIETARY SUPPLY | $8,546,964 | $8,546,964 | |
| OHIO HOSPITAL TAX | $1,043,652 | $1,043,652 | |
| EQUIPMENT | $1,033,524 | $1,031,497 | $2,027 |
| DUES AND SUBSCRIPTIONS | $146,930 | $89,445 | $57,485 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,774 | TotalAmt |
| Program Services | $154,403 | ProgramServicesAmt |
| Management And General | $48,371 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,170,556 | TotalAmt |
| Program Services | $42,933,643 | ProgramServicesAmt |
| Management And General | $7,236,913 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,479 | BOYAmt |
| EOY | $2,473 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $810,803 | BOYAmt |
| EOY | $1,264,657 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,957,871 | BOYAmt |
| EOY | $5,278,484 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,830 | BOYAmt |
| EOY | $312,019 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $910,947 | BOYAmt |
| EOY | $932,378 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $655,886 | BOYAmt |
| EOY | $585,805 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,559,323 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,616,516 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,844,839 | BOYAmt |
| EOY | $39,942,807 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,912,617 | BOYAmt |
| EOY | $7,402,266 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,695,845 | BOYAmt |
| EOY | $405,818 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,205,117 | BOYAmt |
| EOY | $56,126,707 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,584,934 | BOYAmt |
| EOY | $3,764,582 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,320,000 | BOYAmt |
| EOY | $9,320,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,528,122 | BOYAmt |
| EOY | $7,774,412 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,652,969 | BOYAmt |
| EOY | $2,941,099 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,086,025 | BOYAmt |
| EOY | $23,800,093 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,091,628 | BOYAmt |
| EOY | $32,303,807 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,464 | BOYAmt |
| EOY | $22,807 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,119,092 | BOYAmt |
| EOY | $32,326,614 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,205,117 | BOYAmt |
| EOY | $56,126,707 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,370,170 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $530,760 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $46,932 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $151 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $151 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | DURING THE TAX YEAR, MCCULLOUGH-HYDE MEMORIAL HOSPITAL PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,548,410 | OtherCostOrOtherBasisAmt |
| Book Value | $7,548,410 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,732,780 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,040,188 | DepreciationAmt |
| Book Value | $18,692,592 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,272,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $940,625 | DepreciationAmt |
| Book Value | $1,331,875 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,322,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,633,470 | DepreciationAmt |
| Book Value | $8,689,319 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,682,844 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,233 | DepreciationAmt |
| Book Value | $3,680,611 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $39,942,807 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $243,098 |
| ACCRUED MALPRACTICE LIABILITY | $377,859 |
| ACCRUED EIB | $198,777 |
| ACCRUED SWAP LIABILITY | $67,983 |
| SECURITY DEPOSITS | $19,327 |
| DUE TO RELATED ORGANIZATION | $2,034,055 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,941,099 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FINANCIAL STATEMENTS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ARE AUDITED AS PART OF TRIHEALTH AND ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE AUDITED COMBINED FINANCIAL STATEMENTS OF TRIHEALTH THAT REPORTS ITS AND ITS SUBSIDIARIES AND AFFILIATES LIABILITY, IF APPLICABLE, FOR CERTAIN TAX POSITIONS UNDER ASC 740-10-25: TRIHEALTH PERFORMED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT EITHER DATE. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $771,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,134,043 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,282,728 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,951,845 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,330,883 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06640 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,054,416 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,085,888 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,330,883 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $64,026 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $64,026 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $185,582 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $185,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $249,608 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $249,608 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,304,024 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,085,888 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,580,491 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07140 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $224,300 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $224,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $224,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $224,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,782,149 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,647,688 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,055,618 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,407,930 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N POPLAR STREET | AddressLine1Txt |
| City | OXFORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MHMH.ORG | WebsiteAddressTxt |
| State License | 55577 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C, PAGE 7 | OwnWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, PAGE 7 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ | 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: PRIMARY RESEARCHCHNA COMMUNITY FOCUS GROUPS/PUBLIC MEETINGS: THE FOCUS GROUPS WERE CONDUCTED BY AN ASSIGNED FACILITATOR AND SCRIBES. THE FACILITATOR INTRODUCED THE ATTENDEES TO THE COUNTY SNAPSHOT AND THE CNI MAP. AFTER A PERIOD OF QUESTIONS AND BRAINSTORMING, EACH ATTENDEE WAS ASKED TO INDICATE WHICH ISSUES WERE MOST IMPORTANT. THE ATTENDEES INCLUDED MEMBERS OF THE COMMUNITY AND REPRESENTATIVES OF ORGANIZATIONS SERVING THE COMMUNITY, INCLUDING COMMUNITY ADVOCATES AND REPRESENTATIVES FROM FAITH-BASED ORGANIZATIONS, PUBLIC HEALTH DEPARTMENTS, AND COMMUNITY-BASED HEALTH CENTERS. THE PURPOSE OF THE MEETINGS WAS TO SOLICIT PUBLIC INPUT. THE RESULTS OF THE COMMUNITY FOCUS GROUPS WERE SUMMARIZED BY COUNTY. THIS DOCUMENT REFERS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY FOCUS GROUPS AS "COMMUNITY FOCUS GROUPS OR "FOCUS GROUPS".CHNA COMMUNITY HEALTH SURVEYS: THE SURVEY WAS CUSTOMIZED FOR THREE DIFFERENT RESPONDENTS: CONSUMERS, AGENCIES, AND HEALTH DEPARTMENTS. A SPANISH LANGUAGE SURVEY WAS ALSO CREATED WITH THE HELP OF COMMUNITY HEALTH WORKERS. THE SURVEY CONTAINED QUESTIONS ABOUT THE HEALTH ISSUES FACING THE COMMUNITY, IF HEALTH ISSUES WERE BEING ADDRESSED, AND WHAT BARRIERS THE COMMUNITY WAS EXPERIENCING. SOME PARTICIPANTS PREFERRED TO RESPOND IN-PERSON OR OVER THE PHONE, THESE RESPONSES WERE TRANSCRIBED INTO THE SURVEY TOOL. THIS DOCUMENT REFERS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY SURVEYS AS "SURVEYS".SECONDARY RESEARCHSECONDARY RESEARCH CONSISTED OF GATHERING AVAILABLE HEALTH-RELATED DATA FOR A COLLECTION OF TWENTY-THREE COUNTIES, INCLUDING BUTLER, CLERMONT, HAMILTON, AND WARREN COUNTIES. BECAUSE THE TARGETED REGION SPANNED THREE STATES, CONSISTENT DATA WERE NOT ALWAYS AVAILABLE, AND NOT ALL DATA WERE AVAILABLE FOR THE ENTIRE REGION. WHENEVER POSSIBLE, DATA WERE COLLECTED AT THE COUNTY LEVEL. SUB-COUNTY LEVEL DATA WERE NOT A FOCUS OF THIS RESEARCH. THE COUNTY HEALTH RANKINGS (CHR) FORMED THE FOUNDATION FOR DATA COLLECTION WITH ITS COUNTY-LEVEL FOCUS ON HEALTH OUTCOMES, HEALTH FACTORS, HEALTH BEHAVIORS, QUALITY OF LIFE, CLINICAL CARE, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC FACTORS. DATA WAS VERIFIED AND FORMATTED CONSISTENTLY; SUPPLEMENTAL DATA WAS ALSO IDENTIFIED AND COLLECTED. THE INTERACTIVE TOOL ON THE CNI (COMMUNITY NEED INDEX) WAS ACCESSED TO CREATE COUNTY-LEVEL MAPS AND ZIP CODE TABLES. THE CHR AND CNI WEBSITES WERE MONITORED FOR PERIODIC DATA UPDATES AND DATA WORKSHEETS WERE REVISED UNTIL SEPTEMBER 2015.STANDARDS FOR RESEARCHING AND INCLUDING THE DATA WERE ESTABLISHED AND INCLUDED THE FOLLOWING CHARACTERISTICS: COMPARABLE, COUNTY-LEVEL, FOCUSED ON HEALTH OUTCOMES, REPRODUCIBLE, REPUTABLE, AND TRENDED. THE CHR SERVED AS A STARTING POINT BUT RESOURCES WITH MORE RECENT DATA AND ADDITIONAL MEASURES WERE ALSO IDENTIFIED.INPUT FROM A BROAD RANGE OF REPRESENTATIVESINPUT WAS RECEIVED FROM INDIVIDUALS REPRESENTING UNDERSERVED POPULATIONS USING, PRIMARILY THE TWO SURVEY APPROACHES DESCRIBED ABOVE. THE COMBINATION OF THESE METHODS PROVIDED A WIDE-RANGE OF DATA COLLECTION OPPORTUNITIES ON WHICH THE CHNA COULD BE BASED.CHNA COMMUNITY FOCUS GROUPS: A TOTAL OF 156 INDIVIDUALS ATTENDED THE 11 FOCUS GROUPS, 134 OF THE ATTENDEES REPRESENTED AN ORGANIZATION. THE ORGANIZATIONS REPRESENTED BY THESE ATTENDEES SERVE THE FOLLOWING POPULATIONS: CHILDREN, ELDERLY, HOMELESS, LOW-INCOME, MEDICALLY UNDERSERVED, MINORITY, PEOPLE WITH MENTAL ILLNESS, AND VICTIMS OF DOMESTIC VIOLENCE. FIFTEEN INDIVIDUALS, ALL REPRESENTING ORGANIZATIONS, ATTENDED THE BUTLER COUNTY FOCUS GROUP ON JULY 30, 2015. THREE INDIVIDUALS ATTENDED THE CLERMONT COUNTY FOCUS GROUP ON JULY 28, 2015. APPROXIMATELY 50 INDIVIDUALS ATTENDED MEETINGS ON BEHALF OF HAMILTON COUNTY, THE MAJORITY REPRESENTED AN ORGANIZATION. ON JULY 7, 2015, SIX INDIVIDUALS ATTENDED THE WARREN COUNTY FOCUS GROUP AND REPRESENTED PREMIER HEALTH: ATRIUM MEDICAL CENTER AND PREVENTIONFIRST OR CAME ON THEIR OWN BEHALF. CHNA SURVEY: IN AGGREGATE, 329 INDIVIDUALS, 55 AGENCY REPRESENTATIVES, 52 LATINOS, AND 24 HEALTH DEPARTMENT REPRESENTATIVES COMPLETED THE CHNA SURVEY. THE CHNA TEAM, CHNA COMMITTEE, AND PARTNERS HELPED DISTRIBUTE THE SURVEY. AT COMMUNITY MEETINGS, A HANDOUT PROVIDED THE SURVEY LINK, AND THE LINKS WERE WRITTEN ON AN EASEL PAD AT THE FRONT OF THE ROOM. THROUGHOUT THE REGION, 381 INDIVIDUAL SURVEYS AND 55 AGENCY SURVEYS WERE COMPLETED, INCLUDING RESPONSES FROM AGENCIES SUCH AS BUTLER COUNTY UNITED WAY, CLERMONT COUNTY MENTAL HEALTH & RECOVERY BOARD, AND THE YMCA OF GREATER CINCINNATI. IN BUTLER, CLERMONT, HAMILTON, AND WARREN COUNTIES, RESPONDENTS INCLUDED CONTACTS FROM LOCAL HEALTH DEPARTMENTS: THE BUTLER COUNTY HEALTH DEPARTMENT, CITY OF HAMILTON HEALTH DEPARTMENT, THE MIDDLETOWN CITY HEALTH DISTRICT, THE CLERMONT COUNTY GENERAL HEALTH DISTRICT, HAMILTON COUNTY PUBLIC HEALTH, NORWOOD CITY HEALTH DISTRICT, SPRINGDALE CITY HEALTH DISTRICT, AND WARREN COUNTY COMBINED HEALTH DISTRICT. OTHER ORGANIZATIONS THAT COMPLETED THE SURVEY INCLUDED GOOD SAMARITAN FREE HEALTH CENTER, AND THE GREATER CINCINNATI FOUNDATION, ETC. |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: ADAMS COUNTY REGIONAL MEDICAL CENTER, ATRIUM MEDICAL CENTER, DEARBORN COUNTY HOSPITAL, LINDNER CENTER OF HOPE, MARGARET MARY COMMUNITY HOSPITAL, MERCY HEALTH, UC HEALTH, BETHESDA NORTH HOSPITAL, BETHESDA BUTLER COUNTY, GOOD SAMARITAN HOSPITAL OF CINCINNATI,THE CHRIST HOSPITAL, CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: HEALTH COLLABORATIVE, CITY OF CINCINNATI HEALTH DEPARTMENT, HAMILTON COUNTY PUBLIC HEALTH, INTERACT FOR HEALTH, XAVIER UNIVERSITY DEPARTMENT OF HEALTH SERVICES ADMINISTRATION |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: AVAILABLE UPON REQUEST WITHOUT CHARGE. |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: OBESITY: TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR OBESITY REDUCTION/PREVENTION WORKGROUP EFFORTS, AS FOLLOWS: **THRIVING COMMUNITY OXFORD (ACTIVE LIVING): THEIR WORK INCLUDES COMMUNITY WALKING CHALLENGES, SOCIAL MARKETING PROGRAM WITH SCHOOLS AND COMMUNITY MEMBERS, "ROX" FOR HEALTHY CHOICES. ** HEALTHY CHOICES IN FOOD, BOTH IN SCHOOLS, KIDS BACKPACK PROGRAMMING, MEALS ON WHEELS. SUPPORT HEALTHY CHOICES WITH SOCIAL MARKETING CAMPAIGN AT LOCAL GROCERY STORES AND RESTAURANTS. ** SUPPORT COMMUNITY GARDENS AND FOOD PANTRIES. ** SAFE ROUTES TO SCHOOL INITIATIVE ** COMMUNITY WALKING CHALLENGES, RESOURCES TO SCHOOLS, ETC. * OXFORD AREA TRAILS: COMMITMENT TO EXTEND THE TRAIL FROM THE CITY TO THE TRAIL HEAD. THIS STARTS ONE BLOCK FROM MHMH/TH AND GOES PAST MANY MEDICAL OFFICE BUILDINGS. * SAFE ACTIVE PLAY IN RURAL AREAS: MHMH/TH WILL BUILD PLAYGROUNDS IN 3 COMMUNITIES, DARRTOWN, OHIO; BROOKVILLE, INDIANA AND CAMDEN, OHIO (ONE EACH YEAR) TO ENCOURAGE PLAY AND INTERACTION WITH ADULTS. * SUPPORT OTHER HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA THAT PROMOTE HEALTHY LIFESTYLES * ASSESS REVIVING MHMH/TH HEALTHY YOU PROGRAM: THIS PROGRAM ALLOWED 2 ONE ON ONE VISITS WITH AN EXERCISE PHYSIOLOGIST AND DIETITIAN. AN INDIVIDUAL PLAN WAS DEVELOPED AND TELEPHONE FOLLOW-UP OCCURRED 6 MONTHS AND 12 MONTHS POST VISIT.MENTAL HEALTH: TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR MENTAL WORKGROUP EFFORTS, AS FOLLOWS: ** LOCAL RESOURCE LIST WHICH IS UPDATED EVERY 6 MONTHS AND SENT OUT TO PHYSICIANS, POLICE, CHURCHES, SOCIAL SERVICE AGENCIES AND SCHOOLS. ** DEVELOP A SOCIAL NORM CAMPAIGN AND COMMUNITY EDUCATION ON MENTAL HEALTH ** WORK WITH BUTLER COUNTY MENTAL HEALTH BOARD TO BRING OUTPATIENT MENTAL HEALTH SERVICES TO OXFORD. * SUPPORT OTHER IDENTIFIED WORK OF THE COALITION AND OTHER MENTAL HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA. * OFFER MENTAL HEALTH FIRST AID THROUGHOUT OUR SERVICE AREA (BOTH THE YOUTH AND ADULT COURSES): THIS EVIDENCE BASED PROGRAM THAT IS NATIONALLY RECOGNIZED. PROGRAM TEACHES HOW TO IDENTIFY WHEN A PERSON IS HAVING MENTAL HEALTH PROBLEMS, HOW TO TALK TO THEM AND HOW TO MAKE REFERRALS. * CONTINUE TO WORK WITH TRIHEALTH 'S BEHAVIORAL HEALTH ON INPATIENT PLACEMENT.ALCOHOL AND OTHER DRUGS (AOD): TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR AOD WORKGROUP EFFORTS: * LOCK BOX PROGRAM: PROVIDE LOCK BOXES TO LOCAL PHYSICIANS TO GIVE TO THEIR PATIENTS TO LOCK UP MEDS. ** COMMUNITY PROGRAMING ON OPIATES AND OTHER DRUGS. ** MEDICATION TAKE BACK DAYS ** SUPPORT OTHER IDENTIFIED WORK OF THE COALITION AND OTHER AOD HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA. * YOUTH LED PREVENTION RETREAT: TALAWANDA'S YOUTH INITIATIVE TEAM (YIT) IS AN ACTIVE/ EXPERIENCED YOUTH PREVENTION TEAM. THE PLAN IS FOR OTHER SCHOOL DISTRICTS TO LEARN FROM THEIR EXPERIENCE. MHMH/TH WOULD INVITE 20 STUDENT LEADERS FROM BROOKVILLE HIGH SCHOOL, PREBLE SHAWNEE HIGH SCHOOL (CAMDEN), ROSS HIGH SCHOOL, COLLEGE CORNER/UNION COUNTY JOINT SCHOOL DISTRICT HIGH SCHOOL, EATON HIGH SCHOOL AND TALAWANDA TO COME TOGETHER TO LEARN ABOUT EVIDENCE BASED PREVENTION STRATEGIES AND TO EMPOWER THE STUDENTS TO TAKE THESE IDEAS BACK TO THEIR SCHOOLS AND COMMUNITIES FOR IMPLEMENTATION. MHMH/TH WOULD ASK EACH SCHOOL DISTRICT TO IDENTIFY A STAFF MEMBER TO PROVIDE ADULT SUPERVISION, ADVISE THE STUDENT LEADERS AND HELP THEM IMPLEMENT THEIR PREVENTION STRATEGY PROJECT. MHMH/TH WOULD PROVIDE A STIPEND TO THESE STAFF LEADERS. EACH SCHOOL DISTRICT WOULD BE ASKED TO DEVELOP A WRITTEN PLAN FOR THEIR PREVENTION STRATEGY AND MAKE PREVENTION TO A PANEL AT MHMH/TH. EACH SCHOOL DISTRICT THAT DOES THIS WOULD BE GIVEN $1000 TO HELP THEM IMPLEMENT THEIR PLAN. MHMH/TH WOULD ASK EACH SCHOOL TO REPORT ON THE SUCCESS OF THEIR PROJECT OR IF NOT SUCCESSFUL, WHAT THEY WOULD CHANGE FOR NEXT TIME. THIS WOULD BE HELD ONCE A YEAR. * MCCULLOUGH-HYDE/TRIHEALTH TASKFORCE: THIS GROUP WILL BE FORMED TO ASSESS PRESCRIBING PRACTICES OF LOCAL PHYSICIANS AND HOW TO CARE FOR PATIENTS WHO ARE ADDICTED BUT NEED CONTROL IN THE HOSPITAL SETTING.ACCESS TO CARE: MHMH/TH IS ASSISTING WITH ACCESS TO CARE AND THE COMMUNITY'S TRANSPORTATION NEEDS, BUT IS NOT TAKING A SUPPORTIVE ROLE IN THIS INITIATIVE. MHMH/TH IS SUPPORTING THE OXFORD FREE CLINIC, WHICH PROVIDES FREE HEALTHCARE TO THE COMMUNITY, AND SUPPORTS COMMUNITY LIFE SQUADS. ADDITIONALLY, MHMH/TH'S AFFILIATION HAS INCREASED THE NUMBER OF SPECIALISTS AVAILABLE TO SERVE THE COMMUNITY, INCLUDING THE INTRODUCTION OF A MAMMOGRAPHY VAN INTO THE AREA. FINALLY, PRIMARY HEALTH SOLUTIONS, A FEDERALLY QUALIFIED HEALTH CENTER, HAS RECENTLY OPENED OFFICES IN MHMH/TH'S COMMUNITY, WHICH WILL FURTHER ACCESS TO CARE. |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13B: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. |
| PART V, SECTION B, LINES 7A AND 10A CHNA & IMPLEMENTATION PLAN WEBSITE | HTTPS://WWW.TRIHEALTH.COM/HOSPITALS-AND-PRACTICES/UNFORTUNATELY, THE URL IS TOO LONG FOR THE SOFTWARE. SO ONCE YOU HAVE USED THE ABOVE URL, PLEASE PERFORM THE NEXT STEPS:UNDER "HOSPITALS (& EMERGENCY)", CLICK ON "MCCULLOUGH-HYDE MEMORIAL HOSPITAL"IN THE GREY BOX ON THE LEFT HAND SIDE OF THE PAGE, CLICK "SERVICES".IN THE GREY BOX ON THE LEFT HAND SIDE OF THE PAGE, CLICK "COMMUNITY SERVICES AND THEN "HEALTH NEEDS ASSESSMENT". |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MCCULLOUGH-HYDE MEDICAL BUILDING | ||||
| 5151 MORNING SUN ROAD | OXFORD | OH | 45056 | PHYSICAL THERAPY |
| 2 - MCCULLOUGH-HYDE MEDICAL BUILDING | ||||
| 10058 COOLEY ROAD | BROOKVILLE | IN | 47012 | OUTPATIENT |
| 3 - MCCULLOUGH-HYDE PT & REHAB | ||||
| 1390 EATON ROAD | HAMILTON | OH | 45013 | PHYSICAL THERAPY |
| 4 - MCCULLOUGH-HYDE OUTPATIENT SERVICES | ||||
| 2449 ROSS-MILLVILLE ROAD | HAMILTON | OH | 45013 | OUTPATIENT, URGENT CARE, PT |
| 5 - MCCULLOUGH-HYDE OUTPATIENT SERVICES | ||||
| 79 W CENTRAL AVENUE | CAMDEN | OH | 45311 | OUTPATIENT |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING CHARITY CARE ELIGIBILITY. SEE THE RESPONSES TO PART I, LINES 3A AND 3B.AN INDIVIDUAL'S INCOME UNDER THE FPG IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR CHARITY CARE. ADDITIONALLY, AN INDIVIDUAL'S INCOME IN RELATION TO HIS/HER MEDICAL EXPENSES IS ALSO TAKEN INTO ACCOUNT AND SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES. FINALLY, MCCULLOUGH-HYDE MEMORIAL HOSPITAL PROVIDES DISCOUNTED CARE AT SELECT CLINICS. |
| PART I, LINE 6A: | IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH, INC TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. IN 2015, TRIHEALTH PURCHASED A 60% INTEREST IN MCCULLOUGH-HYDE MEMORIAL HOSPITAL TO SUPPORT ITS MISSION.THE COMMUNITY BENEFIT PROVIDED BY MCCULLOUGH-HYDE MEMORIAL HOSPITAL IS TRACKED ON A STANDALONE BASIS; HOWEVER, ITS COMMUNITY BENEFIT IS REPORTED IN A REPORT PREPARED BY TRIHEALTH IN COMBINATION WITH ITS RELATED HOSPITALS - BETHESDA HOSPITAL, INC., THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND TRIHEALTH HOSPITAL, INC. |
| PART I, LINE 7: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL UTILIZED WORKSHEET 2 - RATIO OF PATIENT CARE COST-TO-CHARGES, WHICH WAS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H, TO CALCULATE THE COST-TO-CHARGE RATIO. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25. IT IS PRESENTED ON FORM 990, PART VIII, LINE 2 AS A DEDUCTION FROM PATIENT SERVICE REVENUE WHICH CORRESPONDS TO ITS FINANCIAL STATEMENT PRESENTATION. SEE RESPONSE TO PART III, LINE 4. THEREFORE, NO ADJUSTMENT TO TOTAL EXPENSES SHOWN ON FORM 990, PART IX, LINE 25 IS NECESSARY. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") PAID FOR THE INSTALLATION OF PLAYGROUNDS (INCLUDING MATERIALS AND LABOR) IN VARIOUS COMMUNITIES IT SERVES.IN ADDITION, MHMH PROMOTES HEALTH AND WELL-BEING IN OUR COMMUNITY IN NUMEROUS WAYS NOT LISTED IN THE COMMUNITY EVENTS AND PROGRAMS SECTION OF THE FORM 990. EXAMPLES INCLUDE:1) MHMH HELPED PROMOTE WELLNESS BY PROVIDING MEETING SPACE TO THE INFANT/CHILD LOSS BEREAVEMENT SUPPORT GROUP AND FIBROMYALGIA SUPPORT GROUP.2) MHMH ASSISTED OUR LOCAL SCHOOL DISTRICT WITH IDENTIFIED HEALTH/WELLNESS NEEDS. EXAMPLES INCLUDE:A) DEVELOPED AND PROVIDED CRISIS CARDS FOR ALL 8TH GRADE STUDENTS AND ALL COUNSELORS IN THE SCHOOL DISTRICT.B) DEVELOPED CURRICULUM THAT COMBINED TRADITIONAL LEARNING WITH EXERCISE TO HELP FIGHT OBESITY IN OUR ELEMENTARY STUDENTS.C) DEVELOPED AND HELD MINI-HEALTH SEMINARS FOR 6TH GRADE STUDENTS ON SLEEP, NUTRITION, EXERCISE AND MENTAL HEALTH.3) MHMH PROVIDED OFFICE SPACE AND MEETING SPACE FOR THE OXFORD COLLEGE CORNER CLINIC, WHICH IS A CLINIC THAT PROVIDES FREE HEALTH CARE TO THE UNINSURED AND UNDERINSURED ADULTS IN OUR COMMUNITY.4) MHMH IMPROVED THEIR EMPLOYEE WELLNESS PROGRAM BY:A) IMPLEMENTING A HEALTH RISK ASSESSMENT FOR THEIR EMPLOYEES TO IDENTIFY HEALTH NEEDS/CONCERNS IN OUR EMPLOYEE POPULATION.B) OFFERING MAMMOGRAMS AND PROSTATE SCREENING TO APPROPRIATE EMPLOYEES FREE OF CHARGE.C) INCENTIVIZING EMPLOYEES TO ADOPT HEALTHIER BEHAVIOR. |
| PART III, LINE 2: | SEE PART VI RESPONSE TO PART III, LINE 4. |
| PART III, LINE 3: | SEE PART VI RESPONSE TO PART III, LINE 4. |
| PART III, LINE 4: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE TRIHEALTH AUDIT REPORT AND AS SUCH FOLLOWING IS THAT REPORT'S FOOTNOTE.NET PATIENT ACCOUNTS RECEIVABLE (PART OF FOOTNOTE B)NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE COLLECTED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY AS NECESSARY THE PROVISIONS FOR BAD DEBT AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS RECEIVABLE IN THE PERIOD OF SERVICE BASED UPON HISTORICAL WRITE-OFF EXPERIENCE.AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, TRIHEALTH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY TRIHEALTH.THERE HAVE BEEN NO SIGNIFICANT CHANGES IN TEH CURRENT YEAR TO THE UNDERLYING ASSUMPTIONS USED BY TRIHEALTH TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.FINANCIAL INSTRUMENTS THAT POTENTIALLY SUBJECT TRIHEALTH TO CONCENTRATIONS OF CREDIT RISK CONSIST PRIMARILY OF NONGOVERNMENTAL PATIENT ACCOUNTS RECEIVABLE. TRIHEALTH GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS.THE PERCENTAGES OF GROSS PATIENT ACCOUNTS RECEIVABLE FROM PATIENTS AND THIRD-PARTY PAYORS AT JUNE 30 APPROXIMATED THE FOLLOWING:2017 - MEDICARE 14%, MEDICAID 2%, MANAGED CARE 28%, SELF PAY 20%, COMMERCIAL AND OTHER 36%2016 - MEDICARE 17%, MEDICAID 3%, MANAGED CARE 32%, SELF PAY 16%, COMMERCIAL AND OTHER 32%TRIHEALTH HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THE BASIS FOR PAYMENT UNDER THESE AGREEMENTS INCLUDES PROSPECTIVELY DETERMINED RATES, COST REIMBURSEMENT, NEGOTIATED DISCOUNTS FROM ESTABLISHED RATES, AND PER DIEMPAYMENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEW AND INVESTIGATIONS. THE DIFFERENCES BETWEEN THE ESTIMATED AND ACTUAL ADJUSTMENTS ARE RECORDED AS PART OF NET PATIENT SERVICE REVENUE IN FUTURE PERIODS, AS THE AMOUNTS BECOME KNOWN, OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. TRIHEALTH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBT IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS.AS FOR THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, MCCULLOUGH-HYDE MEMORIAL HOSPITAL DOES NOT REPORT ACTUAL BAD DEBT EXPENSE AS COMMUNITY BENEFIT. IF UPON FURTHER RESEARCH, IT IS ULTIMATELY DETERMINED THAT A PORTION OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER TRIHEALTH'S CHARITY CARE POLICY, THOSE COSTS WOULD BE RECLASSIFIED, AS APPROPRIATE, TO COMMUNITY BENEFIT AT THAT TIME.PLEASE NOTE THAT BAD DEBT EXPENSE IS NOT DETERMINED UNTIL AFTER ALL DISCOUNTS AND ANY ASSOCIATED PAYMENTS ARE TAKEN INTO ACCOUNT. IF ANY PAYMENTS ARE RECEIVED AFTER A PATIENT ACCOUNT IS DETERMINED TO BE BAD DEBT, THE ACCOUNT WILL BE ADJUSTED ACCORDINGLY AT THAT TIME. |
| PART III, LINE 9B: | AS OF THE FILING OF THIS RETURN, MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AS PART OF TRIHEALTH, INC., MAINTAINS A WRITTEN DEBT COLLECTION POLICY. TRIHEALTH, INC., WHO PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS, WILL NOT INITIATE COLLECTION PRACTICES ON PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BEFORE COLLECTION ACTIONS ARE TAKEN, TRIHEALTH, INC. WILL MAKE REASONABLE EFFORTS, GENERALLY AS EARLY IN THE BILLING PROCESS AS POSSIBLE, TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. AFTER SUCH EFFORTS HAVE BEEN MADE AND A BALANCE REMAINS THAT IS THE RESPONSIBILITY OF THE PATIENT OR GUARANTOR, TRIHEALTH, INC. MAY PURSUE, IN ITS SOLE DISCRETION, WHATEVER ACTIONS IT MAY BE ENTITLED TO TAKE UNDER LAW. |
| PART VI, LINE 2: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") PARTICIPATED IN A PROCESS OF COMMUNITY HEALTH NEEDS ASSESSMENT DURING TAX YEAR 2013 AND TAX YEAR 2015. THE PROCESS INCLUDED THE FOLLOWING ELEMENTS:1) A NEEDS ASSESSMENT THAT SERVES AS A FOUNDATION FOR DEVELOPING AN IMPLEMENTATION STRATEGY TO ADDRESS THOSE NEEDS. THE QUESTION OF HOW MHMH CAN BEST USE ITS LIMITED RESOURCES TO ASSIST COMMUNITIES IN NEED WILL BE ADDRESSED IN THE IMPLEMENTATION PHASE.2) THE NEEDS ASSESSMENT SEEKS TO IDENTIFY PRIORITY HEALTH STATUS AND ACCESS ISSUES FOR OUR SERVICE AREA. MHMH IS COMMITTED TO TAKING A LEADERSHIP ROLE IN THE ASSESSMENT AND IMPLEMENTATION PHASES. THE ASSESSMENT FOCUSED ON THE FOLLOWING QUESTIONS:* WHO IN THE COMMUNITY IS MOST VULNERABLE IN TERMS OF HEALTH STATUS OR ACCESS TO CARE?* WHAT ARE THE UNIQUE HEALTH STATUS AND/OR ACCESS NEEDS FOR OUR POPULATION?* WHERE DO THESE PEOPLE LIVE IN OUR COMMUNITY?* WHY ARE THESE PROBLEMS PRESENT?3) MHMH HAS IDENTIFIED ITS COMMUNITY AS THE RESIDENTS OF FIVE (5) COUNTIES. IN OHIO: BUTLER AND PREBLE AND IN INDIANA: FAYETTE, FRANKLIN AND UNION. OHIO COUNTIES REPRESENT 63% OF THE SERVICE AREA WHILE INDIANA COUNTIES COMPRISE 37%.4) BASED ON THE DATA GATHERED, THE MAJOR NEEDS OF THE COMMUNITY SERVED BY MHMH ARE ACCESS TO CARE AND OBESITY (INCLUDING RELATED ISSUES SUCH AS DIABETES AND HEART DISEASE).THE FULL TEXT OF THIS NEEDS ASSESSMENT IS AVAILABLE ON MHMH'S WEBSITE. SEE SCHEDULE H, PART V, LINE 7A FOR THE URL. |
| PART VI, LINE 3: | TRIHEALTH, INC. PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS INCLUDING TRIHEALTH HOSPITAL, INC. BROCHURES/APPLICATIONS, PROVIDED IN MULTIPLE LANGUAGES, ARE VISIBLE AND AVAILABLE IN THE REGISTRATION AND ADMITTING AREAS OF ALL TRIHEALTH AFFILIATED HOSPITALS. IN ADDITION, THE APPLICATION IS PRINTED ON THE REVERSE SIDE OF A PATIENT'S BILL WITH INSTRUCTIONS ON HOW TO COMPLETE THE APPLICATION AS WELL AS HOW TO RETURN IT. FINANCIAL COUNSELORS ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. FINALLY, TRIHEALTH, INC.'S WEBSITE CONTAINS INFORMATION REGARDING ITS CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS WITH DIRECTIONS ON HOW TO CONTACT THE APPROPRIATE PERSONNEL TO INITIATE AN APPLICATION OR ASK QUESTIONS ABOUT THE PROCESS. |
| PART VI, LINE 4: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") SERVES A DIVERSE DEMOGRAPHIC INCLUDING THE NORTHWESTERN CORNER OF BUTLER COUNTY, OHIO, THE SOUTHWESTERN CORNER OF PREBLE COUNTY, OHIO AND THE COUNTIES OF FRANKLIN, UNION AND FAYETTE IN INDIANA. THE MAIN CAMPUS IS LOCATED IN OXFORD, OHIO, THE HOME OF MIAMI UNIVERSITY. OXFORD HAS A POPULATION RANGING FROM 30,000 DURING THE SCHOOL YEAR TO HALF THAT NUMBER DURING THE SUMMER.MHMH COUNTS ITS PRIMARY SERVICE AREA AS THE FOLLOWING:*OXFORD, OH (ZIP CODE 45056) - POPULATION 29,739*BROOKVILLE, IN (ZIP CODE 47012) - POPULATION 10,455*COLLEGE CORNER, OH (ZIP CODE 45003) - POPULATION 971*EATON, OH (ZIP CODE 45320) - POPULATION 15,354*SOMERSVILLE, OH (ZIP CODE 45064) - POPULATION 2,963*CAMDEN, OH (ZIP CODE 45311) - POPULATION 7,215*LIBERTY, IN (ZIP CODE 47353) - POPULATION 5,698*WEST COLLEGE CORNER, IN (ZIP CODE 47003) - 834TOTAL PRIMARY SERVICE AREA POPULATION - 73,229AND ITS SECONDARY SERVICE AREAS ARE THE FOLLOWING:*HAMILTON, OH (ZIP CODE 45013) - POPULATION 54,814*CONNERSVILLE, IN (ZIP CODE 47331) - POPULATION 23,438*METAMORA, IN (ZIP CODE 47030) - POPULATION 1,631*OKEANA, OH (ZIP CODE 45053) - POPULATION 3,712TOTAL SECONDARY SERVICE AREA POPULATION - 83,595IN TERMS OF SOCIO-ECONOMIC DEMOGRAPHICS, THE EDUCATIONAL ATTAINMENT IS LOWER THAN COUNTY, STATE AND NATIONAL AVERAGES ANDD THE UNEMPLOYMENT RATE IS HIGHER THAN COUNTY, STATE AND NATIONAL AVERAGES IN ALL OF THE UNINCORPORATED RURAL AREAS SERVED BY MHMH. ALL OF THE AREAS IN INDIANA AND THE RURAL AREAS IN PREBLE AND BUTLER COUNTIES (CAMDEN, SOMERVILLE) ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS BY THE NATIONAL HEALTH SERVICE CORPS. MHMH HAS RECRUITED, SUPPORTED AND WILL CONTINUE TO RECRUIT AND SUPPORT BOTH PRIMARY CARE PHYSICIANS AND SPECIALISTS TO MEET THE NEEDS OF RESIDENTS OF THESE COMMUNITIES. |
| PART VI, LINE 5: | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") IS BASED ON A PATIENT-CENTERED, CARING PHILOSOPHY. ITS STAFF IS DEDICATED TO PROVIDING SAFE AND HIGH-QUALITY SERVICES, WITH THE UTMOST KINDNESS AND COMPASSION. MHMH HAS AN OPEN MEDICAL STAFF WHO HAVE IMPECCABLE TRAINING, EXPERIENCE AND SKILLS. THE VAST MAJORITY ARE BOARD-CERTIFIED IN THEIR CHOSEN PROFESSIONAL FIELD. MHMH PROVIDES A 24-HOUR EMERGENCY ROOM AT ITS MAIN CAMPUS IN OXFORD, OHIO. IT ALSO PROVIDES PREVENTATIVE, DIAGNOSTIC/THERAPEUTIC REHABILITATIVE SERVICES AT MULTIPLE LOCATIONS: OXFORD, CAMDEN, HAMILTON, ROSS. |
| PART VI, LINE 6: | IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH IN ORDER TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION.THROUGH FIVE (5) HOSPITALS, THREE (3) AMBULATORY LOCATIONS AND OVER 125 SITES OF CARE (EMPLOYING OVER 600 PHYSICIANS INCLUDING RESIDENTS), TRIHEALTH PROVIDES A WIDE RANGE OF CLINICAL, EDUCATIONAL, PREVENTIVE AND SOCIAL PROGRAMS. TRIHEALTH'S NON-HOSPITAL SERVICES INCLUDE PHYSICIAN PRACTICE MANAGEMENT, FITNESS CENTERS AND FITNESS CENTER MANAGEMENT, OCCUPATIONAL HEALTH CENTERS, HOME HEALTH AND HOSPICE CARE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| OXFORD COLLEGE CORNER CLINIC | |||||||
| PO BOX 390 | OXFORD | OH | 45056 | 204253386 | 501(C)(3) | $10,000 | ANNUAL FUNDING |
| SANE OF BUTLER COUNTY | |||||||
| PO BOX 18818 | FAIRFIELD | OH | 45018 | 311604036 | 501(C)(3) | $7,500 | FORENSIC CARE |
| CITY OF OXFORD | |||||||
| 101 EAST HIGH STREET | OXFORD | OH | 45056 | GOVERNMENT | $140,000 | DONATION TO ASSIST IN COMPLETING SIDEWALK FROM THE CITY TO THE OXFORD HEAD TRAILS. | |
| GAMETIME | |||||||
| 150 PLAYCORE DR SE | FORT PAYNE | AL | 35967 | $50,364 | DONATION OF PLAYGROUND TO THE VILLAGE OF CAMDEN, OHIO INCLUDING PURCHASE AND INSTALLATION. | ||
| GAMETIME | |||||||
| 150 PLAYCORE DR SE | FORT PAYNE | AL | 35967 | $51,600 | DONATION OF PLAYGROUND TO THE TOWN OF BROOKVILLE INCLUDING PURCHASE AND INSTALLATION. | ||
| DAVID WILLIAMS & ASSOCIATES | |||||||
| PO BOX 208 | HARRISON | OH | 45030 | $51,159 | DONATION OF PLAYGROUND TO MILFORD TOWNSHIP, OH INCLUDING PURCHASE AND INSTALLATION. | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") PROVIDES FUNDS TO ONLY LOCAL ORGANIZATIONS FOR SPECIFIC ACTIVITIES AND NOT ONGOING ACTIVITIES. THE LOCAL ORGANIZATION PROVIDES A RECEIPT OF SUCH FUNDS WHICH SERVES AS MHMH'S SUBSTANTIATION. THUS, THE NEED TO MONITOR THE USE OF THE FUNDS IS NOT NEEDED BY MHMH. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT COLLINS MD | ||||||||||||||
| DIRECTOR | $0 | $427,064 | $0 | $119,473 | $0 | $22,379 | $0 | $124,996 | $0 | $16,269 | $0 | $710,181 | $0 | $0 |
| MICHAEL CROFTON | ||||||||||||||
| ASSISTANT TREASURER | $0 | $379,000 | $0 | $123,542 | $0 | $30,713 | $0 | $102,850 | $0 | $27,912 | $0 | $664,017 | $0 | $0 |
| MARK CLEMENT | ||||||||||||||
| SECRETARY | $0 | $955,818 | $0 | $296,481 | $0 | $36,985 | $0 | $254,562 | $0 | $21,511 | $0 | $1,565,357 | $0 | $0 |
| GAIL DONOVAN | ||||||||||||||
| VICE CHAIR | $0 | $644,732 | $0 | $193,447 | $0 | $57,378 | $0 | $126,278 | $0 | $7,376 | $0 | $1,029,211 | $0 | $0 |
| JASON NIEHAUS | ||||||||||||||
| DIRECTOR (START 10/16) | $0 | $152,068 | $0 | $0 | $0 | $59 | $0 | $5,556 | $0 | $7,342 | $0 | $165,025 | $0 | $0 |
| BRETT KIRKPATRICK | ||||||||||||||
| EXECUTIVE DIRECTOR-MHMH | $0 | $183,048 | $0 | $40,229 | $0 | $7,146 | $0 | $10,071 | $0 | $24,311 | $0 | $264,805 | $0 | $0 |
| GREGORY CALKINS MD | ||||||||||||||
| PHYSICIAN | $174,383 | $0 | $0 | $0 | $0 | $0 | $188 | $0 | $29,641 | $0 | $204,212 | $0 | $0 | $0 |
| DONALD WATSON | ||||||||||||||
| DIRECTOR-PHARMACY | $129,895 | $0 | $0 | $0 | $1,795 | $0 | $0 | $188 | $0 | $26,238 | $131,690 | $26,426 | $0 | $0 |
| BRYAN HEHEMANN | ||||||||||||||
| FORMER OFFICER | $0 | $45,730 | $0 | $0 | $90,257 | $177,149 | $0 | $4,331 | $0 | $14,573 | $90,257 | $241,783 | $0 | $0 |
| JOHN PROUT | ||||||||||||||
| FORMER OFFICER | $0 | $541,905 | $0 | $308,973 | $0 | $539,030 | $0 | $18,967 | $0 | $5,142 | $0 | $1,414,017 | $0 | $200,215 |
| DWIGHT ELLINGWOOD | ||||||||||||||
| FORMER OFFICER | $0 | $175,051 | $0 | $89,942 | $0 | $167,498 | $0 | $48,026 | $0 | $22,886 | $0 | $503,403 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENTS AND ABOVE) PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUAL LISTED IN SCHEDULE J, PART II, RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WHICH WAS TREATED AS TAXABLE COMPENSATION BY TRIHEALTH, INC.: JOHN PROUT - $200,215 |
| PART I, LINES 3 | TRIHEALTH, INC., A RELATED ORGANIZATION OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. |
| PART I, LINE 4A | THE REPORTABLE INDIVIDUALS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, INCORPORATED ARE PAID BY TRIHEALTH, INC., A RELATED ORGANIZATION, RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3). TRIHEALTH, INC. HAS A STANDARD EMPLOYEE SEVERANCE PACKAGE. GENERAL SEVERANCE PAY IS BASED ON LENGTH OF SERVICE. IN ADDITION, NOTICE PAY, IF APPLICABLE UNDER TRIHEALTH, INC. POLICY, MAY BE ADDED TO THE SEVERANCE PACKAGE AND THE AMOUNT OF NOTICE PAY WILL BE DETERMINED BY HUMAN RESOURCES IN ACCORDANCE WITH TRIHEALTH, INC. POLICY. PAYMENTS OF SEVERANCE ARE CONDITIONED UPON SIGNING A SEPARATION AND RELEASE AGREEMENT. DURING THE 2016 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: BRYAN HEHEMANN - $167,456 DWIGHT ELLINGWOOD - $136,338 |
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 | BUTLER COUNTY-SERIES 2015 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316000061 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2015-09-29 | BondIssuedDt |
| Issue Price | $9,320,000 | IssuePriceAmt |
| Purpose | REFUNDING OF 2009 SERIES | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $9,320,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $146,198 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $33,454 | WorkingCapitalExpendituresAmt |
| Other Spent Proceeds | $9,140,348 | OtherSpentProceedsAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | DURING THE INTERVALS BETWEEN BOARD OF DIRECTORS MEETINGS, THE EXECUTIVE COMMITTEE SHALL, SUBJECT TO SECTIONS 5.07, 7.04 AND 7.05 OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S CODE OF REGULATIONS, POSSESS AND MAY EXERCISE ALL THE POWERS AND FUNCTIONS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT AND DIRECTION OF THE AFFAIRS OF THE CORPORATION IN MATTERS OF URGENCY WHICH REQUIRE ACTION BETWEEN REGULARLY SCHEDULED OR SPECIAL MEETINGS OF THE BOARD OF DIRECTORS. ALL ACTIONS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD OF DIRECTORS AT ITS NEXT MEETING SUCCEEDING SUCH ACTION. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR AND FOUR (4) ADDITIONAL BOARD MEMBERS ELECTED TO THE COMMITTEE BY THE BOARD OF DIRECTORS SUCH THAT THE EXECUTIVE COMMITTEE SHALL CONSIST OF A PERCENTAGE OF TRIHEALTH-APPOINTED DIRECTORS AND TRUST-APPOINTED DIRECTORS CONSISTENT WITH COMPOSITION OF THE BOARD OF DIRECTORS (I.E. TRIHEALTH, INC.-60% AND MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST-40%). THE CEO OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL SHALL BE A MEMBER, EX OFFICIO, WITHOUT A VOTE. THE BOARD CHAIR SHALL CHAIR THE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 2 | JAMES FORMAL, ALAN OAK, HILLARY EVANS, MD AND JOHN HARLAN, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST, ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF TRIHEALTH, INC., ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. AS WELL AS, SITTING ON THE BOARDS OF DIRECTORS OF BETHESDA HOSPITAL, INC., THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE AND TRIHEALTH HOSPITAL, INC., ALL AFFILIATED ENTITIES OF TRIHEALTH, INC. MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF BETHESDA FOUNDATION, INC., AN AFFILIATED ENTITY. MARK CLEMENT, GAIL DONOVAN, ROBERT COLLINS, MD, AND MICHAEL CROFTON HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF BEING EMPLOYEES OF TRIHEALTH, INC., ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 6 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL HAD TWO (2) CLASSES OF MEMBERS. THE FIRST CLASS CONSISTS SOLELY OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST OR ITS PERMITTED SUCCESSOR (40%). THE SECOND CLASS CONSISTS SOLELY OF TRIHEALTH, INC. OR ITS PERMITTED SUCCESSOR (60%). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF MHMH SHALL CONSIST OF TEN (10) INDIVIDUALS APPOINTED BY THE MEMBERS IN ACCORDANCE WITH THEIR RESPECTIVE MEMBERSHIP INTERESTS IN MHMH. FOUR (4) DIRECTORS SHALL BE APPOINTED EXCLUSIVELY BY THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST (THE "TRUST APPOINTED DIRECTORS"). THE TRUST APPOINTED DIRECTORS SHALL BE SELECTED SOLELY BY THE MCCULLOUGH-HYDE MEMORIAL TRUST AND MAY INCLUDE PERSONS WHO ARE TRUSTEES OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST, PHYSICIANS, MEMBERS OF THE COMMUNITY AND SUCH OTHER PERSONS AS THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST DETERMINES APPROPRIATE, BUT WITH NO MINIMUM REPRESENTATION OF ANY STAKEHOLDERS. IN MAKING SUCH DETERMINATION, THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST SHALL CONSIDER (TOGETHER WITH SUCH OTHER FACTORS, AS DEEMED APPROPRIATE) THE VALUE OF A PHYSICIAN ON THE MEDICAL STAFF OF MHMH BEING ON THE BOARD OF DIRECTORS. SIX (6) DIRECTORS SHALL BE APPOINTED EXCLUSIVELY BY TRIHEALTH, INC. (THE "TRIHEALTH APPOINTED DIRECTORS"). THE TRIHEALTH APPOINTED DIRECTORS SHALL BE SELECTED SOLELY BY TRIHEALTH, INC. AND MAY INCLUDE ITS SENIOR MANAGEMENT, PHYSICIANS, MEMBERS OF THE COMMUNITY AND SUCH OTHER PERSONS AS TRIHEALTH, INC. DETERMINES APPROPRIATE, WITH NO MINIMUM REPRESENTATION OF ANY STAKEHOLDER. THE MEMBERS SHALL RECEIVE RECOMMENDATIONS FROM THE GOVERNANCE AND NOMINATING COMMITTEE FOR FILLING ANY VACANCIES ON THE BOARD OF DIRECTORS DUE TO EXPIRATION OF TERMS OR FOR ANY OTHER REASON; HOWEVER, THE COMMITTEE SHALL NOT EXERCISE ANY POWER OR AUTHORITY OVER THE BOARD OF DIRECTORS OR THE MEMBERS AND THE MEMBERS RETAIN THE EXCLUSIVE RIGHT TO APPOINT THE BOARD OF DIRECTORS. EACH DIRECTOR SHALL SERVE FOR A TERM OF FOUR (4) YEARS AND SERVE NO MORE THAN TWO CONSECUTIVE TERMS, HOWEVER, THE TRIHEALTH CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS AND MANAGEMENT PERSONNEL OF TRIHEALTH WHO SERVE AS TRIHEALTH APPOINTED DIRECTORS MAY SERVE AN UNLIMITED NUMBER OF TERMS AS A DIRECTOR. ANY DIRECTOR MAY RESIGN AT ANY TIME BY GIVING WRITTEN NOTICE TO THE BOARD OF DIRECTORS AND THE MEMBER WHICH APPOINTED THE DIRECTOR. ANY DIRECTOR MAY BE REMOVED FROM OFFICE, WITH OR WITHOUT CAUSE, BY THE MEMBER WHICH APPOINTED THE DIRECTOR AT ANY TIME. THE RESIGNATION OR REMOVAL OF A DIRECTOR SHALL BE DEEMED TO CREATE A VACANCY ON THE BOARD, WHICH WILL BE FILLED BY THE MEMBER APPOINTING A SUCCESSOR TO SERVE THE BALANCE OF THAT DIRECTOR'S TERM. |
| FORM 990, PART VI, SECTION A, LINE 7B | EACH MEMBER OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") SHALL HAVE ALL RIGHTS AFFORDED TO MEMBERS OF NONPROFIT CORPORATIONS UNDER SECTION 1702 OF THE OHIO REVISED CODE, AS AMENDED. NOTWITHSTANDING ANY OTHER PROVISION OF THIS CODE OR OF OHIO LAW, MHMH SHALL HAVE NO POWER OR AUTHORITY TO TAKE ANY ACTION DESCRIBED IN SECTION 3.02 OF ITS CODE OF REGULATIONS WITHOUT PRIOR CONSENT, EXPRESSED IN WRITING AND FILED WITH THE SECRETARY OF MHMH AS PART OF THE ITS MINUTES, OF BOTH MEMBERS. THE FOLLOWING MATTERS SHALL BE SUBJECT TO UNANIMOUS APPROVAL OF THE MEMBERS: A) ANY ACTION WHICH INTENTIONALLY AFFECTS THE STATUS OF MHMH AS AN ORGANIZATION EXEMPT FROM FEDERAL TAXATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE IRC; B) ANY CHANGES TO THE EXISTING MISSION, VISION AND VALUES STATEMENT OF MHMH, AS REVISED; C) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION; D) ANY AMENDMENT TO THIS CODE OF REGULATIONS THAT AFFECTS THE RIGHTS OF EITHER MEMBER INDIVIDUALLY, OR THE MEMBERS COLLECTIVELY, THE SPECIAL VOTING MATTERS, AS DEFINED IN ARTICLE V HEREOF, OR THE RIGHTS, RESPONSIBILITIES, POWER AND AUTHORITY OF THE BOARD OF DIRECTORS, THE TRIHEALTH APPOINTED DIRECTORS OR THE TRUST APPOINTED DIRECTORS; E) ANY SALE, TRANSFER, OR OTHER DISPOSITION OF ASSETS OF THE CORPORATION WITH A NET BOOK VALUE WHICH IS IN EXCESS OF 40% OF THE NET VALUE OF THE CORPORATION'S ASSETS, WITHIN ANY PERIOD OF THREE (3) CONSECUTIVE FISCAL YEARS. FOR THE PURPOSE OF CALCULATING THE 40% THRESHOLD, THE ASSETS TRANSFERRED SHALL BE VALUED AT THEIR NET BOOK VALUE AND THE PERCENTAGE SHALL BE MEASURED BY REFERENCE TO MHMH'S TOTAL NET ASSETS AS OF THE END OF FISCAL QUARTER PRIOR TO THE FIRST TRANSFER OF ANY THREE-YEAR MEASUREMENT PERIOD; F) ANY TRANSFER, SALE, OR OTHER DISPOSITION OF EITHER MEMBER'S MEMBERSHIP INTEREST IN MHMH OTHER THAN TO A CONTROLLED AFFILIATE OF THE MEMBER THAT IS AN ENTITY DESCRIBED IN SECTION 501(C)(3) OF THE IRC. G) EXCEPT AS SET FORTH IN SECTION 11.3 OF THE AFFILIATION AGREEMENT, ANY ACTION THAT (I) WOULD CAUSE MHMH TO BE SUBJECT TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (THE "ERDS"), (II) THE EFFECT OF WHICH IS TO CONVERT MHMH FROM ITS NONSECTARIAN STATUS INTO A FAITH-BASED OR RELIGIOUSLY-AFFILIATED HOSPITAL, OR (III) WHICH WOULD RESTRICT THE SERVICES PROVIDED BY MHMH IN A MANNER WHICH WOULD BE REQUIRED IF MHMH WERE SUBJECT TO THE ERDS; H) ANY CONTRIBUTION TO CAPITAL BY EITHER MEMBER (OTHER THAN AS CONTEMPLATED BY SECTIONS 4.2 AND 4.3 OF THE AFFILIATION AGREEMENT), OR THE LOAN OF $1.0 MILLION OR MORE TO MHMH MADE OR GUARANTEED BY ANY MEMBER OR ANY AFFILIATE OF ANY MEMBER; AND I) THE STANDARD AS TO WHAT CONSTITUTES A "MATERIAL AMENDMENT OR VARIATION" FROM AN APPROVED ANNUAL BUDGET (AS CONTEMPLATED IN SECTION 3.04(E) OF MHMH'S CODE OF REGULATIONS). IN ADDITION, THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST SOLELY SHALL HAVE THE POWER TO APPROVE ANY ACTION OF MHMH THAT WOULD NOT BE CONSISTENT WITH THE 1966 ORDER OF THE BUTLER COUNTY COMMON PLEAS COURT OR THE 1989 ORDER OF THE BUTLER COUNTY PROBATE COURT RELATING TO THE IT. TRIHEALTH, INC. SHALL HAVE SOLE AUTHORITY TO APPROVE THE FOLLOWING MATTERS, AFTER RECEIVING A RECOMMENDATION FROM THE BOARD OF DIRECTORS (OR, IN THE CASE OF THE APPOINTMENT OF THE CEO, THE CEO SELECTION COMMITTEE): A) APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"); B) TERMINATION OF THE CEO; C) AN INITIAL FIVE-YEAR FINANCIAL PLAN ("THE "FINANCIAL PLAN") FOR MAINTAINING AND IMPROVING THE KEY FINANCIAL INDICATORS OF MHMH(ON A STAND-ALONE BASIS) IN A MANNER DETERMINED TO BE IN MHMH'S BEST INTERESTS CONSISTENT WITH PRUDENT HOSPITAL OPERATIONS. THE KEY FINANCIAL INDICATORS INCLUDED IN THE FINANCIAL PLAN WILL BE SELECTED BASED ON INDICATORS REPORTED BY RATING AGENCIES IN THEIR HOSPITAL METRIC REPORTS; D) ANNUAL CAPITAL AND OPERATING BUDGETS FOR MHMH; E) ANY MATERIAL AMENDMENT OR DEVIATION FROM AN APPROVED CAPITAL OR OPERATING BUDGET; AND F) ANY AMENDMENT OF THE FINANCIAL PLAN OR ACTION THAT WOULD CAUSE A DEVIATION FROM THE FINANCIAL PLAN SUCH THAT THE KEY FINANCIAL INDICATORS SPECIFIED IN THE FINANCIAL PLAN ARE NOT PROJECTED TO BE ATTAINED. EXCEPT AS SPECIFIED IN SECTION 7.02(E) OF MHMH'S CODE OF REGULATIONS, TRIHEALTH, INC. MAY APPROVE SUCH ACTION AS IT SEES FIT AFTER RECEIVING THE RECOMMENDATION OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE, FOR REVIEW AND APPROVAL PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE CERTAIN FINANCIAL INTERESTS AND FIDUCIARY RELATIONSHIPS. THE EXECUTIVE COMMITTEE AND CORPORATE COUNSEL REVIEW RESPONSES, CONDUCT FURTHER INVESTIGATION, IF NECESSARY, AND DETERMINE WHEN A CONFLICT EXISTS WITH RESPECT TO A CERTAIN TRANSACTION. IF A CONFLICT EXISTS, THE TRANSACTION IS NOT TO BE ENTERED INTO UNLESS ALTERNATIVES ARE FULLY INVESTIGATED AND, IN THEIR ABSENCE, THE BOARD, WITHOUT PARTICIPATION OF THE INTERESTED MEMBER(S), DETERMINES THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. PLANS TO MANAGE THE CONFLICT DURING THE RELATIONSHIP ARE IMPLEMENTED. ALL DISCUSSIONS ARE APPROPRIATELY DOCUMENTED. ALL DIRECTORS AND MANAGERS, WHICH INCLUDE OFFICERS AND KEY EMPLOYEES, ARE REQUIRED TO ANNUALLY DISCLOSE ANY CIRCUMSTANCES, INCLUDING FAMILY AND BUSINESS RELATIONSHIPS, THAT MAY CAUSE A CONFLICT OF INTEREST FOR THE ORGANIZATION. THESE RESPONSES ARE REVIEWED AND ACTED UPON BY A CONFLICT OF INTEREST COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, THE FINANCIAL STATEMENTS ARE PRESENTED TO THE CITY COUNCIL OF OXFORD ANNUALLY AT A MEETING THAT IS OPEN TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | CAPITAL CONTRIBUTION 46,932. |
| FORM 990, PART XII, LINE 2C | THE FINANCIAL STATEMENTS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ARE AUDITED AS PART OF TRIHEALTH, INC. AND ITS SUBSIDARIES AND AFFILIATES ("TRIHEALTH"). TRIHEALTH HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES AND AFFILIATES FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF THE INDEPENDENT AUDITOR. DURING THE TAX YEAR, THERE WAS NOT A CHANGE IN THE PROCESS OF AUDIT OVERSIGHT AND/OR SELECTION OF AN INDEPENDENT AUDITOR BY TRIHEALTH. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TRIHEALTH INC | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311438846 | SUPPORT TO AFFILIATED HOSPITALS | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 12B | N/A | 0 | |
| MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND | |||||||||||
| 110 NORTH POPLAR | OXFORD | OH | 45056 | 237374256 | OBTAIN CHARITABLE CONTRIBUTIONS, MANAGE THEM AND DISBURSE BY BOARD | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 12C | N/A | 0 | |
| GOOD SAMARITAN HOSPITAL FREE CLINIC | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 273893817 | HEALTHCARE SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 7 | Yes (1) | TRIHEALTH INC | |
| TRIHEALTH PHYSICIAN ENTERPRISE CORP | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311383365 | PHYSICIAN PRACTICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 10 | Yes (1) | TRIHEALTH INC | |
| TRIHEALTH PHYSICIAN INSTITUTE | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311074519 | PHYSICIAN PRACTICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 10 | Yes (1) | TRIHEALTH INC | |
| BETHESDA HOSPITAL INC | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 310537122 | INPATIENT AND OUTPATIENT SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 3 | 0 | TRIHEALTH INC | |
| BETHESDA HEALTHCARE INC | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311027660 | HEALTHCARE SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 12B | Yes (1) | BETHESDA INC | |
| BETHESDA FAMILY PRACTICE CENTER | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311242442 | HEALTHCARE SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 12A | Yes (1) | BETHESDA HOSPITAL INC | |
| BETHESDA PROPERTIES INC | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311352694 | PROPERTY MANAGEMENT | OH | SECTION 501(C)(2) | Yes (1) | BETHESDA HOSPITAL INC | ||
| HOSPICE OF CINCINNATI INCORPORATED | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 310917155 | HOSPICE SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 10 | Yes (1) | BETHESDA HOSPITAL INC | |
| FERNSIDE INC A CENTER FOR GRIEVING CHILDREN | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311179234 | COUNSELING TO GRIEVING CHILDREN | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 7 | Yes (1) | HOSPICE OF CINCINNATI INCORPORATED | |
| THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 310537486 | INPATIENT AND OUTPATIENT SERVICES | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 3 | 0 | TRIHEALTH INC | |
| GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311778403 | EDUCATION | OH | SECTION 501(C)(3) | SCHEDULE A, LINE 2 | Yes (1) | THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO | |
| COMMUNITY LIMITED CARE DIALYSIS CENTER | |||||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 237419853 | DIALYSIS | OH | SECTION 501(C)(2) | Yes (1) | THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE SOLUTIONS NETWORK LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 619 OAK STREET | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472103334 | EIN |
| Primary Activities | PHYSICIAN HOSPITAL ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| TRIHEALTH PHYSICIANS OF INDIANA INC | |||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 461125130 | PHYSICIAN PRACTICES | OH | N/A | C | Yes (1) |
| TRIHEALTH PHYSICIAN SOLUTIONS INC | |||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 311444353 | CLAIMS ADMINISTRATION | OH | N/A | C | Yes (1) |
| TRIHEALTH CIPHO INC | |||||||||
| 619 OAK STREET-ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 463294306 | PHYSICIAN HEALTH ORGANIZATION | OH | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| TRIHEALTH PHYSICIAN ENTERPRISE CORP | ||
| A | $142,466 | FMV |
| TRIHEALTH INC | ||
| M | $1,002,411 | COST |
| TRIHEALTH INC | ||
| P | $26,076,253 | COST |