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        <BookValueAmt>2059676</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>64381581</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>34030777</DepreciationAmt>
        <BookValueAmt>30350804</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>46131349</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>37358026</DepreciationAmt>
        <BookValueAmt>8773323</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>2452191</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2452191</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>43635994</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>INTEREST IN FOUNDATION'S ASSET</Desc>
        <BookValueAmt>9528000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Other A/R</Desc>
        <BookValueAmt>155967</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Meaningful Use</Desc>
        <BookValueAmt>308000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Accrued Interest</Desc>
        <BookValueAmt>22233</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deposits</Desc>
        <BookValueAmt>483652</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Other Assets</Desc>
        <BookValueAmt>535314</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Estimated Third-Party Settlements</Desc>
        <BookValueAmt>1311328</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Financing Costs</Desc>
        <BookValueAmt>134621</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>12479115</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>income guarantee</Desc>
        <Amt>83250</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>83250</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The endowment funds were established for a variety of purposes. The endowment funds consist of four separate funds, including the mary keiser Hospice Fund, the ruth health and equipment fund, the ross home health care and hospice fund, and the crimm fund for surgical equipment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken and recognize a tax liability if an uncertain position has been taken that more likely than not would not be sustained upon examination by various federal and state taxing authorities. Management has analyzed the tax positions taken by these entities and has concluded that as of December 31, 2016 and 2015, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the accompanying financial statements. The entities are subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <FinancialAssistancePolicyInd>1</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>1</WrittenPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <Percent100Ind>X</Percent100Ind>
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      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>0</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>991790</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>548227</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>443563</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00450</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>15141075</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>11242489</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>3898586</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03960</TotalExpensePct>
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      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>16132865</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>11790716</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4342149</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04410</TotalExpensePct>
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      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>103165</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>103165</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00100</TotalExpensePct>
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      <TotalOtherBenefitsGrp>
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        <NetCommunityBenefitExpnsAmt>103165</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00100</TotalExpensePct>
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      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>16236030</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>11790716</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>4445314</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04510</TotalExpensePct>
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      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>5572602</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>1160464</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>18060580</ReimbursedByMedicareAmt>
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      <MedicareSurplusOrShortfallAmt>-4413740</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
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      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>1 WILSON SLEEP LLC</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>sleep studies</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.60000</OrgProfitOrOwnershipPct>
        <OfcrEtcProfitOrOwnershipPct>0.00000</OfcrEtcProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.40000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>2 HONDA HEALTH PARTNERS</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>PROVIDING OCCUPATIONAL HEALTH SERVICES TO HONDA</PrimaryActivitiesTxt>
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      <HospitalFacilitiesGrp>
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        <BusinessName>
          <BusinessNameLine1Txt>SHELBY COUNTY MEMORIAL HOSPITAL ASSOC</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>915 w michigan street</AddressLine1Txt>
          <CityNm>sidney</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45365</ZIPCd>
        </USAddress>
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        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>THE SHELBY COUNTY MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>16</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>1</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>0</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>http://www.wilsonhealth.org/community-health-needs-assessment</OwnWebsiteURLTxt>
        <OtherWebsiteInd>X</OtherWebsiteInd>
        <OtherWebsiteURLTxt>HTTP://SHELBYCOUNTYHEALTHDEPT.ORG</OtherWebsiteURLTxt>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>16</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>http://www.wilsonhealth.org/community-health-needs-assessment</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>http://www.wilsonhealth.org/patient-visitor-information</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>http://www.wilsonhealth.org/patient-visitor-information</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>HTTP://WWW.WILSONHEALTH.ORG/PATIENT-VISITOR-INFORMATION</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <OtherActionsTakenInd>X</OtherActionsTakenInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>1</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 5: Representatives from 3 healthcare systems (representing 13 hospitals) met twice in person and held four conference calls in the fall of 2015. Primary data collection involved interviews of public health officials, online and paper surveys, and community focus groups. There were 4 distinct stakeholder groups with separate analysis for comparison: 1) consumers and organizations which attended focus group meetings, 2) individuals surveyed, 3) organizations surveyed, and 4) health departments. In total, 629 people provided input for the regional Community Health Needs Assessment process.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 6a: Kettering Health Network (Fort Hamilton Hospital, Grandview Medical Center, Greene Memorial Hospital, Kettering Medical Center, Soin Medical Center, Southview Medical Center, Sycamore Medical Center); Premier Health (Atrium Medical Center, Good Samaritan Hospital, Miami Valley Hospital, Miami Valley South Hospital, Upper Valley Medical Center)</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 6b: Representatives from 3 healthcare systems (representing 13 hospitals) met twice in person and held four conference calls in the fall of 2015. Primary data collection involved interviews of public health officials, online and paper surveys, and community focus groups. There were 4 distinct stakeholder groups with separate analysis for comparison: 1) consumers and organizations which attended focus group meetings, 2) individuals surveyed, 3) organizations surveyed, and 4) health departments. In total, 629 people provided input for the regional Community Health Needs Assessment process.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 11: ACCESS TO CARE: Open an After Hours Clinic in 2017 that will extend clinic hours and is integrated into Wilson Health Medical Group (WHMG) to provide opportunities for unattached patients to seek ongoing care with a provider. DIABETES/CHRONIC DISEASE; HEART DISEASE; OBESITY: Increase awareness through community educational events including partnering with the Sidney-Shelby County YMCA for the YMCA's Diabetes Prevention Program. Support of the Health YOUth Clinic developed by pediatrician Dr. Rabia Akbar that allows patients age 2-18 access to a clinical team (WHMG Pediatrics, Wilson Health Physical Therapy Services, and Wilson Health Nutrition Services) dedicated to addressing barriers and goal setting to achieve healthy weight. Partner with the Sidney-Shelby County Health Department for the Healthy Family Backpack Program which incorporates the national 5-2-1-0 campaign message where children take home a backpack containing a healthy message children's book and a folder with nutrition education, easy healthy recipes, and portion control information designed to set healthy goals. SUBSTANCE ABUSE; MENTAL HEALTH: Implement during the fall of 2016 the BABY &amp; ME Tobacco Free program which is a smoking cessation program created to reduce the burden of tobacco use on the pregnant and post-partum population. To increase youth awareness and prevention efforts in Shelby County High Schools by partnering with The Herron Project and implementing the Project Purple Initiative (a student driven program that empowers youth to stand up and make a difference).CANCER: Build a comprehensive cancer care center in Shelby County to better educate, prevent, diagnose and treat patients in the Shelby County community.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 16j: Signs at registration as well as information added to the front of the statement to make those utilizing services aware.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 20e: Notified patients of the financial assistance policy on admissionNotified patients of the financial assistance policy prior to discharge</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>THE SHELBY COUNTY MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 24: All Patients are charged the gross amount and a discount is applied for those that qualify.Wilson Health limits the amounts charged for emergency and medically necessary services provided to individuals eligible for assistance under this Policy to not more than the amounts generally billed to individuals who have insurance coverage for such care. The AGB is derived by dividing (1) the sum of all claims for Medically Necessary services provided at Wilson Health and paid during the relevant period by Medicare fee-for-service and all private health insurers as primary payers, together with any associated portions of these claims paid by Medicare beneficiaries or insured individuals in the form of co-pays, co-insurance or deductibles, by (2) the charges set forth in the Wilson Health Chargemaster at the time the services are rendered. Wilson Health-Specific AGB Percentage shall be calculated annually for a twelve (12) month period from January 1 to December 31 and allows 120 days for such calculation to be made and updated in the FAP. The calculation of the Hospital-Specific AGB Percentage shall comply with the "look-back method" described in the IRS Regulation 501(r)-5(b) (1) (B).</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>2</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - WILSON HOME HEALTH AND HOSPICE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1081 fairington street</AddressLine1Txt>
            <CityNm>sidney</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45365</ZIPCd>
          </USAddress>
          <FacilityTxt>home health</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - wilson sleep llc</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>915 west michigan street</AddressLine1Txt>
            <CityNm>sidney</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45365</ZIPCd>
          </USAddress>
          <FacilityTxt>sleep services</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Community Building Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>n/a</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>pdf PAGE 13 OF THE FINANCIAL STATEMENTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>The elderly are often an underserved population that experience issues regarding access to healthcare services. Medicare is our largest payer, and hospitals must accept Medicare patients regardless of whether they have a surplus or deficit from providing these services. Providing Medicare services promotes access to healthcare services which is a community benefit. If tax exempt hospitals did not provide Medicare services, the Federal Government would bear the burden of directly providing services to the Medicare eligible. The source used to determine the amount of Medicare allowable costs reported for Part III, Section B, Medicare has been provided from the Year Ended 12/31/16 report: Hospital Statement of Reimbursable Cost.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>In order for the Hospital to continue operating efficiently, the following collection policy has been adopted.A. Each patient/guarantor is individually responsible for payment of all charges unless his/her third-party payer has a contract with the hospital.B. The hospital will accept assignment of health insurance benefits for Medicare, Medicaid, Tricare, and others per individual contract.1. Deductible, co-insurance, or non-covered services are payable at the time of service unless financial arrangements have been made with the Financial Advisor.2. Any balance after the application of health insurance payments to the patient's account is to be paid within thirty (30) days following notification. If paid within 30 days of receipt of first statement, patient is eligible for a 10% discount on the balance of the bill.3. The Hospital will accept Master Card, Visa, and Discover charge cards for payments on patient accounts.4. Payments or arrangement for payment plans are to commence within thirty (30) days of bill date. 5. Patients are asked to "pay in full" however, if the patient/guarantor indicates an inability to make payment in full, the patient/guarantor will be given the option to establish a contract account with Wilson Memorial Hospital.A monthly contract account can be established. The monthly agreement must be set up so that the entire amount will be paid off in twelve months, unless otherwise approved by Director of Patient Financial Services. No monthly payment will be less than $25.00If the patient or any family member of the responsible party or guarantor's family is currently paying on a bill and has need of the hospital's services again, the payment must then be adjusted upwards to reflect the next balance due.Wilson Memorial Hospital employees, along with their spouse and children under the age of eighteen, who indicate difficulty in meeting payment obligations on their account are given the option to make monthly payments, or have payments deducted from their pay check. (Payroll Deduction Program)Payment on the accounts not received according to the above provision will be subject to becoming a "Delinquent Account". Actions taken by the hospital toward such accounts will be at the Hospital's discretion.The hospital retains the right to refer the patient's delinquent accounts to a professional collection agency.The first statement a patient receives will be sent out by Wilson Hospital. If within 30 days there has been no payment on the account, it will be sent to our Early Out Program. They will act as a Wilson Memorial Financial Advisor and receive a percentage of the account if any payment is made to them. If the Early Out agency cannot collect on the accounts, they are sent back to the hospital to be sent to one of 3 Collection Agencies.Director of Patient Financial Services must approve all accounts sent to the Collection Agency and must approve any Legal Action that is suggested by the Collection agency.Wilson Memorial Hospital is required by law to give "Free Care"to those persons who are eligible based on state statutes.Wilson Memorial Hospital has a Charity Care Policy for those eligible who cannot afford to pay for care. The current federal poverty income guidelines will be used to determine eligibility of the patient.Any Hospital services resulting from an accident or other causes involving a dispute as to liability between the patient and others, does not involve the Hospital. The Hospital will expect payment in the same manner as all other services. The Hospital will accept a Letter Of Protection for a duration of 90 days. After 90 days the Hospital will actively pursue the patient or guarantor for payment of rendered services.Exceptions to the above items can be made with the approval of the Director of Patient Financial Services. All unusual arrangements and circumstances are reviewed and approved by the Vice President of Finance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Sch H Pt V, line 22</FormAndLineReferenceDesc>
        <ExplanationTxt>In fulfilling Wilson Memorial Hospital's Mission, we recognize that we will not receive payment from certain individuals for care that has been rendered, and a certain degree of judgment will be required in determining Charity Care levels of the patients.POLICYWilson Memorial Hospital is a not-for-profit entity established to meet the health care needs of all citizens of Sidney and surrounding communities. Wilson Memorial Hospital will provide charitable care for those individuals who can demonstrate the inability to pay based on their financial status as it relates to Hospital and Federal Poverty Level Guidelines.RESPONSBILITYThe Hospital has a legal and moral obligation to provide Emergency, Trauma and Obstetrical Care before determining the source of payment.ELIGIBILITY REQUIREMENTSI. All Wilson Memorial Hospital patients who are unable to pay for hospital services will be eligible to apply for charity assistance.II. Charity assistance may be approved on total or partial patient responsibility. Dollar amounts are based on financial information supplied by the patient.III. Patients will be eligible for total charity assistance if:A. The patient is ineligible for public assistance (Medicaid, General Assistance, etc.).B. The patient completes a financial statement indicating current earnings, expenses and personal/family information. We will accept the patient's declaration of income.C. The patients and/or family income does not exceed 1.25 times the poverty guidelines as established by the U.S. Department of Health and Human Services.IV. Patients will be eligible for partial charity assistance if:A. The patient is ineligible for public assistance (Medicaid, General Assistance, etc.) either or partial coverage.B. The patient completes a financial statement indicating current earnings, expenses and personal/family information. We will accept the patient's declaration of income.C. The patients and/or family income does not exceed three times the poverty guidelines as established by the U.S. Department of Health and Human Services.D. The patient and/or family income exceeds three times the income poverty/guidelines, determination of eligibility and amount of charity care will be based on financial statement from patient on an account by account basis.V. Patients may not be eligible for charity care assistance if the procedure provided is elective. Each instance will be reviewed on a case by case basis with medical staff and management input.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ANNUAL STRATEGIC PLANNING PROCESS UTILIZES MARKET DATA WHICH SHOWS SERVICES THAT SHELBY COUNTY RESIDENTS LEAVE TO OBTAIN ELSEWHERE. INPUT IS PROVIDED BY COMMUNITY MEMBERS WHO SIT ON HOSPITAL BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>Income eligiblity guidelines are conspicuously posted at all registration points. In addition, the guidelines are printed on patient statements and bills. The hospital employs financial counselors who meet personally and by phone with patients to assist them in completing forms to determine the extent of their eligiblity for any financial assistance.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The primary service area is Shelby and surrounding counties. With the exception of Miami county to the south all of the service area is considered ruraL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Shelby County Memorial Hospital Association's Board of Trustees is comprised of volunteers from our community. The majority of our Board members live and work within the community and are actively involved with other non-profit agencies. The majority of our Senior Managers and staff also live in our primary service area and many sit on other community based governance boards. The "spirit" of community based healthcare resides in our Board of Trustees and Hospital staff and is further evidenced by our open medical staff.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JULIE RESSLER</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANTHONY BEARDMORE</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Part I, Line 1A: THE HOSPITAL PAYS A REC BONUS FOR DUES FOR MR. DOOLEY, THE PRESIDENT/CEO, FOR Club Membership. The amount is included in his taxable salary.</ExplanationTxt>
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    </IRS990ScheduleJ>
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          <PersonNm>rudy keister</PersonNm>
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        <TransactionDesc>insurance services</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>andy counts</PersonNm>
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        <RelationshipDescriptionTxt>hospital trustee is regional vp at us bank</RelationshipDescriptionTxt>
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        <TransactionDesc>banking services</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>john deeds</PersonNm>
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        <RelationshipDescriptionTxt>hospital trustee is partner in faulkner, garmhausen, keister &amp; shenk</RelationshipDescriptionTxt>
        <TransactionAmt>28095</TransactionAmt>
        <TransactionDesc>legal services</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>the return will be reviewed by the board of trustees prior to submission.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>any duality of interest or possible conflict of interest on the part of any governing board member should be disclosed to the other members of the board and made a matter of record, either through the annual procedure or when the interest becomes a matter of board action. any governing board member having a duality of interest or possible conflict of interest on any matter should not vote or use his personal influence on the matter, and the person shall not be counted in determining the quorum of the meeting. the minutes of the meeting shall reflect that a disclosure was made, the abstention from voting, and the quorum situation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>the HR committee of the Board conducts an annual evaluation process involving input from Board member, Senior Managers and Medical Staff. Compensation is benchmarked with surveys from like sized Healthcare Organizations. The Board of Trustees approves the CEO compensation package annually.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>the documents are made available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Purchased Services: Program service expenses 13,549,705. Management and general expenses 1,888,036. Fundraising expenses 0. Total expenses 15,437,741.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>transfers -347,423.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMITTEE THAT ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE CURRENT TAX YEAR.</ExplanationTxt>
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          <BusinessNameLine1Txt>Wilson Care LLC</BusinessNameLine1Txt>
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          <AddressLine1Txt>915 W Michigan Street</AddressLine1Txt>
          <CityNm>Sidney</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45365</ZIPCd>
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        <EndOfYearAssetsAmt>2577384</EndOfYearAssetsAmt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>WILSON MEMORIAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
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          <CityNm>sidney</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
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        <EIN>521771615</EIN>
        <PrimaryActivitiesTxt>supporting hospital activities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12a, I</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SLEEP LAB LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
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          <CityNm>sidney</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
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        </USAddress>
        <PrimaryActivitiesTxt>sleep lab studies</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>shelby county memorial hospital</BusinessNameLine1Txt>
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        <PredominantIncomeTypeTxt>related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>349962</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>180732</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
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      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>