STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

THE CITY HOSPITAL ASSOCIATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
THE CITY HOSPITAL ASSOCIATION (EIN 34-0714583)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201643209349313409
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T15:50:22-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Blue & Co LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18800 Lyra Drive Suite 450AddressLine1Txt
CityColumbusCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43240ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN340714583EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1City Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCITYBusinessNameControlTxt
Phone3303857200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 West Fifth StreetAddressLine1Txt
CityEast LiverpoolCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43920ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTARUN GHOSHPersonNm
Person TitleCFOPersonTitleTxt
Phone3303857200PhoneNum
Signature2016-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMatthew DastaPreparerPersonNm
PTINP00544683PTIN
Phone6148852583PhoneNum
Preparation2016-11-15PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1east liverpool city hospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTARUN GHOSHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 West Fifth StreetAddressLine1Txt
CityEast LiverpoolCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43920ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$54,486,871GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ELCH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1905FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION IS ORGANIZED AND OPERATED TO PROVIDE THE PEOPLE OF THE TRI-STATE AREA HIGH QUALITY HEALTH CARE SERVICES, REGARDLESS OF THE PERSON'S ABILITY TO PAY. THESE SERVICES INCLUDE THE PREVENTION OF ILLNESS, RELIEF OF SUFFERING, HEALTH RESTORATION, AND HEALTH CARE EDUCATION.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,490PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$60,262,469PYProgramServiceRevenueAmt
CY Program Service Revenue$51,105,500CYProgramServiceRevenueAmt
PY Investment Income$1,117,908PYInvestmentIncomeAmt
CY Investment Income$884,368CYInvestmentIncomeAmt
PY Other Revenue$4,089,732PYOtherRevenueAmt
CY Other Revenue$2,497,003CYOtherRevenueAmt
PY Total Revenue$65,473,599PYTotalRevenueAmt
CY Total Revenue$54,486,871CYTotalRevenueAmt
PY Grants And Similar Paid$106,067PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$25,994CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$28,800,867PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,726,704CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$43,600,914PYOtherExpensesAmt
CY Other Expenses$40,054,704CYOtherExpensesAmt
PY Total Expenses$72,507,848PYTotalExpensesAmt
CY Total Expenses$66,807,402CYTotalExpensesAmt
PY Revenues Less Expenses-$7,034,249PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$12,320,531CYRevenuesLessExpensesAmt
Total Assets BOY$92,365,159TotalAssetsBOYAmt
Total Assets EOY$68,944,950TotalAssetsEOYAmt
Total Liabilities BOY$41,678,880TotalLiabilitiesBOYAmt
Total Liabilities EOY$36,584,683TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$50,686,279NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$32,360,267NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWe will provide high quality, compassionate health care services within the available resources. Healthcare services will be provided to prevent illness, relieve suffering, aid in health restoration and to promote wellness. we will provide services to any person, without discrimination.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescCITY HOSPITAL ASSOCIATION DBA EAST LIVERPOOL CITY HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO AFFORD ESSENTIAL MEDICAL SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY WITH FREE CARE AND OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COSTS, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY HAVE BEEN CONSIDERED WHERE THE NEED AND AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL CONSIDERS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. THE HOSPITAL IS LOCATED IN EAST LIVERPOOL, OHIO AND SERVICES THE SURROUNDING COMMUNITIES; STAFFING 158 BEDS FOR ACUTE CARE, INTENSIVE CARE, NURSERY, AND SKILLED NURSING IN THIS MEDICALLY UNDERSERVED AREA.DURING 2015, THE HOSPITAL PROVIDED NUMEROUS BENEFITS TO THE SURROUNDING COMMUNITY, INCLUDING FINANCIAL SUPPORT THROUGH THE COMMUNITY BENEFIT INITIATIVE PROGRAM.COMMUNITY BENEFIT INITIATIVE - THE HOSPITAL PROVIDED FINANCIAL SUPPORT TOTALING $25,994 TO LOCAL PROGRAMS.COMMUNITY EDUCATION AND WELLNESS PROGRAMS - THE HOSPITAL OFFERED THE FOLLOWING TO THE COMMUNITY FREE OR AT A NOMINAL CHARGE:HEALTH FAIRSCPR CLASSESCHILDBIRTH CLASSESGARFIELD ELEMENTARY WELLNESS PROGRAMCOVER THE UNINSURED PROGRAMHEARTSAVER FIRST AID CLASSESADVANCE CARDIAC LIFE SUPPORTHEALTHCARE PROVIDE RECERTIFICATIONBREAST FEEDING SUPPORTPASTORAL OUTREACH PROGRAMSDIABETES EDUCATIONARTHRITIS AQUATICS CLASSESSMOKING CESSATION CLASSESBASICS IN BABYSITTING CLASSESAUTISM SUPPORT GROUPCONDUCTED HOSPITAL TOURS FOR AREA SCHOOLS AND COMMUNITY GROUPS. SERVED AS AN OBSERVATION SITE FOR THE HIGH SCHOOL FOR HEALTH PROFESSIONS DEVELOPED BY THE PUBLIC SCHOOLS. HOSTED SEVERAL SHADOW STUDENTS FROM AREA SCHOOLS. SERVED AS HOST SITE FOR OHIO HIGHER EDUCATION TELECOMMUNICATION SYSTEM.OPERATED A PHYSICIAN REFERRAL LINE FREE TO THE COMMUNITY.SPENT $44,313 TO RECRUIT PHYSICIANS TO THE UNDERSERVED COMMUNITY;HOSTED PROGRAMS FOR STUDENT NURSES AND RADIOLOGY TECHNICIANS IN TRAINING.SALVATION ARMY: PROVIDED FOOD TO NEEDY FAMILIES FOR THANKSGIVING, AND GIFTS TO NEEDY CHILDREN FOR CHRISTMAS.DAY OF CARING, DAY OF GIVING PROGRAM - MONEY AND FOOD DRIVE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$50,003,306ExpenseAmt
Grant$25,994GrantAmt
Revenue$53,417,224RevenueAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$50,003,306TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANThONY PUORROBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3303862633PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W FIFTH STREETAddressLine1Txt
CityEAST LIVERPOOLCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43920ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
kenneth cochran
CEO40.00Yes (X)Yes (X)$169,169$0$0
JOSEPH LUDOVICI
trustee1.00Yes (X)$0$0$0
Dr Donald Williams
trUSTEE1.00Yes (X)$0$0$0
jeryl schreiner
trUSTEE1.00Yes (X)$0$0$0
JD GAURON
TRUSTEE1.00Yes (X)$0$0$0
PETE WICKS
secretary/treasurer1.00Yes (X)Yes (X)$0$0$0
rob o'hara
trUSTEE1.00Yes (X)$0$0$0
Tammie Mcintosh
TRUSTEE1.00Yes (X)$0$0$0
william miller
vice chairman of the board1.00Yes (X)Yes (X)$0$0$0
joseph shemasek
trUSTEE1.00Yes (X)$0$0$0
David Hamilton
trUSTEE1.00Yes (X)$0$0$0
gretchen nickell do
trusTEE1.00Yes (X)$0$0$0
MARK MANGANO
TRustee1.00Yes (X)$0$0$0
TRACY MANGANO
TRustee1.00Yes (X)$0$0$0
TERRENCE ZIPFEL MD
TRUstee1.00Yes (X)$0$0$0
JAY B VOTAW DVM
TRUStee1.00Yes (X)$0$0$0
frank mader
information services direc40.00$106,635$0$0Yes (X)
charles parry
administrator40.00$103,637$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$379,441TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CARDINAL HEALTH
21377 network plchicagoIL60673pharmacy services$3,499,755
avi foodsystems inc
2590 elm road newarrenOH44483food/supplies/professional services$2,388,271
psychiatric resource partners
6100 tower circle drive ste 1000franlkinTN37067behavioral health professional fees$1,597,001
OHIO VALLEY ANESTHIETISTIS LLC
425 W 5th STREETEAST LIVERPOOLOH43920HEALTH CARE PROFESSIONALS$953,620
INTERNATIONAL SHARED SERVICES
2010 CABOT BLVD WESTLANGHORNEPA19047TECHNOLOGY SYSTEM$877,364
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business900099BusinessCd
Total Revenue Column$51,105,500TotalRevenueColumnAmt
Related Or Exempt Func Income$51,105,500RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$51,105,500TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$766,122TotalRevenueColumnAmt
Exclusion$766,122ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$118,246SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$118,246SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$118,246TotalRevenueColumnAmt
Exclusion$118,246ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
HCAP900099$1,738,128$1,738,128
Ancillary Charges900099$573,596$573,596
CAFETERIA INCOME900099$185,279$185,279
FieldValueIRS element (for citing)
Other Revenue Total$2,497,003OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,486,871TotalRevenueColumnAmt
Related Or Exempt Func Income$53,417,224RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,069,647ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$25,994TotalAmt
Program Services$25,994ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$379,441TotalAmt
Program Services$227,665ProgramServicesAmt
Management And General$151,776ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$17,905,092TotalAmt
Program Services$10,743,055ProgramServicesAmt
Management And General$7,162,037ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$772,448TotalAmt
Program Services$772,448ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,358,497TotalAmt
Program Services$6,358,497ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,311,226TotalAmt
Program Services$957,195ProgramServicesAmt
Management And General$354,031ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$14,455,636TotalAmt
Program Services$8,673,382ProgramServicesAmt
Management And General$5,782,254ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$251,503TotalAmt
Management And General$251,503ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,561TotalAmt
Management And General$25,561ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$202,254TotalAmt
Program Services$202,254ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$147,980TotalAmt
Management And General$147,980ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$137,342TotalAmt
Program Services$82,405ProgramServicesAmt
Management And General$54,937ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,492,090TotalAmt
Program Services$2,695,254ProgramServicesAmt
Management And General$1,796,836ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$9,054TotalAmt
Program Services$5,432ProgramServicesAmt
Management And General$3,622ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$73,519TotalAmt
Program Services$73,519ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,206,637TotalAmt
Program Services$1,206,637ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,815,895TotalAmt
Program Services$3,815,895ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$247,898TotalAmt
Program Services$247,898ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$7,785,024$7,006,522$778,502
BAD DEBTS$5,684,712$5,684,712
miscellaneous$1,475,286$1,180,229$295,057
recruitment$44,313$44,313

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$66,807,402TotalAmt
Program Services$50,003,306ProgramServicesAmt
Management And General$16,804,096ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$411,281EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,476,879BOYAmt
EOY$8,066,220EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$59,940BOYAmt
EOY$38,804EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$987,191BOYAmt
EOY$511,848EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$95,829,446LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$72,023,860LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,407,035BOYAmt
EOY$23,805,586EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$42,148,838BOYAmt
EOY$34,441,356EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,285,276BOYAmt
EOY$1,669,855EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$92,365,159BOYAmt
EOY$68,944,950EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,415,460BOYAmt
EOY$8,235,437EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,501,239BOYAmt
EOY$26,015,364EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,747,538BOYAmt
EOY$1,325,581EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,014,643BOYAmt
EOY$1,008,301EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$41,678,880BOYAmt
EOY$36,584,683EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$50,548,456BOYAmt
EOY$32,218,093EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$79,385BOYAmt
EOY$83,736EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,438BOYAmt
EOY$58,438EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$50,686,279BOYAmt
EOY$32,360,267EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,365,159BOYAmt
EOY$68,944,950EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$12,320,531ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,056,504NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$4,948,977OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$926OtherActivitiesAmt
Total Lobbying Expenditures$926TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationA PERCENTAGE OF AHA AND OHA DUES ARE USED FOR LOBBYING PURPOSES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,434,347OtherCostOrOtherBasisAmt
Book Value$1,434,347BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,210,771OtherCostOrOtherBasisAmt
Depreciation$27,657,967DepreciationAmt
Book Value$15,552,804BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,500,000OtherCostOrOtherBasisAmt
Depreciation$937,500DepreciationAmt
Book Value$562,500BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,093,993OtherCostOrOtherBasisAmt
Depreciation$42,924,111DepreciationAmt
Book Value$6,169,882BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$590,335OtherCostOrOtherBasisAmt
Depreciation$504,282DepreciationAmt
Book Value$86,053BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,805,586TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
INTEREST RATE SWAP$2,984,843
GUARANTEES-$1,976,542
FieldValueIRS element (for citing)
Total Liability$1,008,301TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$841,041TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$841,041NetCommunityBenefitExpnsAmt
Total Expense0.01260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,653,218TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,268,894DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,384,324NetCommunityBenefitExpnsAmt
Total Expense0.06560TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,494,259TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,268,894DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,225,365NetCommunityBenefitExpnsAmt
Total Expense0.07820TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,519,695TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$937,850DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,581,845NetCommunityBenefitExpnsAmt
Total Expense0.02370TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,519,695TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$937,850DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,581,845NetCommunityBenefitExpnsAmt
Total Expense0.02370TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,013,954TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,206,744DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,807,210NetCommunityBenefitExpnsAmt
Total Expense0.10190TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$5,684,712BadDebtExpenseAmt
Reimbursed By Medicare$13,358,624ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,997,525CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$638,901MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdOtherOtherDescLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalInd
elch rehab
115655 st rte 170east liverpoolOH43920pt, ot, speech services
elch
25th streeteast liverpoolOH43920dshYes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1EAST LIVERPOOL CITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.ELCH.ORG/COMMUNITYHEALTH/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.ELCH.ORG/COMMUNITYHEALTH/StrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.ELCH.ORG/PATIENTS-VISITORS/INSURANCE-FINANCIAL-INFO/FINANCIAL-AIFAPAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
EAST LIVERPOOL CITY HOSPITALPart V, Section B, Line 6a: Salem Community Hospital
EAST LIVERPOOL CITY HOSPITALPart V, Section B, Line 24: All Patients are billed the same gross charge. Discounts are applied at the time of payment.

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part II, Community Building Activities:Ongoing efforts and evaluation of management, staff, physicians with feedback from patients and community. Demographic research and studies also utilized to determine type and quantity of services needed by specialty to best serve our community.
Part III, Line 4:Although not described in the footnotes to the hospital'S financial statements, the practice of the hospital is to record bad debt expense at the unpaid balances after contractual discounts for patient'S with insurance and at the full or discounted charge level for those who do not have insurance. The hospital negotiates with payers to come up with a fair discounted rate to be paid for services rendered. These discounts are not recorded as bad debt expenses. Similarly for patients without any insurance, the hospital offers several different discount programs, based upon financial need, to these patients and once again these discounts are not recorded as bad debts. For patients who do not meet or do not follow-through to demonstrate financial hardship, the hospital does expect to be reimbursed at our full charge level. All of the remaining balances that are not paid are recorded as bad debts.The hospital has costed the bad debt expense in line 2 of this section at the full unpaid contracted rate for patients with insurance as this represents the "CONTRACTED COST" for the service and thus not applicable to an overall cost-to-charge ration. For patients with no insurance, the costs on line 2 represent the full charge levels multiplied by the overall cost-to-charge ratio from the audited financial statements.The criteria the hospital uses for distinguishing between charity care and bad debt is that in order for a patient to qualify as charity care, they must share their financial information and show that they fall within the federal poverty guidelines. Thus the hospital believes that 23% of the figure recorded as bad debt expense on line 2 would qualify for charity care if the patients had shared their financial information. This percentage was derived from demographic studies of the community for families falling below the federal poverty guidelines in our market area. Thus this amount should be included in the total community benefit provided by the hospital.
Part III, Line 8:The hospital contends that the entire amount of the Medicare shortfall should also be considered as a community benefit. The reason for this is that the Medicare rates are set unilaterally by the federal government and the hospital agrees to service these patients at these rates as part of our mission and service to the community.The cost included on line 6 comes from the Medicare cost report which the federal government has set up as their way to capture and segregate the costs of services provided to Medicare patients.
Part III, Line 9b:the hospital practice is that upon verification that a patient qualifies for charity or financial assistance, the hospital discontinues collection efforts and makes the appropriate adjustment to the patient's account based upon the patient's individual circumstances.
Part VI, Line 2:ONGOING EFFORTS AND EVALUATION OF MANAGEMENT, STAFF, PHYSICIANS WITH FEEDBACK FROM PATIENTS AND COMMUNITY. DEMOGRAPHIC RESEARCH AND STUDIES ALSO UTILIZED TO DETERMINE TYPE AND QUANTITY OF SERVICES NEEDED BY SPECIALTY TO BEST SERVE OUR COMMUNITY.
Part VI, Line 3:Information regarding financial assistance and charity care is made available at time of registration, on the hospital's website, and on patient statements. Applications are also made available to patients at time of registration if appropriate.
Part VI, Line 4:East Liverpool City Hospital is the only hospital within 20 miles of the city. The hospital serves patients within a 10-15 mile radius including patients from neighboring Pennsylvania and West Virginia. Most residents have lived here all their lives and the community served is comprised of a significant bias of senior citizens.
Part VI, Line 5:East Liverpool City Hospital has an open medical staff, a community board of trustees and is extremely generous with funding community charities and donating employee time to serve the general population of the area served.
Part VI, Line 6:not applicable

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
RSVP (RX PROGRAM)
966 1/2 north market streetlisbonOH44432501c3$16,988funding of medication services
ceramic city senior center
600 e 4th streeteast liverpoolOH43920501c3$9,006community support

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 2:the organization maintains records to substantiate the amount of grants or assistance, and the selection criteria used to award the grants or assistance.
schedule IDEAR COMMUNITY BENEFIT FUND APPLICANT: THE COMMUNITY BENEFIT INITIATIVE PROGRAM (CBI), WHICH IS ADMINISTERED BY EAST LIVERPOOL CITY HOSPITAL, INVITES YOUR APPLICATION TO RECEIVE FUNDING FOR YOUR PROGRAM, PROJECT, OR ACTIVITY. EACH YEAR, CBI SUPPORTS PROJECTS AND ACTIVITIES THAT IMPROVE LOCAL HEALTH STATUS, IMPROVE THE QUALITY OF LIFE, AND PROVIDE A BENEFIT TO OUR COMMUNITY AND RESIDENTS. WE ARE CONTINUALLY LOOKING FOR NEW AND INNOVATIVE PROJECTS THAT TARGET AN UNMET NEED OR UNDERSERVED SEGMENT OF OUR POPULATION. ELCH MAKES INVESTMENTS IN COMMUNITY ASSETS AND THOSE GRANTED FUNDING ARE NOT MERELY RECIPIENTS, BUT HAVE SHARED ACCOUNTABILITY FOR IMPROVING HEALTH AND QUALITY OF LIFE IN OUR COMMUNITY. OVER THE PAST SEVERAL YEARS, THE NUMBER OF REQUESTS FOR PROJECT FUNDING HAS INCREASED DRAMATICALLY. IN AN EFFORT TO REDUCE DUPLICATION OF SERVICES, EFFICIENTLY USE EXISTING RESOURCES, AND INSURE THE INTEGRITY OF THE PROGRAMS OFFERED, WE ARE REQUESTING THAT YOUR AGENCY OR ORGANIZATION PROVIDE THE FOLLOWING INFORMATION: A. GENERAL INFORMATION 1. LOCAL ORGANIZATION APPLYING _______________________________________________________________ (NAME OF ORGANIZATION OR AGENCY) _______________________________________________________________ (LOCAL STREET ADDRESS) _______________________________________________________________ (CITY) (STATE) (ZIP) (COUNTY) 2. LOCAL DIRECTOR / LOCAL CONTACT PERSON OF ORGANIZATION OR AGENCY APPLYING _______________________________________________________________ (NAME/TITLE) (PHONE) _______________________________________________________________ (FAX) (EMAIL) 3. IF PROJECT IS APPROVED, LIST CONTACT NAME, TITLE, AND ADDRESS WHERE FUNDING SHOULD BE SENT: ____________________________________________________________ ____________________________________________________________ B. PROJECT INFORMATION FOR CALENDAR YEAR 2015 1. WHAT IS THE TOTAL BUDGET FOR THE PROJECT OR ACTIVITY? $___________ 2. AMOUNT OF FUNDING BEING REQUESTED FROM ELCH? $_________________ 3. WILL THERE BE ADDITIONAL FUNDING SOURCES? _____YES _____NO PLEASE LIST SOURCES: SOURCE __________________________AMOUNT $ __________________ SOURCE __________________________AMOUNT $ __________________ SOURCE __________________________AMOUNT $ __________________ 4. WHAT IS THE PROJECT / ACTIVITY TIME PERIOD? FROM: _______________________ TO: _______________________ 5. WHAT IS THE OVERALL MISSION OF YOUR AGENCY OR PROGRAM? 6. A. LIST TWO SPECIFIC COMMUNITY NEEDS, QUALITY OF LIFE, OR HEALTH CONCERNS AFFECTING OUR RESIDENTS: 1. ________________________________________________________ 2. ________________________________________________________ B. BRIEFLY SUMMARIZE YOUR PROJECT / ACTIVITY, 2015 GOALS, AND THE PURPOSE FOR THE REQUESTED FUNDING: C. EXPLAIN HOW THIS PROGRAM SPECIFICALLY ADDRESSES THE NEEDS LISTED IN QUESTION 6A: D. WHAT ARE THE GEOGRAPHIC LIMITS OF THIS PROGRAM OR AGENCY (EX: INDIVIDUALS RESIDE IN EAST LIVERPOOL, CHESTER, MIDLAND, ETC) AND DESCRIBE THE POPULATION SERVED: 7. HOW DO YOU TRACK THE EFFECTIVENESS OF YOUR PROJECT OR PROGRAM? (EX: DO YOU HAVE A DESIGNATED PERSON OR COMMITTEE THAT COMPILES DATA QUARTERLY, ANNUALLY, ETC? WHAT SYSTEM IS IN PLACE TO AVOID DUPLICATION OF EFFORTS?) 8. LIST COLLABORATING AGENCIES: (PRIORITY CONSIDERATION WILL BE GIVEN TO THOSE WHO SHOW COLLABORATIVE EFFORT WITH OTHER AGENCIES TO BUILD PARTNERSHIPS AND DECREASE DUPLICATION OF SERVICES) B. CERTIFICATION AS A CONDITION OF RECEIVING A GRANT, THE APPLICANT AGREES TO PROVIDE TO EAST LIVERPOOL CITY HOSPITAL: TWO EVALUATION REPORTS, ONE TO BE SUBMITTED BY APRIL 30, 2015 AND THE SECOND TO BE SUBMITTED BY AUGUST 31, 2015, DESCRIBING HOW FUNDS HAVE BEEN USED, MEASURABLE RESULTS (WHO WAS SERVED BY THE PROGRAM ACTIVITIES AND ACCOMPLISHMENTS), AND PLANS FOR CONTINUING THE PROGRAM AFTER THIS YEAR. THE APPLICANT ALSO AGREES TO CONTACT THE PLANNING DEPARTMENT AND OBTAIN PERMISSION TO CREDIT EAST LIVERPOOL CITY HOSPITAL IN PUBLIC RELEASES AND REFERENCES TO PROJECTS, EQUIPMENT/MATERIALS PURCHASED, AND ACTIVITIES MADE POSSIBLE THROUGH THIS GRANT. I CERTIFY THAT THE FOREGOING INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND THE TERMS OF THE GRANT HAVE BEEN MET. NAME _______________________________________________________ TITLE _________________________________DATE ________________ ALL APPLICATIONS AND SUBSEQUENT REPORTS SHOULD BE SENT TO: ROBERT STEFFEN PLANNING DEPARTMENT - EAST LIVERPOOL CITY HOSPITAL 425 WEST FIFTH STREET EAST LIVERPOOL, OH 43920 IF YOU HAVE ANY QUESTIONS PERTAINING TO THIS APPLICATION, I CAN BE REACHED AT (330) 386-2086. APPLICATIONS MUST BE RETURNED BY AUGUST 31, 2015. NOTE: THE RECEIPT OF THESE MONIES CARRIES NO OBLIGATION TO REFER OR OTHERWISE DIRECT PATIENTS TO SERVICES PROVIDED BY EAST LIVERPOOL CITY HOSPITAL.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
Personkenneth cochranPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$169,169BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$169,169TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 1aFormAndLineReferenceDesc
Explanationcity hospital association allows companion travel by executives only when it serves a justified business purpose. if it is later determined that there was not a justified business purpose, this will result in taxable compensation to the executive in question. city hospital provides a membership to an area social club in order for executives to conduct hospital business. any personal use by the executives in included in that executive's taxable wages.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1city of east liverpoolBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN346000900BondIssuerEIN
CUSIP2734505duCUSIPNum
Bond Issued2006-04-24BondIssuedDt
Issue Price$17,165,000IssuePriceAmt
Purposefinance the acquisition, construction, installation, & equipping facilitiesPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$17,165,000TotalProceedsAmt
Issuance Costs From Proceeds$131,212IssuanceCostsFromProceedsAmt
Credit Enhancement$33,788CreditEnhancementAmt
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec Maint0AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6TRI-COUNTY CARE SYSTEMS, inc. is the sole member
Form 990, Part VI, Section B, line 11information was compiled by the finance department and reviewed by a third party cpa firm. a formal board review did not occur this year due to time constraints.
Form 990, Part VI, Section B, line 12call duality of interest or possible conflict of interest, on the part of any members of the board of trustees, on any issue, should be disclosed to the other members of the board of trustees and made a matter of record. any member of the board of trustees having a duality of interest or possible conflict of interest, on any matter should not vote or use his/her personal influence on the matter. the minutes of the meeting should reflect that a disclosure was made and the abstention from voting.
Form 990, Part VI, Section B, line 15For the CEO, Executive Director or top management: established by board personnel compensation committee and reviewed and approved by the entire board in executive session. For other officers or key employees: submitted and reviewed by board chairman and then presented by board executive committee for review and approval. the last review was completed in november, 2012.
Form 990, Part VI, Section C, line 19the documents are available upon request
Form 990, Part XI, line 9:change in restricted net assets -553,708. transfer to affiliates -4,395,269.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1east liverpool professionalsBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 w 5th streetAddressLine1Txt
Cityeast liverpoolCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43290ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesPROFESSIONAL MEDICAL SERVICESPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1tri-county careBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
tri-county care systems
425 w fiftheast liverpoolOH43920341552205PARENT HOLDING COMPANYOH501(c)(3)Line 3none0
ohio valley home health services
15679 st rte 170east liverpoolOH43920341014198HOME HEALTH SERVICESOH501(c)(3)Line 9tri-county care systems0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
american community services
422 w 6th steast liverpoolOH43290341522019management servicesOHOhio Valley Home health servicesC0
monroe health
422 w 6th steast liverpoolOH43290341562035PHYSICIAN SERVICESOHamerican community servicesC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd