STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

HOLZER HEALTH SYSTEM: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HOLZER HEALTH SYSTEM (EIN 31-1156690)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-16
IRS object ID
201641379349306734
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-16T14:17:20-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE STREET SUITE 600AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311156690EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOLZER HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOLZBusinessNameControlTxt
Phone7404465060PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 JACKSON PIKEAddressLine1Txt
CityGALLIPOLISCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45631ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAN JANICAKPersonNm
Person TitleCFOPersonTitleTxt
Phone7404465060PhoneNum
Signature2016-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBERNIE OSTROWSKIPreparerPersonNm
PTINP00366367PTIN
Phone6148493000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HOLZER CONSOLIDATED HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerCHRISTOPHER MEYERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 JACKSON PIKEAddressLine1Txt
CityGALLIPOLISCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45631ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$124,659,563GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOLZER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHE PRIMARY EXEMPT PURPOSE OF HOLZER HEALTH SYSTEM IS TO ACT AS THE MANAGING PARENT, SOLE VOTING MEMBER OF THE FOLLOWING 501(C)(3) ENTITIES, WHOSE PRIMARY PURPOSES ARE TO MEET THE HEALTHCARE NEEDS OF THEIR COMMUNITIES: HOLZER HOSPITAL FOUNDATION, HOLZER MEDICAL CENTER-JACKSON, HOLZER SENIOR CARE CENTER, HOLZER ASSISTED LIVING-GALLIPOLIS, HOLZER ASSISTED LIVING-JACKSON, HOLZER FOUNDATION AND HOLZER VANGUARD, A FOR-PROFIT SUBSIDIARY (COLLECTIVELY REFERRED TO AS CONSOLIDATED).ActivityOrMissionDesc
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee464TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$148,060,356PYProgramServiceRevenueAmt
CY Program Service Revenue$123,921,290CYProgramServiceRevenueAmt
PY Investment Income$10,314PYInvestmentIncomeAmt
CY Investment Income$104,112CYInvestmentIncomeAmt
PY Other Revenue$1,490,333PYOtherRevenueAmt
CY Other Revenue$29,328CYOtherRevenueAmt
PY Total Revenue$149,561,003PYTotalRevenueAmt
CY Total Revenue$124,054,730CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$105,697,172PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$81,783,507CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$81,526,060PYOtherExpensesAmt
CY Other Expenses$76,172,401CYOtherExpensesAmt
PY Total Expenses$187,223,232PYTotalExpensesAmt
CY Total Expenses$157,955,908CYTotalExpensesAmt
PY Revenues Less Expenses-$37,662,229PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$33,901,178CYRevenuesLessExpensesAmt
Total Assets BOY$176,843,446TotalAssetsBOYAmt
Total Assets EOY$170,028,849TotalAssetsEOYAmt
Total Liabilities BOY$174,662,045TotalLiabilitiesBOYAmt
Total Liabilities EOY$167,621,973TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,181,401NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,406,876NetAssetsOrFundBalancesEOYAmt
MissionTO ADVANCE THE HEALTH AND WELL BEING OF THOSE WE SERVEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$3,382,193RevenueAmt
DescHOLZER HEALTH SYSTEM PROVIDED MANAGEMENT SERVICES TO ITS SUBSIDIARIES WHOSE EXEMPT PURPOSES ARE TO MEET THE HEALTHCARE NEEDS OF THEIR COMMUNITIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,413,242ExpenseAmt
Grant$0GrantAmt
Revenue$1,156,001RevenueAmt
DescHOLZER DENTAL CLINIC-JACKSON STRIVES TO IMPROVE THE DENTAL HEALTH STATUS OF THE PEOPLE AND COMMUNITIES WE SERVE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$96,038,408ExpenseAmt
Grant$0GrantAmt
Revenue$119,383,096RevenueAmt
DescHOLZER CLINIC, LLC IS A MULTIPLE DISCIPLINE HEALTH CARE SYSTEM OF OVER 111 BOARD CERTIFIED PHYSICIANS PROVIDING CARE IN MORE THAN THIRTY AREAS OF EXPERTISE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$97,451,650TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
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 AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
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 EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document110IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee464EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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 Members22GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process 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 Line1DAN JANICAK CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7404465060PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 JACKSON PIKEAddressLine1Txt
CityGALLIPOLISCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45631ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BRENT SAUNDERS
CHAIRMAN1.0039.00Yes (X)Yes (X)$400,203$0$27,975
DR CHRISTOPHER MEYER
CEO - HHS36.004.00Yes (X)Yes (X)$420,724$0$0
DAN JANICAK
CFO - HHS36.004.00Yes (X)Yes (X)$0$0$0
DR WAYNE MUNRO
CEO - HHS THROUGH 12/31/1438.002.00Yes (X)Yes (X)$590,452$0$0
ALAN STOCKMEISTER
TRUSTEE1.003.00Yes (X)$12,000$0$0
DR ART ROA
TRUSTEE40.000.00Yes (X)$1,059,983$0$0
BARBARA CAMPFIELD
TRUSTEE1.000.00Yes (X)$0$0$0
BOB GRILLO
TRUSTEE1.002.00Yes (X)$18,000$0$0
BRAD MUNN
TRUSTEE1.002.00Yes (X)$18,000$0$0
DANNY HOLSCHUH
TRUSTEE1.003.00Yes (X)$18,000$0$0
DR DANIELLE CAPPELLETTI
TRUSTEE40.000.00Yes (X)$253,276$0$0
GARY ROACH
TRUSTEE1.003.00Yes (X)$18,000$0$0
DR GREG MICKUNAS
TRUSTEE40.000.00Yes (X)$425,778$0$0
DR JARED SHEETS
TRUSTEE40.000.00Yes (X)$272,110$0$0
JOHN CUNNINGHAM
TRUSTEE/EXECUTIVE VP40.000.00Yes (X)Yes (X)$295,798$0$11,723
DR JON SULLIVAN
TRUSTEE40.000.00Yes (X)$300,701$0$0
LARRY KIDD
TRUSTEE1.003.00Yes (X)$18,000$0$0
DR LOIS BOSLEY
TRUSTEE40.000.00Yes (X)$174,868$0$0
DR MICHAEL CANADY
TRUSTEE40.000.00Yes (X)$365,223$0$0
PAUL REED
TRUSTEE1.000.00Yes (X)$18,000$0$0
DR RENUKA KANDULA
TRUSTEE40.000.00Yes (X)$375,458$0$0
DR RODNEY STOUT
TRUSTEE40.000.00Yes (X)$212,252$0$0
DR SCOTT DAVIS
TRUSTEE40.000.00Yes (X)$232,045$0$0
STEPHEN DOYLE
TRUSTEE1.000.00Yes (X)$0$0$0
STEVE CHAPMAN
TRUSTEE1.002.00Yes (X)$18,000$0$0
TODD FOWLER
TRUSTEE/EXECUTIVE VP40.000.00Yes (X)Yes (X)$112,304$0$0
TOM WISEMAN
TRUSTEE1.002.00Yes (X)$10,000$0$0
CHOUDHARY RAYANI
PHYSICIAN40.000.00$747,215$0$0Yes (X)
DEAN SICILIANO
PHYSICIAN40.000.00$760,226$0$0Yes (X)
PHILLIP LONG
PHYSICIAN40.000.00$730,524$0$0Yes (X)
ROBERT BRADLEY
PHYSICIAN40.000.00$947,608$0$0Yes (X)
ROSS GERMANI
PHYSICIAN40.000.00$796,398$0$0Yes (X)
JAMES R PHILLIPPE II
EXECUTIVE VP PART YEAR0.000.00$373,286$0$26,735Yes (X)
KENNETH PAYNE
EXECUTIVE VP PART YEAR0.001.00$346,237$0$27,676Yes (X)
G PATRICK CONNORS
EXECUTIVE VP PART YEAR0.000.00$323,408$0$4,442Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,664,077TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$98,551TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K166IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BERKELEY RESEARCH GROUP LLC
2200 POWELL ST SUITE 2200EMERYVILLECA94608CONSULTING SERVICES$4,557,378
PRECYSE SOLUTIONS LLC
PO BOX 11407BIRMINGHAMAL352461736CONSULTING AND CONTRACT LABOR$1,765,283
DELTA LOCUM TENENS
PO BOX 202940DALLASTX753202056LOCUM FIRM/CONTRACT LABOR$1,231,674
COMFORCE
3492 MOMENTUM PLACECHICAGOIL606895334CONTRACT LABOR/STAFFING$816,562
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX753972633LOCUM FIRM/CONTRACT LABOR$590,402
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K30CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$120,558,774$120,558,774
RENTAL INCOME531120$3,384,599$3,384,599
MANAGEMENT FEES561000-$22,083-$22,083
FieldValueIRS element (for citing)
Total Program Service Revenue$123,921,290TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$108,042TotalRevenueColumnAmt
Exclusion$108,042ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$29,328RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$29,328RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,328TotalRevenueColumnAmt
Exclusion$29,328ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$600,903OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$604,833OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$3,930OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,930TotalRevenueColumnAmt
Exclusion-$3,930ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$124,054,730TotalRevenueColumnAmt
Related Or Exempt Func Income$123,921,290RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$133,440ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,793,668TotalAmt
Management And General$2,793,668ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$68,641,685TotalAmt
Program Services$54,824,616ProgramServicesAmt
Management And General$13,817,069ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,890,889TotalAmt
Program Services$4,740,451ProgramServicesAmt
Management And General$2,150,438ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,457,265TotalAmt
Program Services$2,241,539ProgramServicesAmt
Management And General$1,215,726ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$8,926,729TotalAmt
Program Services$7,329,006ProgramServicesAmt
Management And General$1,597,723ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$687,651TotalAmt
Management And General$687,651ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$342,756TotalAmt
Management And General$342,756ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$21,920,582TotalAmt
Program Services$4,493,546ProgramServicesAmt
Management And General$17,427,036ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,184,982TotalAmt
Program Services$3,381,372ProgramServicesAmt
Management And General$1,803,610ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,036,865TotalAmt
Program Services$54,068ProgramServicesAmt
Management And General$3,982,797ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$553,157TotalAmt
Program Services$375,861ProgramServicesAmt
Management And General$177,296ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$667,084TotalAmt
Program Services$333,138ProgramServicesAmt
Management And General$333,946ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,997,238TotalAmt
Program Services$654,623ProgramServicesAmt
Management And General$10,342,615ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,989,729TotalAmt
Program Services$573,421ProgramServicesAmt
Management And General$2,416,308ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,243,742TotalAmt
Program Services$3,469,591ProgramServicesAmt
Management And General$774,151ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT EXPENSE$14,669,986$14,669,986
MEDICAL SUPPLIES$464,021$464,021

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$487,879TotalAmt
Program Services-$153,589ProgramServicesAmt
Management And General$641,468ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$157,955,908TotalAmt
Program Services$97,451,650ProgramServicesAmt
Management And General$60,504,258ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,396,120BOYAmt
EOY$13,421,002EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,356,451BOYAmt
EOY$18,720,045EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$686,227BOYAmt
EOY$479,018EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$95,647,407LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,136,436LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$85,120,083BOYAmt
EOY$82,510,971EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,654,444BOYAmt
EOY$5,656,494EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,847,609BOYAmt
EOY$1,672,878EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,904,000BOYAmt
EOY$3,904,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$18,812,055BOYAmt
EOY$18,812,055EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$26,066,457BOYAmt
EOY$24,852,386EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$176,843,446BOYAmt
EOY$170,028,849EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$37,318,760BOYAmt
EOY$32,309,342EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$129,138,446BOYAmt
EOY$126,513,032EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,618,664BOYAmt
EOY$4,640,063EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,586,175BOYAmt
EOY$4,159,536EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$174,662,045BOYAmt
EOY$167,621,973EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,181,401BOYAmt
EOY$2,406,876EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,181,401BOYAmt
EOY$2,406,876EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$176,843,446BOYAmt
EOY$170,028,849EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$33,901,178ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$182NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$34,126,471OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations4SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (4 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
HOLZER HOSPITAL FOUNDATION
3143794913Yes (1)$0$0
HOLZER MEDICAL CENTER-JACKSON
3117240853Yes (1)$0$0
HOLZER SENIOR CARE CENTER
3115340519Yes (1)$0$0
HOLZER HERITAGE FOUNDATION
3109274827Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total4SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (1)TimelyProvidedDocumentsInd
Officers Close RelationshipYes (1)OfficersCloseRelationshipInd
Supported Org Voice Investment0SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Parent Supported OrgYes (X)ParentSupportedOrgInd
Appoint Elect Majority OfficerYes (1)AppointElectMajorityOfficerInd
Exercise Direction PoliciesYes (1)ExerciseDirectionPoliciesInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE A, PART I, LINE 11:HOLZER HEALTH SYSTEM PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO RELATED ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION E, LINE 3A:HOLZER HEALTH SYSTEM IS THE SOLE MEMBER OF EACH OF ITS SUPPORTED ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION E, LINE 3B:DECISIONS MADE BY THE BOARD OF DIRECTORS OF EACH SUPPORTED ORGANIZATION CAN BE OVERRULED BY THE BOARD OF DIRECTORS OF HOLZER HEALTH SYSTEM.

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,762,601OtherCostOrOtherBasisAmt
Book Value$6,762,601BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,216,193OtherCostOrOtherBasisAmt
Depreciation$11,670,172DepreciationAmt
Book Value$72,546,021BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,373,222OtherCostOrOtherBasisAmt
Depreciation$1,466,264DepreciationAmt
Book Value$2,906,958BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$295,391OtherCostOrOtherBasisAmt
Book Value$295,391BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$82,510,971TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
RELATED PARTY RECEIVABLES$5,989,194
ASSETS LIMITED TO USE$18,863,192
FieldValueIRS element (for citing)
Total Book Value Other Assets$24,852,386TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescRELATED PARTY PAYABLESDesc
Amt$4,159,536Amt
FieldValueIRS element (for citing)
Total Liability$4,159,536TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF JUNE 30, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE SYSTEM FILES FEDERAL AND STATE TAX RETURNS AND BELIEVES IT IS NO LONGER SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE FISCAL YEAR 2012.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRENT SAUNDERS
CHAIRMAN$400,203$0$0$0$0$0$27,975$0$0$0$428,178$0$0$0
DR CHRISTOPHER MEYER
CEO - HHS$420,724$0$0$0$0$0$0$0$0$0$420,724$0$0$0
DR WAYNE MUNRO
CEO - HHS THROUGH 12/31/14$590,452$0$0$0$0$0$0$0$0$0$590,452$0$0$0
DR ART ROA
TRUSTEE$1,059,983$0$0$0$0$0$0$0$0$0$1,059,983$0$0$0
DR DANIELLE CAPPELLETTI
TRUSTEE$253,276$0$0$0$0$0$0$0$0$0$253,276$0$0$0
DR GREG MICKUNAS
TRUSTEE$425,778$0$0$0$0$0$0$0$0$0$425,778$0$0$0
DR JARED SHEETS
TRUSTEE$272,110$0$0$0$0$0$0$0$0$0$272,110$0$0$0
JOHN CUNNINGHAM
TRUSTEE/EXECUTIVE VP$295,798$0$0$0$0$0$11,723$0$0$0$307,521$0$0$0
DR JON SULLIVAN
TRUSTEE$300,701$0$0$0$0$0$0$0$0$0$300,701$0$0$0
DR LOIS BOSLEY
TRUSTEE$174,868$0$0$0$0$0$0$0$0$0$174,868$0$0$0
DR MICHAEL CANADY
TRUSTEE$365,223$0$0$0$0$0$0$0$0$0$365,223$0$0$0
DR RENUKA KANDULA
TRUSTEE$375,458$0$0$0$0$0$0$0$0$0$375,458$0$0$0
DR RODNEY STOUT
TRUSTEE$212,252$0$0$0$0$0$0$0$0$0$212,252$0$0$0
DR SCOTT DAVIS
TRUSTEE$232,045$0$0$0$0$0$0$0$0$0$232,045$0$0$0
CHOUDHARY RAYANI
PHYSICIAN$747,215$0$0$0$0$0$0$0$0$0$747,215$0$0$0
DEAN SICILIANO
PHYSICIAN$760,226$0$0$0$0$0$0$0$0$0$760,226$0$0$0
PHILLIP LONG
PHYSICIAN$730,524$0$0$0$0$0$0$0$0$0$730,524$0$0$0
ROBERT BRADLEY
PHYSICIAN$947,608$0$0$0$0$0$0$0$0$0$947,608$0$0$0
ROSS GERMANI
PHYSICIAN$796,398$0$0$0$0$0$0$0$0$0$796,398$0$0$0
JAMES R PHILLIPPE II
EXECUTIVE VP PART YEAR$168,632$0$0$0$204,654$0$26,735$0$0$0$400,021$0$0$0
KENNETH PAYNE
EXECUTIVE VP PART YEAR$143,218$0$0$0$203,019$0$24,115$0$3,561$0$373,913$0$0$0
G PATRICK CONNORS
EXECUTIVE VP PART YEAR$136,825$0$0$0$186,583$0$4,442$0$0$0$327,850$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4AFormAndLineReferenceDesc
ExplanationDURING THE CALENDAR YEAR 2014, THE FOLLOWING FORMER OFFICERS RECEIVED SEVERANCE PAY AS A LUMP SUM OF THE FOLLOWING AMOUNT: JAMES R. PHILLIPPE II $204,654 KENNETH PAYNE $203,019 G. PATRICK CONNORS $186,583ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF GALLIA OHIO- BONDS SERIES 2012 A20BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN316400068BondIssuerEIN
CUSIP36381PAP2CUSIPNum
Bond Issued2012-03-27BondIssuedDt
Issue Price$155,315,000IssuePriceAmt
PurposeSEE SCHEDULE OPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$155,315,478TotalProceedsAmt
In Reserve Fund$10,989,938InReserveFundAmt
Issuance Costs From Proceeds$3,087,477IssuanceCostsFromProceedsAmt
Capital Expenditures$106,281,906CapitalExpendituresAmt
Other Spent Proceeds$3,817,000OtherSpentProceedsAmt
Unspent$519,735UnspentAmt
Substantial Completion2012SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

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
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
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 RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
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 ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART IFormAndLineReferenceDesc
ExplanationDESCRIPTION OF PURPOSE: (A) CURRENTLY REFUNDED THE ENTITY'S (I) SERIES 1998 BONDS ISSUED ON OCTOBER 1, 1998; (II) SERIES 2009 BONDS, ISSUED ON NOVEMBER 3, 2009, WHICH WERE A REISSUANCE OF THE SERIES 2005 BONDS ISSUES ON MARCH 10, 2005; AND (III) VARIOUS TAXABLE OBLIGATIONS; AND (B) ACQUISITION OF HOSPITAL FACILITIES INCLUDING A CLINIC AND FUTURE CAPITAL EQUIPMENT ACQUISITIONS AND FACILITY RENOVATIONS; AND CANCER CENTER PROJECT.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3HOLZER HEALTH SYSTEM PAYS BERKELEY RESEARCH GROUP, LLC FOR CFO SERVICES BY DAN JANICAK. THE CONTRACT WITH THE MANAGEMENT COMPANY IS $35,000 PER MONTH STARTING MAY 2014. THE SAME MANAGEMENT COMPANY IS USED FOR EMPLOYING THE EXECUTIVE V.P. FOR INTERIM CHIEF NURSING OFFICER, BARBARA CAMPFIELD (SERVES ON THE BOARD). THE CONTRACT WITH THE MANAGEMENT COMPANY IS $35,000 STARTING IN MAY 2014.
FORM 990, PART VI, SECTION B, LINE 11THE CONTROLLER AND THE CFO REVIEW FORM 990 AND A COPY WILL BE PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION FOLLOWS THE ADOPTED POLICIES OF HOLZER MEDICAL CENTER- JACKSON AND HOLZER HOSPITAL FOUNDATION, RELATED TAX-EXEMPT ORGANIZATIONS. CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY BY ALL BOARD MEMBERS AND OFFICERS, AND ARE REVIEWED BY THE CONFLICT OF INTEREST REVIEW COMMITTEE. MEMBERS OF THE BOARD ARE AWARE THAT THEY SHOULD DISCLOSE CONFLICTS WHEN THEY ARISE, AND MEMBERS ABSTAIN FROM PARTICIPATING IN DISCUSSIONS OR VOTING ON MATTERS WHERE A CONFLICT IS PRESENT.
FORM 990, PART VI, SECTION B, LINE 15THE HOLZER HEALTH SYSTEM BOARD APPROVES COMPENSATION OF THE CEO AND OTHER OFFICERS. THE BOARD UTILIZES WAGE RECOMMENDATIONS FROM AN UNRELATED CONSULTANT TO DETERMINE THE COMPENSATION. THE CEO MAY BE INVOLVED IN DETERMINING OTHER OFFICERS' COMPENSATION, HOWEVER THE ULTIMATE DECISION RESTS WITH THE BOARD. THE PROCESS WAS LAST UNDERTAKEN DURING MARCH 2015.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT HAVE ITS OWN CONFLICT OF INTEREST POLICY.
FORM 990, PART IX, LINE 11GOUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 4,196,862. MANAGEMENT AND GENERAL EXPENSES 12,163,646. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,360,508. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 41,246. MANAGEMENT AND GENERAL EXPENSES 4,484,211. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,525,457. OTHER FEES: PROGRAM SERVICE EXPENSES 255,438. MANAGEMENT AND GENERAL EXPENSES 779,179. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,034,617.
FORM 990, PART XI, LINE 9:TRANSFERS TO/FROM AFFILIATES 34,126,471.
FORM 990, PART XI, LINE 2CTHE AUDIT OVERSIGHT PROCESS AND THE PROCESS OF SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART VI, LINE 16THE ORGANIZATION DOES NOT HAVE IN PLACE A WRITTEN POLICY TO EVALUATE ITS PARTICIPATION IN JOINT VENTURES, HOWEVER IT MAKES SURE TO TAKE THE NECESSARY PRECAUTIONS TO SAFEGUARD ITS TAX-EXEMPT STATUS. IN ADDITION, LEGAL COUNSEL IS CONSULTED BEFORE CONSIDERING A NEW JOINT VENTURE.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HOLZER DENTAL CLINIC JACKSON
100 JACKSON PIKEGALLIPOLISOH45631275346256HEALTHCAREOH$1,156,001$2,868,822HOLZER HEALTH SYSTEM
HOLZER CLINIC LLC
90 JACKSON PIKEGALLIPOLISOH45631310917085PHYSICIAN PRACTICESOH$119,383,096$26,046,533HOLZER HEALTH SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
HOLZER FOUNDATION
100 JACKSON PIKEGALLIPOLISOH45631310927482CONTINUING ADVANCEMENT OF HEALTH AND MEDICAL CAREOH501(C)(3)LINE 7HOLZER HEALTH SYSTEMYes (1)
HOLZER MEDICAL CENTER - JACKSON
100 JACKSON PIKEGALLIPOLISOH45631311724085HEALTH CAREOH501(C)(3)LINE 3HOLZER HEALTH SYSTEMYes (1)
HOLZER SENIOR CARE CENTER
380 COLONIAL DRIVEBIDWELLOH45614311534051SKILLED NURSING FACILITYOH501(C)(3)LINE 9HOLZER HEALTH SYSTEMYes (1)
HOLZER HOSPITAL FOUNDATION
100 JACKSON PIKEGALLIPOLISOH45631314379491HEALTH CAREOH501(C)(3)LINE 3HOLZER HEALTH SYSTEMYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOLZER VANGUARD INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 JACKSON PIKEAddressLine1Txt
CityGALLIPOLISCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45631ZIPCd
FieldValueIRS element (for citing)
EIN311192567EIN
Primary ActivitiesSTOCK HOLDING COMPANYPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOLZER HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$3,233,663ShareOfTotalIncomeAmt
Share Of EOY Assets$3,483,451ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HOLZER HOSPITAL FOUNDATION
M$2,100,000ACCRUAL TRANSACTION
HOLZER HOSPITAL FOUNDATION
L$36,808,169ACCRUAL TRANSACTION
HOLZER HOSPITAL FOUNDATION
N$543,824ACCRUAL TRANSACTION
HOLZER HOSPITAL FOUNDATION
K$108,176ACCRUAL TRANSACTION
HOLZER HOSPITAL FOUNDATION
Q$414,949ACCRUAL TRANSACTION
HOLZER VANGUARD
S$275,944ACCRUAL TRANSACTION
HOLZER HOSPITAL FOUNDATION
A$13,805ACCRUAL TRANSACTION