HOLZER HEALTH SYSTEM: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HOLZER HEALTH SYSTEM (EIN 31-1156690)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-15
- IRS object ID
- 201501359349303180
- Schema version
- 2013v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-15T10:40:08-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65 EAST STATE STREET SUITE 600 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311156690 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLZER HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOLZ | BusinessNameControlTxt |
| Phone | 7404465060 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 JACKSON PIKE | AddressLine1 |
| City | GALLIPOLIS | City |
| State | OH | State |
| ZIP Code | 45631 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAN JANICAK | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7404465060 | PhoneNum |
| Signature | 2015-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BERNIE OSTROWSKI | PreparerPersonNm |
| PTIN | P00366367 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLZER CONSOLIDATED HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WAYNE MUNRO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 JACKSON PIKE | AddressLine1 |
| City | GALLIPOLIS | City |
| State | OH | State |
| ZIP Code | 45631 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $149,561,003 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOLZER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THE 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 Body | 25 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 1389 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $173,734,837 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $148,060,356 | CYProgramServiceRevenueAmt |
| PY Investment Income | $49,685 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,314 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,136,041 | PYOtherRevenueAmt |
| CY Other Revenue | $1,490,333 | CYOtherRevenueAmt |
| PY Total Revenue | $175,920,563 | PYTotalRevenueAmt |
| CY Total Revenue | $149,561,003 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $111,915,666 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $105,697,172 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $81,477,018 | PYOtherExpensesAmt |
| CY Other Expenses | $81,526,060 | CYOtherExpensesAmt |
| PY Total Expenses | $193,392,684 | PYTotalExpensesAmt |
| CY Total Expenses | $187,223,232 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$17,472,121 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$37,662,229 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $186,461,553 | TotalAssetsBOYAmt |
| Total Assets EOY | $176,843,446 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $179,797,525 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $174,662,045 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,664,028 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,181,401 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ADVANCE THE HEALTH AND WELL BEING OF THOSE WE SERVE | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,529,425 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,811,834 | RevenueAmt |
| Desc | HOLZER 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $990,107 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,062,072 | RevenueAmt |
| Desc | HOLZER DENTAL CLINIC-JACKSON STRIVES TO IMPROVE THE DENTAL HEALTH STATUS OF THE PEOPLE AND COMMUNITIES WE SERVE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $99,603,436 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $135,408,450 | RevenueAmt |
| Desc | HOLZER CLINIC, LLC IS A MULTIPLE DISCIPLINE HEALTH CARE SYSTEM OF OVER 140 BOARD CERTIFIED PHYSICIANS PROVIDING CARE IN MORE THAN THIRTY AREAS OF EXPERTISE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $129,122,968 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 92 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1389 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 25 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAN JANICAK CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7404465060 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 JACKSON PIKE | AddressLine1 |
| City | GALLIPOLIS | City |
| State | OH | State |
| ZIP Code | 45631 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BRENT SAUNDERS | ||||||||
| CHAIRMAN | 1.00 | 39.00 | Yes (X) | Yes (X) | $187,231 | $239,077 | $40,567 | |
| LOIS BOSLEY | ||||||||
| TRUSTEE | 40.00 | 0.00 | Yes (X) | $155,776 | $0 | $0 | ||
| STEVE CHAPMANCPA | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $18,000 | $0 | $0 | ||
| RENUKA KANDULA MD | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $416,570 | $0 | $0 | ||
| BOB GRILLO | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $18,000 | $0 | $0 | ||
| DANNY HOLSCHUH | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $18,000 | $0 | $0 | ||
| LARRY KIDD | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $18,000 | $0 | $0 | ||
| CHRISTOPHER MEYER MD | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $442,488 | $0 | $0 | ||
| BRAD MUNN | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $18,000 | $0 | $0 | ||
| WAYNE MUNRO MD | ||||||||
| CEO- HHS | 1.00 | 39.00 | Yes (X) | Yes (X) | $609,876 | $0 | $0 | |
| RODNEY STOUT MD | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $189,948 | $0 | $0 | ||
| PAUL REED | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $18,000 | $0 | $0 | ||
| GARY ROACH | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $18,000 | $0 | $0 | ||
| ALAN STOCKMEISTER | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $18,000 | $0 | $0 | ||
| DR JON SULLIVAN | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $306,986 | $0 | $0 | ||
| KENNETH G PAYNE | ||||||||
| CFO- HHS 7/1/13-3/31/14 | 1.00 | 39.00 | Yes (X) | Yes (X) | $167,192 | $167,706 | $37,712 | |
| ARTURO ROA | ||||||||
| TRUSTEE | 39.00 | 1.00 | Yes (X) | $938,047 | $0 | $0 | ||
| PATRICK CONNERS | ||||||||
| TRUSTEE | 36.00 | 4.00 | Yes (X) | $345,991 | $0 | $0 | ||
| JOHN CUNNINGHAM | ||||||||
| TRUSTEE | 36.00 | 4.00 | Yes (X) | $295,572 | $0 | $0 | ||
| GREG MICKUNAS | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $383,105 | $0 | $0 | ||
| JARED SHEETS | ||||||||
| TRUSTEE | 38.00 | 2.00 | Yes (X) | $265,616 | $0 | $0 | ||
| DAN JANICAK | ||||||||
| CFO 4/1/14-CURRENT | 36.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BARBARA CAMPFIELD | ||||||||
| TRUSTEE | 36.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM PHILLIPPE | ||||||||
| TRUSTEE | 1.00 | 39.00 | Yes (X) | $144,462 | $169,057 | $31,300 | ||
| RYAN SMITH | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ELLEN GARLING | ||||||||
| CHIEF LEGAL COUNSEL | 40.00 | 0.00 | $275,782 | $0 | $0 | Yes (X) | ||
| DONALD MICHAEL ROACH | ||||||||
| MANAGER ANESTHESIA | 40.00 | 0.00 | $256,832 | $0 | $0 | Yes (X) | ||
| ROBERT TOWNSEND | ||||||||
| CRNA | 40.00 | 0.00 | $241,304 | $0 | $0 | Yes (X) | ||
| CLIFFORD QUEEN | ||||||||
| CRNA | 40.00 | 0.00 | $234,268 | $0 | $0 | Yes (X) | ||
| VERNON ROUSH | ||||||||
| CRNA | 40.00 | 0.00 | $233,630 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,234,676 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $575,840 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $109,579 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 193 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BERKELEY RESEARCH GROUP LLC | |||||
| 2200 POWELL ST SUITE 2200 | EMERYVILLE | CA | 94608 | CONSULTING SERVICES | $2,231,593 |
| PLANTE AND MORAN PLLC | |||||
| 16060 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | FINANCIAL SERVICES | $459,559 |
| NUANCE COMMUNICATIONS | |||||
| DEPT AT 952896 | ATLANTA | GA | 311922896 | TRANSCRIPTION SERVICES | $434,335 |
| ACCENTURE LLP | |||||
| PO BOX 70629 | CHICAGO | IL | 606730629 | CONSULTING SERVICES | $295,060 |
| DELTA LOCUM TENENS LLC | |||||
| PO BOX 202940 | DALLAS | TX | 753202056 | LOCUM SERVICES | $241,961 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $136,473,390 | $136,473,390 |
| AMBULATORY SURGERY CENTER REVENUE | 621110 | $5,668,028 | $5,668,028 |
| RENTAL INCOME | 531120 | $5,284,652 | $5,284,652 |
| REVENUE FROM CHEMO SERVICES | 621110 | $575,328 | $575,328 |
| MANAGEMENT FEES | 561000 | $58,958 | $58,958 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $148,060,356 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,314 | TotalRevenueColumnAmt |
| Exclusion | $10,314 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,794 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,794 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,794 | TotalRevenueColumnAmt |
| Exclusion | $78,794 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| MEANINGFUL USE | 900099 | $1,325,000 | $1,325,000 | |
| REBATES, REIMBURSEMENTS, REWARDS | 900099 | $163,000 | $163,000 | |
| RESEARCH STUDY REIMBURSEMENT | 900099 | $113,000 | $113,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$189,461 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,000 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$298,461 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,411,539 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $149,561,003 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $148,282,356 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $557,861 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,121,931 | TotalAmt |
| Management And General | $2,121,931 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,412,751 | TotalAmt |
| Program Services | $65,841,946 | ProgramServicesAmt |
| Management And General | $18,570,805 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,030,977 | TotalAmt |
| Program Services | $3,924,162 | ProgramServicesAmt |
| Management And General | $1,106,815 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,264,782 | TotalAmt |
| Program Services | $8,006,530 | ProgramServicesAmt |
| Management And General | $2,258,252 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,866,731 | TotalAmt |
| Program Services | $3,016,050 | ProgramServicesAmt |
| Management And General | $850,681 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,000 | TotalAmt |
| Management And General | $192,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,440 | TotalAmt |
| Management And General | $453,440 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,333,217 | TotalAmt |
| Management And General | $1,333,217 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,607,128 | TotalAmt |
| Program Services | $3,163,212 | ProgramServicesAmt |
| Management And General | $15,443,916 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,247,305 | TotalAmt |
| Program Services | $1,247,305 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,588,401 | TotalAmt |
| Program Services | $5,018,249 | ProgramServicesAmt |
| Management And General | $6,570,152 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,306,971 | TotalAmt |
| Program Services | $732,185 | ProgramServicesAmt |
| Management And General | $3,574,786 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,521,493 | TotalAmt |
| Program Services | $1,966,765 | ProgramServicesAmt |
| Management And General | $554,728 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,093 | TotalAmt |
| Program Services | $128,876 | ProgramServicesAmt |
| Management And General | $629,217 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,583,470 | TotalAmt |
| Program Services | $9,035,107 | ProgramServicesAmt |
| Management And General | $2,548,363 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,129,600 | TotalAmt |
| Program Services | $4,781,088 | ProgramServicesAmt |
| Management And General | $1,348,512 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,469,315 | TotalAmt |
| Program Services | $1,926,066 | ProgramServicesAmt |
| Management And General | $543,249 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $11,030,251 | $11,030,251 |
| MEDICAL SUPPLIES | $8,823,184 | $8,823,184 |
| RECRUITMENT | $254,252 | $254,252 |
| BOND EXPENSES | $8,280 | $8,280 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,660 | TotalAmt |
| Program Services | $219,460 | ProgramServicesAmt |
| Management And General | $200 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,223,232 | TotalAmt |
| Program Services | $129,122,968 | ProgramServicesAmt |
| Management And General | $58,100,264 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,863,378 | BOYAmt |
| EOY | $13,396,120 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,478,521 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,043,711 | BOYAmt |
| EOY | $20,356,451 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $382,420 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,228,144 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,502 | BOYAmt |
| EOY | $686,227 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $95,859,823 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,739,740 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,224,616 | BOYAmt |
| EOY | $85,120,083 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,026,352 | BOYAmt |
| EOY | $5,654,444 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $625,582 | BOYAmt |
| EOY | $2,847,609 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,904,000 | BOYAmt |
| EOY | $3,904,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,812,055 | BOYAmt |
| EOY | $18,812,055 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,828,272 | BOYAmt |
| EOY | $26,066,457 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,461,553 | BOYAmt |
| EOY | $176,843,446 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,276,168 | BOYAmt |
| EOY | $37,318,760 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,419,196 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,598,471 | BOYAmt |
| EOY | $129,138,446 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,628,201 | BOYAmt |
| EOY | $4,618,664 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,875,489 | BOYAmt |
| EOY | $3,586,175 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,797,525 | BOYAmt |
| EOY | $174,662,045 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,664,028 | BOYAmt |
| EOY | $2,181,401 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,664,028 | BOYAmt |
| EOY | $2,181,401 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,461,553 | BOYAmt |
| EOY | $176,843,446 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$37,662,229 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $210 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $33,179,392 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Certification | Yes (X) | CertificationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (4 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| HOLZER HOSPITAL FOUNDATION | |||||
| 314379491 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| HOLZER MEDICAL CENTER-JACKSON | |||||
| 311724085 | 3 | Yes (1) | Yes (1) | Yes (1) | $0 |
| HOLZER SENIOR CARE CENTER | |||||
| 311534051 | 9 | Yes (1) | Yes (1) | Yes (1) | $0 |
| HOLZER FOUNDATION | |||||
| 310927482 | 7 | Yes (1) | Yes (1) | Yes (1) | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 4 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART I, LINE 11 | FormAndLineReferenceDesc |
| Explanation | HOLZER HEALTH SYSTEM PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO RELATED ORGANIZATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,962,336 | OtherCostOrOtherBasisAmt |
| Book Value | $6,962,336 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $85,136,549 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,846,479 | DepreciationAmt |
| Book Value | $75,290,070 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,620,903 | OtherCostOrOtherBasisAmt |
| Depreciation | $893,261 | DepreciationAmt |
| Book Value | $2,727,642 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $140,035 | OtherCostOrOtherBasisAmt |
| Book Value | $140,035 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $85,120,083 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RELATED PARTY RECEIVABLES | $8,439,993 |
| ASSETS LIMITED TO USE | $17,626,464 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $26,066,457 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RELATED PARTY PAYABLES | Desc |
| Amt | $3,586,175 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,586,175 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING 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, 2014, 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 2011. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRENT SAUNDERS | ||||||||||||||
| CHAIRMAN | $187,231 | $239,077 | $0 | $0 | $0 | $0 | $18,723 | $21,844 | $0 | $0 | $205,954 | $260,921 | $0 | $0 |
| LOIS BOSLEY | ||||||||||||||
| TRUSTEE | $155,776 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $155,776 | $0 | $0 | $0 |
| RENUKA KANDULA MD | ||||||||||||||
| TRUSTEE | $416,570 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $416,570 | $0 | $0 | $0 |
| CHRISTOPHER MEYER MD | ||||||||||||||
| TRUSTEE | $442,488 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $442,488 | $0 | $0 | $0 |
| WAYNE MUNRO MD | ||||||||||||||
| CEO- HHS | $609,876 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $609,876 | $0 | $0 | $0 |
| RODNEY STOUT MD | ||||||||||||||
| TRUSTEE | $189,948 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $189,948 | $0 | $0 | $0 |
| DR JON SULLIVAN | ||||||||||||||
| TRUSTEE | $306,986 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $306,986 | $0 | $0 | $0 |
| KENNETH G PAYNE | ||||||||||||||
| CFO- HHS 7/1/13-3/31/14 | $167,192 | $167,706 | $0 | $0 | $0 | $0 | $16,719 | $16,719 | $4,274 | $0 | $188,185 | $184,425 | $0 | $0 |
| ARTURO ROA | ||||||||||||||
| TRUSTEE | $938,047 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $938,047 | $0 | $0 | $0 |
| PATRICK CONNERS | ||||||||||||||
| TRUSTEE | $345,991 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $345,991 | $0 | $0 | $0 |
| JOHN CUNNINGHAM | ||||||||||||||
| TRUSTEE | $295,572 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $295,572 | $0 | $0 | $0 |
| GREG MICKUNAS | ||||||||||||||
| TRUSTEE | $383,105 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $383,105 | $0 | $0 | $0 |
| JARED SHEETS | ||||||||||||||
| TRUSTEE | $265,616 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $265,616 | $0 | $0 | $0 |
| JIM PHILLIPPE | ||||||||||||||
| TRUSTEE | $144,462 | $169,057 | $0 | $0 | $0 | $0 | $14,446 | $16,854 | $0 | $0 | $158,908 | $185,911 | $0 | $0 |
| ELLEN GARLING | ||||||||||||||
| CHIEF LEGAL COUNSEL | $275,782 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $275,782 | $0 | $0 | $0 |
| DONALD MICHAEL ROACH | ||||||||||||||
| MANAGER ANESTHESIA | $256,832 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $256,832 | $0 | $0 | $0 |
| ROBERT TOWNSEND | ||||||||||||||
| CRNA | $241,304 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $241,304 | $0 | $0 | $0 |
| CLIFFORD QUEEN | ||||||||||||||
| CRNA | $234,268 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $234,268 | $0 | $0 | $0 |
| VERNON ROUSH | ||||||||||||||
| CRNA | $233,630 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $233,630 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF GALLIA OHIO- BONDS SERIES 2012 A20 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316400068 | BondIssuerEIN |
| CUSIP | 36381PAP2 | CUSIPNum |
| Bond Issued | 2012-03-27 | BondIssuedDt |
| Issue Price | $155,315,000 | IssuePriceAmt |
| Purpose | SEE SCHEDULE O | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $155,315,478 | TotalProceedsAmt |
| In Reserve Fund | $10,998,893 | InReserveFundAmt |
| Issuance Costs From Proceeds | $3,087,477 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $106,281,906 | CapitalExpendituresAmt |
| Other Spent Proceeds | $3,817,000 | OtherSpentProceedsAmt |
| Unspent | $519,735 | UnspentAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | HOLZER 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 COMPANCY IS $35,000 STARTING IN MAY 2014. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 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 12C | THE 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 15 | HE 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 2014. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE 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 XI, LINE 9: | TRANSFERS TO/FROM AFFILIATES 33,179,392. |
| FORM 990, PART XI, LINE 2C | THE AUDIT OVERSIGHT PROCESS AND THE PROCESS OF SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. |
| SCHEDULE K, PART I | DESCRIPTION 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. |
| FORM 990, PART VI, LINE 16 | THE 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| HOLZER DENTAL CLINIC JACKSON | |||||||||
| 100 JACKSON PIKE | GALLIPOLIS | OH | 45631 | 275346256 | HEALTHCARE | OH | $1,018,798 | $1,930,742 | HOLZER HEALTH SYSTEM |
| HOLZER CLINIC LLC | |||||||||
| 90 JACKSON PIKE | GALLIPOLIS | OH | 45631 | 310917085 | PHYSICIAN PRACTICES | OH | $132,214,873 | $33,638,376 | HOLZER HEALTH SYSTEM |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HOLZER FOUNDATION | ||||||||||
| 100 JACKSON PIKE | GALLIPOLIS | OH | 45631 | 310927482 | CONTINUING ADVANCEMENT OF HEALTH AND MEDICAL CARE | OH | 501(C)(3) | LINE 7 | HOLZER HEALTH SYSTEM | Yes (1) |
| HOLZER MEDICAL CENTER - JACKSON | ||||||||||
| 100 JACKSON PIKE | GALLIPOLIS | OH | 45631 | 311724085 | HEALTH CARE | OH | 501(C)(3) | LINE 3 | HOLZER HEALTH SYSTEM | Yes (1) |
| HOLZER SENIOR CARE CENTER | ||||||||||
| 380 COLONIAL DRIVE | BIDWELL | OH | 45614 | 311534051 | SKILLED NURSING FACILITY | OH | 501(C)(3) | LINE 9 | HOLZER HEALTH SYSTEM | Yes (1) |
| HOLZER HOSPITAL FOUNDATION | ||||||||||
| 100 JACKSON PIKE | GALLIPOLIS | OH | 45631 | 314379491 | HEALTH CARE | OH | 501(C)(3) | LINE 3 | HOLZER HEALTH SYSTEM | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLZER VANGUARD INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 JACKSON PIKE | AddressLine1 |
| City | GALLIPOLIS | City |
| State | OH | State |
| ZIP Code | 45631 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311192567 | EIN |
| Primary Activities | STOCK HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLZER HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $3,193,271 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $3,888,877 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HOLZER HOSPITAL FOUNDATION | ||
| K | $108,176 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| J | $6,655,400 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| M | $40,630,125 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| N | $3,256,609 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| Q | $532,989 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| P | $1,737,640 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| S | $131,746 | ACCRUAL TRANSACTION |
| HOLZER MEDICAL CENTER - JACKSON | ||
| L | $1,294,000 | ACCRUAL TRANSACTION |
| HOLZER SENIOR CARE CENTER | ||
| A | $11,333 | ACCRUAL TRANSACTION |
| HOLZER HOSPITAL FOUNDATION | ||
| A | $427,312 | ACCRUAL TRANSACTION |