2015-11-12T20:05:33-06:00 2014-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE STE 4200 INDIANAPOLIS IN 462045108 990 2014-01-01 341831624 VISITING NURSE HOSPICE AND HEALTH CARE VISI 4198247434 5855 MONROE STREET SYLVANIA OH 43560 LEE W HAMMERLING PRESIDENT 4194693842 2015-11-12 1 SAMANTHA BOKORI P01057347 3174648600 2014 2016-02-25 16:41:14Z LEE W HAMMERLING 1801 RICHARDS ROAD TOLEDO OH 43607 9159143 0 X WWW.PROMEDICA.ORG X 1996 OH VISITING NURSE HOSPICE AND HEALTH CARE (VNH&HC) PROVIDES QUALITY HOSPICE CARE AND OTHER HEALTHCARE SERVICES TO THE RESIDENTS OF NORTHWEST OHIO AND SOUTHEAST MICHIGAN. THIS FULL RANGE OF COMPREHENSIVE HOME HEALTHCARE SERVICES IS TAILORED TO THE INDIVIDUAL PATIENT'S NEEDS. SKILLED HOME CARE CLINICIANS, IN COLLABORATION WITH PHYSICIANS, OFFER SERVICES SUCH AS PROFESSIONAL NURSING, INFUSION THERAPY, INTERMITTENT CARE, MEDICAL SOCIAL SERVICES, HOME HEALTH AIDES, AND SPEECH THERAPIES. THROUGH VNH&HC, SERVICES PROVIDED ARE GUIDED BY THE HOSPICE PHILOSOPHY IN WHICH THE FOCUS OF CARE IS ON THE QUALITY OF AN INDIVIDUAL'S LIFE. THE GOAL IS TO IMPROVE THE PATIENT'S QUALITY OF LIFE THROUGH PAIN AND SYMPTOM MANAGEMENT, IMPROVE THE FUNCTIONAL CAPACITY FOR PATIENTS WITH SERIOUS CHRONIC AND TERMINAL ILLNESSES, AND MEET THE NEEDS OF THE PATIENT'S FAMILY MEMBERS. 20 10 174 83 0 0 145845 50250 8427629 8794519 28614 42937 0 0 8602088 8887706 0 0 0 0 2853388 5951001 0 0 0 2012195 2158836 4865583 8109837 3736505 777869 10721844 11751916 478840 733341 10243004 11018575 X VISITING NURSE HOSPICE AND HEALTH CARE WILL SUPPORT PROMEDICA HEALTH SYSTEM, INC. BY PROVIDING ACCESS TO A SEAMLESS CONTINUUM OF SERVICES IN THE COMMUNITIES WE SERVE. 0 0 5062507 5870540 VISITING NURSE HOSPICE AND HEALTH CARE (VNH&HC) PROVIDES HOSPICE (HOME CARE) THAT FOCUSES ON THE QUALITY OF AN INDIVIDUAL'S LIFE. THE GOAL IS TO IMPROVE THE PATIENT'S QUALITY OF LIFE THROUGH PAIN AND SYMPTOM MANAGEMENT, IMPROVE THE FUNCTIONAL CAPACITY FOR PATIENTS WITH SERIOUS CHRONIC AND TERMINAL ILLNESSES AND MEET THE NEEDS OF THE PATIENT'S FAMILY MEMBERS. SEE SCHEDULE O. 1890880 2302171 VISITING NURSE HOSPICE AND HEALTH CARE (VNH&HC) PROVIDES INPATIENT HOSPICE FOR RESIDENTS OF NORTHWEST OHIO. SEE SCHEDULE O. 552882 435080 VISITING NURSE HOSPICE AND HEALTH CARE (VNH&HC) PROVIDES PRIVATE DUTY NURSE CARE FOR RESIDENTS OF NORTHWEST OHIO. SEE SCHEDULE O. 167835 186728 VISITING NURSE HOSPICE AND HEALTH CARE PROVIDES RESIDENTIAL EMERGENCY RESPONSE SYSTEMS AND LOCAL SCHOOL SYSTEM NURSE CARE. 167835 186728 7674104 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 174 1 0 0 0 0 0 0 0 0 0 0 X 20 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X RICH POTTER 4198918506 5901 MONCLOVA ROAD MAUMEE OH 43537 MICHELLE D BOOSE MD MPH TRUSTEE 1.00 45.00 X 0 199759 18583 JAMES H BRENNAN JR TRUSTEE 1.00 6.00 X 0 0 0 GREGORY B DENNY TRUSTEE 1.00 6.00 X 0 0 0 BRIAN A DOLSEY MD TRUSTEE 1.00 45.00 X 0 591466 29963 LYNN L FRUTH TRUSTEE 1.00 6.00 X 0 323 0 THEODORE T HAHN TRUSTEE 1.00 6.00 X 0 0 0 JONATHAN K HARDING TRUSTEE 1.00 6.00 X 0 0 0 JILL K KEGLER TRUSTEE 1.00 6.00 X 0 0 0 MARGARET L LENT MSN TRUSTEE 1.00 45.00 X 0 87957 15257 BRIAN MILLER MD TRUSTEE 1.00 45.00 X 0 279332 34696 JOSEPH D NAPOLI TRUSTEE 1.00 7.00 X 0 0 0 ROBERT J NAVARRE MD FACS TRUSTEE 1.00 45.00 X 0 482109 40012 RANDALL OOSTRA EX OFFICIO 1.00 54.00 X 0 1409151 92942 KEVIN T RAHE TRUSTEE 1.00 6.00 X 0 0 0 ALLAN M RUBIN MD PHD TRUSTEE 1.00 45.00 X 0 439434 35392 DEBRA G SCHAEFER TRUSTEE 1.00 6.00 X 0 0 0 C MICHAEL SMITH TRUSTEE 1.00 6.00 X 0 0 0 STEPHEN H STAELIN EX OFFICIO 1.00 9.00 X 0 0 0 RONALD J WAINZ MD TRUSTEE 1.00 45.00 X 0 545007 44307 LEE W HAMMERLING MD PRESIDENT, EX OFFICIO 1.00 47.00 X X 0 739430 68260 ROBERT J CHIRDON CHAIRPERSON 1.00 7.00 X X 0 0 0 KATHLEEN S HANLEY TREASURER (THRU 5/14) 0.50 50.50 X 0 704046 822147 ALAN M SATTLER TREASURER 0.50 52.50 X 0 438639 68941 JEFFREY C KUHN SECRETARY 0.50 50.00 X 0 532963 69020 KIM MCCLURE VP FINANCE, PPCS 0.50 42.50 X 0 223383 42225 RANDALL SCHIMMOELLER SR. VP OPS, PCCS 0.50 41.50 X 0 287347 38898 GARY AKENBERGER FORMER KEY EMPLOYEE 0.00 44.00 X 0 342500 69169 KATHLEEN KRUEGER FORMER OFFICER 0.00 40.00 X 0 293051 25199 GLADEEN ROBERTS FORMER OFFICER 0.00 0.00 X 0 284472 21408 0 7880369 1536419 0 1 1 0 0 50250 50250 NET PATIENT SERVICES 621610 8794519 8794519 8794519 23062 23062 291312 271437 19875 19875 19875 8887706 8794519 0 42937 X 4709633 4450497 259136 72392 68409 3983 761870 719950 41920 407106 384706 22400 5574 5574 1253937 1253937 118904 115896 3008 142990 46384 96606 267805 265721 2084 131701 131701 INTERCOMPANY SERVICES 78042 78042 DRUGS 63971 63971 MEDICAL SUPPLIES 43030 43030 EQUIPMENT RENTAL 33302 32957 345 19580 18903 677 8109837 7674104 435733 0 5002706 3526537 584892 1002438 7992 4291662 962101 3399829 3329561 1355300 3466635 379117 418753 10721844 11751916 240008 464531 238832 268810 478840 733341 X 10243004 11018575 0 0 10243004 11018575 10721844 11751916 777869 -2298 0 X 0 1 X 1 0 X 270272 248194 227668 145845 50250 942229 3536454 3698841 5716184 8427629 8794519 30173627 3806726 3947035 5943852 8573474 8844769 31115856 59222 44880 22527 126629 0 59222 44880 22527 126629 30989227 33751 12835 17794 17337 23062 104779 33751 12835 17794 17337 23062 104779 3840477 3959870 5961646 8590811 8867831 31220635 0.99260 0.98450 0.00340 0.00720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3576553 580891 2995662 291969 80097 211872 423140 301113 122027 3329561 DUE TO AFFILIATES 268810 268810 X PART X, LINE 2: VISITING NURSE HOSPICE AND HEALTH CARE IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES (PHS). THE FOLLOWING REFLECTS PHS'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740. EXCEPT AS NOTED BELOW, PHS DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2014 AND 2013. FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013, A TAXABLE SUBSIDIARY OF PHS RECOGNIZED A LIABILITY FOR UNCERTAIN TAX POSITIONS OF $9,027,000 AND $1,059,000, RESPECTIVELY. THE SUBSIDIARY RECOGNIZED A CREDIT FOR INTEREST AND PENALTIES WITHIN THE INCOME TAX EXPENSE LINE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS RELATED TO UNRECOGNIZED TAX BENEFITS OF $1,000 AND $20,000 AS OF DECEMBER 31, 2014 AND 2013, RESPECTIVELY. VISITING NURSE HOSPICE AND HEALTH CARE DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2014 AND 2013. 1 1 0 0 0 0 1 0 0 MICHELLE D BOOSE MD MPH TRUSTEE 0 192979 0 0 0 6780 0 5049 0 13534 0 218342 0 0 BRIAN A DOLSEY MD TRUSTEE 0 458506 0 115385 0 17575 0 9635 0 20328 0 621429 0 0 BRIAN MILLER MD TRUSTEE 0 255018 0 22444 0 1870 0 16084 0 18612 0 314028 0 0 ROBERT J NAVARRE MD FACS TRUSTEE 0 432782 0 33925 0 15402 0 7800 0 32212 0 522121 0 0 RANDALL OOSTRA EX OFFICIO 0 889303 0 470455 0 49393 0 78755 0 14187 0 1502093 0 35100 ALLAN M RUBIN MD PHD TRUSTEE 0 423275 0 0 0 16159 0 17000 0 18392 0 474826 0 0 RONALD J WAINZ MD TRUSTEE 0 527631 0 0 0 17376 0 14167 0 30140 0 589314 0 0 LEE W HAMMERLING MD PRESIDENT, EX OFFICIO 0 516622 0 180962 0 41846 0 52693 0 15567 0 807690 0 0 KATHLEEN S HANLEY TREASURER (THRU 5/14) 0 457284 0 200510 0 46252 0 805713 0 16434 0 1526193 0 0 ALAN M SATTLER TREASURER 0 309066 0 97460 0 32113 0 48009 0 20932 0 507580 0 0 JEFFREY C KUHN SECRETARY 0 363111 0 157073 0 12779 0 45715 0 23305 0 601983 0 0 KIM MCCLURE VP FINANCE, PPCS 0 154861 0 39241 0 29281 0 35465 0 6760 0 265608 0 10629 RANDALL SCHIMMOELLER SR. VP OPS, PCCS 0 208694 0 51148 0 27505 0 25904 0 12994 0 326245 0 0 GARY AKENBERGER FORMER KEY EMPLOYEE 0 238713 0 69268 0 34519 0 48981 0 20188 0 411669 0 0 KATHLEEN KRUEGER FORMER OFFICER 0 217758 0 70411 0 4882 0 14977 0 10222 0 318250 0 0 GLADEEN ROBERTS FORMER OFFICER 0 0 0 0 0 284472 0 9305 0 12103 0 305880 0 280908 PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF VISITING NURSE HOSPICE AND HEALTH CARE, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4A: UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: GLADEEN ROBERTS $280,908 PART I, LINE 4B: ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KIM MCCLURE $10,667 RANDALL OOSTRA $54,312 IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. PART I, LINE 6: CERTAIN LISTED PERSONS RECEIVE INCENTIVES BASED ON INDIVIDUAL PRODUCTIVITY NET EARNINGS. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF PROMEDICA PHYSICIANS & CONTINUUM SERVICES, WHICH IS THE SOLE MEMBER OF VISITING NURSE HOSPICE AND HEALTH CARE. PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF VISITING NURSE HOSPICE AND HEALTH CARE, AND (B) FILL ANY VACANCY OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11 UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE WITHIN 30 DAYS OF NOTIFICATION. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED, COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT, AND A LIST OF ALL NEW EMPLOYEES HIRED DURING THE PREVIOUS 12 MONTHS. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 VISITING NURSE HOSPICE AND HEALTH CARE'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF VISITING NURSE HOSPICE AND HEALTH CARE'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G HOSPICE ROOM AND BOARD: PROGRAM SERVICE EXPENSES 1,056,236. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,056,236. PHYSICIAN/THERAPY SERVICES: PROGRAM SERVICE EXPENSES 131,909. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 131,909. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 65,792. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,792. FORM 990, PART III, LINE 4: PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2014 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 332 SITES, MORE THAN 2,100 PHYSICIANS AND APPROXIMATELY 17,000 EMPLOYEES AND VOLUNTEERS. DURING 2014, PROMEDICA DISCHARGED 72,595 INPATIENTS AND SERVED MORE THAN 1,407,416 OUTPATIENTS, WHILE HANDLING 305,747 EMERGENCY VISITS SYSTEM-WIDE. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2014, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 34 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $3.7 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. ADDITIONALLY, OUR PHYSICIANS, LEADERSHIP TEAM MEMBERS AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE GOODS TO NUMEROUS LOCAL FOOD PANTRIES AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); MEMORIAL HOSPITAL; AND ST. LUKE'S HOSPITAL. IN 2014, PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH MORE THAN 800 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS. TOGETHER, THIS GROUP HELPS PROMEDICA BROADEN THE CARE WE OFFER TO AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2014, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 220,000 MEMBERS ACROSS ALL OF OHIO'S 88 COUNTIES. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF THE TOLEDO HOSPITAL. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH MORE THAN 300 LOCAL NONPROFIT AGENCIES AND ORGANIZATIONS IN 2014 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN. PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES, TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2014 INCLUDE THE FOLLOWING: - PROMEDICA SIGNED A DEFINITIVE AGREEMENT WITH MERCY MEMORIAL HOSPITAL CORPORATION IN MONROE, MICHIGAN, WITH THE HEALTH SYSTEM BECOMING A MEMBER OF PROMEDICA EFFECTIVE JAN. 1, 2015. BY SHARING RESOURCES AND CLINICAL EXPERTISE, THE JOINDER HELPS BROADEN THE DEPTH AND BREADTH OF OUR SERVICES FOR RESIDENTS OF SOUTHEASTERN MICHIGAN. - PROMEDICA FORMED A JOINT OPERATING COMPANY (JOC) WITH LOCAL BEHAVIORAL HEALTH PROVIDER HARBOR TO ADDRESS A GROWING COMMUNITY NEED FOR MENTAL HEALTH SERVICES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. THE JOC WILL HELP INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES AND ENHANCE CARE THROUGH A MORE INTEGRATED, COORDINATED MODEL. - PROMEDICA SPONSORED A SCHOOL-BASED FOOD DRIVE CHALLENGE AS PART OF ITS COME TO THE TABLE INITIATIVE. SCHOOLS HAVE RAISED MORE THAN 24,000 POUNDS OF NON-PERISHABLE FOOD ITEMS OVER THE PAST TWO YEARS FOR COMMUNITY FOOD PROGRAMS ACROSS PROMEDICA'S SERVICE AREA. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 74 CENTRAL-CITY TEENS AGES 16-19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA CONTINUED ITS CHILDHOOD OBESITY PILOT PROGRAM, WHICH FOCUSED ON CHILDREN AND ADOLESCENTS WITH A BODY MASS INDEX (BMI) THAT CLASSIFIES THEM AS OBESE. FAMILIES MET QUARTERLY OVER A 12-MONTH PERIOD WITH A DIETITIAN IN A PHYSICIAN'S OFFICE OR OUTPATIENT CLINIC TO RECEIVE NUTRITION COUNSELING AND ASK QUESTIONS. EACH CHILD'S BMI AND RESPONSES TO A HEALTH QUESTIONNAIRE WERE COLLECTED BEFORE, DURING AND AFTER THE 12-MONTH PERIOD TO DETERMINE THE PROGRAM'S EFFECTIVENESS. - COORDINATED THROUGH OUR ADVOCACY DEPARTMENT, PROMEDICA CONTINUED TO PROVIDE HEALTH AND NUTRITION EDUCATION TO ELEMENTARY SCHOOL CHILDREN IN GRADES 1 - 6. THE HEALTHY KIDS CONVERSATION MAP(R) PROGRAM IS DESIGNED TO EMPOWER STUDENTS AND THEIR PARENTS/GUARDIANS TO MAKE HEALTHY CHOICES ABOUT FOOD AND EXERCISE. - PROMEDICA PHYSICIANS EXPANDED CARE TO BETTER COVER LOCAL AND RURAL COMMUNITIES, ADDING MORE THAN 95 NEW PRIMARY CARE PHYSICIANS, SPECIALISTS AND ADVANCED PRACTICE PROVIDERS IN 2014. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS THAT INCLUDED NEARLY 8,000 FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - AS PART OF ITS HUNGER-FREE INITIATIVE, PROMEDICA CONTINUED TO IMPLEMENT A FOOD RECLAMATION PROGRAM IN PARTNERSHIP WITH HOLLYWOOD CASINO (ROSSFORD, OHIO), AS WELL AS THE TOLEDO AND FLOWER HOSPITALS, PROVIDING MORE THAN 160,000 POUNDS OF REPACKAGED, UN-SERVED FOOD TO COMMUNITY FEEDING SITES. THE TOLEDO MUD HENS AND OWENS COMMUNITY COLLEGE ARE THE NEWEST PARTNERS TO JOIN THE INITIATIVE. - MORE THAN 150 PEOPLE JOINED PROMEDICA AND THE ALLIANCE TO END HUNGER IN FEBRUARY IN WASHINGTON D.C. TO DISCUSS HOW HUNGER AFFECTS AMERICANS' HEALTH AND WELL-BEING AS WELL AS WAYS TO ADDRESS AND SOLVE THE HUNGER PROBLEM. BASED ON PROMEDICA'S COME TO THE TABLE INITIATIVE TO ADDRESS HUNGER AS A HEALTH ISSUE, THE NATIONAL SUMMIT FEATURED AN ARRAY OF SPEAKERS ON HUNGER AND HEALTH AS THE PARTNERS CONTINUE WORKING TO END U.S. HUNGER BY ENCOURAGING JOINT EFFORTS NATIONWIDE. THE SUCCESS OF THE PROGRAM PROMPTED ADDITIONAL REGIONAL HUNGER SUMMITS - IN CHICAGO IN MAY, AND ATLANTA IN NOVEMBER - FEATURING GUEST SPEAKERS AND OTHER AGENCIES ADDRESSING HUNGER THROUGHOUT THE COUNTRY. - PROMEDICA CANCER INSTITUTE'S COMMUNITY OUTREACH INCLUDED SCREENINGS FOR SKIN CANCER; EDUCATION SESSIONS ON COLON CANCER; THE FIFTH ANNUAL SURVIVOR CELEBRATIONS FOR CANCER SURVIVORS, FRIENDS AND CAREGIVERS; AND SPONSORSHIP OF THE ANNUAL SUSAN G. KOMEN(R) RACE FOR THE CURE IN SUPPORT OF BREAST CANCER RESEARCH. - PROMEDICA RETAIL GROUP (PROMEDICA FLOWER MARKET) - A STAND-ALONE RETAIL BUSINESS LOCATED NEAR THE CAMPUS OF THE TOLEDO HOSPITAL - BEGAN HOSTING MONTHLY GARDEN GROCER "FIRST FRIDAY" EVENTS TO DISCUSS GOOD NUTRITION AND OFFER HEALTHY COOKING DEMONSTRATIONS ALONG WITH RECIPES AND OTHER HANDOUTS. THE EVENTS WERE HELD THE FIRST FRIDAY OF EACH MONTH AND FEATURED TIPS AND ADVICE FROM PROMEDICA'S CLINICAL DIETITIANS. - THROUGH ITS ADVOCACY FUND, PROMEDICA CONTINUED TO SUPPORT LOCAL COMMUNITY ORGANIZATIONS THAT PROVIDE ASSISTANCE TO THOSE IN NEED WITH BASIC NECESSITIES THAT DIRECTLY IMPACT INDIVIDUALS' HEALTH AND WELL-BEING. THIS SUPPORT AMOUNTED TO GRANTS TOTALING NEARLY $375,000 IN 2014. - PROMEDICA OPENED ITS 55,000 SQUARE FOOT MARY ELLEN FALZONE DIABETES CENTER IN FEBRUARY 2014. THE FACILITY IS NAMED FOR A YOUNG GIRL WHO DIED FROM JUVENILE DIABETES BEFORE HER FAMILY EVEN KNEW SHE HAD THE DISEASE. LOCATED ON THE CAMPUS OF THE TOLEDO HOSPITAL, THE CENTER OFFERS DIABETES PROGRAMS, SERVICES AND PHYSICIANS TOGETHER IN ONE CONVENIENT LOCATION TO SERVE ALL COMMUNITY MEMBERS WORKING TO MANAGE THEIR DIABETES. - FLOWER HOSPITAL COMPLETED EXPANSION OF ITS PSYCHIATRIC CARE UNIT IN MARCH. THE ADDITION INCLUDES 18 INPATIENT ROOMS, A COMMON SPACE FOR PATIENTS AND SPECIAL SECURITY MEASURES TO PROVIDE ADDED PROTECTION FOR THIS PATIENT POPULATION. PROMEDICA IS COMMITTED TO EXPANDING BEHAVIORAL HEALTH SERVICES SYSTEM-WIDE TO MEET THE NEEDS OF OUR COMMUNITIES. - THE TOLEDO AND TOLEDO CHILDREN'S HOSPITALS COMPLETED CONSTRUCTION OF NEW IMAGING AND INPATIENT PHARMACY CENTERS IN THE EXISTING RENAISSANCE TOWER. LOCATED ON THE FIRST LEVEL, THE NEW RADIOLOGY SPACE PROVIDES A CENTRALIZED LOCATION FOR ALL RADIOLOGY SERVICES, EXCLUDING BREAST CARE. THE SPACE ALSO FEATURES A LAB DRAW SITE, WHILE A NEW INPATIENT PHARMACY LOCATION PROVIDES OPERATIONAL EFFICIENCIES AND IMPROVED WORKFLOW TO BETTER SERVE OUR PATIENTS AND CAREGIVERS. - ST. LUKE'S HOSPITAL'S EMERGENCY DEPARTMENT RENOVATION WAS COMPLETED, ENHANCING PATIENT PRIVACY AND COMFORT WHILE IMPROVING DEPARTMENT WORKFLOW FOR CAREGIVERS AND PATIENTS ALIKE. - PROMEDICA HOME HEALTH CARE'S ER2HOME PROGRAM LAUNCHED AT FLOWER HOSPITAL IS DESIGNED TO AVOID HOSPITAL READMISSIONS FOR HIGH-RISK, HIGH-COST PATIENTS WHO COME TO THE EMERGENCY CENTER. THROUGH ER2HOME, PATIENTS RECEIVE A 30-DAY INTENSIVE SKILLED NURSING AND TELEHEALTH MONITORING PROGRAM TO HELP THEM BETTER MANAGE THEIR HEALTH CONDITION. - PROMEDICA SIGNED A MULTI-YEAR CONTRACT TO IMPLEMENT EPIC ENTERPRISE SOLUTIONS SYSTEM-WIDE. THE NEW CONTRACT WILL MOVE PROMEDICA TO A MORE INTEGRATED ELECTRONIC HEALTH RECORD (EHR) PLATFORM THAT WILL FURTHER ENABLE ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF THE SERVICE. - PROMEDICA PHYSICIANS OPENED A SECOND PROMEDICA AFTERHOURS LOCATION IN OREGON, OHIO PROVIDING RESIDENTS WITH DIAGNOSIS AND TREATMENT FOR NON-EMERGENCY MEDICAL ISSUES AS WELL AS PRESCRIPTION SERVICES. PROVIDING NEW OPTIONS FOR MEDICAL CARE WHEN PHYSICIAN OFFICES NORMALLY ARE CLOSED, AFTERHOURS IS STAFFED BY PROMEDICA PHYSICIANS CERTIFIED NURSE PRACTITIONERS AND IS OPEN NIGHTS, WEEKENDS AND HOLIDAYS - 365 DAYS A YEAR. - PROMEDICA EMPLOYEES PLEDGED MORE THAN $400,000 TO THE UNITED WAY CAMPAIGN IN 2014, SUPPORTING NUMEROUS COMMUNITY PROGRAMS AND SERVICES ACROSS NORTHWEST OHIO AND SOUTHEAST MICHIGAN. - PROMEDICA'S CULTURE OF SAFETY PROGRAM WAS EXPANDED THROUGH IMPLEMENTATION OF ERROR PREVENTION TRAINING FOR EMPLOYEES SYSTEM-WIDE. BY YEAR END, MORE THAN 90 PERCENT OF PHYSICIANS AND MORE THAN 13,000 ACUTE CARE EMPLOYEES HAD COMPLETED ERROR PREVENTION TRAINING. THE PATH TO SAFE, PATIENT-CENTERED CARE AND SERVICE IS DESIGNED TO ENGAGE PATIENTS AND FAMILIES AND IMPROVE CARE COORDINATION TO DELIVER BETTER OUTCOMES AND SERVICES ACROSS THE SYSTEM. IN 2014, PROMEDICA CONTRIBUTED $148,727,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $51,018,000 IN 2014. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; COLLEGE SCHOLARSHIPS FOR STUDENTS ENTERING HEALTHCARE CAREERS; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $20,165,000 IN FINANCIAL ASSISTANCE FOR PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2014 WAS $24,864,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $148,727,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. ADDITIONALLY DURING 2014, PROMEDICA PROVIDED $77,544,000 OF COMMUNITY BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2014 WAS $89,329,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $148,727,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. VISITING NURSE HOSPICE AND HEALTH CARE - PROGRAM SERVICE ACCOMPLISHMENTS VISITING NURSE HOSPICE AND HEALTH CARE (VNHHC) PROVIDES QUALITY HOSPICE CARE AND OTHER HEALTHCARE SERVICES TO RESIDENTS OF NORTHWEST OHIO AND SOUTHEAST MICHIGAN. THIS FULL RANGE OF COMPREHENSIVE HOME HEALTHCARE SERVICES IS TAILORED TO THE INDIVIDUAL PATIENT'S NEEDS. SKILLED HOME CARE CLINICIANS, IN COLLABORATION WITH PHYSICIANS, OFFER SERVICES SUCH AS PROFESSIONAL NURSING, INFUSION THERAPY, INTERMITTENT CARE, MEDICAL SOCIAL SERVICES, HOME HEALTH AIDES, AND SPEECH THERAPIES. IN OHIO, VNHHC SERVES LUCAS, WOOD, FULTON, HENRY, WILLIAMS, DEFIANCE, HANCOCK, SENECA, OTTAWA, AND SANDUSKY COUNTIES. IN MICHIGAN, VNHHC SERVES HILLSDALE, LENAWEE AND MONROE COUNTIES. VNHHC IS PART OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. VNHHC SERVICES ARE PROVIDED IN A MANNER THAT SUPPORTS THE HOSPICE PHILOSOPHY, WITH A FOCUS ON PALLIATIVE CARE AND QUALITY OF LIFE. THE GOAL IS TO IMPROVE THE PATIENT'S QUALITY OF LIFE THROUGH PAIN AND SYMPTOM MANAGEMENT, IMPROVE THE FUNCTIONAL CAPACITY FOR PATIENTS WITH SERIOUS CHRONIC AND LIFE-LIMITING ILLNESSES, AND MEET THE NEEDS OF THE PATIENT'S FAMILY MEMBERS. THIS CARE MAY BE OFFERED IN PATIENTS' HOMES OR IN THE EBEID HOSPICE RESIDENCE ON THE CAMPUS OF FLOWER HOSPITAL IN SYLVANIA, OHIO. IN 2014, VNHHC ADMITTED 867 PATIENTS TO THE SERVICE AND PROVIDED 37,637 DAYS OF HOSPICE CARE. VNHHC CONTRIBUTED $74,000 IN COMMUNITY BENEFIT THROUGH FINANCIAL ASSISTANCE. VNHHC PROVIDED FINANCIAL ASSISTANCE TO THE COMMUNITY WHICH REPRESENTS UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DO NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HEALTHCARE SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. VNHHC'S COST OF BAD DEBT FOR 2014 WAS $21,000. THIS AMOUNT IS NOT INCLUDED IN VNHHC'S COMMUNITY BENEFIT AMOUNT OF $74,000 NOTED ABOVE. FURTHER, VNHHC PROVIDED $1,284,000 OF TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $74,000 NOTED ABOVE. DURING 2014, VNHHC ALSO EXPENDED $3,539,000 IN NET PAYROLL, PROVIDING 129 JOBS IN NORTHWEST OHIO. A TOTAL OF $202,000 WAS WITHHELD FROM EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, VNHHC DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, PROMEDICA PROVIDES THESE HEALTHCARE SERVICES; RECRUITS AND TRAINS HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDES APPROPRIATE FINANCIAL ASSISTANCE; OFFERS SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENTS FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. COMMUNITY BENEFIT DEFINITIONS PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (THE SYSTEM) PREPARES ITS COMMUNITY BENEFIT REPORTS USING REPORTING GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY THE SYSTEM RESPOND TO AN IDENTIFIED COMMUNITY NEED AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE MEDICAL OR HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, THE SYSTEM PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH FEDERAL, STATE AND LOCAL MEANS-TESTED PROGRAMS SUCH AS MEDICAID. THE SYSTEM INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN THE SYSTEM'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY THE SYSTEM. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR INTERNSHIPS AND RESIDENCY EDUCATION, THE PROVISION OF A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING FOR STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR EDUCATION THAT IS LINKED TO COMMUNITY SERVICES AND HEALTH IMPROVEMENT. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET PATIENT DEMAND. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR THE SYSTEM IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND/OR THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF TO THE COMMUNITY WHILE ON WORK TIME; AS WELL AS DONATION OF FOOD, EQUIPMENT AND SUPPLIES. 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