2014-11-14T12:34:54-06:00 2013-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE STREET SUITE 600 COLUMBUS OH 43215 990 2013-01-01 344441792 H B MAGRUDER MEMORIAL HOSPITAL HBMA 4197343131 615 FULTON STREET PORT CLINTON OH 43452 RONALD A WEINER CFO 4197343131 2014-11-13 1 BERNIE OSTROWSKI P00366367 6148493000 2013 2015-11-30 17:44:51Z MAGRUDER HOSPITAL JON TODD ALMENDINGER 615 FULTON STREET PORT CLINTON OH 43452 51250549 0 X WWW.MAGRUDERHOSPITAL.COM X 1940 OH MAGRUDER HOSPITAL SHALL PROVIDE COMPASSIONATE CARE WITH EXCELLENT OUTCOMES. 14 12 441 100 0 0 132591 167459 48112866 49984521 150874 253035 4372184 568787 52768515 50973802 7000 7500 0 0 21746040 22095770 0 0 5255 26897789 27507596 48650829 49610866 4117686 1362936 47800167 50305893 8483634 8727561 39316533 41578332 X SEE SCHEDULE OMAGRUDER SHALL:-PROVIDE QUALITY AND COMPASSIONATE MEDICAL CARE AND TREATMENT-PROMOTE HEALTH EDUCATION AND PREVENTATIVE CARE-IMPROVE THE COMMUNITY'S HEALTH STATUS-WORK COLLABORATIVELY AND COOPERATIVELY WITH AREA HEALTH PROVIDERS-STRIVE FOR CONTINUAL QUALITY IMPROVEMENT-BE COST-EFFECTIVE IN HOSPITAL OPERATIONS-ACHIEVE ALIGNMENT WITH THE GOALS AND OBJECTIVES OF THE STAFF PHYSICIANS 0 0 44441269 7500 50547057 SEE SCHEDULE OFOUNDED IN 1940, H B MAGRUDER MEMORIAL HOSPITAL (MAGRUDER) IS A 25 BED, MEDICARE DESIGNATED CRITICAL ACCESS TAX EXEMPT HEALTHCARE FACILITY, LOCATED IN PORT CLINTON, OHIO. THE HOSPITAL PROVIDES DIRECT HEALTHCARE SERVICES TO THE RESIDENTS IN THE COMMUNITIES OF OTTAWA COUNTY THAT INCLUDE BOTH INPATIENT AND OUTPATIENT SERVICES INCLUDING EMERGENCY SERVICES 24 HOURS PER DAY, 7 DAYS PER WEEK. PATIENTS ARE ACCEPTED REGARDLESS OF NATIONAL ORIGIN, AGE, RACE, CREED, SEX, OR ABILITY TO PAY.IN 2013, MAGRUDER EXPERIENCED A TOTAL OF 2,424 INPATIENT DAYS, INCLUDING 1,885 DAYS TO MEDICARE PATIENTS AND 49 DAYS TO MEDICAID PATIENTS. THE HOSPITAL EXPERIENCED 15,717 VISITS TO THE EMERGENCY DEPARTMENT, AND TREATED A TOTAL OF 74,526 OUTPATIENTS.WHILE MEDICARE, MEDICAID, AND PRIVATE INSURANCE PLANS AND PROGRAMS PAID FOR THE SERVICES OF MOST PATIENTS TREATED AND RELEASED AT MAGRUDER, UNCOMPENSATED CARE WAS PROVIDED BY THE HOSPITAL TO PATIENTS WHO WERE EITHER UNABLE OR UNWILLING TO PAY. THIS REFLECTED THE HOSPITAL'S MISSION TO CARE FOR PATIENTS EVEN IF UNABLE OR UNWILLING TO PAY FOR SERVICES NOT OTHERWISE COVERED BY PRIVATE INSURANCE AND/OR GOVERNMENTAL PROGRAMS.MAGRUDER CONTINUES ITS COMMITMENT TO SERVING THE PUBLIC HEALTH PREVENTION AND HEALTH EDUCATION NEEDS IN THE COMMUNITIES OF OTTAWA COUNTY. MAGRUDER CONTINUES TO KEEP AN ACTIVE ROLE IN THE OTTAWA COUNTY HEALTH PARTNERS, WHICH WAS A COLLABORATION WITH THE OTTAWA COUNTY HEALTH DEPARTMENT TO ASSESS THE SIGNFICANT NEEDS OF THE COMMUNITY. MAGRUDER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2012. RESULTS WERE ROLLED OUT IN OCTOBER 2012.OUR OUTREACH PROGRAMS CONTINUE TO TOUCH HUNDREDS OF LIVES IN OUR COMMUNITIES. -REDUCED FEE CHOLESTEROL SCREENING FOR THE COMMUNITY EACH MONTH (113 PARTICIPANTS)-ADMINISTERED FLU SHOTS AT BUSINESSES, HEALTH FAIRS AND PUBLIC CLINICS (404 PARTICIPANTS)-MEDICARE EDUCATION FOR THE COMMUNITY (IN ADDITION TO A LARGE PUBLIC EDUCATIONAL SESSION (55), WE HAD STAFF THROUGHOUT THE END OF THE YEAR OFFERING ONE ON ONE APPOINTMENTS FOR PART D COMPARISONS AND OTHER RESOURCES.)-KIWANIS LAB SCREENING TEST FOR 7 DIFFERENT MEDICAL CONDITIONS (170 PARTICIPANTS)-FREE SKIN CANCER SCREENING TO THE COMMUNITY (124 PARTICIPANTS)-FREE PROSTATE CANCER SCREENING TO THE COMMUNITY (70 PARTICIPANTS)-FREE COLORECTAL HEALTH SCREENING KITS TO THE COMMUNITY (46 PARTICIPANTS)-CANCER SUPPORT GROUP (53 PARTICIPANTS)-REDUCED FEE WELLNESS CLASSES FOR THE COMMUNITY (1,202 PARTICIPANTS)-GENERAL HEALTH SCREENINGS (USUALLY BLOOD PRESSURE & BLOOD SUGAR) AT COMMUNITY EVENTS (238 PARTICIPANTS)-BOARD INVOLVEMENT IN: PROJECT LIFESAVER, 3 AREA CHAMBERS OF COMMERECE, 3 LOCAL SCHOOL WELLNESS COMMITTEES, COUNCIL OF HEALTH AND SOCIAL CONCERNS.-MAGRUDER SPONSORED 4 BLOOD DRIVES IN 2013 WHICH INCLUDES NOT ONLY THE SPACE AND PROMOTION FOR THE EVENT BUT ALSO ALLOWED 72 EMPLOYEES TO DONATE ON WORK TIME.-EDUCATION PROGRAMS (OVER 1,000 PARTICIPANTS)-COMMUNITY EVENTS: MEN'S PRAYER BREAKFAST (PHYSICAL ACTIVITY), THE VINEYARD (MEDICARE), REBIRTH CHURCH (HEALTH SCREENINGS), MEDICAL INFORMATION NOTEBOOK, FAMILY FUN NIGHT AT DANBURY SCHOOLS (YOUTH NUTRITION).-MONTHLY LUNCHEONS: WOMEN'S HEALTH, ELECTRONC MEDICAL RECORDS, HIP REPLACEMENT, ADVANCE DIRECTIVES, MENTAL HEALTH, SLEEP AND HEART, BREAST RECONSTRUCTION.-"TIME FOR HEALTH" TV SHOW: FITNESS, CRIME PREVENTION, ADVANCE DIRECTIVES, FLU, GARDENING/CANNING, NUTRITION, CHRONIC PAIN, WOMEN'S HEALTH, CHANGING HABITS. -MAGRUDER HOSPITAL ALSO SPONSORS OR PARTICIPATES IN THE FOLLOWING COMMUNITY BUILDING ACTIVITIES: -OTTAWA COUNTY FAIR -JOYFUL CONNECTIONS (SUPERVISED VISITATION AND EXCHANGE) -HABITAT FOR HUMANITY -JUVENILE DIABETES -PORT CLINTON SAFETY PATROL -PORT CLINTON ARTS COUNCIL -PORT CLINTON & OAK HARBOR ATHLETIC BOOSTER -AMERICAN RED CROSSOPPORTUNITIES ARE PROVIDED TO ASSIST IN THE DELIVERY OF HEALTHCARE AT THE HOSPITAL THROUGH VOLUNTEER SERVICE COORDINATED BY THE H B MAGRUDER MEMORIAL HOSPITAL AUXILIARY (AUXILIARY). THE AUXILIARY OPERATES THE HOSPITAL'S GIFT SHOP, AND PROVIDES VOLUNTEERS THAT WORK IN VARIOUS HOSPITAL DEPARTMENTS, INCLUDING: TRANSPORT, RADIOLOGY, NURSING, FOOD SERVICE, HEALTH INFORMATION SERVICES, LAB AND THE BUSINESS OFFICE. 44441269 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 89 0 1 441 1 0 0 0 0 0 1 1 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 1 0 OH X TONI MAGSIG ACCOUNTING DIRECTOR 4197343131 615 FULTON STREET PORT CLINTON OH 43452 PAUL DRUCKENMILLER CHAIR 1.00 0.00 X X 0 0 0 BRUCE SMITH VICE CHAIR 1.00 0.00 X X 0 0 0 NANCY OSBORN SECRETARY 1.00 0.00 X X 0 0 0 DAVID SODERBERG TREASURER 1.00 0.00 X X 0 0 0 DANIEL ALMENDINGER ASSISTANT SECRETARY 1.00 0.00 X X 0 0 0 JOHN BODIE MD DIRECTOR 1.00 0.00 X 0 0 0 EMIL CELLIER DIRECTOR 1.00 0.00 X 0 0 0 DOUGLAS FOCHT DIRECTOR 1.00 0.00 X 0 0 0 MARK HABLITZEL DDS DIRECTOR 1.00 0.00 X 0 0 0 RON MILLER DIRECTOR 1.00 0.00 X 0 0 0 KEVIN SNEIDER DPM DIRECTOR 1.00 0.00 X 0 0 0 LOCKWOOD ZEIS DIRECTOR 1.00 0.00 X 0 0 0 SUE CROSSER DIRECTOR 1.00 0.00 X 0 0 0 GREG DEERHAKE DIRECTOR 1.00 0.00 X 0 0 0 JON TODD ALMENDINGER PRESIDENT & CEO 40.00 0.00 X 249820 0 35054 KATHLEEN DURFLINGER VP OF NURSING 40.00 X 151262 0 10953 NICKOLAS MARSICO VP OF ANCILLARY SERVICES 40.00 X 89793 0 16279 RON WEINER CHIEF FINANCIAL OFFICER 40.00 X 125292 0 19027 DAVID BODIE PHYSICIAN 40.00 0.00 X 234703 0 36855 LEONARDO QUE PHYSICIAN 40.00 0.00 X 301685 0 371 JAMES MCLEAN PHYSICIAN 40.00 0.00 X 233211 0 36765 STEVEN JACKSON PHYSICIAN 40.00 0.00 X 256981 0 12704 DONALD REED PHYSICIAN 40.00 0.00 X 242678 0 23048 MICHAEL E LONG FORMER OFFICER 0.00 0.00 X 200969 0 18062 2086394 0 209118 25 1 1 0 PORT CLINTON EMERGENCY PHYSICIANS INC 3914 MEMORIAL SHOREWAY LAKESIDEMARBLEHEAD OH 43440 EMERGENCY PHYSICIANS 1996439 ADVANCED HEALTH LTD 2500 W STRUB RD STE 150 SANDUSKY OH 44870 PHYSICAL THERAPY 1327265 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 COMPUTER SUPPORT 972882 NET REVENUE ASSOCIATE 1330 CORPORATE SUITE 100 HUDSON OH 44236 CONSULTANTS 740015 ABAN AFFAN MD 4446 MARIN HARBOR UNIT C PORT CLINTON OH 43452 ANESTHESIOLOGIST 573775 12 41149 126310 167459 HEALTHCARE SERVICES 622110 49205612 49205612 PHYSICIAN OFFICE RENTAL 622110 407167 407167 MOBILE MEALS/FOOD SERVICE 622110 371742 371742 49984521 504971 504971 1800 253736 0 -253736 1800 -251936 -251936 29262 41149 23011 6251 6251 FLOW THROUGH INCOME 900099 364272 364272 PM CLINIC-MISC REV 900099 130146 130146 EHR INCENTIVE PAYMENTS 900099 43812 43812 24306 24306 562536 50973802 50547057 0 259286 X 7500 7500 697481 697481 15028866 12999969 2028897 991079 857283 133796 4041550 3495941 545609 1336794 1156327 180467 105091 99836 5255 110673 110673 11685918 11058376 627542 218314 218314 1667370 1341656 325714 900036 783031 117005 1475378 1261345 214033 89842 44921 44921 2447425 2447425 429477 429477 MEDICAL SUPPLIES 5761799 5761799 BAD DEBT EXPENSE 2471007 2471007 PHYSICIAN RECRUITMENT 60746 53244 7502 EDUCATION 59539 51799 7740 24981 1855 23126 49610866 44441269 5164342 5255 2350 2700 9596147 10746821 6737526 6247065 516787 873836 357461 349656 719914 694253 60099630 35278704 24101667 24820926 5372979 6168433 395336 402203 47800167 50305893 4813778 4463819 497452 376836 3172404 3886906 8483634 8727561 X 39281885 41536930 34648 41402 39316533 41578332 47800167 50305893 X 1362936 819772 79091 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 851 851 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO THE OHIO HOSPITAL ASSOCIATION RELATES TO LOBBYING. 686533 686533 33882599 16680425 17202174 626816 597165 29651 24716898 18001114 6715784 186784 186784 24820926 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 3578700 ACCRUED POST-RETIREMENT BEN. OBLIGATION 308206 3886906 X 49800801 819772 -2010417 -1190645 50991446 -17644 -17644 50973802 47545756 369099 369099 47176657 2434209 2434209 49610866 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, 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 HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. PART XI, LINE 2D - OTHER ADJUSTMENTS: POSTRETIREMENT RELATED COSTS 55,870. BAD DEBT EXPENSES -2,471,007. RECLASS OF CARDIAC SALARY OFFSET 58,633. PAIN MANAGEMENT REVENUE 346,087. PART XI, LINE 4B - OTHER ADJUSTMENTS: BOOK TO TAX DIFFERENCES FROM FLOW THROUGH INVESTMENTS 5,367. RECLASS OF SPECIAL EVENT EXPENSE -23,011. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS OF SPECIAL EVENT EXPENSE 23,011. PAIN MANAGEMENT EXPENSES 346,088. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSES 2,471,007. RECLASS OF CARDIAC SALARY OFFSET -58,633. AUXILIARY NET LOSS 21,835. X X CHARITY BALL 28967 19487 9480 9413 GOLF OUTING 41444 21662 19782 13598 70411 41149 29262 9413 13598 23011 6251 1 1 X 1 X 1 X 1 1 1 0 1 1 1327007 537860 789147 0.01670 5163452 2630438 2533014 0.05370 6490459 3168298 3322161 0.07040 9 2658 30332 5807 24525 0.00050 5 274574 274574 0.00580 3 450 15652 15652 0.00030 17 3108 320558 5807 314751 0.00660 17 3108 6811017 3174105 3636912 0.07700 5503 5503 0.00010 5503 5503 0.00010 0 2471007 123550 14589066 14603214 -14148 X 1 1 1 OTTAWA COUNTY CARENET GROUP CONTRACTING 0.50000 0.50000 1 1 HB MAGRUDER MEMORIAL HOSPITAL 615 FULTON STREET PORT CLINTON OH 43452 HTTP://WWW.MAGRUDERHOSPITAL.COM/ STATE REGIS X X X HB MAGRUDER MEMORIAL HOSPITAL 1 1 X X X X X X X 12 1 0 1 X HTTP://WWW.MAGRUDERHOSPITAL.COM/ X X X X X X X 1 0 1 1 100.000000000000 1 400.000000000000 1 X 1 1 X X X X X 1 0 X X X X 1 X 0 0 HB MAGRUDER MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: PLEASE SEE THE BELOW URL TO ACCESS THE 2012 IMPLEMENTATION STRATEGY.HTTP://WWW.MAGRUDERHOSPITAL.COM/ HB MAGRUDER MEMORIAL HOSPITAL PART V, SECTION B, LINE 20D: ALL PATIENTS ARE CHARGED AT GROSS CHARGES PER THE CHARGEMASTER. THOSE APPROVED FOR FINANCIAL ASSISTANCE ARE THEN GIVEN THE APPROPRIATE ALLOWANCE AND BILLED ANY REMAINING AMOUNT. 9 PHYSICIAN OFFICE 611 E 6TH STREET PORT CLINTON OH 43452 PHYSICIAN OFFICE PHYSICIAN OFFICE 621 FULTON STREET PORT CLINTON OH 43452 PHYSICIAN OFFICE PHYSICAL THERAPY 7725 W STATE ROUTE 163 OAK HARBOR OH 43449 PHYSICAL THERAPY PHYSICIAN OFFICE 11697 W STATE ROUTE 163 OAK HARBOR OH 43449 PHYSICIAN OFFICE PHYSICAL THERAPY 4058 E HARBOR RD PORT CLINTON OH 43452 PHYSICAL THERAPY PHYSICIAN OFFICE 1297 W MAIN STREET LAKESIDE MARBLEHEAD OH 43440 PHYSICIAN OFFICE PHYSICIAN OFFICE 2861 EAST HARBOR ROAD PORT CLINTON OH 43452 PHYSICIAN OFFICE PHYSICIAN OFFICE 730 JEFFERSON STREET PORT CLINTON OH 43452 PHYSICIAN OFFICE PHYSICIAN OFFICE 1250 FULTON STREET PORT CLINTON OH 43452 PHYSICIAN OFFICE PART I, LINE 7: TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO CHARITY CARE WAS CALCULATED USING A COST-TO-CHARGE RATIO. TOTAL COMMUNITY BENEFIT RELATED TO MEDICAID WAS CALCULATED FROM THE MEDICAID COST REPORT. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,471,007. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES THAT MAGRUDER HOSPITAL SUPPORTS ENCOURAGE EXERCISE (AREA SCHOOL ATHLETIC BOOSTERS), EDUCATION (AREA SCHOOLS HONOR BANQUETS), SAFETY (OFFICER PHIL), AND OTHER HEALTH-RELATED ORGANIZATIONS (EMS, EASTER SEALS, HOSPICE). PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS.THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINES 2 AND 3 IS BASED DIRECTLY ON THE BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIAL STATEMENTS, WITH LINE 3 BEING ESTIMATED AS 5% OF THE TOTAL BAD DEBT EXPENSE REPORTED IN LINE 2. THE ENTIRE BAD DEBT EXPENSE RELATES SOLELY TO PATIENT ACCOUNTS. MAGRUDER HOSPITAL DOES NOT BELIEVE BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 8: BASED ON A COST TO CHARGE RATIO CALCULATED AS REQUIRED UNDER MEDICARE RULES, THE COSTS OF PROVIDING CARE TO THE MEDICARE POPULATION IN 2013 WAS $14,603,214. THE PAYMENTS RELATED TO THESE SERVICES WERE $14,589,066, LEAVING A MEDICARE SHORTFALL OF $14,148 FOR THE YEAR. PART III, LINE 9B: ALL COLLECTION EFFORTS ARE PLACED ON HOLD UNTIL FINANCIAL ASSISTANCE IS PROCESSED. IF APPROVED, THE BALANCES ARE WRITTEN OFF. PART VI, LINE 2: MAGRUDER PARTNERS WITH THE OTTAWA COUNTY HEALTH DEPARTMENT, THE PROBATE/JUVENILE COURT, UNITED WAY, MENTAL HEALTH & RECOVERY BOARD, JOB & FAMILY SERVICES, LOCAL SCHOOL DISTRICTS, BOARD OF DEVELOPMENTAL DISABILITIES AND RIVERVIEW HEALTHCARE CAMPUS TO WORK ON THE ACTION PLAN FROM OUR 2012 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE ASSESSMENTS HAVE BEEN COMPLETED IN 2001, 2006 AND 2012. THE HOSPITAL COUNCIL OF NW OHIO AND THE UNIVERSITY OF TOLEDO CARRY OUT THE ASSESSMENTS AND PROVIDE RESULTS TO OUR COMMUNITY. THE THREE AREAS OF FOCUS THIS GROUP OF AGENCIES HAS CHOSEN TO ADDRESS ARE: INCREASE HEALTHY LIVING, DECREASE ADULT & YOUTH SUBSTANCE ABUSE AND BUILDING RESILIENT YOUTH. THE GROUP MEETS AT LEAST QUARTERLY AS A WHOLE WITH SMALLER WORK GROUPS MEETING IN BETWEEN THOSE DATES. PART VI, LINE 3: PATIENTS RECEIVE INFORMATION AT REGISTRATION, IN THEIR FIRST STATEMENT, AND OFFERED ON FOLLOW-UP PHONE CALLS. THERE ARE BROCHURES AT OUR PHYSICIAN OFFICES AND THROUGHOUT THE HOSPITAL. PART VI, LINE 4: MAGRUDER HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN PORT CLINTON, OHIO SERVING THE HEALTHCARE NEEDS OF OTTAWA COUNTY. OTTAWA COUNTY IS LOCATED ON LAKE ERIE ABOUT 15 MILES SOUTHEAST OF TOLEDO, OHIO AND IS MADE UP OF VARIOUS COMMUNITIES THAT INCLUDE SEVEN VILLAGES, TWELVE TOWNSHIPS AND THE ONLY CITY IN OTTAWA COUNTY, PORT CLINTON. THE POPULATION OF 40,000 HAS EASY ACCESS TO MAJOR STATE ARTERIES TO TOLEDO AND CLEVELAND. PART VI, LINE 5: MAGRUDER HOSPITAL ACTIVELY RECRUITS PHYSICIANS WITH THE SPECIALTIES NEEDED WITHIN THE COMMUNITY, SO THE COMMUNITY CAN ACCESS THE HEALTHCARE IT NEEDS. EXCESS FUNDS ARE PUT INTO STATE OF THE ART TECHNOLOGY TO BETTER SERVE OUR COMMUNITY. 1 SCHOLARSHIPS 15 7500 PART I, LINE 2: THE ROY SCHOLARSHIP IS FUNDED BY A TRUST, AND IS RELEASED ONLY TO NURSING STUDENTS PURSUING THEIR RN DEGREE BASED ON FINANCIAL NEED AS DETERMINED THROUGH AN APPLICATION PROCESS. THE AUXILIARY ALSO AWARDS SCHOLARSHIPS BASED ON AN APPLICATION PROCESS TO QUALIFIED STUDENTS PERSUING A HEALTH-RELATED DEGREE. X 1 1 X X X 1 0 0 0 0 0 0 0 0 JON TODD ALMENDINGER PRESIDENT & CEO 249820 0 0 0 0 0 15912 0 19142 0 284874 0 0 0 KATHLEEN DURFLINGER VP OF NURSING 151262 0 0 0 0 0 9786 0 1167 0 162215 0 0 0 DAVID BODIE PHYSICIAN 228703 0 6000 0 0 0 15088 0 21767 0 271558 0 0 0 LEONARDO QUE PHYSICIAN 301685 0 0 0 0 0 0 0 371 0 302056 0 0 0 JAMES MCLEAN PHYSICIAN 227211 0 6000 0 0 0 14958 0 21807 0 269976 0 0 0 STEVEN JACKSON PHYSICIAN 256981 0 0 0 0 0 5100 0 7604 0 269685 0 0 0 DONALD REED PHYSICIAN 242678 0 0 0 0 0 11644 0 11404 0 265726 0 0 0 MICHAEL E LONG FORMER OFFICER 0 0 0 0 200969 0 0 0 18062 0 219031 0 0 0 PART I, LINE 1A THE CEO RECEIVES REIMBURSEMENT FOR SOCIAL CLUB DUES; REIMBURSEMENT IS TREATED AS TAXABLE COMPENSATION TO THE CEO. THE ORGANIZATION USES FACILITY FOR VARIOUS STAFF FUNCTIONS THROUGHOUT THE YEAR. THIS TRANSACTION IS ANNUALLY BOARD APPROVED. PART I, LINE 4A MICHAEL LONG WAS CEO UNTIL 10/30/12. HIS SEVERANCE PAY STARTED AFTER THAT DATE, AND WAS PAID IN ACCORDANCE WITH A WRITTEN AGREEMENT. IN 2013, HE RECEIVED SEVERANCE OF $200,969. DAVID BODIE SON OF JOHN BODIE 234703 COMPENSATION 0 DOUGLAS FOCHT COMMON LEADERSHIP 288109 INDEPENDENT CONTRACTOR THROUGH FOCHT CONSTRUCTION 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWED THE FORM 990 WITH THE BOARD TREASURER TO THE LEVEL OF DETAIL REQUESTED BY THE BOARD TREASURER. THE FORM 990 WAS THEN ELECTRONICALLY DELIVERED TO EACH MEMBER OF THE BOARD WITH A DISCUSSION OF KEY POINTS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C WRITTEN DISCLOSURE OF CONFLICTS OF INTEREST ARE REQUESTED ANNUALLY FOR ALL BOARD MEMBERS. THE CEO REVIEWS ALL DISCLOSURES. THE CODE OF REGULATIONS ASKS FOR PROMPT DISCLOSURE IF SITUATIONS CHANGE DURING THE YEAR. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT IS RESTRICTED FROM PARTICIPATING IN VOTING ON MATTERS WHERE THERE IS A CONFLICT OR POTENTIAL CONFLICT. DOUG FOCHT, DIRECTOR, IS RESTRICTED FROM PARTICIPATING IN DECISIONS IN REGARDS TO BUILDING CONSTRUCTION TRANSACTIONS (SEE SCHEDULE L, PART VI DISCLOSURE). FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS APPROVED BY THE BOARD. THE EXECUTIVE COMMITTEE REVIEWS THE OHA SALARY SURVEY FOR COMPARISON. RECOMMENDATIONS TO THE FULL BOARD ARE MADE BASED ON SALARY SURVEY FINDINGS, MARKET FINDINGS, AND PERFORMANCE REVIEW FOR EXECUTIVES; ALL OTHER NON-EXECUTIVE EMPLOYEES' SALARIES ARE DETERMINED IN A SIMILAR FASHION EXCLUDING BOARD APPROVAL. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING IS COMPLETED WITH RESPECT TO THIS PROCESS. THIS PROCESS WAS LAST PERFORMED IN 2013. FORM 990, PART VI, SECTION C, LINE 18 FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. AN ABBREVIATED FINANCIAL STATEMENT IS INCLUDED IN THE HOSPITAL'S ANNUAL REPORT. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 6,604,608. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,604,608. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,453,768. MANAGEMENT AND GENERAL EXPENSES 627,542. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,081,310. FORM 990, PART XI, LINE 9: POST RETIREMENT RELATED COSTS 55,870. AUXILIARY NET LOSS 21,835. FLOW THROUGH BOOK TO TAX DIFFERENCES -5,368. CHANGE IN TEMPORARY RESTRICTED NET ASSETS 6,754. FORM 990, PART XI, LINE 2C MEMBERS OF THE HOSPITAL'S BOARD OVERSEE THE AUDIT PROCESS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.