2014-04-24T13:19:19-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 314394942 OhioHealth Corporation OHIO 6145444076 180 East Broad Street 33rd Floor Columbus OH 432153707 MICHAEL W LOUGE 6145444076 2013-03-13 1 Mary E Rauschenberg P00172604 5137847100 2012 2015-11-30 17:44:51Z See Schedule O for DBA Listing David P Blom 180 East Broad Street 33rd Floor Columbus OH 432153707 7190582686 0 3858 X www.ohiohealth.com X 1891 OH To improve the health of those we serve. 20 13 14870 1802 -508309 -612426 3260692 1277159 1884053092 1926575576 49434326 75959554 63147912 100365596 1999896022 2104177885 965471 1535474 0 0 860470852 947021694 0 0 0 834472830 806919570 1695909153 1755476738 303986869 348701147 3120743143 3757326846 1296894090 1512619851 1823849053 2244706995 X To improve the health of those we serve. 0 0 970575125 1535474 1707599840 OhioHealth's primary purpose is to provide diversified healthcare services to the community and is a provider of services under contractual arrangements with the Medicare and Medicaid programs as well as other third-party reimbursement arrangements. Together, Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital and Dublin Methodist Hospital, are united in our mission to provide quality, compassionate healthcare and to be responsible stewards for our community's health. For more than 100 years it has been this way. Even as the face of healthcare continues to change, the commitment of OhioHealth endures: ensuring quality care for everyone, regardless of their faith, race, age, or ability to pay. We never lose sight of our mission "to improve the health of those we serve" and our core values - compassion, excellence, stewardship, and integrity. They continue to guide us in our work today. OhioHealth touches thousands of people, saves lives, improves their health and makes their future a little brighter. Through our shared mission, vision and values, we touch more lives in Central Ohio than any other health system. As a system of faith-based, not-for-profit healthcare providers - together, we are OhioHealth. 433566364 247691091 In fiscal year 2013 (July 1, 2012 through June 30, 2013), OhioHealth with its member hospitals and homecare organizations provided charity care and community benefit programs to a greater degree than ever. In total, OhioHealth provided $258 million in charity care and community benefit programs and services reaching hundreds of thousands of people in the communities we serve. Of this total, $185 million was provided by the hospitals of OhioHealth Corporation (Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, and Dublin Methodist Hospital). OhioHealth provides medically necessary services without charge or at amounts less than its established rates to patients who meet certain criteria under its charity care policies. In assessing a patient's ability to pay, OhioHealth not only utilizes generally recognized poverty income levels of the communities they serve, but also includes certain cases where incurred charges are significant when compared to the patient's financial resources. Charity care is determined based on established polices, using patient income and assets to determine payment ability. OhioHealth provides community services intended to benefit the underserved and enhance the health status of the communities it serves. These services include 24 hour a day emergency rooms, community health screenings, forums for various support groups, health education classes, speakers and publications, hospice and medical research. OhioHealth has been able to achieve a greater impact in the community by partnering financial and human resources with other organizations. These expenditures include a commitment to the project to reduce infant mortality, pastoral care service, various civic sponsorships, and other community partnership programs.The Corporation's total benefit to the community includes the cost of charity care (net of assistance received from the Hospital Care Assurance Program), unpaid cost of Medicaid, and medical education programs as well as certain programs discussed above. 52510515 15350852 OhioHealth is teaching the doctors of tomorrow at its three teaching hospitals. Together, Riverside Methodist Hospital, Grant Medical Center and Doctors Hospital trained 478 residents at a cost of $52.5 million. These residents performed services to produce offsetting revenue of $15.4 million for a net community benefit of $37.1 million. 1456652004 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 0 1 X 1096 0 1 14870 1 1 1 1 CJ BD LU UK 0 0 0 0 0 0 0 0 X 20 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Craig Bjerke 6145444076 180 East Broad Street 33rd Floor Columbus OH 432153707 X Rasmussen Steven 2.00 1.00 X X 0 0 0 Wilcox Randy 2.00 1.00 X X 0 0 0 Hondros Linda 2.00 1.00 X X 0 0 0 Endres Michael J 2.00 1.00 X X 0 0 0 Abbott Lawrence C 2.00 1.00 X 0 0 0 Anderson Kerrii B 2.00 1.00 X 0 0 0 Auseon John DO 2.00 1.00 X 0 0 0 Blom David P 40.00 1.00 X X 1530606 0 948309 Blosser T Laurence MD 15.00 1.00 X 122479 0 40 Chambers Linda MD 2.00 1.00 X 47200 0 0 Crane Tanny 2.00 1.00 X 0 0 0 Dewire Rev Dr Norman E 2.00 1.00 X 0 0 0 James Donna 2.00 1.00 X 0 0 0 Jennings Matthew 2.00 1.00 X 0 0 0 Levin Howard B DO 2.00 1.00 X 0 0 0 McConnell John P 2.00 1.00 X 0 0 0 Ough Bishop Bruce R 2.00 1.00 X 0 0 0 Palmer Bishop Gregory 2.00 1.00 X 0 0 0 Scott Bradley N 2.00 1.00 X 0 0 0 Sims Gary K 2.00 1.00 X 0 0 0 Stevens Rev Dr Deborah 2.00 1.00 X 0 0 0 Louge Michael W 40.00 1.00 X 982758 0 466324 Millen Robert P 40.00 1.00 X 982707 0 320573 Pandora Frank T II Esq 40.00 1.00 X 1567129 0 227247 Bernstein Michael S 40.00 1.00 X 626262 0 176703 Garlock Steven J 40.00 1.00 X 419859 0 77634 Hagen Bruce P 20.00 20.00 X 682607 0 176138 Hanly Donna L 40.00 1.00 X 318706 0 47327 Herbert-Sinden Cheryl L 40.00 1.00 X 444055 0 154050 Huffman Michael Sean 40.00 0.00 X 298530 0 43808 Jablonski Susan F 40.00 1.00 X 406935 0 101731 Kontner John G 40.00 1.00 X 491975 0 37468 Krouse Michael T 40.00 1.00 X 516505 0 152700 Lozada Leonardo J MD 40.00 0.00 X 515030 0 30797 Markovich Stephen E MD 40.00 1.00 X 676103 0 212590 Morrison Karen J 1.00 40.00 X 473292 0 133246 Quinn Andrew S 40.00 1.00 X 662127 0 169307 Reichfield Michael L 40.00 1.00 X 497831 0 153656 Tuchow Genevieve 40.00 0.00 X 174649 0 3144 Umland Steve 40.00 1.00 X 458418 0 15038 Vanderhoff Bruce MD 40.00 1.00 X 684584 0 186855 Yates Vinson M 40.00 1.00 X 484647 0 142119 Caulin-Glaser Teresa L MD 40.00 1.00 X 582110 0 61078 Imm Amy A MD 40.00 0.00 X 452123 0 47240 Knutson Douglas J MD 40.00 1.00 X 418772 0 39403 Sanders John W 1.00 40.00 X 444378 0 34980 Thornhill Hugh A 1.00 40.00 X 490877 0 149832 Boggs Martha Bruce 0.00 0.00 X 508447 0 12806 Connors Karen H 0.00 0.00 X 508775 0 1395 Gallaher Connie 40.00 0.00 X 332795 0 43414 Lawson Michael S 40.00 0.00 X 321625 0 20474 Seckinger Mark R 0.00 40.00 X 267496 0 61598 Tomaszewski James A 0.00 40.00 X 380625 0 41067 18773017 0 4490091 745 1 1 0 The Whiting-Turner Contracting Co (Sch 300 E Joppa Road 8th Floor Baltimore MD 21286 Construction Services 34039000 Dawson Personnel Systems PO Box 711503 Cincinnati OH 452711503 Temporary Help Services 12094000 Cardinal Health - Valuelink 2320 Mcgaw Road Obetz OH 43207 Logistics Services 10157000 Daimler Group Inc (Sch O) 1533 Lake Shore Drive Columbus OH 432044891 Construction Services 9544000 McKesson Technologies (Sch O) PO Box 98347 Chicago IL 606939430 Healthcare IT Solutions 8394000 556 1153739 64101 59319 1153739 1277159 Health and Medical Svc 900099 1175458788 1175458788 Medicare and Medicaid 923130 734386177 734386177 Investment Income 621990 16730611 17238920 -508309 1926575576 54186557 54186557 39113625 20887837 18225788 18225788 18225788 5077838003 3064030 5055423884 3705152 22414119 -641122 21772997 21772997 6127419 6387928 -260509 -260509 Intercompany Admin 900099 43557898 43557898 Cafeteria/Food Service 722210 9068684 9068684 Parking Revenue 812930 1318955 1318955 28454780 28454780 82400317 2104177885 1970641783 -508309 132767252 X 1526474 1526474 9000 9000 18041798 4099869 13941929 1031423 1031423 738754593 624745651 114008942 49694338 37827330 11867008 98768009 75182208 23585801 40731533 31004843 9726690 6524879 4966738 1558141 526850 526850 173447 173447 5072851 5072851 179857085 136907213 42949872 10601285 10601285 56976537 43370540 13605997 26182680 19930256 6252424 19528318 14864956 4663362 3597146 2738148 858998 973 741 232 18791941 14304425 4487516 98472181 74957024 23515157 4225882 3216741 1009141 Medical Supply Expense 299084382 299084382 0 0 Medicaid Tax Expense 27440384 27440384 0 0 Repair & Maintenance 27419767 20871927 6547840 0 Maintenance & Service 10550904 10550904 11892078 9052250 2839828 1755476738 1456652004 298824734 0 14464 22285 99485558 128708262 0 191554851 204736909 0 0 18364908 21258919 25181844 25113550 24649722 28810258 1505590200 787101083 635033858 718489117 1650642941 1751638428 330515510 589171731 36128521 53994668 12645727 12892130 96525239 222490589 3120743143 3757326846 253842192 297341989 0 4347838 4114566 671678198 788093973 0 0 1267573 932554 365758289 422136769 1296894090 1512619851 X 1823849053 2244706995 0 0 1823849053 2244706995 3120743143 3757326846 X 348701147 82948981 -10792186 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 0 1 618 0 0 1 96033 1 76796 0 0 0 0 173447 0 Explanation of Lobbying Activities: Part II-B, Line 1: Lobbying activity entails membership in American Hospital Association, Ohio Hospital Association, Association of American Medical Colleges and other healthcare related resources. 0 0.00 0 0 0 0 0.00 0 38114038 288256 2967661 72449 833896 549631 39913979 39340742 277730 745018 116994 1435648 696810 38114038 40797139 325956 5688665 63000 6681909 726109 39340742 38589258 266046 3942850 24850 1288068 688097 40797139 46414673 370999 -5396453 0 2757845 42116 38589258 0.40700 0.36500 0.22800 0 1 1 38708280 38708280 573482113 319904325 253577788 703364 126795 576569 501700681 346772995 154927686 390995762 120296968 270698794 718489117 Limited Partnerships 297140131 F Alternative Investments 292031600 F 589171731 Due from Affiliate - Loans & Notes 194588256 Unamortized Bond Issue Costs 6034222 Investment in Subsidiaries & Non-Program Related Joint Ventures 2002708 Other 19865403 222490589 Due to Affiliates - Loans & Notes 178538142 Pension Liability 127213581 Swap Liability 31268852 Deferred Long Term Liabilities 14784595 Other 70331599 422136769 X Description of Intended Use of Endowment Funds: Part V, Line 4: To earn investment income for use in medical charity care, medical procedures, medical education and various other hospital services. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Management has analyzed the tax positions taken by the Corporation and its subsidiaries and has concluded that as of June 30, 2013, there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements. Central America & the Caribbean 0 1 Program Services Offshore Captive Management 78572 Europe (including Iceland & Greenland) 0 0 Investments 115128934 Central America & the Caribbean 0 0 Investments 258164437 0 1 0 0 0 1 373371943 0 373371943 1 0 1 1 1 0 Method Used to Acccount for Expenditures: Schedule F, Part I, Line 3: The amounts shown in column (f) for investment activities in Europe (including Iceland & Greenland) and Central America & the Caribbean represent investments in those regions. The amount shown as program service activities in Central America & the Caribbean represents total expenditures in the region. 1 1 X 1 X 1 X 1 1 1 0 1 1 114003164 21265342 92737822 0.05280 265531643 214961832 50569811 0.02880 0 0 379534807 236227174 143307633 0.08160 1818278 9578 1808700 0.00100 48795964 11428878 37367086 0.02130 1241425 0 1241425 0.00070 311480 0 311480 0.00020 1864411 25461 1838950 0.00100 54031558 11463917 42567641 0.02420 433566365 247691091 185875274 0.10580 154207 154207 0.00010 9428 9428 0.00000 2815 2815 0.00000 166450 166450 0.00010 1 82609599 0 525882132 567135749 -41253617 X 1 1 1 Grant Scope Center LLC Ambulatory Surgery Center 0.50500 0.49490 2 Knightsbridge Surgery Center Ambulatory Surgery Center 0.49820 0.42240 3 OhioHealth Sleep Services LLC Sleep Lab Services 0.78530 0.20390 4 Polaris Surgery Center LLC Ambulatory Surgery Center 0.50760 0.49980 5 The Eye Center Opthamological Surgery Center 0.03040 0.93920 6 Upper Arlington Medical Limited Partnership Property Management 0.38850 0.29710 7 Upper Arlington Surgery Center Ltd Ambulatory Surgery Center 0.40630 0.56930 8 Whitehall Surgery Center Ambulatory Surgery Center 0.40630 0.57830 9 Greater Columbus Regional Dialysis Dialysis Services 0.25000 0.75000 10 OhioHealth Group Ltd Managed Care Services 0.50000 0.50000 11 The Hand Center LLC Orthopedic Surgery 0.49000 0.51000 12 Westerville Endoscopy Center LLC Ambulatory Surgery Center 0.50000 0.50000 4 1 Riverside Methodist Hospital

3535 Olentangy River Road Columbus OH 432143908

www.ohiohealth.com X X X A 2 Grant Medical Center

111 South Grant Avenue Columbus OH 432154701

www.ohiohealth.com X X X A 3 Doctors Hospital

5100 West Broad Street Columbus OH 432281607

www.ohiohealth.com X X X A 4 Dublin Methodist Hospital

7500 Hospital Drive Dublin OH 430168518

www.ohiohealth.com X X A Facility Reporting Group - A 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X 1 0 1 X X 0 0 28 Polaris Surgery Center

300 Polaris Parkway Westerville OH 430827989

Surgery Center Upper Arlington Surgery Center

2240 North Bank Drive Columbus OH 432205420

Surgery Center Knightsbridge Surgery Center

4845 Knightsbridge Blvd Suite 110 Columbus OH 432142463

Surgery Center OhioHealth Urgent Care

2030 Stringtown Road Grove City OH 43123

Urgent Care Facility OhioHealth Urgent Care

5610 North Hamilton Road Columbus OH 43230

Urgent Care Facility OhioHealth Urgent Care

6955 Hospital Drive Dublin OH 43016

Urgent Care Facility East Side Surgery Center

4850 East Main Street Columbus OH 432133162

Surgery Center Grant Scope Center LLC

700 E Broad St First Floor Columbus OH 43215

Endoscopy Surgery Center OhioHealth Urgent Care

24 Hidden Ravines Drive Powell OH 43068

Urgent Care Facility OhioHealth Sleep Services

300 Polaris Parkway Suite 2450 Westerville OH 43082

Sleep Diagnostic Center OhioHealth Sleep Services

974 Bethel Road Suite C Grove City OH 43214

Sleep Diagnostic Center OhioHealth Sleep Services

7811 Flint Road Suite B Columbus OH 43235

Sleep Diagnostic Center OhioHealth Sleep Services

2041 Stringtown Road Grove City OH 43123

Sleep Diagnostic Center OhioHealth Sleep Services

151 Clint Drive Pickerington OH 43147

Sleep Diagnostic Center OhioHealth Urgent Care

1132 Hunter Avenue Dublin OH 43201

Urgent Care Facility OhioHealth Sleep Services

6770 Avery-Muirfield Drive Dublin OH 43017

Sleep Diagnostic Center OhioHealth Sleep Services

801 OhioHealth Blvd Suite 250 Delaware OH 43015

Sleep Diagnostic Center OhioHealth Sleep Services

285 East State Street Suite 425 Columbus OH 43215

Sleep Diagnostic Center OhioHealth Sleep Services

1810 Mackenzie Drive Columbus OH 43220

Sleep Diagnostic Center Eye Center of Columbus

262 Neil Avenue Columbus OH 43215

Eye Care Services OhioHealth Sleep Services

7600 Olentangy River Road Suite 200B Columbus OH 43235

Sleep Diagnostic Center OhioHealth Sleep Services

3545 Olentangy River Road Suite 200 Columbus OH 43214

Sleep Diagnostic Center The Hand Center

1210 Gemini Place Suite 200 Columbus OH 43240

Surgery Center Greater Columbus Regional Dialysis

285 East State Street Suite 170 Columbus OH 43215

Dialysis Marion Area Physicians

1040 Delaware Avenue Marion OH 43302

Multi-Purpose Physician Group Westerville ED

300 Polaris Parkway Westerville OH 43082

Surgery Center OhioHealth Urgent Care

2014 Baltimore-Reynoldsburg Road Reynoldsburg OH 43068

Urgent Care Facility Westerville Endoscopy Center LLC

300 Polaris Parkway Westerville OH 43082

Endoscopy Surgery Center Part I, Line 7: For the cost of charity care, a cost-to-charge ratio was used that was derived from Worksheet 2. For unreimbursed Medicaid, a cost accounting system was used for all amounts reported in the table. This cost accounting system includes all patient segments. All other amounts reported on the table are based on actual costs tracked through cost centers. Costs related to the volunteer time of employees were determined using standard wage rates for hours contributed during work hours. Part I, L7 Col(f): A system wide community benefit of $258 million reflects all entities within the system that provide community benefit and this amount is reported in the Statement of Program Service Accomplishments. The $185 million portion of total community benefit reported in Schedule H reflects all community benefit provided by OhioHealth Corporation doing business as Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, and Dublin Methodist Hospital. Part II: Community involvement is an important part of our mission "to improve the health of those we serve." Our associates and physicians live, work and raise families in the communities we serve and aspire to improve our collective community well-being, believing that healthy communities support healthy living."Team OhioHealth" is comprised of associates who volunteer their time at various community events such as the Central Ohio Heart Walk, Komen Race for the Cure, Arthritis Foundation's Jingle Bell Run/Walk, and March of Dimes March for Babies. OhioHealth associates and physicians also collaborate with various non-profit organizations to ensure that our communities are provided with the appropriate services that will enable them to live a healthy life. For example:-YWCA Family Center OhioHealth associates serve meals to residents of the emergency shelter supporting families experiencing housing crises. -United Way of Central Ohio - OhioHealth associates participate in Community Care Day, during which the United Way assigns projects such as repair, painting, gardening and construction at various non-profit agencies. -Simon Kenton Council, Boy Scouts of America OhioHealth partners with the Learning for Life exploring program to carry out the Medical Explorer's program for the Simon Kenton Council, Boy Scouts of America. -Big Brothers Big Sisters of Central Ohio OhioHealth participates in Big Brothers Big Sisters' Project Mentor, through Columbus City Schools, to empower individual students to improve academic performance and thereby increase high school graduation rates. Part III, Line 4: Accounts receivable for patients, insurance companies, and governmental agencies are based on gross charges. An allowance for contractual adjustments 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. 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 Corporation'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. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Corporation records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (including uninsured discount) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts in the period they are determined to be uncollectable.Each OhioHealth entity applies a discount to self-pay patient accounts that do not qualify for charity at the time of billing. If the account is deemed uncollectible, the balance is written off to bad debt. OhioHealth makes all reasonable efforts to qualify eligible patients for charity, including periodic retrospective account reviews to determine if patients that were written off to bad debt should have qualified for charity. Part III, Line 8: In accordance with the Catholic Health Association guidelines per "A Guide for Planning and Reporting Community Benefits" OhioHealth does not report Medicare shortfall as community benefit. Part III, Line 2 For the cost of bad debt, a cost-to-charge ratio was used that was derived from Worksheet 2. Part III, Line 3 OhioHealth Corporation has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. Part VI, Line 2: OhioHealth Mission and Ministry, and the Mission/Ministry and Community Needs Committee of the OhioHealth Board of Trustees are responsible for corporate oversight and strategic direction for community benefit services. These two entities are responsible for monitoring community health needs and providing oversight of metrics on community benefit and mission effectiveness. OhioHealth has ongoing partnerships with Columbus Public Health, Ohio Department of Health, and Healthcare Collaborative of Greater Columbus in identifying health priorities locally and statewide. OhioHealth is active in direct discussions regarding epidemiologic data and what OhioHealth can do to impact public health issues. Healthcare Collaborative of Greater Columbus' goal is to improve access to healthcare for all individuals in central Ohio, specifically the most vulnerable. A representative of OhioHealth's leadership is a part of these mentioned organizations and agencies to ensure that our planning and practice are meeting the identified needs of central Ohio.OhioHealth collaborated with other community stakeholders to develop its Community Health Needs Assessment, and in doing so, gathered significant additional demographic and community profile information. This information is published in the Community Health Needs Assessment and is available to the public via www.OhioHealth.com. Part VI, Line 3: Signs are posted at multiple entry points and patient registration locations stating our intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's charity care program. Informational materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. OhioHealth patient billing statements also include information regarding HCAP and can be used to apply for financial assistance. Part VI, Line 4: The following demographic information was obtained from Claritas 2013. Columbus is the capital and largest city in the state of Ohio. The city has a diverse economy based on education, insurance, banking, fashion, defense, aviation, food, logistics, steel, energy, medical research, health care, hospitality, retail and technology. OhioHealth's primary service area covers Franklin and Delaware counties as well as a few rural communities in neighboring counties. Over the next five years, the population in this area is estimated to change from 1,530,765 to 1,589,844, resulting in a growth of 3.9%. Of this area's current year estimated population: 70.0% are White alone, 18.3% are Black or African American alone, 4.7% are Hispanic, 4.0% are Asian alone, and 3.0% are other races.In 2013, the average household income in the primary service area is estimated to be $71,281.The primary service area demographics are impacted by the number of colleges and universities. Currently, it is estimated that 36.3% of the population age 25 and over in this area have earned a bachelor's degree or greater. As a result of the student population, the primary service area is relatively young. For this area, 25% of the population is estimated to be 0-17 years old, 25% are between ages 18-34, 28% are between ages 35-54, and 22% are older than 54. OhioHealth is a healthcare system covering Franklin, Delaware, Athens, Hardin and Marion counties that in total includes eight hospitals, ambulatory healthcare services, physician clinics, hospice care and other entities in support of the hospital and healthcare services. Of those eight hospitals, OhioHealth Corporation operates four hospitals (OhioHealth Riverside Methodist Hospital, OhioHealth Grant Medical Center, OhioHealth Doctors Hospital and OhioHealth Dublin Methodist Hospital) in its primary service area of Franklin County. - OhioHealth Riverside Methodist Hospital is a 1,059-bed facility recognized locally, regionally and nationally for quality care, service and reputation. Riverside Methodist offers world-class medical care and advanced medical innovations in multiple specialties including heart and vascular, neuroscience, cancer care, and maternity care.- OhioHealth Grant Medical Center is a 645-bed comprehensive healthcare facility in downtown Columbus with a national reputation for specialized trauma capabilities, orthopedic and surgical excellence, and nursing expertise. Grant has one of the busiest Level I trauma centers in Ohio.- OhioHealth Doctors Hospital is a 262-bed community facility with a full complement of healthcare services and technology. It stands out among other Ohio hospitals as a premier osteopathic teaching institution.- OhioHealth Dublin Methodist Hospital is a 107-bed facility with a full-service Emergency Department, as well as inpatient and outpatient medical and surgical services. Using evidence-based design concepts, the hospital's environment is designed to achieve health benefits including increased patient satisfaction, improved safety and fewer patient transfers. Part VI, Line 5: A majority of OhioHealth's governing body is comprised of persons who reside in its primary service area who are neither OhioHealth employees nor contractors of the organization, nor family members thereof. OhioHealth extends medical staff privileges and/or membership to all qualified physicians in the communities it serves to ensure that each community has access to the necessary medical services.OhioHealth reinvests in the community to improve quality of care, increase access to care and enhance service to patients and their families. Instead of paying dividends to shareholders or owners, OhioHealth uses its earnings to provide a broad array of community benefits. For example, OhioHealth:-Provides charity care to those without adequate resources to pay for their care, in conjunction with its charity care policies.-Invests in research, innovation, technology, and medical education and training, to advance medical knowledge and provide the highest quality of care and service to patients.-Subsidizes essential community health services trauma centers, poison control, psychiatric services, kidney dialysis, that might not otherwise pay for themselves.-Supports a wide range of vital community outreach services, targeting the most vulnerable and historically-underserved residents of the community.-Extends care via outpatient facilities in the surrounding neighborhoods, thus providing excellent access to care.In total, OhioHealth Corporation and its affiliates provided $257,920,000 (per Community Benefit Report) of community benefit (which includes the Medicaid shortfall). The total community benefit represents an appropriate balance of charity care, community health services, subsidized health services, research and net medical education costs, and cash or in-kind community building. Part VI, Line 6: OhioHealth Corporation operates general acute care hospitals as well as outpatient facilities. In addition, OhioHealth Corporation is the parent organization and sole voting member of several rural community hospitals, organizations providing multidisciplinary home care and rehabilitation, medical research, fundraising in support of the system hospitals, medical facility property management, and physician foundations. All serving in OhioHealth "systemness" to improve the health of those we serve. Reports Filed With States Part VI, Line 7 OH Facility Reporting Group Part V The four hospitals utilize the same charity care policy. They offer different levels of financial assistance based on the patient's income compared to the federal poverty level (FPL). Any patient with income at 200% or below the FPL gets a 100% discount. A patient between 201 and 267% receives a 75% discount (average Medicaid discount). A patient between 268 and 334% receives a 70% discount (average Medicare discount). A patient between 335 and 400% receives a 45% discount (average managed care discount). All patients without insurance receive a 35% uninsured discount, regardless of their income level. Part V, Line 8 Facility Reporting Group A See below Facility 1 -- Riverside Methodist Hospital Part V, Section B, line 3: Community input for this report was provided through a series of meetings with community representatives on the Franklin County Community Health Needs Assessment Steering Committee, led by the Central Ohio Hospital Council. OhioHealth intentionally engaged individuals with special expertise in public health. Among those who participated as members of the Steering Committee were: Kathy Cowen, director, Office of Epidemiology, Columbus Public Health; Michelle Groux, epidemiologist, Columbus Public Health; Beth Pierson, epidemiologist, Planning and Assessment, Franklin County Public Health; and Joanne Pearsol, associate director, Center for Public Health Practice, The Ohio State University College of Public Health. Facility 1 -- Riverside Methodist Hospital Part V, Section B, line 4: The CHNA was conducted as a collaboration led by the Central Ohio Hospital Council, including OhioHealth, Mount Carmel Health System, Nationwide Children's Hospital, and The Ohio State University Wexner Medical Center. The following hospital facilities were included in this collaboration:Riverside Methodist HospitalGrant Medical CenterDoctors HospitalDublin Methodist HospitalMount Carmel St. Ann'sMount Carmel New AlbanyMount Carmel WestMount Carmel EastNationwide Children's HospitalThe Ohio State University HospitalThe Ohio State University EastThe Ohio State's James Cancer Hospital and Solove Research InstituteThe Ohio State's Richard M. Ross Heart HospitalOSU Harding Hospital Facility 1 -- Riverside Methodist Hospital Part V, Section B, line 14g: Signs are posted at multiple Riverside Methodist Hospital entry points and patient registration locations stating OhioHealth's intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's charity care program. Informational materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. Riverside Methodist Hospital billing statements also include information regarding HCAP and can be used to apply for financial assistance. Patient billing brochures explain that Riverside Methodist Hospital provides care to everyone who comes for services, regardless of their ability to pay. The brochures provide information about HCAP and the hospitals' charity care programs, how to apply and the numbers to call with questions.Patient billing brochures are handed to every self-pay patient with the financial assistance application and are available upon request for insured patients. Financial counselors are located at each of the main hospital campuses to provide patients with information about the financial assistance programs and to assist with completing the financial assistance application.Upon registration, all self-pay patients are referred to the financial counselors or on-site vendors. The counselors and/or vendors attempt to directly contact the patient to discuss and complete the financial assistance application. There may be times, such as very late in the evening or very early morning, when all self-pay patients are not seen face-to-face before they are discharged. However, counselors attempt phone calls and mail letters to these patients to explain financial assistance and to encourage completion of the financial assistance application.The front of every patient billing statement references assistance for amounts not covered by insurance to those individuals whose income is below the established poverty level. The front of the billing statement also includes customer service telephone numbers, service hours and email address. The back of every patient billing statement includes Riverside Methodist Hospital's financial assistance application with the federal poverty guidelines listed. During the pre-registration/preadmissions process, the registration representative will inform self-pay patients via telephone that financial assistance may be available and that he/she may be referred to the Customer Call Center for assistance in applying. The registration representative will transfer the patient to the verbal financial assistance queue and/or will provide its telephone number.The Customer Call Center representative will discuss financial assistance with any patient who expresses need or concern in paying the balance on their account. The representative will forward the caller to the verbal financial assistance queue or have a financial assistance application mailed to the patient. The financial assistance application is available in five different languages based on the needs of the communities. Facility 1 -- Riverside Methodist Hospital Part V, Section B, line 20d: Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital and Dublin Methodist Hospital utilize the same charity care policy. They offer different levels of financial assistance based on the patient's income compared to the federal poverty level (FPL). Any patient with income at 200% or below the FPL gets a 100% discount. A patient between 201 and 267% receives a 75% discount (average Medicaid discount). A patient between 268 and 334% receives a 70% discount (average Medicare discount). A patient between 335 and 400% receives a 45% discount (average managed care discount). All patients without insurance receive a 35% uninsured discount, regardless of their income level. Facility 2 -- Grant Medical Center Part V, Section B, line 3: Community input for this report was provided through a series of meetings with community representatives on the Franklin County Community Health Needs Assessment Steering Committee, led by the Central Ohio Hospital Council. OhioHealth intentionally engaged individuals with special expertise in public health. Among those who participated as members of the Steering Committee were: Kathy Cowen, director, Office of Epidemiology, Columbus Public Health; Michelle Groux, epidemiologist, Columbus Public Health; Beth Pierson, epidemiologist, Planning and Assessment, Franklin County Public Health; and Joanne Pearsol, associate director, Center for Public Health Practice, The Ohio State University College of Public Health. Facility 2 -- Grant Medical Center Part V, Section B, line 4: The CHNA was conducted as a collaboration led by the Central Ohio Hospital Council, including OhioHealth, Mount Carmel Health System, Nationwide Children's Hospital, and The Ohio State University Wexner Medical Center. The following hospital facilities were included in this collaboration:Riverside Methodist HospitalGrant Medical CenterDoctors HospitalDublin Methodist HospitalMount Carmel St. Ann'sMount Carmel New AlbanyMount Carmel WestMount Carmel EastNationwide Children's HospitalThe Ohio State University HospitalThe Ohio State University EastThe Ohio State's James Cancer Hospital and Solove Research InstituteThe Ohio State's Richard M. Ross Heart HospitalOSU Harding Hospital Facility 2 -- Grant Medical Center Part V, Section B, line 14g: Signs are posted at multiple Grant Medical Center entry points and patient registration locations stating OhioHealth's intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's charity care program. Informational materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. Grant Medical Center patient billing statements also include information regarding HCAP and can be used to apply for financial assistance. Patient billing brochures explain that Grant Medical Center provides care to everyone who comes for services, regardless of their ability to pay. The brochures provide information about HCAP and the hospitals' charity care programs, how to apply and the numbers to call with questions.Patient billing brochures are handed to every self-pay patient with the financial assistance application and are available upon request for insured patients. Financial counselors are located at each of the main hospital campuses to provide patients with information about the financial assistance programs and to assist with completing the financial assistance application.Upon registration, all self-pay patients are referred to the financial counselors or on-site vendors. The counselors and/or vendors attempt to directly contact the patient to discuss and complete the financial assistance application. There may be times, such as very late in the evening or very early morning, when all self-pay patients are not seen face-to-face before they are discharged. However, counselors attempt phone calls and mail letters to these patients to explain financial assistance and to encourage completion of the financial assistance application.The front of every patient billing statement references assistance for amounts not covered by insurance to those individuals whose income is below the established poverty level. The front of the billing statement also includes customer service telephone numbers, service hours and email address. The back of every patient billing statement includes Grant Medical Center's financial assistance application with the federal poverty guidelines listed. During the pre-registration/preadmissions process, the registration representative will inform self-pay patients via telephone that financial assistance may be available and that he/she may be referred to the Customer Call Center for assistance in applying. The registration representative will transfer the patient to the verbal financial assistance queue and/or will provide its telephone number.The Customer Call Center representative will discuss financial assistance with any patient who expresses need or concern in paying the balance on their account. The representative will forward the caller to the verbal financial assistance queue or have a financial assistance application mailed to the patient. The financial assistance application is available in five different languages based on the needs of the communities. Facility 2 -- Grant Medical Center Part V, Section B, line 20d: Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital and Dublin Methodist Hospital utilize the same charity care policy. They offer different levels of financial assistance based on the patient's income compared to the federal poverty level (FPL). Any patient with income at 200% or below the FPL gets a 100% discount. A patient between 201 and 267% receives a 75% discount (average Medicaid discount). A patient between 268 and 334% receives a 70% discount (average Medicare discount). A patient between 335 and 400% receives a 45% discount (average managed care discount). All patients without insurance receive a 35% uninsured discount, regardless of their income level. Facility 3 -- Doctors Hospital Part V, Section B, line 3: Community input for this report was provided through a series of meetings with community representatives on the Franklin County Community Health Needs Assessment Steering Committee, led by the Central Ohio Hospital Council. OhioHealth intentionally engaged individuals with special expertise in public health. Among those who participated as members of the Steering Committee were: Kathy Cowen, director, Office of Epidemiology, Columbus Public Health; Michelle Groux, epidemiologist, Columbus Public Health; Beth Pierson, epidemiologist, Planning and Assessment, Franklin County Public Health; and Joanne Pearsol, associate director, Center for Public Health Practice, The Ohio State University College of Public Health. Facility 3 -- Doctors Hospital Part V, Section B, line 4: The CHNA was conducted as a collaboration led by the Central Ohio Hospital Council, including OhioHealth, Mount Carmel Health System, Nationwide Children's Hospital, and The Ohio State University Wexner Medical Center. The following hospital facilities were included in this collaboration:Riverside Methodist HospitalGrant Medical CenterDoctors HospitalDublin Methodist HospitalMount Carmel St. Ann'sMount Carmel New AlbanyMount Carmel WestMount Carmel EastNationwide Children's HospitalThe Ohio State University HospitalThe Ohio State University EastThe Ohio State's James Cancer Hospital and Solove Research InstituteThe Ohio State's Richard M. Ross Heart HospitalOSU Harding Hospital Facility 3 -- Doctors Hospital Part V, Section B, line 14g: Signs are posted at multiple Doctors Hospital entry points and patient registration locations stating OhioHealth's intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's charity care program. Informational materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. Doctors Hospital patient billing statements also include information regarding HCAP and can be used to apply for financial assistance. Patient billing brochures explain that Doctors Hospital provides care to everyone who comes for services, regardless of their ability to pay. The brochures provide information about HCAP and the hospitals' charity care programs, how to apply and the numbers to call with questions.Patient billing brochures are handed to every self-pay patient with the financial assistance application and are available upon request for insured patients. Financial counselors are located at each of the main hospital campuses to provide patients with information about the financial assistance programs and to assist with completing the financial assistance application.Upon registration, all self-pay patients are referred to the financial counselors or on-site vendors. The counselors and/or vendors attempt to directly contact the patient to discuss and complete the financial assistance application. There may be times, such as very late in the evening or very early morning, when all self-pay patients are not seen face-to-face before they are discharged. However, counselors attempt phone calls and mail letters to these patients to explain financial assistance and to encourage completion of the financial assistance application.The front of every patient billing statement references assistance for amounts not covered by insurance to those individuals whose income is below the established poverty level. The front of the billing statement also includes customer service telephone numbers, service hours and email address. The back of every patient billing statement includes Doctors Hospital's financial assistance application with the federal poverty guidelines listed. During the pre-registration/preadmissions process, the registration representative will inform self-pay patients via telephone that financial assistance may be available and that he/she may be referred to the Customer Call Center for assistance in applying. The registration representative will transfer the patient to the verbal financial assistance queue and/or will provide its telephone number.The Customer Call Center representative will discuss financial assistance with any patient who expresses need or concern in paying the balance on their account. The representative will forward the caller to the verbal financial assistance queue or have a financial assistance application mailed to the patient. The financial assistance application is available in five different languages based on the needs of the communities. Facility 3 -- Doctors Hospital Part V, Section B, line 20d: Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital and Dublin Methodist Hospital utilize the same charity care policy. They offer different levels of financial assistance based on the patient's income compared to the federal poverty level (FPL). Any patient with income at 200% or below the FPL gets a 100% discount. A patient between 201 and 267% receives a 75% discount (average Medicaid discount). A patient between 268 and 334% receives a 70% discount (average Medicare discount). A patient between 335 and 400% receives a 45% discount (average managed care discount). All patients without insurance receive a 35% uninsured discount, regardless of their income level. Facility 4 -- Dublin Methodist Hospital Part V, Section B, line 3: Community input for this report was provided through a series of meetings with community representatives on the Franklin County Community Health Needs Assessment Steering Committee, led by the Central Ohio Hospital Council. OhioHealth intentionally engaged individuals with special expertise in public health. Among those who participated as members of the Steering Committee were: Kathy Cowen, director, Office of Epidemiology, Columbus Public Health; Michelle Groux, epidemiologist, Columbus Public Health; Beth Pierson, epidemiologist, Planning and Assessment, Franklin County Public Health; and Joanne Pearsol, associate director, Center for Public Health Practice, The Ohio State University College of Public Health. Facility 4 -- Dublin Methodist Hospital Part V, Section B, line 4: The CHNA was conducted as a collaboration led by the Central Ohio Hospital Council, including OhioHealth, Mount Carmel Health System, Nationwide Children's Hospital, and The Ohio State University Wexner Medical Center. The following hospital facilities were included in this collaboration:Riverside Methodist HospitalGrant Medical CenterDoctors HospitalDublin Methodist HospitalMount Carmel St. Ann'sMount Carmel New AlbanyMount Carmel WestMount Carmel EastNationwide Children's HospitalThe Ohio State University HospitalThe Ohio State University EastThe Ohio State's James Cancer Hospital and Solove Research InstituteThe Ohio State's Richard M. Ross Heart HospitalOSU Harding Hospital Facility 4 -- Dublin Methodist Hospital Part V, Section B, line 14g: Signs are posted at multiple Dublin Methodist Hospital entry points and patient registration locations stating OhioHealth's intent to comply with the State of Ohio's Hospital Care Assurance Program (HCAP). Additionally, the signage contains reference to the organization's charity care program. Informational materials are available at registration locations and interpretive services can be arranged if the patient/guarantor does not speak English. Dublin Methodist Hospital patient billing statements also include information regarding HCAP and can be used to apply for financial assistance. Patient billing brochures explain that Dublin Methodist Hospital provides care to everyone who comes for services, regardless of their ability to pay. The brochures provide information about HCAP and the hospitals' charity care programs, how to apply and the numbers to call with questions.Patient billing brochures are handed to every self-pay patient with the financial assistance application and are available upon request for insured patients. Financial counselors are located at each of the main hospital campuses to provide patients with information about the financial assistance programs and to assist with completing the financial assistance application.Upon registration, all self-pay patients are referred to the financial counselors or on-site vendors. The counselors and/or vendors attempt to directly contact the patient to discuss and complete the financial assistance application. There may be times, such as very late in the evening or very early morning, when all self-pay patients are not seen face-to-face before they are discharged. However, counselors attempt phone calls and mail letters to these patients to explain financial assistance and to encourage completion of the financial assistance application.The front of every patient billing statement references assistance for amounts not covered by insurance to those individuals whose income is below the established poverty level. The front of the billing statement also includes customer service telephone numbers, service hours and email address. The back of every patient billing statement includes Dublin Methodist Hospital's financial assistance application with the federal poverty guidelines listed. During the pre-registration/preadmissions process, the registration representative will inform self-pay patients via telephone that financial assistance may be available and that he/she may be referred to the Customer Call Center for assistance in applying. The registration representative will transfer the patient to the verbal financial assistance queue and/or will provide its telephone number.The Customer Call Center representative will discuss financial assistance with any patient who expresses need or concern in paying the balance on their account. The representative will forward the caller to the verbal financial assistance queue or have a financial assistance application mailed to the patient. The financial assistance application is available in five different languages based on the needs of the communities. Facility 4 -- Dublin Methodist Hospital Part V, Section B, line 20d: Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital and Dublin Methodist Hospital utilize the same charity care policy. They offer different levels of financial assistance based on the patient's income compared to the federal poverty level (FPL). Any patient with income at 200% or below the FPL gets a 100% discount. A patient between 201 and 267% receives a 75% discount (average Medicaid discount). A patient between 268 and 334% receives a 70% discount (average Medicare discount). A patient between 335 and 400% receives a 45% discount (average managed care discount). All patients without insurance receive a 35% uninsured discount, regardless of their income level. 1 Columbus Speech & Hearing Center 510 E North Broadway Columbus OH 43214 314379449 501(c)(3) 345000 Strategic Plan Contribution St Stephen's Community House 1500 E 17th Ave Columbus OH 43219 314379568 501(c)(3) 305000 Bravo for the Children Columbus Metropolitan Library 96 South Grant Ave Columbus OH 43215 311692755 501(c)(3) 250000 Renovation of the Main Library COSI 333 West Broad St Columbus OH 43215 311351334 501(c)(3) 208108 Body Worlds; Annual Contribution; COSI's Luncheon Sponsorship American Heart Association 5455 N High St Columbus OH 43214 135613797 501(c)(3) 47500 Heart Walk 2012; Go Red for Women; GR HB 2013 M3S Sports LLC 5003 Horizons Drive Suite 200 Columbus OH 43220 263884206 35000 Cap City Half Marathon Komen Columbus Race for the Cure 929 Eastwind Drive Suite 211 Westerville OH 43081 751835298 501(c)(3) 30000 Race for the Cure Sponsorship; Pink Tie Ball March of Dimes 975 Eastwind Dr Suite 150 Westerville OH 43081 131846366 501(c)(3) 26500 Greater Columbus March for Babies; Corporate Table Sponsor Signature Chefs The Columbus Partnership 150 S Front Street Suite 200 Columbus OH 43215 020580058 501(c)(3) 25000 Columbus Education Fund Charitable Pharmacy of Central Ohio Inc 200 E Livingston Ave Columbus OH 43215 270147099 501(c)(3) 25000 Grant Funding of 2012 Operations Who's Who Publishing 920 Leona Ave Columbus OH 43201 264163198 20000 Black Columbus Publication; Latino Columbus Publication; Columbus GLBT 2nd Edition Oasis Shriners 604 Doug Mayes Place Charlotte NC 28262 560122203 501(c)(10) 15000 Ohio Community Event Tech Columbus 1275 Kinnear Road Columbus OH 43212 311658220 501(c)(3) 12800 Innovation Awards Pre-Event Networking Reception Sponsorship YWCA 65 S 4th Street Columbus OH 43215 311418939 501(c)(3) 12250 Woman to Woman Sponsorship; Women of Achievement; Meal Sponsorships; AIDS Resource Center Ohio 4400 N High Street Suite 300 Columbus OH 43214 311126780 501(c)(3) 10000 Corporate Sponsorship Franklin Park Conservatory 1777 E Broad St Columbus OH 43203 311364884 10000 Hat Day Sponsorship Mid-Ohio Regional Planning Commission 111 Liberty Street Suite 100 Columbus OH 43215 311009675 501(c)(3) 10000 Mid-Ohio Regional Planning Commission - State of the Region Strand Theatre PO Box 111 Delaware OH 43015 203948576 501(c)(3) 10000 Preserve, Refurbish, and Upgrade Strand Theatre Simon Kenton Council 807 Kinnear Road Columbus OH 43212 314388520 501(c)(3) 10000 Boy Scouts of America Congressional Black Caucus Foundation 1720 Massachusetts Ave NW Washington DC 20036 521160561 501(c)(3) 8734 Annual Legislative Conference; Inauguration Celebration New Albany Community Foundation 220 Market Street Suite 205 New Albany OH 43054 311409264 501(c)(3) 8660 Remarkable Evening Sponsorship The Peggy R McConnell Worthington Center for the Arts 777 Evening Street Worthington OH 43085 263919517 501(c)(3) 7500 Board Contribution; Arts Enchanted Evening Sponsorships American Cancer Society 5555 Frantz Road Dublin OH 43017 251798733 501(c)(3) 7500 Drive for Life; Cattle Baron's Ball LifeCare Alliance 1699 W Mound Street Columbus OH 43223 314379494 501(c)(3) 7000 Annual Contribution Columbus Cancer Clinic; Big Wheels Sponsorship Council on Healthy Mothers and Babies 380 S Fifth Street Suite G-4 Columbus OH 43215 421546970 501(c)(3) 6500 Annual Contribution American Red Cross 995 E Broad Street Columbus OH 43205 310642918 501(c)(3) 6500 Humanitarian of the Year Awards; FY13 Board Campaign; Hereo's Breakfast; Golf Classic; HSMP 174 W 18th Ave Columbus OH 43210 311161944 501(c)(3) 6000 HSMP Management Institute The Gathering 3520 Snouffer Road Suite 200 Columbus OH 43235 592810392 501(c)(3) 5750 2013 Leadership Forum; Leadership Prayer Breakfast The Center for Healthy Families 500 S Front Street Columbus OH 43215 208701526 501(c)(3) 5172 Friends of the Center Donation Circle 27 2 Scholarships 9 9000 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: OhioHealth Corporation primarily makes general contributions and pays for sponsorships to other tax exempts organizations that benefit the community. In accordance with OhioHealth Corporation's Authority Matrix for issuance of payments, all payments contributed were authorized by the approved level of management X X 0 1 X X X X X 1 1 0 0 0 0 0 1 0 Blom David P 976740 0 523489 0 30377 0 931170 0 17139 0 2478915 0 0 0 Louge Michael W 672051 0 295000 0 15707 0 443409 0 22915 0 1449082 0 0 0 Millen Robert P 654197 0 305000 0 23510 0 297351 0 23222 0 1303280 0 0 0 Pandora Frank T II Esq 371878 0 172500 0 1022751 0 209853 0 17394 0 1794376 0 863525 0 Bernstein Michael S 435324 0 177853 0 13085 0 152987 0 23716 0 802965 0 0 0 Garlock Steven J 276186 0 117663 0 26010 0 59119 0 18515 0 497493 0 0 0 Hagen Bruce P 461731 0 186000 0 34876 0 159396 0 16742 0 858745 0 0 0 Hanly Donna L 231528 0 74025 0 13153 0 29840 0 17487 0 366033 0 0 0 Herbert-Sinden Cheryl L 291159 0 125000 0 27896 0 135950 0 18100 0 598105 0 0 0 Huffman Michael Sean 198143 0 96148 0 4239 0 18868 0 24940 0 342338 0 0 0 Jablonski Susan F 286890 0 115000 0 5045 0 92231 0 9500 0 508666 0 0 0 Kontner John G 323982 0 162725 0 5268 0 18531 0 18937 0 529443 0 0 0 Krouse Michael T 345030 0 145018 0 26457 0 133775 0 18925 0 669205 0 0 0 Lozada Leonardo J MD 357207 0 51000 0 106823 0 13541 0 17256 0 545827 0 0 0 Markovich Stephen E MD 457836 0 195000 0 23267 0 189947 0 22643 0 888693 0 0 0 Morrison Karen J 319244 0 131000 0 23048 0 111636 0 21610 0 606538 0 0 0 Quinn Andrew S 483226 0 167000 0 11901 0 150337 0 18970 0 831434 0 0 0 Reichfield Michael L 333377 0 137500 0 26954 0 130010 0 23646 0 651487 0 0 0 Tuchow Genevieve 174617 0 0 0 32 0 0 0 3144 0 177793 0 0 0 Umland Steve 340193 0 86916 0 31309 0 686 0 14352 0 473456 0 0 0 Vanderhoff Bruce MD 479475 0 195000 0 10109 0 166098 0 20757 0 871439 0 0 0 Yates Vinson M 321827 0 140000 0 22820 0 116287 0 25832 0 626766 0 0 0 Caulin-Glaser Teresa L MD 409548 0 145000 0 27562 0 45985 0 15093 0 643188 0 0 0 Imm Amy A MD 330063 0 100000 0 22060 0 23213 0 24027 0 499363 0 0 0 Knutson Douglas J MD 306581 0 90000 0 22191 0 31071 0 8332 0 458175 0 0 0 Sanders John W 295918 0 121000 0 27460 0 20410 0 14570 0 479358 0 0 0 Thornhill Hugh A 346058 0 132000 0 12819 0 123917 0 25915 0 640709 0 0 0 Boggs Martha Bruce 115471 0 115000 0 277976 0 410 0 12396 0 521253 0 0 0 Connors Karen H 0 0 0 0 508775 0 1395 0 0 0 510170 0 155004 0 Gallaher Connie 248744 0 75000 0 9051 0 22371 0 21043 0 376209 0 0 0 Lawson Michael S 235394 0 81442 0 4789 0 12834 0 7640 0 342099 0 0 0 Seckinger Mark R 190207 0 55000 0 22289 0 45883 0 15715 0 329094 0 0 0 Tomaszewski James A 272923 0 82322 0 25380 0 33826 0 7241 0 421692 0 0 0 Part I, Line 1a OhioHealth's travel policy states "No fare higher than coach accommodations are acceptable. Business class is considered acceptable for flights with air travel time of five hours or greater (not including layovers)." Current year disclosure required due to two first class travel flights by executives as a result of international travel and seat availability. Housing allowance or residence for personal use - For key executives, OhioHealth provides a temporary housing allowance, administered by Human Resources, if relocation is required in order to accept employment with OhioHealth. As part of a relocation package, the following individuals received a cash payment to offset the cost of temporary housing. The full amount was treated as taxable compensation reported on the individuals' W-2. Steven J. Umland - $12,873 Part I, Lines 4a-b The following individuals listed in Form 990, Part VII received severance payments: Martha Bruce Boggs - $227,136 Karen H. Connors - $353,771 Leonardo J. Lozada M.D. - $60,515 The following individuals listed in Form 990, Part VII participated in a supplemental non-qualified retirement plan: David P. Blom - $896,681 Michael S. Bernstein - $131,889 Martha Bruce Boggs - $0 Steven J. Garlock - $17,142 Bruce P. Hagen - $136,393 Cheryl L. Herbert-Sinden - $92,659 Susan F. Jablonski - $74,053 Michael T. Krouse - $99,294 Michael W. Louge - $419,629 Stephen E. Markovich, M.D. - $155,526 Robert P. Millen - $274,654 Karen J. Morrison - $85,721 Frank T. Pandora II Esq. - $153,931 Frank T. Pandora II Esq. - $986,585 (payout at age 65) Andrew S. Quinn - $132,503 Michael L. Reichfield - $101,731 Mark R. Seckinger - $1,625 Hugh Thornhill - $106,083 Bruce Vanderhoff, M.D. - $141,979 Vinson M. Yates - $83,441 Karen H. Connors - $155,004 These arrangements are an industry standard and are unfunded. Due to the substantial risk of forfeiture provision, there is no guarantee that these officers will ever receive these benefits. Amounts for these arrangements are included in the deferred compensation amount. Part I, Line 7 Incentive bonuses are calculated using an objective formula that includes clinical quality, patient, physician and employee satisfaction, and financial items. Minor modifications to increase or decrease incentive payments, within the maximum amount established for each position, may be made based on individual performance and accountabilities. In addition, one time bonuses may be awarded to recognize exemplary performance. All payments are examined for reasonableness and are reviewed and approved by either the Executive Compensation Committee (for disqualified persons) or through management and the company's human resources function (for non-disqualified persons). A County of Franklin Ohio 316400067 3531866P9 2009-02-25 165800000 To Refund Series 2006, issued on 5/10/06 0 0 0 B County of Franklin Ohio 316400067 3531868AO 2011-06-23 320668797 To Refund Series 2008A, issued on 8/1/08 and Series 2001, issued 9/1/01 0 0 0 C County of Franklin Ohio 316400067 3531863Q0 2003-11-05 27755000 To Refund Series 2000A, issued on 1/27/00 0 0 0 D County of Franklin Ohio 316400067 353187AV9 2013-05-31 226000000 To Refund Series 2003C, issued on 11/05/2003 0 0 0 A 165800000 1195000 164605000 2009 1 0 1 1 B 1560000 320668797 2122360 116879007 202446437 2011 1 0 1 1 C 16560000 27755000 211270 6710 27537020 2003 1 0 1 1 D 246455971 130925971 115530000 2003 1 0 0 1 A 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 1 1 0 0 0.00800 0.00000 0.00800 0 0 0 C 0 0 0 0 0.01300 0.01300 0 0 0 D 0 1 1 0 0 0.00100 0.00100 0 0 0 A 0 0 0 0 1 0 0 0 1 B 0 0 0 0 1 0 0 0 1 C 0 0 0 0 1 0 0 0 1 D 0 0 0 0 1 0 0 0 1 A 0 B 0 C 0 D 0 Part I: Series 2003D Arbitrage Rebate Report for Period November 4, 2008 through November 4, 2012, showed that no rebate amount had accrued. Part I, Line B, Column (e): Issue price of $313,765,000 is the par issue price of the bonds. Part II, Line 3, Column B total proceeds of issue of $320,668,797 includes a premium of $6,903,797 received over par from the sale of the bonds. Part I, Line C, Column E: Form 8038 for the bonds erroneously presented the issue price for the bonds as $27,755,533, but the correct value is $27,755,000. Part II, Column B, Line 11: $13,336,000 of the proceeds was used to pay off a draw on a taxable line of credit which had been used to pay the termination amount on the 2006 Swap. While this is a refunding debt issuance, the proceeds flowed through the project fund. Part III: Part III has not been completed with respect to the 2003D bonds shown in columns C and D, since such bonds refunded pre-2003 bond issues. Had completion of Part III been required, line 7 would have been answered "yes" for these bonds. Part IV, Line 2, Column B: Portions of this bond issue bear fixed interest rates, but some bear variable rates. Hence, it is a variable yield issue for tax purposes. Live Technologies Inc Director of Org - Entity more than 35% owned by Director (Lawrence Abbott) 437231 Payments - Goods or services provided to OhioHealth Corporation. 0 Time Warner Cable Director of Org - A Director of OhioHealth (Donna James) is a Director 824924 Payments - Goods or services provided to OhioHealth Corporation. 0 Jacob Millen Officer of Org - Son of Officer (Robert P. Millen) 49044 Comp/Ben - Son is employed at Riverside Methodist Hospital and receives compensation. 0 Mark Vanderhoff Key Employee - Brother of Key Employee (Bruce Vanderhoff, M.D.) 112355 Comp/Ben - Brother is employed at Grant Medical Center and receives compensation. 0 Sarcom Director of Org - A Dir/Off of OhioHealth (Randy Wilcox) is a Dir 206763 Payments - Goods or services provided to OhioHealth Corporation. 0 Columbus Radiology Group Key Employee - Son-in-law of Key Employee (Steven J. Garlock) is a Director 113456 Payments - Goods or services provided to OhioHealth Corporation. 0 Abigail Hagen Key Employee - Daughter of Key Employee (Bruce P. Hagen) 17647 Comp/Ben - Daughter is employed at McConnell Heart and Health Center and receives compensation. 0 Ohio Hospital Association Insurance Solutions Officer of Org - An Officer of OhioHealth (Frank T. Pandora) is a Director 201735 Payments - Goods or services provided to OhioHealth Corporation. 0 Linda Kress Key Employee - Sister of Key Employee (Donna L. Hanly) 31257 Comp/Ben - Sister is employed at OhioHealth Corporation and receives compensation. 0 National Backgroup Check Inc Director of Org - Entity more than 35% owned by a Dir & Off (Linda Hondros) 332317 Payments - Goods or services provided to OhioHealth Corporation. 0 Gregory E Morrison MD Key Employee - Spouse of a Key Employee (Karen J. Morrison) 378144 Comp/Ben - Husband is employed at OhioHealth Corporation and receives compensation. 0 OhioHealth Group Ltd Officer/Key Employee of Org - An Officer and Key Employees are Directors 2928378 Payments - Goods or services provided to OhioHealth Corporation. Continued from relationship between interested person and organization: CFO, CMO and Sr. VP of Managed Care of OhioHealth Corporation are Directors. 0 John T Lashbrook Director of Org - Son-in-Law of Director (Linda Chambers) 39161 Comp/Ben - Son-in-Law is employed by OhioHealth Corporation and receives compensation. 0 X Hospital PP&E 39 1153739 Cost/Selling Price 0 1 0 Method for Determining Number of Contributions: Part I, Column (b): OhioHealth Foundation contributes Property, Plant & Equipment necessary to the operations of OhioHealth Corporation Hospitals. The number reported in column (b) for all amounts represents the number of contributions. Form 990, Part I, Doing Business As: Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, Dublin Methodist Hospital, and OhioHealth Neighborhood Care Form 990, Part VI, Section A, line 2 Many of the persons listed in Part VII have a "business relationship" with each other by virtue of sitting on related OhioHealth entity boards. OhioHealth Corporation has an ownership interest in limited liability companies (LLCs) that provide healthcare or related services. As a member of such LLCs, OhioHealth Corporation has the right to appoint two individuals to the managing board of such LLCs. As a result, these individuals may be deemed to have a "business relationship" with each other for purposes of Part VII, Section A, Line 2. Michael J. Endres, Treasurer of OhioHealth Corporation, Kerrii B. Anderson, Director of OhioHealth Corporation, and John P. McConnell, Director of OhioHealth Corporation, have a business relationship. Form 990, Part VI, Section A, line 6 The West Ohio Conference of The United Methodist Church is the sole member of OhioHealth Corporation, and this membership is permissible under Ohio Revised Code Section 1702.13. Form 990, Part VI, Section A, line 7a The West Ohio Conference of The United Methodist Church is the sole voting member of OhioHealth Corporation which in turn is the sole voting member of all subsidiary organizations. This membership is permissible under Ohio Revised Code Section 1702.13. Form 990, Part VI, Section A, line 7b Revisions of the Code of Regulations that affect the rights of the Member must be approved by the Member. Form 990, Part VI, Section B, line 11 Corporate Finance, using a public accounting tax firm, prepares the Form 990. Multiple levels of internal review occur, as well as a presentation to the OhioHealth Board Finance and Audit Committee, prior to copies being provided to the OhioHealth Corporation Board before filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy has been reviewed by independent tax counsel to assure its compliance with the requirements of the Internal Revenue Service. The policy requires all officers, directors and key employees to complete an annual questionnaire pertaining to conflicts of interest. The questionnaire is administered by the General Counsel of OhioHealth. The responses are recorded and reported to the Board in the format approved by the Chair of the Board (a community member). In the interim between questionnaires, conflicts are to be reported to the General Counsel, who will advise the conflicted officer, director or key employee on the steps required to manage or clear the conflict. Failure to report a conflict, or failure to follow the steps advised to clear the conflict, constitutes grounds for disciplinary action. Members of the governing board with a transactional conflict are required to recuse themselves from any discussion and/or vote pertaining to the conflicted transaction, and this is reflected in the minutes of the organization. Legal counsel attends Board meetings and Board committee meetings with the instruction to assure the conflict of interest policy is followed. Form 990, Part VI, Section B, line 15 The CEO's compensation is set by the Compensation Committee, which is composed of independent and disinterested members of the Board of Directors. The CEO's 2012 base salary and his 2012 total compensation (which includes annual incentive and all benefits) were estimated to approximate the 73rd percentile. The organization's performance for FY6/30/2013 was at the 82nd percentile as measured by the Balanced Scorecard using Quality, Customer Service, Worklife and Finance indicators. The Compensation Committee annually receives a report from its independent executive compensation consultant, which includes third-party comparability data for functionally-similar positions in comparable not-for-profit health systems across the United States. The annual report to the Compensation Committee, completed each fall, includes market analyses for base salaries, total cash compensation, benefits and perquisites, and aggregate total compensation values for the Chief Executive Officer, Executive Vice Presidents, Senior Vice Presidents and Entity Presidents, to support OhioHealth's qualification for the rebuttable presumption of reasonableness. The Compensation Committee reviews and approves each executive's compensation, based on performance and the compensation philosophy, and rationale for the Committee's decisions is documented in meeting minutes. With respect to non-disqualified positions, compensation is determined in the same manner as set forth above, however it is not reviewed by the Executive Compensation Committee and is instead determined by management. Form 990, Part VI, Section C, line 19 Information is made available as required. Form 990, Part VII, Section B: Amounts paid to The Whiting-Turner Contracting Company, Daimler Group, and McKesson Technologies represent amounts paid for materials and services. These amounts cannot be separated. Other Fees Form 990, Part IX, line 11g Intercompany Purchased Services: Program service expenses 88,044,608. Management and general expenses 18,058,800. Fundraising expenses 0. Total expenses 106,103,408. Physician Fees: Program service expenses 29,875,310. Management and general expenses 6,127,715. Fundraising expenses 0. Total expenses 36,003,025. Other: Program service expenses 18,987,295. Management and general expenses 18,763,357. Fundraising expenses 0. Total expenses 37,750,652. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Pension-Related Changes Other Than Net Periodic Pension Costs 45,914,055. Change in Fair Value of Interest Rate Swaps 21,092,923. Intercompany Transactions -80,863,007. Other Unrestricted Net Asset Changes 3,063,843. DH Ventures Ltd 180 East Broad Street 33rd Floor Columbus OH 432153707 311686358 Holding Company OH 0 0 OhioHealth Corporation CG Broad Norton LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 261564783 Real Estate Holding Company OH 2993 243155 OhioHealth Corporation OhioHealth Medical Specialty Foundation LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 261210223 Holding Company OH 0 0 OhioHealth Corporation OhioHealth Hospital Management Services 180 East Broad Street 33rd Floor Columbus OH 432153707 300632745 Hospital Management Services OH 272856 0 OhioHealth Corporation Pickerington Fairfield Land Company LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 452035147 Real Estate Holding Company OH 0 7317548 OhioHealth Corporation Grove City Land Company LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 452651557 Real Estate Holding Company OH 0 3624067 OhioHealth Corporation OhioHealth Urgent Care LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 273371022 Urgent Care Services OH 198270 3689274 OhioHealth Corporation Marion Practices LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 455500349 Holding Company OH 0 0 OhioHealth Corporation Marion Area Physicians LLC 180 East Broad Street 33rd Floor Columbus OH 432153707 800835324 Physician Practices OH 0 8162720 OhioHealth Corporation Marion General Hospital 1000 McKinley Park Drive Marion OH 43302 311070877 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 Grady Memorial Hospital 561 West Central Avenue Delaware OH 43015 314379436 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 Hardin Memorial Hospital 921 East Franklin Street Kenton OH 43326 344440479 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 Hardin Physician Foundation Inc 921 East Franklin Street Kenton OH 43326 311414276 Foundation OH 501(c)(3) Schedule A, Line 3 Hardin Memorial Hospital 1 Hardin Memorial Hospital Foundation 921 East Franklin Street Kenton OH 43326 341521537 Foundation OH 501(c)(3) Schedule A, Line 3 Hardin Memorial Hospital 1 Doctors Health Corporation of Nelsonville 1950 Mount St Mary Drive Nelsonville OH 45764 311620551 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 GrantRiverside Medical Care Foundation (dba OHPMS & dba OHMSF) 180 East Broad Street 33rd Floor Columbus OH 432153707 311351965 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 OhioHealth Foundation 180 East Broad Street 33rd Floor Columbus OH 432153707 237446919 Foundation OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 HomeReach 180 East Broad Street 33rd Floor Columbus OH 432153707 311372702 Health Care OH 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 HomeReach HomeCare 180 East Broad Street 33rd Floor Columbus OH 432153707 311417595 Health Care OH 501(c)(3) Schedule A, Line 3 HomeReach 1 OhioHealth Research Institute 180 East Broad Street 33rd Floor Columbus OH 432153707 316059784 Research OH Section 501(c)(3) Schedule A, Line 3 OhioHealth Corporation 1 Hospital Properties Inc 180 East Broad Street 33rd Floor Columbus OH 432153707 311206071 Property Management OH Section 501(c)(2) N/A OhioHealth Corporation 1 OhioHealth Sleep Services LLC 6186 Huntley Road STE B Columbus OH 43229 201547399 Physician Practice OH OhioHealth Corporation Related 2071905 4964262 0 0 0.78530 Upper Arlington Medical Limited Partnership 180 East Broad Street 33rd Floor Columbus OH 43215 311472667 Medical Services OH N/A ESWL Real Estate & Equipment Limited Partnership 100 West Third Avenue Suite 350 Columbus OH 43201 311138732 Equipment Rental OH N/A Grant Scope Center LLC 180 East Broad Street 33rd Floor Columbus OH 43215 260765486 Endoscopy Services OH OhioHealth Corporation Related 2127631 1131895 0 0 0.50500 Polaris Surgery Center LLC 6200 Cleveland Avenue Columbus OH 43231 208074623 Medical Services OH OhioHealth Corporation Related 4280288 3038064 0 1 0.51250 OhioHealth Star Corporation 180 East Broad Street 33rd Floor Columbus OH 432153707 311119936 Administrative Services OH OhioHealth Corporation C 292210 2487693 1.00000 0 MedStart Inc 180 East Broad Street 33rd Floor Columbus OH 432153707 311482649 Administrative Services OH N/A C 0 GM Health Services 561 West Central Avenue Delaware OH 43015 311094787 Industrial Health, DME Home, Collection Agency OH N/A C 0 HealthWorks 561 West Central Avenue Delaware OH 43015 311435822 Medical Service Phys Practices OH N/A C 0 Grady Anesthesia Services 561 West Central Avenue Delaware OH 43015 203750671 Anesthesia Services OH N/A C 0 HardinCare Inc 921 East Franklin Street Kenton OH 43326 341492617 Property Management OH N/A C 0 Intel Health Services PO Box 1051 Governors Square Bu Grand Cayman KY1-1102 CJ 314394942 Insurance/Reinsurance CJ OhioHealth Corporation C 3256401 9087361 1.00000 0 0 0 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 Hospital Properties Inc K 3429553 FMV of Rent Hospital Properties Inc K 3122569 IC AR and IC Net Assets hospital Properties Inc P 57535 actual Amount Transferred Hospital Properties Inc Q 2916039 Actual Expenses Paid Hospital Properties Inc S 6109659 Actual Amount Transferred Hospital Properties Inc R 9274406 Actual Amount Transferred Hospital Properties Inc P 71588 Actual Amount Transferred OhioHealth Foundation C 1153739 FMV OhioHealth Foundation R 6968093 Actual Amount Transferred Grady Hospital Foundation R 86488 Actual Amount Transferred OhioHealth Research Foundation R 217121 Actual Amount Transferred OhioHealth Star Corporation R 506858 Actual Amount Transferred Grady Memorial Hospital Q 219762 Actual Amount Transferred Marion General Hospital Q 1939860 Actual Amount Transferred Intel Health Services O 2242266 Actual Amount Transferred