PIKE HEALTH SERVICES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PIKE HEALTH SERVICES INC (EIN 31-1072406)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201343189349307189
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T18:05:25-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65 EAST STATE ST STE 600 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311072406 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PIKE | NameControl |
| Phone | 7409472186 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG E SOLLE | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 7409472186 | Phone |
| Date Signed | 2013-11-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BERNIE OSTROWSKI | Name |
| PTIN | P00366367 | PTIN |
| Phone | 6148493000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CRAIG E SOLLE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 21885412 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | ADENA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | PIKE HEALTH SERVICES, INC. IS HIGH QUALITY; COMPASSIONATE HEALTHCARE; ACCESSIBLE TO THE COMMUNITY; COMMITTED TO EXCELLENCE; RESPECTFUL OF EACH INDIVIDUAL; AND FOUNDED ON SERVICE TO OTHERS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 271 | TotalNbrEmployees |
| Total Nbr Volunteers | 67 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 73327 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 38278 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 21456193 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20840203 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1549 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1325 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 999065 | OtherRevenuePriorYear |
| Other Revenue Current Year | 991157 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 22530134 | TotalRevenuePriorYear |
| Total Revenue Current Year | 21870963 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 3350 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11869383 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10932075 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11421614 | OtherExpensePriorYear |
| Other Expenses Current Year | 10637182 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23294347 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21572257 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -764213 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 298706 | RevenuesLessExpensesCY |
| Total Assets BOY | 12322628 | TotalAssetsBOY |
| Total Assets EOY | 15732254 | TotalAssetsEOY |
| Total Liabilities BOY | 9950904 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9872430 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2371724 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5859824 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PIKE HEALTH SERVICES, INC. IS HIGH QUALITY; COMPASSIONATE HEALTHCARE; ACCESSIBLE TO THE COMMUNITY; COMMITTED TO EXCELLENCE; RESPECTFUL OF EACH INDIVIDUAL; AND FOUNDED ON SERVICE TO OTHERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18777363 | Expense |
| Grants | 3000 | Grants |
| Revenue | 20840203 | Revenue |
| Description | SEE SCHEDULE OPIKE HEALTH SERVICES, INC. IS A 25-BED CRITICAL ACCESS HOSPITAL AND PHYSICIAN PRACTICE LOCATED IN THE STATE OF OHIO IN PIKE COUNTY. INCLUDED IN THE BED COUNT ARE 21 ACUTE BEDS AND 4 INTENSIVE CARE BEDS WITH AUTHORIZATION FOR SWING BEDS ON AN AS NEEDED BASIS. IN 2012, PIKE HEALTH SERVICES, INC. HAD 602 INPATIENT ADMISSIONS, 302 SURGERY CASES (INCLUDING AMBULATORY), AND 13,648 VISITS TO THE EMERGENCY DEPARTMENT. ADENA PIKE COMMUNITY HOSPITAL PROVIDED CHARITY CARE TO THE COMMUNITY IN THE AMOUNT OF $4,417,653, INCLUDING 11.9% SELF PAY PATIENTS, WHO HAVE NO INSURANCE.PIKE HEALTH SERVICES, INC'S COMMUNITY OUTREACH ACTIVITY HAS SERVED 570 CITIZENS IN VARIOUS PROGRAMS THROUGHOUT PIKE COUNTY. DURING THE YEAR, THEY PARTICIPATED IN 9 HEALTH FAIRS OFFERING SCREENING AND EDUCATION FOR DIABETES, CHOLESTEROL AND ARTHRITIS FOR BOTH ADULTS AND CHILDREN. ADDITIONALLY, THEY SUPPORT THE YOUNG RESIDENTS OF THE COUNTY IN VARIOUS PROGRAMS INCLUDING HEAD START AND CHILD SAFETY PRESENTATIONS. | Description |
| Total Program Service Expense | 18777363 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 74 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 271 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHARON NOVAK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7409476306 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| PAUL ADKINS | ||||||||
| TRUSTEE (JUNE-DEC) | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| TODD BURKITT | ||||||||
| TRUSTEE | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| CATHERINE FARINET | ||||||||
| CHIEF OF MEDICAL STAFF | 50.00 | 0.00 | X | 50890 | 185569 | 11333 | ||
| ANTHONY FISH | ||||||||
| CHAIRMAN | 2.00 | 0.00 | X | 0 | 0 | 0 | X | |
| MARGARET FOILL | ||||||||
| TREASURER | 2.00 | 0.00 | X | 0 | 0 | 0 | X | |
| VAL FRANCIS | ||||||||
| VICE CHAIRMAN | 2.00 | 0.00 | X | 0 | 0 | 0 | X | |
| RON HINES | ||||||||
| TRUSTEE | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| CONNIE SHELLEY | ||||||||
| TRUSTEE (JUNE-DEC) | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| LINDA SHOEMAKER | ||||||||
| SECRETARY | 2.00 | 0.00 | X | 0 | 0 | 0 | X | |
| MELBY WILLIAMS | ||||||||
| TREASURER (JAN-JUNE) | 2.00 | 0.00 | X | 0 | 0 | 0 | X | |
| SHARON NOVAK | ||||||||
| VP FINANCE/CFO | 50.00 | 0.00 | 15064 | 78873 | 13676 | X | ||
| CRAIG SOLLE | ||||||||
| PRESIDENT AND CEO | 50.00 | 0.00 | 22213 | 128482 | 23574 | X | ||
| CINDY INGRAM | ||||||||
| CRNA | 50.00 | 0.00 | 42425 | 165108 | 19585 | X | ||
| DAVID KESSLER | ||||||||
| DOCTOR | 50.00 | 0.00 | 43136 | 179636 | 0 | X | ||
| ELLIS FRAZIER | ||||||||
| DOCTOR | 50.00 | 0.00 | 34045 | 126736 | 5607 | X | ||
| JOHN CRAWFORD | ||||||||
| DOCTOR | 50.00 | 0.00 | 35165 | 112176 | 15991 | X | ||
| CHERYL SMITH | ||||||||
| PHARMACIST | 50.00 | 0.00 | 21160 | 90744 | 2346 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 264098 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1067324 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 92112 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PREMIER HEALTH CARE SERVICES INC | |||||
| 221 CONGRESS PARK DRIVE | DAYTON | OH | 45456 | EMERGENCY DEPT PHYSICIANS | 640000 |
| M MODAL SERVICES LTD | |||||
| PO BOX 102467 | ATLANTA | GA | 30368 | TRANSCRIPTION | 240842 |
| QUEST DIAGNOSTICS | |||||
| 12436 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | LAB SERVICES | 201762 |
| WISE MEDICAL STAFFING | |||||
| 432 MAGAZINE ST | TUPELO | MO | 38804 | CONTRACT NURSING SERVICES | 171036 |
| SIEMENS MEDICAL SOLUTION | |||||
| 51 VALLEY STREAM PARKWAY | MALVERN | PA | 19355 | SERVICE CONTRACT | 152530 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| All Other Contributions | 38278 | AllOtherContributions |
| Total Contributions | 38278 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REV | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 20840203 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20840203 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20840203 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 10060 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 10060 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10060 | TotalRevenueColumn |
| Exclusion | $10,060 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1325 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1325 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1325 | TotalRevenueColumn |
| Exclusion | $1,325 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 34601 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 14449 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20152 | TotalRevenueColumn |
| Exclusion | $20,152 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| COUNTY TAX LEVY | 622110 | 922592 | $922,592 |
| CAFETERIA REVENUE | 622110 | 38353 | $38,353 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 960945 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21870963 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20840203 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $992,482 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3000 | Total |
| Program Services | 3000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 529674 | Total |
| Management And General | 529674 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7489607 | Total |
| Program Services | 6343575 | ProgramServices |
| Management And General | 1146032 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2351897 | Total |
| Program Services | 2253815 | ProgramServices |
| Management And General | 98082 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 560897 | Total |
| Program Services | 463520 | ProgramServices |
| Management And General | 97377 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2081 | Total |
| Management And General | 2081 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101192 | Total |
| Management And General | 101192 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1588722 | Total |
| Program Services | 1281142 | ProgramServices |
| Management And General | 307580 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1508001 | Total |
| Program Services | 1260124 | ProgramServices |
| Management And General | 247877 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 786394 | Total |
| Program Services | 707755 | ProgramServices |
| Management And General | 78639 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24698 | Total |
| Program Services | 16164 | ProgramServices |
| Management And General | 8534 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326674 | Total |
| Program Services | 294007 | ProgramServices |
| Management And General | 32667 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1447033 | Total |
| Program Services | 1301874 | ProgramServices |
| Management And General | 145159 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| BAD DEBT EXPENSE | 3438201 | 3438201 |
| MEDICAL SUPPLIES | 1414186 | 1414186 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21572257 | Total |
| Program Services | 18777363 | ProgramServices |
| Management And General | 2794894 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 167282 | BOY |
| EOY | 1237644 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93545 | BOY |
| EOY | 98511 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2094661 | BOY |
| EOY | 2197152 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18710 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 32446 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 255839 | BOY |
| EOY | 233139 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 151323 | BOY |
| EOY | 597208 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8982138 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1264257 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7293655 | BOY |
| EOY | 7717881 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1258687 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 166824 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 822102 | BOY |
| EOY | 3618273 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12322628 | BOY |
| EOY | 15732254 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3906272 | BOY |
| EOY | 1761207 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4790000 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 33920 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1254632 | BOY |
| EOY | 8077303 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9950904 | BOY |
| EOY | 9872430 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2371724 | BOY |
| EOY | 5859824 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2371724 | BOY |
| EOY | 5859824 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12322628 | BOY |
| EOY | 15732254 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 298706 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 32065 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 3157329 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $761 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 761 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | OHIO HOSPITAL ASSOCIATION STRATEGIC ISSUES | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 350000 | OtherCostOrOtherBasis |
| Book Value | 350000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4847110 | OtherCostOrOtherBasis |
| Depreciation | 186612 | Depreciation |
| Book Value | 4660498 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3526075 | OtherCostOrOtherBasis |
| Depreciation | 1056065 | Depreciation |
| Book Value | 2470010 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 258953 | OtherCostOrOtherBasis |
| Depreciation | 21580 | Depreciation |
| Book Value | 237373 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7717881 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 2263889 |
| COST REPORT SETTLEMENT RECEIVABLE | 1354384 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3618273 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE OBLIGATION | $15,621 |
| DUE TO/FROM ADENA HEALTH SYSTEM | $8,061,682 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8077303 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANGEMENT BELIEVES THAT IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2009. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FESTIVAL OF TREES | NameOfEvent1 |
| Gross Receipts Event1 | 34601 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 34601 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 4842 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 9607 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 34601 | GrossReceiptsTotal |
| Gross Revenue Total Events | 34601 | GrossRevenueTotalEvents |
| Food And Beverage Total Events | 4842 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 9607 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 14449 | DirectExpenseSummaryEvents |
| Net Income Summary | 20152 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2204819 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 923177 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1281642 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07070 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4849342 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3244465 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1604877 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08850 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7054161 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4167642 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2886519 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15920 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 570 | PersonsServed |
| Total Community Benefit Expense | 9625 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 570 | PersonsServed |
| Total Community Benefit Expense | 9625 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 570 | PersonsServed |
| Total Community Benefit Expense | 7063786 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4167782 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2896004 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15970 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1500 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1500 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $3,438,201 | BadDebtExpenseAmount |
| Amount Attributable To | 2796127 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6906037 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6717912 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 188125 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE HEALTH SERVICES INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 6A: ADENA HEALTH SYSTEM EIN: 31-4379443 | ||
| PART I, LINE 7: THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. ACTUAL COSTS WERE USED IN LINE 7E. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $3,438,201 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN. | ||
| PART II: THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE POPULATION OF PIKE COUNTY BY EDUCATING FOR A HEALTHIER LIFESTYLE, SCREENING THE GENERAL PUBLIC FOR MAJOR HEALTH RISKS. ONGOING EDUCATION IN FIRST AID AND CPR IS GIVEN THROUGHOUT THE COMMUNITY. | ||
| PART III, LINE 4: PART III, LINE 2THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS. PART III, LINE 3THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FAP LISTED ON PART III, LINE 3 IS DERIVED FROM THE HCAP REPORT. THE AMOUNT IS DETERMINED BY ANALYZING THE BAD DEBTS THAT WERE DENIED BY THE HCAP PROGRAM BECAUSE OF PATIENTS POTENTIALLY BEING ELIGIBLE UNDER PIKE HEALTH SERVICES, INC'S FAP.PART III, LINE 4 WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR PIKE HEALTH SERVICES, INC. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF 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 SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE ACCOUNTS 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 ESTABLISHED BASED ON EXPECTED PAYMENT RATES FROM PAYORS UTILIZING CURRENT REIMBURSEMENT METHODOLOGIES AND PAYMENT RATES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT 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 (OR THE DISCOUNTED RATES, IF NEGOTIATED) 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 UNCOLLECTIBLE." | ||
| PART III, LINE 8: THE HOSPITAL USED THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT WHEN DETERMINING THE AMOUNT ON PART III - LINE 6. | ||
| PART III, LINE 9B: ALL NON INSURED PATIENTS MUST COMPLETE APPLICATIONS FOR FINANCIAL ASSISTANCE. IF THEY DO NOT, THEY WILL ALL BE TREATED EQUALLY PER THE COLLECTION POLICY. IF THE PATIENT COMPLETES THE APPLICATION AND QUALIFIES, THE ACCOUNT WILL BE ADJUSTED PER THE POLICY. | ||
| PART V, SECTION B, LINE 20D: THE HOSPITAL HAS A NONDISCRIMINATORY POLICY RELATED TO EMERGENCY MEDICAL CARE. ALL PATIENTS ARE TREATED BEFORE EMERGENCY MEDICAL CARE BEFORE PAYMENT IS DISCUSSED.THE MAXIMUM AMOUNT CHARGED TO THOSE PATIENTS THAT ARE FAP ELIGIBLE IS CALCULATED AS FOLLOWS: IF PATIENT'S INCOME LEVEL IS 100% OF FPG (FEDERAL POVERTY GUIDELINES)OR LESS THEN 100% DISCOUNT IS APPLIED AND THE DISCOUNTED AMOUNT IS WRITTEN OFF TO CHARITY CARE. THE REMAINING DISCOUNTS ARE CALCULATED ON A SLIDING SCALE DIRECTLY RELATED TO THE PATIENTS INCOME LEVEL AS COMPARED TO FPG. FOR EXAMPLE, IF THE PATIENT'S INCOME LEVEL IS 140% OF FPG THEN 60% DISCOUNT IS APPLIED. IF THE PATIENT'S INCOME LEVEL IS 180% OF FPG THEN 20% DISCOUNT IS APPLIED. | PIKE HEALTH SERVICES, INC. | |
| PART VI, LINE 2: MANY PROGRAMS ARE IN AFFECT INVOLVING PATIENT SCREENING TO COVER THE HEALTH CARE NEEDS OF THE COMMUNITY INCLUDING THE RISKS THAT HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT. | ||
| PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY IS POSTED AT ALL PATIENT ENTRANCES, IN WAITING ROOMS, IN THE ADMISSION'S OFFICE, IN TREATMENT ROOMS, ON THE HOSPITAL'S WEBSITE, AND IS AVAILABLE UPON REQUEST. THE POLICY IS ALSO PROVIDED TO PATIENTS UPON ADMISSION. BROCHURES ARE AVAILABLE THROUGHOUT THE HOSPITAL AND PHYSICIAN OFFICES. AWARENESS OF THE ASSISTANCE PROGRAMS ARE PROMOTED THROUGH THE MANY HEALTH FAIRS AND SCREENING THROUGHOUT AREA. | ||
| PART VI, LINE 4: PIKE COUNTY IS LOCATED IN THE APPALACHIAN REGION OF THE US WITH A POPULATION OF 28,700. THE MEDIUM INCOME IS $31,649, WITH 15.10% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL. OVER 10% OF THE POPULATION IS OVER 65 YEARS OF AGE. | ||
| PART VI, LINE 5: MEDICAL AND HOSPITAL STAFF ARE ACTIVE PARTICIPANTS ON NUMEROUS BOARDS THROUGHOUT THE AREA AND REGION IN AN EFFORT TO PROMOTE COMMUNITY HEALTH AND HEALTHIER LIFESTYLES. | ||
| FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES THREE HOSPITALS AND SIX REGIONAL CLINICS, WITH A TOTAL OF 311 BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. GREENFIELD AREA MEDICAL CENTER AND PIKE HEALTH SERVICES, INC.: BOTH ARE CRITICAL ACCESS HOSPITALS, EACH WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (GREENFIELD AREA MEDICAL CENTER) AND PIKE COUNTY (PIKE HEALTH SERVICES, INC.) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WASHINGTON COURT HOUSE AND WAVERLY, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE AND WAVERLY. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN), A PARTNERSHIP OF THE REGION'S THREE LARGEST HEALTHCARE PROVIDERS -- ADENA, O'BLENESS HEALTH SYSTEM AND HOLZER CONSOLIDATED HEALTH SYSTEMS. THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS. | SCHEDULE H, PART VI, LINE 6 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CATHERINE FARINET | ||||||||||||||
| CHIEF OF MEDICAL STAFF | 50890 | 185171 | 0 | 0 | 0 | 398 | 0 | 0 | 0 | 13853 | 50890 | 199422 | 0 | 0 |
| CRAIG SOLLE | ||||||||||||||
| PRESIDENT AND CEO | 22213 | 128114 | 0 | 0 | 0 | 368 | 0 | 8464 | 0 | 17065 | 22213 | 154011 | 0 | 0 |
| CINDY INGRAM | ||||||||||||||
| CRNA | 42425 | 164977 | 0 | 0 | 0 | 131 | 0 | 162 | 0 | 19423 | 42425 | 184693 | 0 | 0 |
| DAVID KESSLER | ||||||||||||||
| DOCTOR | 43136 | 179257 | 0 | 0 | 0 | 379 | 0 | 0 | 0 | 0 | 43136 | 179636 | 0 | 0 |
| ELLIS FRAZIER | ||||||||||||||
| DOCTOR | 34045 | 126268 | 0 | 0 | 0 | 468 | 0 | 0 | 0 | 5607 | 34045 | 132343 | 0 | 0 |
| JOHN CRAWFORD | ||||||||||||||
| DOCTOR | 35165 | 111871 | 0 | 0 | 0 | 305 | 0 | 0 | 0 | 15991 | 35165 | 128167 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 3 | ReturnReference |
| Explanation | PIKE HEALTH SERVICES, INC. WAS ACQUIRED DURING 2012 BY ADENA HEALTH SYSTEM. THE METHODS DISCLOSED ON SCHEDULE J, PART I, LINE 3 DIRECTLY RELATE TO THE METHODS USED BY PIKE HEALTH SERVICES, INC. TO DETERMINE TOP MANAGEMENT OFFICIAL'S COMPENSATION BEFORE THE ACQUISITION. POST ACQUISITION, THE TOP MANAGEMENT OFFICIAL'S COMPENSATION IS REVIEWED ON A BI-ANNUAL BASIS IN CONJUNCTION WITH OTHER MANAGEMENT POSITIONS BY THE HUMAN RESOURCE DEPARTMENT OF ADENA HEALTH SYSTEM, A RELATED ENTITY, WHICH IS RESPONSIBLE FOR EMPLOYEE COMPENSATION. IN ADDITION TO AN THE USE OF AN INDEPENDENT CONSULTANT, VARIOUS MARKET SURVEYS ARE USED AS APPROPRIATE FOR THE APPLICABLE POSITIONS AND RECOMMENDATIONS FOR SALARY SCALE CHANGES ARE APPROVED BY THE HUMAN RESOURCES COMMITTEE OF THE ADENA HEALTH SYSTEM BOARD OF DIRECTORS, A RELATED ENTITY. SPECIFIC WAGE INCREASES FOR INDIVIDUALS ARE BASED ON THE EMPLOYEE MEETING AGREED UPON DEVELOPMENTAL AND PERFORMANCE-BASED GOALS FOR THE FISCAL YEAR. THE PROCESS WAS LAST UNDERTAKEN DURING 2012 AND ALSO IN APRIL/JUNE 2013. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION'S GOVERNING DOCUMENTS HAVE BEEN UPDATED TO ALIGN WITH THE GOVERNING DOCUMENTS OF ADENA HEALTH SYSTEM. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF PIKE HEALTH SERVICES, INC. IS ADENA HEALTH SYSTEM. | |
| FORM 990, PART VI, SECTION A, LINE 7A | PIKE HEALTH SYSTEM, INC. ELECTS AND APPOINTS MEMBERS TO THE GOVERNING BODY SUBJECT TO THE APPROVAL ADENA HEALTH SYSTEM, THE SOLE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN GOVERNING DECISIONS ARE SUBJECT TO THE APPROVAL OF ADENA HEALTH SYSTEM, THE SOLE MEMBER OF PIKE HEALTH SERVICES, INC. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO OR VICE PRESIDENT OF FINANCE REVIEWS THE FORM 990 AND THE BOARD WILL BE PRESENTED WITH A COPY OF THE FORM 990 PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE OFFICE OF ADENA HEALTH SYSTEM, PIKE HEALTH SERVICES, INC.'S SOLE MEMBER, ANNUALLY COORDINATES THE DISTRIBUTION AND RETURN OF THE CONFLICT OF INTEREST STATEMENTS. THE CORPORATE COMPLIANCE OFFICE IS RESPONSIBLE FOR REVIEWING THE RESPONSES AND COMMUNICATING ANY EXTRA STEPS THAT NEED TO TAKE PLACE REGARDING ANY OF THE RESPONSES. AT EVERY BOARD MEETING AND COMMITTEE OF THE BOARD, THE AGENDA ITEM OF CONFLICT OF INTEREST IS INCLUDED AND CALLED OUT. CONFLICTED BOARD MEMBERS ABSTAIN FROM VOTING ON THE PARTICULAR ITEMS. ANY MEMBER ABSTAINING FROM VOTING IS DOCUMENTED IN THE MINUTES. ALL ADENA HEALTH SYSTEM WORKFORCE MEMBERS AND BOARD MEMBERS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE TOP MANAGEMENT OFFICIAL AT PIKE HEALTH SERVICES, INC., ALONG WITH ANY KEY EMPLOYEES HAVE THEIR COMPENSATION REVIEWED ON A BI-ANNUAL BASIS IN CONJUNCTION WITH OTHER MANAGEMENT POSITIONS BY THE HUMAN RESOURCE DEPARTMENT RESPONSIBLE FOR EMPLOYEE COMPENSATION. VARIOUS MARKET SURVEYS ARE USED AS APPROPRIATE FOR THE APPLICABLE POSITIONS AND RECOMMENDATIONS FOR SALARY SCALE CHANGES ARE APPROVED BY THE HUMAN RESOURCES COMMITTEE OF THE ADENA HEALTH SYSTEM BOARD OF DIRECTORS, A RELATED ENTITY. SPECIFIC WAGE INCREASES FOR INDIVIDUALS ARE BASED ON THE EMPLOYEE MEETING AGREED UPON DEVELOPMENTAL AND PERFORMANCE-BASED GOALS FOR THE FISCAL YEAR. THE PROCESS WAS LAST UNDERTAKEN DURING 2012 AND ALSO IN APRIL/JUNE 2013. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | REDUCTION IN INHERENT CONTRIBUTION FROM PIKE FOR BEG. UNRSCT NET ASSETS -2,371,724. ADJUSTMENT TO REDUCTION IN INHERENT CONTRIBUTION FOR 2 MONTHS OF ACTIVITY 350,087. INHERENT CONTRIBUTION FROM ACQUISITION OF PIKE HEALTH SERVICES INC 5,178,966. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. PIKE HEALTH SERVICES, INC. IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GREENFIELD AREA MEDICAL CENTER | |||||||||||
| 550 MIRABEAU ST | GREENFIELD | OH | 45123 | 310993422 | HOSPITAL | OH | 501(C)(3) | 3 | ADENA HEALTH SYSTEM | 1 | |
| ADENA HEALTH FOUNDATION | |||||||||||
| 242 HOSPITAL ROAD | CHILLICOTHE | OH | 45601 | 753008742 | FUNDRAISING | OH | 501(C)(3) | 11A | ADENA HEALTH SYSTEM | 1 | |
| SOUTHERN OHIO HEALTHCARE NETWORK | |||||||||||
| 550 MIRABEAU ST | GREENFIELD | OH | 45123 | 261566590 | FIBEROPTIC NETWORK GRANTS | OH | 501(C)(3) | 11A | ADENA HEALTH SYSTEM | 1 | |
| ADENA HEALTH SYSTEM | |||||||||||
| 242 HOSPITAL ROAD | CHILLICOTHE | OH | 45601 | 314379443 | HOSPITAL | OH | 501(C)(3) | 3 | 0 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADENA CARE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 HOSPITAL ROAD | AddressLine1 |
| City | CHILLICOTHE | City |
| State | OH | State |
| ZIP Code | 45601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453980850 | EIN |
| Primary Activity | PROVIDE EMPLOYEE HEALTH INSURANCE | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ADENA HEALTH SYSTEM | ||
| C | 5178966 | BOOK VALUE |
| ADENA HEALTH SYSTEM | ||
| O | 9979354 | TIME SHEET ALLOCATION |