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GALION COMMUNITY HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
GALION COMMUNITY HOSPITAL (EIN 34-4451872)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201101369349306790
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-16T18:14:01-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE ST STE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN344451872EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GALION COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGALINameControl
Phone4194684841Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1269 PORTLAND WAY SOUTHAddressLine1
CityGALIONCity
StateOHState
ZIP Code448332399ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameD ERIC DRAIMEName
TitleCFOTitle
Phone4194684841Phone
Date Signed2011-05-16DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBERNARD A OSTROWSKIName
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonD ERIC DRAIMENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1269 PORTLAND WAY SOUTHAddressLine1
CityGALIONCity
StateOHState
ZIP Code448332399ZIPCode
FieldValueIRS element (for citing)
Gross Receipts54500981GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.GALIONHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees563TotalNbrEmployees
Total Nbr Volunteers128TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year570917ContributionsGrantsPriorYear
Contributions Grants Current Year160900ContributionsGrantsCurrentYear
Program Service Revenue Prior Year49656930ProgramServiceRevenuePriorYear
Program Service Revenue CY53614626ProgramServiceRevenueCY
Investment Income Prior Year89548InvestmentIncomePriorYear
Investment Income Current Year403874InvestmentIncomeCurrentYear
Other Revenue Prior Year337594OtherRevenuePriorYear
Other Revenue Current Year313064OtherRevenueCurrentYear
Total Revenue Prior Year50654989TotalRevenuePriorYear
Total Revenue Current Year54492464TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year44333GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY281101GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year23470239SalariesEtcPriorYear
Salaries Etc Current Year24381563SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year26484536OtherExpensePriorYear
Other Expenses Current Year28803962OtherExpensesCurrentYear
Total Expenses Prior Year49999108TotalExpensesPriorYear
Total Expenses Current Year53466626TotalExpensesCurrentYear
Revenues Less Expenses Prior Year655881RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1025838RevenuesLessExpensesCY
Total Assets BOY42501326TotalAssetsBOY
Total Assets EOY45620375TotalAssetsEOY
Total Liabilities BOY26472715TotalLiabilitiesBOY
Total Liabilities EOY26582752TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16028611NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19037623NetAssetsOrFundBalancesEOY
Mission DescriptionTO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense46246087Expense
Grants0Grants
Revenue57129441Revenue
DescriptionGALION COMMUNITY HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL LOCATED WITHIN THE CITY OF GALION, OH. IT SERVES THE GREATER GALION AREA INCLUDING MUCH OF CRAWFORD COUNTY. THE FACILITY SERVES THE GENERAL PUBLIC AND IS OPEN SEVEN DAYS A WEEK, TWENTY-FOUR HOURS PER DAY. DURING THE FISCAL YEAR OF 2010, GALION HOSPITAL AND ITS AFFILIATES SERVED 2,008 INPATIENTS, 17,904 EMERGENCY VISITS, AND 53,920 OUTPATIENT VISITS. THESE WERE ALL SERVED REGARDLESS OF THE ABILITY TO PAY. GALION HOSPITAL IS AN INTRICATE PART OF THE COMMUNITY. IT IS ONE OF THE LARGEST EMPLOYERS IN THE COUNTY AT 408 FULL TIME EQUIVALENTS.Description
Total Program Service Expense46246087TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096102NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees563NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ERIC DRAIMEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4194680501TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1269 PORTLAND WAY SOUTHAddressLine1
CityGALIONCity
StateOHState
ZIP Code44833ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
CHARLES WALKER
DIRECTOR1.90X000
DOUGLAS SCHILLING
DIRECTOR0.80X000
DAVE CHANDLER
DIRECTOR1.90X000
MICHELE MCELLIGOTT
DIRECTOR1.50X000
REX CRAMER
DIRECTOR0.80X000
DONALD BARR
DIRECTOR0.80X000
LINDA CHAMBERS
DIRECTOR0.80X000
MARGARET CAGLE
DIRECTOR0.80X000
BOYD EPPERSON
DIRECTOR0.80X000
STEVEN ERLSTEN
DIRECTOR0.80X000
KYMBERLY FOX
DIRECTOR0.80X000
ERIC GEYER
DIRECTOR0.80X000
TYLER HUGGINS
DIRECTOR0.80X000
MARK SCHNEIDER
DIRECTOR0.80X000
DR MARCIA BROWN
DIRECTOR/PHYSICIAN40.00X202194026298
JERRY MORASKO
CEO-PART YEAR39.40109416016535X
LAMAR WYSE
CEO-PART YEAR39.40245869012650X
ROBERT MELARAGNO
CFO-THRU 2/1039.40159399016500X
REBECCA MILLER
VICE PRESIDENT40.00101659026715X
TRACI OSWALD
VICE PRESIDENT40.0010641501542X
SHIRLEY FITZ
DIRECTOR OF NURSING40.009072305163X
D ERIC DRAIME
CFO-FROM 3/1039.40000X
DR MARK WOOD
DIRECTOR/PHYSICIAN40.00185860020764X
DR JOHN T HANNA
PHYSICIAN40.0030449703727X
DR ANDREW J LEE
PHYSICIAN40.00207035023032X
DR LAWRENCE S LEONE
PHYSICIAN40.00198120025123X
MIHAI-LIVIU C URSACHI
PHYSICIAN40.00167180016531X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2078367TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation194580TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MID AMERICAN THERAPY
2511 STATE HIGHWAYNEVADAOH44849THERAPY SERVICES1241387
GALION ANESTHESIA SERVICES INC
4575 TOWNSHIP ROAD 126CARDINGTONOH43315CRNA SERVICES968051
ARAMARK HEALTH SUPPORT SERVICE
PO BOX 651009CHARLOTTENC28265FOOD SERVICE719401
MEDBEN ADMINISTRATORS
PO BOX 1009NEWARKOH43058HEALTH INSURANCE CONSULTANTS685729
BRICKLER & ECKLER
100 S THIRD STREETCOLUMBUSOH43215LEGAL SERVICES320678
FieldValueIRS element (for citing)
Number Of Contractors GT100 K32NumberOfContractorsGT100K
Related Organizations48840RelatedOrganizations
All Other Contributions112060AllOtherContributions
Total Contributions160900TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column53614626TotalRevenueColumn
Related Or Exempt Function Income53614626RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue53614626TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column402694TotalRevenueColumn
Exclusion$402,694ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real22957Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real9697Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real13260Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column13260TotalRevenueColumn
Exclusion$13,260ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other-1180Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other1180Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1180TotalRevenueColumn
Exclusion$1,180ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFETERIA & CATERINGDescription
Business Code621110BusinessCode
Total Revenue Column228936TotalRevenueColumn
Related Or Exempt Function Income228936RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column70868TotalRevenueColumn
Related Or Exempt Function Income70868RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue299804TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column54492464TotalRevenueColumn
Related Or Exempt Function Income53914430RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$417,134ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total237003Total
Program Services237003ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total44098Total
Program Services44098ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total832769Total
Management And General832769ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17716832Total
Program Services15590812ProgramServices
Management And General2126020ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1068404Total
Program Services940196ProgramServices
Management And General128208ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3414840Total
Program Services3005059ProgramServices
Management And General409781ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1348718Total
Program Services1186872ProgramServices
Management And General161846ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total126048Total
Management And General126048ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total418472Total
Management And General418472ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total68000Total
Management And General68000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9046765Total
Program Services7961153ProgramServices
Management And General1085612ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total250545Total
Program Services220480ProgramServices
Management And General30065ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8002509Total
Program Services7042208ProgramServices
Management And General960301ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2764010Total
Program Services2432329ProgramServices
Management And General331681ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total97993Total
Program Services86234ProgramServices
Management And General11759ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total969267Total
Program Services852955ProgramServices
Management And General116312ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2547648Total
Program Services2241930ProgramServices
Management And General305718ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total720647Total
Program Services634169ProgramServices
Management And General86478ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE36131513613151
PHYSICIAN RECRUITING17810915673621373

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total798Total
Program Services702ProgramServices
Management And General96ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total53466626Total
Program Services46246087ProgramServices
Management And General7220539ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3535509BOY
EOY2449683EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4795019BOY
EOY7304303EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY256565BOY
EOY413631EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY337584BOY
EOY348747EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY580285BOY
EOY768727EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis57039769LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec29569362LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY26678879BOY
EOY27470407EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5305650BOY
EOY5719977EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY559206BOY
EOY569779EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY452629BOY
EOY575121EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42501326BOY
EOY45620375EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3733156BOY
EOY3918391EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12230000BOY
EOY11655000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10509559BOY
EOY11009361EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY26472715BOY
EOY26582752EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY15520922BOY
EOY18559104EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY507689BOY
EOY478519EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16028611BOY
EOY19037623EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42501326BOY
EOY45620375EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$956GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB956TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationGALION COMMUNITY HOSPITAL PAYS DUES TO OHIO HOSPITAL ASSOCIATION. FOR 2009, THE PORTION OF DUES RELATED TO LOBBYING ACTIVITIES WAS $956.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis345285OtherCostOrOtherBasis
Book Value345285BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis35219311OtherCostOrOtherBasis
Depreciation14513477Depreciation
Book Value20705834BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis18917429OtherCostOrOtherBasis
Depreciation14580577Depreciation
Book Value4336852BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2557744OtherCostOrOtherBasis
Depreciation475308Depreciation
Book Value2082436BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings27470407TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
FV OF INTEREST RATE SWAP AGMT$641,992
ACCRUED PENSION$8,414,223
CAPITAL LEASES$1,854,710
SECURITY DEPOSITS$13,900
MINORITY INTEREST$84,536
FieldValueIRS element (for citing)
Total Of Amounts11009361TotalOfAmounts
Total Revenue54492464TotalRevenue
Total Expenses53466626TotalExpenses
Excess Or Deficit For Year1025838ExcessOrDeficitForYear
Net Unrealized GL On Investments635587NetUnrealizedGLOnInvestments
Other$1,347,587OtherAmount
Total Adjustments1983174TotalAdjustments
Excess Or Deficit Per FS3009012ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8 - Other Adjustments:Identifier
ExplanationCHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS: -136654. CHANGE IN PENSION COSTS: 1485243. CHANGE IN VALUE OF PERPETUAL TRUST: -1002.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense765964TotalCommunityBenefitExpense
Direct Offsetting Revenue650896DirectOffsettingRevenue
Net Community Benefit Expense115068NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5268755TotalCommunityBenefitExpense
Direct Offsetting Revenue2768354DirectOffsettingRevenue
Net Community Benefit Expense2500401NetCommunityBenefitExpense
Percent Of Total Expense0.05020PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6034719TotalCommunityBenefitExpense
Direct Offsetting Revenue3419250DirectOffsettingRevenue
Net Community Benefit Expense2615469NetCommunityBenefitExpense
Percent Of Total Expense0.05250PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served3942PersonsServed
Total Community Benefit Expense41989TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense41989NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served3942PersonsServed
Total Community Benefit Expense41989TotalCommunityBenefitExpense
Net Community Benefit Expense41989NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served3942PersonsServed
Total Community Benefit Expense6076708TotalCommunityBenefitExpense
Direct Offsetting Revenue3419250DirectOffsettingRevenue
Net Community Benefit Expense2657458NetCommunityBenefitExpense
Percent Of Total Expense0.05330PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$3,613,151BadDebtExpenseAmount
Amount Attributable To2132120AmountAttributableTo
Amount Reimbursed By Medicare8760071AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8673337CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall86734MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
GALION COMMUNITY VASCULAR SERVICES LLC
SERVICES FOR VASCULAR DIFFICULTIES0.510000.000000.49000
GALION COMMUNITY PAIN MANAGEMENT LLC
PAIN CLINIC0.510000.000000.49000

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1GALION COMMUNITY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1269 PORTLAND WAY SOUTHAddressLine1
CityGALIONCity
StateOHState
ZIP Code44833ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: GALION DOES USE FEDERAL POVERTY GUIDELINES. FOR HCAP, IT IS 200% OF THE POVERTY LEVEL. THERE IS A SLIDING SCALE UP TO 400% FOR PEOPLE WHO DO NOT QUALIFY FOR HCAP. THE PROCESS IS VERY SIMPLE. THE PATIENT ACCOUNT REPRESENTATIVE MEETS WITH THE PATIENT TO DETERMINE ELIGIBILITY. THE FORM IS VERY EASY TO COMPLETE AND VERY USER FRIENDLY. THE PATIENT REPRESENTATIVE HAS A TEMPLATE THAT LETS THEM DETERMINE ELIGIBILITY AND LEVEL OF CHARITY. THE ACCOUNT IS ADJUSTED IMMEDIATELY.PART I, LINE 6A: NOT APPLICABLEIncomeBasedCriteria
Annual Community Benefit ExplnPart I, Line 6a:AnnualCommunityBenefitExpln
Costing Method UsedPart I, Line 7: THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS THE COSTING METHOD USED.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g: NOT APPLICABLESubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: COLUMN F IS CALCULATED BASED ON THE TOTAL OF FORM 990, PART IX, LESS BAD DEBT EXPENSE ($3,613,151) REPORTED IN PART IX.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: FINANCIAL STATEMENT FOOTNOTE: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL LOSS RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.Bad debt at cost was calculated using a cost-to-charge ratio. Galion Community Hospital does not believe bad debt should be included as a community benefit.Additional bad debt attributable to patients identified under Charity Care was calculated using actual costs from specifically identified patients that were misclassified as bad debt originally. Galion Community Hospital does not believe bad debt identified under Charity Care should be included as a community benefit.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: WE REPORT MEDICARE COSTS BY THE COST TO CHARGE METHOD. BECAUSE WE ARE A CRITICAL ACCESS HOSPITAL WE DO NOT HAVE A MEDICARE SHORTFALL. WE ARE REIMBURSED 1% ABOVE OUR COST.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: EVEN IF THE HOSPITAL KNOWS A PATIENT QUALIFIES FOR FINANCIAL AID, IT IS NOT PROVIDED WITHOUT A SIGNED APPLICATION. GALION COMMUNITY HOSPITAL DOES MAKE AN EFFORT TO GET THE APPLICATION TO ALL PATIENTS. THE FINANCIAL COUNSELORS WILL TRY TO MAKE PHONE CONTACT WITH THOSE WHO ARE KNOWN TO QUALIFY TO ENCOURAGE COMPLETION OF THE FORMS. HOWEVER, THE PROCESS IS THE SAME FOR ALL PATIENTS. GALION COMMUNITY HOSPITAL UTILIZES INTERNAL AND EXTERNAL COLLECTION EFFORTS (INCLUDING COLLECTION AGENCIES) FOR ALL PATIENTS.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: COMMUNITY HEALTH SCREENINGS ARE CONDUCTED TO EVALUATE BLOOD PRESSURE, BLOOD SUGAR LEVELS, AND CHOLESTEROL. THE SCREENINGS ARE MONITORED TO DETERMINE THE TEACHING NEEDS OF THE COMMUNITY. GALION HOSPITAL ALSO DOES SCREENINGS FOR LOCAL BUSINESS AND COMMUNITY OUTREACH EVENTS. WE PARTICIPATE IN EVENTS SPONSORED BY THE CHAMBER OF COMMERCE AND THE CRAWFORD COUNTY FAIR. WE OFFER FREE DIABETES SUPPORT GROUPS AND PROSTATE CANCER SUPPORT GROUPS. GALION HOSPITAL ALSO MONITORS THE LOCAL HEALTH DEPARTMENT FOR ADVICE ON FLU TRENDS AND VACCINATION NEEDS.NeedsAssessment
Patient Education AssistancePart VI, Line 3: EVERY BILL THAT IS SENT TO A PATIENT HAS INFORMATION ON THE REVERSE SIDE ABOUT HCAP AND THE CRITERIA FOR MEETING THE HCAP REQUIREMENTS. IT ALSO HAS THE GENERAL CHARITY POLICY AND INFORMS THE PATIENT OF AVAILABLE ASSISTANCE. THE PATIENT REPRESENTATIVE OR THE REGISTRATION PERSONNEL ARE ALL WELL VERSED IN THE REQUIREMENTS FOR HCAP AND CHARITY CARE. THEY WOULD BE HAPPY TO HELP ANY PATIENT TO FILL OUT THE FORMS AND REQUEST AID. THERE ARE ALSO SIGNS THROUGHOUT THE HOSPITAL THAT ADVISE THE PATIENT TO ASK ABOUT DISCOUNTS.PatientEducationAssistance
Community InformationPart VI, Line 4: GALION COMMUNITY HOSPITAL IS LOCATED IN CRAWFORD COUNTY, OHIO. THE COMMUNITY THAT GALION COMMUNITY HOSPITAL SERVES IS ABOUT 11,000 IN POPULATION. TWENTY-EIGHT PERCENT ARE UNDER THE AGE OF 19 AND SIXTEEN PERCENT ARE OVER THE AGE OF 65. THE LATEST STATISTICS FOR GALION SHOW THE MEDIAN HOUSEHOLD INCOME AT $31,513 VERSUS THE STATE AVERAGE OF $40,956. THE PER CAPITA INCOME IS $16,113 COMPARED TO THE STATE AT $21,003. IT IS AN AREA HARD HIT BY THE RECESSION AND THE MOVEMENT OF JOBS OUT OF OHIO. UNEMPLOYMENT IS HIGHER THAN THE STATE AND NATIONAL AVERAGE AND THE POPULATION IS NEEDY. CRAWFORD COUNTY IS ONE OF THE LEADING COUNTIES IN THE STATE FOR PERSONS WITH DRUG ABUSE ISSUES.CommunityInformation
Community Building ActivitiesPart VI, Line 5: GALION COMMUNITY HOSPITAL LEADERS ARE VERY INVOLVED IN CIVIC GROUPS IN THE COMMUNITY. THROUGH THESE GROUPS THEY ARE ABLE TO BUILD RELATIONSHIPS AND PARTNERSHIPS WITH INDUSTRY AND BUSINESS IN THE AREA. THEY ALSO PARTICIPATE WITH THE LOCAL HEALTH OFFICIALS IN DETERMINING WHAT THE COMMUNITY NEEDS. COMMUNITY BUILDING ACTIVITIES INCLUDE BLOOD PRESSURE SCREENING AND PROSTATE CANCER SCREENING. TWICE A YEAR GALION HOSPITAL OFFERS REDUCED FEE LAB DAYS WHERE THE COMMUNITY CAN HAVE BLOOD DRAWN FOR $50 AND A COMPLETE PANEL OF TESTS ARE RUN. THE TESTS WOULD NORMALLY COST SEVERAL HUNDRED DOLLARS.CommunityBuildingActivities
Other InformationPart VI, Line 6: GALION COMMUNITY HOSPITAL BELIEVES THAT IT IS THEIR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY. TO THAT END, THERE ARE MANY PROFESSIONALS WHO VOLUNTEER THEIR TIME IN THE AREA TO WORK WITH LOCAL GROUPS TO SCREEN THE NEEDS OF THE COMMUNITY. GALION HOSPITAL IS VERY ACTIVE IN THE AREA AND VERY PROACTIVE WITH PREVENTIVE DISEASE EDUCATION. VARIOUS HEALTH EDUCATION EVENTS ARE HELD EACH YEAR, INCLUDING WOMEN'S HEALTH CLINIC, PROSTATE CANCER SCREENING, MUSCULOSKELETAL EVALUATION, AND BLOOD PRESSURE SCREENINGS.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: GALION IS NOT PART OF A HEALTHCARE SYSTEM. HOWEVER, THEY DO EMPLOY PHYSICIANS THROUGH TWO PHYSICIAN GROUPS: COMMUNITY HEALTH ASSOCIATES AND NORTH CENTRAL OHIO FAMILY CARE CENTER. THESE ENTITIES ALL DELIVER CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE PHYSICIAN OFFICES SEE MANY PATIENTS WHO ARE NOT ABLE TO PAY. THE HOSPITAL WILL ALWAYS TREAT A PATIENT FOR MEDICALLY NECESSARY SERVICES.AffiliatedHealthCareSystem
Reports Filed With StatesOHReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
COMMUNITY HEALTH ASSOCIATES INC
269 PORTLAND WAY SOUTHGALIONOH44833341784017501(C)(3)165042RELATED PARTY COD
NORTH CRENTAL OHIO FAMILY CARE CENTER
269 PORTLAND WAY SOUTHGALIONOH44833341807906501(C)(3)71961RELATED PARTY COD

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantTUITION REIMBURSEMENT FOR GALION COMMUNITY HOSPITAL EMPLOYEESTypeOfGrant
Number Of Recipients8NumberOfRecipients
Amount Of Cash Grant44098AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: ALL GALION COMMUNITY HOSPITAL EMPLOYEES ARE ELIGIBLE FOR REIMBURSEMENT. APPLICATIONS ARE APPROVED BY HUMAN RESOURCES. TUITION INVOICES AND GRADES ARE MONITORED BY THE CONTROLLER TO MAKE SURE THE STUDENT MEETS CERTAIN CRITERIA TO RECEIVE THE FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR MARCIA BROWN
201936000258022000042980228492000
LAMAR WYSE
2458690000010154024960258519000
ROBERT MELARAGNO
159141000258016500000175899000
DR MARK WOOD
185722000138016500042640206624000
DR JOHN T HANNA
3044070009000037270308224000
DR ANDREW J LEE
20697500060014379086530230067000
DR LAWRENCE S LEONE
197982000138019884052390223243000
MIHAI-LIVIU C URSACHI
167120000600165000310183711000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aA MEMBERSHIP AT THE LOCAL COUNTRY CLUB IS PAID FOR THE CEO, JERRY MOROSKO. THIS BENEFIT HAS NOT BEEN TREATED AS TAXABLE COMPENSATION.
Part I, Line 4aLAMAR WYSE RECEIVED $219,914 OF SEVERANCE PAY. SEVERANCE AMOUNT IS PAID IN ACCORDANCE WITH WRITTEN AGREEMENT.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
GALION COUNTY
132555119224888AA52003-10-019525000NEW E/R BLDG & OLD DEBT00
GALION COUNTY
132555119224888AB32006-12-015000000SURGERY PROJECT00

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
9525000383506914149420061011
5000000205038479496220090011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000001
000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
HUNTINGTON BANK
01110.000000000000000
(no name)
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part III, line 2New Program ServicesGALION COMMUNITY HOSPITAL BEGAN A JOINT VENTURE FOR A PAIN MANAGEMENT CLINIC (GALION COMMUNITY PAIN MANAGEMENT, LLC) AND A JOINT VENTURE FOR A PERIVASCULAR SERVICE (GALION COMMUNITY VASCULAR SERVICES, LLC).
Form 990, Part VI, Section A, line 8bTHE ORGANIZATION DOES NOT HAVE SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
Form 990, Part VI, Section B, line 11THE FORM 990 IS SENT TO THE EXECUTIVE COMMITTEE OF GALION COMMUNITY HOSPITAL'S BOARD FOR THEIR REVIEW. THE BOARD EXECUTIVE COMMITTEE APPROVES THE FORM 990 FOLLOWING REVIEW, AS AUTHORIZED BY THE FULL GOVERNING BODY.
Form 990, Part VI, Section B, line 12cGALION COMMUNITY HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD OF DIRECTORS AND OFFICERS OF THE CORPORATION. CONFLICT OF INTEREST SURVEYS ARE REVIEWED BY BOARD CHAIRMAN AND THE CEO TO ENSURE COMPLIANCE. VARIOUS RESTRICTIONS ARE IMPOSED ON INDIVIDUALS WITH POTENTIAL CONFLICTS OF INTEREST (I.E. INABILITY TO VOTE) UNTIL DECISION HAS BEEN MADE ON POTENTIAL CONFLICT.
Form 990, Part VI, Section B, line 15aGALION COMMUNITY HOSPITAL'S PROCESS FOR DETERMINING COMPENSATION CONSISTED OF BOARD EXECUTIVE COMMITTEE REVIEW OF OHIO HOSPITAL ASSOCIATION COMPENSATION SURVEYS, AND THE COMMITTEE DETERMINES EXECUTIVE COMPENSATION BASED ON THIS COMPARABILITY DATA. CONTEMPORANEOUS MINUTES ARE KEPT OF MEETINGS HELD BY THE EXECUTIVE COMMITTEE REGARDING DECISIONS AND DELIBERATIONS OF THIS PROCESSS. THIS PROCESS WAS LAST COMPLETED IN 2010.
Form 990, Part VI, Section C, line 18FORM 990 AND FORM 1023 ARE MADE AVAILABLE UPON REQUEST.
Form 990, Part VI, Section C, line 19NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 2CTHE ORGANIZATION HAS A FINANCE COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS, BUT IS NOT INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT.
FORM 990, PART VI, LINE 9THE FOLLOWING 2 BOARD MEMBERS, WHICH ARE NO LONGER EMPLOYED AT GALION COMMUNITY HOSPITAL, CAN BE REACHED AT THE FOLLOWING ADDRESS: -ROBERT MELARAGNO--269 PORTLAND WAY SOUTH, GALION, OH 44833-2399 -LAMAR WYZE--269 PORTLAND WAY SOUTH, GALION, OH 44833-2399

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GALION HEALTH FOUNDATION
269 PORTLAND WAY SOUTHGALIONOH44833200934451FUNDRAISING FOR GALION COMMUNITY HOSPITALOH501(C)(3)Line 7GALION COMMUNITY HOSPITAL
COMMUNITY HEALTH ASSOCIATES INC
955 BUCYRUS ROADGALIONOH44833341784017PHYSICIAN OFFICEOH501(C)(3)Line 11a, IGALION COMMUNITY HOSPITAL
NORTH CENTRAL OHIO FAMILY CARE CENTER INC
269 PORTLAND WAY SOUTHGALIONOH44833341807906PHYSICIAN OFFICEOH501(C)(3)Line 11a, IGALION COMMUNITY HOSPITAL

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
GALION COMMUNITY PAIN MANAGEMENT LLC
269 PORTLAND WAY SOUTHGALIONOH44833300602607HOSPITAL SUPPORTOHGALION COMMUNITY HOSPITAL41228448173700
GALION COMMUNITY VASCULAR SERVICES LLC
269 PORTLAND WAY SOUTHGALIONOH44833611613817HOSPITAL SUPPORTOHGALION COMMUNITY HOSPITAL52173660194100
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
NORTH CENTRAL OHIO FAMILY CARE CENTER
B71961
COMMUNITY HEALTH ASSOCIATES INC
K3825910
COMMUNITY HEALTH ASSOCIATES INC
C12119
COMMUNITY HEALTH ASSOCIATES INC
B177161
GALION HEALTH FOUNDATION
C48840