2011-05-16T14:55:22-05:00 2010-06-30 PLANTE & MORAN PLLC 65 EAST STATE STREET SUITE 600 COLUMBUS OH 43215 990 2009-07-01 311417566 SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY SOUT 7403567622 1805 27TH STREET PORTSMOUTH OH 45662 DEAN WRAY 7403567622 2011-05-13 1 Bernie Ostrowski 6148493000 2009 2016-02-24 21:20:13Z MR RANDAL ARNETT 1805 27TH STREET PORTSMOUTH OH 45662 1922712 0 X N/A X 1994 OH OWN AND MANAGE REAL ESTATE ON BEHALF OF SOUTHERN OHIO MEDICAL CENTER, A RELATED 501(C)(3) ORGANIZATION. 11 10 0 11 0 0 0 1934949 1922712 9470 -2126 0 1944419 1920586 489000 0 0 0 0 2475488 2619108 2475488 3108108 -531069 -1187522 20668816 20751749 201760 217167 20467056 20534582 We will make a difference. At SOMC, our mission is to make a difference. We strive to live out that mission by providing our region with the highest quality of care, delivered by professionals who are among the best in their fields. We extend that care and passion to make a difference in the community by being a very good neighbor, employer, and community supporter. 0 0 0 0 1922712 MAINTAINED AND MANAGED REAL PROPERTY USED TO ACCOMPLISH THE EXEMPT PURPOSE OF SOUTHERN OHIO MEDICAL CENTER, A RELATED IRC SEC. 501(C)(3) ORGANIZATION. 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X RICHARD GILCHER 7403567622 1248 KINNEYS LANE PORTSMOUTH OH 45662 X ROBERT E DEVER 2.00 X X 0 0 0 RANDAL ARNETT 2.00 X X 0 638464 284902 GARY DUZAN 2.00 X X 0 0 0 STEVEN A CONLEY 2.00 X 0 0 0 DAVID HANZEL MD 2.00 X 0 0 0 RONALD ARRICK MD 2.00 X 0 0 0 JAMES W STAKER 2.00 X 0 0 0 RITA RICE-MORRIS PHD 2.00 X 0 0 0 GEORGE LAWSON 2.00 X X 0 0 0 HARRY DRIEDGER MD 2.00 X X 0 0 0 DAVID FOWLER 2.00 X 0 0 0 ERNESTO BANALAGAY MD 2.00 X X 0 0 0 DEAN WRAY 2.00 X X 0 318671 117966 0 957135 402868 0 0 1 0 0 RENTAL INCOME 532000 1922712 1922712 1922712 2126 -2126 -2126 -2126 1920586 1922712 0 -2126 489000 400215 82878 800655 9680 1325467 213 3108108 34410859 13659110 20668816 20751749 20668816 20751749 201760 217167 201760 217167 X 20467056 20534582 20467056 20534582 20668816 20751749 X 0 1 1 X 0 558580 558580 18167967 7924940 10243027 14790 11705 3085 14976568 5234028 9742540 692954 488437 204517 20751749 1920586 3108108 -1187522 1255048 1255048 67526 Part XI, Line 8 - Other Adjustments: CAPITAL CONTRIBUTION FROM SOMC: 1255048. 1 SOMC MEDICAL CARE FOUNDATION INC 1248 KINNEYS LANE PORTSMOUTH OH 45662 311374523 501(C)(3) 489000 CONTRIBUTION OF SERVICE 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY MAKES CONTRIBUTIONS OF SERVICES IN SUPPORT OF ITS RELATED PARTIES. 0 1 0 RANDAL ARNETT 0 499005 0 117193 0 22266 0 258430 0 26472 0 923366 0 0 DEAN WRAY 0 251692 0 48840 0 18139 0 97957 0 20009 0 436637 0 0 Part I, Line 4a SOUTHERN OHIO MEDICAL CENTER, A RELATED ORGANIZATION, MADE CONTRIBUTIONS TO A SERP FOR RANDAL ARNETT IN THE AMOUNT OF $242,030. THE AMOUNT LISTED ABOVE IS INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II. Supplemental Information Part III PART I, LINE 3: COMPENSATION PAID TO THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION AND INCLUDES USE OF AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS, A WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Form 990, Part VI, Section A, line 6 SOMC TITLE HOLDING COMPANY IS ORGANIZED AS A SUBSIDIARY OF SOMC, THE PARENT ORGANIZATION AND SOLE VOTING MEMBER FOR THE CONSOLIDATED GROUP. Form 990, Part VI, Section A, line 7a SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY'S BOARD OF DIRECTORS ARE ELECTED BY SOUTHERN OHIO MEDICAL CENTER'S BOARD OF DIRECTORS. Form 990, Part VI, Section A, line 7b SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY'S DECISIONS THAT ARE MADE BY THEIR BOARD OF DIRECTORS CAN BE OVERRULED BY SOUTHERN OHIO MEDICAL CENTER'S BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11 FORM 990 INFORMATION IS COMPILED IN THE ACCOUNTING DEPARTMENT THEN SENT TO THE INDEPENDENT TAX ACCOUNTANTS TO ANALYZE THE INFORMATION AND COMPLETE THE RETURN. THE FORM IS THEN REVIEWED BY FINANCIAL STAFF AND E-MAILED TO THE BOARD, AND THE CFO PRESENTED FORM 990 TO THE COMPENSATION COMMITTEE BEFORE THE TAX RETURN IS FILED. IN ADDITION, THE ACCOUNTING DEPARTMENT REVIEWED THE NUMBERS TO TIE OUT TO THE TRIAL BALANCE. Form 990, Part VI, Section B, line 12c CONFLICT OF INTEREST STATEMENTS ARE FILLED OUT ANNUALLY IN JANUARY FOR NEW AND RETURNING BOARD MEMBERS. COMPLETED CONFLICT OF INTEREST POLICIES ARE REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE. ANY CONFLICTS ARE DOCUMENTED IN THE MINUTES AND ADDRESSED. CONFLICTS OF INTEREST ARE RAISED BY BOARD MEMBERS ONCE THEY ARE KNOWN BY THE INDIVIDUAL. BOARD MEMBERS ABSTAIN FROM VOTING IF A CONFLICT IS IDENTIFIED THAT THE BOARD MEMBER IS INVOLVED WITH. Form 990, Part VI, Section B, line 15 ON AN ANNUAL BASIS, AN INDEPENDENT CONSULTANT PROVIDES THE BOARD COMPENSATION COMMITTEE WITH COMPARABLE DATA AND OTHER FACTS WHICH ARE USED BY THE COMMITTEE TO DETERMINE EXECUTIVE PAY PHILOSOPHY. THE DECISIONS FOR OFFICER COMPENSATION ARE DOCUMENTED IN THE BOARD COMPENSATION COMMITTEE MINUTES, WHICH WAS LAST PERFORMED DURING 2010. THIS COMMITTEE DETERMINES THE CEO'S PAY AND SETS PAY RANGES FOR THE OTHER EXECUTIVES. Form 990, Part VI, Section C, line 19 SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY PROVIDES ITS FINANCIAL STATEMENTS TO THE PUBLIC THROUGH THE FILING OF ITS FORM 990 AS WELL AS ITS BOND DISCLOSURE. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC ON SOUTHERN OHIO MEDICAL CENTER'S WEBSITE. FORM 990, PART XI, LINE 2B: SOMC TITLE HOLDING COMPANY DID NOT HAVE AN AUDIT COMPLETED ON A STAND-ALONE BASIS BUT THE ORGANIZATION WAS INCLUDED IN A CONSOLIDATED AUDIT WITH SOMC, SOMC MEDICAL CARE FOUNDATION INC., THE FRIENDS OF SOMC, AND SOMC FOUNDATION, INC. FORM 990, PART XI, LINE 2C: THE AUDIT OVERSIGHT PROCESS AND THE PROCESS OF SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 7, PART VII THE FOLLOWING OFFICERS DEVOTED TIME TO SOUTHERN OHIO MEDICAL CENTER: RANDAL ARNETT 40 HRS DEAN WRAY 40 HRS SOUTHERN OHIO MEDICAL CENTER 1248 KINNEYS LANE PORTSMOUTH OH 45662 310678022 HEALTH CARE OH 501(C)(3) 3 N/A SOMC FOUNDATION INC 1805 27TH STREET PORTSMOUTH OH 45662 311564440 HOLD INVESTMENTS FOR BENEFIT OF SOUTHERN OHIO MEDICAL CENTER OH 501(C)(3) 11 SOUTHERN OHIO MEDICAL CENTER SOMC MEDICAL CARE FOUNDATION INC 1248 KINNEYS LANE PORTSMOUTH OH 45662 311374523 MEDICINE AND SURGERY OH 501(C)(3) 11 SOUTHERN OHIO MEDICAL CENTER THE FRIENDS OF SOUTHERN OHIO MEDICAL CENTER 1805 27TH STREET PORTSMOUTH OH 45662 310677520 FUNDRAISING OH 501(C)(3) 11 SOUTHERN OHIO MEDICAL CENTER 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 SOUTHERN OHIO MEDICAL CENTER I 1433712 sOUTHERN OHIO MEDICAL CENTER O 2688761 sOUTHERN OHIO MEDICAL CENTER C 1255048 SOMC MEDICAL CARE FOUNDATION I 489000 SOMC MEDICAL CARE FOUNDATION B 489000