2011-11-11T09:52:11-06:00 2010-12-31 GILMORE JASION & MAHLER LTD 1715 INDIAN WOOD CIRCLE STE 100 MAUMEE OH 43537 990 2010-01-01 341116795 HOSPITAL COUNCIL OF NORTHWEST OHIO HOSP 4198420800 3231 CENTRAL PARK WEST NO 200 TOLEDO OH 43617 W SCOTT FRY 4198420800 2011-11-11 1 HEIDI FERGUSON 4197942000 2011-11-10 2010 2016-03-07 17:11:31Z W SCOTT FRY 3231 CENTRAL PARK WEST NO 200 TOLEDO OH 43617 3615944 0 X WWW.HCNO.ORG X 1973 OH SEE BELOW.WORKING IN PARTNERSHIP TO IMPROVE THE HEALTH OF NORTHWEST OHIO COMMUNITIES. THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 17 17 17 42 0 0 3633414 2370103 1084655 1214702 14229 3652 27087 27487 4759385 3615944 1631217 1114853 0 0 1087539 1240306 0 0 0 1931547 1021247 4650303 3376406 109082 239538 2838899 2984131 302459 208294 2536440 2775837 X WORKING IN PARTNERSHIP TO IMPROVE THE HEALTH OF NORTHWEST OHIO COMMUNITIES. THE HOSPITAL COUNCIL IS DEDICATED TO: -BRINGING TOGETHER NORTHWEST OHIO'S HEALTH CARE LEADERS. -PROVIDING COLLABORATIVE OPPORTUNITIES TO ADDRESS HEALTHCARE PROVIDERS' SHARED CONCERNS. -DEVELOPING CREATIVE HEALTH-RELATED INITIATIVES TO IMPROVE THE REGION'S HEALTH STATUS. -PROVIDING EDUCATIONAL PROGRAMS FOR THE HEALTHCARE SECTOR. 0 0 3108470 1114853 1242189 THE HOSPITAL COUNCIL OF NW OHIO IS A MEMBER DRIVEN ORGANIZATION THAT BOTH REPRESENTS AND ADVOCATES ON BEHALF OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS, AND PROVIDES COLLABORATIVE OPPORTUNITIES TO ENHANCE THE HEALTH STATUS OF CITIZENS OF NORTHWEST OHIO. 3108470 1 1 0 1 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 22 0 1 17 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 0 0 1 1 0 OH X W SCOTT FRY 4198420800 3231 CENTRAL PARK WEST TOLEDO OH 43617 CLIFFORD HARMON 4.00 X 0 0 0 JOHN C YANES 4.00 X 0 0 0 PATRICK MARTIN 4.00 X X 0 0 0 E DEAN BECK 4.00 X 0 0 0 KIM BORDENKIRCHER 4.00 X 0 0 0 DALE THORNTON 4.00 X 0 0 0 SCOTT C MALANEY 4.00 X 0 0 0 GARY ADKINS 4.00 X X 0 0 0 IMRAN A ANDRABI MD 4.00 X 0 0 0 MICHAEL WINTHROP 4.00 X 0 0 0 RICHARD EVENS 4.00 X X 0 0 0 DANIEL L WAKEMAN 4.00 X 0 0 0 MARK CHASTANG 4.00 X 0 0 0 STANLEY KORDUCKI 4.00 X X 0 0 0 LYNN DETTERMAN 4.00 X 0 0 0 KATHY HUNT 4.00 X 0 0 0 ROBERT E GOSPODAREK 4.00 X 0 0 0 W SCOTT FRY 20.30 X 106682 115341 60400 JAN RUMA 44.30 X 138250 0 41835 244932 115341 102235 2 0 1 0 0 45500 1534464 790139 2370103 CONTRACT INCOME 900099 817620 817620 MEMBERSHIP DUES 900099 397082 397082 1214702 3652 3652 27487 27487 27487 3615944 1242189 0 3652 1114853 1114853 282423 189421 93002 679007 645839 33168 68122 60629 7493 142506 128179 14327 68248 60751 7497 2290 2290 17254 17254 131357 105702 25655 7765 765 7000 95990 67366 28624 20954 17493 3461 67547 56896 10651 29139 24973 4166 16889 6238 10651 4107 3409 698 11697 10753 944 PROGRAM EXPENSE 610640 610640 0 ORG DUES AND MEMBERSHIP 2805 2376 429 SUBSCRIPTIONS 418 418 0 TRAINING 237 218 19 2158 1551 607 3376406 3108470 267936 0 695 695 2565261 2874198 259908 99918 6080 6472 92026 89178 6955 2848 2838899 2984131 115441 113219 187018 89675 5400 302459 208294 X 1519707 1575659 1016733 1200178 2536440 2775837 2838899 2984131 X 239538 -141 X X 0 1 1 X 1 1 X 2327022 2616389 3459099 3633414 2370103 14406027 2327022 2616389 3459099 3633414 2370103 14406027 14406027 49886 88195 44580 14229 3652 200542 67424 22989 31696 27087 27487 176683 14783252 5499431 0.97450 0.97450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 379 0 0 1 852 1 144 0 1375 0 0 1 38820 35972 2848 53206 53206 0 2848 3615944 3376406 239538 -141 -141 239397 3615803 -141 -141 3615944 0 3615944 3376406 0 3376406 0 3376406 PART IV, LINE 2B: HOSPITAL COUNCIL IS A FISCAL AGENT FOR THE LUCAS COUNTY SUICIDE PREVENTION COALITION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FASB ISSUED NEW GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION ADOPTED THIS NEW GUIDANCE EFFECTIVE JANUARY 1, 2009. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO OR DISCLOSURE IN THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. 1 BAY PARK COMMUNITY HOSPITAL 2801 BAY PARK DRIVE OREGON OH 43616 341883132 501(C)(3) 60615 SUPPORT BELLEVUE HOSPITAL 1400 WEST MAIN STREET PO BOX 8004 BELLEVUE OH 44811 344428205 501(C)(3) 23640 SUPPORT BLUFFTON HOSPITAL 139 GARAU STREET BLUFFTON OH 45817 341369963 501(C)(3) 19310 SUPPORT BLANCHARD VALLEY HEALTH SYSTEM 1900 SOUTH MAIN STREET FINDLAY OH 45840 341369963 501(C)(3) 33979 SUPPORT COMMUNITY HOSPITALS AND WELLNESS CENTERSARCHBOLD 121 WESTFIELD DRIVE ARCHBOLD OH 43502 341048666 501(C)(3) 12156 SUPPORT COMMUNITY HOSPITALS AND WELLNESS CENTERSBRYAN 433 W HIGH STREET BRYAN OH 43506 341048666 501(C)(3) 20224 SUPPORT COMMUNITY HOSPITALS AND WELLNESS CENTERSMONTPELIER 909 SNYDER MONTPELIER OH 43543 341048666 501(C)(3) 16659 SUPPORT COMMUNITY HEALTH SERVICES 410 BIRCHARD AVENUE FREMONT OH 43420 341120194 501(C)(3) 6000 SUPPORT COMMUNITY MEMORIAL HOSPITAL 208 N COLUMBUS STREET HICKSVILLE OH 43526 311597925 501(C)(3) 14138 SUPPORT DEFIANCE REGIONAL MEDICAL CENTER 1200 RALSTON AVENUE DEFIANCE OH 43512 344446484 23638 SUPPORT FIRELANDS REGIONAL MEDICAL CENTER 1101 DECATUR STREET SANDUSKY OH 44870 344428218 501(C)(3) 21018 SUPPORT FISHER-TITUS MEDICAL CENTER 272 BENEDICT AVE NORWALK OH 44857 344430716 501(C)(3) 8169 SUPPORT FLOWER MEMORIAL HOSPITAL 5200 HARROUN ROAD SYLVANIA OH 43560 344428794 501(C)(3) 19632 SUPPORT FOSTORIA COMMUNITY HOSPITAL 501 VAN BUREN STREET PO BOX 907 FOSTORIA OH 44830 340898745 501(C)(3) 24495 SUPPORT FULTON COUNTY HEALTH CENTER 725 SOUTH SHOOP AVENUE WAUSEON OH 43567 344428214 501(C)(3) 14369 SUPPORT HENRY COUNTY HOSPITAL 1600 EAST RIVERVIEW AVENUE NAPOLEON OH 43545 344477047 501(C)(3) 10635 SUPPORT JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL 200 ST CLAIR STREET ST MARYS OH 45885 341623770 501(C)(3) 12915 SUPPORT LIMA MEMORIAL HOSPITAL 1001 BELLEFONTAINE AVE LIMA OH 43504 341883284 501(C)(3) 25566 SUPPORT MAGRUDER HOSPITAL 615 FULTON STREET PORT CLINTON OH 43452 344441792 501(C)(3) 13656 SUPPORT MEMORIAL HOSPITAL 715 SOUTH TAFT AVENUE FREMONT OH 43420 344430849 501(C)(3) 28959 SUPPORT MERCER COUNTY JT TWP COMMUNITY HOSPITAL 800 WEST MAIN STREET COLDWATER OH 45828 341101385 11817 SUPPORT MERCY HOSPITAL OF DEFIANCE 1404 E SECOND STREET DEFIANCE OH 43512 020701635 24076 SUPPORT MERCY HOSPITAL OF TIFFIN 485 W MARKET STREET TIFFIN OH 44883 344431174 501(C)(3) 13707 SUPPORT MERCY HOSPITAL OF WILLARD 110 EAST HOWARD STREET WILLARD OH 44890 341577110 501(C)(3) 9484 SUPPORT PAULDING COUNTY HOSPITAL 1035 W WAYNE STREET PAULDING OH 45879 346405718 12511 SUPPORT ST ANNE MERCY HOSPITAL 3404 SYLVANIA AVENUE TOLEDO OH 43623 311556401 501(C)(3) 14941 SUPPORT ST CHARLES MERCY HOSPITAL 2600 NAVARRE AVENUE OREGON OH 43616 344445373 501(C)(3) 20876 SUPPORT ST LUKES HOSPITAL 5901 MONCLOVA RD MAUMEE OH 43537 344428232 501(C)(3) 27085 SUPPORT ST RITA'S MEDICAL CENTER 730 W MARKET STREET LIMA OH 45801 341105619 501(C)(3) 25539 SUPPORT ST VINCENT MERCY MEDICAL CENTER 2213 CHERRY STREET TOLEDO OH 43608 344428250 501(C)(3) 52899 SUPPORT TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO OH 43606 344428256 501(C)(3) 39528 SUPPORT VAN WERT COUNTY HOSPITAL 1250 SOUTH WASHINGTON STREET VAN WERT OH 45891 344429514 501(C)(3) 13278 SUPPORT WOOD COUNTY HOSPITAL 950 W WOOSTER STREET BOWLING GREEN OH 43402 344440884 501(C)(3) 26084 SUPPORT PUTNAM COUNTY EMERGENCY MANAGEMENT PO BOX 370 117 THATYE DRIVE OTTAWA OH 45875 346401116 61542 SUPPORT UNIVERSITY OF TOLEDO ASPR 3000 ARLINGTON TOLEDO OH 43614 346401483 59750 SUPPORT DEFIANCE COLLEGE 701 NORTH CLINTON DEFIANCE OH 43512 344430762 501(C)(3) 15709 SUPPORT FIRELANDS PHYSICIAN 1031 PIERCE STREET SANDUSKY OH 44870 341608091 7200 SUPPORT AMERICAN HEALTHWAYS SERVICES LLC 701 COOL SPRINGS BLVD FRANKLIN TN 37067 621216689 7213 SUPPORT ISTHMUS LTD 240 BRYANT AVE WORTHINGTON OH 43085 010730930 10610 SUPPORT PROMEDICA CONT' SVCSDBA LAKE PARK 5855 MONROE STREET SUITE 200 SYLVANIA OH 43560 344492440 501(C)(3) 25994 SUPPORT PROMEDICA PHYSICIANS 5855 MONROE STREET SYLVANIA OH 43560 341880767 501(C)(3) 100800 SUPPORT SENECA CO EMS & FIRE 126 HOPEWELL AVE TIFFIN OH 44883 346401331 5000 SUPPORT SHEALY GROUP LTD 68 PARK AVENUE WEST MANSFIELD OH 44902 010724512 8400 SUPPORT 32 11 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE PROGRAM STAFF WORK CLOSELY WITH EACH SUB GRANTEE REGARDING PAPER WORK NEEDED. ALL SUB GRANTEES MUST SUBMIT DOCUMENTATION FOR REIMBURSEMENT OF ALL EXPENDITURES. THE PROGRAM DIRECTOR WORKS WITH FINANCE TO OVERSEE THE GRANT AND MANTAIN COMPLIANCE WITH APPLICABLE MANDATES. X X X 0 0 0 0 0 0 0 0 0 W SCOTT FRY 96318 104136 5766 6234 4598 4971 15456 16710 13566 14668 135704 146719 0 0 JAN RUMA 137542 0 0 0 708 0 17280 0 24555 0 180085 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 AREA HOSPITALS COMPRISE THE MEMBERSHIP OF HOSPITAL COUNCIL OF NORTHWEST OHIO. FORM 990, PART VI, SECTION A, LINE 7A THESE MEMBER HOSPITALS MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING DECISIONS OF THE FILING ENTITY ARE SUBJECT TO APPROVAL BY THE MEMBER HOSPITALS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S SIGNING OFFICER SCANS THE FORM 990 FOR COMPLETENESS PRIOR TO SIGNATURE, IN ADDITION TO RELYING UPON THE INDEPENDENT ACCOUNTANT FOR ACCURACY. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BODY USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO OR TOP MANAGEMENT OFFICIALS WHICH INCLUDES A COMPARISON TO OTHER ORGANIZATIONS, SALARY SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. THE ORGANIZATION USES A PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES WHICH INCLUDES A REVIEW AND APPROVAL BY THE CEO, USE OF MANAGEMENT SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII: W. SCOTT FRY'S TOTAL AVERAGE HOURS PER WEEK ARE 42.30 HOURS. HOURS APPLICABLE TO HOSPITAL COUNCIL OF NORTHWEST OHIO ARE 20.30 HOURS PER WEEK. HOURS FOR THE RELATED ORGANIZATION, NORTHWEST OHIO SHARED SERVICES, ARE 22.00 PER WEEK. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -141. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES REPSONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. NORTHWEST OHIO SHARED SERVICES 3231 CENTRAL PARK WEST DR TOLEDO OH 43617 341388279 PURCHASE CORPORATION OH N/A C 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 NORTHWEST OHIO SHARED SERVICES INC K 114281 NORTHWEST OHIO SHARED SERVICES INC C 45500 NORTHWEST OHIO SHARED SERVICES INC N 146719 NORTHWEST OHIO SHARED SERVICES INC P 91796