TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) HOLLY L BRISTOLL........................................................................ EX OFFICIO	1.00 .......................41.00	X		0	322,854	53,301
(2) NANCY CULLEN........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(3) THOMAS F DEWEY JR........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(4) JONATHAN DILLER MD........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(5) JOHN J HIESTAND MD........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(6) TOM H HOFFMAN........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(7) JENNIFER G HOHMAN MD........................................................................ TRUSTEE	1.00 .......................0.00	X		2,700	0	0
(8) CATHERINE R KNIPP........................................................................ EX OFFICIO	1.00 .......................0.00	X		0	0	0
(9) DARYL L KNIPP........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(10) ALLAN E MEHLOW........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(11) DENNIS S NEWMAN........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(12) JUDITH M REINO........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(13) MICHAEL WALERYSZAK........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(14) KEVIN C WEBB PHD........................................................................ EX OFFICIO	1.00 .......................50.00	X		0	575,645	49,020
(15) LISA N WILLIAMS........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(16) PAMELA JENSEN........................................................................ PRESIDENT, EX OFFICIO	40.00 .......................0.00	X	X	0	248,404	40,612
(17) KENNETH A MYERS........................................................................ CHAIRPERSON	1.00 .......................1.00	X	X	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
PT SERVICES INC 2550 S STATE RT 100 TIFFIN,OH44883	PHYSICAL THERAPY SERVICES	4,956,472
CLEVELAND CINIC PO BOX 931058 CLEVELAND,OH44193	LAB SERVICES	684,616
KEYBRIDGE MEDICAL REVENUE MANAGEMENT GRO PO BOX 747 LIMA,OH43420	COLLECTION SERVICES	356,639
MEDICAL DOCTOR ASSOCIATES PO BOX 277185 ATLANTA,GA303847185	PHYSICIAN SERVICES	346,930
ZIRRM PATHOLOGY INC 715 S TAFT AVE FREMONT,OH43420	LAB SERVICES	257,609
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 19

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	138,302	138,302
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	38,029		38,029
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages ....	25,599,087	22,794,478	2,804,609
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	223,920	185,269	38,651
9	Other employee benefits .......	4,540,027	4,042,554	497,473
10	Payroll taxes ...........	1,827,863	1,625,492	202,371
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	164,782		164,782
c	Accounting ...........	9,012		9,012
d	Lobbying ...........	6,246		6,246
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	186,937		186,937
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	10,743,633	9,660,592	1,083,041
12	Advertising and promotion ....	160,490	144,441	16,049
13	Office expenses .......	894,465	796,276	98,189
14	Information technology ......	100,274	90,247	10,027
15	Royalties ..
16	Occupancy ...........	4,567,602	4,108,386	459,216
17	Travel ............	359,338	318,267	41,071
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	869,801	869,801
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	3,610,654	3,249,589	361,065
23	Insurance ..............	532,673	478,750	53,923
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	4,657,499	4,657,499
b	EQUIPMENT RENTAL	2,010,057	1,809,051	201,006
c	DRUGS	1,634,205	1,634,205
d	INTERCOMPANY SERVICES	956,139	860,525	95,614
e	All other expenses	903,484	881,885	21,599
25	Total functional expenses. Add lines 1 through 24e	64,734,519	58,345,609	6,388,910	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	5,439,336	1	1,838,572
2	Savings and temporary cash investments .........	13,898,906	2	4,134,893
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	9,069,584	4	8,649,948
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	651,669	8	572,841
9	Prepaid expenses and deferred charges ..........	1,447,138	9	2,053,981
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	37,614,358
b	Less: accumulated depreciation .....	10b	3,612,130	32,409,713	10c	34,002,228
11	Investments—publicly traded securities ..........	7,058,389	11	23,917,760
12	Investments—other securities. See Part IV, line 11 .....	709,965	12	312,847
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	3,733,502	15	7,282,616
16	Total assets. Add lines 1 through 15 (must equal line 34)......	74,418,202	16	82,765,686
	17	Accounts payable and accrued expenses .........	16,782,113	17	4,566,902
18	Grants payable .................		18
19	Deferred revenue ................	67,103	19
20	Tax-exempt bond liabilities .............	20,755,000	20	19,840,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	6,964,256	23	6,548,582
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	485,170	25	4,516,707
26	Total liabilities. Add lines 17 through 25.........	45,053,642	26	35,472,191
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	29,364,560	27	42,760,513
28	Temporarily restricted net assets ...........		28	4,202,782
29	Permanently restricted net assets ...........		29	330,200
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	29,364,560	33	47,293,495
34	Total liabilities and net assets/fund balances ........	74,418,202	34	82,765,686

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization MEMORIAL HOSPITAL

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization MEMORIAL HOSPITAL

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

6,246

Total. Add lines 1c through 1i ...............................

6,246

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	MEMORIAL HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year
1a	Beginning of year balance ....	0
b	Contributions ........	1,094,539
c	Net investment earnings, gains, and losses	31,133
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	1,125,672

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

29.330 %

Permanent endowment SchDMd Bullet

70.670 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,156,120		1,156,120
b	Buildings ................	23,768,478	1,210,576	22,557,902
c	Leasehold improvements ............	33,533	4,711	28,822
d	Equipment ................	14,412	1,323	13,089
e	Other .................	12,641,815	2,395,520	10,246,295
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				34,002,228

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM AFFILIATES				61,681
(2) BENEFICIAL INTEREST IN FOUNDATION				4,532,982
(3) OTHER RECEIVABLES				1,991,572
(4) DEFERRED COSTS				696,381





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				7,282,616

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
DUE TO AFFILIATES		925,010
ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE		1,412,697
ASBESTOS REMEDIATION		2,179,000






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		4,516,707
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT MEMORIAL HOSPITAL CONSISTENT WITH DONOR INTENT.

PART X, LINE 2:

MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES (PHS). THE FOLLOWING REFLECTS PHS'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740. EXCEPT AS NOTED BELOW, PHS DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2014 AND 2013. FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013, A TAXABLE SUBSIDIARY OF PHS RECOGNIZED A LIABILITY FOR UNCERTAIN TAX POSITIONS OF $9,027,000 AND $1,059,000, RESPECTIVELY. THE SUBSIDIARY RECOGNIZED A CREDIT FOR INTEREST AND PENALTIES WITHIN THE INCOME TAX EXPENSE LINE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS RELATED TO UNRECOGNIZED TAX BENEFITS OF $1,000 AND $20,000 AS OF DECEMBER 31, 2014 AND 2013, RESPECTIVELY. MEMORIAL HOSPITAL DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2014 AND 2013.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..
b	Medicaid (from Worksheet 3, column a) ....	5,561,709	3,124,430	2,437,279	3.760 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	5,561,709	3,124,430	2,437,279	3.760 %
Other Benefits		99,478	1,436	98,042	0.150 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	99,478	1,436	98,042	0.150 %
f	Health professions education (from Worksheet 5) ..	565,291		565,291	0.870 %
g	Subsidized health services (from Worksheet 6) ..	1,281,970	970,912	311,058	0.480 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	57,229		57,229	0.090 %
j	Total. Other Benefits ..	2,003,968	972,348	1,031,620	1.590 %
k	Total. Add lines 7d and 7j .	7,565,677	4,096,778	3,468,899	5.350 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,056,194

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

72,152

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

10,335,053

Enter Medicare allowable costs of care relating to payments on line 5.....

12,943,378

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,608,325

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 COOPERATIVE CARE FKA FREMONT HOSPITALPHYSICIAN ORGANIZATION	PHYSICIAN ORGANIZATION	50.000 %	1.280 %	48.720 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	MEMORIAL HOSPITAL 715 SOUTH TAFT AVE FREMONT,OH43420 WWW.PROMEDICA.ORG 1263	X	X	X

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.PROMEDICA.ORG/CHNA

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000%
and FPG family income limit for eligibility for discounted care of 200.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: MEMORIAL HOSPITAL ("THE HOSPITAL FACILITY") TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THESE PERSONS INCLUDED STAFF OF COMMUNITY HEALTH SERVICES, FIRELANDS COUNSELING & RECOVERY SERVICES, THE BELLEVUE HOSPITAL, FREMONT CITY SCHOOLS, MENTAL HEALTH AND RECOVERY SERVICES BOARDS OF SENECA, SANDUSKY AND WYANDOT COUNTIES, SANDUSKY COUNTY HEALTH DEPARTMENT, SANDUSKY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, FAMILY AND CHILDREN FIRST COUNCIL, UNITED WAY OF SANDUSKY COUNTY, WSOS COMMUNITY ACTION, AND VARIOUS LOCAL MEMORIAL HOSPITAL STAFF MEMBERS INVOLVED IN COMMUNITY HEALTH PROGRAMMING. THE HOSPITAL FACILITY CONSULTED WITH THESE PERSONS THROUGH MEETINGS AND ALSO VIA EMAIL CORRESPONDENCE. ADDITIONALLY, THE HOSPITAL FACILITY CONSULTED WITH OTHER ORGANIZATIONS AND OTHER GROUPS WITHIN THE COMMUNITY IN CONDUCTING ITS MOST RECENT CHNA. THESE CONSULTING INDIVIDUALS REPRESENTED THE FOLLOWING ORGANIZATIONS: - THE AMERICAN CANCER SOCIETY - NATIONAL ALLIANCE FOR THE MENTALLY ILL OF SENECA, SANDUSKY, AND WYANDOT COUNTIES- CITY OF FREMONT - SANDUSKY COUNTY COMMUNITIES FOUNDATION, INC.- SANDUSKY COUNTY CONVENTION AND VISITORS BUREAU - SANDUSKY COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES- SANDUSKY COUNTY ECONOMIC DEVELOPMENT CORPORATION - TERRA STATE COMMUNITY COLLEGE - YMCA OF SANDUSKY COUNTY- LIBERTY CENTER OF SANDUSKY COUNTY
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: MEMORIAL HOSPITAL'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITY:- THE BELLEVUE HOSPITAL
MEMORIAL HOSPITAL:	PART V, SECTION B, LINE 11: MEMORIAL HOSPITAL WILL SPECIFICALLY IMPLEMENT PROGRAMS TO ADDRESS THE FOLLOWING HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - OBESITY/HUNGER/WELLNESS INITIATIVES- CANCER SCREENINGS - LUNG, BREAST, COLORECTAL AND PROSTATE- MENTAL HEALTH - DEPRESSION/ANXIETY/SUICIDE AND BINGE DRINKING- RISKY BEHAVIORS IN YOUTH - TEEN PREGNANCY AND PRESCIPTION MISUSE ACTIONS TAKEN DURING 2014 TO ADDRESS THE ABOVE IDENTIFIED NEEDS ARE INCLUDED BELOW:HEALTH NEED IDENTIFIED: OBESITY/HUNGER/WELLNESS INITIATIVESSTRATEGY #1 - EXPAND "WALK WITH A DOC" PROGRAM.ACTIONS TAKEN:- EXPANDED "WALK WITH A DOC" PROGRAM. NUMBER OF PARTICIPANTS WAS 400.STRATEGY #2 - CONTINUE REPLACING MEMORIAL HOSPITAL VENDING MACHINES WITH HEALTHY VENDING.ACTIONS TAKEN:- CONTINUED REPLACING MEMORIAL HOSPITAL VENDING MACHINES WITH HEALTHY VENDING ITEMS. NUMBER OF HEALTH VENDING MACHINE OPTIONS OFFERING HEALTHY OPTIONS IS 50% OF MACHINES.STRATEGY #3 - PROVIDE A FARMER'S MARKET AT MEMORIAL HOSPITAL BIWEEKLY JUNE THROUGH SEPTEMBER.ACTIONS TAKEN:- PROVIDED A FARMER'S MARKET AT MEMORIAL HOSPITAL BIWEEKLY JUNE THROUGH SEPTEMBER. NUMBER OF FARMER'S MARKETS OFFERED IN 2014 WAS 8.STRATEGY #4 - OFFER HEALTHY HOT ENTREE CHOICES IN THE HOSPITAL CAFETERIA DAILY (CAFE CUISINE).ACTIONS TAKEN:- OFFERED HEALTHY HOT ENTREE CHOICES IN THE HOSPITAL CAFETERIA DAILY (CAFE CUISINE). DEVELOPED CAFE CUISINE TO PROMOTE HEALTHY OPTIONS AND OFFERED DAILY SALAD BAR ALONG WITH 1-2 ALTERNATE HEALTHY FOOD CHOICES.STRATEGY #5 - PROVIDE COMMUNITY NUTRITION EDUCATION AT LOCAL GROCERY STORES AT LEAST ONE TIME PER QUARTER.ACTIONS TAKEN:- PROVIDED COMMUNITY NUTRITION EDUCATION AT LOCAL GROCERY STORES AT LEAST ONE TIME PER QUARTER. NUMBER OF EDUCATION SESSIONS OFFERED AT LOCAL GROCERY STORES WAS THREE. ONE SESSION WAS CANCELLED DUE TO WEATHER CONDITIONS.STRATEGY #6 - PARTNER WITH SANDUSKY COUNTY SCHOOLS TO ACHIEVE THEIR OBESITY/HUNGER GOALS.ACTIONS TAKEN:- PARTNERED WITH THE FREMONT CITY SCHOOLS TO ACHIEVE THEIR OBESITY/HUNGER GOALS. NUMBER OF ACTION PLANS BUILT AROUND OBESITY/HUNGER GOALS WITH SANDUSKY COUNTY SCHOOLS INCLUDED 'PROJECT GO' WHICH HAD A COUNTY WIDE PARTICIPATION OF 42%. PURPLE PRIDE COLLABORATION RESULTING IN DELIVERING DAILY LUNCHES AND RECREATIONAL EXERCISE DAILY DURING THE SUMMER BREAK. 2,573 LUNCHES WERE PROVIDED DURING THE WEEK, AND 1,250 WEEKEND MEALS WERE PROVIDED.STRATEGY #7 - PARTNER WITH FREMONT CITY SCHOOLS ON ACHIEVING THEIR GOALS IN REGARDS TO THE SUMMER MEAL PROGRAM.ACTIONS TAKEN:- PURPLE PRIDE COLLABORATION RESULTING IN DELIVERING DAILY LUNCHES AND RECREATIONAL EXERCISE DAILY DURING THE SUMMER BREAK. 2,573 LUNCHES WERE PROVIDED DURING THE WEEK, AND 1,250 WEEKEND MEALS WERE PROVIDED.STRATEGY #8 - EXPAND SUMMER CAMPS FOCUSING ON NUTRITION, ACTIVITIES AND SELF-ESTEEM FOR YOUTH OF THE COMMUNITY.ACTIONS TAKEN:- EXPANDED SUMMER CAMPS FOCUSING ON NUTRITION, ACTIVITIES AND SELF-ESTEEM FOR YOUTH OF THE COMMUNITY. NUMBER OF CHILDREN WHO PARTICIPATED IN SUMMER YOUTH CAMPS WAS 56.STRATEGY #9 - EXPAND HEALTHY COOKING NIGHTSACTIONS TAKEN:- EXPANDED HEALTHY COOKING NIGHTS - PROVIDED DIABETES COOKING CLASS AND HAD TEN (10) PARTICIPANTS.STRATEGY #10 - CONTINUE PARTICIPATION IN THE COMMUNITY'S GARDEN PROJECT.ACTIONS TAKEN:- CONTINUED PARTICIPATION IN THE COMMUNITY'S GARDEN PROJECT. A HOSPITAL GARDEN PLOT WAS INITIATED AND TENDED BY 19 ADULT VOLUNTEERS AND 8 ADOLESCENTS. PRODUCE WAS HARVESTED THREE (3) TIMES AND DELIVERED TO THE COMMUNITY HOMELESS SHELTER. HEALTH NEED IDENTIFIED: CANCER SCREENINGS - LUNG, BREAST, COLORECTAL AND PROSTATESTRATEGY #1 - TO ANNUALLY PROVIDE EDUCATION AND RESOURCE INFORMATION ON LUNG, BREAST, COLORECTAL AND PROSTATE CANCER. ACTIONS TAKEN:- ANNUALLY PROVIDED EDUCATION AND RESOURCE INFORMATION ON LUNG, BREAST, COLORECTAL AND PROSTATE CANCER. NUMBER OF ACTIVITIES THAT CANCER EDUCATION WAS PROVIDED WAS 36 AND THE NUMBER OF PARTICIPANTS WAS 190.- RELAY FOR LIFE - PARTICIPATED TO RAISE FUNDS FOR SANDUSKY COUNTY RELAY FOR LIFE AND PROVIDED A TABLE WITH EDUCATIONAL CANCER MATERIALS AT THIS EVENT. SEVENTEEN TEAM MEMBERS PARTICIPATED AND RAISED OVER $13,000.- HEALTHLINK NEWSLETTER HIGHLIGHTED EACH CANCER LISTED ABOVE ANNUALLY.- AT LOCAL SENIOR CENTERS PROVIDED EDUCATIONAL TALKS AND RESOURCES RELATED TO EACH CANCER LISTED ABOVE ANNUALLY. NUMBER OF SESSIONS WAS 22, AND THE NUMBER OF PARTICIPANTS WAS 222.- MEMORIAL HOSPITAL'S FAMILY FEST PROVIDED A TABLE WITH EDUCATIONAL CANCER MATERIALS. APPROXIMATELY 1,500 ATTENDED THE FAMILY FEST AND RECEIVED EDUCATIONAL MATERIALS.- USED APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN(R) TO PROVIDE BREAST EXAMS AND MAMMOGRAMS. NUMBER OF MAMMOGRAMS PROVIDED WAS 80.- MAINTAINED WIGS PROGRAM TO FIT CANCER PATIENTS. FITTED 12 PATIENTS.- CONTINUED TO OFFER CANCER RELATED SUPPORT GROUPS. OFFERED 11 CANCER SUPPORT GROUPS.- PARTICIPATED IN SANDUSKY COUNTY'S CANCER COALITION.- SUPPORTED LOCAL CANCER RELATED EVENTS SUCH AS THE CANCER CARE FUND FUNDRAISER AND KICK BALL TOURNAMENT BENEFITING CANCER CARE RAISING OVER $500.- CONTINUED SUPPORT OF THE AMERICAN CANCER SOCIETY THROUGH EVENT SPONSORSHIP AND BOARD PARTICIPATION.HEALTH NEED IDENTIFIED: MENTAL HEALTH - DEPRESSION/ANXIETY/SUICIDE AND BINGE DRINKINGSTRATEGY #1 - INCREASE HOSPITAL-WIDE PARTICIPATION IN RED RIBBON WEEK.ACTIONS TAKEN:- HAD DISPLAY SET UP IN HOSPITAL ENTIRE WEEK OF RED RIBBON WITH INFORMATION ON DANGERS OF DRUG/ALCOHOL USE FREE FOR COMMUNITY MEMBERS TO TAKE. WE HAVE DONE THIS ANNUALLY SINCE THE INCEPTION OF OUR CHNA TEAM.- 45 YOUTH AND 30 ADULT PLEDGES TO REMAIN DRUG FREE WERE SECURED. THIS WASN'T OFFERED IN THE PAST SO THIS IS AN INCREASE OF ZERO IN PREVIOUS YEARS. RESEARCH SUGGESTS PARENTAL INVOLVEMENT AND SUPPORT OF SOBRIETY IS A POSITIVE PROTECTIVE FACTOR IN YOUTH RISKY BEHAVIORS.- A CME ON DRUGS/ALCOHOL TRENDS AND TREATMENT WAS OFFERED TO OUR MEDICAL COMMUNITY DURING RED RIBBON WEEK, WHICH HAD NOT HAPPENED IN THE PAST. THIS OBJECTIVE HOPED TO RAISE AWARENESS IN PCP'S OF REFERRAL OPTIONS AND TREATMENT OF DRUGS AND ALCOHOL. PARTICIPANTS INCLUDED PHYSICIANS, NURSES, AND OTHER HEALTHCARE PROVIDERS (APPROXIMATELY 15 IN ATTENDANCE).- GAVE OUT EDUCATIONAL AND RESOURCE MATERIAL AT RED RIBBON EVENT AT TERRA STATE COMMUNITY COLLEGE TO 455 REGISTERED PARTICIPANTS. THIS IS A YEARLY EVENT THAT WE HAVE PARTICIPATED IN.STRATEGY #2 - CONTINUE EFFORTS AT MEMORIAL HOSPITAL FAMILY FEST TO EDUCATE ATTENDEES ON ALCOHOL/BINGE DRINKING ISSUES.ACTIONS TAKEN:- CONTINUED EFFORTS AT MEMORIAL HOSPITAL FAMILY FEST TO EDUCATE ATTENDEES ON ALCOHOL/BINGE DRINKING ISSUES. OBTAINED PLEDGES TO REMAIN DRUG AND ALCOHOL FREE FROM 45 YOUTHS AND 30 ADULTS.STRATEGY #3 - CONTINUE COLLABORATIVE EFFORTS WITH COMMUNITY TEAM TO ADDRESS ALCOHOL ABUSE.ACTIONS TAKEN: - CONTINUED COLLABORATIVE EFFORTS WITH COMMUNITY TEAM TO ADDRESS ALCOHOL ABUSE. HOSTED RED RIBBON WEEK EVENT.STRATEGY #4 - PARTICIPATE IN NAMI WALK TO RAISE FUNDS TO SUPPORT RELATED COMMUNITY PROGRAMS. ACTIONS TAKEN:- PARTICIPATED IN NAMI WALK TO RAISE FUNDS TO SUPPORT RELATED COMMUNITY PROGRAMS. NUMBER OF PARTICIPANTS IN NAMI WALK WAS 40 AND THE TEAM RAISED OVER $1,000.STRATEGY #5 - PARTICIPATE IN THREE DEPRESSION SCREENINGS.ACTIONS TAKEN:- PARTICIPATED IN THREE DEPRESSION SCREENINGS. NUMBER OF PARTICIPANTS IN DEPRESSION SCREENINGS WAS 305. MOST OF THESE WERE HELD AT A SENIOR DAY EVENT.STRATEGY #6 - CONTINUE TO MEET QUARTERLY WITH TEAM OF MENTAL HEALTH PROFESSIONALS/COMMUNITY LEADERS. ACTIONS TAKEN:- CONTINUED TO PARTICIPATE IN THE SANDUSKY COUNTY MENTAL HEALTH COALITION. STRATEGY #7 - DEVELOP MENTAL HEALTH RESOURCES BASED ON INPUT FROM COMMUNITY TEAM.ACTIONS TAKEN: - TEAM DEVELOPED A RESOURCE PAMPHLET, THAT WAS DISTRIBUTED AT EVENTS DURING RED RIBBON WEEK AND THROUGHOUT THE YEAR, ON HOW TO RECOGNIZE USE OF SUBSTANCES.STRATEGY #8 - DEVELOP MENTAL HEALTH RESOURCES BASED ON OUTCOMES OF FOCUS GROUPS AND COMMUNITY TEAM MEETINGS.ACTIONS TAKEN:- AS PART OF STRATEGY, HELD COMMUNITY MEETINGS TO GET INPUT ON DEVELOPING A RESOURCE PAMPHLET, THAT WAS DISTRIBUTED AT EVENTS DURING RED RIBBON WEEK AND THROUGHOUT THE YEAR, ON HOW TO RECOGNIZE USE OF SUBSTANCES.STRATEGY #9 - FACILITATE AT LEAST FOUR PARENT INFORMATIONAL SESSIONS WITH PANEL OF PROFESSIONALS.ACTIONS TAKEN:- FACILITATED AT LEAST FOUR PARENT INFORMATIONAL SESSIONS WITH PANEL OF PROFESSIONALS. NUMBER OF ATTENDEES AT PARENT INFORMATION SESSIONS WAS 30.STRATEGY #10 - CONTINUE TO BUILD CHILD AND ADOLESCENT PSYCHIATRIC PRACTICE IN COMMUNITY.ACTIONS TAKEN:- CONTINUED TO BUILD CHILD AND ADOLESCENT PSYCHIATRIC PRACTICE IN COMMUNITY. NUMBER OF CHILD/ADOLESCENT PSYCHIATRY VISITS WAS APPROXIMATELY 2,239.HEALTH NEED IDENTIFIED: RISKY BEHAVIORS IN YOUTH - TEEN PREGNANCY AND PRESCRIPTION MISUSESTRATEGY #1 - EXPAND HIV SCREENINGS IN THE COMMUNITY. IMPLEMENT UNIVERSAL HIV SCREENING IN THE EMERGENCY DEPARTMENT. PARTNER WITH THE SANDUSKY COUNTY HEALTH DEPARTMENT TO EXPAND HIV TESTING IN THE COMMUNITY. PARTNER WITH THE AIDS RESOURCE CENTER TO DEVELOP ANONYMOUS HIV SCREENINGS.ACTIONS TAKEN:- EVALUATED THE FEASIBILITY OF UNIVERS
STRATEGY #2 - CONTINUE MEMORIAL HOSPITAL'S INVOLVEMENT WITH SANDUSKY COUNTY	HEALTH DEPARTMENT'S PREVENTION PARTNERSHIP. ACTIONS TAKEN:- HELD TOWN HALL MEETING. VISITED PHYSICIAN OFFICES AND PHARMACIES PROVIDING EDUCATION ON OARRS. PROVIDED 6 MEDICATION TAKE BACK BOXES IN THE COUNTY. CREATED OPIATE GUIDE AND RESOURCE PAMPHLET ON OPIATES.STRATEGY #3 - CONTINUE MEMORIAL HOSPITAL STAFF INVOLVEMENT AND SUPPORTIN THE FAMILY AND CHILDREN FIRST COUNCIL.ACTIONS TAKEN:- THERE ARE CURRENTLY A MINIMUM OF 4 MEMORIAL HOSPITAL LEADERS WHO ARE PROVIDING MENTORING FOR AREA YOUTHS WITH AN EFFORT TO EXPAND THAT NUMBER IN THE FUTURE.STRATEGY #4 - CONTINUE MEMORIAL HOSPITAL STAFF INVOLVEMENT AND SUPPORT OF RED RIBBON WEEK.ACTIONS TAKEN:- PARTICIPATED IN ANNUAL SPOOKTACULAR EVENT AT TERRA STATE COMMUNITY COLLEGE WITH OVER 800 ATTENDEES RECEIVING EDUCATION ON RED RIBBON INITIATIVES.STRATEGY #5 - EXPAND YOUTH MENTORING IN SANDUSKY COUNTY.ACTIONS TAKEN:- REINSTATED BIG BROTHER PROGRAM IN COUNTY. PARTNERING WITH THE COURT SYSTEM WITH THE PROGRAM AND HAVE A SEAT ON THEIR BOARD.STRATEGY #6 - PARTNER WITH THE SANDUSKY COUNTY HEALTH DEPARTMENT TO EXPAND THE ASSET DEVELOPMENT PROGRAM WITHIN THE SANDUSKY COUNTY SCHOOLS.ACTIONS TAKEN:- DEVELOPED FIVE ASSET TEAMS INVOLVING THE MIDDLE SCHOOL. GRANT MONEY MADE AVAILABLE FOR TEAMS WHO CREATED PROGRAMS SUCH AS ANTI-BULLYING EDUCATIONAL EVENT. DEVELOPED PROGRAM "CREATING A CARING SCHOOL CLIMATE".STRATEGY #7 - PARTNER WITH THE SANDUSKY COUNTY SCHOOLS TO ACHIEVE THEIR STRATEGIC GOALS IN RELATION TO RISKY BEHAVIOR IN YOUTH. ACTIONS TAKEN:- DEVELOPING STIPENDS FOR HIGH SCHOOL STUDENTS WHO DEVELOP YOUTH LED ACTIVITIES ON ANTI-DRUGS.STRATEGY #8 - CHALLENGE THE COMMUNITY WITH A VIDEO COMPETITION REGARDING MISUSE OF PRESCRIPTION DRUGS, SEXUALLY TRANSMITTED INFECTIONS AND TEEN PREGNANCY.ACTIONS TAKEN:- CHALLENGED THE COMMUNITY WITH A VIDEO COMPETITION REGARDING MISUSE OF PRESCRIPTION DRUGS, SEXUALLY TRANSMITTED INFECTIONS AND TEEN PREGNANCY. MET WITH SCHOOL ADMINISTRATORS AND UNABLE TO ACCESS TIME IN SCHOOLS DUE TO ACADEMIC TIME CONSTRAINTS.STRATEGY #9 - EXPAND AWARENESS OF MISUSE OF PRESCRIPTION DRUGS. HOST EDUCATIONAL SESSIONS FOCUSING ON PRESCRIPTION DRUG ABUSE. DEVELOP A POLICY AND TRACKING PROCESS THAT ENSURES ALL PHYSICIANS WHO PRACTICE AT MEMORIAL HOSPITAL ARE REGISTERED IN THE OHIO AUTOMATED RX REPORTING SYSTEM (OARRS).ACTIONS TAKEN:- HOSTED THREE EVENTS ON PRESCRIPTION DRUG ABUSE. (1) PROVIDED A CME FOR PHYSICIANS ON OARRS, (2) PROVIDED EDUCATIONAL MATERIAL AT ANNUAL FAMILY FEST, AND (3) PROVIDED EDUCATIONAL MATERIAL IN HOSPITAL LOBBY DURING ANNUAL RED RIBBON WEEK- DEVELOPED A POLICY AND TRACKING PROCESS THAT ENSURES ALL PHYSICIANS WHO PRACTICE AT MEMORIAL HOSPITAL ARE REGISTERED IN THE OHIO AUTOMATED RX REPORTING SYSTEM (OARRS). PHYSICIANS HAVE BEEN ACTIVELY REGISTERING IN OARRS, WITH 21 ALREADY REGISTERED. CONTINUE TO TRACK NARCOTICS USED IN THE EMERGENCY DEPARTMENT.- BEGAN TO DEVELOP A PROGRAM FOR JUVENILE DETENTION CENTER THAT CAN BE REPLICATED IN OTHER PLACES.MEMORIAL HOSPITAL DID NOT ADDRESS ALL OF THE SPECIFIC NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AS THESE AREAS EITHER ARE ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. ALTHOUGH PROMEDICA PHYSICIANS AND OTHER PROGRAMS ADDRESS THE HEALTH NEEDS OF PATIENTS AS NEEDED, THE NEEDS SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS PLAN, INCLUDE (INDICATES PROMEDICA HAS, OR PARTICIPATES IN, COMMUNITY OUTREACH PROGRAMS ADDRESSING THESE ISSUES):- HEALTH STATUS - ADDRESSED AT PHYSICIAN VISITS; MEMORIAL NEWSLETTERS TO SENIORS AND BUSINESSES- HEALTH CARE COVERAGE - PARAMOUNT HEALTH CARE; MEMORIAL HOSPITAL GOLDEN THREADS SENIOR PROGRAM- HEALTH CARE ACCESS - PARAMOUNT HEALTH CARE; COMMUNITY HEALTH PLAN ALLIANCE- CANCER - ADDRESSED AT PHYSICIAN VISITS; UNITED WAY OF SANDUSKY COUNTY; AMERICAN CANCER SOCIETY; NORTHWEST OHIO KOMEN- CARDIOVASCULAR HEALTH - PROMEDICA HEART & VASCULAR INSTITUTE; PROMEDICA WELLNESS; AMERICAN HEART ASSOCIATION- DIABETES - MEMORIAL HOSPITAL DIABETES EDUCATION; MEMORIAL HOSPITAL DIABETES SUPPORT GROUP; MEMORIAL HOSPITAL ANNUAL DIABETES FORUM- ARTHRITIS - ADDRESSED AT PHYSICIAN VISITS; ARTHRITIS FOUNDATION; YMCA OF SANDUSKY COUNTY- ASTHMA - ADDRESSED AT PHYSICIAN VISITS- ALCOHOL USE - ADDRESSED AT PHYSICIAN VISITS; FIRELANDS COUNSELING & RECOVERY SERVICES- SUBSTANCE ABUSE - ADDRESSED AT PHYSICIAN VISITS; PARTNER PREVENTION PROGRAM; MEMORIAL HOSPITAL AT-RISK TEAM; FIRELANDS COUNSELING & RECOVERY SERVICES- WOMEN'S HEALTH - ADDRESSED AT PHYSICIAN VISITS; SANDUSKY COUNTY HEALTH DEPARTMENT; COMMUNITY HEALTH SERVICES; NORTHWEST OHIO KOMEN- MEN'S HEALTH - ADDRESSED AT PHYSICIAN VISITS; MEMORIAL HOSPITAL PROSTATE SUPPORT GROUP; COMMUNITY HEALTH SERVICES- MENTAL HEALTH - ADDRESSED AT PHYSICIAN VISITS; MENTAL HEALTH AND RECOVERY SERVICES BOARD OF SENECA, SANDUSKY AND WYANDOT COUNTIES; NORTHWEST OHIO ALLIANCE FOR MENTAL ILLNESS; FIRELANDS COUNSELING & RECOVERY SERVICES- MINORITY HEALTH - SANDUSKY COUNTY HEALTH DEPARTMENT; MIGRANT HEALTH CLINIC- PREVENTIVE SCREENINGS AND IMMUNIZATIONS - ADDRESSED AT PHYSICIAN VISITS; NORTHWEST OHIO KOMEN- SEXUAL BEHAVIOR - ADDRESSED AT PHYSICIAN VISITS; SANDUSKY COUNTY HEALTH DEPARTMENT; MEMORIAL HOSPITAL AT-RISK TEAM- PERCEIVED QUALITY OF LIFE- TOBACCO USE - AMERICAN LUNG ASSOCIATION; BELLEVUE HOSPITAL - WEIGHT CONTROL - SANDUSKY COUNTY HEALTH DEPARTMENT; FREMONT COMMUNITY RECREATION CENTER, YMCA OF FREMONT; SANDUSKY COUNTY PARK DISTRICT- YOUTH SAFETY - PROMEDICA SAFE KIDS; MEMORIAL HOSPITAL SAFE SITTER COURSE; WSOS COMMUNITY ACTION; LAW ENFORCEMENT- YOUTH VIOLENCE - SCHOOLS; LAW ENFORCEMENT- YOUTH PERCEPTIONS - SCHOOLS; FAMILY AND CHILDREN FIRST COUNCIL; SANDUSKY COUNTY HEALTH DEPARTMENT- ORAL HEALTH - SANDUSKY COUNTY HEALTH DEPARTMENT; DR. NELSON SMITH/ANNUAL FAMILY FEST- EARLY CHILDHOOD (0-5 YEARS) ISSUES - FAMILY FEST; EARLY HEAD START; HELP ME GROW; - MIDDLE CHILDHOOD (6-11 YEARS) ISSUES - SCHOOLS; FAMILY FEST- FAMILY FUNCTIONING - VILLAGE HOUSE*; WSOS COMMUNITY ACTION- NEIGHBORHOOD AND COMMUNITY CHARACTERISTICS - MEMORIAL HOSPITAL CPR AND FIRST AID CLASSES- PARENTAL HEALTHTO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND/OR WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.MEMORIAL HOSPITAL:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILBLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/FINANCIALASSISTANCEMEMORIAL HOSPITAL:PART V, SECTION B, LINE 20B: A PATIENT FINANCIAL ADVOCATE (PFA) IS ASSIGNED TO EACH PATIENT WHO HAS BEEN ADMITTED TO THE HOSPITAL FACILITY TO NOTIFY THE INDIVIDUAL OF THE FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE.
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
MEMORIAL HOSPITAL PART V, SECTION B, LINE 16B WEBSITE:	SEE PART V, SECTION C

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	HERBERT-PERNA CTR FOR PHYSICAL HEALTH 710 CLEVELAND AVENUE FREMONT,OH43420	OCCUPATIONAL MEDICINE
2	MEMORIAL HOME HEALTH & HOSPICE 430 S MAIN ST CLYDE,OH43410	HOME HEALTH & HOSPICE
3	HAYES AVENUE LAB 2575 HAYES AVENUE SUITE 2 FREMONT,OH43420	LAB
4	CLYDE PT OT ST 507 MCPHERSON HWY CLYDE,OH43410	PHYSICAL/OCCUPATIONAL THERAPY
5	GIBSONBURG PT OT ST 116 S MAIN STREET GIBSONBURG,OH43431	PHYSICAL/OCCUPATIONAL THERAPY
6	CTR FOR MENTAL HEALTH AND WELL-BEING 1100 EAST MAIN CROSS ST FINDLAY,OH45840	COUNSELING CLINIC
7
8
9
10

Schedule H (Form 990) 2014

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 6A:	MEMORIAL HOSPITAL REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	MEMORIAL HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART III, LINE 2:	MEMORIAL HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	MEMORIAL HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT USING THE RATIO OF FINANCIAL ASSISTANCE AS COMPARED TO GROSS CHARGES.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGES 16 AND 17 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8:	MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, MANDATED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS THAT PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.MEMORIAL HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS 2014 AS-FILED MEDICARE COST REPORT, AS ADJUSTED, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS, SUCH AS SERVICES AND CLINICS.
PART III, LINE 9B:	FINANCIAL ASSISTANCE APPLICATIONS ARE GIVEN TO PATIENTS IN REGISTRATION. THEY ALSO RECEIVE A LETTER WHEN THE ACCOUNT FINAL BILLS EXPLAINING HOW TO CONTACT FINANCIAL COUNSELING AND EXPLANATIONS OF DIFFERENT PROGRAMS (I.E. FINANCIAL ASSISTANCE, HCAP). THE BACK OF ALL STATEMENTS ALSO CONTAIN INFORMATION ON FINANCIAL ASSISTANCE.
PART VI, LINE 2:	PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: HEART DISEASE, CANCERS, AND STROKE, DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CARDIOVASCULAR DISEASE, CANCERS AND OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, ORTHOPAEDICS AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	MEMORIAL HOSPITAL, LOCATED IN FREMONT, OHIO, SERVES AN AREA PRIMARILY AROUND SANDUSKY AND SENECA COUNTIES WITH A POPULATION OF APPROXIMATELY 83,000. APPROXIMATELY, 17% OF THE SERVICE AREA IS AGE 65 OR OVER; 40% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $43,000; 53% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 58% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. SANDUSKY COUNTY HAS A POPULATION OF APPROXIMATELY 61,000 WITH APPROXIMATELY 6% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 23% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 16% OF SANDUSKY COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SANDUSKY COUNTY IN 2014 WAS 7.1%. THE LEADING CAUSES OF DEATH IN THE SERVICE AREA, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, LUNG DISEASE, DIABETES, CANCER, AND UNINTENTIONAL INJURIES/ACCIDENTS. ACCORDING TO 2014 COUNTY HEALTH RANKINGS, SANDUSKY COUNTY RANKED 37 OF 88 COUNTIES FOR HEALTH OUTCOMES, 38 OF 88 FOR MORTALITY, AND 47 OF 88 FOR MORBIDITY. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 56,000 WITH APPROXIMATELY 6% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 23% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 17% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2014 WAS 7.5%. ACCORDING TO 2014 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 16 OF 88 COUNTIES FOR HEALTH OUTCOMES, 20 OF 88 FOR MORTALITY, AND 19 OF 88 FOR MORBIDITY. THERE ARE SEVEN HOSPITALS WITHIN A SIX COUNTY AREA AROUND FREMONT, BELLEVUE HOSPITAL, H.B. MAGRUDER MEMORIAL HOSPITAL, MERCY HOSPITAL, WOOD COUNTY HOSPITAL, FIRELANDS REGIONAL MEDICAL CENTER, FISHER-TITUS MEDICAL CENTER, AND MERCY HOSPITAL OF WILLARD.
PART VI, LINE 5:	IN 2014, THERE WERE 515 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA). OF THESE, 100% LIVED WITHIN PROMEDICA'S 27-COUNTY SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN METRO TOLEDO WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. TRUSTEE REPRESENTATION IS COMPRISED OF DIVERSE MEMBERS, INCLUDING 82 PHYSICIANS, FROM NORTHWEST OHIO AND SOUTHEAST MICHIGAN; ALL TRUSTEES RESIDE WITHIN PROMEDICA'S SERVICE REGION IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. - BOARD MEMBERS ARE NOT COMPENSATED BY PROMEDICA FOR THEIR SERVICE TO OUR HOSPITALS AND OTHER BUSINESS UNITS; THEIR DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, ARE PERFORMED ON A VOLUNTEER BASIS. IN 2014, PROMEDICA BOARD MEMBERS GAVE APPROXIMATELY 27,090 HOURS IN SERVICE TO THE ORGANIZATION, WHICH EQUATES TO AN ESTIMATED CONTRIBUTION OF APPROXIMATELY $3 MILLION TO OUR COMMUNITIES.- PROMEDICA'S MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITIES WHICH PROMEDICA SERVES. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MEETS THOSE QUALIFICATIONS MAY BE GRANTED PRIVILEGES.- THE PROMEDICA BIOREPOSITORY HAS COLLECTED MORE THAN 200 BLOOD AND TISSUE SAMPLES DONATED BY PATIENTS TO ADVANCE RESEARCH IN AREAS OF NEW TREATMENTS, PREVENTION AND CURES FOR CANCER AND OTHER MEDICAL CONDITIONS. - THE PROMEDICA ADVOCACY FUND PROVIDED GRANTS TOTALING NEARLY $375,000 TO MORE THAN A DOZEN NONPROFIT ORGANIZATIONS, HELPING THEM PROVIDE FOOD, CLOTHING AND SHELTER TO AT-RISK INDIVIDUALS IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN.- PROMEDICA CONTINUED ITS CHILDHOOD OBESITY PILOT PROGRAM, WHICH FOCUSED ON CHILDREN AND ADOLESCENTS WITH A BODY MASS INDEX (BMI) THAT CLASSIFIES THEM AS OBESE. FAMILIES MET QUARTERLY OVER A 12-MONTH PERIOD WITH A DIETITIAN IN A PHYSICIAN'S OFFICE OR OUTPATIENT CLINIC TO RECEIVE NUTRITION COUNSELING AND ASK QUESTIONS. EACH CHILD'S BMI AND RESPONSES TO A HEALTH QUESTIONNAIRE WERE COLLECTED BEFORE, DURING AND AFTER THE 12-MONTH PERIOD TO DETERMINE THE PROGRAM'S EFFECTIVENESS. - PROMEDICA CONTINUED TO IMPLEMENT ITS FOOD RECLAMATION PROGRAM IN PARTNERSHIP WITH HOLLYWOOD CASINO (ROSSFORD, OHIO), AS WELL AS THE TOLEDO AND FLOWER HOSPITALS, PROVIDING MORE THAN 160,000 POUNDS OF REPACKAGED, UN-SERVED FOOD TO COMMUNITY FEEDING SITES. THE TOLEDO MUD HENS AND OWENS COMMUNITY COLLEGE ARE THE NEWEST PARTNERS TO JOIN THE INITIATIVE.- PROMEDICA OPENED ITS 55,000 SQUARE FOOT MARY ELLEN FALZONE DIABETES CENTER IN FEBRUARY 2014. THE FACILITY BRINGS DIABETES PROGRAMS, SERVICES AND PHYSICIANS TOGETHER, PROVIDING COORDINATED CARE IN ONE CONVENIENT LOCATION TO SERVE COMMUNITY MEMBERS LEARNING TO MANAGE THEIR DIABETES.- PROMEDICA ALSO OFFERED FREE VASCULAR SCREENINGS FOR OLDER ADULTS THROUGH JOBST VASCULAR CENTER TO AID IN THE DETECTION OF VASCULAR DISEASE, WHICH MAY LEAD TO STROKE OR PERIPHERAL ARTERIAL DISEASE. NEARLY 8,000 ADDITIONAL HEALTH SCREENINGS WERE PROVIDED TO COMMUNITY MEMBERS THROUGHOUT 2014, INCLUDING BLOOD PRESSURE, BLOOD GLUCOSE AND BODY MASS INDEX SCREENINGS AT NUMEROUS HEALTH FAIRS AND SPORTING EVENTS. ADDITIONALLY, THE PROMEDICA CANCER INSTITUTE OFFERED FREE SKIN CANCER AND PROSTATE CANCER SCREENINGS FOR THE GENERAL PUBLIC AT PROMEDICA HOSPITALS.
PART VI, LINE 6:	PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2014, PROMEDICA WAS COMPRISED OF 17,000 EMPLOYEES, APPROXIMATELY 2,700 VOLUNTEERS AND MORE THAN 2,300 HEALTHCARE PROVIDERS, INCLUDING MORE THAN 800 PROVIDERS EMPLOYED BY PROMEDICA PHYSICIANS, WHO HAVE JOINED TOGETHER TO FORM A NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO HELP ENSURE AREA RESIDENTS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. - PROMEDICA MEMBERS INCLUDE: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); FLOWER HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA BIXBY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC. D/B/A PROMEDICA HERRICK HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; ST. LUKE'S HOSPITAL D/B/A PROMEDICA ST. LUKE'S HOSPITAL; PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIANS, A NETWORK OF SYSTEM-EMPLOYED PHYSICIANS AND MIDLEVEL PROVIDERS; AND PROMEDICA CONTINUING SERVICES, WITH SERVICES SUCH AS SENIOR CARE, HOSPICE, REHABILITATION, AND HOME CARE.- IN 2014, PROMEDICA MANAGED MORE THAN 4.5 MILLION PATIENT ENCOUNTERS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF NEARLY $149 MILLION, WHICH INCLUDED FREE HEALTH SCREENINGS AND PUBLIC HEALTH FAIRS TO MEDICAL LECTURES AT AREA SENIOR CENTERS AND IN ELEMENTARY SCHOOLS, PLUS MUCH MORE.- IN ADDITION, THE PROMEDICA ADVOCACY FUND ASSISTED LOCAL NONPROFIT AGENCIES WITH SIMILAR MISSIONS THROUGH DONATIONS TOTALING NEARLY $375,000. AS IN PRIOR YEARS, EMPHASIS WAS PLACED ON ORGANIZATIONS WORKING TO ENSURE BASIC NEEDS SUCH AS CLOTHING, SHELTER AND FOOD AS THESE ARE TIED CLOSELY TO PROMEDICA'S MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES IT SERVES.- WITH REGARD TO HEALTH PROFESSIONS EDUCATION, MONTHLY, BIWEEKLY AND ANNUAL PROGRAMS WERE OFFERED THROUGHOUT 2014 FOR CONTINUING MEDICAL EDUCATION CREDIT. MORE THAN 1,570 CREDIT HOURS OF PHYSICIAN EDUCATION WERE OFFERED. THERE WERE APPROXIMATELY 8,000 PHYSICIANS WHO PARTICIPATED IN EDUCATIONAL PROGRAMS, AND APPROXIMATELY 7,800 NON-PHYSICIANS (I.E., ALLIED HEALTH PROFESSIONALS).- PROMEDICA'S FOUNDATIONS RAISED NEARLY $10 MILLION FOR PHILANTHROPY IN SUPPORT OF THE SYSTEM'S MISSION TO IMPROVE HEALTH AND WELL-BEING. ALL OF PROMEDICA'S FOUNDATIONS ARE SEPARATE ORGANIZATIONS, AND ANNUAL DONOR PROGRAMS, CAPITAL CAMPAIGNS, PLANNED GIVING, AND EVENT FUNDRAISING ACTIVITIES ARE CONDUCTED TO RAISE FUNDS THAT SUPPORT THEIR RESPECTIVE PATIENTS AND FAMILIES, AS WELL AS THE LOCAL COMMUNITY, THROUGH HEALTH-RELATED PROGRAMS, SERVICES, EQUIPMENT, AND FACILITY CONSTRUCTION/RENOVATION THAT HAVE BEEN IDENTIFIED, IN PART, THROUGH A COMMUNITY NEEDS ASSESSMENT.

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
MEMORIAL HOSPITAL

Employer identification number
34-4430849

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) PROMEDICA FOUNDATION 2142 N COVE BLVD TOLEDO,OH43606	34-1517672	501(C)(3)	138,302	OPERATING GRANT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1HOLLY L BRISTOLLEX OFFICIO	(i) (ii)	0 ............................... 230,778	0 ............................... 79,392	0 ............................... 12,684	0 ............................... 38,317	0 ............................... 14,984	0 ............................... 376,155	0 ............................... 0
2KEVIN C WEBB PHDEX OFFICIO	(i) (ii)	0 ............................... 399,505	0 ............................... 147,572	0 ............................... 28,568	0 ............................... 36,188	0 ............................... 12,832	0 ............................... 624,665	0 ............................... 0
3PAMELA JENSENPRESIDENT, EX OFFICIO	(i) (ii)	0 ............................... 198,229	0 ............................... 47,063	0 ............................... 3,112	0 ............................... 23,214	0 ............................... 17,398	0 ............................... 289,016	0 ............................... 0
4KATHLEEN S HANLEYTREASURER (THRU 5/14)	(i) (ii)	0 ............................... 457,284	0 ............................... 200,510	0 ............................... 46,252	0 ............................... 805,713	0 ............................... 16,434	0 ............................... 1,526,193	0 ............................... 0
5ALAN M SATTLERTREASURER	(i) (ii)	0 ............................... 309,066	0 ............................... 97,460	0 ............................... 32,113	0 ............................... 48,009	0 ............................... 20,932	0 ............................... 507,580	0 ............................... 0
6JEFFREY C KUHNSECRETARY	(i) (ii)	0 ............................... 363,111	0 ............................... 157,073	0 ............................... 12,779	0 ............................... 45,715	0 ............................... 23,305	0 ............................... 601,983	0 ............................... 0
7GARY AKENBERGERSR. VP FINANCE, PHS	(i) (ii)	0 ............................... 238,713	0 ............................... 69,268	0 ............................... 34,519	0 ............................... 48,981	0 ............................... 20,188	0 ............................... 411,669	0 ............................... 0
8JILL TROSINCNO, MH	(i) (ii)	29,856 ............................... 125,324	0 ............................... 10,000	0 ............................... 1,445	4,125 ............................... 9,057	1,348 ............................... 6,030	35,329 ............................... 151,856	0 ............................... 0
9TERENCE ROSSMEDICAL DIR. ANESTHESIOLOGY	(i) (ii)	405,438 ............................... 0	0 ............................... 0	1,290 ............................... 0	23,000 ............................... 0	28,922 ............................... 0	458,650 ............................... 0	0 ............................... 0
10JAMES STIERWALTANESTHESIOLOGIST	(i) (ii)	362,879 ............................... 0	0 ............................... 0	1,290 ............................... 0	23,000 ............................... 0	24,382 ............................... 0	411,551 ............................... 0	0 ............................... 0
11JAMES WILLIAMSPHYSICIAN	(i) (ii)	344,090 ............................... 0	0 ............................... 0	1,980 ............................... 0	0 ............................... 0	29,515 ............................... 0	375,585 ............................... 0	0 ............................... 0
12SANJAY SANGALANESTHESIOLOGIST	(i) (ii)	342,262 ............................... 0	0 ............................... 0	2,941 ............................... 0	22,230 ............................... 0	24,382 ............................... 0	391,815 ............................... 0	0 ............................... 0
13KEVIN SMITHPHYSICIAN HEALTHLINK	(i) (ii)	293,671 ............................... 0	0 ............................... 0	18,790 ............................... 0	23,000 ............................... 0	29,515 ............................... 0	364,976 ............................... 0	0 ............................... 0
14DAVID BREWERFORMER OFFICER	(i) (ii)	0 ............................... 113,441	0 ............................... 2,800	0 ............................... 5,251	0 ............................... 11,310	0 ............................... 17,339	0 ............................... 150,141	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference

Explanation

PART I, LINE 3

PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF MEMORIAL HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

PART I, LINE 4B

ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO PAYMENTS WERE MADE TO LISTED PERSONS IN PART VII UNDER THE VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS DURING THE YEAR.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
MEMORIAL HOSPITAL

Employer identification number
34-4430849

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	COUNTY OF SANDUSKY OHIO	34-6401312		11-29-2010	23,191,875	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	22,935,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	23,191,875
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	256,875
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .
11 Other spent proceeds . . . . . . . . . . . . . .	22,935,000
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X
b Exception to rebate? . . . . . . . .		X
c No rebate due? . . . . . . . .		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X
b Name of provider . . . . . . . . .	MORGAN STANLEY CAPI
c Term of hedge . . . . . . . . . .	5.400000000000
d Was the hedge superintegrated? . . . .		X
e Was the hedge terminated? . . . . . .		X

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
SCHEDULE K, SUPPLEMENTAL INFORMATION:	PART I: ISSUER NAME: COUNTY OF SANDUSKY, OHIO ISSUER EIN: 34-6401312 CUSIP#: NONE DATE ISSUED: 11/29/10 ISSUE PRICE: $23,191,875 PURPOSE: REFUND BONDS ISSUED 8/5/2002 AND 2/16/2006.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2014

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) PART V	PART V	213,258	PART V		No
(2) PART V	PART V	132,821	PART V		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: VALLEY ELECTRIC CO.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:GREATER THAN 35% CONTROLLED ENTITY BY TOM H. HOFFMAN (TRUSTEE).(C) AMOUNT OF TRANSACTION: $213,258(D) DESCRIPTION OF TRANSACTION: ELECTRICAL SERVICES(E) SHARING OF ORGANIZATION REVENUES? = NO
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: REINO LINEN SERVICE, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:GREATER THAN 35% CONTROLLED ENTITY BY JUDITH M. REINO (TRUSTEE).(C) AMOUNT OF TRANSACTION: $132,821(D) DESCRIPTION OF TRANSACTION: LINEN SERVICES(E) SHARING OF ORGANIZATION REVENUES? = NO

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	CATHERINE R. KNIPP AND DARYL L. KNIPP HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 4	EFFECTIVE JANUARY 1, 2014, MEMORIAL HOSPITAL AMENDED ITS ARTICLES OF INCORPORATION AND CODE OF REGULATIONS. THE SIGNIFICANT CHANGES ARE AS FOLLOWS: - PROMEDICA HEALTH SYSTEM, INC. BECAME THE SOLE CORPORATE MEMBER OF MEMORIAL HOSPITAL. - THE NUMBER OF THE BOARD OF TRUSTEES MEMBERS SHALL CONSIST OF NOT LESS THAN ELEVEN NOR MORE THAN TWENTY. - A QUORUM FOR TRANSACTION OF BUSINESS AT ANY MEETING OF THE BOARD OF TRUSTEES MUST INCLUDE AT LEAST ONE PROMEDICA HEALTH SYSTEM, INC. APPOINTED TRUSTEE OR THE PRESIDENT OF MEMORIAL HOSPITAL AS WELL AS A MAJORITY OF THE REMAINING TRUSTEES. - PROMEDICA HEALTH SYSTEM, INC., AS THE SOLE CORPORATE MEMBER, HAS SPECIFIC RESERVED POWERS DEFINED WITHIN THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION A, LINE 6	AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF MEMORIAL HOSPITAL OR IS THE SOLE MEMBER OF THE SOLE MEMBER OF MEMORIAL HOSPITAL. AS THE MEMBER, PHS HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF MEMORIAL HOSPITAL, AND (B) APPROVE THE NOMINEES TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11	UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE WITHIN 30 DAYS OF NOTIFICATION. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED, COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT, AND A LIST OF ALL NEW EMPLOYEES HIRED DURING THE PREVIOUS 12 MONTHS. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT.
FORM 990, PART VI, SECTION B, LINE 15	MEMORIAL HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF MEMORIAL HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIAN AND NON-PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 5,863,190. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,863,190. OTHER GENERAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,797,402. MANAGEMENT AND GENERAL EXPENSES 1,083,041. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,880,443.
FORM 990, PART XI, LINE 9:	BENEFICIAL INTEREST IN FOUNDATIONS 4,532,982. VALUATION ADJUSTMENT PER ASC 958 -3,034,118.
FORM 990, PART VI, SECTION B, LINE 16B:	JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES.
FORM 990, PART III, LINE 4:	PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2014 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 332 SITES, MORE THAN 2,100 PHYSICIANS AND APPROXIMATELY 17,000 EMPLOYEES AND VOLUNTEERS. DURING 2014, PROMEDICA DISCHARGED 72,595 INPATIENTS AND SERVED MORE THAN 1,407,416 OUTPATIENTS, WHILE HANDLING 305,747 EMERGENCY VISITS SYSTEM-WIDE. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2014, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 34 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $3.7 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. ADDITIONALLY, OUR PHYSICIANS, LEADERSHIP TEAM MEMBERS AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE GOODS TO NUMEROUS LOCAL FOOD PANTRIES AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); MEMORIAL HOSPITAL; AND ST. LUKE'S HOSPITAL. IN 2014, PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH MORE THAN 800 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS. TOGETHER, THIS GROUP HELPS PROMEDICA BROADEN THE CARE WE OFFER TO AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2014, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 220,000 MEMBERS ACROSS ALL OF OHIO'S 88 COUNTIES. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF THE TOLEDO HOSPITAL. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH MORE THAN 300 LOCAL NONPROFIT AGENCIES AND ORGANIZATIONS IN 2014 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN. PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES, TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2014 INCLUDE THE FOLLOWING:
- PROMEDICA SIGNED A DEFINITIVE AGREEMENT WITH MERCY MEMORIAL HOSPITAL	CORPORATION IN MONROE, MICHIGAN, WITH THE HEALTH SYSTEM BECOMING A MEMBER OF PROMEDICA EFFECTIVE JAN. 1, 2015. BY SHARING RESOURCES AND CLINICAL EXPERTISE, THE JOINDER HELPS BROADEN THE DEPTH AND BREADTH OF OUR SERVICES FOR RESIDENTS OF SOUTHEASTERN MICHIGAN. - PROMEDICA FORMED A JOINT OPERATING COMPANY (JOC) WITH LOCAL BEHAVIORAL HEALTH PROVIDER HARBOR TO ADDRESS A GROWING COMMUNITY NEED FOR MENTAL HEALTH SERVICES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. THE JOC WILL HELP INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES AND ENHANCE CARE THROUGH A MORE INTEGRATED, COORDINATED MODEL. - PROMEDICA SPONSORED A SCHOOL-BASED FOOD DRIVE CHALLENGE AS PART OF ITS COME TO THE TABLE INITIATIVE. SCHOOLS HAVE RAISED MORE THAN 24,000 POUNDS OF NON-PERISHABLE FOOD ITEMS OVER THE PAST TWO YEARS FOR COMMUNITY FOOD PROGRAMS ACROSS PROMEDICA'S SERVICE AREA. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 74 CENTRAL-CITY TEENS AGES 16-19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA CONTINUED ITS CHILDHOOD OBESITY PILOT PROGRAM, WHICH FOCUSED ON CHILDREN AND ADOLESCENTS WITH A BODY MASS INDEX (BMI) THAT CLASSIFIES THEM AS OBESE. FAMILIES MET QUARTERLY OVER A 12-MONTH PERIOD WITH A DIETITIAN IN A PHYSICIAN'S OFFICE OR OUTPATIENT CLINIC TO RECEIVE NUTRITION COUNSELING AND ASK QUESTIONS. EACH CHILD'S BMI AND RESPONSES TO A HEALTH QUESTIONNAIRE WERE COLLECTED BEFORE, DURING AND AFTER THE 12-MONTH PERIOD TO DETERMINE THE PROGRAM'S EFFECTIVENESS. - COORDINATED THROUGH OUR ADVOCACY DEPARTMENT, PROMEDICA CONTINUED TO PROVIDE HEALTH AND NUTRITION EDUCATION TO ELEMENTARY SCHOOL CHILDREN IN GRADES 1 - 6. THE HEALTHY KIDS CONVERSATION MAP(R) PROGRAM IS DESIGNED TO EMPOWER STUDENTS AND THEIR PARENTS/GUARDIANS TO MAKE HEALTHY CHOICES ABOUT FOOD AND EXERCISE. - PROMEDICA PHYSICIANS EXPANDED CARE TO BETTER COVER LOCAL AND RURAL COMMUNITIES, ADDING MORE THAN 95 NEW PRIMARY CARE PHYSICIANS, SPECIALISTS AND ADVANCED PRACTICE PROVIDERS IN 2014. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS THAT INCLUDED NEARLY 8,000 FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - AS PART OF ITS HUNGER-FREE INITIATIVE, PROMEDICA CONTINUED TO IMPLEMENT A FOOD RECLAMATION PROGRAM IN PARTNERSHIP WITH HOLLYWOOD CASINO (ROSSFORD, OHIO), AS WELL AS THE TOLEDO AND FLOWER HOSPITALS, PROVIDING MORE THAN 160,000 POUNDS OF REPACKAGED, UN-SERVED FOOD TO COMMUNITY FEEDING SITES. THE TOLEDO MUD HENS AND OWENS COMMUNITY COLLEGE ARE THE NEWEST PARTNERS TO JOIN THE INITIATIVE. - MORE THAN 150 PEOPLE JOINED PROMEDICA AND THE ALLIANCE TO END HUNGER IN FEBRUARY IN WASHINGTON D.C. TO DISCUSS HOW HUNGER AFFECTS AMERICANS' HEALTH AND WELL-BEING AS WELL AS WAYS TO ADDRESS AND SOLVE THE HUNGER PROBLEM. BASED ON PROMEDICA'S COME TO THE TABLE INITIATIVE TO ADDRESS HUNGER AS A HEALTH ISSUE, THE NATIONAL SUMMIT FEATURED AN ARRAY OF SPEAKERS ON HUNGER AND HEALTH AS THE PARTNERS CONTINUE WORKING TO END U.S. HUNGER BY ENCOURAGING JOINT EFFORTS NATIONWIDE. THE SUCCESS OF THE PROGRAM PROMPTED ADDITIONAL REGIONAL HUNGER SUMMITS - IN CHICAGO IN MAY, AND ATLANTA IN NOVEMBER - FEATURING GUEST SPEAKERS AND OTHER AGENCIES ADDRESSING HUNGER THROUGHOUT THE COUNTRY. - PROMEDICA CANCER INSTITUTE'S COMMUNITY OUTREACH INCLUDED SCREENINGS FOR SKIN CANCER; EDUCATION SESSIONS ON COLON CANCER; THE FIFTH ANNUAL SURVIVOR CELEBRATIONS FOR CANCER SURVIVORS, FRIENDS AND CAREGIVERS; AND SPONSORSHIP OF THE ANNUAL SUSAN G. KOMEN(R) RACE FOR THE CURE IN SUPPORT OF BREAST CANCER RESEARCH. - PROMEDICA RETAIL GROUP (PROMEDICA FLOWER MARKET) - A STAND-ALONE RETAIL BUSINESS LOCATED NEAR THE CAMPUS OF THE TOLEDO HOSPITAL - BEGAN HOSTING MONTHLY GARDEN GROCER "FIRST FRIDAY" EVENTS TO DISCUSS GOOD NUTRITION AND OFFER HEALTHY COOKING DEMONSTRATIONS ALONG WITH RECIPES AND OTHER HANDOUTS. THE EVENTS WERE HELD THE FIRST FRIDAY OF EACH MONTH AND FEATURED TIPS AND ADVICE FROM PROMEDICA'S CLINICAL DIETITIANS. - THROUGH ITS ADVOCACY FUND, PROMEDICA CONTINUED TO SUPPORT LOCAL COMMUNITY ORGANIZATIONS THAT PROVIDE ASSISTANCE TO THOSE IN NEED WITH BASIC NECESSITIES THAT DIRECTLY IMPACT INDIVIDUALS' HEALTH AND WELL-BEING. THIS SUPPORT AMOUNTED TO GRANTS TOTALING NEARLY $375,000 IN 2014. - PROMEDICA OPENED ITS 55,000 SQUARE FOOT MARY ELLEN FALZONE DIABETES CENTER IN FEBRUARY 2014. THE FACILITY IS NAMED FOR A YOUNG GIRL WHO DIED FROM JUVENILE DIABETES BEFORE HER FAMILY EVEN KNEW SHE HAD THE DISEASE. LOCATED ON THE CAMPUS OF THE TOLEDO HOSPITAL, THE CENTER OFFERS DIABETES PROGRAMS, SERVICES AND PHYSICIANS TOGETHER IN ONE CONVENIENT LOCATION TO SERVE ALL COMMUNITY MEMBERS WORKING TO MANAGE THEIR DIABETES. - FLOWER HOSPITAL COMPLETED EXPANSION OF ITS PSYCHIATRIC CARE UNIT IN MARCH. THE ADDITION INCLUDES 18 INPATIENT ROOMS, A COMMON SPACE FOR PATIENTS AND SPECIAL SECURITY MEASURES TO PROVIDE ADDED PROTECTION FOR THIS PATIENT POPULATION. PROMEDICA IS COMMITTED TO EXPANDING BEHAVIORAL HEALTH SERVICES SYSTEM-WIDE TO MEET THE NEEDS OF OUR COMMUNITIES. - THE TOLEDO AND TOLEDO CHILDREN'S HOSPITALS COMPLETED CONSTRUCTION OF NEW IMAGING AND INPATIENT PHARMACY CENTERS IN THE EXISTING RENAISSANCE TOWER. LOCATED ON THE FIRST LEVEL, THE NEW RADIOLOGY SPACE PROVIDES A CENTRALIZED LOCATION FOR ALL RADIOLOGY SERVICES, EXCLUDING BREAST CARE. THE SPACE ALSO FEATURES A LAB DRAW SITE, WHILE A NEW INPATIENT PHARMACY LOCATION PROVIDES OPERATIONAL EFFICIENCIES AND IMPROVED WORKFLOW TO BETTER SERVE OUR PATIENTS AND CAREGIVERS. - ST. LUKE'S HOSPITAL'S EMERGENCY DEPARTMENT RENOVATION WAS COMPLETED, ENHANCING PATIENT PRIVACY AND COMFORT WHILE IMPROVING DEPARTMENT WORKFLOW FOR CAREGIVERS AND PATIENTS ALIKE. - PROMEDICA HOME HEALTH CARE'S ER2HOME PROGRAM LAUNCHED AT FLOWER HOSPITAL IS DESIGNED TO AVOID HOSPITAL READMISSIONS FOR HIGH-RISK, HIGH-COST PATIENTS WHO COME TO THE EMERGENCY CENTER. THROUGH ER2HOME, PATIENTS RECEIVE A 30-DAY INTENSIVE SKILLED NURSING AND TELEHEALTH MONITORING PROGRAM TO HELP THEM BETTER MANAGE THEIR HEALTH CONDITION. - PROMEDICA SIGNED A MULTI-YEAR CONTRACT TO IMPLEMENT EPIC ENTERPRISE SOLUTIONS SYSTEM-WIDE. THE NEW CONTRACT WILL MOVE PROMEDICA TO A MORE INTEGRATED ELECTRONIC HEALTH RECORD (EHR) PLATFORM THAT WILL FURTHER ENABLE ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF THE SERVICE. - PROMEDICA PHYSICIANS OPENED A SECOND PROMEDICA AFTERHOURS LOCATION IN OREGON, OHIO PROVIDING RESIDENTS WITH DIAGNOSIS AND TREATMENT FOR NON-EMERGENCY MEDICAL ISSUES AS WELL AS PRESCRIPTION SERVICES. PROVIDING NEW OPTIONS FOR MEDICAL CARE WHEN PHYSICIAN OFFICES NORMALLY ARE CLOSED, AFTERHOURS IS STAFFED BY PROMEDICA PHYSICIANS CERTIFIED NURSE PRACTITIONERS AND IS OPEN NIGHTS, WEEKENDS AND HOLIDAYS - 365 DAYS A YEAR. - PROMEDICA EMPLOYEES PLEDGED MORE THAN $400,000 TO THE UNITED WAY CAMPAIGN IN 2014, SUPPORTING NUMEROUS COMMUNITY PROGRAMS AND SERVICES ACROSS NORTHWEST OHIO AND SOUTHEAST MICHIGAN. - PROMEDICA'S CULTURE OF SAFETY PROGRAM WAS EXPANDED THROUGH IMPLEMENTATION OF ERROR PREVENTION TRAINING FOR EMPLOYEES SYSTEM-WIDE. BY YEAR END, MORE THAN 90 PERCENT OF PHYSICIANS AND MORE THAN 13,000 ACUTE CARE EMPLOYEES HAD COMPLETED ERROR PREVENTION TRAINING. THE PATH TO SAFE, PATIENT-CENTERED CARE AND SERVICE IS DESIGNED TO ENGAGE PATIENTS AND FAMILIES AND IMPROVE CARE COORDINATION TO DELIVER BETTER OUTCOMES AND SERVICES ACROSS THE SYSTEM. IN 2014, PROMEDICA CONTRIBUTED $148,727,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $51,018,000 IN 2014. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; COLLEGE SCHOLARSHIPS FOR STUDENTS ENTERING HEALTHCARE CAREERS; AND MANY OTHER COMMUNITY-BASED INITIATIVES.
PROMEDICA ALSO CONTRIBUTED $20,165,000 IN FINANCIAL ASSISTANCE FOR PATIENTS	WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2014 WAS $24,864,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $148,727,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. ADDITIONALLY DURING 2014, PROMEDICA PROVIDED $77,544,000 OF COMMUNITY BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2014 WAS $89,329,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $148,727,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
MEMORIAL HOSPITAL - PROGRAM SERVICE ACCOMPLISHMENTS	MEMORIAL HOSPITAL (D/B/A PROMEDICA MEMORIAL HOSPITAL) IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. A 186 LICENSED BED HOSPITAL IN FREMONT, OHIO, PROMEDICA MEMORIAL HOSPITAL (MH) HAS 695 EMPLOYEES WHO PROVIDE EXTENSIVE HEALTHCARE SERVICES SUCH AS EMERGENCY MEDICINE; SURGICAL SERVICES; OUTPATIENT PHYSICAL REHABILITATION; CARDIAC SERVICES; LABOR AND DELIVERY; MENTAL HEALTH SERVICES; AND A FULL RANGE OF LABORATORY AND RADIOLOGY SERVICES. MH SERVED 2,125 INPATIENTS AND 60,695 OUTPATIENTS IN 2014. FURTHER, 24,830 INDIVIDUALS SOUGHT EMERGENCY CARE AT MH. THE HOSPITAL CONTRIBUTED $3,469,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, MH CONTRIBUTED $1,032,000 TO THE COMMUNITY DURING 2014. INCLUDED IN THIS FIGURE ARE PROGRAMS AND EVENTS SUCH AS: - SUMMER CAMPS FOCUSING ON NUTRITION, ACTIVITIES AND SELF-ESTEEM FOR YOUTH OF THE COMMUNITY. - STAFF INVOLVEMENT AND SUPPORT OF RED RIBBON WEEK. - YOUTH MENTORING PROGRAMS IN SANDUSKY COUNTY. - HEALTH SCREENINGS FOR BLOOD PRESSURE, BLOOD SUGAR AND CHOLESTEROL AT LOCAL FAIRS AND COMMUNITY EVENTS, AS WELL AS FIRST AID COVERAGE FOR SPECIAL EVENTS. - SCREENINGS FOR SKIN AND BREAST CANCER. - PARTICIPATION IN THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) WALK TO RAISE FUNDS TO SUPPORT MENTAL HEALTH COMMUNITY PROGRAMS. - PROVIDE EDUCATIONAL TALKS AND RESOURCES RELATED TO CANCER AT DANBURY AND ELMORE SENIOR CENTERS. - USE APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN(R) TO PROVIDE BREAST EXAMS AND MAMMOGRAMS. MH PROVIDED $2,437,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. COMMUNITY BENEFIT DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. MH'S COST OF BAD DEBT FOR 2014 WAS $1,695,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,469,000 NOTED ABOVE. ALSO IN 2014, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $3,378,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,469,000 NOTED ABOVE. DURING 2014, MH EXPENDED $16,784,000 IN NET PAYROLL, PROVIDING 695 JOBS IN NORTHWEST OHIO. A TOTAL OF $1,283,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, MH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
COMMUNITY BENEFIT DEFINITIONS	PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (THE SYSTEM) PREPARES ITS COMMUNITY BENEFIT REPORTS USING REPORTING GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY THE SYSTEM RESPOND TO AN IDENTIFIED COMMUNITY NEED AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE MEDICAL OR HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, THE SYSTEM PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH FEDERAL, STATE AND LOCAL MEANS-TESTED PROGRAMS SUCH AS MEDICAID. THE SYSTEM INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN THE SYSTEM'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY THE SYSTEM. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR INTERNSHIPS AND RESIDENCY EDUCATION, THE PROVISION OF A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING FOR STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR EDUCATION THAT IS LINKED TO COMMUNITY SERVICES AND HEALTH IMPROVEMENT. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET PATIENT DEMAND. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR THE SYSTEM IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND/OR THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF TO THE COMMUNITY WHILE ON WORK TIME; AS WELL AS DONATION OF FOOD, EQUIPMENT AND SUPPLIES.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) COBRA VENTURES LLC 5901 MONCLOVA RD MAUMEE,OH43537 20-4671613	LAND LEASING	OH	5,320	90,714	ST LUKE'S HOSPITAL FOUNDATION
(2) MIDWEST CARDIOVASCULAR CONSULTANTS LLC 5855 MONROE ST SYLVANIA,OH43560 61-1448753	EMPLOYS PHYSICIANS	OH	0	534,176	PROMEDICA PHYSICIAN GROUP
(3) PROMEDICA CENTRAL PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 34-1881137	EMPLOYS PHYSICIANS	OH	183,766,608	201,173,402	PROMEDICA PHYSICIAN GROUP
(4) PROMEDICA EAST PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 34-1881145	EMPLOYS PHYSICIANS	OH	8,548,443	-216,940	PROMEDICA PHYSICIAN GROUP
(5) PROMEDICA ORTHOPEDIC PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 20-8050622	EMPLOYS PHYSICIANS	OH	3,005,634	-1,465,225	PROMEDICA PHYSICIAN GROUP
(6) PROMEDICA SOUTH PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 34-1898679	EMPLOYS PHYSICIANS	OH	3,208,029	527,953	PROMEDICA PHYSICIAN GROUP
(7) PROMEDICA WEST PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 34-1893773	EMPLOYS PHYSICIANS	OH	14,427,121	-3,018,823	PROMEDICA PHYSICIAN GROUP
(8) PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC 5855 MONROE ST SYLVANIA,OH43560 26-3888045	EMPLOYS PHYSICIANS	OH	30,673,335	-32,259,756	PROMEDICA PHYSICIAN GROUP
(9) PROMEDICA GI PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 26-3015991	EMPLOYS PHYSICIANS	OH	9,033,278	-10,550,415	PROMEDICA PHYSICIAN GROUP
(10) PROMEDICA CARDIOTHORACIC PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 27-0978204	EMPLOYS PHYSICIANS	OH	4,458,099	-4,736,913	PROMEDICA PHYSICIAN GROUP
(11) WELLCARE PHYSICIANS LLC 5901 MONCLOVA RD MAUMEE,OH43537 61-1528443	EMPLOYS PHYSICIANS	OH	15,132,363	6,251,117	PROMEDICA PHYSICIAN GROUP
(12) PROMEDICA HEMATOLOGY-ONCOLOGY PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 27-1401750	EMPLOYS PHYSICIANS	OH	3,977,621	-5,216,293	PROMEDICA PHYSICIAN GROUP
(13) PROMEDICA ENT LLC 5855 MONROE ST SYLVANIA,OH43560 27-2404505	EMPLOYS PHYSICIANS	OH	1,810,346	-1,237,123	PROMEDICA PHYSICIAN GROUP
(14) THE PHARMACY COUNTER LLC 5855 MONROE ST SYLVANIA,OH43560 27-1325141	MEDICAL EQUIPMENT & PHARMACY	OH	55,156,717	15,766,325	PROMEDICA PHYSICIAN GROUP
(15) WOLF CREEK ASSOCIATES LLC 901 KIMOLE LN ADRIAN,MI49221 38-3164818	FACILITY LEASING	MI	279,165	1,185,111	EMMA L BIXBY MEDICAL CENTER
(16) PROMEDICA MONROE CARDIOLOGY PLLC 5855 MONROE ST SYLVANIA,OH43560 27-2920342	EMPLOYS PHYSICIANS	MI	2,568,582	-1,082,904	PROMEDICA PHYSICIAN GROUP
(17) ERIE WEST HOSPICE & PALLIATIVE CARE LLC 5855 MONROE ST SYLVANIA,OH43560 20-5752995	PROVIDES HOSPICE CARE	OH	2,796,665	7,159,564	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES
(18) PROMEDICA ANESTHESIA CONSULTANTS LLC 5855 MONROE ST SYLVANIA,OH43560 45-3251737	EMPLOYS PHYSICIANS	OH	30,289,341	-20,847,530	PROMEDICA PHYSICIAN GROUP
(19) PROMEDICA CRITICAL CARE LLC 5855 MONROE ST SYLVANIA,OH43560 27-5165922	EMPLOYS PHYSICIANS	OH	4,706,125	-4,923,207	PROMEDICA PHYSICIAN GROUP
(20) PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC 5855 MONROE ST SYLVANIA,OH43560 45-3230331	PRACTICE MANAGEMENT	OH	93,971	78,774	PROMEDICA PHYSICIAN GROUP
(21) PROMEDICA SURGICAL SERVICES LLC 5855 MONROE ST SYLVANIA,OH43560	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(22) MISSION POINTE GOLF COURSE LLC 2142 NORTH COVE TOLEDO,OH43606	GOLF COURSE	OH	0	406,069	PROMEDICA FOUNDATION
(23) PROMEDICA INNOVATIONS LLC 1801 RICHARDS RD TOLEDO,OH43607	INVESTMENT COMPANY	OH	-627,870	836,477	PROMEDICA HEALTH SYSTEM INC
(24) PROMEDICA GENITO-URINARY SURGEONS LLC 5855 MONROE ST SYLVANIA,OH43560 46-1120436	EMPLOYS PHYSICIANS	OH	12,215,066	-6,078,309	PROMEDICA PHYSICIAN GROUP
(25) PROMEDICA MONROE PHYSICIANS PLLC 5855 MONROE ST SYLVANIA,OH43560 46-1111822	EMPLOYS PHYSICIANS	MI	553,582	-501,343	PROMEDICA PHYSICIAN GROUP
(26) PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC 5855 MONROE ST SYLVANIA,OH43560 45-4976786	EMPLOYS PHYSICIANS	OH	0	159,481	PROMEDICA PHYSICIAN GROUP
(27) PROMEDICA HOSPITALISTS LLC 5855 MONROE ST SYLVANIA,OH43560	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(28) PROMEDICA HOSPITALISTS PLLC 5855 MONROE ST SYLVANIA,OH43560	EMPLOYS PHYSICIANS	MI	0	0	PROMEDICA PHYSICIAN GROUP
(29) MEMORIAL ANESTHESIA LTD 715 SOUTH TAFT AVE FREMONT,OH43420 20-5763680	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(30) MEMORIAL PROFESSIONAL SERVICES LTD 715 SOUTH TAFT AVE FREMONT,OH43420 27-3763993	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(31) PHS VENTURES LLC 1801 RICHARDS RD TOLEDO,OH43607 34-1880473	HEALTH CARE MANAGEMENT SERVICES	DE	0	0	PROMEDICA HEALTH SYSTEM INC

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) BAY PARK COMMUNITY HOSPITAL 2801 BAY PARK DR OREGON,OH43616 34-1883132	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(2) CARE ENTERPRISES INC 5901 MONCLOVA RD MAUMEE,OH43537 34-1366709	FACILITY LEASING	OH	501(C)(3)	11B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(3) DEFIANCE HOSPITAL AUXILIARY 1200 RALSTON DEFIANCE,OH43512 51-0173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	11D, III-O	DEFIANCE HOSPITAL INC	Yes
(4) DEFIANCE HOSPITAL INC 1200 RALSTON DEFIANCE,OH43512 34-4446484	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(5) EMMA L BIXBY MEDICAL CENTER 818 RIVERSIDE AVE ADRIAN,MI49221 38-2796005	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(6) EMMA L BIXBY MEDICAL CENTER AUXILIARY 818 RIVERSIDE AVE ADRIAN,MI49221 38-2149602	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	11B, II	EMMA L BIXBY MEDICAL CENTER	Yes
(7) FLOWER HOSPITAL 5200 HARROUN RD SYLVANIA,OH43560 34-4428794	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(8) FOSTORIA HOSPITAL ASSOCIATION 501 VAN BUREN STREET FOSTORIA,OH44830 34-0898745	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(9) FOSTORIA HOSPITAL AUXILIARY PO BOX 907 FOSTORIA,OH44830 34-6517634	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	11A, I	FOSTORIA HOSPITAL ASSOCIATION	Yes
(10) HERRICK MEDICAL CENTER AUXILIARY 500 E POTTAWATAMIE ST TECUMSEH,MI49286 38-3076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	11B, II	HERRICK MEMORIAL HOSPITAL INC	Yes
(11) HERRICK MEMORIAL HOSPITAL INC 500 E POTTAWATAMIE ST TECUMSEH,MI49286 38-3049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(12) LENAWEE LONG TERM CARE 700 LAKESHIRE TR ADRIAN,MI49221 38-2879330	LONG TERM CARE	MI	501(C)(3)	9	EMMA L BIXBY MEDICAL CENTER	Yes
(13) PROMEDICA CONTINUING CARE SERVICES CORP 5855 MONROE ST SYLVANIA,OH43560 34-4492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	9	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	Yes
(14) PROMEDICA COURIER SERVICES INC 3170 W CENTRAL AVE TOLEDO,OH43606 26-0324790	COURIER SERVICE	OH	501(C)(3)	11B, II	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	Yes
(15) PROMEDICA HEALTH SYSTEM INC 1801 RICHARDS RD TOLEDO,OH43607 34-1517671	PARENT COMPANY OF HEALTH SYSTEM	OH	501(C)(3)	11B, II	N/A		No
(16) PHS VENTURES 1801 RICHARDS RD TOLEDO,OH43607 34-1880473	HEALTH CARE MANAGEMENT SERVICES	OH	501(C)(3)	11C, III-FI	PROMEDICA HEALTH SYSTEM INC	Yes
(17) PROMEDICA INDEMNITY CORP ONE CHURCH ST 5TH FLOOR BURLINGTON,VT05401 34-1931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	11B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(18) PROMEDICA PHYSICIANS AND CONTINUUM SERVICES 5855 MONROE ST SYLVANIA,OH43560 34-1880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	11B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(19) PROMEDICA PHYSICIAN GROUP 5855 MONROE ST SYLVANIA,OH43560 34-1899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	9	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	Yes
(20) ST LUKE'S HOSPITAL 5901 MONCLOVA RD MAUMEE,OH43537 34-4428232	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(21) ST LUKE'S HOSPITAL FOUNDATION 5901 MONCLOVA RD MAUMEE,OH43537 34-1292849	FOUNDATION	OH	501(C)(3)	11B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(22) PROMEDICA FOUNDATION 2142 N COVE BLVD TOLEDO,OH43606 34-1517672	FOUNDATION	OH	501(C)(3)	11B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(23) THE TOLEDO HOSPITAL 2142 N COVE BLVD TOLEDO,OH43606 34-4428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(24) TOLEDO DISTRICT NURSE ASSOCIATION 1946 N 13TH STREET TOLEDO,OH43624 34-4427949	SKILLED HOME CARE	OH	501(C)(3)	9	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	Yes
(25) VISITING NURSE HOSPICE AND HEALTH CARE 5855 MONROE ST SYLVANIA,OH43560 34-1831624	HOSPICE HOME CARE	OH	501(C)(3)	9	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	Yes
(26) KAITLYN'S COTTAGE INC 1260 RALSTON AVE DEFIANCE,OH43512 45-4781053	RESPITE CARE	OH	501(C)(3)	9	DEFIANCE HOSPITAL INC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) BIXBY MEDICAL OFFICE LIMITED PARTNERSHIP 818 RIVERSIDE AVE ADRIAN,MI49221 38-2972398	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	RELATED	15,825	1,196,338		No		Yes		64.600 %
(2) REYNOLDS RD SURGICAL CENTER LLC 2865 N REYNOLDS RD TOLEDO,OH43615 31-1569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	642,865	2,632,389		No			No	65.040 %
(3) WATERVILLE MEDICAL CENTER LLC 5901 MONCLOVA RD MAUMEE,OH43537 32-0160784	FACILITY LEASING	OH	CARE ENTERPRISES INC	RELATED	8,237	768,144		No			No	70.000 %
(4) NORTHWEST OHIO DEDICATED BREAST MRI LLC 5901 MONCLOVA RD MAUMEE,OH43537 26-0679898	MEDICAL DIAGNOSTICS	OH	THE TOLEDO HOSPITAL	RELATED	149,057	524,190		No			No	50.000 %
(5) WEST CENTRAL SURGICAL CENTER LLC 7055 W CENTRAL TOLEDO,OH43617 20-0088459	AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	302,421	2,977,839		No		Yes		50.000 %
(6) OHIO CARE AMBULATORY SURGICAL CENTER LLC 5959 MONCLOVA RD MAUMEE,OH43537 34-1863472	AMBULATORY SURGICAL CENTER	OH	ST LUKE'S HOSPITAL	RELATED	137,982	1,227,515		No			No	57.570 %
(7) LENAWEE PHYSICIAN HOSPITAL ORGANIZATION LLC 818 RIVERSIDE AVE ADRIAN,MI49221 38-3605511	PHYSICIAN MANAGEMENT SERVICES	MI	EMMA L BIXBY MEDICAL CENTER	RELATED	83,151	262,824		No		Yes		50.000 %
(8) PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC 5901 MONCLOVA RD MAUMEE,OH43537 46-1989695	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA HEALTH SYSTEM INC	RELATED	874,703	934,742		No			No	51.920 %
(9) EAST-WEST HOLDINGS LTD 715 SOUTH TAFT AVE FREMONT,OH43420 20-4066818	REAL ESTATE	OH	MEMORIAL HOSPITAL	RELATED	4,086	310,627		No			No	50.000 %
(10) SURGICAL INSTITUTE OF MONROE LLC 1051 S TELEGRAPH RD MONROE,MI48161 27-0843485	AMBULATORY SURGICAL CENTER	MI	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	RELATED		4,026,218		No			No	51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) CARE HOLDINGS 5901 MONCLOVA RD MAUMEE,OH43537 34-1796790	HOLDING COMPANY	OH	PROMEDICA HEALTH SYSTEM INC	C			100.000 %	Yes
(2) HERRICK MEMORIAL DEVELOPMENT CORP 500 E POTTAWATAMIE TR ADRIAN,MI49221 38-3146907	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	C	49,679	1,056,484	100.000 %	Yes
(3) LHA PHYSICIAN SERVICES CORPORATION 818 RIVERSIDE AVE ADRIAN,MI49221 61-1451576	PHYSICIAN BILLING	MI	EMMA L BIXBY MEDICAL CENTER	C	-16,737	44,878	100.000 %	Yes
(4) PHYSICIANS ADVANTAGE MSO 5901 MONCLOVA RD MAUMEE,OH43537 06-1811760	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA HEALTH SYSTEM INC	C			100.000 %	Yes
(5) PROMEDICA CENTRAL CORPORATION OF MICHIGAN 5855 MONROE ST SYLVANIA,OH43560 38-3322278	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C	-1,555,757	-3,682,110	100.000 %	Yes
(6) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1901 INDIAN WOOD CIR MAUMEE,OH43537 34-1570675	HEALTH CARE INSURANCE	OH	PROMEDICA HEALTH SYSTEM INC	C	38,468,000	425,832,000	100.000 %	Yes
(7) PROMEDICA NORTH PHYSICIAN CORPORATION 5855 MONROE ST SYLVANIA,OH43560 38-3482148	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C		203,340	100.000 %	Yes
(8) PROMEDICA PHYSICIAN HOSPITAL ORGANIZATION 5855 MONROE ST SYLVANIA,OH43560 34-1887065	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	C			100.000 %	Yes
(9) PROMEDICA RETAIL GROUP INC 3890 MONROE ST TOLEDO,OH43606 34-1159928	FLORIST	OH	PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	C	20,020	1,906,368	100.000 %	Yes
(10) HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION 818 RIVERSIDE AVE ADRIAN,MI49221 38-3639616	FACILITY MANAGEMENT	MI	HERRICK MEMORIAL DEVELOPMENT CORP	C	-70	45,040	71.800 %	Yes
(11) MEMORIAL MEDICAL CENTER INC 715 SOUTH TAFT AVE FREMONT,OH43420 34-0939146	RENTAL REAL ESTATE	OH	MEMORIAL HOSPITAL	C	-211,938		100.000 %	Yes

Schedule R (Form 990) 2014

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PROMEDICA FOUNDATION	B	138,302	FMV
(2) PROMEDICA HEALTH SYSTEM INC	C	15,000,000	FMV
(3) PROMEDICA FOUNDATION	C	242,464	FMV
(4) PROMEDICA PHYSICIANS AND CONTINUUM SERVICES	C	148,503	FMV
(5) PROMEDICA PHYSICIAN GROUP	J	81,097	FMV
(6) FOSTORIA HOSPITAL ASSOCIATION	O	96,275	FMV
(7) PROMEDICA HEALTH SYSTEM INC	P	658,706	FMV
(8) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	P	177,475	FMV

Schedule R (Form 990) 2014

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	15,504,406
9	Program service revenue (Part VIII, line 2g) .........	19,611,891	64,142,663
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	632,803	-206,746
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	52,610	1,873,385
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	20,297,304	81,313,708
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	10,941	138,302
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	9,056,016	32,228,926
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	10,397,922	32,367,291
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	19,464,879	64,734,519
19	Revenue less expenses. Subtract line 18 from line 12.......	832,425	16,579,189
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	74,418,202	82,765,686
21	Total liabilities (Part X, line 26).............	45,053,642	35,472,191
22	Net assets or fund balances. Subtract line 21 from line 20.....	29,364,560	47,293,495

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 53,904,362 including grants of $ 138,302 ) (Revenue $ 64,238,373 )
	MEMORIAL HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 2,437,279 including grants of $ ) (Revenue $ )
	CONSISTENT WITH OUR MISSION, MEMORIAL HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. - SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 2,003,968 including grants of $ ) (Revenue $ 972,348 )
	CONSISTENT WITH OUR MISSION, MEMORIAL HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND CASH AND IN-KIND CONTRIBUTIONS. - SEE SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses58,345,609

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)					(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KATHLEEN S HANLEY........................................................................ TREASURER (THRU 5/14)	0.50 .......................50.50	X				0	704,046	822,147
(19) ALAN M SATTLER........................................................................ TREASURER	0.50 .......................52.50	X				0	438,639	68,941
(20) JEFFREY C KUHN........................................................................ SECRETARY	0.50 .......................50.00	X				0	532,963	69,020
(21) GARY AKENBERGER........................................................................ SR. VP FINANCE, PHS	0.50 .......................43.50		X			0	342,500	69,169
(22) JILL TROSIN........................................................................ CNO, MH	0.50 .......................40.00		X			29,856	136,769	20,560
(23) TERENCE ROSS........................................................................ MEDICAL DIR. ANESTHESIOLOGY	40.00 .......................0.00			X		406,728	0	51,922
(24) JAMES STIERWALT........................................................................ ANESTHESIOLOGIST	40.00 .......................0.00			X		364,169	0	47,382
(25) JAMES WILLIAMS........................................................................ PHYSICIAN	40.00 .......................0.00			X		346,070	0	29,515
(26) SANJAY SANGAL........................................................................ ANESTHESIOLOGIST	40.00 .......................0.00			X		345,203	0	46,612
(27) KEVIN SMITH........................................................................ PHYSICIAN HEALTHLINK	40.00 .......................0.00			X		312,461	0	52,515
(28) DAVID BREWER........................................................................ FORMER OFFICER	40.00 .......................0.00				X	0	121,492	28,649

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,807,187	3,423,312	1,449,365

1	Briefly describe the organization’s mission or most significant activities: MEMORIAL HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY AND SURROUNDING AREAS REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY, AND OUTPATIENT CARE. OUR MISSION IS TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND FAMILIES IN THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	695
6	Total number of volunteers (estimate if necessary) .............	6	268
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		15,390,967
e	Government grants (contributions)1e		88,439

f	All other contributions, gifts, grants, and similar amounts not included above1f		25,000

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			15,504,406
			Business Code
2a	NET PATIENT SERVICES		622110	64,070,644	64,070,644
b	AFFIL. ORG. RENT. REV.		531120	72,019			72,019
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			64,142,663
3	Investment income (including dividends, interest, and other similar amounts).......			345,526			345,526
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	203,754
b	Less: rental expenses	204,491
c	Rental income or (loss)	-737
d	Net rental income or (loss).......			-737			-737
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	8,285,937	78,720
b	Less: cost or other basis and sales expenses	8,227,660	689,269
c	Gain or (loss)	58,277	-610,549
d	Net gain or (loss)..........			-552,272			-552,272
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a		118,806
b	Less: cost of goods sold ..b		111,030
c	Net income or (loss) from sales of inventory..			7,776			7,776
Miscellaneous Revenue			Business Code
11a	EHR INCENTIVE		900099	1,084,671	1,084,671
b	CAFETERIA/DIETARY		722514	447,149			447,149
c	MEDICAL RECORDS		900099	55,406	55,406
d	All other revenue ....			279,120			279,120
e	Total. Add lines 11a–11d ......			1,866,346
12	Total revenue. See Instructions......			81,313,708	65,210,721	0	598,581


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			5,439,336	1	1,838,572
2	Savings and temporary cash investments .........			13,898,906	2	4,134,893
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			9,069,584	4	8,649,948
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			651,669	8	572,841
9	Prepaid expenses and deferred charges ..........			1,447,138	9	2,053,981
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	37,614,358
b	Less: accumulated depreciation .....	10b	3,612,130	32,409,713	10c	34,002,228
11	Investments—publicly traded securities ..........			7,058,389	11	23,917,760
12	Investments—other securities. See Part IV, line 11 .....			709,965	12	312,847
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			3,733,502	15	7,282,616
16	Total assets. Add lines 1 through 15 (must equal line 34)......			74,418,202	16	82,765,686
17	Accounts payable and accrued expenses .........			16,782,113	17	4,566,902
18	Grants payable .................				18
19	Deferred revenue ................			67,103	19
20	Tax-exempt bond liabilities .............			20,755,000	20	19,840,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			6,964,256	23	6,548,582
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			485,170	25	4,516,707
26	Total liabilities. Add lines 17 through 25.........			45,053,642	26	35,472,191
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			29,364,560	27	42,760,513
28	Temporarily restricted net assets ...........				28	4,202,782
29	Permanently restricted net assets ...........				29	330,200
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			29,364,560	33	47,293,495
34	Total liabilities and net assets/fund balances ........			74,418,202	34	82,765,686