TY 2018 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) AMY J ANWAY...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(2) BARRY F LUSE...................................................................... EX OFFICIO	1.00 ................. 0.00	X		0	0
(3) CHARLES F HEID...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(4) DARYL L KNIPP...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(5) DENNIS S NEWMAN...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(6) HEATHER A HAYNES MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(7) IRACEMA AREVALO MD...................................................................... TRUSTEE	1.00 ................. 40.00	X		371,320	34,734
(8) JAMES L NORTH MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(9) JUDITH M REINO...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(10) KENNETH A MYERS...................................................................... CHAIRPERSON	1.00 ................. 0.00	X	X	0	0
(11) KEVIN C WEBB PHD...................................................................... EX OFFICIO	1.00 ................. 55.00	X		825,525	58,089
(12) MICHAEL E GRILLIS DO...................................................................... TRUSTEE	1.00 ................. 40.00	X		533,516	53,077
(13) MICHAEL M WALERYSZAK...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(14) NATHAN D EGBERT MD...................................................................... EX OFFICIO	1.00 ................. 0.00	X		0	0
(15) PAMELA M JENSEN...................................................................... EX OFFICIO	1.00 ................. 43.00	X		413,785	53,000
(16) ROBIN J RICHTER...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(17) THOMAS F DEWEY JR...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) TOM H HOFFMAN........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(19) TY N TRACY DC........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(20) WILSON E FORNEY IV........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(21) JEFFREY C KUHN........................................................................ SECRETARY	0.50 .......................53.50		X				0	809,040	69,385
(22) MICHAEL P BROWNING........................................................................ TREASURER	0.50 .......................51.50		X				0	1,246,637	81,854
(23) RANDALL OOSTRA........................................................................ PHS PRES & CEO, EX OFFICIO	0.50 .......................55.50		X				0	2,904,245	157,073
(24) DARRIN M ARQUETTE........................................................................ SR. VP, NEURO, HEART AND VASC	0.50 .......................46.50			X			0	314,477	60,173
(25) DEANA L SIEVERT........................................................................ SR. VP, PAT CARE/CNO, SYSTEM	0.50 .......................44.50			X			0	403,997	122,688
(26) GARY W AKENBERGER........................................................................ COO, ACUTE CARE & SVP, DIAG	0.50 .......................44.50			X			0	548,253	64,476
(27) JODI RUCKER........................................................................ VP, PAT CARE/CNO, MH & FCH	0.50 .......................40.50			X			0	171,655	5,738
(28) KENT E BISHOP MD........................................................................ CXO & CMO, PPG & ACUTE CARE	0.50 .......................51.50			X			0	559,579	53,747
(29) MIKE M ARISS........................................................................ VP, OPERATIONAL SERVICES	0.50 .......................45.00			X			0	252,351	32,018
(30) SCOTT FOUGHT........................................................................ VP, FINANCE, ACUTE CARE OPS	0.50 .......................45.50			X			0	354,288	60,945
(31) THADIUS L WADSWORTH........................................................................ VP SURGICAL SERVICES OPERATION	0.50 .......................45.00			X			0	188,374	21,125
(32) COREY LEBER........................................................................ ASSOCIATE VP, NON-CLINICAL	40.00 .......................0.00				X		111,807	0	17,805
(33) MATTHEW GOETZ........................................................................ PHARMACIST	40.00 .......................0.00				X		118,356	0	13,031
(34) NATHAN PERKINS........................................................................ CLINICAL DIRECTOR	40.00 .......................0.00				X		117,740	0	26,552
(35) PATRICIA BEASCHLER........................................................................ PHARMACIST	40.00 .......................0.00				X		106,541	0	34,855
(36) RANDAL KOCH........................................................................ DIRECTOR, PHARMACY	40.00 .......................0.00				X		143,239	0	32,446
(37) ALAN M SATTLER........................................................................ FORMER OFFICER	0.00 .......................40.00					X	0	162,522	54,541
(38) DAVID BREWER........................................................................ FORMER OFFICER	0.00 .......................41.00					X	0	158,741	54,517
(39) KATHLEEN S HANLEY........................................................................ FORMER OFFICER	0.00 .......................0.00					X	0	1,569,411	0

(A) Name and business address	(B) Description of services	(C) Compensation
PT SERVICES INC 2550 S STATE ROUTE 100 TIFFIN,OH448830833	PHYSICAL THERAPY SERVICES	4,724,044
TELAMON CONSTRUCTION INC 5505 MILAN RD SANDUSKY,OH44870	GENERAL CONSTRUCTION	2,094,088
OMNI HEALTH SERVICES LTD 1650 EBER RD HOLLAND,OH43528	PHYSICIAN SERVICES	1,065,740
TOLEDO PAIN SERVICES 7053 W CENTRAL AVE TOLEDO,OH43617	MEDICAL SERVICES	833,253
UNIVERSITY OF TOLEDO PHYSICIANS LLC 3355 GLENDALE RD 3RD FLOOR TOLEDO,OH43614	PHYSICIAN SERVICES	405,000
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 13

- 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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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

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 12, 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 (Form 990 or 990-EZ).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2018

Page 6

Part V

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

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). 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

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) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

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 other 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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization MEMORIAL HOSPITAL		Employer identification number 34-4430849

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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.) $ 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) (2018)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

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) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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 on 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

4,988

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

4,988

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) 2018

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," on 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

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" on 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2018

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	380,200	380,200	330,200	1,125,672	0
b	Contributions ...			50,000	10,184	1,094,539
c	Net investment earnings, gains, and losses				-13,648	31,133
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...				792,008
f	Administrative expenses ....
g	End of year balance ......	380,200	380,200	380,200	330,200	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

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages on 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)

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

3a(ii)

Yes

If "Yes" on 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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,248,784		1,248,784
b	Buildings ....	32,438,162	7,180,295	25,257,867
c	Leasehold improvements	9,257	6,156	3,101
d	Equipment ....	24,635,146	14,682,251	9,952,895
e	Other .....	8,471,140	674,988	7,796,152
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				44,258,799

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) DUE FROM AFFILIATES				430,425
(2) OTHER RECEIVABLES				184,855
(3) OTHER INVESTMENTS				2,699,232
(4) ESTIMATED THIRD PARTY RECEIVABLE				1,326,537
(5) BENEFICIAL INTEREST IN FOUNDATION				6,092,082
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				10,733,131

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO AFFILIATES	2,255,177
ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE	682,501
ASSET REMEDIATION OBLIGATION	2,215,930
INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL	19,856,051
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	25,009,659
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) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

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) . . .	821,576		821,576	1.360 %
b	Medicaid (from Worksheet 3, column a) . . . . .	10,691,649	7,920,381	2,771,268	4.600 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	5,544	4,815	729	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	11,518,769	7,925,196	3,593,573	5.960 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	484,081	81,069	403,012	0.670 %
f	Health professions education (from Worksheet 5) . . .	49,776		49,776	0.080 %
g	Subsidized health services (from Worksheet 6) . . . .	457,561	200,051	257,510	0.430 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	49,861		49,861	0.080 %
j	Total. Other Benefits . .	1,041,279	281,120	760,159	1.260 %
k	Total. Add lines 7d and 7j .	12,560,048	8,206,316	4,353,732	7.220 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	34,950	34,950	0.060 %
3	Community support	1,000	1,000	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	210	210	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	36,160	36,160	0.060 %

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. ......

6,649,405

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. ......

450,013

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).....

11,546,704

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

14,459,252

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

-2,912,548

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	PHYSICIAN ORGANIZATION	50.000 %	2.780 %	47.220 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?1Name, 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) 2018

Page 4

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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

6 a

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

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): HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/DEFAULT.ASPX

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 16

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

12b

If "Yes" on 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

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)

Was widely publicized 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):

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

Did the hospital facility or other authorized 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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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: IN CONDUCTING ITS MOST RECENT CHNA, 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 OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, SANDUSKY COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE SANDUSKY COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED:BELLEVUE HOSPITAL, COMMUNITY HEALTH SERVICES, FIRELANDS COUNSELING & RECOVERY SERVICES, FREMONT CITY SCHOOL DISTRICT, MEMORIAL HOSPITAL, MENTAL HEALTH AND RECOVERY SERVICES BOARD OF SENECA, SANDUSKY, AND WYANDOT COUNTIES, SANDUSKY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, SANDUSKY COUNTY FAMILY & CHILDREN FIRST COUNCIL, SANDUSKY COUNTY HEALTH DEPARTMENT, UNITED WAY OF SANDUSKY COUNTY, AND WSOS COMMUNITY ACTION COMMISSION.
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO.
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: MEMORIAL HOSPITAL CONDUCTED AND ADOPTED ITS THIRD COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - CANCER - ACCESS, EDUCATION, AND SCREENING - RISKY BEHAVIOR IN YOUTH - TEEN PREGNANCY AND SEXUALLY TRANSMITTED DISEASES - OBESITY - MENTAL HEALTH - DEPRESSION SCREENINGS AND SUICIDETHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2017-2019.MEMORIAL HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICAIN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: HEALTH STATUS PERCEPTIONS, HEALTH CARE COVERAGE, ARTHRITIS, DIABETES, CARDIOVASCULAR HEALTH, ALCOHOL CONSUMPTION, MARIJUANA AND OTHER DRUG USE, TOBACCO USE, WOMEN'S HEALTH/PREGNANCY, MEN'S HEALTH, PREVENTIVE MEDICINE AND HEALTH SCREENINGS, ORAL HEALTH, PARENTING, YOUTH MENTAL HEALTH, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH MARIJUANA AND OTHER DRUG USE, YOUTH PERCEPTIONS, YOUTH SAFETY, YOUTH VIOLENCE ISSUES, YOUTH SEXUAL BEHAVIOR, CHILD HEALTH AND FUNCTIONAL STATUS, CHILD HEALTH INSURANCE/ACCESS/UTILIZATION/MEDICAL HOME, EARLY CHILDHOOD HEALTH, MIDDLE CHILDHOOD HEALTH, FAMILY FUNCTIONING/NEIGHBORHOOD/COMMUNITY CHARACTERISTICS, AND PARENT HEALTH.MEMORIAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2018 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016:HEALTH NEED IDENTIFIED: CANCER - ACCESS, EDUCATION, AND SCREENINGSTRATEGY #1 - PROVIDE EDUCATION AND CANCER RESOURCE MATERIALS ON LUNG, BREAST, COLORECTAL, AND PROSTATE CANCER SCREENINGS.ACTIONS TAKEN: - TWO (2) EDUCATIONAL PROGRAMS WERE PROVIDED ON THE IMPORTANCE OF CANCER SCREENINGS. - AN ARTICLE WAS PUBLISHED REGARDING PROSTATE CANCER SCREENING BENEFITS AND MAILED TO OVER 12,000 COMMUNITY MEMBERS TO INCREASE AWARENESS AND EDUCATION RELATED TO EARLY CANCER SCREENING. - ADDITIONAL EDUCATIONAL MATERIALS WERE DISTRIBUTED ON LUNG, BREAST, COLORECTAL AND PROSTATE CANCERS AND RELATED SCREENINGS DURING EIGHT (8) LOCAL FARMER'S MARKETS. STRATEGY #2 - USE APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN TO PROVIDE FREE BREAST EXAMS AND MAMMOGRAMS WITH AN INCREASE OF 10 PERCENT FROM PREVIOUS YEAR FOR UNDERSERVED WOMEN.ACTIONS TAKEN: - NO INCREASE IN SUSAN G. KOMEN FUNDING WAS AVAILABLE THIS YEAR AS MOST SCREENINGS ARE PROVIDED THROUGH INSURANCE. WE DID PARTNER WITH A LOCAL DERMATOLOGIST AND HELD A CANCER SCREENING WHERE 171 COMMUNITY MEMBERS RECEIVED FREE SKIN CANCER SCREENINGS.HEALTH NEED IDENTIFIED: RISKY BEHAVIOR IN YOUTH - TEEN PREGNANCY AND SEXUALLY TRANSMITTED DISEASESSTRATEGY #1 - EDUCATE PHYSICIANS ON SEXUAL ACTIVITY/BELIEFS OF SANDUSKY COUNTY YOUTH.ACTIONS TAKEN:- CME ON HUMAN TRAFFICKING WAS PROVIDED WITH OVER 20 PROVIDERS IN ATTENDANCE. THE SAME EDUCATIONAL OPPORTUNITY WAS PROVIDED TO NURSING STAFF AND WAS WELL ATTENDED. STRATEGY #2 - PROVIDE EDUCATIONAL MATERIALS FOR PARENTS AND HEALTHCARE PROVIDERS TO USE IN CLINICAL/HOME SETTING TO INITIATE DISCUSSIONS OF RISKY SEXUAL BEHAVIOR IN YOUTH. ACTIONS TAKEN: - IMPLEMENTED PLAN TO HAVE MATERIAL AVAILABLE AT FOUR (4) PEDIATRICIAN OFFICES FOR A BROADER OUTREACH TO OUR YOUTH. EDUCATIONAL MATERIAL WAS ALSO SHARED WITH THE LOCAL COMMUNITY HEALTH SERVICES FOR DISTRIBUTION TO PATIENTS. HEALTH NEED IDENTIFIED: OBESITY STRATEGY #1 - PROVIDE FOOD CHOICES MEETING SODEXO MINDFUL NUTRITIONAL STANDARDS IN CAFETERIA, VENDING MACHINES AND CATERING (50% VEGETABLES AND FRUITS, 25% WHOLESOME CARBOHYDRATES, 25% LEAN PROTEINS, MINIMUM HEALTHY FATS).ACTIONS TAKEN: - IN 2018 THERE WERE 80% OF SODEXO MINDFUL OFFERINGS IN THE CAFETERIA; 75% OF SODEXO MINDFUL FOOD OFFERINGS IN VENDING MACHINES; AND 80% OF SODEXO MINDFUL FOOD OFFERINGS IN CATERING. IN ADDITION THERE HAVE BEEN SEVERAL NEW OFFERINGS WHICH INCLUDE OPTIONS FOR VEGAN MEALS WITH CATERING ALONG WITH VEGETARIAN OPTIONS TO PROMOTE MINDFUL OPTIONS.STRATEGY #2 - PROVIDE EXERCISE OPPORTUNITIES FIVE (5) DAYS PER WEEK TO UNDERPRIVILEGED CHILDREN IN SANDUSKY COUNTY DURING THE SUMMER SCHOOL BREAK BY PARTICIPATING WITH THE FREMONT CITY SCHOOLS PURPLE PRIDE PROGRAM.ACTIONS TAKEN: - AVERAGED FIFTEEN (15) CHILDREN PER DAY WHO PARTICIPATED IN THE HOSPITAL SPONSORED EXERCISE PROGRAMS MONDAY THROUGH FRIDAY JUNE 11 - AUGUST 17, 2018. 1,949 NUTRITIONAL MEALS WERE SERVED DURING THAT TIME PERIOD.HEALTH NEED IDENTIFIED: MENTAL HEALTH - DEPRESSION SCREENINGS AND SUICIDE STRATEGY #1 - CONDUCT TWO DEPRESSION SCREENING EVENTS IN SANDUSKY COUNTY.ACTIONS TAKEN: - 250 DEPRESSION SCREENING FORMS WERE PROVIDED AT THE ANNUAL SENIOR EXPO IN MAY. CARDIAC REHABILITATION PROVIDES DEPRESSION SCREENS FOR ALL PATIENTS AND 93 WERE COMPLETED MARCH THROUGH DECEMBER. STRATEGY #2 - DISTRIBUTE RESOURCE MATERIALS RELATED TO DEPRESSION AND SUICIDE TO AT LEAST FIVE (5) COMMUNITY EVENTS.ACTIONS TAKEN: - SUICIDE PREVENTION COALITION EVENTS WERE ATTENDED BY HOSPITAL STAFF, WITH RESOURCE MATERIALS PROVIDED TO PARTICIPANTS. ADDITIONAL EVENTS ATTENDED WHERE MATERIAL WAS DISTRIBUTED INCLUDE: BELLEVUE HOSPITAL HEALTH FAIR, NAMI WALK AND HEALTHY WEALTHY AND WISE EVENT, GOLDEN THREADS EXPO, PROMEDICA FAMILY FUN FESTIVAL, RED RIBBON COMMUNITY "SPOOKTACULAR AND COMMUNITY HEALTH SAFETY FAIR. SPOKE AT COMMUNITY PROSTATE SUPPORT GROUP AND SPOKE TO EMPLOYEES AT A LUNCH AND LEARN FOR NATIONAL MACHINERY.STRATEGY #3 - RECRUIT PHYSICIAN LEADER TO PROMOTE USE OF PHQ (PATIENT HEALTH QUESTIONNAIRE) SCREENING TOOL IN PRIMARY CARE THROUGH CME (CONTINUING MEDICAL EDUCATION).ACTIONS TAKEN: - THE MEDICAL STAFF OFFICE SENT AN ELECTRONIC PHQ EDUCATIONAL UPDATE TO 247 PHYSICIANS AND 98 ADVANCED MEDICAL PROVIDERS.
MEMORIAL HOSPITAL:	PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXMEMORIAL HOSPITAL:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXMEMORIAL HOSPITAL:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX

Schedule H (Form 990) 2018

Page 9

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?20
Name and address		Type of Facility (describe)
1	1 - DOROTHY L KERN CANCER CENTER 2390 ENTERPRISE DRIVE FREMONT,OH43420	CANCER CARE
2	2 - MEMORIAL - FREMONT 710 N CLEVELAND AVE FREMONT,OH43420	PHYSICAL THERAPY
3	3 - HEALTHLINK FREMONT 710 CLEVELAND AVE FREMONT,OH43420	OCCUPATIONAL MEDICINE
4	4 - PROMEDICA MEMORIAL HAYES - LAB 2575 HAYES AVE FREMONT,OH43420	LAB
5	5 - CLYDE PT OT ST 509 W MCPHERSON HWY CLYDE,OH43410	PHYSICAL/OCCUPATIONAL MEDICINE
6	6 - GIBSONBURG PT OT ST 116 SOUTH MAIN ST GIBSONBURG,OH43431	PHYSICAL/OCCUPATIONAL MEDICINE
7	7 - HEALTHLINK GREENVILLE 742 SWEITZER ST GREENVILLE,OH45331	OCCUPATIONAL MEDICINE
8	8 - EDEN SPRINGS NURSING AND REHAB WEST 401 N BROADWAY ST GREEN SPRINGS,OH44836	LAB
9	9 - BETHESDA CARE CENTER 600 N BRUSH ST FREMONT,OH43420	LAB
10	10 - ELMWOOD ASSISTED LIVING 1545 FANGBONER RD FREMONT,OH43420	LAB
11	11 - COUNTRYSIDE CONTINUING CARE CENTER 1865 COUNTRYSIDE DR FREMONT,OH43420	LAB
12	12 - EDEN SPRINGS NURSING AND REHAB EAST 430 N BROADWAY ST GREEN SPRINGS,OH44836	LAB
13	13 - ELMWOOD SKILLED NURSING 1545 FANGBONER RD FREMONT,OH43420	LAB
14	14 - GARDEN OF CLYDE 700 COULSON ST CLYDE,OH43410	LAB
15	15 - EDEN SPRINGS HEALTHCARE CENTER 401 N BROADWAY ST GREEN SPRINGS,OH44836	LAB
16	16 - MEMORIAL HOME HEALTH 430 S MAIN ST CLYDE,OH43410	LAB
17	17 - PROMEDICA MEMORIAL HOSPITAL FREMONT 715 S TAFT AVE FREMONT,OH43420	LAB
18	18 - DAVITA DIALYSIS 100 PINNACLE DR FREMONT,OH43420	LAB
19	19 - VALLEY VIEW HEALTH CAMPUS 1247 N RIVER RD FREMONT,OH43420	LAB
20	20 - PROMEDICA HOSPICE 430 S MAIN ST CLYDE,OH43410	LAB

Schedule H (Form 990) 2018

Page 10

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 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
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 II, COMMUNITY BUILDING ACTIVITIES:	MEMORIAL HOSPITAL PROMOTES THE HEALTH OF ITS COMMUNITY BY SUPPORTING VARIOUS LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.
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 WRITE-OFFS 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 19 AND 20 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
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, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE 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 2018 AS-FILED MEDICARE COST REPORTS, 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.
PART III, LINE 9B:	FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
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: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY 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 CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, 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 AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 70,000. APPROXIMATELY, 21% OF THE SERVICE AREA IS AGE 65 OR OVER; 40% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $50,000; 51% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 45% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. SANDUSKY COUNTY HAS A POPULATION OF APPROXIMATELY 59,000 WITH APPROXIMATELY 11% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 21% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 12% OF SANDUSKY COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SANDUSKY COUNTY IN 2018 WAS 4.7%. THE LEADING CAUSES OF DEATH IN SANDUSKY AND SENECA COUNTIES, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, LUNG DISEASE, DIABETES, CANCER, STROKE, ALZHEIMER'S AND UNINTENTIONAL INJURIES/ACCIDENTS. ACCORDING TO 2018 COUNTY HEALTH RANKINGS, SANDUSKY COUNTY RANKED 48 OF 88 COUNTIES FOR HEALTH OUTCOMES, 47 OF 88 FOR LENGTH OF LIFE, AND 46 OF 88 FOR QUALITY OF LIFE. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 55,000 WITH APPROXIMATELY 14% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 21% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 13% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2018 WAS 4.8%. ACCORDING TO 2018 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 41 OF 88 COUNTIES FOR HEALTH OUTCOMES, 43 OF 88 FOR LENGTH OF LIFE, AND 43 OF 88 FOR QUALITY OF LIFE. THERE ARE ELEVEN HOSPITALS WITHIN A 30-MILE RADIUS OF MEMORIAL HOSPITAL: BELLEVUE HOSPITAL, H.B. MAGRUDER MEMORIAL HOSPITAL, MERCY HOSPITAL - TIFFIN, FOSTORIA HOSPITAL ASSOCIATION, FIRELANDS REGIONAL MEDICAL CENTER, BAY PARK COMMUNITY HOSPITAL, ST. CHARLES MERCY HOSPITAL, MERCY HEALTH - PERRYSBURG, WOOD COUNTY HOSPITAL, FISHER-TITUS MEDICAL CENTER, AND MERCY HOSPITAL OF WILLARD.
PART VI, LINE 5:	MEMORIAL HOSPITAL IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2018:- THERE WERE MORE THAN 340 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), INCLUDING ITS SUBSIDIARIES. OF THOSE BOARD MEMBERS, 99% 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. EACH BOARD WAS COMPRISED OF DIVERSE MEMBERS, INCLUDING, IN THE AGGREGATE, 42% WOMEN, 15% RACIAL/ETHNIC MINORITIES, AND 20% PHYSICIANS. - PROMEDICA DID NOT COMPENSATE BOARD MEMBERS FOR THEIR SERVICE TO OUR HOSPITALS AND OTHER BUSINESS UNITS. BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITIES WHICH PROMEDICA SERVES. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED THE SYSTEM-WIDE UPGRADE TO THE NEW EPIC 2018 PLATFORM. THE UPGRADE ALLOWS PROMEDICA TO TAKE ADVANTAGE OF ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. SCREENINGS WERE ALSO EXPANDED TO HOSPITAL INPATIENTS, USING THE SAME QUESTIONS. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- FREE MAMMOGRAMS AND LUNG CANCER SCREENINGS WERE PROVIDED WITH THE GOAL OF EARLY DETECTION. ADDITIONALLY, COLORECTAL CANCER EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED FOR THOSE AT RISK. SUN SAFETY EDUCATION WAS PROVIDED TO ELEMENTARY SCHOOL CHILDREN TO HELP PREVENT FUTURE CASES OF SKIN CANCER, AS WELL.- PROMEDICA'S FOUNDATION RAISED FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. ANNUAL DONOR PROGRAMS, CAPITAL CAMPAIGNS, PLANNED GIVING, AND EVENT FUNDRAISING ACTIVITIES WERE CONDUCTED TO RAISE FUNDS THAT SUPPORT PATIENTS AND FAMILIES, AS WELL AS LOCAL COMMUNITIES. NEEDS OF LOCAL COMMUNITIES INCLUDING, BUT NOT LIMITED TO HEALTH-RELATED PROGRAMS, SERVICES, EQUIPMENT, AND FACILITY CONSTRUCTION/RENOVATION ARE IDENTIFIED, IN PART, THROUGH A COMMUNITY NEEDS ASSESSMENT.
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 2018 PROMEDICA WAS COMPRISED OF MORE THAN 57,000 EMPLOYEES, APPROXIMATELY 2,500 VOLUNTEERS AND MORE THAN 2,600 HEALTHCARE PROVIDERS, INCLUDING APPROXIMATELY 900 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP (PPG), WHO FORM A PROVIDER 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 ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2018:- PROMEDICA MEMBERS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO 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; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL; PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION.- PROMEDICA MANAGED APPROXIMATELY 1.9 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 62,000 SURGERIES, 7,800 BIRTHS, AND 345,000 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $266,410,000, WHICH INCLUDED FREE HEALTH SCREENINGS, PARTICIPATION IN PUBLIC HEALTH FAIRS, MEDICAL LECTURES AT AREA SENIOR CENTERS, AND NUTRITION EDUCATION IN ELEMENTARY SCHOOLS, PLUS MUCH MORE. - PROMEDICA CONTINUED TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM EITHER FOOD CLINIC. AS PART OF THE PROGRAM, EACH PATIENT RECEIVED TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2018, THERE WERE MORE THAN 10,000 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,300 UNIQUE HOUSEHOLDS, IN EFFORTS TO HELP REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 78,255 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 234,765 MEALS. - PROMEDICA BIXBY AND HERRICK HOSPITALS PROVIDED THE $5 VEGGIE MOBILE VOUCHERS TO PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. THESE PATIENTS COULD REDEEM THEM FOR FRESH PRODUCE AT ANY OF THE VEGGIE MOBILE STOPS. IN 2018, NEARLY 100 PATIENTS IDENTIFIED AS FOOD INSECURE WERE PROVIDED A FOOD BOX AND VEGGIE MOBILE VOUCHERS UPON DISCHARGE.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. SCREENINGS WERE ALSO EXPANDED TO HOSPITAL INPATIENTS, USING THE SAME QUESTIONS. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE. PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD.- PROMEDICA ANNOUNCED ITS PARTNERSHIP WITH THE NATIONAL NON-PROFIT LOCAL INITIATIVES SUPPORT CORPORATION (LISC) TO INVEST $10 MILLION EACH AS PART OF THE EBEID NEIGHBORHOOD PROMISE INITIATIVE BEGUN IN 2017. WORK HAS BEGUN IN TOLEDO'S UPTOWN NEIGHBORHOOD, WHERE PROMEDICA AND LISC ALREADY WORK TOGETHER TO OPERATE THE FINANCIAL OPPORTUNITY CENTER (FOC) HOUSED AT THE EBEID CENTER. NEW PROJECTS INCLUDE REDEVELOPING A VACANT BUILDING INTO RETAIL AND OFFICE SPACE, AND TRANSFORMING A NEARBY VACANT BUILDING FOR COMMERCIAL AND RESIDENTIAL USE. ADDITIONALLY, PROMEDICA IS PARTNERING WITH GOODWILL INDUSTRIES OF NORTHWEST OHIO TO ADD A JOB-TRAINING COMPONENT TO ITS EBEID NEIGHBORHOOD PROMISE. - BIWEEKLY, MONTHLY AND ANNUAL PROGRAMS FOR HEALTH PROFESSIONS EDUCATION (CONTINUING MEDICAL EDUCATION) WERE OFFERED THROUGHOUT 2018. MORE THAN 1,500 CREDIT HOURS OF PHYSICIAN EDUCATION WERE OFFERED TO PROMEDICA PHYSICIAN GROUP PROVIDERS, MEDICAL STAFF MEMBERS, NURSES, AND OTHER ALLIED HEALTH PROFESSIONALS.

Schedule H (Form 990) 2018

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

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" on 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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO,OH43604	34-1517672	501(C)(3)	79,385				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) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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) 2018

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

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

Were any amounts reported on 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" on 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) 2018

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 on 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 on 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)
1IRACEMA AREVALO MD TRUSTEE	(i) (ii)	0 ------------- 340,210	0 ------------- 30,000	0 ------------- 1,110	0 ------------- 0	0 ------------- 34,734	0 ------------- 406,054	0 ------------- 0
2KEVIN C WEBB PHD EX OFFICIO	(i) (ii)	0 ------------- 553,892	0 ------------- 261,069	0 ------------- 10,564	0 ------------- 28,858	0 ------------- 29,231	0 ------------- 883,614	0 ------------- 0
3MICHAEL E GRILLIS DO TRUSTEE	(i) (ii)	0 ------------- 431,995	0 ------------- 80,399	0 ------------- 21,122	0 ------------- 0	0 ------------- 53,077	0 ------------- 586,593	0 ------------- 0
4PAMELA M JENSEN EX OFFICIO	(i) (ii)	0 ------------- 252,071	0 ------------- 158,994	0 ------------- 2,720	0 ------------- 16,670	0 ------------- 36,330	0 ------------- 466,785	0 ------------- 75,000
5JEFFREY C KUHN SECRETARY	(i) (ii)	0 ------------- 540,493	0 ------------- 238,408	0 ------------- 30,139	0 ------------- 40,353	0 ------------- 29,032	0 ------------- 878,425	0 ------------- 0
6MICHAEL P BROWNING TREASURER	(i) (ii)	0 ------------- 703,353	0 ------------- 516,162	0 ------------- 27,122	0 ------------- 25,025	0 ------------- 56,829	0 ------------- 1,328,491	0 ------------- 0
7RANDALL OOSTRA PHS PRES & CEO, EX OFFICIO	(i) (ii)	0 ------------- 1,514,553	0 ------------- 1,012,405	0 ------------- 377,287	0 ------------- 122,095	0 ------------- 34,978	0 ------------- 3,061,318	0 ------------- 0
8DARRIN M ARQUETTE SR. VP, NEURO, HEART AND VASC	(i) (ii)	0 ------------- 221,026	0 ------------- 91,800	0 ------------- 1,651	0 ------------- 11,201	0 ------------- 48,972	0 ------------- 374,650	0 ------------- 0
9DEANA L SIEVERT SR. VP, PAT CARE/CNO, SYSTEM	(i) (ii)	0 ------------- 245,666	0 ------------- 143,500	0 ------------- 14,831	0 ------------- 81,382	0 ------------- 41,306	0 ------------- 526,685	0 ------------- 75,000
10GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG	(i) (ii)	0 ------------- 331,601	0 ------------- 172,000	0 ------------- 44,652	0 ------------- 27,580	0 ------------- 36,896	0 ------------- 612,729	0 ------------- 75,000
11JODI RUCKER VP, PAT CARE/CNO, MH & FCH	(i) (ii)	0 ------------- 137,047	0 ------------- 33,900	0 ------------- 708	0 ------------- 3,464	0 ------------- 2,274	0 ------------- 177,393	0 ------------- 0
12KENT E BISHOP MD CXO & CMO, PPG & ACUTE CARE	(i) (ii)	0 ------------- 543,307	0 ------------- 0	0 ------------- 16,272	0 ------------- 0	0 ------------- 53,747	0 ------------- 613,326	0 ------------- 0
13MIKE M ARISS VP, OPERATIONAL SERVICES	(i) (ii)	0 ------------- 183,976	0 ------------- 59,700	0 ------------- 8,675	0 ------------- 5,095	0 ------------- 26,923	0 ------------- 284,369	0 ------------- 0
14SCOTT FOUGHT VP, FINANCE, ACUTE CARE OPS	(i) (ii)	0 ------------- 258,064	0 ------------- 67,597	0 ------------- 28,627	0 ------------- 14,276	0 ------------- 46,669	0 ------------- 415,233	0 ------------- 0
15THADIUS L WADSWORTH VP SURGICAL SERVICES OPERATION	(i) (ii)	0 ------------- 164,477	0 ------------- 23,400	0 ------------- 497	0 ------------- 4,748	0 ------------- 16,377	0 ------------- 209,499	0 ------------- 0
16RANDAL KOCH DIRECTOR, PHARMACY	(i) (ii)	138,858 ------------- 0	0 ------------- 0	4,381 ------------- 0	0 ------------- 0	32,446 ------------- 0	175,685 ------------- 0	0 ------------- 0
17ALAN M SATTLER FORMER OFFICER	(i) (ii)	0 ------------- 148,474	0 ------------- 11,047	0 ------------- 3,001	0 ------------- 8,443	0 ------------- 46,098	0 ------------- 217,063	0 ------------- 0
18DAVID BREWER FORMER OFFICER	(i) (ii)	0 ------------- 147,185	0 ------------- 3,500	0 ------------- 8,056	0 ------------- 5,836	0 ------------- 48,681	0 ------------- 213,258	0 ------------- 0
19KATHLEEN S HANLEY FORMER OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 1,569,411	0 ------------- 0	0 ------------- 0	0 ------------- 1,569,411	0 ------------- 1,569,411

Schedule J (Form 990) 2018

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. SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KATHLEEN S. HANLEY $1,569,411 IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR.

Schedule J (Form 990) 2018

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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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

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) 2018

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) SEE PART V	SEE PART V	103,530	SEE 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: REINO LINEN SERVICES, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: GREATER THAN 35% CONTROLLED ENTITY BY JUDITH M. REINO (TRUSTEE).(C) AMOUNT OF TRANSACTION: $103,530(D) DESCRIPTION OF TRANSACTION: LINEN SERVICES(E) SHARING OF ORGANIZATION REVENUES? = NO

Schedule L (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Return Reference	Explanation
FORM 990, PART IV, LINE 24A:	MEMORIAL HOSPITAL IS A HEALTH FACILITY THAT IS A SUBSIDIARY OF PROMEDICA HEALTH SYSTEM, INC. (PHS). MEMORIAL HOSPITAL HOLDS AN INTERCOMPANY NOTE PAYABLE TO THE TOLEDO HOSPITAL, WHICH IS ALSO A SUBSIDIARY OF PHS. THE NOTE PAYABLE REPRESENTS MEMORIAL HOSPITAL'S PORTION OF TAXABLE AND TAX-EXEMPT BONDS ISSUED BY PROMEDICA HEALTHCARE OBLIGATED GROUP.
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. AS THE SOLE MEMBER, PHS HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE (WITH CAUSE) 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 11B	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 A PRINCIPAL OFFICER 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 SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE 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 SOC SURVEYS (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 COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, 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 SURVEY RESULTS 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, EXCLUDING EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. 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 AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. 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, THE CHIEF HUMAN RESOURCE OFFICER, 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. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT, PROVIDERS, ACUTE AND AMBULATORY CARE AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PRESIDENT, PROVIDERS, ACUTE AND AMBULATORY CARE, THE CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PRESIDENT, PROVIDERS, ACUTE AND AMBULATORY CARE, THE CHIEF OPERATING OFFICER OR THEIR DESIGNEE IN ADVANCE OF THE POSTING. THE PRESIDENT, PROVIDERS, ACUTE AND AMBULATORY CARE, THE CHIEF OPERATING OFFICER OR THEIR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PHS WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE.
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 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 IX, LINE 11G	PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,631,296. MANAGEMENT AND GENERAL EXPENSES 24,549. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,655,845. NON-PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 3,887,203. MANAGEMENT AND GENERAL EXPENSES 175,385. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,062,588. OTHER GENERAL SERVICES: PROGRAM SERVICE EXPENSES 2,772,613. MANAGEMENT AND GENERAL EXPENSES 2,165,837. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,938,450.
FORM 990, PART XI, LINE 9:	BENEFICIAL INTEREST IN FOUNDATION -479,955.
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 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. 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 2018 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 MORE THAN 600 SITES, MORE THAN 2,000 PHYSICIANS AND APPROXIMATELY 57,000 EMPLOYEES AND VOLUNTEERS. DURING 2018, PROMEDICA DISCHARGED 65,585 INPATIENTS AND SERVED 1,259,585 OUTPATIENTS, WHILE HANDLING 294,959 EMERGENCY VISITS SYSTEM-WIDE AS WELL AS 92,795 URGENT CARE VISITS AND MORE THAN 1,456 VIRTUAL VISITS THROUGH PROMEDICA ONDEMAND. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2018, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 27 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $4.0 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. OUR PHYSICIANS AND PROVIDERS, LEADERSHIP TEAM MEMBERS, RESIDENTS, AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING AND OTHER LIFE SKILLS, 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 FOODS AND CLOTHING ITEMS TO NUMEROUS LOCAL COMMUNITY ORGANIZATIONS 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); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; MEMORIAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY. IN 2018 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 900 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 2018, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 248,000 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 PROMEDICA FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF PROMEDICA 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 APPROXIMATELY 300 NONPROFIT AGENCIES AND ORGANIZATIONS ACROSS OUR REGION IN 2018 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 2018 INCLUDE THE FOLLOWING: - IN JULY 2018, PROMEDICA ACQUIRED THE OPERATIONS OF HCR MANORCARE, INC. (EIN: 27-4239231). CONCURRENTLY, A JOINT VENTURE WAS FORMED BETWEEN HCR MANORCARE, INC. (EIN: 82-5373223, FORMERLY SUBURBAN HEALTHCO, INC.) AND A REAL ESTATE INVESTMENT TRUST (REIT) WHICH ACQUIRED THE REAL PROPERTY USED IN HCR MANORCARE, INC.'S OPERATIONS. AS THE OPERATOR, HCR MANORCARE, INC. (EIN: 82-5373223) ENTERED INTO AN AMENDED AND RESTATED MASTER LEASE WITH THE JOINT VENTURE FOR THE REAL PROPERTY. HCR MANORCARE, INC. IS A LEADING PROVIDER OF SHORT-TERM, POST-ACUTE CARE SERVICES AND LONG-TERM CARE, WITH A NETWORK OF MORE THAN 400 ASSISTED LIVING FACILITIES, SKILLED NURSING AND REHABILITATION CENTERS, MEMORY CARE COMMUNITIES, OUTPATIENT REHABILITATION CLINICS, AND HOSPICE AND HOME HEALTH AGENCIES. THE ACQUISITION POSITIONS PROMEDICA AS ONE OF THE TOP 15 LARGEST U.S. HEALTH SYSTEMS IN THE NATION, ALLOWING US TO EXPAND THE CONTINUUM OF CARE AND ENHANCE THE HEALTH AND WELL-BEING OF AMERICA'S AGING POPULATION. - PROMEDICA EARNED THE GOLD AWARD FOR EXCELLENCE FROM THE PARTNERSHIP FOR EXCELLENCE (TPE) FOLLOWING A RIGOROUS EVALUATION OF PROMEDICA'S APPLICATION BASED ON CRITERIA OF THE BALDRIGE FRAMEWORK FOR EXCELLENCE. APPLICANTS ARE EVALUATED IN SEVEN AREAS DEFINED BY THE FRAMEWORK, INCLUDING: LEADERSHIP; STRATEGY; CUSTOMERS; MEASUREMENT, ANALYSIS AND KNOWLEDGE MANAGEMENT; WORKFORCE; OPERATIONS; AND RESULTS. - IN ADDITION TO SYSTEM RECOGNITION, PROMEDICA MEMORIAL HOSPITAL RECEIVED THE 2018 PLATINUM GOVERNOR'S AWARD FOR EXCELLENCE FROM THE PARTNERSHIP FOR EXCELLENCE, THE HIGHEST HONOR FOR PERFORMANCE EXCELLENCE IN OUR REGION. - A NEW NEUROSCIENCES CENTER ON THE PROMEDICA TOLEDO HOSPITAL CAMPUS OPENED ITS DOORS TO PATIENTS IN 2018. PROMEDICA PHYSICIANS, NEUROLOGISTS, AND NEUROSURGEONS AS WELL AS UNIVERSITY OF TOLEDO (UT) NEUROLOGISTS AND NEUROSURGEONS HAVE ALL RELOCATED TO THIS ONE COLLABORATIVE SPACE AS AN EXTENSION OF PROMEDICA'S ACADEMIC AFFILIATION WITH THE UT COLLEGE OF MEDICINE. - PROMEDICA ANNOUNCED IT IS TEAMING UP WITH THE NATIONAL NON-PROFIT LOCAL INITIATIVES SUPPORT CORPORATION (LISC) TO INVEST $10 MILLION EACH AS PART OF THE EBEID NEIGHBORHOOD PROMISE INITIATIVE BEGUN IN 2017. WORK WILL BEGIN IN TOLEDO'S UPTOWN NEIGHBORHOOD WHERE PROMEDICA AND LISC ALREADY WORK TOGETHER TO OPERATE THE FINANCIAL OPPORTUNITY CENTER (FOC) HOUSED AT THE EBEID CENTER. ADDITIONALLY, PROMEDICA ANNOUNCED THAT IT IS PARTNERING WITH GOODWILL INDUSTRIES OF NORTHWEST OHIO TO ADD A JOB-TRAINING COMPONENT TO ITS EBEID NEIGHBORHOOD PROMISE. - THE GENERATIONS OF CARE PROJECT CAPITAL CAMPAIGN, FOR THE NEW BED TOWER ON THE PROMEDICA TOLEDO HOSPITAL CAMPUS, RECEIVED A $2.5 MILLION DONATION FROM TOUCHSTONE WEALTH PARTNERS. THE GENERATIONS TOWER WILL OPEN TO PATIENTS IN SUMMER 2019, EQUIPPED WITH THE LATEST MEDICAL TECHNOLOGY AND EQUIPMENT, AND OFFERING ALL PRIVATE PATIENT ROOMS, HELPING TO ADVANCE PROMEDICA'S MISSION NOW AND WELL INTO THE FUTURE.
- PROMEDICA RECEIVED A $500,000 DONATION FROM KEYBANK TOWARD THE EBEID	NEIGHBORHOOD PROMISE THAT WILL SUPPORT THE FINANCIAL OPPORTUNITY CENTER (FOC) PROGRAM, AS WELL AS OTHER HEALTH EFFORTS AT THE CENTER AND FOR THE COMMUNITY. - PROMEDICA CONTINUES TO EMPHASIZE A CULTURE OF SAFETY ACROSS ITS HOSPITALS AND OUTPATIENT SERVICES. THE YEAR-END SERIOUS SAFETY EVENT RATE (SSER) WAS 0.82, WITH A SERIOUS SAFETY EVENT (SSE) OCCURRING SOMEWHERE IN THE SYSTEM EVERY 6.3 DAYS. - PROMEDICA CONTINUED TO GROW AS AN ACADEMIC HEALTH CENTER, WITH MORE THAN 125 RESIDENTS AND FELLOWS FROM THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES (UT COM) JOINING THE RESIDENCY PROGRAM AT PROMEDICA TOLEDO HOSPITAL IN 2018. THIS MARKS THE THIRD WAVE OF INTEGRATION OF LEARNERS AT PROMEDICA UNDER THE ACADEMIC AFFILIATION WITH UT COM, WITH PROMEDICA NOW HOSTING FOUR TIMES THE NUMBER OF RESIDENTS AND FELLOWS THAN BEFORE THE AFFILIATION WAS SIGNED. - THE PROMEDICA HEART RHYTHM CENTER OPENED AT PROMEDICA TOLEDO HOSPITAL IN 2018 TO ENSURE THAT PATIENTS WITH HEART RHYTHM CONDITIONS HAVE ACCESS TO THE HIGHEST QUALITY AND MOST ADVANCED CARE. THE 6,500 SQUARE-FOOT CENTER FEATURES THREE DEDICATED ELECTROPHYSIOLOGY LABS AND NEW EQUIPMENT INCLUDING THREE TYPES OF 3D-CARDIAC IMAGING. - IN 2018, COMMUNITY HEALTH CENTER OF BRANCH COUNTY, BECAME PROMEDICA'S 13TH HOSPITAL. THE HOSPITAL, DOING BUSINESS AS PROMEDICA COLDWATER REGIONAL HOSPITAL, SERVES THE COLDWATER, MICHIGAN COMMUNITY PROVIDING COMPASSIONATE CARE AND OUTSTANDING CLINICAL OUTCOMES, WHILE SUPPORTING THE PROMEDICA MISSION TO IMPROVE HEALTH AND WELL-BEING. - THE NEW LENAWEE COUNTY HOSPITAL, TO BE NAMED THE PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL, COMMEMORATED THE HIGHEST STEEL BEAM BEING PLACED ATOP THE FACILITY WITH A "TOPPING OFF" CEREMONY. THE 205,000 SQUARE FOOT FACILITY WILL REPLACE BOTH PROMEDICA BIXBY AND HERRICK HOSPITALS WHEN IT IS COMPLETED. THE NEW FACILITY WILL FEATURE 58 ACUTE CARE BEDS AND A 28-BED EMERGENCY CENTER, AS WELL AS DEDICATED BEHAVIORAL HEALTH BEDS, INPATIENT AND OUTPATIENT SURGERY CENTERS, AND A WOMEN'S HEALTH CENTER, ALONG WITH MANY OTHERS. THE HOSPITAL IS NAMED FOR THE HICKMAN FAMILY, WHO MADE THE LARGEST DONATION IN THE HISTORY OF PROMEDICA TO HELP US BETTER SERVE THE LENAWEE COUNTY COMMUNITY. - PROMEDICA GRANTS SECURED $336,000 FROM THE MICHIGAN HEALTH ENDOWMENT FUND TO BE USED TO ESTABLISH A FARM ON THE NEW HOSPITAL CAMPUS IN LENAWEE COUNTY. THE FUND SUPPORTS EFFORTS TO IMPROVE THE QUALITY OF HEALTH CARE WHILE REDUCING COSTS AND ADVANCING HEALTH AND WELLNESS. THE NEW PROMEDICA GROWS PROGRAM WILL CONSIST OF GROWING ORGANIC PRODUCE YEAR-ROUND ON A 3-ACRE FARM. THE FARM WILL INCLUDE EDUCATIONAL SPACE FOR YOUTH, A THERAPEUTIC HEALING SPACE FOR PATIENTS AND SENIORS, AND A SANCTUARY OF QUIET REFLECTION FOR STAFF AND THE COMMUNITY. - PROMEDICA AND SONIC HEALTHCARE USA ENTERED INTO A JOINT VENTURE THROUGH ITS RESPECTIVE SUBSIDIARIES. THE JOINT VENTURE PROVIDES A GROWTH OPPORTUNITY FOR PROMEDICA, AS IT EXTENDS OUR FOOTPRINT ACROSS OHIO, MICHIGAN, AND INDIANA FOR LABORATORY SERVICES. - AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED THE SYSTEM-WIDE UPGRADE TO THE NEW EPIC 2018 PLATFORM. THE UPGRADE ALLOWS PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT. - THE UNIVERSITY OF TOLEDO (UT) COLLEGE OF NURSING AND PROMEDICA EXPANDED THEIR PARTNERSHIP TO ADDRESS NURSING EDUCATION AS WELL AS CURRENT AND FUTURE HEALTHCARE INDUSTRY CHALLENGES. THE PLANNED PARTNERSHIP WILL FOCUS ON ENHANCING UNDERGRADUATE AND GRADUATE NURSING EDUCATION. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS ACROSS THE REGION THAT INCLUDED FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - PROMEDICA CANCER INSTITUTE'S (PCI) COMMUNITY OUTREACH INCLUDED CANCER SCREENINGS AND EDUCATION TO THE MOST VULNERABLE IN OUR COMMUNITY. FREE SCREENING MAMMOGRAMS AS WELL AS LUNG CANCER SCREENINGS WERE PROVIDED FOR EARLY DETECTION. COLORECTAL CANCER EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY, WHILE SUN SAFETY EDUCATION WAS PROVIDED TO ELEMENTARY SCHOOL CHILDREN TO HELP PREVENT FUTURE CASES OF SKIN CANCER. PCI ALSO HOSTED ANNUAL CANCER SURVIVOR CELEBRATIONS FOR SURVIVORS, FRIENDS AND CAREGIVERS ACROSS THE REGION AND SPONSORED COMMUNITY EVENTS INCLUDING THE ANNUAL NW OHIO SUSAN G. KOMEN, RACE FOR THE CURE AND AMERICAN CANCER SOCIETY RELAY FOR LIFE IN LUCAS COUNTY. - PROMEDICA AND THE TOLEDO ZOO ANNOUNCED A PARTNERSHIP TO RENOVATE THE ZOO'S MORE THAN 80-YEAR-OLD MUSEUM OF SCIENCE. RENOVATIONS ARE EXPECTED TO BE COMPLETED IN SPRING 2019 WITH A FOCUS ON BIODIVERSITY THROUGHOUT THE COURSE OF HISTORY IN NORTHWEST OHIO. - PROMEDICA WAS THE LEAD SPONSOR FOR THE SECOND ANNUAL SUMMER CONCERT SERIES IN 2018. THE WEEKLY CONCERTS TOOK PLACE AT THE RENOVATED PROMENADE PARK, IN DOWNTOWN TOLEDO, FROM JUNE THROUGH SEPTEMBER AND FEATURED A VARIETY OF LOCAL AND NATIONAL MUSICIANS AND MUSIC GENRES. - PROMEDICA OPENED THE MAUMEE CANCER CENTER IN 2018 TO PROVIDE HIGH-QUALITY CANCER CARE CLOSE TO HOME FOR MAUMEE RESIDENTS. CLINICAL SERVICES AT THE CENTER INCLUDE MEDICAL AND RADIATION ONCOLOGY, CARE NAVIGATION, AND A WIDE RANGE OF SUPPORT PROGRAMS SUCH AS SOCIAL WORK, NUTRITION COUNSELING WITH DIETITIANS, HEALING CARE PROGRAMS, AND GENETIC COUNSELING. THROUGH THE CENTER, PATIENTS NOW HAVE ACCESS TO THE PROMEDICA CANCER INSTITUTE'S COMPLETE SPECTRUM OF CANCER CARE SERVICES AND RESOURCES. - PROMEDICA HOSTED ITS FIRST SOCIAL DETERMINANTS OF HEALTH RESEARCH CONFERENCE IN 2018. MORE THAN 250 PHYSICIANS, EXECUTIVES, CLINICIANS, AND COMMUNITY LEADERS ATTENDED THE FULL-DAY CONFERENCE, WHICH WAS FOCUSED ON USING RESEARCH TO VALIDATE HOW PROMEDICA IS IMPROVING OUTCOMES AND REDUCING COSTS VIA ITS SOCIAL DETERMINANTS OF HEALTH (SDOH) INTERVENTIONS. - PROMEDICA CONTINUES TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2018, MORE THAN 10,000 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,300 UNIQUE HOUSEHOLDS, IN EFFORTS TO HELP REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 78,255 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 234,765 MEALS. - FOR ITS MICHIGAN PATIENTS, PROMEDICA OFFERED VEGGIE MOBILE VOUCHERS TO PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. PROMEDICA BIXBY AND HERRICK HOSPITALS PROVIDE THE $5 VOUCHERS SO PATIENTS CAN REDEEM THEM FOR FRESH PRODUCE AT ANY OF THE VEGGIE MOBILE STOPS. IN 2018, NEARLY 100 PATIENTS IDENTIFIED AS FOOD INSECURE WERE PROVIDED A FOOD BOX AND VEGGIE MOBILE VOUCHERS UPON DISCHARGE. - PROMEDICA'S FINANCIAL OPPORTUNITY CENTER (FOC), PROVIDED EDUCATION AND COUNSELING TO APPROXIMATELY 1,000 INDIVIDUALS. HOUSED IN THE EBEID INSTITUTE, FOC HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING, AS WELL AS FREE TAX PREPARATION THROUGH THE OHIO BENEFIT BANK. FOC ALSO OFFERS A DIGITAL LITERACY SERIES TO ASSIST INDIVIDUALS WISHING TO IMPROVE THEIR COMPUTER LITERACY AND SKILLS TO BE MORE MARKETABLE TO PROSPECTIVE EMPLOYERS. IN 2018, PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. SCREENINGS ALSO WERE EXPANDED TO HOSPITAL INPATIENTS, USING THE SAME QUESTIONS. PATIENTS WHO SCREEN POSITIVE FOR ANY OF THE FACTORS ARE CONNECTED TO NECESSARY COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 34 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 INNOVATION'S BUSINESS INCUBATOR ALLOWS CLIENT COMPANIES IN THE HEALTHCARE FIELD TO ACCELERATE DEVELOPMENT AND COMMERCIALIZATION OF MEDICAL DEVICES AND HEALTH INFORMATION TECHNOLOGY TO IMPROVE PATIENT CARE LOCALLY AND NATIONALLY.
IN 2018, PROMEDICA CONTRIBUTED $266,410,000 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 ACTIVITIES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $72,488,000 IN 2018. 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; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $12,791,000 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 2018 WAS $54,439,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $266,410,000 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 2018, PROMEDICA PROVIDED $181,131,000 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 2018 WAS $116,399,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $266,410,000 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 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. 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 100 BED HOSPITAL IN FREMONT, OHIO, PROMEDICA MEMORIAL HOSPITAL (MH) PROVIDES EXTENSIVE HEALTHCARE SERVICES SUCH AS EMERGENCY MEDICINE; SURGICAL SERVICES; OUTPATIENT PHYSICAL REHABILITATION; HEART, VASCULAR AND PULMONARY CARE; LABOR AND DELIVERY; MENTAL HEALTH SERVICES; A WOUND CARE CLINIC, AND A FULL RANGE OF LABORATORY AND RADIOLOGY SERVICES. THE DOROTHY L. KERN CANCER CENTER ON THE CAMPUS OF MH, EXPANDS CANCER CARE TO PATIENTS IN THE FREMONT, OHIO, AREA. THE CANCER CENTER OFFERS OUTPATIENT RADIATION, CHEMOTHERAPY, AND INFUSION SERVICES AS WELL AS COMPLEMENTARY SERVICES SUCH AS GENETIC TESTING AND COUNSELING, HEALING CARE, AND SURVIVORSHIP CARE PLANNING. IN 2018, MH CELEBRATED ITS 100 YEAR ANNIVERSARY OF SERVING THE COMMUNITY WITH CARE AND COMPASSION. MH IS ALSO DESIGNATED AS A NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS (NICHE). THE NICHE PROGRAM IS DESIGNED TO HELP IMPROVE CARE FOR PATIENTS THAT ARE 65 YEARS AND OLDER THROUGH RESEARCH AND IMPLEMENTATION SPECIFIC INDUSTRY BEST PRACTICES. IN 2018, THE PARTNERSHIP FOR EXCELLENCE (TPE) RECOGNIZED MH, WITH ITS PLATINUM GOVERNOR'S AWARD, THE HIGHEST RECOGNITION POSSIBLE, FOR PERFORMANCE EXCELLENCE THAT DEMONSTRATES A CLEAR COMMITMENT TO PROVIDING EXCEPTIONAL, SAFE PATIENT CARE WITHIN IN THE COMMUNITY. MH SERVED 1,236 INPATIENTS AND 58,963 OUTPATIENTS IN 2018, FURTHER, 20,078 INDIVIDUALS SOUGHT EMERGENCY CARE AT MH. THE HOSPITAL CONTRIBUTED $4,354,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS, MH CONTRIBUTED $760,000 TO THE COMMUNITY DURING 2018. 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. - USE APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN TO PROVIDE BREAST EXAMS AND MAMMOGRAMS. MH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE DURING 2018, OF WHICH $822,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. MH COST OF BAD DEBT FOR 2018 WAS $1,801,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $4,354,000 NOTED ABOVE. FURTHERMORE, MH PROVIDED $2,772,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. ALSO IN 2018 THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $5,432,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $4,354,000 NOTED ABOVE. DURING 2018, MH EXPENDED $10,753,000 IN NET PAYROLL, PROVIDING 287 JOBS IN NORTHWEST OHIO. A TOTAL OF $630,000 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 (PROMEDICA) PREPARES ITS COMMUNITY BENEFIT REPORTS CONSISTENT WITH 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 PROMEDICA RESPOND TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, PROMEDICA 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 GOVERNMENT MEANS-TESTED PROGRAMS SUCH AS MEDICAID. PROMEDICA 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 PROMEDICA'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 GENERALLY DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY PROMEDICA. 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 ALL EDUCATIONAL PROGRAMS PROMEDICA IS INVOLVED WITH, THE PROVISION OF A CLINICAL SETTING FOR TRAINING FOR HEALTHCARE STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR HEALTHCARE EDUCATION. 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 COMMUNITY NEEDS. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR PROMEDICA 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 THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF FOR COMMUNITY NEEDS WHILE ON WORK TIME; AS WELL AS DONATIONS 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) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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) MIDWEST CARDIOVASCULAR CONSULTANTS LLC 100 MADISON AVE TOLEDO,OH43604 61-1448753	EMPLOYS PHYSICIANS	OH	0	736,336	PROMEDICA PHYSICIAN GROUP
(2) PROMEDICA CENTRAL PHYSICIANS LLC 100 MADISON AVE TOLEDO,OH43604 34-1881137	EMPLOYS PHYSICIANS	OH	354,649,647	181,933,294	PROMEDICA PHYSICIAN GROUP
(3) PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC 100 MADISON AVE TOLEDO,OH43604 26-3888045	EMPLOYS PHYSICIANS	OH	17,769,096	-80,836,806	PROMEDICA PHYSICIAN GROUP
(4) THE PHARMACY COUNTER LLC 100 MADISON AVE TOLEDO,OH43604 27-1325141	MEDICAL EQUIPMENT & PHARMACY	OH	56,708,108	20,301,908	PROMEDICA PHYSICIAN GROUP
(5) WOLF CREEK ASSOCIATES LLC 901 KIMOLE LN ADRIAN,MI49221 38-3164818	FACILITY LEASING	MI	119,263	1,642,312	EMMA L BIXBY MEDICAL CENTER
(6) PROMEDICA MONROE CARDIOLOGY PLLC 100 MADISON AVE TOLEDO,OH43604 27-2920342	EMPLOYS PHYSICIANS	MI	980,675	-4,689,889	PROMEDICA PHYSICIAN GROUP
(7) ERIE WEST HOSPICE & PALLIATIVE CARE LTD 100 MADISON AVE TOLEDO,OH43604 20-5752995	PROVIDES HOSPICE CARE	OH	4,904,176	11,613,404	PROMEDICA CONTINUUM SERVICES
(8) PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC 100 MADISON AVE TOLEDO,OH43604 45-3230331	PRACTICE MANAGEMENT	OH	0	-3,618,016	PROMEDICA PHYSICIAN GROUP
(9) PROMEDICA SURGICAL SERVICES LLC 100 MADISON AVE TOLEDO,OH43604	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(10) MISSION POINTE GOLF COURSE LLC 2142 NORTH COVE TOLEDO,OH43606	GOLF COURSE	OH	0	394,588	PROMEDICA FOUNDATION
(11) PROMEDICA INNOVATIONS LLC 100 MADISON AVE TOLEDO,OH43604	INVESTMENT COMPANY	OH	0	0	PROMEDICA HEALTH SYSTEM INC
(12) PROMEDICA GENITO-URINARY SURGEONS LLC 100 MADISON AVE TOLEDO,OH43604 46-1120436	EMPLOYS PHYSICIANS	OH	5,837,695	-17,434,894	PROMEDICA PHYSICIAN GROUP
(13) PROMEDICA MONROE PHYSICIANS PLLC 100 MADISON AVE TOLEDO,OH43604 46-1111822	EMPLOYS PHYSICIANS	MI	10,180,701	-12,596,368	PROMEDICA PHYSICIAN GROUP
(14) PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC 100 MADISON AVE TOLEDO,OH43604 45-4976786	EMPLOYS PHYSICIANS	OH	0	162,176	PROMEDICA PHYSICIAN GROUP
(15) PROMEDICA HOSPITALISTS LLC 100 MADISON AVE TOLEDO,OH43604	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(16) PROMEDICA HOSPITALISTS PLLC 100 MADISON AVE TOLEDO,OH43604	EMPLOYS PHYSICIANS	MI	0	0	PROMEDICA PHYSICIAN GROUP
(17) MEMORIAL ANESTHESIA LTD 715 SOUTH TAFT AVE FREMONT,OH43420 20-5763680	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(18) MEMORIAL PROFESSIONAL SERVICES LTD 715 SOUTH TAFT AVE FREMONT,OH43420 27-3763993	EMPLOYS PHYSICIANS	OH	11,357,703	-13,164,795	PROMEDICA PHYSICIAN GROUP
(19) PHS VENTURES LLC 100 MADISON AVE TOLEDO,OH43604 34-1880473	HEALTH CARE MANAGEMENT SERVICES	DE	0	0	PROMEDICA HEALTH SYSTEM INC
(20) 300 MADISON BUILDING LLC 100 MADISON AVE TOLEDO,OH43604 82-2062486	REAL ESTATE	OH	2,478,025	16,935,384	PROMEDICA HEALTH SYSTEM INC
(21) MARINA DISTRICT DEVELOPMENT LLC 100 MADISON AVE TOLEDO,OH43604	REAL ESTATE	OH	0	3,915,257	PROMEDICA HEALTH SYSTEM INC
(22) PHS INVESTMENTS LLC 100 MADISON AVE TOLEDO,OH43604	INVESTMENT COMPANY	OH	0	19,882,948	THE TOLEDO HOSPITAL
(23) PROMEDICA INTERNATIONAL LLC 100 MADISON AVE TOLEDO,OH43604	CONSULTING SERVICES	OH	785,700	0	PROMEDICA HEALTH SYSTEM INC
(24) PROMEDICA ACTIVE MOBILITY LLC 100 MADISON AVE TOLEDO,OH43604 81-5178173	DURABLE MEDICAL EQUIPMENT	OH	217,481	35,124	PROMEDICA HEALTH SYSTEM INC
(25) 1611 MONROE INVESTORS LLC 100 MADISON AVE TOLEDO,OH43604	REAL ESTATE	OH	0	151,840	PROMEDICA HEALTH SYSTEM INC
(26) BALL PARK PROPERTIES LLC 100 MADISON AVE TOLEDO,OH43604 82-3954332	REAL ESTATE	OH	0	1,118,158	PROMEDICA HEALTH SYSTEM INC
(27) PROMEDICA PRIMARY CARE PROVIDERS LLC 100 MADISON AVE TOLEDO,OH43604 83-1731861	EMPLOYS PHYSICIANS	OH	0	0	PROMEDICA PHYSICIAN GROUP
(28) TOLEDO RIVERFRONT HOTEL LLC 100 MADISON AVE TOLEDO,OH43604 47-2211190	REAL ESTATE	OH	517,083	8,774,753	PROMEDICA HEALTH SYSTEM INC
(29) KAPIOS LLC 2865 N REYNOLDS RD TOLEDO,OH43615 81-2624635	SOFTWARE DEVELOPMENT	OH	-331,796	193,400	PROMEDICA HEALTH SYSTEM INC
(30) ANCILLARY SERVICES MANAGEMENT LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1636874	MEDICAL SUPPLIES	OH	0	0	HCR HEALTHCARE LLC
(31) ARDEN COURTS OF ARLINGTON TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624126	ASSISTED LIVING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(32) ARDEN COURTS OF HAMDEN CT LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625105	ASSISTED LIVING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(33) ARDEN COURTS OF HAZEL CREST IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621940	ASSISTED LIVING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(34) ARDEN COURTS OF LOUISVILLE KY LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622079	ASSISTED LIVING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(35) HCR CANTERBURY VILLAGE LLC 333 N SUMMIT ST TOLEDO,OH43604 38-2032536	SKILLED NURSING FACILITY	DE	0	0	HCR HEALTHCARE LLC
(36) HCR HEALTHCARE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624435	HOLDING COMPANY	DE	0	0	HCR MANORCARE INC
(37) HCR II HEALTHCARE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-1250342	HOLDING COMPANY	DE	0	0	HCR HEALTHCARE LLC
(38) HCR III HEALTHCARE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624411	HOLDING COMPANY	DE	0	0	HCR II HEALTHCARE LLC
(39) HCR IV HEALTHCARE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-1283803	HOLDING COMPANY	DE	0	0	HCR III HEALTHCARE LLC
(40) HEARTLAND CARE LLC 333 N SUMMIT ST TOLEDO,OH43604 32-0091717	HOLDING COMPANY	OH	0	0	HCR MANOR CARE SERVICES LLC
(41) HEARTLAND EMPLOYMENT SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1903270	EMPLOYMENT SERVICES	OH	0	0	HCR HEALTHCARE LLC
(42) HEARTLAND-OAK PAVILION OF CINCINNATI OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614533	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(43) MANOR CARE AVIATION LLC 333 N SUMMIT ST TOLEDO,OH43604 52-1462072	AVIATION	DE	0	0	HCR HEALTHCARE LLC
(44) MANOR CARE OF DELAWARE COUNTY LLC 333 N SUMMIT ST TOLEDO,OH43604 52-1916053	HOLDING COMPANY	DE	0	0	HCR HEALTHCARE LLC
(45) MANOR CARE OF OKLAHOMA CITY (NORTHWEST) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610163	SKILLED NURSING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(46) MANOR CARE OF WINTER PARK FL LLC 333 N SUMMIT ST TOLEDO,OH43604 36-2899194	SKILLED NURSING FACILITY	DE	0	0	WINTER PARK NURSING CENTER LLC
(47) MANOR CARE SUPPLY LLC 333 N SUMMIT ST TOLEDO,OH43604 52-2055097	PURCHASING COMPANY	DE	0	0	HCR HEALTHCARE LLC
(48) MANORCARE HEALTH SERVICES OF OKLAHOMA LLC 333 N SUMMIT ST TOLEDO,OH43604 52-2055078	HOLDING COMPANY	DE	0	0	HCR HEALTHCARE LLC
(49) MANORCARE HEALTH SERVICES OF TOLEDO OH LLC 333 N SUMMIT ST TOLEDO,OH43604 90-0904333	HOLDING COMPANY	DE	0	0	HCR HEALTHCARE LLC
(50) PROMEDICA OF ADRIAN MI LLC 333 N SUMMIT ST TOLEDO,OH43604 38-3985660	SKILLED NURSING FACILITY	DE	0	0	MANORCARE HEALTH SERVICES OF TOLEDO OH LLC
(51) PROMEDICA OF SYLVANIA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 61-1771805	SKILLED NURSING FACILITY	DE	0	0	MANORCARE HEALTH SERVICES OF TOLEDO OH LLC
(52) REHABILITATION ADMINISTRATION LLC 333 N SUMMIT ST TOLEDO,OH43604 61-1295825	REHABILITATION SERVICES	DE	0	0	HEARTLAND REHABILITATION SERVICES LLC
(53) SPRINGHOUSE OF BETHESDA MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622235	ASSISTED LIVING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(54) SPRINGHOUSE OF SILVER SPRING MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622508	ASSISTED LIVING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(55) WINTER PARK NURSING CENTER LLC 333 N SUMMIT ST TOLEDO,OH43604 37-1019107	HOLDING COMPANY	DE	0	0	MANORCARE HEALTH SERVICES LLC
(56) AMERICAN REHABILITATION GROUP LLC 333 N SUMMIT ST TOLEDO,OH43604 61-1284533	OUTPATIENT REHABILITATION	DE	357,897	0	REHABILITATION ADMINISTRATION LLC
(57) HCR HOME HEALTH CARE AND HOSPICE LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1787978	HOLDING COMPANY	OH	0	0	HCR HEALTHCARE LLC
(58) HCR MANOR CARE SERVICES OF FLORIDA III LLC 333 N SUMMIT ST TOLEDO,OH43604 45-2507279	HOSPICE SERVICE	FL	7,601,384	0	HCR HOME HEALTH CARE AND HOSPICE LLC
(59) HCR MANOR CARE SERVICES OF FLORIDA LLC 333 N SUMMIT ST TOLEDO,OH43604 74-3193136	HOSPICE SERVICE	FL	2,547,629	836,753	HCR HOME HEALTH CARE AND HOSPICE LLC
(60) HCR MANOR CARE SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1838217	ADMINISTRATIVE SERVICES	OH	599,756	161,295,137	HCR HEALTHCARE LLC
(61) HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC 333 N SUMMIT ST TOLEDO,OH43604 65-0666550	OUTPATIENT REHABILITATION	FL	6,836,271	1,442,008	HEARTLAND REHABILITATION SERVICES LLC
(62) HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-1305723	SKILLED NURSING FACILITY	DE	11,516,998	12,455,542	HCR HEALTHCARE LLC
(63) HEARTLAND HOME CARE LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1787895	HOME HEALTH CARE SERVICE	OH	13,557,751	4,231,835	HEARTLAND REHABILITATION SERVICES LLC
(64) HEARTLAND HOME HEALTH CARE SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1787967	HOME HEALTH CARE SERVICE	OH	1,060,030	593,380	HCR HOME HEALTH CARE AND HOSPICE LLC
(65) HEARTLAND HOSPICE SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1788398	HOSPICE SERVICE	OH	147,578,096	49,934,309	HCR HOME HEALTH CARE AND HOSPICE LLC
(66) HEARTLAND REHABILITATION EXTENSION SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 81-2116419	OUTPATIENT REHABILITATION	DE	1,017,906	483,609	HEARTLAND REHABILITATION SERVICES LLC
(67) HEARTLAND REHABILITATION SERVICES OF FLORIDA LLC 333 N SUMMIT ST TOLEDO,OH43604 59-2504386	OUTPATIENT REHABILITATION	FL	3,679,481	1,105,318	HEARTLAND REHABILITATION SERVICES LLC
(68) HEARTLAND REHABILITATION SERVICES OF KENTUCKY LLC 333 N SUMMIT ST TOLEDO,OH43604 61-1301414	OUTPATIENT REHABILITATION	DE	2,082,011	432,938	REHABILITATION ADMINISTRATION LLC
(69) HEARTLAND REHABILITATION SERVICES OF MICHIGAN LLC 333 N SUMMIT ST TOLEDO,OH43604 30-0535129	OUTPATIENT REHABILITATION	DE	93,947	24,753	HEARTLAND REHABILITATION SERVICES LLC
(70) HEARTLAND REHABILITATION SERVICES OF NEW JERSEY LLC 333 N SUMMIT ST TOLEDO,OH43604 22-2137595	OUTPATIENT REHABILITATION	DE	867,058	292,792	HEARTLAND REHABILITATION SERVICES LLC
(71) HEARTLAND REHABILITATION SERVICES OF OHIO LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1479648	OUTPATIENT REHABILITATION	OH	898,549	324,393	HEARTLAND REHABILITATION SERVICES LLC
(72) HEARTLAND REHABILITATION SERVICES OF VIRGINIA LLC 333 N SUMMIT ST TOLEDO,OH43604 54-1508699	OUTPATIENT REHABILITATION	DE	1,644,895	447,583	HEARTLAND REHABILITATION SERVICES LLC
(73) HEARTLAND REHABILITATION SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1280619	OUTPATIENT REHABILITATION	OH	958,156	327,878	HCR HEALTHCARE LLC
(74) HEARTLAND SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 34-1760503	HOLDING COMPANY	OH	0	34,918,396	HCR HEALTHCARE LLC
(75) HEARTLAND THERAPY PROVIDER NETWORK LLC 333 N SUMMIT ST TOLEDO,OH43604 37-1027432	OUTPATIENT REHABILITATION	DE	130,485	57,156	HCR HEALTHCARE LLC
(76) IN HOME HEALTH LLC 333 N SUMMIT ST TOLEDO,OH43604 41-1458213	HOME HEALTH CARE SERVICE	MN	88,661,581	26,905,184	MANORCARE HEALTH SERVICES LLC
(77) INDUSTRIAL WASTES LLC 333 N SUMMIT ST TOLEDO,OH43604 25-1457630	REAL ESTATE	DE	0	119,760	HCR HEALTHCARE LLC
(78) MANOR CARE OF LACEY WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624391	SKILLED NURSING FACILITY	DE	6,346,828	2,662,465	MANORCARE HEALTH SERVICES LLC
(79) MANOR CARE OF SALMON CREEK WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624375	SKILLED NURSING FACILITY	DE	8,380,593	2,860,598	MANORCARE HEALTH SERVICES LLC
(80) MANORCARE HEALTH SERVICES LLC 333 N SUMMIT ST TOLEDO,OH43604 26-1305666	SKILLED NURSING FACILITY	DE	29,454,418	36,766,648	HCR HEALTHCARE LLC
(81) MILESTONE HEALTHCARE LLC 333 N SUMMIT ST TOLEDO,OH43604 75-2592398	MEDICAL STAFFING	DE	9,458,894	3,690,676	HEARTLAND REHABILITATION SERVICES LLC
(82) PORTFOLIO ONE LLC 333 N SUMMIT ST TOLEDO,OH43604 22-1604502	SKILLED NURSING FACILITY	OH	5,772,775	2,178,718	HCR HEALTHCARE LLC
(83) ARDEN COURTS OF AKRON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623857	ASSISTED LIVING FACILITY	DE	1,031,626	125,145	HCR IV HEALTHCARE LLC
(84) ARDEN COURTS OF ALLENTOWN PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623965	ASSISTED LIVING FACILITY	DE	1,502,508	168,523	HCR III HEALTHCARE LLC
(85) ARDEN COURTS OF ANNANDALE VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624314	ASSISTED LIVING FACILITY	DE	2,315,691	148,596	HCR IV HEALTHCARE LLC
(86) ARDEN COURTS OF AUSTIN TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624145	ASSISTED LIVING FACILITY	DE	1,025,560	73,192	HCR IV HEALTHCARE LLC
(87) ARDEN COURTS OF AVON CT LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625113	ASSISTED LIVING FACILITY	DE	1,018,425	87,237	HCR III HEALTHCARE LLC
(88) ARDEN COURTS OF BINGHAM FARMS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622828	ASSISTED LIVING FACILITY	DE	1,459,700	171,004	HCR IV HEALTHCARE LLC
(89) ARDEN COURTS OF CHERRY HILL NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623009	ASSISTED LIVING FACILITY	DE	1,707,003	245,920	HCR III HEALTHCARE LLC
(90) ARDEN COURTS OF DELRAY BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625237	ASSISTED LIVING FACILITY	DE	1,650,566	167,328	HCR III HEALTHCARE LLC
(91) ARDEN COURTS OF ELK GROVE VILLAGE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625405	ASSISTED LIVING FACILITY	DE	1,270,152	111,021	HCR IV HEALTHCARE LLC
(92) ARDEN COURTS OF FARMINGTON CT LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625092	ASSISTED LIVING FACILITY	DE	1,571,345	95,573	HCR III HEALTHCARE LLC
(93) ARDEN COURTS OF FT MYERS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625314	ASSISTED LIVING FACILITY	DE	1,275,216	204,006	HCR III HEALTHCARE LLC
(94) ARDEN COURTS OF GENEVA IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625428	ASSISTED LIVING FACILITY	DE	1,715,410	104,899	HCR IV HEALTHCARE LLC
(95) ARDEN COURTS OF GLEN ELLYN IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625418	ASSISTED LIVING FACILITY	DE	788,946	115,398	HCR IV HEALTHCARE LLC
(96) ARDEN COURTS OF JEFFERSON HILLS PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624075	ASSISTED LIVING FACILITY	DE	1,718,387	164,734	HCR III HEALTHCARE LLC
(97) ARDEN COURTS OF KENSINGTON MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622568	ASSISTED LIVING FACILITY	DE	2,307,631	136,099	HCR III HEALTHCARE LLC
(98) ARDEN COURTS OF KENWOOD OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623245	ASSISTED LIVING FACILITY	DE	1,089,007	119,433	HCR IV HEALTHCARE LLC
(99) ARDEN COURTS OF KING OF PRUSSIA PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624032	ASSISTED LIVING FACILITY	DE	1,768,271	300,563	HCR III HEALTHCARE LLC
(100) ARDEN COURTS OF LARGO FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625141	ASSISTED LIVING FACILITY	DE	1,438,088	207,538	HCR III HEALTHCARE LLC
(101) ARDEN COURTS OF LIVONIA MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622866	ASSISTED LIVING FACILITY	DE	1,547,718	200,154	HCR IV HEALTHCARE LLC
(102) ARDEN COURTS OF MONROEVILLE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623898	ASSISTED LIVING FACILITY	DE	1,651,324	229,530	HCR III HEALTHCARE LLC
(103) ARDEN COURTS OF NORTHBROOK IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625378	ASSISTED LIVING FACILITY	DE	1,659,213	72,769	HCR IV HEALTHCARE LLC
(104) ARDEN COURTS OF PALM HARBOR FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625222	ASSISTED LIVING FACILITY	DE	1,715,777	160,045	HCR III HEALTHCARE LLC
(105) ARDEN COURTS OF PALOS HEIGHTS IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625390	ASSISTED LIVING FACILITY	DE	1,496,914	160,775	HCR IV HEALTHCARE LLC
(106) ARDEN COURTS OF PARMA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623801	ASSISTED LIVING FACILITY	DE	1,636,023	126,253	HCR IV HEALTHCARE LLC
(107) ARDEN COURTS OF PIKESVILLE MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622121	ASSISTED LIVING FACILITY	DE	1,811,739	226,979	HCR III HEALTHCARE LLC
(108) ARDEN COURTS OF POTOMAC MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622198	ASSISTED LIVING FACILITY	DE	1,585,371	167,883	HCR III HEALTHCARE LLC
(109) ARDEN COURTS OF RICHARDSON TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624214	ASSISTED LIVING FACILITY	DE	1,436,555	149,305	HCR IV HEALTHCARE LLC
(110) ARDEN COURTS OF SAN ANTONIO TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624189	ASSISTED LIVING FACILITY	DE	1,448,958	217,237	HCR IV HEALTHCARE LLC
(111) ARDEN COURTS OF SARASOTA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625246	ASSISTED LIVING FACILITY	DE	1,514,233	93,167	HCR III HEALTHCARE LLC
(112) ARDEN COURTS OF SEMINOLE FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625266	ASSISTED LIVING FACILITY	DE	1,586,505	210,850	HCR III HEALTHCARE LLC
(113) ARDEN COURTS OF SILVER SPRING MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622164	ASSISTED LIVING FACILITY	DE	1,676,433	99,248	HCR III HEALTHCARE LLC
(114) ARDEN COURTS OF SOUTH HOLLAND IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622045	ASSISTED LIVING FACILITY	DE	1,224,034	78,562	HCR IV HEALTHCARE LLC
(115) ARDEN COURTS OF STERLING HEIGHTS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622772	ASSISTED LIVING FACILITY	DE	1,354,384	142,940	HCR IV HEALTHCARE LLC
(116) ARDEN COURTS OF TAMPA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625330	ASSISTED LIVING FACILITY	DE	1,296,073	194,751	HCR III HEALTHCARE LLC
(117) ARDEN COURTS OF TOWSON MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622661	ASSISTED LIVING FACILITY	DE	1,592,511	103,316	HCR III HEALTHCARE LLC
(118) ARDEN COURTS OF W ORANGE NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622938	ASSISTED LIVING FACILITY	DE	2,357,550	193,121	HCR III HEALTHCARE LLC
(119) ARDEN COURTS OF W PALM BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625258	ASSISTED LIVING FACILITY	DE	1,637,004	272,272	HCR III HEALTHCARE LLC
(120) ARDEN COURTS OF WAYNE NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622912	ASSISTED LIVING FACILITY	DE	2,045,949	286,955	HCR III HEALTHCARE LLC
(121) ARDEN COURTS OF WESTLAKE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623289	ASSISTED LIVING FACILITY	DE	1,769,581	161,572	HCR IV HEALTHCARE LLC
(122) ARDEN COURTS OF WILMINGTON DE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625127	ASSISTED LIVING FACILITY	DE	1,916,646	251,469	HCR III HEALTHCARE LLC
(123) ARDEN COURTS OF WINTER SPRINGS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625340	ASSISTED LIVING FACILITY	DE	1,679,315	172,294	HCR III HEALTHCARE LLC
(124) ARDEN COURTS OF YARDLEY PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623944	ASSISTED LIVING FACILITY	DE	1,758,955	282,618	HCR III HEALTHCARE LLC
(125) ARDEN COURTS-ANDERSON OF CINCINNATI OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623677	ASSISTED LIVING FACILITY	DE	1,899,465	188,795	HCR IV HEALTHCARE LLC
(126) ARDEN COURTS-BAINBRIDGE OF CHAGRIN FALLS OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623202	ASSISTED LIVING FACILITY	DE	1,977,662	195,675	HCR IV HEALTHCARE LLC
(127) ARDEN COURTS-FAIR OAKS OF FAIRFAX VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624353	ASSISTED LIVING FACILITY	DE	1,979,567	83,368	HCR IV HEALTHCARE LLC
(128) ARDEN COURTS-LELY PALMS OF NAPLES FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625279	ASSISTED LIVING FACILITY	DE	1,516,410	198,295	HCR III HEALTHCARE LLC
(129) ARDEN COURTS-NORTH HILLS OF PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623920	ASSISTED LIVING FACILITY	DE	1,542,450	136,809	HCR III HEALTHCARE LLC
(130) ARDEN COURTS-SUSQUEHANNA OF HARRISBURG PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624065	ASSISTED LIVING FACILITY	DE	1,661,906	212,943	HCR III HEALTHCARE LLC
(131) ARDEN COURTS-WARMINSTER OF HATBORO PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623869	ASSISTED LIVING FACILITY	DE	1,397,480	150,712	HCR III HEALTHCARE LLC
(132) ARDEN COURTS OF WHIPPANY NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623155	ASSISTED LIVING FACILITY	DE	1,287,566	215,472	HCR III HEALTHCARE LLC
(133) CHRISTOPHER EAST HEALTH CARE CENTER OF LOUISVILLE KY LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619900	SKILLED NURSING FACILITY	DE	-2,103	6,097	HCR IV HEALTHCARE LLC
(134) COLUMBIA REHABILITATION AND NURSING CENTER-COLUMBIA SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623408	OUTPATIENT REHABILITATION	DE	3,818,328	1,662,629	HCR III HEALTHCARE LLC
(135) DEVON MANOR-DEVON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622826	SKILLED NURSING FACILITY	DE	0	45,972	HCR III HEALTHCARE LLC
(136) DONAHOE MANOR-BEDFORD PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623108	SKILLED NURSING FACILITY	DE	2,651,327	935,535	HCR III HEALTHCARE LLC
(137) FOSTRIAN COURTS ASSISTED LIVING-FLUSHING MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622894	SKILLED NURSING FACILITY	DE	561,361	59,714	HCR IV HEALTHCARE LLC
(138) HAMPTON HOUSE-WILKES-BARRE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610244	SKILLED NURSING FACILITY	DE	3,218,534	1,713,249	HCR III HEALTHCARE LLC
(139) HEARTLAND OF BOYNTON BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623523	SKILLED NURSING FACILITY	DE	4,425,436	1,218,132	HCR III HEALTHCARE LLC
(140) HEARTLAND OF ADELPHI MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620015	SKILLED NURSING FACILITY	DE	5,847,325	2,453,062	HCR III HEALTHCARE LLC
(141) HEARTLAND OF ALLEN PARK MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611286	SKILLED NURSING FACILITY	DE	6,566,504	2,115,831	HCR IV HEALTHCARE LLC
(142) HEARTLAND OF ANN ARBOR MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612384	SKILLED NURSING FACILITY	DE	7,465,249	3,041,311	HCR IV HEALTHCARE LLC
(143) HEARTLAND OF AUSTIN TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624533	SKILLED NURSING FACILITY	DE	310,859	458,239	HCR IV HEALTHCARE LLC
(144) HEARTLAND OF BATTLE CREEK MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612206	SKILLED NURSING FACILITY	DE	2,365,104	900,006	HCR IV HEALTHCARE LLC
(145) HEARTLAND OF BECKLEY WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625053	SKILLED NURSING FACILITY	DE	2,923	0	HCR IV HEALTHCARE LLC
(146) HEARTLAND OF BEDFORD TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624511	SKILLED NURSING FACILITY	DE	208,279	85,969	HCR IV HEALTHCARE LLC
(147) HEARTLAND OF BELLEFONTAINE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609497	SKILLED NURSING FACILITY	DE	2,203,715	326,390	HCR IV HEALTHCARE LLC
(148) HEARTLAND OF BOCA RATON FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623949	SKILLED NURSING FACILITY	DE	4,880,221	1,567,009	HCR III HEALTHCARE LLC
(149) HEARTLAND OF BROOKSVILLE FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623416	SKILLED NURSING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(150) HEARTLAND OF BUCYRUS OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614610	SKILLED NURSING FACILITY	DE	2,518,435	702,813	HCR IV HEALTHCARE LLC
(151) HEARTLAND OF CANTON IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0604153	SKILLED NURSING FACILITY	DE	1,408,288	325,285	HCR IV HEALTHCARE LLC
(152) HEARTLAND OF CANTON MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620527	SKILLED NURSING FACILITY	DE	8,461,874	3,376,143	HCR IV HEALTHCARE LLC
(153) HEARTLAND OF CENTERBURG OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614447	SKILLED NURSING FACILITY	DE	16	0	HCR IV HEALTHCARE LLC
(154) HEARTLAND OF CENTERVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609683	SKILLED NURSING FACILITY	DE	3,463,994	1,224,480	HCR IV HEALTHCARE LLC
(155) HEARTLAND OF CHAMPAIGN IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615806	SKILLED NURSING FACILITY	DE	2,355,667	595,879	HCR IV HEALTHCARE LLC
(156) HEARTLAND OF CHILLICOTHE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609311	SKILLED NURSING FACILITY	DE	3,769,323	1,081,912	HCR IV HEALTHCARE LLC
(157) HEARTLAND OF CLARKSBURG WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625029	SKILLED NURSING FACILITY	DE	-53	0	HCR IV HEALTHCARE LLC
(158) HEARTLAND OF DEARBORN HEIGHTS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611231	SKILLED NURSING FACILITY	DE	4,908,389	1,661,957	HCR IV HEALTHCARE LLC
(159) HEARTLAND OF DECATUR IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615541	SKILLED NURSING FACILITY	DE	1,506,101	368,034	HCR IV HEALTHCARE LLC
(160) HEARTLAND OF EATON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609364	SKILLED NURSING FACILITY	DE	-1,119	0	HCR IV HEALTHCARE LLC
(161) HEARTLAND OF FORT MYERS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623726	SKILLED NURSING FACILITY	DE	5,658,908	1,777,363	HCR III HEALTHCARE LLC
(162) HEARTLAND OF GALESBURG IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624455	SKILLED NURSING FACILITY	DE	2,550,484	743,397	HCR IV HEALTHCARE LLC
(163) HEARTLAND OF GRAND RAPIDS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611403	SKILLED NURSING FACILITY	DE	319,372	252,513	HCR IV HEALTHCARE LLC
(164) HEARTLAND OF GREENVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614250	SKILLED NURSING FACILITY	DE	1,997,078	326,584	HCR IV HEALTHCARE LLC
(165) HEARTLAND OF HENRY IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614845	SKILLED NURSING FACILITY	DE	2,602,637	572,088	HCR IV HEALTHCARE LLC
(166) HEARTLAND OF HILLSBORO OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609351	SKILLED NURSING FACILITY	DE	3,475,320	1,071,332	HCR IV HEALTHCARE LLC
(167) HEARTLAND OF HOLLAND MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611679	SKILLED NURSING FACILITY	DE	0	23,039	HCR IV HEALTHCARE LLC
(168) HEARTLAND OF HYATTSVILLE MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619980	SKILLED NURSING FACILITY	DE	5,582,764	2,367,288	HCR III HEALTHCARE LLC
(169) HEARTLAND OF IONIA MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611974	SKILLED NURSING FACILITY	DE	243,176	279,540	HCR IV HEALTHCARE LLC
(170) HEARTLAND OF JACKSON MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611756	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(171) HEARTLAND OF JACKSON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614303	SKILLED NURSING FACILITY	DE	2,231,996	177,886	HCR IV HEALTHCARE LLC
(172) HEARTLAND OF JACKSONVILLE FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623590	SKILLED NURSING FACILITY	DE	4,394,621	1,742,763	HCR III HEALTHCARE LLC
(173) HEARTLAND OF KALAMAZOO MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612121	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(174) HEARTLAND OF KENDALL FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623392	SKILLED NURSING FACILITY	DE	1,842,824	41,961	HCR III HEALTHCARE LLC
(175) HEARTLAND OF KETTERING OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609231	SKILLED NURSING FACILITY	DE	3,675,808	1,035,642	HCR IV HEALTHCARE LLC
(176) HEARTLAND OF KEYSER WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624987	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(177) HEARTLAND OF LAUDERHILL FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623998	SKILLED NURSING FACILITY	DE	1,188,178	0	HCR III HEALTHCARE LLC
(178) HEARTLAND OF MACOMB IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624476	SKILLED NURSING FACILITY	DE	2,541,398	750,063	HCR IV HEALTHCARE LLC
(179) HEARTLAND OF MADEIRA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609604	SKILLED NURSING FACILITY	DE	3,288,999	725,455	HCR IV HEALTHCARE LLC
(180) HEARTLAND OF MARIETTA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609259	SKILLED NURSING FACILITY	DE	3,315,880	877,449	HCR IV HEALTHCARE LLC
(181) HEARTLAND OF MARION OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0613105	SKILLED NURSING FACILITY	DE	5,314,000	1,336,440	HCR IV HEALTHCARE LLC
(182) HEARTLAND OF MARTINSBURG WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625081	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(183) HEARTLAND OF MARYSVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609393	SKILLED NURSING FACILITY	DE	51,096	0	HCR IV HEALTHCARE LLC
(184) HEARTLAND OF MENTOR OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610122	SKILLED NURSING FACILITY	DE	4,475,700	1,485,605	HCR IV HEALTHCARE LLC
(185) HEARTLAND OF MIAMISBURG OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0794075	SKILLED NURSING FACILITY	DE	3,207,755	1,460,710	HCR IV HEALTHCARE LLC
(186) HEARTLAND OF MOLINE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624491	SKILLED NURSING FACILITY	DE	4,811,537	1,261,983	HCR IV HEALTHCARE LLC
(187) HEARTLAND OF NORMAL IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615386	SKILLED NURSING FACILITY	DE	1,911,332	343,831	HCR IV HEALTHCARE LLC
(188) HEARTLAND OF ORANGE PARK FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623613	SKILLED NURSING FACILITY	DE	5,037,490	1,876,032	HCR III HEALTHCARE LLC
(189) HEARTLAND OF OREGON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609590	SKILLED NURSING FACILITY	DE	3,537,767	740,673	HCR IV HEALTHCARE LLC
(190) HEARTLAND OF PAXTON IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614884	SKILLED NURSING FACILITY	DE	1,162,199	140,835	HCR IV HEALTHCARE LLC
(191) HEARTLAND OF PEORIA IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615478	SKILLED NURSING FACILITY	DE	1,755,048	388,841	HCR IV HEALTHCARE LLC
(192) HEARTLAND OF PERRYSBURG OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609189	SKILLED NURSING FACILITY	DE	4,550,267	1,348,123	HCR IV HEALTHCARE LLC
(193) HEARTLAND OF PIQUA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609466	SKILLED NURSING FACILITY	DE	2,502,901	297,321	HCR IV HEALTHCARE LLC
(194) HEARTLAND OF PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610260	SKILLED NURSING FACILITY	DE	6,256,027	2,350,871	HCR III HEALTHCARE LLC
(195) HEARTLAND OF PLATTEVILLE WI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624818	SKILLED NURSING FACILITY	DE	1,325,127	93,532	HCR III HEALTHCARE LLC
(196) HEARTLAND OF PORTSMOUTH OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609290	SKILLED NURSING FACILITY	DE	3,574,131	751,680	HCR IV HEALTHCARE LLC
(197) HEARTLAND OF RAINELLE WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625009	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(198) HEARTLAND OF SAGINAW MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612275	SKILLED NURSING FACILITY	DE	-161	0	HCR IV HEALTHCARE LLC
(199) HEARTLAND OF SAN ANTONIO TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623701	SKILLED NURSING FACILITY	DE	377,785	340,148	HCR IV HEALTHCARE LLC
(200) HEARTLAND OF SARASOTA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623968	SKILLED NURSING FACILITY	DE	5,775,561	1,670,368	HCR III HEALTHCARE LLC
(201) HEARTLAND OF SPRINGFIELD OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609416	SKILLED NURSING FACILITY	DE	3,011,017	708,683	HCR IV HEALTHCARE LLC
(202) HEARTLAND OF TAMARAC FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623500	SKILLED NURSING FACILITY	DE	1,851,238	275,171	HCR III HEALTHCARE LLC
(203) HEARTLAND OF THREE RIVERS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612325	SKILLED NURSING FACILITY	DE	3,264,886	634,037	HCR IV HEALTHCARE LLC
(204) HEARTLAND OF URBANA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614353	SKILLED NURSING FACILITY	DE	0	59,006	HCR IV HEALTHCARE LLC
(205) HEARTLAND OF WEST BLOOMFIELD MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611547	SKILLED NURSING FACILITY	DE	-7,984	263,361	HCR IV HEALTHCARE LLC
(206) HEARTLAND OF WATERVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609511	SKILLED NURSING FACILITY	DE	4,050,108	648,845	HCR IV HEALTHCARE LLC
(207) HEARTLAND OF WAUSEON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614568	SKILLED NURSING FACILITY	DE	1,431,768	247,386	HCR IV HEALTHCARE LLC
(208) HEARTLAND OF WEST HOUSTON TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623684	SKILLED NURSING FACILITY	DE	0	18,779	HCR IV HEALTHCARE LLC
(209) HEARTLAND OF WHITEHALL MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612438	SKILLED NURSING FACILITY	DE	213,969	0	HCR IV HEALTHCARE LLC
(210) HEARTLAND OF ZEPHYRHILLS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623476	SKILLED NURSING FACILITY	DE	4,607,616	1,272,744	HCR III HEALTHCARE LLC
(211) HEARTLAND VILLAGE OF WESTERVILLE OH (NC) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609323	SKILLED NURSING FACILITY	DE	4,704,520	1,222,279	HCR IV HEALTHCARE LLC
(212) HEARTLAND VILLAGE OF WESTERVILLE OH (RC) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609337	SKILLED NURSING FACILITY	DE	1,598,239	224,857	HCR IV HEALTHCARE LLC
(213) HEARTLAND-BEAVERCREEK OF DAYTON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609445	SKILLED NURSING FACILITY	DE	3,315,570	1,157,761	HCR IV HEALTHCARE LLC
(214) HEARTLAND-BRIARWOOD MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611711	SKILLED NURSING FACILITY	DE	5,218,853	1,595,879	HCR IV HEALTHCARE LLC
(215) HEARTLAND-CHARLESTON OF HANAHAN SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623167	SKILLED NURSING FACILITY	DE	4,155,282	1,797,665	HCR III HEALTHCARE LLC
(216) HEARTLAND-CRESTVIEW MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611487	SKILLED NURSING FACILITY	DE	150,557	0	HCR IV HEALTHCARE LLC
(217) HEARTLAND-DORVIN OF LIVONIA MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611095	SKILLED NURSING FACILITY	DE	34,028	110,557	HCR IV HEALTHCARE LLC
(218) HEARTLAND-FAIRFIELD OF PLEASANTVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0613145	SKILLED NURSING FACILITY	DE	21	0	HCR IV HEALTHCARE LLC
(219) HEARTLAND-FOSTRIAN OF FLUSHING MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611818	SKILLED NURSING FACILITY	DE	5,344,718	2,330,962	HCR IV HEALTHCARE LLC
(220) HEARTLAND-GEORGIAN BLOOMFIELD OF BLOOMFIELD HILLS MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611630	SKILLED NURSING FACILITY	DE	75,066	177,136	HCR IV HEALTHCARE LLC
(221) HEARTLAND-GEORGIAN EAST OF GROSSE POINTE MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611334	SKILLED NURSING FACILITY	DE	4,381,607	1,801,523	HCR IV HEALTHCARE LLC
(222) HEARTLAND-GREENVIEW MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611920	SKILLED NURSING FACILITY	DE	45,856	311,944	HCR IV HEALTHCARE LLC
(223) HEARTLAND-HAMPTON OF BAY CITY MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611865	SKILLED NURSING FACILITY	DE	2,371,829	771,893	HCR IV HEALTHCARE LLC
(224) HEARTLAND-HOLLY GLEN OF TOLEDO OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614404	SKILLED NURSING FACILITY	DE	2,531,891	374,892	HCR IV HEALTHCARE LLC
(225) HEARTLAND-INDIAN LAKE OF LAKEVIEW OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614489	SKILLED NURSING FACILITY	DE	0	22,304	HCR IV HEALTHCARE LLC
(226) HEARTLAND-KNOLLVIEW MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612021	SKILLED NURSING FACILITY	DE	111,647	312,812	HCR IV HEALTHCARE LLC
(227) HEARTLAND-LANSING OF BRIDGEPORT OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609376	SKILLED NURSING FACILITY	DE	-176	0	HCR IV HEALTHCARE LLC
(228) HEARTLAND-MIAMI LAKES OF HIALEAH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623652	SKILLED NURSING FACILITY	DE	1,716,842	185,223	HCR III HEALTHCARE LLC
(229) HEARTLAND-MT AIRY OF CINCINNATI OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610060	SKILLED NURSING FACILITY	DE	-66	0	HCR IV HEALTHCARE LLC
(230) HEARTLAND-OAKLAND MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620480	SKILLED NURSING FACILITY	DE	8,922,093	3,329,722	HCR IV HEALTHCARE LLC
(231) HEARTLAND-PEWAUKEE OF WAUKESHA WI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624873	SKILLED NURSING FACILITY	DE	2,633,206	129,136	HCR III HEALTHCARE LLC
(232) HEARTLAND-PLYMOUTH COURT MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610995	SKILLED NURSING FACILITY	DE	115,538	442,699	HCR IV HEALTHCARE LLC
(233) HEARTLAND-PRESTON COUNTY OF KINGWOOD WV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625067	SKILLED NURSING FACILITY	DE	-3,880	0	HCR IV HEALTHCARE LLC
(234) HEARTLAND-PRESTWICK IN LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619176	SKILLED NURSING FACILITY	DE	370,884	0	HCR IV HEALTHCARE LLC
(235) HEARTLAND-PROSPERITY OAKS OF PALM BEACH GARDENS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623909	SKILLED NURSING FACILITY	DE	4,565,973	1,066,290	HCR III HEALTHCARE LLC
(236) HEARTLAND-RIVERVIEW OF EAST PEORIA IL (SNF) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619009	ASSISTED LIVING FACILITY	DE	3,099,707	333,293	HCR IV HEALTHCARE LLC
(237) HEARTLAND-RIVERVIEW OF SOUTH POINT OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609484	SKILLED NURSING FACILITY	DE	3,734,965	1,050,785	HCR IV HEALTHCARE LLC
(238) HEARTLAND-SOUTH JACKSONVILLE OF JACKSONVILLE FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623559	SKILLED NURSING FACILITY	DE	4,723,751	2,039,377	HCR III HEALTHCARE LLC
(239) HEARTLAND-UNIVERSITY OF LIVONIA MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611184	SKILLED NURSING FACILITY	DE	4,512,610	1,420,315	HCR IV HEALTHCARE LLC
(240) HEARTLAND-VICTORIAN VILLAGE OF COLUMBUS OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609432	SKILLED NURSING FACILITY	DE	-291	0	HCR IV HEALTHCARE LLC
(241) HEARTLAND-WASHINGTON MANOR OF KENOSHA WI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624859	SKILLED NURSING FACILITY	DE	2,785,221	288,448	HCR III HEALTHCARE LLC
(242) HEARTLAND-WILLOW LANE OF BUTLER MO LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612474	SKILLED NURSING FACILITY	DE	0	19,659	HCR III HEALTHCARE LLC
(243) HEARTLAND-WILLOWBROOK OF HOUSTON TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624408	SKILLED NURSING FACILITY	DE	9,984	64,522	HCR IV HEALTHCARE LLC
(244) HEARTLAND-WOODRIDGE OF FAIRFIELD OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609646	SKILLED NURSING FACILITY	DE	4,749,613	654,166	HCR IV HEALTHCARE LLC
(245) HOLIDAY NURSING CENTER-CENTER TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624488	SKILLED NURSING FACILITY	DE	0	20,680	HCR IV HEALTHCARE LLC
(246) KENSINGTON MANOR-SARASOTA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623931	SKILLED NURSING FACILITY	DE	3,120,236	1,007,571	HCR III HEALTHCARE LLC
(247) LEXINGTON REHABILITATION AND NURSING CENTER-LEXINGTON SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623428	OUTPATIENT REHABILITATION	DE	0	0	HCR III HEALTHCARE LLC
(248) MANOR CARE OF FOUNTAIN VALLEY CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622988	SKILLED NURSING FACILITY	DE	7,802,947	2,510,139	HCR IV HEALTHCARE LLC
(249) MANOR CARE NURSING CENTER OF SARASOTA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624159	SKILLED NURSING FACILITY	DE	6,701,089	1,356,329	HCR III HEALTHCARE LLC
(250) MANOR CARE OF ABERDEEN SD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623462	SKILLED NURSING FACILITY	DE	-12,474	8,471	HCR IV HEALTHCARE LLC
(251) MANOR CARE OF AKRON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610034	SKILLED NURSING FACILITY	DE	2,986,647	672,087	HCR IV HEALTHCARE LLC
(252) MANOR CARE OF ALEXANDRIA VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624590	SKILLED NURSING FACILITY	DE	3,809,637	1,222,573	HCR IV HEALTHCARE LLC
(253) MANOR CARE OF ALLENTOWN PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610673	SKILLED NURSING FACILITY	DE	5,828,744	2,961,195	HCR III HEALTHCARE LLC
(254) MANOR CARE OF ANDERSON IN LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619221	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(255) MANOR CARE OF ARLINGTON VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624619	SKILLED NURSING FACILITY	DE	5,787,032	2,059,964	HCR IV HEALTHCARE LLC
(256) MANOR CARE OF BARBERTON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609528	SKILLED NURSING FACILITY	DE	3,396,300	1,178,734	HCR IV HEALTHCARE LLC
(257) MANOR CARE OF BETHEL PARK PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622002	SKILLED NURSING FACILITY	DE	5,410,193	2,048,823	HCR III HEALTHCARE LLC
(258) MANOR CARE OF BETHESDA MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620122	SKILLED NURSING FACILITY	DE	4,187,377	1,209,415	HCR III HEALTHCARE LLC
(259) MANOR CARE OF BETHLEHEM PA (2021) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614878	SKILLED NURSING FACILITY	DE	7,551,038	4,035,422	HCR III HEALTHCARE LLC
(260) MANOR CARE OF BETHLEHEM PA (2029) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621845	SKILLED NURSING FACILITY	DE	7,232,630	3,572,893	HCR III HEALTHCARE LLC
(261) MANOR CARE OF BOCA RATON FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624217	SKILLED NURSING FACILITY	DE	6,926,170	1,957,617	HCR III HEALTHCARE LLC
(262) MANOR CARE OF BOULDER CO LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623287	SKILLED NURSING FACILITY	DE	5,895,656	1,488,677	HCR IV HEALTHCARE LLC
(263) MANOR CARE OF BOYNTON BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624241	SKILLED NURSING FACILITY	DE	7,074,478	2,393,813	HCR III HEALTHCARE LLC
(264) MANOR CARE OF CAMP HILL PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623070	SKILLED NURSING FACILITY	DE	4,544,977	2,499,660	HCR III HEALTHCARE LLC
(265) MANOR CARE OF CARLISLE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610623	SKILLED NURSING FACILITY	DE	5,254,466	2,609,613	HCR III HEALTHCARE LLC
(266) MANOR CARE OF CEDAR RAPIDS IA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624378	SKILLED NURSING FACILITY	DE	3,680,960	1,149,016	HCR III HEALTHCARE LLC
(267) MANOR CARE OF CHAMBERSBURG PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614915	SKILLED NURSING FACILITY	DE	7,200,386	3,710,223	HCR III HEALTHCARE LLC
(268) MANOR CARE OF CHERRY HILL NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612749	SKILLED NURSING FACILITY	DE	0	54,214	HCR III HEALTHCARE LLC
(269) MANOR CARE OF CHEVY CHASE MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620158	SKILLED NURSING FACILITY	DE	6,185,609	1,610,840	HCR III HEALTHCARE LLC
(270) MANOR CARE OF CITRUS HEIGHTS CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622564	SKILLED NURSING FACILITY	DE	9,107,366	3,584,142	HCR IV HEALTHCARE LLC
(271) MANOR CARE OF DALLAS TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623497	SKILLED NURSING FACILITY	DE	-4,504	45,192	HCR IV HEALTHCARE LLC
(272) MANOR CARE OF DALLASTOWN PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614534	SKILLED NURSING FACILITY	DE	6,926,112	3,312,780	HCR III HEALTHCARE LLC
(273) MANOR CARE OF DAVENPORT IA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624394	SKILLED NURSING FACILITY	DE	2,796,870	976,674	HCR III HEALTHCARE LLC
(274) MANOR CARE OF DELRAY BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624068	SKILLED NURSING FACILITY	DE	5,501,210	1,591,827	HCR III HEALTHCARE LLC
(275) MANOR CARE OF DENVER CO LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623262	SKILLED NURSING FACILITY	DE	5,695,931	2,106,835	HCR IV HEALTHCARE LLC
(276) MANOR CARE OF DUBUQUE IA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624416	SKILLED NURSING FACILITY	DE	3,286,295	1,013,219	HCR III HEALTHCARE LLC
(277) MANOR CARE OF DUNEDIN FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624190	SKILLED NURSING FACILITY	DE	5,369,064	1,424,683	HCR III HEALTHCARE LLC
(278) MANOR CARE OF EASTON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621877	SKILLED NURSING FACILITY	DE	7,716,907	3,607,188	HCR III HEALTHCARE LLC
(279) MANOR CARE OF ELGIN IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615951	SKILLED NURSING FACILITY	DE	24,788	0	HCR IV HEALTHCARE LLC
(280) MANOR CARE OF ELIZABETHTOWN PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622774	SKILLED NURSING FACILITY	DE	12,319	347,549	HCR III HEALTHCARE LLC
(281) MANOR CARE OF ELK GROVE VILLAGE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0618782	SKILLED NURSING FACILITY	DE	9,446,125	2,641,647	HCR IV HEALTHCARE LLC
(282) MANOR CARE OF FARGO ND LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612718	SKILLED NURSING FACILITY	DE	1,842,410	427,166	HCR IV HEALTHCARE LLC
(283) MANOR CARE OF FLORISSANT MO LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612550	SKILLED NURSING FACILITY	DE	100,784	49,269	HCR III HEALTHCARE LLC
(284) MANOR CARE OF FOND DU LAC WI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624802	SKILLED NURSING FACILITY	DE	1,503,096	191,183	HCR III HEALTHCARE LLC
(285) MANOR CARE OF FORT WORTH TX (NRH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623538	SKILLED NURSING FACILITY	DE	276,262	0	HCR IV HEALTHCARE LLC
(286) MANOR CARE OF FORT WORTH TX (NW) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623570	SKILLED NURSING FACILITY	DE	220,260	172,830	HCR IV HEALTHCARE LLC
(287) MANOR CARE OF FT MYERS FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624272	SKILLED NURSING FACILITY	DE	4,930,242	1,219,504	HCR III HEALTHCARE LLC
(288) MANOR CARE OF GIG HARBOR WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624719	SKILLED NURSING FACILITY	DE	3,791,837	1,281,888	HCR IV HEALTHCARE LLC
(289) MANOR CARE OF GREEN BAY WI (EAST) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624767	SKILLED NURSING FACILITY	DE	1,210,037	240,914	HCR III HEALTHCARE LLC
(290) MANOR CARE OF GREEN BAY WI (WEST) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624786	SKILLED NURSING FACILITY	DE	1,664,572	213,250	HCR III HEALTHCARE LLC
(291) MANOR CARE OF HEMET CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623107	SKILLED NURSING FACILITY	DE	7,778,694	2,497,433	HCR IV HEALTHCARE LLC
(292) MANOR CARE OF HINSDALE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615984	SKILLED NURSING FACILITY	DE	9,224,477	3,897,288	HCR IV HEALTHCARE LLC
(293) MANOR CARE OF HOMEWOOD IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614920	SKILLED NURSING FACILITY	DE	5,617,197	1,306,944	HCR IV HEALTHCARE LLC
(294) MANOR CARE OF HUNTINGDON VALLEY PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610582	SKILLED NURSING FACILITY	DE	4,542,855	2,352,592	HCR III HEALTHCARE LLC
(295) MANOR CARE OF INDY (SOUTH) IN LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619623	SKILLED NURSING FACILITY	DE	4,230,915	1,318,322	HCR IV HEALTHCARE LLC
(296) MANOR CARE OF JERSEY SHORE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614957	SKILLED NURSING FACILITY	DE	4,160,543	2,247,249	HCR III HEALTHCARE LLC
(297) MANOR CARE OF KANKAKEE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615706	SKILLED NURSING FACILITY	DE	-3,361	0	HCR IV HEALTHCARE LLC
(298) MANOR CARE OF KING OF PRUSSIA PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610645	SKILLED NURSING FACILITY	DE	5,951,070	3,238,851	HCR III HEALTHCARE LLC
(299) MANOR CARE OF KINGSFORD MI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0611592	SKILLED NURSING FACILITY	DE	4,460,343	1,363,142	HCR IV HEALTHCARE LLC
(300) MANOR CARE OF KINGSTON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615323	SKILLED NURSING FACILITY	DE	5,372,005	2,533,654	HCR III HEALTHCARE LLC
(301) MANOR CARE OF LANCASTER PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621637	SKILLED NURSING FACILITY	DE	6,066,219	3,242,054	HCR III HEALTHCARE LLC
(302) MANOR CARE OF LAURELDALE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615380	SKILLED NURSING FACILITY	DE	6,779,879	3,352,233	HCR III HEALTHCARE LLC
(303) MANOR CARE OF LEBANON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615358	SKILLED NURSING FACILITY	DE	5,744,913	2,856,436	HCR III HEALTHCARE LLC
(304) MANOR CARE OF LIBERTYVILLE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615859	SKILLED NURSING FACILITY	DE	6,427,475	1,690,491	HCR IV HEALTHCARE LLC
(305) MANOR CARE OF LYNNWOOD WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624675	SKILLED NURSING FACILITY	DE	5,949,273	1,936,882	HCR IV HEALTHCARE LLC
(306) MANOR CARE OF MARIETTA GA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624336	SKILLED NURSING FACILITY	DE	6,318,740	1,493,649	HCR III HEALTHCARE LLC
(307) MANOR CARE OF MAYFIELD HEIGHTS OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609565	SKILLED NURSING FACILITY	DE	4,424,503	669,343	HCR IV HEALTHCARE LLC
(308) MANOR CARE OF MCMURRAY PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614341	SKILLED NURSING FACILITY	DE	4,648,710	1,405,196	HCR III HEALTHCARE LLC
(309) MANOR CARE OF MIDWEST CITY OK LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610183	SKILLED NURSING FACILITY	DE	0	73,621	HCR III HEALTHCARE LLC
(310) MANOR CARE OF MINOT ND LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612693	SKILLED NURSING FACILITY	DE	0	2,408	HCR IV HEALTHCARE LLC
(311) MANOR CARE OF MONROEVILLE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614497	SKILLED NURSING FACILITY	DE	5,298,063	2,166,633	HCR III HEALTHCARE LLC
(312) MANOR CARE OF MOUNTAINSIDE NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612791	SKILLED NURSING FACILITY	DE	5,185,444	1,772,092	HCR III HEALTHCARE LLC
(313) MANOR CARE OF NAPERVILLE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615638	SKILLED NURSING FACILITY	DE	2,098,065	258,153	HCR IV HEALTHCARE LLC
(314) MANOR CARE OF NAPLES FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624049	SKILLED NURSING FACILITY	DE	4,997,355	1,570,434	HCR III HEALTHCARE LLC
(315) MANOR CARE OF NEW PROVIDENCE NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612827	SKILLED NURSING FACILITY	DE	759,722	351,546	HCR III HEALTHCARE LLC
(316) MANOR CARE OF NORTH OLMSTED OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610082	SKILLED NURSING FACILITY	DE	3,453,034	800,733	HCR IV HEALTHCARE LLC
(317) MANOR CARE OF NORTHBROOK IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0618960	SKILLED NURSING FACILITY	DE	3,806,340	823,205	HCR IV HEALTHCARE LLC
(318) MANOR CARE OF OAK LAWN (EAST) IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615929	SKILLED NURSING FACILITY	DE	6,060,268	2,464,476	HCR IV HEALTHCARE LLC
(319) MANOR CARE OF OAK LAWN (WEST) IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0616038	SKILLED NURSING FACILITY	DE	6,401,108	2,358,084	HCR IV HEALTHCARE LLC
(320) MANOR CARE OF OKLAHOMA CITY (SOUTHWEST) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610197	SKILLED NURSING FACILITY	DE	-187	59,718	HCR III HEALTHCARE LLC
(321) MANOR CARE OF PALM DESERT CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623221	SKILLED NURSING FACILITY	DE	8,725,576	2,816,692	HCR IV HEALTHCARE LLC
(322) MANOR CARE OF PALM HARBOR FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624018	SKILLED NURSING FACILITY	DE	8,358,111	2,209,486	HCR III HEALTHCARE LLC
(323) MANOR CARE OF PALOS HEIGHTS (WEST) IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0618879	SKILLED NURSING FACILITY	DE	4,906,373	865,076	HCR IV HEALTHCARE LLC
(324) MANOR CARE OF PALOS HEIGHTS IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615889	SKILLED NURSING FACILITY	DE	8,380,350	2,453,909	HCR IV HEALTHCARE LLC
(325) MANOR CARE OF PARMA OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609661	SKILLED NURSING FACILITY	DE	4,272,062	1,422,233	HCR IV HEALTHCARE LLC
(326) MANOR CARE OF PINEHURST NC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612589	SKILLED NURSING FACILITY	DE	-4,600	182,229	HCR III HEALTHCARE LLC
(327) MANOR CARE OF PLANTATION FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624255	SKILLED NURSING FACILITY	DE	1,545,895	142,037	HCR III HEALTHCARE LLC
(328) MANOR CARE OF POTOMAC MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620187	SKILLED NURSING FACILITY	DE	8,243,687	2,742,571	HCR III HEALTHCARE LLC
(329) MANOR CARE OF POTTSTOWN PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615421	SKILLED NURSING FACILITY	DE	4,476,317	2,278,769	HCR III HEALTHCARE LLC
(330) MANOR CARE OF POTTSVILLE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615453	SKILLED NURSING FACILITY	DE	4,690,643	2,813,544	HCR III HEALTHCARE LLC
(331) MANOR CARE OF RENO NV LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0613035	SKILLED NURSING FACILITY	DE	310,711	554,402	HCR IV HEALTHCARE LLC
(332) MANOR CARE OF ROLLING MEADOWS IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619150	SKILLED NURSING FACILITY	DE	2,320,805	443,823	HCR IV HEALTHCARE LLC
(333) MANOR CARE OF SAN ANTONIO (NORTH) TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623600	SKILLED NURSING FACILITY	DE	-768	0	HCR IV HEALTHCARE LLC
(334) MANOR CARE OF SHAWANO WI LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624831	SKILLED NURSING FACILITY	DE	0	0	HCR III HEALTHCARE LLC
(335) MANOR CARE OF SILVER SPRING MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620058	SKILLED NURSING FACILITY	DE	6,119,659	1,749,854	HCR III HEALTHCARE LLC
(336) MANOR CARE OF SINKING SPRING PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621908	SKILLED NURSING FACILITY	DE	7,356,904	3,785,117	HCR III HEALTHCARE LLC
(337) MANOR CARE OF SOUTH HOLLAND IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615010	SKILLED NURSING FACILITY	DE	4,171,065	838,906	HCR IV HEALTHCARE LLC
(338) MANOR CARE OF SOUTH OGDEN UT LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624547	SKILLED NURSING FACILITY	DE	0	3,614	HCR IV HEALTHCARE LLC
(339) MANOR CARE OF SPOKANE WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624687	SKILLED NURSING FACILITY	DE	4,836,326	1,587,647	HCR IV HEALTHCARE LLC
(340) MANOR CARE OF SPRINGFIELD MO LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612506	SKILLED NURSING FACILITY	DE	208,554	583,711	HCR III HEALTHCARE LLC
(341) MANOR CARE OF SUNBURY PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615499	SKILLED NURSING FACILITY	DE	4,238,474	2,354,700	HCR III HEALTHCARE LLC
(342) MANOR CARE OF SUNNYVALE CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623034	SKILLED NURSING FACILITY	DE	8,096,075	2,407,414	HCR IV HEALTHCARE LLC
(343) MANOR CARE OF TACOMA WA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624696	SKILLED NURSING FACILITY	DE	6,205,419	1,840,600	HCR IV HEALTHCARE LLC
(344) MANOR CARE OF TOPEKA KS LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619810	SKILLED NURSING FACILITY	DE	2,550,889	441,601	HCR IV HEALTHCARE LLC
(345) MANOR CARE OF TOWSON LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620456	SKILLED NURSING FACILITY	DE	5,612,691	1,743,016	HCR III HEALTHCARE LLC
(346) MANOR CARE OF TUCSON AZ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622500	SKILLED NURSING FACILITY	DE	0	0	HCR IV HEALTHCARE LLC
(347) MANOR CARE OF TULSA OK LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610215	SKILLED NURSING FACILITY	DE	-14	103,422	HCR III HEALTHCARE LLC
(348) MANOR CARE OF VENICE FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624092	SKILLED NURSING FACILITY	DE	5,567,619	1,802,710	HCR III HEALTHCARE LLC
(349) MANOR CARE OF VOORHEES NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612955	SKILLED NURSING FACILITY	DE	4,509,313	1,568,960	HCR III HEALTHCARE LLC
(350) MANOR CARE OF W PALM BEACH FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624142	SKILLED NURSING FACILITY	DE	4,543,083	1,356,189	HCR III HEALTHCARE LLC
(351) MANOR CARE OF WALNUT CREEK CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623196	SKILLED NURSING FACILITY	DE	9,766,923	3,370,555	HCR IV HEALTHCARE LLC
(352) MANOR CARE OF WATERLOO IA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624363	SKILLED NURSING FACILITY	DE	3,112,911	1,058,995	HCR III HEALTHCARE LLC
(353) MANOR CARE OF WEBSTER TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623637	SKILLED NURSING FACILITY	DE	1,703	24,880	HCR IV HEALTHCARE LLC
(354) MANOR CARE OF WEST DES MOINES IA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624438	SKILLED NURSING FACILITY	DE	2,899,506	849,477	HCR III HEALTHCARE LLC
(355) MANOR CARE OF WEST READING PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615529	SKILLED NURSING FACILITY	DE	5,915,278	2,982,491	HCR III HEALTHCARE LLC
(356) MANOR CARE OF WESTERVILLE OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609626	SKILLED NURSING FACILITY	DE	5,153,032	1,096,790	HCR IV HEALTHCARE LLC
(357) MANOR CARE OF WESTMONT IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619027	SKILLED NURSING FACILITY	DE	2,351,565	246,188	HCR IV HEALTHCARE LLC
(358) MANOR CARE OF WHEATON MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620376	SKILLED NURSING FACILITY	DE	4,489,867	1,262,691	HCR III HEALTHCARE LLC
(359) MANOR CARE OF WICHITA KS LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619870	SKILLED NURSING FACILITY	DE	1,675,180	702,882	HCR IV HEALTHCARE LLC
(360) MANOR CARE OF WILLIAMSPORT PA (NORTH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621747	SKILLED NURSING FACILITY	DE	4,311,268	2,265,326	HCR III HEALTHCARE LLC
(361) MANOR CARE OF WILLIAMSPORT PA (SOUTH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621778	SKILLED NURSING FACILITY	DE	3,111,291	1,861,434	HCR III HEALTHCARE LLC
(362) MANOR CARE OF WILLOUGHBY OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610097	SKILLED NURSING FACILITY	DE	4,931,002	1,588,985	HCR IV HEALTHCARE LLC
(363) MANOR CARE OF WILMETTE IL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0615773	SKILLED NURSING FACILITY	DE	7,148	0	HCR IV HEALTHCARE LLC
(364) MANOR CARE OF WILMINGTON DE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623367	SKILLED NURSING FACILITY	DE	6,269,461	2,024,956	HCR III HEALTHCARE LLC
(365) MANOR CARE OF WINTER PARK FL LLC 333 N SUMMIT ST TOLEDO,OH43604 36-2899194	SKILLED NURSING FACILITY	DE	1,285,200	238,061	WINTER PARK NURSING CENTER LLC
(366) MANOR CARE OF YARDLEY PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614171	SKILLED NURSING FACILITY	DE	6,933,272	3,359,755	HCR III HEALTHCARE LLC
(367) MANOR CARE OF YEADON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621815	SKILLED NURSING FACILITY	DE	7,422,114	3,687,025	HCR III HEALTHCARE LLC
(368) MANOR CARE OF YORK PA (NORTH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622887	SKILLED NURSING FACILITY	DE	5,812,804	2,665,126	HCR III HEALTHCARE LLC
(369) MANOR CARE OF YORK PA (SOUTH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622947	SKILLED NURSING FACILITY	DE	5,932,573	2,707,165	HCR III HEALTHCARE LLC
(370) MANOR CARE REHABILITATION CENTER OF DECATUR GA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624293	OUTPATIENT REHABILITATION	DE	6,067,369	2,131,599	HCR III HEALTHCARE LLC
(371) MANOR CARE-BELDEN VILLAGE OF CANTON OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0613074	SKILLED NURSING FACILITY	DE	2,353,891	510,937	HCR IV HEALTHCARE LLC
(372) MANOR CARE-CARROLLWOOD OF TAMPA FL LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624118	SKILLED NURSING FACILITY	DE	1,602,031	235,023	HCR III HEALTHCARE LLC
(373) MANOR CARE-DULANEY MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619923	SKILLED NURSING FACILITY	DE	-13,642	673,160	HCR III HEALTHCARE LLC
(374) MANOR CARE-EUCLID BEACH OF CLEVELAND OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0609550	SKILLED NURSING FACILITY	DE	3,844,163	681,162	HCR IV HEALTHCARE LLC
(375) MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624605	SKILLED NURSING FACILITY	DE	5,356,088	1,638,625	HCR IV HEALTHCARE LLC
(376) MANOR CARE-GREENTREE OF PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622713	SKILLED NURSING FACILITY	DE	7,006,292	2,539,023	HCR III HEALTHCARE LLC
(377) MANOR CARE-IMPERIAL OF RICHMOND VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624643	SKILLED NURSING FACILITY	DE	5,024,471	1,676,365	HCR IV HEALTHCARE LLC
(378) MANOR CARE-KINGSTON COURT OF YORK PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610561	SKILLED NURSING FACILITY	DE	5,380,550	2,328,848	HCR III HEALTHCARE LLC
(379) MANOR CARE-LANSDALE OF MONTGOMERYVILLE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0614451	SKILLED NURSING FACILITY	DE	5,571,413	2,799,865	HCR III HEALTHCARE LLC
(380) MANOR CARE-LARGO MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620266	SKILLED NURSING FACILITY	DE	5,297,867	2,044,403	HCR III HEALTHCARE LLC
(381) MANOR CARE- LELY PALMS OF NAPLES FL (SH) LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0625295	ASSISTED LIVING FACILITY	DE	2,687,841	681,478	HCR III HEALTHCARE LLC
(382) MANOR CARE-LINDEN VILLAGE OF LEBANON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0621960	SKILLED NURSING FACILITY	DE	1,183,605	119,892	HCR III HEALTHCARE LLC
(383) MANOR CARE-NORTH HILLS OF PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610604	SKILLED NURSING FACILITY	DE	6,977,380	2,528,473	HCR III HEALTHCARE LLC
(384) MANOR CARE-PIKE CREEK OF WILMINGTON DE LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623346	SKILLED NURSING FACILITY	DE	8,477,987	2,961,737	HCR III HEALTHCARE LLC
(385) MANOR CARE-ROCKY RIVER OF CLEVELAND OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610139	SKILLED NURSING FACILITY	DE	-5,495	12,548	HCR IV HEALTHCARE LLC
(386) MANOR CARE-ROLAND PARK MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620341	SKILLED NURSING FACILITY	DE	4,889,032	1,968,398	HCR III HEALTHCARE LLC
(387) MANOR CARE-ROSSVILLE MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620310	SKILLED NURSING FACILITY	DE	6,449,428	2,827,548	HCR III HEALTHCARE LLC
(388) MANOR CARE-RUXTON MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620431	SKILLED NURSING FACILITY	DE	7,956,409	3,413,366	HCR III HEALTHCARE LLC
(389) MANOR CARE-SHARPVIEW OF HOUSTON TX LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623656	SKILLED NURSING FACILITY	DE	-650	0	HCR IV HEALTHCARE LLC
(390) MANOR CARE-STRATFORD HALL OF RICHMOND VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624664	SKILLED NURSING FACILITY	DE	6,565,257	2,122,703	HCR IV HEALTHCARE LLC
(391) MANOR CARE-SUMMER TRACE OF CARMEL IN LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619716	SKILLED NURSING FACILITY	DE	3,431,906	1,120,512	HCR IV HEALTHCARE LLC
(392) MANOR CARE-TICE VALLEY CA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622591	SKILLED NURSING FACILITY	DE	8,037,193	2,763,872	HCR IV HEALTHCARE LLC
(393) MANOR CARE-WEST DEPTFORD OF PAULSBORO NJ LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0612993	SKILLED NURSING FACILITY	DE	5,816,269	1,685,649	HCR III HEALTHCARE LLC
(394) MANOR CARE-WOODBRIDGE VALLEY MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620223	SKILLED NURSING FACILITY	DE	-3,853	366,641	HCR III HEALTHCARE LLC
(395) MANOR CARE OF OVERLAND PARK KS LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0619843	SKILLED NURSING FACILITY	DE	0	29,038	HCR IV HEALTHCARE LLC
(396) MEDICAL CARE CENTER-LYNCHBURG VA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0624567	SKILLED NURSING FACILITY	DE	3,848,309	1,169,941	HCR IV HEALTHCARE LLC
(397) OAKMONT EAST-GREENVILLE SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623316	SKILLED NURSING FACILITY	DE	3,744,385	1,162,696	HCR III HEALTHCARE LLC
(398) OAKMONT OF UNION SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623208	SKILLED NURSING FACILITY	DE	3,383,194	1,137,734	HCR III HEALTHCARE LLC
(399) OAKMONT WEST-GREENVILLE SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623335	SKILLED NURSING FACILITY	DE	4,185,275	1,242,794	HCR III HEALTHCARE LLC
(400) OLD ORCHARD HEALTH CARE CENTER-EASTON PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623007	SKILLED NURSING FACILITY	DE	7,642,801	3,674,733	HCR III HEALTHCARE LLC
(401) PERRYSBURG COMMONS SENIOR HOUSING-PERRYSBURG OH LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623264	ASSISTED LIVING FACILITY	DE	1,043,257	191,375	HCR IV HEALTHCARE LLC
(402) SHADYSIDE NURSING AND REHABILITATION CENTER-PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610325	SKILLED NURSING FACILITY	DE	5,128,889	1,809,040	HCR III HEALTHCARE LLC
(403) SKY VUE TERRACE-PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610347	SKILLED NURSING FACILITY	DE	3,300,600	1,163,693	HCR III HEALTHCARE LLC
(404) SPRINGHOUSE OF PIKESVILLE MD LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0620079	SKILLED NURSING FACILITY	DE	1,278,636	217,578	HCR III HEALTHCARE LLC
(405) TWINBROOK MEDICAL CENTER-ERIE PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610373	SKILLED NURSING FACILITY	DE	-3,514	94,025	HCR III HEALTHCARE LLC
(406) WALLINGFORD NURSING AND REHABILITATION CENTER-WALLINGFORD PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0610542	SKILLED NURSING FACILITY	DE	7,751,617	3,651,622	HCR III HEALTHCARE LLC
(407) WEST ASHLEY REHABILITATION AND NURSING CENTER-CHARLESTON SC LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0623364	SKILLED NURSING FACILITY	DE	3,774,027	1,461,347	HCR III HEALTHCARE LLC
(408) WHITEHALL BOROUGH-PITTSBURGH PA LLC 333 N SUMMIT ST TOLEDO,OH43604 26-0622805	SKILLED NURSING FACILITY	DE	7,185,892	2,413,868	HCR III HEALTHCARE LLC

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)COMMUNITY HEALTH CENTER OF BRANCH COUNTY 274 E CHICAGO ST COLDWATER,MI49036 38-6108110	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(3)DEFIANCE HOSPITAL AUXILIARY 1200 RALSTON DEFIANCE,OH43512 51-0173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	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)	12B, 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)	10	FOSTORIA HOSPITAL ASSOCIATION	Yes
(10)HCR MANORCARE INC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 82-5373223	SKILLED NURSING FACILITIES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes
(11)HERRICK MEDICAL CENTER AUXILIARY 500 E POTTAWATAMIE ST TECUMSEH,MI49286 38-3076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	HERRICK MEMORIAL HOSPITAL INC	Yes
(12)HERRICK MEMORIAL HOSPITAL INC 500 E POTTAWATAMIE ST TECUMSEH,MI49286 38-3049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(13)KAITLYN'S COTTAGE INC 1260 RALSTON AVE DEFIANCE,OH43512 45-4781053	RESPITE CARE	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes
(14)LENAWEE LONG TERM CARE 700 LAKESHIRE TR ADRIAN,MI49221 38-2879330	LONG TERM CARE	MI	501(C)(3)	10	EMMA L BIXBY MEDICAL CENTER	Yes
(15)MERCY MEMORIAL HOSPITAL CORPORATION 718 N MACOMB MONROE,MI48162 38-1984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(16)MONROE CANCER CENTER 800 STEWART RD MONROE,MI48162 27-1302183	CANCER CENTER	MI	501(C)(3)	10	MERCY MEMORIAL HOSPITAL CORPORATION	Yes
(17)MONROE COMMUNITY HEALTH SERVICES 718 N MACOMB MONROE,MI48162 38-2934134	LONG TERM CARE	MI	501(C)(3)	10	MERCY MEMORIAL HOSPITAL CORPORATION	Yes
(18)PARAMOUNT ADVANTAGE 1901 INDIAN WOOD CIR MAUMEE,OH43537 20-3376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes
(19)PROMEDICA CONTINUING CARE SERVICES CORP 100 MADISON AVE TOLEDO,OH43604 34-4492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes
(20)PROMEDICA CONTINUUM SERVICES 100 MADISON AVE TOLEDO,OH43604 34-1880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(21)PROMEDICA COURIER SERVICES INC 3170 W CENTRAL AVE TOLEDO,OH43606 26-0324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes
(22)PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO,OH43604 34-1517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(23)PROMEDICA HEALTH SYSTEM INC 100 MADISON AVE TOLEDO,OH43604 34-1517671	PARENT COMPANY OF HEALTH SYSTEM	OH	501(C)(3)	12B, II	N/A		No
(24)PROMEDICA INDEMNITY CORP ONE CHURCH ST 5TH FLOOR BURLINGTON,VT05401 34-1931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(25)PROMEDICA PHYSICIAN GROUP 100 MADISON AVE TOLEDO,OH43604 34-1899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes
(26)THE TOLEDO HOSPITAL 2142 N COVE BLVD TOLEDO,OH43606 34-4428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(27)TOLEDO DISTRICT NURSE ASSOCIATION 1946 N 13TH STREET TOLEDO,OH43624 34-4427949	SKILLED HOME CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes
(28)VISITING NURSE HOSPICE AND HEALTH CARE 5855 MONROE ST SYLVANIA,OH43560 34-1831624	HOSPICE HOME CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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) REYNOLDS ROAD SURGICAL CENTER LLC 2865 N REYNOLDS RD TOLEDO,OH43615 31-1569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	776,837	2,023,248		No			No	74.380 %
(2) NORTHWEST OHIO DEDICATED BREAST MRI LLC 100 MADISON AVE TOLEDO,OH43604 26-0679898	MEDICAL DIAGNOSTICS	OH	THE TOLEDO HOSPITAL	RELATED	336,554	952,999		No			No	50.000 %
(3) WEST CENTRAL SURGICAL CENTER LLC 7055 W CENTRAL TOLEDO,OH43617 20-0088459	AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	359,382	3,292,102		No		Yes		50.000 %
(4) PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC 100 MADISON AVE TOLEDO,OH43604 46-1989695	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA HEALTH SYSTEM INC	RELATED	819,457	742,776		No			No	51.430 %
(5) EAST-WEST HOLDINGS LTD 715 SOUTH TAFT AVE FREMONT,OH43420 20-4066818	REAL ESTATE	OH	MEMORIAL HOSPITAL	RELATED	5,652	290,844		No			No	50.000 %
(6) SURGICAL INSTITUTE OF MONROE LLC 1051 S TELEGRAPH RD MONROE,MI48161 27-0843485	AMBULATORY SURGICAL CENTER	MI	PROMEDICA CONTINUUM SERVICES	RELATED	-210,859	3,336,375		No			No	55.990 %
(7) PROMEDICA MASTER TENANT LLC 100 MADISON AVE TOLEDO,OH43604 47-5288490	REAL ESTATE	OH	PROMEDICA MANAGER MEMBER LLC	RELATED	-8,484	99,042		No		Yes		1.000 %
(8) PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC 100 MADISON AVE TOLEDO,OH43604 47-3163945	REAL ESTATE	OH	PROMEDICA MANAGER MEMBER LLC	RELATED	-361,523	42,429,986		No		Yes		90.000 %
(9) ROCKET VENTURE FUND II LLC 2865 N REYNOLDS RD STE 220 TOLEDO,OH43615 47-5603627	INVESTMENT FUND	OH	PROMEDICA HEALTH SYSTEM INC	RELATED	-17,026	833,243		No			No	66.660 %
(10) KAPIOS LLC 2865 N REYNOLDS RD TOLEDO,OH43615 81-2624635	SOFTWARE DEVELOPMENT	OH	PROMEDICA HEALTH SYSTEM INC	UNRELATED	-252,106	366,573		No			No	100.000 %
(11) HCRMC-PROMEDICA JV LLC 333 N SUMMIT STREET TOLEDO,OH43604 46-1343453	NURSING AND REHAB SERVICES	DE	MANORCARE HEALTH SERVICES OF TOLEDO OH LLC	RELATED	-214,736	11,761,142		No		Yes		91.210 %
(12) MERCYMANOR PARTNERSHIP PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 52-1931012	SKILLED NURSING	PA	MANOR CARE OF DELAWARE COUNTY LLC	RELATED	2,161,826	124,799		No		Yes		50.000 %
(13) NORMAN SPECIALTY HOSPITAL LLC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 42-1627672	HEALTH CARE	DE	MANORCARE HEALTH SERVICES OF OKLAHOMA LLC	RELATED	-113,690			No		Yes		60.500 %
(14) PROMEDICA PATHOLOGY LABORATORIES LLC 2130 W CENTRAL AVE STE 300 TOLEDO,OH43606 83-1022842	CLINICAL LABORATORY	DE	THE TOLEDO HOSPITAL	RELATED	711,991	42,273,516		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) HERRICK MEMORIAL DEVELOPMENT CORP 500 E POTTAWATAMIE TR ADRIAN,MI49221 38-3146907	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	C	76,263	1,011,261	100.000 %	Yes
(2) PROMEDICA CENTRAL CORPORATION OF MICHIGAN 100 MADISON AVE TOLEDO,OH43604 38-3322278	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C	-7,573,074	7,815,812	100.000 %	Yes
(3) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1901 INDIAN WOOD CIR MAUMEE,OH43537 34-1570675	HEALTH CARE INSURANCE	OH	PROMEDICA HEALTH SYSTEM INC	C	75,748,553	395,567,114	100.000 %	Yes
(4) PROMEDICA NORTH PHYSICIANS CORPORATION 100 MADISON AVE TOLEDO,OH43604 38-3482148	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C		149,134	100.000 %	Yes
(5) PROMEDICA RETAIL GROUP INC 3890 MONROE ST TOLEDO,OH43606 34-1159928	FLORIST	OH	PROMEDICA CONTINUUM SERVICES	C	-265,124	965,581	100.000 %	Yes
(6) HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION 818 RIVERSIDE AVE ADRIAN,MI49221 38-3639616	FACILITY MANAGEMENT	MI	HERRICK MEMORIAL DEVELOPMENT CORP	C	73	54,773	71.800 %	Yes
(7) PROMEDICA HEALTH NETWORK INC 100 MADISON AVE TOLEDO,OH43604 47-4006496	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA HEALTH SYSTEM INC	C	-306,751	83,546	100.000 %	Yes
(8) MONROE HEALTH VENTURES 718 N MACOMB MONROE,MI48164 38-2704426	PHARMACY	MI	MERCY MEMORIAL HOSPITAL CORPORATION	C			100.000 %	Yes
(9) PROMEDICA MANAGER MEMBER LLC 100 MADISON AVE TOLEDO,OH43604 47-5168737	REAL ESTATE	OH	PROMEDICA HEALTH SYSTEM INC	C	-12,740	31,358,211	100.000 %	Yes
(10) MANOR CARE INSURANCE INC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 98-0428947	INSURANCE	UT	HCR HEALTHCARE LLC	C	71,248	27,797,572	100.000 %	Yes

Schedule R (Form 990) 2018

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) ............................

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

Schedule R (Form 990) 2018

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) 2018

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) 2018

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,314,121	6,343,187
9	Program service revenue (Part VIII, line 2g) .........	60,435,705	59,693,758
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,428,340	2,286,105
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	691,537	413,990
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	67,869,703	68,737,040
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	140,403	79,385
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)	22,954,124	21,801,520
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)....	37,036,674	38,205,391
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	60,131,201	60,086,296
19	Revenue less expenses. Subtract line 18 from line 12.......	7,738,502	8,650,744
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	99,708,245	103,849,310
21	Total liabilities (Part X, line 26).............	36,283,061	37,111,114
22	Net assets or fund balances. Subtract line 21 from line 20.....	63,425,184	66,738,196

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 44,737,827 including grants of $ 79,385 ) (Revenue $ 59,012,150 )
	MEMORIAL HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 3,593,573 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 $ 1,041,279 including grants of $ ) (Revenue $ 281,120 )
	CONSISTENT WITH OUR MISSION, MEMORIAL HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH SERVICES, COMMUNITY BENEFIT OPERATIONS, 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 expenses49,372,679

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	597,683	11,787,716	1,161,869

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	6,331,245
e	Government grants (contributions)		1e	11,942

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		6,343,187

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	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	363
6	Total number of volunteers (estimate if necessary) .............	6	164
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

		Business Code
2a	NET PATIENT SERVICES	622110	59,352,311	59,352,311
b	AFFIL. ORG. RENT REV.	531120	341,447		341,447
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		59,693,758

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,213,508			1,213,508
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		96,132
b	Less: rental expenses		155,342
c	Rental income or (loss)		-59,210
d	Net rental income or (loss)......			-59,210			-59,210
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	4,495	13,130,137
b	Less: cost or other basis and sales expenses	63,536	11,998,499
c	Gain or (loss)	-59,041	1,131,638
d	Net gain or (loss).....			1,072,597	-59,041		1,131,638
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		52,978
b	Less: cost of goods sold ..b		64,116
c	Net income or (loss) from sales of inventory..			-11,138			-11,138
Business Code			Miscellaneous Revenue
11a	SUPPORT SERVICES		561210	315,128			315,128
b	CAFETERIA/DIETARY		722514	169,210			169,210
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			484,338
12	Total revenue. See Instructions......			68,737,040	59,293,270	0	3,100,583

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	79,385	79,385
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, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
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	17,311,499	14,672,540	2,638,959
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	437,094	364,426	72,668
9	Other employee benefits .......	2,555,435	2,130,155	425,280
10	Payroll taxes ...........	1,497,492	1,248,531	248,961
11	Fees for services (non-employees):
a	Management ......	274		274
b	Legal .........	84,512	58,362	26,150
c	Accounting ...........	31,392	26,173	5,219
d	Lobbying ...........	4,988		4,988
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	136,691		136,691
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	11,656,883	9,291,112	2,365,771
12	Advertising and promotion ....	211,027	161,288	49,739
13	Office expenses .......	598,289	355,270	243,019
14	Information technology ......	193,560	166,122	27,438
15	Royalties ..
16	Occupancy ...........	2,044,907	292,440	1,752,467
17	Travel ............	152,669	110,994	41,675
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,187,158	1,420,417	-233,259
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,665,083	4,132,664	1,532,419
23	Insurance ...	311,272	251,323	59,949
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	INTERCOMPANY SERVICES	5,279,539	4,598,393	681,146
b	DRUGS	4,200,618	4,200,618
c	MEDICAL SUPPLIES	3,773,112	3,755,931	17,181
d	PROVIDER TAXES	1,496,996	1,496,996
e	All other expenses	1,176,421	559,539	616,882
25	Total functional expenses. Add lines 1 through 24e	60,086,296	49,372,679	10,713,617	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).

1	Cash–non-interest-bearing ........			3,893,962	1	556,660
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,345,528	4	8,653,224
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 ........			801,992	8	1,104,422
9	Prepaid expenses and deferred charges ......			349,296	9	154,755
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	66,802,489
b	Less: accumulated depreciation	10b	22,543,690	38,295,094	10c	44,258,799
11	Investments—publicly traded securities .			35,804,340	11	37,435,474
12	Investments—other securities. See Part IV, line 11 .....			298,146	12	290,845
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14	662,000
15	Other assets. See Part IV, line 11 ...........			9,919,887	15	10,733,131
16	Total assets. Add lines 1 through 15 (must equal line 34)...			99,708,245	16	103,849,310

17	Accounts payable and accrued expenses .....	5,436,305	17	6,752,904
18	Grants payable ...		18
19	Deferred revenue .........	-28,451	19
20	Tax-exempt bond liabilities .........		20
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 ..	5,862,162	23	5,348,551
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	25,013,045	25	25,009,659
26	Total liabilities. Add lines 17 through 25..	36,283,061	26	37,111,114

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	56,853,147	27	60,646,114
28	Temporarily restricted net assets ...........	6,191,837	28	5,711,882
29	Permanently restricted net assets	380,200	29	380,200
	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 ...........	63,425,184	33	66,738,196
34	Total liabilities and net assets/fund balances ........	99,708,245	34	103,849,310