Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2019 , and ending 12-31-2019
BCheck if applicable:
CName of organization
MEMORIAL HOSPITAL
 
 
Doing business as
PROMEDICA MEMORIAL HOSPITAL
 
Number and street (or P.O. box if mail is not delivered to street address)
100 MADISON AVE ATTN TAX DEPT
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
TOLEDO, OH43604
D Employer identification number

34-4430849
E Telephone number

G Gross receipts $ 107,542,344
F Name and address of principal officer:
STEVEN M CAVANAUGH
100 MADISON AVE
TOLEDO,OH43604
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.PROMEDICA.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1918
M State of legal domicile: OH
Part I
Summary
Activities  & Governance 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 MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 23
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 17
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 374
6 Total number of volunteers (estimate if necessary) ............. 6 114
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 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 6,343,187 105,550
9 Program service revenue (Part VIII, line 2g) ......... 59,693,758 67,791,707
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,286,105 1,942,934
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 413,990 608,510
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 68,737,040 70,448,701
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 79,385 111,317
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) 21,801,520 24,569,819
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 38,205,391 39,360,892
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 60,086,296 64,042,028
19 Revenue less expenses. Subtract line 18 from line 12....... 8,650,744 6,406,673
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 103,849,310 120,404,973
21 Total liabilities (Part X, line 26)............. 37,111,114 35,798,357
22 Net assets or fund balances. Subtract line 21 from line 20..... 66,738,196 84,606,616
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: OUR MISSION IS TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND FAMILIES IN THE COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 52,433,164 including grants of $ 111,317 ) (Revenue $ 67,428,530 )
MEMORIAL HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet52,433,164
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
46
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
374
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
23
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
17
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCONNIE DOWNS100 MADISON AVE   TOLEDO,OH43604 (567) 585-8505
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) PAMELA M JENSEN......................................................................
PRESIDENT
1.00
.................
43.00
X   X       0 372,905 36,519
(2) KENNETH A MYERS......................................................................
CHAIRMAN
1.00
.................
6.00
X   X       0 0 0
(3) KEVIN C WEBB PHD......................................................................
EX OFFICIO
1.00
.................
54.00
X           0 1,375,143 235,820
(4) MICHAEL E GRILLIS DO......................................................................
TRUSTEE
1.00
.................
40.00
X           0 562,359 28,638
(5) IRACEMA AREVALO MD......................................................................
TRUSTEE
1.00
.................
46.00
X           0 356,137 26,522
(6) JAMES L NORTH MD......................................................................
TRUSTEE
1.00
.................
40.00
X           0 260,250 23,730
(7) DASA A DZIERWA......................................................................
TRUSTEE
1.00
.................
42.00
X           0 122,977 4,366
(8) AMY J ANWAY......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(9) BARRY F LUSE......................................................................
VICE CHAIRMAN
1.00
.................
0.00
X           0 0 0
(10) BETHANY S BROWN MSN RN......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(11) CHARLES F HEID......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(12) CHRISTIAN R MOORE......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(13) DARYL KNIPP......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(14) DENNIS S NEWMAN......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(15) DON A NALLEY......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(16) DOROTHY KERN......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
(17) JOHN L YUHAS DO......................................................................
TRUSTEE
1.00
.................
0.00
X           0 0 0
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JUDITH M REINO........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(19) KRISTIE A BILGER........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(20) NATHAN D EGBERT MD........................................................................
EX OFFICIO
1.00
.......................0.00
X           0 0 0
(21) REGINA VINCENT-WILLIAMS EDD........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(22) ROBIN J RICHTER........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(23) STACEY COX........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(24) THOMAS M BOWLUS ESQ........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(25) TOM H HOFFMAN........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(26) TY N TRACY DC........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(27) WILSON E FORNEY IV........................................................................
TRUSTEE
1.00
.......................0.00
X           0 0 0
(28) RANDALL OOSTRA........................................................................
PHS PRES. & CEO, EX OFFICIO
1.00
.......................60.00
    X       0 3,848,858 938,751
(29) STEVEN M CAVANAUGH........................................................................
TREASURER (BEG 06/03/19)
1.00
.......................60.00
    X       0 2,049,453 6,413
(30) JEFFREY KUHN........................................................................
SECRETARY
1.00
.......................60.00
    X       0 1,542,825 255,983
(31) MICHAEL BROWNING........................................................................
TREASURER (THRU 06/03/19)
1.00
.......................60.00
    X       0 1,216,014 3,813
(32) GARY AKENBERGER........................................................................
COO, ACUTE CARE & SVP, DIAG
1.00
.......................48.00
      X     0 450,803 44,563
(33) DEANA SIEVERT........................................................................
SR VP, PAT CARE/CNO, SYSTEM
1.00
.......................48.00
      X     0 365,549 35,214
(34) RANDAL KOCH........................................................................
DIRECTOR OF PHARMACY
40.00
.......................0.00
        X   144,354 0 17,124
(35) NATHAN PERKINS........................................................................
ADMIN DIRECTOR, RADIOLOGY
40.00
.......................0.00
        X   117,727 0 14,338
(36) COREY LEBER........................................................................
ASSOCIATE VP, NON-CLINICAL
40.00
.......................0.00
        X   122,841 0 8,530
(37) MATTHEW GOETZ........................................................................
PHARMACIST
40.00
.......................0.00
        X   120,789 0 6,925
(38) MATTHEW BARBOUR........................................................................
CLINICAL PHARMACIST
40.00
.......................0.00
        X   118,316 0 4,630
(39) ALAN M SATTLER........................................................................
FORMER OFFICER
0.00
.......................40.00
          X 0 347,990 44,375
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 624,027 12,871,263 1,736,254
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet9
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
THE SPIEKER COMPANY

2541 TRACY RD
NORTHWOOD,OH43619
CONTRUCTION CONTRACTOR 2,010,316
OMNI HEALTH SERVICES LTD

1650 EDER RD
HOLLAND,OH43528
PHYSICIAN SERVICES 1,063,500
TOLEDO PAIN SERVICES

7053 W CENTRAL AVE
TOLEDO,OH43617
MEDICAL SERVICES 655,157
UNIVERSITY OF TOLEDO PHYSICIANS LLC

3355 GLENDALE RD 3RD FLOOR
TOLEDO,OH43614
PHYSICIAN SERVICES 369,584
CHUCKS LAWN CARE LLC

720 WALNUT ST
FREMONT,OH43420
LAWN SERVICE 264,502
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet11
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 105,550
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 105,550
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 622110 67,428,530 67,428,530    
b AFFILIATED ORG RENT RE 531120 363,177     363,177
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 67,791,707
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,022,285     1,022,285
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   102,044 6a
b Less: rental expenses   61,571 6b
c Rental income or (loss)   40,473 6c
d Net rental income or (loss).......MediumBullet 40,473     40,473
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 238,283 37,638,581 7a
b Less: cost or other basis and sales expenses 238,283 36,717,932 7b
c Gain or (loss) 0 920,649 7c
d Net gain or (loss).........MediumBullet 920,649     920,649
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 80,846
b Less: cost of goods sold .. 10b 75,857
c Net income or (loss) from sales of inventory..MediumBullet 4,989     4,989
Business Code Miscellaneous Revenue
11a SUPPORT SERVICES 561210 399,968     399,968
b CAFETERIA/DIETARY 722514 163,080     163,080
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 563,048
12 Total revenue. See instructions.....MediumBullet 70,448,701 67,428,530 0 2,914,621
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 111,317 111,317
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ...........        
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........ 19,201,586 16,286,027 2,915,559  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 503,111 422,517 80,594  
9 Other employee benefits ....... 3,476,723 2,918,530 558,193  
10 Payroll taxes ........... 1,388,399 1,166,658 221,741  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 81,670 58,783 22,887  
c Accounting ........... 32,173 27,019 5,154  
d Lobbying ........... 6,567 6,567    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 96,296   96,296  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 9,019,438 6,569,526 2,449,912  
12 Advertising and promotion .... 182,975 111,604 71,371  
13 Office expenses ....... 692,720 422,869 269,851  
14 Information technology ...... 168,984 143,620 25,364  
15 Royalties ..        
16 Occupancy ........... 1,879,762 363,896 1,515,866  
17 Travel ............ 140,852 107,670 33,182  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 1,059,151 835,026 224,125  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 6,387,376 5,364,177 1,023,199  
23 Insurance ... 316,309 247,731 68,578  
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 DRUGS 6,529,594 6,459,101 70,493  
b INTERCOMPANY SERVICES 5,513,884 4,852,178 661,706  
c MEDICAL SUPPLIES 4,058,483 3,942,403 116,080  
d PROVIDER TAXES 1,460,239 1,226,322 233,917  
e All other expenses 1,734,419 789,623 944,796  
25 Total functional expenses. Add lines 1 through 24e 64,042,028 52,433,164 11,608,864 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 556,660 1 7,828,154
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 8,653,224 4 7,702,947
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 1,104,422 8 1,100,632
9 Prepaid expenses and deferred charges ...... 154,755 9 137,361
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 69,741,226
b Less: accumulated depreciation 10b 27,428,197 44,258,799 10c 42,313,029
11 Investments—publicly traded securities . 37,435,474 11 48,556,145
12 Investments—other securities. See Part IV, line 11 ..... 290,845 12 279,002
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 662,000 14 756,405
15 Other assets. See Part IV, line 11 ........... 10,733,131 15 11,731,298
16 Total assets. Add lines 1 through 15 (must equal line 33)... 103,849,310 16 120,404,973
Liabilities 17 Accounts payable and accrued expenses ..... 6,752,904 17 5,285,581
18 Grants payable ...   18  
19 Deferred revenue .........   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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 5,348,551 23 4,696,264
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 25,009,659 25 25,816,512
26 Total liabilities. Add lines 17 through 25.. 37,111,114 26 35,798,357
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 60,646,114 27 77,711,147
28 Net assets with donor restrictions ........... 6,092,082 28 6,895,469
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 66,738,196 32 84,606,616
33 Total liabilities and net assets/fund balances ........ 103,849,310 33 120,404,973
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
70,448,701
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
64,042,028
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
6,406,673
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
66,738,196
5
Net unrealized gains (losses) on investments ...............
5
5,068,792
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,392,955
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
84,606,616
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
MEMORIAL HOSPITAL
 
Employer identification number

34-4430849
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
MEMORIAL HOSPITAL
 
Employer identification number
34-4430849
Part I
Contributors
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
MEMORIAL HOSPITAL
 
Employer identification number

34-4430849
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2019)

Additional Data


Software ID:  
Software Version:  
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(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? ...................................................................................................................

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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
6,567
j
Total. Add lines 1c through 1i ....................................................................................................
6,567
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 instructions and the latest information.
OMB No. 1545-0047
2019
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 38,200 330,200 1,125,672
b Contributions ...       50,000 10,184
c Net investment earnings, gains, and losses         -13,648
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 38,200 380,200 330,200
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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 .....   1,248,776 1,248,776
b Buildings ....   31,855,879 8,233,367 23,622,512
c Leasehold improvements   9,257 7,388 1,869
d Equipment ....   26,158,274 17,342,477 8,815,797
e Other .....   10,469,040 1,844,965 8,624,075
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 42,313,029
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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 753,317
(2)OTHER RECEIVABLES 273,606
(3)OTHER INVESTMENTS 3,732,099
(4)ESTIMATED THIRD PARTY RECEIVABLE 76,806
(5)BENEFICIAL INTEREST IN FOUNDATION 6,895,470
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 11,731,298
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  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 25,816,512
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) 2019

Schedule D (Form 990) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2019
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
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . .
    604,002   604,002 0.940 %
b Medicaid (from Worksheet 3, column a) . . . . .     12,454,769 8,178,498 4,276,271 6.680 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     8,491 6,441 2,050 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     13,067,262 8,184,939 4,882,323 7.620 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     625,696 125,894 499,802 0.780 %
f Health professions education (from Worksheet 5) . . .     54,573   54,573 0.090 %
g Subsidized health services (from Worksheet 6) . . . .     487,830 192,520 295,310 0.460 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     97,585   97,585 0.150 %
j Total. Other Benefits . .     1,265,684 318,414 947,270 1.480 %
k Total. Add lines 7d and 7j .     14,332,946 8,503,353 5,829,593 9.100 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     20,000   20,000 0.030 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy     12,077   12,077 0.020 %
8 Workforce development            
9 Other            
10 Total     32,077   32,077 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,643,655
3
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. ......
3
585,134
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
12,958,543
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
15,272,287
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,313,744
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 % 4.290 % 47.140 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MEMORIAL HOSPITAL
715 SOUTH TAFT AVE
FREMONT,OH43420
WWW.PROMEDICA.ORG
1263
X X         X      
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/DEFAULT.ASPX
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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 PROCESSES, MEMORIAL HOSPITAL STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE, DEVELOP AND IMPLEMENT A PRIORITIZED, STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR SANDUSKY COUNTY. A GAP ANALYSIS AND RESOURCE ASSESSMENT WERE COMPLETED AS PART OF THIS PROCESS.MEMORIAL HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE SANDUSKY COUNTY CHIP AND AVAILABLE HEALTH DATA, SELECT AND PRIORITIZE KEY INDICATORS FOR THEIR DEFINED COMMUNITY, REVIEW RESOURCES AND GAPS IN THESE AREAS, AND DEVELOP STRATEGIC PLANS TO ADDRESS THESE HEALTH ISSUES IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA PLAN FROM THE SANDUSKY COUNTY PUBLIC HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE.THE SANDUSKY COUNTY CHIP PROCESS AND GROUPS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: BELLEVUE HOSPITAL (PH), CITY OF FREMONT, COMMUNITY HEALTH SERVICES (PH), FIRELANDS COUNSELING & RECOVERY SERVICES (PH), FREMONT CITY SCHOOLS, MENTAL HEALTH AND RECOVERY SERVICES BOARD OF SANDUSKY (PH), SANDUSKY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES (PH), SANDUSKY COUNTY FAMILY & CHILDREN FIRST COUNCIL (PH), SANDUSKY COUNTY HEALTH DEPARTMENT (PH), UNITED WAY OF SANDUSKY COUNTY (PH), WSOS SANDUSKY COUNTY
MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE MOST RECENT CHNA, CONDUCTED IN 2019, WILL BE IMPLEMENTED FOR REPORTING YEARS 2020-2022. THE SIGNIFICANT HEALTH NEEDS ADDRESSED BY THE FACILITY IN 2019 WERE IDENTIFIED IN THE CHNA ADOPTED IN 2016 AS DESCRIBED BELOW: 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 PHYSICIAN 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 2019 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: - THREE (3) EDUCATIONAL PROGRAMS WERE PROVIDED ON THE IMPORTANCE OF CANCER SCREENINGS.- 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 112 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 RISKY BEHAVIOR IN YOUTH WAS PROVIDED WITH OVER 17 PROVIDERS IN ATTENDANCE. 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:- 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: OBESITYSTRATEGY #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 2019 WE CONTINUE TO MEET OUR GOAL OF 80% 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 SUCH AS A NATURALLY SLIM PROGRAM OFFERED TO EMPLOYEES FREE OF CHARGE. 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:- PARTNERED WITH THE FREMONT CITY SCHOOLS TO PROVIDE MEALS AND EXCERSISE AT FOUR LOCAL SITES. THIS FREE PROGRAM OFFERED NUTRITIONAL MEALS AND ENCOURAGED CHILDREN TO PARTICPATE IN PHYSICAL ACTIVITIES LED BY PARTNERING AGENCIES. 2,362 NUTRITIONAL MEALS WERE SERVED DURING THAT TIME PERIOD. - THE HOSPITAL BEGAN WORKING WITH "NO KID HUNGRY" PROGRAM, PART OF THE "SHARE OUR STRENGTH" PROGRAM TO IMPROVE MARKETING OF SUMMER PROGRAMS TO YOUTH AT RISK FOR FOOD INSECURITY. RESEARCHING GRANT OPPORTUNITIES INCLUDING PARENTS IN THE MEALS TO INCREASE OVERALL PARTICIPATION. ENROLLED IN 2020 SUMMIT TO NETWORK WITH LIKE AGENCIES FOR BEST PRACTICES.HEALTH NEED IDENTIFIED: MENTAL HEALTH - DEPRESSION SCREENINGS AND SUICIDESTRATEGY #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 WITH 174 SCREENINGS COMPLETED IN 2019.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. CME 'TREATMENT OF DEPRESSION, ANXIETY & BIPOLAR DISORDER WITH 43 PROVIDERS IN ATTENDANCE. ADDITIONAL EVENTS ATTENDED WHERE MATERIAL WAS DISTRIBUTED INCLUDE: NAACP JUNETEETH EVENT, FREMONT YMCA EVENT, HEALTHY, WEALTHY AND WISE FAIR, NAMI WALK, GOLDEN THREADS EXPO, PROMEDICA FAMILY FUN FESTIVAL, RED RIBBON COMMUNITY "SPOOKTACULAR", SPOKE AT COMMUNITY PROSTATE SUPPORT GROUP.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:- SENT EMAIL REGARDING PHQ-9 USE/REMINDER TO 247 ON THE MEDICAL STAFF AND 98 ADVANCED PRACTICE PROFESSIONALS
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.ASPX
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.ASPX
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) 2019
Schedule H (Form 990) 2019
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?19
Name and address Type of Facility (describe)
1 1 - DOROTHY KERN CANCER CENTER
2390 ENTERPRISE ST
FREMONT,OH434208507
CANCER CARE
2 2 - HEATHLINK FREMONT
710 CLEVELAND AVE
FREMONT,OH434203224
OCCUPATIONAL MEDICINE
3 3 - PROMEDICA MEMORIAL HAYES - LAB
2575 HAYES AVE
FREMONT,OH434205201
LAB
4 4 - CLYDE PHYSICAL MEDICINE
509 W MCPHERSON HWY
CLYDE,OH434101107
PHYSICAL/OCCUPATIONAL MEDICINE
5 5 - GIBSONBURG PHYSICAL MEDICINE
116 S MAIN ST
GIBSONBURG,OH434311337
PHYSICAL/OCCUPATIONAL MEDICINE
6 6 - EDEN SPRINGS NURSING AND REHAB WEST CAMPUS
401 N BROADWAY ST
GREEN SPRINGS,OH448369653
LAB
7 7 - HEALTHLINK GREENVILLE
742 SWEITZER ST
GREENVILLE,OH45331
OCCUPATIONAL MEDICINE
8 8 - BETHESDA CARE CENTER
600 N BRUSH ST
FREMONT,OH434201402
LAB
9 9 - ELMWOOD ASSISTED LIVING
1545 FANGBONER RD
FREMONT,OH434201128
LAB
10 10 - COUNTRYSIDE CONTINUING CARE CENTER
1865 COUNTRYSIDE DR
FREMONT,OH434208748
LAB
11 11 - EDEN SPRINGS NURSING AND REHAB EAST CAMPUS
430 N BROADWAY ST
GREEN SPRINGS,OH448369734
LAB
12 12 - ELMWOOD SKILLED NURSING
1545 FANGBONER RD
FREMONT,OH434201128
LAB
13 13 - GARDEN OF CLYDE
700 COULSON ST
CLYDE,OH434102065
LAB
14 14 - EDEN SPRINGS HEALTHCARE CENTER
401 N BROADWAY ST
GREEN SPRINGS,OH448369653
LAB
15 15 - PROMEDICA MEMORIAL HOSPITAL FREMONT - LAB
715 S TAFT AVE
FREMONT,OH434203237
LAB
16 16 - MEMORIAL HOME HEALTH
430 S MAIN ST
CLYDE,OH434102142
LAB
17 17 - PROMEDICA HOSPICE
430 S MAIN ST
CLYDE,OH434102142
LAB
18 18 - DAVITA DIALYSIS
100 PINNACLE DR
FREMONT,OH434207400
LAB
19 19 - VALLEY VIEW HEALTH CAMPUS
1247 N RIVER RD
FREMONT,OH43420
LAB
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7: MEMORIAL HOSPITAL, INC. 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, INC. PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.
PART III, LINE 2: MEMORIAL HOSPITAL, INC.'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, INC. 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 PAGE 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, INC. USED THE MEDICARE ALLOWABLE COSTS PER ITS 2019 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; 39% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $51,000; 90% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR HIGHER; 45% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. SANDUSKY COUNTY HAS A POPULATION OF APPROXIMATELY 59,000 WITH APPROXIMATELY 10% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 21% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 8% OF SANDUSKY COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SANDUSKY COUNTY IN 2019 WAS 4.7%. THE LEADING CAUSES OF DEATH IN SANDUSKY COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE CANCER, HEART DISEASE, LUNG DISEASE, STROKE, DIABETES, UNINTENTIONAL INJURIES/ACCIDENTS, AND DIABETES. ACCORDING TO 2019 COUNTY HEALTH RANKINGS, SANDUSKY COUNTY RANKED 46 OF 88 COUNTIES FOR HEALTH OUTCOMES, 46 OF 88 FOR LENGTH OF LIFE, AND 45 OF 88 FOR QUALITY OF LIFE. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 55,000 WITH APPROXIMATELY 12% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 21% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 7% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2019 WAS 4.8%. THE LEADING CAUSES OF DEATH IN HANCOCK AND SENECA COUNTIES, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, AND ALZHEIMER'S. ACCORDING TO 2019 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 30 OF 88 COUNTIES FOR HEALTH OUTCOMES, 18 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, INC. IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2019:- PROMEDICA IMPLEMENTED A NEW GOVERNANCE STRUCTURE TO BETTER SUPPORT ITS NEW OPERATING MODEL, BASED ON THE ACQUISITION OF HCR MANORCARE. MAJOR CHANGES INCLUDED A DECREASE IN THE NUMBER OF PARENT BOARD MEMBERS, A DECREASE IN THE NUMBER OF STANDING COMMITTEES AND THE MIRRORING OF ALL HOSPITAL SUBSIDIARY OPERATING AND FOUNDATION BOARDS. THESE CHANGES WILL ALLOW FOR ALL PROMEDICA BOARDS TO BETTER SUPPORT THE EXPANDED ORGANIZATION.- THERE WERE APPROXIMATELY 340 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON 34 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. - 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 AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. 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 FEBRUARY/MAY 2019 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 AND OFFERS ADDED LAYERS OF SAFETY IN PATIENT CARE FOR IMPROVED CLINICAL OUTCOMES.- 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. ADDITIONALLY, PROMEDICA LAUNCHED ITS PROGRAM MEN'S HEALTH AND WELLNESS AT THE BARBERSHOP, WHICH PROVIDED 183 MEN WITH PROSTATE AND COLORECTAL CANCER EDUCATION.- PROMEDICA'S FOUNDATIONS 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 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 NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2019 PROMEDICA WAS COMPRISED OF MORE THAN 56,000 EMPLOYEES, APPROXIMATELY 1,400 VOLUNTEERS AND MORE THAN 2,600 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING 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 2019: - PROMEDICA MEMBERS AND AFFILIATE HOSPITALS 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; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE HCR MANORCARE UMBRELLA. - PROMEDICA MANAGED APPROXIMATELY 2 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 62,000 SURGERIES, 7,600 BIRTHS, AND 318,000 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $307,430,000, 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 OPENED ITS THIRD FOOD CLINIC AT PROMEDICA BAY PARK HOSPITAL IN 2019, WHILE CONTINUING TO OPERATE THE TWO ORIGINAL LOCATIONS 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 ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2019, MORE THAN 11,000 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,600 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 91,748 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 275,242 MEALS. - PROMEDICA BIXBY AND HERRICK HOSPITALS PROVIDED $5 VEGGIE MOBILE VOUCHERS TO PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. THESE PATIENTS COULD REDEEM THESE VOUCHERS FOR FRESH PRODUCE GROWN AT PROMEDICA FARMS OR FROM ANY OF THE VEGGIE MOBILE STOPS. IN 2019, APPROXIMATELY 75 PATIENTS IDENTIFIED AS FOOD INSECURE WERE PROVIDED A FOOD BOX AND VEGGIE MOBILE VOUCHERS UPON DISCHARGE. - PROMEDICA'S SENIOR CARE DIVISION (HCR MANORCARE) IMPLEMENTED MEALS-TO-GO, A FOOD ASSISTANCE PROGRAM THAT PROVIDES PATIENTS WITH A SHELF-STABLE SUPPLY OF FOOD AFTER A LENGTHY SKILLED NURSING STAY. THE PROGRAM BEGAN AS A PILOT IN THE DETROIT, MICH., WITH PLANS TO EXPAND TO OTHER FACILITIES ACROSS THE COUNTRY BY THE END OF 2020. - 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. ADDITIONALLY, THE FINANCIAL OPPORTUNITY CENTER (FOC) LOCATED WITHIN THE EBEID CENTER, PROVIDED EDUCATION AND COUNSELING TO NEARLY 700 INDIVIDUALS. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION. - PROMEDICA TEAMED UP WITH LOCAL INITIATIVES SUPPORT CORPORATION (LISC) TOLEDO TO CREATE THE YR16 INITIATIVE TO HELP INDIVIDUALS IN TOLEDO FIND SAFE AND AFFORDABLE HOUSING. SAFE AND AFFORDABLE HOUSING FOR RESIDENTS IN UNDERSERVED NEIGHBORHOODS IS JUST ONE OF THE KEY SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT PROMEDICA IS ADDRESSING WITH LISC AND OTHER COMMUNITY PARTNERS.
Schedule H (Form 990) 2019
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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
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HOSPITAL
 
Employer identification number
34-4430849
Part I
General Information on Grants and Assistance
1
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? ........................
2
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 STREET
TOLEDO,OH43604
34-1517672 501(C)(3) 111,317       OPERATING GRANT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
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 DISTIRBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES.
Schedule I (Form 990) 2019



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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
2019
Open to Public Inspection
Name of the organization
MEMORIAL HOSPITAL
 
Employer identification number

34-4430849
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .........
1b
 
 
2
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 on Line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1PAMELA M JENSEN
PRESIDENT
(i)

(ii)
0
-------------
276,630
0
-------------
73,400
0
-------------
22,875
0
-------------
15,004
0
-------------
21,515
0
-------------
409,424
0
-------------
0
2KEVIN C WEBB PHD
EX OFFICIO
(i)

(ii)
0
-------------
578,513
0
-------------
783,928
0
-------------
12,702
0
-------------
219,114
0
-------------
16,706
0
-------------
1,610,963
0
-------------
0
3MICHAEL E GRILLIS DO
TRUSTEE
(i)

(ii)
0
-------------
430,574
0
-------------
110,703
0
-------------
21,082
0
-------------
0
0
-------------
28,638
0
-------------
590,997
0
-------------
0
4IRACEMA AREVALO MD
TRUSTEE
(i)

(ii)
0
-------------
335,216
0
-------------
20,000
0
-------------
921
0
-------------
0
0
-------------
26,522
0
-------------
382,659
0
-------------
0
5JAMES L NORTH MD
TRUSTEE
(i)

(ii)
0
-------------
253,701
0
-------------
4,193
0
-------------
2,356
0
-------------
0
0
-------------
23,730
0
-------------
283,980
0
-------------
0
6RANDALL OOSTRA
PHS PRES. & CEO, EX OFFICIO
(i)

(ii)
0
-------------
1,952,660
0
-------------
1,856,635
0
-------------
39,563
0
-------------
919,062
0
-------------
19,689
0
-------------
4,787,609
0
-------------
0
7STEVEN M CAVANAUGH
TREASURER (BEG 06/03/19)
(i)

(ii)
0
-------------
1,277,261
0
-------------
772,192
0
-------------
0
0
-------------
0
0
-------------
6,413
0
-------------
2,055,866
0
-------------
0
8JEFFREY KUHN
SECRETARY
(i)

(ii)
0
-------------
645,968
0
-------------
843,953
0
-------------
52,904
0
-------------
239,428
0
-------------
16,555
0
-------------
1,798,808
0
-------------
0
9MICHAEL BROWNING
TREASURER (THRU 06/03/19)
(i)

(ii)
0
-------------
514,787
0
-------------
677,898
0
-------------
23,329
0
-------------
0
0
-------------
3,813
0
-------------
1,219,827
0
-------------
0
10GARY AKENBERGER
COO, ACUTE CARE & SVP, DIAG
(i)

(ii)
0
-------------
355,163
0
-------------
90,077
0
-------------
5,563
0
-------------
22,535
0
-------------
22,028
0
-------------
495,366
0
-------------
0
11DEANA SIEVERT
SR VP, PAT CARE/CNO, SYSTEM
(i)

(ii)
0
-------------
290,059
0
-------------
73,600
0
-------------
1,890
0
-------------
11,130
0
-------------
24,084
0
-------------
400,763
0
-------------
0
12RANDAL KOCH
DIRECTOR OF PHARMACY
(i)

(ii)
138,845
-------------
0
0
-------------
0
5,509
-------------
0
0
-------------
0
17,124
-------------
0
161,478
-------------
0
0
-------------
0
13ALAN M SATTLER
FORMER OFFICER
(i)

(ii)
0
-------------
198,731
0
-------------
139,306
0
-------------
9,953
0
-------------
17,597
0
-------------
26,778
0
-------------
392,365
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF MEMORIAL HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII.
SCHEDULE J, SUPPLEMENTAL INFORMATION: 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) 2019

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2019
Schedule L (Form 990 or 990-EZ) 2019
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?
Yes No
(1) JUSTINE FRANKART
 
FAMILY MEMBER OF AMY ANWAY (TRUSTEE) 42,467 EMPLOYMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  




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
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HOSPITAL
 
Employer identification number

34-4430849
Return Reference Explanation
FORM 990, PART III, LINE 4: 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 2019, MH BECAME A DESIGNATED LUNG CANCER SCREENING CENTER BY THE AMERICAN COLLEGE OF RADIOLOGY. MH ALSO RECEIVED AN "A" RATING FROM THE LEAPFROG GROUP FOR HOSPITAL SAFETY, AND EARNED CLINICAL RECOGNITION FROM HEALTHGRADES FOR CARDIAC, PULMONARY, GASTROINTESTINAL, AND CRITICAL CARE. 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. EXTENSIVE HOSPITAL RENOVATIONS WERE COMPLETED IN 2019 TO ENHANCE QUALITY OF CARE AND THE PATIENT EXPERIENCE. A NEW BIRTHING CENTER NOW INCLUDES SIX PRIVATE LABOR, DELIVERY, RECOVERY, AND POSTPARTUM ROOMS AS WELL AS ONE LABOR TUB, TWO TRIAGE ROOMS, A NURSERY WITH LARGER VIEWING AREA, ONE CRITICAL RESUSCITATION ROOM, AND NEW NON-STRESS TEST ROOM. OTHER RENOVATIONS INCLUDED THE RELOCATION OF ALL OUTPATIENT SERVICES (CARDIOLOGY, RESPIRATORY AND PULMONARY) TO THE GROUND FLOOR, THE ADDITION OF A NEW ECHO LAB, EKG ROOM, STRESS LAB, AND PULMONARY FUNCTION TEST ROOM, AND A NEW PATIENT-CENTERED ACUTE CARE UNIVERSAL UNIT. IN 2019, MH SERVED 1,663 INPATIENTS AND 64,575 OUTPATIENTS. FURTHER, 20,351 INDIVIDUALS SOUGHT EMERGENCY CARE AT MH. THE HOSPITAL CONTRIBUTED $5,830,000 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 $947,000 TO THE COMMUNITY DURING 2019. INCLUDED IN THIS FIGURE ARE PROGRAMS AND EVENTS SUCH AS: - WALK WITH EASE, A PROGRAM DEVELOPED IN COLLABORATION WITH GREAT LAKES COMMUNITY ACTION PARTNERSHIP TO HELP PREVENT FALLS IN OLDER ADULTS. - STAFF INVOLVEMENT AND SUPPORT OF RED RIBBON WEEK. - COMMUNITY EVENTS SUCH AS THE ANNUAL FAMILY FEST AND A SENIOR WELLNESS EXPO.SKIN CANCER SCREENINGS. - PARTICIPATION IN SAFETY TOWN, WHICH TEACHES CHILDREN ABOUT WATER SAFETY, GUN SAFETY, BIKE SAFETY, FIRST AID, FIRE SAFETY, AND NUTRITION. USE APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN TO PROVIDE BREAST EXAMS AND MAMMOGRAMS. MH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE DURING 2019, OF WHICH $604,000 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 2019 WAS $1,379,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $5,830,000 NOTED ABOVE. FURTHERMORE, MH PROVIDED $4,278,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. ALSO IN 2019 THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $5,114,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $5,830,000 NOTED ABOVE. MH EXPENDED $12,154,000 IN NET PAYROLL, PROVIDING 374 JOBS IN NORTHWEST OHIO IN 2019. A TOTAL OF $697,000 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.
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, FOR 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/CHIEF MEDICAL OFFICER 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 PPG PRESIDENT/CHIEF MEDICAL OFFICER, 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 PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. 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 PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11G OTHER GENERAL SERVICES: PROGRAM SERVICE EXPENSES 3,196,434. MANAGEMENT AND GENERAL EXPENSES 2,449,912. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,646,346. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 3,373,092. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,373,092.
FORM 990, PART XI, LINE 9: BENEFICIAL INTEREST IN FOUNDATION 803,387. TRANSFERS BETWEEN RELATED ENTITIES 5,589,568.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
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 INC
 
(2) IST THEATRE LLC
100 MADISON AVE
TOLEDO,OH43604
COMMUNITY ARTS FACILITY OH 0 3,554,701 PROMEDICA HEALTH SYSTEM INC
 
(3) PROMEDICA HICKMAN CANCER CENTER PHARMACY LLC
100 MADISON AVE
TOLEDO,OH43604
PHARMACY OH 104,465,623 0 THE TOLEDO HOSPITAL
 
(4) PROMEDICA PHARMACY GROUP LLC
100 MADISON AVE
TOLEDO,OH43604
36-4949156
PHARMACY OH 0 0 PROMEDICA CONTINUUM SERVICES
 
(5) FORT INDUSTRY JV PARTNER LLC
100 MADISON AVE
TOLEDO,OH43604
84-4675266
HOLDS INVESTMENTS OH 0 8,540,000 PROMEDICA HEALTH SYSTEM INC
 
(6) HCRMC-PROMEDICA LLC
333 N SUMMIT ST
TOLEDO,OH43604
46-1343453
NURSING AND REHAB SERVICES DE -2,185,288 12,184,508 MANOR CARE HEALTH SERVICES OF TOLEDO OH LLC
 
(7) PROMEDICA CENTRAL PHYSICIANS LLC
100 MADISON AVE
TOLEDO,OH43604
34-1881137
EMPLOYS PHYSICIANS OH 387,466,023 296,438,519 PROMEDICA PHYSICIAN GROUP INC
 
(8) PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC
100 MADISON AVE
TOLEDO,OH43604
26-3888045
EMPLOYS PHYSICIANS OH 18,301,472 -105,269,559 PROMEDICA PHYSICIAN GROUP INC
 
(9) THE PHARMACY COUNTER LLC
100 MADISON AVE
TOLEDO,OH43604
27-1325141
MEDICAL EQUIPMENT & PHARMACY OH 65,105,182 99,954,514 PROMEDICA PHYSICIAN GROUP INC
 
(10) WOLF CREEK ASSOCIATES LLC
901 KIMOLE LN
ADRIAN,MI49221
38-3164818
FACILITY LEASING MI 119,263 1,724,405 EMMA L BIXBY MEDICAL CENTER
 
(11) PROMEDICA MONROE CARDIOLOGY PLLC
100 MADISON AVE
TOLEDO,OH43604
27-2920342
EMPLOYS PHYSICIANS MI 889,668 -6,438,944 PROMEDICA PHYSICIAN GROUP INC
 
(12) ERIE WEST HOSPICE & PALLIATIVE CARE LTD
100 MADISON AVE
TOLEDO,OH43604
20-5752995
PROVIDES HOSPICE CARE OH 5,497,909 7,841,474 PROMEDICA CONTINUUM SERVICES
 
(13) PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC
100 MADISON AVE
TOLEDO,OH43604
45-3230331
PRACTICE MANAGEMENT OH 0 -3,618,834 PROMEDICA PHYSICIAN GROUP INC
 
(14) PROMEDICA SURGICAL SERVICES LLC
100 MADISON AVE
TOLEDO,OH43604
EMPLOYS PHYSICIANS OH 0 0 PROMEDICA PHYSICIAN GROUP INC
 
(15) MISSION POINTE GOLF COURSE LLC
2142 NORTH COVE
TOLEDO,OH43606
GOLF COURSE MI 0 0 PROMEDICA FOUNDATION
 
(16) PROMEDICA INNOVATIONS LLC
100 MADISON AVE
TOLEDO,OH43604
30-1221601
INVESTMENT COMPANY OH 0 0 PROMEDICA HEALTH SYSTEM INC
 
(17) PROMEDICA GENITO-URINARY SURGEONS LLC
100 MADISON AVE
TOLEDO,OH43604
46-1120436
EMPLOYS PHYSICIANS OH 5,873,200 -23,434,097 PROMEDICA PHYSICIAN GROUP INC
 
(18) PROMEDICA MONROE PHYSICIANS PLLC
100 MADISON AVE
TOLEDO,OH43604
46-1111822
EMPLOYS PHYSICIANS MI 11,895,015 -23,671,344 PROMEDICA PHYSICIAN GROUP INC
 
(19) PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
100 MADISON AVE
TOLEDO,OH43604
45-4976786
EMPLOYS PHYSICIANS OH 0 154,765 PROMEDICA PHYSICIAN GROUP INC
 
(20) PROMEDICA HOSPITALISTS LLC
100 MADISON AVE
TOLEDO,OH43604
EMPLOYS PHYSICIANS OH 0 0 PROMEDICA PHYSICIAN GROUP INC
 
(21) PROMEDICA HOSPITALISTS PLLC
100 MADISON AVE
TOLEDO,OH43604
EMPLOYS PHYSICIANS MI 0 0 PROMEDICA PHYSICIAN GROUP INC
 
(22) MEMORIAL ANESTHESIA LTD
715 SOUTH TAFT AVE
FREMONT,OH43420
20-5763680
EMPLOYS PHYSICIANS OH 0 0 PROMEDICA PHYSICIAN GROUP INC
 
(23) MEMORIAL PROFESSIONAL SERVICES LTD
715 SOUTH TAFT AVE
FREMONT,OH43420
27-3763993
EMPLOYS PHYSICIANS OH 13,381,935 -24,321,708 PROMEDICA PHYSICIAN GROUP INC
 
(24) PHS VENTURES LLC
100 MADISON AVE
TOLEDO,OH43604
34-1880473
HEALTH CARE MANAGEMENT SERVICES DE 0 0 PROMEDICA HEALTH SYSTEM INC
 
(25) 300 MADISON BUILDING LLC
100 MADISON AVE
TOLEDO,OH43604
82-2062486
REAL ESTATE OH 2,185,490 17,703,607 PROMEDICA HEALTH SYSTEM INC
 
(26) MARINA DISTRICT DEVELOPMENT LLC
100 MADISON AVE
TOLEDO,OH43604
REAL ESTATE OH 0 6,885 PROMEDICA HEALTH SYSTEM INC
 
(27) PHS INVESTMENTS LLC
100 MADISON AVE
TOLEDO,OH43604
INVESTMENT COMPANY OH 2,564,760 22,447,708 THE TOLEDO HOSPITAL
 
(28) PROMEDICA INTERNATIONAL LLC
100 MADISON AVE
TOLEDO,OH43604
83-2427163
CONSULTING SERVICES OH 144,100 0 PROMEDICA HEALTH SYSTEM INC
 
(29) PROMEDICA ACTIVE MOBILITY LLC
100 MADISON AVE
TOLEDO,OH43604
81-5178173
DURABLE MEDICAL EQUIPMENT OH 159,929 194,981 PROMEDICA HEALTH SYSTEM INC
 
(30) 1611 MONROE INVESTORS LLC
100 MADISON AVE
TOLEDO,OH43604
REAL ESTATE OH 0 308,507 PROMEDICA HEALTH SYSTEM INC
 
(31) BALL PARK PROPERTIES LLC
100 MADISON AVE
TOLEDO,OH43604
82-3954332
REAL ESTATE OH 0 1,118,158 PROMEDICA HEALTH SYSTEM INC
 
(32) PROMEDICA PRIMARY CARE PROVIDERS LLC
100 MADISON AVE
TOLEDO,OH43604
83-1731861
EMPLOYS PHYSICIANS OH 0 0 PROMEDICA PHYSICIAN GROUP INC
 
(33) KAPIOS LLC
2865 N REYNOLDS RD
TOLEDO,OH43615
81-2624635
SOFTWARE DEVELOPMENT OH 90,319 0 PROMEDICA HEALTH SYSTEM INC
 
(34) PROMEDICA NATURAL WELLNESS LLC
100 MADISON AVE
TOLEDO,OH43604
82-1587026
NATURAL WELLNESS PRODUCTS OH 0 16,500 PROMEDICA HEALTH SYSTEM INC
 
(35) ANCILLARY SERVICES MANAGEMENT LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1636874
MEDICAL SUPPLIES OH 0 0 HCR HEALTHCARE LLC
 
(36) ARDEN COURTS OF ARLINGTON TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624126
ASSISTED LIVING FACILITY DE 0 0 HCR IV HEALTHCARE LLC
 
(37) ARDEN COURTS OF HAMDEN CT LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625105
ASSISTED LIVING FACILITY DE 0 0 HCR III HEALTHCARE LLC
 
(38) 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
 
(39) ARDEN COURTS OF LOUISVILLE KY LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622079
ASSISTED LIVING FACILITY DE 0 0 HCR IV HEALTHCARE LLC
 
(40) HCR CANTERBURY VILLAGE LLC
333 N SUMMIT ST
TOLEDO,OH43604
38-2032536
SKILLED NURSING FACILITY DE 0 0 HCR HEALTHCARE LLC
 
(41) HCR HEALTHCARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624435
HOLDING COMPANY DE 0 0 HCR MANORCARE INC
 
(42) HCR II HEALTHCARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-1250342
HOLDING COMPANY DE 0 0 HCR HEALTHCARE LLC
 
(43) HCR III HEALTHCARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624411
HOLDING COMPANY DE 0 0 HCR II HEALTHCARE LLC
 
(44) HCR IV HEALTHCARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-1283803
HOLDING COMPANY DE 0 0 HCR III HEALTHCARE LLC
 
(45) HEARTLAND CARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
32-0091717
HOLDING COMPANY OH 0 0 HCR MANOR CARE SERVICES LLC
 
(46) HEARTLAND EMPLOYMENT SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1903270
EMPLOYMENT SERVICES OH 0 0 HCR HEALTHCARE LLC
 
(47) 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
 
(48) MANOR CARE AVIATION LLC
333 N SUMMIT ST
TOLEDO,OH43604
52-1462072
AVIATION DE 0 0 HCR HEALTHCARE LLC
 
(49) MANOR CARE OF DELAWARE COUNTY LLC
333 N SUMMIT ST
TOLEDO,OH43604
52-1916053
HOLDING COMPANY DE 0 0 HCR HEALTHCARE LLC
 
(50) 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
 
(51) MANOR CARE OF WINTER PARK FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
36-2899194
SKILLED NURSING FACILITY DE 30,065 52,974 WINTER PARK NURSING CENTER LLC
 
(52) MANOR CARE SUPPLY LLC
333 N SUMMIT ST
TOLEDO,OH43604
52-2055097
PURCHASING COMPANY DE 0 0 HCR HEALTHCARE LLC
 
(53) MANORCARE HEALTH SERVICES OF OKLAHOMA LLC
333 N SUMMIT ST
TOLEDO,OH43604
52-2055078
HOLDING COMPANY DE 0 0 HCR HEALTHCARE LLC
 
(54) MANORCARE HEALTH SERVICES OF TOLEDO OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
90-0904333
HOLDING COMPANY DE 0 0 HCR HEALTHCARE LLC
 
(55) PROMEDICA OF ADRIAN MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
38-3985660
SKILLED NURSING FACILITY DE 0 174,888 MANORCARE HEALTH SERVICES OF TOLEDO OH LLC
 
(56) PROMEDICA OF SYLVANIA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
61-1771805
SKILLED NURSING FACILITY DE 2,398,322 2,980,176 MANORCARE HEALTH SERVICES OF TOLEDO OH LLC
 
(57) REHABILITATION ADMINISTRATION LLC
333 N SUMMIT ST
TOLEDO,OH43604
61-1295825
REHABILITATION SERVICES DE 0 0 HEARTLAND REHABILITATION SERVICES LLC
 
(58) SPRINGHOUSE OF BETHESDA MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622235
ASSISTED LIVING FACILITY DE 0 0 HCR III HEALTHCARE LLC
 
(59) SPRINGHOUSE OF SILVER SPRING MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622508
ASSISTED LIVING FACILITY DE 0 0 HCR III HEALTHCARE LLC
 
(60) WINTER PARK NURSING CENTER LLC
333 N SUMMIT ST
TOLEDO,OH43604
37-1019107
HOLDING COMPANY DE 0 0 MANORCARE HEALTH SERVICES LLC
 
(61) AMERICAN REHABILITATION GROUP LLC
333 N SUMMIT ST
TOLEDO,OH43604
61-1284533
OUTPATIENT REHABILITATION DE 839,878 68,000 REHABILITATION ADMINISTRATION LLC
 
(62) HCR HOME HEALTH CARE AND HOSPICE LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1787978
HOLDING COMPANY OH 0 0 HCR HEALTHCARE LLC
 
(63) HCR MANOR CARE SERVICES OF FLORIDA III LLC
333 N SUMMIT ST
TOLEDO,OH43604
45-2507279
HOSPICE SERVICE FL 15,832,514 0 HCR HOME HEALTH CARE AND HOSPICE LLC
 
(64) HCR MANOR CARE SERVICES OF FLORIDA LLC
333 N SUMMIT ST
TOLEDO,OH43604
74-3193136
HOSPICE SERVICE FL 6,785,299 621,242 HCR HOME HEALTH CARE AND HOSPICE LLC
 
(65) HCR MANOR CARE SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1838217
ADMINISTRATIVE SERVICES OH 1,572,282 201,035,602 HCR HEALTHCARE LLC
 
(66) HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC
333 N SUMMIT ST
TOLEDO,OH43604
65-0666550
OUTPATIENT REHABILITATION FL 19,614,832 2,014,379 HEARTLAND REHABILITATION SERVICES LLC
 
(67) HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-1305723
SKILLED NURSING FACILITY DE 27,125,758 11,632,269 HCR HEALTHCARE LLC
 
(68) HEARTLAND HOME CARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1787895
HOME HEALTH CARE SERVICE OH 29,609,446 4,669,269 HEARTLAND REHABILITATION SERVICES LLC
 
(69) HEARTLAND HOME HEALTH CARE SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1787967
HOME HEALTH CARE SERVICE OH 2,431,094 536,691 HCR HOME HEALTH CARE AND HOSPICE LLC
 
(70) HEARTLAND HOSPICE SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1788398
HOSPICE SERVICE OH 355,102,905 65,663,113 HCR HOME HEALTH CARE AND HOSPICE LLC
 
(71) HEARTLAND REHABILITATION EXTENSION SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
81-2116419
OUTPATIENT REHABILITATION DE 2,721,752 570,500 HEARTLAND REHABILITATION SERVICES LLC
 
(72) HEARTLAND REHABILITATION SERVICES OF FLORIDA LLC
333 N SUMMIT ST
TOLEDO,OH43604
59-2504386
OUTPATIENT REHABILITATION FL 0 0 HEARTLAND REHABILITATION SERVICES LLC
 
(73) HEARTLAND REHABILITATION SERVICES OF KENTUCKY LLC
333 N SUMMIT ST
TOLEDO,OH43604
61-1301414
OUTPATIENT REHABILITATION DE 5,214,772 429,919 REHABILITATION ADMINISTRATION LLC
 
(74) HEARTLAND REHABILITATION SERVICES OF MICHIGAN LLC
333 N SUMMIT ST
TOLEDO,OH43604
30-0535129
OUTPATIENT REHABILITATION DE 185,831 15,692 HEARTLAND REHABILITATION SERVICES LLC
 
(75) HEARTLAND REHABILITATION SERVICES OF NEW JERSEY LLC
333 N SUMMIT ST
TOLEDO,OH43604
22-2137595
OUTPATIENT REHABILITATION DE 1,965,100 257,774 HEARTLAND REHABILITATION SERVICES LLC
 
(76) HEARTLAND REHABILITATION SERVICES OF OHIO LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1479648
OUTPATIENT REHABILITATION OH 2,096,295 181,802 HEARTLAND REHABILITATION SERVICES LLC
 
(77) HEARTLAND REHABILITATION SERVICES OF VIRGINIA LLC
333 N SUMMIT ST
TOLEDO,OH43604
54-1508699
OUTPATIENT REHABILITATION DE 13,680,736 1,598,193 HEARTLAND REHABILITATION SERVICES LLC
 
(78) HEARTLAND REHABILITATION SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1280619
OUTPATIENT REHABILITATION OH 2,374,070 362,463 HCR HEALTHCARE LLC
 
(79) HEARTLAND SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
34-1760503
HOLDING COMPANY OH 0 28,847,119 HCR HEALTHCARE LLC
 
(80) HEARTLAND THERAPY PROVIDER NETWORK LLC
333 N SUMMIT ST
TOLEDO,OH43604
37-1027432
OUTPATIENT REHABILITATION DE 377,794 75,846 HCR HEALTHCARE LLC
 
(81) IN HOME HEALTH LLC
333 N SUMMIT ST
TOLEDO,OH43604
41-1458213
HOME HEALTH CARE SERVICE MN 221,483,544 22,798,793 MANORCARE HEALTH SERVICES LLC
 
(82) INDUSTRIAL WASTES LLC
333 N SUMMIT ST
TOLEDO,OH43604
25-1457630
REAL ESTATE DE 0 477,790 HCR HEALTHCARE LLC
 
(83) MANOR CARE OF LACEY WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624391
SKILLED NURSING FACILITY DE 9,884,874 2,627,300 MANORCARE HEALTH SERVICES LLC
 
(84) MANOR CARE OF SALMON CREEK WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624375
SKILLED NURSING FACILITY DE 12,619,842 2,686,332 MANORCARE HEALTH SERVICES LLC
 
(85) MANORCARE HEALTH SERVICES LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-1305666
SKILLED NURSING FACILITY DE 67,059,139 30,895,335 HCR HEALTHCARE LLC
 
(86) MILESTONE HEALTHCARE LLC
333 N SUMMIT ST
TOLEDO,OH43604
75-2592398
MEDICAL STAFFING DE 23,135,833 3,997,062 HEARTLAND REHABILITATION SERVICES LLC
 
(87) PORTFOLIO ONE LLC
333 N SUMMIT ST
TOLEDO,OH43604
22-1604502
SKILLED NURSING FACILITY OH 14,118,573 1,956,181 HCR HEALTHCARE LLC
 
(88) ARDEN COURTS OF AKRON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623857
ASSISTED LIVING FACILITY DE 2,113,027 361,591 HCR IV HEALTHCARE LLC
 
(89) ARDEN COURTS OF ALLENTOWN PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623965
ASSISTED LIVING FACILITY DE 3,667,410 281,390 HCR III HEALTHCARE LLC
 
(90) ARDEN COURTS OF ANNANDALE VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624314
ASSISTED LIVING FACILITY DE 4,748,932 278,762 HCR IV HEALTHCARE LLC
 
(91) ARDEN COURTS OF AUSTIN TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624145
ASSISTED LIVING FACILITY DE 2,717,343 91,462 HCR IV HEALTHCARE LLC
 
(92) ARDEN COURTS OF AVON CT LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625113
ASSISTED LIVING FACILITY DE 2,383,088 329,371 HCR III HEALTHCARE LLC
 
(93) ARDEN COURTS OF BINGHAM FARMS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622828
ASSISTED LIVING FACILITY DE 2,919,042 196,624 HCR IV HEALTHCARE LLC
 
(94) ARDEN COURTS OF CHERRY HILL NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623009
ASSISTED LIVING FACILITY DE 3,879,658 338,171 HCR III HEALTHCARE LLC
 
(95) ARDEN COURTS OF DELRAY BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625237
ASSISTED LIVING FACILITY DE 3,995,276 457,193 HCR III HEALTHCARE LLC
 
(96) ARDEN COURTS OF ELK GROVE VILLAGE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625405
ASSISTED LIVING FACILITY DE 3,043,600 166,574 HCR IV HEALTHCARE LLC
 
(97) ARDEN COURTS OF FARMINGTON CT LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625092
ASSISTED LIVING FACILITY DE 4,542,685 237,268 HCR III HEALTHCARE LLC
 
(98) ARDEN COURTS OF FT MYERS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625314
ASSISTED LIVING FACILITY DE 3,040,654 518,258 HCR III HEALTHCARE LLC
 
(99) ARDEN COURTS OF GENEVA IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625428
ASSISTED LIVING FACILITY DE 4,229,289 222,812 HCR IV HEALTHCARE LLC
 
(100) ARDEN COURTS OF GLEN ELLYN IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625418
ASSISTED LIVING FACILITY DE 1,797,438 317,967 HCR IV HEALTHCARE LLC
 
(101) ARDEN COURTS OF JEFFERSON HILLS PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624075
ASSISTED LIVING FACILITY DE 4,068,113 321,284 HCR III HEALTHCARE LLC
 
(102) ARDEN COURTS OF KENSINGTON MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622568
ASSISTED LIVING FACILITY DE 5,744,260 347,352 HCR III HEALTHCARE LLC
 
(103) ARDEN COURTS OF KENWOOD OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623245
ASSISTED LIVING FACILITY DE 2,752,330 289,455 HCR IV HEALTHCARE LLC
 
(104) ARDEN COURTS OF KING OF PRUSSIA PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624032
ASSISTED LIVING FACILITY DE 3,968,944 396,047 HCR III HEALTHCARE LLC
 
(105) ARDEN COURTS OF LARGO FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625141
ASSISTED LIVING FACILITY DE 3,570,405 493,177 HCR III HEALTHCARE LLC
 
(106) ARDEN COURTS OF LIVONIA MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622866
ASSISTED LIVING FACILITY DE 3,793,905 252,415 HCR IV HEALTHCARE LLC
 
(107) ARDEN COURTS OF MONROEVILLE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623898
ASSISTED LIVING FACILITY DE 3,986,225 297,560 HCR III HEALTHCARE LLC
 
(108) ARDEN COURTS OF NORTHBROOK IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625378
ASSISTED LIVING FACILITY DE 4,074,284 90,998 HCR IV HEALTHCARE LLC
 
(109) ARDEN COURTS OF PALM HARBOR FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625222
ASSISTED LIVING FACILITY DE 4,233,976 429,556 HCR III HEALTHCARE LLC
 
(110) ARDEN COURTS OF PALOS HEIGHTS IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625390
ASSISTED LIVING FACILITY DE 3,975,584 323,892 HCR IV HEALTHCARE LLC
 
(111) ARDEN COURTS OF PARMA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623801
ASSISTED LIVING FACILITY DE 3,985,002 212,366 HCR IV HEALTHCARE LLC
 
(112) ARDEN COURTS OF PIKESVILLE MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622121
ASSISTED LIVING FACILITY DE 4,392,566 308,182 HCR III HEALTHCARE LLC
 
(113) ARDEN COURTS OF POTOMAC MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622198
ASSISTED LIVING FACILITY DE 3,578,434 529,765 HCR III HEALTHCARE LLC
 
(114) ARDEN COURTS OF RICHARDSON TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624214
ASSISTED LIVING FACILITY DE 3,959,768 252,306 HCR IV HEALTHCARE LLC
 
(115) ARDEN COURTS OF SAN ANTONIO TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624189
ASSISTED LIVING FACILITY DE 3,448,046 254,006 HCR IV HEALTHCARE LLC
 
(116) ARDEN COURTS OF SARASOTA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625246
ASSISTED LIVING FACILITY DE 2,913,686 341,999 HCR III HEALTHCARE LLC
 
(117) ARDEN COURTS OF SEMINOLE FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625266
ASSISTED LIVING FACILITY DE 3,734,618 546,008 HCR III HEALTHCARE LLC
 
(118) ARDEN COURTS OF SILVER SPRING MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622164
ASSISTED LIVING FACILITY DE 4,566,743 221,892 HCR III HEALTHCARE LLC
 
(119) ARDEN COURTS OF SOUTH HOLLAND IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622045
ASSISTED LIVING FACILITY DE 3,018,882 115,258 HCR IV HEALTHCARE LLC
 
(120) ARDEN COURTS OF STERLING HEIGHTS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622772
ASSISTED LIVING FACILITY DE 2,755,822 177,315 HCR IV HEALTHCARE LLC
 
(121) ARDEN COURTS OF TAMPA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625330
ASSISTED LIVING FACILITY DE 3,686,680 438,736 HCR III HEALTHCARE LLC
 
(122) ARDEN COURTS OF TOWSON MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622661
ASSISTED LIVING FACILITY DE 3,577,536 352,337 HCR III HEALTHCARE LLC
 
(123) ARDEN COURTS OF W ORANGE NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622938
ASSISTED LIVING FACILITY DE 5,660,548 280,085 HCR III HEALTHCARE LLC
 
(124) ARDEN COURTS OF W PALM BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625258
ASSISTED LIVING FACILITY DE 3,609,989 586,494 HCR III HEALTHCARE LLC
 
(125) ARDEN COURTS OF WAYNE NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622912
ASSISTED LIVING FACILITY DE 4,621,330 377,228 HCR III HEALTHCARE LLC
 
(126) ARDEN COURTS OF WESTLAKE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623289
ASSISTED LIVING FACILITY DE 4,663,905 247,315 HCR IV HEALTHCARE LLC
 
(127) ARDEN COURTS OF WILMINGTON DE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625127
ASSISTED LIVING FACILITY DE 4,726,495 393,877 HCR III HEALTHCARE LLC
 
(128) ARDEN COURTS OF WINTER SPRINGS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625340
ASSISTED LIVING FACILITY DE 4,331,958 525,670 HCR III HEALTHCARE LLC
 
(129) ARDEN COURTS OF YARDLEY PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623944
ASSISTED LIVING FACILITY DE 5,274,145 367,262 HCR III HEALTHCARE LLC
 
(130) ARDEN COURTS-ANDERSON OF CINCINNATI OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623677
ASSISTED LIVING FACILITY DE 3,808,990 365,003 HCR IV HEALTHCARE LLC
 
(131) ARDEN COURTS-BAINBRIDGE OF CHAGRIN FALLS OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623202
ASSISTED LIVING FACILITY DE 5,242,728 251,147 HCR IV HEALTHCARE LLC
 
(132) ARDEN COURTS-FAIR OAKS OF FAIRFAX VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624353
ASSISTED LIVING FACILITY DE 4,901,722 115,266 HCR IV HEALTHCARE LLC
 
(133) ARDEN COURTS-LELY PALMS OF NAPLES FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625279
ASSISTED LIVING FACILITY DE 3,135,725 501,365 HCR III HEALTHCARE LLC
 
(134) ARDEN COURTS-NORTH HILLS OF PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623920
ASSISTED LIVING FACILITY DE 3,750,857 272,383 HCR III HEALTHCARE LLC
 
(135) ARDEN COURTS-SUSQUEHANNA OF HARRISBURG PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624065
ASSISTED LIVING FACILITY DE 4,134,524 355,633 HCR III HEALTHCARE LLC
 
(136) ARDEN COURTS-WARMINSTER OF HATBORO PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623869
ASSISTED LIVING FACILITY DE 3,648,518 242,311 HCR III HEALTHCARE LLC
 
(137) ARDEN COURTS OF WHIPPANY NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623155
ASSISTED LIVING FACILITY DE 3,767,702 517,701 HCR III HEALTHCARE LLC
 
(138) CHRISTOPHER EAST HEALTH CARE CENTER OF LOUISVILLE KY LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619900
SKILLED NURSING FACILITY DE -6,097 0 HCR IV HEALTHCARE LLC
 
(139) COLUMBIA REHABILITATION AND NURSING CENTER-COLUMBIA SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623408
OUTPATIENT REHABILITATION DE 9,757,653 2,006,730 HCR III HEALTHCARE LLC
 
(140) DEVON MANOR-DEVON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622826
SKILLED NURSING FACILITY DE -45,972 0 HCR III HEALTHCARE LLC
 
(141) DONAHOE MANOR-BEDFORD PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623108
SKILLED NURSING FACILITY DE 6,269,264 790,799 HCR III HEALTHCARE LLC
 
(142) FOSTRIAN COURTS ASSISTED LIVING-FLUSHING MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622894
SKILLED NURSING FACILITY DE 1,271,278 91,564 HCR IV HEALTHCARE LLC
 
(143) HAMPTON HOUSE-WILKES-BARRE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610244
SKILLED NURSING FACILITY DE 8,094,538 1,577,029 HCR III HEALTHCARE LLC
 
(144) HEARTLAND OF BOYNTON BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623523
SKILLED NURSING FACILITY DE 10,695,010 1,407,882 HCR III HEALTHCARE LLC
 
(145) HEARTLAND OF ADELPHI MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620015
SKILLED NURSING FACILITY DE 13,709,635 2,641,097 HCR III HEALTHCARE LLC
 
(146) HEARTLAND OF ALLEN PARK MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611286
SKILLED NURSING FACILITY DE 15,447,064 2,641,572 HCR IV HEALTHCARE LLC
 
(147) HEARTLAND OF ANN ARBOR MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612384
SKILLED NURSING FACILITY DE 17,770,633 2,836,128 HCR IV HEALTHCARE LLC
 
(148) HEARTLAND OF AUSTIN TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624533
SKILLED NURSING FACILITY DE -32,639 61,022 HCR IV HEALTHCARE LLC
 
(149) HEARTLAND OF BATTLE CREEK MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612206
SKILLED NURSING FACILITY DE 5,697,388 989,172 HCR IV HEALTHCARE LLC
 
(150) HEARTLAND OF BECKLEY WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625053
SKILLED NURSING FACILITY DE 118,456 0 HCR IV HEALTHCARE LLC
 
(151) HEARTLAND OF BEDFORD TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624511
SKILLED NURSING FACILITY DE 2,529 0 HCR IV HEALTHCARE LLC
 
(152) HEARTLAND OF BELLEFONTAINE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609497
SKILLED NURSING FACILITY DE -11,307 188,301 HCR IV HEALTHCARE LLC
 
(153) HEARTLAND OF BOCA RATON FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623949
SKILLED NURSING FACILITY DE 11,996,079 1,906,578 HCR III HEALTHCARE LLC
 
(154) HEARTLAND OF BROOKSVILLE FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623416
SKILLED NURSING FACILITY DE 48,498 0 HCR III HEALTHCARE LLC
 
(155) HEARTLAND OF BUCYRUS OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614610
SKILLED NURSING FACILITY DE 5,922,615 755,745 HCR IV HEALTHCARE LLC
 
(156) HEARTLAND OF CANTON IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0604153
SKILLED NURSING FACILITY DE -17,700 0 HCR IV HEALTHCARE LLC
 
(157) HEARTLAND OF CANTON MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620527
SKILLED NURSING FACILITY DE 18,802,025 2,622,394 HCR IV HEALTHCARE LLC
 
(158) HEARTLAND OF CENTERBURG OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614447
SKILLED NURSING FACILITY DE 7,857 0 HCR IV HEALTHCARE LLC
 
(159) HEARTLAND OF CENTERVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609683
SKILLED NURSING FACILITY DE 8,536,549 1,452,701 HCR IV HEALTHCARE LLC
 
(160) HEARTLAND OF CHAMPAIGN IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615806
SKILLED NURSING FACILITY DE 10,810 0 HCR IV HEALTHCARE LLC
 
(161) HEARTLAND OF CHILLICOTHE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609311
SKILLED NURSING FACILITY DE 8,583,778 1,206,966 HCR IV HEALTHCARE LLC
 
(162) HEARTLAND OF CLARKSBURG WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625029
SKILLED NURSING FACILITY DE 120,062 0 HCR IV HEALTHCARE LLC
 
(163) HEARTLAND OF DEARBORN HEIGHTS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611231
SKILLED NURSING FACILITY DE 13,677,339 1,617,969 HCR IV HEALTHCARE LLC
 
(164) HEARTLAND OF DECATUR IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615541
SKILLED NURSING FACILITY DE -5,854 0 HCR IV HEALTHCARE LLC
 
(165) HEARTLAND OF EATON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609364
SKILLED NURSING FACILITY DE -1,000 0 HCR IV HEALTHCARE LLC
 
(166) HEARTLAND OF FORT MYERS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623726
SKILLED NURSING FACILITY DE 12,721,275 1,304,802 HCR III HEALTHCARE LLC
 
(167) HEARTLAND OF GALESBURG IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624455
SKILLED NURSING FACILITY DE 6,210,367 657,107 HCR IV HEALTHCARE LLC
 
(168) HEARTLAND OF GRAND RAPIDS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611403
SKILLED NURSING FACILITY DE -3,791 189,804 HCR IV HEALTHCARE LLC
 
(169) HEARTLAND OF GREENVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614250
SKILLED NURSING FACILITY DE 12,525 16,206 HCR IV HEALTHCARE LLC
 
(170) HEARTLAND OF HENRY IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614845
SKILLED NURSING FACILITY DE 5,973,172 788,083 HCR IV HEALTHCARE LLC
 
(171) HEARTLAND OF HILLSBORO OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609351
SKILLED NURSING FACILITY DE 7,580,309 1,075,801 HCR IV HEALTHCARE LLC
 
(172) HEARTLAND OF HOLLAND MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611679
SKILLED NURSING FACILITY DE -13,554 9,486 HCR IV HEALTHCARE LLC
 
(173) HEARTLAND OF HYATTSVILLE MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619980
SKILLED NURSING FACILITY DE 13,108,975 2,167,005 HCR III HEALTHCARE LLC
 
(174) HEARTLAND OF IONIA MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611974
SKILLED NURSING FACILITY DE -11,467 143,186 HCR IV HEALTHCARE LLC
 
(175) HEARTLAND OF JACKSON MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611756
SKILLED NURSING FACILITY DE -17,543 0 HCR IV HEALTHCARE LLC
 
(176) HEARTLAND OF JACKSON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614303
SKILLED NURSING FACILITY DE -34,816 39,736 HCR IV HEALTHCARE LLC
 
(177) HEARTLAND OF JACKSONVILLE FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623590
SKILLED NURSING FACILITY DE 10,323,308 2,095,666 HCR III HEALTHCARE LLC
 
(178) HEARTLAND OF KALAMAZOO MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612121
SKILLED NURSING FACILITY DE -18,820 0 HCR IV HEALTHCARE LLC
 
(179) HEARTLAND OF KENDALL FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623392
SKILLED NURSING FACILITY DE 8,527 60,793 HCR III HEALTHCARE LLC
 
(180) HEARTLAND OF KETTERING OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609231
SKILLED NURSING FACILITY DE 8,990,299 1,163,490 HCR IV HEALTHCARE LLC
 
(181) HEARTLAND OF KEYSER WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624987
SKILLED NURSING FACILITY DE 123,233 0 HCR IV HEALTHCARE LLC
 
(182) HEARTLAND OF LAUDERHILL FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623998
SKILLED NURSING FACILITY DE -141 63,888 HCR III HEALTHCARE LLC
 
(183) HEARTLAND OF MACOMB IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624476
SKILLED NURSING FACILITY DE 5,621,754 843,565 HCR IV HEALTHCARE LLC
 
(184) HEARTLAND OF MADEIRA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609604
SKILLED NURSING FACILITY DE -10,238 0 HCR IV HEALTHCARE LLC
 
(185) HEARTLAND OF MARIETTA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609259
SKILLED NURSING FACILITY DE 6,990,028 1,078,593 HCR IV HEALTHCARE LLC
 
(186) HEARTLAND OF MARION OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0613105
SKILLED NURSING FACILITY DE 11,835,994 1,269,108 HCR IV HEALTHCARE LLC
 
(187) HEARTLAND OF MARTINSBURG WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625081
SKILLED NURSING FACILITY DE 220,614 0 HCR IV HEALTHCARE LLC
 
(188) HEARTLAND OF MARYSVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609393
SKILLED NURSING FACILITY DE -17,681 0 HCR IV HEALTHCARE LLC
 
(189) HEARTLAND OF MENTOR OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610122
SKILLED NURSING FACILITY DE 10,904,511 1,932,624 HCR IV HEALTHCARE LLC
 
(190) HEARTLAND OF MIAMISBURG OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0794075
SKILLED NURSING FACILITY DE 8,341,817 1,600,311 HCR IV HEALTHCARE LLC
 
(191) HEARTLAND OF MOLINE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624491
SKILLED NURSING FACILITY DE 11,412,256 1,345,365 HCR IV HEALTHCARE LLC
 
(192) HEARTLAND OF NORMAL IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615386
SKILLED NURSING FACILITY DE 33,202 0 HCR IV HEALTHCARE LLC
 
(193) HEARTLAND OF ORANGE PARK FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623613
SKILLED NURSING FACILITY DE 11,423,803 1,864,388 HCR III HEALTHCARE LLC
 
(194) HEARTLAND OF OREGON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609590
SKILLED NURSING FACILITY DE -65,791 114,662 HCR IV HEALTHCARE LLC
 
(195) HEARTLAND OF PAXTON IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614884
SKILLED NURSING FACILITY DE 28,857 0 HCR IV HEALTHCARE LLC
 
(196) HEARTLAND OF PEORIA IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615478
SKILLED NURSING FACILITY DE 10,931 0 HCR IV HEALTHCARE LLC
 
(197) HEARTLAND OF PERRYSBURG OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609189
SKILLED NURSING FACILITY DE 10,392,751 1,645,063 HCR IV HEALTHCARE LLC
 
(198) HEARTLAND OF PIQUA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609466
SKILLED NURSING FACILITY DE -16,194 3,564 HCR IV HEALTHCARE LLC
 
(199) HEARTLAND OF PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610260
SKILLED NURSING FACILITY DE 15,031,984 2,582,481 HCR III HEALTHCARE LLC
 
(200) HEARTLAND OF PLATTEVILLE WI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624818
SKILLED NURSING FACILITY DE 27,923 0 HCR III HEALTHCARE LLC
 
(201) HEARTLAND OF PORTSMOUTH OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609290
SKILLED NURSING FACILITY DE -5,833 21,537 HCR IV HEALTHCARE LLC
 
(202) HEARTLAND OF RAINELLE WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625009
SKILLED NURSING FACILITY DE 83,656 0 HCR IV HEALTHCARE LLC
 
(203) HEARTLAND OF SAGINAW MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612275
SKILLED NURSING FACILITY DE -7,539 0 HCR IV HEALTHCARE LLC
 
(204) HEARTLAND OF SAN ANTONIO TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623701
SKILLED NURSING FACILITY DE 2,787 8,228 HCR IV HEALTHCARE LLC
 
(205) HEARTLAND OF SARASOTA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623968
SKILLED NURSING FACILITY DE 13,523,040 2,001,772 HCR III HEALTHCARE LLC
 
(206) HEARTLAND OF SPRINGFIELD OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609416
SKILLED NURSING FACILITY DE 30,909 0 HCR IV HEALTHCARE LLC
 
(207) HEARTLAND OF TAMARAC FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623500
SKILLED NURSING FACILITY DE -6,631 83,229 HCR III HEALTHCARE LLC
 
(208) HEARTLAND OF THREE RIVERS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612325
SKILLED NURSING FACILITY DE 7,685,198 898,843 HCR IV HEALTHCARE LLC
 
(209) HEARTLAND OF URBANA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614353
SKILLED NURSING FACILITY DE -14,888 0 HCR IV HEALTHCARE LLC
 
(210) HEARTLAND OF WEST BLOOMFIELD MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611547
SKILLED NURSING FACILITY DE -11,585 202,831 HCR IV HEALTHCARE LLC
 
(211) HEARTLAND OF WATERVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609511
SKILLED NURSING FACILITY DE -25,116 0 HCR IV HEALTHCARE LLC
 
(212) HEARTLAND OF WAUSEON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614568
SKILLED NURSING FACILITY DE -30,037 21,809 HCR IV HEALTHCARE LLC
 
(213) HEARTLAND OF WEST HOUSTON TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623684
SKILLED NURSING FACILITY DE -18,779 0 HCR IV HEALTHCARE LLC
 
(214) HEARTLAND OF WHITEHALL MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612438
SKILLED NURSING FACILITY DE -4,160 0 HCR IV HEALTHCARE LLC
 
(215) HEARTLAND OF ZEPHYRHILLS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623476
SKILLED NURSING FACILITY DE 10,716,076 1,447,936 HCR III HEALTHCARE LLC
 
(216) HEARTLAND VILLAGE OF WESTERVILLE OH (NC) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609323
SKILLED NURSING FACILITY DE 11,376,510 1,729,776 HCR IV HEALTHCARE LLC
 
(217) HEARTLAND VILLAGE OF WESTERVILLE OH (RC) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609337
SKILLED NURSING FACILITY DE 3,837,889 355,292 HCR IV HEALTHCARE LLC
 
(218) HEARTLAND-BEAVERCREEK OF DAYTON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609445
SKILLED NURSING FACILITY DE 9,023,514 1,544,690 HCR IV HEALTHCARE LLC
 
(219) HEARTLAND-BRIARWOOD MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611711
SKILLED NURSING FACILITY DE 12,248,269 2,268,699 HCR IV HEALTHCARE LLC
 
(220) HEARTLAND-CHARLESTON OF HANAHAN SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623167
SKILLED NURSING FACILITY DE 10,552,237 4,205,348 HCR III HEALTHCARE LLC
 
(221) HEARTLAND-CRESTVIEW MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611487
SKILLED NURSING FACILITY DE -13,044 0 HCR IV HEALTHCARE LLC
 
(222) HEARTLAND-DORVIN OF LIVONIA MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611095
SKILLED NURSING FACILITY DE 49,167 138,696 HCR IV HEALTHCARE LLC
 
(223) HEARTLAND-FAIRFIELD OF PLEASANTVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0613145
SKILLED NURSING FACILITY DE 16,084 0 HCR IV HEALTHCARE LLC
 
(224) HEARTLAND-FOSTRIAN OF FLUSHING MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611818
SKILLED NURSING FACILITY DE 11,688,819 1,553,631 HCR IV HEALTHCARE LLC
 
(225) HEARTLAND-GEORGIAN BLOOMFIELD OF BLOOMFIELD HILLS MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611630
SKILLED NURSING FACILITY DE -30,428 0 HCR IV HEALTHCARE LLC
 
(226) HEARTLAND-GEORGIAN EAST OF GROSSE POINTE MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611334
SKILLED NURSING FACILITY DE 10,490,002 1,813,169 HCR IV HEALTHCARE LLC
 
(227) HEARTLAND-GREENVIEW MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611920
SKILLED NURSING FACILITY DE -31,937 200,852 HCR IV HEALTHCARE LLC
 
(228) HEARTLAND-HAMPTON OF BAY CITY MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611865
SKILLED NURSING FACILITY DE 5,630,888 696,126 HCR IV HEALTHCARE LLC
 
(229) HEARTLAND-HOLLY GLEN OF TOLEDO OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614404
SKILLED NURSING FACILITY DE -18,232 0 HCR IV HEALTHCARE LLC
 
(230) HEARTLAND-INDIAN LAKE OF LAKEVIEW OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614489
SKILLED NURSING FACILITY DE -17,359 0 HCR IV HEALTHCARE LLC
 
(231) HEARTLAND-KNOLLVIEW MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612021
SKILLED NURSING FACILITY DE -9,417 73,366 HCR IV HEALTHCARE LLC
 
(232) HEARTLAND-LANSING OF BRIDGEPORT OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609376
SKILLED NURSING FACILITY DE 10,997 0 HCR IV HEALTHCARE LLC
 
(233) HEARTLAND-MIAMI LAKES OF HIALEAH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623652
SKILLED NURSING FACILITY DE -6,347 78,524 HCR III HEALTHCARE LLC
 
(234) HEARTLAND-MT AIRY OF CINCINNATI OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610060
SKILLED NURSING FACILITY DE 119,560 0 HCR IV HEALTHCARE LLC
 
(235) HEARTLAND-OAKLAND MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620480
SKILLED NURSING FACILITY DE 20,107,372 3,016,102 HCR IV HEALTHCARE LLC
 
(236) HEARTLAND-PEWAUKEE OF WAUKESHA WI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624873
SKILLED NURSING FACILITY DE -3,928 0 HCR III HEALTHCARE LLC
 
(237) HEARTLAND-PLYMOUTH COURT MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610995
SKILLED NURSING FACILITY DE -24,092 355,371 HCR IV HEALTHCARE LLC
 
(238) HEARTLAND-PRESTON COUNTY OF KINGWOOD WV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625067
SKILLED NURSING FACILITY DE 118,798 0 HCR IV HEALTHCARE LLC
 
(239) HEARTLAND-PRESTWICK IN LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619176
SKILLED NURSING FACILITY DE 1,022 0 HCR IV HEALTHCARE LLC
 
(240) HEARTLAND-PROSPERITY OAKS OF PALM BEACH GARDENS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623909
SKILLED NURSING FACILITY DE 11,528,091 1,545,349 HCR III HEALTHCARE LLC
 
(241) HEARTLAND-RIVERVIEW OF EAST PEORIA IL (SNF) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619009
ASSISTED LIVING FACILITY DE -38,572 0 HCR IV HEALTHCARE LLC
 
(242) HEARTLAND-RIVERVIEW OF SOUTH POINT OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609484
SKILLED NURSING FACILITY DE 9,049,419 1,076,416 HCR IV HEALTHCARE LLC
 
(243) HEARTLAND-SOUTH JACKSONVILLE OF JACKSONVILLE FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623559
SKILLED NURSING FACILITY DE 10,647,447 1,946,831 HCR III HEALTHCARE LLC
 
(244) HEARTLAND-UNIVERSITY OF LIVONIA MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611184
SKILLED NURSING FACILITY DE 10,651,153 1,341,459 HCR IV HEALTHCARE LLC
 
(245) HEARTLAND-VICTORIAN VILLAGE OF COLUMBUS OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609432
SKILLED NURSING FACILITY DE 199,492 0 HCR IV HEALTHCARE LLC
 
(246) HEARTLAND-WASHINGTON MANOR OF KENOSHA WI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624859
SKILLED NURSING FACILITY DE -28,830 0 HCR III HEALTHCARE LLC
 
(247) HEARTLAND-WILLOW LANE OF BUTLER MO LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612474
SKILLED NURSING FACILITY DE -19,659 0 HCR III HEALTHCARE LLC
 
(248) HEARTLAND-WILLOWBROOK OF HOUSTON TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624408
SKILLED NURSING FACILITY DE -67,256 0 HCR IV HEALTHCARE LLC
 
(249) HEARTLAND-WOODRIDGE OF FAIRFIELD OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609646
SKILLED NURSING FACILITY DE 96,853 0 HCR IV HEALTHCARE LLC
 
(250) HOLIDAY NURSING CENTER-CENTER TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624488
SKILLED NURSING FACILITY DE -20,680 0 HCR IV HEALTHCARE LLC
 
(251) KENSINGTON MANOR-SARASOTA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623931
SKILLED NURSING FACILITY DE 7,862,640 1,195,912 HCR III HEALTHCARE LLC
 
(252) LEXINGTON REHABILITATION AND NURSING CENTER-LEXINGTON SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623428
OUTPATIENT REHABILITATION DE 28,635 0 HCR III HEALTHCARE LLC
 
(253) MANOR CARE OF FOUNTAIN VALLEY CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622988
SKILLED NURSING FACILITY DE 18,871,502 2,541,021 HCR IV HEALTHCARE LLC
 
(254) MANOR CARE NURSING CENTER OF SARASOTA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624159
SKILLED NURSING FACILITY DE 15,615,163 1,622,118 HCR III HEALTHCARE LLC
 
(255) MANOR CARE OF ABERDEEN SD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623462
SKILLED NURSING FACILITY DE -3,654 0 HCR IV HEALTHCARE LLC
 
(256) MANOR CARE OF AKRON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610034
SKILLED NURSING FACILITY DE -22,438 0 HCR IV HEALTHCARE LLC
 
(257) MANOR CARE OF ALEXANDRIA VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624590
SKILLED NURSING FACILITY DE 9,394,445 1,935,437 HCR IV HEALTHCARE LLC
 
(258) MANOR CARE OF ALLENTOWN PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610673
SKILLED NURSING FACILITY DE 13,409,754 2,413,335 HCR III HEALTHCARE LLC
 
(259) MANOR CARE OF ANDERSON IN LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619221
SKILLED NURSING FACILITY DE -15,276 0 HCR IV HEALTHCARE LLC
 
(260) MANOR CARE OF ARLINGTON VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624619
SKILLED NURSING FACILITY DE 15,469,921 2,786,514 HCR IV HEALTHCARE LLC
 
(261) MANOR CARE OF BARBERTON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609528
SKILLED NURSING FACILITY DE 7,872,886 1,079,548 HCR IV HEALTHCARE LLC
 
(262) MANOR CARE OF BETHEL PARK PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622002
SKILLED NURSING FACILITY DE 12,881,152 1,624,316 HCR III HEALTHCARE LLC
 
(263) MANOR CARE OF BETHESDA MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620122
SKILLED NURSING FACILITY DE 10,330,120 1,478,364 HCR III HEALTHCARE LLC
 
(264) MANOR CARE OF BETHLEHEM PA (2021) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614878
SKILLED NURSING FACILITY DE 17,584,815 3,096,341 HCR III HEALTHCARE LLC
 
(265) MANOR CARE OF BETHLEHEM PA (2029) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621845
SKILLED NURSING FACILITY DE 16,962,485 2,779,442 HCR III HEALTHCARE LLC
 
(266) MANOR CARE OF BOCA RATON FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624217
SKILLED NURSING FACILITY DE 16,452,200 1,951,627 HCR III HEALTHCARE LLC
 
(267) MANOR CARE OF BOULDER CO LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623287
SKILLED NURSING FACILITY DE 13,870,574 1,570,905 HCR IV HEALTHCARE LLC
 
(268) MANOR CARE OF BOYNTON BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624241
SKILLED NURSING FACILITY DE 17,193,982 2,724,196 HCR III HEALTHCARE LLC
 
(269) MANOR CARE OF CAMP HILL PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623070
SKILLED NURSING FACILITY DE 11,591,479 2,387,319 HCR III HEALTHCARE LLC
 
(270) MANOR CARE OF CARLISLE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610623
SKILLED NURSING FACILITY DE 12,327,406 2,175,215 HCR III HEALTHCARE LLC
 
(271) MANOR CARE OF CEDAR RAPIDS IA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624378
SKILLED NURSING FACILITY DE 8,275,998 1,108,304 HCR III HEALTHCARE LLC
 
(272) MANOR CARE OF CHAMBERSBURG PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614915
SKILLED NURSING FACILITY DE 16,876,849 3,640,958 HCR III HEALTHCARE LLC
 
(273) MANOR CARE OF CHERRY HILL NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612749
SKILLED NURSING FACILITY DE -54,214 0 HCR III HEALTHCARE LLC
 
(274) MANOR CARE OF CHEVY CHASE MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620158
SKILLED NURSING FACILITY DE 14,602,023 1,913,664 HCR III HEALTHCARE LLC
 
(275) MANOR CARE OF CITRUS HEIGHTS CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622564
SKILLED NURSING FACILITY DE 22,667,131 3,822,220 HCR IV HEALTHCARE LLC
 
(276) MANOR CARE OF DALLAS TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623497
SKILLED NURSING FACILITY DE -46,365 0 HCR IV HEALTHCARE LLC
 
(277) MANOR CARE OF DALLASTOWN PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614534
SKILLED NURSING FACILITY DE 16,829,723 2,739,652 HCR III HEALTHCARE LLC
 
(278) MANOR CARE OF DAVENPORT IA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624394
SKILLED NURSING FACILITY DE 6,629,094 1,000,907 HCR III HEALTHCARE LLC
 
(279) MANOR CARE OF DELRAY BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624068
SKILLED NURSING FACILITY DE 12,581,986 1,819,787 HCR III HEALTHCARE LLC
 
(280) MANOR CARE OF DENVER CO LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623262
SKILLED NURSING FACILITY DE 12,440,191 2,372,437 HCR IV HEALTHCARE LLC
 
(281) MANOR CARE OF DUBUQUE IA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624416
SKILLED NURSING FACILITY DE 7,474,908 1,008,056 HCR III HEALTHCARE LLC
 
(282) MANOR CARE OF DUNEDIN FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624190
SKILLED NURSING FACILITY DE 13,495,689 1,540,936 HCR III HEALTHCARE LLC
 
(283) MANOR CARE OF EASTON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621877
SKILLED NURSING FACILITY DE 17,873,458 3,157,559 HCR III HEALTHCARE LLC
 
(284) MANOR CARE OF ELGIN IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615951
SKILLED NURSING FACILITY DE -4,121 0 HCR IV HEALTHCARE LLC
 
(285) MANOR CARE OF ELIZABETHTOWN PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622774
SKILLED NURSING FACILITY DE -65,672 2,508 HCR III HEALTHCARE LLC
 
(286) MANOR CARE OF ELK GROVE VILLAGE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0618782
SKILLED NURSING FACILITY DE 18,832,611 2,111,387 HCR IV HEALTHCARE LLC
 
(287) MANOR CARE OF FARGO ND LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612718
SKILLED NURSING FACILITY DE -12,026 0 HCR IV HEALTHCARE LLC
 
(288) MANOR CARE OF FLORISSANT MO LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612550
SKILLED NURSING FACILITY DE -454 0 HCR III HEALTHCARE LLC
 
(289) MANOR CARE OF FOND DU LAC WI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624802
SKILLED NURSING FACILITY DE -13,264 680 HCR III HEALTHCARE LLC
 
(290) MANOR CARE OF FORT WORTH TX (NRH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623538
SKILLED NURSING FACILITY DE -11,151 2,022 HCR IV HEALTHCARE LLC
 
(291) MANOR CARE OF FORT WORTH TX (NW) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623570
SKILLED NURSING FACILITY DE -29,662 26,214 HCR IV HEALTHCARE LLC
 
(292) MANOR CARE OF FT MYERS FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624272
SKILLED NURSING FACILITY DE 11,772,914 1,580,305 HCR III HEALTHCARE LLC
 
(293) MANOR CARE OF GIG HARBOR WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624719
SKILLED NURSING FACILITY DE 6,002,034 1,321,571 HCR IV HEALTHCARE LLC
 
(294) MANOR CARE OF GREEN BAY WI (EAST) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624767
SKILLED NURSING FACILITY DE -2,606 0 HCR III HEALTHCARE LLC
 
(295) MANOR CARE OF GREEN BAY WI (WEST) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624786
SKILLED NURSING FACILITY DE -8,599 0 HCR III HEALTHCARE LLC
 
(296) MANOR CARE OF HEMET CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623107
SKILLED NURSING FACILITY DE 18,428,739 3,676,624 HCR IV HEALTHCARE LLC
 
(297) MANOR CARE OF HINSDALE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615984
SKILLED NURSING FACILITY DE 21,677,003 4,083,716 HCR IV HEALTHCARE LLC
 
(298) MANOR CARE OF HOMEWOOD IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614920
SKILLED NURSING FACILITY DE 13,737,797 2,238,645 HCR IV HEALTHCARE LLC
 
(299) MANOR CARE OF HUNTINGDON VALLEY PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610582
SKILLED NURSING FACILITY DE 10,641,800 1,942,496 HCR III HEALTHCARE LLC
 
(300) MANOR CARE OF INDY (SOUTH) IN LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619623
SKILLED NURSING FACILITY DE 9,717,744 1,567,276 HCR IV HEALTHCARE LLC
 
(301) MANOR CARE OF JERSEY SHORE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614957
SKILLED NURSING FACILITY DE 9,381,980 1,911,848 HCR III HEALTHCARE LLC
 
(302) MANOR CARE OF KANKAKEE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615706
SKILLED NURSING FACILITY DE 5,163 0 HCR IV HEALTHCARE LLC
 
(303) MANOR CARE OF KING OF PRUSSIA PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610645
SKILLED NURSING FACILITY DE 14,571,983 2,121,235 HCR III HEALTHCARE LLC
 
(304) MANOR CARE OF KINGSFORD MI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0611592
SKILLED NURSING FACILITY DE 9,779,302 1,212,621 HCR IV HEALTHCARE LLC
 
(305) MANOR CARE OF KINGSTON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615323
SKILLED NURSING FACILITY DE 12,666,434 1,969,241 HCR III HEALTHCARE LLC
 
(306) MANOR CARE OF LANCASTER PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621637
SKILLED NURSING FACILITY DE 14,306,151 2,840,277 HCR III HEALTHCARE LLC
 
(307) MANOR CARE OF LAURELDALE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615380
SKILLED NURSING FACILITY DE 17,423,571 3,168,792 HCR III HEALTHCARE LLC
 
(308) MANOR CARE OF LEBANON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615358
SKILLED NURSING FACILITY DE 13,897,760 2,516,954 HCR III HEALTHCARE LLC
 
(309) MANOR CARE OF LIBERTYVILLE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615859
SKILLED NURSING FACILITY DE 14,016,285 1,870,846 HCR IV HEALTHCARE LLC
 
(310) MANOR CARE OF LYNNWOOD WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624675
SKILLED NURSING FACILITY DE 9,101,466 1,881,590 HCR IV HEALTHCARE LLC
 
(311) MANOR CARE OF MARIETTA GA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624336
SKILLED NURSING FACILITY DE 14,709,218 2,120,754 HCR III HEALTHCARE LLC
 
(312) MANOR CARE OF MAYFIELD HEIGHTS OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609565
SKILLED NURSING FACILITY DE -72,397 0 HCR IV HEALTHCARE LLC
 
(313) MANOR CARE OF MCMURRAY PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614341
SKILLED NURSING FACILITY DE 10,877,516 1,377,221 HCR III HEALTHCARE LLC
 
(314) MANOR CARE OF MIDWEST CITY OK LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610183
SKILLED NURSING FACILITY DE -73,592 0 HCR III HEALTHCARE LLC
 
(315) MANOR CARE OF MINOT ND LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612693
SKILLED NURSING FACILITY DE -2,408 0 HCR IV HEALTHCARE LLC
 
(316) MANOR CARE OF MONROEVILLE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614497
SKILLED NURSING FACILITY DE 12,125,555 1,824,138 HCR III HEALTHCARE LLC
 
(317) MANOR CARE OF MOUNTAINSIDE NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612791
SKILLED NURSING FACILITY DE 13,234,450 2,255,610 HCR III HEALTHCARE LLC
 
(318) MANOR CARE OF NAPERVILLE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615638
SKILLED NURSING FACILITY DE 45,200 65,408 HCR IV HEALTHCARE LLC
 
(319) MANOR CARE OF NAPLES FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624049
SKILLED NURSING FACILITY DE 11,404,133 1,456,956 HCR III HEALTHCARE LLC
 
(320) MANOR CARE OF NEW PROVIDENCE NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612827
SKILLED NURSING FACILITY DE 8,556 947 HCR III HEALTHCARE LLC
 
(321) MANOR CARE OF NORTH OLMSTED OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610082
SKILLED NURSING FACILITY DE 106,999 61,648 HCR IV HEALTHCARE LLC
 
(322) MANOR CARE OF NORTHBROOK IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0618960
SKILLED NURSING FACILITY DE 299,714 7,186 HCR IV HEALTHCARE LLC
 
(323) MANOR CARE OF OAK LAWN (EAST) IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615929
SKILLED NURSING FACILITY DE 14,735,039 2,422,407 HCR IV HEALTHCARE LLC
 
(324) MANOR CARE OF OAK LAWN (WEST) IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0616038
SKILLED NURSING FACILITY DE 16,616,784 3,096,362 HCR IV HEALTHCARE LLC
 
(325) MANOR CARE OF OKLAHOMA CITY (SOUTHWEST) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610197
SKILLED NURSING FACILITY DE -69,124 0 HCR III HEALTHCARE LLC
 
(326) MANOR CARE OF PALM DESERT CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623221
SKILLED NURSING FACILITY DE 19,330,871 3,484,211 HCR IV HEALTHCARE LLC
 
(327) MANOR CARE OF PALM HARBOR FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624018
SKILLED NURSING FACILITY DE 19,571,781 2,316,608 HCR III HEALTHCARE LLC
 
(328) MANOR CARE OF PALOS HEIGHTS (WEST) IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0618879
SKILLED NURSING FACILITY DE 13,294,758 1,051,299 HCR IV HEALTHCARE LLC
 
(329) MANOR CARE OF PALOS HEIGHTS IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615889
SKILLED NURSING FACILITY DE 19,551,786 3,524,276 HCR IV HEALTHCARE LLC
 
(330) MANOR CARE OF PARMA OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609661
SKILLED NURSING FACILITY DE 11,061,792 1,547,388 HCR IV HEALTHCARE LLC
 
(331) MANOR CARE OF PINEHURST NC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612589
SKILLED NURSING FACILITY DE 3,596 19,871 HCR III HEALTHCARE LLC
 
(332) MANOR CARE OF PLANTATION FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624255
SKILLED NURSING FACILITY DE -3,772 70,137 HCR III HEALTHCARE LLC
 
(333) MANOR CARE OF POTOMAC MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620187
SKILLED NURSING FACILITY DE 20,144,229 2,976,525 HCR III HEALTHCARE LLC
 
(334) MANOR CARE OF POTTSTOWN PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615421
SKILLED NURSING FACILITY DE 10,677,192 1,468,868 HCR III HEALTHCARE LLC
 
(335) MANOR CARE OF POTTSVILLE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615453
SKILLED NURSING FACILITY DE 9,199,555 2,001,173 HCR III HEALTHCARE LLC
 
(336) MANOR CARE OF RENO NV LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0613035
SKILLED NURSING FACILITY DE 7,674 16,664 HCR IV HEALTHCARE LLC
 
(337) MANOR CARE OF ROLLING MEADOWS IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619150
SKILLED NURSING FACILITY DE -585 57,590 HCR IV HEALTHCARE LLC
 
(338) MANOR CARE OF SAN ANTONIO (NORTH) TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623600
SKILLED NURSING FACILITY DE 4,350 0 HCR IV HEALTHCARE LLC
 
(339) MANOR CARE OF SHAWANO WI LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624831
SKILLED NURSING FACILITY DE 0 0 HCR III HEALTHCARE LLC
 
(340) MANOR CARE OF SILVER SPRING MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620058
SKILLED NURSING FACILITY DE 14,542,364 2,231,590 HCR III HEALTHCARE LLC
 
(341) MANOR CARE OF SINKING SPRING PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621908
SKILLED NURSING FACILITY DE 18,125,439 3,341,174 HCR III HEALTHCARE LLC
 
(342) MANOR CARE OF SOUTH HOLLAND IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615010
SKILLED NURSING FACILITY DE 23,190 173,235 HCR IV HEALTHCARE LLC
 
(343) MANOR CARE OF SOUTH OGDEN UT LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624547
SKILLED NURSING FACILITY DE -426 0 HCR IV HEALTHCARE LLC
 
(344) MANOR CARE OF SPOKANE WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624687
SKILLED NURSING FACILITY DE 7,636,164 1,459,711 HCR IV HEALTHCARE LLC
 
(345) MANOR CARE OF SPRINGFIELD MO LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612506
SKILLED NURSING FACILITY DE -706 0 HCR III HEALTHCARE LLC
 
(346) MANOR CARE OF SUNBURY PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615499
SKILLED NURSING FACILITY DE 9,971,029 1,730,841 HCR III HEALTHCARE LLC
 
(347) MANOR CARE OF SUNNYVALE CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623034
SKILLED NURSING FACILITY DE 19,197,376 2,896,500 HCR IV HEALTHCARE LLC
 
(348) MANOR CARE OF TACOMA WA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624696
SKILLED NURSING FACILITY DE 8,893,506 1,235,019 HCR IV HEALTHCARE LLC
 
(349) MANOR CARE OF TOPEKA KS LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619810
SKILLED NURSING FACILITY DE 79,393 0 HCR IV HEALTHCARE LLC
 
(350) MANOR CARE OF TOWSON LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620456
SKILLED NURSING FACILITY DE 13,617,049 1,761,874 HCR III HEALTHCARE LLC
 
(351) MANOR CARE OF TUCSON AZ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622500
SKILLED NURSING FACILITY DE 0 0 HCR IV HEALTHCARE LLC
 
(352) MANOR CARE OF TULSA OK LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610215
SKILLED NURSING FACILITY DE -81,955 0 HCR III HEALTHCARE LLC
 
(353) MANOR CARE OF VENICE FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624092
SKILLED NURSING FACILITY DE 12,670,800 1,764,124 HCR III HEALTHCARE LLC
 
(354) MANOR CARE OF VOORHEES NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612955
SKILLED NURSING FACILITY DE 11,491,163 1,546,547 HCR III HEALTHCARE LLC
 
(355) MANOR CARE OF W PALM BEACH FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624142
SKILLED NURSING FACILITY DE 10,946,789 1,517,440 HCR III HEALTHCARE LLC
 
(356) MANOR CARE OF WALNUT CREEK CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623196
SKILLED NURSING FACILITY DE 23,929,269 3,079,498 HCR IV HEALTHCARE LLC
 
(357) MANOR CARE OF WATERLOO IA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624363
SKILLED NURSING FACILITY DE 7,437,848 1,140,315 HCR III HEALTHCARE LLC
 
(358) MANOR CARE OF WEBSTER TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623637
SKILLED NURSING FACILITY DE -47,048 0 HCR IV HEALTHCARE LLC
 
(359) MANOR CARE OF WEST DES MOINES IA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624438
SKILLED NURSING FACILITY DE 7,307,729 1,133,709 HCR III HEALTHCARE LLC
 
(360) MANOR CARE OF WEST READING PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615529
SKILLED NURSING FACILITY DE 14,073,071 2,780,675 HCR III HEALTHCARE LLC
 
(361) MANOR CARE OF WESTERVILLE OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609626
SKILLED NURSING FACILITY DE 30,971 0 HCR IV HEALTHCARE LLC
 
(362) MANOR CARE OF WESTMONT IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619027
SKILLED NURSING FACILITY DE 124,833 28,996 HCR IV HEALTHCARE LLC
 
(363) MANOR CARE OF WHEATON MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620376
SKILLED NURSING FACILITY DE 10,375,126 1,677,921 HCR III HEALTHCARE LLC
 
(364) MANOR CARE OF WICHITA KS LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619870
SKILLED NURSING FACILITY DE 2,447 0 HCR IV HEALTHCARE LLC
 
(365) MANOR CARE OF WILLIAMSPORT PA (NORTH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621747
SKILLED NURSING FACILITY DE 10,108,269 2,121,244 HCR III HEALTHCARE LLC
 
(366) MANOR CARE OF WILLIAMSPORT PA (SOUTH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621778
SKILLED NURSING FACILITY DE 7,874,261 1,820,683 HCR III HEALTHCARE LLC
 
(367) MANOR CARE OF WILLOUGHBY OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610097
SKILLED NURSING FACILITY DE 11,982,731 1,601,851 HCR IV HEALTHCARE LLC
 
(368) MANOR CARE OF WILMETTE IL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0615773
SKILLED NURSING FACILITY DE 0 0 HCR IV HEALTHCARE LLC
 
(369) MANOR CARE OF WILMINGTON DE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623367
SKILLED NURSING FACILITY DE 15,767,121 2,091,313 HCR III HEALTHCARE LLC
 
(370) MANOR CARE OF YARDLEY PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614171
SKILLED NURSING FACILITY DE 17,220,894 2,968,430 HCR III HEALTHCARE LLC
 
(371) MANOR CARE OF YEADON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621815
SKILLED NURSING FACILITY DE 16,991,638 2,476,006 HCR III HEALTHCARE LLC
 
(372) MANOR CARE OF YORK PA (NORTH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622887
SKILLED NURSING FACILITY DE 14,696,493 2,674,061 HCR III HEALTHCARE LLC
 
(373) MANOR CARE OF YORK PA (SOUTH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622947
SKILLED NURSING FACILITY DE 14,428,438 2,733,402 HCR III HEALTHCARE LLC
 
(374) MANOR CARE REHABILITATION CENTER OF DECATUR GA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624293
OUTPATIENT REHABILITATION DE 14,192,825 1,786,235 HCR III HEALTHCARE LLC
 
(375) MANOR CARE-BELDEN VILLAGE OF CANTON OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0613074
SKILLED NURSING FACILITY DE -18,370 0 HCR IV HEALTHCARE LLC
 
(376) MANOR CARE-CARROLLWOOD OF TAMPA FL LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624118
SKILLED NURSING FACILITY DE -4,234 0 HCR III HEALTHCARE LLC
 
(377) MANOR CARE-DULANEY MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619923
SKILLED NURSING FACILITY DE 5,932 64,527 HCR III HEALTHCARE LLC
 
(378) MANOR CARE-EUCLID BEACH OF CLEVELAND OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0609550
SKILLED NURSING FACILITY DE 85,584 0 HCR IV HEALTHCARE LLC
 
(379) MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624605
SKILLED NURSING FACILITY DE 15,547,420 2,203,327 HCR IV HEALTHCARE LLC
 
(380) MANOR CARE-GREENTREE OF PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622713
SKILLED NURSING FACILITY DE 16,403,219 2,753,898 HCR III HEALTHCARE LLC
 
(381) MANOR CARE-IMPERIAL OF RICHMOND VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624643
SKILLED NURSING FACILITY DE 10,819,138 1,825,696 HCR IV HEALTHCARE LLC
 
(382) MANOR CARE-KINGSTON COURT OF YORK PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610561
SKILLED NURSING FACILITY DE 13,975,929 2,281,662 HCR III HEALTHCARE LLC
 
(383) MANOR CARE-LANSDALE OF MONTGOMERYVILLE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0614451
SKILLED NURSING FACILITY DE 13,689,052 2,143,410 HCR III HEALTHCARE LLC
 
(384) MANOR CARE-LARGO MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620266
SKILLED NURSING FACILITY DE 12,962,459 2,179,699 HCR III HEALTHCARE LLC
 
(385) MANOR CARE- LELY PALMS OF NAPLES FL (SH) LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0625295
ASSISTED LIVING FACILITY DE 6,454,270 1,974,964 HCR III HEALTHCARE LLC
 
(386) MANOR CARE-LINDEN VILLAGE OF LEBANON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0621960
SKILLED NURSING FACILITY DE 3,090,597 317,926 HCR III HEALTHCARE LLC
 
(387) MANOR CARE-NORTH HILLS OF PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610604
SKILLED NURSING FACILITY DE 17,337,526 3,091,828 HCR III HEALTHCARE LLC
 
(388) MANOR CARE-PIKE CREEK OF WILMINGTON DE LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623346
SKILLED NURSING FACILITY DE 21,549,669 3,224,542 HCR III HEALTHCARE LLC
 
(389) MANOR CARE-ROCKY RIVER OF CLEVELAND OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610139
SKILLED NURSING FACILITY DE 41,593 0 HCR IV HEALTHCARE LLC
 
(390) MANOR CARE-ROLAND PARK MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620341
SKILLED NURSING FACILITY DE 11,414,955 2,022,318 HCR III HEALTHCARE LLC
 
(391) MANOR CARE-ROSSVILLE MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620310
SKILLED NURSING FACILITY DE 16,243,417 2,743,821 HCR III HEALTHCARE LLC
 
(392) MANOR CARE-RUXTON MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620431
SKILLED NURSING FACILITY DE 18,668,883 3,378,734 HCR III HEALTHCARE LLC
 
(393) MANOR CARE-SHARPVIEW OF HOUSTON TX LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623656
SKILLED NURSING FACILITY DE 33,716 0 HCR IV HEALTHCARE LLC
 
(394) MANOR CARE-STRATFORD HALL OF RICHMOND VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624664
SKILLED NURSING FACILITY DE 14,857,311 2,056,424 HCR IV HEALTHCARE LLC
 
(395) MANOR CARE-SUMMER TRACE OF CARMEL IN LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619716
SKILLED NURSING FACILITY DE 8,242,823 1,200,110 HCR IV HEALTHCARE LLC
 
(396) MANOR CARE-TICE VALLEY CA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622591
SKILLED NURSING FACILITY DE 18,669,586 2,764,247 HCR IV HEALTHCARE LLC
 
(397) MANOR CARE-WEST DEPTFORD OF PAULSBORO NJ LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0612993
SKILLED NURSING FACILITY DE 14,478,849 1,864,039 HCR III HEALTHCARE LLC
 
(398) MANOR CARE-WOODBRIDGE VALLEY MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620223
SKILLED NURSING FACILITY DE -13,915 90,616 HCR III HEALTHCARE LLC
 
(399) MANOR CARE OF OVERLAND PARK KS LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0619843
SKILLED NURSING FACILITY DE -30,476 0 HCR IV HEALTHCARE LLC
 
(400) MEDICAL CARE CENTER-LYNCHBURG VA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0624567
SKILLED NURSING FACILITY DE 9,761,761 1,441,294 HCR IV HEALTHCARE LLC
 
(401) OAKMONT EAST-GREENVILLE SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623316
SKILLED NURSING FACILITY DE 9,561,313 1,540,579 HCR III HEALTHCARE LLC
 
(402) OAKMONT OF UNION SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623208
SKILLED NURSING FACILITY DE 7,837,626 1,203,226 HCR III HEALTHCARE LLC
 
(403) OAKMONT WEST-GREENVILLE SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623335
SKILLED NURSING FACILITY DE 10,456,661 1,373,467 HCR III HEALTHCARE LLC
 
(404) OLD ORCHARD HEALTH CARE CENTER-EASTON PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623007
SKILLED NURSING FACILITY DE 18,771,066 3,601,035 HCR III HEALTHCARE LLC
 
(405) PERRYSBURG COMMONS SENIOR HOUSING-PERRYSBURG OH LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623264
ASSISTED LIVING FACILITY DE 2,532,476 246,432 HCR IV HEALTHCARE LLC
 
(406) SHADYSIDE NURSING AND REHABILITATION CENTER-PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610325
SKILLED NURSING FACILITY DE 11,482,067 1,441,966 HCR III HEALTHCARE LLC
 
(407) SKY VUE TERRACE-PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610347
SKILLED NURSING FACILITY DE 7,535,887 1,179,990 HCR III HEALTHCARE LLC
 
(408) SPRINGHOUSE OF PIKESVILLE MD LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0620079
SKILLED NURSING FACILITY DE 4,114,911 381,433 HCR III HEALTHCARE LLC
 
(409) TWINBROOK MEDICAL CENTER-ERIE PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610373
SKILLED NURSING FACILITY DE 55,824 0 HCR III HEALTHCARE LLC
 
(410) WALLINGFORD NURSING AND REHABILITATION CENTER-WALLINGFORD PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0610542
SKILLED NURSING FACILITY DE 17,669,548 2,345,012 HCR III HEALTHCARE LLC
 
(411) WEST ASHLEY REHABILITATION AND NURSING CENTER-CHARLESTON SC LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0623364
SKILLED NURSING FACILITY DE 9,232,596 1,772,132 HCR III HEALTHCARE LLC
 
(412) WHITEHALL BOROUGH-PITTSBURGH PA LLC
333 N SUMMIT ST
TOLEDO,OH43604
26-0622805
SKILLED NURSING FACILITY DE 17,423,123 2,559,799 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?
Yes No
(1)BAY PARK COMMUNITY HOSPITAL
100 MADISON AVE

TOLEDO,OH43604
34-1883132
HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(2)COMMUNITY HEALTH CENTER OF BRANCH COUNTY
100 MADISON AVE

TOLEDO,OH43604
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
100 MADISON AVE

TOLEDO,OH43604
34-4446484
HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(5)EMMA L BIXBY MEDICAL CENTER
100 MADISON AVE

TOLEDO,OH43604
38-2796005
HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(6)EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVE

ADRIAN,MI43604
38-2149602
HOSPITAL / FOUNDATION SUPPORT MI 501(C)(3) 12B, II EMMA L BIXBY MEDICAL CENTER
 
Yes
 
(7)FOSTORIA HOSPITAL ASSOCIATION
100 MADISON AVE

TOLEDO,OH43604
34-0898745
HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(8)FOSTORIA HOSPITAL AUXILIARY
PO BOX 907

FOSTORIA,OH44830
34-6517634
HOSPITAL / FOUNDATION SUPPORT OH 501(C)(3) 10 FOSTORIA HOSPITAL ASSOCIATION
 
Yes
 
(9)HCR MANORCARE INC
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
82-5373223
SKILLED NURSING FACILITIES OH 501(C)(3) 10 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(10)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
 
(11)HERRICK MEMORIAL HOSPITAL INC
100 MADISON AVE

TOLEDO,OH43604
38-3049015
HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(12)KAITLYN'S COTTAGE INC
100 MADISON AVE

TOLEDO,OH43604
45-4781053
RESPITE CARE OH 501(C)(3) 10 DEFIANCE HOSPITAL INC
 
Yes
 
(13)LENAWEE LONG TERM CARE
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
38-2879330
LONG TERM CARE MI 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(14)MEMORIAL HOSPITAL
100 MADISON AVE

TOLEDO,OH43604
34-4430849
HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(15)MERCY MEMORIAL HOSPITAL CORPORATION
100 MADISON AVE

TOLEDO,OH43604
38-1984289
HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(16)MONROE COMMUNITY HEALTH SERVICES
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
38-2934134
LONG TERM CARE MI 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(17)PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIR

MAUMEE,OH43537
20-3376102
HEALTH INSURANCE OH 501(C)(3) 10 PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
 
Yes
 
(18)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
 
(19)PROMEDICA CONTINUUM SERVICES
100 MADISON AVE

TOLEDO,OH43604
34-1880767
PHYSICIAN MANAGEMENT SERVICES OH 501(C)(3) 12B, II PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(20)PROMEDICA COURIER SERVICES INC
100 MADISON AVE

TOLEDO,OH43604
26-0324790
COURIER SERVICE OH 501(C)(3) 12B, II PROMEDICA CONTINUUM SERVICES
 
Yes
 
(21)MANOR CARE OF LYNNWOOD WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624675
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(22)MANOR CARE OF SPOKANE WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624687
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(23)MANOR CARE OF TACOMA WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624696
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(24)MANOR CARE OF GIG HARBOR WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624719
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(25)MANOR CARE OF LACEY WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624391
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(26)MANOR CARE OF SALMON CREEK WA ASSOCIATION
PO BOX 10086 ATTN TAX-5

TOLEDO,OH43699
26-0624375
SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC
 
Yes
 
(27)PROMEDICA FOUNDATION
444 N SUMMIT ST

TOLEDO,OH43604
34-1517672
FOUNDATION OH 501(C)(3) 12B, II PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(28)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
(29)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
 
(30)PROMEDICA PHYSICIAN GROUP INC
100 MADISON AVE

TOLEDO,OH43604
34-1899439
PHYSICIAN HEALTH CARE SERVICES OH 501(C)(3) 10 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(31)THE TOLEDO HOSPITAL
100 MADISON AVE

TOLEDO,OH43604
34-4428256
HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC
 
Yes
 
(32)VISITING NURSE HOSPICE AND HEALTH CARE
100 MADISON AVE

TOLEDO,OH43604
34-1831624
HOSPICE HOME CARE OH 501(C)(3) 10 PROMEDICA CONTINUUM SERVICES
 
Yes
 
(33)HCR MANORCARE FOUNDATION INC
444 N SUMMIT ST

TOLEDO,OH43604
52-2031975
FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION
 
Yes
 
(34)HEARTLAND HOSPICE MEMORIAL FUND INC
444 N SUMMIT ST

TOLEDO,OH43604
27-0497199
FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION
 
Yes
 
(35)THE HUG FUND
444 N SUMMIT ST

TOLEDO,OH43604
20-2272848
FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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


Yes No Yes No
(1) REYNOLDS ROAD SURGICAL CENTER LTD

2865 N REYNOLDS RD
TOLEDO,OH43615
31-1569454
FREESTANDING AMBULATORY SURGICAL CENTER OH N/A
                 
(2) NORTHWEST OHIO DEDICATED BREAST MRI LLC

100 MADISON AVE
TOLEDO,OH43604
26-0679898
MEDICAL DIAGNOSTICS OH N/A
                 
(3) WEST CENTRAL SURGICAL CENTER LLC

7055 W CENTRAL
TOLEDO,OH43617
20-0088459
AMBULATORY SURGICAL CENTER OH THE TOLEDO HOSPITAL
 
RELATED 654,618 3,442,936   No   Yes   50.000 %
(4) PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC

100 MADISON AVE
TOLEDO,OH43604
46-1989695
PHYSICIAN MANAGEMENT SERVICES OH N/A
                 
(5) EAST-WEST HOLDINGS LTD

715 SOUTH TAFT AVE
FREMONT,OH43420
20-4066818
REAL ESTATE OH N/A
                 
(6) THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC

1051 S TELEGRAPH RD
MONROE,MI48161
27-0843485
AMBULATORY SURGICAL CENTER MI N/A
                 
(7) PROMEDICA MASTER TENANT LLC

100 MADISON AVE
TOLEDO,OH43604
47-5288490
REAL ESTATE OH PROMEDICA MANAGER MEMBER LLC
 
RELATED -5,362 225,028   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 -353,705 41,521,692   No   Yes   90.000 %
(9) ROCKET VENTURE FUND II LLC

2865 N REYNOLDS RD STE 220
TOLEDO,OH43615
47-5603627
INVESTMENT FUND OH N/A
                 
(10) HCRMC-PROMEDICA JV LLC

PO BOX 10086 ATTN TAX-5
TOLEDO,OH43604
46-1343453
NURSING AND REHAB SERVICES DE MANOR CARE HEALTH SERVICES OF TOLEDO OH LLC
 
RELATED -199,789 9,548,146   No   Yes   100.000 %
(11) MERCYMANOR PARTNERSHIP

PO BOX 10086 ATTN TAX-5
TOLEDO,PA43604
52-1931012
SKILLED NURSING PA MANOR CARE OF DELAWARE COUNTY LLC
 
RELATED -13,406 110,778   No   Yes   50.000 %
(12) NORMAN SPECIALTY HOSPITAL LLC

PO BOX 10086 ATTN TAX-5
TOLEDO,DE43604
42-1627672
HEALTH CARE DE MANOR CARE HEALTH SERVICES OF OKLAHOMA LLC
 
RELATED -391,047     No   Yes   60.500 %
(13) PROMEDICA PATHOLOGY LABORATORIES LLC

2130 W CENTRAL AVE STE 300
TOLEDO,OH43606
83-1022842
CLINICAL LABORATORY DE N/A
                 
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?
Yes No
(1) HERRICK MEMORIAL DEVELOPMENT CORP

500 E POTTAWATAMIE TR
ADRIAN,MI49221
38-3146907
FACILITY LEASING MI EMMA L BIXBY MEDICAL CENTER
 
C 74,545 1,120,556 100.000 %   No
(2) PROMEDICA CENTRAL CORPORATION OF MICHIGAN

100 MADISON AVE
TOLEDO,OH43604
38-3322278
PHYSICIAN HEALTH CARE SERVICES OH PROMEDICA PHYSICIAN GROUP INC
 
C -7,383,080 7,408,642 100.000 %   No
(3) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES

1901 INDIAN WOOD CIR
MAUMEE,OH43537
34-1570675
HEALTH CARE INSURANCE OH PROMEDICA HEALTH SYSTEM INC
 
C 527,769,598 349,588,322 100.000 %   No
(4) PROMEDICA NORTH PHYSICIAN CORPORATION

100 MADISON AVE
TOLEDO,OH43604
38-3482148
PHYSICIAN HEALTH CARE SERVICES OH PROMEDICA PHYSICIAN GROUP INC
 
C   149,134 100.000 %   No
(5) PROMEDICA RETAIL GROUP INC

3890 MONROE ST
TOLEDO,OH43606
34-1159928
FLORIST OH PROMEDICA CONTINUUM SERVICES
 
C     100.000 %   No
(6) HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION

818 RIVERSIDE AVE
ADRIAN,MI49221
38-3639616
FACILITY MANAGEMENT MI HERRICK MEMORIAL DEVELOPMENT CORP
 
C 36 41,818 71.800 %   No
(7) PROMEDICA HEALTH NETWORK INC

100 MADISON AVE
TOLEDO,OH43604
47-4006496
PHYSICIAN MANAGEMENT SERVICES OH PROMEDICA HEALTH SYSTEM INC
 
C 438,847 2,444,310 100.000 %   No
(8) MONROE HEALTH VENTURES INC

718 N MACOMB
MONROE,MI48164
38-2704426
PHARMACY MI MERCY MEMORIAL HOSPITAL CORPORATION
 
C     100.000 %   No
(9) PROMEDICA MANAGER MEMBER LLC

100 MADISON AVE
TOLEDO,OH43604
47-5168737
REAL ESTATE OH PROMEDICA HEALTH SYSTEM INC
 
C -4,241 30,990,896 100.000 %   No
(10) MANOR CARE INSURANCE INC

PO BOX 10086 ATTN TAX-5
TOLEDO,OH43604
98-0428947
INSURANCE UT HCR HEALTHCARE LLC
 
C -42,847   100.000 %   No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
Yes
 
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) 2019
Schedule R (Form 990) 2019
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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