TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) GREG ADAMS...................................................................... TREASURER	5.00 .................	X	X	0
(2) SHAWN RAY...................................................................... TRUSTEE	2.00 .................	X		0
(3) BRIAN SHANAHAN...................................................................... CHAIR	8.00 .................	X	X	0
(4) PHILIP HEARING...................................................................... TRUSTEE	2.00 .................	X		0
(5) MATTHEW P ELLI...................................................................... TRUSTEE	2.00 .................	X		0
(6) COLLEEN H HEACOCK...................................................................... VICE CHAIR	5.00 .................	X	X	0
(7) MARK DILUCIANO MD...................................................................... TRUSTEE	2.00 .................	X		0
(8) MARIBETH WRIGHT...................................................................... SECRETARY	5.00 .................	X	X	0
(9) MICHAEL D SARAP MD...................................................................... TRUSTEE	2.00 .................	X		5,000
(10) MARCIA WINNETT...................................................................... TRUSTEE	2.00 .................	X		0
(11) KATHLEEN JAMIEL...................................................................... TRUSTEE	2.00 .................	X		0
(12) THOMASINA CROCK...................................................................... TRUSTEE	2.00 .................	X		0
(13) CINDY REID...................................................................... TRUSTEE	2.00 .................	X		0
(14) WENDY ELLIOTT...................................................................... PRESIDENT & CEO	0.00 ................. 40.00	X	X	0
(15) JAMES A ENDLY...................................................................... TRUSTEE	2.00 .................	X		0
(16) CHERYL HERBERT...................................................................... TRUSTEE	2.00 .................	X		0
(17) JOHNATHAN KELLY...................................................................... INTERIM CFO	0.00 ................. 40.00		X	0

(A) Name and business address	(B) Description of services	(C) Compensation
OHIO VALLEY PHYSICIANS 3455 MILL RUN RD HILLIARD,OH43026	MEDICAL SERVICES	2,184,220
OHIO HEALTH 6905 HOSPITAL DRIVE SUITE 230 DUBLIN,OH43016	MEDICAL SERVICES	1,565,216
LABORATORY CORPORATION 133 E DAVIS ST BURLINGTON,NC27216	MEDICAL SERVICES	1,305,134
NORTHSTAR ANESTHESIA 6225 NORTH STATE HIGHWAY 161 STE 20 IRIVING,TX75038	MEDICAL SERVICES	1,220,512
MEDSTAFF SERVICES PO BOX 1895 POWELL,OH43065	MEDICAL SERVICES	510,425
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 24

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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

2020

Open to Public
Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

Part I

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

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

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

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

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

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)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

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

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

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

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

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

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

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

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

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

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

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

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

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 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 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 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 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	23,218	19,676	20,717	18,028	16,871
b	Contributions ...	300	250	200	450	150
c	Net investment earnings, gains, and losses	2,597	3,631	-926	2,544	1,278
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	348	339	315	305	271
g	End of year balance ......	25,767	23,218	19,676	20,717	18,028

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

Board designated or quasi-endowment SchDMd Bullet

100.000 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

0 %

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

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

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	1,106,933		1,106,933
b	Buildings ....	55,814,243	42,904,748	12,909,495
c	Leasehold improvements
d	Equipment ....	55,228,265	45,886,021	9,342,244
e	Other .....	143,754		143,754
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				23,502,426

Schedule D (Form 990) 2020

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.)

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.)

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)RESTRICTED CASH BOND FUND				1,193,357
(2)TRUSTEE HELD BOND FUND ESCROW				6,477,542
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				7,670,899

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2020

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	106,374,938
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	2,313,671
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	2,313,671
3	Subtract line 2e from line 1..................			3	104,061,267
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	40,082
b	Other (Describe in Part XIII.) ...........	4b	5,289,192
c	Add lines 4a and 4b....................			4c	5,329,274
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	109,390,541

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	90,229,811
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	0
3	Subtract line 2e from line 1...................			3	90,229,811
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	40,082
b	Other (Describe in Part XIII.) ............	4b	5,289,196
c	Add lines 4a and 4b.....................			4c	5,329,278
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	95,559,089

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:	ENDOWMENT FUND HELD BY PARENT COMPANY, GUERNSEY HEALTH SYSTEMS. USED FOR SUPPORT OF CHARITABLE HEALTH CARE SERVICES.
PART X, LINE 2:	SEORMC IS TAX EXEMPT; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY SEORMC AND TO RECOGNIZE A TAX LIABILITY IF SEORMC HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 5,217,042. REBATES AND REIMBURSEMENTS 72,150.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 5,217,042. REBATES AND REIMBURSEMENTS 72,154.

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .		2,573	1,622,184	0	1,622,184	1.800 %
b	Medicaid (from Worksheet 3, column a) . . . . .		30,796	18,592,389	13,501,446	5,090,943	5.640 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .		0	0	0
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		33,369	20,214,573	13,501,446	6,713,127	7.440 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	14	607	14,220	0	14,220	0.020 %
f	Health professions education (from Worksheet 5) . . .	2	3	11,494	0	11,494	0.010 %
g	Subsidized health services (from Worksheet 6) . . . .	1	62	3,765	0	3,765	0 %
h	Research (from Worksheet 7) .	0	0	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2	0	3,157	0	3,157	0 %
j	Total. Other Benefits . .	19	672	32,636		32,636	0.030 %
k	Total. Add lines 7d and 7j .	19	34,041	20,247,209	13,501,446	6,745,763	7.470 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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	0	0	0	0
2	Economic development	1	0	69	0	69	0 %
3	Community support	1	12	559	0	559	0 %
4	Environmental improvements	0	0	0	0
5	Leadership development and training for community members	0	0	0	0
6	Coalition building	0	0	0	0
7	Community health improvement advocacy	0	0	0	0
8	Workforce development	0	0	0	0
9	Other	0	0	0	0
10	Total	2	12	628		628	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

5,930,324

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. ......

4,853,526

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

Section B. Medicare

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

34,339,407

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

34,730,777

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

-391,370

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER INC 1341 CLARK STREET CAMBRIDGE,OH43725 SEORMC.ORG	X	X	X

Schedule H (Form 990) 2020

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)

	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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

Yes

6 a

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

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

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

Yes

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

Hospital facility’s website (list url): WWW.SEORMC.ORG

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

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

Yes

If "Yes" (list url): SEORMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 250.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

SEORMC.ORG

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

SEORMC.ORG

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

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

	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

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
SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: SEE ATTACHED SUPPLEMENTAL INFORMATION
SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: SEE ATTACHED SUPPLEMENTAL INFORMATION

Schedule H (Form 990) 2020

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?9
Name and address		Type of Facility (describe)
1	1 - SOUTHEASTERN OHIO REGIONAL MEDICAL CENTE 10095 BRICK CHURCH ROAD CAMBRIDGE,OH43725	OUTPATIENT FACILITY
2	2 - EYAD MAHAYRI MD 1335 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
3	3 - CLIFFORD MAXIMO MD 1200 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
4	4 - MELISSA NAU MD 1210 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
5	5 - MARY LILKO DO 1210 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
6	6 - SIVARAM KOLLENGODE MD 1210 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
7	7 - BECKY HALL NP 18125 WOODSFIELD ROAD CALDWELL,OH43724	PHYSICIAN OFFICE
8	8 - SUPERIOR MED PEDIATRICS & ADOLESCENT MED 1420 CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
9	9 - SUPERIOR MED ORTHOPEDICS 1230A CLARK STREET CAMBRIDGE,OH43725	PHYSICIAN OFFICE
10

Schedule H (Form 990) 2020

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 7:	THE COSTING METHODOLOGY USED IS BASED UPON THE SOUTHEASTERN MED'S DETAILED COST-TO-CHARGE RATIO. THE RATIO WAS BASED UPON THE DETAILED CALCULATIONS IN ACCORDANCE WITH THE IRS FORM 990 SCHEDULE H INSTRUCTIONS. THIS CALCULATION ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICARE, MEDICAID, UNINSURED AND SELF-PAY SERVICES. THE COST-TO-CHARGE RATIO WAS USED FOR SCHEDULE H CALCULATIONS IN LIEU OF USING A COST ACCOUNTING SYSTEM, AND WAS DERIVED FROM SCHEDULE H WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,217,042.
PART III, LINE 2:	SOUTHEASTERN MED'S COST-TO-CHARGE RATIO IS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H. OTHER BAD DEBT AMOUNTS HAVE NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS REPORTED IN PART I LINE 7 OF SCHEDULE H. THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H HAVE BEEN REDUCED BY BAD DEBT RECOVERIES RECEIVED AND COSTS ARE REPORTED NET OF APPLICABLE DISCOUNTS. AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE HAVE BEEN DETERMINED BASED UPON HISTORICAL AVERAGES RELATING TO THE AMOUNT OF SERVICES PROVIDED TO SUCH PATIENTS.
PART III, LINE 3:	SOUTHEASTERN MED'S COST-TO-CHARGE RATIO IS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H. OTHER BAD DEBT AMOUNTS HAVE NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS REPORTED IN PART I LINE 7 OF SCHEDULE H. THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III SECTION A OF SCHEDULE H HAVE BEEN REDUCED BY BAD DEBT RECOVERIES RECEIVED AND COSTS ARE REPORTED NET OF APPLICABLE DISCOUNTS. AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE HAVE BEEN DETERMINED BASED UPON HISTORICAL AVERAGES RELATING TO THE AMOUNT OF SERVICES PROVIDED TO SUCH PATIENTS.
PART II:	COSTS ASSOCIATE WITH COMMUNITY HEALTH NEEDS PERFORMED WITH OTHER COMMUNITY BASED ORGANIZATIONS. ITEMS INCLUDE COMMUNITY DISASTER READINESS PLANNING AND PREPARATION, SPONSORSHIP OF MEDICAL EXPLORER POST WITH BOY SCOUTS OF AMERICA, AND HOSPITAL REPRESENTATION.
PART III, LINE 4:	FOOTNOTE FROM AUDIT DESCRIBING BAD DEBT EXPENSE: --------------------------------------------------------------------------------------------------------------------- ALLOWANCE FOR DOUBTFUL ACCOUNTS - ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON SOUTHEASTERN MED'S EVALUATION OF ITS MAJOR PAYER SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, SOUTHEASTERN MED RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE DECEMBER 31, 2020 AND 2019 ALLOWANCE FOR DOUBTFUL ACCOUNTS OF $4,724,900 AND $5,084,000, RESPECTIVELY, RELATES TO RESERVES FOR SELF-PAY BALANCES AND CERTAIN THIRD-PARTY RECEIVABLES. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON A PERCENTAGE OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2020 AND 2019. SOUTHEASTERN MED'S SELF-PAY WRITE-OFFS DECREASED PRIMARILY DUE TO LOWER GROSS REVENUE DRIVEN BY LOWER VOLUME OF PATIENTS IN THE CURRENT YEAR DUE TO COVID-19 REGULATIONS. SOUTHEASTERN MED ALSO RESERVES A CERTAIN PORTION OF AMOUNTS DUE FROM THIRD-PARTY PAYERS THAT ARE MORE THAN 365 DAYS OUTSTANDING.
PART III, LINE 8:	SOUTHEASTERN MED HAS USED ITS COST-TO-CHARGE RATIO AS THE BASIS TO PREPARE ITS MEDICARE COST REPORT. THE AMOUNTS REPORTED ON PART III SECTION B LINE 8 ARE TAKEN DIRECTLY FROM THE MEDICARE AND MEDICAID COST REPORTS. THE SHORTFALL REPORTED ON PART III SECTION B LINE 7 HAS NOT BEEN INCLUDED IN THE COMMUNITY BENEFIT AMOUNTS INCLUDED IN PART I LINE 7 OF SCHEDULE H, BUT THEY DO PROVIDE A DIRECT BENEFIT TO THE COMMUNITY IN THAT LOCAL RESIDENTS ARE TREATED IN SPITE OF THIS OUT-OF-POCKET SHORTFALL NOT REIMBURSED TO SOUTHEASTERN MED.
PART III, LINE 9B:	SOUTHEASTERN MED'S FINANCIAL ASSISTANCE GUIDELINES ALLOW PATIENTS TO RECEIVE HEALTHCARE AT REDUCED RATES BASED ON FINANCIAL STATUS. THE GOAL IS TO WORK WITH EACH INDIVIDUAL PATIENT TO FULLY EXPLORE PAYMENT OPTIONS, INCLUDING GOVERNMENT ASSISTANCE PROGRAMS AND PAYMENT PLANS.
PART VI, LINE 7, REPORTS FILED WITH STATES	OH
SHEDULE H, PART VI:	COMMUNITY INFORMATION SOUTHEASTERN MED IS THE SOLE HOSPITAL PROVIDER FOR GUERNSEY COUNTY. THE ORGANIZATION EMPLOYS MORE THAN 700 ASSOCIATES AND INCLUDES A MEDICAL STAFF OF APPROXIMATELY 269 PHYSICIANS AND EXTENDED CARE PROVIDERS. SOUTHEASTERN MED IS LOCATED IN CAMBRIDGE, OHIO WHICH IS IN THE RURAL APPALACHIAN AREA OF EAST CENTRAL AND SOUTHEASTERN OHIO. MORE THAN TWO-THIRDS OF SOUTHEASTERN MED'S PATIENTS ARE RESIDENTS OF THE GUERNSEY COUNTY COMMUNITY, MAKING GUERNSEY COUNTY THE PRIMARY COMMUNITY SERVED BY THE HOSPITAL. SOUTHEASTERN MED ALSO PROVIDES MEDICAL CARE FOR RESIDENTS OF SURROUNDING COMMUNITIES, SUCH AS NOBLE, MUSKINGUM, BELMONT, AND TUSCARAWAS COUNTIES. SOUTHEASTERN MED OFFERS HIGH-QUALITY HEALTH CARE SERVICES AND CONTINUOUSLY REINVESTS TO IMPROVE ITS FACILITIES AND TECHNOLOGY. THE HOSPITAL DEDICATES COUNTLESS RESOURCES TO THE BENEFIT OF THE COMMUNITY IN THE FORM OF HEALTH SCREENINGS, HEALTH FAIRS, EDUCATION, AND FREE OR REDUCED-COST HEALTH SERVICES.THE ACTIVE PROVIDERS ON THE SOUTHEASTERN MED MEDICAL STAFF BRING VAST EXPERIENCE, KNOWLEDGE, AND COMPASSION TO PATIENTS THROUGHOUT GUERNSEY AND NOBLE COUNTIES. WITH MORE THAN 28 MEDICAL SPECIALTIES, SOUTHEASTERN MED PHYSICIANS OFFER QUALITY CARE WITH CLOSE-TO-HOME COMFORT. NINETY-THREE PERCENT OF SOUTHEASTERN MED PHYSICIANS HAVE EARNED BOARD CERTIFICATION, WHICH INVOLVES UNDERGOING RIGOROUS TRAINING, PASSING A NATIONAL EXAM, AND TAKING STEPS TO MAINTAIN BOARD-CERTIFIED STATUS. BOARD CERTIFICATION DEMONSTRATES SOUTHEASTERN MED'S MEDICAL PROFESSIONALS' EXCEPTIONAL EXPERTISE IN THEIR PARTICULAR SPECIALTY OF MEDICAL PRACTICE.SOUTHEASTERN MED IS PROUD TO BE ACCREDITED BY THE JOINT COMMISSION, WHICH IS THE NATIONAL ACCREDITING BODY FOR HOSPITALS AND OTHER HEALTH CARE DELIVERY ORGANIZATIONS. THE JOINT COMMISSION'S MISSION IS TO CONTINUOUSLY IMPROVE THE SAFETY AND QUALITY OF CARE PROVIDED TO THE PUBLIC THROUGH THE PROVISION OF HEALTH CARE ACCREDITATION AND RELATED SERVICES THAT SUPPORT PERFORMANCE IMPROVEMENT IN HEALTH CARE ORGANIZATIONS.MYHEALTH PATIENT PORTAL - TECHNOLOGY CONTINUES TO QUICKLY ADVANCE, AND SOUTHEASTERN MED IS COMMITTED TO MEETING THE NEEDS OF OUR COMMUNITY WHILE EMBRACING CHANGES IN TECHNOLOGY. ONE IMPORTANT ADVANCEMENT IN THAT TECHNOLOGY IS THE MYHEALTH PATIENT PORTAL. THE PORTAL ACTIVELY ENGAGES PATIENTS IN THEIR CARE BY GIVING THEM ACCESS TO VALUABLE HEALTH INFORMATION ONLINE. THIS ONLINE TOOL ALLOWS PATIENTS THE ABILITY TO MANAGE A WIDE RANGE OF HEALTH DATA FROM WHEREVER THEY ARE AND AT THEIR CONVENIENCE. PATIENTS CAN ACCESS THEIR ACCOUNT FROM ANYWHERE USING THE INTERNET, INCLUDING THEIR COMPUTER, SMARTPHONE, OR TABLET. IN ADDITION TO HANDLING THEIR OWN CARE, PARENTS AND THOSE WITH AUTHORIZED CONSENT WILL APPRECIATE THE ABILITY TO ACCESS THE RECORDS OF THOSE INDIVIDUALS FOR WHOM THEY MANAGE CARE.THE MYHEALTH PATIENT PORTAL GIVES PATIENTS INSTANT AND SECURE ACCESS TO THE PERSONAL HEALTH INFORMATION THEIR CARE TEAM ENTERED INTO THEIR RECORD. ALL THE INFORMATION IN THE PORTAL COMES FROM SOUTHEASTERN MED'S ELECTRONIC HEALTH RECORD. THIS ENSURES THAT PATIENTS HAVE ACCESS TO THE MOST UP-TO-DATE INFORMATION. THE INFORMATION AVAILABLE THROUGH THE PORTAL INCLUDES ALLERGIES, DISCHARGE INSTRUCTIONS, MEDICATION LISTS, UPCOMING APPOINTMENTS AT SOUTHEASTERN MED, CONDITIONS, LAB RESULTS, DIAGNOSTIC IMAGING RESULTS, AND VISIT HISTORIES. SOUTHEASTERN MED ASSOCIATES PROVIDE EDUCATION TO PATIENTS AND FAMILIES ABOUT THE MYHEALTH PATIENT PORTAL AND ARE AVAILABLE TO ASSIST PATIENTS WITH PORTAL REGISTRATION BEFORE BEING DISCHARGED FROM THE HOSPITAL. THERE ARE MANY RESOURCES AVAILABLE AT SOUTHEASTERN MED TO HELP PATIENTS EASILY SIGN-UP AND VIEW THEIR PORTAL ACCOUNT. PROMOTION OF COMMUNITY HEALTH ADDRESSING THE HEALTH NEEDS OF OUR COMMUNITY IS AN IMPORTANT PART OF OUR NOT-FOR-PROFIT ORGANIZATION'S MISSION. SOUTHEASTERN MED IS COMMITTED TO AND RESPONDS TO THE COMMUNITY'S HEALTH AND WELLNESS NEEDS. IN ADDITION TO PROVIDING HOSPITAL-BASED SERVICES, SOUTHEASTERN MED OFFERS A VARIETY OF HEALTH EDUCATION AND WELLNESS SCREENING OPPORTUNITIES THROUGHOUT THE YEAR. EFFORTS ARE MADE TO ENSURE THAT MEMBERS OF THE COMMUNITY WHO HAVE LIMITED ACCESS TO CARE DUE TO LACK OF FINANCIAL RESOURCES OR AVAILABLE HEALTHCARE COVERAGE ARE ABLE TO RECEIVE REGULAR HEALTH AND WELLNESS SCREENINGS AND/OR EDUCATION. SOUTHEASTERN MED'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND SURROUNDING COMMUNITIES. OTHER THAN THE PHYSICIAN CHIEF OF STAFF AND DR. MICHAEL SARAP, TRUSTEE, THEY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF SOUTHEASTERN MED, BUT ARE SUPPORTIVE OF THE EFFORTS BY SOUTHEASTERN MED TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY. RESOURCES ARE APPROVED AND PROVIDED FOR SUPPORTING IMPROVEMENTS IN PATIENT CARE, EDUCATION, AND HEALTH PROMOTION ACROSS THE BROADER COMMUNITY. THE FOLLOWING ARE EXAMPLES OF PROGRAMS REGULARLY OFFERED BY SOUTHEASTERN MED: HEALTH FAIRS FOR TARGETED POPULATIONS: HEARING SCREENINGS; DIABETES RISK SCREENINGS; BLOOD CHEMISTRY TESTS; SKIN CANCER SCREENINGS; COLORECTAL AND BREAST CANCER AWARENESS EDUCATION. OTHER SIGNIFICANT HEALTH AND WELLNESS COMMITMENTS BY SOUTHEASTERN MED INCLUDE FREE DIABETES EDUCATION CONSULTATIONS AND CLASSES, LOW-COST LUNG CANCER SCREENINGS, A VARIETY OF SUPPORT GROUPS, UNITED WAY FUNDRAISERS, AS WELL AS CPR CLASSES. SCREENINGS/EVENTS- HEART DISEASE & STROKE - TO INCREASE THE SCOPE OF EDUCATIONAL OPPORTUNITIES FOR AWARENESS OF HEART DISEASE AND STROKE RISK FACTORS AND PREVENTIVE STRATEGIES, SOUTHEASTERN MED OFFERS CPR CLASSES AND FIRST AID CLASSES. IN 2020, ONE COMMUNITY CPR AND FIRST AID CLASS WAS HELD WITH 13 PARTICIPANTS. THE CARDIAC HEALTH SCREENING WAS EXPANDED IN 2018 TO INCLUDE OHIOHEALTH CARDIOLOGY AND PROVIDE ONSITE EKG. IN 2020 THERE WERE 44 INDIVIDUALS WHO PARTICIPATED IN THE CARDIAC HEALTH SCREENING. PARTICIPANTS RECEIVED FREE EKG, BLOOD PRESSURE, BODY COMPOSITION, ANKLE BRACHIAL INDEX (ABI), LIPID PANEL AND GLUCOSE LAB SCREENINGS, AS WELL AS ONSITE EDUCATION REGARDING THEIR RESULTS FROM NURSES, DIETITIANS, EXERCISE PHYSIOLOGIST AND CARDIOLOGIST.SOUTHEASTERN MED HOSTED THE GUERNSEY COUNTY EMPLOYEES AND JOB & FAMILY SERVICES HEALTH FAIR, SEEING CLOSE TO 90 INDIVIDUALS. HEALTH SCREENINGS CONSISTED OF BASIC LAB WORK THAT CHECKED A1C, BLOOD PRESSURE, & A LIPID PROFILE. LAB RESULTS WERE PROVIDED TO THE INDIVIDUALS, AND THEY WERE INSTRUCTED TO FOLLOW UP WITH THEIR PRIMARY CARE PROVIDER.
SCHEDULE H, PART VI: CONTINUED	SOUTHEASTERN MED ALSO HOSTED LUNG CANCER SCREENINGS FOUR TIMES THIS YEAR. EACH EVENT IS 5 HOURS IN LENGTH AND WERE HELD AT THE COMMUNITY HEALTHLINK. 21 PEOPLE WERE SCREENED IN 2020.THERE WERE NO SKIN CANCER SCREENINGS HELD IN 2020. APRIL IS NATIONAL DONATE LIFE MONTH. SOUTHEASTERN MED WAS AWARDED THE LIFELINE OF OHIO PLATINUM AWARD IN 2020.DIABETES EDUCATION PRESENTATION - THE DIABETES SUPPORT GROUP MET IN MARCH 2020 AND WAS ATTENDED BY 10 PARTICIPANTS. A DIABETES HEALTH PRESENTATION WAS HELD BY OUR COMMUNITY DIETITIAN IN MARCH, WITH 13 PEOPLE IN ATTENDANCE. THE TOPIC WAS "ENJOYING THE COLORS OF THE RAINBOW IN YOUR DIET".ANNUAL FUNDRAISERS:THE UNITED WAY OF GUERNSEY AND NOBLE COUNTIES USES LOCALLY RAISED MONEY TO HELP THOSE IN NEED IN GUERNSEY, MONROE, AND NOBLE COUNTIES. SOUTHEASTERN MED IS A BIG SUPPORTER OF THE LOCAL UNITED WAY AGENCY. FIFTY-FOUR HOURS WERE SPENT TO RAISE THE $15,023.00, WHICH WAS DONATED TO THE UNITED WAY BY SOUTHEASTERN MED ASSOCIATES IN 2020. A PORTION OF THIS MONEY WAS RAISED THROUGH VOLUNTARY PAYROLL DEDUCTION FROM SOUTHEASTERN MED ASSOCIATES. ACCESS TO CARE SENIOR MANAGEMENT CONTINUED TO IMPLEMENT THE PHYSICIAN RECRUITMENT PLAN IN 2020. THIS PLAN WAS TO RECRUIT PHYSICIANS TO JOIN THE SUPERIOR MED MULTI-PHYSICIAN SPECIALTY GROUP OWNED BY SOUTHEASTERN MED OR TO JOIN INDEPENDENT LOCAL PHYSICIAN PRACTICES.FINANCIAL COUNSELORS ARE CAC (CERTIFIED APPLICATION COUNSELOR) CERTIFIED BY HEALTHCARE MARKETPLACE AND CONTINUE TO ASSIST PATIENTS WITH APPLICATION FOR MEDICAID ONSITE AT SOUTHEASTERN MED AND TO PROVIDE GUIDANCE REGARDING THEIR MEDICAL INSURANCE. SOUTHEASTERN MED IS A QUALIFIED ENTITY FOR MEDICAID ENROLLMENT.KEEPING CANCER PATIENTS CLOSE TO HOMESOUTHEASTERN MED EXPANDED ITS SUCCESSFUL CANCER SERVICE LINE IN 2012 BY PURCHASING THE CAMBRIDGE REGIONAL CANCER CENTER, LOCATED ACROSS THE STREET FROM SOUTHEASTERN MED.THE CAMBRIDGE REGIONAL CANCER CENTER OFFERS ADVANCED HEMATOLOGY AND MEDICAL ONCOLOGY SERVICES FOR PATIENTS WITH MANY DIFFERENT TYPES OF CANCER, INCLUDING BREAST, LUNG, COLON AND GENITOURINARY CANCERS, AS WELL AS BENIGN AND MALIGNANT BLOOD DISORDERS, SUCH AS ANEMIA, LYMPHOMA, LEUKEMIA AND MYELOMA.CHRONIC DISEASE (CANCER) WAS IDENTIFIED AS THE SECOND HEALTH NEED IN THE COMMUNITY THROUGH THE 2016 AND 2019 CHNAS. SOUTHEASTERN MED CONTINUES TO PROVIDE SERVICES TO THE COMMUNITY FIVE DAYS A WEEK.SOUTHEASTERN MED'S CANCER REGISTRY, BREAST HEALTH NAVIGATOR, AND DR. MICHAEL SARAP, SURGEON WITH SOUTHEASTERN OHIO PHYSICIANS, INC., AND SOUTHEASTERN MED MEDICAL STAFF MEMBER, CONTINUE THE VIRTUAL BREAST CARE CLINIC. THE IDEAL ARRANGEMENT FOR QUALITY BREAST CARE IS A CENTER OR CLINIC HOUSING MULTIPLE SPECIALISTS THAT ACT AS A TEAM TO CARE FOR BENIGN AND MALIGNANT BREAST DISEASE. THE SPECIALISTS INVOLVED IN SUCH A CLINIC INCLUDE SURGEONS, RADIOLOGISTS, ONCOLOGISTS, GENETICS COUNSELORS AND BREAST NAVIGATORS. AN ALL-ENCOMPASSING BREAST CENTER IS NOT FEASIBLE IN RESOURCE-LIMITED AREAS. IN MOST SMALL TOWNS AND RURAL AREAS, THERE IS NO ORGANIZED TEAM APPROACH TO BREAST CARE. SCREENING AND DIAGNOSTIC MAMMOGRAMS, ULTRASOUNDS, AND MRI SCANS, AND EVEN BREAST BIOPSIES MAY BE ORDERED BY PRIMARY CARE PHYSICIANS, GYNECOLOGISTS AND EVEN NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. CERTAINLY, IT IS VITALLY IMPORTANT FOR EVERY WOMAN TO BE INVOLVED IN A SCREENING PROGRAM, BUT IT IS JUST AS IMPORTANT FOR ALL WOMEN TO GET THE BEST RETURN ON INVESTMENT IN TERMS OF PROPER INTERPRETATION OF THE FINDINGS AND APPROPRIATE FOLLOW-UP. IN 2016, SOUTHEASTERN MED PURCHASED AND BEGAN OFFERING 3D MAMMOGRAPHY TO OUR COMMUNITY. ALL PRIMARY CARE PROVIDERS CAN AND DO ORDER BREAST IMAGING AND BREAST BIOPSIES WHEN SUGGESTED BY THE INTERPRETING RADIOLOGIST. MANY PRACTITIONERS WILL IMMEDIATELY REFER THE PATIENT TO A SURGEON AT THE TIME OF THE INITIAL ABNORMAL IMAGING. INDIVIDUAL PRACTITIONERS RECEIVE THE RESULTS OF ALL IMAGING AND BIOPSY RESULTS. IN ADDITION, THE BREAST NAVIGATOR COLLECTS RESULTS OF ALL ABNORMAL MAMMOGRAMS, ULTRASOUND STUDIES AND MRI STUDIES AND ALL BIOPSY REPORTS. THE INFORMATION IS COLLATED IN A NOTEBOOK ALONG WITH OTHER PERTINENT PATIENT INFORMATION REGARDING SYMPTOMS AND PHYSICAL EXAMINATIONS. THE LEADERSHIP OF THE BREAST CARE TEAM (BCT) THEN REVIEWS EVERY BIRADS CATEGORY IV AND V MAMMOGRAM AND EACH BIOPSY PERFORMED BY RADIOLOGY OR OTHER PRACTITIONERS. OUR PROGRAM CARES FOR 30-35 NEW BREAST CANCER PATIENTS PER YEAR. OUR RADIOLOGY DEPARTMENT PERFORMED 25 BREAST BIOPSIES IN 2020 AND 274 OVERALL BIOPSIES WERE COMPLETED. THE BREAST HEALTH NAVIGATOR AND BCT ACT AS A TEAM TO REVIEW AND TRACK EVERY PATIENT THAT HAS HAD A BIOPSY OR WHO NEEDS RADIOLOGIC FOLLOW-UP FOR ABNORMAL IMAGES. ANY DISCORDANCE OR IRREGULARITY TRIGGERS CONTACT WITH THE PRIMARY CARE PROVIDER, RADIOLOGIST, PATHOLOGIST, OR SURGEON TO RESOLVE THE ISSUE. THERE IS NO COST TO THE PATIENT FOR THIS QUALITY ASSURANCE ACTIVITY ORGANIZED BY THE BREAST TEAM LEADERSHIP.THE SOUTHEASTERN MED BREAST HEALTH NAVIGATOR SAW 23 WOMEN IN 2020 AND PROVIDED ONE-ON-ONE EDUCATIONAL TRAINING REGARDING THEIR LUMPECTOMY AND OR MASTECTOMY, RESOURCES NEEDED TO NAVIGATE APPOINTMENTS, FINANCIAL RESOURCES, AND EMOTIONAL SUPPORT.SOUTHEASTERN MED SPONSORS THE BREAST CANCER SUPPORT GROUP AND POSITIVELY PINK. POSITIVELY PINK IS A GROUP THAT MEETS MONTHLY AND IS GEARED TOWARD THOSE WHO HAVE OR ARE CURRENTLY BATTLING BREAST CANCER. THE BREAST CANCER SUPPORT GROUP APPROACHES CANCER IN AN ACTIVE, POSITIVE WAY AND HELPS PARTICIPANTS GAIN A SENSE OF CONTROL OVER THEIR DISEASE. FOR OVER 30 YEARS, SOUTHEASTERN MED HAS ALSO SPONSORED A SURVIVOR'S DAY CELEBRATION. CANCER SURVIVORS, CAREGIVERS, FAMILY MEMBERS AND FRIENDS ARE INVITED TO ATTEND THIS FREE EVENT. LUNCH, SPEAKERS, AND ENTERTAINMENT ARE PROVIDED AT NO COST TO PARTICIPANTS. IN 2020, THERE WERE NO COMMUNITY BREAST SCREENING CLINICS HELD DUE TO THE COVID-19 PANDEMIC. SOUTHEASTERN MED AND PHYSICIANS CONTINUE TO OFFER A FREE OR LOW-COST COLONOSCOPY TO ALL PERSONS WHO NEED THE PROCEDURE BUT DO NOT HAVE HEALTH CARE INSURANCE. IN 2020, 1,344 COLONOSCOPIES WERE PERFORMED AT SOUTHEASTERN MED. DR. MICHAEL SARAP, ALONG WITH HIS PARTNERS, DONATES HIS TIME TO PROVIDE FREE EDUCATION AND COLONOSCOPIES TO THE COMMUNITY ON AN AS-NEEDED BASIS. SOUTHEASTERN MED PHYSICIANS ALSO REGULARLY HOSTS FREE SKIN CANCER SCREENINGS TO COMMUNITY MEMBERS. IN 2020, SOUTHEASTERN MED WAS ACCREDITED BY THE COMMISSION ON CANCER (COC), A PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS, RECOGNIZES CANCER CARE PROGRAMS FOR THEIR COMMITMENT FOR PROVIDING COMPREHENSIVE, HIGH-QUALITY, AND MULTIDISCIPLINARY PATIENT-CENTERED CARE. SOUTHEASTERN MED, THROUGH COC, HAS ACCESS TO REPORTING TOOLS TO AID IN BENCHMARKING AND IMPROVING OUTCOMES, AS WELL AS EDUCATIONAL AND TRAINING OPPORTUNITIES, DEVELOPMENT RESOURCES, AND ADVOCACY. THE COMMISSION ON CANCER (COC) IS A CONSORTIUM OF PROFESSIONAL ORGANIZATIONS DEDICATED TO IMPROVING SURVIVAL AND QUALITY OF LIFE FOR CANCER PATIENTS THROUGH STANDARD SETTING, WHICH PROMOTES CANCER PREVENTION, RESEARCH, EDUCATION, AND MONITORING OF COMPREHENSIVE QUALITY CARE.THE MULTIDISCIPLINARY COC: ESTABLISHES STANDARDS TO ENSURE QUALITY, MULTIDISCIPLINARY, AND COMPREHENSIVE CANCER CARE DELIVERY IN HEALTH CARE SETTINGS CONDUCTS SURVEYS IN HEALTH CARE SETTINGS TO ASSESS COMPLIANCE WITH THOSE STANDARDS COLLECTS STANDARDIZED DATA FROM COC-ACCREDITED HEALTH CARE SETTINGS TO MEASURE CANCER CARE QUALITY USES DATA TO MONITOR TREATMENT PATTERNS AND OUTCOMES AND ENHANCE CANCER CONTROL AND CLINICAL SURVEILLANCE ACTIVITIES DEVELOPS EFFECTIVE EDUCATIONAL INTERVENTIONS TO IMPROVE CANCER PREVENTION, EARLY DETECTION, CANCER CARE DELIVERY, AND OUTCOMES IN HEALTH CARE SETTINGS.INDIVIDUALS AND REPRESENTATIVES OF MORE THAN 50 CANCER-RELATED ORGANIZATIONS COMPRISE THE MEMBERSHIP OF THE COC AND CONTRIBUTE TO THE DEVELOPMENT OF THE COC STANDARDS AND ACCREDITATION PROGRAM.TODAY, THERE ARE MORE THAN 1,500 COC-ACCREDITED CANCER PROGRAMS IN THE UNITED STATES AND PUERTO RICO. COC ACCREDITATION ENCOURAGES HOSPITALS, TREATMENT CENTERS, AND OTHER FACILITIES TO IMPROVE THEIR QUALITY OF CARE THROUGH VARIOUS CANCER-RELATED PROGRAMS AND ACTIVITIES. THESE PROGRAMS ARE CONCERNED WITH THE FULL CONTINUUM OF CANCERFROM PREVENTION TO SURVIVORSHIP AND END-OF-LIFE-CAREWHILE ADDRESSING BOTH SURVIVAL AND QUALITY OF LIFE.
SCHEDULE H, PART VI: CONTINUED	IN 2019, SOUTHEASTERN MED'S BREAST CANCER SERVICES TEAM HAS BEEN CERTIFIED FOR ANOTHER THREE YEARS BY THE NAPBC, WHICH IS THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS. LIKE THE COC CERTIFICATION EARNED, THE FOCUS OF THE NAPBC IS IN PART ON MULTI-DISCIPLINARY CARE. THE STANDARDS ALSO REQUIRE A FOCUS ON PREVENTION, EARLY DETECTION, PRE-TREATMENT EVALUATION, STAGING, AND MORE. ACCREDITATION BY THE NAPBC IS GRANTED ONLY TO THOSE CENTERS THAT HAVE VOLUNTARILY COMMITTED TO PROVIDE THE HIGHEST QUALITY CARE TO PATIENTS WITH DISEASES OF THE BREAST. EACH CENTER MUST UNDERGO A RIGOROUS EVALUATION AND REVIEW OF ITS PERFORMANCE AND COMPLIANCE WITH THE NAPBC STANDARDS. DISASTER PREPAREDNESS PLAN THE EMERGENCY MANAGEMENT COORDINATOR FOR SOUTHEASTERN MED IS APPOINTED TO THE LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) BY THE COUNTY COMMISSIONERS. IT IS THE JOB OF THE LEPC TO DEVELOP AN EMERGENCY RESPONSE PLAN FOR THE COUNTY AND REVIEW IT EVERY YEAR. THE LEPC IS MADE UP OF: ELECTED STATE AND LOCAL OFFICIALS POLICE, FIRE, CIVIL DEFENSE, AND PUBLIC HEALTH PROFESSIONALS ENVIRONMENTAL, TRANSPORTATION, AND HOSPITAL OFFICIALS FACILITY REPRESENTATIVES REPRESENTATIVES FROM COMMUNITY GROUPS AND THE MEDIASOUTHEASTERN MED SHARES ITS OWN EMERGENCY OPERATIONS PLAN (EOP) AND HAZARD VULNERABILITY ANALYSIS (HVA) WITH OUR COMMUNITY PARTNERS.THE EMERGENCY MANAGEMENT COORDINATOR IS A MEMBER OF THE GUERNSEY AND NOBLE COUNTY LEPC. THE LEPC MEETS AT LEAST QUARTERLY. SOUTHEASTERN MED PARTICIPATES IN BOTH GUERNSEY AND NOBLE COUNTY DISASTER DRILLS.SOUTHEASTERN MED IS A PART OF THE OHIO HOSPITAL ASSOCIATION (OHA) REGIONAL HOSPITAL COALITION. THE REGIONAL COALITION MEETS MONTHLY TO DISCUSS AND SHARE IDEAS FOR DISASTER PREPAREDNESS. HOSPITALS THAT PARTICIPATE IN THE REGIONAL COALITION CAN OBTAIN GRANTS FOR EMERGENCY PREPAREDNESS EQUIPMENT, WHICH REMAIN AVAILABLE TO OTHER HOSPITALS IN THE STATE IN THE EVENT OF A SIGNIFICANT DISASTER IN THEIR SERVICE AREA. PART VI LINE 6 SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. WHICH OPERATES A NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL, IS A SUBSIDIARY OF GUERNSEY HEALTH SYSTEMS, A NOT-FOR-PROFIT OHIO CORPORATION. GUERNSEY HEALTH SYSTEMS IS INVOLVED IN FUNDRAISING, THE OWNERSHIP AND OPERATION OF MEDICAL OFFICE BUILDINGS AND OTHER HEALTHCARE RELATED FACILITIES, AND THE EXECUTIVE-LEVEL MANAGEMENT OF ITS RELATED CORPORATIONS. GUERNSEY HEALTH ENTERPRISES, INC., A SUBSIDIARY OF GUERNSEY HEALTH SYSTEMS, IS A FOR-PROFIT HEALTH SERVICES CORPORATION AND IS THE PARENT COMPANY OF UNITED AMBULANCE SERVICE OF CAMBRIDGE, INC., AN EMERGENCY RESPONSE AND TRANSPORT AMBULANCE SERVICE. SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. IS THE SOLE MEMBER OF SUPERIOR MED, LLC, A DISREGARDED TAX-EXEMPT ORGANIZATION THAT OPERATES PHYSICIAN OFFICES IN THE COMMUNITY.

Schedule H (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .....

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? ....

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2020

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KARL W KUMLER MD PHYSICIAN	(i) (ii)	618,105 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	32,588 ------------- 0	650,693 ------------- 0	0 ------------- 0
2ELAINE BEED MD PHYSICIAN	(i) (ii)	553,944 ------------- 0	34,498 ------------- 0	0 ------------- 0	0 ------------- 0	6,754 ------------- 0	595,196 ------------- 0	0 ------------- 0
3CARL F JUENG MD PHYSICIAN	(i) (ii)	546,938 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	31,341 ------------- 0	578,279 ------------- 0	0 ------------- 0
4EYAD MAHAYRI MD PHYSICIAN	(i) (ii)	476,451 ------------- 0	41,418 ------------- 0	0 ------------- 0	0 ------------- 0	31,642 ------------- 0	549,511 ------------- 0	0 ------------- 0
5CLIFFORD B MAXIMO MD PHYSICIAN	(i) (ii)	476,432 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	32,167 ------------- 0	508,599 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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

Schedule J (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number
31-4391798

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF CAMBRIDGE OHIO	31-6400220	NONEAVAIL	05-15-2015	15,000,000	SEE PART VI SUPPLEMENTAL INFORMATION		X		X		X
B	CITY OF CAMBRIDGE OHIO	31-6400220	NONEAVAIL	10-01-2019	7,500,000	CONSTRUCTION OF CANCER CENTER		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	15,000,000		7,500,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	118,400		58,500
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	4,596,600		963,958
11 Other spent proceeds .............	10,285,000
12 Other unspent proceeds .............			6,477,542
13 Year of substantial completion .............	2016		2021
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
PT I-A COL (F):	10,285,000 FOR CURRENT REFUNDING OF 2001 AND 2002 BOND ISSUES, 118,400 FOR BOND ISSUANCE COSTS, AND 4,596,600 FOR CAPITAL IMPROVEMENTS.

Schedule K (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

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

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

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

Part II

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

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






Total ............... $

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) DOMINIC D CROCK	FAMILY MEMBER OF TRUSTEE	110,915	EMPLOYMENT		No
(2) SOUTHEASTERN OHIO PHYSICIANS INC	PARTIAL OWNERSHIP BY TRUSTEE	234,400	MEDICAL TRANSACTIONS		No
(3) JOSEPH OHANLON DO	FAMILY MEMBER OF TRUSTEE	1,620	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) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	BOARD MEMBERS ARE ELECTED BY BOARD MEMBERS OF GUERNSEY HEALTH SYSTEMS, THE NOT-FOR-PROFIT PARENT COMPANY OF SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 3	EFFECTIVE OCTOBER 10, 2018 GUERNSEY HEALTH SYSTEMS AND THE SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER ENTERED INTO A MANAGEMENT AGREEMENT WITH OHIO HEALTH CORPORATION TO PROVIDE SENIOR LEVEL MANAGEMENT FOR GUERNSEY HEALTH SYSTEMS AND THE SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER BY PROVIDING THE PRESIDENT & CEO, VICE PRESIDENT OF FINANCE, AND CHIEF NURSING OFFICER OF THE ORGANIZATION. THESE OFFICERS ARE LISTED IN PART VII, SECTION A. THE MANAGEMENT DUTIES PERFORMED INCLUDED HIRING, FIRING, AND SUPERVISING PERSONNEL, PLANNING AND EXECUTING BUDGETS AND FINANCIAL OPERATIONS, AND SUPERVISING EXEMPT AND NON EXEMPT OPERATIONS. NEITHER GUERNSEY HEALTH SYSTMES NOR SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER, INC. MADE ANY PAYMENTS TO OHIO HEALTH CORPORATION RELATED TO WENDY ELLIOTT, PRESIDENT & CEO. ALL AMOUNTS OF REPORTABLE COMPENSATION PAID TO WENDY ELLIOTT WERE MADE DIRECTLY BY OHIO HEALTH CORPORATION AND WOULD BE REPORTED ON OHIO HEALTH CORPORATION'S FORM 990. 2020 REPORTABLE COMPENSATION AMOUNTS PAID BY OHIO HEALTH THAT WERE REIMBURSED BY GUERNSEY HEALTH SYSTEMS FOR TIMOTHY R. EVANCHO, VICE PRESIDENT OF FINANCE, AND GINA F. WOODS, CHIEF NURSING OFFICER.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD BEFORE FILING. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C	DIRECTORS COMPLETE AN ANNUAL STATEMENT DISCLOSING ALL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15B	THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PERFORMS A COMPENSATION STUDY OF MANAGEMENT POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19	ALL SUCH ITEMS ARE AVAILABLE UPON REQUEST
FORM 990, PART IX, LINE 11G	MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 9,013,452. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,013,452. OTHER SERVICES: PROGRAM SERVICE EXPENSES 3,539,524. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,539,524. LINEN SERVICES: PROGRAM SERVICE EXPENSES 140,513. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,513. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 187,921. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 187,921. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 230,727. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,727. PHYSICIAN LOAN LOSSES: PROGRAM SERVICE EXPENSES 55,498. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,498. PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 113,283. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 113,283. ANSWERING SERVICES: PROGRAM SERVICE EXPENSES 2,138. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,138. BILLING SERVICES: PROGRAM SERVICE EXPENSES 431,763. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 431,763. OTHER FEES-MNGMNT-990: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 434,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 434,283.
FORM 990, PART XI, LINE 9:	NET CHANGE IN PENSION -2,321,143. TRANSFER TO AFFILIATE -576,522.
FORM 990, PART XII, LINE 2C	THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

SOUTHEASTERN OHIO REGIONAL MEDICAL
CENTER INC

Employer identification number

31-4391798

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) SUPERIOR MED LLC 1341 CLARK STREET CAMBRIDGE,OH43725 31-1311881	PHYSICIAN OFFICES	OH	6,778,430	2,482,326	SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)GUERNSEY HEALTH SYSTEMS 1341 CLARK STREET CAMBRIDGE,OH43725 31-1148352	MANAGEMENT & FUNDRAISING	OH	501(C)(3)	12 TYPE II	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) SOUTHEASTERN HOME CARE LLC 170 EDISON DRIVE MILFORD,OH45150 27-1219638	HOME HEALTH SERVICES	OH	N/A	RELATED	511,600	610,400		No			No	40.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) GUERNSEY HEALTH ENTERPRISES INC 1341 CLARK STREET CAMBRIDGE,OH43725 31-1191428	AMBULANCE SERVICE	OH	GUERNSEY HEALTH SYSTEMS	C					No
(2) UNITED AMBULANCE SERVICE OF CAMBRIDGE INC 1341 CLARK STREET CAMBRIDGE,OH43725 31-1086097	AMBULANCE SERVICE	OH	GUERNSEY HEALTH SYSTEMS	C					No

Schedule R (Form 990) 2020

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

Yes

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

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

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

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

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

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

Yes

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

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

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

Yes

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

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

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

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) GUERNSEY HEALTH SYSTEMS	E	9,514,467	LOANS GUARANTEED
(2) GUERNSEY HEALTH SYSTEMS	K	447,805	CASH PAID
(3) GUERNSEY HEALTH SYSTEMS	N	100,000	ESTIMATED
(4) GUERNSEY HEALTH SYSTEMS	R	84,605	CASH PAID
(5) UNITED AMBULANCE SERVICE OF CAMBRIDGE	R	491,920	CASH PAID

Schedule R (Form 990) 2020

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: GENERAL COMMUNITY HOSPITAL WITH A MISSION TO PROVIDE HIGH QUALITY, COMPREHENSIVE, AFFORDABLE, PATIENT-CENTERED HEALTHCARE IN A CARING AND SAFE ENVIRONMENT, WHILE ADDRESSING COMMUNITY NEEDS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	891
6	Total number of volunteers (estimate if necessary) .............	6	62
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	65,940	13,105,671
9	Program service revenue (Part VIII, line 2g) .........	103,697,010	95,594,272
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,390,526	450,628
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	398,329	239,970
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	105,551,805	109,390,541
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	48,459,671	43,689,530
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	50,746,912	51,869,559
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	99,206,583	95,559,089
19	Revenue less expenses. Subtract line 18 from line 12.......	6,345,222	13,831,452
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	70,331,693	95,546,765
21	Total liabilities (Part X, line 26).............	42,651,449	54,619,063
22	Net assets or fund balances. Subtract line 21 from line 20.....	27,680,244	40,927,702

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 83,112,770 including grants of $ ) (Revenue $ 87,625,410 )
	GENERAL HOSPITAL - MEDICAL SERVICES FOR INPATIENTS AND OUTPATIENTS - SEE ATTACHED SCHEDULE H FOR ADDITONAL INFORMATION

4b	(Code: ) (Expenses $ 9,813,591 including grants of $ ) (Revenue $ 7,970,529 )
	OPERATION OF PHYSICIAN OFFICES

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses92,926,361

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,752,786	0	134,492

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) GINA F WOODS........................................................................ VP OF PATIENT CARE	0.00 .......................40.00	X		0	0	0
(19) ELAINE BEED MD........................................................................ PHYSICIAN	40.00 .......................		X	588,442	0	6,754
(20) KARL W KUMLER MD........................................................................ PHYSICIAN	40.00 .......................		X	618,105	0	32,588
(21) CARL F JUENG MD........................................................................ PHYSICIAN	40.00 .......................		X	546,938	0	31,341
(22) EYAD MAHAYRI MD........................................................................ PHYSICIAN	40.00 .......................		X	517,869	0	31,642
(23) CLIFFORD B MAXIMO MD........................................................................ PHYSICIAN	40.00 .......................		X	476,432	0	32,167

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	13,072,301

f	All other contributions, gifts, grants, and similar amounts not included above		1f	33,370

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		13,105,671

		Business Code
2a	HEALTH & MEDICAL SERVICES	622110	45,443,593	45,443,593
b	MEDICARE & MEDICAID	622110	42,181,817	42,181,817
c	PHYSICIAN OFFICES	622110	7,968,862	7,968,862
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		95,594,272

3 Investment income (including dividends, interest, and othersimilar amounts) ......			399,496			399,496
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		2,324,721	7a
b	Less: cost or other basis and sales expenses		2,273,589	7b
c	Gain or (loss)		51,132	7c
d	Net gain or (loss).........			51,132			51,132
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..
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..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA SALES		722300	238,303			238,303
b	SALE OF SCRAP		900099	1,667	1,667
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			239,970
12	Total revenue. See instructions.....			109,390,541	95,595,939	0	688,931

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
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 ...........	5,000	5,000
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	622,549	622,549
7	Other salaries and wages........	35,724,900	35,247,450	477,450
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	727,151	726,715	436
9	Other employee benefits .......	3,659,702	3,601,575	58,127
10	Payroll taxes ...........	2,950,228	2,922,397	27,831
11	Fees for services (non-employees):
a	Management ......	795,127		795,127
b	Legal .........	151,458		151,458
c	Accounting ...........	63,275		63,275
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	40,082		40,082
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	14,149,102	13,714,819	434,283
12	Advertising and promotion ....	151,094	151,094
13	Office expenses .......	1,426,413	1,385,603	40,810
14	Information technology ......	1,862,694	1,862,694
15	Royalties ..
16	Occupancy ...........	1,808,107	1,808,107
17	Travel ............	4,678	4,475	203
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,974	1,974
20	Interest ...........	272,883	272,883
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,286,007	4,114,835	171,172
23	Insurance ...	777,497	777,497
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	16,190,322	16,190,322
b	BAD DEBT EXPENSE	5,217,042	5,217,042
c	REPAIRS & MAINTENANCE	1,953,051	1,952,611	440
d	FRANCHISE FEE	1,631,231	1,631,231
e	All other expenses	1,087,522	715,488	372,034
25	Total functional expenses. Add lines 1 through 24e	95,559,089	92,926,361	2,632,728	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			10,023,715	1	9,727,707
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,198,851	4	10,029,459
5	Loans and other receivables from 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 ...........			77,683	7	66,190
8	Inventories for sale or use ............			2,621,645	8	2,526,223
9	Prepaid expenses and deferred charges ......			3,104,520	9	2,720,353
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	112,293,195
b	Less: accumulated depreciation	10b	88,790,769	16,318,778	10c	23,502,426
11	Investments—publicly traded securities .			13,776,491	11	39,103,108
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			335,400	13	200,400
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			13,874,610	15	7,670,899
16	Total assets. Add lines 1 through 15 (must equal line 33)...			70,331,693	16	95,546,765

17	Accounts payable and accrued expenses .....	29,196,973	17	32,070,341
18	Grants payable ...		18
19	Deferred revenue .........		19	12,460,864
20	Tax-exempt bond liabilities .........	4,625,374	20	9,091,658
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 ..	8,829,102	23	996,200
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
26	Total liabilities. Add lines 17 through 25..	42,651,449	26	54,619,063

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	27,680,244	27	40,927,702
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here 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 ...........	27,680,244	32	40,927,702
33	Total liabilities and net assets/fund balances ........	70,331,693	33	95,546,765