TY 2021 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/1099-NEC)
(1) WILLIAM R MCDONNELL...................................................................... CHAIRMAN	1.00 ................. 1.00	X	X	0	0
(2) DAWN M BUSKEY...................................................................... PRES., EX OFFICIO	1.00 ................. 54.00	X	X	805,499	49,161
(3) JAMES H BRENNAN JR...................................................................... EX OFFICIO	1.00 ................. 1.00	X		0	0
(4) MARK FOX...................................................................... EX OFFICIO	1.00 ................. 0.00	X		0	0
(5) MATTHEW KANG...................................................................... EX OFFICIO, CFO SENIOR CARE	1.00 ................. 50.00	X		854,217	30,573
(6) MARGARET G RESSNER...................................................................... EX OFFICIO (PARTIAL YEAR)	1.00 ................. 0.00	X		0	0
(7) RAVI K ADUSUMILLI MD...................................................................... TRUSTEE, PHYSICIAN	1.00 ................. 40.00	X		575,150	22,493
(8) JAMES BINGLE...................................................................... TRUSTEE (PARTIAL YEAR), PHYSICIAN	1.00 ................. 40.00	X		201,773	505
(9) AARON A BUERK MD...................................................................... TRUSTEE, PHYSICIAN	1.00 ................. 40.00	X		833,581	20,609
(10) RODNEY L EASON JR...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(11) ADRIENNE J GREEN...................................................................... TRUSTEE (PARTIAL YEAR)	1.00 ................. 0.00	X		0	0
(12) TIMOTHY M HUSTED MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(13) JACQUELINE HYLANT BERENWEIG...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(14) AMIR A KHAN...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(15) MARLON P KISER...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(16) WILLIAM J LANGE...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(17) RICHARD D LANTZ...................................................................... TRUSTEE (PARTIAL YEAR)	1.00 ................. 0.00	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SARAH A MCHUGH........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(19) THOMAS GEORGE PADANILAM MD........................................................................ TRUSTEE, PHYSICIAN	1.00 .......................40.00	X					0	606,477	26,868
(20) CHARLES A PARCHER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(21) ROBERT P SCHLATTER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(22) CHARLES MICHAEL SMITH........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(23) SUSAN K STAELIN........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(24) MARTIN P SUTTER........................................................................ TRUSTEE (PARTIAL YEAR)	1.00 .......................0.00	X					0	0	0
(25) SARA M SWISHER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(26) BRADLEY J TOFT........................................................................ TRUSTEE (PARTIAL YEAR)	1.00 .......................0.00	X					0	0	0
(27) JOAN UHL-BROWNE........................................................................ TRUSTEE (PARTIAL YEAR)	1.00 .......................0.00	X					0	0	0
(28) DARRELL J WACHOWIAK RN BSN MHA........................................................................ TRUSTEE, PRES. FLOWER HOSPITAL	1.00 .......................40.00	X					0	213,495	28,402
(29) THADIUS L WADSWORTH MBA BSN RN C........................................................................ TRUSTEE, PRES. BAY PARK	1.00 .......................40.00	X					0	247,127	12,891
(30) ERICH L WEINLANDER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(31) RANDALL OOSTRA........................................................................ PHS PRES. & CEO	1.00 .......................55.00		X				0	7,155,772	300,344
(32) JEFFREY C KUHN........................................................................ SECRETARY, CHIEF LEGAL OFFICER	1.00 .......................55.00		X				0	1,347,615	68,186
(33) STEVEN M CAVANAUGH........................................................................ TREASURER, CFO	1.00 .......................55.00		X				0	3,497,904	60,660
(34) DEANA SIEVERT........................................................................ SR VP, PAT CARE/CNO, SYSTEM	1.00 .......................54.00			X			0	530,514	33,176
(35) GARY W AKENBERGER........................................................................ COO, ACUTE CARE & SVP, DIAG	0.00 .......................50.00			X			0	525,467	38,467
(36) QIN-SHENG CHEN........................................................................ SR. MEDICAL PHYSICIST	40.00 .......................0.00				X		286,874	0	21,335
(37) KATE GATES........................................................................ PHYSICIAN	16.00 .......................24.00				X		287,047	284,083	19,899
(38) JAMES BURNS........................................................................ SR. MEDICAL PHYSICIST	40.00 .......................0.00				X		246,244	0	27,992
(39) JOSHUA OVENS........................................................................ RN CRITICAL CARE TRANSPORT	40.00 .......................0.00				X		238,192	0	30,605
(40) FEDOR LURIE........................................................................ ASSOC DIR RESEARCH ED VASC	40.00 .......................0.00				X		230,625	0	22,550
(41) ALAN M SATTLER........................................................................ FORMER TREASURER, VP BUSINESS DEV.	0.00 .......................40.00					X	0	269,627	37,223
(42) ARTURO POLIZZI........................................................................ FORMER PRESIDENT, COO	0.00 .......................40.00					X	0	1,230,742	25,127
(43) KEVIN C WEBB PHD........................................................................ FORMER CHIEF ACUTE OFFICER	0.00 .......................0.00					X	0	438,239	9,616

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

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) .

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

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

Did one or more disqualified persons (as defined on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described on 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 on 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) 2021

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) 2021

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 2021 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-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2021

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization THE TOLEDO HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization THE TOLEDO HOSPITAL		Employer identification number 34-4428256

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization THE TOLEDO HOSPITAL			Employer identification number 34-4428256
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2021

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

36,141

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

36,141

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

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

Schedule C (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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) 2021

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 ....	33,317,596	32,425,291	28,747,861	10,674,678	9,839,115
b	Contributions ...	2,000	2,000	8,000	21,592,265
c	Net investment earnings, gains, and losses	3,131,916	890,305	3,669,430	-3,519,082	835,563
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	36,451,512	33,317,596	32,425,291	28,747,861	10,674,678

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

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

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

Yes

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

3a(i)

Yes

(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 .....	52,366,930		52,366,930
b	Buildings ....	1,252,005,150	617,219,977	634,785,173
c	Leasehold improvements	3,764,347	3,754,274	10,073
d	Equipment ....	407,967,373	318,982,841	88,984,532
e	Other .....	62,536,303	37,281,416	25,254,887
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				801,401,595

Schedule D (Form 990) 2021

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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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

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

Part IX

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

(a) Description				(b) Book value
(1)OTHER RECEIVABLES				5,551,708
(2)BENEFICIAL INTEREST IN FOUNDATION				302,553,092
(3)OTHER SEGREGATED INVESTMENTS				7,396,859
(4)INTERCOMPANY DEBT FROM RELATED ENTITIES				186,311,145
(5)THIRD PARTY PAYER RECEIVABLE				11,552,266
(6)GRANTS RESEARCH FUND				2,450,290
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				515,815,360

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
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	212,616,706
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) 2021

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART V, LINE 4:	THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT THE TOLEDO HOSPITAL CONSISTENT WITH DONOR INTENT.

Schedule D (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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 60000.0000000000 %

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? . . . . . .

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	6,474,346		6,474,346	0.540 %
b	Medicaid (from Worksheet 3, column a) . . . . .	262,212,645	184,221,238	77,991,407	6.450 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	103,242	91,977	11,265	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	268,790,233	184,313,215	84,477,018	6.990 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	9,334,253	881,056	8,453,197	0.700 %
f	Health professions education (from Worksheet 5) . . .	51,764,561	23,655,444	28,109,117	2.320 %
g	Subsidized health services (from Worksheet 6) . . . .	11,303,027	6,045,761	5,257,266	0.430 %
h	Research (from Worksheet 7) .	287,129		287,129	0.020 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	659,075		659,075	0.050 %
j	Total. Other Benefits . .	73,348,045	30,582,261	42,765,784	3.520 %
k	Total. Add lines 7d and 7j .	342,138,278	214,895,476	127,242,802	10.510 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	150,472	150,472	0.010 %
2	Economic development	418,553	418,553	0.030 %
3	Community support	1,286,686	1,286,686	0.110 %
4	Environmental improvements
5	Leadership development and training for community members	3,701	3,701	0 %
6	Coalition building	446,208	446,208	0.040 %
7	Community health improvement advocacy
8	Workforce development	174,504	174,504	0.010 %
9	Other
10	Total	2,480,124	2,480,124	0.200 %

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. ......

61,930,966

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

3,498,097

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).....

179,674,126

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

199,222,306

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

-19,548,180

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 PROMEDICA ORTHOPEDIC CO-MANAGEMENT CO LLC	PHYSICIAN SERVICES	35.000 %	6.000 %	51.000 %
22 PROMEDICA SURGICAL SERVICES CO-MANAGEMENT	PHYSICIAN SERVICES	45.280 %	0.940 %	40.560 %
33 REYNOLD ROAD SURGICAL CENTER LLC	SURGICAL CENTER	63.000 %	4.990 %	27.020 %
44 NORTHWEST OHIO DEDICATED BREAST MRI LLC	MEDICAL DIAGNOSTIC	50.000 %	0 %	50.000 %
55 WEST CENTRAL SURGICAL CENTER LLC	SURGICAL CENTER	50.000 %	0 %	25.000 %
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

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?4Name, 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)								Other (describe)	Facility reporting group
1	THE TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO,OH43606 WWW.PROMEDICA.ORG 1226	X	X	X	X	X	X		A
2	FLOWER HOSPITAL 5200 HARROUN RD SYLVANIA,OH43560 WWW.PROMEDICA.ORG 1227	X	X		X		X		A
3	WILDWOOD ORTHOPAEDIC HOSPITAL 2901 N REYNOLDS RD TOLEDO,OH43615 WWW.PROMEDICA.ORG 1501	X	X						A
4	ARROWHEAD BEHAVIORAL HEALTH 1725 TIMBERLINE RD MAUMEE,OH43537 WWW.ARROWHEADBEHAVIORAL.COM 1543	X						PSYCHIATRIC/ SUBSTANCE ABUSE FACILITY	B

Schedule H (Form 990) 2021

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)

	REPORTING GROUP A
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..................................

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): SEE PART V, SECTION C

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): SEE PART V, SECTION C

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 600.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (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) 2021

Page 7

Part VFacility Information (continued)

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

	REPORTING GROUP A
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) 2021

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)

	REPORTING GROUP B
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?........................

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

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..................................

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): SEE PART V, SECTION C

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): SEE PART V, SECTION C

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

10b

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	REPORTING GROUP B
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 600.000000000000%

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

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):

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

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

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

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

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

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	REPORTING GROUP B
Name of hospital facility or letter of facility reporting group

Yes

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

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

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) 2021

Page 7

Part VFacility Information (continued)

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

	REPORTING GROUP B
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 prospective Medicare or Medicaid method

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) 2021

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
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: THE TOLEDO HOSPITAL, - FACILITY 2: FLOWER HOSPITAL, - FACILITY 3: WILDWOOD ORTHOPAEDIC HOSPITAL
GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 5:	IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO
GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6A:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL, FLOWER HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH.
GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6B:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 11:	THE TOLEDO HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - TRAUMA- EDUCATION - MENTAL HEALTH/SUBSTANCE ABUSE THIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022. THE TOLEDO HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE ADULT: HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, , ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS,YOUTH WEIGHT CONTROL, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH PERCEPTIONS OF SUBSTANCE ABUSE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH SOCIAL DETERMINANTS OF HEALTH, YOUTH VIOLENCE; CHILD; HEALTH AND FUNCTION STATUS, CHILD CARE HEALTH ACCESS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH.TOLEDO HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2019: HEALTH NEED IDENTIFIED: TRAUMA EDUCATION STRATEGY #1 - PROVIDE AT LEAST FOUR (4) FREE, "STOP THE BLEED" TRAININGS AND EDUCATION TO COMMUNITY ORGANIZATIONS PER YEAR.ACTIONS TAKEN: - IN 2021, 22 "STOP THE BLEED" TRAININGS SESSIONS WERE CONDUCTED, WITH 15 KITS DISTRIBUTED AND 489 TOTAL PARTICIPANTS.STRATEGY #2 - PROVIDE AT LEAST TEN FREE CONTINUING MEDICAL EDUCATION TO LOCAL EMERGENCY MEDICAL SERVICES PROVIDERS PER YEARACTIONS TAKEN:- IN 2021, 50 FREE CONTINUING MEDICAL EDUCATION SESSIONS WERE PROVIDE TO 526 LOCAL EMERGENCY MEDICAL SERVICES PROVIDERS TO IMPROVE MEDICAL CARE AT THE SCENE OF INJURY OR EMEGENCY.STRATEGY #3 - ASSESS INDIVIDUALS FOR FALL PREVENTION AND PROVIDE CONNECTIONS TO RESOURCES IN THE COMMUNITY.ACTIONS TAKEN: - IN 2021, 8,635 INDIVIDUALS WERE ASSESSED FOR FALL RISK AND PROVIDED EDUCATION IN THE TOLEDO HOSPITAL EMERGENCY DEPARTMENT (ED).- 27 REFERRALS WERE MADE TO COMMUNITY RESOURCES.- THE PERCENTAGE OF COMPLIANCE OF FALL RISK ASSESSMENTS IN THE ED WAS 67% THE PLAN TO IMPROVE THIS COMPLIANCE PERCENTAGE INCLUDES NURSING AND PROVIDER EDUCATION, AS WELL AS INCLUDING INPATIENT NURSING AND CARE COORDINATION TEAM. HEALTH NEED IDENTIFIED: MENTAL HEALTH/SUBSTANCE ABUSE STRATEGY #1 - DEPLOYMENT OF FREE NARCAN KITS TO PATIENTS AND FAMILIES IN THE ED WHO ARE AT RISK FOR OVERDOSEACTIONS TAKEN:- 875 FREE NARCAN KITS WERE DISTRIBUTED TO PATIENT AND FAMILIES IN THE ED WHO WERE AT RISK FOR OVERDOSE.STRATEGY #2 - PROVIDE AT LEAST TWO FREE EDUCATIONAL CLASSES IN THE COMMUNITY ON MOCK HEROIN OVERDOSE ACTIONS TAKEN: - THREE (3) EDUCATIONAL SESSESION WERE OFFERED, TWO SESSIONS AT LOURDES COLLEGE AMD ONE SESSION AT UNIVERSITY OF TOLEDO, WITH 88 TOTAL PARTICIPANTS. RUSSELL J. EBEID CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11:PROMEDICA RUSSEL J. EBEID CHILDREN'S HOSPITAL, FORMERLY TOLEDO CHILDREN'S HOSPITAL (OPERATING WITHIN AND AS PART OF THE TOLEDOHOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- MENTAL HEALTH/SUBSTANCE ABUSE- INFANT MORTALITY/MATERNAL HEALTH- INJURY PREVENTION/SAFETY- CHRONIC DISEASE ASTHMA AND FOOD INSECURITY- INCREASE SCHOOL READINESSTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2020-2022. RUSSEL J. EBEID CHILDREN'S HOSPITAL (ECH), DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH 3STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, ADULT MENTAL HEALTH, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, ENVIRONMENTAL CONDITIONS, YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH VIOLENCE, CHILD HEALTH AND FUNCTION STATUS, MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. RUSSELL J. EBEID CHILDREN'S HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN2019:HEALTH NEED IDENTIFIED: MENTAL HEALTH/SUBSTANCE ABUSESTRATEGY #1 - CONDUCT EPIC AUDIT OF SCREENS COMPLETED AND % WITH APPROPRIATE FOLLOW THROUGH. SCREENS WILL BE AUDITED TO DETERMINE HOW MANY WERE COMPLETED AND HANDLED APPROPRIATELY ACCORDING TO RISK LEVEL. CULLEN CENTER WILL SCREEN ALL CLIENTS FOR SUICIDE RISK AND REFER AS APPROPRIATE.ACTIONS TAKEN: - AUDIT SHOWED 90% COMPLIANCE WITH DATA SHARED WITH STAFF TO IMPROVE COMPLIANCE. STRATEGY #2 IMPROVE YOUTH MENTAL HEALTH THROUGH:1. PROVIDE TRAUMA AND TRAUMA INFORMED TRAININGS TO RUSSELL J. EBEID CHILDREN'S HOSPITAL STAFF, PROFESSIONALS, AND COMMUNITY MEMBERS AT LARGE TO HELP THEM PROVIDE APPROPRIATE TRAUMA INFORMED SERVICES TO YOUTH WHO HAVE HISTORIES OF TRAUMA.2. PROVIDE TRAUMA INFORMED PARENTING GROUPS TO PARENTS OF CHILDREN WITH HISTORIES OF TRAUMA.3. PROVIDE RISK PREVENTION PROGRAM, HIP HOP HEALTH, TO AT-RISK TEENS, AND, ALSO PROVIDE EDUCATION FOR OTHER PROVIDERS WHO PROVIDE PREVENTION PROGRAMS FOR AT-RISK YOUTH.ACTIONS TAKEN: - 28 COMMUNITY AND HOSPITAL ZOOM TRAININGS WERE PROVIDED, WITH 1,022 PARTICIPANTS TRAINED.- 90% OF PARTICIPANTS REPORTED AN INCREASE IN KNOWLEDGE AFTER THE ZOOM TRAINING.-TWO 6-WEEK LONG TRAUMA INFORMED PARENTING SUPPORT GROUPS WERE HELD FOR 41 CAREGIVERS.- FOURTEEN (14) AT RISK TEENS WERE PROVIDED EDUCATION DURING A 14 WEEK GROUP. STRATEGY #3 - PROVIDE PEER-LED BULLYING/VIOLENCE PREVENTION AWARENESS EDUCATION TO ELEMENTARY AND MIDDLE SCHOOL AGED KIDS. HAVE A POSITIVE IMPACT ON PEER BULLYING BY PROVIDING EDUCATION TO SCHOOLS (Y1-500 YOUTH, Y2-750 YOUTH, Y3-1000 YOUTH).ACTIONS TAKEN: - 374 STUDENT LEADERS RECEIVED MULTI-SESSION TRAININGS ON BYSTANDER INTERVENTION IN 2021.- 1,892 STUDENTS RECEIVED PEER LED EDUCATION ON HOW THEY CAN REDUCE BULLYING IN THEIR SCHOOLS.- EDUCATED PEERS VIA SOCIAL MEDIA MESSAGING CAMPAIGNS CENTERED AROUND BYSTANDER INTERVENTION, BULLYING PREVENTION, INCREASING KINDNESS, MENTAL HEALTH AWARENESS AND DE-STIGMATIZATION, WITH 2017 TOTAL REACH.
GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 5:	IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO
GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 6A:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: TOLEDO HOSPITAL, WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH.
GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 6B:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 11:	FLOWER HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- MENTAL HEALTH- CANCERTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022.FLOWER HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS,YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE; YOUTH PERCEPTIONS, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. FLOWER HOSPITAL TOOK THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 - ADVOCACY & CAPACITY BUILDINGA. SPONSOR A BI-ANNUAL CONFERENCE TO HELP PROVIDERS BETTER SERVE PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS.ACTIONS TAKEN: - ONE (1) CONFERENCE WAS HELD IN 2021, THE BIANNUAL ANNUAL PSYCHIATRIC SYMPOSIUM, WITH 129 PARTICIPANTS. (NOTE: PARTICIPANTS PAID TO ATTEND THE CONFERENCE FOR CEU'S.)B. JOIN OR CREATE THREE ADVOCACY ACTIVITIES EACH YEAR THAT SUPPORT LOCAL, STATE, OR NATIONAL EFFORTS TO HELP PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS.ACTIONS TAKEN: - THE ADMINISTRATIVE DIRECTOR OF FLOWER PSYCHIATRIC SERVICES, OR THEIR REPRESENTATIVE, ATTENDED VARIOUS COUNTY OR STATE MENTAL HEALTH BOARD AND RELATED MEETINGS, FOR A TOTAL OF 119 HOURS OF ADVOCACY WORK.- FLOWER HOSPITAL FUNDED A .PART-TIME NAMI FAMILY NAVIGATOR WHO PARTICIPATED IN 28 MENTAL HEALTH ADVOCACY EVENTS, WITH 269 PARTICIPANTS.- FLOWER HOSPITAL STAFF PARTICIPATED IN THE NAMI WALK IN WHICH 62 EMPLOYEES PARTICIPATED AND RAISED $2,888. THESE FUNDS WILL GO NAMI TOLEDO CHAPTER TO HELP SUPPORT THE COMMUNITY INITIATIVE OF MENTAL HEALTH EDUCATION AND SUPPORT FOR PATIENTS AND FAMILIES.STRATEGY #2 A. MAINTAIN A FAMILY SUPPORT GROUP FOR PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSISACTIONS TAKEN:- THERE WERE 308 PARTICIPANTS IN FAMILY SUPPORT GROUP INITIATIVES. B. PARTNER WITH COMMUNITY GROUPS TO INCREASE COMMUNITY ORGANIZATION'S STAFFING THAT PROVIDES SYSTEM AND RESOURCE NAVIGATION SUPPORT TO PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSISACTIONS TAKEN: - PARTICIPATED IN OREGON CITY FAIR AND SUICIDE PREVENTION "OUT OF THE DARKNESS" TO SERVE 197 PERSONS.PROMEDICA-FUNDED A PART TIME FAMILY NAVIGATOR IN COLLABORATION WITH THE NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI) WHO WORKED 1040 HOURS (BASELINE 2019 0 HOURS).C. PARTNER WITH COMMUNITY GROUPS TO CREATE INFORMATION AND REFERRAL RESOURCES FOR PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS. ACTIONS TAKEN: - THE DIRECTOR OF FLOWER HOSPITAL PSYCHIATRY DEPARTMENT AND THE NAMI TEAM UPDATED THE NORTHWEST OHIO MENTAL HEALTH RESOURCE GUIDE. THIS RESOURCE GUIDE IS AVAILABLE FREE ONLINE FOR PRINTING, SOCIAL MEDIA/WEB SUPPORT, ETC. AVAILABLE ONLINE: HTTPS://WWW.PROMEDICA.ORG/PUBLIC%20DOCUMENTS/MEDICAL-SERVICES/BEHAVIORAL-HEALTH/NW_OHIO_MENTAL_HEALTH_RESOURCE.PDF AND IN PRINT THROUGH PROMEDICA, (THESE BOOKLETS ARE DISTRIBUTED TO THE COMMUNITY AT HEALTH FAIRS, ETC.). STRATEGY #3 - EDUCATION: HOLD FIVE EDUCATIONAL SESSIONS EACH YEAR THAT PROVIDE EDUCATION AND INFORMATION ON VARIOUS TOPICS AND ISSUES THAT ARE IMPORTANT TO PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS. ACTIONS TAKEN: - A TOTAL OF 50 EDUCATIONAL SESSIONS WERE HELD, WITH 211 PARTICIPANTS.HEALTH NEED IDENTIFIED: CANCERSTRATEGY #1 - ADVOCACY & CAPACITY BUILDING: WORK WITH SALONS AND BARBERSHOP OWNERS TO PROVIDE EDUCATION AND RESOURCES TO INCREASE HEALTH EQUITY IN THE COMMUNITIES THEY SERVE.ACTIONS TAKEN: - AS PART OF V-PROJECT (COVID VACCINE) EDUCATION MATERIALS WITH 1,200 THERMOMETERS AND HAND SANITIZERS WERE DISTRIBUTED TO SALON AND BARBERSHOP CUSTOMERS TO INCREASE COVID VACCINES AND PREVENT SPREAD OF COVID IN THESE MINORITY AND UNDERSERVED POPULATIONS.- STAFF PARTICIPATED IN 31 ADVOCACY AND CAPACITY BUILDING MEETINGSSTRATEGY #2 - PROGRAMMING: EDUCATE THE COMMUNITY ON EARLY DETECTION OF BREAST AND PROSTATE CANCER THROUGH AT LEAST TWO EDUCATIONAL PROGRAMS PER YEAR.ACTIONS TAKEN:- NINE (9) EDUCATIONAL SESSIONS WERE PROVIDED IN THE COMMUNITY TO INCREASE KNOWLEDGE OF EARLY DETECTION OF CANCER WITH A TOTAL OF 1,179 PARTICIPANTS.STRATEGY #3 - EDUCATION: PROVIDE EDUCATION ON HEALTH TOPICS TO REDUCE THE INCIDENCE OF LATE TERM CANCER DIAGNOSIS. ACTIONS TAKEN:- EIGHTEEN (18) SALON AND BARBERSHOPS PARTICIPATED IN EDUCATION SESSIONS TO EDUCATE THEIR CUSTOMERS ON CANCER SCREENING EDUCATION. THESE SHOPS WERE LOCATED IN UNDERSERVED, HIGH MINORITY ZIP CODES. - 1,255 AMERICAN CANCER SOCIETY CANCER PREVENTION RESOURCE GUIDES WERE DISTRIBUTED BY SALONS AND BARBERSHOPS TO IMPROVE AWARENESS AND ACCESS TO RELATED RESOURCES.
GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 5:	IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO
GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 6A:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH.
GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 6B:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 11:	WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- HUNGER- OBESITYTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022.WILDWOOD HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT TOBACCO USE, ADULT DRUG USE, ADULT ALCOHOL CONSUMPTION, ADULT SEXUAL BEHAVIOR, ADULT MENTAL HEALTH, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, ENVIRONMENTAL CONDITIONS, YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE; YOUTH PERCEPTIONS, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: HUNGERSTRATEGY #1 - SCREEN INPATIENTS ON ADMISSION FOR FOOD INSECURITY, AND PROVIDE FOOD TO TAKE HOME AT DISCHARGE, IF FOOD INSECURITY IS IDENTIFIED.ACTIONS TAKEN:- IN 2021, WITH TOLEDO HOSPITAL, 521 INPATIENTS SCREENED POSITIVE FOR FOOD INSECURITY, AND 89 FOOD AT DISCHARGE BOXES WITH COMMUNITY FOOD RESOURCE LISTINGS, WERE PROVIDED. PATIENTS HAVE THE OPTION OF DECLINING THE FOOD AT DISCHARGE BOX.STRATEGY #2 - SCREEN OUTPATIENTS IN SPECIFIC PROMEDICA PRIMARY CARE OFFICES FOR FOOD INSECURITY AND PROVIDE A REFERRAL TO A PROMEDICA FOOD PHARMACY AND/OR PROVIDE A LISTING OF FOOD AGENCIES TO ASSIST PATIENTS WITH FOOD ACCESS.ACTIONS TAKEN:- 1,658 UNIQUE HOUSEHOLDS WITHOUT CHILDREN WERE SERVED BY THE CENTER FOR HEALTH SERVICES AND PROMEDICA HEALTH AND WELLNESS CENTER FOOD CLINICS IN 2021. PATIENTS ARE REFERRED BY THEIR PROMEDICA PRIMARY CARE PROVIDER AND MAY VISIT THE FOOD CLINICS ONCE A MONTH FOR 2-3 DAYS OF HEALTHY FOOD.HEALTH NEED IDENTIFIED: OBESITYSTRATEGY #1 - PROVIDE FREE COOKING MATTERS PROGRAMMING TO PARENTS AND FAMILIES THROUGHOUT THE COMMUNITY. COOKING MATTERS IS A 6-WEEK HEALTHY EATING AND COOKING CLASS FOR LOW-INCOME FAMILIES, WHICH WILL BE OFFERED AT THE PROMEDICA EBEID CENTER'S TEACHING KITCHEN.ACTIONS TAKEN:- THROUGH THE EBEID NEIGHBORHOOD PROMISE, TWO (2) COOKING MATTERS CLASS SERIES WERE COMPLETED AT THE EBEID CENTER IN 2021, WITH 34 PARTICIPANTS. THE EBEID CENTER IS A PARTNER PROGRAM IN URBAN TOLEDO. - FIFTY (50) NUTRITION BITES, A HEALTHY EATING NEWSLETTER WITH FITNESS TIPS, WERE DISTRIBUTED MONTHLY BY THE MARKET ON THE GREEN GROCERY STORE, LOCATED IN URBAN TOLEDO, FOR A TOTAL OF 600 DISTRIBUTED IN 2021.STRATEGY #2 - PROVIDE FREE COOKING MATTERS AT THE STORE PROGRAMMING TO PARENTS AND FAMILIES. COOKING MATTERS AT THE STORE IS A ONE-TIME, EDUCATIONAL GROCERY STORE TOUR TEACHING HEALTHY EATING ON A BUDGET.ACTIONS TAKEN:- IN LIEU OF THE GROCERY STORE TOUR THAT WAS PREVIOUSLY OFFERED, AND NOT WELL PARTICPATED IN, VIRTUAL COOKING CLASSES WERE PROVIDED BY THE RD THROUGH THE EBEID CENTER, VIA THE EBEID CENTER FACEBOOK PAGE, WITH 1,080 VIDEO VIEWS.STRATEGY #3 - PROVIDE PHYSICAL ACTIVITY EDUCATION AS PART OF THE PROGRAMMING AT THE EBEID CENTER.ACTIONS TAKEN:- THROUGH THE EBEID NEIGHBORHOOD PROMISE PROGRAM, ONE UPTOWN WALK AND ROLL EVENT WAS HELD WITH A TOTAL OF 175 PARTICIPANTS, TO INCREASE PHYSICAL ACTIVITY IN THE NEIGHBORHOOD.- 600 EDUCATIONAL FLYERS, ON PHYSICAL ACTIVITY WERE SENT TO MARKET ON THE GREEN FOR DISTRIBUTION TO THEIR CUSTOMERS.
PART V, SECTION B	FACILITY REPORTING GROUP B
FACILITY REPORTING GROUP B CONSISTS OF:	- FACILITY 4: ARROWHEAD BEHAVIORAL HEALTH
GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 5:	IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO
GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6A:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, & WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL.
GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6B:	THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 11:	ARROWHEAD BEHAVIORAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019, THEREFORE THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2020-2022:- SUBSTANCE ABUSE- MENTAL HEALTHARROWHEAD BEHAVIORAL HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT HEALTHCARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS, YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE, YOUTH PERCEPTION, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. ARROWHEAD BEHAVIORAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: SUBSTANCE ABUSESTRATEGY #1 FREE TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS (WHEN NEEDED).ACTIONS TAKEN: - NO COST TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS WERE PROVIDED TO 51 INDIVIDUALS.STRATEGY #2 - COLLABORATION WITH TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT TO PROVIDE NO COST HEPATITIS A VACCINATIONS TO INDIVIDUALS IN HIGH RISK POPULATIONS.ACTIONS TAKEN:- DUE TO COVID RESTRICTIONS THIS ACTIVITY DID NOT TAKE PLACE IN 2021, PER THE HEALTH DEPARTMENT.STRATEGY #3 - PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES, INCLUDING: RELAPSE PREVENTION, ALCOHOLICS ANONYMOUS AND NAMI FAMILY TO FAMILY. ACTIONS TAKEN:- 5/21/21 PARTICIPATED IN ANGEL WALK TO PROVIDE EDUCATION TO APPROXIMATELY 500 ATTENDEES.- 9/14/21 PROVIDED EDUCATION TO APPROXIMATELY 50 PARTICIPANTS AT ROAD TO RECOVERY.- 11/9/21 PROVIDED EDUCATION TO APPROXIMATELY 20 PARTICIPANTS AT WOOD COUNTY ARC TOWN HALL.HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES TO INCREASE EDUCATION AND AWARENESS TO THE COMMUNITY ABOUT MENTAL HEALTH AND MENTAL HEALTH RESOURCES.ACTIONS TAKEN: DISTRIBUTED MATERIALS FOCUSING ON DEPRESSION, ANXIETY AND SUBSTANCE USE DISORDERS AT THE FOLLOWING EVENTS:- 7/8/21 PARTICIPATED IN AFRICAN AMERICAN LEADERSHIP INITIATIVE WITH NAMI WITH APPROXIMATELY 50 PARTICIPANTS- 8/28/2021 PARTICIPATED IN WALK THE WORD MINISTRY WITH NAMI WITH APPROXIMATELY 50 PARTICIPANTS- 9/14/2021 PARTICIPATED WITH ROAD TO RECOVERY WITH APPROXIMATELY 30 PARTICIPANTS- 11/9/2021 PARTICIPATED IN OWENS COMUNITY COLLEGE "ART WITH IMPACT" EVENT WITH APPROXIMATELY 55 PARTICIPANTS- 1/11/2021 PARTICIPATED IN AMERICAN RED CROSS VETEREN'S EVENT WITH APPROXIMATELY 1000 PARTICIPANTS
GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 20E:	PRIOR TO PURSUING COLLECTION ACTIONS, THE HOSPITAL FACILITY INITIATED THE FOLLOWING ACTIONS:- PATIENTS ARE OFFERED PAYMENT PLANS TO WORK WITH THE HOSPITAL FACILITYTO PAY THEIR OUTSTANDING BALANCES WITH COMMUNICATION MADE TO THEPATIENT ON A MONTHLY BASIS VIA PAPER INVOICES AND PHONE CALLS- PATIENT ACCOUNTS WILL NOT GO TO BAD DEBT COLLECTION IF THE PATIENTMAKES MONTHLY PAYMENTS AS AGREED TO WITH THE HOSPITAL FACILITY OR IFTHE PATIENT COMMUNICATES THEIR INABILITY TO MAKE PAYMENTS TIMELY- PATIENT ACCOUNTS WILL GO TO BAD DEBT COLLECTION IF THE PATIENT DOESNOT COMMUNICATE WITH THE HOSPITAL FACILITY OR RESPOND TO PAPER INVOICESAND PHONE CALLS FOR MULTIPLE MONTHS
PART V, SECTION B, LINE 7A	THE 2019 CHNA FOR TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE AND ARROWHEAD BEHAVIORAL HOSPITALS CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-FLOWER-WILDWOOD-AND-ARROWHEAD-HOSPITALS-2019-JOINT-CHNA.PDFTHE 2019 CHNA FOR PROMEDICA TOLEDO CHILDREN'S HOSPITAL CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-CHILDRENS-HOSPITAL-2019-CHNA.PDF
PART V, SECTION B, LINE 10A	THE 2020-2020 CHNA IMPLEMENTATION PLAN FOR TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE AND ARROWHEAD BEHAVIORAL HOSPITALS CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-FLOWER-WILDWOOD-AND-ARROWHEAD-BEHAVIORAL-HOSPITALS-2019-JOINT-CHNA-IMPLEMENTATION-PLAN-2020-2022-(1).PDFTHE 2020-2020 CHNA IMPLEMENTATION PLAN FOR PROMEDICA TOLEDO CHILDREN'S HOSPITAL CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-CHILDRENS-HOSPITAL-2019-CHNA-IMPLEMENTATION-PLAN-2020-2022.PDF
PART V, SECTION B, LINE 16A:	THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF
PART V, SECTION B, LINE 16B:	THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF
PART V, SECTION B, LINE 16C:	A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF
RUSSELL J. EBEID CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED:	STRATEGY #4 - DEMONSTRATE CHANGE AS EVIDENCED BY PARTICIPANT RETROSPECTIVE TESTING. INCREASE CONFIDENCE LEVEL "YOUR PEERS ARE MAKING FUN OF A CLASSMATE. HOW CONFIDENT ARE YOU THAT YOU WOULD STAND UP FOR THE PERSON EVEN IF YOU DID NOT KNOW THEM?" (Y1-10%, Y2-15%, Y3-20%).ACTIONS TAKEN:- TRACKED CONFIDENCE LEVEL OF TEENS. TEEN LEADERS DEMONSTRATED AN 84% OVERALL INCREASE IN THEIR CONFIDENCE LEVEL FOR INTERVENING (BYSTANDER INTERVENTION). DATA COLLECTED ONCE/ANNUALLY AT CONCLUSION OF SCHOOL YEAR MAY/JUNE.STRATEGY #5: 1. PROVIDE ANTENATAL EDUCATION BY NEONATAL NURSE PRACTITIONER FROM NEONATAL INTENSIVE CARE UNIT (NICU) ABOUT MATERNAL BONDING AND THE USE OF NON-PHARMACOLOGICAL BUNDLE ITEMS TO DECREASE THE NEED FOR PHARMACOLOGICAL TREATMENT FOR NEONATAL ABSTINENCE SYNDROME (NAS) STRESSING THE IMPORTANCE OF THE USE OF MATERNAL BREAST MILK IN THE NAS POPULATION. 2. CONTINUE CONSULTS AT CENTER FOR HEALTH SERVICES (CHS) AS ORDERED BY PRIMARY CARE PROVIDER/OBSTETRICIAN.3. CONTINUE PARTICIPATION AT THE MONTHLY "MOM'S GROUP" MEETINGS AT ZEPF CENTER.ACTIONS TAKEN: -NINE (9) NEONATAL ABSTINENCE SYNDROME (NAS) CONSULTS WERE COMPLETED AT THE CENTER FOR HEALTH SERVICES (CHS) IN 2021 WHERE A NEONATAL NURSE PRACTITIONER FROM THE NEONATAL INTENSIVE CARE UNIT (NICU) INSTRUCTED NEW MOTHERS ABOUT MATERNAL BONDING AND THE USE OF NON-PHARMACOLOGICAL BUNDLE ITEMS TO DECREASE THE NEED FOR PHARMACOLOGICAL TREATMENT FOR NAS, AND STRESSING THE IMPORTANCE OF THE USE OF MATERNAL BREAST MILK IN THE NAS POPULATION. -A LICENSED THERAPIST EDUCATED THREE (3) INDIVIDUALS AT MOM'S GROUP AT ZEPF MENTAL HEALTH CENTER. IN JANUARY AND FEBRUARY, STAFF WAS UNABLE TO HOLD MEETINGS DUE TO COVID RESTRICTIONS. PREVIOUSLY ATTEMPTED ZOOM MEETING FOR "MOM'S GROUP" AT THE ZEPF CENTER, BUT DUE TO MULTIPLE FACTORS THIS ONLINE GROUP WAS NOT SUCCESSFUL, AND DISCONTINUED.HEALTH NEED IDENTIFIED: INFANT MORTALITY/MATERNAL HEALTHSTRATEGY #1 SAFE SLEEP1. PROVIDE ACCESS TO SAFE SLEEP EDUCATION TO LOW INCOME CAREGIVERS WITH CHILDREN LESS THAN 12 MONTHS OF AGE AND REFER PARENTS TO CLASSES AS APPROPRIATE. PROVIDE ASSESSMENTS TO FAMILIES RECEIVING PORTABLE CRIB TO ENSURE SAFE SLEEP PRACTICES AND USE OF CRIB.2. PROVIDE SAFE SLEEP SACKS AND SAFE SLEEP EDUCATION TO LOW INCOME CAREGIVERS WITH NEWBORN INFANTS WHEN APPROPRIATE.3. EXPAND AS POSSIBLE BASED ON FUNDING AVAILABILITY.ACTIONS TAKEN:NOTE: ALL NEW MOTHERS RECEIVE EDUCATION ON SAFE SLEEP DURING THEIR DELIVERY STAY IN THE HOSPITAL.-SAFE SLEEP ASSESSMENT WAS PROVIDED TO 19 FAMILIES RECEIVING PORTABLE CRIBS TO ENSURE SAFE SLEEP PRACTICES. - SAFE SLEEP SACKS AND SAFE SLEEP EDUCATION WAS PROVIDED TO 32 LOW INCOME CAREGIVERS WITH NEWBORN INFANTS.STRATEGY #2 BREASTFEEDING 1. TH/ECH WOMEN, INFANT AND CHILDREN SUPPLEMENTAL FOOD PROGRAM (WIC) DIETITIANS AND SUPPORT STAFF DISCUSS BREASTFEEDING WITH EACH PREGNANT/BREASTFEEDING WOMAN, ENROLLED IN THE TH/ECH WIC PROGRAM, AND ENCOURAGE ATTENDANCE TO THE FREE, UNLIMITED, BREASTFEEDING EDUCATION CLASSES. 2. OFFER BREASTFEEDING EDUCATION CLASSES TO EACH PREGNANT/BREASTFEEDING WOMAN ENROLLED IN THE WIC PROGRAM.3. MAKE REFERRALS TO WIC LACTATION CONSULTANT AND WIC BREASTFEEDING STAFF.4. WIC PEER BREASTFEEDING COUNSELOR CONTACTS THE TH/ECH BREASTFEEDING MOMS TO OFFER SUPPORT AND ANSWER BREASTFEEDING QUESTIONS.5. EDUCATE PREGNANT WOMEN PARTICIPATING IN PATHWAYS AND HMG HOME VISITING PROGRAMS REGARDING BREASTFEEDING AND/OR FEEDING BREASTMILK DURING HOME VISITS AND USE LACTATION CONSULTANTS IF NEEDED TO SUSTAIN INFANTS RECEIVING BREASTMILK UNTIL AT LEAST 5 WEEKS OLD. INCORPORATE THE ODH BREASTFEEDING/BREAST MILK INITIATIVE MATERIALS. ACTIONS TAKEN:- THE NUMBER OF PREGNANT/BREASTFEEDING WOMEN ENROLLED IN TH/ECH WIC PROGRAM WAS 1,873.- ECH PROVIDED FREE BREASTFEEDING CLASSES THROUGH WIC WITH A TOTAL OF 76 WOMEN ATTENDING. - ECH WIC PEER BREASTFEEDING COUNSELOR CONTACTS, TO EDUCATE AND ENCOURAGE, BREASTFEEDING MOMS (VIA TEXTS, IN PERSON, PHONE CALLS) WAS 18,059 TOTAL CONTACTS.- PROMOTED BREASTFEEDING THROUGH EDUCATION AND SUPPORT TO 100% PARTICIPANTS OF PATHWAYS AND HELP ME GROW PROGRAM FOR A TOTAL OF 32 PARTICANTS. THE ECH CERTIFIED LACTATION COUNSELOR REFERRED THESE PATIENTS TO HEALTH DEPARTMENT LACTATION CONSULTANT.- THE NUMBER OF INFANTS WHO RECEIVED BREASTMILK UNTIL AT LEAST FIVE WEEKS OF AGE WAS 41. HEALTH NEED IDENTIFIED: INJURY PREVENTION STRATEGY #11. KIDS IN SAFE SEATS (KISS) AND OHIO BUCKLES BUCKEYES (OBB) PROGRAMS WILL EDUCATE PARENTS AND CAREGIVERS ON THE IMPORTANCE OF PROPER CAR SEAT USE AT RUSSELL J. EBEID CHILDREN'S HOSPITAL FITTING STATIONS AND COMMUNITY CAR SEAT CHECK EVENTS.2. PROVIDE OPPORTUNITIES FOR PARENTS AND CAREGIVERS TO RECEIVE CAR SEAT INFORMATION (Y1-40, Y2-50, Y3-60).3. KISS AND OBB PROGRAMS WILL PROVIDE ACCESS TO CAR SEATS AND BOOSTER SEATS TO LOW INCOME FAMILIES AT RUSSELL J. CHILDREN'S HOSPITAL CAR SEAT FITTING STATION AND COMMUNITY EVENTS AND WE WILL DISTRIBUTE TO LOW INCOME FAMILIES.4. PROMOTE AND FACILITATE AT LEAST 2 TRAININGS PER YEAR TO INCREASE THE NUMBER OF CHILD SAFETY TECHNICIANS TRAINED (Y1-16, Y2-18, Y3-20).ACTIONS TAKEN: -ECH STAFF EDUCATED 832 INDIVIDUALS ON CAR SEAT SAFETY THROUGH 8 EVENTS WITH 83 FITTING STATIONS, AND 360 CAR SEATS WERE CHECKED. -ECH STAFF PROVIDED 19 CAR SEAT PRESENTATIONS WITH 187 PARTICIPANTS-240 NO COST OR GRANT FUNDED CAR SEATS WERE DISTRIBUTED TO FAMILIES.- ECH STAFF PROVIDED CHILD PASSENGER SAFETY TRAINING (CPST) WITH 33 TOTAL PEOPLE TRAINED.STRATEGY #2 INCREASE AWARENESS OF DISTRACTED DRIVING DANGERS.1. PROMOTE AND FACILITATE DISTRACTED DRIVING PRESENTATIONS FOR LOCAL HIGH SCHOOLS AND COMMUNITY LOCATIONS THROUGHOUT NORTHWEST OHIO.2. CONDUCT DISTRACTED DRIVING PROGRAMMING FOR HIGH SCHOOLS (Y1-3, Y2-5, Y3-6) AND AT COMMUNITY LOCATIONS (Y1-1, Y2-2, Y3-3).ACTIONS TAKEN:- APPROXIMATELY 1,017 PEOPLE WERE PROVIDED DISTRACTED DRIVING EDUCATION AND OFFERED USE OF DISTRACTED DRIVING SIMULATOR.-IN LIEU OF ONSITE HIGH SCHOOL DISTRACTED DRIVING PROGRAMMING, SOCIAL MEDIA OUTREACH INCLUDED 25 POSTS WITH 2,969 PEOPLE REACHED (NO IN-PERSON PROGRAMS FROM MARCH-DECEMBER DUE TO COVID SCHOOL RESTRICTIONS).STRATEGY #3 INCREASE ACCESS TO SAFETY ITEMS AND PROVIDE EDCUATION ON CHILD/HOME SAFETY. 1. R CHILDREN'S HOSPITAL (ECH) TRAUMA DEPT. AND SAFE KIDS GREATER TOLEDO WILL EDUCATE PARENTS/CAREGIVERS AND THE COMMUNITY ON CONCUSSION PREVENTION AND SPORTS RELATED INJURIES AT EVENTS, COACHES TRAININGS, CONCUSSIONS CLINIC, AND AREA SCHOOLS. EDUCATE AT LEAST 50 PARTICIPANTS AT PRESENTATIONS AND EVENTS (Y1-50 Y2,3-75). NOTE: THIS IS A DUPLICATE STRATEGY TO STRATEGY 5 (#1) BELOW, AND WILL ONLY BE REPORTED HERE, IN ACTIONS TAKEN.2. ECH COMMUNITY OUTREACH/SAFE KIDS GREATER TOLEDO AND TOLEDO HEALTHY TOMORROWS WILL EDUCATE PARENTS, CAREGIVERS, AND THE COMMUNITY ON HOME SAFETY ISSUES INCLUDING ACCIDENTAL POISONINGS, MEDICATION SAFETY, WATER SAFETY, FALLS, FIRE, BURN, ETC.3. DIRECTLY EDUCATE INDIVIDUALS (Y1-150, Y2-175, Y3-185) THROUGH PRESENTATIONS AND EDUCATIONAL SESSIONS; INDIRECTLY EDUCATE THOUSANDS MORE THROUGH AT SOCIAL MEDIA POSTS, TRADITIONAL MEDIA AND BROCHURES (Y1-5, Y2-10, Y3-15).ACTIONS TAKEN:-ECH EDUCATED 1,039 INDIVIDUALS AT PRESENTATIONS AND EVENTS RELATED TO CONCUSSIONS, SKILLS AND DRILLS AND TNCC.-69 FAMILIES PARTICIPATED IN HOME SAFETY PROGRAMS WITH 157 SAFETY ITEMS WERE DISTRIBUTED TO THESE FAMILIES.-A REACH OF 251,868 WAS ATTAINED WITH A SOCIAL MEDIA CAMPAIGN FOR NATIONAL DISTRACTED DRIVING AWARENESS MONTH IN APRIL 2021.STRATEGY #4 - IMPROVE SAFETY OF CHILDREN WHO WALK OR BIKE TO SCHOOL.1. ECH COMMUNITY OUTREACH/SAFE KIDS GREATER TOLEDO AND SAFE ROUTES TO SCHOOL (PROGRAMS) WILL EDUCATE STUDENTS AND THE COMMUNITY ON THE FACILITATE WALK TO SCHOOL DAY AND BIKE TO SCHOOL DAY WITH LOCAL SCHOOLS AND EDUCATE ON SAFE WALKING/BIKE PRACTICES AND BENEFITS OF GOING TO SCHOOL IN GROUPS (Y1&2-50 CHILDREN, Y3-60 CHILDREN).ACTIONS TAKEN:- PROVIDED WALK TO SCHOOL DAY AT HAWKINS ELEMENTARY WITH APPROXIMATELY 100 STUDENTS PARTICIPATING. PROVIDED SAFE /TRICK OR TREATING EDUCATION AT "BOO AT THE ZOO" WITH APPROXIMATELY 3000 PARTICIPANTS.STRATEGY #5 - INCREASE AWARENESS OF CONCUSSION PREVENTION AND SPORTS RELATED INJURIES.1. RUSSELL J. EBEID CHILDREN'S HOSPITAL TRAUMA DEPT. AND SAFE KIDS GREATER TOLEDO WILL EDUCATE PARENTS/CAREGIVERS AND THE COMMUNITY ON CONCUSSION PREVENTION AND SPORTS RELATED INJURIES AT EVENTS, COACHES TRAININGS, CONCUSSIONS CLINIC, AND AREA SCHOOLS (Y1-AT LEAST 50 PARTICIPANTS, Y2&3-AT LEAST 75 PARTICIPANTS). NOTE: THIS IS A DUPLICATE STRATEGY TO STRATEGY 3 (#1) ABOVE AND IS REPORTED THERE.2. RUSSEL J. EBEID CHILDREN'S HOSPITAL TRAUMA DEPT. WILL ASSIST SCHOOLS AND MEDICAL PROFESSIONALS WITH RETURN2PLAY AND RETURN TO LEARN POLICY AND PROCEDURE ADOPTION BY PROVIDING EDUCATIONAL MATERIALS AND SESSIONS (Y1-AT LEAST 4 SCHOOLS OR MEDICAL PROFESSIONALS, Y2-5, Y3-6).
RUSSELL J. EBEID CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED:	ACTIONS TAKEN: -ECH TRAUMA DEPARTMENT HELD EDUCATIONAL SESSIONS ON VARIOUS TRAUMA RELATED CHILD INJURIES, REPORTED IN STRATEGY #4 ABOVE.-ECH TRAUMA DEPARTMENT PROVIDED EDUCATION TO 225 INDIVUIDUALS ON RETURN2PLAY AND RETURN TO LEARN.STRATEGY #6 - DEVELOP AND IMPLEMENT SAFETY EDUCATION FOR CHILDREN AND PARENTS OF CHILDREN WITH AUTISM (YEAR 1-AT LEAST 2 EVENTS, YEAR 2-4 EVENTS, YEAR 3-6 EVENTS).ACTIONS TAKEN:-NO EDUCATION WAS PROVIDED TO THIS GROUP IN 2021 - IN PERSON EVENTS WERE DIFFICULT TO SCHEDULE DUE TO COVID GROUP RESTRICTIONS.HEALTH NEED IDENTIFIED: CHRONIC DISEASE/ASTHMA/FOOD INSECURITYSTRATEGY #1 - RUSSELL J. EBEID CHILDREN'S HOSPITAL WILL PROVIDE NURSE COVERAGE IN COLLABORATION WITH THE LUCAS COUNTY HEALTH DEPARTMENT "SHOTS FOR TOTS" PROGRAM TO PROVIDE IMMUNIZATIONS TO CHILDREN.ACTIONS TAKEN: - RUSSEL J. EBEID CHILDREN'S HOSPITAL PROVIDED NURSE COVERAGE AT ONE EVENT SERVING FOUR (4) CHILDREN AT "SHOTS FOR TOTS" PROGRAM AT WEST TOLEDO YMCA.STRATEGY # 2 - INCREASE ACCESS TO ASTHMA EDUCATIONAL PROGRAMS AND INTERVENTIONAL HEALTHCARE. IMPROVE ASTHMA MANAGEMENT FOR CHILDREN. INCREASE UTILIZATION OF CARE FOR HIGHER RISK CHILDREN WITH ASTHMA.1. UTILIZE EVIDENCE BASED ASTHMA DISEASE MANAGEMENT PROGRAM UTILIZED AT PROMEDICA RUSSEL J. EBEID CHILDREN'S HOSPITAL FOR ASTHMA EDUCATION AT THE PEDIATRIC AMBULATORY DEPARTMENT.2. UTILIZE RESPIRATORY THERAPISTS TRAINED TO PROVIDE CONSISTENT ASTHMA EDUCATION TO PARENTS AND CHILDREN WITH ASTHMA AND PROVIDE ACTION PLANS.3. PROVIDE ASTHMA EDUCATION 2 DAYS PER WEEK TO ALL PARENTS OF ASTHMATIC CHILDREN SEEN IN THE PEDIATRIC AMBULATORY DEPARTMENT AND PROVIDE ASTHMA INSTRUCTION BOOKLET TO THOSE RECEIVING EDUCATION. 4. SURVEY PARENTS/PATIENTS AFTER ASTHMA EDUCATION TO ASSESS PERCEPTION OF CARE.5. UTILIZE HOME CARE NURSES TO PROVIDE HOME EVALUATIONS AND FOLLOW UP CARE FOR ASSESSMENT OF PATIENT/FAMILY UNDERSTANDING OF ASTHMA EDUCATION, IMPLEMENTATION OF MANAGEMENT SKILLS AND UNDERSTANDING OF NEED TO TAKE MEDICATIONS AS ORDERED. WILL MAKE HOME HEALTH REFERRAL IF PATIENT ANSWERS YES TO HOSPITALIZATION IN LAST YEAR.ACTIONS TAKEN: - EVIDENCE BASED ASTHMA EDUCATION PROVIDED IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS TO 2,247 PATIENTS/FAMILIES. THESE ARE FREE EDUCATIONAL SESSIONS AT PATIENTS AND FAMILY ONE ON ONE APPOINTMENT. -66 PATIENTS WITH A POSITIVE HIGH-RISK ASTHMA SCREEN WERE REFERRED FOR ASTHMA EDUCATION. FREE SCREENING; NO CHARGE. -2374 ACTION PLANS WERE GIVEN TO PARENTS OF CHILDREN IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS WITH AN ASTHMA DIAGNOSIS. FREE ACTION PLAN AT NO CHARGE.-PATIENTS RECEIVE EDUCATION AT EVERY VISIT - NO PATIENTS RETURNED FOR EDUCATION OR SOUGHT CLASS INSTRUCTION, ALTHOUGH WE OFFER MORE EDUCATION IF NEEDED. -COMPLIANCE AUDITS OF PEDIATRIC PATIENT CHARTS ARE PERFORMED AND EDUCATION IS PROVIDED TOO STAFF AND RESIDENTS, AS NEEDED TO IMPROVE COMPLIANCE.STRATEGY #3 - DECREASE ASTHMA-RELATED HOSPITAL ADMISSIONS AND ED VISITS BY IMPROVED FAMILY/CHILD KNOWLEDGE AND APPROPRIATE MANAGEMENT OF CHILD'S ASTHMA.1. PROMEDICA RUSSEL J. EBEID CHILDREN'S HOSPITAL AND OUTPATIENT PRACTICES HAVE BEEN CERTIFIED BY THE JOINT COMMISSION FOR PEDIATRIC ASTHMA DISEASE MANAGEMENT AND IS THE ONLY HOSPITAL IN OHIO WITH THIS DISTINCTION. THIS TEAM MEETS REGULARLY TO EVALUATE PROGRESS BASED ON TARGET GOALS.2. PROVIDE EVIDENCED BASED EDUCATION TO PATIENTS USING QUALITY MEASURES TO DETERMINE SUCCESS. A. UTILIZE ASTHMA ORDER SETS IN PEDIATRIC EMERGENCY DEPARTMENT.B. UTILIZE ASTHMA ORDER SETS IN PEDIATRIC INPATIENT UNITC. UTILIZE ASTHMA ORDER SETS AT PULMONARY CLINIC AT PEDS AMBULATORY CLINIC (MEANT TO STATE PEDIATRIC ICU)3. PROVIDE ASTHMA INSTRUCTION BOOKLETS TO THOSE RECEIVING PARENT EDUCATION AND CONDUCT EVALUATIONS. 4. PROVIDE ASTHMA ACTION PLAN TO ALL PATIENTS AND FAMILIES WITH ASTHMA DIAGNOSIS FROM PROMEDICA RUSSELL J. EBEID CHILDRENS HOSPITAL AND MONITOR NUMBER OF PATIENTS SEEN IN ED WITHIN 7 OR 30 DAYS FROM LAST ED VISIT.ACTIONS TAKEN:- # OF PATIENTS IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS RECEIVING ASTHMA EDUCATION WAS 2347- # OF PATIENTS WITH POSITIVE HIGH-RISK ASTHMA SCREEN REFERRED FOR ASTHMA EDUCATION WAS 66- # OF ACTION PLANS GIVEN TO PARENTS OF CHILDREN IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS WITH AN ASTHMA DIAGNOSIS WAS 2347- ZER0 (0) PATIENTS RETURNED FOR ADDITIONAL EDUCATION OR CLASS INSTRUCTION.- 99% OF PARENTS ANSWERED "YES" TO THEY WERE GIVEN ENOUGH TIME WITH EDUCATOR TO GET QUESTIONS ANSWERED% OF PATIENTS RECEIVING APPROPRIATE ORDER SETS AND EDUCATION, PER CRITERIA:- 91.125% OF ED PATIENTS WERE GIVEN ASTHMA ORDER SETS- 92.5% OF INPATIENTS WERE GIVEN ASTHMA ORDER SETS- 85.675% OF ASTHMA ORDER SETS USED IN PEDIATRIC INTENSIVE CARE UNIT - 95.8% OF PATIENTS RECEIVED HOME MEDICAL PLAN OF CARE- 96.5% OF HIGH-RISK ASTHMA SCREENS COMPLETED ON INPATIENTS- 91.87% OF INPATIENT TOBACCO CESSATION EDUCATION COMPLETED- 99.75% COMPLETION OF INPATIENT INFLUENZA SCREENING COMPLETED- 99.075% INPATIENT SATISFACTION WITH "ALL YOUR QUESTIONS ANSWERED"- 98.9% OF PARENTS OF PATIENTS WITH ASTHMA RECEIVED EDUCATIONSTRATEGY #4 - ASSESS FOOD INSECURITY FOR EACH WIC PARTICIPANT DURING ALL WIC CERTIFICATION APPOINTMENTS. YEAR 1 (2020)1. REVIEW ALL HEALTH HISTORY FORMS AT EACH WIC CERTIFICATION APPOINTMENT AND ADDRESS THE QUESTION THAT INDICATES FOOD INSECURITY.2. DISCUSS THE PROMEDICA HEALTH SYSTEM FOOD CLINIC WITH EACH FOOD INSECURE FAMILY. STAFF ALSO PHYSICALLY WALK WIC PATIENTS DOWN TO THE CHS FOOD CLINIC. IF THE FOOD CLINIC IS CLOSED, WE OFFER HOURS OF OPERATION AND SUGGEST THAT ALL PROMEDICA HEALTH SYSTEM PATIENTS OBTAIN A REFERRAL TO THE FOOD CLINIC FROM THEIR PRIMARY PHYSICIAN.3. YEAR 2 AND 3 (2021-2022) EVALUATE PROGRAM TO DETERMINE ANY CHANGES NEEDED.ACTIONS TAKEN:- 351 PATIENTS HAD POSITIVE/AT RISK RESPONSES TO FOOD INSECUITY QUESTIONS ASKED AT WIC CERTIFICATION APPOINTMENT. -DISCUSSED PATIENTS DESIRE FOR A REFERRAL TO THE PROMEDICA FOOD CLINIC WITH 158 PATIENTS WERE DIRECTED TO THE FOOD CLINIC FOR MONTHLY FOOD FOR HOUSEHOLD FOR 2-3 DAYS OF FOOD. BASED ON PATIENT FEEDBACK FROM PATIENTS, THE REMAINDER OF THE PATIENTS DECLINED A REFERRAL TO THE FOOD CLINICS DUE TO FOOD STAMP/SNAP BENEFITS, IN ADDITION TO FREE UNIVERSAL BREAKFAST AND LUNCH AT SCHOOLS.STRATEGY #5 PROMEDICA ECH AMBULATORY PEDIATRIC PRACTICES WILL CONTINUE TO SCREEN ALL PATIENTS FOR FOOD INSECURITY AND REFER PATIENTS TO THE PROMEDICA FOOD CLINIC. THE FOOD CLINIC PROVIDES ACCESS TO HEALTHY FOOD AND NUTRITION EDUCATION FOR PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. THE FOOD CLINIC WILL PROVIDE CONTINUED EDUCATION/TRAINING TO PRACTICES ON ADDRESSING FOOD INSECURITY. ALL PATIENTS REFERRED TO THE FOOD CLINIC WILL BE OFFERED NUTRITION COUNSELING AND NUTRITION RESOURCES.1. THE FOOD CLINIC WILL EXPLORE WAYS TO INCREASE EDUCATION THROUGH IMPROVED COMMUNICATION WITH PROVIDERS AND INCREASED EDUCATION OPPORTUNITIES. 2. YEARS 2 AND 3 (2021-2022) EVALUATE FOOD CLINIC PROGRAM EXPANSION TO PROVIDE SERVICES TO ADDITIONAL PRACTICES AND PATIENTS. REFINE NUTRITION EDUCATION OPPORTUNITIES PROVIDED THROUGH THE FOOD CLINIC. 3. YEARS 2 AND 3 (2021-2022) ALL PATIENTS/FAMILIES AT ECH WILL BE SCREENED FOR FOOD INSECURITY PRI - OR TO DISCHARGE AND WILL BE OFFERED AN EMERGENCY FOOD BAG UPON DISCHARGE.4. YEAR 1 (2020) - CONTINUE TO PROVIDE FOOD BAGS AT DISCHARGE FOR PATIENTS IDENTIFIED AS FOOD INSECURE. YEARS 2 AND 3 (2021-2022) - EVALUATE FOOD SECURITY SCREENING RATES TO DETERMINE NEED FOR ADDITIONAL TRAINING ACROSS ECH STAFF. ACTIONS TAKEN:- ALL METRO TOLEDO ONCOLOGY PROVIDERS WERE TRAINED TO REFER PATIENTS TO THE FOOD CLINIC, WHO HAD POSITIVE FOOD INSECURITY SCREENING. - 12,592 FOOD INSECURITY SCREENS WERE CONDUCTED AT CENTER FOR HEALTH SERVICES (CHS) PEDIATRIC PRACTICE IN 2021- 789 REFERRALS WERE WRITTEN TO THE FOOD CLINIC FROM CHS PEDIATRIC PRACTICES IN 2021.- 1,127 UNIQUE HOUSEHOLDS WITH CHILDREN WERE SERVED BY THE CHS AND PROMEDICA HEALTH AND WELLNESS FOOD CLINICS IN 2021.- ALL NEW PATIENTS ARE OFFERED NUTRITION EDUCATION BY REGISTERED DIETITIAN AND PROVIDED WITH WRITTEN EDUCATION AND FOOD RESOURCES IN THE COMMUNITY.- 60 FOOD AT DISCHARGE FOOD BAGS WERE PROVIDED TO FOOD INSECURE FAMILIES AT ECH IN 2021.
RUSSELL J. EBEID CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED:	HEALTH NEED IDENTIFIED: INCREASE SCHOOL READINESS1. EDUCATE LOW INCOME PARENTS ABOUT PARENTING AND BENEFITS OF READING TO THEIR CHILDREN DURING HOME VISITS AND PROVIDE FREE CHILDREN'S BOOKS TO HOMES.A. YEAR 1 (2020) - TOLEDO HEALTHY TOMORROWS (THT)/HELP ME GROW (HMG) HOME VISITORS PROVIDE LITERACY EDUCATION AND BOOKS TO FAMILIES.B. YEAR 2 THRU 3 (2021-2022) - CONTINUE EDUCATION AND BOOK DISTRIBUTION WITH FAMILIES ENROLLED IN THT PROGRAMS AND PROVIDE RESOURCES FOR FAMILIES TO CONTINUE LITERACY ACTIVITIES AFTER DISCHARGED FROM THT PROGRAMS.2. PROVIDE AGE SPECIFIC DEVELOPMENTAL SCREENING FROM BIRTH TO AGE 3 FOR CHILDREN ENROLLED IN THT/HMG PROGRAMS.3. YEARS 1 THRU 3 (2020-2022)SCREEN ALL INFANTS AND CHILDREN TO AGE 3 YEARS OLD WITH AGE APPROPRIATE AGES AND STAGES, THIRD EDITION AND REFER ALL CHILDREN TO EARLY INTERVENTION THROUGH ESTABLISHED PROCEDURE IF SCREENING DETERMINES NEED FOR EVALUATION.ACTIONS TAKEN: -PROVIDED EDUCATION ABOUT READING AND DISTRIBUTED BOOKS DURING HOME VISITS, BETWEEN THE TWO HOME VISITING PROGRAMS, 452 FAMILIES EDUCATED. WITH 884 BOOKS DISTRIBUTED.- SCREENED 297CHILDREN ENROLLED IN THT/HMG PROGRAM WITH AGES AND STAGES ASSESSMENT. - 23 REFERRALS WERE MADE TO EARLY INTERVENTION THROUGH THESE HOME VISIT ASSESSMENTS.

Schedule H (Form 990) 2021

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?57
Name and address		Type of Facility (describe)
1	1 - PROMEDICA HICKMAN CANCER CENTER 5300 HARROUN RD STE 010 SYLVANIA,OH435602182	ONCOLOGY
2	2 - PARKWAY SURGERY CENTER 2120 W CENTRAL AVE TOLEDO,OH436063834	SURGERY/LAB
3	3 - ENDOSCOPY CENTER 5700 MONROE ST UNIT 102 SYLVANIA,OH435602767	ENDOSCOPY
4	4 - PROMEDICA MAUMEE ONCOLOGY 5805 MONCLOVA RD MAUMEE,OH435371839	ONCOLOGY
5	5 - HARRIS-MCINTOSH RADIOLOGYEBEID CHILDRENS 2121 HUGHES DR TOLEDO,OH436063845	RADIOLOGY/CARDIOLOGY/PULMONARY
6	6 - PROMEDICA LABS 2130 W CENTRAL AVE STE 300 TOLEDO,OH436062920	LAB
7	7 - PROMEDICA HEALTH AND WELLNESS CENTER 5700 MONROE ST SYLVANIA,OH435602779	LAB & RADIOLOGY
8	8 - NORTHWEST OHIO CARDIOLOGY 2940 N MCCORD RD TOLEDO,OH436151753	CARDIOLOGY
9	9 - PROMEDICA NEUROSCIENCE CENTER 2130 W CENTRAL AVE TOLEDO,OH436063818	NEUROSCIENCE
10	10 - SPORTSCARE AT WILDWOOD MEDICAL CTR 2865 N REYNOLDS RD STE 110 TOLEDO,OH436152069	PHYSICAL THERAPY
11	11 - PMV CARDIOVASCULAR 5705 MONCLOVA RD STE 201 MAUMEE,OH435371877	CARDIAC TESTING
12	12 - TOLEDO HOSP TOTAL REHAB AT CTR FOR HEALTH 2150 W CENTRAL AVENUE TOLEDO,OH436063834	PHYSICAL THERAPY/WOMEN'S CARE/INFUSION CENTER/PEDIATRICS
13	13 - FLOWER MOB LAB 5308 HARROUN RD STE 0050 SYLVANIA,OH435602193	LAB
14	14 - TOTAL REHAB PEDIATRICS 4041 W SYLVANIA AVE STE 100 TOLEDO,OH436234465	PHYSICAL THERAPY
15	15 - PERRYSBURG MEDICAL CTR 1601 BRIGHAM DR 180 PERRYSBURG,OH435517118	LAB/RADIOLOGY
16	16 - PROMEDICA HEALTH CTR ARROWHEAD 660 BEAVER CREEK CIR STE 120 MAUMEE,OH435371745	LAB/RADIOLOGY/PT
17	17 - PAT METRO PAT CLINIC 3500 EXECUTIVE PKWY TOLEDO,OH436061319	LAB
18	18 - PROMEDICA VISION ASSOCIATES AMB SURGERY 3330 MEIJER DR STE 2 TOLEDO,OH436173103	EYE CARE
19	19 - CENTER FOR HEALTH SVCSREHABRADIOLOGYWOM 2150 W CENTRAL AVENUE ROOM H TOLEDO,OH436063859	LAB
20	20 - JOBST VASCULAR VASCULAR INSTITUTE 2109 HUGHES DR STE 500 TOLEDO,OH436063856	VASCULAR
21	21 - TOTAL REHAB AT PERRYSBURG 1601 BRIGHAM DR 100 PERRYSBURG,OH435517121	PHYSICAL THERAPY
22	22 - PROMEDICA WILDWOODTOTAL REHAB WILDWOOD 2865 N REYNOLDS RD SUITE 150 TOLEDO,OH436152069	LAB & RADIOLOGY
23	23 - MONROE CARDIOLOGY TESTING CENTER 730 N MACOMB ST 429 MONROE,MI481622904	CARDIOLOGY
24	24 - TOLEDO HOSP AT CONRAD JOBST TOWER 2109 HUGHES DR STE 130 TOLEDO,OH436063856	LAB
25	25 - PROMEDICA FREESTANDING EMERGENCY ROOM-URGE 1075 MEDICAL CENTER PKWY MAUMEE,OH435371904	EMERGENCY/URGENT CARE
26	26 - TOLEDO HOSPITAL CARDIAC TESTING CENTER 1601 BRIGHAM DR 120 PERRYSBURG,OH435517121	PHYSICAL THERAPY/CARDIOLOGY/VASCULAR
27	27 - PROMEDICA VASCULAR LAB - SYLVANIA 5700 MONROE ST UNIT 309 SYLVANIA,OH435602767	VASCULAR
28	28 - TOTAL REHAB AT BEDFORD 2000 W DEAN RD TEMPERANCE,MI481829427	PHYSICAL THERAPY
29	29 - PROMEDICA TOLEDO HOSPITAL - INFANT MONITOR 2121 HUGHES DR STE 850 TOLEDO,OH436063845	INFANT MONITORING
30	30 - SPORTSCARE AT PROFESSIONAL PARK 4848 N HOLLAND SYLVANIA RD STE 202 SYLVANIA,OH435602148	PHYSICAL THERAPY
31	31 - TOTAL REHAB AT SPRING MEADOWS 6855 SPRING VALLEY DR STE 155 HOLLAND,OH435289374	PHYSICAL THERAPY
32	32 - TOTAL REHAB AT MAUMEE ARROWHEAD 660 BEAVER CREEK CIR STE 210 MAUMEE,OH435371745	PHYSICAL THERAPY
33	33 - PROMEDICA LABS MCCORD RD 3020 N MCCORD RD 101 TOLEDO,OH436151701	LAB
34	34 - PROMEDICA SECOR RD LAB 7300 SECOR RD STE 6 LAMBERTVILLE,MI481449360	LAB
35	35 - PROMEDICA HEARING CTR 5300 HARROUN RD SUITE 218 SYLVANIA,OH435602168	AUDIOLOGY
36	36 - TFL METRO PAT CLINIC 5300 HARROUN RD STE 202 226 SYLVANIA,OH435602146	LAB
37	37 - PROMEDICA WELLNESS CENTER - PULMONARY FUNC 5700 MONROE ST STE 307 SYLVANIA,OH435602768	PULMONARY
38	38 - PROMEDICA LAB - TOLEDO HOSPITAL MEDICAL 2100 W CENTRAL AVE STE 130 TOLEDO,OH436063800	LAB
39	39 - JOBST ANTICOAGULATION - TOLEDO 2109 HUGHES DR STE 550 TOLEDO,OH436065103	ANTICOAGULATION CLINIC
40	40 - PROMEDICA HEALTH CTR SWANTON 22 TURTLE CREEK CIR STE E SWANTON,OH435588591	LAB
41	41 - PROMEDICA LAB - POINT PLACE 4805 SUDER RD TOLEDO,OH436111800	LAB
42	42 - PROMEDICA HEALTH CENTER - EAST 3156 DUSTIN RD STE102 OREGON,OH436164342	LAB
43	43 - PROMEDICA ROSSFORD 1215 GRASSY LANE ROSSFORD,OH434601525	LAB
44	44 - PROMEDICA MEDICAL CENTER 455 W 4TH STREET FOSTORIA,OH448301849	LAB
45	45 - PROMEDICA MARY ELLEN FALZONE DIABETES 2100 W CENTRAL AVE STE 120 TOLEDO,OH436063800	DIABETES CARE
46	46 - PROMEDICA PHYSICIANS GENERAL SURGERY 5700 MONROE ST SYLVANIA,OH435602767	BARIATRIC
47	47 - PCJ HEART FAILURE CLINIC 2109 HUGHES DR TOLEDO,OH436063856	HEART FAILURE CLINIC
48	48 - PROMEDICA TRANSPORTATION NETWORK 2142 NORTH COVE BLVD TOLEDO,OH436063895	GROUND AND AIR TRANSPORT
49	49 - TOTAL REHAB- PROMEDICA OWENS CORNING 1 OWENS CORNING PARKWAY TOLEDO,OH436591000	PHYSICAL THERAPY
50	50 - PROMEDICA WELLNESS SERVICES-MAUMEE 1789 INDIAN WOOD CIRCLE STE 210 MAUMEE,OH435374022	COMMUNITY EDUCATION
51	51 - REMOTE 1801 RICHARDS RD TOLEDO,OH436071037	ACUTE CARE AT HOME
52	52 - PROMEDICA NORTHWEST OHIO HEMOPHILIA CENT 2109 HUGHES DR STE 860 TOLEDO,OH436065114	HEMOPHILIA
53	53 - PROMEDICA HEALTH AND WELLNESS CENTER 5700 MONROE ST STE 100 SYLVANIA,OH435602767	VASCULAR
54	54 - PROMEDICA HEMATOLOGYONCOLOGY ASSOC 5308 HARROUN RD STE 0055 SYLVANIA,OH435602174	CANCER CARE
55	55 - RENAL CARE GROUP DIALYSIS 3100 W CENTRAL AVE STE 100 TOLEDO,OH436062924	DIALYSIS
56	56 - CHS OCCUHEALTH 2142 NORTH COVE BLVD TOLEDO,OH436063895	CHECK LAB OR RAD
57	57 - CENTER FOR WOUND CARE OF NW OHIO 3110 W CENTRAL AVENUE SUITE A TOLEDO,OH436062956	WOUND CARE

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	THE TOLEDO HOSPITAL REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	THE TOLEDO HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE TOLEDO HOSPITAL PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.
PART III, LINE 2:	THE TOLEDO HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	THE TOLEDO HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
PART III, LINE 8:	MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM. - THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS. - MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER. - MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.THE TOLEDO HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS 2021 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS.
PART III, LINE 9B:	FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
PART VI, LINE 2:	PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	THE TOLEDO HOSPITAL, WITH LOCATIONS IN THE TOLEDO, OHIO METROPOLITAN AREA, SERVES AN AREA PRIMARILY AROUND LUCAS COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 650,000. APPROXIMATELY, 14% OF THE SERVICE AREA IS AGE 65 OR OVER; 60% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $48,000; 89% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 50% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LUCAS COUNTY HAS A POPULATION OF APPROXIMATELY 431,000 WITH APPROXIMATELY 18% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 32% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 8% OF LUCAS COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR LUCAS COUNTY IN 2021 WAS 3.9%. THE LEADING CAUSES OF DEATH IN LUCAS COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, UNINTENTIONAL INJURIES/ACCIDENTS, LUNG DISEASE, ALZHEIMER'S, AND DIABETES. ACCORDING TO 2021 COUNTY HEALTH RANKINGS, LUCAS COUNTY RANKED 72 OF 88 COUNTIES FOR HEALTH OUTCOMES, 69 OF 88 FOR LENGTH OF LIFE, AND 77 OF 88 FOR QUALITY OF LIFE. THERE ARE THIRTEEN HOSPITALS WITHIN A 30-MILE RADIUS OF THE TOLEDO HOSPITAL: ST. ANNE MERCY HOSPITAL, ST. VINCENT MERCY MEDICAL CENTER, UNIVERSITY OF TOLEDO MEDICAL CENTER, FLOWER HOSPITAL, ST. CHARLES MERCY HOSPITAL, BAY PARK COMMUNITY HOSPITAL, ST. LUKE'S HOSPITAL, MERCY MEMORIAL HOSPITAL CORPORATION, WOOD COUNTY HOSPITAL, EMMA L. BIXBY MEDICAL CENTER, HERRICK MEMORIAL HOSPITAL, INC., MONROE REGIONAL HOSPITAL, AND FULTON COUNTY HEALTH CENTER.
PART VI, LINE 5:	THE TOLEDO HOSPITAL IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2021:- THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERSHIP IS COMPOSED OF 43% FEMALES, 20% PHYSICIANS, 11% UNDER THE AGE OF 40, AND 18% RACIAL OR ETHNIC MINORITIES. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 3,300 LUNG CANCER SCREENINGS, NEARLY 55,000 SCREENING MAMMOGRAMS AND NEARLY 13,000 SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. IN 2021, APPROXIMATELY 8,000 DOSES OF THE TREATMENT WERE PROVIDED. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. IN 2021, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.- IN THE METRO TOLEDO AREA, PROMEDICA WORKED CLOSELY WITH LUCAS COUNTY DEPARTMENT OF HEALTH OFFICIALS TO ASSIST WITH MASS COVID VACCINE CLINICS AS WELL AS CLINICS IN UNDERSERVED AREAS OF THE COMMUNITY WHERE VACCINE HESITANCY WAS AN ONGOING CONCERN. ONE OF THE PROJECTS PROMEDICA HELPED SPEARHEAD WAS THE V PROJECT, WHICH WORKED ACROSS THE NORTHWEST OHIO COMMUNITY TO INCREASE VACCINE PARTICIPATION. THE V PROJECT HELPED TO BRING RESOURCES TO PEOPLE IN ZIP CODES THAT HAD LOWER VACCINATION PARTICIPATION RATES WITH THE GOAL OF EASING ANY BARRIERS THAT MAY HAVE PROHIBITED THEM FROM PREVIOUSLY GETTING THEIR VACCINE. - PROMEDICA ALSO ALLOCATED 20% OF THE VACCINES IT RECEIVED TO UNDERSERVED COMMUNITIES. THIS LED TO OTHER OPPORTUNITIES SUCH AS THE PARTNERSHIP WITH THE FIRST CHURCH OF GOD ON COLLINGWOOD IN TOLEDO. LED BY THE PPG CLINICAL OPERATIONS TEAM, VARIOUS TEAMS FROM ACROSS PROMEDICA CAME TOGETHER AND HELD VACCINATION CLINICS ON SUNDAYS. PROMEDICA ALSO EXPANDED PARTICIPATION IN COMMUNITY MASS COVID VACCINE CLINICS AT AN ARE UAW HALL TO REACH A LARGER PROPORTION OF THE UNDERSERVED COMMUNITIES.
PART VI, LINE 6:	PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2021 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2021:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA MANAGED APPROXIMATELY 2.28 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 57,200 SURGERIES, 6,000 BIRTHS, AND MORE THAN 262,600 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $259,433,000.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2021, APPROXIMATELY 5,794 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,093 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 44,100 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 132,300 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. IN 2021, 49 PEOPLE WERE SUPPORTED BY THE INITIATIVE. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2021, NEARLY 2,560 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 21 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 4 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION.

Schedule H (Form 990) 2021

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
THE TOLEDO HOSPITAL

Employer identification number
34-4428256

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO,OH43604	34-1517672	501(C)(3)	24,527	0			OPERATING GRANT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2021

Page 2

Part III

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

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

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

Part IV

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

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

Schedule I (Form 990) 2021

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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 .....

Yes

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? ....

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1RANDALL OOSTRA PHS PRES. & CEO	(i) (ii)	0 ------------- 1,956,043	0 ------------- 5,028,392	0 ------------- 171,337	0 ------------- 283,814	0 ------------- 16,530	0 ------------- 7,456,116	0 ------------- 0
2STEVEN M CAVANAUGH TREASURER, CFO	(i) (ii)	0 ------------- 1,300,553	0 ------------- 2,196,109	0 ------------- 1,242	0 ------------- 35,041	0 ------------- 25,619	0 ------------- 3,558,564	0 ------------- 0
3JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER	(i) (ii)	0 ------------- 724,534	0 ------------- 616,992	0 ------------- 6,089	0 ------------- 53,463	0 ------------- 14,723	0 ------------- 1,415,801	0 ------------- 0
4ARTURO POLIZZI FORMER PRESIDENT, COO	(i) (ii)	0 ------------- 927,363	0 ------------- 300,000	0 ------------- 3,379	0 ------------- 0	0 ------------- 25,127	0 ------------- 1,255,869	0 ------------- 0
5MATTHEW KANG EX OFFICIO, CFO SENIOR CARE	(i) (ii)	0 ------------- 567,481	0 ------------- 285,926	0 ------------- 810	0 ------------- 8,577	0 ------------- 21,996	0 ------------- 884,790	0 ------------- 0
6DAWN M BUSKEY PRES., EX OFFICIO	(i) (ii)	0 ------------- 545,228	0 ------------- 256,990	0 ------------- 3,281	0 ------------- 32,280	0 ------------- 16,881	0 ------------- 854,660	0 ------------- 0
7AARON A BUERK MD TRUSTEE, PHYSICIAN	(i) (ii)	0 ------------- 811,134	0 ------------- 22,085	0 ------------- 362	0 ------------- 0	0 ------------- 20,609	0 ------------- 854,190	0 ------------- 0
8THOMAS GEORGE PADANILAM MD TRUSTEE, PHYSICIAN	(i) (ii)	0 ------------- 606,227	0 ------------- 0	0 ------------- 250	0 ------------- 0	0 ------------- 26,868	0 ------------- 633,345	0 ------------- 0
9RAVI K ADUSUMILLI MD TRUSTEE, PHYSICIAN	(i) (ii)	0 ------------- 479,881	0 ------------- 91,453	0 ------------- 3,816	0 ------------- 0	0 ------------- 22,493	0 ------------- 597,643	0 ------------- 0
10KATE GATES PHYSICIAN	(i) (ii)	222,047 ------------- 284,054	65,000 ------------- 0	0 ------------- 29	0 ------------- 0	15,612 ------------- 4,287	302,659 ------------- 288,370	0 ------------- 0
11GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG	(i) (ii)	0 ------------- 387,188	0 ------------- 133,715	0 ------------- 4,564	0 ------------- 20,943	0 ------------- 17,524	0 ------------- 563,934	0 ------------- 0
12DEANA SIEVERT SR VP, PAT CARE/CNO, SYSTEM	(i) (ii)	0 ------------- 330,172	0 ------------- 190,593	0 ------------- 9,749	0 ------------- 10,552	0 ------------- 22,624	0 ------------- 563,690	0 ------------- 0
13KEVIN C WEBB PHD FORMER CHIEF ACUTE OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 438,239	0 ------------- 0	0 ------------- 8,700	0 ------------- 916	0 ------------- 447,855	0 ------------- 0
14QIN-SHENG CHEN SR. MEDICAL PHYSICIST	(i) (ii)	276,693 ------------- 0	350 ------------- 0	9,831 ------------- 0	5,720 ------------- 0	15,615 ------------- 0	308,209 ------------- 0	0 ------------- 0
15ALAN M SATTLER FORMER TREASURER, VP BUSINESS DEV.	(i) (ii)	0 ------------- 210,556	0 ------------- 50,619	0 ------------- 8,452	0 ------------- 10,550	0 ------------- 26,673	0 ------------- 306,850	0 ------------- 0
16JAMES BURNS SR. MEDICAL PHYSICIST	(i) (ii)	241,446 ------------- 0	350 ------------- 0	4,448 ------------- 0	9,836 ------------- 0	18,156 ------------- 0	274,236 ------------- 0	0 ------------- 0
17JOSHUA OVENS RN CRITICAL CARE TRANSPORT	(i) (ii)	210,505 ------------- 0	27,563 ------------- 0	124 ------------- 0	6,048 ------------- 0	24,557 ------------- 0	268,797 ------------- 0	0 ------------- 0
18THADIUS L WADSWORTH MBA BSN RN C TRUSTEE, PRES. BAY PARK	(i) (ii)	0 ------------- 200,427	0 ------------- 46,090	0 ------------- 610	0 ------------- 4,876	0 ------------- 8,015	0 ------------- 260,018	0 ------------- 0
19FEDOR LURIE ASSOC DIR RESEARCH ED VASC	(i) (ii)	230,625 ------------- 0	0 ------------- 0	0 ------------- 0	3,479 ------------- 0	19,071 ------------- 0	253,175 ------------- 0	0 ------------- 0
20DARRELL J WACHOWIAK RN BSN MHA TRUSTEE, PRES. FLOWER HOSPITAL	(i) (ii)	0 ------------- 180,531	0 ------------- 30,639	0 ------------- 2,325	0 ------------- 6,404	0 ------------- 21,998	0 ------------- 241,897	0 ------------- 0
21JAMES BINGLE TRUSTEE (PARTIAL YEAR), PHYSICIAN	(i) (ii)	0 ------------- 154,410	0 ------------- 43,549	0 ------------- 3,814	0 ------------- 0	0 ------------- 505	0 ------------- 202,278	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 1A	CHARTER TRAVEL: 1 OFFICER- NOT INCLUDED IN TAXABLE COMPENSATION
PART I, LINE 3	PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF THE TOLEDO HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B	ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII.
SCHEDULE J, SUPPLEMENTAL INFORMATION:	IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR.

Schedule J (Form 990) 2021

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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

2021

Open to Public
Inspection

Name of the organization
THE TOLEDO HOSPITAL

Employer identification number
34-4428256

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	COUNTY OF LUCAS OHIO (2015B)	34-6400806	549310VL1	09-30-2015	45,586,125	SEE PART VI		X		X		X
B	COUNTY OF LUCAS OHIO	34-6400806	000000000	12-29-2017	299,500,000	SEE PART VI		X		X		X
C	COUNTY OF LUCAS OHIO	34-6400806	549310VM9	12-29-2017	142,500,000	SEE PART VI		X		X		X
D	COUNTY OF LUCAS OHIO	34-6400806	549310WE6	10-25-2018	261,485,311	SEE PART VI		X		X		X
	COUNTY OF LUCAS OHIO (2021A-C)	34-6400806	000000000	08-17-2021	79,650,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................					80,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	45,598,957				62,500,000		262,545,834
4 Gross proceeds in reserve funds .............	2
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	586,084		4,263				1,559,890
8 Credit enhancement from proceeds .............							839,544
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	45,012,873				80,000,000		170,995,519
11 Other spent proceeds .............	79,650,000		299,495,737		62,500,000		89,150,881
12 Other unspent proceeds .............
13 Year of substantial completion .............	2018
	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 2020, a current refunding issue)? ........		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X	X			X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

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		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		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?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		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?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		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		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		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		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X			X		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		X			X

Schedule K (Form 990) 2021

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		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		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		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		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		X		X

Part Ⅵ

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

Return Reference	Explanation
PART I:	SERIES 2015 BOND DETAIL ISSUER NAME: 2015 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VL1 DATE ISSUED: 09/30/2015 ISSUE PRICE: $45,586,125 PURPOSE: FINANCE THE CONSTRUCTION AND EQUIPPING OF A 302 BED PATIENT TOWER ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2045 SERIES 2017 BOND DETAIL ISSUER NAME: 2017 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $54,710,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008D BONDS ISSUED 05/15/2008. MATURITY: 11/15/2040 ISSUER NAME: 2017 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $120,010,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $84,980,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $39,800,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011. MATURITY: 11/15/2029 ISSUER NAME: 2017 SERIES F AND G - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VM9 DATE ISSUED: 12/29/2017 ISSUE PRICE: $142,500,000 PURPOSE: TO REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008A BONDS ISSUED 05/15/2008 AND TO FINANCE THE CONSTRUCTION AND EQUIPPING OF A REPLACEMENT HOSPITAL ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2034 SERIES 2018 BOND DETAIL ISSUER NAME: 2018 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310WE6 DATE ISSUED: 10/25/2018 ISSUE PRICE: $261,485,311 PURPOSE: REFINANCING THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011C BONDS ISSUED 05/25/2011 & 2017G BONDS ISSUED 12/29/2017 AND FINANCE THE CONSTRUCTION AND EQUIPPING OF REPLACEMENT HOSPITAL CAMPUS ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2048 SERIES 2021A BOND DETAIL ISSUER NAME: 2021 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 SERIES 2021B BOND DETAIL ISSUER NAME: 2021 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 SERIES 2021C BOND DETAIL ISSUER NAME: 2021 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 PART I, COLUMN (E): DIFFERENCE BETWEEN THE ISSUE PRICE SHOWN IN PART I, COUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 2 ARE DUE TO INVESTMENT EARNINGS PART IV, LINE 6: CERTAIN OF THESE BOND ISSUES CONSTITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH THE PROCEEDS OF THE BONDS. PART IV COLUMN (B) SERIES 2017 BONDS REBATE CALCULATION PERFORMED 12/21/2021
PART I, LINE C OF ENTITY 2, COLUMN (C):	ENTERED HERE IS THE CUSIP FOR THE LATEST MATURITY; THIS INFORMATION WAS INADVERTENTLY OMITTED FROM THE FORM 8038 FOR THE ISSUE.
PART I, COLUMN (E):	DIFFERENCE BETWEEN THE ISSUE PRICES SHOWN IN PART I, COLUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 3 ARE DUE TO INVESTMENT EARNINGS.
PART III, COLUMN (C), SERIES 2011 D & E BONDS:	PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE SERIES 2011 D & E BONDS, SINCE SUCH BONDS REFUNDED PRE-2003 BOND ISSUES.
PART IV, COLUMN (A), SERIES 2015 B BONDS:	DATE THE REBATE COMPUTATION WAS PERFORMED: 10/10/2020
PART IV, COLUMN (B), LINE 2C, SERIES 2011 A & B BONDS:	DATE THE REBATE COMPUTATION WAS PERFORMED: 02/22/2016.
PART IV, LINE 6:	CERTAIN OF THESE BOND ISSUES CONSITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.

Schedule K (Form 990) 2021

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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

2021

Open to Public
Inspection

Name of the organization
THE TOLEDO HOSPITAL

Employer identification number
34-4428256

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	COUNTY OF LUCAS OHIO (2015B)	34-6400806	549310VL1	09-30-2015	45,586,125	SEE PART VI		X		X		X
B	COUNTY OF LUCAS OHIO	34-6400806	000000000	12-29-2017	299,500,000	SEE PART VI		X		X		X
C	COUNTY OF LUCAS OHIO	34-6400806	549310VM9	12-29-2017	142,500,000	SEE PART VI		X		X		X
D	COUNTY OF LUCAS OHIO	34-6400806	549310WE6	10-25-2018	261,485,311	SEE PART VI		X		X		X
	COUNTY OF LUCAS OHIO (2021A-C)	34-6400806	000000000	08-17-2021	79,650,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................					80,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	45,598,957				62,500,000		262,545,834
4 Gross proceeds in reserve funds .............	2
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	586,084		4,263				1,559,890
8 Credit enhancement from proceeds .............							839,544
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	45,012,873				80,000,000		170,995,519
11 Other spent proceeds .............	79,650,000		299,495,737		62,500,000		89,150,881
12 Other unspent proceeds .............
13 Year of substantial completion .............	2018
	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 2020, a current refunding issue)? ........		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X	X			X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

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		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		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?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		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?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		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		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		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		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X			X		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		X			X

Schedule K (Form 990) 2021

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		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		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		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		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		X		X

Part Ⅵ

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

Return Reference	Explanation
PART I:	SERIES 2015 BOND DETAIL ISSUER NAME: 2015 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VL1 DATE ISSUED: 09/30/2015 ISSUE PRICE: $45,586,125 PURPOSE: FINANCE THE CONSTRUCTION AND EQUIPPING OF A 302 BED PATIENT TOWER ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2045 SERIES 2017 BOND DETAIL ISSUER NAME: 2017 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $54,710,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008D BONDS ISSUED 05/15/2008. MATURITY: 11/15/2040 ISSUER NAME: 2017 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $120,010,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $84,980,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $39,800,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011. MATURITY: 11/15/2029 ISSUER NAME: 2017 SERIES F AND G - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VM9 DATE ISSUED: 12/29/2017 ISSUE PRICE: $142,500,000 PURPOSE: TO REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008A BONDS ISSUED 05/15/2008 AND TO FINANCE THE CONSTRUCTION AND EQUIPPING OF A REPLACEMENT HOSPITAL ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2034 SERIES 2018 BOND DETAIL ISSUER NAME: 2018 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310WE6 DATE ISSUED: 10/25/2018 ISSUE PRICE: $261,485,311 PURPOSE: REFINANCING THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011C BONDS ISSUED 05/25/2011 & 2017G BONDS ISSUED 12/29/2017 AND FINANCE THE CONSTRUCTION AND EQUIPPING OF REPLACEMENT HOSPITAL CAMPUS ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2048 SERIES 2021A BOND DETAIL ISSUER NAME: 2021 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 SERIES 2021B BOND DETAIL ISSUER NAME: 2021 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 SERIES 2021C BOND DETAIL ISSUER NAME: 2021 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 8/17/2021 ISSUE PRICE: $25,885,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011 MATURITY: 11/15/2029 PART I, COLUMN (E): DIFFERENCE BETWEEN THE ISSUE PRICE SHOWN IN PART I, COUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 2 ARE DUE TO INVESTMENT EARNINGS PART IV, LINE 6: CERTAIN OF THESE BOND ISSUES CONSTITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH THE PROCEEDS OF THE BONDS. PART IV COLUMN (B) SERIES 2017 BONDS REBATE CALCULATION PERFORMED 12/21/2021
PART I, LINE C OF ENTITY 2, COLUMN (C):	ENTERED HERE IS THE CUSIP FOR THE LATEST MATURITY; THIS INFORMATION WAS INADVERTENTLY OMITTED FROM THE FORM 8038 FOR THE ISSUE.
PART I, COLUMN (E):	DIFFERENCE BETWEEN THE ISSUE PRICES SHOWN IN PART I, COLUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 3 ARE DUE TO INVESTMENT EARNINGS.
PART III, COLUMN (C), SERIES 2011 D & E BONDS:	PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE SERIES 2011 D & E BONDS, SINCE SUCH BONDS REFUNDED PRE-2003 BOND ISSUES.
PART IV, COLUMN (A), SERIES 2015 B BONDS:	DATE THE REBATE COMPUTATION WAS PERFORMED: 10/10/2020
PART IV, COLUMN (B), LINE 2C, SERIES 2011 A & B BONDS:	DATE THE REBATE COMPUTATION WAS PERFORMED: 02/22/2016.
PART IV, LINE 6:	CERTAIN OF THESE BOND ISSUES CONSITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

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

2021

Open to Public Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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) 2021

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) LISA TOFT	FAMILY MEMBER OF BRADLEY J. TOFT (TRUSTEE)	50,797	EMPLOYED MEDTECHII		No
(2) SANDRA WACHOWIAK	FAMILY MEMBER OF DARRELL WACHOWIAK (TRUSTEE)	131,058	EMPLOYED LEAD PHARMACIST		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

Return Reference	Explanation
FORM 990, PART III, LINE 4	THE TOLEDO HOSPITAL - PROGRAM SERVICE ACCOMPLISHMENTS THE TOLEDO HOSPITAL (D/B/A PROMEDICA TOLEDO HOSPITAL) IS THE ADULT TERTIARY HOSPITAL OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. FOR MORE THAN 130 YEARS, PROMEDICA TOLEDO HOSPITAL (TH) HAS SERVED METROPOLITAN TOLEDO AND SURROUNDING COMMUNITIES WITH STATE-OF-THE-ART EMERGENCY, MEDICAL, DIAGNOSTIC, AND SURGICAL SERVICES. THE 794-BED HOSPITAL OFFERS ACCESS TO THE AREA'S LARGEST BOARD-CERTIFIED MEDICAL STAFF, WITH MORE THAN 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS AS WELL AS ADVANCE PRACTICE PROVIDERS, OFFERING THE LARGEST BOARD-CERTIFIED MEDICAL STAFF IN THE AREA. ADDITIONALLY, TH OFFERS A NUMBER OF KEY SERVICES TO THE METRO-TOLEDO AREA, SUCH AS THE CENTER FOR WOMEN'S HEALTH, WHICH INCLUDES MATERNAL-FETAL MEDICINE FOR HIGH-RISK PREGNANCIES AND A LEVEL III PERINATAL UNIT; JOBST VASCULAR INSTITUTE; PROMEDICA BREAST CARE; AND A LEVEL I TRAUMA CENTER. OTHER PROGRAMS AND SERVICES INCLUDE WELL-ESTABLISHED NEUROSCIENCES, CARDIOVASCULAR AND ORTHOPAEDIC DEPARTMENTS, A NATIONALLY RECOGNIZED BARIATRIC PROGRAM, A CERTIFIED COMPREHENSIVE STROKE CENTER, AND AN EMERGENCY CENTER THAT TREATS MORE THAN 100,000 PATIENTS ANNUALLY. ALL SERVICES ARE FULLY BACKED BY ACCREDITED ANCILLARY SERVICES, SUCH AS LABORATORY, RADIOLOGY, AS WELL AS PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES. THE PROMEDICA RUSSELL J. EBEID CHILDREN'S HOSPITAL (ECH) OPERATES AS PART OF TH, PROVIDING PEDIATRIC TERTIARY CARE. ECH EXCLUSIVELY SERVES THE HEALTHCARE NEEDS OF CHILDREN AND ADOLESCENTS UNDER THE AGE OF 18. ECH'S MEDICAL STAFF INCLUDES BOARD-CERTIFIED PHYSICIANS AND ADVANCE PRACTICE PROVIDERS, WHILE A NEWBORN INTENSIVE CARE UNIT INCLUDES A NEONATAL PHYSICIAN AND PEDIATRIC HOSPITALIST WHO ARE ON DUTY 24 HOURS A DAY. OTHER ECH SPECIALTY SERVICES INCLUDE A PEDIATRIC CANCER CENTER, ASTHMA TREATMENT AND EDUCATION SERVICES, PEDIATRIC PSYCHIATRY, AND A DEDICATED LEVEL II PEDIATRIC TRAUMA CENTER. IN 2020, PROMEDICA TOLEDO HOSPITAL EARNED A FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) AS PART OF ITS UPDATED OVERALL HOSPITAL QUALITY STAR RATING. THE TH RECOGNITION WAS EARNED IN A COLLABORATIVE EFFORT WITH PROMEDICA FLOWER AND WILDWOOD ORTHOPAEDIC AND SPINE HOSPITALS. TH ALSO WAS RATED THE NUMBER 1 HOSPITAL IN THE METRO TOLEDO AREA BY U.S. NEWS AND WORLD REPORT AND WAS RECOGNIZED BY BECKER'S HOSPITAL REVIEW AS ONE OF THE "100 GREATEST HOSPITALS IN AMERICA" FOR 2021. THEY ACHIEVED THE TOP 50 HOSPITAL RECOGNITION AS WELL AS RECOGNITION AS A TOP 50 HOSPITAL FOR CARDIAC SURGERY. IN 2021, PROMEDICA TOLEDO HOSPITAL OPENED ITS NEW FREESTANDING EMERGENCY DEPARTMENT AND URGENT CARE CLINIC IN MAUMEE, OHIO TO MEET THE NEEDS OF THAT COMMUNITY'S RESIDENTS. THE FACILITY IS THE FIRST FREESTANDING, COMBINED ER AND URGENT CARE IN LUCAS COUNTY. THE FACILITY IS EQUIPPED TO HANDLE ALL LEVELS OF URGENT AND EMERGENCY CARE, AND PATIENTS ONLY WILL BE BILLED FOR THE LEVEL OF CARE THEY NEED PROMEDICA FLOWER HOSPITAL (FH), A DIVISION OF TH, IS A 315-BED FACILITY IN SYLVANIA, OHIO, WHICH PROVIDES EXTENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY MEDICINE, INPATIENT REHABILITATION, SURGICAL SERVICES, CARDIAC AND PULMONARY REHABILITATION, LABOR AND DELIVERY, INPATIENT ONCOLOGY CARE, OUTPATIENT ONCOLOGY SERVICES THROUGH THE HICKMAN CANCER CENTER, AND A FULL RANGE OF DIAGNOSTIC, LABORATORY AND RADIOLOGY SERVICES. FH ALSO HOUSES THE LARGEST ADULT INPATIENT PSYCHIATRIC UNIT IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. IN 2021, FH WAS NAMED A DESIGNATED STEMI CENTER BY THE OHIO DEPARTMENT OF HEALTH. NOW, LOCAL EMS CAN TAKE PATIENTS IN NEED OF EMERGENCY HEART CARE DIRECTLY TO FH INSTEAD OF TO ANOTHER LOCATION. A NEW CARDIAC CATH LAB AND SEVERAL MONTHS OF PLANNING, PREPARATION AND TRAINING HELPED BRING THIS CARE TO FH PATIENTS AND THE COMMUNITY. FH ALSO IS A DESIGNATED GET WITH THE GUIDELINES STROKE GOLD PLUS HOSPITAL IN RECOGNITION OF ITS COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED BEST PRACTICES. PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (WOSH), ALSO A DIVISION OF TH, IS AN ALL-DIGITAL, 42-BED ACUTE CARE FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT ORTHOPAEDIC SURGERY TO ADDRESS THE NEEDS OF AGING BABY BOOMERS AND OTHERS WHO EXPERIENCE CHRONIC PAIN FROM JOINT DISEASE. THIS UNIQUE, FREE-STANDING HOSPITAL SERVES ONLY ORTHOPAEDIC AND SPINE PATIENTS, OFFERING DIAGNOSTIC, SURGICAL AND REHABILITATION SERVICES ALL IN ONE CONVENIENT AND EASILY ACCESSIBLE LOCATION. IN 2021, WOSH RECEIVED NATIONAL RECOGNITION WITH THE PRESS GANEY GUARDIAN OF EXCELLENCE AWARD, PRESENTED TO ORGANIZATIONS SCORING IN THE 95TH PERCENTILE OR HIGHER FOR PATIENT EXPERIENCE METRICS. THIS MARKS THE NINTH CONSECUTIVE YEAR THAT THE HOSPITAL HAS RECEIVED THIS RECOGNITION. IN 2021, TH SERVED 39,726 INPATIENTS; 617,356 OUTPATIENTS; AND 115,145 EMERGENCY CENTER PATIENTS. TH CONTRIBUTED $127,243,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH ACTIVITIES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, TH CONTRIBUTED $42,766,000 TO THE COMMUNITY DURING 2021. INCLUDED IN THIS FIGURE ARE PROGRAMS SUCH AS: - THE COME TO THE TABLE INITIATIVE THAT PROVIDES 24 HOURS' WORTH OF FOOD TO PATIENTS WHO QUALIFY FOR FOOD INSECURITY BY COMPLETING A QUESTIONNAIRE UPON DISCHARGE FOLLOWING AN INPATIENT STAY. - THE AUTISM COLLABORATIVE A COLLABORATION BETWEEN ECH AND LOCAL AUTISM ORGANIZATIONS AND UNIVERSITIES TO PROVIDE EXPERT KNOWLEDGE AND SERVICES UNDER ONE UMBRELLA ORGANIZATION, ALLOWING THOSE WITH AUTISM AND THEIR FAMILIES TO RESEARCH AND FIND THE BEST POSSIBLE CARE. - SUPPORT GROUPS FOR PATIENTS' FAMILIES TO ASSIST WITH MANAGING CHRONIC DISEASE AND TO OFFER SOCIAL SERVICES INFORMATION. - WITH THE GOAL OF IMPROVING INFANT MORTALITY RATES IN OUR REGION, A NURSING MOTHERS SUPPORT GROUP IS OFFERED AT NO CHARGE THROUGHOUT THE YEAR. - THE TEEN PEP (PEERS EDUCATING PEERS) PROGRAM EXTENDS CARE AND EDUCATION OUTSIDE THE HOSPITAL, IN MORE NONTRADITIONAL WAYS, BY ENCOURAGING TEENS TO TALK WITH THEIR PEERS ABOUT IMPORTANT TOPICS SUCH AS TEEN RELATIONSHIPS, BULLYING, MENTAL HEALTH, AND PHYSICAL AND EMOTIONAL ABUSE. - VIRTUAL PREPARATION FOR PARENTHOOD CLASSES THAT HELP PREPARE EXPECTANT PARENTS FOR A HEALTHY LABOR AND DELIVERY, AND OFFER INFANT SAFETY TIPS, AS WELL AS NEW MOTHER CARE AND HEALTHY BABY EDUCATION. - FREE SCREENING MAMMOGRAMS AND BREAST CARE EDUCATION THAT EMPHASIZES THE IMPORTANCE OF ROUTINE SELF-BREAST EXAMS FOR UNINSURED AND UNDERINSURED WOMEN IN THE TOLEDO AREA. - IN-KIND DONATIONS AND GENERAL CONTRIBUTIONS, WHICH SUPPORT LOCAL NON-PROFIT ORGANIZATIONS WITH SIMILAR VALUES. TH ALSO PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2021, OF WHICH $6,474,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DID NOT PAY THEIR BILLS. TH'S COST OF BAD DEBT FOR 2021 WAS $10,956,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT TOTAL OF $127,243,000 INDICATED ABOVE. FURTHER, TH PROVIDED $78,003,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO, IN 2021, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT- FOR TREATING MEDICARE PATIENTS WAS $75,276,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $127,243,000 NOTED ABOVE. DURING 2021 TH EXPENDED $295,931,000 IN NET PAYROLL, PROVIDING 8,298 JOBS IN NORTHWEST OHIO. A TOTAL OF $18,349,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES.
FORM 990, PART III, LINE 4A	IN SUMMARY, TH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
PART V, 1A	THE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART VI, SECTION A, LINE 6	AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF THE TOLEDO HOSPITAL. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF THE TOLEDO HOSPITAL AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE IDENTIFIED PROVIDER BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, WILL PROVIDE THE PROVIDER-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PHS WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE.
FORM 990, PART VI, SECTION B, LINE 15	THE TOLEDO HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:	JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES.
PART VII, SECTION B	PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART IX, LINE 11G	OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 30,061,342. MANAGEMENT AND GENERAL EXPENSES 11,892,215. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,953,557. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,364,568. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,364,568. SERVICE CONTRACTOR FEES: PROGRAM SERVICE EXPENSES 51,838,727. MANAGEMENT AND GENERAL EXPENSES 26,914,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,752,885. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 18,425,714. MANAGEMENT AND GENERAL EXPENSES 9,335,382. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,761,096. TESTING FEES: PROGRAM SERVICE EXPENSES 19,605,498. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,605,498.
FORM 990, PART XI, LINE 9:	PENSION EXPENSE ADJUSTMENT 21,977. BENEFICIAL INTEREST IN FOUNDATION 21,124,856. TRANSFERS BETWEEN RELATED ENTITIES -328,137,086. NET TRANSFER OF ASSETS TO PCS 127,081.
FORM 990, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

THE TOLEDO HOSPITAL

Employer identification number

34-4428256

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) PROMEDICA HICKMAN CANCER CENTER PHARMACY LLC 100 MADISON AVE TOLEDO,OH43604	PHARMACY	OH	125,131,127		THE TOLEDO HOSPITAL
(2) PHS INVESTMENTS LLC 100 MADISON AVE TOLEDO,OH43604	INVESTMENT COMPANY	OH		7,617,124	THE TOLEDO HOSPITAL

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BAY PARK COMMUNITY HOSPITAL 100 MADISON AVE TOLEDO,OH43604 34-1883132	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(2)COMMUNITY HEALTH CENTER OF BRANCH COUNTY 100 MADISON AVE TOLEDO,OH43604 38-6108110	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(3)DEFIANCE HOSPITAL AUXILIARY 1200 RALSTON DEFIANCE,OH43512 51-0173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes
(4)DEFIANCE HOSPITAL INC 100 MADISON AVE TOLEDO,OH43604 34-4446484	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(5)EMMA L BIXBY MEDICAL CENTER 100 MADISON AVE TOLEDO,OH43604 38-2796005	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(6)EMMA L BIXBY MEDICAL CENTER AUXILIARY 818 RIVERSIDE AVE ADRIAN,MI43604 38-2149602	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	EMMA L BIXBY MEDICAL CENTER	Yes
(7)FOSTORIA HOSPITAL ASSOCIATION 100 MADISON AVE TOLEDO,OH43604 34-0898745	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(8)FOSTORIA HOSPITAL AUXILIARY PO BOX 907 FOSTORIA,OH44830 34-6517634	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	FOSTORIA HOSPITAL ASSOCIATION	Yes
(9)HCR MANORCARE FOUNDATION INC 444 N SUMMIT ST TOLEDO,OH43604 52-2031975	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes
(10)HCR MANORCARE INC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 82-5373223	SKILLED NURSING FACILITIES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes
(11)HEARTLAND HOSPICE MEMORIAL FUND INC 444 N SUMMIT ST TOLEDO,OH43604 27-0497199	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes
(12)HERRICK MEDICAL CENTER AUXILIARY 500 E POTTAWATAMIE ST TECUMSEH,MI49286 38-3076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	HERRICK MEMORIAL HOSPITAL INC	Yes
(13)HERRICK MEMORIAL HOSPITAL INC 100 MADISON AVE TOLEDO,OH43604 38-3049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(14)KAITLYN'S COTTAGE INC 100 MADISON AVE TOLEDO,OH43604 45-4781053	RESPITE CARE	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes
(15)LENAWEE LONG TERM CARE PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 38-2879330	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes
(16)MANOR CARE OF GIG HARBOR WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624719	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(17)MANOR CARE OF LACEY WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624391	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(18)MANOR CARE OF LYNNWOOD WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624675	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(19)MANOR CARE OF SALMON CREEK WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624375	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(20)MANOR CARE OF SPOKANE WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624687	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(21)MANOR CARE OF TACOMA WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 26-0624696	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes
(22)MEMORIAL HOSPITAL 100 MADISON AVE TOLEDO,OH43604 34-4430849	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(23)MEMORIAL PROFESSIONAL SERVICES 100 MADISON AVE TOLEDO,OH43604 27-3763993	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(24)MERCY MEMORIAL HOSPITAL CORPORATION 100 MADISON AVE TOLEDO,OH43604 38-1984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(25)MONROE COMMUNITY HEALTH SERVICES PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 38-2934134	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes
(26)PARAMOUNT ADVANTAGE 1901 INDIAN WOOD CIR MAUMEE,OH43537 20-3376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes
(27)PROMEDICA CENTRAL PHYSICIANS 100 MADISON AVE TOLEDO,OH43604 34-1881137	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(28)PROMEDICA CHILDRENS SPECIALISTS 100 MADISON AVE TOLEDO,OH43604 20-8734161	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(29)PROMEDICA CONTINUING CARE SERVICES CORP 100 MADISON AVE TOLEDO,OH43604 34-4492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes
(30)PROMEDICA CONTINUUM SERVICES 100 MADISON AVE TOLEDO,OH43604 34-1880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(31)PROMEDICA COURIER SERVICES INC 100 MADISON AVE TOLEDO,OH43604 26-0324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes
(32)PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO,OH43604 34-1517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(33)PROMEDICA GENITO-URINARY SURGEONS 100 MADISON AVE TOLEDO,OH43604 46-1120436	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(34)PROMEDICA HEALTH SYSTEM INC 100 MADISON AVE TOLEDO,OH43604 34-1517671	PARENT COMPANY OF HEALTH SYSTEM	OH	501(C)(3)	12B, II	N/A		No
(35)PROMEDICA INDEMNITY CORP ONE CHURCH ST 5TH FLOOR BURLINGTON,VT05401 34-1931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(36)PROMEDICA MONROE CARDIOLOGY 100 MADISON AVE TOLEDO,OH43604 27-2920342	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(37)PROMEDICA MONROE PHYSICIANS 100 MADISON AVE TOLEDO,OH43604 46-1111822	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(38)PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC 100 MADISON AVE TOLEDO,OH43604 45-4976786	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(39)PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS 100 MADISON AVE TOLEDO,OH43604 26-3888045	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(40)PROMEDICA PHYSICIAN GROUP INC 100 MADISON AVE TOLEDO,OH43604 34-1899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes
(41)PROMEDICA PHYSICIANS AT HOME INC 100 MADISON AVE TOLEDO,OH43604 85-2181349	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(42)PROMEDICA PRIMARY CARE PROVIDERS 100 MADISON AVE TOLEDO,OH43604 83-1731861	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(43)THE HUG FUND 444 N SUMMIT ST TOLEDO,OH43604 20-2272848	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes
(44)VISITING NURSE HOSPICE AND HEALTH CARE 100 MADISON AVE TOLEDO,OH43604 34-1831624	HOSPICE HOME CARE	OH	501(C)(3)	10	HCR MANORCARE INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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) EAST-WEST HOLDINGS LTD 715 SOUTH TAFT AVE FREMONT,OH43420 20-4066818	REAL ESTATE	OH	N/A					No			No
(2) MERCYMANOR PARTNERSHIP PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 52-1931012	SKILLED NURSING	PA	N/A					No		Yes
(3) NORMAN SPECIALTY HOSPITAL LLC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 42-1627672	HEALTH CARE	DE	N/A					No		Yes
(4) NORTHWEST OHIO DEDICATED BREAST MRI LLC 100 MADISON AVE TOLEDO,OH43604 26-0679898	MEDICAL DIAGNOSTICS	OH	THE TOLEDO HOSPITAL	RELATED	210,328	392,240		No			No	50.000 %
(5) PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC 100 MADISON AVE TOLEDO,OH43604 47-3163945	REAL ESTATE	OH	N/A					No		Yes
(6) PROMEDICA MASTER TENANT LLC 100 MADISON AVE TOLEDO,OH43604 47-5288490	REAL ESTATE	OH	N/A					No		Yes
(7) PROMEDICA PATHOLOGY LABORATORIES LLC 2130 W CENTRAL AVE STE 300 TOLEDO,OH43606 83-1022842	CLINICAL LABORATORY	DE	THE TOLEDO HOSPITAL	RELATED	20,923,076	101,400,664		No			No	51.000 %
(8) PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC 100 MADISON AVE TOLEDO,OH43604 46-1989695	PHYSICIAN MANAGEMENT SERVICES	OH	N/A					No			No
(9) REYNOLDS ROAD SURGICAL CENTER LTD 2865 N REYNOLDS RD TOLEDO,OH43615 31-1569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	56,022	1,568,233		No			No	63.000 %
(10) ROCKET VENTURE FUND II LLC 2865 N REYNOLDS RD STE 220 TOLEDO,OH43615 47-5603627	INVESTMENT FUND	OH	N/A					No			No
(11) THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC 1051 S TELEGRAPH RD MONROE,MI48161 27-0843485	AMBULATORY SURGICAL CENTER	MI	N/A					No			No
(12) WEST CENTRAL SURGICAL CENTER LLC 7055 W CENTRAL TOLEDO,OH43617 20-0088459	AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	585,480	1,232,322		No		Yes		50.000 %

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) HERRICK MEMORIAL DEVELOPMENT CORP 500 E POTTAWATAMIE TR ADRIAN,MI49221 38-3146907	FACILITY LEASING	MI	N/A	C					No
(2) HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION 818 RIVERSIDE AVE ADRIAN,MI49221 38-3639616	FACILITY MANAGEMENT	MI	N/A	C					No
(3) MONROE HEALTH VENTURES INC 718 N MACOMB MONROE,MI48164 38-2704426	PHARMACY	MI	N/A	C					No
(4) PROMEDICA AT HOME INC 100 MADISON AVE TOLEDO,OH43604 85-2320857	PHYSICAN SUPPORT	MI	N/A	C					No
(5) PROMEDICA CENTRAL CORPORATION OF MICHIGAN 100 MADISON AVE TOLEDO,OH43604 38-3322278	PHYSICIAN HEALTH CARE SERVICES	OH	N/A	C					No
(6) PROMEDICA HEALTH NETWORK INC 100 MADISON AVE TOLEDO,OH43604 47-4006496	PHYSICIAN MANAGEMENT SERVICES	OH	N/A	C					No
(7) PROMEDICA INNOVATIONS LLC 100 MADISON AVE TOLEDO,OH43604 30-1221601	INVESTMENT COMPANY	OH	N/A	C					No
(8) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1901 INDIAN WOOD CIR MAUMEE,OH43537 34-1570675	HEALTH CARE INSURANCE	OH	N/A	C					No
(9) PROMEDICA MANAGER MEMBER LLC 100 MADISON AVE TOLEDO,OH43604 47-5168737	REAL ESTATE	OH	N/A	C					No
(10) PROMEDICA NORTH PHYSICIAN CORPORATION 100 MADISON AVE TOLEDO,OH43604 38-3482148	PHYSICIAN HEALTH CARE SERVICES	OH	N/A	C					No
(11) PROMEDICA SENIOR CARE OF PISCATAWAY NJ LLC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 86-1179270	SKILLED NURSING	NJ	N/A	C					No

Schedule R (Form 990) 2021

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 .....................

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PROMEDICA INTUITIVE MANAGEMENT OF OHIO	Q	384,136	FMV
(2) PROMEDICA INTUITIVE MANAGEMENT OF OHIO	R	770,035	FMV
(3) PROMEDICA PATHOLOGY LABORATORIES	A	3,997,886	FMV
(4) PROMEDICA PATHOLOGY LABORATORIES	O	21,936,400	FMV
(5) PROMEDICA PATHOLOGY LABORATORIES	Q	36,577,643	FMV
(6) REYNOLDS ROAD SURGICAL CENTER LLC	A	187,200	FMV
(7) REYNOLDS ROAD SURGICAL CENTER LLC	B	315,000	FMV
(8) REYNOLDS ROAD SURGICAL CENTER LLC	J	157,500	FMV
(9) REYNOLDS ROAD SURGICAL CENTER LLC	O	58,900	FMV

Schedule R (Form 990) 2021

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) 2021

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) 2021

Additional Data

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Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY AND THE ADULT TERTIARY FACILITY OF PROMEDICA HEALTH SYSTEM, INC. PROVIDING INPATIENT AND OUTPATIENT HEALTH SERVICES TO THE GENERAL PUBLIC OF NORTHWEST OHIO AND SOUTHEAST MICHIGAN.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	23
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	8,298
6	Total number of volunteers (estimate if necessary) .............	6	279
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,237,138
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	668,881

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	52,682,314	23,604,534
9	Program service revenue (Part VIII, line 2g) .........	1,110,165,661	1,291,859,234
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-18,491,763	52,021,492
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,271,724	6,115,642
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,152,627,936	1,373,600,902
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	774,334	25,000
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)	479,150,594	538,565,419
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)....	667,352,019	671,373,987
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,147,276,947	1,209,964,406
19	Revenue less expenses. Subtract line 18 from line 12.......	5,350,989	163,636,496
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,740,360,333	2,477,516,014
21	Total liabilities (Part X, line 26).............	2,783,305,295	2,652,639,862
22	Net assets or fund balances. Subtract line 21 from line 20.....	-42,944,962	-175,123,848

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 968,767,980 including grants of $ 25,000 ) (Revenue $ 1,283,375,195 )
	THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 547,116 including grants of $ ) (Revenue $ 724,792 )
	THE TOLEDO HOSPITAL OPERATES A HEALTH CLUB FACILITY. - SEE SCHEDULE O.

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses969,315,096

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,288,982	19,617,282	886,682

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,455,815
e	Government grants (contributions)		1e	17,024,249

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,124,470

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

h Total. Add lines 1a-1f.......		23,604,534

		Business Code
2a	NET PATIENT SERVICES	622110	1,277,797,088	1,277,229,441	567,647
b	AFFIL. ORG. RENT REV.	531120	12,633,854			12,633,854
c	MEMBERSHIP REVENUE	713940	724,792	724,792
d	MANAGEMENT FEES	541610	703,500	703,500
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,291,859,234

3 Investment income (including dividends, interest, and othersimilar amounts) ......			27,035,654		1,493,913	25,541,741
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,416,782	6a
b	Less: rental expenses		2,346,493	6b
c	Rental income or (loss)		70,289	6c
d	Net rental income or (loss).......			70,289			70,289
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	66,065	426,971,759	7a
b	Less: cost or other basis and sales expenses	49,519	402,002,467	7b
c	Gain or (loss)	16,546	24,969,292	7c
d	Net gain or (loss).........			24,985,838			24,985,838
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	732,946
b	Less: cost of goods sold ..		10b	305,425
c	Net income or (loss) from sales of inventory..			427,521			427,521
Business Code			Miscellaneous Revenue
11a	PHARMACY		446110	1,927,641	1,752,063	175,578
b	LAB		541380	1,130,644	1,130,644
c	SCHOOL NURSE BILLING		900099	262,288	262,288
d	All other revenue ....			2,297,259	2,297,259
e	Total. Add lines 11a–11d ......			5,617,832
12	Total revenue. See instructions.....			1,373,600,902	1,284,099,987	2,237,138	63,659,243

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	25,000	25,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	445,133,915	379,353,070	65,780,845
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	14,330,018	12,212,362	2,117,656
9	Other employee benefits .......	44,352,707	37,798,368	6,554,339
10	Payroll taxes ...........	34,748,779	29,613,686	5,135,093
11	Fees for services (non-employees):
a	Management ......	1,217,316		1,217,316
b	Legal .........	2,970,026		2,970,026
c	Accounting ...........	915,392		915,392
d	Lobbying ...........	36,141		36,141
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	2,214,892		2,214,892
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	178,437,604	130,295,849	48,141,755
12	Advertising and promotion ....	3,961,408	225,396	3,736,012
13	Office expenses .......	11,664,239	663,672	11,000,567
14	Information technology ......	1,618,141	1,074,000	544,141
15	Royalties ..
16	Occupancy ...........	21,212,497	19,303,372	1,909,125
17	Travel ............	883,071	50,245	832,826
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	32,515,265	32,515,265
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	73,097,217	63,962,922	9,134,295
23	Insurance ...	9,418,509	8,570,843	847,666
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	126,952,047	126,952,047
b	DRUGS	88,624,364	88,624,364
c	PROVIDER TAXES	32,572,743	32,572,743
d	UBI TAXES	200,000	200,000
e	All other expenses	82,863,115	5,301,892	77,561,223
25	Total functional expenses. Add lines 1 through 24e	1,209,964,406	969,315,096	240,649,310	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 ........			185,104,121	1	67,251,880
2	Savings and temporary cash investments .........			6,422,335	2	7,137,055
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			159,235,222	4	187,954,137
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 ...........			7,109,391	7	7,617,124
8	Inventories for sale or use ............			21,333,257	8	21,797,986
9	Prepaid expenses and deferred charges ......			4,387,951	9	9,643,363
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,778,640,103
b	Less: accumulated depreciation	10b	977,238,508	845,949,684	10c	801,401,595
11	Investments—publicly traded securities .			837,644,957	11	807,834,216
12	Investments—other securities. See Part IV, line 11 .....			9,007,034	12	9,536,303
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			28,610,457	14	41,526,995
15	Other assets. See Part IV, line 11 ...........			635,555,924	15	515,815,360
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,740,360,333	16	2,477,516,014

17	Accounts payable and accrued expenses .....	242,296,631	17	188,183,567
18	Grants payable ...		18
19	Deferred revenue .........	1,000,000	19	896,100
20	Tax-exempt bond liabilities .........	780,439,191	20	743,696,840
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 ..	1,513,550,926	23	1,507,246,649
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	246,018,547	25	212,616,706
26	Total liabilities. Add lines 17 through 25..	2,783,305,295	26	2,652,639,862

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-326,484,394	27	-480,013,500
28	Net assets with donor restrictions ...........	283,539,432	28	304,889,652
	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 ...........	-42,944,962	32	-175,123,848
33	Total liabilities and net assets/fund balances ........	2,740,360,333	33	2,477,516,014