TY 2023 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) STEVE SADOWSKI...................................................................... SECRETARY/CHIEF LEGAL OFFICER	1.00 ................. 54.00	X	X	1,407,180	6,028
(2) TERRENCE METZGER...................................................................... TRUSTEE/TREASURER	1.00 ................. 54.00	X	X	1,055,090	4,079
(3) MICHAEL GRILLIS...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 44.00	X		630,007	5,646
(4) DAVID SOMMERS MD...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 44.00	X		456,442	0
(5) IRACEMA AREVALO MD...................................................................... TRUSTEE/PHYSICIAN - PART YEAR	1.00 ................. 44.00	X		348,475	5,857
(6) JAMES WILLIAMS MD PHD...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 44.00	X		265,058	4,687
(7) JODI RUCKER...................................................................... TRUSTEE/PRESIDENT	1.00 ................. 44.00	X	X	263,653	3,717
(8) DASA DZIERWA...................................................................... TRUSTEE/ASSOCIATE VP, NON CLINICAL	1.00 ................. 44.00	X		194,061	2,796
(9) LISA DAVIS MD MBA...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 44.00	X		164,736	0
(10) BARRY LUSE...................................................................... CHAIRMAN	1.00 ................. 0.00	X	X	0	0
(11) LOUIS ROBICHAUX...................................................................... TREASURER - PART YEAR	1.00 ................. 54.00	X	X	0	0
(12) VINCE MILITELLO...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(13) PAUL HERSHEY...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(14) ROBERT GROSS...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(15) ROBIN RICHTER...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(16) ROGER KUNS...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0
(17) RONALD M SCHUMACHER EDD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) SCOTT LANG........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(19) SCOTT MILLER........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(20) ANTHONY RUSHER MD........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(21) JOSEPH LISZAK III........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(22) BETHANY BROWN........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(23) JULIE CHUDZINSKI........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(24) CHRISTIAN MOORE........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(25) JIM NORTH MD........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(26) KRISTIE BILGER........................................................................ TRUSTEE	1.00 .......................0.00	X				0	0	0
(27) ARTURO POLIZZI........................................................................ PRESIDENT AND CEO	1.00 .......................54.00		X			0	2,121,593	5,857
(28) RANDAL KOCH........................................................................ DIRECTOR OF PHARMACY	45.00 .......................0.00			X		165,116	0	5,022
(29) MARLO MAYLE........................................................................ NURSING ADMIN SUPERVISOR	45.00 .......................0.00			X		154,338	0	7,062
(30) NATHAN PERKINS........................................................................ ASSOCIATE VP CLINICAL	45.00 .......................0.00			X		149,419	0	3,781
(31) CATHY DULL........................................................................ NURSE MANAGER	45.00 .......................0.00			X		144,779	0	4,364
(32) PATRICIA BEASCHLER........................................................................ PHARMACIST	45.00 .......................0.00			X		146,135	0	1,665
(33) STEVEN M CAVANAUGH........................................................................ TREASURER, CFO - FORMER	0.00 .......................0.00				X	0	1,335,180	5,657
(34) JEFFREY C KUHN........................................................................ SECRETARY, CHIEF LEGAL OFFICER - FORMER	0.00 .......................0.00				X	0	748,426	30,922
(35) GARY AKENBERGER........................................................................ CHIEF OFFICER - FORMER	0.00 .......................0.00				X	0	528,647	43,532

- 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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

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

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

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

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

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

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

2023

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization MEMORIAL 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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization MEMORIAL HOSPITAL		Employer identification number 34-4430849

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization MEMORIAL HOSPITAL			Employer identification number 34-4430849
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2023)

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

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2022

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

7,601

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

7,601

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

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

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	380,200	380,200	380,200	380,200	380,200
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	380,200	380,200	380,200	380,200	380,200

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

100.000 %

Term endowment right arrow

0 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	1,050,506		1,050,506
b	Buildings ....	42,138,616	18,254,661	23,883,955
c	Leasehold improvements	124,157	12,022	112,135
d	Equipment ....	22,788,633	18,811,909	3,976,724
e	Other .....	4,818,777	3,184,265	1,634,512
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				30,657,832

Schedule D (Form 990) 2022

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				423,520
(2)OTHER INVESTMENTS				851,804
(3)BENEFICIAL INTEREST IN FOUNDATION				6,927,637
(4)THIRD PARTY RECEIVABLES				2,152,297
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				10,355,258

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO AFFILIATES	10,358,203
ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE	2,133,920
ASSET REMEDIATION OBLIGATION	2,484,516
INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL	19,891,929
OPERATING LEASE LIABILITY	317,251




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	35,185,819
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) 2022

Page 4

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

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

Part XIII

Supplemental Information

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

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

Schedule D (Form 990) 2022

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

200% 250% 300% 350% 400% Other 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? . . . . . .

Yes

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			720,748		720,748	0.960 %
b	Medicaid (from Worksheet 3, column a) . . . . .			12,831,597	11,524,611	1,306,986	1.740 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			13,552,345	11,524,611	2,027,734	2.700 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	56	6,075	66,745		66,745	0.090 %
f	Health professions education (from Worksheet 5) . . .			242,830		242,830	0.320 %
g	Subsidized health services (from Worksheet 6) . . . .	103		6,195	3,166	3,029	0 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			65,775		65,775	0.090 %
j	Total. Other Benefits . .	159	6,075	381,545	3,166	378,379	0.500 %
k	Total. Add lines 7d and 7j .	159	6,075	13,933,890	11,527,777	2,406,113	3.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

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

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

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with 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. ......

3,687,909

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. ......

184,629

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).....

14,902,815

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

18,972,031

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

-4,069,216

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 COOPERATIVE CARE	PHYSICIAN ORGANIZATION	50.000 %	5.000 %	45.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

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

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

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

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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

Yes

6 a

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

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

Yes

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

Yes

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

Hospital facility’s website (list url): 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 22

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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

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

Yes

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

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

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

SEE PART V, SECTION C

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (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) 2023

Page 7

Part VFacility Information (continued)

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

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

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH SURVEY ASSESSMENT PROCESS, MEMORIAL HOSPITAL STAFF JOINED SANDUSKY COUNTY HEALTH PARTNERS, WHERE MULTIPLE COMMUNITY ORGANIZATIONS COLLABORATED TO DEVELOP AND IMPLEMENT A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR SANDUSKY COUNTY. A RESOURCE ASSESSMENT AND GAP ANALYSIS WERE COMPILED AS PART OF THIS PROCESS.IN 2022, MEMORIAL HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE MOST RECENT SANDUSKY COUNTY CHA AND CHIP WITH GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THE DEFINED COMMUNITY AND DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND/OR UNDERSERVED POPULATIONS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA PLAN FROM THE SANDUSKY COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE.THE SANDUSKY COUNTY CHIP PROCESS AND GROUPS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: BELLEVUE HOSPITAL (PH), COMMUNITY HEALTH SERVICES, FIRELANDS COUNSELING & RECOVERY SERVICES, FREMONT CITY SCHOOL DISTRICT, GREAT LAKES COMMUNITY ACTION PARTNERSHIP, MENTAL HEALTH AND RECOVER SERVICES BOARD, PROMEDICA MEMORIAL HOSPITAL, SANDUSKY COUNTY BOARD OF DD, SANDUSKY COUNTY FAMILY AND CHILDREN FIRST COUNCIL, SANDUSKY COUNTY JOB AND FAMILY SERVICES, SANDUSKY COUNTY JUVENILE AND PROBATE COURT, SANDUSKY COUNTY PUBLIC HEALTH, UNITED WAY OF SANDUSKY COUNTY
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2022 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO
MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: 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 2022 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2022-2025 IMPLEMENTATION PLAN INCLUDE: ADULT MARIJUANA OTHER DRUGS, ADULT ALCOHOL USE, ADULT SEXUAL BEHAVIOR, ADULT TOBACCO USE, ADULT WEIGHT CONTROL, ARTHRITIS, ASTHMA, DIABETES, CANCER, CARDIOVASCULAR, CHILDREN'S HEALTH FUNCTIONAL STATUS, CHILDREN'S HEALTH INSURANCE ACCESS UTILIZATION, FAMILY FUNCTIONING NEIGHBORHOOD COMMUNITY, HEALTH CARE ACCESS, HEALTH COVERAGE, HEALTH PERCEPTION, MENTAL HEALTH, ORAL HEALTH, PARENT HEALTH, PREVENTIVE MEDICINE, QUALITY OF LIFE, WOMEN'S HEALTH, YOUTH ALCOHOL, YOUTH MARIJUANA OTHER DRUGS, YOUTH MENTAL HEALTH, YOUTH PERCEPTIONS, YOUTH SAFETY, YOUTH VIOLENCE ISSUES, YOUTH SEXUAL BEHAVIOR AND TEEN PREGNANCY OUTCOMES, YOUTH TOBACCO, YOUTH WEIGHT STATUS.MEMORIAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2023 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2022:HEALTH NEED IDENTIFIED: HEALTH BEHAVIORS RELATED TO OBESITY STRATEGY #1 - PROVIDE AND DISTRIBUTE EDUCATION AND RESOURCES RELATED TO OUTDOOR EXERCISE TO THE COMMUNITY TO EDUCATE THEM ON BENEFITS OF HEALTHY OUTDOOR ACTIVITY.ACTIONS TAKEN:- 318 COMMUNITY MEMBERS RECEIVED EDUCATION ABOUT HEALTHY OUTDOOR ACTIVITY, PLANT BASED CHICKEN AND FLYERS ABOUT PHYSICAL ACTIVITY OUTDOORS.- 29 COMMUNITY MEMBERS PARTICIPATED IN EDUCATION AND EXERCISE AT THE HOSPITAL'S OUTDOOR EXERCISE STATIONS. STRATEGY #2 - PROVIDE AND DISTRIBUTE EDUCATION AND RESOURCES RELATED TO INDOOR EXERCISE TO THE COMMUNITY TO EDUCATE THEM ON BENEFITS OF HEALTHY INDOOR ACTIVITY.ACTIONS TAKEN:- 831 COMMUNITY MEMBERS RECEIVED EDUCATION ABOUT INDOOR EXERCISE THROUGH FLYERS, HOSPITAL EXERCISE ROOM, LUNCH AND LEARN EVENTS, AND THE FAMILY FEST HEALTH FAIR.- ON OCTOBER 2, 2023, THE HOSPITAL OPENED ITS EXERCISE ROOM FOR USE TO IMPROVE ACCESS TO PHYSICAL ACTIVITY. STRATEGY #3 - PROVIDE AND DISTRIBUTE EDUCATION AND RESOURCES RELATED TO HEALTHY COOKING, INCLUDING COOKING DEMONSTRATIONS. ACTIONS TAKEN:- 93 COMMUNITY MEMBERS RECEIVED EDUCATION ABOUT HEALTHY COOKING THROUGH PARTNERSHIPS WITH STACEY PLACE, GLCAP AND HEALTHY EATING WHICH PROVIDED PARTICIPANTS WITH FOOD SCALES AND INFORMATION ABOUT READING FOOD LABELS. - 35 COMMUNITY MEMBERS PARTICIPATED IN COOKING DEMONSTRATIONS. HEALTH NEED IDENTIFIED: CHRONIC DISEASE WOMEN'S HEALTH: BREAST CANCER AND GYNECOLOGICAL CANCER SCREENINGS.STRATEGY #1 - PROVIDE EDUCATION AND RESOURCES RELATED TO BREAST AND GYNECOLOGICAL CANCER TO THE COMMUNITY. ACTIONS TAKEN:- 570 COMMUNITY MEMBERS RECEIVED EDUCATION THROUGH DISTRIBUTION OF FLYERS AND RESOURCES AT STACEY PLACE AND EXPO AND DOROTHY KERN CANCER CENTER. STRATEGY #2 - PROVIDE EDUCATION AND RESOURCES RELATED TO BREAST AND GYNECOLOGICAL CANCER AT COMMUNITY EVENTS.ACTIONS TAKEN: - 335 COMMUNITY MEMBERS RECEIVED EDUCATION AT THE SENIOR HEALTH FAIR AT OLE ZIMS AND OTHER EVENTS.HEALTH NEED IDENTIFIED: SOCIAL DETERMINANTS OF HEALTH FOOD INSECURITY STRATEGY #1 - SCREEN INPATIENTS ON ADMISSIONS FOR FOOD INSECURITY AND OFFER FOOD AT DISCHARGE WITH COMMUNITY FOOD RESOURCE LISTING TO INPATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. ACTIONS TAKEN:- 1278 PATIENTS WERE SCREENED FOR FOOD INSECURITY IN 2023 AND FOOD RESOURCES WERE OFFERED TO PATIENTS SCREENING POSITIVE.- 152 FOOD BAGS WERE DISTRIBUTED TO PATIENTS AT DISCHARGE IN 2023. - 2 EMPLOYEES EXPERIENCING FOOD INSECURITY RECEIVED FOOD IN 2023. HEALTH NEED IDENTIFIED: HEALTHY AGING STRATEGY #1 - PROVIDE EDUCATION ON BEHAVIORAL HEALTH IMPROVEMENT OPPORTUNITIES. SURVEY PARTICIPANTS TO DETERMINE INTENTION TO USE EDUCATION AFTER THE SESSION.ACTIONS TAKEN:- 85 COMMUNITY MEMBERS RECEIVED EDUCATION THROUGH DISTRIBUTION OF FLYERS WITH A QR CODE DIRECTING PEOPLE TO PROMEDICA'S YOUTUBE CHANNEL WITH COMMUNITY HEALTH EDUCATION. - PRE AND POST SURVEY RESULTS REPORTED THAT 100% OF PARTICIPANTS INDICATED THEY PLAN TO USE WHAT THEY LEARNED FROM THE SESSION. STRATEGY #2 - PROVIDE AND DISTRIBUTE EDUCATIONAL AND RESOURCE MATERIALS ON POSITIVE BEHAVIORAL HEALTH IMPROVEMENT.ACTIONS TAKEN:- 775 COMMUNITY MEMBERS RECEIVED EDUCATION ABOUT THE SUICIDE PREVENTION HOTLINE, ADULT DEPRESSION, SUICIDE PREVENTION AND RESILIENCE FOR YOUTH.STRATEGY #3 - PROVIDE AND DISTRIBUTE EDUCATIONAL AND RESOURCE MATERIALS ABOUT MENTAL HEALTH FIRST AID TO THE COMMUNITY. ACTIONS TAKEN:- 275 COMMUNITY MEMBERS RECEIVE EDUCATION ABOUT MENTAL HEALTH FIRST AID IN 2023.
PART V, SECTION B, LINE 7A	THE 2022 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ABOUT-PROMEDICA/COMMUNITY
PART V, SECTION B, LINE 10A	THE 2023-2025 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ABOUT-PROMEDICA/COMMUNITY
PART V, SECTION B, LINE 16A:	THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX
PART V, SECTION B, LINE 16B:	THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX
PART V, SECTION B, LINE 16C:	A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX

Schedule H (Form 990) 2023

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?6
Name and address		Type of Facility (describe)
1	1 - PROMEDICA GIBSONBURG - TOTAL REHAB 116 S MAIN ST GIBSONBURG,OH43431	TOTAL REHAB
2	2 - DOROTHY L KERN CANCER CENTER - ONCOLOGY 2390 ENTERPRISE ST FREMONT,OH43420	DOROTHY L KERN CANCER CENTER
3	3 - PROMEDICA CLYDE - TOTAL REHAB 509 W MCPHERSON HWY CLYDE,OH43410	TOTAL REHAB
4	4 - PROMEDICA HERBERT PERNA CENTER - TOTAL REH 710 CLEVELAND AVE FREMONT,OH43420	TOTAL REHAB
5	5 - PROMEDICA MEMORIAL HOSPITAL FREMONT - SLEE 710 CLEVELAND AVE FREMONT,OH43420	SLEEP DISORDERS
6	6 - PROMEDICA MEMORIAL HOSPITAL FREMONT - PAIN 715 S TAFT AVE FREMONT,OH43420	PAIN MGMT
7
8
9
10

Schedule H (Form 990) 2023

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 7:	MEMORIAL HOSPITAL, INC. 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 I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,687,909.
PART III, LINE 2:	MEMORIAL HOSPITAL, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	MEMORIAL HOSPITAL, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 16 AND 17 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
PART III, LINE 8:	MEMORIAL HOSPITAL HAS A MEDICARE SURPLUS, WHICH IS THE EXCESS REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT OVER THE EXPENSES TO TREAT MEDICARE PATIENTS.MEMORIAL HOSPITAL, INC. USED THE MEDICARE ALLOWABLE COSTS PER ITS 2023 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 THIS DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	MEMORIAL HOSPITAL, LOCATED IN FREMONT, OHIO, SERVES AN AREA PRIMARILY AROUND SANDUSKY AND SENECA COUNTIES. SANDUSKY COUNTY HAS A POPULATION OF APPROXIMATELY 59,000 WITH APPROXIMATELY 20% OF THE SERVICE AREA IS AGE 65 OR OVER; 58% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $54,000; 93% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR HIGHER. APPROXIMATELY, 9% OF SANDUSKY COUNTY IS UNINSURED AND 18% OF FAMILIES BELOW THE POVERTY LEVEL. THE AVERAGE UNEMPLOYMENT RATE FOR SANDUSKY COUNTY IN 2023 WAS 5.2%. THE LEADING CAUSES OF DEATH IN SANDUSKY COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE AND DIABETES. ACCORDING TO 2023 COUNTY HEALTH RANKINGS, SANDUSKY COUNTY RANKED 41 OF 88 COUNTIES FOR HEALTH OUTCOMES AND 35 OF 88 FOR QUALITY OF LIFE. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 55,000 WITH APPROXIMATELY 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 59% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $59,000; 93% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR HIGHER. 19% OF FAMILIES ARE BELOW THE POVERTY LEVEL AND AN APPROXIMATE 8% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2023 WAS 4.7%. THE LEADING CAUSES OF DEATH IN HANCOCK AND SENECA COUNTIES, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, DIABETES AND ALZHEIMER'S. ACCORDING TO 2023 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 47 OF 88 COUNTIES FOR HEALTH OUTCOMES AND 36 OF 88 FOR QUALITY OF LIFE. THERE ARE ELEVEN HOSPITALS WITHIN A 30-MILE RADIUS OF MEMORIAL HOSPITAL: BELLEVUE HOSPITAL, H.B. MAGRUDER MEMORIAL HOSPITAL, MERCY HOSPITAL TIFFIN, FOSTORIA HOSPITAL ASSOCIATION, FIRELANDS REGIONAL MEDICAL CENTER, BAY PARK COMMUNITY HOSPITAL, ST. CHARLES MERCY HOSPITAL, MERCY HEALTH PERRYSBURG, WOOD COUNTY HOSPITAL, FISHER-TITUS MEDICAL CENTER, AND MERCY HOSPITAL OF WILLARD.
PART VI, LINE 5:	MEMORIAL HOSPITAL, INC. IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2023:- 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. - 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 LUNG CANCER SCREENINGS, SCREENING MAMMOGRAMS AND 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.- 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. RECENTLY, 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.
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 2023 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS INCLUDING 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 2023:- 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 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. - 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. 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. - 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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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) 2023

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)
1ARTURO POLIZZI PRESIDENT AND CEO	(i) (ii)	0 ------------- 1,315,647	0 ------------- 789,979	0 ------------- 15,967	0 ------------- 0	0 ------------- 5,857	0 ------------- 2,127,450	0 ------------- 0
2STEVE SADOWSKI SECRETARY/CHIEF LEGAL OFFICER	(i) (ii)	0 ------------- 625,095	0 ------------- 774,925	0 ------------- 7,160	0 ------------- 0	0 ------------- 6,028	0 ------------- 1,413,208	0 ------------- 0
3STEVEN M CAVANAUGH TREASURER, CFO - FORMER	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 1,335,180	0 ------------- 0	0 ------------- 5,657	0 ------------- 1,340,837	0 ------------- 0
4TERRENCE METZGER TRUSTEE/TREASURER	(i) (ii)	0 ------------- 480,090	0 ------------- 575,000	0 ------------- 0	0 ------------- 0	0 ------------- 4,079	0 ------------- 1,059,169	0 ------------- 0
5JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER - FOR	(i) (ii)	0 ------------- 26,526	0 ------------- 0	0 ------------- 721,900	0 ------------- 26,526	0 ------------- 4,396	0 ------------- 779,348	0 ------------- 0
6MICHAEL GRILLIS TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 534,800	0 ------------- 91,343	0 ------------- 3,864	0 ------------- 0	0 ------------- 5,646	0 ------------- 635,653	0 ------------- 0
7GARY AKENBERGER CHIEF OFFICER - FORMER	(i) (ii)	0 ------------- 246,095	0 ------------- 83,570	0 ------------- 198,982	0 ------------- 36,639	0 ------------- 6,893	0 ------------- 572,179	0 ------------- 0
8DAVID SOMMERS MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 445,099	0 ------------- 11,293	0 ------------- 50	0 ------------- 0	0 ------------- 0	0 ------------- 456,442	0 ------------- 0
9IRACEMA AREVALO MD TRUSTEE/PHYSICIAN - PART YEAR	(i) (ii)	0 ------------- 333,381	0 ------------- 13,552	0 ------------- 1,542	0 ------------- 0	0 ------------- 5,857	0 ------------- 354,332	0 ------------- 0
10JAMES WILLIAMS MD PHD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 254,918	0 ------------- 6,702	0 ------------- 3,438	0 ------------- 0	0 ------------- 4,687	0 ------------- 269,745	0 ------------- 0
11JODI RUCKER TRUSTEE/PRESIDENT	(i) (ii)	0 ------------- 229,112	0 ------------- 33,750	0 ------------- 791	0 ------------- 0	0 ------------- 3,717	0 ------------- 267,370	0 ------------- 0
12DASA DZIERWA TRUSTEE/ASSOCIATE VP, NON CLINICAL	(i) (ii)	0 ------------- 167,116	0 ------------- 26,620	0 ------------- 325	0 ------------- 0	0 ------------- 2,796	0 ------------- 196,857	0 ------------- 0
13RANDAL KOCH DIRECTOR OF PHARMACY	(i) (ii)	159,297 ------------- 0	5,819 ------------- 0	0 ------------- 0	0 ------------- 0	5,022 ------------- 0	170,138 ------------- 0	0 ------------- 0
14LISA DAVIS MD MBA TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 151,126	0 ------------- 13,310	0 ------------- 300	0 ------------- 0	0 ------------- 0	0 ------------- 164,736	0 ------------- 0
15MARLO MAYLE NURSING ADMIN SUPERVISOR	(i) (ii)	147,381 ------------- 0	3,405 ------------- 0	3,552 ------------- 0	0 ------------- 0	7,062 ------------- 0	161,400 ------------- 0	0 ------------- 0
16NATHAN PERKINS ASSOCIATE VP CLINICAL	(i) (ii)	143,852 ------------- 0	5,267 ------------- 0	300 ------------- 0	0 ------------- 0	3,781 ------------- 0	153,200 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 3

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

PART I, LINES 4A-B

UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. -STEVEN CAVANAUGH RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $1,335,180 DURING 2023. -JEFFERY KUHN RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $721,900 DURING 2023. -MATTHEW KANG RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $583,664 DURING 2023. -GARY AKENBERGER RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, THE TOLEDO HOSPITAL, IN THE AMOUNT OF $195,150 DURING 2023. 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 (Form 990) 2023

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Return Reference	Explanation
PART V, LINE 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 MEMORIAL HOSPITAL. AS THE SOLE MEMBER, PHS HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE (WITH CAUSE) THE MEMBERS OF THE BOARD OF TRUSTEES OF MEMORIAL HOSPITAL, AND (B) APPROVE THE NOMINEES TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE RETURN IS REVIEWED BY MANAGEMENT BEFORE BEING PROVIDED TO THE 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 STATEMENT OF CONFLICT (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	MEMORIAL HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
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 VII, SECTION A	LOUIS ROBICHAUX IS EMPLOYED BY A MANAGEMENT AGENCY THAT IS UNDER A CONTRACT TO PROVIDE MANAGEMENT SERVICES TO PROMEDICA HEALTH SERVICES.
FORM 990, PART IX, LINE 11G	CONTRACTED MEDICAL PERSONNEL: PROGRAM SERVICE EXPENSES 4,051,067. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,051,067. TEMPORARY AGENCY FEES: PROGRAM SERVICE EXPENSES 1,861,129. MANAGEMENT AND GENERAL EXPENSES 1,165,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,026,854. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,367,094. MANAGEMENT AND GENERAL EXPENSES 1,530,096. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,897,190. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 250,746. MANAGEMENT AND GENERAL EXPENSES 282,038. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532,784.
FORM 990, PART XI, LINE 9:	TRANSFERS BETWEEN RELATED ENTITIES -26,801,460. REVERSE OF BOOK ENTRY FOR AUXILIARY ACTIVITY -58,327.
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) 2023

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

34-4430849

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

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 PROFESSIONAL SERVICES 100 MADISON AVE TOLEDO,OH43604 27-3763993	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(23)MERCY MEMORIAL HOSPITAL CORPORATION 100 MADISON AVE TOLEDO,OH43604 38-1984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(24)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
(25)PARAMOUNT ADVANTAGE 1901 INDIAN WOOD CIR MAUMEE,OH43537 20-3376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes
(26)PROMEDICA CENTRAL PHYSICIANS 100 MADISON AVE TOLEDO,OH43604 34-1881137	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(27)PROMEDICA CHILDRENS SPECIALISTS 100 MADISON AVE TOLEDO,OH43604 20-8734161	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(28)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
(29)PROMEDICA CONTINUUM SERVICES 100 MADISON AVE TOLEDO,OH43604 34-1880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(30)PROMEDICA COURIER SERVICES INC 100 MADISON AVE TOLEDO,OH43604 26-0324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes
(31)PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO,OH43604 34-1517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes
(32)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
(33)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
(34)PROMEDICA MONROE CARDIOLOGY 100 MADISON AVE TOLEDO,OH43604 27-2920342	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(35)PROMEDICA MONROE PHYSICIANS 100 MADISON AVE TOLEDO,OH43604 46-1111822	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes
(36)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
(37)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
(38)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
(39)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
(40)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
(41)THE HUG FUND 444 N SUMMIT ST TOLEDO,OH43604 20-2272848	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes
(42)THE TOLEDO HOSPITAL 100 MADISON AVE TOLEDO,OH43604 34-4428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes
(43)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
(44)PROMEDICA HEALTH SYSTEM INC 100 MADISON AVE TOLEDO,OH43604 34-1517671	PARENT COMPANY OF HEALTH SERVICES	OH	501(C)(3)	12B, II	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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) NORMAN SPECIALTY HOSPITAL LLC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 42-1627672	HEALTH CARE	DE	N/A				No		Yes
(2) MERCYMANOR PARTNERSHIP PO BOX 10086 ATTN TAX-5 TOLEDO,OH43604 52-1931012	SKILLED NURSING	PA	N/A				No		Yes
(3) 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
(4) PROMEDICA SENIOR CARE OF GEORGIA LLC 100 MADISON AVE TOLEDO,OH43604 87-1802834	SKILLED NURSING	OH	N/A				No		Yes
(5) PROMEDICA VENTURES INNOVATION FUND III LLC 100 MADISON AVE TOLEDO,OH43604 87-3197533	HOLDING COMPANY	OH	N/A				No			No
(6) ROCKET VENTURE FUND II LLC 2865 N REYNOLDS RD STE 220 TOLEDO,OH43615 47-5603627	INVESTMENT FUND	OH	N/A				No			No
(7) SENIOR & REHAB CARE AT METROHEALTH LLC 100 MADISON AVE ATTN TAX DEPT TOLEDO,OH43604 87-2465544	SKILLED NURSING	OH	N/A				No		Yes
(8) AIR DIVERTER SOLUTIONS LLC 100 MADISON AVE TOLEDO,OH43604 85-3725776	DEVELOPMENT	OH	N/A				No			No
(9) PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC 100 MADISON AVE TOLEDO,OH43604 47-3163945	REAL ESTATE	OH	N/A				No		Yes
(10) NORTHWEST OHIO DEDICATED BREAST MRI LLC 100 MADISON AVE TOLEDO,OH43604 26-0679898	MEDICAL DIAGNOSTICS	OH	N/A				No		Yes
(11) PROMEDICA INTUITIVE MANAGEMENT OF OHIO LLC 100 MADISON AVE TOLEDO,OH43604 85-2085627	HEALTH CARE	MI	N/A				No			No
(12) REYNOLDS ROAD SURGICAL CENTER LTD 2865 N REYNOLDS RD TOLEDO,OH43615 31-1569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	N/A				No			No
(13) WEST CENTRAL SURGICAL CENTER LLC 7055 W CENTRAL TOLEDO,OH43617 20-0088459	AMBULATORY SURGICAL CENTER	OH	N/A				No		Yes
(14) PROMEDICA MASTER TENANT LLC 100 MADISON AVE TOLEDO,OH43604 47-5288490	REAL ESTATE	OH	N/A				No		Yes
(15) ARROWHEAD BEHAVIORAL HEALTH LLC 367 SOUTH GULPH ROAD PO BOX 61558 KING OF PRUSSIA,PA19406 27-0608044	HEALTH CARE	PA	N/A				No		Yes

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				Yes
(2) LENAWEE CLINICAL PARTNERS 100 MADISON AVE TOLEDO,OH43604 82-1072356	PHYSICIAN SUPPORT	OH	N/A	C				Yes
(3) PROMEDICA SENIOR CARE OF PISCATAWAY NJ LLC PO BOX 10086 ATTN TAX-5 TOLEDO,OH43699 86-1179270	SKILLED NURSING	NJ	N/A	C				Yes
(4) HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION 818 RIVERSIDE AVE ADRIAN,MI49221 38-3639616	FACILITY MANAGEMENT	MI	N/A	C				Yes
(5) MONROE HEALTH VENTURES INC 718 N MACOMB MONROE,MI48164 38-2704426	PHARMACY	MI	N/A	C				Yes
(6) PROMEDICA MANAGER MEMBER LLC 100 MADISON AVE TOLEDO,OH43604 47-5168737	REAL ESTATE	OH	N/A	C				Yes
(7) PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1901 INDIAN WOOD CIR MAUMEE,OH43537 34-1570675	HEALTH CARE INSURANCE	OH	N/A	C				Yes
(8) PROMEDICA INNOVATIONS LLC 100 MADISON AVE TOLEDO,OH43604 30-1221601	INVESTMENT COMPANY	OH	N/A	C				Yes
(9) PROMEDICA HEALTH NETWORK INC 100 MADISON AVE TOLEDO,OH43604 47-4006496	PHYSICIAN MANAGEMENT SERVICES	OH	N/A	C				Yes
(10) PHS TOLEDO INNOVATION CENTER HOLDINGS LLC 100 MADISON AVE TOLEDO,OH43604 87-1433009	HOLDING COMPANY	OH	N/A	C				Yes
(11) FORT INDUSTRY JV PARTNER LLC 100 MADISON AVE TOLEDO,OH43604 84-4675266	REAL ESTATE	OH	N/A	C				Yes
(12) PROMEDICA NORTH PHYSICIAN CORPORATION 100 MADISON AVE TOLEDO,OH43604 38-3482148	PHYSICIAN HEALTH CARE SERVICES	OH	N/A	C				Yes
(13) PROMEDICA AT HOME INC 100 MADISON AVE TOLEDO,OH43604 85-2320857	PHYSICIAN SUPPORT	MI	N/A	C				Yes
(14) PROMEDICA CENTRAL CORPORATION OF MICHIGAN 100 MADISON AVE TOLEDO,OH43604 38-3322278	PHYSICIAN HEALTH CARE SERVICES	OH	N/A	C				Yes

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

Yes

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

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: MEMORIAL HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY AND SURROUNDING AREAS REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY, AND OUTPATIENT CARE. OUR MISSION IS TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND FAMILIES IN THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	24
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	414
6	Total number of volunteers (estimate if necessary) .............	6	103
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	250,041	942,869
9	Program service revenue (Part VIII, line 2g) .........	84,623,533	91,920,546
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-60,485	329,040
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,459,525	698,518
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	86,272,614	93,890,973
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	23,577,321	24,334,366
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)....	57,378,160	54,509,064
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	80,955,481	78,843,430
19	Revenue less expenses. Subtract line 18 from line 12.......	5,317,133	15,047,543
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	65,046,432	59,012,522
21	Total liabilities (Part X, line 26).............	35,887,052	41,665,386
22	Net assets or fund balances. Subtract line 21 from line 20.....	29,159,380	17,347,136

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 55,503,406 including grants of $ 0 ) (Revenue $ 91,920,546 )
	MEMORIAL HOSPITAL (D/B/A PROMEDICA MEMORIAL HOSPITAL) IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. A 100-BED HOSPITAL IN FREMONT, OHIO, PROMEDICA MEMORIAL HOSPITAL (MH) PROVIDES EXTENSIVE HEALTHCARE SERVICES SUCH AS EMERGENCY MEDICINE; SURGICAL SERVICES; OUTPATIENT PHYSICAL REHABILITATION; HEART, VASCULAR AND PULMONARY CARE; LABOR AND DELIVERY; MENTAL HEALTH SERVICES; A WOUND CARE CLINIC, AND A FULL RANGE OF LABORATORY AND RADIOLOGY SERVICES. THE DOROTHY L. KERN CANCER CENTER ,ON THE CAMPUS OF MH, EXPANDS CANCER CARE TO PATIENTS IN THE FREMONT, OHIO, AREA. THE CANCER CENTER OFFERS OUTPATIENT RADIATION, CHEMOTHERAPY, AND INFUSION SERVICES AS WELL AS COMPLEMENTARY SERVICES SUCH AS GENETIC TESTING AND COUNSELING, HEALING CARE, AND SURVIVORSHIP CARE PLANNING. MH ALSO IS A DESIGNATED LUNG CANCER SCREENING CENTER BY THE AMERICAN COLLEGE OF RADIOLOGY. MH IS ALSO DESIGNATED AS A NURSES IMPROVING CARE FOR HEALTH SYSTEM ELDERS (NICHE). THE NICHE PROGRAM IS DESIGNED TO HELP IMPROVE CARE FOR PATIENTS THAT ARE 65 YEARS AND OLDER THROUGH RESEARCH AND IMPLEMENTATION SPECIFIC INDUSTRY BEST PRACTICES. IN 2023, MH RECEIVED AN 'A' RATING FROM THE LEAPFROG GROUP FOR PROTECTING PATIENTS FROM ERRORS, INJURIES, ACCIDENTS AND INFECTIONS. MH ALSO WAS RECOGNIZED BY CENTERS FOR MEDICARE AND MEDICAID (CMS) WITH A FIVE STAR RATING FOR OUTCOMES IN MORTALITY, SAFETY, READMISSIONS, PATIENT EXPERIENCE, AND TIMELY AND EFFECTIVE CARE. MH ALSO WAS RECOGNIZED BY BECKER'S HOSPITAL REVIEW AS ONE OF ITS TOP 100 RURAL & COMMUNITY HOSPITALS, BY STATE, BASED ON INPATIENT AND OUTPATIENT MARKET SHARE AS WELL AS QUALITY OUTCOMES, PATIENT EXPERIENCE, COSTS AND FINANCIAL EFFICIENCY.IN 2023, MH SERVED 1,580 INPATIENTS AND 80,468 OUTPATIENTS. FURTHER, 19,834 INDIVIDUALS SOUGHT EMERGENCY CARE AT MH. THE HOSPITAL CONTRIBUTED $13,934,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE.THROUGH COMMUNITY HEALTH SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS, MH CONTRIBUTED $382,000 TO THE COMMUNITY DURING 2023. INCLUDED IN THIS FIGURE ARE PROGRAMS AND EVENTS SUCH AS: -USE APPROVED AND FUNDED RESOURCES FROM SUSAN G. KOMEN TO PROVIDE BREAST EXAMS AND MAMMOGRAMS.-PROVIDING CARE PACKAGES AND HOMEMADE COOKIES FROM NUTRITION SERVICES TO PATIENTS RECEIVING CARE THROUGH HOSPICE, HOME HEALTH, DIALYSIS, MOBILE MEALS, THE CANCER CENTER, AND PAIN CLINIC AS WELL AS SEVERAL SENIOR HOUSING COMMUNITIES. - PARTNERSHIP WITH STACEY PLACE AND GREAT LAKES COMMUNITY ACTION PARTNERSHIP TO PROVIDE COMMUNITY MEMBERS WITH EDUCATION ABOUT COOKING HEALTHY RECIPES. THIS EVENT DISTRIBUTED FOOD SCALES AND INFORMATION ABOUT HOW TO READ NUTRITION LABELS FOR PARTICIPANTS. MH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE DURING 2023, OF WHICH $3,391,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. MH COST OF BAD DEBT FOR 2023 WAS $3,688,000 . THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $13,934,000 NOTED ABOVE.FURTHERMORE, MH PROVIDED $1,307,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. MH EXPENDED $21,432,000 IN NET PAYROLL, PROVIDING 403 JOBS IN NORTHWEST OHIO IN 2023. A TOTAL OF $1,235,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES.IN SUMMARY, MH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses55,503,406

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	759,787	9,518,548	140,672

(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	86,806
e	Government grants (contributions)		1e	856,063

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

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

h Total. Add lines 1a-1f.......		942,869

		Business Code
2a	NET PATIENT SERVICES	622110	91,283,192	91,283,192
b	AFFILIATED ORG RENT RE	531120	637,354	637,354
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		91,920,546

3 Investment income (including dividends, interest, and othersimilar amounts) ......			19,681			19,681
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	48,189
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	48,189
d	Net rental income or (loss).......			48,189			48,189
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b		-309,359
c	Gain or (loss)	7c		309,359
d	Net gain or (loss).........			309,359			309,359
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	SUPPORT SERVICES		561499	650,329			650,329
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			650,329
12	Total revenue. See instructions.....			93,890,973	91,920,546	0	1,027,558

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	19,838,694	17,472,708	2,365,986
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	3,093,798	2,724,828	368,970
10	Payroll taxes ...........	1,401,874	1,234,685	167,189
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	74,446		74,446
c	Accounting ...........
d	Lobbying ...........	7,601		7,601
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,507,895	7,530,036	2,977,859
12	Advertising and promotion ....	93,049	15,063	77,986
13	Office expenses .......	2,146,374	347,461	1,798,913
14	Information technology ......	78,012	52,043	25,969
15	Royalties ..
16	Occupancy ...........	2,660,115	32,963	2,627,152
17	Travel ............	68,242	11,048	57,194
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,006,297	1,006,297
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,191,308	3,594,662	596,646
23	Insurance ...	21,664		21,664
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	INTERCOMPANY SERVICES	14,518,757	2,350,345	12,168,412
b	DRUGS	8,530,877	8,530,877
c	MEDICAL SUPPLIES	4,330,422	4,330,422
d	PROVISION FOR BAD DEBTS	3,687,909	3,687,909
e	All other expenses	2,586,096	2,582,059	4,037
25	Total functional expenses. Add lines 1 through 24e	78,843,430	55,503,406	23,340,024	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 ........			11,485,750	1	4,923,596
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,643,619	4	11,062,072
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
8	Inventories for sale or use ............			1,082,886	8	1,272,332
9	Prepaid expenses and deferred charges ......			183,377	9	306,241
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	70,920,689
b	Less: accumulated depreciation	10b	40,262,857	33,015,680	10c	30,657,832
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			232,836	12	153,191
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			731,647	14	282,000
15	Other assets. See Part IV, line 11 ...........			7,670,637	15	10,355,258
16	Total assets. Add lines 1 through 15 (must equal line 33)...			65,046,432	16	59,012,522

17	Accounts payable and accrued expenses .....	6,077,304	17	6,448,623
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	61,888	23	30,944
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	29,747,860	25	35,185,819
26	Total liabilities. Add lines 17 through 25..	35,887,052	26	41,665,386

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	22,139,480	27	10,419,499
28	Net assets with donor restrictions ...........	7,019,900	28	6,927,637
	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 ...........	29,159,380	32	17,347,136
33	Total liabilities and net assets/fund balances ........	65,046,432	33	59,012,522