2023-11-15T11:42:27-06:00 2022-12-31 310800053 Clark Schaefer Hackett 10100 Innovation Drive Suite 400 Dayton OH 45342 990 2022-01-01 452036966 Fort Hamilton Hospital Foundation FORT 9377621629 1 Prestige Place 910 Miamisburg OH 45342 Tim Ko Interim CFO KH 9377621629 2023-11-14 1 Tim Ko 999009999 0 Jane E Pfeifer P00014949 9372260070 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Paul Hoover 1 Prestige Place Suite 910 Miamisburg OH 45342 720811 0 X www.ketteringhealth.org X 2011 OH Fort Hamilton Hospital Foundation supports Kettering Health Hamilton and the well-being of the entire community. We connect the community's legacy of generosity to opportunities that ensure patients receive our best in healthcare so they can live their best life. Through your support, we improve patient care, grow our medical center's capacity, and provide state-of-the-art medical technology to serve patients in Hamilton and the surrounding communities. 8 5 0 0 0 0 221916 191433 9254 8672 588404 476456 -2181 6209 817393 682770 945304 240666 0 0 157246 161672 0 0 25054 149842 164189 1252392 566527 -434999 116243 9289675 7129634 921121 103734 8368554 7025900 Fort Hamilton Hospital Foundation serves donors by providing assistance in fulfilling philanthropic wishes and maintaining an efficient conduit for gifts to benefit The Fort Hamilton Hospital and its affiliated programs and facilities. 0 0 451744 240666 8672 Fort Hamilton Hospital Foundation contributed $240,666 throughout the year to support The Fort Hamilton Hospital and its affiliated programs and facilities. 451744 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 8 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Dann Hotelling 9377621629 1 Prestige Place Suite 910 Miamisburg OH 45342 Mewhirter Michael KH CFO until Nov 22, Interim CEO until July 23, CA 1.00 50.00 X 0 1013346 113016 Hoover Paul President KHHM 1.00 50.00 X X 0 527916 81306 Lewis John Rev Community Volunteer 1.00 1.00 X 0 0 0 Reilman Linda MD Physician 1.00 1.00 X 0 0 0 Belew Joseph Community Volunteer 1.00 1.00 X 0 0 0 Quinn Denise Community Volunteer 1.00 X 0 0 0 Halcomb Todd Community Volunteer 1.00 X 0 0 0 Weigel Robert Community Volunteer 1.00 2.00 X 0 0 0 Chavez Steve VP Finance & Operations - KH Hamilton 1.00 50.00 X 0 460239 76258 Kranbuhl Sonja C Director FHHF 40.00 X 0 119307 30294 Connovich Ron Former Director 0.00 X 0 607313 40262 0 2728121 341136 0 1 1 0 0 78296 113137 191433 Fundraising 813211 8672 8672 8672 160053 160053 316403 0 316403 316403 316403 44250 78296 38041 6209 6209 682770 8672 0 482665 X 238066 238066 2600 2600 161672 129338 16167 16167 1670 1670 57832 57832 13348 10678 1335 1335 6895 1377 5346 172 8002 6402 800 800 6106 4885 610 611 215 172 21 22 52946 42356 5295 5295 Community Sponsorship 10650 10650 Hospitality 6445 5156 645 644 Membership 80 64 8 8 566527 451744 89729 25054 126342 10312 10100 1401 755312 136579 671678 618733 8481555 6499188 9289675 7129634 921121 103734 921121 103734 X 3925596 3062396 4442958 3963504 8368554 7025900 9289675 7129634 116243 -1458897 0 X X 0 1 X 1 0 X X 1 The Fort Hamilton Hospital 310536662 3 1 238066 0 1 238066 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 61944 626 62570 6094 6094 743816 132077 611739 5402 4502 900 618733 X Part X, Line 2: The System completed an analysis of its certain and uncertain tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2022 or 2021. Ticket to Hollywood 122546 78296 44250 7267 18900 11874 0 122546 78296 44250 7267 18900 11874 38041 6209 1 The Fort Hamilton Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310536662 501(c)(3) 238066 0 Support 1 0 Part I, Line 2: Internal records document donor intent for fund distribution. Funds are monitored and use is determined by board members. 1 1 0 0 0 0 0 0 0 Mewhirter Michael KH CFO until Nov 22, Interim CEO unt 0 817010 0 189750 0 6586 0 83432 0 29584 0 1126362 0 0 Hoover Paul President KHHM 0 420173 0 105900 0 1843 0 53099 0 28207 0 609222 0 0 Chavez Steve VP Finance & Operations - KH Hamilto 0 362948 0 91889 0 5402 0 47629 0 28629 0 536497 0 0 Connovich Ron Former Director 0 384676 0 138352 0 84285 0 16387 0 23875 0 647575 0 0 Part I, Line 3 Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. Part I, Lines 4a-b Ron Connovich received a severance payment of $607,313 and medical and retirement benefits of $40,262. Kettering Health has a supplemental executive retirement plan available only to a certain class of management. Part II, Col Biii Column Biii includes compensation reported on the W-2 that may or may not have gone through the current year Statement of Operations and Changes in Net Assets. Form 990, Part VI, Section B, line 11b A tax specialist is engaged to review the 990. The 990 is reviewed and accepted by the audit committee which reports this to the governing body (board). Form 990, Part VI, Section B, line 12c Kettering Health regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employees' annual reviews. Employees must certify that they have read the conflict of interest policy and have disclosed any potential conflicts and agree to immediately notify Corporate Integrity if one should arise. Board members are required to annually review Kettering Health's policy, sign a conflict of interest statement, and notify Kettering Health if a conflict should arise. Form 990, Part VI, Section B, line 15 Compensation is established by a related organization. The process of determining compensation of CEO's, executive directors, officers, and key employees is to have an independent board approve the compensation. The compensation is determined to be reasonable compared to independent comparability data. The approval of the amounts is documented in the Board minutes within the appropriate time frame. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Part IX, Lines 5, 7, 8, 9, & 10 Salaries, retirement plan contributions, other benefits, and payroll taxes are paid by and allocated from Kettering Medical Center and Kettering Network Services. Part XII, Line 2c Neither the oversight process nor the selection process changed during the tax year. Alliance Physicians Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311175717 Physician Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Beavercreek Medical Center 1 Prestige Place Suite 910 Miamisburg OH 45342 270712680 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Dayton Osteopathic Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310564121 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Greene Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 310886949 Fundraising OH 501(c)(3) 509(a)(3) Greene Memorial Hospital 0 Greene Memorial Hospital Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 310809436 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettering Adventist Healthcare 1 Prestige Place Suite 910 Miamisburg OH 45342 311051688 Management OH 501(c)(3) 509(a)(3) N/A 0 Kettering Affiliated Health Services Inc 1 Prestige Place Suite 910 Miamisburg OH 45342 311127485 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Independent Medical Group 1 Prestige Place Suite 910 Miamisburg OH 45342 272649285 Health Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 Kettering Medical Center 1 Prestige Place Suite 910 Miamisburg OH 45342 310621866 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Kettering Medical Center Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 237419897 Fundraising OH 501(c)(3) 509(a)(3) Kettering Medical Center 0 Kettering Network Services 1 Prestige Place Suite 910 Miamisburg OH 45342 832687866 Administrative Support Services OH 501(c)(3) 509(a)(3) Kettering Adventist Healthcare 0 The Fort Hamilton Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310536662 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 Kettering Adventist Healthcare M 0 FMV Kettering Medical Center M 0 FMV Kettering Medical Center N 0 FMV Kettering Medical Center O 0 FMV Kettering Medical Center P 0 FMV Kettering Network Services M 0 FMV Kettering Network Services N 0 FMV Kettering Network Services O 0 FMV Kettering Network Services P 0 FMV The Fort Hamilton Hospital B 238066 FMV The Fort Hamilton Hospital L 0 FMV The Fort Hamilton Hospital N 0 FMV Part V, Line 2 Kettering Medical Center and Kettering Network Services are conduits through which revenue is received and expenses are paid.