2023-11-15T10:41:35-06:00 2022-12-31 310800053 Clark Schaefer Hackett & Co 10100 Innovation Drive Suite 400 Dayton OH 45342 990 2022-01-01 270712680 Beavercreek Medical Center BEAV 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 The Indu and Raj Soin Medical Center Daniel Tryon 1 Prestige Place Suite 910 Miamisburg OH 45342 264836112 0 X www.ketteringhealth.org X 2009 OH Our mission is to improve the quality of life of the people in the communities we serve through healthcare and education.We are dedicated to excellence and to providing each individual the most appropriate care in the most appropriate setting. In the spirit of the Seventh-day Adventist healthcare ministry, we strive to be innovative and to convey God's love in a caring environment. 13 4 0 260 3727 806 1678802 1440690 231613809 262473630 1360877 840510 0 0 234653488 264754830 9909 12985 0 0 89095707 98793520 0 0 0 131062628 161500653 220168244 260307158 14485244 4447672 315696444 290328286 284614854 274284399 31081590 16043887 To provide quality healthcare to individuals and the community as a whole in a Judeo-Christian manner 0 0 251585676 12985 257724640 Care was provided for 8,821 discharges, adult & ped days of 36,335, and 144,267 outpatient visits. 251585676 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 4 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 Manchur Fred CEO - KH until Dec 22 1.00 51.00 X 0 2385157 46619 Sackett Walter President KH until Oct 22 1.00 51.00 X 0 1166094 50463 Burns Terry EVP Chief Administration Officer until Oct-22 1.00 51.00 X 0 1148326 61238 Mewhirter Michael KH CFO until Nov 22, Interim CEO until July 23, CA 1.00 50.00 X 0 1013346 113016 Manchur Richard President of KHDO 1.00 51.00 X 0 783529 98787 Ko Tim Interim KH CFO 1.00 50.00 X 0 632119 85792 Smith Robert T Physician 1.00 37.00 X 0 582654 40601 Tryon Daniel W President Soin & KHGM 26.00 25.00 X X 0 454137 76159 Tyner Troy A Physician 1.00 39.00 X 0 264636 33927 Prutzman Cherish J Physician 1.00 39.00 X 0 226817 29547 Chew Roy Consultant 0.25 5.75 X 0 25000 11696 Weigley David Pres. Columbia Union Conference of SDA until 1/23 1.00 5.00 X 0 16000 0 Soin Amol MD Physician 1.00 1.00 X 0 0 0 Peebles Thomas Community Volunteer 1.00 2.00 X 0 0 0 Delthony Gordon Community Volunteer 1.00 1.00 X 0 0 0 Parker Phillip Pres, Dayton Chamber of Commerce 1.00 1.00 X 0 0 0 Villegas William CFO -Region #2 16.00 32.00 X 0 537915 84782 Fahey Aimee VP Patient Care Soin/KHGM 25.00 24.00 X 0 350000 69909 Dickason Martina M RN Resource Gold Option 40.00 X 292742 0 13624 Williams Eric A Medical Physicist MS Certified 40.00 X 210943 0 33913 Gruia Ovidiu E APRN 40.00 X 201727 0 33624 Gerhardt Jessica M RN Charge Nurse Leader 40.00 X 188699 0 8667 Kurapati Nikhil T Physician 40.00 X 187790 0 20179 Montes Josefer Former Director 0.00 X 0 307614 40874 Dodds Rick Former Director/Officer Jun 21 0.00 X 0 0 20109 1081901 9893344 973526 98 1 1 0 0 275867 1164823 1440690 Patient care services 622000 261431834 256686571 4745263 Leasing activities related to mis 531120 1038069 1038069 Reference lab 621500 3727 3727 262473630 896797 896797 24995 80858 424 -80858 24571 -56287 -56287 264754830 257724640 3727 5585773 X 12985 12985 3391916 2929004 462912 75720935 74150875 1570060 1902701 1863249 39452 12287741 12032957 254784 5490227 5376388 113839 40395 40395 2845 2845 30381 30381 25357053 24872861 484192 2372952 2353139 19813 433662 371536 62126 3722793 3722165 628 89560 74566 14994 80873 79999 874 7005034 7003851 1183 17039025 17036148 2877 679380 367958 311422 Medical supplies 41736319 41208149 528170 Network services 29824104 25753861 4070243 Physician services 20542973 20542973 Cost of goods sold 2970542 2970542 9572762 8822075 750687 260307158 251585676 8721482 0 104519 51184 29660729 32873642 3002365 3457310 2214502 650 337871746 127374679 223904468 210497067 56531425 41649131 278436 1799302 315696444 290328286 19487061 21830488 9095588 9143 248070909 245654151 7961296 6790617 284614854 274284399 X 31081590 16043887 31081590 16043887 315696444 290328286 X 4447672 -7061700 -12423675 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20671041 20671041 245866371 81303066 164563305 69480911 46071613 23409298 1853423 1853423 210497067 Estimated amounts due to third-party payors 2442557 Operating lease liabilities 1022924 Other long-term contracts 120000 Physician income guarantee commitments 157291 Professional self-insurance liability 3047845 6790617 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. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 3974374 1869191 2105183 0.00810 53277657 23962700 29314957 0.11260 57252031 25831891 31420140 0.12070 2339184 3166 2336018 0.00900 3299157 2625577 673580 0.00260 1292968 295061 997907 0.00380 59402 59402 0.00020 6990711 2923804 4066907 0.01560 64242742 28755695 35487047 0.13630 1 2078929 49894 39894429 44366250 -4471821 X 1 1 1 1 Soin Medical Center 3535 Pentagon Boulevard Beavercreek OH 45431 ketteringhealth.org/soin/ X X X X Soin Medical Center 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X https://ketteringhealth.org/about/community-health-needs/ X 1 22 1 https://ketteringhealth.org/about/community-health-needs/ 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X X 1 X https://ketteringhealth.org/billing-insurance/financial-assistance/ X https://ketteringhealth.org/billing-insurance/financial-assistance/ X https://ketteringhealth.org/billing-insurance/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Part V, Section A: The facility listed is required to be licensed, registered, or recognized as a healthcare facility under state law. Soin Medical Center Part V, Section B, Line 5: The Health Collaborative (THC), in partnership with the Greater Dayton Area Hospital Association (GDAHA), facilitated the 2021 Regional Community Health Needs Assessment (CHNA). This Regional CHNA includes 36 hospitals, 22 health departments, across 26 counties in southwest Ohio and the Greater Dayton Area, southeast Indiana, and northern Kentucky. Soin Medical Center Part V, Section B, Line 6a: Bon Secours Mercy Health Clermont HospitalBon Secours Mercy Health Fairfield HospitalBon Secours Mercy Health Jewish HospitalBon Secours Mercy Health West HospitalCincinnati Children's HospitalCincinnati Children's Burnet CampusCincinnati Children's Liberty CampusCincinnati Children's College Hill CampusThe C&F Lindner Center of HOPEThe Christ Hospital, Mt. AuburnTriHealth Good Samaritan HospitalTriHealth Good Samaritan Evendale HospitalTriHealth Bethesda North HospitalTriHealth Bethesda Butler HospitalTriHealth McCullough Hyde Memorial HospitalUC Health University of Cincinnati Medical CenterUC Health West Chester HospitalUC Health Drake Center for Post-Acute CareMiami Valley HospitalAtrium Medical CenterUpper Valley Medical CenterMiami Valley Hospital SouthMiami Valley Hospital NorthWilson Memorial HealthWayne HealthcareMercy Health Springfield Regional Medical CenterMercy Health Urbana HospitalAdams County Regional Medical CenterMargaret Mary Health Soin Medical Center Part V, Section B, Line 6b: The Health CollaborativeGreater Dayton Area Hospital AssociationCity Health Departments:City: Cincinnati, Hamilton (City), Norwood, Piqua, SpringdaleCounty: Adams, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Darke, Fayette,Greene, Hamilton, Highland, Miami, Montgomery, Preble, Shelby, WarrenCounty Health Departments:Indiana: Franklin, Dearborn, Ohio, Ripley, UnionKentucky: Campbell, Boone, Grant, KentonOhio: Adams, Auglaize, Brown, Butler, Champaign, Clark, Clermont, Clinton, Darke, Greene,Hamilton, Highland, Miami, Montgomery, Preble, Shelby, Warren Soin Medical Center Part V, Section B, Line 11: Soin Medical Center is addressing the significant needs identified in the Community Health Needs Assessment through support for Good Neighbor House, Cancer Support Group, Tobacco Cessation, OneFifteen, Work Force Development, Community Health Worker Training, Kettering Health Community Outreach, Miami Valley Leadership Foundation, Intensive Outpatient Program, Behavioral Health Support Model, HerStory, and Midwifery Care. 2 1 - Kettering Health Springfield 2300 N Limestone St Springfield OH 45503 Emergency, Outpatient Clinic, and Diagnostic Center 2 - Kettering Health Springfield Health Ctr 2100 Emmanuel Way Springfield OH 45502 Outpatient Clinic and Diagnostic Center Part I, Line 6a: The organization provides an annual community benefit report that is made available to the public. Part I, Line 7: Charity care is calculated using a cost to charge ratio following the methodology of Worksheet 2. Medical costs are calculated using a cost accounting system that addresses all patient segments. Community health improvement services are calculated on the basis of direct expenditures. Health professions education is calculated based on Medicare cost report. Subsidized health services is calculated based on the non-Medicare, Medicaid, and charity care proportion of departmental losses for the specific programs. Cash and in-kind contributions are calculated on the basis of direct expenditures. Part I, Line 7g: Subsidized health services represent the non-needs based and non-Medicare program losses of services the hospital offers. Part III, Line 2: The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Part III, Line 3: An industry average was used to estimate this amount. It was not included as part of community benefit. Part III, Line 4: Generally, patients who are covered by third-party payors are responsible for patient responsibility balances, including deductibles and coinsurance, which vary in amount. The System estimates the transaction price for patients with deductibles and coinsurance based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any explicit price concessions, discounts, and/or implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenue in the period of change. Part III, Line 8: The costing methodology used to determine Medicare costs is the Medicare cost report. Medicare costs have not been included in community benefit in Part I. Part III, Line 9b: Financial counselors establish a payment plan for any amount due after the Charity Sliding Scale Discounts are applied, upon individual request. Collection procedures consistent with self-pay accounts are applied to these balances. Kettering Health includes a financial assistance brochure in all patient information kits given at the time of intake or registration. Additional patient information kits are available, upon individual request. Part VI, Line 3: Soin Medical Center informs and educates patients or persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under Soin Medical Center's charity care policy as follows:-Soin Medical Center has a financial assistance brochure that is included in all of the patient information kits given at the time of intake or registration into any facility or department.-There is information posted in all of the admitting and registration areas about charity care and financial assistance.-During the registration process there is specific scripting to ask patients if they would like to disclose family size and income to screen them for federal/state/local and hospital based charity/assistance programs. This data is available for future visits as well.-Soin Medical Center has the reporting capability to review and screen any patient who may have been admitted during registration "off hours" for eligibility and assistance.- The Financial Assistance section on the back of patient statements contain the website associated to Financial Assistance, along with contact details for more information.-Soin Medical Center's patient account representatives in customer service screen patients that are unable to pay their bill for the various financial assistance programs. Part VI, Line 4: Kettering Health serves a population of approximately 1,620,000. The seven-county service area includes Butler, Clark, Greene, Miami, Montgomery, Preble, and Warren counties. The 88 counties in Ohio were ranked by County Health Rankings & Road Maps in terms of health outcomes and health factors. A top-ranked county (rank=1) has the best health score. The counties served by Kettering Health have health outcome ranks from 2-80. Part VI, Line 5: Soin Medical Center furthers its exempt purpose by promoting the health of the community by:-Retaining a Board of Directors with a majority (excluding employees and contractors) living in the primary service area;-Extending medical staff privileges to all qualified physicians in its community for a majority of its departments.-Utilizing surplus funds to help support ongoing improvements in patient care through equipment upgrades, acquisition of the most advanced medical technology, upgrades of existing hospital structures, and construction of new facilities in order to provide accessible, efficient, quality care. Part VI, Line 6: Soin Medical Center promotes the health of the communities served as described below:-Soin Medical Center, a part of Kettering Health, is dedicated to the creation and maintenance of community wellness programs, support groups, and health education programs. Soin Medical Center provides numerous screenings, family-focused classes, health fairs, conferences, donations, and education programs to ensure the long-term well-being of people living in the community.-Kettering Affiliated Health Services Inc includes Sycamore Glen Retirement Community which provides services to the surrounding communities which complement those services provided by Soin Medical Center as part of Kettering Health.-Medical research is supported through the Innovation Center, which cultivates new technologies and fosters best practices among partners from industry, academia and health care. Part VI, Line 7, Reports Filed With States OH 1 Assistance to employees for hardship 12 12985 FMV Part I, Line 2: Funds are monitored and use is determined by Human Resources management in conjunction with Greene Foundation management. 1 1 0 0 0 0 0 0 0 Manchur Fred CEO - KH until Dec 22 0 1633630 0 572738 0 178789 0 16387 0 30232 0 2431776 0 0 Sackett Walter President KH until Oct 22 0 878622 0 270000 0 17472 0 16387 0 34076 0 1216557 0 0 Burns Terry EVP Chief Administration Officer unt 0 880810 0 265356 0 2160 0 16387 0 44851 0 1209564 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 Manchur Richard President of KHDO 0 598381 0 182754 0 2394 0 69183 0 29604 0 882316 0 0 Ko Tim Interim KH CFO 0 515077 0 115560 0 1482 0 56448 0 29344 0 717911 0 0 Smith Robert T Physician 0 438834 0 138828 0 4992 0 17287 0 23314 0 623255 0 0 Tryon Daniel W President Soin & KHGM 0 362194 0 91080 0 863 0 47961 0 28198 0 530296 0 0 Tyner Troy A Physician 0 249636 0 15000 0 0 0 17287 0 16640 0 298563 0 0 Prutzman Cherish J Physician 0 201817 0 25000 0 0 0 14107 0 15439 0 256363 0 0 Villegas William CFO -Region #2 0 429994 0 104698 0 3223 0 55230 0 29552 0 622697 0 0 Fahey Aimee VP Patient Care Soin/KHGM 0 272071 0 76500 0 1429 0 41762 0 28147 0 419909 0 0 Dickason Martina M RN Resource Gold Option 292474 0 268 0 0 0 13624 0 0 0 306366 0 0 0 Williams Eric A Medical Physicist MS Certified 209858 0 1085 0 0 0 13359 0 20554 0 244856 0 0 0 Gruia Ovidiu E APRN 165748 0 30883 0 5096 0 11985 0 21639 0 235351 0 0 0 Gerhardt Jessica M RN Charge Nurse Leader 177168 0 10684 0 847 0 8419 0 247 0 197365 0 0 0 Kurapati Nikhil T Physician 187705 0 85 0 0 0 0 0 20179 0 207969 0 0 0 Montes Josefer Former Director 0 307614 0 0 0 0 0 16387 0 24487 0 348488 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 Walter Sackett received a severance payment of $168,487. Terry Burns received a severance payment of $144,238. Josefer Montes received a severance payment of $307,614. 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. A County of Greene Ohio 316000271 394650BV6 2009-11-03 97931091 Construct and equip a hospital 0 0 0 B County of Montgomery Ohio 316000172 613520LA1 2016-05-04 12087009 Hospital building improvements and equipment 0 0 0 C County of Miami Ohio 316000055 593328EW3 2019-03-07 85486838 Hospital facilities improvement and refunding 0 0 0 D County of Montgomery Ohio 316000172 613520MM4 2021-02-10 155352670 Hospital facilities improvement and refunding 0 0 0 A 100867503 9296792 2633592 1612304 85213731 2111084 2012 0 0 1 1 B 12087009 110713 11976296 2016 0 0 1 1 C 85486838 521348 4790564 80174926 2019 1 0 1 1 D 155352670 1021205 75000000 79331465 2021 0 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 D 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Fred Manchur Father of Director Richard Manchur 2431776 Compensation 0 Richard Manchur Son of Director Fred Manchur 882316 Compensation 0 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. Form 990, Part XI, line 9: Net transfers to affiliate -12,423,675. 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 Dayton Osteopathic Hospital 1 Prestige Place Suite 910 Miamisburg OH 45342 310564121 Hospital OH 501(c)(3) 509(a)(1) Kettering Adventist Healthcare 0 Fort Hamilton Hospital Foundation 1 Prestige Place Suite 910 Miamisburg OH 45342 452036966 Fundraising OH 501(c)(3) 509(a)(3) The Fort Hamilton Hospital 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 Kettcor 1 Prestige Place Suite 910 Miamisburg OH 45342 311078381 Health Services OH N/A C 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 Alliance Physicians Inc J 590213 FMV Alliance Physicians Inc M 0 FMV Dayton Osteopathic Hospital J 325661 FMV Greene Foundation C 275867 FMV Greene Foundation M 0 FMV Greene Memorial Hospital Inc O 0 FMV 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 Medical Center R 12423675 FMV Kettering Network Services J 37819 FMV Kettering Network Services K 930673 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 Part V, Line 2 Kettering Medical Center and Kettering Network Services are conduits through which revenue is received and expenses are paid.