2025-11-14T17:13:08-06:00 2024-12-31 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 270712680 BEAVERCREEK MEDICAL CENTER BEAV 9377621629 1 PRESTIGE PLACE 910 MIAMISBURG OH 45342 TIMOTHY KO CFO KH 9377621629 2025-11-12 1 1 AMY CIMINELLO P00796388 6148493000 2025-11-12 2024 2025-03-06 01:10:19Z THE INDU AND RAJ SOIN MEDICAL CENTER DANIEL TRYON 1 PRESTIGE PLACE 910 MIAMISBURG OH 45342 292795704 0 X WWW.KETTERINGHEALTH.ORG X 2009 OH OUR MISSION IS TO LIVE GOD'S LOVE BY PROMOTING AND RESTORING HEALTH. 14 8 0 267 7767 2116 253372 221796 288298454 292569613 1487415 1831 0 0 290039241 292793240 10875 12546 0 0 106423267 109979831 0 0 0 170654637 172723572 277088779 282715949 12950462 10077291 290278016 273927417 273381909 269652068 16896107 4275349 OUR MISSION IS TO LIVE GOD'S LOVE BY PROMOTING AND RESTORING HEALTH. 0 0 272910123 12546 286690924 CARE WAS PROVIDED FOR 10,240 DISCHARGES, ADULT & PED DAYS OF 40,682, AND 171,547 OUTPATIENT VISITS. 272910123 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 X 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X TIMOTHY KO 9377621629 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 MICHAEL V GENTRY CEO 1.00 49.00 X X 0 1906322 190042 TIMOTHY KO CFO - KH 1.00 49.00 X X 0 790319 101139 TAMARA THOMAS DIRECTOR 1.00 8.00 X 0 0 0 JOHN SACKETT DIRECTOR 1.00 8.00 X 0 0 0 MARCELLUS ROBINSON DIRECTOR 1.00 8.00 X 0 0 0 ADELE RILEY DIRECTOR 1.00 7.00 X 0 0 0 ROBERT PATTERSON DIRECTOR 1.00 8.00 X 0 0 0 LES NEFF DIRECTOR 1.00 8.00 X 0 0 0 KEISHA BONE DIRECTOR 1.00 8.00 X 0 0 0 ROBERT WEIGEL DIRECTOR 1.00 8.00 X 0 0 0 PHIL PARKER DIRECTOR - PART YEAR 1.00 1.00 X 0 0 0 RANDY TANGUAY DIRECTOR - PART YEAR 1.00 8.00 X 0 0 0 ROY SIMPSON DIRECTOR - PART YEAR 1.00 8.00 X 0 0 0 LOUIE SHARALAYA DIRECTOR - PART YEAR 1.00 7.00 X 0 0 0 DELTHONY GORDON DIRECTOR - PART YEAR 1.00 1.00 X 0 0 0 TERRY FORDE DIRECTOR - PART YEAR 1.00 8.00 X 0 0 0 ROBERT T SMITH DIRECTOR - PART YEAR 1.00 44.00 X 0 622995 36694 AMOL SOIN DIRECTOR - PART YEAR 1.00 1.00 X 0 0 0 THOMAS PEEBLES DIRECTOR - PART YEAR 1.00 7.00 X 0 0 0 CELESTE BLYDEN DIRECTOR - PART YEAR 1.00 6.00 X 0 0 0 KEVIN SHARRETT DIRECTOR/PHYSICIAN 1.00 44.00 X 0 586263 20569 CHERISH J PRUTZMAN DIRECTOR/PHYSICIAN 1.00 44.00 X 0 232913 31021 TROY A TYNER DIRECTOR/PHYSICIAN 1.00 44.00 X 0 304212 30134 SARAH HEDRICK DIRECTOR/PHYSICIAN - PART YEAR 1.00 44.00 X 0 140058 10344 JONATHAN E VELASCO DIRECTOR/PHYSICIAN - PART YEAR 1.00 44.00 X 0 703405 35658 DANIEL W TRYON PRESIDENT - KH SOIN/KH GM 24.00 26.00 X X 0 425296 69286 WENDI L BARBER CFO - ACUTE CARE 10.00 40.00 X 0 674097 87547 WILLIAM E VILLEGAS CFO - SOIN/GM - PART YEAR 24.00 26.00 X 0 273437 6638 HARMAT G BEEBE CFO - SOIN/GM/DAYTON 17.00 33.00 X 0 68774 3246 DANIEL A WOLCOTT PRESIDENT - KH ACUTE CARE 10.00 40.00 X 0 884799 110697 AIMEE J FAHEY VP PATIENT CARE - SOIN/GM 25.00 25.00 X 0 334259 60262 MICHAEL MEWHIRTER FORMER CEO/CAO - PART YEAR 0.00 50.00 X 0 1154725 6409 WALTER J SACKETT FORMER OFFICER/DIRECTOR 0.00 0.00 X 0 578513 11192 TERRANCE BURNS FORMER OFFICER/DIRECTOR 0.00 0.00 X 0 552825 0 0 10233212 810878 0 1 1 0 0 221796 221796 PATIENT SERVICE REVENUE 622000 291333270 285462348 5870922 RENT TO AFFILIATES 531120 1228576 1228576 REFERENCE LAB 621500 7272 7272 CATERING REVENUE 722320 495 495 292569613 145 145 4150 2464 1686 1686 1686 292793240 286690924 7767 5872753 12546 12546 88176741 87063978 1112763 2027226 2001643 25583 13407689 13238488 169201 6368175 6287810 80365 2548 1201 1347 3130 3130 18915094 18697691 217403 95 95 3036395 3023151 13244 362432 345885 16547 3645564 3645564 98547 88618 9929 122419 122419 7143115 7143115 20164333 20164333 1616089 1175158 440931 MEDICAL SUPPLIES 44412706 44410865 1841 NETWORK SERVICES 41546865 34393477 7153388 PHYSICIAN SERVICES 23658212 23658212 COST OF GOODS SOLD 3818341 3818341 4177687 3617533 560154 282715949 272910123 9805826 0 37160359 36130631 5331906 5635897 1668552 77451 395984322 166278864 245036994 229705458 0 1644761 1080205 733219 290278016 273927417 22530975 21660029 2520 2301 239756458 234261691 11091956 13728047 273381909 269652068 X 16896107 4275349 16896107 4275349 290278016 273927417 X 10077291 -22698049 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22435214 22435214 298344045 111009955 187334090 73373347 55268909 18104438 1831716 1831716 229705458 THIRD PARTY PRIOR YEAR SETTLEMENTS 9903856 PROFESSIONAL LIABILITY ACCRUAL 3347109 INCOME GUARANTEE COMMITMENT 13333 LEASE LIABILITY 463749 13728047 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, 2024 OR 2023. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 0 4867885 2839777 2028108 0.00720 52418522 30210431 22208091 0.07860 57286407 33050208 24236199 0.08580 48076 4855 43221 0.00020 3557191 2624751 932440 0.00330 8703667 7289443 1414224 0.00500 12308934 9919049 2389885 0.00850 69595341 42969257 26626084 0.09430 1 17610179 422644 43764670 41464248 2300422 X 1 0 1 1 SOIN MEDICAL CENTER 3535 PENTAGON BLVD BEAVERCREEK OH 45431 KETTERINGHEALTH.ORG X X X X SOIN MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 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 2021/2022 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 COLLABORATIVE GREATER DAYTON AREA HOSPITAL ASSOCIATION CITY 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, WARREN COUNTY 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. 3 1 - KETTERING HEALTH SPRINGFIELD 2300 N LIMESTONE ST SPRINGFIELD OH 45503 EMERGENCY, OUTPATIENT CLINIC, AND DIAGNOSTIC CENTER 2 - KETTERING HEALTH SPRINGFIELD HEALTH CT 2100 EMMANUEL WAY SPRINGFIELD OH 45502 OUTPATIENT CLINIC AND DIAGNOSTIC CENTER 3 - KETTERING HEALTH WILMINGTON HEALTH CTR 1500 ROMBACH AVE WILMINGTON OH 45177 OUTPATIENT CLINIC AND DIAGNOSTIC CENTER 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 VI, LINE 2: SOIN MEDICAL CENTER, AS PART OF KETTERING HEALTH, HAS DEDICATED AN ENTIRE DEPARTMENT TO COMMUNITY HEALTH AND WELLNESS. THE COMMUNITY OUTREACH DEPARTMENT IS COMPRISED OF COORDINATORS WHO DEVELOP PROGRAMS, SCREENINGS AND OTHER HEALTH RELATED EVENTS. THE DEPARTMENT ALSO HAS FITNESS SPECIALISTS, NURSES, DIETITIANS, MASSAGE AND BEHAVIORAL THERAPISTS, A COMMUNICATION SPECIALIST, HEALTH COACHES, A PHYSICIAN MEDICAL DIRECTOR, A FULL SERVICE CALL CENTER, AND MANY OTHER RESOURCE PERSONNEL. 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 1,635,000. 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 OF 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 ASDESCRIBED BELOW:- SOIN MEDICAL CENTER, AS 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 NUMEROUSSCREENINGS, 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 PROVIDES SENIOR LIVING 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 15 12546 0 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 MICHAEL V GENTRY CEO 0 1717488 0 139500 0 49334 0 175252 0 14790 0 2096364 0 0 MICHAEL MEWHIRTER FORMER CEO/CAO - PART YEAR 0 293591 0 205150 0 655984 0 0 0 6409 0 1161134 0 325259 DANIEL A WOLCOTT PRESIDENT - KH ACUTE CARE 0 834287 0 47881 0 2631 0 96296 0 14401 0 995496 0 0 TIMOTHY KO CFO - KH 0 727793 0 61291 0 1235 0 86687 0 14452 0 891458 0 0 WENDI L BARBER CFO - ACUTE CARE 0 578319 0 72869 0 22909 0 72757 0 14790 0 761644 0 0 JONATHAN E VELASCO DIRECTOR/PHYSICIAN - PART YEAR 0 599916 0 98926 0 4563 0 19687 0 15971 0 739063 0 0 ROBERT T SMITH DIRECTOR - PART YEAR 0 386665 0 74275 0 162055 0 19687 0 17007 0 659689 0 0 KEVIN SHARRETT DIRECTOR/PHYSICIAN 0 338186 0 180860 0 67217 0 16237 0 4332 0 606832 0 0 WALTER J SACKETT FORMER OFFICER/DIRECTOR 0 0 0 0 0 578513 0 0 0 11192 0 589705 0 0 TERRANCE BURNS FORMER OFFICER/DIRECTOR 0 0 0 0 0 552825 0 0 0 0 0 552825 0 0 DANIEL W TRYON PRESIDENT - KH SOIN/KH GM 0 375969 0 48307 0 1020 0 54940 0 14346 0 494582 0 0 AIMEE J FAHEY VP PATIENT CARE - SOIN/GM 0 287796 0 42195 0 4268 0 45969 0 14293 0 394521 0 0 TROY A TYNER DIRECTOR/PHYSICIAN 0 288238 0 8910 0 7064 0 18512 0 11622 0 334346 0 0 WILLIAM E VILLEGAS CFO - SOIN/GM - PART YEAR 0 205066 0 59427 0 8944 0 0 0 6638 0 280075 0 0 CHERISH J PRUTZMAN DIRECTOR/PHYSICIAN 0 232355 0 0 0 558 0 13814 0 17207 0 263934 0 0 SARAH HEDRICK DIRECTOR/PHYSICIAN - PART YEAR 0 124808 0 15000 0 250 0 7376 0 2968 0 150402 0 0 PART I, LINE 3 CEO COMPENSATION IS PAID BY PARENT ORGANIZATION, KETTERING ADVENTIST HEALTHCARE. AN INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE REVIEWS AN INDEPENDENT FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. COMPENSATION IS DETERMINED TO BE COMMITTEE MEETING. AT YEAR END, THE ACTUAL COMPENSATION IS COMPARED TO CONSULTANT'S REPORT THAT IDENTIFIES THE CURRENT AND PROPOSED COMPENSATION REASONABLE, AND THE APPROVAL AMOUNT IS DOCUMENTED IN THE MINUTES OF THE APPROVED COMPENSATION BY THE EXECUTIVE COMPENSATION COMMITTEE. PART I, LINES 4A-B THE FOLLOWING PEOPLE LISTED ON PART VII RECEIVED SEVERANCE DURING 2024: WALTER SACKETT - $578,513 MICHAEL MEWHIRTER- $297,348 TERRANCE BURNS - $552,825 ROBERT T. SMITH -$152,358 KETTERING HEALTH HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AVAILABLE ONLY TO A CERTAIN CLASS OF MANAGEMENT. IN 2024, THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: MICHAEL MEWHIRTER - $325,259 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 BUILDINGS AND IMPROVEMENTS AND EQUIPMENT 0 0 0 C COUNTY OF MIAMI OHIO 316000055 593328EW3 2019-03-07 85486838 HOSPITAL FACILITIES IMPROVEMENTS AND REFUNDING 0 0 0 D COUNTY OF MONTGOMERY OHIO 316000172 613520MM4 2021-02-10 155352670 HOSPITAL FACILITIES IMPROVEMENTS AND REFUNDING 0 0 0 A 100867503 9296792 2633592 1612304 85213731 2111084 2021 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 JESSICA NEFF FAMILY MEMBER OF LES NEFF (BOARD MEMBER) 16176 W-2 COMPENSATION 0 BREANNA SHARRETT FAMILY MEMBER OF KEVIN SHARRETT 23609 W-2 COMPENSATION 0 PART V, LINE 1A ALL 1099 FORMS FOR KETTERING ADVENTIST HEALTHCARE AND RELATED ENTITIES ARE FILED UNDER KETTERING NETWORK SERVICES. FEIN 83-2687866. FORM 990, PART VI, SECTION A, LINE 6 KETTERING ADVENTIST HEALTHCARE IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF KETTERING ADVENTIST HEALTHCARE HAVE THE POWER TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A TAX SPECIALIST IS ENGAGED TO REVIEW THE 990, AND A COPY OF THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C KETTERING HEALTH REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS 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 DISCLOSURE FORM, AND NOTIFY KETTERING HEALTH IF A CONFLICT SHOULD ARISE. SENIOR LEADERS ARE ALSO REQUIRED TO COMPLETE CONFLICT OF INTEREST DISCLOSURE FORMS ANNUALLY. KETTERING HEALTH'S CORPORATE INTEGRITY DEPARTMENT REVIEWS CONFLICT OF INTEREST DISCLOSURES AND DETERMINES THE APPROPRIATE ACTION(S) TO RESOLVE THE CONFLICT, WHICH MAY INCLUDE RECUSAL FROM CERTAIN DISCUSSIONS OR DECISIONS, JOB REASSIGNMENT, ETC. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION TO EXECUTIVES ARE PAID AND REVIEWED BY THE PARENT ORGANIZATION, KETTERING ADVENTIST HEALTHCARE. AN INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE REVIEWS AN INDEPENDENT CONSULTANT'S REPORT THAT IDENTIFIES THE CURRENT AND PROPOSED COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. COMPENSATION IS DETERMINED TO BE REASONABLE, AND THE APPROVAL AMOUNT IS DOCUMENTED IN THE MINUTES OF THE COMMITTEE MEETING. AT YEAR END, THE ACTUAL COMPENSATION IS COMPARED TO APPROVED COMPENSATION BY THE EXECUTIVE COMPENSATION COMMITTEE. THE COMPENSATION REVIEW PROCESS WAS LAST UNDERTAKEN IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET TRANSFER TO AFFILIATES -22,698,049. ALLIANCE PHYSICIANS INC 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 311175717 PHYSICIANS SERVICES OH 501(C)(3) LINE 12B, II KETTERING ADVENTIST HEALTHCARE 0 DAYTON OSTEOPATHIC HOSPITAL 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 310564121 HOSPITAL OH 501(C)(3) LINE 3 KETTERING ADVENTIST HEALTHCARE 0 FORT HAMILTON HOSPITAL FOUNDATION 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 452236966 FUNDRAISING OH 501(C)(3) LINE 12B, II FORT HAMILTON HOSPITAL 0 GREENE MEMORIAL HOSPITAL INC 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 310809436 HOSPITAL OH 501(C)(3) LINE 3 KETTERING ADVENTIST HEALTHCARE 0 KETTERING ADVENTIST HEALTHCARE 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 311051688 MANAGEMENT OH 501(C)(3) LINE 12B, II N/A 0 KETTERING AFFILIATED HEALTH SERVICES INC 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 311127485 HEALTH SERVICES OH 501(C)(3) LINE 12B, II KETTERING ADVENTIST HEALTHCARE 0 KETTERING INDEPENDENT MEDICAL GROUP 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 272649285 HEALTH SERVICES OH 501(C)(3) LINE 12B, II KETTERING ADVENTIST HEALTHCARE 0 KETTERING MEDICAL CENTER 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 310621866 HOSPITAL OH 501(C)(3) LINE 3 KETTERING ADVENTIST HEALTHCARE 0 KETTERING MEDICAL CENTER FOUNDATION 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 237419897 FUNDRAISING OH 501(C)(3) LINE 12B, II KETTERING MEDICAL CENTER 0 KETTERING NETWORK SERVICES 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 832687866 ADMINISTRATIVE SUPPORT SERVICES OH 501(C)(3) LINE 12B, II KETTERING ADVENTIST HEALTHCARE 0 THE FORT HAMILTON HOSPITAL 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 310536662 HOSPITAL OH 501(C)(3) LINE 3 KETTERING ADVENTIST HEALTHCARE 0 GREENE FOUNDATION 1 PRESTIGE PLACE SUITE 910 MIAMISBURG OH 45342 310886949 FUNDRAISING OH 501(C)(3) LINE 12B, II GREENE MEMORIAL HOSPITAL 0 GRANDVIEW FOUNDATION 405 W GRAND AVENUE DAYTON OH 45405 311649591 FUNDRAISING OH 501(C)(3) LINE 12A, I N/A 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