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Nonprofiteer
← JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL

Form 990 for tax year 2023

Filed by JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL.

Totals

Total revenue
$102,859,181
Total expenses
$96,470,628
Contributions and grants received
$1,542,114
Grants paid
$75,400
Program service revenue
$99,620,274
Investment income
$808,832
Other revenue
$887,961
Total assets, end of year
$85,266,230
Total liabilities, end of year
$28,026,690
Net assets or fund balances, end of year
$57,239,540
Program services expenses (Part IX)
$75,585,957
Management and general expenses
$20,733,833
Fundraising expenses
$150,838
Program service expenses (Part III)
$75,585,957

Program services were 78.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $349,097

  • 1e · Government grants (contributions)

    $1,188,587

  • 1f · All other contributions, gifts and grants

    $4,430

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $99,469,903 · related or exempt $99,469,903

  • 2b · Program service revenue: PASSTHROUGH INCOME

    total $150,371 · related or exempt $150,371

  • 3 · Investment income

    total $827,047 · excluded $827,047

  • 6a · Gross rents

    real property $892,111

  • 6b · Less rental expenses

    real property $532,561

  • 6c · Rental income or loss

    real property $359,550

  • 6d · Net rental income or loss

    total $359,550 · unrelated business -$17,659 · excluded $377,209

  • 7a · Gross sales of assets other than inventory

    other assets $20,977

  • 7b · Less cost or other basis and sales expenses

    other assets $39,192

  • 7c · Gain or loss

    other assets -$18,215

  • 7d · Net gain or loss

    total -$18,215 · excluded -$18,215

  • 11a · Other revenue: CAFETERIA AND VENDING SALES

    total $379,244 · excluded $379,244

  • 11b · Other revenue: HPSA INCENTIVES

    total $65,754 · related or exempt $65,754

  • 11c · Other revenue: OUTREACH

    total $41,597 · related or exempt $41,597

  • 11d · All other revenue

    total $41,816 · related or exempt $13,514 · unrelated business $17,558 · excluded $10,744

  • 11e · Other revenue, total

    $528,411

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $75,400 · program services $75,400

  • 5 · Compensation of officers, directors and key employees

    total $1,424,871 · management and general $1,424,871

  • 7 · Other salaries and wages

    total $21,862,701 · program services $17,920,555 · management and general $3,849,737 · fundraising $92,409

  • 8 · Pension plan contributions

    total $1,119,408 · program services $924,730 · management and general $190,055 · fundraising $4,623

  • 9 · Other employee benefits

    total $9,978,199 · program services $7,908,218 · management and general $2,030,440 · fundraising $39,541

  • 10 · Payroll taxes

    total $1,991,593 · program services $1,556,473 · management and general $427,339 · fundraising $7,781

  • 11b · Fees: legal

    total $117,528 · management and general $117,528

  • 11c · Fees: accounting

    total $98,050 · management and general $98,050

  • 11f · Fees: investment management

    total $61,682 · management and general $61,682

  • 11g · Fees: other

    total $26,036,691 · program services $22,389,389 · management and general $3,643,647 · fundraising $3,655

  • 12 · Advertising and promotion

    total $253,487 · program services $16,242 · management and general $237,245

  • 13 · Office expenses

    total $3,518,096 · program services $1,913,647 · management and general $1,602,547 · fundraising $1,902

  • 16 · Occupancy

    total $7,910,458 · program services $3,868,175 · management and general $4,042,283

  • 17 · Travel

    total $142,882 · program services $128,554 · management and general $13,401 · fundraising $927

  • 19 · Conferences, conventions and meetings

    total $667,745 · program services $567,472 · management and general $100,273

  • 20 · Interest

    total $476,967 · management and general $476,967

  • 22 · Depreciation, depletion and amortization

    total $4,415,101 · program services $3,355,477 · management and general $1,059,624

  • 23 · Insurance

    total $1,074,827 · management and general $1,074,827

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $10,141,622 · program services $10,141,622

  • 24b · Other expenses: BAD DEBT EXPENSE

    total $4,787,535 · program services $4,787,535

  • 24c · Other expenses: PHYSICIAN RECRUITMENT

    total $142,374 · management and general $142,374

  • 24d · Other expenses: AWARDS AND RECOGNITION

    total $72,926 · management and general $72,926

  • 24e · All other expenses

    total $100,485 · program services $32,468 · management and general $68,017

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $155,614 · end of year $355,882

  • 2 · Savings and temporary cash investments

    beginning of year $15,115,291 · end of year $16,992,626

  • 4 · Accounts receivable

    beginning of year $16,459,827 · end of year $15,762,956

  • 8 · Inventories for sale or use

    beginning of year $1,558,078 · end of year $1,494,730

  • 9 · Prepaid expenses and deferred charges

    beginning of year $1,648,414 · end of year $2,252,750

  • 10a · Land, buildings and equipment: cost or other basis

    $103,174,913

  • 10b · Land, buildings and equipment: accumulated depreciation

    $74,826,875

  • 10c · Land, buildings and equipment, net

    beginning of year $30,717,858 · end of year $28,348,038

  • 11 · Investments: publicly traded securities

    beginning of year $13,519,708 · end of year $15,068,508

  • 13 · Investments: program-related

    beginning of year $2,363,562 · end of year $2,766,361

  • 15 · Other assets

    beginning of year $4,731,014 · end of year $2,224,379

  • 17 · Accounts payable and accrued expenses

    beginning of year $7,472,597 · end of year $7,266,867

  • 20 · Tax-exempt bond liabilities

    beginning of year $2,307,693 · end of year $2,051,282

  • 23 · Secured mortgages and notes payable

    beginning of year $6,985,039 · end of year $6,496,557

  • 25 · Other liabilities

    beginning of year $12,127,889 · end of year $12,211,984

  • 27 · Net assets without donor restrictions

    beginning of year $57,376,148 · end of year $57,239,540

Mission and programs · 2023

Mission

THE MISSION OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL IS TO OPTIMIZE THE HEALTH STATUS OF THOSE WE SERVE BY PROVIDING THE HIGHEST QUALITY, VALUE AND SERVICE WHILE REMAINING FINANCIALLY STRONG.VISION: TO BE: THE REGION'S LEADER AND PREFERRED CHOICE FOR HEALTHCARE; THE MOST DESIRED PLACE FOR EMPLOYMENT; THE RECOGNIZED SOURCE FOR HEALTH AND WELLNESS; AND THE COORDINATOR OF PATIENT SERVICES THAT EXCEED THE SCOPE OF OUR HEALTH SYSTEM.VALUES: COMPASSION TO SERVE WITH DIGNITY, CONCERN, TRUST AND KINDNESS RESPECT FOR OUR PATIENTS, FAMILIES, COMMUNITIES AND EACH OTHER STEWARDSHIP MAKING THE BEST USE OF OUR HUMAN AND ECONOMIC RESOURCES SERVICE EXCELLENCE ANTICIPATING CUSTOMER NEEDS, CONTINUOUSLY IMPROVING AND CONSISTENTLY EXCEEDING EXPECTATIONS COLLABORATION TO WORK IN PARTNERSHIP, INTERNALLY AND EXTERNALLY, TO BETTER SERVE OUR COMMUNITIES WORKFORCE TO VALUE AND RESPECT THE TALENTED, COMMITTED AND DIVERSE PEOPLE WHO MAKE UP OUR HEALTH SYSTEM

Activities or mission (Part I)

SEE SCHEDULE O FOR THE MISSION STATEMENT

  • GRAND LAKE HEALTH SYSTEM AND AFFILIATED HEALTH CENTERS ARE ORGANIZED AS A CHARITABLE, NON-PROFIT COMMUNITY HOSPITAL OFFERING A WIDE RANGE OF PRIMARY, ACUTE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF THE GRAND LAKE REGION.THE ANCHOR OF GRAND LAKE HEALTH SYSTEM IS JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL (JTDMH) IN ST. MARYS OHIO. JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL OPENED ITS DOORS ON MAY 5, 1953 AND TODAY AS THE GRAND LAKE HEALTH SYSTEM, HAS GROWN TO A STATE-OF-THE-ART COMMUNITY HOSPITAL INCLUDING OVER 800 MEDICAL PROFESSIONALS, 200 + PHYSICIANS AND OVER 20 AFFILIATES.JTDMH IS LOCATED IN ST. MARYS (AUGLAIZE COUNTY), A RURAL SMALL-TOWN ENVIRONMENT DOMINATED BY AGRICULTURE AND MANUFACTURING. JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL'S CORE SERVICE AREA OF ST. MARYS, MINSTER, NEW BREMEN AND NEW KNOXVILLE ZIP CODES INCLUDES A POPULATION OF 24,600 WITH THE ADJACENT COMMUNITIES OF CELINA (ZIP CODE POPULATION OF 20,484) AND WAPAKONETA (POPULATION 18,438) ALSO BEING SERVED BY THE HOSPITAL. THE ABOVE COMMUNITIES ACCOUNT FOR OVER 80% OF JTDMH'S PATIENTS. THOSE ZIP CODES HAVE A TOTAL POPULATION OF 63,522 WITH 19% IN THE MEDICARE AGE GROUP (65+).JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL PROVIDES A FULL RANGE OF ACUTE AND OUTPATIENT SERVICES INCLUDING A 24-HOUR EMERGENCY ROOM AND OBSTETRICAL SERVICE. MAJOR SERVICES INCLUDE SURGICAL; MEDICAL; SKILLED NURSING UNIT; INPATIENT REHABILITATION UNIT; GERIATRIC PSYCHIATRIC UNIT; ICU/CCU; DIAGNOSTIC RADIOLOGY INCLUDING CT, MRI AND 3D MAMMOGRAPHY; PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY; OCCUPATIONAL MEDICINE; CARDIAC SERVICES; URGENT CARE; HOME HEALTH SERVICES; HOSPICE; WOUND CARE; HEARTBURN CENTER AND VEIN CLINIC SERVICES.THE GRAND LAKE SYSTEM COMMUNITY OUTREACH DEPARTMENT OFFERS A VARIETY OF OUTREACH PROGRAMS THAT PROMOTE GOOD HEALTH AMONG ALL AREA CITIZENS NOT JUST PATIENTS. THE GOAL IS TO EDUCATE PEOPLE SO THEY GAIN THE SKILLS AND KNOWLEDGE TO KEEP THEMSELVES AND THOSE AROUND THEM HEALTHY. MANY OF THE CLASSES, SERVICES, AND PROGRAMS HAVE EVOLVED FROM A SUGGESTION BY A HEALTHCARE PROVIDER OR LOCAL RESIDENT. THE OUTREACH DEPARTMENT OFFERS HUNDREDS OF PROGRAMS A YEAR RANGING FROM BLOOD PRESSURE SCREENINGS, SUPPORT GROUPS, SCHOOL PROGRAMS, AND COMMUNITY HEALTH FAIRS TO NAME A FEW. DURING 2023, JTDMH PROVIDED SERVICES TO THE FOLLOWING BY CATEGORY:ACUTE PATIENTS ADMITTED: 1,656SNF PATIENTS ADMITTED: 90INPATIENT PSYCH PATIENTS ADMITTED: 177BIRTHS: 323OUTPATIENT VISITS: 79,286 E.R. VISITS: 11,979HOME HEALTH VISITS: 4,972OCCUPATIONAL HEALTH VISITS: 10,349URGENT CARE VISITS: 6,374JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL AND GRAND LAKE HEALTH SYSTEM IS THE HUB OF THE LOCAL HEALTH CARE DELIVERY SYSTEM IN ST. MARYS AND SURROUNDING COMMUNITIES. THE NON-PROFIT COMMUNITY HOSPITAL ALSO HAS A MAJOR ECONOMIC IMPACT ON THE LOCAL COMMUNITY BY PROVIDING EMPLOYMENT TO APPROXIMATELY 800 INDIVIDUALS. THE GRAND LAKE HEALTH SYSTEM INCLUDES PHYSICIAN PRACTICES AND FACILITIES IN CELINA, ST. MARYS, WAPAKONETA, AND MINSTER. IN 2023, THESE PRACTICES HAD 94,629 PATIENT VISITS.GRAND LAKE AFFILIATES INCLUDE: JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL GRAND LAKE FAMILY PRACTICE & PEDIATRICS AT THE CELINA MEDICAL CENTER WAPAKONETA PRIMARY CARE AT THE WAPAKONETA MEDICAL CENTER GRAND LAKE FOOT & ANKLE CENTER GRAND LAKE HOME HEALTH GRAND LAKE HOSPICE GRAND LAKE PRIMARY CARE AT ST. MARYS GRAND LAKE OB/GYN GRAND LAKE OCCUPATIONAL MEDICINE GRAND LAKE REHAB & WELLNESS CENTER GRAND LAKE HEARTBURN CENTER MIAMI & ERIE FAMILY PRACTICE & PEDIATRICS GRAND LAKE SLEEP CENTER NEW DAY PAIN MANAGEMENT CENTER GRAND LAKE NEUROLOGICAL CENTER VANAN ENT & SINUS CENTER JTDMH TRANSITIONAL CARE UNIT JTDMH INPATIENT REHAB UNIT AUGLAIZE + MERCER GENERAL & BARIATRIC SURGERY AUGLAIZE + MERCER GENERAL SURGERY URGENT CARE AT JTDMH INPATIENT PSYCHIATRIC CENTER CANCER CENTER OF NORTHWEST OHIO GRAND LAKE PEDIATRICS KEMMLER ORTHOPAEDIC MOR REHAB CIAO MED SPA MARIA STEIN FAMILY PRACTICE GRAND LAKE UROLOGYWE HAVE INVESTED SIGNIFICANTLY IN THE BUILDING DURING THE PAST TEN YEARS INCLUDING COMPLETING A NEW WOMEN'S CENTER, LABORATORY, WOUND CARE CENTER WITH TWO HYPERBARIC CHAMBERS, A NEUROLOGY CENTER, SLEEP CENTER, THE MIAMI & ERIE MEDICAL CENTER IN MINSTER, AND COMPLETE MODERIZATION OF THE HOSPITAL ELEVATORS. IN CONJUNCTION WITH PREMIER HEALTH, GRAND LAKE HEALTH SYSTEM ENTERED INTO A TEN-YEAR NAMING RIGHTS PARTNERSHIP WITH THE AUGLAIZE MERCER FAMILY YMCA LOCATED IN MINSTER & CELINA. THIS PARTNERSHIP FOCUSES ON MEETING THE NEEDS OF THOSE SERVED BY EXTENDING THE MUTUAL MISSION TO BUILD HEALTHY COMMUNITIES.JTDMH RECEIVED THE FOLLOWING CERTIFICATIONS AND WAS THE RECIPIENT OF THE FOLLOWING AWARDS IN THE PAST THREE YEARS. ACUTE CARE 2023 DNV HEART FAILURE CERTIFICATIONBIRTHING CENTER 2021 ANTHEM BLUE DISTINCTION 2021 OHIO FIRST STEPS FOR HEALTHY BABIES, THREE STAR AWARD 2022 OHIO FIRST STEPS FOR HEALTHY BABIES, FOUR STAR AWARD 2023 BLUE DISTINCTION CENTER + FOR MATERNITY CARECARDIAC REHAB 2021 INTENSIVE CARDIAC REHAB NEW SERVICE 2023 AACVPR CARDIAC REACCREDITATIONCHAMBER AWARDS 2023 NON-PROFIT ORGANIZATION OF THE YEAROHIO DEPARTMENT OF HEALTH - HEALTHY WORKSITE AWARDS 2021 HEALTHY WORKSITE GOLD AWARD 2022 HEALTHY WORKSITE PLATINUM AWARD 2023 HEALTHY WORKSITE PLATINUM AWARDCOMMUNITY OUTREACH AWARDS 2023 AWARDED WAPAKONETA AREA COMMUNITY FOUNDATION GRANT FOR 2023 GRAND HEALTH CHALLENGE DIABETIC EDUCATION & CLINICAL NUTRITION 2021-2027 OUTPATIENT DIABETES SELF-MANAGEMENT EDUCATION PROGRAM, CERTIFICATE OF RECOGNITION FOR MEETING NATIONAL STANDARDS, FROM AMERICAN DIABETES ASSOCIATION (CONTINUED RECOGNITION SINCE 2008) 2021-2024 CDC FULL RECOGNITION FOR DIABETES PREVENTION PROGRAM EMERGENCY DEPARTMENT 2021 DNV ACUTE STROKE READY CERTIFICATION 2023 WOMEN'S CHOICE AWARD BEST HOSPITAL FOR EMERGENCY CARE Q12023, Q22023 & Q32023 PREMIER HEALTH DOOR TO NEEDLE CHALLENGE WINNERINPATIENT PSYCHIATRIC CENTER 2021 ODMHAS SURVEY DEFICIENCY FREE SURVEY 2022 HORIZON HEALTH CLINICAL PROGRAM OF THE YEAR HOME HEALTH & HOSPICE AWARDS 2022 CMS COMPARE QUALITY REFRESH REPORT FOR GRAND LAKE HOSPICE 5 STARS 2023 NATIONAL BEST PRACTICE AGENCY BY WELLSKYMEDICAL IMAGING 2021 ACR REACCREDITATION IN MRI 2021 ACR REACCREDITATION IN CT 2021-2024 ACR ACCREDITATION IN 3D MAMMOGRAPHY 2022-2025 ACR REACCREDITATION IN MRI 2022-2025 ACR REACCREDITATION IN CTNEW VISION MEDICAL LABORATORY 2021 RECERTIFICATION BY HFAP 2021-2023 RECERTIFICATION BY ACCREDITATION COMMISSION FOR HEALTH CARE (ACHC) 2023-2025 RECERTIFICATION BY ACHCPATIENT SAFETY 2023 WOMEN'S CHOICE AWARD BEST HOSPITAL FOR PATIENT SAFETYSLEEP 2021 AASM SLEEP CENTER REACCREDITATION TRANSITIONAL CARE UNIT 2021 5-STAR MEDICARE COMPARE FACILITY 2022 5-STAR MEDICARE COMPARE FACILITY 2023 5-STAR MEDICARE COMPARE FACILITYWOUND CARE CENTER 2021 ROBERT A WARRINER III, MD CENTER OF EXCELLENCE AWARD 2021 CENTER OF DISTINCTION AWARD 2021 PRESIDENT'S CIRCLE AWARD 2022 CENTER FOR DISTINCTION 2022 ROBERT A WARRINER III, MD CENTER OF EXCELLENCE AWARD 2023 ROBERT A WARRINER III, MD CENTER OF EXCELLENCE AWARD 2023 ROBERT A WARRINER III, MD CLINICAL EXCELLENCE AWARD 2023 ROBERT A WARRINER III, MD CENTER OF DISTINCTION AWARDWELCOMED THE FOLLOWING PROVIDERS IN 2023:WHITNEY CLARK, APRN/CNMAMANDA PERRY, APRN/AGACNP-BCKRISTA HUBER, PA-CALEXANDER MAST, D.O.JENNIFER OLIVER, APRN/FNP-CJAMES SCHWIETERMAN, M.D.

    Expenses $75,585,957 · Grants $75,400 · Revenue $99,741,139

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Rajendra Kakarla

    DIRECTOR

    Total calculated
    $41,208
    From this org
    $41,208
    From related orgs
    $0
    Other
    $0
    Hours/week
    15

  • Chris Shroer

    CHAIR

    Total calculated
    $0
    Hours/week
    2

  • Jeffrey Squire

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1.5

  • Claudia Coe

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Ken Fox

    DIRECTOR

    Total calculated
    $4,200
    From this org
    $4,200
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Issac Hoying

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Randall Niekamp

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Brian Schlosser

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Wally Wagner

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Cynthia Berning

    PRESIDENT

    Total calculated
    $513,263
    From this org
    $326,549
    From related orgs
    $149,042
    Other
    $37,672
    Hours/week
    24 + 21 related

    Schedule J breakdown matched by us

    Base
    $305,864 + $134,042 related
    Bonus
    $20,685 + $15,000 related
    Other
    $0
    Deferred
    $6,000
    Nontaxable benefits
    $30,635 + $1,037 related
    Filer's total
    $363,184 + $150,079 related

  • Tricia Pohl

    TREASURER

    Total calculated
    $283,632
    From this org
    $228,874
    From related orgs
    $0
    Other
    $54,758
    Hours/week
    38 + 7 related

    Schedule J breakdown matched by us

    Base
    $222,874
    Bonus
    $6,000
    Other
    $0
    Deferred
    $24,248
    Nontaxable benefits
    $30,510
    Filer's total
    $283,632

  • Leslie Wobler

    SECRETARY

    Total calculated
    $103,151
    From this org
    $70,308
    From related orgs
    $0
    Other
    $32,843
    Hours/week
    30 + 10 related

  • Lana Hinders

    CHIEF CLINICAL OFFICER

    Total calculated
    $255,748
    From this org
    $203,738
    From related orgs
    $0
    Other
    $52,010
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $197,738
    Bonus
    $6,000
    Other
    $0
    Deferred
    $21,545
    Nontaxable benefits
    $30,465
    Filer's total
    $255,748

  • Tyler Kroeger

    VP OF OPERATIONS

    Total calculated
    $207,556
    From this org
    $171,123
    From related orgs
    $0
    Other
    $36,433
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $166,123
    Bonus
    $5,000
    Other
    $0
    Deferred
    $6,000
    Nontaxable benefits
    $30,433
    Filer's total
    $207,556

  • Holly Jacomet

    VP OF QUALITY AND PHYSICIAN PRACTICES

    Total calculated
    $166,193
    From this org
    $162,059
    From related orgs
    $0
    Other
    $4,134
    Hours/week
    22.5 + 22.5 related

    Schedule J breakdown matched by us

    Base
    $157,059
    Bonus
    $5,000
    Other
    $0
    Deferred
    $3,134
    Nontaxable benefits
    $1,000
    Filer's total
    $166,193

  • Shelly Ruppert

    ED OF HUMAN RESOURCES

    Total calculated
    $223,328
    From this org
    $174,115
    From related orgs
    $0
    Other
    $49,213
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $171,115
    Bonus
    $3,000
    Other
    $0
    Deferred
    $18,816
    Nontaxable benefits
    $30,397
    Filer's total
    $223,328

  • Amy Dirksen

    ED OF SPECIALTY CARE SERVICES

    Total calculated
    $201,822
    From this org
    $155,282
    From related orgs
    $0
    Other
    $46,540
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $155,282
    Bonus
    $0
    Other
    $0
    Deferred
    $16,162
    Nontaxable benefits
    $30,378
    Filer's total
    $201,822

  • Lesia Arnett

    ED. OF DEVELOPMENT, MARKETING

    Total calculated
    $182,447
    From this org
    $147,508
    From related orgs
    $0
    Other
    $34,939
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $144,508
    Bonus
    $3,000
    Other
    $0
    Deferred
    $4,563
    Nontaxable benefits
    $30,376
    Filer's total
    $182,447

  • Lori Miller

    CHIEF OF INFORMATION SERVICES

    Total calculated
    $182,393
    From this org
    $139,533
    From related orgs
    $0
    Other
    $42,860
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $139,533
    Bonus
    $0
    Other
    $0
    Deferred
    $12,498
    Nontaxable benefits
    $30,362
    Filer's total
    $182,393

  • Marcus Bergman

    PHARMACIST

    Total calculated
    $174,582
    From this org
    $138,569
    From related orgs
    $0
    Other
    $36,013
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $138,569
    Bonus
    $0
    Other
    $0
    Deferred
    $5,658
    Nontaxable benefits
    $30,355
    Filer's total
    $174,582

  • Kevin Harlan

    FORMER PRESIDENT

    Total calculated
    $199,767
    From this org
    $0
    From related orgs
    $199,767
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $199,767 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $199,767 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL PROVIDES A PORTION OF YMCA DUES TO THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES; HOWEVER, THIS IS AN EMPLOYEE BENEFIT AVAILABLE TO ALL ELIGIBLE EMPLOYEES OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL TO PROMOTE COMMUNITY WELLNESS (ONE OF THE PEOPLE LISTED IN PART VII, SECTION A, LINE 1A RECEIVED THIS BENEFIT). THE YMCA DUES WERE NOT INCLUDED IN THE RECIPIENT'S COMPENSATION.
PART I, LINE 4B
KEVIN HARLAN, THE FORMER PRESIDENT, HAS RECEIVED A PAYOUT FROM THE NON QUALIFIED RETIREMENT PLAN OF $199,767 IN THE CURRENT YEAR DUE TO HIS DEPARTURE FROM JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. THE PLAN IS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN MAINTAINED BY A RELATED ORGANIZATION FOR KEY EMPLOYEES OF THE RELATED ORGANIZATION. THERE IS AN INCENTIVE BONUS PLAN AND A PRODUCTION COMPENSATION PLAN. VESTING HAPPENS OVER A 5 YEAR TIME FRAME IF THE CONTRIBUTION WAS MADE TO THE PRODUCTION COMPENSATION PLAN. THERE ARE CERTAIN CIRCUMSTANCES WHERE A PARTICIPANT WILL FORFEIT ANY AND ALL OF THE COMPANY CONTRIBUTIONS MADE INTO THE PLAN INCLUDING ENGAGING IN ACTIVITIES WHICH ARE DEEMED TO BE SIGNIFICANTLY COMPETITIVE WITH THE COMPANY WITHIN A 50 MILE RADIUS OF ANY EXISTING OFFICE, IF IT IS DEEMED THE PARTICIPANT ACTED IN A DISHONEST WAY, BREACHES HIS OR HER FIDUCIARY OBLIGATIONS, CONVICTED OF A FELONY INVOLVING SIGNIFICANT MORAL TURPITUDE, OR OTHER ACTS WHICH WOULD CAUSE THE COMPANY SUBSTANTIAL HARM.
PART I, LINE 7
EMPLOYEE'S BONUSES ARE DETERMINED AT THE DISCRETION OF THE PRESIDENT.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

  • JTD HOSPITAL FOUNDATION

    501(C)(3) · TO RAISE FUNDS FOR JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. · OH · controlled entity

    Directly controlled by JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • JTDMH PAIN MANAGEMENT LLC

    RELATED · PAIN MANAGEMENT SERVICES · OH · 51% owned · share of income $150,371 · share of assets $264,113 · general or managing partner

    Directly controlled by JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • JTDM FAMILY PRACTICE LLC

    C · PHYSICIANS PROVIDING MEDICAL SERVICES · OH · 100% owned · share of income -$7,561,834 · share of assets $8,445,564 · controlled entity

    Directly controlled by JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL

Provenance

Return type
form_990
Tax year
2023
Filed
13 November 2024
IRS schema version
2023v5.1
Source object
202433189349303613

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