2024-11-01T07:38:05-05:00 2023-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-01-01 311674981 HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORP HIGH 9373936100 1275 N HIGH ST HILLSBORO OH 451338512 MEGHANN ACKLEY VP FINANCE 9378406617 2024-11-01 1 0 TYLER K GREENE CPA P00057872 3176334705 2024-11-01 2023 2024-10-15 13:58:12Z TIM PARRY 1275 N HIGH ST HILLSBORO OH 451338512 5608784 0 X N/A X 2000 OH THE MISSION OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION IS TO SERVE THE COMMUNITY BY PROVIDING ACCESSIBLE, EFFICIENT, QUALITY HEALTH CARE IN AN ATMOSPHERE OF SAFETY, COMPASSION, AND EXCELLENCE. 10 10 16 10 0 0 1674472 2600000 1686900 2987634 0 0 6062 7544 3367434 5595178 0 0 0 0 2333000 2568700 0 0 0 990712 2765450 3323712 5334150 43722 261028 881829 1155840 276732 289715 605097 866125 THE MISSION OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION IS TO SERVE THE COMMUNITY BY PROVIDING ACCESSIBLE, EFFICIENT, QUALITY HEALTH CARE IN AN ATMOSPHERE OF SAFETY, COMPASSION, AND EXCELLENCE. 0 0 5334150 2987638 HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION ENGAGES IN THE PRACTICE AND PROFESSIONAL SERVICES OF MEDICINE. HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION SAW 11,281 VISITS IN 2023. 5334150 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 16 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 0 1 0 X MEGHANN ACKLEY 9373936100 1275 N HIGH ST HILLSBORO OH 451338512 LARRY PARKER PRESIDENT 0.25 0.25 X X 0 0 0 PHILLIP WILSON PHD TREASURER 0.25 0.25 X X 0 0 0 DWIGHT CREEK SECRETARY 0.25 0.25 X X 0 0 0 GINA EARLEY DIRECTOR 0.25 0.25 X 0 0 0 BILL COUCH DIRECTOR 0.25 0.25 X 0 0 0 WENDEL HAREWOOD DIRECTOR 0.25 0.00 X 0 0 0 STEVE THOMPSON DIRECTOR 0.25 0.00 X 0 0 0 RINDY MATTHEWS DC DIRECTOR 0.25 0.50 X 0 0 0 BRIAN SETTY DIRECTOR 0.25 0.50 X 0 0 0 LARRY E BURNS JR DIRECTOR 0.25 0.75 X 0 0 0 TIMOTHY PARRY CEO 1.00 39.00 X 0 372159 94745 MEGHANN ACKLEY VP FINANCE 1.00 39.00 X 0 172173 61310 STEVEN BATTAGLIA PHYSICIAN 40.00 0.00 X 181642 0 20893 CRAIG MCKINNEY PHYSICIAN 40.00 0.00 X 412451 0 29418 BRYAN GIESY PHYSICIAN 40.00 0.00 X 120733 0 6450 VINAYAK KULKARNI PHYSICIAN 20.00 0.00 X 361451 0 12319 ALEX RENSHAW PHYSICIAN 40.00 0.00 X 795754 0 60623 1872031 544332 285758 8 0 1 0 JAMIE WASELENKO 1773 CLOUGH PIKE BATAVIA OH 45103 NURSE PRACTITIONER 315339 NOBILITY LLC PO BOX 310843 DES MOINES IA 50331 BILLING SERVICES 145824 2 2600000 2600000 NET PATIENT SERVICE RE 621110 2987634 2987634 2987634 21146 13606 7540 7540 7540 4 4 4 5595178 2987638 0 7540 X 2262813 2262813 58248 58248 102844 102844 144795 144795 2348451 2348451 7718 7718 264264 264264 73 73 18110 18110 28 28 22421 22421 73810 73810 MEDICAL SUPPLIES 23974 23974 DUES & LICENSES 1704 1704 4897 4897 5334150 5334150 0 0 167695 136898 234828 260491 172693 50691 67511 422270 175638 255922 246632 0 444308 881829 1155840 276732 289715 276732 289715 X 605097 866125 605097 866125 881829 1155840 261028 0 X 0 1 X 1 0 X X 1 HIGHLAND DISTRICT HOSPITAL 310653685 6 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART I, LINE 12G, COLUMN (VI): HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION PROVIDES SUPPORT TO THE STAFF AT HIGHLAND DISTRICT HOSPITAL TO CARRY OUT THE PURPOSE OF PROVIDING MEDICAL SERVICES TO THE COMMUNITY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15200 15200 329805 112252 217553 77265 63386 13879 246632 OTHER RECEIVABLES 41593 DUE FROM HIGHLAND DISTRIST HOSPITAL 402715 444308 X PART X, LINE 2: HIGHLAND COUNTY JOINT TOWNSHIP DISTRICT HOSPITAL, AS A POLITICAL SUBDIVISION OF THE STATE OF OHIO, IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 115 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. PSC, HDH FOUNDATION, AND HJTDH FOUNDATION ARE EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PSC, HDH FOUNDATION, AND HJTDH FOUNDATION ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. DURING THE CALENDAR YEARS ENDING DECEMBER 31, 2023 AND 2022, THE ENTITIES DID NOT REPORT ANY UNRELATED BUSINESS INCOME. 0 0 0 0 0 0 0 0 0 ALEX RENSHAW PHYSICIAN 763649 0 31679 0 426 0 13450 0 47173 0 856377 0 0 0 TIMOTHY PARRY CEO 0 369745 0 1955 0 459 0 46200 0 48545 0 466904 0 0 CRAIG MCKINNEY PHYSICIAN 396674 0 13971 0 1806 0 13759 0 15659 0 441869 0 0 0 VINAYAK KULKARNI PHYSICIAN 229555 0 131867 0 29 0 11874 0 445 0 373770 0 0 0 MEGHANN ACKLEY VP FINANCE 0 170067 0 1955 0 151 0 17815 0 43495 0 233483 0 0 STEVEN BATTAGLIA PHYSICIAN 176567 0 0 0 5075 0 7560 0 13333 0 202535 0 0 0 PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY A RELATED NONPROFIT ORGANIZATION, HIGHLAND DISTRICT HOSPITAL, USING THE FOLLOWING METHODS: -COMPENSATION SURVEY -APPROVAL BY THE BOARD FORM 990, PART VI, SECTION A, LINE 2 TIMOTHY PARRY AND MEGHANN ACKLEY HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 HIGHLAND DISTRICT HOSPITAL FOUNDATION IS THE SOLE MEMBER OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION, HIGHLAND DISTRICT HOSPITAL FOUNDATION APPOINTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B HIGHLAND DISTRICT HOSPITAL PROFESSIONAL SERVICES CORPORATION DOES NOT HAVE COMMITTEES. THEREFORE, THIS QUESTION HAS BEEN ANSWERED NO. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE VP FINANCE; ONCE A FINAL DRAFT IS COMPLETED, THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE FINAL VERSION. THE BOARD APPROVED FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENTS COVERS ALL INTERESTED PERSONS OF THE ORGANIZATION. THIS INCLUDES ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS. THESE INDIVIDUALS MUST AFFIRM THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST STATEMENT, HAVE READY AND UNDERSTAND THE POLICY AND AGREE TO COMPLY WITH THE POLICY. IN THE EVENT OF AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AS SOON AS IT IS KNOWN. UPON DISCLOSURE, THE REMAINING BOARD MEMBERS DISCUSS AND VOTE TO DETERMINE IF A CONFLICT EXISTS. IN THE EVENT OF A CONFLICT, THE INTERESTED PERSON WILL ABSTAIN FROM ANY PART OF ANY BUSINESS DECISION RELATED TO THE CONFLICT. IF IT IS DETERMINED THAT AN INDIVIDUAL HAS VIOLATED THE CONFLICT OF INTEREST POLICY, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WILL BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION OF KEY EMPLOYEES IS BASED UPON INFORMATION OBTAINED REGARDING COMPENSATION LEVELS OF INDIVIDUALS IN SIMILAR POSITIONS AT A SIMILARLY SIZED HEALTH CARE FACILITIES COMPARED TO THE NATIONAL AVERAGE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. A NOTICE IS PLACED IN THE NEWSPAPER AFTER THE AUDIT IS COMPLETED AND APPROVED BY THE STATE OF OHIO AUDITOR. FORM 990, PART IX, LINE 11G REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 55,437. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,437. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,293,014. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,293,014. HIGHLAND DISTRICT HOSPITAL 1275 N HIGH STREET HILLSBORO OH 45133 310653685 HOSPITAL OH 501(C)(3) LINE 6 HIGHLAND DISTRICT HOSPITAL 0 HIGHLAND DISTRICT HOSPITAL FOUNDATION 1275 N HIGH STREET HILLSBORO OH 45133 311666318 FOUNDATION OH 501(C)(3) LINE 7 HIGHLAND DISTRICT HOSPITAL 0 HIGHLAND JOINT TOWNSHIP DISTRICT HOSPITAL FOUNDATION 1275 N HIGH STREET HILLSBORO OH 45133 383643733 FOUNDATION OH 501(C)(3) LINE 12A, I HIGHLAND DISTRICT HOSPITAL 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0