2024-11-13T11:04:05-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-01-01 314380038 BETHESDA HOSPITAL ASSOCIATION BETH 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 ADAM HOPPER CFO 7404545000 2024-11-12 1 1 AMY CIMINELLO P00796388 6148493000 2024-11-05 2023 2024-10-15 13:58:12Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 183666 0 X WWW.GENESISHCS.ORG X 1990 OH BETHESDA HOSPITAL ASSOCIATION IS ORGANIZED AND OPERATED TO SUPPORT BETHESDA CARE SYSTEM AND THE GENESIS HEALTHCARE SYSTEM AFFILIATE GROUP, RELATED 501(C)(3) ORGANIZATIONS. 12 12 0 12 0 0 0 0 0 0 166041 183666 0 0 166041 183666 0 0 0 0 0 0 0 0 0 258 90607 258 90607 165783 93059 4805691 5869251 63388 794156 4742303 5075095 TO PROMOTE CHARITABLE SUPPORT FOR GENESIS HEALTHCARE SYSTEM AS WE SHARE ITS MISSION TO PROVIDE COMPASSIONATE, QUALITY HEALTHCARE. 0 0 0 0 0 BETHESDA HOSPITAL ASSOCIATION IS ORGANIZED AND OPERATED TO SUPPORT BETHESDA CARE SYSTEM AND THE GENESIS HEALTHCARE SYSTEM AFFILIATE GROUP, RELATED 501(C)(3) ORGANIZATIONS. 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ADAM HOPPER 7404544773 2951 MAPLE AVENUE ZANESVILLE OH 43701 X TOD KLOTZBACH CHAIR 0.20 0.20 X X 0 0 0 JAMES NICHOLSON VICE CHAIR 0.14 0.14 X X 0 0 0 BRIDGET TETAK SECRETARY 0.20 0.20 X X 0 0 0 JAMES MCDONALD DIRECTOR 0.17 0.17 X 0 0 0 ADAM BARCLAY DIRECTOR 0.12 0.12 X 0 0 0 JODY BALLAS DIRECTOR 0.17 0.25 X 0 0 0 JOANN BUTCHER DIRECTOR 0.20 0.20 X 0 0 0 MARY HILDEBRAND DIRECTOR 0.17 0.17 X 0 0 0 PATRICK NASH DIRECTOR 0.20 0.20 X 0 0 0 EMILY TARBERT DIRECTOR 0.14 0.14 X 0 0 0 SHIRLEY VANWYE DIRECTOR 0.20 0.28 X 0 0 0 CHAD WINEGARDNER DIRECTOR 0.03 0.03 X 0 0 0 MATTHEW PERRY PRESIDENT/CEO 0.17 0.17 X 0 0 0 MICHAEL NORMAN CHIEF FINANCIAL OFFICER 0.06 0.10 X 0 0 0 0 0 0 0 0 0 0 0 76906 76906 106760 0 106760 106760 106760 183666 0 0 183666 90607 90607 90607 0 90607 0 32235 181213 4773456 5212670 0 475368 4805691 5869251 0 564 63388 793592 63388 794156 X 4742303 5075095 4742303 5075095 4805691 5869251 93059 239732 1 0 X 0 0 0 X X 1 GENESIS HEALTHCARE SYSTEM 311480941 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART IV, SECTION A, LINE 1: BETHESDA HOSPITAL ASSOCIATION WAS PART OF A MERGER TO FORM GENESIS HEALTHCARE SYSTEM IN 1997. THE PURPOSE OF THE MERGER WAS TO PROVIDE AN INTEGRATED COMMUNITY BASED HEALTHCARE DELIVERY SYSTEM. PER THE AFFILIATION AGREEMENT, BETHESDA HOSPITAL ASSOCIATION, RETAINED PROPERTY HAVING A MARKET VALUE OF $5.71 MILLION IN CASH, CASH EQUIVALENTS AND OTHER INVESTMENTS. THESE ASSETS CAN BE USED TO SUPPORT GENESIS HEALTHCARE SYSTEM AS NEEDED. PART IV, SECTION E, LINE 2A: BETHESDA HOSPITAL ASSOCIATION WAS PART OF A MERGER TO FORM GENESIS HEALTHCARE SYSTEM IN 1997. THE PURPOSE OF THE MERGER WAS TO PROVIDE AN INTEGRATED COMMUNITY BASED HEALTHCARE DELIVERY SYSTEM. PER THE AFFILIATION AGREEMENT, BETHESDA HOSPITAL ASSOCIATION, RETAINED PROPERTY HAVING A MARKET VALUE OF $5.71 MILLION IN CASH, CASH EQUIVALENT AND OTHER INVESTMENTS. THESE ASSETS CAN BE USED, UPON BOARD APPROVAL, TO FURTHER THE EXEMPT PURPOSE OF GENESIS HEALTHCARE SYSTEM. PART IV, SECTION E, LINE 2B: BETHESDA HOSPITAL ASSOCIATION WAS PART OF A MERGER TO FORM GENESIS HEALTHCARE SYSTEM IN 1997. THE PURPOSE OF THE MERGER WAS TO PROVIDE AN INTEGRATED COMMUNITY BASED HEALTHCARE DELIVERY SYSTEM. PER THE AFFILIATION AGREEMENT, BETHESDA HOSPITAL ASSOCIATION, RETAINED PROPERTY HAVING A MARKET VALUE OF $5.71 MILLION IN CASH, CASH EQUIVALENTS AND OTHER INVESTMENTS. THESE ASSETS CAN BE USED, UPON BOARD APPROVAL, TO FURTHER THE EXEMPT PURPOSE OF GENESIS HEALTHCARE SYSTEM. SECTION E, LINE 3A FRANCISCAN SISTERS OF CHRISTIAN CHARITY AND BETHESDA CARE SYSTEM ARE BOTH 50/50 MEMBERS OF GENESIS HEALTHCARE SYSTEM. THE MEMBERS HAVE THE POWER TO REGULARLY APPOINT OR ELECT THE OFFICERS AND DIRECTORS OF THE SUPPORTED ORGANIZATION, GENESIS HEALTHCARE SYSTEM. BETHESDA CARE SYSTEM IS THE SOLE MEMBER OF BETHESDA HOSPITAL ASSOCIATION. SECTION D, LINE 3 THERE IS MANAGEMENT AND BOARD MEMBER OVERLAP BETWEEN BETHESDA CARE SYSTEM AND GENESIS HEALTHCARE SYSTEM. BETHESDA CARE SYSTEM IS THE SOLE MEMBER OF BETHESDA HOSPITAL ASSOCIATION. 0 DUE FROM ALTERNACARE 475368 475368 INTERCOMPANY PAYABLES 793592 793592 FORM 990, PART VI, SECTION A, LINE 6 BETHESDA CARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A BETHESDA CARE SYSTEM, THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY, WHETHER PERIODICALLY, OR AS VACANCIES ARISE, OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 7B BETHESDA CARE SYSTEM, THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY SUCH AS APPROVAL OF THE GOVERNING BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ITS ENTIRETY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL POTENTIAL CONFLICTS OF INTEREST OF BOARD MEMBERS AND OFFICERS MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. BETHESDA CARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311067174 SPONSOR OF GHS OH 501(C)(3) LINE 12C, III-FI N/A 1 ALTERNACARE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311487187 STERILIZATIONS OH 501(C)(3) LINE 3 BETHESDA CARE SYSTEM 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0