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ObjectId: 201611339349302866 - Submission: 2016-05-12
TIN: 32-0007056
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
14
Open to Public Inspection
Name of the organization
OhioHealth Corporation Group Return
Employer identification number
32-0007056
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
Grant Anesthesia Services Ltd
180 East Broad Street 33rd Floor
Columbus
,
OH
432153707
20-1501295
Practice Management Services
OH
0
0
GrantRiverside Medical Care Foundation
(2)
Orthopedic Trauma Services Ltd
180 East Broad Street 33rd Floor
Columbus
,
OH
432153707
56-2294320
Practice Management Services
OH
0
0
GrantRiverside Medical Care Foundation
(3)
Marion Physician Billing LLC
1000 McKinley Park Drive
Marion
,
OH
43302
61-1605305
Medical Billing
OH
1,523,293
0
Marion General Hospital
(4)
Marion Ancillary Services LLC
1000 McKinley Park Drive
Marion
,
OH
43302
31-1704991
Outpatient Services
OH
0
0
Marion General Hospital
(5)
Marion Health Systems LLC
1000 McKinley Park Drive
Marion
,
OH
43302
31-1639538
Outpatient Surgery Center
OH
0
0
Marion General Hospital
(6)
Healthworks LLC
561 West Central Avenue
Delaware
,
OH
43015
31-1435822
Medical Services Physician Practices
OH
-6,214,294
6,732,651
Grady Memorial Hospital
(7)
OhioHealth MedCentral Professional Foundation
335 Glessner Avenue
Mansfield
,
OH
44903
26-1775665
Healthcare
OH
-20,093,284
0
MedCentral Health System
(8)
Athens Medical Associates LLC
75 Hospital Drive
Athens
,
OH
45701
02-0734615
Physician Services
OH
-5,791,456
2,110,556
O'Bleness Memorial Hospital
(9)
OhioHealth Regional Physician Services LLC
180 East Broad Street 33rd Floor
Columbus
,
OH
432153707
47-2512005
Healthcare
OH
0
0
GrantRiverside Medical Care Foundation
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Hospital Properties Inc
180 East Broad Street 33rd Floor
Columbus
,
OH
432153707
31-1206071
Property Management
OH
501(c)(2)
N/A
OhioHealth Corporation
Yes
(2)
Doctors Hospital at Nelsonville
1950 Mount Saint Marys Drive
Nelsonville
,
OH
457641280
31-1620551
Healthcare Services
OH
501(c)(3)
N/A
OhioHealth Corporation
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Page 2
Schedule R (Form 990) 2014
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
OhioHealth Sleep Services LLC
6185 Huntley Road Suite B
Columbus
,
OH
43229
20-1547399
Physician Practice
OH
N/A
(2)
Polaris Surgery Center LLC
6200 Cleveland Avenue
Columbus
,
OH
43231
20-8074623
Medical Services
OH
N/A
(3)
Upper Arlington Medical Limited Partnership
180 East Broad Street 33rd Floor
Columbus
,
OH
43215
31-1472667
Medical Services
OH
N/A
(4)
ESWL Real Estate & Equipment Limited Partnership
100 West Third Avenue Suite 350
Columbus
,
OH
43201
31-1138732
Equipment Rental
OH
N/A
(5)
Grant Scope Center LLC
180 East Broad Street 33rd Floor
Columbus
,
OH
43215
26-0765486
Endoscopy Services
OH
N/A
(6)
OhioHealth Rehabilitation Hospital LLC
4714 Gettysburg Road
Mechanicsburg
,
OH
17055
46-2458436
Medical Services
OH
N/A
(7)
Westerville Endoscopy Center LLC
262 Neil Avenue
Columbus
,
OH
43215
46-2755661
Endoscopy Services
OH
N/A
(8)
OhioHealth Group Ltd
155 East Broad Street Suite 1700
Columbus
,
OH
43215
31-1446804
Managed Health Care
OH
N/A
(9)
Whitehall Surgery Center
4850 E Main Street
Whitehall
,
OH
43213
31-1479613
Ambulatory Surgery Center
OH
N/A
(10)
O'Bleness Memorial Pain Management LLC
55 Hospital Drive
Athens
,
OH
45701
45-4587317
Medical Services
OH
O'Bleness Hospital
Related
27,893
146,122
No
Yes
51.000 %
(11)
Athens Surgery Center
75 Hospital Drive
Athens
,
OH
45701
55-0840856
Medical Services
OH
O'Bleness Hospital
Related
220,561
448,674
No
Yes
65.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
OhioHealth Star Corporation
180 East Broad Street 33rd Floor
Columbus
,
OH
432153707
31-1119936
Administrative Services
OH
N/A
C
No
(2)
HardinCare Inc
921 East Franklin Street
Kenton
,
OH
43326
34-1492617
Property Management
OH
Hardin Memorial Hospital
C
-3,123
897,642
100.000 %
Yes
(3)
Intel Health Services
PO Box 1051 Governors Square Bu
Grand Cayman
KYI-1102
CJ
31-4394942
Insurance/Reinsurance
CJ
N/A
C
No
(4)
Athens Medical Laboratory Associates Inc
265 W Union Street Suite B
Athens
,
OH
45701
31-1381808
Medical Lab Services
OH
O'Bleness Memorial Hospital
S
97,825
100.000 %
Yes
Schedule R (Form 990) 2014
Page 3
Schedule R (Form 990) 2014
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
Yes
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
OhioHealth Corporation
B
1,530,753
Actual Amount Paid
(2)
Doctors Health Corporation of Nelsonville
L
1,053,156
Actual Amount Received
(3)
Intel Health Services
Q
632,850
Actual Amount Transferred
(4)
OhioHealth Corporation
R
126,620,733
Actual Amount Transferred
(5)
OhioHealth Corporation
S
76,365,420
Actual Amount Transferred
Schedule R (Form 990) 2014
Page 4
Schedule R (Form 990) 2014
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2014
Page 5
Schedule R (Form 990) 2014
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2014
Additional Data
Software ID:
Software Version: