2025-09-22T10:06:47-05:00 2024-12-31 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 311031277 HOSPICE OF MIAMI COUNTY INC HOSP 9372569507 3230 N COUNTY RD 25A TROY OH 45373 ROBERT MORRIS CFO 9372569507 2025-09-18 1 1 AMY CIMINELLO P00796388 6148493000 2025-09-01 2024 2025-03-06 01:10:19Z GAIL STOKES 3230 N COUNTY RD 25A TROY OH 45373 5403609 0 X WWW.HOSPICEOFMIAMICOUNTY.ORG X 1982 OH TO PROVIDE HOSPICE AND PALLIATIVE CARE FOR THE TERMINALLY ILL AND SUPPORT FOR THEIR FAMILIES. 13 13 29 159 0 0 984753 96154 11053935 5262025 72270 45430 180 0 12111138 5403609 0 0 0 0 6199233 3277240 0 0 0 4980273 2873005 11179506 6150245 931632 -746636 23935884 21015844 14335774 12020113 9600110 8995731 X THE HOSPICE OF MIAMI COUNTY, INC. IS COMMITTED TO MAKING QUALITY HOSPICE CARE AVAILABLE AND ACCESSIBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY PAY, AND IN A MANNER CONSISTENT WITH THE HIGHEST HOSPICE STANDARDS. OUR COMMITMENT TO THE HOSPICE PHILOSOPHY OF CARE INCLUDES A COMPASSIONATE STAFF PLEDGED TO CONTINUOUSLY IMPROVE AND ENHANCE THE CARE WE PROVIDE, RESPECT THE PATIENTS' CHOICES OF CARE, RESPOND TO CHANGING COMMUNITY NEEDS, AND SERVE AS A RESOURCE TO OTHERS FOR IMPROVING THE AVAILABILITY OF QUALITY HOSPICE CARE. 0 1 4454181 0 5262025 COORDINATES A PROGRAM OF HOME, OUTPATIENT, AND INPATIENT HOSPICE CARE THAT PROVIDES PALLIATIVE CARE, SUPPORTIVE MEDICAL SERVICES, AND OTHER SUPPORT SERVICES TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY. 4454181 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 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 1 0 0 0 1 0 0 29 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ROBERT MORRIS 9372569507 7575 PARAGON RD DAYTON OH 45459 PETE HALEY CHAIR 2.00 16.00 X X 0 0 0 GARY LEROY VICE CHAIR 2.00 14.00 X X 0 0 0 GENE THORN TREASURER 2.00 14.00 X X 0 0 0 TONI SPRINKEL SECRETARY 2.00 14.00 X X 0 0 0 CHARLES BANE MD BOARD MEMBER 2.00 14.00 X 0 0 0 DAVID REYNOLDS MD BOARD MEMBER 2.00 14.00 X 0 0 0 DOUG HELMAN BOARD MEMBER - PART YEAR 2.00 14.00 X 0 0 0 KEVIN BLACK BOARD MEMBER 2.00 14.00 X 0 0 0 KEVIN HARLAN BOARD MEMBER 2.00 14.00 X 0 0 0 KIMBERLY MORRISON BOARD MEMBER 2.00 14.00 X 0 0 0 MARY JUSTICE BOARD MEMBER 2.00 14.00 X 0 0 0 MICHAEL BOLAND BOARD MEMBER 2.00 16.00 X 0 0 0 PAM GERBER BOARD MEMBER 2.00 14.00 X 0 0 0 THOMAS MANN BOARD MEMBER 2.00 16.00 X 0 0 0 KENT ANDERSON CHIEF EXECUTIVE OFFICER 2.00 58.00 X 0 600653 59881 ROBERT MORRIS CHIEF FINANCIAL OFFICER 2.00 58.00 X 0 383933 53196 HIEP THANH LUU TEAM PHYSICIAN 40.00 0.00 X 269112 0 28225 LORA WILCHER DIRECTOR OF CARE 40.00 0.00 X 136951 0 17549 RUTHIE COPPERSMITH RN HOSPICE HOUSE/IPU 40.00 0.00 X 101481 0 5074 CAREY SHORT EXECUTIVE DIRECTOR - FORMER 0.00 40.00 X 0 195234 40993 507544 1179820 204918 3 1 1 0 0 96154 96154 PATIENT SERVICE REVENU 624100 5262025 5262025 5262025 23505 23505 21925 0 21925 21925 21925 5403609 5262025 0 45430 2632220 2564415 67805 109773 107123 2650 340719 332039 8680 194528 189268 5260 425 425 5275 5275 9624 9624 5424 2116 3308 427 427 106043 87671 18372 6464 6464 244578 16519 228059 134341 130508 3833 11900 4233 7667 211419 211419 377860 324765 53095 28182 28182 ALLOCATED COSTS 1013547 1013547 MEDICAL SUPPLIES 405772 405772 ROOM AND BOARD 129409 129409 PATIENT SERVICE 110352 110317 35 71963 50026 21937 6150245 4454181 1696064 0 200 200 1199244 88288 0 0 0 12108856 0 1219289 1397307 9320007 19618337 23935884 21015844 535676 96451 12126390 11923662 1673708 0 14335774 12020113 X 9600110 8995731 9600110 8995731 23935884 21015844 -746636 142257 0 X X 0 1 X 1 0 X 986144 1452231 832407 984753 96154 4351689 986144 1452231 832407 984753 96154 4351689 4351689 20984 19882 21034 60207 23505 145612 598 598 4497899 48680179 0.96750 0.97390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 INVESTMENT - COMMUNITY FOUNDATION 1397307 C 1397307 RELATED PARTY RECEIVABLES 19618337 19618337 0 0 0 0 0 0 0 1 0 KENT ANDERSON CHIEF EXECUTIVE OFFICER 0 468653 0 132000 0 0 0 28750 0 31131 0 660534 0 0 ROBERT MORRIS CHIEF FINANCIAL OFFICER 0 307854 0 76079 0 0 0 18965 0 34231 0 437129 0 0 HIEP THANH LUU TEAM PHYSICIAN 254112 0 15000 0 0 0 13570 0 14655 0 297337 0 0 0 CAREY SHORT EXECUTIVE DIRECTOR - FORMER 0 164274 0 30960 0 0 0 13086 0 27907 0 236227 0 0 LORA WILCHER DIRECTOR OF CARE 118687 0 18264 0 0 0 6928 0 10621 0 154500 0 0 0 PART I, LINE 3 THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. PART I, LINE 7 THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL PERFORMANCE REVIEW TO DETERMINE THE COMPENSATION AND BENEFITS OF THE CEO. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MAY ALSO AWARD BONUS COMPENSATION TO THE CEO BASED UPON THE ANNUAL PERFORMANCE REVIEW. THE CEO CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE OTHER OFFICERS AND EMPLOYEES TO DETERMINE THEIR COMPENSATION AND BENEFITS. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE CEO, WITH THE APPROVAL OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, MAY ALSO AWARD BONUS COMPENSATION TO THE OTHER OFFICERS AND EMPLOYEES BASED UPON THEIR ANNUAL PERFORMANCE REVIEW. A COUNTY OF MONTGOMERY OHIO 316000172 2020-04-23 13005897 SEE PART IV 0 0 0 A 1076338 13005897 662897 190000 424726 11728274 2022 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 A 0 0 0 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COUNTY OF MONTGOMERY, OHIO DATE THE REBATE COMPUTATION WAS PERFORMED: 11/06/2023 PART I, LINE A, (F) THE PROCEEDS OF THE SERIES 2020 BONDS WERE USED TO FINANCE THE ACQUISITION, CONSTRUCTION, IMPROVEMENT, RENOVATION AND/OR EQUIPPING OF THE FACILITIES KNOWN AS OHIO'S HOSPICE OF MIAMI COUNTY. PART II, LINE 3 THE AMOUNT OF PROCEEDS OF THE ISSUE DIFFERS FROM THE ISSUE PRICE OF THE ISSUE AS A RESULT OF $5,896.84 OF INTEREST EARNINGS ON THE INVESTMENT OF BOND PROCEEDS. PART I AND II THE SERIES 2020 BONDS WERE ISSUED FOR THE BENEFIT OF OHIO'S HOSPICE, INC., THE HOSPICE OF DAYTON, INCORPORATED, PURE HEALTHCARE, LLC (A DISREGARDED ENTITY OF THE HOSPICE OF DAYTON, INCORPORATED), HOSPICE OF MIAMI COUNTY, INC. AND LIFECARE HOSPICE. ONLY A PORTION OF THE PROCEEDS OF THE SERIES 2020 BONDS ARE ALLOCABLE TO HOSPICE OF MIAMI COUNTY, INC. AND THE AMOUNTS IN PART I AND PART II LINES 1-15 REFLECT SUCH ALLOCATION. THE PORTION OF THE SERIES 2020 BONDS ALLOCABLE TO THE OTHER ENTITIES IS BEING REPORTED ON SCHEDULE K TO EACH OTHER ENTITY'S FORM 990. FORM 990, PART III, LINE 3 HOSPICE OF MIAMI COUNTY IS CURRENTLY IN THE PROCESS OF TRANSITIONING ITS OPERATIONS AS PART OF AN INTERNAL CONSOLIDATION WITH RELATED EXEMPT ORGANIZATION, HOSPICE OF DAYTON. AS PART OF THIS TRANSITION, PATIENT CARE RESPONSIBILITIES HAVE BEEN SHIFTED TO HOSPICE OF DAYTON. THESE OPERATIONAL ADJUSTMENTS HAVE RESULTED IN A DECREASE IN OVERALL ACTIVITY. FORM 990, PART VI, SECTION A, LINE 6 OHIO'S HOSPICE, INC BECAME THE SOLE MEMBER OF HOSPICE OF MIAMI COUNTY WITH AN AFFILIATION AGREEMENT SIGNED IN JULY 2013. FORM 990, PART VI, SECTION A, LINE 7A OHIO'S HOSPICE INC. HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS. THE BOARD SHALL RECOMMEND INDIVIDUALS TO FILL ANY OPENINGS. OHIO'S HOSPICE HAS THE RIGHT TO ELECT FROM THESE INDIVIDUALS OR OTHER INDIVIDUALS AT ITS DISCRETION. FORM 990, PART VI, SECTION A, LINE 7B OHIO'S HOSPICE INC. RETAINS THE POWER TO AMEND THE ARTICLES OF INCORPORATION, CODE OF REGULATIONS, ETC. OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY THE CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS SENT VIA EMAIL TO THE FULL BOARD AND WILL BE REVIEWED IN SESSION BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 12C IN THE EVENT ANY DIRECTOR, OFFICER OR EXECUTIVE OF THE ORGANIZATION SHALL HAVE ANY DIRECT OR INDIRECT INTEREST IN OR RELATIONSHIP WITH ANY INDIVIDUAL OR ORGANIZATION THAT PROPOSES TO ENTER INTO ANY TRANSACTION WITH THE ORGANIZATION FOR THE SALE, PURCHASE, LEASE OR RENTAL OF PROPERTY OR TO RENDER OR EMPLOY SERVICES, PERSONAL OR OTHERWISE, SUCH DIRECTOR, OFFICER OR EXECUTIVE SHALL FORTHWITH GIVE THE BOARD OF DIRECTORS, CHAIR OF THE BOARD OR PRESIDENT OF THE ORGANIZATION NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER NOT BE COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM AND SHALL REFRAIN FROM VOTING OR OTHERWISE ATTEMPTING TO AFFECT ITS DECISION TO PARTICIPATE IN SUCH TRANSACTION. IN THE EVENT THAT A CHALLENGE OR QUESTION IS RAISED WHETHER CONFLICT OR DUALITY OF INTEREST EXISTS, THE BOARD OR CHAIR OF THE BOARD OF THE ORGANIZATION SHALL DETERMINE THAT A DUALITY OF INTEREST EXISTS (BY A 2/3 VOTE OF THE BODY). MINUTES OF APPROPRIATE MEETINGS SHOULD REFLECT THAT SUCH DISCLOSURE WAS MADE, AND THAT SUCH DIRECTOR REMOVED HIMSELF/HERSELF FROM THE ROOM AND DID NOT PARTICIPATE IN THE FINAL DISCUSSION, AND WAS NOT COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM.THE CONFLICT OF INTEREST STATEMENT SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS, OFFICERS OR EXECUTIVES AND THAT ANY NEW DIRECTORS, OFFICERS OR EXECUTIVES BE ADVISED OF THE POLICY UPON UNDERTAKING THE DUTIES OF SUCH OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. PART XII LINE 2C OHI'S FINANCE COMMITTEE HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT THIS PROCESS IS CONSISTENT WITH PRIOR YEAR. OHI HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 371495725 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF CENTRAL OHIO 2269 CHERRY VALLEY ROAD NEWARK OH 43055 311059756 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE FOUNDATION 7575 PARAGON ROAD DAYTON OH 45459 311769696 TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, OHIO'S HOSPICE, INC. OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF DAYTON INC 324 WILMINGTON AVE DAYTON OH 45420 310933339 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 1 LIFECARE HOSPICE 1900 AKRON ROAD WOOSTER OH 44691 341352875 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 463215586 TO PROVIDE MANAGEMENT SERVICES AS A SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12C, III-FI N/A 0 LOVING CARE HOSPICE 779 LONDON AVENUE MARYSVILLE OH 43040 311370625 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 1 HOSPICE OF FAYETTE COUNTY 222 N OAKLAND AVE WASHINGTON COURTHOUSE OH 43160 311243376 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF TUSCARAWAS COUNTY INC 716 COMMERCIAL AVENUE SW NEW PHILADELPHIA OH 44663 341522329 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 NATIONAL HOSPICE COOPERATIVE 7575 PARAGON ROAD DAYTON OH 45459 832087147 BUSINESS SUPPORT OH N/A C 1 CENTRAL OHIO GERIATRICS 7575 PARAGON ROAD DAYTON OH 45459 264273198 PHYSICIAN OFFICE OH N/A S 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0