Liabilities / Assets
68th percentile
Higher debt load relative to assets than 68% of similar nonprofits.
EIN 31-0538525 • 501(c)3 • Cincinnati, OH
Profile
Improve the health of our community and create patient value by providing exceptional outcomes and the finest experiences, all in an affordable way.
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
68th percentile
Higher debt load relative to assets than 68% of similar nonprofits.
Liabilities / Revenue
46th percentile
Higher debt load relative to revenue than 46% of similar nonprofits.
Net Margin
18th percentile
Higher net margin than 18% of similar nonprofits.
Top Officer Pay
Score unavailable
No filing with officer rows is available for this organization yet.
Asset Growth
6th percentile
Faster asset growth than 6% of similar nonprofits.
Revenue Growth
28th percentile
Faster revenue growth than 28% of similar nonprofits.
Assets
Up$1,436,406,751
Up $26,655,161 (+1.9%) from 2023
Liabilities
Up$606,953,241
Up $2,898,229 (+0.5%) from 2023
Net Assets
Up$829,453,510
Up $23,756,932 (+2.9%) from 2023
Revenue
Up$1,385,143,950
Up $84,355,516 (+6.5%) from 2023
Expenses
Up$1,373,225,648
Up $79,401,658 (+6.1%) from 2023
Net Income
Up$11,918,302
Up $4,953,858 (+71%) from 2023
Most recent year
2024 • Form 990Detailed filing. Detailed filing data is available for this year.
To improve the health of our community and create patient value by providing exceptional outcomes, affordable care, and the finest experiences.
Improve the health of our community and create patient value by providing exceptional outcomes and the finest experiences, all in an affordable way.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Land, Buildings, and Equipment, Net | $539,220,940 | $542,890,640 | ▲ $3,669,700 |
| Investments in Publicly Traded Securities | $236,019,568 | $282,441,318 | ▲ $46,421,750 |
| Investments Other Securities | $207,363,003 | $219,795,068 | ▲ $12,432,065 |
| Accounts Receivable | $132,224,207 | $131,355,556 | ▼ $868,651 |
| Cash and Non-Interest-Bearing Accounts | $3,885,350 | $48,849,135 | ▲ $44,963,785 |
| Prepaid Expenses and Deferred Charges | $32,469,239 | $31,244,465 | ▼ $1,224,774 |
| Inventories for Sale or Use | $28,086,013 | $27,983,244 | ▼ $102,769 |
| Savings and Temporary Cash Investments | $85,280,999 | $16,611,831 | ▼ $68,669,168 |
| Intangible Assets | $15,042,833 | $15,030,869 | ▼ $11,964 |
| Other Notes and Loans Receivable, Net | $0 | $0 | → $0 |
| Pledges and Grants Receivable | $0 | $0 | → $0 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Investments Program Related | $0 | - | - |
| Pd in Cap Srpls Land Bldg Eqp Fund | $0 | - | - |
| Rtn Earn Endowment Incm Other Fnds | $0 | - | - |
| Cap Stk Tr Prin Current Funds | $0 | - | - |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Total Assets | $1,409,751,590 | $1,436,406,751 | ▲ $26,655,161 |
| Other Assets Total | $130,159,438 | $120,204,625 | ▼ $9,954,813 |
| Liabilities | |||
| Mortgage Notes Payable Secured by Investment Property | $272,250,629 | $210,566,663 | ▼ $61,683,966 |
| Accounts Payable and Accrued Expenses | $157,658,519 | $188,826,239 | ▲ $31,167,720 |
| Tax Exempt Bond Liabilities | $107,194,697 | $145,062,260 | ▲ $37,867,563 |
| Other Liabilities | $65,446,167 | $61,998,079 | ▼ $3,448,088 |
| Deferred Revenue | $1,505,000 | $500,000 | ▼ $1,005,000 |
| Grants Payable | $0 | $0 | → $0 |
| Unsecured Notes Loans Payable | $0 | $0 | → $0 |
| Escrow Account Liability | $0 | $0 | → $0 |
| Total Liabilities | $604,055,012 | $606,953,241 | ▲ $2,898,229 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $724,086,411 | $814,382,914 | ▲ $90,296,503 |
| Net Assets With Donor Restrictions | $81,610,167 | $15,070,596 | ▼ $66,539,571 |
| Total Net Assets Fund Balance | $805,696,578 | $829,453,510 | ▲ $23,756,932 |
| Total Liabilities and Net Assets / Fund Balance | $1,409,751,590 | $1,436,406,751 | ▲ $26,655,161 |
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Equipment | $90,059,617 | $600,901,955 | $690,961,572 |
| Buildings | $340,814,115 | $258,467,209 | $599,281,324 |
| Other Land Buildings | $60,389,828 | $180,086,617 | $240,476,445 |
| Leasehold Improvements | $16,455,479 | $21,605,569 | $38,061,048 |
| Land | $35,171,601 | - | $35,171,601 |
| Other Assets Org | $4,030,715 | - | - |
| Other Securities | $219,795,068 | - | - |
| Period | Beginning | Contrib. | Gain/Loss | Other Uses | End |
|---|---|---|---|---|---|
| 2023 | $110,296,000 | $15,313,000 | ▲ $2,554,000 | $78,149,000 | $49,903,000 |
| 2022 | $109,200,000 | $65,407,000 | ▼ $80,000 | $63,921,000 | $110,296,000 |
| 2021 | $46,689,000 | $106,898,000 | ▼ $88,000 | $44,058,000 | $109,200,000 |
| 2020 | $44,305,000 | $33,114,000 | ▲ $2,164,000 | $32,733,000 | $46,689,000 |
| 2019 | $66,758,000 | $13,544,000 | ▼ $132,000 | $35,812,000 | $44,305,000 |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Marc Schneider Md | Physician | FT | $1,530,441 | $89,824 | $1,620,265 |
| Deborah Hayes | President/CEO | FT | $967,805 | $613,429 | $1,581,234 |
| Dean J Kereiakes Md | Physician | FT | $1,417,932 | $121,981 | $1,539,913 |
| John Smith Md | Physician | FT | $1,127,546 | $209,444 | $1,336,990 |
| Geoffrey Answini Md | Physician | FT | $1,203,695 | $58,220 | $1,261,915 |
| Robert Dowling Md | Physician | FT | $978,585 | $281,289 | $1,259,874 |
| Theodore Scherpenberg | VP & CFO | FT | $500,003 | $238,579 | $738,582 |
| Jennifer Manders | Physician & Director | FT | $423,425 | $97,862 | $521,287 |
| Geraldine M Vehr | Physician & Director (thru 9/23) | FT | $203,639 | $51,962 | $255,601 |
| Name | Title |
|---|---|
| Jeb Head | Director/board Chairman |
| Barbara Turner | Director |
| John Lanier | Director |
| Patrick Lafley | Director |
| R Kerry Clark | Director |
| Robert Heimann | Director |
| Thomas R Gerdes | Director |
| Victoria B Gluckman | Director |
| Shailesh Jejurikar | Director (beg 7/23) |
| Mark Manley Md | Director (beg 9/23) |
| R Glen Mayfield | Director (thru 10/23) |
| George H Vincent | Secretary (beg 10/23) |
| Deborah P Majoras | Secretary (thru 10/23) |
| Amy Hanson | Treasurer |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Ensemble Rcm LLC | Financial Services | PO BOX 639076, Cincinnati, OH 45263 | $15,182,662 |
| Team Anesthesia LLC | Healthcare Services | PO BOX 639425, Cincinnati, OH 45263 | $14,541,171 |
| Danis Building Construction Co | Construction | 3233 NEWARK DRIVE, Miamisburg, OH 45342 | $10,226,535 |
| University Of Cincinnati | Healthcare Services | PO BOX 932379, Cleveland, OH 44193 | $6,937,136 |
| Laboratory Corporation | Healthcare Services | PO BOX 2270, Burlington, NC 27216 | $5,687,684 |
| Line Item | Amount |
|---|---|
| Salaries, Compensation, and Employee Benefits | $692,961,678 |
| Other Expenses | $678,974,842 |
| Grants and Similar Amounts Paid | $1,289,128 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $439,808,136 | $145,219,666 | - | $585,027,802 |
| Fees for Services Other | $82,350,839 | $54,897,383 | $0 | $137,248,222 |
| Depreciation Depletion | $62,625,652 | $551,566 | - | $63,177,218 |
| Other Employee Benefits | $46,514,556 | $9,113,357 | - | $55,627,913 |
| Payroll Taxes | $29,622,988 | $7,131,175 | - | $36,754,163 |
| Occupancy | $17,965,481 | $6,722,775 | - | $24,688,256 |
| Information Technology | $1,265,441 | $16,557,573 | - | $17,823,014 |
| Pension Plan Contributions | $9,741,942 | $2,575,250 | - | $12,317,192 |
| Interest | $12,215,417 | - | - | $12,215,417 |
| Insurance | $7,662,239 | $1,643,134 | - | $9,305,373 |
| Office Expenses | $2,794,642 | $2,537,714 | - | $5,332,356 |
| Advertising | $770,410 | $3,109,539 | - | $3,879,949 |
| Current Officers, Directors, Trustees, and Key Employees | - | $3,096,703 | - | $3,096,703 |
| Other Expenses | $792,876 | $1,605,544 | - | $2,398,420 |
| Fees for Service Investment Mgmnt Fees | - | $2,179,720 | - | $2,179,720 |
| Conferences and Meetings | $1,124,816 | $401,888 | - | $1,526,704 |
| All Other Expenses | $391,473 | $889,899 | $0 | $1,281,372 |
| Grants to Domestic Orgs | $1,178,376 | - | - | $1,178,376 |
| Fees for Services Legal | - | $1,038,194 | - | $1,038,194 |
| Travel | $244,345 | $366,629 | - | $610,974 |
| Fees for Services Accounting | - | $556,200 | - | $556,200 |
| Comp Disqual Persons | $110,324 | $27,581 | - | $137,905 |
| Grants to Domestic Individuals | $110,752 | - | - | $110,752 |
| Fees for Services Lobbying | - | $7,750 | - | $7,750 |
| Total Functional Expenses | $1,102,440,674 | $270,784,974 | $0 | $1,373,225,648 |
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Oak Hills Local School District | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $205,750 |
| Forest Hills Local School District | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $200,000 |
| Lakota Local School District | Liberty Township, OH | Govt | General Sponsorship | $155,000 |
| American Heart Association Inc | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $135,000 |
| Wyoming City School District | Wyoming, OH | Govt | General Sponsorship | $135,000 |
| Center for Respite Care | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $100,000 |
| Redi Cincinnati LLC | Cincinnati, OH | Govt | General Sponsorship | $50,000 |
| The Abercrumbie Group | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $50,000 |
| Giving Voice Foundation | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $32,000 |
| Artswave | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $28,975 |
| American City Business Journals Inc | Charlotte, NC | 501 (c) (3) | General Sponsorship | $17,500 |
| Sam Hubbard Foundation | Evendale, OH | 501 (c) (6) | General Sponsorship | $15,000 |
| Ywca Greater Cincinnati | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $12,500 |
| West Chester Liberty Chamber Alliance | West Chester, OH | 501 (c) (3) | General Sponsorship | $10,850 |
| University of Cincinnati Foundation | Cincinnati, OH | 501 (c) (3) | General Sponsorship | $10,800 |
| Arthritis Foundation Inc | Atlanta, GA | - | General Sponsorship | $10,000 |
| Cincinnati USA Regional Chamber Foundation | Cincinnati, OH | - | General Sponsorship | $10,000 |
| Region | Activity | Services | Offices | Employees | Spending |
|---|---|---|---|---|---|
| Central America and the Caribbean | Investments | - | 0 | 1 | $19,903,314 |
| Central America and the Caribbean | Program Services | Gen & Prof Liab | 0 | 1 | $219,424 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
| Interested Party | Relationship | Description | Shared Revenue | Amount |
|---|---|---|---|---|
| - | 35% CONTROLLED ENTITY | Healthcare Services - See Part V | No | $179,434 |
| - | Family Member | Compensation - See Part V | No | $137,905 |
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Liability | Amount |
|---|---|
| Deferred Pension | $56,728,706 |
| Operating Lease Liability | $4,957,999 |
| Other Liabilities | $308,377 |
| Due to Third-Party Payors | $2,997 |
| Due to Related Parties | - |
| Contract Liabilties | - |
| Bond | Issuer | Issued | Issue Price | Purpose |
|---|---|---|---|---|
| B | Hamilton County Ohio | 2022-06-01 | $81,910,000 | the purpose of the issue is to refund the series 2012 Bonds dated 06/26/2012. |
| D | Hamilton County Ohio | 2023-12-11 | $49,135,000 | The purpose of the issue is to refund a portion of the Series 2019 Bonds dated 12/31/2019. |
| A | Hamilton County Ohio | 2010-12-20 | $30,000,000 | Healthcare facilities revenue bonds |
| C | Hamilton County Ohio | 2022-10-24 | $22,451,000 | To refund a taxable line of credit used to acquire an ambu. Ctr. |
| Bond | Total Proceeds | Spent | Retired | Issuance Costs |
|---|---|---|---|---|
| B | $81,910,000 | $22,319,122 | $19,535,000 | $131,000 |
| D | $50,856,497 | - | $0 | - |
| A | $30,021,765 | $81,695,000 | $18,228,000 | $215,000 |
| C | $22,451,000 | $49,864,803 | $1,108,000 | $991,694 |
“The sole voting member of the christ hospital (tch) is the christ hospital, inc. (tchi).”
“The sole voting member has the authority to: - to appoint members to the governing board of tch”
“The following governance decisions are reserved to the sole corporate member: 1.) to receive the net assets of tch upon dissolution and 2.) to approve significant decisions of the governing board of tch. Significant decisions include those with the potential to impact the mission and vision of tch. The elizabeth gamble deaconess home association (egdha) is a consenting member of tch. Egdha must consent to the dissolution, merger, sale or disposition of material assets of tch.”
“The form 990 is prepared and reviewed by an outside accounting firm. The form 990 is then reviewed by the assistant controller, the controller, the cfo, and the ceo. The form is then presented to the audit and risk management committee and board for final review.”
“Conflict of interest (coi) disclosure forms are distributed annually to certain potentially affected individuals. Individuals are under a duty to disclose any potential conflicts that may arise between the annual filings of the disclosure form. Individuals covered under the conflict of interest policy include officers and directors. Conflicts of interest are determined based on responses to the coi annual certification. These are reviewed by legal services and forwarded to senior management. Based on the nature of the job duties and specific disclosures in the certification, further clarification may be requested and/or a decision to implement alternative procedures that will eliminate the potential conflict of interest will be made.”
“Compensation of the organization's ceo is reviewed annually by the compensation and governance committee of the board of directors. The review was last performed in july 2024. The compensation committee and governance committee is comprised of independent board members and performs the review with the assistance of, and comparable data provided by, mercer. Compensation arrangements have been determined reasonable and contemporaneously documented.”
“Compensation of the organization's vice presidents is reviewed annually by the compensation and governance committee of the board of directors. The review was last performed in july 2024. The compensation committee and governance committee is comprised of independent board members and performs the review with the assistance of, and comparable data provided by, mercer. Compensation arrangements have been determined reasonable and contemporaneously documented.”
“The organization's governing documents, conflict of interest policy, and financial statements are made available to the public upon a reasonable request and as requested.”
“Officers, directors, trustees, key employees and highest compensated employees devote significant time and effort to the operations and oversight of tch. From time to time, as situations dictate, these individuals may devote significantly more time to the operations and oversight of the organization than is reported on form 990, part vii.”
“It is possible that a portion of the amounts reported for construction services may include expense reimbursement, in addition to amounts paid for services. However, the amounts are not distinguishable.”
“OTHER OPERATING REVENUE - Total Revenue: 15811826, Related or Exempt Function Revenue: 15722381, Unrelated Business Revenue: 89445, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”
“The christ hospital ("tch") is an ohio nonprofit corporation formed in june of 1891. Tch is tax-exempt under section 501(c)(3) of the internal revenue code ("the code") and functions as a hospital organization as described in section 509(a)(1) and 170(b)(1)(a)(iii) of the code. Tch's mission for the over 130 years of its operations has been to improve the health of our community and to be a regional exemplar in creating patient value through exceptional outcomes and patient experience provided at an affordable and responsible cost that ensures access to all members of our community without regard to financial status or other factors such as race, ethnicity, beliefs or gender. Through its main hospital campus in mt. Auburn, tch is dedicated to its urban-hospital roots, remaining steadfast in commitment to diverse and economically challenged neighborhoods in the uptown section of cincinnati, ohio. While maintaining this urban commitment through its base operations, tch has also developed a network of outpatient centers, a remote hospital location and physician practices that ensure access to care throughout the greater cincinnati region, including suburban and rural regions of the area that serve 19 counties located in three states. Tch has organized and maintains an accredited staff of more than 1,600 physicians, and offers advanced services and technologies through executive leadership of seven key service lines: cardiovascular care, orthopaedic and spine treatment, women's health, oncology, special surgery, comprehensive medicine and primary care. Tch maintains its sacred trust with the community and governmental oversight partners in earning and maintaining the privilege and responsibilities of tax-exemption. These core commitments include activities that are not undertaken for economic gain, but in fact are performed at a loss or are wholly unreimbursed and are performed as a matter of public trust and commitment. These core commitments include: 1. Charity care & care provided under governmental assistance programs - access to care regardless of ability to pay and full participation in medicare and medicaid programs wherein entitlement payments are insufficient to cover the costs of services provided. 2. Medical education - assurance of sufficient numbers and competency of trained and licensed medical professionals to meet the needs of our community. This includes residency and fellowship training for physicians that are operated at a financial loss, and formal undergraduate degree training through its college of nursing that requires subsidization through philanthropy and private support. 3. Research & innovation - through the carl & edyth lindner center for research and education at the christ hospital, tch invests substantial internal and philanthropic resources in supporting the advancement of medical discovery and improvement for the public good through an array of clinical trials and other application research. The above activities are the enduring and sacred commitment and responsibility of tch. Year in and year out these commitments will serve to demonstrate how tch has earned and maintains its tax-exempt privilege. Tch has consistently been recognized by u.s. News & world report as one of the nation's top hospitals, including the number one hospital in the greater cincinnati region, the top 10% in the region for orthopedic care, and as "high performing" in 14 areas of care. Further, tch ranked as one of newsweek's "the world's best hospitals," ranking first in the cincinnati region and fifth in the state of ohio. While maintaining its commitments to the community, tch is in a period of rapid growth, including the expansion of an ambulatory outpatient strategy consisting of an employed primary care and specialty physician network, numerous outpatient centers offering a variety of services, and other community initiatives. With a staff of more than 1,600 physicians, tch offers advanced services and technologies in ca”
“Women's health services: labor and delivery unit post-partum family unit special care nursery unit outpatient lactation program perinatal services gynecology & gynecological services diagnostic mammography pelvic floor center orthopaedic and spine: total joint replacement/reconstruction general orthopaedics and sports medicine orthopaedic/neurosurgical spine care inpatient rehabilitation services outpatient rehabilitation services interventional pain management services physiatry podiatry electrodiagnostic services imaging and diagnostic services: ct scanning diagnostic imaging mri nuclear medicine pet/ct surgical services: colon/rectal ent/otolaryngology general surgery neurological urology solid organ kidney transplant tissue/bone grafting cardiovascular services: cardiovascular surgery vascular surgery coronary care advanced heart failure treatment electrophysiology lab mechanical assist device program cardiac rehabilitation services wound center interventional cardiology interventional radiology oncology: radiation oncology chemotherapy department physics cancer research cancer/tumor registry oncological surgery intensive care services: cardiovascular icu medical icu surgical icu critical connections eicu”
“Egdha grant funding - -42690831; changes in pension - 1744438; loss on impairment of lease - -104675; gain on extinguishment of debt - 9686104; other changes - 3072789;”
“All funds received by the christ hospital ('tch'), both permanent endowments and temporary endowments, are used in line with the donor's intent. All funds are monitored by the network's officers, a gift fund review committee, and general accounting and if expenses are identified as appropriate to the fund, the fund will be charged for the expenditure.”
“The christ hospital (tch) is recognized as exempt from federal income tax under section 501(a) of the internal revenue code as a charitable organization qualifying under internal revenue code section 501(c)(3). Tch completed an analysis of uncertain tax positions in accordance with applicable accounting guidance at june 30, 2024 and 2023, and determined no amounts were required to be recognized in the consolidated financial statements at june 30, 2024 and 2023.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | false |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 157658519 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 188826239 |
| IRS990/AccountsReceivableGrp/BOYAmt | 0 | 132224207 |
| IRS990/AccountsReceivableGrp/EOYAmt | 0 | 131355556 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | false |
| IRS990/ActivityOrMissionDesc | 0 | IMPROVE THE HEALTH OF OUR COMMUNITY AND CREATE PATIENT VALUE BY PROVIDING EXCEPTIONAL OUTCOMES AND THE FINEST EXPERIENCES, ALL IN AN AFFORDABLE WAY. |
| IRS990/AdvertisingGrp/ManagementAndGeneralAmt | 0 | 3109539 |
| IRS990/AdvertisingGrp/ProgramServicesAmt | 0 | 770410 |
| IRS990/AdvertisingGrp/TotalAmt | 0 | 3879949 |
| IRS990/AllOtherExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/AllOtherExpensesGrp/ManagementAndGeneralAmt | 0 | 889899 |
| IRS990/AllOtherExpensesGrp/ProgramServicesAmt | 0 | 391473 |
| IRS990/AllOtherExpensesGrp/TotalAmt | 0 | 1281372 |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | true |
| IRS990/AuditCommitteeInd | 0 | true |
| IRS990/AuditedFinancialStmtAttInd | 0 | true |
| IRS990/BackupWthldComplianceInd | 0 | true |
| IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt | 0 | JENNIFER KREHBIEL |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 5132631528 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 2139 AUBURN AVENUE |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | CINCINNATI |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | OH |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 45219 |
| IRS990/BusinessRlnWith35CtrlEntInd | 0 | false |
| IRS990/BusinessRlnWithFamMemInd | 0 | true |
| IRS990/BusinessRlnWithOrgMemInd | 0 | false |
| IRS990/CapStkTrPrinCurrentFundsGrp/BOYAmt | 0 | 0 |
| IRS990/CashNonInterestBearingGrp/BOYAmt | 0 | 3885350 |
| IRS990/CashNonInterestBearingGrp/EOYAmt | 0 | 48849135 |
| IRS990/ChangeToOrgDocumentsInd | 0 | false |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 184 |
| IRS990/CollectionsOfArtInd | 0 | false |
| IRS990/CompCurrentOfcrDirectorsGrp/ManagementAndGeneralAmt | 0 | 3096703 |
| IRS990/CompCurrentOfcrDirectorsGrp/TotalAmt | 0 | 3096703 |
| IRS990/CompDisqualPersonsGrp/ManagementAndGeneralAmt | 0 | 27581 |
| IRS990/CompDisqualPersonsGrp/ProgramServicesAmt | 0 | 110324 |
| IRS990/CompDisqualPersonsGrp/TotalAmt | 0 | 137905 |
| IRS990/CompensationFromOtherSrcsInd | 0 | false |
| IRS990/CompensationProcessCEOInd | 0 | true |
| IRS990/CompensationProcessOtherInd | 0 | true |
| IRS990/ConferencesMeetingsGrp/ManagementAndGeneralAmt | 0 | 401888 |
| IRS990/ConferencesMeetingsGrp/ProgramServicesAmt | 0 | 1124816 |
| IRS990/ConferencesMeetingsGrp/TotalAmt | 0 | 1526704 |
| IRS990/ConflictOfInterestPolicyInd | 0 | true |
| IRS990/ConservationEasementsInd | 0 | false |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | true |
| IRS990/ContractorCompensationGrp/CompensationAmt | 0 | 15182662 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 1 | 14541171 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 2 | 10226535 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 3 | 6937136 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 4 | 5687684 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 0 | PO BOX 639076 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 1 | PO BOX 639425 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 2 | 3233 NEWARK DRIVE |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 3 | PO BOX 932379 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 4 | PO BOX 2270 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 0 | CINCINNATI |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 1 | CINCINNATI |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 2 | MIAMISBURG |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 3 | CLEVELAND |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 4 | BURLINGTON |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 0 | OH |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 1 | OH |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 2 | OH |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 3 | OH |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 4 | NC |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 0 | 45263 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 1 | 45263 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 2 | 45342 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 3 | 44193 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 4 | 27216 |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 0 | ENSEMBLE RCM LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 1 | TEAM ANESTHESIA LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 2 | DANIS BUILDING CONSTRUCTION CO |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 3 | UNIVERSITY OF CINCINNATI |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 4 | LABORATORY CORPORATION |
| IRS990/ContractorCompensationGrp/ServicesDesc | 0 | FINANCIAL SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 1 | HEALTHCARE SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 2 | CONSTRUCTION |
| IRS990/ContractorCompensationGrp/ServicesDesc | 3 | HEALTHCARE SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 4 | HEALTHCARE SERVICES |
| IRS990/CreditCounselingInd | 0 | false |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/CYContributionsGrantsAmt | 0 | 327345 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 1289128 |
| IRS990/CYInvestmentIncomeAmt | 0 | 10741325 |
| IRS990/CYOtherExpensesAmt | 0 | 678974842 |
| IRS990/CYOtherRevenueAmt | 0 | 100931498 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 1273143782 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 11918302 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 692961678 |
| IRS990/CYTotalExpensesAmt | 0 | 1373225648 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 1385143950 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | true |
| IRS990/DeductibleArtContributionInd | 0 | false |
| IRS990/DeductibleNonCashContriInd | 0 | false |
| IRS990/DeferredRevenueGrp/BOYAmt | 0 | 1505000 |
| IRS990/DeferredRevenueGrp/EOYAmt | 0 | 500000 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | false |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 551566 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 62625652 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 63177218 |
| IRS990/Desc | 0 | SEE SCHEDULE O |
| IRS990/DescribedInSection501c3Ind | 0 | true |
| IRS990/DisregardedEntityInd | 0 | true |
| IRS990/DocumentRetentionPolicyInd | 0 | true |
| IRS990/DonorAdvisedFundInd | 0 | false |
| IRS990/DonorRestrictionNetAssetsGrp/BOYAmt | 0 | 81610167 |
| IRS990/DonorRestrictionNetAssetsGrp/EOYAmt | 0 | 15070596 |
| IRS990/DonorRstrOrQuasiEndowmentsInd | 0 | true |
| IRS990/ElectionOfBoardMembersInd | 0 | true |
| IRS990/EmployeeCnt | 0 | 8386 |
| IRS990/EmploymentTaxReturnsFiledInd | 0 | true |
| IRS990/EngagedInExcessBenefitTransInd | 0 | false |
| IRS990/EscrowAccountInd | 0 | false |
| IRS990/EscrowAccountLiabilityGrp/BOYAmt | 0 | 0 |
| IRS990/EscrowAccountLiabilityGrp/EOYAmt | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 1102440674 |
| IRS990/FamilyOrBusinessRlnInd | 0 | false |
| IRS990/FederalGrantAuditPerformedInd | 0 | true |
| IRS990/FederalGrantAuditRequiredInd | 0 | true |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 556200 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 556200 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 1038194 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 1038194 |
| IRS990/FeesForServicesLobbyingGrp/ManagementAndGeneralAmt | 0 | 7750 |
| IRS990/FeesForServicesLobbyingGrp/TotalAmt | 0 | 7750 |
| IRS990/FeesForServicesOtherGrp/FundraisingAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 54897383 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 82350839 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 137248222 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ManagementAndGeneralAmt | 0 | 2179720 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 2179720 |
| IRS990/ForeignActivitiesInd | 0 | true |
| IRS990/ForeignCountryCd | 0 | CJ |
| IRS990/ForeignFinancialAccountInd | 0 | true |
| IRS990/ForeignOfficeInd | 0 | true |
| IRS990/Form8282PropertyDisposedOfInd | 0 | false |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 0 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 1 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 2 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 3 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 4 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 5 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 6 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 7 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 8 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 9 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 10 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 11 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 12 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 13 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 14 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 15 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 16 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 17 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 18 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 19 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 20 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 21 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 22 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 6 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 7 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 5.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 14 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 15 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 16 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 17 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 18 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 19 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 20 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 21 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 22 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 7 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 8 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 9 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 10 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 11 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 12 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 13 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 14 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 15 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 16 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 363982 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 7 | 15275 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 8 | 35090 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 17 | 79439 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 18 | 25997 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 19 | 32948 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 20 | 41870 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 21 | 34272 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 22 | 34448 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | DEBORAH HAYES |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | DEBORAH P MAJORAS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | GEORGE H VINCENT |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | JEB HEAD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | THOMAS R GERDES |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | AMY HANSON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | BARBARA TURNER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | GERALDINE M VEHR |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | JENNIFER MANDERS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | JOHN LANIER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | MARK MANLEY MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | PATRICK LAFLEY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | R GLEN MAYFIELD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | R KERRY CLARK |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 14 | ROBERT HEIMANN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 15 | SHAILESH JEJURIKAR |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 16 | VICTORIA B GLUCKMAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 17 | THEODORE SCHERPENBERG |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 18 | DEAN J KEREIAKES MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 19 | GEOFFREY ANSWINI MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 20 | JOHN SMITH MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 21 | MARC SCHNEIDER MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 22 | ROBERT DOWLING MD |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 1217252 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 240326 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 486197 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 17 | 659143 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 18 | 1513916 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 19 | 1228967 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 20 | 1295120 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 21 | 1585993 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 22 | 1225426 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 17 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 18 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 19 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 20 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 21 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 22 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | PRESIDENT/CEO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | SECRETARY (THRU 10/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | SECRETARY (BEG 10/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | DIRECTOR/BOARD CHAIRMAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | TREASURER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | PHYSICIAN & DIRECTOR (THRU 9/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | PHYSICIAN & DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | DIRECTOR (BEG 9/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | DIRECTOR (THRU 10/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 14 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 15 | DIRECTOR (BEG 7/23) |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 16 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 17 | VP & CFO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 18 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 19 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 20 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 21 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 22 | PHYSICIAN |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | true |
| IRS990/Form990TFiledInd | 0 | true |
| IRS990/FormationYr | 0 | 1891 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | false |
| IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | true |
| IRS990/FundraisingActivitiesInd | 0 | false |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 0 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | -3836017 |
| IRS990/GamingActivitiesInd | 0 | false |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 14 |
| IRS990/GrantAmt | 0 | 1289128 |
| IRS990/GrantsPayableGrp/BOYAmt | 0 | 0 |
| IRS990/GrantsPayableGrp/EOYAmt | 0 | 0 |
| IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt | 0 | 110752 |
| IRS990/GrantsToDomesticIndividualsGrp/TotalAmt | 0 | 110752 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 1178376 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 1178376 |
| IRS990/GrantsToIndividualsInd | 0 | true |
| IRS990/GrantsToOrganizationsInd | 0 | true |
| IRS990/GrantToRelatedPersonInd | 0 | false |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 0 |
| IRS990/GrossReceiptsAmt | 0 | 1388979967 |
| IRS990/GrossRentsGrp/RealAmt | 0 | 2441509 |
| IRS990/GroupReturnForAffiliatesInd | 0 | false |
| IRS990/IncludeFIN48FootnoteInd | 0 | true |
| IRS990/IndependentAuditFinclStmtInd | 0 | false |
| IRS990/IndependentVotingMemberCnt | 0 | 9 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 1050 |
| IRS990/IndoorTanningServicesInd | 0 | false |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartVInd | 0 | X |
| IRS990/InfoInScheduleOPartXIInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 16557573 |
| IRS990/InformationTechnologyGrp/ProgramServicesAmt | 0 | 1265441 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 17823014 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 1643134 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 7662239 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 9305373 |
| IRS990/IntangibleAssetsGrp/BOYAmt | 0 | 15042833 |
| IRS990/IntangibleAssetsGrp/EOYAmt | 0 | 15030869 |
| IRS990/InterestGrp/ProgramServicesAmt | 0 | 12215417 |
| IRS990/InterestGrp/TotalAmt | 0 | 12215417 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 28086013 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 27983244 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 14577342 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 14577342 |
| IRS990/InvestmentInJointVentureInd | 0 | true |
| IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt | 0 | 207363003 |
| IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt | 0 | 219795068 |
| IRS990/InvestmentsProgramRelatedGrp/BOYAmt | 0 | 0 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 236019568 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 282441318 |
| IRS990/InvestTaxExemptBondsInd | 0 | false |
| IRS990/IRPDocumentCnt | 0 | 309 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipAccumDeprecAmt | 0 | 1061061350 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 539220940 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 542890640 |
| IRS990/LandBldgEquipCostOrOtherBssAmt | 0 | 1603951990 |
| IRS990/LegalDomicileStateCd | 0 | OH |
| IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt | 0 | 3836017 |
| IRS990/LoanOutstandingInd | 0 | false |
| IRS990/LoansFromOfficersDirectorsGrp/BOYAmt | 0 | 0 |
| IRS990/LoansFromOfficersDirectorsGrp/EOYAmt | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | true |
| IRS990/LocalChaptersInd | 0 | false |
| IRS990/MaterialDiversionOrMisuseInd | 0 | false |
| IRS990/MembersOrStockholdersInd | 0 | true |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
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