2024-11-11T09:18:42-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-01-01 341935236 LIMA MEMORIAL PROFESSIONAL CORPORATION LIMA 4192283335 1001 BELLEFONTAINE AVENUE LIMA OH 45804 TIMOTHY A BUIT VICE-PRESIDENT/CFO 4192283335 2024-11-08 1 0 AMY CIMINELLO P00796388 6148493000 2024-11-08 2023 2024-10-15 13:58:12Z MICHAEL D SWICK 1001 BELLEFONTAINE AVENUE LIMA OH 45804 29518790 0 X WWW.LIMAMEMORIAL.ORG X 2000 OH WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. 12 1 142 2 1643 0 0 0 30635807 29517194 531 0 2238 1596 30638576 29518790 0 10000 0 0 37470909 37377454 0 0 0 11121192 12483446 48592101 49870900 -17953525 -20352110 8208300 9636079 233498431 255278320 -225290131 -245642241 X WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. 0 0 49363335 10000 29517194 LIMA MEMORIAL PROFESSIONAL CORPORATION IS AN EXTENDED NETWORK OF PRIMARY CARE, PEDIATRIC AND SPECIALIST PHYSICIANS. THE PRIMARY CARE SERVICE LINE IS THE PATIENT'S GATEWAY TO A WHOLE TEAM OF SPECIALTY PHYSICIANS. WITH AN EMPHASIS ON COLLABORATIVE, PATIENT-FOCUSED CARE, PATIENTS CAN TAKE GREAT COMFORT KNOWING AN ENTIRE TEAM IS WORKING TO PROVIDE YOU WITH THE VERY BEST CARE. THERE ARE 10 FAMILY MEDICINE LOCATIONS ACROSS LIMA AND THE SURROUNDING REGIONS, EXTENDED HOURS AND SAME-DAY APPOINTMENTS. LIMA MEMORIAL HAS THE TOP MEDICAL AND SURGICAL SPECIALISTS IN THE AREA WHO WORK COLLABORATIVELY WITH YOUR PRIMARY CARE PHYSICIAN. THE SPECIALTY SERVICES INCLUDES: ANESTHESIOLOGY, CARDIAC SERVICES, DIABETES, EAR, NOSE & THROAT, GENERAL SURGERY, HEMATOLOGY/MEDICAL ONCOLOGY, INTERNAL MEDICINE, KIDNEY SERVICES, NEUROSURGERY & NEUROLOGY, NURSE-MIDWIFERY, OBSTETRICS/GYNECOLOGY, PALLIATIVE CARE, PEDIATRIC SERVICES, PODIATRY, PROCTOLOGY, PULMONARY MEDICINE, RADIATION ONCOLOGY, RHEUMATOLOGY, SLEEP DISORDERS, UROLOGY AND VEIN CARE. 49363335 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 67 0 1 142 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 1 0 X MATT BROWN 4192265197 1001 BELLEFONTAINE AVENUE LIMA OH 45804 JEREMY HEFFNER MD BOARD MEMBER (SEE SCH J) 50.00 0.00 X 864113 0 53691 MASROOR ABRO MD BOARD MEMBER (SEE SCH J) 50.00 0.00 X 823779 0 74081 G ALLEN BRYANT BOARD MEMBER (SEE SCH J) 50.00 0.00 X 205774 0 27412 ERIC MILLER DPM BOARD MEMBER (SEE SCH J) 50.00 0.00 X 461240 0 35094 SUSAN KAUFMAN BOARD MEMBER (SEE SCH J) 50.00 0.00 X 0 358846 4667 JAMES DOONE MD BOARD MEMBER (SEE SCH J) 50.00 0.00 X 238070 0 22301 JENNIFER MAAG BOARD MEMBER (SEE SCH J) 50.00 0.00 X 257437 0 35320 CHERYL WAYMAN PA-C BOARD MEMBER (SEE SCH J) 50.00 0.00 X 162851 0 20054 MICHAEL KERRIGAN CNP BOARD MEMBER (SEE SCH J) 50.00 0.00 X 133571 0 31590 TRACIE SANCHEZ BOARD MEMBER 1.00 2.00 X 0 0 0 PRAVEEN MALHOTRA BOARD MEMBER 1.00 3.00 X 0 0 0 MICHAEL D SWICK PRESIDENT/CEO (SEE SCH J) 6.00 44.00 X 0 818346 129892 ERIC D POHJALA VP/CFO (SEE SCH J) 6.00 44.00 X 0 454334 60625 ROBERT E ARMSTRONG JR BOARD MEMBER (SEE SCH J) 10.00 40.00 X 0 466408 67235 ANN POHL VP/CNO (SEE SCH J) EX-OFFICIO 1.00 49.00 X 0 346650 30140 JEFFREY LOBEL PHYSICIAN (SEE SCH J) 40.00 0.00 X 1330006 0 51233 VENKAT R BATTULA PHYSICIAN (SEE SCH J) 40.00 0.00 X 1232871 0 52500 PAUL N ANIKE PHYSICIAN (SEE SCH J) 40.00 0.00 X 1129936 0 52500 MEHRAN ARABPOUR PHYSICIAN (SEE SCH J) 40.00 0.00 X 983252 0 52253 RONALD L POHL PHYSICIAN (SEE SCH J) 40.00 0.00 X 1039798 0 52500 8862698 2444584 853088 112 0 1 0 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 30384 LOCUM TENEMS 1648348 NATIONAL ANESTHESIA SERVICES INC 31040 LAHSER ROAD BEVERLY HILLS MI 48025 LOCUM TENEMS 1168171 CENTRAL ANESTHESIA STAFFING 2243 BRIXTON ROAD COLUMBUS OH 43221 LOCUM TENEMS 973360 ECLINICALWORKS LLC 110 TURNPIKE ROAD WESTBORO MA 01581 SOFTWARE SERVICES 718676 WEATHERBY HEALTH CARE 25 VAN ZANT ST NORWALK CT 06855 LOCUM TENEMS 675004 10 PATIENT SERVICE REVENUE 621110 29517194 29517194 29517194 BILLING SERVICES 561000 1643 1643 PURCHASE DISCOUNTS 621110 -47 -47 1596 29518790 29517194 1643 -47 10000 10000 33012652 32804718 207934 1278541 1273214 5327 1511305 1494082 17223 1574956 1556433 18523 8515207 8461353 53854 200825 200825 60904 60904 119070 119070 47832 47832 898813 898813 BAD DEBT EXPENSE 2130117 2130117 DUES & SUBSCRIPTIONS 219595 219595 CME EXPENSE 120877 120877 MANAGED CARE 79592 79179 413 90614 87148 3466 49870900 49363335 507565 0 665545 458977 1919963 2748216 4297288 4822743 1043979 1102970 281525 503173 8208300 9636079 5162186 5070507 228336245 250207813 233498431 255278320 X -225290131 -245642241 -225290131 -245642241 8208300 9636079 -20352110 0 X X 0 1 X 1 0 X 0 ADVANCES FROM LIMA MEMORIAL JOINT OPERATING CO 245883255 LONG TERM PROFESSIONAL LIABILITY RESERVE 1576342 PENSION FUND 457B & F 2748216 250207813 X PART X, LINE 2: THE HEALTH SYSTEM, LIMA MEMORIAL HOSPITAL, LIMA MEMORIAL PROFESSIONAL CORPORATION, LIMA MEMORIAL HOSPITAL FOUNDATION, AND LIMA MEMORIAL HOSPITAL AUXILIARY ARE NOT-FOR-PROFIT CORPORATIONS, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. ELM TREE FOUNDATION, A FOR-PROFIT CORPORATION AND SUBSIDIARY OF THE HEALTH SYSTEM, WAS A TAXABLE CORPORATION THAT CONVERTED TO A NOT-FOR-PROFIT LLC IN 2021. THE RELATED ASSETS TRANSFERRED TO THE HEALTH SYSTEM, LEAVING ELM TREE FOUNDATION AS A DEFUNCT ENTITY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HEALTH SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE HEALTH SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. 1 LIMA MEMORIAL FOUNDATION 1001 BELLEFOUNTAINE AVENUE LIMA OH 45804 341707570 501(C)(3) 10000 0 CAPSTONE SPONSORSHIP 1 0 PART I, LINE 2: GRANTS WERE PAID TO A RELATED TAX-EXEMPT ENTITY TO SUPPORT ITS MISSION. THIS IS MONITORED INTERNALLY. THE LIMA MEMORIAL HOSPITAL SYSTEM MONITORS BOTH LIMA MEMORIAL PROFESSIONAL CORPORATION AND LIMA MEMORIAL FOUNDATION. 0 1 0 0 0 0 0 0 0 JEFFREY LOBEL PHYSICIAN (SEE SCH J) 1243510 0 86000 0 496 0 30000 0 21233 0 1381239 0 0 0 VENKAT R BATTULA PHYSICIAN (SEE SCH J) 791182 0 441193 0 496 0 30000 0 22500 0 1285371 0 0 0 PAUL N ANIKE PHYSICIAN (SEE SCH J) 745386 0 384054 0 496 0 30000 0 22500 0 1182436 0 0 0 RONALD L POHL PHYSICIAN (SEE SCH J) 849317 0 189985 0 496 0 30000 0 22500 0 1092298 0 0 0 MEHRAN ARABPOUR PHYSICIAN (SEE SCH J) 591012 0 391744 0 496 0 29753 0 22500 0 1035505 0 0 0 MICHAEL D SWICK PRESIDENT/CEO (SEE SCH J) 0 418259 0 380104 0 19983 0 110546 0 19346 0 948238 0 0 JEREMY HEFFNER MD BOARD MEMBER (SEE SCH J) 413307 0 450310 0 496 0 32458 0 21233 0 917804 0 0 0 MASROOR ABRO MD BOARD MEMBER (SEE SCH J) 526898 0 296385 0 496 0 50078 0 24003 0 897860 0 0 0 ROBERT E ARMSTRONG JR BOARD MEMBER (SEE SCH J) 0 290090 0 164098 0 12220 0 43232 0 24003 0 533643 0 0 ERIC D POHJALA VP/CFO (SEE SCH J) 0 285160 0 156954 0 12220 0 41279 0 19346 0 514959 0 0 ERIC MILLER DPM BOARD MEMBER (SEE SCH J) 285264 0 175480 0 496 0 13861 0 21233 0 496334 0 0 0 ANN POHL VP/CNO (SEE SCH J) EX-OFFICIO 0 221249 0 115803 0 9598 0 30140 0 0 0 376790 0 0 SUSAN KAUFMAN BOARD MEMBER (SEE SCH J) 0 334647 0 12188 0 12011 0 0 0 4667 0 363513 0 0 JENNIFER MAAG BOARD MEMBER (SEE SCH J) 202747 0 54194 0 496 0 7743 0 27577 0 292757 0 0 0 JAMES DOONE MD BOARD MEMBER (SEE SCH J) 228749 0 8825 0 496 0 7139 0 15162 0 260371 0 0 0 G ALLEN BRYANT BOARD MEMBER (SEE SCH J) 205278 0 0 0 496 0 6179 0 21233 0 233186 0 0 0 CHERYL WAYMAN PA-C BOARD MEMBER (SEE SCH J) 144517 0 17838 0 496 0 4892 0 15162 0 182905 0 0 0 MICHAEL KERRIGAN CNP BOARD MEMBER (SEE SCH J) 120588 0 12487 0 496 0 4013 0 27577 0 165161 0 0 0 PART I, LINE 3: RELATED ORGANIZATION, LIMA MEMORIAL JOINT OPERATING COMPANY, DETERMINES THE COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES BY 1)REVIEW AND APPROVAL OF THE COMPENSATION COMMITTEE; 2)UTILIZATION OF AN INDEPENDENT COMPENSATION CONSULTANT; 3)COMPARABLE DATA; AND 4) CONTEMPORANEOUS DOCUMENTATION. PART I, LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN AN IRC 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN. THIS PLAN IS FUNDED BY THE HOSPITAL AND VESTS WITH SERVICE THEREFORE IS SUBJECT TO RISK OF FORFEITURE. ROBERT E. ARMSTRONG, JR.: $43,232 MICHAEL D. SWICK: $110,546 ANN POHL: $30,140 ERIC D. POHJALA: $41,279 ADDITIONAL INFORMATION: COMPENSATION PRESENTED ON FORM 990, PART VII AND SCHEDULE J RELATED TO THE BOARD MEMBERS ARE FOR SERVICES PERFORMED FOR THE ORGANIZATION OUTSIDE THOSE SERVICES PERFORMED ON THE BOARD. THERE IS NO COMPENSATION PAID FOR BOARD SERVICES. RONALD L POHL RONALD L. POHL IS THE HUSBAND OF VP/CNO ANN-MARIE JEAN POHL 1039998 EMPLOYMENT 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE BOARD REVIEWS AND APPROVES FORM 990. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15B THE PROCESS FOR DETERMINING THE ORGANIZATION'S KEY EMPLOYEES' COMPENSATION INCLUDES: 1) REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE; 2) THE UTILIZATION OF AN INDEPENDENT COMPENSATION CONSULTANT; 3) COMPARABLE DATA; AND 4) CONTEMPORANEOUS DOCUMENTATION. THIS PROCESS WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE CURRENTLY NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 2C EXPLANATION: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LIMA MEMORIAL HOSPITAL 1001 BELLEFONTAINE AVENUE LIMA OH 45804 344434676 HEALTHCARE OH 501(C)(3) LINE 3 LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL HOSPITAL FOUNDATION 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341707570 SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL OH 501(C)(3) LINE 12B, II LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL HOSPITAL AUXILIARY 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341694632 SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL OH 501(C)(3) LINE 12B, II LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL JOINT OPERATING COMPANY 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341883284 HEALTHCARE OH 501(C)(3) LINE 3 N/A 0 LMHS WOMEN'S HEALTH CO-MANAGEMENT COMPANY LLC 1001 BELLEFONTAINE AVE LIMA OH 45804 271023520 WOMEN'S HEALTH CO-MANAGEMENT OH N/A 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 1