2023-08-01T11:06:29-05:00 2022-09-30 621517792 PYA PC 3000 Bayport Drive Suite 860 Tampa FL 33607 990 2021-10-01 592650456 Lakeland Regional Medical Center Inc LAKE 8636871100 1324 Lakeland Hills Boulevard Lakeland FL 33805 Lance Green EVP/Chief Financial Officer 8636871100 2023-08-01 1 Lance Green 999009999 Terry Haefner P01258953 8134243700 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Danielle Drummond 1324 Lakeland Hills Boulevard Lakeland FL 33805 1028284243 0 X www.myLRH.org X 1914 FL See Schedule OLakeland Regional Health's strategic imperative is to develop as a nationally recognized, fiscally strong and growing collaborative regional health system that improves lives by offering safe, high quality, equitable and affordable healthcare, while demonstrating an equal commitment to the promotion of individual and community health, wellness and disease prevention. 14 14 7003 78 3233 0 25039573 11742589 993167676 1016430537 11856 111117 0 0 1018219105 1028284243 0 0 0 0 394464771 453974053 0 0 0 515491873 505802560 909956644 959776613 108262461 68507630 1077871158 1047675429 678448779 663481552 399422379 384193877 X See Schedule OLakeland Regional Health's strategic imperative is to develop as a nationally recognized, fiscally strong and growing collaborative regional health system that improves lives by offering safe, high quality, equitable and affordable healthcare, while demonstrating an equal commitment to the promotion of individual and community health, wellness and disease prevention. 0 0 849186841 1016427812 See Schedule O for Program Services Statement 849186841 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 127 0 1 7003 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X George Eighmy 8636871101 230 S Florida Ave 4th Floor Lakeland FL 33801 Clayton Hollis Chair 1.00 1.00 X 0 0 0 Dale Dreyer Vice Chair 1.00 1.00 X 0 0 0 John Attaway Jr Director 1.00 1.00 X 0 0 0 Sylvia Blackmon-Roberts Director 1.00 1.00 X 0 0 0 Kimberly Elmhorst Director 1.00 1.00 X 0 0 0 Ed Garcia MD Director 1.00 1.00 X 0 0 0 Matt Green Director 1.00 1.00 X 0 0 0 Jack Harrell III Director 1.00 1.00 X 0 0 0 Anne Kerr PhD Director 1.00 1.00 X 0 0 0 Cory Petcoff Director 1.00 1.00 X 0 0 0 Bill Pou Director 1.00 1.00 X 0 0 0 Mark Preziosi MD Director 1.00 1.00 X 0 0 0 Weymon Snuggs Director 1.00 1.00 X 0 0 0 Tracy Wilson Director 1.00 1.00 X 0 0 0 Danielle Drummond President/Chief Exec. Offi 50.00 1.00 X 1125808 0 89605 Lance Green EVP - Chief Financial Offi 50.00 1.00 X 576208 0 104209 Sarah Bhagat COO/SVP Ambulatory Oper. & 50.00 X 478632 0 75668 Stacy Bolton VP - CIO/Chief Technology 50.00 X 368186 0 99929 Timothy Boynton VP of Development, Chief P 50.00 1.00 X 377319 0 72688 Francisco J Chebly Executive Director LRH Phy 50.00 X 462147 0 46533 Scott Dimmick SVP - Chief Human Resource 50.00 X 460600 0 81640 Hal Escowitz Chief Quality & Medical In 50.00 X 512564 0 43649 Caroline Gay SVP - Chief Analytics Offi 50.00 1.00 X 457615 0 88105 Graham Greene Chief Academic Officer & U 50.00 X 0 563853 55768 Terry Hamilton EVP - Chief Operating Offi 50.00 X 658608 0 134684 Jonn Hoppe EVP - Chief Legal Officer 50.00 X 675260 0 90936 Ana Kalman VP - CIO/Chief Application 50.00 X 397653 0 87984 Deana L Nelson SVP - Administration & Cor 50.00 X 454774 0 63999 April Novotny VP - Chief Nurse Executive 50.00 X 325738 0 68832 Patrick Phillips SVP - Business Development/Chief Strategy Officer 50.00 X 372854 0 101332 Timothy Regan President/Chief Medical Of 50.00 X 838659 0 76444 Michael Spake SVP - External Affairs and 50.00 X 444291 0 63049 Catherine Pesek Bird Physician Advisor 50.00 X 270586 0 27000 Rodriguez Dangerfield Director of Pharmacy 50.00 X 243489 0 45609 Jason Driskell VP - Revenue Cycle 50.00 X 282748 0 43756 Nancy Finnigan Designated Institutional Official/Nephrologist 50.00 X 412120 0 34475 Lori L Williams Shea AVP - Women's & Children's 50.00 X 250812 0 43497 Elaine Thompson PhD Former President/Chief Executive 50.00 1.00 X 454732 0 7929 10901403 563853 1647320 484 1 1 0 Creative Contractors Inc 101 Creative Way Clearwater FL 33759 Construction Contractor 18857919 Cerner Corporation PO Box 412702 Kansas City MO 641412702 Software Maintenance & Support 13657284 Nemours Foundation 10140 Centurion Pkwy N Jacksonville FL 322560532 Professional Services 5942371 University Medical Services PO Box 917492 Orlando FL 32891 Neuro Professional Services 4223577 VAYA WORKFORCE SOLUTIONS LLC DEPT CH18001 PALATINE IL 600558001 Contract Labor 4014058 336 193616 11548973 11742589 Patient Service Revenu 621990 775329485 775329485 Medicare/Medicaid 621990 223246942 223246942 Other Operating Revenu 561000 9146726 9144001 3233 -508 Cafeteria Revenue 722210 5209795 5209795 3497589 3497589 1016430537 111117 0 111117 111117 111117 1028284243 1016427812 3233 110609 9212554 7685786 1526768 355132688 307636519 47496169 13729822 11882464 1847358 50371346 43593842 6777504 25527643 22092879 3434764 740402 740402 262000 262000 137090 137090 64134734 51399521 12735213 1145843 818160 327683 15770122 11695836 4074286 34850372 30904132 3946240 9576493 8492110 1084383 109743 109743 11985229 10628096 1357133 57425607 50923087 6502520 17531228 17531228 Patient Supplies & Phar 196360629 196360629 Bad Debts 70550427 70550427 Repairs & Maintenance 13638826 13008308 630518 HCCB Indigent Assessmen 10538280 10538280 1045535 976765 68770 959776613 849186841 110589772 0 14468 13850 101233650 105064282 24223075 20638514 13027696 13316662 1585168663 835853435 735002739 749315228 20225995 16730880 42298609 42085649 141844926 100510364 1077871158 1047675429 31639690 32537687 100000 250000 521684550 500025821 125024539 130668044 678448779 663481552 X 370074716 348435736 29347663 35758141 399422379 384193877 1077871158 1047675429 X 68507630 -3309066 -80427066 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 137090 137090 0 Part II-B, Line 1: Lakeland Regional Medical Center, Inc. provided payment to an independent lobbying firm to notify the Medical Center of any pending legislation that affects hospitals and healthcare. 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1.00000 0 1 1 240975832 240975832 394225231 193060486 201164745 2055565 1955475 100090 885287327 640837474 244449853 62624708 62624708 749315228 Other Receivables 3677731 Due to Affiliates 89706254 Project Fund 6034708 Net ROU ASSETS 1091671 100510364 FL Medical Assistance Assessment 16868319 Employee Compensation 49290000 Malpractice Claims 45583753 Workers Compensation 2448290 Other Long Term Liabilities 438834 Bond Interest Payable 7629722 Estimated Third Party Settlements 7754208 Short-Term Right of Use Liability 654918 130668044 X 951125000 -3309066 -3106134 -6415200 957540200 70744043 70744043 1028284243 889227000 0 889227000 70549613 70549613 959776613 Part V, Line 4: The purpose of the Organization's Endowment funds is to grow the corpus and use the unrestricted earnings from the invested endowment fund to support the Medical Center's mission. Part X, Line 2: The Parent, Medical Center, and Foundation have been recognized by the Internal Revenue Service as tax-exempt organizations as described in Section 501(c)(3) of the Internal Revenue Code of 1986. Income earned in furtherance of the organizations' tax-exempt purposes is exempt from federal and state income taxes. Income taxes related the Health System's ownership interests in joint venture partnerships are not material to the Health System. U.S. GAAP requires the Health System's management to evaluate tax positions taken by the Health System and recognize a tax liability (or asset) 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. The Health System has analyzed its tax positions and has concluded that as of September 30, 2022, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) in the consolidated financial statements or disclosure in the notes to the consolidated financial statements. The Health System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Health System believes it is no longer subject to income tax examination for tax years prior to 2018. Part XI, Line 2d - Other Adjustments: Foundation Transfer -3,106,384. Other 250. Part XI, Line 4b - Other Adjustments: Bad Debts Netted with Revenue on Audited Financials 70,550,427. Related Transactions 193,616. Part XII, Line 4b - Other Adjustments: Bad Debts Netted with Revenue on Audited Financials 70,550,427. Other -814. 1 1 X 1 X 1 X 1 1 1 0 1 1 20789564 20789564 0.02340 158818118 61690794 97127324 0.10920 7972304 2274122 5698182 0.00640 187579986 63964916 123615070 0.13900 75992141 65239465 10752676 0.01210 75992141 65239465 10752676 0.01210 263572127 129204381 134367746 0.15110 1 70550427 161556148 144573316 16982832 X 1 1 1 1 Lakeland Regional Medical Center 1324 Lakeland Hills Blvd Lakeland FL 33805 X X X X Pediatrics Emergency Department Lakeland Regional Medical Center 1 0 0 1 X X X X X X X X X X 22 1 0 1 1 X mylrh.org X 1 22 1 mylrh.org 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X mylrh.org X mylrh.org X mylrh.org X X X X X X 1 X 0 X X X X 1 X 0 0 Lakeland Regional Medical Center Part V, Section B, Line 3j: Since our last Community Health Needs Assessment (2018-2021), so much in our community, state, and world has changed. Between the COVID-19 pandemic that changed the way we sought, delivered, and advanced healthcare to the unrest that followed incidents of social injustice, we learned to face extraordinary challenges in new ways with the constant goal of building a stronger, healthier tomorrow for every Polk County resident.Upon review of our County's current health data and as a result of the CHNA process, Lakeland Regional Health has identified the following areas of need:1. Cultural Competency2. Access to Quality, Coordinated Care3. Cancer Screening and Prevention4. Diabetes5. Heart Disease and Stroke6. Injury Prevention7. Mental Healthcare8. Obesity, Nutrition, and Physical ActivityIn response to the identified areas of need, the following initiatives and anticipated outcomes were established:1. CULTURAL COMPETENCEInitiatives and Actions: - Recruit and retain top diverse talent.- Develop an intentional curriculum for team members that works to enhance cultural competency and awareness.- Launch a Diversity Advisory Council that works to advance commitment to eliminating bias, advocates for the underserved, and establishes processes and procedures to reinforce cultural competency in patient care.- Further develop community partnerships that work to foster health equity and improve pathways to care.Anticipated Impact:- Greater understanding of health equity in our community.- Creation of an environment where all people feel a sense of belonging, are valued and respected, and have access to the same opportunities.2. ACCESS TO QUALITY, COORDINATED CAREInitiatives and Actions:- Increase capacity by attracting and retaining diverse, adaptable and highly qualified providers and team members.- Establish a Graduate Medical Education program that will foster health and healing, engage a diverse community and work collaboratively for positive medical and social transformation.- Establish new locations and optimize existing sites of service to provide clinical services in convenient, easily accessible locations.- Collaborate with local, regional and national partner organizations and affiliates to continue to expand and strengthen healthcare services to provide convenient access and highest quality outcomes.- Engage community members in education regarding their access to primary care.Anticipated Impact:- Care that is convenient as well as culturally sensitive and appropriate.- Increased patient satisfaction.- Reduction of barriers that impact a patient's ability to achieve health and wellbeing.- Increased compliance with preventive care recommendations (screenings, immunizations, lifestyle changes).- Reduction in the percentage of community members who delay obtaining needed medical care.3. CANCER SCREENING AND PREVENTIONInitiatives and Actions:- Engage with community partners to improve cancer screening rates in order to facilitate early detection of cancer.- Empower community members to engage in cancer prevention and early detection through use of cancer screenings. - Provide resources for community providers and community members experiencing cancer-related illness.- Increase education outreach opportunities through programs such as ShopTalk and the Congregational Health Partnership program. - Increase participation in the tobacco cessation program held in collaboration with Tobacco Free Florida. The program encourages participants to work on the process and problems of quitting, both individually and as part of a group.- Increase the number of adolescents aged 9-14 years who are up to date with the HPV vaccine series. (In partnership with the American Cancer Society, Florida Department of Health in Polk, Central Florida Healthcare).Anticipated Impact:- Increased compliance with preventive care recommendations (screenings and lifestyle changes).- Decreased cancer incidence and/or rate of late-stage cancer diagnoses.- Increased public awareness of cancer prevention strategies.- Increased focus on barriers that prevent timely and equitable cancer prevention, early detection, and treatment.4. DIABETESInitiatives and Actions:- Increase knowledge of and access to diabetes education programs.- Increase access to the Diabetes Prevention Program (DPP) for high-risk community members.- Provide education outreach opportunities through programs such as ShopTalk and the Congregational Health Partnership Program.- Continue to offer glucose screenings throughout the community and provide education about diabetes, pre-diabetes, risk factors, and early intervention.- Explore ways to assist providers and team members in providing culturally appropriate education to diabetic patients.Anticipated Impact:- Increased knowledge of available resources.- Increased referrals to diabetes education classes and to the Diabetes Prevention Program (DPP).- Decrease new incidences of diabetes.- Reduction in hospitalization rates due to diabetes.5. HEART DISEASE AND STROKEInitiatives and Actions:- Provide health education through community health events and in the media to encourage healthy behaviors and recognition of signs and symptoms of heart disease and stroke.- Continue to provide blood pressure screenings at community events and in faith-based organizations through the Congregational Health Partnership program.- Increase the number of community residents who know how to perform CPR and use an automated external defibrillator or AED.- Provide support programs and education on cardiovascular health, stroke prevention and recovery.- Increase knowledge and awareness of self-monitoring practices and signs/symptoms.- Reduced mortality rates for cardiovascular disease.Anticipated Impact:- Increased knowledge and awareness of self-monitoring practices and signs/symptoms.- Reduced mortality rates for cardiovascular disease.6. INJURY PREVENTIONInitiatives and Actions:- Continue to participate in the Coalition on Injury Prevention. The Coalition provides injury prevention education and activities by leveraging partnerships, community effort, support networks and community events.- Increase the use of safety equipment and knowledge of preventing childhood injuries (i.e. helmet safety, car seat safety,drowning prevention) across the county.- Continue to provide Stop the Bleed education to community residents.- Provide resources for community providers and members experiencing cancer-related illness, asthma and diabetes.Anticipated Impact:- Increased awareness and knowledge of injury prevention activities.- Increased participation in education/prevention programs.7. MENTAL HEALTHCAREInitiatives and Actions: - Construct the new Center for Behavioral Health and Wellness by 2022.- Increase integration of physical and behavioral health services through streamlined access to behavioral health resources across organization service lines including primary care.- Reduce deaths by suicide by increasing ability for patients to get care before it reaches crisis in addition to education and advocacy in the community.- Coordinate and work collaboratively with community stakeholders to expand access to a continuum of behavioral health services.- Conduct community-wide awareness campaigns aimed at reducing stigma and enhancing access to community education programs.Anticipated Impact:- Increased capacity for inpatient services.- Creation of new and expanded outpatient services that support a more comprehensive care continuum.- Increased awareness of the treatment of mental health.- Improved coordination among healthcare providers, community resources and programs.- Reduction in the percentage of residents who delay obtaining needed behavioral health and substance abuse intervention and care.- Reduction in stigma surrounding mental illness.OBESITYInitiatives and Actions:- Create innovative prevention and wellness initiatives and outreach efforts to improve overall population health status in our community.- Promote weight management programs and services.- Partner with community organizations and surrounding neighborhoods to implement impactful community education that increases knowledge and skills that promote healthy lifestyles for community residents.- Reduce cancer risk and increase support for cancer survivors by providing free and low-cost physical activity opportunities that allow participants to maintain a healthy weight, eat a healthy diet, and be physically active.- Continue to implement the Congregational Health Partnership program and annual FitChurch Challenge program (with the addition of FitKids curriculum).- Develop interactive childhood obesity education that promotes healthy nutrition, increased physical activity, and decreased screen time. Lakeland Regional Medical Center Part V, Section B, Line 5: The health of Polk County residents is influenced by many factors. In order to gain a broad perspective of these factors, the potential barriers they may create and to determine the priorities for the 2022-2025 Community Health Needs Assessment, Lakeland Regional Health and AdventHealth utilized a process that included the review of existing secondary data and collection of primary data through a number of focus groups. During focus groups and a community dialogue session, we looked to our community residents and partners to represent their respective communities and provide feedback on how health systems could most effectively address specific areas of need.The assessment was performed by reviewing data from sources including:1. United States Census Bureau2. Centers for Disease Control and Prevention3. Florida Health Assessment Resource Tool Set (CHARTS)4. Florida Behavioral Risk Factor Surveillance System (BRFSS)5. Community Commons6. Robert Wood Johnson Foundation County Health RankingsOver 900 community members participated in the 2022-2025 Community Health Needs Assessment survey. The survey was available both online and in hard copy in the following languages: English, Spanish and Creole. The survey opened on March 17, 2021, and closed on June 30, 2021. Part V, Section B, Line 22b: To be eligible for a 100% Financial Assistance Adjustment (i.e., full write-off), the patient's Household Income must be less than or equal to 200% of the current FPG (adjusted for family size). If the patient's Household Income is greater than 200% and less than or equal to 400% of the current FPG (adjusted for family size), the patient will receive a Financial Assistance Adjustment that is based upon LRMC's Amounts Generally Billed (AGB) percentage. By January 28th of each year, the AGB percentage will calculated by dividing the sum of allowed amounts for claims for services allowed by Medicare Fee-For-Service and all private health insurers during the prior twelve-month period ended September 30 by the gross charges for such claims. No individual eligible under this Financial Assistance Policy will be given a Financial Assistance Adjustment which is less than amount calculated using the AGB percentage. The AGB percentage in effect is 20%, thus the Financial Assistance Adjustment based on the AGB percentage is 80%. In all situations described in this paragraph, the Financial Assistance Adjustment will be applied to the outstanding balance of an account after payments by third parties, if any.The Financial Assistance Adjustment based on the AGB percentage will also be applied to the outstanding balance, after payments by insurance, if any, of patients with Catastrophic Medical Expenses, as defined above, who are not eligible for financial assistance based on the other provisions of this policy. Uninsured patients of LRMC who are not eligible for financial assistance based on the other provisions of the policy will also receive an Uninsured Discount based on the AGB percentage. 6 1 - Hollis Cancer Center 3525 Lakeland Hills Blvd Lakeland FL 33805 Outpatient Clinic (Chemo/RadTx/Infusion Therapy) 2 - LRMC Morrell Internal Medicine Clinic 300 Parkview Place Lakeland FL 33805 Outpatient Clinic 3 - Lakeland Regional Rehab & Sports Clinic 3030 Harden Blvd Lakeland FL 33803 Outpatient Clinic 4 - Lakeland Reg Health Ctr for Wound Care 3030 Harden Blvd Lakeland FL 33803 Outpatient Clinic 5 - Lakeland Regional Rehab & Sports Clinic 2125 Sleepy Hills Rd Lakeland FL 33810 Outpatient Clinic 6 - Cardiac Rehabilitation 3525 Lakeland Hills Blvd Lakeland FL 33805 Outpatient Clinic Part I, Line 7: Lakeland Regional Medical Center determines the cost of charity by calculating a ratio of cost to charges as derived from the Medicare Cost Report and then multiplying that ratio by the gross uncompensated charges associated with providing care to charity patients. Similarly, the cost of subsidized health services is based on the unreimbursed cost of caring for the patients' services less the cost associated with Bad Debt, Charity, Medicaid and other means-tested government programs. The actual expenses paid for providing community health improvements and community benefits operations less any payments received for those activities is reflected above. Part I, Line 7g: Subsidized health services are clinical services that are essential to meet the health care needs of the entire community and are provided with a financial loss to Lakeland Regional Medical Center (LRMC). The financial loss is measured after removing losses associated with Bad Debt, Charity, Medicaid and other means-tested government programs. LRMC operates one of the busiest Emergency Departments in the nation with over 200,000 emergency visits each year prior to the COVID-19 pandemic. We treat all patients regardless of their ability to pay for the care they receive. In addition, we staff a Level II Trauma Center to provide critical care access to residents of Lakeland and surrounding communities. The cost of providing emergency and trauma care 24 hours each day exceeds the payments LRMC receives for providing that care. LRMC also operates the only inpatient Behavioral Health Unit in Lakeland to provide care for the mentally ill population who have nowhere else to go for essential inpatient psychiatric care. Part I, Ln 7 Col(f): There is $70,550,427 of bad debt expense which is included in Form 990, Part IX, Line 24(b). This amount was removed in the calculation of the Percent of Total Expense on Schedule H Line 7f. Part II, Community Building Activities: Lakeland Regional Medical Center is the only hospital in Lakeland and serves as a tertiary referral hospital serving the broader Polk County, Florida. As the only state-designated trauma center for Polk, Highlands, and Hardee counties, we provide critical access and care to the area's most seriously injured residents. A shortage of primary care physicians and mental health services has resulted in our ER becoming the highest volume ER in the nation, offering essential medical care to many underserved residents in our community.Ongoing education programs for diabetes and cardiac rehab are designed to help patients with chronic conditions maintain their health and avoid repeated hospitalizations. Support groups assist those living with chronic and life-threatening illnesses to access resources and critical peer support. Education and screening programs have identified those at risk of various conditions, allowing them to seek treatment. Participation in and support of community events helps to ensure a vibrant community and a positive quality of life for our employees as well as our patient-base. Part III, Line 2: LRMC follows the guidance provided in the Healthcare Financial Management Association Principles and Practices Board "Statement 15: Valuation and Financial Statement Presentation of Charity Care and Bad Debts by Institutional Healthcare Providers" in determining bad debt expenses. Bad debt expense results when a patient who does not meet the criteria for Charity Care and who has been determined to have the financial capacity to pay for healthcare services and is unwilling to settle the claim. The hospital utilizes an overall ratio of cost to charges from the applicable Medicare cost report and this is applied to the bad debt expense. Part III, Line 4: The consolidated, audited financial statements of Lakeland Regional Health Systems, Inc. and Subsidiaries are attached to this return and contain language addressing Bad Debts on pages 9 thru 11. Part III, Line 8: Medicare allowable costs are determined using the approved standardized Medicare Cost Report methodology. The Medicare cost is derived using the Medicare Cost-to-Charge ratio from the Medicare cost report times the Medicare charges for service. Part III, Line 9b: LRH will not engage in the following collection activities for any patients (even if they do not qualify for financial assistance): - Place a lien on an individual's property- Foreclose on an individual's real property- Attach or seize an individual's bank account or any other personal property- Commence a civil action against an individual- Cause an individual's arrest- Cause an individual to be subject to a writ of body attachment- Garnish an individual's wages- Demand payment for a prior bill as condition of receiving future services at LRMC. This prohibition does not apply to office-based services provided by LRHS.LRMC or its representatives (i.e., a collection agency) may report a patient to a credit bureau if the patient has received a written notice (and an attempt has been made to provide oral notification) specifying the date, which shall be not less than 30 days after the date of the notice, after which credit bureau reporting may occur. Credit Bureau reporting may not occur earlier than 240 days after the date the patient received the first billing statement for the care provided. These limitations do not apply to LRHS. Part VI, Line 2: Lakeland Regional Medical Center collaborates with medical staff, community leaders and the Polk County Health Department to determine the health needs of the citizens of Lakeland and Polk County, Florida. LRMC sponsors various Medical Staff Committees where community health needs are frequently discussed. Our senior management and staff identify unmet community health needs through participation in community coalitions, partnerships, boards, committees, and advisory groups. Using available data on the demographics and service utilization for our primary and secondary markets, the LRMC executive team and Board develop a comprehensive annual Strategic Plan to address the healthcare needs of the community. For the 2022-2025 CHNA, stakeholders representing broad interests of the community served by Lakeland Regional Health attended a dialogue session to discuss the overall health of the community, available health services, in addition to opportunities to bridge gaps and access to current services. Following the community dialogue session, the data review process involved the formal prioritization method known as the Prioritization Matrix, which included ranking health priorities based on the six primary criteria: alignment with the health system's mission; existing programs; ability to impact within three years; financial resources required; human resources required and the availability of measurable outcomes to assess effectiveness of the intervention/plan.In 2012, LRMC opened a primary health clinic to provide a medical home for the uninsured and underinsured population. This clinic is designed to both improve the quality of care for low income patients and also reduce visits to the emergency room. In the fall of 2012 and continuing through 2015, LRMC partnered with the Polk County Health Department, Peace River Center and the Polk Healthcare Plan as part of the state Low Income Pool for primary care to offer a patient-centered, primary care integrated medical home within the I-4 corridor of Polk County. Beginning in 2016 and through 2018, LRMC continued its partnership with the Polk HealthcarePlan and Peace River to provide primary care and mental health screenings to the indigent population of Polk County and members of the Polk Healthcare Plan which was partially subsidized by a grant funded by Polk County. In 2020, the Family Health Center had 7,061 visits in which patients and their families were able to receive primary care. Part VI, Line 3: For scheduled admissions, LRMC conducts a pre-admission interview to discuss the financial plan with the patient, the guarantor, and/or his or her legal representative. If a pre-admission interview is not possible, this interview is conducted upon admission. In the case of an emergency admission, LRMC's evaluation of payment alternatives does not take place until the required stabilizing medical care has been provided. Identification of patients eligible for assistance can take place at any time during the rendition of services or during the patient account collection process (including bad debt).Those patients who may qualify for financial assistance from a government program are referred to the appropriate program, such as Medicaid or the Polk Healthcare Plan. LRMC provides on-site access to Medicaid eligibility specialists to assist patients in qualifying for governmental medical assistance programs. All patients identified as potential financial assistance recipients are offered the opportunity to apply for financial assistance. If this evaluation is not conducted until after the patient leaves, or in the case of outpatients or emergency patients, an LRMC representative mails a financial assistance application to the patient. For the first 120 days after the date of service, the hospital will notify an individual about the Financial Assistance Policy. The patient will receive at least three billing statements that include language about applying for financial assistance. The hospital will accept and process any financial assistance applications submitted by an individual for up to 240 days after the patient received the first billing statement for the care. Part VI, Line 4: The Lakeland Urban Area is considered the primary service area and the remainder of Polk County is considered the secondary/extended service area. Polk County has a population of over 742,777 with 20.4% of residents being over the age of 65 and 14.4% of residents living below the Federal Poverty Level. Children under 18 years of age make up 22% of the population. Located between Orange and Hillsborough Counties, it is the fourth (4th) largest county in Florida consisting of 1,797.84 square miles. Lakeland is the largest city in Polk County and is located between Tampa and Orlando on Interstate 4. The unemployment rate for Polk County was 3.3% as of November 2019. Census data reflects a population that is 24.6% Hispanic or Latino, 16.2% Black and under 5% from other minorities. Part VI, Line 5: Lakeland Regional Medical Center's senior management, directors, managers, physicians and staff provide leadership and resources to equip local organizations with the skills needed to create a healthy community. Our staff participates on boards, advisory committees, and coalitions benefiting the community we serve without compensation for their time. Our leaders and physicians participate in educational programs, workshops and health fair events that are provided free to members of the community. We provide cancer screening services to the community for early detection of breast, skin and colon cancers. We participate and provide support for educational programs for healthcare workers in partnership with local colleges, universities and trade schools. Lakeland Regional Medical Center has a vibrant volunteer program, offering varied opportunities for service to the members of the community. The medical staff of Lakeland Regional Medical Center consists of over 600 physicians and is organized to promote the public interest of healthcare. No part of the income of LRMC inures to the benefit of any private individual, nor is any private interest being served. All surplus funds are reinvested into the facilities, equipment, programs and resources needed to continually improve the quality of patient care, expand our outreach, and advance the medical training and education of our staff. As noted above, the primary health clinic opened in 2012, and the Low Income Pool partnership clinic with Polk County located on the I-4 corridor are excellent examples of LRH's commitment to community health promotion. Part VI, Line 6: Lakeland Regional Medical Center is a subsidiary of Lakeland Regional Health Systems, Inc., a not-for-profit system that reinvests its profits back into the community through programs that benefit the residents of Lakeland and Polk County, Florida. The Health System facilities are leased from the City of Lakeland and the operations of the Hospital and Health System directly benefit the citizens of the community.Under the terms of the Agreement prior to fiscal year 2016, annual rent of $1.00 per operating year plus additional payments were made to the City of Lakeland (the City) based on a formula, which took into consideration the net revenues of the Medical Center, and net income of certain affiliated organizations, as defined in the Agreement.An amendment to the Agreement was reached and became effective October 1, 2015. The amendment provided a lump sum payment of $15,000,000 to the City on October 1, 2015, with fixed annual additional payments due beginning in fiscal year ending September 30, 2016 through fiscal year ending September 30, 2040. The additional payment for fiscal year ending September 30, 2021 was $14,379,000 with future scheduled payments per operating year through the duration of the Agreement ranging from $14,379,000 in fiscal year 2022 to $22,194,000 in fiscal year 2040 totaling approximately $335,100,000.In March 2021, the Agreement was amended whereby the Medical Center provided the City a $215,000,000 lump sum payment in lieu of the aforementioned remaining lease payments under the Agreement scheduled for fiscal years 2022 through 2040. In addition to the lump sum payment, the lease was extended in perpetuity with annual payments beginning in fiscal year 2041 and beyond at $10.00 per year. The $215,000,000 million lump sum payment was funded in part with proceeds from the Series 2021 Bonds. As part of the amendment, the Medical Center's total consideration of $235,000,000, inclusive of additional payments made to the City during 2021 and throughout the Agreement was recorded as property and equipment in the accompanying consolidated balance sheet as a land purchase due to the right to control the use on the property in perpetuity.In addition, the Health System provides for the health of the community by directly employing physicians in underserved medical specialties, such as orthopedics, trauma surgery, oncology and behavioral health. The Health System's medical clinics provide access to all residents, regardless of income, and many operate at a loss. Despite this, LRH believes that the role these clinics provide in the community, and in the promotion and maintenance of health, is part of our mission and our significant contribution to the community. X X X X X 0 1 0 0 0 0 0 0 0 Danielle Drummond President/Chief Exec. Offi 825402 0 154560 0 145846 0 58975 0 30630 0 1215413 0 36989 0 Lance Green EVP - Chief Financial Offi 446990 0 91640 0 37578 0 72211 0 31998 0 680417 0 11917 0 Sarah Bhagat COO/SVP Ambulatory Oper. & 347650 0 75101 0 55881 0 46770 0 28898 0 554300 0 20804 0 Stacy Bolton VP - CIO/Chief Technology 310160 0 57257 0 769 0 70865 0 29064 0 468115 0 0 0 Timothy Boynton VP of Development, Chief P 277926 0 64187 0 35206 0 47598 0 25090 0 450007 0 11910 0 Francisco J Chebly Executive Director LRH Phy 390337 0 71110 0 700 0 14521 0 32012 0 508680 0 0 0 Scott Dimmick SVP - Chief Human Resource 343548 0 74229 0 42823 0 52792 0 28848 0 542240 0 15322 0 Hal Escowitz Chief Quality & Medical In 437810 0 74054 0 700 0 14400 0 29249 0 556213 0 0 0 Caroline Gay SVP - Chief Analytics Offi 351460 0 75572 0 30583 0 57495 0 30610 0 545720 0 9689 0 Graham Greene Chief Academic Officer & U 0 521114 0 24357 0 18382 0 26520 0 29248 0 619621 0 9235 Terry Hamilton EVP - Chief Operating Offi 565754 0 92239 0 615 0 101949 0 32735 0 793292 0 0 0 Jonn Hoppe EVP - Chief Legal Officer 492974 0 104235 0 78051 0 60007 0 30929 0 766196 0 28735 0 Ana Kalman VP - CIO/Chief Application 336550 0 60990 0 113 0 74549 0 13435 0 485637 0 0 0 Deana L Nelson SVP - Administration & Cor 339846 0 72734 0 42194 0 51753 0 12246 0 518773 0 15681 0 April Novotny VP - Chief Nurse Executive 278257 0 47138 0 343 0 55562 0 13270 0 394570 0 0 0 Patrick Phillips SVP - Business Development/Chief Str 319658 0 52992 0 204 0 68616 0 32716 0 474186 0 0 0 Timothy Regan President/Chief Medical Of 590807 0 128767 0 119085 0 47195 0 29249 0 915103 0 37612 0 Michael Spake SVP - External Affairs and 310693 0 69236 0 64362 0 31075 0 31974 0 507340 0 20068 0 Catherine Pesek Bird Physician Advisor 260733 0 0 0 9853 0 0 0 27000 0 297586 0 0 0 Rodriguez Dangerfield Director of Pharmacy 222942 0 20418 0 129 0 12812 0 32797 0 289098 0 0 0 Jason Driskell VP - Revenue Cycle 254643 0 27912 0 193 0 13370 0 30386 0 326504 0 0 0 Nancy Finnigan Designated Institutional Official/Ne 410571 0 0 0 1549 0 0 0 34475 0 446595 0 0 0 Lori L Williams Shea AVP - Women's & Children's 229099 0 21583 0 130 0 12783 0 30714 0 294309 0 0 0 Elaine Thompson PhD Former President/Chief Executive 66056 0 387949 0 727 0 7374 0 555 0 462661 0 0 0 Part I, Line 4b Danielle Drummond - President and Chief Executive Officer - participated in a supplemental nonqualified deferred compensation plan. She had $145,539 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). She had an additional $44,575 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Lance Green - Executive VP and Chief Financial Officer - participated in a supplemental nonqualified deferred compensation plan. He had $37,553 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $57,811 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Timothy Boynton - Vice President of Development and Chief Public Relations and Communications Officer - participated in a supplemental nonqualified deferred compensation plan. He had $35,181 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $33,198 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Timothy Regan - President/Chief Medical Officer - participated in a supplemental nonqualified deferred compensation plan. He had $119,060 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $32,795 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Michael Spake - SVP of External Affairs and Chief Compliance and Integrity Officer - participated in a supplemental nonqualified deferred compensation plan. He had $63,843 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $17,634 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Sarah Bhagat - Chief Operating Officer and SVP of Ambulatory Operations and Organizational Effectiveness - participated in a supplemental nonqualified deferred compensation plan. She had $55,856 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). She had an additional $32,370 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Jonn Hoppe - EVP and Chief Legal Officer - participated in a supplemental nonqualified deferred compensation plan. He had $78,026 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $45,607 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Scott Dimmick - SVP and Chief Human Resources Officer - participated in a supplemental nonqualified deferred compensation plan. He had $42,452 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $38,392 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Deana Nelson - SVP and Administration and Corporate Initiatives Officer - participated in a supplemental nonqualified deferred compensation plan. She had $42,169 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). She had an additional $37,334 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Caroline Gay - Senior VP, Chief Population Health Officer and Chief Analytics Officer - participated in a supplemental nonqualified deferred compensation plan. She had $30,083 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). She had an additional $45,948 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Graham Greene - Chief Academic Officer - participated in a supplemental nonqualified deferred compensation plan. He had $18,357 of taxable benefits during calendar year 2021. This amount is included in Part II Column (B)(iii). He had an additional $12,120 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. April Novotny - VP Chief Nurse Executive - participated in a supplemental nonqualified deferred compensation plan. She had $49,299 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Ana Kalman - VP CIO/Chief Applications Officer - participated in a supplemental nonqualified deferred compensation plan. She had $60,149 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Stacy Bolton - VP CIO/Chief Technology Officer - participated in a supplemental nonqualified deferred compensation plan. She had $56,465 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Terry Hamilton - EVP and Chief Operating Officer - participated in a supplemental nonqualified deferred compensation plan. He had $100,602 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. Patrick Phillips - SVP of Business Development/Chief Strategy Officer - participated in a supplemental nonqualified deferred compensation plan. He had $57,798 of nontaxable benefits accrue during calendar year 2021. This amount is included in Part II Column C. A City of Lakeland Florida 596000354 511665JE2 2011-07-28 81113255 2011 Bonds refunded the 96A, 97A, 97B & 99B Bonds & paid 2011 issuance costs 1 0 0 B City of Lakeland Florida 596000354 511665JN2 2015-02-05 205545053 2015 Hospital Revenue Bonds for capital projects 0 0 0 C City of Lakeland Florida 596000354 511665KFJ 2016-09-15 97381865 2016 Hospital Revenue Refunding Bonds 0 0 0 D Florida Development Finance Corporation 593270584 34061QBF3 2021-08-17 277011519 2021 Healthcare Facilities Revenue Bonds 0 0 0 A 22915000 81113255 1012480 0 1 1 1 B 31815000 205545053 1892439 205545053 2018 0 0 1 1 C 97381865 99742693 937638 1 0 1 1 D 277011520 23481655 2822900 250706964 2022 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: City of Lakeland, Florida Date the Rebate Computation was Performed: 09/15/2021 Form 990, Part III, Line 4a Lakeland Regional Medical Center provides free care to patients who meet the State of Florida charity care guidelines and who are not eligible for public assistance. Lakeland Regional Medical Center provided care to emergency patients, regardless of their ability to pay. In addition to the primary Emergency Department, specialty care for children was provided in the separate Pediatric Emergency unit and provides a walk-in center for those patients in need of primary care under non-emergent conditions. Lakeland Regional Medical Center additionally provided inpatient and outpatient mental health services to patients, regardless of their ability to pay. Comprehensive care was offered for a variety of illnesses, including clinical depression, anxiety and memory disorders, addiction recovery and various adolescent services. All services are provided in a distinct part unit within the hospital, and programs are directed by board-certified psychiatrists. Form 990, Part VI, Section A, line 6 Certain decisions of the governing body of Lakeland Regional Medical Center are subject to approval of the sole member Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section A, line 7a The sole member of Lakeland Regional Medical Center, Inc. is Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section A, line 7b Certain decisions of the governing board of Lakeland Regional Medical Center are subject to approval of the sole member Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed prior to filing by senior management, including the CEO and CFO. Additionally, the form and schedules related to compensation are reviewed by the Executive and Physician Compensation Committee of the Board and a copy of the Form 990 and schedules are provided to each member of the Board of Directors before filing with the IRS. Form 990, Part VI, Section B, line 12c Lakeland Regional Medical Center has a conflict of interest policy which is monitored by the Corporate Integrity Services department. All new hires, students, volunteers and contractors are trained on the ethics policy during general orientation. All staff is to comply with ethics training annually as part of their mandatory education requirements. Annually, a certification is required by all managers, directors, and officers who must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Medical Center also has a "Policy of the Board of Directors Regarding Board Members Doing Business with Lakeland Regional Medical Center or Lakeland Regional Health Systems". All Board Members are annually required to execute a "Corporate Compliance Acknowledgement and answer a comprehensive "Annual Conflict of Interest Questionnaire". Additionally, all Senior Corporate Management are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire". Form 990, Part VI, Section B, line 15 Lakeland Regional Medical Center, Inc. Executive and Physician Compensation Committee (the "Committee") of the Board is charged with determining, in advance, all compensation issues for all executive positions including the President & CEO, the CFO and all Vice Presidents of the organization. Only independent and "disinterested" persons may serve as members of the Committee and no member may be employed by the organization or any of its affiliates. Additionally, no physician on the medical staff of the organization may serve as a member of the Committee nor may any member have any business or financial relationships with the organization, either directly or indirectly through family members. The Committee engages an independent nationally recognized human resource management consulting firm which specializes in executive and employee compensation in the health care industry. This firm, among other things: a. Conducts a competitive executive total cash compensation analysis relative to comparable healthcare organizations nationally; and b. Conducts a competitive executive benefits analysis relative to comparable healthcare organizations; and c. Conducts a competitive executive total compensation analysis relative to comparable healthcare organizations; and d. Assists the Committee in ensuring compliance with regulatory requirements; and e. Provides guidance and counsel to the Committee and Board in matters relating to executive compensation; and f. Participates in Committee meeting and presents their findings and recommendations to the Committee and to the Board. In determining compensation, the Committee relies on the independent, reliable market data presented by the consulting firm to set all compensation levels and the consulting firm's opinion as to the reasonableness of total compensation to be paid the executives of the organization. The Committee fully documents the basis for all determinations and records, at a minimum, 1) the terms of the compensation agreement and the date on which it was approved; 2)the members of the Committee where were present during the discussion and those who voted on it; 3) the comparability data used and its source; and 4) the basis for the ultimate decision. In fulfilling its responsibility, the Committee has full authority to consult with outside counsel, regarding the legality of the compensation and other legal issues which may be relevant to the Committee's responsibilities. Form 990, Part VI, Section C, line 19 The organization's Articles of Incorporation are public records and may be obtained from the State of Florida's Division of Corporations in Tallahassee, Florida. Additionally, the Lease & Transfer Agreement between the organization and the City of Lakeland, Florida, under which the organization operates, is recorded in the Public Records of Polk County, Florida, the County in which the organization is located. Financial statements and similar information, both audited and unaudited, are periodically furnished to the City of Lakeland, Florida, and various regulatory agencies within the State of Florida. As such, said financial statements and information are public records under the pertinent Florida public records laws. Form 990, Part XI, line 9: Intercompany Transfers -80,213,513. Change in Beneficial Interest in Foundation -212,960. Other Adjustments -593. Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 237134974 Fundraising FL 501(c)(3) Line 12a, I Lakeland Regional Health Systems Inc 0 Lakeland Regional Health Systems Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 592650464 Support Other 501(c)(3) organizations FL 501(c)(3) Line 12a, I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0