UNIVERSITY HOSPITALS HEALTH SYSTEM INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: UNIVERSITY HOSPITALS HEALTH SYSTEM INC (EIN 34-1425870)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2022-09-07
IRS object ID: 202202509349300715
Schema version: 2020v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-09-07T09:41:35-05:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	381357951	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PLANTE & MORAN PLLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	250 S HIGH ST SUITE 100	AddressLine1Txt
City	COLUMBUS	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43215	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	341425870	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LAKE HOSPITAL SYSTEM INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LAKE	BusinessNameControlTxt
Phone	4403541991	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3605 WARRENSVILLE CTR RD MSC 9155	AddressLine1Txt
City	SHAKER HEIGHTS	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44122	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ROBERT TRACZ	PersonNm
Person Title	SENIOR VP & CFO	PersonTitleTxt
Phone	4403541991	PhoneNum
Signature	2022-08-25	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	ROBERT	PersonFirstNm
Person Last	TRACZ	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	AMY CIMINELLO	PreparerPersonNm
PTIN	P00796388	PTIN
Phone	6148493000	PhoneNum
Preparation	2022-08-25	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Amended Return	Yes (X)	AmendedReturnInd

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	LAKE HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	CYNTHIA MOORE-HARDY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3605 WARRENSVILLE CTR RD MSC 9155	AddressLine1Txt
City	SHAKER HEIGHTS	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44122	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$808,276,344	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.LAKEHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1983	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RESIDENTS OF LAKE COUNTY AND NEIGHBORING COMMUNITIES IN PARTNERSHIP WITH THOSE WHO SHARE A COMMITMENT TO LOCAL ACCESS, HEALING WITH COMPASSION, AND SUPERIOR QUALITY.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	3466	TotalEmployeeCnt
Total Volunteers	438	TotalVolunteersCnt
Total Gross UBI	$867,365	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,225,849	PYContributionsGrantsAmt
CY Contributions Grants	$12,062,589	CYContributionsGrantsAmt
PY Program Service Revenue	$383,138,453	PYProgramServiceRevenueAmt
CY Program Service Revenue	$346,342,471	CYProgramServiceRevenueAmt
PY Investment Income	$10,091,405	PYInvestmentIncomeAmt
CY Investment Income	$26,041,896	CYInvestmentIncomeAmt
PY Other Revenue	$23,653,182	PYOtherRevenueAmt
CY Other Revenue	$26,655,602	CYOtherRevenueAmt
PY Total Revenue	$420,108,889	PYTotalRevenueAmt
CY Total Revenue	$411,102,558	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$158,900	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$153,530,797	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$153,691,022	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$257,139,076	PYOtherExpensesAmt
CY Other Expenses	$247,620,636	CYOtherExpensesAmt
PY Total Expenses	$410,674,873	PYTotalExpensesAmt
CY Total Expenses	$401,470,558	CYTotalExpensesAmt
PY Revenues Less Expenses	$9,434,016	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$9,632,000	CYRevenuesLessExpensesAmt
Total Assets BOY	$620,500,630	TotalAssetsBOYAmt
Total Assets EOY	$660,977,812	TotalAssetsEOYAmt
Total Liabilities BOY	$368,953,326	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$413,098,945	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$251,547,304	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$247,878,867	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	IT IS THE MISSION OF LAKE HOSPITAL SYSTEM TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RESIDENTS OF LAKE COUNTY AND NEIGHBORING COMMUNITIES IN PARTNERSHIP WITH THOSE WHO SHARE A COMMITMENT TO LOCAL ACCESS, HEALING WITH COMPASSION, AND SUPERIOR QUALITY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$354,585,234	ExpenseAmt
Grant	$158,900	GrantAmt
Revenue	$369,750,356	RevenueAmt
Desc	AS AN INDEPENDENT, COMMUNITY-BASED HOSPITAL SYSTEM, LAKE HOSPITAL SYSTEM, INC., DBA LAKE HEALTH, HAS HAD A LONG-STANDING TRADITION OF PROVIDING SERVICES AND PROGRAMS BASED ON THE HEALTH CARE NEEDS OF THE COMMUNITIES THAT WE SERVE. WE ARE GUIDED BY OUR MISSION TO PROVIDE LOCAL ACCESS, HEALING WITH COMPASSION AND SUPERIOR QUALITY, AND BY OUR CORE VALUES - RESPECT, INNOVATION, TEAMWORK, STEWARDSHIP AND INTEGRITY. LAKE HEALTH'S GROWTH AS A COMMUNITY-BASED HEALTH CARE SYSTEM CONTINUES TO BUILD ON ITS LONG HISTORY OF PROVIDING PROGRESSIVE, PERSONALIZED CARE THAT YOU NORMALLY WOULDN'T EXPECT TO FIND AT A COMMUNITY HOSPITAL. GUIDED BY A COLLABORATIVE HEALTH NEEDS ASSESSMENT CONDUCTED IN COOPERATION WITH THE LAKE COUNTY GENERAL HEALTH DISTRICT, LAKE HEALTH HAS DEVELOPED PROGRAMS, SERVICES AND PARTNERSHIPS TO ADDRESS THE MOST PRESSING HEALTH ISSUES. THE HIGH PRIORITY AREAS INCLUDE DIABETES, OBESITY, MENTAL HEALTH, HIGH BLOOD PRESSURE, DRUG OVERDOSE DEATHS, AND HEART DISEASE.LAKE HEALTH IS COMPRISED OF 11 FACILITIES IN LAKE, GEAUGA AND CUYAHOGA COUNTIES, WHICH INCLUDE THE FOLLOWING:1. TRIPOINT MEDICAL CENTER (FULL-SERVICE, ACUTE CARE HOSPITAL)2. WEST MEDICAL CENTER (FULL-SERVICE, ACUTE CARE HOSPITAL)3. BEACHWOOD MEDICAL CENTER (FULL-SERVICE ACUTE CARE HOSPITAL)4. MENTOR CAMPUS (OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, OUTPATIENT SURGERY, CANCER SERVICES)5. MENTOR WELLNESS CAMPUS (URGENT CARE, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, PHYSICAL THERAPY, OCCUPATIONAL HEALTH SERVICES AND A MEDICALLY BASED FITNESS CENTER)6. MADISON CAMPUS (FREE-STANDING ER, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, PHYSICAL THERAPY)7. WILLOWICK CAMPUS (URGENT CARE, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES)8. CHARDON CAMPUS (OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES)9. PERRICO HEALTH CAMPUS (PHYSICIAN OFFICES, PHYSICAL THERAPY, OUTPATIENT LAB AND DIAGNOSTICS)10. SOM CENTER CAMPUS (PHYSICIAN OFFICES, LAB AND DIAGNOSTICS)11. CONTINUING CARE CAMPUS (COMPREHENSIVE, INPATIENT REHABILITATION; GERIATRIC PSYCHIATRY)ACCESSIBILITY IS KEY TO OUR MISSION. WE HAVE CONTRACTED WITH MOST INSURANCE PROVIDERS TO ENSURE A VAST ARRAY OF PRIMARY CARE PHYSICIANS AND SPECIALISTS. LAKE HEALTH OPERATES THREE FULL-SERVICE EMERGENCY DEPARTMENTS WITHIN LAKE COUNTY AT TRIPOINT MEDICAL CENTER IN CONCORD TOWNSHIP, WEST MEDICAL CENTER IN WILLOUGHBY AND THE FREE-STANDING MADISON EMERGENCY DEPARTMENT IN MADISON, AND A FULL-SERVICE EMERGENCY DEPARTMENT IN CUYAHOGA COUNTY AT BEACHWOOD MEDICAL CENTER IN BEACHWOOD. THESE EMERGENCY DEPARTMENTS ARE OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY.FOR THE 20TH YEAR IN A ROW, LAKE HEALTH WAS RECOGNIZED AS ONE OF NORTHCOAST 99'S "BEST PLACES TO WORK IN NORTHEAST OHIO". OUR GROWTH AS A HOSPITAL SYSTEM REFLECTS THE MANY WAYS WE ARE BUILDING ON OUR MISSION AND HOW WE ASPIRE TO BE MORE THAN YOUR TYPICAL COMMUNITY HOSPITAL. WE WANT OUR PATIENTS TO RECEIVE SUPERIOR PATIENT CARE WITHOUT HAVING TO LEAVE THE COMMUNITY, AND THAT'S WHY WE ARE COMMITTED TO BRINGING THE BEST RESOURCES TOGETHER TO PROVIDE AN EXPANDED LEVEL OF COMMUNITY CARE.LAKE HEALTH PROVIDES SERVICES AND PROGRAMS BASED ON THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. BRINGING HEALTH EDUCATION PROGRAMS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK AND PLAY IS FUNDAMENTAL TO OUR MISSION. THE COVID-19 CRISIS DEFINED 2020 FOR ALL HOSPITALS, WHICH RE-SHAPED HOW WE PROVIDED HEALTH EDUCATION PROGRAMS TO OUR COMMUNITIES. INSTEAD OF IN-PERSON PHYSICIAN LECTURES AND SCREENINGS, MORE INFORMATION WAS PROVIDED DIGITALLY THROUGH WEBINARS, E-MAIL AND SOCIAL MEDIA ALONG WITH SENDING PRINT MATERIAL DIRECT TO THE HOME. IN 2020, LAKE HEALTH PROVIDED APPROXIMATELY $200,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION, WHICH MOSTLY FOCUSED ON HOW TO PREVENT, TREAT AND SLOW THE SPREAD OF COVID-19 IN THE COMMUNITY AND HOW TO SEEK SAFE CARE DURING THE PANDEMIC. LAKE HEALTH CONTRIBUTED APPROXIMATELY $675,000 IN 2020 IN CASH AND IN-KIND DONATIONS TO CIVIC AND COMMUNITY PROGRAMS AND PARTNERSHIPS WITH A HEALTH AND WELLNESS FOCUS. SOME OF THE PROGRAMS AND EVENTS ARE HIGHLIGHTED BELOW. MANY OF THEM ARE FACILITATED THROUGH OUR HEALTH PROMOTION AND MARKETING DEPARTMENTS.COMMUNITY PROGRAMS AND EVENTS: AMERICAN HEART WALKWALK TO END ALZHEIMER'SEND 68 HOURS OF HUNGER INFANT AND CHILDBIRTH PROGRAMS INCLUDING CHILDBIRTH PREPARATION, INFANT CARE, BREASTFEEDINGPROGRAM, SIBLING PROGRAM, INFANT AND CHILD CPR, AND CAR SEAT CHECKS. SUPPORT GROUPS, INCLUDING BREASTFEEDING, BREAST CANCER, DIABETES, STROKE, AND AMPUTEE UNITED WAY DAY OF CARING AND HARVEST FOR HUNGER SCHOOL PARTNERSHIPS MALL WALKING PROGRAM IN PARTNERSHIP WITH GREAT LAKES MALL, WHICH INCLUDES BI-MONTHLY LECTURES/ACTIVITIES AND BLOOD PRESSURE SCREENINGS. BREAST HEALTH FOR HISPANIC WOMEN NUTRITION AND FITNESS EDUCATION SERIES ARTHRITIS EXPO STRESS MANAGEMENT COOKING FOR WELLNESS INTEGRATIVE HEALTH AND WELLNESS TRADITIONAL CHINESE MEDICINE PROBLEM-BASED LEARNING IN ELEMENTARY SCHOOLS	Desc
Total Program Service Expenses	$354,585,234	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	Yes (1)	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	156	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3466	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LISA MOTHERSBAUGH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4403541984	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7590 AUBURN ROAD	AddressLine1Txt
City	CONCORD	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44077	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
THOMAS P JUBECK
CHAIR	5.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
BRETT HIMES
VICE CHAIR	5.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
DAWN GUBANC-ANDERSON
SECRETARY	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
ADAM SANDEN
TREASURER	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
MICHAEL E MAYHER
TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
RAYMOND PAGANINI
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
CHETAN PATEL MD
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
DAVID ROLLINS MD
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
RAYMOND SINES
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
DAVID STEIGER MD
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
KEITH ZIEGLER
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
RODNEY HOWELL
TRUSTEE (THRU 3/31)	0.00	0.00	Yes (X)		$0	$0	$0
CYNTHIA MOORE-HARDY
PRESIDENT AND CEO	55.00	10.00		Yes (X)	$1,072,719	$0	$27,051
ROBERT TRACZ
SR. VP/CFO	50.00	10.00		Yes (X)	$573,784	$0	$30,186
JOHN BANIEWICZ MD
SR VP, MEDICAL AFFAIRS	45.00	10.00			$583,411	$0	$30,166	Yes (X)
RICHARD D CICERO
SR VP, MARKETING & BUSINESS	45.00	10.00			$400,272	$0	$22,806	Yes (X)
ADETINUKE TADESE
CHIEF MEDICAL INFORMATICS OFFICER	40.00	5.00			$321,422	$0	$33,605	Yes (X)
BILL OSTERMAN
VP, ACUTE CARE SERVICES	40.00	0.00			$259,941	$0	$23,964	Yes (X)
DAVID HERMAN
VP, FINANCE	40.00	10.00			$255,862	$0	$27,356		Yes (X)
JOYCE A TAYLOR
VP, QUALITY SERVICES, CQO	40.00	0.00			$246,691	$0	$11,405		Yes (X)
CYNTHIA J RACER
VP, CLINICAL SERVICES	40.00	0.00			$219,572	$0	$19,258		Yes (X)
DINO DISANTO
VP, MARKETING & GOVERNMENT AFFAIRS	40.00	0.00			$216,859	$0	$0		Yes (X)
JERROLD PETERS
VP, HUMAN RESOURCES	40.00	0.00			$214,859	$0	$11,473		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,365,392	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$237,270	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	163	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
COMMUNITY HOSPITALISTS LLC
30680 BAINBRIDGE ROAD	SOLON	OH	44139	HOSPITAL MEDICAL STAFFING COVERAGE AND M	$6,679,695
CROTHALL HEALTHCARE INC
13028 COLLECTIONS CENTER DR	CHICAGO	IL	60693	HOUSEKEEPING SERVICES	$3,987,690
SODEXO INC AND AFFILIATES
PO BOX 360170	PITTSBURG	PA	152516170	NUTRITION SERVICES OPERATIONS	$3,085,102
PHILIPS MEDICAL CAPITAL LLC
1111 OLD EAGLE SCHOOL ROAD	WAYNE	PA	19087	HOSPITAL WIDE UPGRADE INSTALLATION SERVI	$2,198,290
PHILIPS MEDICAL SYSTEMS
595 MINER RD	CLEVELAND	OH	44143	SERVICE AGREEMENTS: INSPECTIONS, MAINTEN	$2,145,535

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	59	CntrctRcvdGreaterThan100KCnt
Related Organizations	$2,291,667	RelatedOrganizationsAmt
Government Grants	$9,176,796	GovernmentGrantsAmt
All Other Contributions	$594,126	AllOtherContributionsAmt
Noncash Contributions	$1,621,703	NoncashContributionsAmt
Total Contributions	$12,062,589	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT CARE	Desc
Business	621110	BusinessCd
Total Revenue Column	$346,342,471	TotalRevenueColumnAmt
Related Or Exempt Func Income	$346,342,471	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$346,342,471	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,044,594	TotalRevenueColumnAmt
Exclusion	$6,044,594	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,913	TotalRevenueColumnAmt
Exclusion	$4,913	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,656,397	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,656,397	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,656,397	TotalRevenueColumnAmt
Unrelated Business Revenue	$412,850	UnrelatedBusinessRevenueAmt
Exclusion	$2,243,547	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$411,390,103	SecuritiesAmt
Other	$5,776,072	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$391,397,268	SecuritiesAmt
Other	$5,776,518	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$19,992,835	SecuritiesAmt
Other	-$446	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$19,992,389	TotalRevenueColumnAmt
Exclusion	$19,992,389	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
SALES AND SERVICES	621110	$10,354,353	$8,137,458	$2,080,090	$136,805
PURCHASE DISCOUNTS	621110	$5,626,684	$5,626,684
CMS INCENTIVE PAYMENTS	621110	$4,766,531	$4,766,531

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,251,637	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,877,212	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$1,625,575	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$23,999,205	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$411,102,558	TotalRevenueColumnAmt
Related Or Exempt Func Income	$369,750,356	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$867,365	UnrelatedBusinessRevenueAmt
Exclusion	$28,422,248	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$153,900	TotalAmt
Program Services	$153,900	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$5,000	TotalAmt
Program Services	$5,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,122,205	TotalAmt
Management And General	$3,122,205	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$127,927,577	TotalAmt
Program Services	$114,849,441	ProgramServicesAmt
Management And General	$13,078,136	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$962,569	TotalAmt
Program Services	$843,576	ProgramServicesAmt
Management And General	$118,993	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$12,471,867	TotalAmt
Program Services	$10,930,098	ProgramServicesAmt
Management And General	$1,541,769	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$9,206,804	TotalAmt
Program Services	$8,068,661	ProgramServicesAmt
Management And General	$1,138,143	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$1,952,745	TotalAmt
Program Services	$1,562,188	ProgramServicesAmt
Management And General	$390,557	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$855,118	TotalAmt
Program Services	$769,606	ProgramServicesAmt
Management And General	$85,512	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$220,750	TotalAmt
Management And General	$220,750	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,330,195	TotalAmt
Program Services	$1,330,195	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$83,765,844	TotalAmt
Program Services	$82,061,303	ProgramServicesAmt
Management And General	$1,704,541	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,263,175	TotalAmt
Program Services	$164,668	ProgramServicesAmt
Management And General	$1,098,507	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,523,130	TotalAmt
Program Services	$1,523,130	ProgramServicesAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$10,688,735	TotalAmt
Program Services	$158,722	ProgramServicesAmt
Management And General	$10,530,013	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$12,302,883	TotalAmt
Program Services	$7,440,153	ProgramServicesAmt
Management And General	$4,862,730	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$400,928	TotalAmt
Program Services	$267,564	ProgramServicesAmt
Management And General	$133,364	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$114,372	TotalAmt
Program Services	$36,682	ProgramServicesAmt
Management And General	$77,690	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,330,704	TotalAmt
Program Services	$5,246,699	ProgramServicesAmt
Management And General	$84,005	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$21,921,553	TotalAmt
Program Services	$14,815,699	ProgramServicesAmt
Management And General	$7,105,854	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$527,298	TotalAmt
Management And General	$527,298	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$64,713,644	$64,713,644
BAD DEBT	$32,733,411	$32,733,411
HOSPITAL FRANCHISE FEE	$6,741,152	$6,741,152
MEMBERSHIP DUES	$1,234,999	$169,742	$1,065,257

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$401,470,558	TotalAmt
Program Services	$354,585,234	ProgramServicesAmt
Management And General	$46,885,324	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,300,677	BOYAmt
EOY	$13,258,149	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$38,208,399	BOYAmt
EOY	$38,112,459	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,064,514	BOYAmt
EOY	$6,527,097	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$23,639,830	BOYAmt
EOY	$21,044,664	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$502,437,115	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$306,670,726	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$205,916,588	BOYAmt
EOY	$195,766,389	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$253,965,238	BOYAmt
EOY	$275,224,064	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$16,519,042	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$92,405,384	BOYAmt
EOY	$94,525,948	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$620,500,630	BOYAmt
EOY	$660,977,812	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$40,756,799	BOYAmt
EOY	$53,168,378	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$783,877	BOYAmt
EOY	$195,490	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$211,081,787	BOYAmt
EOY	$206,205,555	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$116,330,863	BOYAmt
EOY	$153,529,522	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$368,953,326	BOYAmt
EOY	$413,098,945	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$251,547,304	BOYAmt
EOY	$247,878,867	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$251,547,304	BOYAmt
EOY	$247,878,867	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$620,500,630	BOYAmt
EOY	$660,977,812	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$9,632,000	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,403,544	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$11,896,893	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	0	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$20,023	OtherActivitiesAmt
Total Lobbying Expenditures	$20,023	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	LINE 1I: MEMBERSHIP DUES PAID TO HOSPITAL INDUSTRY ASSOCIATIONS AND ORGANIZATIONS, THE PERCENTAGE OF WHICH IS REPORTED UNDER IRS RULES AS LOBBYING EXPENSE.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Protection Natural Habitat	Yes (X)	ProtectionNaturalHabitatInd
Total Easements	1	TotalEasementsCnt
Total Acreage	1507.00	TotalAcreageCnt
Historic Structure Easements	0	HistoricStructureEasementsCnt
Historic Strctr Easements Aftr	0	HistoricStrctrEasementsAftrCnt
Modified Easements	0	ModifiedEasementsCnt
States Easements Held	1	StatesEasementsHeldCnt
Written Policy Monitoring	Yes (1)	WrittenPolicyMonitoringInd
Staff Hours Spent Enforcement	0.00	StaffHoursSpentEnforcementCnt
Expenses Incurred Enforcement	$0	ExpensesIncurredEnforcementAmt

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,503,815	BeginningYearBalanceAmt
Contributions	$1,793,553	ContributionsAmt
Investment Earnings Or Losses	$402,960	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$73,639	GrantsOrScholarshipsAmt
Other Expenditures	$1,440,035	OtherExpendituresAmt
End Year Balance	$7,186,654	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,272,122	BeginningYearBalanceAmt
Contributions	$541,913	ContributionsAmt
Investment Earnings Or Losses	$606,520	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$87,443	GrantsOrScholarshipsAmt
Other Expenditures	$829,297	OtherExpendituresAmt
End Year Balance	$6,503,815	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,834,614	BeginningYearBalanceAmt
Contributions	$829,389	ContributionsAmt
Investment Earnings Or Losses	-$207,803	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$26,377	GrantsOrScholarshipsAmt
Other Expenditures	$1,157,701	OtherExpendituresAmt
End Year Balance	$6,272,122	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,265,843	BeginningYearBalanceAmt
Contributions	$1,432,011	ContributionsAmt
Investment Earnings Or Losses	$434,510	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$30,544	GrantsOrScholarshipsAmt
Other Expenditures	$1,267,206	OtherExpendituresAmt
End Year Balance	$6,834,614	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,930,675	BeginningYearBalanceAmt
Contributions	$1,469,849	ContributionsAmt
Investment Earnings Or Losses	$235,080	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$5,200	GrantsOrScholarshipsAmt
Other Expenditures	$364,561	OtherExpendituresAmt
End Year Balance	$6,265,843	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.50200	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.49800	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,668,329	OtherCostOrOtherBasisAmt
Book Value	$13,668,329	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$207,436,030	OtherCostOrOtherBasisAmt
Depreciation	$90,002,646	DepreciationAmt
Book Value	$117,433,384	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,392,717	OtherCostOrOtherBasisAmt
Depreciation	$3,491,993	DepreciationAmt
Book Value	$4,900,724	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$248,632,691	OtherCostOrOtherBasisAmt
Depreciation	$200,317,516	DepreciationAmt
Book Value	$48,315,175	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,307,348	OtherCostOrOtherBasisAmt
Depreciation	$12,858,571	DepreciationAmt
Book Value	$11,448,777	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$195,766,389	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DEFERRED COMPENSATION	$2,922,283
FINANCE RIGHT OF USE ASSETS NET	$1,448,166
INVESTMENTS IN AFFILIATES	$36,691,127
OPERATING RIGHT OF USE ASSETS	$53,464,372

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$94,525,948	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDesc	AmtAmt
THIRD PARTY SETTLEMENTS	$18,954,375
WORKERS COMPENSATION LIABILITY	$1,714,114
DEFERRED COMPENSATION	$5,566,688
LEASE OBLIGATION	$54,750,606
ACCRUED SELF-INSURANCE	$685,961
MARKETING LIABILITY	$10,000
INTEREST RATE SWAP	$52,805,965
PAYER ADVANCES	$14,729,994
DEFERRED PAYROLL TAX	$4,311,819

Field	Value	IRS element (for citing)
Total Liability	$153,529,522	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

LAKE HEALTH'S ENDOWMENT FUNDS WITH DONOR RESTRICTIONS ARE HELD BY THE LAKE HOSPITAL FOUNDATION, INC. DBA LAKE HEALTH FOUNDATION (THE "FOUNDATION"), A RELATED ORGANIZATION. THE FOUNDATION'S MISSION IS TO SECURE FINANCIAL AND NON-FINANCIAL SUPPORT FOR USE IN REALIZING LAKE HEALTH'S VISION OF PROVIDING HEALTH CARE FOR THE COMMUNITY. THE FOUNDATION'S SOLE MEMBER IS LAKE HEALTH.

PART X, LINE 2:

THE SYSTEM, THE FOUNDATION , AND LH PHYSICIAN GROUP ARE NOT-FOR-PROFIT CORPORATIONS, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CAPTIVE IS AN EXEMPTED COMPANY UNDER THE LAWS OF THE CAYMAN ISLANDS AND OPERATES UNDER THE TERMS OF A CAYMAN ISLANDS CLASS "B(I)" INSURER'S LICENSE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THESE ENTITIES. NEW MANNA IS A FOR-PROFIT LIMITED LIABILITY COMPANY. THE ENTITY IS TREATED AS A PARTNERSHIP FOR FEDERAL INCOME TAX PURPOSES. CONSEQUENTLY, FEDERAL INCOME TAXES ARE NOT PAYABLE OR PROVIDED FOR BY THE ENTITY. MEMBERS ARE TAXED INDIVIDUALLY ON THEIR PRO RATA OWNERSHIP SHARE OF THE ENTITY'S EARNINGS. THE ENTITY'S NET INCOME OR LOSS IS ALLOCATED AMONG THE MEMBERS IN ACCORDANCE WITH THE ENTITY'S OPERATING AGREEMENT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxt	OfficesOfficesCnt	EmployeeEmployeeCnt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,	0	0	PROGRAM SERVICES	PROGRAM-RELATED INVESTMENTS	$22,472,561
CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,	0	0	PROGRAM SERVICES	MANAGEMENT FEES RELATED TO LHS ASSURANCE, LTD.	$134,220

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$22,606,781	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$22,606,781	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART III ACCOUNTING METHOD:	FormAndLineReferenceDesc

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,654,060	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$148,581	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,505,479	NetCommunityBenefitExpnsAmt
Total Expense	0.00410	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$62,967,977	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$36,029,182	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,938,795	NetCommunityBenefitExpnsAmt
Total Expense	0.07310	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$64,622,037	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$36,177,763	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,444,274	NetCommunityBenefitExpnsAmt
Total Expense	0.07720	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$203,480	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$203,480	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,568,112	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,449,452	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$118,660	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$539,130	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$539,130	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,310,722	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,449,452	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$861,270	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$67,932,759	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$38,627,215	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$29,305,544	NetCommunityBenefitExpnsAmt
Total Expense	0.07960	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$147,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$147,873	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$147,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$147,873	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$32,733,411	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$61,347,326	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$76,602,728	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$15,255,402	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (7 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 MENTOR SURGERY CENTER LLC
OUTPATIENT SURGICAL CENTER	0.42000	0.00000	0.58000
2 LAKE WEST MEDICAL SPECIALISTS
MEDICAL OFFICE BUILDING	0.12000	0.00000	0.88000
3 CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
MEDICAL OFFICE BUILDING	0.51470	0.00000	0.48530
4 MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
MEDICAL OFFICE BUILDING	0.40390	0.00000	0.39610
5 LAKE PHO INC
PHYSICIAN SERVICES	0.50000	0.00000	0.50000
6 LAKE WILLOUGHBY PROPERTIES LLC
MEDICAL OFFICE BUILDING	0.35000	0.00000	0.65000
7 NEW MANNA CLG LLC
MEDICAL OFFICE BUILDING	0.51000	0.00000	0.49000

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd
WEST MEDICAL CENTER
1	36000 EUCLID AVENUE	WILLOUGHBY	OH	44094	WWW.LAKEHEALTH.ORG	Yes (X)	Yes (X)	Yes (X)
TRIPOINT MEDICAL CENTER
2	7590 AUBURN ROAD	CONCORD	OH	44077	WWW.LAKEHEALTH.ORG	Yes (X)	Yes (X)	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Income Level CriteriaIncomeLevelCriteriaInd	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Residency CriteriaResidencyCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Other MethodOtherMethodInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Prospective Medicare MedicaidProspectiveMedicareMedicaidInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
WEST MEDICAL CENTER
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	19	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	HTTPS://LAKEHEALTH.ORG/ABOUT/HEALTH-NEEDS-ASSESSMENT	Yes (X)	Yes (1)	20	Yes (1)	HTTPS://LAKEHEALTH.ORG/ABOUT/HEALTH-NEEDS-ASSESSMENT	0	Yes (1)	Yes (X)	250.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION/FINANCIAL-AID	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION/FINANCIAL-AID	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
TRIPOINT MEDICAL CENTER
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	19	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	HTTPS://LAKEHEALTH.ORG/ABOUT/HEALTH-NEEDS-ASSESSMENT	Yes (X)	Yes (1)	20	Yes (1)	HTTPS://LAKEHEALTH.ORG/ABOUT/HEALTH-NEEDS-ASSESSMENT	0	Yes (1)	Yes (X)	250.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION/FINANCIAL-AID	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION/FINANCIAL-AID	Yes (X)	HTTPS://LAKEHEALTH.ORG/PATIENTS/FINANCIAL-INFORMATION	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
WEST MEDICAL CENTER	PART V, SECTION B, LINE 5: LAKE HEALTH IDENTIFIED COMMUNITY HEALTH NEEDS BY UNDERGOING A NEEDS ASSESSMENT PROCESS. THIS PROCESS INCORPORATED A COMPREHENSIVE REVIEW BY LAKE HEALTH'S SENIOR LEADERSHIP TEAM ALONG WITH SECONDARY AND PRIMARY DATA INPUT COMPILED USING THE EXPERTISE OF DIXON HUGHES GOODMAN, LLP ("DHG") AND ARTOWER ADVISORY SERVICES, LLC ("ARTOWER"). THE COLLECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA")TEAM REVIEWED SEVERAL SOURCES OF QUANTITATIVE HEALTH, AS WELL AS SOCIAL AND DEMOGRAPHIC DATA SPECIFIC TO LAKE HEALTH'S SERVICE AREA. LAKE HEALTH ALSO TOOK ADVANTAGE OF THIS OPPORTUNITY TO COLLABORATE WITH ITS ADMINISTRATORS, PHYSICIANS, PUBLIC HEALTH AGENCIES, AND LOCAL ORGANIZATIONS IN IDENTIFYING AND ADDRESSING THE NEEDS OF THE COMMUNITY.
TRIPOINT MEDICAL CENTER	PART V, SECTION B, LINE 5: LAKE HEALTH IDENTIFIED COMMUNITY HEALTH NEEDS BY UNDERGOING A NEEDS ASSESSMENT PROCESS. THIS PROCESS INCORPORATED A COMPREHENSIVE REVIEW BY LAKE HEALTH'S SENIOR LEADERSHIP TEAM ALONG WITH SECONDARY AND PRIMARY DATA INPUT COMPILED USING THE EXPERTISE OF DIXON HUGHES GOODMAN, LLP ("DHG") AND ARTOWER ADVISORY SERVICES, LLC ("ARTOWER"). THE COLLECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA")TEAM REVIEWED SEVERAL SOURCES OF QUANTITATIVE HEALTH, AS WELL AS SOCIAL AND DEMOGRAPHIC DATA SPECIFIC TO LAKE HEALTH'S SERVICE AREA. LAKE HEALTH ALSO TOOK ADVANTAGE OF THIS OPPORTUNITY TO COLLABORATE WITH ITS ADMINISTRATORS, PHYSICIANS, PUBLIC HEALTH AGENCIES, AND LOCAL ORGANIZATIONS IN IDENTIFYING AND ADDRESSING THE NEEDS OF THE COMMUNITY.
WEST MEDICAL CENTER	PART V, SECTION B, LINE 6A: AS ALLOWED BY IRS GUIDELINES, LAKE HEALTH DECIDED TO PRODUCE A JOINT CHNA REPORT FOR ITS TWO LAKE COUNTY HOSPITALS, WEST MEDICAL CENTER AND TRIPOINT MEDICAL CENTER. GUIDELINES STATE THAT COLLABORATING FACILITIES MUST DEFINE THEIR COMMUNITIES TO BE THE SAME AND CONDUCT A JOINT CHNA PROCESS.
TRIPOINT MEDICAL CENTER	PART V, SECTION B, LINE 6A: AS ALLOWED BY IRS GUIDELINES, LAKE HEALTH DECIDED TO PRODUCE A JOINT CHNA REPORT FOR ITS TWO LAKE COUNTY HOSPITALS, WEST MEDICAL CENTER AND TRIPOINT MEDICAL CENTER. GUIDELINES STATE THAT COLLABORATING FACILITIES MUST DEFINE THEIR COMMUNITIES TO BE THE SAME AND CONDUCT A JOINT CHNA PROCESS.
WEST MEDICAL CENTER	PART V, SECTION B, LINE 11: IN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, LAKE HEALTH WILL FOCUS ON THOSE MOST WITHIN ITS IMMEDIATE ABILITY TO INFLUENCE.
TRIPOINT MEDICAL CENTER	PART V, SECTION B, LINE 11: IN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, LAKE HEALTH WILL FOCUS ON THOSE MOST WITHIN ITS IMMEDIATE ABILITY TO INFLUENCE.
WEST MEDICAL CENTER	PART V, SECTION B, LINE 15E: THE CONTACT INFORMATION FOR SOURCES OF ASSISTANCE WITH FAP APPLICATIONS IS ON THE LAKE HEALTH WEBSITE BUT NOT CURRENTLY ON THE FAP OR FAP APPLICATION.
TRIPOINT MEDICAL CENTER	PART V, SECTION B, LINE 15E: THE CONTACT INFORMATION FOR SOURCES OF ASSISTANCE WITH FAP APPLICATIONS IS ON THE LAKE HEALTH WEBSITE BUT NOT CURRENTLY ON THE FAP OR FAP APPLICATION.
PART V, SECTION B, LINE 22D	UNINSURED PATIENTS WHO DO NOT QUALIFY FOR LAKE HEALTH'S FINANCIAL ASSISTANCE PROGRAM ARE BILLED FOR GROSS CHARGES AND ARE OFFERED A 30% PROMPT PAY DISCOUNT IF PAYMENT IS RECEIVED WITHIN 30 DAYS OF THE FIRST PATIENT STATEMENT OR A PAYMENT PLAN IS AGREED UPON. THEMAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE.

Field	Value	IRS element (for citing)
Facility	53	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (53 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - MENTOR MEDICAL CAMPUS
9485 MENTOR AVENUE SUITE 101	MENTOR	OH	44060	GENERAL MEDICAL & SURGICAL OUTPATIENT
2 - MADISON MEDICAL CAMPUS
6270 NORTH RIDGE RD	MADISON	OH	44057	GENERAL MEDICAL & EMERGENCY DEPARTMENT
3 - LAKE COUNTY FAMILY PRACTICE
9500 MENTOR AVENUE SUITE 100	MENTOR	OH	44060	PHYSICIAN OFFICE
4 - WILLOWICK URGENT CARE
29804 LAKESHORE BLVD	WILLOWICK	OH	44095	URGENT CARE CENTER
5 - LHPG OBGYN WOMEN'S HEALTH SPECIALISTS
4176 STATE ROUTE 306	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
6 - WILLOUGHBY DIAGNOSTIC SERVICES
4176 STATE ROUTE 306	WILLOUGHBY	OH	44094	DIAGNOSTIC CENTER
7 - LHPG MENTOR IMED
9485 MENTOR AVENUE SUITE 210	MENTOR	OH	44060	PHYSICIAN OFFICE
8 - LHPG MENTOR PEDIATRICS
9485 MENTOR AVENUE SUITE 101	MENTOR	OH	44060	PHYSICIAN OFFICE
9 - LHPG NORTH COAST FAMILY PRACTICE
7580 AUBURN RD SUITE 202	CONCORD	OH	44077	PHYSICIAN OFFICE
10 - CHARDON URGENT CARE
510 FIFTH AVENUE	CHARDON	OH	44024	URGENT CARE CENTER
11 - LHPG MADISON FAMILY PRACTICE
6270 NORTH RIDGE RD	MADISON	OH	44057	PHYSICIAN OFFICE
12 - LHPG WILLOUGHBY IMED
36100 EUCLID AVENUE SUITE 240	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
13 - LHPG WILLOUGHBY PEDIATRICS
36100 EUCLID AVENUE SUITE 300	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
14 - LHPG IMED AT PERRICO
4176 STATE ROUTE 306	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
15 - LHPG CHARDON FAMILY PRACTICE
510 FIFTH AVENUE SUITE 130	CHARDON	OH	44024	PHYSICIAN OFFICE
16 - LHPG MENTOR FAMILY PRACTICE
8655 MARKET STREET	MENTOR	OH	44060	PHYSICIAN OFFICE
17 - LHPG MADISON PEDIATRICS
6270 NORTH RIDGE RD	MADISON	OH	44057	PHYSICIAN OFFICE
18 - LHPG MENTOR GENERAL SURGERY
9500 MENTOR AVENUE SUITE 300	MENTOR	OH	44060	PHYSICIAN OFFICE
19 - LHPG WILLOWICK FAMILY PRACTICE
29804 LAKESHORE BLVD	WILLOWICK	OH	44095	PHYSICIAN OFFICE
20 - LHPG PLASTIC SURGERY
36060 EUCLID AVENUE SUITE 204	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
21 - LHPG SOM GENERAL SURGERY
2105 SOM CENTER ROAD SUITE 107	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
22 - LHPG CHARDON PEDIATRICS
510 FIFTH AVENUE	CHARDON	OH	44024	PHYSICIAN OFFICE
23 - LAKE WELLNESS AND REHABILITATION
5105 SOM CENTER ROAD	WILLOUGHBY	OH	44094	REHABILITATION CLINIC
24 - LHPG WEST CARDIO ELECTROPHYSIOLOGY
36100 EUCLID AVENUE SUITE 400	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
25 - LHPG WEST IMED
36100 EUCLID AVENUE SUITE 210	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
26 - LHPG ORTHOPEDIC SURGERY
36060 EUCLID AVENUE SUITE 203	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
27 - LHPG MENTOR OBGYN
9485 MENTOR AVENUE SUITE 202	MENTOR	OH	44060	PHYSICIAN OFFICE
28 - LHPG SPORTS MEDICINE & REHAB
36060 EUCLID AVENUE SUITE 105	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
29 - LHPG INTEGRATIVE MEDICINE
8655 MARKET STREET MENTOR	MENTOR	OH	44060	PHYSICIAN OFFICE
30 - MENTOR MEDICAL PHYSICIAN BUILDING
9485 MENTOR AVENUE SUITES 200 203	MENTOR	OH	44060	PHYSICIAN OFFICE
31 - LHPG OBGYN WILLOUGHBY
5105 SOM CENTER ROAD SUITE 201	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
32 - CHARDON RADIOLOGY
510 FIFTH AVE SUITE 110	CHARDON	OH	44024	PHYSICIAN OFFICE
33 - LHPG BARIATRIC SURGERY
36100 EUCLID AVENUE SUITE 170	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
34 - LAKE AMBULATORY BLDG PHLEBOTOMIST
9500 MENTOR AVE SUITE 220	MENTOR	OH	44060	DIAGNOSTIC CENTER
35 - LAKE WEST MEDICAL CENTER REFERENCE LAB
36100 EUCLID AVE SUITE 190	WILLOUGHBY	OH	44094	DIAGNOSTIC CENTER
36 - LAKE WELLNESS & REHAB PT (WILLOUGHBY YMCA)
37100 EUCLID AVE	WILLOUGHBY	OH	44094	REHABILITATION CLINIC
37 - LHPG NORTHEAST OHIO HEART ASSOCIATES
36100 EUCLID AVENUE SUITE 120	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
38 - LHPG SPORTS MEDICINE
8655 MARKET STREET	MENTOR	OH	44060	PHYSICIAN OFFICE
39 - BEACON HEALTH
36100 EUCLID AVENUE SUITE 120	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
40 - OPHTHALMOLOGY ASSOCIATES
36100 EUCLID AVE SUITE 450	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
41 - LHPG NORTHEAST OHIO HEART ASSOCIATES
7580 AUBURN ROAD SUITE 106	CONCORD	OH	44077	PHYSICIAN OFFICE
42 - MENTOR MEDICAL PHYSICAL FITNESS CENTE
8655 MARKET STREET MENTOR	MENTOR	OH	44060	MEDICAL FITNESS CENTER
43 - PERRICO HEALTH CENTER
4176 STATE ROUTE 306	WILLOUGHBY	OH	44060	PHYSICIAN OFFICE
44 - ARTHRITIS ASSOCIATES
5105 SOM CENTER ROAD SUITE 200	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
45 - LHPG OHIO HAND AND SHOULDER CENTER
13170 RAVENNA ROAD	CHARDON	OH	44024	PHYSICIAN OFFICE
46 - CONCORD CONTINUING CARE CAMPUS
10977 CAPITAL PARKWAY	CONCORD	OH	44077	REHABILITATION AND PSYCHIATRIC DEPARTMENTS
47 - LHPG MIDDLEFIELD FAMILY PRACTICE
16030 EAST HIGH STREET	MIDDLEFIELD	OH	44062	PHYSICIAN OFFICE
48 - LHPG HACKETT MEDICAL GROUP
8300 TYLER BOULEVARD SUITE 300	MENTOR	OH	44060	PHYSICIAN OFFICE
49 - AGM PHYSICAL THERAPY
6000 HEISLEY ROAD	MENTOR	OH	44060	REHABILITATION CLINIC
50 - WELLNESS CLINIC AT MHS
8655 MARKET STREET MENTOR	MENTOR	OH	44060	WALK IN CLINIC
51 - LHPG PAIN MANAGEMENT
5105 SOM CENTER ROAD SUITE 202	WILLOUGHBY	OH	44094	PHYSICIAN OFFICE
52 - LHPG PAIN MANAGEMENT
9485 MENTOR AVE SUITE 103	MENTOR	OH	44060	PHYSICIAN OFFICE
53 - LHPG MENTOR ENDOCRINOLOGY
8300 TYLER BOULEVARD SUITE 102	MENTOR	OH	44060	PHYSICIAN OFFICE

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	THE FOLLOWING STEPS WILL BE FOLLOWED TO EVALUATE PATIENT'S REQUESTS FOR CONSIDERATION UNDER THE UNINSURED/UNCOMPENSATED CARE GUIDELINES: FINANCIAL INTERVIEW: A HOSPITAL REPRESENTATIVE WILL DISCUSS WITH PATIENTS THEIR INDIVIDUAL FINANCIAL POSITION AND OBTAIN FROM THEM INFORMATION REGARDING THEIR FINANCES. THIS INFORMATION WILL BE RECORDED ON THE HCAP APPLICATION. PATIENTS WILL BE REQUESTED TO SUPPLY COPIES OF THEIR TWO MOST RECENT PAY STUBS FOR ALL FAMILY MEMBERS EMPLOYED, COPIES OF THE PREVIOUS YEAR'S TAX RETURN AND ANY OTHER PERTINENT DOCUMENTATION SUPPORTING THEIR FINANCIAL POSITION. EVALUATION PROCESS: THE HOSPITAL REPRESENTATIVE WILL COMPLETE THE FINANCIAL INTERVIEW FORM. THE HOSPITAL REPRESENTATIVE WILL EVALUATE THE APPLICATION TO DETERMINE WHETHER THE PATIENT MAY BE ELIGIBLE FOR WELFARE OR MEDICAID COVERAGE. IF THIS COVERAGE IS AVAILABLE, THE REPRESENTATIVE WILL MAKE ARRANGEMENTS WITH THE PATIENT FOR COMPLETION OF THE MEDICAID ELIGIBILITY FORMS. IF WELFARE OR MEDICAID ELIGIBILITY IS NOT AVAILABLE, THE PATIENT WILL BE SENT AN APPLICATION AND WILL BE CONSIDERED FOR UNCOMPENSATED CARE. A COPY OF THE APPLICATION WILL BE FORWARDED TO THE PATIENT ACCOUNTING DEPARTMENT. DETERMINATION OF ELIGIBILITY: THE PATIENT ACCOUNTING DEPARTMENT WILL REVIEW THE APPLICATION AND THE PATIENT'S QUALIFICATION STATUS UNDER THE UNINSURED/UNCOMPENSATED CARE GUIDELINES. IF THE PATIENT QUALIFIES FOR UNINSURED/UNCOMPENSATED CARE AND SERVICES ARE PROVIDED, THEN THE ADJUSTMENT WILL BE RECORDED AS AN ADJUSTMENT FROM CHARGES FOR LAKE HOSPITAL'S UNINSURED/UNCOMPENSATED CHARITY CARE. PATIENTS NOT ELIGIBLE: PATIENTS WHO ARE DETERMINED NOT TO BE ELIGIBLE UNDER THE GUIDELINES WILL BE REQUESTED TO PAY A DEPOSIT EQUAL TO 50% OF THE ESTIMATED PATIENT RESPONSIBILITY FOR EITHER THE ELECTIVE INPATIENT OR OUTPATIENT SERVICES, AND TO MAKE ARRANGEMENTS FOR A PAYMENT PLAN TO SATISFY THE REMAINING BALANCE AFTER SERVICES ARE PROVIDED. ELIGIBILITY: EACH ADMISSION REPRESENTS A SEPARATE FINANCIAL ENCOUNTER AND WILL BE EVALUATED WITH NEW DATA TO DETERMINE IF A CHANGE HAS TAKEN PLACE. EACH OUTPATIENT APPLICATION WILL BE REVIEWED TO DETERMINE IF THERE HAS BEEN ANY CHANGE IN FINANCIAL STATUS. A NEW APPLICATION WILL BE REQUIRED EACH MONTH.
PART I, LINE 7:	A COST-TO-CHARGE RATIO IS USED. THIS RATIO TAKES THE TOTAL COSTS, INCLUDING ALLOCATED COSTS FROM OVERHEAD DEPARTMENTS, OF PROVIDING PATIENT CARE DIVIDED BY TOTAL GROSS REVENUE.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES INCLUDE VARIOUS FREE COMMUNITY SCREENING EVENTS FOR HEALTH CONDITIONS SUCH AS BLOOD PRESSURE, CHOLESTEROL, BONE DENSITY, PROSTATE CANCER, SKIN CANCER, HEART DISEASE AND OBESITY.
PART I, LN 7 COL(F):	AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE ESTIMATED AMOUNTS EXPECTED TO BE COLLECTED. PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ESTIMATION OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED PRIMARILY ON THE TYPE AND AGE OF THE PATIENT ACCOUNTS RECEIVABLE AND THE EFFECTIVENESS OF COLLECTION EFFORTS. THE POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY RECEIVABLES, INCLUDING AMOUNTS DUE FROM THE UNINSURED AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES, AS THESE CHARGES ARE RECORDED. PATIENT ACCOUNTS RECEIVABLE BALANCES AND THE EFFECTIVENESS OF THE RESERVE POLICIES ARE REVIEWED ON A MONTHLY BASIS, AND VARIOUS ANALYTICS SUPPORT THE BASIS FOR THE ESTIMATES. ROUTINE HINDSIGHT PROCEDURES ARE PERFORMED TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE TO DETERMINE THE REASONABLENESS OF THE PROCESS FOR ESTIMATING THE ALLOWANCE FOR BAD DEBT. CHARITY CARE AND OTHER COMMUNITY BENEFITS AS A PERCENTAGE OF EXPENSE IS CALCULATED USING TOTAL EXPENSES FROM FORM 990, PART IX LESS BAD DEBT EXPENSE OF $32,733,411 FROM PART IX.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIESLAKE HEALTH PROVIDES SERVICES AND PROGRAMS BASED ON THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. TAKING HEALTH EDUCATION PROGRAMS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK AND PLAY IS FUNDAMENTAL TO THE LAKE HEALTH MISSION. THE COVID-19 CRISIS DEFINED 2020 FOR ALL HOSPITALS, WHICH RE-SHAPED HOW WE PROVIDED HEALTH EDUCATION PROGRAMS TO OUR COMMUNITIES. INSTEAD OF IN-PERSON PHYSICIAN LECTURES AND SCREENINGS, WE PROVIDED MORE INFORMATION DIGITALLY THROUGH WEBINARS, E-MAIL AND SOCIAL MEDIA ALONG WITH SENDING PRINT MATERIAL DIRECT TO THE HOME. IN 2020, LAKE HEALTH PROVIDED APPROXIMATELY $200,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION, WHICH MOSTLY FOCUSED ON HOW TO PREVENT, TREAT AND SLOW THE SPREAD OF COVID-19 IN THE COMMUNITY AND HOW TO SEEK SAFE CARE DURING THE PANDEMIC. LAKE HEALTH ALSO CONTRIBUTED OVER $539,000 IN CASH AND IN-KIND DONATIONS TO CIVIC AND COMMUNITY PROGRAMS AND PARTNERSHIPS WITH A HEALTH AND WELLNESS FOCUS. COALITION BUILDING LAKE HEALTH IS COMMITTED TO BRINGING THE BEST RESOURCES TOGETHER TO PROVIDE AN EXPANDED LEVEL OF COMMUNITY CARE, WHICH IS WHY IT IS INVOLVED IN MANY COMMUNITY COALITIONS AND PARTNERSHIPS TO IMPROVE THE HEALTH OF INDIVIDUALS IN THE SERVICE AREA. SOME OF THESE INCLUDE PARTICIPATION IN THE LAKE COUNTY STRATEGIC PLAN, ACHIEVE (A COMMUNITY COALITION TO IMPROVE THE ENVIRONMENT IN LAKE COUNTY), AND UNITED WAY PROGRAMS DESIGNED TO IMPROVE HEALTH, PARTICULARLY IN VULNERABLE COMMUNITIES.UNEQUIVOCALLY, 2020 WAS A YEAR LIKE NO OTHER. FOR LAKE HEALTH, WE SUDDENLY FOUND OURSELVES ON THE FRONT LINES OF A GLOBAL BATTLE, NOT ONLY AGAINST COVID-19, BUT AGAINST UNCERTAINTY, FEAR AND SHORTAGES THAT THREATENED OUR ENTIRE STATE. WE KNEW EARLY ON THAT THE COVID-19 CRISIS WOULD DEMAND OUR UNWAVERING FOCUS AND ACTION. ONE OF OUR FIRST STEPS WAS TO FORM A MULTIDISCIPLINARY RESPONSE TEAM CONSISTING OF PHYSICIANS, NURSES, ADMINISTRATORS AND CLINICAL LEADERS. THIS TEAM MET MULTIPLE TIMES A DAY TO COORDINATE OUR RESPONSE, SHAPE BEST PRACTICES, MANAGE OUR RESOURCES AND GUIDE US THROUGH UNCERTAINTY. WE ALSO PARTICIPATED IN AD HOC COMMITTEES WITH OTHER HEALTH CARE SYSTEMS TO SHARE BEST PRACTICES ACROSS THE REGION. AS PART OF ITS MISSION, LAKE HEALTH HAS A LONG HISTORY OF PARTNERING WITH OTHERS IN THE COMMUNITY WHO SHARE OUR VALUES OF PROVIDING LOCAL ACCESS, HEALING WITH COMPASSION AND SUPERIOR QUALITY. THESE PARTNERSHIPS PROVED TO BE INVALUABLE DURING THIS CHALLENGING TIME. OUR PARTNERSHIP WITH THE LAKE COUNTY ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH SERVICES (ADAMHS) BOARD ALLOWED US TO PROVIDE IMMEDIATE SUPPORT TO OUR TEAM MEMBERS COPING WITH THE STRESS OF THE PANDEMIC, ALONG WITH LAKE HEALTH'S BEHAVIORAL HEALTH AND CRISIS INTERVENTION TEAM. A RAPID ASSESSMENT TEAM WAS QUICKLY DEPLOYED TO PROVIDE ASSISTANCE AND GUIDANCE TO NURSING HOMES IN LAKE COUNTY AND SURROUNDING COMMUNITIES. LAKE HEALTH COORDINATED WITH THE LAKE COUNTY GENERAL HEALTH DISTRICT, LAKE COUNTY COMMISSIONERS, LAKE COUNTY EMERGENCY MANAGEMENT AGENCY AND LOCAL FIRE DEPARTMENTS TO ADMINISTER VACCINES.
PART III, LINE 2:	BAD DEBT IS ESTIMATED USING A HINDSIGHT ANALYSIS ON PREVIOUS YEARS ACCOUNTS RECEIVABLE. THOSE PERCENTAGES ARE THEN APPLIED TO CURRENT YEAR ACCOUNTS RECEIVABLE BY PAYOR TO ESTIMATE THE AMOUNT OF UNCOLLECTIBLE. ANYTHING OVER 365 DAYS IS FULLY RESERVED.
PART III, LINE 4:	PAGE 13 OF ATTACHED AUDITED FINANCIAL STATEMENTS, NOTE 2 - SIGNIFICANT ACCOUNTING POLICIES, NET PATIENT SERVICE REVENUE ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE SYSTEM'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.
PART III, LINE 8:	BASED ON A COST TO CHARGE RATIO DETERMINED IN ACCORDANCE WITH MEDICARE COST REPORT REQUIREMENTS, THE COSTS OF PROVIDING CARE TO THE MEDICARE POPULATION IN 2020 WAS $61,347,326 THE PAYMENTS RELATED TO THESE SERVICES WERE $76,602,728 LEAVING A MEDICARE SHORTFALL OF $15,255,402 FOR THE YEAR.
PART III, LINE 9B:	PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTS: PATIENTS WHO DO NOT HAVE THE MEANS TO PAY FOR SERVICES PROVIDED AT LAKE HOSPITAL SYSTEM REQUEST TO BE CONSIDERED UNDER THE UNINSURED/UNCOMPENSATED CHARITY CARE GUIDELINES. THESE GUIDELINES DEFINE LAKE HOSPITAL SYSTEM'S COMMITMENT TO PROVIDING CARE TO PATIENTS WHO ARE IN THE GREATEST FINANCIAL NEED. PATIENTS WHO DO NOT HAVE INSURANCE COVERAGE, OR WHOSE OUT OF POCKET RESPONSIBILITY IS SUBSTANTIAL AFTER INSURANCE COVERAGE, OR WHOSE INCOME LEVEL IS AT OR BELOW 250% OF THE FEDERAL INCOME POVERTY GUIDELINES, ARE ELIGIBLE TO APPLY FOR UNINSURED CHARITY CARE ASSISTANCE.THE UNINSURED/UNCOMPENSATED CHARITY CARE PROGRAM DOES NOT RELIEVE NOR FORGIVE POINT-OF-SERVICE COPAYMENTS THAT THE PATIENT MAY BE REQUIRED TO PAY UNDER THE TERMS OF THEIR INSURANCE BENEFIT PLAN. PER VISIT COPAYMENTS WILL BE COLLECTED AT THE POINT OF SERVICE IN COMPLIANCE WITH THE INSURANCE BENEFIT TERMS.PROCEDURE ELIGIBILITY FOR LAKE'S UNINSURED/UNCOMPENSATED CARE IS DETERMINED BY THE FOLLOWING TWO-PART TEST. THE LAKE HOSPITAL SYSTEMS UNINSURED/UNCOMPENSATED CARE PROGRAM REQUIRES PATIENTS TO MEET AT LEAST ONE CONDITION IN BOTH PART ONE AND PART TWO:PART ONE: INSURANCE TEST 1. PATIENT DOES NOT HAVE GOVERNMENTAL OR PRIVATE INSURANCE COVERAGE; OR2. PATIENT'S INSURANCE DOES NOT COVER THE MEDICALLY NECESSARY SERVICE; OR3. PATIENT'S INSURANCE BENEFITS ARE EXHAUSTED (I.E. LIFETIME RESERVE DAYS, MEDICARE); OR4. PATIENT HAS OR WILL OBTAIN MEDICALLY NECESSARY SERVICES FROM THE HOSPITAL FOR WHICH THEY DO NOT HAVE THE FINANCIAL MEANS TO PAY; OR5. PATIENT IS RESPONSIBLE FOR CO-PAYMENTS AND DEDUCTIBLES, CARRIES NO SECONDARY INSURANCE COVERAGE AND ONLY SOURCE OF INCOME IS SOCIAL SECURITY.PART TWO: INCOME TEST (RELATIVE TO LAKE HOSPITAL CHARGES)1. FAMILY INCOME IS COMPARED TO THE FEDERAL POVERTY INCOME GUIDELINES (FAMILY INCLUDES PATIENT, PATIENT'S SPOUSE, AND ALL OF THE PATIENT'S CHILDREN, NATURAL OR ADOPTIVE, UNDER THE AGE OF EIGHTEEN WHO LIVE IN THE HOME). THE SCHEDULE SHOWN BELOW WILL BE USED TO COMPARE FAMILY INCOME TO A SLIDING SCALE BASED UPON THE FEDERAL POVERTY INCOME GUIDELINES. IFFAMILY INCOME IS AT OR BELOW THE DESIGNATED THRESHOLD, THE PATIENT IS ELIGIBLE FOR THE PERCENT CHARITY DISCOUNT ASSOCIATED WITH THAT LEVEL OF INCOME; OR2. THE RELATIONSHIP BETWEEN THE PATIENT'S MEDICAL BILLS, FAMILY INCOME AND FAMILY ASSETS (INCLUDING, BUT NOT LIMITED TO SUCH ITEMS AS BANK ACCOUNTS, TRUSTS, PROPERTY, HOME EQUITY, ESTATE OR INVESTMENTS) INDICATES THAT THE PURSUIT OF PAYMENT WOULD ADVERSELY AFFECT THE WELL BEING OF THE PATIENT AND FAMILY MEMBERS, AND WHERE THE PAYMENT OF LAKE HOSPITAL'S BILL WOULD RESULT IN UNDUE HARDSHIP; OR3. PATIENT'S FAMILY INCOME EXCEEDS 250% OF THE FEDERAL INCOME POVERTY GUIDELINES, HOWEVER PATIENT HAS SUPPLIED INFORMATION TO SUPPORT EXCEPTIONAL LIVING CIRCUMSTANCES (I.E. TERMINAL ILLNESS, EXCESSIVE MEDICAL BILLS AND/OR MEDICATIONS, ETC.) OR 100% OF INCURRED CHARGES GREATER THAN 25% OF ANNUAL FAMILY INCOME (INCLUDING BANK ACCOUNTS, TRUSTS AND INVESTMENTS, BUT EXCLUDING PRIMARY RESIDENCE). BEFORE UNINSURED/UNCOMPENSATED CARE CAN BE AWARDED, THE FOLLOWING CONDITIONS MUST BE MET:1. IF LAKE HOSPITAL DETERMINES THAT THE PATIENT IS POTENTIALLY ELIGIBLE FOR MEDICAL ASSISTANCE, THE PATIENT MUST COOPERATE WITH LAKE HOSPITAL'S EFFORTS TO ESTABLISH ELIGIBILITY FOR GOVERNMENT ASSISTANCE PROGRAMS.2. IF LAKE HOSPITAL AWARDS UNINSURED/UNCOMPENSATED CARE, IT WILL ONLY COVER THE SERVICES PROVIDED UNDER THE ACCOUNT NUMBER(S) SHOWN ON THE ACCOMPANYING APPLICATION.3. PROOF OF INCOME AND FINANCIAL DOCUMENTATION WILL BE REQUESTED. (SEE HOSPITAL CARE ASSURANCE POLICY.)
PART VI, LINE 2:	AS AN INDEPENDENT, COMMUNITY-BASED HOSPITAL SYSTEM, LAKE HEALTH HAS HAD A LONG-STANDING TRADITION OF PROVIDING SERVICES AND PROGRAMS BASED ON THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. WE ARE GUIDED BY OUR MISSION TO PROVIDE LOCAL ACCESS, HEALING WITH COMPASSION AND SUPERIOR QUALITY, AND OUR CORE VALUES - RESPECT, INNOVATION, TEAMWORK, STEWARDSHIP AND INTEGRITY. THE SYSTEM HAS MADE SIGNIFICANT STRATEGIC ADVANCEMENTS IN SERVING THE RESIDENTS OF LAKE COUNTY AND SURROUNDING COMMUNITIES, RANGING FROM A CLINICAL INTEGRATION INITIATIVE TO INVESTMENTS IN NEW FACILITIES AND PROVIDER-CENTERED TECHNOLOGIES. RATHER THAN FOCUSING ON EPISODES OF CARE, THE SYSTEM AND ITS PHYSICIAN PARTNERS PROVIDE A LIFETIME OF HEALTH AND WELLNESS, EMBRACING A PHILOSOPHY OF PATIENT AND FAMILY-CENTERED CARE. THE SYSTEM AND ITS PHYSICIAN PARTNERS CONTINUE TO MOVE FORWARD IN FURTHER DEVELOPING A STRATEGIC PLAN THAT INCLUDES A FOCUS ON VALUE-BASED PURCHASING AND EVOLVING CARE MODELS.GUIDED BY A COLLABORATIVE HEALTH NEEDS ASSESSMENT CONDUCTED IN COOPERATION WITH THE LAKE COUNTY GENERAL HEALTH DISTRICT, LAKE HEALTH HAS DEVELOPED PROGRAMS, SERVICES AND PARTNERSHIPS TO ADDRESS THE MOST PRESSING HEALTH ISSUES IN OUR SERVICE AREAS AND THE SURROUNDING COMMUNITIES. THE HIGH PRIORITY AREAS INCLUDE ACCESS TO CARE, ALCOHOL ABUSE, DIABETES, DRUG OVERDOSE DEATHS, HEART DISEASE, HIGH BLOOD PRESSURE, LIMITED ACCESS TO HEALTHY FOODS, MENTAL HEALTH AND OBESITY. OUR GROWTH AS A HEALTH SYSTEM REFLECTS THE MANY WAYS WE ARE BUILDING ON OUR MISSION AND HOW WE ASPIRE TO BE MORE THAN YOUR TYPICAL COMMUNITY HOSPITAL. WE WANT OUR PATIENTS AND THEIR FAMILIES TO RECEIVE SUPERIOR CARE WITHOUT HAVING TO LEAVE THE COMMUNITY. LAKE HEALTH AND ITS PARTNERS ARE COMMITTED TO OFFERING THE BEST RESOURCES TO PROVIDE AN EXPANDED LEVEL OF CARE TO MEET THE NEEDS OF THE COMMUNITY.
PART VI, LINE 3:	1. SIGNAGE POSTED AT FACILITY ACCESS POINTS FOR PATIENTS WHO CANNOT AFFORD TO PAY FOR MEDICAL CARE.2. CHARITY/HCAP APPLICATION FORMS GIVEN TO SELF-PAY PATIENTS AT TIME OF REGISTRATION. EXPLANATION OF ASSISTANCE PROVIDED TO COMPLETE APPLICATION IF NEEDED.3. UNINSURED INPATIENTS ARE VISITED BEDSIDE TO ASSIST WITH THE COMPLETION OF THE CHARITY/HCAP APPLICATION AND TO PROVIDE APPLICATION ASSISTANCE WITH OTHER PROGRAMS SUCH AS MEDICAID, FOOD STAMPS, ETC.4. UNINSURED PATIENTS WHO RECEIVE OUTPATIENT SERVICES ARE CONTACTED BY PHONE TO ASSIST WITH THE CHARITY/HCAP APPLICATION AND OTHER PROGRAMS LISTED ABOVE.5. CHARITY/HCAP APPLICATION APPEARS ON THE BACK OF ALL PATIENT STATEMENTS.6. CHARITY/HCAP APPLICATION APPEARS ON LAKE HEALTH WEBSITE.
PART VI, LINE 4:	LAKE HEALTH'S PRIMARY SERVICE AREA IS LAKE COUNTY (POPULATION ABOUT 232,600) AND SELECTED ZIP CODES IN ITS SECONDARY SERVICE AREAS (CUYAHOGA, ASHTABULA AND GEAUGA COUNTIES WITH A POPULATION IN THE DEFINED ZIP CODES) OF 125,000. (POPULATION FIGURES ARE AS OF 2020.)
PART VI, LINE 5:	PRIOR TO 1985, LAKE HEALTH'S FACILITIES WERE PUBLICLY OPERATED AS LAKE COUNTY MEMORIAL HOSPITALS. HOWEVER, IN 1985 THE BOARD OF COUNTY COMMISSIONERS AND HOSPITAL TRUSTEES AGREED TO PRIVATIZE THE HOSPITAL TO ENSURE THE VIABILITY OF A TECHNOLOGICALLY PROGRESSIVE HOSPITAL SYSTEM FOR LAKE COUNTY RESIDENTS. COUNTY COMMISSIONERS SERVE AS MEMBERS OF THE LAKE HOSPITAL CORPORATION AND, AS SUCH, APPOINT THE COMMUNITY LEADERS WHO SERVE ON THE SYSTEM'S GOVERNING BOARD.LAKE HEALTH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. OVER 725 PHYSICIANS/ADVANCE PRACTICE PROVIDERS COMPRISE LAKE HEALTH'S MEDICAL STAFF.LAKE HEALTH'S COMMITMENT TO THE COMMUNITY IS READILY APPARENT IN THE BOARD OF TRUSTEES, WHICH IS COMPRISED SOLELY OF COMMUNITY MEMBERS, APPOINTED BY THE COUNTY COMMISSIONERS. ALL PROCEEDS ARE REINVESTED IN CAPITAL OR OTHER PROGRAMS AND SERVICES DESIGNED TO MEET THE COMMUNITIES WE SERVE.LAKE HEALTH PROVIDES SERVICES AND PROGRAMS BASED ON THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. IN FACT, TAKING HEALTH PROGRAMS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK AND PLAY IS FUNDAMENTAL TO OUR MISSION. THE COVID-19 CRISIS DEFINED 2020 FOR ALL HOSPITALS, WHICH RE-SHAPED HOW WE PROVIDED HEALTH EDUCATION PROGRAMS TO OUR COMMUNITIES. INSTEAD OF IN-PERSON PHYSICIAN LECTURES AND SCREENINGS, WE PROVIDED MORE INFORMATION DIGITALLY THROUGH WEBINARS, EMAIL AND SOCIAL MEDIA ALONG WITH SENDING PRINT MATERIAL DIRECT TO THE HOME. IN 2020, WE PROVIDED APPROXIMATELY $200,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION PROGRAMS, EXCLUDING BLOOD DRIVES, WHICH MOSTLY FOCUSED ON HOW TO PREVENT, TREAT AND SLOW THE SPREAD OF COVID-19 IN THE COMMUNITY AND HOW TO SEEK SAFE CARE DURING THE PANDEMIC. LAKE HEALTH'S COMMITMENT TO HEALTH IMPROVEMENT SERVICES THAT PROVIDE A DEMONSTRATED COMMUNITY BENEFIT CAN BE BROADLY CATEGORIZED INTO THREE AREAS: COMMUNITY HEALTH EDUCATION, COMMUNITY-BASED CLINICAL SERVICES, AND CASH AND IN-KIND GIFTS. SOME OF THE PROGRAMS AND EVENTS ARE HIGHLIGHTED BELOW.COMMUNITY HEALTH EDUCATIONLAKE HEALTH HAS AN EXTENSIVE COMMUNITY HEALTH PROGRAM THAT PROVIDES HEALTH SCREENINGS, PHYSICIAN LECTURES, SELF-HELP AND EXERCISE PROGRAMS IN MULTIPLE COMMUNITY LOCATIONS THROUGHOUT LAKE COUNTY AND SURROUNDING AREAS. OUR SUPPORT GROUPS HELP MEET EDUCATIONAL AND EMOTIONAL NEEDS RELATED TO A VARIETY OF CONDITIONS. WE ALSO PARTNER WITH MANY LOCAL ORGANIZATIONS, INCLUDING THE UNITED WAY, THE AMERICAN RED CROSS, THE AMERICAN HEART ASSOCIATION, THE ARTHRITIS FOUNDATION, THE ALZHEIMER'S ASSOCIATION, THE LAKE COUNTY YMCA, LAKE COUNTY GENERAL HEALTH DISTRICT AND THE LAKE METROPARKS TO INCREASE AWARENESS OF HEALTH ISSUES IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE:A. COMMUNITY CALENDARS AND NEWSLETTERS MONTHLY E-NEWSLETTER REGARDING IMPORTANT HEALTH ISSUES AND UPCOMING HEALTH AND WELLNESS EVENTS, EMAILED TO APPROXIMATELY 55,000 PEOPLE IN OUR PRIMARY AND SECONDARY SERVICE AREASB. EDUCATION ON SPECIFIC DISEASE CONDITIONS ARTHRITIS EXPO (VIRTUAL) STRESS MANAGEMENT BREAST HEALTH FOR HISPANIC WOMEN NUTRITION AND FITNESS EDUCATION SERIES INFANT AND CHILDBIRTH PROGRAMS COVID-19C. HEALTH PROMOTION AND WELLNESS PROGRAMS COOKING FOR WELLNESS SERIES INTEGRATIVE HEALTH & WELLNESS SERIES TRADITIONAL CHINESE MEDICINE SERIES MALL WALKING PROGRAM LIVEHEALTHY MUSIC THERAPYE. EDUCATION TO THE PUBLIC ABOUT HEALTH ISSUES INFORMATION THROUGH MEDIA RELEASES WEBSITE SOCIAL MEDIA (FACEBOOK, TWITTER, GOOGLE+) DIRECT MAIL DIGITAL (SEARCH AND DISPLAY) E-NEWSLETTERS AND E-BLASTS VIDEOF. SCHOOL HEALTH EDUCATION PROGRAMS PROBLEM-BASED LEARNING IN ELEMENTARY SCHOOLS 68 HOURS OF HUNGER SUPPORT SPORTS MEDICINE TRAINERSG. DIGITAL CONSUMER HEALTH INFORMATION MONTHLY E-NEWSLETTER E-BLASTS SOCIAL MEDIA (FACEBOOK, TWITTER, GOOGLE+) WEBSITE VIDEOS SEARCH AND DISPLAYH. SOCIAL MEDIA CONSUMER HEALTH INFORMATION FACEBOOK POSTS AND REMINDERS TWITTER POSTS AND REMINDERS GOOGLE+ VIDEOSI. SELF-HELP GRATITUDE PROJECT
PART VI, LINE 6:	LAKE HOSPITAL SYSTEM, INC. DBA LAKE HEALTH IS THE PRIMARY HEALTHCARE-PROVIDING ENTITY WHICH OPERATES TWO HOSPITAL FACILITIES, A FREE-STANDING EMERGENCY DEPARTMENT, AND SEVERAL OTHER OUTPATIENT, URGENT CARE AND PHYSICIAN CLINICS THROUGHOUT LAKE COUNTY AND THE SURROUNDING COMMUNITY. LAKE HEALTH IS THE SOLE MEMBER OF LAKE HEALTH FOUNDATION, INC. DBA LAKE HEALTH FOUNDATION, A NOT-FOR-PROFIT ORGANIZATION WHICH IS THE FUNDRAISING ARM OF LAKE HEALTH. LAKE HEALTH IS ALSO THE SOLE MEMBER OF PRIMEHEALTH, INC. DBA LAKE HEALTH PHYSICIAN GROUP ("LHPG") WHICH EMPLOYS LAKE HEALTH'S NETWORK OF PHYSICIANS. LAKE HEALTH IS A 50% SHAREHOLDER IN LAKE PHO, INC. DBA LAKE HEALTH PHO ("THE PHO") WHICH IS A PHYSICIAN CREDENTIALING AND MEMBERSHIP ORGANIZATION. PHYSICIANS MUST BE A MEMBER OF THE PHO IN ORDER TO PRACTICE MEDICINE AT A LAKE HEALTH HOSPITAL OR PHYSICIAN CLINIC. THE LAKE HEALTH / UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER IS A JOINT VENTURE BETWEEN LAKE HEALTH AND UNIVERSITY HOSPITALS HEALTH SYSTEM OF CLEVELAND THAT PROVIDES CANCER TREATMENT IN MENTOR, OHIO.MENTOR SURGERY CENTER, LLC, MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING, LLC, LAKE WEST MEDICAL SPECIALISTS, INC., AND CONCORD MEDICAL CAMPUS PHYSICIANS BUILDING, INC. ARE ENTITIES IN WHICH LAKE HEALTH OWNS A MINORITY STAKE. THESE ENTITIES LEASE MEDICAL OFFICE SPACE AT WHICH BOTH LAKE HEALTH AND NON-AFFILIATED PRACTITIONERS PRACTICE.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SIGNATURE HEALTH INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	24200 CHAGRIN BLVD	AddressLine1Txt
City	BEACHWOOD	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44122	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	341751703	RecipientEIN
Cash Grant	$153,900	CashGrantAmt
Purpose Of Grant	COMMUNITY OPIOID CARE FACILITY PROJECT	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	COLLEGE TUITION GRANTS TO MARKETING CONTEST WINNERS	GrantTypeTxt
Recipient	1	RecipientCnt
Cash Grant	$5,000	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	IN COOPERATION WITH LAKELAND COMMUNITY COLLEGE AND LAKE ERIE COLLEGE, TUITION GRANTS WERE AWARDED TO THE FIRST BABY BORN AT EACH LOCATION OF LAKE HEALTH IN THE NEWLY RENOVATED LABOR AND DELIVERY WINGS. THE GRANTS ARE MONITORED THROUGH SUBMISSION OF INFORMATION SUPPORTING THE RELEASE OF FUNDS OVER A FOUR YEAR PERIOD DIRECTLY TO AN INSTITUTION OF HIGHER LEARNING FOR BENEFIT OF THE WINNERS. TUITION REIMBURSEMENT PROGRAMS FOR EMPLOYEES ARE AVAILABLE THROUGH SUBMISSION OF AN APPLICATION TO HUMAN RESOURCES, REVIEWED BY A COMMITTEE FOR APPLICABILITY TO THE CRITERIA, FOR BENEFITS OF THE COMMUNITY AND LAKE HEALTH.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CYNTHIA MOORE-HARDY
PRESIDENT AND CEO	$849,540	$0	$151,594	$0	$71,585	$0	$6,359	$0	$20,692	$0	$1,099,770	$0	$0	$0
JOHN BANIEWICZ MD
SR VP, MEDICAL AFFAIRS	$464,994	$0	$88,000	$0	$30,417	$0	$6,231	$0	$23,935	$0	$613,577	$0	$0	$0
ROBERT TRACZ
SR. VP/CFO	$466,542	$0	$85,625	$0	$21,617	$0	$6,469	$0	$23,717	$0	$603,970	$0	$0	$0
RICHARD D CICERO
SR VP, MARKETING & BUSINESS	$318,597	$0	$58,500	$0	$23,175	$0	$5,498	$0	$17,308	$0	$423,078	$0	$0	$0
ADETINUKE TADESE
CHIEF MEDICAL INFORMATICS OFFICER	$296,061	$0	$23,250	$0	$2,111	$0	$0	$0	$33,605	$0	$355,027	$0	$0	$0
BILL OSTERMAN
VP, ACUTE CARE SERVICES	$222,515	$0	$28,750	$0	$8,676	$0	$0	$0	$23,964	$0	$283,905	$0	$0	$0
DAVID HERMAN
VP, FINANCE	$222,165	$0	$27,875	$0	$5,822	$0	$0	$0	$27,356	$0	$283,218	$0	$0	$0
JOYCE A TAYLOR
VP, QUALITY SERVICES, CQO	$214,162	$0	$21,000	$0	$11,529	$0	$0	$0	$11,405	$0	$258,096	$0	$0	$0
CYNTHIA J RACER
VP, CLINICAL SERVICES	$191,013	$0	$19,000	$0	$9,559	$0	$0	$0	$19,258	$0	$238,830	$0	$0	$0
JERROLD PETERS
VP, HUMAN RESOURCES	$183,314	$0	$22,500	$0	$9,045	$0	$0	$0	$11,473	$0	$226,332	$0	$0	$0
DINO DISANTO
VP, MARKETING & GOVERNMENT AFFAIRS	$191,592	$0	$18,375	$0	$6,892	$0	$0	$0	$0	$0	$216,859	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	CYNTHIA MOORE-HARDY, RECEIVED THE FOLLOWING TAXABLE BENEFIT IN 2020: SOCIAL CLUB DUES OF $12,230
PART I, LINE 4B	THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENT. THERE ARE NO DISTRIBUTIONS FROM OR AMOUNTS VESTED IN THE PLAN. CYNTHIA MOORE-HARDY
PART I, LINE 7	DISCRETIONARY BONUS MAY BE AWARDED BASED ON PERFORMANCE. THOSE BONUSES ARE DETERMINED BY THE STRATEGIC LEADERSHIP TEAM. THE FOLLOWING INDIVDUALS RECEIVED THESE BONUSES: - CYNTHIA MOORE-HARDY: $151,594 RETENTION BONUS - ROBERT TRACZ: $85,625 RETENTION BONUS - JOHN BANIEWICZ MD: $88,000 RETENTION BONUS - RICHARD CICERO: $58,500 RETENTION BONUS - ADETINUKE TADESE: $23,250 RETENTION BONUS - WILLIAM OSTERMAN: $28,750 RETENTION BONUS - DAVID HERMAN: $27,875 RETENTION BONUS - JOYCE TAYLOR: $21,000 RETENTION BONUS - CYNTHIA RACER: $19,000 RETENTION BONUS - DINO DISANTO: $18,375 RETENTION BONUS -JERROLD PETERS: $22,500 RETENTION BONUS

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
COUNTY OF LAKE OHIO SERIES 2008
A	346001618	50943PBL2	2008-06-26	$187,820,719	SEE PART VI	Yes (1)	0	0
COUNTY OF LAKE OHIO SERIES 2015
B	346001618	50943PCC1	2015-08-03	$69,960,181	SEE PART VI	0	0	0
COUNTY OF LAKE OHIO SERIES 2017
C	346001618		2017-12-19	$138,445,000	SEE PART VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capital ExpendituresCapitalExpendituresAmt
A	$132,215,000	$60,245,000	$193,519,247	$888,050	$1,808,396	$57,940	$190,764,861	2009	Yes (1)	0	Yes (1)	Yes (1)
B	$4,655,000		$70,003,111		$268,650		$50,544,201	2016	0	Yes (1)	Yes (1)	Yes (1)	$19,190,260
C	$4,670,000		$138,445,000				$138,445,000	2017	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
A	0	Yes (1)	0	0	Yes (1)
B	0	Yes (1)	0	0	Yes (1)
C	Yes (1)	0	Yes (1)	Yes (1)	Yes (1)	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: COUNTY OF LAKE, OHIO SERIES 2008 DATE THE REBATE COMPUTATION WAS PERFORMED: 06/26/2018 ISSUER NAME: COUNTY OF LAKE, OHIO SERIES 2015 DATE THE REBATE COMPUTATION WAS PERFORMED: 08/01/2020
SCHEDULE K, PART I, BOND ISSUES:	(A) ISSUER NAME: COUNTY OF LAKE, OHIO SERIES 2008 (B) ISSUER NAME: COUNTY OF LAKE, OHIO SERIES 2015 (C) ISSUER NAME: COUNTY OF LAKE, OHIO SERIES 2017
SCHEDULE K, PART I,	LINE A, COLUMN (F) DESCRIPTION OF PURPOSE: CONSTRUCT A HOSPITAL; REFUNDING OF SERIES 2004 (ISSUED ON 08/15/2004) AND SERIES 2007 (ISSUED ON 08/15/2007). LINE B, COLUMN (F) DESCRIPTION OF PURPOSE: CONSTRUCTION, REMODELING, IMPROVEMENT, AND EQUIPPING OF HOSPITAL FACILITIES; PARTIAL REFUNDING OF SERIES 2008C (ISSUED ON 08/15/2008). LINE C, COLUMN (F) DESCRIPTION OF PURPOSE: REFUNDING OF SERIES 2012A (ISSUED ON 06/15/2012) AND SERIES 2012C (ISSUED ON 06/15/2012), REISSUANCE FOR FEDERAL INCOME TAX PURPOSES OF SERIES 2012B (ISSUED ON 06/05/2012).
SCHEDULE K, PART I, COLUMN (E) & SCHEDULE K, PART, II, LINE 3:	THE DIFFERENCE BETWEEN ISSUE PRICE IN PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN PART II, LINE 3 IS INVESTMENT INCOME EARNED ON BOND FUNDS BEFORE THE BOND PROCEEDS WERE EXPENDED.
SCHEDULE K, PART IV, COLUMN C, LINES 4B AND 4C:	SERIES 2017 PROVIDER KEYBANK, NATIONAL ASSOCIATION, TERM 20.48 YEARS; SERIES 2017 PROVIDER PNC BANK, TERM 28.81 YEARS; AND SERIES 2017 PROVIDER PNC BANK, TERM 29.15 YEARS.
SCHEDULE K, PART II, COLUMN A, LINE 6: PROCEEDS IN REFUNDING ESCROWS	PROCEEDS IN REFUNDING ESCROWS - A PORTION OF THE AMOUNT SHOWN CONSISTS OF REPLACEMENT PROCEEDS OF THE 2008 BONDS
SCHEDULE K, PART II, COLUMN A, LINE 11:	THESE BOND PROCEEDS WERE USED TO CURRENT REFUND PRIOR DEBT, AS NOTED IN THE NOTES FOR PART I.
SCHEDULE K, PART II, COLUMN B, LINE 10:	CAPITAL EXPENDITURES FROM PROCEEDS LINE INCLUDES $24,000 OF INTEREST ON THE 2015 BONDS AND INVESTMENT
SCHEDULE K, PART II, COLUMN B, LINE 11:	OTHER SPENT PROCEEDS - THESE BOND PROCEEDS WERE USED TO CURRENT REFUND PRIOR DEBT, AS NOTED IN THENOTES FOR PART I, AND INCLUDES INVESTMENT EARNINGS IN THE AMOUNT OF $1,185
SCHEDULE K, PART II, COLUMN C, LINE 11:	OTHER SPENT PROCEEDS - THESE BOND PROCEEDS WERE USED TO CURRENT REFUND PRIOR DEBT, AS NOTED IN THE NOTES FOR PART I. IN ADDITION, THE SERIES 2012B BONDS WERE REISSUED FOR FEDERAL INCOME TAX PURPOSES ON THE DATE OF ISSUE OF THE SERIES 2017 BONDS, AND THOSE REISSUED SERIES 2012B BONDS ARE PART OF A SINGLE ISSUE OF OBLIGATIONS WITH THE SERIES 2017 BONDS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
MATT J CICERO
FAMILY MEMBER OF KEY EMPLOYEE, RICHARD D. CICERO	$66,093	SEE PART V	0
ABIGAIL CICERO
FAMILY MEMBER OF KEY EMPLOYEE, RICHARD D. CICERO	$90,850	SEE PART V	0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, COLUMN D	FormAndLineReferenceDesc
Explanation	MATT J. CICERO, WHO HAS A FAMILY RELATIONSHIP WITH RICHARD D. CICERO, SERVED AS A HOSPITAL EMPLOYEE DURING 2020 AND RECEIVED COMPENSATION.ABIGAIL CICERO, WHO HAS A FAMILY RELATIONSHIP WITH RICHARD D. CICERO, SERVED AS A HOSPITAL EMPLOYEE DURING 2020 AND RECEIVED COMPENSATION.	ExplanationTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	COVID-19 PPE	1	$1,246,028	ESTIMATE QTY X MKT C
Yes (X)	WALK NONCASH VENDOR DONATIONS	7	$51,390	RETAIL VALUE

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	THE PROCESS FOLLOWED BEFORE FILING THE LAKE HEALTH FORM 990 INCLUDES A DETAILED REVIEW COMPLETED BY AN INDEPENDENT OUTSIDE CPA FIRM, PRESENTATION TO AND REVIEW BY THE LAKE HEALTH CFO AND CEO, PRESENTATION AND REVIEW BY THE LAKE HEALTH FINANCE COMMITTEE, AND PRESENTATION TO THE LAKE HEALTH BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12C	THE LAKE HOSPITAL SYSTEM, INC. BOARD OF TRUSTEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY, WHICH IS THEN REVIEWED BY THE LHS CFO AND A DIRECTOR OF THE BOARD OF TRUSTEES. BOARD MEMBERS WILL EXCUSE THEMSELVES FROM THE BOARD MEETING WHEN A TOPIC OF POTENTIAL CONFLICT IS PRESENTED AND RETURN TO THE MEETING FOLLOWING THE COMPLETION OF DISCUSSION, MOTION, AND VOTE. COMPLIANCE WITH THE LHS CONFLICT OF INTEREST POLICY MONITORED AND ENFORCED BY THE BOARD CHAIR, COMMITTEE CHAIRS, AND THE DIRECTOR RESPONSIBLE FOR BOARD OF TRUSTEE MATTERS.
FORM 990, PART VI, SECTION B, LINE 15	THE PROCESS FOR DETERMINING COMPENSATION OF THE LAKE HOSPITAL SYSTEM, INC. CEO, OTHER OFFICERS, AND KEY EMPLOYEES INCLUDES MARKET RESEARCH, REVIEW, AND ASSESSMENT BY AN INDEPENDENT CONSULTING FIRM TO MAKE A RECOMMENDATION TO THE LHS BOARD OF DIRECTORS. THE BOARD REVIEWS THE REPORT PROVIDED IN CONJUNCTION WITH PERFORMANCE ASSESSMENTS, AND UTILIZES THIS INFORMATION TO DETERMINE COMPENSATION LEVEL. IN ADDITION, THE PROCEDURE FOR OTHER OFFICERS AND KEY EMPLOYEES INCLUDES REVIEW BY THE CEO. THE REVIEW WAS LAST CONDUCTED IN NOVEMBER 2020.
FORM 990, PART VI, SECTION C, LINE 19	LAKE HOSPITAL SYSTEM, INC. MAKES ITS FORM 990, FORM 990-T, AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST, FOR THE SAME PERIOD OF TIME AS SET FORTH IN THE INTERNAL REVENUE CODE SECTION 6104(D), IN ADDITION TO FILING QUARTERLY FINANCIAL INFORMATION WITH THE ELECTRONIC MUNICIPAL MARKET ACCESS SYSTEM FOR COMPLIANCE WITH BOND ISSUES AND ANNUAL FINANCIAL INFORMATION WITH THE ATTORNEY GENERAL OF THE STATE OF OHIO. GOVERNING DOCUMENTS FOR LAKE HOSPITAL SYSTEM, INC. ARE AVAILABLE THROUGH THE WEBSITE OF THE OHIO SECRETARY OF STATE.
AMENDED RETURN EXPLANATION	PART VII, SECTION A, COLUMNS D-F, SCH. J, PART II, COLUMNS B-E & PART III AMENDED AMOUNTS TO REPORT CORRECT COMPENSATION REFLECTED ON 2020 W-2.
FORM 990, PART IX, LINE 11G	OUTSOURCED SERVICES: PROGRAM SERVICE EXPENSES 12,083,950. MANAGEMENT AND GENERAL EXPENSES 203,848. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,287,798. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,725,097. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,725,097. CONSULTING: PROGRAM SERVICE EXPENSES 4,924,938. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,924,938. MAINTENANCE & REPAIR: PROGRAM SERVICE EXPENSES 7,064,091. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,064,091. DATA PROCESSING & COLLECTION: PROGRAM SERVICE EXPENSES 2,756,394. MANAGEMENT AND GENERAL EXPENSES 897,577. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,653,971. RESEARCH & MARKETING: PROGRAM SERVICE EXPENSES 676,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 676,457. SUBSCRIPTIONS & PUBLICATIONS: PROGRAM SERVICE EXPENSES 418,919. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 418,919. MISCELLANEOUS OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 603,116. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 603,116. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 42,411,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,411,457.
FORM 990, PART XI, LINE 9:	NET GAIN FROM AFFILIATED ENTITIES 591,433. DERIVATIVE INSTRUMENTS LOSS -13,808,809. UNDERWRITING SUPPORT OF FOUNDATION -305,092. NEW MANNA UBI 1,625,575.
FORM 990, PART XII, LINE 2C:	LAKE HEALTH'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.
FORM 990, PAGE 12, PART XII, LINE 3B	THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT BEEN COMPLETED YET, BUT PLANS HAVE BEEN MADE TO HAVE IT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	LAKE HEALTH IPHE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3605 WARRENSVILLE CTR RD MSC 9155	AddressLine1Txt
City	SHAKER HEIGHTS	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44122	ZIPCd

Field	Value	IRS element (for citing)
Primary Activities	PHYSICIAN SERVICES	PrimaryActivitiesTxt
Legal Domicile State	OH	LegalDomicileStateCd
Total Income	-$18,375	TotalIncomeAmt
End Of Year Assets	$0	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	LAKE HOSPITAL SYSTEM INC	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
LAKE HEALTH UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER
3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	311565964	TREATMENT OF CANCER PATIENTS	OH	501(C)(3)	LINE 3	N/A	0
LAKE HOSPITAL FOUNDATION INC DBA LAKE HEALTH FOUNDATION
3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	341425872	FUNDRAISING FOR BENEFIT OF LAKE HOSPITAL SYSTEM, INC.	OH	501(C)(3)	LINE 12A, I		Yes (1)	LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH
PRIMEHEALTH INC
3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	341778204	PHYSICIAN CORPORATION	OH	501(C)(3)	LINE 3		Yes (1)	LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH
THE AUXILIARY OF LAKE HOSPITAL SYSTEM INC
3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	341605226	SUPPORT SERVICES FOR LAKE HEALTH HOSPITALS	OH	501(C)(3)	LINE 10		Yes (1)	LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	260550261	OFFICE SPACE	OH	N/A	EXCLUDED	$253,262	$1,738,599	0	0	0.51470
LAKE WEST MEDICAL SPECIALISTS LLC
36060 EUCLID AVE	WILLOUGHBY	OH	44094	341964657	OFFICE SPACE	OH	N/A	EXCLUDED	$9,175		0	0	0.12000
MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
9485 MENTOR AVE	MENTOR	OH	44060	341958475	OFFICE SPACE	OH	N/A	UBI	$100,702		0	0	0.40390
MENTOR SURGERY CENTER LLC
9485 MENTOR AVE	MENTOR	OH	44060	341863257	OUTPATIENT SURGERY	OH	N/A	RELATED	$406,985	$1,249,825	0	0	0.42210
LAKE WILLOUGHBY PROPERTIES LLC
4166 CHILLICOTHE RD	WILLOUGHBY	OH	44094	364837155	OFFICE SPACE	OH	N/A	UBI	$78,042		0	0	0.35000
NEW MANNA CLG LLC DBA LAKE HEALTH BEACHWOOD MEDICAL CENTER
25501 CHAGRIN BLVD	BEACHWOOD	OH	44122	371848577	SPECIALTY HOSPITAL	OH		UBI	-$1,625,575	$442,889	0	Yes (1)	0.51000	YES

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Share Of Total IncomeShareOfTotalIncomeAmt
LHS ASSURANCE LTD
23 LIME TREE BAY AVENUE	GRAND CAYMAN	CJ	980456229	INSURANCE COMPANY	CJ	LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH	C	$25,646,874	1.00000	Yes (1)
LAKE PHO INC DBA LAKE HEALTH PHYSICIAN HOSPITAL ORGANIZATION
			341696001	PHYSICIAN SERVICES			C	$2,116,084	0.50000	0	3605 WARRENSVILLE CTR RD MSC 9155	SHAKER HEIGHTS	OH	44122	OH	N/A	$215,426

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	Yes (1)	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (23 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
PRIMEHEALTH INC
P	$30,763,559	BOOK VALUE
LHS ASSURANCE LTD
C	$500,000	BOOK VALUE
LAKE HEALTH FOUNDATION
C	$1,791,667	BOOK VALUE
LAKE HEALTH FOUNDATION
M	$305,092	BOOK VALUE
LAKE WEST MEDICAL SPECIALISTS LLC
F	$57,000	BOOK VALUE
LAKE WEST MEDICAL SPECIALISTS LLC
K	$310,521	BOOK VALUE
LAKE WEST MEDICAL SPECIALISTS LLC
J	$38,854	BOOK VALUE
LAKE WEST MEDICAL SPECIALISTS LLC
D	$118,511	BOOK VALUE
LHUH SEIDMAN CANCER CENTER
J	$942,072	BOOK VALUE
MENTOR SURGERY CENTER LLC
F	$517,223	BOOK VALUE
MENTOR SURGERY CENTER LLC
J	$480,804	BOOK VALUE
MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
F	$171,949	BOOK VALUE
MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
J	$83,102	BOOK VALUE
MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
K	$592,313	BOOK VALUE
MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC
D	$558,866	BOOK VALUE
LAKE WILLOUGHBY PROPERTIES LLC
K	$753,788	BOOK VALUE
LAKE WILLOUGHBY PROPERTIES LLC
F	$81,550	BOOK VALUE
CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
D	$1,087,194	BOOK VALUE
CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
F	$197,421	BOOK VALUE
CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
J	$129,260	BOOK VALUE
CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC
K	$1,381,189	BOOK VALUE
NEW MANNA CLG LLC
D	$5,614,920	BOOK VALUE
NEW MANNA CLG LLC
L	$2,693,601	BOOK VALUE