UNIVERSITY HOSPITALS HEALTH SYSTEM INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY HOSPITALS HEALTH SYSTEM INC (EIN 34-1425870)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202213189349309671
- Schema version
- 2021v4.2
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T12:58:23-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | 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 | 2021-01-01 | 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 | 2022-11-11 | 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 | 2022-11-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
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 | ROBERT TRACZ | 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 | $944,998,078 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UHHOSPITALS.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 | 3320 | TotalEmployeeCnt |
| Total Volunteers | 450 | TotalVolunteersCnt |
| Total Gross UBI | $1,803,494 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,062,589 | PYContributionsGrantsAmt |
| CY Contributions Grants | $15,516,333 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $346,342,471 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $385,477,854 | CYProgramServiceRevenueAmt |
| PY Investment Income | $26,041,896 | PYInvestmentIncomeAmt |
| CY Investment Income | $36,603,703 | CYInvestmentIncomeAmt |
| PY Other Revenue | $26,655,602 | PYOtherRevenueAmt |
| CY Other Revenue | $37,861,849 | CYOtherRevenueAmt |
| PY Total Revenue | $411,102,558 | PYTotalRevenueAmt |
| CY Total Revenue | $475,459,739 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $158,900 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $153,691,022 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $165,947,185 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $247,620,636 | PYOtherExpensesAmt |
| CY Other Expenses | $268,232,969 | CYOtherExpensesAmt |
| PY Total Expenses | $401,470,558 | PYTotalExpensesAmt |
| CY Total Expenses | $434,180,154 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,632,000 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $41,279,585 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $660,977,812 | TotalAssetsBOYAmt |
| Total Assets EOY | $631,158,601 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $413,098,945 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $121,765,594 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $247,878,867 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $509,393,007 | 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 | $359,562,227 | ExpenseAmt |
| Revenue | $418,863,977 | RevenueAmt |
| Desc | LAKE HOSPITAL SYSTEM, INC., IS A 120-YEAR-OLD HEALTH CARE INSTITUTION THAT HAS PRIMARILY SERVED THE HEALTH CARE NEEDS OF RESIDENTS IN LAKE COUNTY AND THE SURROUNDING COMMUNITIES SINCE 1902. 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 HAVE BEEN GUIDED BY OUR MISSION TO PROVIDE LOCAL ACCESS, HEALING WITH COMPASSION AND SUPERIOR QUALITY AND OUR CORE VALUES - RESPECT, INNOVATION, TEAMWORK, STEWARDSHIP, AND INTEGRITY. WE HAVE BEEN 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 COVID 19, DIABETES, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND ACCESS TO CARE. IN APRIL 2021, LAKE HEALTH JOINED UNIVERSITY HOSPITALS. AS SUCH, LAKE HEALTH'S TAX ID REMAINS THE SAME, AND IT FILES ITS TAX RETURN INDEPENDENTLY FROM UH.LAKE HEALTH IS COMPRISED OF 11 FACILITIES IN LAKE, GEAUGA, AND CUYAHOGA COUNTIES, AND WHICH INCLUDE THE FOLLOWING:1. TRIPOINT MEDICAL CENTER (FULL-SERVICE, ACUTE CARE HOSPITAL)2. LAKE WEST MEDICAL CENTER (FULL-SERVICE, ACUTE CARE HOSPITAL)3. BEACHWOOD MEDICAL CENTER (FULL-SERVICE ACUTE CARE HOSPITAL)4. MENTOR HEALTH CENTER (OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, OUTPATIENT SURGERY, CANCER SERVICES)5. BRUNNER, SANDEN DEITRICK WELLNESS CENTER (URGENT CARE, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, PHYSICAL THERAPY, OCCUPATIONAL HEALTH SERVICES AND A MEDICALLY BASED FITNESS CENTER)6. MADISON HEALTH CENTER (OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES, PHYSICAL THERAPY)7. WILLOWICK HEALTH CENTER (URGENT CARE, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES)8. CHARDON HEALTH CENTER (, OUTPATIENT LAB AND DIAGNOSTICS, PHYSICIAN OFFICES)9. PERRICO HEALTH CENTER (PHYSICIAN OFFICES, PHYSICAL THERAPY, OUTPATIENT LAB AND DIAGNOSTICS)10. LAKE SOM HEALTH CENTER (PHYSICIAN OFFICES, LAB, AND DIAGNOSTICS)11. LAKE CONTINUING CARE CENTER (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 ALSO OPERATES THREE FULL-SERVICE EMERGENCY DEPARTMENTS INCLUDING: TRIPOINT MEDICAL CENTER IN CONCORD TOWNSHIP, LAKE WEST MEDICAL CENTER IN WILLOUGHBY AND BEACHWOOD MEDICAL CENTER IN BEACHWOOD. THESE EMERGENCY DEPARTMENTS ARE OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY.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. IN FACT, TAKING HEALTH EDUCATION PROGRAMS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK AND PLAY IS FUNDAMENTAL TO OUR MISSION. IN 2021, WE CONTINUED OUR MISSION OF HELPING TO CARE AND EDUCATE OUR COMMUNITIES REGARDING COVID-19. WE ALSO PUT A FOCUS ON HELPING PATIENTS FEEL COMFORTABLE TO RETURN FOR HEALTH CARE IN OUR COMMUNITIES AND PROVIDING ADDITIONAL ACCESS FOR PATIENTS.IN 2021, LAKE HEALTH PROVIDED APPROXIMATELY $450,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION, WHICH CONTINUED TO FOCUS ON LAKE HEALTH CONTRIBUTED APPROXIMATELY $8.5 MILLION IN 2021 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.COMMUNITY PROGRAMS AND EVENTS:LAKE HEALTH CONTINUED TO BE AN ANCHOR INSTITUTE IN COMMUNITY BY SUPPORTING OVER 50 LOCAL ORGANIZATION WITH AN EMPHASIS ON SUPPORTING ORGANIZATIONS THAT ALIGNED WITH PROVIDING SUPPORT AS IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT. INCLUDING, LAKE COUNTY FREE MEDICAL CLINIC, LAKE COUNTY COUNCIL ON AGING, AND FORBES HOUSE. WE ALSO CONTINUED TO PROVIDING COMMUNITY PROGRAMS INCLUDING: 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 HUNGERSCHOOL PARTNERSHIPSBREAST HEALTH FOR HISPANIC WOMENINTEGRATIVE HEALTH AND WELLNESS | Desc |
| Total Program Service Expenses | $359,562,227 | 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 | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | 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 | 134 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3320 | 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 | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | ROBERT TRACZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4403541984 | 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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | |||
| CYNTHIA MOORE-HARDY | |||||||||
| PRESIDENT AND CEO | 55.00 | 10.00 | Yes (X) | $3,284,651 | $0 | $18,431 | |||
| ROBERT TRACZ | |||||||||
| SR. VP/CFO | 50.00 | 10.00 | Yes (X) | $694,972 | $0 | $26,066 | |||
| JOHN BANIEWICZ MD | |||||||||
| SR VP, MEDICAL AFFAIRS | 45.00 | 10.00 | $694,597 | $0 | $23,813 | Yes (X) | |||
| RICHARD D CICERO | |||||||||
| SR VP, MARKETING & BUSINESS | 45.00 | 10.00 | $444,530 | $0 | $23,201 | Yes (X) | |||
| ADETINUKE TADESE | |||||||||
| CHIEF MEDICAL INFORMATICS OFFICER | 40.00 | 5.00 | $348,804 | $0 | $31,219 | Yes (X) | |||
| BILL OSTERMAN | |||||||||
| VP, ACUTE CARE SERVICES | 40.00 | 0.00 | $281,475 | $0 | $8,163 | Yes (X) | |||
| MICHELE PIRC | |||||||||
| PRIMARY NURSE PRACTITIONER | 40.00 | 0.00 | $280,248 | $0 | $0 | Yes (X) | |||
| DAVID HERMAN | |||||||||
| VP, FINANCE | 40.00 | 10.00 | $271,483 | $0 | $27,923 | Yes (X) | |||
| JOYCE A TAYLOR | |||||||||
| VP, QUALITY SERVICES, CQO | 40.00 | 0.00 | $251,540 | $0 | $11,603 | Yes (X) | |||
| JERROLD PETERS | |||||||||
| VP, CIO | 40.00 | 5.00 | $235,631 | $0 | $11,672 | Yes (X) | |||
| CYNTHIA J RACER | |||||||||
| VP, CLINICAL SERVICES | 40.00 | 0.00 | $230,078 | $0 | $19,626 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,018,009 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $201,717 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 122 | 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 |
|---|---|---|---|---|---|
| MAXIM HEALTHCARE SERVICES INC | |||||
| 25000 COUNTRY CLUB BLVD SUITE 200 | NORTH OLMSTED | OH | 44070 | MEDICAL STAFFING | $10,251,055 |
| COMMUNITY HOSPITALISTS LLC | |||||
| 30680 BAINBRIDGE ROAD | SOLON | OH | 44139 | HOSPITAL MEDICAL STAFFING COVERAGE AND M | $7,307,983 |
| CROTHALL HEALTHCARE INC | |||||
| 13028 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | HOUSEKEEPING SERVICES | $4,276,605 |
| SODEXO INC AND AFFILIATES | |||||
| PO BOX 360170 | PITTSBURG | PA | 152516170 | NUTRITION SERVICES OPERATIONS | $3,310,761 |
| PHILIPS MEDICAL SYSTEMS | |||||
| 595 MINER RD | CLEVELAND | OH | 44143 | SERVICE AGREEMENTS: INSPECTIONS, MAINTEN | $2,692,718 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 210 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $591,848 | RelatedOrganizationsAmt |
| Government Grants | $14,328,711 | GovernmentGrantsAmt |
| All Other Contributions | $595,774 | AllOtherContributionsAmt |
| Noncash Contributions | $16,488 | NoncashContributionsAmt |
| Total Contributions | $15,516,333 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $385,477,854 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $385,477,854 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $385,477,854 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,339,469 | TotalRevenueColumnAmt |
| Exclusion | $4,339,469 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $300 | TotalRevenueColumnAmt |
| Exclusion | $300 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,569,663 | 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 | $2,569,663 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,569,663 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $42,723 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,526,940 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $493,620,586 | SecuritiesAmt |
| Other | $8,181,687 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $461,924,421 | SecuritiesAmt |
| Other | $7,613,918 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $31,696,165 | SecuritiesAmt |
| Other | $567,769 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,263,934 | TotalRevenueColumnAmt |
| Exclusion | $32,263,934 | 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 | $17,585,467 | $16,778,742 | $661,433 | $145,292 |
| PURCHASE DISCOUNTS | 621110 | $7,165,941 | $7,165,941 | ||
| CMS INCENTIVE PAYMENTS | 621110 | $5,073,893 | $5,073,893 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,466,885 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,367,547 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,099,338 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $35,292,186 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $475,459,739 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $418,863,977 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,803,494 | UnrelatedBusinessRevenueAmt |
| Exclusion | $39,275,935 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,042,282 | TotalAmt |
| Management And General | $7,042,282 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,080,863 | TotalAmt |
| Program Services | $114,589,740 | ProgramServicesAmt |
| Management And General | $19,491,123 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,181,778 | TotalAmt |
| Program Services | $1,771,569 | ProgramServicesAmt |
| Management And General | $410,209 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,127,088 | TotalAmt |
| Program Services | $10,658,986 | ProgramServicesAmt |
| Management And General | $2,468,102 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,515,174 | TotalAmt |
| Program Services | $7,726,169 | ProgramServicesAmt |
| Management And General | $1,789,005 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,054,385 | TotalAmt |
| Program Services | $1,529,292 | ProgramServicesAmt |
| Management And General | $525,093 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $353,976 | TotalAmt |
| Program Services | $35,398 | ProgramServicesAmt |
| Management And General | $318,578 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,000 | TotalAmt |
| Management And General | $89,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,193,698 | TotalAmt |
| Management And General | $1,193,698 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,479,356 | TotalAmt |
| Program Services | $78,177,965 | ProgramServicesAmt |
| Management And General | $5,301,391 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,273,893 | TotalAmt |
| Program Services | $320,545 | ProgramServicesAmt |
| Management And General | $1,953,348 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,988,029 | TotalAmt |
| Program Services | $2,125,647 | ProgramServicesAmt |
| Management And General | $1,862,382 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,376,135 | TotalAmt |
| Program Services | $215,642 | ProgramServicesAmt |
| Management And General | $14,160,493 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,437,248 | TotalAmt |
| Program Services | $10,571,661 | ProgramServicesAmt |
| Management And General | $1,865,587 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,359 | TotalAmt |
| Program Services | $306,313 | ProgramServicesAmt |
| Management And General | $1,046 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,960 | TotalAmt |
| Program Services | $2,694 | ProgramServicesAmt |
| Management And General | $15,266 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,545,835 | TotalAmt |
| Program Services | $3,500,787 | ProgramServicesAmt |
| Management And General | $45,048 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,911,631 | TotalAmt |
| Program Services | $5,512,532 | ProgramServicesAmt |
| Management And General | $14,399,099 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,096,319 | TotalAmt |
| Program Services | $5,339,185 | ProgramServicesAmt |
| Management And General | $757,134 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $71,190,582 | $71,190,582 | |
| BAD DEBT | $35,625,368 | $35,625,368 | |
| HOSPITAL FRANCHISE FEE | $10,053,078 | $10,053,078 | |
| MEMBERSHIP DUES | $1,239,117 | $309,074 | $930,043 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,180,154 | TotalAmt |
| Program Services | $359,562,227 | ProgramServicesAmt |
| Management And General | $74,617,927 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,258,149 | BOYAmt |
| EOY | $27,770,102 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,112,459 | BOYAmt |
| EOY | $42,521,682 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,527,097 | BOYAmt |
| EOY | $6,280,323 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,044,664 | BOYAmt |
| EOY | $11,756,580 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $201,903,409 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,306,826 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,766,389 | BOYAmt |
| EOY | $187,596,583 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,224,064 | BOYAmt |
| EOY | $274,056,047 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,519,042 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,525,948 | BOYAmt |
| EOY | $81,177,284 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,977,812 | BOYAmt |
| EOY | $631,158,601 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,168,378 | BOYAmt |
| EOY | $41,974,398 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,490 | BOYAmt |
| EOY | $1,266,241 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,205,555 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,529,522 | BOYAmt |
| EOY | $78,524,955 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,098,945 | BOYAmt |
| EOY | $121,765,594 | 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 | $247,878,867 | BOYAmt |
| EOY | $509,393,007 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,878,867 | BOYAmt |
| EOY | $509,393,007 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,977,812 | BOYAmt |
| EOY | $631,158,601 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $41,279,585 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$21,068,425 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $241,302,980 | 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 | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $19,839 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $19,839 | 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 | $7,186,654 | BeginningYearBalanceAmt |
| Contributions | $474,754 | ContributionsAmt |
| Investment Earnings Or Losses | $582,521 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $89,913 | GrantsOrScholarshipsAmt |
| Other Expenditures | $336,209 | OtherExpendituresAmt |
| End Year Balance | $7,817,807 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.47350 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.52650 | 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 | $21,980,000 | OtherCostOrOtherBasisAmt |
| Book Value | $21,980,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,691,805 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,122,326 | DepreciationAmt |
| Book Value | $107,569,479 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,579,919 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,468,774 | DepreciationAmt |
| Book Value | $51,111,145 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,651,685 | OtherCostOrOtherBasisAmt |
| Depreciation | $715,726 | DepreciationAmt |
| Book Value | $6,935,959 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $187,596,583 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED COMPENSATION | $2,045,450 |
| FINANCE RIGHT OF USE ASSETS NET | $77,344 |
| INVESTMENTS IN AFFILIATES | $29,801,603 |
| OPERATING RIGHT OF USE ASSETS | $49,252,887 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $81,177,284 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY SETTLEMENTS | $6,630,447 |
| DEFERRED COMPENSATION | $2,525,337 |
| LEASE OBLIGATION | $49,318,121 |
| MARKETING LIABILITY | $10,000 |
| PAYER ADVANCES | $20,041,050 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $78,524,955 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
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 | $20,353 |
| CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | 0 | 0 | PROGRAM SERVICES | MANAGEMENT FEES RELATED TO LHS ASSURANCE, LTD. | $115,635 |
| 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 | $135,988 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $135,988 | 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 | $1,083,757 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,083,757 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,196,273 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,047,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,149,260 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,280,030 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,047,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,233,017 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04570 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $443,453 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $443,453 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,332,501 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,244,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,501 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,493,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,493,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,269,542 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,244,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,025,542 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,549,572 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,291,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,258,559 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06830 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $120,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $120,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $120,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $120,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $35,625,368 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $61,097,345 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $77,335,563 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$16,238,218 | 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 | 0.42860 | 0.00000 | 0.57140 |
| 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 | 0.45650 | 0.00000 | 0.54350 |
| 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 | 0.25000 |
| 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 | 50 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (50 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - UH MENTOR HEALTH CENTER | ||||
| 9485 MENTOR AVENUE SUITE 101 | MENTOR | OH | 44060 | GENERAL MEDICAL & SURGICAL OUTPATIENT |
| 2 - UH MADISON HEALTH CENTER | ||||
| 6270 NORTH RIDGE RD | MADISON | OH | 44057 | GENERAL MEDICAL & EMERGENCY DEPARTMENT |
| 3 - UH LHPG LAKE COUNTY FAMILY PRACTICE | ||||
| 9500 MENTOR AVENUE SUITE 100 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 4 - UH WILLOWICK HEALTH CENTER | ||||
| 29804 LAKESHORE BLVD | WILLOWICK | OH | 44095 | URGENT CARE CENTER |
| 5 - UH LHPG PHYSICIANS PERRICO HEALTH CENTER | ||||
| 4176 STATE ROUTE 306 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 6 - UH DIAGNOSTICS PERRICO HEALTH CENTER | ||||
| 4176 STATE ROUTE 306 | WILLOUGHBY | OH | 44094 | DIAGNOSTIC CENTER |
| 7 - UH LHPG MENTOR IMED | ||||
| 9485 MENTOR AVENUE SUITE 210 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 8 - UH LHPG MENTOR PEDIATRICS | ||||
| 9485 MENTOR AVENUE SUITE 101 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 9 - UH LHPG NORTH COAST FAMILY PRACTICE | ||||
| 7580 AUBURN RD SUITE 202 | CONCORD | OH | 44077 | PHYSICIAN OFFICE |
| 10 - UH CHARDON HEALTH CENTER | ||||
| 510 FIFTH AVENUE | CHARDON | OH | 44024 | URGENT CARE CENTER |
| 11 - UH LHPG MADISON FAMILY PRACTICE | ||||
| 6270 NORTH RIDGE RD | MADISON | OH | 44057 | PHYSICIAN OFFICE |
| 12 - UH LHPG WILLOUGHBY IMED | ||||
| 36100 EUCLID AVENUE SUITE 240 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 13 - UH LHPG WILLOUGHBY PEDIATRICS | ||||
| 36100 EUCLID AVENUE SUITE 300 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 14 - UH LHPG CHARDON FAMILY PRACTICE | ||||
| 510 FIFTH AVENUE SUITE 130 | CHARDON | OH | 44024 | PHYSICIAN OFFICE |
| 15 - UH LHPG MENTOR FAMILY PRACTICE | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 16 - UH LHPG MADISON PEDIATRICS | ||||
| 6270 NORTH RIDGE RD | MADISON | OH | 44057 | PHYSICIAN OFFICE |
| 17 - UH LHPG MENTOR GENERAL SURGERY | ||||
| 9500 MENTOR AVENUE SUITE 300 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 18 - UH LHPG WILLOWICK FAMILY PRACTICE | ||||
| 29804 LAKESHORE BLVD | WILLOWICK | OH | 44095 | PHYSICIAN OFFICE |
| 19 - UH LHPG PLASTIC SURGERY | ||||
| 36060 EUCLID AVENUE SUITE 204 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 20 - UH LHPG SOM GENERAL SURGERY | ||||
| 2105 SOM CENTER ROAD SUITE 107 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 21 - UH LHPG CHARDON PEDIATRICS | ||||
| 510 FIFTH AVENUE | CHARDON | OH | 44024 | PHYSICIAN OFFICE |
| 22 - UH LAKE SOM HEALTH CENTER WELLNESS & REHAB | ||||
| 5105 SOM CENTER ROAD | WILLOUGHBY | OH | 44094 | REHABILITATION CLINIC |
| 23 - UH LHPG CARDIO ELECTROPHYSIOLOGY | ||||
| 36100 EUCLID AVENUE SUITE 400 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 24 - UH LHPG WEST IMED | ||||
| 36100 EUCLID AVENUE SUITE 210 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 25 - UH LHPG ORTHOPEDIC SURGERY | ||||
| 36060 EUCLID AVENUE SUITE 203 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 26 - UH LHPG MENTOR OBGYN | ||||
| 9485 MENTOR AVENUE SUITE 202 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 27 - UH LHPG SPORTS MEDICINE & REHAB | ||||
| 36060 EUCLID AVENUE SUITE 105 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 28 - UH LHPG INTEGRATIVE MEDICINE | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 29 - UH LHPG PHYSICIANS MENTOR MEDICAL PHYSICIA | ||||
| 9485 MENTOR AVENUE SUITES 200 203 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 30 - UH LHPG OBGYN WILLOUGHBY | ||||
| 5105 SOM CENTER ROAD SUITE 201 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 31 - UH CHARDON HEALTH CENTER RADIOLOGY | ||||
| 510 FIFTH AVE SUITE 110 | CHARDON | OH | 44024 | PHYSICIAN OFFICE |
| 32 - UH LHPG BARIATRIC SURGERY | ||||
| 36100 EUCLID AVENUE SUITE 170 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 33 - UH LABORATORY LAKE AMBULATORY BLDG | ||||
| 9500 MENTOR AVE SUITE 220 | MENTOR | OH | 44060 | DIAGNOSTIC CENTER |
| 34 - UH LAKE WEST MEDICAL CENTER REFERENCE LAB | ||||
| 36100 EUCLID AVE SUITE 190 | WILLOUGHBY | OH | 44094 | DIAGNOSTIC CENTER |
| 35 - UH LHPG NORTHEAST OHIO HEART ASSOCIATES | ||||
| 36100 EUCLID AVENUE SUITE 120 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 36 - UH LHPG SPORTS MEDICINE | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 37 - UH IMED NP BEACON HEALTH | ||||
| 36100 EUCLID AVENUE SUITE 120 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 38 - UH LHPG OPHTHALMOLOGY ASSOCIATES | ||||
| 36100 EUCLID AVE SUITE 450 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 39 - UH LHPG NORTHEAST OHIO HEART ASSOCIATES | ||||
| 7580 AUBURN ROAD SUITE 106 | CONCORD | OH | 44077 | PHYSICIAN OFFICE |
| 40 - UH BRUNNER SANDEN DEITRICK WELLNESS CENTER | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | MEDICAL FITNESS CENTER |
| 41 - UH LHPG ARTHRITIS ASSOCIATES | ||||
| 5105 SOM CENTER ROAD SUITE 200 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 42 - UH LHPG OHIO HAND AND SHOULDER CENTER | ||||
| 13170 RAVENNA ROAD | CHARDON | OH | 44024 | PHYSICIAN OFFICE |
| 43 - UH LAKE CONTINUING CARE CENTER | ||||
| 10977 CAPITAL PARKWAY | CONCORD | OH | 44077 | REHABILITATION AND PSYCHIATRIC DEPARTMENTS |
| 44 - UH LHPG MIDDLEFIELD FAMILY PRACTICE | ||||
| 16030 EAST HIGH STREET | MIDDLEFIELD | OH | 44062 | PHYSICIAN OFFICE |
| 45 - UH LHPG HACKETT MEDICAL GROUP | ||||
| 8300 TYLER BOULEVARD SUITE 300 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 46 - UH WELLNESS CLINIC AT MHS | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | WALK IN CLINIC |
| 47 - UH LHPG PAIN MANAGEMENT | ||||
| 5105 SOM CENTER ROAD SUITE 202 | WILLOUGHBY | OH | 44094 | PHYSICIAN OFFICE |
| 48 - UH LHPG PAIN MANAGEMENT | ||||
| 9485 MENTOR AVE SUITE 103 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 49 - UH LHPG MENTOR ENDOCRINOLOGY | ||||
| 8300 TYLER BOULEVARD SUITE 102 | MENTOR | OH | 44060 | PHYSICIAN OFFICE |
| 50 - UH URGENT CARE BRUNNER SANDEN DEITRICK WEL | ||||
| 8655 MARKET STREET | MENTOR | OH | 44060 | URGENT CARE CENTER |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | OHIO HOSPITAL CARE ASSURANCE PROGRAM (HCAP)AS A PARTICIPANT IN THE HCAP PROGRAM, LAKE HEALTH OFFERS EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL-LEVEL SERVICES FREE OF CHARGE IF YOU ARE A RESIDENT OF OHIO AND EITHER (1) YOU ARE CURRENTLY AN ELIGIBLE RECIPIENT OF THE GENERAL ASSISTANCE OR THE DISABILITY ASSISTANCE PROGRAMS OR (2) YOUR INCOME IS AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES (FPG).LAKE HEALTH ASSISTIN ADDITION TO HCAP, LAKE HEALTH HAS A FINANCIAL ASSISTANCE POLICY CALLED LAKE HEALTH ASSIST. THIS PROVIDES FINANCIAL ASSISTANCE FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE DISCOUNTED FROM OUR NORMAL CHARGES IF YOU ARE AN UNINSURED OHIO RESIDENT AND YOUR INCOME DOES NOT EXCEED FOUR TIMES THE FEDERAL POVERTY GUIDELINES (FPG). ALL APPLICANTS WILL BE SCREENED FOR MEDICAID COVERAGE AND MUST COOPERATE WITH THE MEDICAID REPRESENTATIVES TO BE ELIGIBLE FOR ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY. THE FINANCIAL ASSISTANCE POLICY DOES NOT APPLY TO NON-OHIO RESIDENTS, INDIVIDUALS WITH INSURANCE, MEDICAID, OR MEDICAID PE. IF YOU ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY, YOU WILL RECEIVE FREE OR OTHER DISCOUNTED ASSISTANCE ACCORDING TO THE SCALE. PAYMENT OF THE FULL BALANCE IS NOT REQUIRED PRIOR TO RECEIVING THE DISCOUNT; AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT. |
| PART I, LINE 6A: | COMMUNITY BENEFIT REPORT IS PREPARED BY UH LAKE HEALTH MARKETING AND FINANCE DEPARTMENT. |
| 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 $35,625,368 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. IN 2021, LAKE HEALTH CONTINUED TO PROVIDE EDUCATION AND ASSISTANCE WITH THE COVID-19 CRISIS EXPANDED TO INCLUDE CHRONIC DISEASES AND ACCESS TO HEALTH CARE. IN 2021, LAKE HEALTH PROVIDED APPROXIMATELY $450,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION. LAKE HEALTH ALSO CONTRIBUTED OVER $8.5 MILLION 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.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. WE ALSO CONTINUE TO OPERATE A SENIOR CARE POST-ACUTE CARE NETWORK IN COORDINATION WITH OUR LONG TERM CARE INSTITUTES. THE NETWORK HELPS US TO PROVIDE A MEDICAL DIRECTOR ON SITE IN ORDER TO HELP BETTER COORDINATE CARE AND KEEP MORE SENIORS OUT OF THE ACUTE HOSPITAL SETTING BY BRINGING CARE ON SITE. WE ALSO CONTINUE TO PARTNER WITH OUR LOCAL SCHOOLS BY OPENING ON SITE SCHOOL CLINICS. THOSE CLINICS INCLUDE: LAKELAND COMMUNITY COLLEGE, MENTOR SCHOOL DISTRICT CARDINAL CLINIC AND THE WILLOUGHBY-EASTLAKE SCHOOL DISTRICT WELLNESS CLINIC. |
| 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 3: | THERE IS NO ESTIMATE OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FOR PATIENTS WHO QUALIFY, THOSE PATIENTS ARE DEEMED TO BE UNABLE TO PAY AND ARE THEREFORE WRITTEN OFF TO CHARITY RATHER THAN BAD DEBT. |
| PART III, LINE 4: | PAGE 11 OF ATTACHED AUDITED FINANCIAL STATEMENTS, NOTE 2(G) - SUMMARY OF 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 2021 WAS $61,097,345 THE PAYMENTS RELATED TO THESE SERVICES WERE $77,335,563 LEAVING A MEDICARE SHORTFALL OF $16,238,218 FOR THE YEAR.THE SYSTEM TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE REASONS FOR THIS TREATMENT INCLUDES (1) NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES NOT ALIGNED WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; (2) THE SYSTEM IS ALLEVIATING THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES; AND (3) IRS REV. RUL. 69-545 NOTES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS ACTION INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| 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: | 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. 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 233,000) AND SELECTED ZIP CODES IN ITS SECONDARY SERVICE AREAS (CUYAHOGA, ASHTABULA AND GEAUGA COUNTIES WITH A POPULATION IN THE DEFINED ZIP CODES) OF 124,000. (POPULATION FIGURES ARE AS OF 2020.) |
| PART VI, LINE 5: | PRIOR TO 1985, UH 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.ON APRIL 16, 2021, UNIVERSITY HOSPITALS HEALTH SYSTEM (UHHS) BECAME THE SOLE CORPORATE MEMBER OF LAKE HEALTH SYSTEM, INC. THROUGH A MEMBERSHIP SUBSTITUTION. UHHS IS THE PARENT OF VARIOUS CORPORATIONS INVOLVED IN THE DELIVERY OF HEALTHCARE SERVICES, INCLUDING A NETWORK OF PHYSICIANS, OUTPATIENT CENTERS, HOSPITALS, WELLNESS, OCCUPATIONAL HEALTH, SKILLED NURSING, ELDER HEALTH, REHABILITATION, AND HOME CARE SERVICES THAT OPERATE IN THE NORTHEAST OHIO REGION. LAKE HEALTH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. OVER 550 PHYSICIANS 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. IN 2016, WE PROVIDED OVER $600,000 IN COMMUNITY BENEFIT THROUGH HEALTH EDUCATION PROGRAMS, EXCLUDING BLOOD DRIVES. DURING THESE COMMUNITY EVENTS AND HEALTH FAIRS, WE PERFORMED OVER 11,600 BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS, GLUCOSE, HEEL SCREENINGS, SKIN CANCER SCREENINGS AND PROSTATE CANCER SCREENINGS FOR FREE OR AT LOW COST. 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 THE BEST OF HEALTH MAGAZINE, MAILED QUARTERLY TO ABOUT 150,000 HOUSEHOLDS CALENDAR OF EVENTS IN THE NEWS-HERALD, TEN TIMES PER YEAR HEALTH TALKS IN THE NEWS-HERALD (WEEKLY)B. EDUCATION ON SPECIFIC DISEASE CONDITIONS SENIOR CONNECTION LUNCH AND LEARNS COMMUNITY HEALTH LECTURE SERIES ARTHRITIS EXPO STRESS MANAGEMENT BREAST HEALTH FOR HISPANIC WOMENC. HEALTH PROMOTION AND WELLNESS PROGRAMS BE FIT FOR LIFEE. EDUCATION TO THE PUBLIC ABOUT HEALTH ISSUES INFORMATION THROUGH MEDIA RELEASES WEBSITE SOCIAL MEDIA (FACEBOOK, TWITTER, GOOGLE+)F. SCHOOL HEALTH EDUCATION PROGRAMS HEART SMART KIDS ASSEMBLYG. DIGITAL CONSUMER HEALTH INFORMATION BABY AND TODDLER E-NEWSLETTER REGARDING HEALTH E-NEWSLETTER CONSTANT CONTACT E-BLASTS SOCIAL MEDIA (FACEBOOK, TWITTER, GOOGLE+) WEBSITE VIDEOSH. SOCIAL MEDIA CONSUMER HEALTH INFORMATION FACEBOOK POSTS AND REMINDERS TWITTER POSTS AND REMINDERS GOOGLE+ VIDEOSI. SELF-HELP WELLNESS WORKSHOP MINDFULNESS RETREATONE OF THE MANY WAYS LAKE HEALTH IS BUILDING THE COMMUNITY IS THROUGH STRONG PARTNERSHIPS WITH OTHERS WHO SHARE OUR COMMITMENT TO LOCAL ACCESS, HEALING WITH COMPASSION AND SUPERIOR QUALITY. LAKE HEALTH JOINED FORCES WITH LAKE METROPARKS, LAKE COUNTY YMCA AND THE LAKE COUNTY HEALTH DISTRICT TO LAUNCH BE FIT FOR LIFE. THE ANNUAL MINDFULNESS RETREAT PROVIDES A DAYLONG EVENT THAT PROVIDES RELAXATION AND THE OPPORTUNITY TO PAUSE, REFLECT AND HEAL. |
| PART VI, LINE 6: | IN 2021, UNIVERSITY HOSPITALS BECAME THE SOLE MEMBER OF LAKE HOSPITAL SYSTEM. AS SUCH, LAKE HOSPITAL SYSTEM'S TAX ID REMAINS THE SAME, AND FILES ITS TAX RETURN INDEPENDENTLY FROM UNIVERSITY HOSPITALS. |
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 | $1,000,062 | $0 | $2,204,523 | $0 | $80,066 | $0 | $6,359 | $0 | $12,072 | $0 | $3,303,082 | $0 | $0 | $0 |
| ROBERT TRACZ | ||||||||||||||
| SR. VP/CFO | $469,898 | $0 | $154,125 | $0 | $70,949 | $0 | $6,390 | $0 | $19,676 | $0 | $721,038 | $0 | $0 | $0 |
| JOHN BANIEWICZ MD | ||||||||||||||
| SR VP, MEDICAL AFFAIRS | $543,713 | $0 | $131,400 | $0 | $19,484 | $0 | $6,000 | $0 | $17,813 | $0 | $718,410 | $0 | $0 | $0 |
| RICHARD D CICERO | ||||||||||||||
| SR VP, MARKETING & BUSINESS | $316,489 | $0 | $105,300 | $0 | $22,741 | $0 | $5,525 | $0 | $17,676 | $0 | $467,731 | $0 | $0 | $0 |
| ADETINUKE TADESE | ||||||||||||||
| CHIEF MEDICAL INFORMATICS OFFICER | $305,357 | $0 | $41,850 | $0 | $1,597 | $0 | $0 | $0 | $31,219 | $0 | $380,023 | $0 | $0 | $0 |
| DAVID HERMAN | ||||||||||||||
| VP, FINANCE | $215,397 | $0 | $50,175 | $0 | $5,911 | $0 | $0 | $0 | $27,923 | $0 | $299,406 | $0 | $0 | $0 |
| BILL OSTERMAN | ||||||||||||||
| VP, ACUTE CARE SERVICES | $223,777 | $0 | $51,750 | $0 | $5,948 | $0 | $0 | $0 | $8,163 | $0 | $289,638 | $0 | $0 | $0 |
| MICHELE PIRC | ||||||||||||||
| PRIMARY NURSE PRACTITIONER | $164,524 | $0 | $109,230 | $0 | $6,494 | $0 | $0 | $0 | $0 | $0 | $280,248 | $0 | $0 | $0 |
| JOYCE A TAYLOR | ||||||||||||||
| VP, QUALITY SERVICES, CQO | $204,529 | $0 | $37,800 | $0 | $9,211 | $0 | $0 | $0 | $11,603 | $0 | $263,143 | $0 | $0 | $0 |
| CYNTHIA J RACER | ||||||||||||||
| VP, CLINICAL SERVICES | $160,987 | $0 | $34,200 | $0 | $34,891 | $0 | $0 | $0 | $19,626 | $0 | $249,704 | $0 | $0 | $0 |
| JERROLD PETERS | ||||||||||||||
| VP, CIO | $185,916 | $0 | $40,500 | $0 | $9,215 | $0 | $0 | $0 | $11,672 | $0 | $247,303 | $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 2021: SOCIAL CLUB DUES OF $12,230 |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENT : CYNTHIA MOORE-HARDY : $80,850 |
| 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: $272,869 RETENTION BONUS; $1,931,654 INCENTIVE BONUS - ROBERT TRACZ: $154,125 RETENTION BONUS - JOHN BANIEWICZ MD: $131,400 RETENTION BONUS - RICHARD CICERO: $105,300 RETENTION BONUS - ADETINUKE TADESE: $41,850 RETENTION BONUS - WILLIAM OSTERMAN: $51,750 RETENTION BONUS - DAVID HERMAN: $50,175 RETENTION BONUS - JOYCE TAYLOR: $37,800 RETENTION BONUS - JERROLD PETERS: $40,500 RETENTION BONUS - CYNTHIA RACER: $34,200 RETENTION BONUS |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MATT J CICERO | |||
| FAMILY MEMBER OF KEY EMPLOYEE, RICHARD D. CICERO | $98,721 | SEE PART V | 0 |
| ABIGAIL CICERO | |||
| FAMILY MEMBER OF KEY EMPLOYEE, RICHARD D. CICERO | $94,332 | SEE PART V | 0 |
| ANNE-MARIE TRACZ | |||
| FAMILY MEMBER OF OFFICER, ROBERT TRACZ | $11,274 | 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 2021 AND RECEIVED COMPENSATION.ABIGAIL CICERO, WHO HAS A FAMILY RELATIONSHIP WITH RICHARD D. CICERO, SERVED AS A HOSPITAL EMPLOYEE DURING 2021 AND RECEIVED COMPENSATION.ANNE-MARIE TRACZ, WHO HAS A FAMILY RELATIONSHIP WITH ROBERT TRACZ, SERVED AS A HOSPITAL EMPLOYEE DURING 2021 AND RECEIVED COMPENSATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | UNIVERSITY HOSPITALS HEALTH SYSTEM (UNIVERSITY HOSPITALS) BECAME THE SOLE MEMBER OF LAKE HOSPITAL SYSTEM IN 2021. |
| FORM 990, PART VI, SECTION A, LINE 6 | UNIVERSITY HOSPITALS IS THE MEMBER OF LAKE HOSPITAL SYSTEM, INC DBA LAKE HEALTH |
| FORM 990, PART VI, SECTION A, LINE 7A | UNIVERSITY HOSPITALS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | UNIVERSITY HOSPITALS HAS THE RIGHT TO MAKE GOVERNANCE DECISIONS SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS OF THE GOVERNING BODY, OR APPROVAL OF THE GOVERNING BODY'S DECISION TO DISSOLVE THE ORGANIZATION. |
| 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, CEO, AND THE DIRECTOR OF TAX FOR UNIVERSITY HOSPITALS HEALTH SYSTEM. A DRAFT IS PRESENTED FOR REVIEW BY THE LAKE HEALTH FINANCE COMMITTEE, AND PRESENTATION TO THE LAKE HEALTH BOARD OF TRUSTEES PRIOR TO FILING. |
| 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 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. A COMPENSATION REVIEW WAS CONDUCTED BY THE COMPENSATION AREA OF THE HUMAN RESOURCE DEPARTMENT OF UNIVERSITY HOSPITALS HEALTH SYSTEM IN 2021. |
| 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), 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. |
| FORM 990, PART IX, LINE 11G | OUTSOURCED SERVICES: PROGRAM SERVICE EXPENSES 12,079,638. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,079,638. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 14,711,243. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,711,243. CONSULTING: PROGRAM SERVICE EXPENSES 220,979. MANAGEMENT AND GENERAL EXPENSES 2,910,967. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,131,946. MAINTENANCE & REPAIR: PROGRAM SERVICE EXPENSES 2,993,819. MANAGEMENT AND GENERAL EXPENSES 2,390,424. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,384,243. DATA PROCESSING & COLLECTION: PROGRAM SERVICE EXPENSES 3,245,464. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,245,464. MISCELLANEOUS OTHER: PROGRAM SERVICE EXPENSES 460,926. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 460,926. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 44,465,896. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,465,896. |
| FORM 990, PART XI, LINE 9: | NET GAIN FROM AFFILIATED ENTITIES 37,259. DERIVATIVE INSTRUMENTS LOSS 4,606,294. UNDERWRITING SUPPORT OF FOUNDATION -2,298,702. NEW MANNA K-1 ALLOCATION -1,099,338. DONATED CAPITAL FROM FOUNDATION 16,488. UH MEMBER SUBSTITUTION AND FV ADJUSTMENTS TRANSACTIONS 240,040,979. |
| FORM 990, PART XII, LINE 2C: | UNIVERSITY HOSPITALS' BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
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 | 7590 AUBURN RD | AddressLine1Txt |
| City | CONCORD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44077 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | PHYSICIAN SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $776,416 | 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 (29 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 | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340714775 | SUPPORT SYSTEM | OH | 501(C)(3) | LINE 12B, II | N/A | 0 | |||||
| ELYRIA MEDICAL CENTER FOUNDATION | |||||||||||||||
| 630 EAST RIVER STREET | ELYRIA | OH | 44035 | 611579760 | SUPPORT HOSPITAL | OH | 501(C)(3) | LINE 12A, I | 0 | ELYRIA MEDICAL CENTER | |||||
| ROBINSON MEMORIAL HOSPITAL FOUNDATION | |||||||||||||||
| 6847 N CHESTNUT STREET PO BOX | RAVENNA | OH | 44266 | 341510544 | SUPPORT HOSPITAL | OH | 501(C)(3) | LINE 12A, I | 0 | ROBINSON HEALTH SYSTEM INC | |||||
| SAMARITAN HOSPITAL FOUNDATION | |||||||||||||||
| 663 EAST MAIN STREET | ASHLAND | OH | 44805 | 341783215 | SUPPORT HOSPITAL | OH | 501(C)(3) | LINE 12C, III-FI | 0 | SAMARITAN REGIONAL MEDICAL CENTER | |||||
| 5805 EUCLID INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 814962989 | SUPPORT HOSPITAL | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS HEALTH SYSTEM - HEATHER HILL INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340771884 | INACTIVE | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| FUND FOR CURES UK LTD | |||||||||||||||
| GRANT FUNDING | 501(C)(3) | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | SUITE 1 3RD FLOOR 11-12 ST JAMES | LONDON | UK | UK | ||||||||
| KETTERING MOHICAN AREA MEDICAL CENTER INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340823455 | INACTIVE | OH | 501(C)(3) | 0 | |||||||
| UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341567805 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 264827222 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS CONNEAUT MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340714550 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS GENEVA MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340714461 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UH REGIONAL HOSPITALS | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341924226 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| PARMA COMMUNITY GENERAL HOSPITAL | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340827442 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| EMH REGIONAL MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340714612 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS ST JOHN MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341260978 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS MEDICAL GROUP INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 204881619 | PHYSICIANS GROUP | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341720429 | LAB SERVICES | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS HOME CARE SERVICES INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341527536 | HOME CARE | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| ROBINSON HEALTH SYSTEM INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 461382538 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| SAMARITAN REGIONAL HEALTH SYSTEM | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340714535 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS COORDINATED CARE ORGANIZATION | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 900794903 | HEALTHCARE | OH | 501(C)(3) | LINE 10 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| COMPREHENSIVE HEALTH CARE OF OHIO INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341492733 | INACTINVE | OH | 501(C)(3) | LINE 12B, II | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| UNIVERSITY HOSPITALS GEAUGA MEDICAL CENTER | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 340816492 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HOSPITALS HEALTH SYSTEM INC | |||||
| LAKE HOSPITAL FOUNDATION INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341425872 | HEALTHCARE | OH | 501(C)(3) | LINE 12A, I | Yes (1) | LAKE HOSPITAL SYSTEM INC | |||||
| PRIMEHEALTH INC | |||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341778204 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | Yes (1) | LAKE HOSPITAL SYSTEM INC | |||||
| LAKE HEALTH UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER | |||||||||||||||
| 9485 MENTOR AVENUE | MENTOR | OH | 44060 | 311565964 | TREATMENT OF CANCER PATIENTS | OH | 501(C)(3) | LINE 3 | N/A | 0 | |||||
| LHS LEGACY | |||||||||||||||
| 3605 WARRENSVILLE CTR RD MSC 9155 | SHAKER HEIGHTS | OH | 44122 | 862916134 | MANAGEMENT | OH | 501(C)(3) | LINE 12C, III-FI | Yes (1) | LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH | |||||
| THE AUXILLARY OF LAKE HOSPITAL SYSTEM INC | |||||||||||||||
| 7590 AUBURN RD | CONCORD TWP | OH | 44077 | 341605226 | PATIENT NEEDS AND PHYSICIAN EQUIPMENT | OH | 501(C)(3) | LINE 3 | Yes (1) | LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEW MANNA CLG LLC | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 371848577 | SPECIALTY HOSPITAL | OH | LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH | UBI | $1,099,337 | $30,453,383 | 0 | Yes (1) | 0.51000 | |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||||||||||||||
| 7580 AUBURN RD | CONCORD | OH | 44077 | 260550261 | OFFICE SPACE | OH | RELATED | $332,750 | $7,362,572 | 0 | 0 | 0.51470 | N/A | |
| LAKE WEST MEDICAL SPECIALISTS LLC | ||||||||||||||
| 36060 EUCLID AVE | WILLOUGHBY | OH | 44094 | 341964657 | OFFICE SPACE | OH | RELATED | $22,232 | $378,680 | 0 | 0 | 0.12460 | N/A | |
| MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||||||||||||||
| 9485 MENTOR AVE | MENTOR | OH | 44060 | 341958475 | OFFICE SPACE | OH | UBI | -$2,544 | $2,052,596 | 0 | 0 | 0.45650 | N/A | |
| MENTOR SURGERY CENTER LLC | ||||||||||||||
| 9485 MENTOR AVE | MENTOR | OH | 44060 | 341863257 | OUTPATIENT SURGERY | OH | RELATED | $401,903 | $2,473,161 | 0 | 0 | 0.42850 | N/A | |
| LAKE WILLOUGHBY PROPERTIES LLC | ||||||||||||||
| 4176 CHILLICOTHE RD | WILLOUGHBY | OH | 44094 | 364837155 | OFFICE SPACE | OH | RELATED | $62,000 | $2,734,468 | 0 | 0 | 0.35000 | N/A | |
| SAMARITAN REGIONAL PAIN MANAGEMENT | ||||||||||||||
| 1025 CENTER STREET | ASHLAND | OH | 44805 | 462286785 | MEDICAL SERVICES | OH | 0 | 0 | N/A | |||||
| UHHS ENDOSCOPY HOLDINGS LLC | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 831284090 | MEDICAL SERVICES | OH | 0 | 0 | N/A | |||||
| UH CANTON-ENDOSCOPY LLC | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 830638696 | MEDICAL SERVICES | OH | 0 | 0 | N/A | |||||
| UNIVERSITY SUBURBAN REAL ESTATE LTD | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | 341397180 | REAL ESTATE | OH | 0 | 0 | N/A | |||||
| UH VALUEHEALTH HOLDINGS LLC | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | HOLDING COMPANY | OH | 0 | 0 | N/A | ||||||
| UH CLINICAL ASSOCIATES LLC | ||||||||||||||
| 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | MEDICAL SERVICES | OH | 0 | 0 | N/A | ||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | CityForeignAddress/CityNm |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN RESERVE ASSURANCE CO LTD SPC | |||||||||||||||||
| PO BOX 1051 GT KY1 | CJ | 980462740 | INSURANCE | CJ | N/A | C | 0 | ||||||||||
| LAKE PHO INC | |||||||||||||||||
| 341696001 | PHYSICIAN SERVICES | C | Yes (1) | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH | $63,090 | $2,271,174 | 0.50000 | |||||
| USHC MANAGEMENT INC | |||||||||||||||||
| 341395971 | HOLDING COMPANY | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| UNIVERSITY PRIMARY CARE PRACTICES INC | |||||||||||||||||
| 341768928 | PHYSICIAN GROUP | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| UNIVERSITY HOSPITALS PHYSICIAN SERVICES | |||||||||||||||||
| 341768929 | PHYSICIAN ADMINISTRATION | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| UNIVERSITY HOSPITALS HOLDINGS INC | |||||||||||||||||
| 341768931 | HOLDING COMPANY | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| UHHS PROVIDER & CENTRAL VERIFICATION ORG | |||||||||||||||||
| 341908517 | MEDICAL MGMT. | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| QUALITY CARE NETWORK | |||||||||||||||||
| 811081563 | MEDICAL MGMT. | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| PRL CORPORATION | |||||||||||||||||
| 341499245 | PHYSICIANS GROUP | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| POWERS PROFESSIONAL CORPORATION | |||||||||||||||||
| 341735290 | PHYSICIANS GROUP | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| NORTH OHIO HEART INC | |||||||||||||||||
| 272574020 | PHYSICIANS GROUP | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| EMH SHEFFIELD MEDICAL BUILDING CONDO | |||||||||||||||||
| 260636602 | REAL ESTATE | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| EMH PROFESSIONAL SERVICES INC | |||||||||||||||||
| 341778419 | PHYSICIANS GROUP | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| EMH MEDICAL OFFICE BUILDING IN AVON INC | |||||||||||||||||
| 341935407 | REAL ESTATE | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| COMPREHENSIVE VENTURES UNLIMITED INC | |||||||||||||||||
| 341596060 | PHYSICIAN ADMINISTRATION | N/A | C | 0 | 3605 WARRENSVILLE CENTER ROAD | SHAKER HEIGHTS | OH | 44122 | OH | ||||||||
| LHS ASSURANCE LTD | |||||||||||||||||
| 23 LIME TREE BAY AVENUE | CJ | 980456229 | INSURANCE COMPANY | CJ | C | Yes (1) | LAKE HOSPITAL SYSTEM INC DBA LAKE HEALTH | 1.00000 | GRAND CAYMAN | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | 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 | 0 | 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 (24 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PRIMEHEALTH INC | ||
| P | $31,677,807 | BOOK VALUE |
| LAKE PHO INC | ||
| Q | $351,514 | BOOK VALUE |
| LAKE HEALTH FOUNDATION | ||
| C | $684,361 | BOOK VALUE |
| LAKE HEALTH FOUNDATION | ||
| M | $298,702 | BOOK VALUE |
| LAKE WEST MEDICAL SPECIALISTS LLC | ||
| Q | $179,765 | BOOK VALUE |
| LAKE WEST MEDICAL SPECIALISTS LLC | ||
| K | $459,467 | BOOK VALUE |
| LAKE WEST MEDICAL SPECIALISTS LLC | ||
| D | $115,867 | BOOK VALUE |
| LHUH SEIDMAN CANCER CENTER | ||
| J | $885,370 | BOOK VALUE |
| MENTOR SURGERY CENTER LLC | ||
| F | $594,254 | BOOK VALUE |
| MENTOR SURGERY CENTER LLC | ||
| J | $505,657 | BOOK VALUE |
| MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| F | $114,127 | BOOK VALUE |
| MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| J | $83,102 | BOOK VALUE |
| MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| K | $573,602 | BOOK VALUE |
| MENTOR MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| D | $613,213 | BOOK VALUE |
| LAKE WILLOUGHBY PROPERTIES LLC | ||
| K | $709,341 | BOOK VALUE |
| LAKE WILLOUGHBY PROPERTIES LLC | ||
| F | $80,500 | BOOK VALUE |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| D | $1,048,727 | BOOK VALUE |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| F | $77,206 | BOOK VALUE |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| J | $114,687 | BOOK VALUE |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| K | $1,453,833 | BOOK VALUE |
| NEW MANNA CLG LLC | ||
| Q | $12,407,657 | BOOK VALUE |
| NEW MANNA CLG LLC | ||
| L | $3,537,362 | BOOK VALUE |
| CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC | ||
| Q | $99,765 | BOOK VALUE |
| UNIVERSITY HOSPITALS HEALTH SYSTEM | ||
| S | $250,483,931 | BOOK VALUE |