2020-08-13T14:01:12-05:00 2019-09-30 621517792 PYA PC 3000 Bayport Drive Suite 860 Tampa FL 33607 990 2018-10-01 592650456 Lakeland Regional Medical Center Inc LAKE 8636871100 1324 Lakeland Hills Boulevard Lakeland FL 33805 Lance Green EVP/Chief Financial Officer 8636871100 2020-08-12 1 Terry Haefner P01258953 7274427110 38.101.210.194 2020-08-13 14:01:05 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF23F2A68CFF53983216DF8908F842EE3670BFA3 2018 2020-09-23 17:36:50Z Elaine C Thompson PHD 1324 Lakeland Hills Boulevard Lakeland FL 33805 906406943 0 X www.myLRH.org X 1914 FL See Schedule OLakeland Regional Health's strategic imperative is to develop as a nationally recognized, fiscally strong and growing collaborative regional health system that improves lives by offering safe, high quality, equitable and affordable healthcare, while demonstrating an equal commitment to the promotion of individual and community health, wellness and disease prevention. 14 14 5832 323 11451 0 5881640 7249107 821058591 897904655 -1976678 268449 0 0 824963553 905422211 0 0 0 0 317776248 333078007 0 0 0 447980585 506596793 765756833 839674800 59206720 65747411 881345735 848882351 468777575 447100858 412568160 401781493 X See Schedule OLakeland Regional Health's strategic imperative is to develop as a nationally recognized, fiscally strong and growing collaborative regional health system that improves lives by offering safe, high quality, equitable and affordable healthcare, while demonstrating an equal commitment to the promotion of individual and community health, wellness and disease prevention. 0 0 767166900 897878069 See Schedule O for Program Services Statement 767166900 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 129 0 1 5832 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X Jason McNeil 8636871100 230 S Florida Ave 4th Floor Lakeland FL 33801 Laura Hawley CFP Chair 1.00 1.00 X 0 0 0 Jay Mulaney MD Past Chair 1.00 1.00 X 0 0 0 Weymon Snuggs Vice Chair 1.00 1.00 X 0 0 0 Jack Harrell Jr Director 1.00 1.00 X 0 0 0 Lee Jackson Director 1.00 1.00 X 0 0 0 James Melton MD Director 1.00 1.00 X 0 0 0 Dale Dreyer Director 1.00 1.00 X 0 0 0 Ayanna Rolette MD Director 1.00 1.00 X 0 0 0 Clayton Hollis Director 1.00 1.00 X 0 0 0 Tracy Wilson Director 1.00 1.00 X 0 0 0 Sylvia Blackmon-Roberts Director 1.00 1.00 X 0 0 0 Anne Kerr PhD Director 1.00 1.00 X 0 0 0 William Pou Director 1.00 1.00 X 0 0 0 Cory Petcoff Director 1.00 1.00 X 0 0 0 Elaine Thompson PhD President/Chief Executive Officer 50.00 1.00 X 1417407 0 138605 Evan C Jones EVP - Former Chief Financial Officer 50.00 1.00 X 819559 0 83885 Lance Green SVP -Current Chief Financial Officer 50.00 1.00 X 232666 0 42849 Sarah Bhagat COO/SVP Organizational Effectiveness 50.00 X 352500 0 84347 Francisco J Chebly Executive Director LRH Physician Group 50.00 X 357988 0 43595 Scott Dimmick SVP - Chief Human Resources Officer 50.00 X 313700 0 90161 Danielle Drummond EVP - Chief Operating Officer 50.00 X 597569 0 88397 Hal Escowitz Chief Quality & Medical Information 50.00 X 380944 0 43192 Janet W Fansler EVP - Chief Nurse Executive 50.00 X 832319 0 226960 Jonn Hoppe EVP - Chief Legal Officer 50.00 X 485760 0 101671 Deana L Nelson SVP - Administration & Corporate Initiatives 50.00 X 340031 0 69806 Timothy Regan President/Chief Medical Officer 50.00 X 670695 0 99728 Michael Spake SVP - External Affairs and CCIO 50.00 X 350407 0 73535 James Sturgill VP - LRH Physician Group 50.00 X 197188 0 27063 Graham Greene Chief Academic Officer & Urologist 50.00 X 0 553208 71177 Timothy Boynton VP of Development, Chief PR & Communications Offic 50.00 1.00 X 204127 0 44801 Stacy Bolton VP - CIO/Chief Technology Officer 50.00 X 239702 0 32168 Rodriguez Dangerfield Director of Pharmacy 50.00 X 218729 0 36077 Ana Kalman VP - CIO/Chief Applications Officer 50.00 X 251536 0 24032 Pradeep Patra Physicist 50.00 X 209934 0 36683 Maureen E Leckie AVP - Clinical Operations 50.00 X 205394 0 29142 8678155 553208 1487874 234 0 1 0 Creative Contractors Inc 620 Drew Street Clearwater FL 33755 Construction Contractor 48586388 Turner Logistics 375 Hudson Street New York NY 10014 Construction Contractor 23926206 Cerner Corporation 2800 Rock Creek Pkwy Kansas City MO 64117 Software Maintenance & Support 18179606 University Medical Services PO Box 917492 Orlando FL 32891 Medical 3856347 Peterson & Meyers PA 225 E Lemon St Suite 300 Lakeland FL 33801 Consulting Services 2357305 327 5832317 1416790 7249107 Patient Service Revenu 621990 479624192 479624192 Medicare/Medicaid 621990 409511351 409511351 Cafeteria Revenue 722210 5089945 5089945 Other Misc. Revenue 541900 3661605 3650154 11451 Other Operating Revenu 561000 17562 2427 15135 897904655 1253181 984732 268449 268449 268449 905422211 897878069 11451 283584 7226305 6229569 996736 251692645 216976179 34716466 10498850 9050723 1448127 45641102 39345734 6295368 18019105 15533694 2485411 1036684 893692 142992 281736 242876 38860 340231 293302 46929 36323691 31313492 5010199 532647 459178 73469 5129906 4422328 707578 25643668 22106586 3537082 8343577 7192731 1150846 275897 237842 38055 26799413 23102917 3696496 59108651 50955677 8152974 8167379 7040836 1126543 Patient Supplies & Phar 165481944 165481944 Bad Debts 148514185 148514185 Repairs & Maintenance 10256749 8842015 1414734 HCCB Indigent Assessmen 8946230 7712259 1233971 1414205 1219141 195064 839674800 767166900 72507900 0 16073 15180 119189074 107638019 14118421 15152778 9361924 10590257 1233944492 689994512 574975872 543949980 15300717 15794527 47124846 46311281 101258808 109430329 881345735 848882351 33111558 20024730 338285051 327873564 97380966 99202564 468777575 447100858 X 375300709 366271594 35729166 33971614 1538285 1538285 412568160 401781493 881345735 848882351 X 65747411 650488 -77184566 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 340231 340231 0 Part II-B, Line 1: Lakeland Regional Medical Center, Inc. provided payment to an independent lobbying firm to notify the Medical Center of any pending legislation that affects hospitals and healthcare. 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1538285 1.00000 0 1 1 5506912 5506912 384980568 167064072 217916496 2055565 1655205 400360 835653109 521275235 314377874 5748338 5748338 543949980 Investment in Net Assets of Foundation 46311281 F 46311281 Other Receivables 6229889 Assets Limited to Use 89187542 Estimated Third Party Settlement 1412898 Lease Deposit 12600000 109430329 FL Medical Assistance Assessment 13460277 Employee Compensation 47044690 Malpractice Claims 30405676 Workers Compensation 2589715 Other Long Term Liabilities 261875 Bond Interest Payable 5440331 99202564 X 752320000 650488 601837 1252325 751067675 154354536 154354536 905422211 691158000 0 691158000 148516800 148516800 839674800 Part V, Line 4: The purpose of the Organization's Endowment funds is to grow the corpus and use the unrestricted earnings from the invested endowment fund to support the Medical Center's mission. Part X, Line 2: The Parent, Medical Center, and Foundation have been recognized by the Internal Revenue Service as tax-exempt organizations as described in Section 501(c)(3) of the Internal Revenue Code of 1986. Income earned in furtherance of the organizations' tax-exempt purposes is exempt from federal and state income taxes. Income taxes related to Health System's ownership interests in joint venture partnerships are not material to the Health System. U.S. GAAP requires the Health System's management to evaluate tax positions taken by the Health System and recognize a tax liability (or asset) if the Health System has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Health System has analyzed the tax positions and has concluded that as of September 30, 2019, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) in the consolidated financial statements or disclosure in the notes to the consolidated financial statements. The Health System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Health System believes it is no longer subject to income tax examinations for years prior to 2015. Part XI, Line 2d - Other Adjustments: Foundation Transfer 601,837. Part XI, Line 4b - Other Adjustments: Bad Debts Netted with Revenue on Audited Financials 148,514,185. Related Transactions 5,832,317. Other 8,034. Part XII, Line 4b - Other Adjustments: Bad Debts Netted with Revenue on Audited Financials 148,514,185. Other 2,615. 1 1 X 1 X 1 X 1 1 1 0 1 1 27546185 27546185 0.03990 122903792 56942131 65961661 0.09540 7234768 2485428 4749340 0.00690 157684745 59427559 98257186 0.14220 543275615 483305377 59970238 0.08680 543275615 483305377 59970238 0.08680 700960360 542732936 158227424 0.22900 14378614 14378614 0.02080 14378614 14378614 0.02080 1 148514185 150117558 161606823 -11489265 X 1 1 1 1 Lakeland Regional Medical Center 1324 Lakeland Hills Blvd Lakeland FL 33805 X X X Lakeland Regional Medical Center 1 0 0 1 X X X X X X X X X X 16 1 0 1 1 X mylrh.org X 1 16 1 mylrh.org 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X mylrh.org X mylrh.org X mylrh.org X X X X X X 1 X 0 X X X X 1 X 0 0 Lakeland Regional Medical Center Part V, Section B, Line 3j: During fiscal year 2017, Community Health Needs Assessment ("CHNA") activities were conducted and the 2018-2021 CHNA assessment was completed. The completion of the 2018-2021 CHNA enables Lakeland Regional Health to take an in-depth look at the status of health in our community and focus on understanding barriers to care so that we may best meet the needs of our community. Healthcare is an essential resource that we are privileged and honored to provide to the community we serve. We understand that this resource can be, at times, unattainable. As a result and upon review of Polk County's current health status, we have identified the following areas of need:1. Reduce obesity2. Enhance maternal and infant care3. Increase access to quality, coordinated care4. Expand mental healthcare initiatives5. Increase cancer screening and prevention6. Target heart disease and stroke screening and prevention7. Promote injury preventionIn response to the identified areas of need, the following initiatives and anticipated outcomes were established:1. REDUCE OBESITYInitiatives: Continued implementation of the Congregational Health Partnership, which is designed to empower faith communities to address the unique health needs of their congregation and proactively addresses disparities that exist, specifically: general wellness and preventative care awareness, obesity, diabetes and nutrition. Develop Community Wellness Programs that promote healthy eating, active living and life balance. Explore the feasibility of implementation of the Blue Zones Project as a well-being improvement initiative in Polk County. Explore partnerships with local food banks to identify food deserts and regions of food insecurity that could result in opportunities for mobile markets/pantries. Create Healthy Kids Programming that supports and provides opportunities including nutrition education and physical activity in school settings. Reduce the number of readmissions of diabetic patients to the emergency department and hospital by increasing education and early intervention opportunities.Anticipated Outcomes: Increased collaboration with local governments, community organizations, employers, education institutions and physician providers to lower the obesity rate in Polk County. The development of programming that directly impacts community member awareness and knowledge as it relates to nutrition and living an active lifestyle leading to a decrease in the obesity rate.2. ENHANCE MATERNAL AND INFANT CAREInitiatives: Enhance and expand services for women in Polk County through expanding the number of OB/GYN providers in the LRH Physician Group, partnering with Nemours Children's Hospital to add Maternal/Fetal Medicine physicians at the Hospital and outpatient LRH facilities, and increasing the number of antepartum beds for high risk expectant moms. Enhance and expand services for children in Polk County through expanding the number of pediatricians in the LRH Physician Group, partnering with Nemours Children's Hospital to add pediatric specialists at LRH in cardiology, gastroenterology, ophthalmology, pulmonology, nephrology, urology, general surgery, endocrinology and orthopedics, expanding the capacity of the pediatric unit by increasing the number of beds and utilizing acuity adaptable beds, expanding the capacity of the Pediatric Emergency Department by increasing the size, and enhancing the services for children and parents by locating it within pediatric designated space, and creating a child-friendly surgical area by creating a pediatric-specific surgical suite.Anticipated Outcomes: Increased access resulting in a greater number of women and children receiving care and staying in Polk County to receive care. Increased number of families participating in support and education programs provided by LRH.3. ACCESS TO QUALITY, COORDINATED CAREInitiatives: Continue work with the Centers for Medicaid and Medicare Services (CMS) to gain approval for Graduate Medical Education (GME). Collaborate with community partners, physicians and providers to increase the level of primary and specialty care providers available within the community served by LRH. Continue to recruit physician providers into the LRH physician group. Expand the role of advanced practice providers in the healthcare system to expand our capacity to care for more people. Enhance initiatives to improve care across the continuum, including the use of evidence-based strategies in social work, case management, pharmacy, the integrated care team and ambulatory settings. Explore creation of a Dental Residency program to improve access to dental care and education around preventative measures. Anticipated Outcomes: Increased provider access for patients through support of a well-trained, culturally competent and diverse healthcare workforce to ensure access to quality care. Improved care management and reduced barriers to preventive screening, primary care and specialty care by deploying a wide range of strategies including programs, outreach, training and policies to further minimize the negative impact of health conditions.4. MENTAL HEALTHCAREInitiatives: Propose and gain support internally and externally to build a new behavioral health hospital and outpatient center. Develop strategy to improve mental and behavioral healthcare access and partner with community stakeholders to develop additional capacity to address health needs impacting behavioral health patients. Increase the number of primary care patients who are screened for depression and, when appropriate, referred to the proper resources. Participate in mental health forums and education opportunities with community partners.Anticipated Outcomes: Increased community access to mental and behavioral healthcare. Reduced stigma surrounding mental health as a result of increased education opportunities.5. CANCER SCREENING AND PREVENTIONInitiatives: Continue to conduct skin cancer education and prevention screenings through the Community Wellness Program. Continue to offer Smoking Cessation Programs in partnership with our physician providers and groups such as the Tobacco Free Alliance to help encourage participants to work on the process and problems of quitting. Expand cervical cancer awareness and education. Expand colon cancer screening initiatives by increasing the screening procedures performed at the Hollis Cancer Center. Evaluate the feasibility of implementing the American Cancer Society's FluFIT program at LRH primary care sites. Continue to provide education sessions and symposiums on cancer prevention, screening and early detection.Anticipated Outcomes: Increased patient access to cancer screening services. Increased community participation in educational programs that highlight resources available for early cancer detection and treatment. Decreased rate of new cancer cases and deaths.6. HEART DISEASE AND STROKEIncrease the number of individuals who "know their numbers and are aware of risk factors for heart disease by utilizing the Community Wellness Program health screenings events. Continue to engage congregations through the Congregational Health Partnership and promote education and workshops that focus on risk factors for cardiovascular disease including: 1) heart health education; 2) nutrition and diet education; and 3) importance of physical activity and exercise. Continued implementation of the STEMI direct to cath lab initiative which reduces the time between arrival of the patient to the hospital and initial contact with treatment team and doctor to balloon time.Anticipated Outcomes: Increased percentage of adults who are aware of signs and symptoms of Cardiovascular Disease. Decrease in the time it takes to identify and treat patients who present with ST Elevation Myocardial Infarction.7. INJURY PREVENTIONInitiatives: Continued participation in the Coalition on Injury Prevention. The Coalition provides injury prevention education and activities by leveraging partnerships, communication effort, support networks and community events. The Coalition is a joint effort between the LRH Trauma Services and the Polk County Health Department and is comprised of injury prevention professionals from various fields. Reduce unintentional fatal and nonfatal injury by improving the health, safety and knowledge of our community by continuing to address priority injury areas.Anticipated Outcomes: Increased patient and community participation in injury education and community outreach services provided by our Trauma Center. Lakeland Regional Medical Center Part V, Section B, Line 5: As noted on page 17 of the CHNA, approximately 45 stakeholders representing broad interests of the community served by Lakeland Regional Health attended the May 2017 dialogue session to review current data trends and discuss relevant and widespread issues in Polk County as well as suggest ways the health system could address community disparities. Organizations represented at this meeting included:- American Cancer Society- CareerSource Polk- Early Learning Coalition of Polk County- Florida Department of Health Polk County- Florida Southern College- Healthy Start Coalition- Heartland for Children- InnerAct Alliance- Lakeland Housing Authority- New Life Outreach Ministry- Parker Street Ministries- Peace River Center- Polk Health Care Plan- Polk State College- Polk Vision- Talbot House- United Way of Central Florida- VISTE Part V, Section B, Line 22b: To be eligible for a 100% Financial Assistance Adjustment (i.e., full write-off), the patient's Household Income must be less than or equal to 200% of the current FPG (adjusted for family size). If the patient's Household Income is greater than 200% and less than or equal to 400% of the current FPG (adjusted for family size), the patient will receive a Financial Assistance Adjustment that is based upon LRMC's Amounts Generally Billed (AGB) percentage. By January 28th of each year, the AGB percentage will calculated by dividing the sum of allowed amounts for claims for services allowed by Medicare Fee-For-Service and all private health insurers during the prior twelve-month period ended September 30 by the gross charges for such claims. No individual eligible under this Financial Assistance Policy will be given a Financial Assistance Adjustment which is less than amount calculated using the AGB percentage. The AGB percentage in effect is 25%, thus the Financial Assistance Adjustment based on the AGB percentage is 75%. In all situations described in this paragraph, the Financial Assistance Adjustment will be applied to the outstanding balance of an account after payments by third parties, if any.The Financial Assistance Adjustment based on the AGB percentage will also be applied to the outstanding balance, after payments by insurance, if any, of patients with Catastrophic Medical Expenses, as defined above, who are not eligible for financial assistance based on the other provisions of this policy. Uninsured patients of LRMC who are not eligible for financial assistance based on the other provisions of the policy will also receive an Uninsured Discount based on the AGB percentage. 5 1 - Hollis Cancer Center 3525 Lakeland Hills Blvd Lakeland FL 33805 Outpatient Clinic 2 - LRMC Family Health Center 300 Parkview Place Lakeland FL 33805 Outpatient Clinic 3 - Lakeland Regional Rehab & Sports Clinic 3030 Harden Blvd Lakeland FL 33803 Outpatient Clinic 4 - Lakeland Reg Health Ctr for Wound Care 3030 Harden Blvd Lakeland FL 33803 Outpatient Clinic 5 - Grasslands Infusion Therapy Center 3030 Harden Blvd Lakeland FL 33803 Outpatient Clinic Part I, Line 7: Lakeland Regional Medical Center determines the cost of charity by calculating a ratio of cost to charges as derived from the Medicare Cost Report and then multiplying that ratio by the gross uncompensated charges associated with providing care to charity patients. Similarly, the cost of subsidized health services is based on the unreimbursed cost of caring for the patients' services less the cost associated with Bad Debt, Charity, Medicaid and other means-tested government programs. The actual expenses paid for providing community health improvements and community benefits operations less any payments received for those activities is reflected above. Part I, Line 7g: Subsidized health services are clinical services that are essential to meet the health care needs of the entire community and are provided with a financial loss to Lakeland Regional Medical Center (LRMC). The financial loss is measured after removing losses associated with Bad Debt, Charity, Medicaid and other means-tested government programs. LRMC operates one of the busiest Emergency Departments in the nation with over 200,000 emergency visits each year. We treat all patients regardless of their ability to pay for the care they receive. In addition, we staff a Level II Trauma Center to provide critical care access to residents of Lakeland and surrounding communities. The cost of providing emergency and trauma care 24 hours each day exceeds the payments LRMC receives for providing that care. LRMC also operates the only inpatient Behavioral Health Unit in Lakeland to provide care for the mentally ill population who have nowhere else to go for essential inpatient psychiatric care. Part I, Ln 7 Col(f): There is $148,514,185 of bad debt expense which is included in Form 990, Part IX, Line 24(b). This amount was removed in the calculation of the Percent of Total Expense on Schedule H Line 7f. Part II, Community Building Activities: Lakeland Regional Medical Center is the only hospital in Lakeland and serves as a tertiary referral hospital serving the broader Polk County, Florida. As the only state-designated trauma center for Polk, Highlands, and Hardee counties, we provide critical access and care to the area's most seriously injured residents. A shortage of primary care physicians and mental health services has resulted in our ER becoming the highest volume ER in the nation, offering essential medical care to many underserved residents in our community.Ongoing education programs for diabetes and cardiac rehab are designed to help patients with chronic conditions maintain their health and avoid repeated hospitalizations. Support groups assist those living with chronic and life-threatening illnesses to access resources and critical peer support. Education and screening programs have identified those at risk of various conditions, allowing them to seek treatment. Participation in and support of community events helps to ensure a vibrant community and a positive quality of life for our employees as well as our patient-base. Part III, Line 2: LRMC follows the guidance provided in the Healthcare Financial Management Association Principles and Practices Board "Statement 15: Valuation and Financial Statement Presentation of Charity Care and Bad Debts by Institutional Healthcare Providers" in determining bad debt expenses. Bad debt expense results when a patient who does not meet the criteria for Charity Care and who has been determined to have the financial capacity to pay for healthcare services and is unwilling to settle the claim. The hospital utilizes an overall ratio of cost to charges from the applicable Medicare cost report and this is applied to the bad debt expense. Part III, Line 4: The consolidated, audited financial statements of Lakeland Regional Health Systems, Inc. and Subsidiaries are attached to this return and contain language addressing Bad Debts on pages 9 thru 11. Part III, Line 8: The Medicare payment shortfall is not treated as a community benefit. Medicare allowable costs are determined using the approved standardized Medicare Cost Report methodology. The Medicare cost is derived using the Medicare Cost-to-Charge ratio from the Medicare cost report times the Medicare charges for service. Part III, Line 9b: LRH will not engage in the following collection activities for any patients (even if they do not qualify for financial assistance): - Place a lien on an individual's property- Foreclose on an individual's real property- Attach or seize an individual's bank account or any other personal property- Commence a civil action against an individual- Cause an individual's arrest- Cause an individual to be subject to a writ of body attachment- Garnish an individual's wages- Demand payment for a prior bill as condition of receiving future services at LRMC. This prohibition does not apply to office-based services provided by LRHS.LRMC or its representatives (i.e., a collection agency) may report a patient to a credit bureau if the patient has received a written notice (and an attempt has been made to provide oral notification) specifying the date, which shall be not less than 30 days after the date of the notice, after which credit bureau reporting may occur. Credit Bureau reporting may not occur earlier than 240 days after the date the patient received the first billing statement for the care provided. These limitations do not apply to LRHS. Part VI, Line 2: Lakeland Regional Medical Center collaborates with medical staff, community leaders and the Polk County Health Department to determine the health needs of the citizens of Lakeland and Polk County, Florida. LRMC sponsors various Medical Staff Committees where community health needs are frequently discussed. Our senior management and staff identify unmet community health needs through participation in community coalitions, partnerships, boards, committees, and advisory groups. Using available data on the demographics and service utilization for our primary and secondary markets, the LRMC executive team and Board develop a comprehensive annual Strategic Plan to address the healthcare needs of the community. For the 2018-2021 CHNA, approximately 45 stakeholders representing broad interests of the community served by Lakeland Regional Health attended the May 2017 dialogue session to review current data trends and discuss relevant and widespread issues in Polk County as well as suggest ways the health system could address community disparities. Following the community dialogue session, the data review process involved the formal prioritization method known as the Prioritization Matrix, which included ranking health priorities based on the six primary criteria: alignment with the health system's mission; existing programs; ability to impact within three years; financial resources required; human resources required and the availability of measurable outcomes to assess effectiveness of the intervention/plan.In 2012, LRMC opened a primary health clinic to provide a medical home for the uninsured and underinsured population. This clinic is designed to both improve the quality of care for low income patients and also reduce visits to the emergency room. In the fall of 2012 and continuing through 2015, LRMC partnered with the Polk County Health Department, Peace River Center and the Polk Healthcare Plan as part of the state Low Income Pool for primary care to offer a patient-centered, primary care integrated medical home within the I-4 corridor of Polk County. Beginning in 2016 and through 2018, LRMC continued its partnership with the Polk HealthcarePlan and Peace River to provide primary care and mental health screenings to the indigent population of Polk County and members of the Polk Healthcare Plan which was partially subsidized by a grant funded by Polk County. In 2019, the Family Health Center had 13,280 visits in which patients and their families were able to receive primary care. Part VI, Line 3: For scheduled admissions, LRMC conducts a pre-admission interview to discuss the financial plan with the patient, the guarantor, and/or his or her legal representative. If a pre-admission interview is not possible, this interview is conducted upon admission. In the case of an emergency admission, LRMC's evaluation of payment alternatives does not take place until the required stabilizing medical care has been provided. Identification of patients eligible for assistance can take place at any time during the rendition of services or during the patient account collection process (including bad debt).Those patients who may qualify for financial assistance from a government program are referred to the appropriate program, such as Medicaid or the Polk Healthcare Plan. LRMC provides on-site access to Medicaid eligibility specialists to assist patients in qualifying for governmental medical assistance programs. All patients identified as potential financial assistance recipients are offered the opportunity to apply for financial assistance. If this evaluation is not conducted until after the patient leaves, or in the case of outpatients or emergency patients, an LRMC representative mails a financial assistance application to the patient. For the first 120 days after the date of service, the hospital will notify an individual about the Financial Assistance Policy. The patient will receive at least three billing statements that include language about applying for financial assistance. The hospital will accept and process any financial assistance applications submitted by an individual for up to 240 days after the patient received the first billing statement for the care. Part VI, Line 4: The Lakeland Urban Area is considered the primary service area and the remainder of Polk County is considered the secondary/extended service area. Polk County has a population of over 680,000 with 20.1% of residents being over the age of 65 and 16.1% of residents living below the Federal Poverty Level. Children under 18 years of age make up 22.3% of the population. Located between Orange and Hillsborough Counties, it is the fourth (4th) largest county in Florida consisting of 2,010 square miles. Lakeland is the largest city in Polk County and is located between Tampa and Orlando on Interstate 4. The unemployment rate for Polk County was 3.3% as of November 2019. Census data reflects a population that is 22.3% Hispanic or Latino, 16.0% Black and under 3% from other minorities. Part VI, Line 5: Lakeland Regional Medical Center's senior management, directors, managers, physicians and staff provide leadership and resources to equip local organizations with the skills needed to create a healthy community. Our staff participates on boards, advisory committees, and coalitions benefiting the community we serve without compensation for their time. Our leaders and physicians participate in educational programs, workshops and health fair events that are provided free to members of the community. We provide cancer screening services to the community for early detection of breast, skin and colon cancers. We participate and provide support for educational programs for healthcare workers in partnership with local colleges, universities and trade schools. Lakeland Regional Medical Center has a vibrant volunteer program, offering varied opportunities for service to the members of the community. The medical staff of Lakeland Regional Medical Center consists of over 600 physicians and is organized to promote the public interest of healthcare. No part of the income of LRMC inures to the benefit of any private individual, nor is any private interest being served. All surplus funds are reinvested into the facilities, equipment, programs and resources needed to continually improve the quality of patient care, expand our outreach, and advance the medical training and education of our staff. As noted above, the primary health clinic opened in 2012, and the Low Income Pool partnership clinic with Polk County located on the I-4 corridor are excellent examples of LRH's commitment to community health promotion. Part VI, Line 6: Lakeland Regional Medical Center is a subsidiary of Lakeland Regional Health Systems, Inc., a not-for-profit system that reinvests its profits back into the community through programs that benefit the residents of Lakeland and Polk County, Florida. The Health System facilities are leased from the City of Lakeland and the operations of the Hospital and Health System directly benefit the citizens of the community. Annually, the Health System pays the City for use of the Medical Center buildings, and the City of Lakeland uses those funds to provide public services and facilities that directly benefit all of the members of the community. During 2016, the Health System's total payments made to the City under the arrangement totaled $39.1 million of which $13.2 million represented the required payments for fiscal year 2016. During 2017, the Health System's total payments made to the City under the arrangement totaled $13.6 million. During 2018, the Health System's total payments made to the City under the arrangement totaled approximately $14.3 million. During 2019, the Health System's total payments made to the City under the arrangement totaled approximately $14.9 million.In addition, the Health System provides for the health of the community by directly employing physicians in underserved medical specialties, such as orthopedics, trauma surgery, oncology and behavioral health. The Health System's medical clinics provide access to all residents, regardless of income, and many operate at a loss. Despite this, LRH believes that the role these clinics provide in the community, and in the promotion and maintenance of health, is part of our mission and our significant contribution to the community. X X X X X 0 1 0 0 0 0 0 0 0 Elaine Thompson PhD President/Chief Executive Officer 909571 0 218373 0 289463 0 115689 0 22916 0 1556012 0 0 0 Evan C Jones EVP - Former Chief Financial Officer 559717 0 75906 0 183936 0 63115 0 20770 0 903444 0 0 0 Lance Green SVP -Current Chief Financial Officer 219072 0 13569 0 25 0 15647 0 27202 0 275515 0 0 0 Sarah Bhagat COO/SVP Organizational Effectiveness 291350 0 40276 0 20874 0 59644 0 24703 0 436847 0 9974 0 Francisco J Chebly Executive Director LRH Physician Gro 337910 0 9383 0 10695 0 15474 0 28121 0 401583 0 0 0 Scott Dimmick SVP - Chief Human Resources Officer 269724 0 37931 0 6045 0 65559 0 24602 0 403861 0 0 0 Danielle Drummond EVP - Chief Operating Officer 490999 0 63708 0 42862 0 69566 0 18831 0 685966 0 7853 0 Hal Escowitz Chief Quality & Medical Information 354938 0 25311 0 695 0 18139 0 25053 0 424136 0 0 0 Janet W Fansler EVP - Chief Nurse Executive 508749 0 71310 0 252260 0 203198 0 23762 0 1059279 0 0 0 Jonn Hoppe EVP - Chief Legal Officer 402575 0 54830 0 28355 0 74379 0 27292 0 587431 0 13592 0 Deana L Nelson SVP - Administration & Corporate Ini 308086 0 31920 0 25 0 65431 0 4375 0 409837 0 0 0 Timothy Regan President/Chief Medical Officer 546469 0 76420 0 47806 0 74975 0 24753 0 770423 0 9419 0 Michael Spake SVP - External Affairs and CCIO 283722 0 40706 0 25979 0 45453 0 28082 0 423942 0 5059 0 James Sturgill VP - LRH Physician Group 181504 0 15644 0 40 0 12350 0 14713 0 224251 0 0 0 Graham Greene Chief Academic Officer & Urologist 0 522674 0 30509 0 25 0 55051 0 16126 0 624385 0 0 Timothy Boynton VP of Development, Chief PR & Commun 189224 0 12032 0 2871 0 42334 0 2467 0 248928 0 0 0 Stacy Bolton VP - CIO/Chief Technology Officer 223604 0 15386 0 712 0 7449 0 24719 0 271870 0 0 0 Rodriguez Dangerfield Director of Pharmacy 209210 0 9456 0 63 0 11588 0 24489 0 254806 0 0 0 Ana Kalman VP - CIO/Chief Applications Officer 236099 0 15386 0 51 0 12733 0 11299 0 275568 0 0 0 Pradeep Patra Physicist 209909 0 0 0 25 0 10976 0 25707 0 246617 0 0 0 Maureen E Leckie AVP - Clinical Operations 194123 0 10617 0 654 0 13005 0 16137 0 234536 0 0 0 Part I, Line 4b Janet W. Fansler - Executive VP and Chief Nursing Executive participated in a supplemental nonqualified deferred compensation plan. She had $250,839 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii) other compensation. She had an additional $185,059 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Elaine Thompson, Ph.D. - President and Chief Executive Officer participated in a supplemental nonqualified deferred compensation plan. She had $285,809 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). She had an additional $97,550 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Evan Jones - Executive VP and Chief Financial Officer participated in a supplemental nonqualified deferred compensation plan. He had $182,535 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). He had an additional $44,976 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Timothy Boynton - Vice President of Development and Chief Public Relations and Communications Officer participated in a supplemental nonqualified deferred compensation plan. He had $30,569 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Timothy Regan - President/Chief Medical Officer participated in a supplemental nonqualified deferred compensation plan. He had $47,781 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). He had an additional $56,836 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Danielle Drummond - Executive VP and Chief Operating Officer participated in a supplemental nonqualified deferred compensation plan. She had $42,530 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). She had an additional $51,427 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Michael Spake - SVP of External Affairs and Chief Compliance and Integrity Officer participated in a supplemental nonqualified deferred compensation plan. He had $25,495 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). He had an additional $30,275 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Sarah Bhagat - Chief Operating Officer and SVP of Organizational Effectiveness participated in a supplemental nonqualified deferred compensation plan. She had $20,849 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). She had an additional $41,505 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Jonn Hoppe - EVP and Chief Legal Officer participated in a supplemental nonqualified deferred compensation plan. He had $28,330 of taxable benefits during calendar year 2018. This amount is included in Part II Column (B)(iii). He had an additional $56,240 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Scott Dimmick - SVP and Chief Human Resources Officer participated in a supplemental nonqualified deferred compensation plan. He had $47,420 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Deana Nelson - SVP and Administration and Corporate Initiatives Officer participated in a supplemental nonqualified deferred compensation plan. She had $51,135 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. Graham Greene - Chief Academic Officer participated in a supplemental nonqualified deferred compensation plan. He had $36,912 of nontaxable benefits accrue during calendar year 2018. This amount is included in Part II Column C. A City of Lakeland Florida 596000354 511665JE2 2011-07-28 81113255 2011 Bonds refunded the 96A, 97A, 97B & 99B Bonds & paid 2011 issuance costs 0 0 0 B City of Lakeland Florida 596000354 511665JN2 2015-02-05 205545053 2015 Hospital Revenue Bonds for capital projects 0 0 0 C City of Lakeland Florida 596000354 511665KFJ 2016-09-15 97381865 2016 Hospital Revenue Refunding Bonds 0 0 0 A 81113255 1012480 0 1 1 1 B 205545053 1892439 205545053 2018 0 0 1 1 C 97381865 99742693 937638 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 Form 990, Part III, Line 4a Lakeland Regional Medical Center provides free care to patients who meet the State of Florida charity care guidelines and who are not eligible for public assistance. Lakeland Regional Medical Center provided care to emergency patients, regardless of their ability to pay. In addition to the primary Emergency Department, specialty care for children was provided in the separate Pediatric Emergency unit and provides a walk-in center for those patients in need of primary care under non-emergent conditions. Lakeland Regional Medical Center additionally provided inpatient and outpatient mental health services to patients, regardless of their ability to pay. Comprehensive care was offered for a variety of illnesses, including clinical depression, anxiety and memory disorders, addiction recovery and various adolescent services. All services are provided in a distinct part unit within the hospital, and programs are directed by board-certified psychiatrists. Form 990, Part VI, Section A, line 6 Certain decisions of the governing body of Lakeland Regional Medical Center are subject to approval of the sole member Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section A, line 7a The sole member of Lakeland Regional Medical Center, Inc. is Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section A, line 7b Certain decisions of the governing board of Lakeland Regional Medical Center are subject to approval of the sole member Lakeland Regional Health Systems, Inc. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed prior to filing by senior management, including the CEO and CFO. Additionally, the form and schedules related to compensation are reviewed by the Executive and Physician Compensation Committee of the Board and a copy of the Form 990 and schedules are provided to each member of the Board of Directors before filing with the IRS. Form 990, Part VI, Section B, line 12c Lakeland Regional Medical Center has a conflict of interest policy which is monitored by the Corporate Integrity Services department. All new hires, students, volunteers and contractors are trained on the ethics policy during general orientation. All staff is to comply with ethics training annually as part of their mandatory education requirements. Annually, a certification is required by all managers, directors, and officers who must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Medical Center also has a "Policy of the Board of Directors Regarding Board Members Doing Business with Lakeland Regional Medical Center or Lakeland Regional Health Systems". All Board Members are annually required to execute a "Corporate Compliance Acknowledgement and answer a comprehensive "Annual Conflict of Interest Questionnaire". Additionally, all Senior Corporate Management are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire". Form 990, Part VI, Section B, line 15 Lakeland Regional Medical Center, Inc. Executive and Physician Compensation Committee (the "Committee") of the Board is charged with determining, in advance, all compensation issues for all executive positions including the President & CEO, the CFO and all Vice Presidents of the organization. Only independent and "disinterested" persons may serve as members of the Committee and no member may be employed by the organization or any of its affiliates. Additionally, no physician on the medical staff of the organization may serve as a member of the Committee nor may any member have any business or financial relationships with the organization, either directly or indirectly through family members. The Committee engages an independent nationally recognized human resource management consulting firm which specializes in executive and employee compensation in the health care industry. This firm, among other things: a. Conducts a competitive executive total cash compensation analysis relative to comparable healthcare organizations nationally; and b. Conducts a competitive executive benefits analysis relative to comparable healthcare organizations; and c. Conducts a competitive executive total compensation analysis relative to comparable healthcare organizations; and d. Assists the Committee in ensuring compliance with regulatory requirements; and e. Provides guidance and counsel to the Committee and Board in matters relating to executive compensation; and f. Participates in Committee meeting and presents their findings and recommendations to the Committee and to the Board. In determining compensation, the Committee relies on the independent, reliable market data presented by the consulting firm to set all compensation levels and the consulting firm's opinion as to the reasonableness of total compensation to be paid the executives of the organization. The Committee fully documents the basis for all determinations and records, at a minimum, 1) the terms of the compensation agreement and the date on which it was approved; 2)the members of the Committee where were present during the discussion and those who voted on it; 3) the comparability data used and its source; and 4) the basis for the ultimate decision. In fulfilling its responsibility, the Committee has full authority to consult with outside counsel, regarding the legality of the compensation and other legal issues which may be relevant to the Committee's responsibilities. Form 990, Part VI, Section C, line 19 The organization's Articles of Incorporation are public records and may be obtained from the State of Florida's Division of Corporations in Tallahassee, Florida. Additionally, the Lease & Transfer Agreement between the organization and the City of Lakeland, Florida, under which the organization operates, is recorded in the Public Records of Polk County, Florida, the County in which the organization is located. Financial statements and similar information, both audited and unaudited, are periodically furnished to the City of Lakeland, Florida, and various regulatory agencies within the State of Florida. As such, said financial statements and information are public records under the pertinent Florida public records laws. Form 990, Part XI, line 9: Intercompany Transfers -77,583,456. Change in Beneficial Interest in Foundation -813,565. Other Adjustments -10,076. Change in Benefit Obligation 1,222,531. Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 237134974 Fundraising FL 501(c)(3) Line 12a, I Lakeland Regional Health Systems Inc 0 Lakeland Regional Health Systems Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 592650464 Support Other 501(c)(3) organizations FL 501(c)(3) Line 12a, I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0