2025-11-13T12:58:43-06:00 2024-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2024-01-01 341425872 LAKE HOSPITAL FOUNDATION INC LAKE 2168441000 7590 AUBURN ROAD CONCORD TOWNSHIP OH 44077 BRADLEY C BOND CFO, UHHS 2168441000 2025-11-13 1 1 SHAWNA M JANSONS P01222873 3174648600 2024 2025-03-06 01:10:19Z LAKE HEALTH FOUNDATION TIMOTHY A CAHILL 7590 AUBURN ROAD CONCORD TOWNSHIP OH 44077 1358100 0 X HTTPS://WWW.UHGIVING.ORG/WAYS-TO-GIVE/SUPPORTING- X 1983 OH SUPPORT AND ASSIST THE MISSION OF LAKE HOSPITAL SYSTEM, INC. 12 8 0 8 0 0 500058 402675 0 0 348010 955425 0 0 848068 1358100 482059 952665 0 0 293462 141146 0 0 0 99626 57926 875147 1151737 -27079 206363 23646363 24366825 5418403 4670225 18227960 19696600 SUPPORT AND ASSIST LAKE HOSPITAL SYSTEM, INC. IN ITS EFFORTS TO SERVE THE NEEDS OF LAKE COUNTY RESIDENTS AND ITS SURROUNDING COMMUNITIES BY PROVIDING FUNDING FOR ENHANCED OR ADDITIONAL PROGRAMS THAT OTHERWISE MIGHT NOT BE AVAILABLE. 0 0 1138447 952665 0 THE FOUNDATION GRANTS ASSISTANCE TO LAKE HOSPITAL SYSTEM, INC. TO FURTHER ENHANCE THE HOSPITAL'S MISSION AND COMMUNITY BENEFIT. 1138447 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X ROBERT GOEBEL 2168441000 3605 WARRENSVILLE CENTER ROAD MSC SHAKER HEIGHTS OH 44122 STROSAKER ROBYN TRUSTEE/PRESIDENT (EX-OFFICIO) 2.00 58.00 X X 0 963253 165563 PATEL CHETAN P MD TRUSTEE 2.00 52.00 X 0 795960 38894 CICERO RICHARD TRUSTEE (EX-OFFICIO) 2.00 54.00 X 0 486999 95101 TADESE TINU MD TRUSTEE (EX-OFFICIO) (END 10/24) 2.00 50.00 X 0 356486 49865 COMBS BRIDGET MD TRUSTEE/SECRETARY 2.00 50.00 X X 0 260286 25926 BAUMBERGER RONALD TRUSTEE/VICE CHAIR (END 07/24) 2.00 0.00 X X 0 0 0 CAHILL TIMOTHY A TRUSTEE/TREASURER (END 03/24) 2.00 0.00 X X 0 0 0 LINGENFELTER ANDREW TRUSTEE/VICE-CHAIR (BEG 09/24) 2.00 0.00 X X 0 0 0 THOMPSON KATHLEEN TRUSTEE/CHAIR 2.00 0.00 X X 0 0 0 BILECI-COCCA AMY TRUSTEE (END 09/24) 2.00 0.00 X 0 0 0 FLYNN OSCAR TRUSTEE 2.00 0.00 X 0 0 0 GUBAN PHILIP TRUSTEE 2.00 0.00 X 0 0 0 KOCHIK GEORGE TRUSTEE (EX-OFFICIO) 2.00 0.00 X 0 0 0 NEKIC JOHN TRUSTEE 2.00 0.00 X 0 0 0 PAGANINI RAYMOND J TRUSTEE 2.00 2.00 X 0 0 0 PERRICO MICHAEL A TRUSTEE (END 01/24) 2.00 0.00 X 0 0 0 TULLAI-MCGUINNESS SUSAN TRUSTEE (BEG 12/24) 2.00 0.00 X 0 0 0 FLASH MARK EXECUTIVE DIRECTOR (END 07/24) 40.00 10.00 X 0 159853 19585 0 3022837 394934 0 0 1 0 0 402675 402675 363894 363894 591531 0 591531 591531 591531 1358100 0 0 955425 952665 952665 123874 116441 7433 3464 3256 208 13808 12980 828 4200 3948 252 3522 3311 211 2547 2394 153 DONOR RECOGNITION 44912 42217 2695 CATERING 2056 925 1131 NON MEDICAL SUPPLIES 89 40 49 600 270 330 1151737 1138447 13290 0 267955 12611 593043 318317 294953 15677 1649 1649 5078 5078 21693489 23045610 525669 591939 264527 375944 23646363 24366825 5355112 6271 7500 0 55791 4663954 5418403 4670225 X 10483433 11973450 7744527 7723150 18227960 19696600 23646363 24366825 X 206363 1332014 -69737 X 0 0 0 X X 1 LAKE HOSPITAL SYSTEM INC 341425870 3 1 952665 0 1 952665 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7744527 263240 553377 837994 7723150 7350507 202983 490439 299402 7744527 7817807 457981 -99652 825629 7350507 7186654 474754 582521 89913 336209 7817807 6503815 1793553 402960 43639 1470035 7186654 0.00000 0.47950 0.52050 1 0 0 DUE TO AFFILIATES 4663954 4663954 PART V, LINE 4: THE ENDOWMENT FUNDS SUPPORT THE IMMEDIATE NEEDS IDENTIFIED BY UNIVERSITY HOSPITALS LAKE HOSPITAL SYSTEM SUCH AS INDIGENT PROGRAMS, INCLUDING HOSPICE, AS WELL AS OTHER PROGRAMS PROVIDING HEALTH, WELLNESS AND OVERALL COMMUNITY BENEFIT. 1 LAKE HOSPITAL SYSTEM INC 3605 WARRENSVILLE CTR RD MSC 9155 SHAKER HEIGHTS OH 44122 341425870 501 (C)(3) 952665 0 GENERAL SUPPORT 1 0 PART I, LINE 2: LAKE HOSPITAL FOUNDATION, INC. HAS A PROCESS WHERE WE RECEIVE AND REVIEW REQUESTS FOR FUNDING, WHICH INCLUDES OUR SENIOR LEADERS. IN THAT REVIEW PROCESS WE CHECK TO BE SURE THE ORGANIZATION IS MISSION ALIGNED TO LAKE HOSPITAL FOUNDATION, INC. AND REVIEW HISTORICAL GIVING. MUCH OF OUR SUPPORT IS REVIEWED BOTH INTERNALLY AND WITH THE EXTERNAL GROUP ON AN ANNUAL BASIS. 1 1 0 0 0 0 0 0 0 STROSAKER ROBYN TRUSTEE/PRESIDENT (EX-OFFICIO) 0 590252 0 286293 0 86708 0 130929 0 34634 0 1128816 0 0 PATEL CHETAN P MD TRUSTEE 0 688989 0 100000 0 6971 0 13200 0 25694 0 834854 0 0 CICERO RICHARD TRUSTEE (EX-OFFICIO) 0 326905 0 130992 0 29102 0 77001 0 18100 0 582100 0 0 TADESE TINU MD TRUSTEE (EX-OFFICIO) (END 10/24) 0 280821 0 55729 0 19936 0 19612 0 30253 0 406351 0 0 COMBS BRIDGET MD TRUSTEE/SECRETARY 0 259576 0 0 0 710 0 17074 0 8852 0 286212 0 0 FLASH MARK EXECUTIVE DIRECTOR (END 07/24) 0 95670 0 29613 0 34570 0 13459 0 6126 0 179438 0 0 PART I, LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM, INC., A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4A: UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSON IN PART VII: FLASH, MARK - $17,248 PART I, LINE 4B: ELIGIBLE EMPLOYEES PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN UNDER CODE 457(F). ANY AMOUNTS ULTIMATELY PAID UNDER THE PLAN TO AN ELIGIBLE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B (III) IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 LAKE HOSPITAL SYSTEM, INC. IS THE SOLE MEMBER OF LAKE HOSPITAL FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A LAKE HOSPITAL SYSTEM, INC. HAS THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES IS GRANTED CERTAIN POWERS WITH RESPECT TO OPERATIONS, AS THE MEMBER, LAKE HOSPITAL SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) FINANCES AND FINANCING, (II) INVESTMENTS, (III) LEGAL MATTERS, (IV) MATERIAL ASSET SALES AND TRANSFERS, AND (V) STRATEGIC PLANNING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT THIRD-PARTY PUBLIC ACCOUNTING FIRM. MANAGEMENT REVIEWS THE 990 BEFORE THE COMPLETE COPY IS MADE AVAILABLE TO THE FOUNDATION BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE SYSTEM HAS ADOPTED SIX CONFLICT OF INTEREST POLICIES THAT SET FORTH GUIDELINES RELATED TO TRANSACTIONS WITH DISQUALIFIED PERSONS (AS DEFINED IN APPLICABLE FEDERAL REGULATION). THESE POLICIES APPLY TO ALL EMPLOYEES, EMPLOYED PHYSICIANS AND OTHER LICENSED PRACTITIONERS (EXCLUDING PHYSICIAN TRAINEES), DIRECTORS, OFFICERS, AND RELATED PARTIES TO UH AND ITS WHOLLY-OWNED SUBSIDIARIES. UH REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICIES. DESIGNATED INDIVIDUALS, (E.G., UH MANAGEMENT, DIRECTORS, EMPLOYED PHYSICIANS, AND ADVANCED PRACTICE PROFESSIONALS), ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE AND PROVIDE INFORMATION REGARDING ANY INTERESTS THAT MAY BE POTENTIAL CONFLICTS PURSUANT TO THE CONFLICT OF INTEREST POLICIES. THEY ARE REQUIRED TO PROVIDE ANY CHANGES OR NEW DISCLOSURES SHOULD THEY OCCUR. ALL DISCLOSURES AND SUBSEQUENT UPDATES TO DISCLOSURES ARE REVIEWED BY THE UH COMPLIANCE AND ETHICS DEPARTMENT. BOARD-LEVEL AND KEY PERSONNEL CONFLICTS ARE REVIEWED AND APPROVED, IF APPROPRIATE, BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE UH BOARD AND/OR THE UH BOARD. IF A CONFLICT EXISTS WITH A DIRECTOR, CERTAIN RESTRICTIONS MAY BE IMPOSED, SUCH AS EXCUSING THE DIRECTOR FROM THE ROOM DURING DISCUSSION AND/OR VOTING WITH REGARD TO A PROPOSED TRANSACTION. EDUCATION REGARDING CONFLICTS OF INTEREST IS INCLUDED IN THE ANNUAL COMPLIANCE TRAINING THAT INCLUDES ALL DIRECTORS, EMPLOYEES, PHYSICIANS AND LICENSED PRACTITIONERS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY FOR LAKE HOSPITAL FOUNDATION, INC. ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON UNCOLLECTIBLE PLEDGES -69,737. 5805 EUCLID INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 814962989 SUPPORT HOSPITAL OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 ELYRIA MEDICAL CENTER FOUNDATION 630 EAST RIVER STREET ELYRIA OH 44035 611579760 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I EMH REGIONAL MEDICAL CENTER 0 FUND FOR CURES UK LTD 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 GRANT FUNDING UK N/A N/A UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 KETTERING MOHICAN AREA MEDICAL CENTER INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340823455 INACTIVE OH 501(C)(3) SAMARITAN REGIONAL HEALTH SYSTEM 0 LHS LEGACY 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 862916134 MANAGEMENT OH 501(C)(3) LINE 12C, III-FI LAKE HOSPITAL SYSTEM INC 0 PARMA HOSPITAL HEALTH CARE FOUNDATION 7007 POWERS BLVD PARMA OH 44129 341626664 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I PARMA COMMUNITY MEDICAL CENTER 0 ROBINSON MEMORIAL HOSPITAL FOUNDATION 6847 N CHESTNUT STREET PO BOX RAVENNA OH 44266 341510544 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I ROBINSON HEALTH SYSTEM INC 0 SAMARITAN HOSPITAL FOUNDATION 663 EAST MAIN STREET ASHLAND OH 44805 341783215 SUPPORT HOSPITAL OH 501(C)(3) LINE 12C, III-FI SAMARITAN REGIONAL MEDICAL CENTER 0 THE AUXILLARY OF LAKE HOSPITAL SYSTEM INC 7590 AUBURN ROAD CONCORD TOWNSHIP OH 44077 341605226 PATIENT NEEDS AND PHYSICIAN EQUIPMENT OH 501(C)(3) LINE 3 LAKE HOSPITAL SYSTEM INC 0 COMPREHENSIVE HEALTH CARE OF OHIO INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 341492733 HEALTHCARE OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 EMH REGIONAL MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340714612 HEALTHCARE OH 501(C)(3) LINE 3 COMPREHENSIVE HEALTHCARE OF OHIO INC 0 LAKE HOSPITAL SYSTEM INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 341425870 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 PARMA COMMUNITY GENERAL HOSPITAL 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340827442 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 PRIMEHEALTH INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 341778204 HEALTHCARE OH 501(C)(3) LINE 3 LAKE HOSPITAL SYSTEM INC 0 ROBINSON HEALTH SYSTEM INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 461382538 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 SAMARITAN REGIONAL HEALTH SYSTEM 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340714535 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UH REGIONAL HOSPITALS 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 341924226 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER INC 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 264827222 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 341567805 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS CONNEAUT MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340714550 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS COORDINATED CARE ORGANIZATION 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 900794903 HEALTHCARE OH 501(C)(3) LINE 10 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS GENEVA MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD-MSC 9 SHAKER HEIGHTS OH 44122 340714461 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 0 UNIVERSITY HOSPITALS HEALTH SYSTEM - 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