LIMA MEMORIAL PROFESSIONAL CORPORATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- LIMA MEMORIAL PROFESSIONAL CORPORATION (EIN 34-1935236)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-07
- IRS object ID
- 201803119349301545
- Schema version
- 2017v2.3
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-07T08:37:27-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341935236 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIMA MEMORIAL PROFESSIONAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIMA | BusinessNameControlTxt |
| Phone | 4192283335 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 BELLEFONTAINE AVENUE | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL D SWICK | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 4192283335 | PhoneNum |
| Signature | 2018-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BERNIE OSTROWSKI | PreparerPersonNm |
| PTIN | P00366367 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Preparation | 2018-10-17 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.113.40.52 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-29 | IPDt |
| IP Tm | 14:55:47 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CDA108602048A852A3C7A9C68094104E2D92ED46 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL D SWICK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 BELLEFONTAINE AVENUE | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,331,264 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LIMAMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 319 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $3,344 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,511 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,202,811 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,322,098 | CYProgramServiceRevenueAmt |
| PY Investment Income | $388 | PYInvestmentIncomeAmt |
| CY Investment Income | $686 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,438 | PYOtherRevenueAmt |
| CY Other Revenue | $8,480 | CYOtherRevenueAmt |
| PY Total Revenue | $22,208,637 | PYTotalRevenueAmt |
| CY Total Revenue | $26,331,264 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $26,469,186 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,567,020 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,249,905 | PYOtherExpensesAmt |
| CY Other Expenses | $8,472,447 | CYOtherExpensesAmt |
| PY Total Expenses | $34,729,091 | PYTotalExpensesAmt |
| CY Total Expenses | $40,049,467 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,520,454 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$13,718,203 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,305,101 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,768,388 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $104,831,132 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $118,012,604 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$98,526,031 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$112,244,216 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,414,196 | ExpenseAmt |
| Grant | $10,000 | GrantAmt |
| Revenue | $26,327,234 | RevenueAmt |
| Desc | LIMA MEMORIAL PHYSICIANS IS AN EXTENDED NETWORK OF PRIMARY CARE, PEDIATRIC AND SPECIALIST PHYSICIANS. THE PRIMARY CARE SERVICE LINE IS THE PATIENT'S GATEWAY TO A WHOLE TEAM OF SPECIALTY PHYSICIANS. WITH AN EMPHASIS ON COLLABORATIVE, PATIENT-FOCUSED CARE, PATIENTS CAN TAKE GREAT COMFORT KNOWING AN ENTIRE TEAM IS WORKING TO PROVIDE YOU WITH THE VERY BEST CARE. THERE ARE 10 FAMILY MEDICINE LOCATIONS ACROSS LIMA AND THE SURROUNDING REGIONS, EXTENDED HOURS AND SAME-DAY APPOINTMENTS. LIMA MEMORIAL HAS THE TOP MEDICAL AND SURGICAL SPECIALISTS IN THE AREA WHO WORK COLLABORATIVELY WITH YOUR PRIMARY CARE PHYSICIAN. THE SPECIALTY SERVICES INCLUDES: CARDIAC SERVICES, DIABETES, EAR, NOSE & THROAT, GENERAL SURGERY, HEMATOLOGY / MEDICAL ONCOLOGY, INTERNAL MEDICINE, KIDNEY SERVICES, NEUROSURGERY & NEUROLOGY, NURSE-MIDWIFERY, OBSTETRICS / GYNECOLOGY, PALLIATIVE CARE, PEDIATRIC SERVICES, PODIATRY, PROCTOLOGY, PULMONARY MEDICINE, RADIATION ONCOLOGY, RHEUMATOLOGY, SLEEP DISORDERS, UROLOGY AND VEIN CARE. | Desc |
| Total Program Service Expenses | $38,414,196 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 319 | 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 | 0 | ForeignFinancialAccountInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERI FOSTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4192265197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 BELLEFONTAINE AVENUE | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| FRANK BALDAUF MD THRU 617 | ||||||||
| CHAIRMAN (SEE SCH J) | 40.00 | 0.00 | Yes (X) | Yes (X) | $49,405 | $0 | $0 | |
| KHA H TRAN MD THRU 917 | ||||||||
| VP/CMO/TREASURER (SEE SCH J) | 20.00 | 20.00 | Yes (X) | Yes (X) | $0 | $391,383 | $93,986 | |
| CHERYL WAYMAN PA-C | ||||||||
| SECRETARY (SEE SCH J) | 40.00 | 0.00 | Yes (X) | Yes (X) | $138,474 | $0 | $21,151 | |
| PRATAP BALUSU MD | ||||||||
| VP/CMO/TREASURER (SEE SCH J) | 20.00 | 20.00 | Yes (X) | Yes (X) | $0 | $68,994 | $16,730 | |
| G ALLEN BRYANT | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $332,821 | $0 | $25,077 | ||
| JEREMY HEFFNER MD | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $1,031,432 | $0 | $41,638 | ||
| SUSAN KAUFMAN | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $346,506 | $0 | $32,475 | ||
| JENNIFER MAAG | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $160,091 | $0 | $35,447 | ||
| JOHN H JOHNSON THRU 617 | ||||||||
| BOARD MEMBER (SEE SCH J) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MASROOR ABRO MD | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $472,852 | $0 | $49,680 | ||
| MICHAEL KERRIGAN CNP | ||||||||
| BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $108,337 | $0 | $33,739 | ||
| ERIC MILLER DPM | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $214,040 | $0 | $30,051 | ||
| JOHN OEHLER DO | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $174,195 | $0 | $5,237 | ||
| MELODY STEWART-CYRUS MD | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $178,692 | $0 | $23,844 | ||
| RUTH WALL | ||||||||
| BOARD MEMBER (SEE SCH J) | 1.00 | 1.00 | Yes (X) | $0 | $11,709 | $0 | ||
| JAMES DOONE MD | ||||||||
| BOARD MEMBER (SEE SCH J) | 40.00 | 0.00 | Yes (X) | $193,799 | $0 | $22,854 | ||
| PRAVEEN MALHOTRA | ||||||||
| BOARD MEMBER (SEE SCH J) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL D SWICK | ||||||||
| PRESIDENT/CEO (SEE SCH J) | 6.00 | 34.00 | Yes (X) | $0 | $903,103 | $255,678 | ||
| ROBERT E ARMSTRONG JR | ||||||||
| VICE PRESIDENT/COO (SEE SCH J) | 10.00 | 30.00 | Yes (X) | $0 | $487,869 | $123,727 | ||
| JOHN T FISCHBACH | ||||||||
| VP OF FINANCE/CFO (SEE SCH J) | 1.00 | 39.50 | Yes (X) | $0 | $306,883 | $111,975 | ||
| PIERRE BAMDAD MD | ||||||||
| PHYSICIAN (SEE SCH J) | 40.00 | 0.00 | $945,170 | $0 | $21,600 | Yes (X) | ||
| MEHRAN ARABPOUR MD | ||||||||
| PHYSICIAN (SEE SCH J) | 40.00 | 0.00 | $948,845 | $0 | $63,180 | Yes (X) | ||
| PAUL N ANIKE MD | ||||||||
| PHYSICIAN (SEE SCH J) | 40.00 | 0.00 | $1,012,798 | $0 | $56,577 | Yes (X) | ||
| VENKAT R BATTULA MD | ||||||||
| PHYSICIAN (SEE SCH J) | 40.00 | 0.00 | $942,554 | $0 | $63,180 | Yes (X) | ||
| PAMELA R GARDNER | ||||||||
| PHYSICIAN (SEE SCH J) | 40.00 | 0.00 | $808,601 | $0 | $48,498 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,058,612 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,169,941 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,176,324 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | 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 |
|---|---|---|---|---|---|
| VEIN CARE CONSULTANTS | |||||
| 229 S CHILLICOTHE STREET | PLAIN CITY | OH | 43064 | PHYSICIAN SERVICES | $525,303 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | LOCUM TENENS | $428,033 |
| ECLINICALWORKS LLC | |||||
| 110 TURNPIKE ROAD SUITE 308 | WESTBORO | MA | 01581 | EMR SOFTWARE | $280,221 |
| COMPHEALTH ASSOCIATES INC | |||||
| PO BOX 972670 | DALLAS | TX | 75397 | LOCUM TENENS | $247,647 |
| INTEGRITY HEALTHCARE LOCUMS LLC | |||||
| 7501 VILLAGE SQUARE DRIVE SUITE 20 | CASTLE PINES NORTH | CO | 80108 | LOCUM TENENS | $211,782 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REV | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $26,322,098 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,322,098 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,322,098 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $686 | TotalRevenueColumnAmt |
| Exclusion | $686 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PURCHASE DISCOUNTS | 621110 | $5,136 | $5,136 | |
| BILLING SERVICES | 561000 | $3,344 | $3,344 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,480 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,331,264 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,327,234 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,344 | UnrelatedBusinessRevenueAmt |
| Exclusion | $686 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,400,644 | TotalAmt |
| Program Services | $3,400,644 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,093,089 | TotalAmt |
| Program Services | $22,172,020 | ProgramServicesAmt |
| Management And General | $921,069 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $527,022 | TotalAmt |
| Program Services | $500,115 | ProgramServicesAmt |
| Management And General | $26,907 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,188,563 | TotalAmt |
| Program Services | $2,925,139 | ProgramServicesAmt |
| Management And General | $263,424 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,357,702 | TotalAmt |
| Program Services | $1,279,248 | ProgramServicesAmt |
| Management And General | $78,454 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,349,710 | TotalAmt |
| Program Services | $4,185,308 | ProgramServicesAmt |
| Management And General | $164,402 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,379 | TotalAmt |
| Program Services | $19,379 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,126 | TotalAmt |
| Program Services | $314,431 | ProgramServicesAmt |
| Management And General | $127,695 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,618 | TotalAmt |
| Program Services | $201,420 | ProgramServicesAmt |
| Management And General | $15,198 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,606 | TotalAmt |
| Program Services | $78,820 | ProgramServicesAmt |
| Management And General | $18,786 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,352 | TotalAmt |
| Program Services | $61,055 | ProgramServicesAmt |
| Management And General | $6,297 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,991 | TotalAmt |
| Program Services | $250,991 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,360,072 | $1,361,485 | -$1,413 |
| BAD DEBT EXPENSE | $1,245,019 | $1,245,019 | |
| EDUCATION & REWARDS | $139,712 | $132,995 | $6,717 |
| MANAGED CARE ORG | $2,025 | $2,025 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,837 | TotalAmt |
| Program Services | $274,102 | ProgramServicesAmt |
| Management And General | $7,735 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,049,467 | TotalAmt |
| Program Services | $38,414,196 | ProgramServicesAmt |
| Management And General | $1,635,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,515 | BOYAmt |
| EOY | $1,157,094 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,297,767 | BOYAmt |
| EOY | $785,468 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,426,159 | BOYAmt |
| EOY | $2,874,838 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,090,275 | BOYAmt |
| EOY | $406,368 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538,432 | BOYAmt |
| EOY | $161,400 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,249,938 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $866,718 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,953 | BOYAmt |
| EOY | $383,220 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,305,101 | BOYAmt |
| EOY | $5,768,388 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,964,308 | BOYAmt |
| EOY | $3,183,974 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,866,824 | BOYAmt |
| EOY | $114,828,630 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,831,132 | BOYAmt |
| EOY | $118,012,604 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$98,526,031 | BOYAmt |
| EOY | -$112,244,216 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$98,526,031 | BOYAmt |
| EOY | -$112,244,216 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,305,101 | BOYAmt |
| EOY | $5,768,388 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$13,718,203 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $18 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,476 | OtherCostOrOtherBasisAmt |
| Book Value | $30,476 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,219,462 | OtherCostOrOtherBasisAmt |
| Depreciation | $866,718 | DepreciationAmt |
| Book Value | $352,744 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $383,220 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ADVANCES FROM LIMA MEMORIAL JOINT OPERATING CO. | $113,886,164 |
| PENSION FUND 457B & F | $785,468 |
| DEFERRED TAX LIABILITY | $156,998 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $114,828,630 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HEALTH SYSTEM, LIMA MEMORIAL HOSPITAL, LIMA MEMORIAL PROFESSIONAL CORPORATION, LIMA MEMORIAL HOSPITAL FOUNDATION, AND LIMA MEMORIAL HOSPITAL AUXILIARY ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. ELM TREE FOUNDATION, THE FOR-PROFIT SUBSIDIARY, IS A TAXABLE CORPORATION. ELM TREE FOUNDATION HAD NET OPERATING LOSS CARRYFORWARDS OF $853,131 AND $763,936 ON ITS FILED INCOME TAX RETURNS IN 2017 AND 2016, RESPECTIVELY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HEALTH SYSTEM AND TO RECOGNIZE A TAX LIABILITY 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 OR OTHER APPLICABLE TAXING AUTHORITIES. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIMA MEMORIAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 BELLEFOUNTAINE AVENUE | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 341707570 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Purpose Of Grant | CAPSTONE SPONSORSHIP | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS WERE PAID TO RELATED TAX-EXEMPT ENTITY TO SUPPORT ITS MISSION. THIS IS MONITORED INTERNALLY. THE LIMA MEMORIAL HOSPITAL SYSTEM MONITORS BOTH LIMA MEMORIAL PROFESSIONAL CORPORATION AND LIMA MEMORIAL FOUNDATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KHA H TRAN MD THRU 917 | ||||||||||||||
| VP/CMO/TREASURER (SEE SCH J) | $0 | $242,532 | $0 | $144,167 | $0 | $4,684 | $0 | $68,754 | $0 | $25,232 | $0 | $485,369 | $0 | $54,910 |
| CHERYL WAYMAN PA-C | ||||||||||||||
| SECRETARY (SEE SCH J) | $120,786 | $0 | $17,688 | $0 | $0 | $0 | $4,174 | $0 | $16,977 | $0 | $159,625 | $0 | $0 | $0 |
| G ALLEN BRYANT | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $296,770 | $0 | $36,051 | $0 | $0 | $0 | $8,100 | $0 | $16,977 | $0 | $357,898 | $0 | $0 | $0 |
| JEREMY HEFFNER MD | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $412,923 | $0 | $618,509 | $0 | $0 | $0 | $18,058 | $0 | $23,580 | $0 | $1,073,070 | $0 | $0 | $0 |
| SUSAN KAUFMAN | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $199,296 | $0 | $147,210 | $0 | $0 | $0 | $8,100 | $0 | $24,375 | $0 | $378,981 | $0 | $0 | $0 |
| JENNIFER MAAG | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $134,890 | $0 | $25,201 | $0 | $0 | $0 | $4,978 | $0 | $30,469 | $0 | $195,538 | $0 | $0 | $0 |
| MASROOR ABRO MD | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $452,852 | $0 | $20,000 | $0 | $0 | $0 | $26,100 | $0 | $23,580 | $0 | $522,532 | $0 | $0 | $0 |
| ERIC MILLER DPM | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $199,336 | $0 | $14,704 | $0 | $0 | $0 | $6,471 | $0 | $23,580 | $0 | $244,091 | $0 | $0 | $0 |
| JOHN OEHLER DO | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $165,482 | $0 | $8,713 | $0 | $0 | $0 | $5,237 | $0 | $0 | $0 | $179,432 | $0 | $0 | $0 |
| MELODY STEWART-CYRUS MD | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $170,192 | $0 | $8,500 | $0 | $0 | $0 | $4,980 | $0 | $18,864 | $0 | $202,536 | $0 | $0 | $0 |
| JAMES DOONE MD | ||||||||||||||
| BOARD MEMBER (SEE SCH J) | $183,596 | $0 | $10,203 | $0 | $0 | $0 | $5,877 | $0 | $16,977 | $0 | $216,653 | $0 | $0 | $0 |
| MICHAEL D SWICK | ||||||||||||||
| PRESIDENT/CEO (SEE SCH J) | $0 | $359,360 | $0 | $533,372 | $0 | $10,371 | $0 | $232,478 | $0 | $23,200 | $0 | $1,158,781 | $0 | $293,973 |
| ROBERT E ARMSTRONG JR | ||||||||||||||
| VICE PRESIDENT/COO (SEE SCH J) | $0 | $240,588 | $0 | $240,165 | $0 | $7,116 | $0 | $98,243 | $0 | $25,484 | $0 | $611,596 | $0 | $121,178 |
| JOHN T FISCHBACH | ||||||||||||||
| VP OF FINANCE/CFO (SEE SCH J) | $0 | $209,058 | $0 | $91,217 | $0 | $6,608 | $0 | $92,602 | $0 | $19,373 | $0 | $418,858 | $0 | $0 |
| PIERRE BAMDAD MD | ||||||||||||||
| PHYSICIAN (SEE SCH J) | $685,225 | $0 | $259,945 | $0 | $0 | $0 | $21,600 | $0 | $0 | $0 | $966,770 | $0 | $204,560 | $0 |
| MEHRAN ARABPOUR MD | ||||||||||||||
| PHYSICIAN (SEE SCH J) | $679,432 | $0 | $269,413 | $0 | $0 | $0 | $39,600 | $0 | $23,580 | $0 | $1,012,025 | $0 | $209,028 | $0 |
| PAUL N ANIKE MD | ||||||||||||||
| PHYSICIAN (SEE SCH J) | $747,600 | $0 | $265,198 | $0 | $0 | $0 | $39,600 | $0 | $16,977 | $0 | $1,069,375 | $0 | $209,813 | $0 |
| VENKAT R BATTULA MD | ||||||||||||||
| PHYSICIAN (SEE SCH J) | $674,944 | $0 | $267,610 | $0 | $0 | $0 | $39,600 | $0 | $23,580 | $0 | $1,005,734 | $0 | $202,225 | $0 |
| PAMELA R GARDNER | ||||||||||||||
| PHYSICIAN (SEE SCH J) | $555,803 | $0 | $252,798 | $0 | $0 | $0 | $39,600 | $0 | $8,898 | $0 | $857,099 | $0 | $197,413 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN AN IRC 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN. THIS PLAN IS FUNDED BY THE HOSPITAL AND VESTS WITH SERVICE THEREFORE IS SUBJECT TO RISK OF FORFEITURE. ROBERT E. ARMSTRONG: $55,943 MICHAEL D. SWICK: $190,178 KHA H. TRAN: $27,534 JOHN FISCHBACH: $40,597 THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: MARK RECKER: $45,734 KHA H. TRAN: $9,443 |
| PART I, LINE 3: | RELATED ORGANIZATION, LIMA MEMORIAL JOINT OPERATING COMPANY, DETERMINES THE COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES BY 1)REVIEW AND APPROVAL OF THE COMPENSATION COMMITTEE; 2)UTILIZATION OF AN INDEPENDENT COMPENSATION CONSULTANT; 3)COMPARABLE DATA; AND 4) CONTEMPORANEOUS DOCUMENTATION. |
| ADDITIONAL INFORMATION: | COMPENSATION PRESENTED ON FORM 990, PART VII AND SCHEDULE J RELATED TO THE BOARD MEMBERS ARE FOR SERVICES PERFORMED FOR THE ORGANIZATION OUTSIDE THOSE SERVICES PERFORMED ON THE BOARD. THERE IS NO COMPENSATION PAID FOR BOARD SERVICES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE BOARD REVIEWS AND APPROVES FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH TRUSTEE, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE CURRENTLY NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 169,836. MANAGEMENT AND GENERAL EXPENSES 6,754. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 176,590. LOCUM TENENS FEE: PROGRAM SERVICE EXPENSES 1,029,295. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,029,295. COLLECTION FEES: PROGRAM SERVICE EXPENSES 564,826. MANAGEMENT AND GENERAL EXPENSES 29,034. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 593,860. EQUIPMENT RENTAL FEES: PROGRAM SERVICE EXPENSES 1,760,580. MANAGEMENT AND GENERAL EXPENSES 111,294. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,871,874. WASTE REMOVAL FEES: PROGRAM SERVICE EXPENSES 11,816. MANAGEMENT AND GENERAL EXPENSES 136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,952. LAUNDRY FEES: PROGRAM SERVICE EXPENSES 15,735. MANAGEMENT AND GENERAL EXPENSES 787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,522. CLEANING FEES: PROGRAM SERVICE EXPENSES 69,090. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,090. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 564,130. MANAGEMENT AND GENERAL EXPENSES 16,397. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 580,527. |
| FORM 990, PART XI, LINE 9: | INTERCOMPANY ALLOCATIONS 18. |
| FORM 990, PART XI, LINE 2C EXPLANATION: | THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LIMA MEMORIAL HOSPITAL | |||||||||||
| 1001 BELLEFONTAINE AVENUE | LIMA | OH | 45804 | 344434676 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | LIMA MEMORIAL JOINT OPERATING COMPANY | Yes (1) | |
| LIMA MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 1001 BELLEFONTAINE AVENUE | LIMA | OH | 45804 | 341707570 | SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL | OH | 501(C)(3) | LINE 12B, II | LIMA MEMORIAL JOINT OPERATING COMPANY | Yes (1) | |
| LIMA MEMORIAL HOSPITAL AUXILIARY | |||||||||||
| 1001 BELLEFONTAINE AVENUE | LIMA | OH | 45804 | 341694632 | SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL | OH | 501(C)(3) | LINE 12B, II | LIMA MEMORIAL JOINT OPERATING COMPANY | Yes (1) | |
| LIMA MEMORIAL JOINT OPERATING COMPANY | |||||||||||
| 1001 BELLEFONTAINE AVENUE | LIMA | OH | 45804 | 341883284 | HEALTHCARE | OH | 501(C)(3) | LINE 3 | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LMHS WOMEN'S HEALTH CO-MANAGEMENT COMPANY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 BELLEFONTAINE AVE | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271023520 | EIN |
| Primary Activities | WOMEN'S HEALTH CO-MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELM TREE FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1220 EAST ELM STREET | AddressLine1Txt |
| City | LIMA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341417720 | EIN |
| Primary Activities | RENTAL REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| LIMA MEMORIAL JOINT OPERATING COMPANY | ||
| S | $14,282,825 | EQUITY TRANSFER |
| LIMA MEMORIAL JOINT OPERATING COMPANY | ||
| K | $828,198 | LEASE CONTRACT |
| ELM TREE FOUNDATION | ||
| K | $354,592 | LEASE CONTRACT |