LICKING MEMORIAL HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- LICKING MEMORIAL HOSPITAL (EIN 31-4379519)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-05
- IRS object ID
- 201823099349300867
- 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 | 2018-11-05T08:38:08-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271235638 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCMCPAS & ADVISORS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 S FOURTH ST SUITE 2600 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402023445 | 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 | 314379519 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LICK | BusinessNameControlTxt |
| Phone | 2205644528 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1Txt |
| City | NEWARK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43055 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CYNTHIA L WEBSTER | PersonNm |
| Person Title | V. P. OF FINANCIAL SERVICES | PersonTitleTxt |
| Phone | 2205644528 | PhoneNum |
| Signature | 2018-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT M MORELAND CPA | PreparerPersonNm |
| PTIN | P00418596 | PTIN |
| Phone | 5027491900 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.135.99.226 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-01 | IPDt |
| IP Tm | 16:11:28 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B70BC32EC9ED83654624C5AFBF3DC482DCF46090 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A82644DF81956D47F138AA72EEE61B1B57B02757 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT A MONTAGNESE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1Txt |
| City | NEWARK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43055 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $259,082,396 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1898 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1860 | TotalEmployeeCnt |
| Total Volunteers | 92 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $236,856,565 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $247,367,661 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,101,820 | PYInvestmentIncomeAmt |
| CY Investment Income | $735,322 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,892,938 | PYOtherRevenueAmt |
| CY Other Revenue | $4,165,689 | CYOtherRevenueAmt |
| PY Total Revenue | $241,851,323 | PYTotalRevenueAmt |
| CY Total Revenue | $252,268,672 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,043 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $97,847,781 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $103,674,241 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $98,066,523 | PYOtherExpensesAmt |
| CY Other Expenses | $103,206,868 | CYOtherExpensesAmt |
| PY Total Expenses | $195,915,347 | PYTotalExpensesAmt |
| CY Total Expenses | $206,881,109 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $45,935,976 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $45,387,563 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $172,780,718 | TotalAssetsBOYAmt |
| Total Assets EOY | $166,403,938 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $83,037,973 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $87,330,712 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $89,742,745 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $79,073,226 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | LICKING MEMORIAL HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $175,859,205 | ExpenseAmt |
| Revenue | $249,922,670 | RevenueAmt |
| Desc | LICKING MEMORIAL HOSPITAL (LMH) PROIVDES HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S RACE, CREED, GENDER, DISABILITY, ETHNICITY, AGE, RELIGION, CITIZENSHIP, NATIONAL ORIGIN OR SOURCES OF PAYMENT FOR CARE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF LMH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. FURTHER, WE BELIEVE OUR PURPOSE IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND EDUCATION. THEREFORE, IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE PROVIDE: - FREE CARE AND/OR SUBSIDIZED CARE - CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COSTS - HEALTH ACTIVITIES AND PROGRAMS FREE-OF-CHARGE TO THE COMMUNITY.THE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED AND MEDICALLY UNDERSERVED.LMH SERVED 7,838 INPATIENTS AND 1,020 NEWBORNS FOR A TOTAL OF 30,538 PATIENT DAYS, AND PROVIDED SERVICES TO 312,878 OUTPATIENTS IN 2017.ADDITIONALLY, LMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, BELOW COST IN MANY CASES. TO THE EXTENT REIMBURSEMENT IS BELOW CHARGES, LMH CONSIDERS THESE AMOUNTS TO BE CONTRACTUAL ADJUSTMENTS, WHICH WILL NEVER BE COLLECTED. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS AMOUNTED TO $279,552,000 IN 2017.UNCOMPENSATED CARE IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES LMH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. THE HOSPITAL ROUTINELY PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO ARE UNWILLING OR UNABLE TO PAY THEIR HOSPITAL BILLS. IN 2017, LMH WROTE OFF CHARGES OF APPROXIMATELY $23,977,000 IN BAD DEBTS AND $9,418,000 IN CHARITY CARE. | Desc |
| Total Program Service Expenses | $175,859,205 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1162 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1860 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID CLAYPOOL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2205644528 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1Txt |
| City | NEWARK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43055 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOYCE L MALAINY | ||||||||
| CHAIRMAN | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID E DONEY | ||||||||
| VICE CHAIRMAN | 1.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DEBORAH A KOHMAN | ||||||||
| TREASURER | 1.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LAUREL B KENNEDY | ||||||||
| SECRETARY | 1.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BART M WEILER | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL A NOBLE | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN J MORTELLARO | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| JOCQUELINE H PARRILL | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| SHARAD THAKKAR | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| DAVID L HILE | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| PAUL M THOMPSON | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| JAMES R COOPER | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| MARK MITCHELL | ||||||||
| DIRECTOR | 1.30 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT MONTAGNESE | ||||||||
| PRESIDENT & CEO | 30.00 | Yes (X) | $675,800 | $0 | $54,230 | 10.00 | ||
| CINDY WEBSTER | ||||||||
| VP FINANCIAL SERVICES | 30.00 | Yes (X) | $232,983 | $0 | $20,914 | 10.00 | ||
| VERONICA PATTON | ||||||||
| VP PR & DEVELOPMENT | 13.00 | $195,367 | $0 | $19,404 | 27.00 | Yes (X) | ||
| CRAIG CAIRNS | ||||||||
| VP MEDICAL STAFF AFFAIRS | 40.00 | $297,760 | $0 | $19,669 | Yes (X) | |||
| DEBBIE YOUNG | ||||||||
| VP PATIENT CARE SERVICES | 40.00 | $204,317 | $0 | $14,763 | Yes (X) | |||
| SALLIE ARNETT | ||||||||
| VP INFORMATION SYSTEMS | 40.00 | $203,790 | $0 | $19,742 | Yes (X) | |||
| ANNE PETERSON | ||||||||
| VP HR AND SUPPORT SERVICES | 40.00 | $199,730 | $0 | $29,650 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,009,747 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $178,372 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 57 | 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 |
|---|---|---|---|---|---|
| GE HEALTHCARE IITS | |||||
| 40 IDX DRIVE | SOUTH BURLINGTON | VT | 05403 | EQUIPMENT MAINTENANCE | $1,556,740 |
| ROBERTSON CONSTRUCTION SEVICES | |||||
| 1801 THORNWOOD DR | HEATH | OH | 43056 | CONSTRUCTION | $1,163,108 |
| MCCLAIN DEVELOPMENT INC | |||||
| 29 W LOCUST ST | NEWARK | OH | 43055 | CONSTRUCTION | $1,087,774 |
| CAREFUSION SOLUTIONS LLC | |||||
| 3750 TORREY VIEW COURT | SAN DIEGO | CA | 92130 | DISPENSING SERVICES | $899,112 |
| QUEST DIAGNOSTICS | |||||
| FILE 51048 | LOS ANGELES | CA | 90074 | LAB SERVICES | $897,017 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 48 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $246,676,007 | $246,676,007 |
| HOME HEALTH CARE | 621610 | $691,654 | $691,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $247,367,661 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $343,316 | TotalRevenueColumnAmt |
| Exclusion | $343,316 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,749,429 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,749,429 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,434,828 | SecuritiesAmt |
| Other | $21,473 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,023,991 | SecuritiesAmt |
| Other | $40,304 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $410,837 | SecuritiesAmt |
| Other | -$18,831 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $392,006 | TotalRevenueColumnAmt |
| Exclusion | $392,006 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MISCELLANEOUS | 900099 | $2,332,510 | $2,332,510 | |
| CAFETERIA | 722210 | $1,610,680 | $1,610,680 | |
| VHA FEES & REBATES | 621110 | $222,499 | $222,499 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,165,689 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $252,268,672 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $249,922,670 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,346,002 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $908,783 | TotalAmt |
| Management And General | $908,783 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,499,267 | TotalAmt |
| Program Services | $64,670,822 | ProgramServicesAmt |
| Management And General | $9,828,445 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,811,370 | TotalAmt |
| Program Services | $19,602,805 | ProgramServicesAmt |
| Management And General | $3,208,565 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,454,821 | TotalAmt |
| Program Services | $4,727,251 | ProgramServicesAmt |
| Management And General | $727,570 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,075 | TotalAmt |
| Management And General | $383,075 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $496,139 | TotalAmt |
| Management And General | $496,139 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,967 | TotalAmt |
| Management And General | $45,967 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,066,253 | TotalAmt |
| Program Services | $14,246,924 | ProgramServicesAmt |
| Management And General | $3,819,329 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $563,632 | TotalAmt |
| Program Services | $264,344 | ProgramServicesAmt |
| Management And General | $299,288 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $994,008 | TotalAmt |
| Program Services | $994,008 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,805 | TotalAmt |
| Program Services | $61,218 | ProgramServicesAmt |
| Management And General | $1,587 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,104 | TotalAmt |
| Program Services | $109,104 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,827 | TotalAmt |
| Program Services | $344,160 | ProgramServicesAmt |
| Management And General | $122,667 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,137,152 | TotalAmt |
| Program Services | $8,947,914 | ProgramServicesAmt |
| Management And General | $3,189,238 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,140,827 | TotalAmt |
| Program Services | $1,140,827 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $41,360,739 | $33,909,498 | $7,451,241 |
| BAD DEBT EXPENSE | $23,977,212 | $23,977,212 | |
| EQUIPMENT RENTAL | $3,403,128 | $2,863,118 | $540,010 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,881,109 | TotalAmt |
| Program Services | $175,859,205 | ProgramServicesAmt |
| Management And General | $31,021,904 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,089,717 | BOYAmt |
| EOY | $6,334,071 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,472,995 | BOYAmt |
| EOY | $14,533,035 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,292,980 | BOYAmt |
| EOY | $27,479,450 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,620,943 | BOYAmt |
| EOY | $4,049,828 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,475,910 | BOYAmt |
| EOY | $3,869,823 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $223,522,638 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $138,501,769 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,348,225 | BOYAmt |
| EOY | $85,020,869 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,399,216 | BOYAmt |
| EOY | $10,204,257 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,080,732 | BOYAmt |
| EOY | $14,912,605 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,780,718 | BOYAmt |
| EOY | $166,403,938 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,959,163 | BOYAmt |
| EOY | $27,414,439 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,000,000 | BOYAmt |
| EOY | $25,000,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,078,810 | BOYAmt |
| EOY | $34,916,273 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,037,973 | BOYAmt |
| EOY | $87,330,712 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,742,745 | BOYAmt |
| EOY | $79,073,226 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,742,745 | BOYAmt |
| EOY | $79,073,226 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,780,718 | BOYAmt |
| EOY | $166,403,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $45,387,563 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $733,565 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$56,790,647 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,987 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,987 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LICKING MEMORIAL HOSPITAL PAYS $46,200 IN ANNUAL DUES TO OHIO HOSPITAL ASSOCIATION(OHA). OF THE TOTAL DUES PAID, 4.3% OR $1,987 ARE USED BY OHA TO SUPPORT LOBBYING ACTIVITIES OF THE ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $427,243 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,021 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $429,264 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $426,403 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $840 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $427,243 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $426,393 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $197 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $187 | OtherExpendituresAmt |
| End Year Balance | $426,403 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $429,425 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $188 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,220 | OtherExpendituresAmt |
| End Year Balance | $426,393 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $428,882 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $543 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $429,425 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,802,878 | OtherCostOrOtherBasisAmt |
| Book Value | $1,802,878 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $103,836,940 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,510,830 | DepreciationAmt |
| Book Value | $55,326,110 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,754,222 | OtherCostOrOtherBasisAmt |
| Depreciation | $87,630,420 | DepreciationAmt |
| Book Value | $24,123,802 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,128,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,360,519 | DepreciationAmt |
| Book Value | $3,768,079 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $85,020,869 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| TRUSTEE FUNDED DEFERRED COMPENSATION | $1,480,268 |
| RECEIVABLE FROM RELATED 501(C)(3) | $13,432,337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,912,605 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED PENSION AND RETIREE LIABILITY | $28,935,330 |
| ACCRUED INTEREST PAYABLE | $65,365 |
| ACCRUED MALPRACTICE | $3,824,444 |
| ESTIMATED DUE TO THIRD PARTY SETTLEMENT | $2,091,134 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $34,916,273 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ENDOWMENT FUNDS HELD BY THE LICKING MEMORIAL FOUNDATION IS TO USE THE EARNINGS FOR CAPITAL EQUIPMENT PURCHASES FOR LICKING MEMORIAL HOSPITAL |
| PART X, LINE 2: | THE INTERNAL REVENUE SERVICE HAS RULED THAT THE SYSTEM,HOSPITAL, PROFESSIONAL CORPORATION AND FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GAAP REQUIRES THE SYSTEM TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10023 | PersonsServedCnt |
| Total Community Benefit Expns | $2,910,087 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,910,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 38257 | PersonsServedCnt |
| Total Community Benefit Expns | $41,181,310 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,101,018 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,080,292 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10340 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 48280 | PersonsServedCnt |
| Total Community Benefit Expns | $44,091,397 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,101,018 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,990,379 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11920 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15805 | PersonsServedCnt |
| Total Community Benefit Expns | $2,552,956 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $125,760 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,427,196 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 619 | PersonsServedCnt |
| Total Community Benefit Expns | $421,817 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,450 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $394,367 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,331 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,331 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3062 | PersonsServedCnt |
| Total Community Benefit Expns | $544,550 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $544,550 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 19486 | PersonsServedCnt |
| Total Community Benefit Expns | $3,523,654 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $153,210 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,370,444 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01810 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 67766 | PersonsServedCnt |
| Total Community Benefit Expns | $47,615,051 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,254,228 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,360,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13730 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17 | PersonsServedCnt |
| Total Community Benefit Expns | $48,701 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $48,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 65 | PersonsServedCnt |
| Total Community Benefit Expns | $45,910 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,910 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 200 | PersonsServedCnt |
| Total Community Benefit Expns | $121,504 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $121,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $250 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 40 | PersonsServedCnt |
| Total Community Benefit Expns | $1,660 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1491 | PersonsServedCnt |
| Total Community Benefit Expns | $70,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $70,639 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1813 | PersonsServedCnt |
| Total Community Benefit Expns | $289,114 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $289,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $23,977,212 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $5,922,371 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $37,931,335 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $44,020,227 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,088,892 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1Txt |
| City | NEWARK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43055 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.LMHEALTH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.LMHEALTH.ORG/PDF-FILES/CHNA-2013.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.LMHEALTH.ORG/PDF-FILES/FORMS/00001-04-23.ASPX | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.LMHEALTH.ORG/PDF-FILES/FORMS/UNCOMPENSATED-CARE-PACKET-LMH.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.LMHEALTH.ORG/PDF-FILES/FORMS/FAP-SUMMARY-FLYER.ASPX | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LICKING MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: REPRESENTATIVES FROM LICKING MEMORIAL HOSPITAL PARTICIPATE IN A COLLABORATIVE COMMITTEE WITH THE LICKING COUNTY HEALTH DEPARTMENT KNOWN AS THE LICKING COUNTY COMMUNITY HEALTH IMPROVEMENT COMMITTEE. THIS COMMITTEE WAS CONVENED TO PRIORITIZE PUBLIC HEALTH ISSUES AND TO IDENTIFY RESOURCES TO ADDRESS THEM. THE COMMITTEE MEETS QUARTERLY ON AN ONGOING BASIS, BEGINNING IN APRIL 2010. MEMBERS OF THE COMMITTEE REPRESENT A VARIETY OF LOCAL PUBLIC HEALTH SYSTEM AGENCIES THAT ARE INTERESTED IN IMPROVING THE HEALTH OF LICKING COUNTY RESIDENTS. PARTICIPATING AGENCIES OF THE COMMITTEE INCLUDE, LICKING COUNTY HEALTH DEPARTMENT, LICKING COUNTY BOARD OF HEALTH, LICKING MEMORIAL HEALTH SYSTEMS, LICKING COUNTY UNITED WAY, FAMILY HEALTH SERVICES OF EAST CENTRAL OHIO, COMMUNITY HEALTH CLINIC, AMERICAN RED CROSS OF LICKING COUNTY, OHIO STATE UNIVERSITY EXTENSION - LICKING COUNTY, PATHWAYS OF CENTRAL OHIO, COMMUNITY MENTAL HEALTH AND RECOVERY BOARD, MENTAL HEALTH AMERICA OF LICKING COUNTY, LICKING COUNTY FIRE CHIEFS ASSOCIATION, LICKING COUNTY AGING PROGRAM, GRANVILLE SCHOOL DISTRICT, HOSPICE OF CENTRAL OHIO, CENTER FOR THE VISUALLY IMPAIRED, LICKING COUNTY AREA TRANSPORTATION, DENISON UNIVERSITY, LICKING COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, MANY OF WHICH REPRESENT PERSONS WHO ARE THE MEMBERS OF THE MEDICALLY UNDERSERVED GROUPS AND THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. |
| LICKING MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: THE LICKING COUNTY HEALTH DEPARTMENT BROUGHT TOGETHER THE LICKING COUNTY COMMUNITY HEALTH IMPROVEMENT COMMITTEE, COMPRISED OF REPRESENTATIVES FROM OVER 20 AGENCIES FROM THE PUBLIC HEALTH SYSTEM IN LICKING COUNTY, TO IDENTIFY COMMUNITY NEEDS AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN THAT ADDRESSES THE TOP FOUR PUBLIC HEALTH PRIORITIES IN THE COUNTY. REPRESENTATIVES FROM LICKING MEMORIAL HOSPITAL PARTICIPATED IN THIS COMMITTEE WHICH PROVIDED AN OPPORTUNITY TO BROADEN THE IMPACT OF ITS PROGRAMS. |
| LICKING MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: AFTER COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT, LICKING MEMORIAL HEALTH SYSTEMS PRIORITIZED FIVE NEEDS TO ADDRESS. BELOW ARE EACH OF THOSE NEEDS AND OUR PLAN TO ADDRESS THEM: REDUCE TOBACCO USAGE A - PROVIDE A QUIT FOR YOUR HEALTH PROGRAM THAT PROVIDES COUNSELING AND SMOKING CESSATION SUPPORT, INCLUDING NICOTINE REPLACEMENT THERAPY, TO ALL INTERESTED COMMUNITY MEMBERS FREE OF CHARGE. WE WILL ALSO ADDRESS ANY NEED FOR ADDITIONAL ADVERTISING OF THE QUIT FOR YOUR HEALTH PROGRAM. B - ENCOURAGE EMPLOYERS TO ADOPT SMOKE-FREE WORKPLACE POLICIES AND OFFER INCENTIVES TO THEIR STAFF TO STOP SMOKING. WE WILL CONSIDER DEVELOPMENT OF BUSINESS WELLNESS TOOLKITS THAT COUNTY EMPLOYERS CAN UTILIZE FOR STAFF EDUCATION. C - CONDUCT FOCUS STUDIES WITH YOUTH GROUPS TO GAUGE TOBACCO USAGE HABITS IN THE YOUTH POPULATION AND LEVERAGE THE INFORMATION FOR TOBACCO CESSATION AND PREVENTION EDUCATION. COLLABORATE WITH THE FUTURES IN LICKING COUNTY INITIATIVE ON YOUTH SMOKING AND ALCOHOL EDUCATION. REDUCE OBESITY A - CONTINUE OUR ACTIVE FIT YOUTH WELLNESS PROGRAM PROMOTING HEALTHY LIFESTYLES, EXERCISE, AND DIET CHOICES AMONG THE YOUTH OF LICKING COUNTY, IN CONJUNCTION WITH OTHER COMMUNITY HEALTH LEADERS. B - PROMOTE MEMBERSHIP IN THE LICKING COUNTY WELLNESS COALITION. C - INCREASE AWARENESS AND PROMOTE DIABETES EDUCATION WITHIN THE COMMUNITY, INCLUDING INTENSIVE ONE-ON-ONE EDUCATION WITH LICENSED DIABETES EDUCATORS AND COMPLIMENTARY COMMUNITY EDUCATION PROGRAMMING. D - PROVIDE FREE DIABETES SCREENINGS AT COMMUNITY EVENTS. E - PROVIDE COMMUNITY EDUCATION PROGRAMMING FOCUSED ON HEALTHIER FOOD CHOICES, EXERCISE AND GOOD LIFESTYLE HABITS. DECREASE BREAST CANCER MORTALITY A - PROVIDE ROUTINE COMMUNITY EDUCATION ON THE IDENTIFICATION AND TREATMENT OF BREAST CANCER, FOCUSING ON SELF-EXAMINATION, PATHOLOGY AND EARLY DETECTION. PROGRAMS WILL INCLUDE FREE BREAST CANCER EXAMS FOR ATTENDEES. B - PROVIDE MAMMOGRAM DAYS IN WHICH UNDERSERVED OR UNINSURED COMMUNITY MEMBERS MAY RECEIVE MAMMOGRAMS FREE OF CHARGE. DECREASE COLON CANCER MORTALITY A - INCREASE COLON CANCER SCREENINGS THROUGH PRIMARY CARE PRACTICES/OFFICES. B - ADD ADDITIONAL GASTROENTEROLOGIST PHYSICIAN COVERAGE TO INCREASE PATIENT ACCESS TO AVAILABLE APPOINTMENTS AND INCREASE OPPORTUNITIES FOR COLON CANCER SCREENINGS. C - EVALUATE THE USE OF SEPTIN 9 BIOMARKERS FOR USE IN PATIENTS WHO ARE AVERSE TO COLONOSCOPY. D - PROVIDE FREE COMMUNITY EDUCATION PROGRAMMING WITH FOCUS ON REGULAR SCREENING, SYMPTOMS/PATHOLOGY AND EARLY DIAGNOSIS. MOBILIZE PARTNERSHIPS AND DEVELOP STRATEGIES TO ADDRESS COMMUNITY HEALTH OBJECTIVES WITHIN THE COMMUNITY HEALTH IMPROVEMENT COMMITTEE A - EVALUATE EXISTING PROGRAMS AND DEVELOP NEW INITIATIVES DESIGNED TO REDUCE CANCER RISKS, PROVIDE EARLY DETECTION, ENHANCE TREATMENT, AND IMPROVE SURVIVOR QUALITY OF LIFE. KEY MEMBERS OF LICKING MEMORIAL HEALTH SYSTEMS WILL SERVE AS ADVISORS OR ON THIS COMMITTEE. B - FOCUS ON IMPROVING COLONOSCOPY RATES WITHIN THE COUNTY. C - PROVIDE EDUCATIONAL SESSIONS ON PRESCRIPTION DRUG ABUSE IN LICKING COUNTY. D - HOLD PRESCRIPTION DRUG "TAKE BACK" EVENTS. |
| LICKING MEMORIAL HOSPITAL | PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE APPLICATION HAS BEEN TRANSLATED INTO THE REQUIRED LANGUAGES. WE ARE IN THE PROCESS OF HAVING OUR POLICY AND PLAIN LANGUAGE SUMMARY TRANSLATED. |
| LICKING MEMORIAL HOSPITAL | PART V, SECTION B, LINE 20E: LICKING MEMORIAL HOSPITAL PROVIDES WRITTEN NOTICE ABOUT EXTRAORDINARY COLLECTIONS ACTIVITIES AND INCLUDES THE FINANCIAL ASSISTANCE PROGRAM APPLICATION WITH THE WRITTEN NOTICE. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE COMMUNITY BENEFIT REPORT IS PREPARED BY LICKING MEMORIAL HEALTH SYSTEMS AND INCLUDES LICKING MEMORIAL HEALTH SYSTEMS, LICKING MEMORIAL HOSPITAL, LICKING MEMORIAL PROFESSIONAL CORPORATION, AND LICKING MEMORIAL HEALTH FOUNDATION. |
| PART I, LINE 7: | THE ORGANIZATION USED THE CBISA SOFTWARE TO DETERMINE THE COST ACCOUNTING METHODOLOGY. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 23,977,212. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | IT IS IMPORTANT TO NOTE THAT ALL ACTIVITIES ASSOCIATED WITH LICKING MEMORIAL HEALTH SYSTEMS (LMHS) REFLECT AND FURTHER THE MISSION OF IMPROVING THE HEALTH OF THE COMMUNITY. WE DEFINE THE HEALTH OF THE COMMUNITY IN A BROAD SENSE IN ORDER TO INCLUDE ACTIVITIES THAT ARE NOT NECESSARILY HEALTH AND MEDICALLY RELATED, BUT WHICH ARE CRITICAL TO SUSTAINING A HEALTHY COMMUNITY, SUCH AS STRONG SCHOOL SYSTEMS, YOUTH AND SENIOR PROGRAMS AND THE ARTS. TO PROMOTE HEALTH EDUCATION TO THE COMMUNITY, WE PUBLISH THE COMMUNITY CONNECTION, A BI-MONTHLY MAGAZINE MAILED TO APPROXIMATELY 44,000 HOUSEHOLDS THAT HIGHLIGHTS ALL OF THE COMMUNITY BUILDING ACTIVITIES THROUGHOUT THE YEAR. ADVOCACY FOR THE HEALTH OF THE COMMUNITY IS NOT ONLY EVIDENT THROUGH THE COMMUNITY CONNECTION PUBLICATION, BUT THROUGH VARIOUS HEALTH-RELATED PROGRAMS, EVENTS AND CLASSES - INCLUDING HEALTH GOAL PROGRAMS, HEALTH FAIRS, SCHOOL PRESENTATIONS, HEALTH IMPROVEMENT SCREENINGS AND WORKSHOPS - THAT AID IN OVERALL HEALTH EDUCATION OF THE COMMUNITY. LMHS REGULARLY WELCOMES COMMUNITY MEMBERS TO ATTEND FREE EDUCATIONAL PROGRAMS AT THE HOSPITAL. PROGRAMS ARE DESIGNED TO EMPOWER COMMUNITY MEMBERS WITH THE INFORMATION NEEDED TO IMPROVE THEIR HEALTH AND THE HEALTH OF THEIR FAMILIES. TO FURTHER IMPROVE THE HEALTH OF THE COMMUNITY, LMHS SUSTAINS ECONOMIC DEVELOPMENT BY EXISTING AS ONE OF THE COUNTY'S LARGEST EMPLOYERS. |
| PART III, LINE 2: | THE ORGANIZATION USES THE CBISA SOFTWARE FOR COSTING METHODOLOGY, A SOFTWARE PROGRAM ENDORSED BY BOTH THE OHIO HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. |
| PART III, LINE 3: | THE ORGANIZATION EMPLOYED A PATIENT SCORING METHODOLOGY WHICH COMBINES NUMEROUS FINANCIAL INDICATORS TO ARRIVE AT A NUMERIC CREDIT SCORE. THIS SCORE INCLUDES THE PATIENT'S ABILITY TO PAY BASED ON THE ESTIMATED HOUSEHOLD INCOME AS WELL AS THE PROBABILITY OF PAYMENT BEING MADE BASED ON HISTORICAL CREDIT INFORMATION. |
| PART III, LINE 4: | SEE PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE MEDICARE SHORTFALL REPRESENTS AN UNDERPAYMENT OF OUR COSTS FOR PROVIDING SERVICES TO TRADITIONAL MEDICARE PATIENTS, OUR LARGEST PAYER. SINCE THIS SHORTFALL RELATES TO SUCH A LARGE PORTION OF OUR COMMUNITY, WE FEEL THE COST SHORTFALL IS A RELEVANT FACTOR WHEN CONSIDERING COMMUNITY BENEFIT.WE USE THE MEDICARE COST REPORT FOR COSTING METHODOLOGY FOR CALCULATING THE MEDICARE SHORTFALL.IN ADDITION TO TRADITIONAL MEDICARE SHORTFALLS, THE HOSPITAL PROVIDES SERVICES TO MEDICARE HMO PATIENTS AT OR BELOW COST AS A FURTHER BENEFIT TO OUR COMMUNITY. BY ADOPTING THE SAME METHODOLOGY FOR TRADITIONAL MEDICARE ABOVE, THE MEDICARE HMO SHORTFALL AMOUNTED TO $6,466,405.ALONG THAT SAME LINE, LICKING MEMORIAL PROFESSIONAL CORPORATION, ANOTHER LMHS SUBSIDIARY, PROVIDED SERVICES TO MEDICARE (TRADITIONAL AND HMO) BENEFICIARIES AT A COST SHORTFALL OF $10,393,543 USING A CBISA SOFTWARE COSTING METHOD. THE CBISA SOFTWARE IS ENDORSED BY BOTH THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION AS A COSTING METHOD UTILIZED FOR DETERMINING SHORTFALLS. |
| PART III, LINE 9B: | THE PATIENT ACCOUNTING DEPARTMENT IS RESPONSIBLE FOR THE COLLECTION OF PATIENTS' ACCOUNTS. THE OBJECTIVE OF THE DEPARTMENT IS TO COLLECT ACCOUNTS DUE THE HOSPITAL WHILE MAINTAINING POSITIVE GUEST RELATIONS.- PRIOR TO OR UPON ADMISSION, PATIENT INFORMATION IS OBTAINED BY THE REGISTRATION DEPARTMENT. THIS INFORMATION IS FORWARDED TO THE PATIENT ACCOUNT REPRESENTATIVE FOR MEDASSIST, INC. UPON ADMISSION.- WHENEVER POSSIBLE, SELF-PAY INPATIENTS ARE INTERVIEWED BY THE PATIENT ACCOUNT REPRESENTATIVE PRIOR TO DISCHARGE. PATIENTS WILL BE SCREENED FOR POSSIBLE STATE OR FEDERAL PROGRAM ELIGIBILITY, SUCH AS MEDICAID OR SOCIAL SECURITY DISABILITY. IF PATIENTS DO NOT MEET THE CRITERIA FOR THESE PROGRAMS, THEY WILL BE INFORMED OF THE UNCOMPENSATED CARE PROGRAMS AVAILABLE.- ALL STATEMENTS CONTAIN INFORMATION AND GUIDELINES FOR UNCOMPENSATED CARE. |
| PART VI, LINE 2: | WITH A MISSION OF IMPROVING THE HEALTH OF THE COMMUNITY, LMHS CONTINUOUSLY MONITORS AND ASSESSES THE NEEDS OF OUR COMMUNITY IN A VARIETY OF METHODS. OUR ENTIRE LEADERSHIP TEAM IS VERY ACTIVE IN THE COMMUNITY SERVING ON LOCAL NOT-FOR-PROFIT BOARDS AND IN SERVICE CLUBS SUCH AS ROTARY AND KIWANIS. AS ONE OF THE LARGEST EMPLOYERS IN LICKING COUNTY, THE COMMUNITY LOOKS TO OUR MANAGEMENT STAFF FOR SUPPORT AND INVOLVEMENT IN MOST, IF NOT ALL, MAJOR INITIATIVES. THIS COMMUNITY INVOLVEMENT PROVIDES THE OPPORTUNITY TO COLLECT INFORMATION REGARDING THE NEEDS OF THE DIFFERENT ORGANIZATIONS. SENIOR MANAGEMENT IS VERY RESPONSIVE IN PROVIDING ASSISTANCE WHERE NEEDED AS THE INFORMATION BECOMES AVAILABLE.THE BOARDS OF DIRECTORS FOR LICKING MEMORIAL HOSPITAL (LMH) AND THE HEALTH SYSTEMS ARE VERY INTERESTED AND ACTIVELY ENGAGED IN THE COMMUNITY; THEREFORE, THEY ARE A GREAT RESOURCE IN MAKING ADMINISTRATION AWARE OF NEEDS. IN ADDITION, THE BOARD RECEIVES A MONTHLY REPORT AT EACH BOARD MEETING, HIGHLIGHTING ALL OF THE COMMUNITY ACTIVITIES SUPPORTED BY THE HOSPITAL INCLUDING DONATIONS MADE DURING THAT MONTH, HEALTH FAIRS, HEALTH SCREENINGS, MANAGEMENT AND PHYSICIAN PRESENTATIONS IN THE COMMUNITY, ETC. PROVIDING ALL OF THIS INFORMATION TO THE BOARD ALLOWS THEM TO BE SUPPORTIVE AS ADMINISTRATION RECOMMENDS IMPLEMENTING NEW SERVICES OR ENHANCING EXISTING OFFERINGS.ORGANIZED UNDER THE HOSPITAL CORPORATION IS A 75-MEMBER DEVELOPMENT COUNCIL WHOSE PURPOSE IS TO EDUCATE THE COMMUNITY ABOUT THE HOSPITAL AND TO COMPLETE FUNDRAISING ACTIVITIES IN SUPPORT OF THE ORGANIZATION. THE MEMBERS OF THE LMH DEVELOPMENT COUNCIL ARE COMMUNITY LEADERS REPRESENTING ALL AREAS OF BUSINESS, INDUSTRY AND EDUCATION IN THE COMMUNITY. THESE ARE THE INDIVIDUALS WHO HAVE THEIR "FINGERS ON THE PULSE" OF THE COMMUNITY, AND ONE OF THEIR RESPONSIBILITIES AS AMBASSADORS IS TO MAKE ADMINISTRATION AWARE OF NEEDS IN THE COMMUNITY, ESPECIALLY PERTAINING TO HEALTH CARE. AMONG MANY OUTREACH ACTIVITIES OF THE DEVELOPMENT COUNCIL, PROBABLY THE MOST PRODUCTIVE ARE THE COMMUNITY LEADER ROUNDTABLES THAT ARE SPONSORED BY THIS GROUP. THESE ARE LUNCHEONS SCHEDULED MONTHLY WITH THE LMHS PRESIDENT & CEO. DEVELOPMENT COUNCIL MEMBERS SERVE AS HOSTS, AND THEY INVITE 20-25 PEOPLE WITH SIMILAR INTEREST. SOME EXAMPLES OF RECENT ROUNDTABLE GROUPS INCLUDE SCHOOL NURSES, SCHOOL ATHLETIC DIRECTORS AND COACHES, REALTORS, FIRE CHIEFS, LOCAL POLITICIANS, ETC. THESE FORUMS ARE ALWAYS VERY INFORMATIVE FOR BOTH ATTENDEES AND THE ADMINISTRATION AS INFORMATION IS SHARED ABOUT THE HOSPITAL AND THEN FEEDBACK IS RECEIVED FROM THE COMMUNITY LEADERS WHO ARE PRESENT. MANY TIMES, IDEAS FOR HOSPITAL INITIATIVES COME FROM THESE EVENTS.ANOTHER ACTIVITY OF THE DEVELOPMENT COUNCIL IS A QUARTERLY CORPORATE BREAKFAST. THESE EDUCATIONAL SESSIONS NORMALLY DRAW 100-125 ATTENDEES FOR BREAKFAST AND PROVIDE AN OPPORTUNITY TO EDUCATE COMMUNITY LEADERSHIP REGARDING HOSPITAL ACTIVITIES AND PROVIDE AN OPEN FORUM TO DISCUSS HEALTH CARE AND OTHER NEEDS WITHIN THE COMMUNITY. SPEAKERS AT THESE EVENTS HAVE INCLUDED PHYSICIANS SPEAKING ABOUT OPHTHALMOLOGY, UROLOGICAL SERVICES, HEART ATTACK AWARENESS, REHABILITATION SERVICES AND OTOLARYNGOLOGY. IN ADDITION, NEW PHYSICIANS ARE INTRODUCED TO THE COMMUNITY LEADERS IN ATTENDANCE AT THE CORPORATE BREAKFAST EVENTS.THE LMHS WEBSITE PROVIDES DETAILED INFORMATION ON THE VARIOUS PROGRAMS AVAILABLE AND PROVIDES A MECHANISM FOR COMMUNITY FEEDBACK. ALL REQUESTS COMING THROUGH THE WEBSITE RECEIVE CAREFUL CONSIDERATION AND A DETAILED RESPONSE. LMHS ALSO ENGAGES THE SOCIAL MEDIA AUDIENCE THROUGH AN ACTIVE FACEBOOK PAGE, AND EMPLOYS A DEDICATED PUBLIC RELATIONS STAFF MEMBER TO ENSURE TIMELY INFORMATION CONCERNING ALL UPCOMING EVENTS, PROGRAMS AND INITIATIVES.AN AFFILIATED PHYSICIAN GROUP, KNOWN AS LICKING MEMORIAL PROFESSIONAL CORPORATION, PROVIDES PHYSICIAN INPUT REGARDING THE NEEDS THEY IDENTIFY IN THEIR DAILY PRACTICE AND COMMUNITY INVOLVEMENT. THESE OBSERVATIONS ARE DISCUSSED WITH ADMINISTRATION FOR DEVELOPMENT OF PROGRAMS AND SERVICES TO ADDRESS SUCH NEEDS. |
| PART VI, LINE 3: | LMHS PROVIDES ASSISTANCE TO THOSE WHO ARE ABOVE THE FEDERAL POVERTY LEVEL BY OFFERING DISCOUNTED CARE BASED UPON A SLIDING SCALE UP TO 250% OF THE FEDERAL POVERTY LEVEL. IN ADDITION, THE ORGANIZATION PROVIDES FREE OR DISCOUNTED CARE FOR THOSE WHO ARE CONSIDERED MEDICALLY INDIGENT. IN 2017, LMHS PROVIDED $37.1 MILLION OF UNCOMPENSATED CARE AT STANDARD CHARGES, INCLUDING $10.4 MILLION OF CHARITY CARE.HOWEVER, LMHS PROVIDES CARE TO THE ENTIRE COMMUNITY, REGARDLESS OF INCOME LEVELS. THAT MESSAGE IS SHARED WITH THE COMMUNITY IN A VARIETY OF WAYS. THE HEALTH SYSTEMS' WEBSITE PROVIDES INFORMATION ON ASSISTANCE FOR PAYING HOSPITAL BILLS THROUGH THE HOSPITAL CARE ASSURANCE PROGRAM/ COMMUNITY ASSISTANCE PROGRAM. THIS IS ALSO COMMUNICATED THROUGH BROCHURES AND APPLICATIONS WHICH HIGHLIGHT THE INCOME LEVEL-BASED NEEDS FOR THE PATIENT. IN ADDITION, THE BILLING STATEMENT SENT TO THE PATIENT OR GUARANTOR PROVIDES INSTRUCTIONS FOR ACCESSING CHARITY CARE. THIS INFORMATION ALSO CAN BE ACCESSED THROUGH THE BILLING OFFICE. FURTHERMORE, THE HEALTH SYSTEMS CONTRACTS WITH AN ELIGIBILITY COMPANY TO SCREEN AND IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR ASSISTANCE, AND EMPLOYS USE OF EARLY-OUT AGENCIES TO PERFORM SELF-PAY BILLING SERVICES. THESE AGENCIES ROUTINELY IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR ASSISTANCE AND PROVIDE APPLICATIONS FOR COMPLETION. THE LMH DEVELOPMENT COUNCIL HAS BEEN EDUCATED ABOUT OUR COMMITMENT TO PROVIDE CARE FOR THE ENTIRE COMMUNITY - THAT MESSAGE IS SHARED IN THE COMMUNITY THROUGH THEIR GRASS ROOTS EFFORTS. |
| PART VI, LINE 4: | LICKING MEMORIAL HOSPITAL IS LOCATED IN NEWARK, OHIO THIRTY MILES EAST OF COLUMBUS. THE CITY OF NEWARK HAS A POPULATION OF 49,423 PEOPLE WITH A MEDIAN INCOME OF APPROXIMATELY $39,000. THE HOSPITAL SERVES THE COMMUNITY OF NEWARK AND LICKING COUNTY. LICKING COUNTY HAS A POPULATION OF APPROXIMATELY 173,000 (PER US CENSUS BUREAU), A PER CAPITA INCOME OF APPROXIMATELY $28,000 AND AN AVERAGE UNEMPLOYMENT RATE OF 4.1%. |
| PART VI, LINE 5: | THROUGH THE MISSION OF IMPROVING THE HEALTH OF THE COMMUNITY, LMHS PROMOTES HEALTH EDUCATION AND WELLNESS IN A VARIETY OF WAYS. LMHS PROVIDES SERVICES, WHICH INCLUDE PARTICIPATION IN MANY COMMUNITY HEALTH FAIRS THROUGHOUT THE COUNTY TO ENCOURAGE AND ADVANCE HEALTHCARE EDUCATION IN AREA SCHOOLS, CHURCHES, AND BUSINESSES; PROVIDED MANY FREE CLASSES REGARDING TOPICS SUCH AS CHILDBIRTH, INFANT AND CHILD CPR, BREASTFEEDING, SIBLING PREPARATION, DIABETES, NEWBORN BASICS, AND TOBACCO CESSATION; PROVIDED SUPPORT GROUPS FOR VICTIMS AND FAMILIES OF CANCER, DIABETES, CHEMICAL DEPENDENCY, AND HEART DISEASE; PROVIDED ASSISTANCE TO EDUCATORS THROUGH COALITIONS WITH STUDENT NURSES, OCCUPATIONAL THERAPY, AND PHYSICAL THERAPY INTERNS; PROVIDED SPEAKERS AT SCHOOLS, BUSINESSES, AND VARIOUS ORGANIZATIONS ON TOPICS SUCH AS TOBACCO CESSATION, LEADING AN ACTIVE AND HEALTHY LIFESTYLE, AND DIABETES EDUCATION. THE SCHEDULE IS FOUND ONLINE OR PRINTED THROUGH OUR BI-MONTHLY COMMUNITY CONNECTION PUBLICATION FOR THE COMMUNITY TO ACKNOWLEDGE.LMHS ALSO PROMOTES HEALTH AND WELLNESS TO THE COMMUNITY THROUGH A VARIETY OF INITIATIVES. IN 2012, THE HEALTH SYSTEMS CREATED THE ACTIVEFIT YOUTH WELLNESS PROGRAM, TARGETING YOUTH AGES 6-12. THE PROGRAM OFFERS A FREE ONLINE GOAL-ORIENTED WELLNESS ACTIVITY PLAN WITH INCENTIVES FOR THOSE WHO COMPLETE THEIR GOALS. THE PROGRAM ALSO FEATURES UNIQUE COMMUNITY EVENTS TO HELP THE PARTICIPANTS STAY ACTIVE AND LEARN HOW TO BETTER CARE FOR THEIR PERSONAL HEALTH. THE PROGRAM HAS BEEN PROMOTED DIRECTLY TO THE YOUTH WITH SCHOOL ASSEMBLY PRESENTATIONS AND THROUGH AN AGGRESSIVE ADVERTISING AND MARKETING CAMPAIGN TO THE COMMUNITY. FOR THE PAST TWO YEARS, LMHS INCORPORATED ACTIVEFIT WITHIN 22 ELEMENTARY SCHOOLS WITH A PROGRAM TO INCENTIVIZE SCHOOLS TO PROMOTE, INITIATE REGISTRATION AND ENCOURAGE THE YOUTH TO ACHIEVE THEIR GOALS. IN 2016, LMHS BEGAN A SIMILAR PROGRAM - ACTIVESENIOR - TO ADULTS, AGES 60 AND UP. CREATED IN CONJUNCTION WITH CLINICAL STAFF AND PHYSICIANS, THE PROGRAM AIMS TO PROVIDE WELL-BEING FOR SENIORS THROUGH A YEAR-LONG GOAL PROGRAM FEATURING FOUR KEY HEALTH AREAS OF FOCUS - PHYSICAL, NUTRITIONAL, MENTAL AND SOCIAL. THE PROGRAM ALSO OFFERS GOAL INCENTIVES AND CREATIVE COMMUNITY ACTIVITIES GEARED TOWARD THE SENIOR DEMOGRAPHIC.LMHS ALSO EMPHASIZES THE NEED FOR EXCELLENT PERSONAL HEALTH TO A VARIETY OF DEMOGRAPHICS THROUGH SPECIAL EVENTS. FOR EXAMPLE, LMHS INVITES COMMUNITY MEMBERS EACH YEAR TO A RED DRESS GALA EVENT FEATURING SPEAKER PRESENTATIONS, DEMONSTRATIONS, HEALTH SCREENINGS AND HEART-HEALTHY FOODS. EACH SUMMER, LMHS OFFERS THE HEART TO PLAY PROGRAM TO LICKING COUNTY JUNIOR AND HIGH SCHOOL STUDENTS. THE PROGRAM FEATURES HEALTH REVIEW EVENTS THROUGHOUT THE EARLY SUMMER MONTHS WITH AN EKG HEART SCREENING, IN ADDITION TO HEALTH AND CONCUSSION SCREENINGS. OTHER MAJOR HEALTH-RELATED ACTIVITIES INCLUDE FAMILY MOVIE NIGHT EVENTS, PATIENT REUNIONS, YOUTH CAMPS, 5K AND WALK EVENT, AND A BABY EXPO. |
| PART VI, LINE 6: | LICKING MEMORIAL HEALTH SYSTEMS IS A NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF OHIO TO PROVIDE AND PROMOTE HEALTH CARE SERVICES IN CENTRAL OHIO.LMHS IS THE PARENT ORGANIZATION AND SOLE CORPORATE MEMBER OF LICKING MEMORIAL HOSPITAL (LMH), LICKING MEMORIAL HEALTH FOUNDATION (LMHF), AND LICKING MEMORIAL PROFESSIONAL CORPORATION (LMPC).LMPC EMPLOYS A STAFF OF PHYSICIANS AND SUPPORT PERSONNEL TO FURTHER THE HEALTH SYSTEMS CHARITABLE PURPOSE. LMPC HAS A SOLE PHYSICIAN SHAREHOLDER, WHO, UNDER A SHARED CONTROL AGREEMENT, ASSIGNED THE VOTING RIGHTS OF THE STOCK TO LMHS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT MONTAGNESE | ||||||||||||||
| PRESIDENT & CEO | $592,738 | $0 | $80,689 | $0 | $2,373 | $0 | $28,223 | $0 | $26,007 | $0 | $730,030 | $0 | $0 | $0 |
| CINDY WEBSTER | ||||||||||||||
| VP FINANCIAL SERVICES | $232,294 | $0 | $689 | $0 | $0 | $0 | $7,841 | $0 | $13,073 | $0 | $253,897 | $0 | $0 | $0 |
| VERONICA PATTON | ||||||||||||||
| VP PR & DEVELOPMENT | $194,685 | $0 | $682 | $0 | $0 | $0 | $6,575 | $0 | $12,829 | $0 | $214,771 | $0 | $0 | $0 |
| CRAIG CAIRNS | ||||||||||||||
| VP MEDICAL STAFF AFFAIRS | $297,071 | $0 | $689 | $0 | $0 | $0 | $10,021 | $0 | $9,648 | $0 | $317,429 | $0 | $0 | $0 |
| DEBBIE YOUNG | ||||||||||||||
| VP PATIENT CARE SERVICES | $203,636 | $0 | $681 | $0 | $0 | $0 | $6,876 | $0 | $7,887 | $0 | $219,080 | $0 | $0 | $0 |
| SALLIE ARNETT | ||||||||||||||
| VP INFORMATION SYSTEMS | $203,108 | $0 | $682 | $0 | $0 | $0 | $6,858 | $0 | $12,884 | $0 | $223,532 | $0 | $0 | $0 |
| ANNE PETERSON | ||||||||||||||
| VP HR AND SUPPORT SERVICES | $199,048 | $0 | $682 | $0 | $0 | $0 | $6,722 | $0 | $22,928 | $0 | $229,380 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | ROBERT MONTAGNESE, PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). A CONTRIBUTION WAS MADE TO THE PLAN ON HIS BEHALF FOR THE 2017 YEAR IN THE AMOUNT OF $5,560. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF THE RETURN IS REVIEWED FIRST BY INTERNAL MANAGEMENT. AFTER INTERNAL MANAGEMENT HAS REVIEWED THE RETURN AND ANY CHANGES ARE MADE A DRAFT IS MADE AVAILABLE FOR REVIEW AND PRESENTATION TO THE BOARD. ONCE THE COMMENTS FROM THE BOARD ARE REVIEWED THE FINAL RETURN IS PREPARED AND SIGNED BY THE VICE PRESIDENT OF FINANCIAL SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST STATEMENT ONCE A YEAR. THE ORGANIZATION DOES NOT PERMIT BOARD MEMBERS TO HAVE A CONFLICT OF INTEREST. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE ASKED TO RESIGN FROM THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION HAS AN INDEPENDENT COMPENSATION COMMITTEE THAT DETERMINES THE COMPENSATION FOR THE CEO THAT IS THEN APPROVED BY THE BOARD. THE CEO DETERMINES THE COMPENSATION FOR THE OTHER OFFICERS BASED UPON INDEPENDENT SALARY SURVEYS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION LIABILITY -712,689. CHANGE IN RETIREE BENEFIT PLAN -1,298,519. NET ASSET TRANSFERS WITH RELATED 501(C)(3) -54,779,439. |
| FORM 990, PAGE 12, PART XII LINE 2C: | THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS OF THE INDEPENDENT AUDITOR. LICKING MEMORIAL HOSPITAL CONTINUES TO BE AUDITED AS PART OF THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED GROUP. LICKING MEMORIAL HOSPITAL IS INCLUDED IN THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS A FINANCE COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. |
| COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP | MONETARY INPUTS/OUTPUTS TITLE / DEPARTMENT EXPENSES OFFSETS BENEFIT PERSONS 12 LEAD EKG PROJECT CARDIOLOGY (1712) 4,331 0 4,331 UNKNOWN 20TH CENTURY CLUB CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN 20TH CENTURY CLUB IN KIND DONATIONS DEVELOPMENT (1955) 1,288 0 1,288 UNKNOWN ACTION OHIO CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN ACTIVE FIT PRESENTATIONS COMMUNITY OUTREACH (1956)1,673 0 1,673 1,364 ACTIVE FIT YOUTH WELLNESS EVENTS COMMUNITY OUTREACH (1956)47,019 0 47,019 704 ACTIVE SENIOR PRESENTATIONS COMMUNITY OUTREACH (1956)1,566 0 1,566 399 ACTIVE SENIOR WELLNESS EVENTS COMMUNITY OUTREACH (1956)59,820 0 59,820 556 ADVANCE CARE PLANNING COMMUNITY OUTREACH (1956)2,750 0 2,750 508 ADVENTURES IN PLANT BASED EATING PROCESS IMPROVEMENT (1945)1,141 0 1,141 58 ALL STAR FOOTBALL GAME TEAM PHYSICIAN FAMILY PRACTICE DOWNTOWN NEWARK (7442)440 0 440 UNKNOWN AMERICAN CANCER SOCIETY CASH DONATIONS DEVELOPMENT (1955) 3,500 0 3,500 UNKNOWN AMERICAN CHILDHOOD CANCER ORGANIZATION CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN AMERICAN HEART ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 15,600 0 15,600 UNKNOWN AMERICAN HEART ASSOCIATION IN KIND DONATIONS DEVELOPMENT (1955) 1,983 0 1,983 75 AMERICAN HERITAGE GIRLS IN KIND DONATIONS DEVELOPMENT (1955) 175 0 175 UNKNOWN AMERICAN RED CROSS IN KIND DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN AMERICAN RED CROSS OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN ASK THE DOC AT SHEPHERD HILL OP CHEMICAL DEPENDENCY (1692)2,568 0 2,568 342 AUTOMATED EXTERNAL DEFIBRILLATORS DEVELOPMENT (1955) 59,386 0 59,386 UNKNOWN BABY EXPO DEVELOPMENT (1955) 12,382 0 12,382 325 BE WISE, IMMUNIZE PEDIATRICS (7460) 9,786 0 9,786 155 BEHAVIORAL HEALTH CARE PARTNERS CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN BEHAVIORAL HEALTH CARE PARTNERS IN KIND DONATIONS DEVELOPMENT (1955) 19,922 0 19,922 UNKNOWN BIG BROTHERS/BIG SISTERS CASH DONATIONS DEVELOPMENT (1955) 8,100 0 8,100 UNKNOWN BIG BROTHERS/BIG SISTERS IN KIND DONATIONS DEVELOPMENT (1955) 6,969 0 6,969 UNKNOWN BIG BROTHERS/BIG SISTERS HOLIDAY HELP PROGRAM DEVELOPMENT (1955) 3,750 0 3,750 UNKNOWN BLOOMBERG EYE CENTER SPEAKER COMMUNITY OUTREACH (1956) 150 0 150 14 BOY SCOUTS OF AMERICA CAMP FALLING ROCK IN KIND DONATION DEVELOPMENT (1955) 213 0 213 UNKNOWN BOY SCOUTS OF AMERICA SIMON KENTON COUNCIL CASH DONATIONS DEVELOPMENT (1955) 26,000 0 26,000 UNKNOWN BOY SCOUTS OF AMERICA SIMON KENTON COUNCIL IN KIND DONATIONS DEVELOPMENT (1955) 111 0 111 UNKNOWN BREAST CA AWARENESS DAY FREE MAMMOGRAMS RADIOLOGY (1721) 15,704 0 15,704 40 BREASTFEEDING BASICS MATERNAL CHILD (1646) 9,019 0 9,019 513 BREASTFEEDING PROMOTION & SUPPORT PROGRAM MATERNAL CHILD (1646) 45,942 0 45,942 268 C TEC CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN C TEC IN KIND DONATIONS DEVELOPMENT (1955) 800 0 800 UNKNOWN C TEC SPEAKER COMMUNITY OUTREACH (1956) 172 0 172 270 C TEC HIGH SCHOOL MEDICAL ASSISTANT PROGRAM COMMUNITY WELLNESS COMMUNITY WELLNESS (1977) 6,056 0 6,056 8 C TEC MEDICAL ASSISTANT EXTERNSHIP PROGRAM LMHP STUDENTS ADMIN LMHP (7445) 1,134 0 1,134 1 C TEC OUTSTANDING STUDENT AWARD SPONSORSHIP DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN C TEC SENIOR CITIZEN DAY COMMUNITY OUTREACH (1956) 485 0 485 160 CALL TO COLLEGE MEMORIAL DONATION DEVELOPMENT (1955) 3,000 0 3,000 UNKNOWN CAMP A1C COMMUNITY OUTREACH (1956) 12,121 0 12,121 13 CAMP COURAGE COMMUNITY OUTREACH (1956) 8,896 0 8,896 11 CAMP FEELIN' FINE COMMUNITY OUTREACH (1956) 11,517 0 11,517 20 CAMP MED COMMUNITY OUTREACH (1956) 27,498 0 27,498 40 CANAL MARKET DISTRICT SPEAKER/INFO TABLE COMMUNITY OUTREACH (1956) 941 0 941 130 CANCER SURVIVOR PICNIC COMMUNITY SUPPORT DEVELOPMENT (1955) 17,084 0 17,084 200 CAREER FAIRS HUMAN RESOURCES (1951) 317 0 317 330 CAREERXPRESS COMMUNITY OUTREACH (1956) 976 0 976 666 CAROL STRAWN CENTER CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN CATHOLIC SOCIAL SERVICES CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN CBISA SOFTWARE FISCAL SERVICES (1901) 995 0 995 UNKNOWN CENTRAL OHIO TECHNICAL COLLEGE CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN CENTRAL OHIO TECHNICAL COLLEGE IN KIND DONATIONS DEVELOPMENT (1955) 9,800 0 9,800 UNKNOWN CHEMICAL DEPENDENCY PRESENTATIONS OP CHEMICAL DEPENDENCY (1692) 5,510 0 5,510 UNKNOWN CHILDBIRTH EDUCATION MATERNAL CHILD (1646) 3,569 0 3,569 194 CHILDREN'S READING FOUNDATION OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN CHIMES TERRACE SPEAKER COMMUNITY OUTREACH (1956) 840 0 840 42 CHRONIC OBSTRUCTIVE PULMONARY DISEASE PROCESS IMPROVEMENT (1945)297 0 297 18 CITIZENS FOR CHILDRENS SERVICES CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN CITIZENS FOR PARKS, PATHS AND TRAILS CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN CITIZENS SUPPORTING 911 CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN COMMUNITY BENEFIT REPORTING HOURS FISCAL SERVICES (1901) 5,808 0 5,808 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY BENEFIT) EXECUTIVE ADMIN (1950) 85,013 0 85,013 200 COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY SUPPORT) EXECUTIVE ADMIN (1950) 73,820 0 73,820 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (ECONOMIC DEVELOPMENT) EXECUTIVE ADMIN (1950) 18,073 0 18,073 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (WORKFORCE DEVELOPMENT) EXECUTIVE ADMIN (1950) 24,485 0 24,485 UNKNOWN COMMUNITY CASE MANAGEMENT SERVICES COMMUNITY CASE MANAGEMENT (1976)1,053,369 77,958 975,411 UNKNOWN COMMUNITY HEALTH IMPROVEMENT COMMITTEE PROCESS IMPROVEMENT (1945) 1,100 0 1,100 UNKNOWN CORPORATE BREAKFASTS DEVELOPMENT (1955) 18,074 0 18,074 467 COTC SPEAKER COMMUNITY OUTREACH (1956) 760 0 760 97 DEFEATING CANCER PROCESS IMPROVEMENT (1945) 3,896 0 3,896 17 DENISON UNIVERSITY EMPLOYEE HEALTH FAIR COMMUNITY OUTREACH (1956) 279 0 279 25 DENISON UNIVERSITY IN KIND DONATIONS DEVELOPMENT (1955) 312 0 312 UNKNOWN DINING WITH DIABETES PROCESS IMPROVEMENT (1945) 5,545 0 5,545 93 DONATION OF LABORATORY SUPPLIES LAB (1702) 1,226 0 1,226 34 DONATION OF MEAT TO SALVATION ARMY DEVELOPMENT (1955) 6,371 0 6,371 UNKNOWN DOWNTOWN NEWARK ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 5,320 0 5,320 UNKNOWN DRUG ASSISTANT INDIGENT DRUG RECOVERY ADMIN LMHP (7445) 48,407 0 48,407 1,125 EAST OHIO ROBOTICS CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN EMERGENCY SERVICES FOR INDIGENT PATIENTS REFERRALS FISCAL SERVICES (1901) 190,135 0 190,135 UNKNOWN EXCELLENCE IN LEARNING COMMUNITY CO OP (ELCC) CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN FAMILY & FRIENDS INFANT AND CHILD CPR MATERNAL CHILD (1646) 1,526 0 1,526 112 FAMILY OF FAITH COMMUNITY CHURCH SPEAKER COMMUNITY OUTREACH (1956) 157 0 157 28 FIRST PRESBYTERIAN CHURCH SPEAKER COMMUNITY OUTREACH (1956) 197 0 197 18 FIRST UNITED METHODIST CHURCH, NEWARK COMMUNITY SUPPORT DEVELOPMENT (1955) 625 0 625 UNKNOWN FOOD PANTRY NETWORK CASH DONATIONS DEVELOPMENT (1955) 7,500 0 7,500 UNKNOWN FOR YOUR HEALTH 5K AND FUN WALK DEVELOPMENT (1955) 41,948 0 41,948 1,600 FREDONIA BAPTIST CHURCH IN KIND DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN FRIENDSHIP CLUB OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN |
| COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP | FRUITS AND VEGETABLE PRESCRIPTION PROGRAM (FVRX) CULINARY SERVICES (1801) 5,931 0 5,931 26 GIRL SCOUTS IN KIND DONATIONS PURCHASING (1675) 443 0 443 UNKNOWN GRANDPARENTS CLASS MATERNAL CHILD (1646) 412 0 412 8 GRANVILLE AREA CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN GRANVILLE AREA CHAMBER OF COMMERCE IN KIND DONATIONS DEVELOPMENT (1955) 475 0 475 UNKNOWN GRANVILLE CHRISTIAN ACADEMY CASH DONATIONS DEVELOPMENT (1955) 1,350 0 1,350 UNKNOWN GRANVILLE HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN GRANVILLE RECREATION DISTRICT CASH DONATIONS DEVELOPMENT (1955) 1,800 0 1,800 UNKNOWN GRANVILLE SENIOR CENTER CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN HABITAT FOR HUMANITY MIDOHIO CASH DONATIONS DEVELOPMENT (1955) 25,000 0 25,000 UNKNOWN HABITAT FOR HUMANITY MIDOHIO PHYSICAL IMPROVEMENTS/HOUSING DEVELOPMENT (1955) 8,924 0 8,924 17 HEALTHCARE MEDIA INTERVIEWS COMMUNITY OUTREACH (1956) 7,895 0 7,895 UNKNOWN HEALTHIER FOR LIFE WORKSHOP & REUNION PROCESS IMPROVEMENT (1945)3,471 0 3,471 95 HEART SAVER CPR AND AED TRAINING PROCESS IMPROVEMENT (1945) 222 0 222 18 HEART TO PLAY PROGRAM SPORTS PHYSICALS (7487) 55,203 0 55,203 490 HEARTBEATS OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN HEATH CHURCH OF CHRIST SPEAKERS BUREAU COMMUNITY OUTREACH (1956) 471 0 471 45 HEATH FIRE DEPARTMENT OPEN HOUSE HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 184 0 184 48 HEATH HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 225 0 225 UNKNOWN HEATH HIGH SCHOOL COMMUNITY BASED CLINICAL SERVICES OCCUPATIONAL HEALTH (7440) 927 0 927 UNKNOWN HEATH HIGH SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 110 0 110 UNKNOWN HEATH MIDDLE SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 117 0 117 UNKNOWN HEATH SERTOMA YOUTH ATHLETIC ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 900 0 900 UNKNOWN HEATH SERTOMA YOUTH ATHLETIC ASSOCIATION IN KIND DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN HEBRON YOUTH SOFTBALL CASH DONATIONS DEVELOPMENT (1955) 350 0 350 UNKNOWN HOMER VOLUNTEER FIRE DEPARTMENT CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN HOMESCHOOL GROUP SPEAKER COMMUNITY OUTREACH (1956) 115 0 115 15 HOSPICE OF CENTRAL OHIO CASH DONATIONS DEVELOPMENT (1955) 6,000 0 6,000 UNKNOWN IMMUNIZATION OF PATIENTS AGES 65 AND OVER FOR TD ADMIN LMHP (7445) 2,100 0 2,100 80 IMPACT CITY CHURCH LEADERCAST PATASKALA SPONSORSHIP DEVELOPMENT (1955) 500 0 500 UNKNOWN JILL GRIESSE MEMORIAL INVITATIONAL IN KIND DONATIONS DEVELOPMENT (1955) 150 0 150 UNKNOWN JOHNSTOWN CHOIR BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN JOHNSTOWN UNITED METHODIST CHURCH COMMUNITY SUPPORT DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN KENDAL AT GRANVILLE HEALTH & WELLNESS FAIR FOR SENIORS COMMUNITY OUTREACH (1956) 219 0 219 100 KINDERGARTEN SCREENINGS FAMILY PRACTICE EAST (7425)940 0 940 UNKNOWN KIWANIS CLUB OF GRANVILLE CASH DONATIONS DEVELOPMENT (1955) 750 0 750 UNKNOWN LAKEWOOD ATHLETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN LAKEWOOD HIGH SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 114 0 114 14 LAKEWOOD YOUTH BASEBALL ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 350 0 350 UNKNOWN LCESC JR. HIGH CAREER EXPLORATION HUMAN RESOURCES (1951) 811 0 811 21 LEADS HEAD START IN KIND DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN LIBERTY MIDDLE SCHOOL SPEAKERS BUREAU COMMUNITY OUTREACH (1956) 115 0 115 25 LICCO INC. CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN LICKING COUNTY AGING PROGRAM SPEAKERS COMMUNITY OUTREACH (1956) 498 0 498 27 LICKING COUNTY CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 5,400 0 5,400 UNKNOWN LICKING COUNTY CHAMBER OF COMMERCE GROUND HOG BREAKFAST DEVELOPMENT (1955) 525 0 525 UNKNOWN LICKING COUNTY CHAMBER OF COMMERCE YOUNG LEADERS CLUB DEVELOPMENT (1955) 650 0 650 40 LICKING COUNTY CHRISTIAN ACADEMY SPEAKER COMMUNITY OUTREACH (1956) 884 0 884 15 LICKING COUNTY COALITION FOR HOUSING CASH DONATIONS DEVELOPMENT (1955) 700 0 700 UNKNOWN LICKING COUNTY COALITION OF CARE CASH DONATIONS DEVELOPMENT (1955) 1,250 0 1,250 UNKNOWN LICKING COUNTY FAMILY YMCA CASH DONATIONS DEVELOPMENT (1955) 8,100 0 8,100 UNKNOWN LICKING COUNTY FOUNDATION CASH DONATIONS DEVELOPMENT (1955) 10,000 0 10,000 UNKNOWN LICKING COUNTY FOUNDATION PHYSICAL IMPROVEMENTS UNKNOWN (0) 10,000 0 10,000 UNKNOWN LICKING COUNTY HEALTH DEPARTMENT CASH DONATIONS DEVELOPMENT (1955) 400 0 400 UNKNOWN LICKING COUNTY HEALTH DEPARTMENT SPEAKER COMMUNITY OUTREACH (1956) 180 0 180 17 LICKING COUNTY HEALTH DEPARTMENT CHLAMYDIA/GC SCREENINGS LAB (1702) 5,132 0 5,132 131 LICKING COUNTY HISTORICAL SOCIETY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LICKING COUNTY LEADERSHIP PROGRAM DEVELOPMENT (1955) 510 0 510 UNKNOWN LICKING COUNTY PUBLIC SAFETY DAY HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 219 0 219 279 LICKING COUNTY SHERIFF'S DEPARTMENT CASH DONATIONS DEVELOPMENT (1955) 360 0 360 UNKNOWN LICKING COUNTY SPECIAL OLYMPICS CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN LICKING COUNTY TASK FORCE ON AGING IN KIND DONATIONS DEVELOPMENT (1955) 750 0 750 UNKNOWN LICKING LAND TRUST ENVIRONMENTAL IMPROVEMENTS DEVELOPMENT (1955) 250 0 250 UNKNOWN LICKING VALLEY BIDDY LEAGUE FOOTBALL CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN LICKING VALLEY HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN LICKING VALLEY HIGH SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 660 0 660 25 LICKING VALLEY LITTLE LEAGUE CASH DONATIONS DEVELOPMENT (1955) 975 0 975 UNKNOWN LICKING MUSKINGUM FOOTBALL CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LOOK UP CENTER CASH DONATIONS DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN LOOK UP CENTER IN KIND DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN LUNGEVITY FOUNDATION CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LYND FRUIT FARM SPEAKER/INFO TABLE COMMUNITY OUTREACH (1956) 159 0 159 140 LYND FRUIT FARM HEALTH FAIR BLOOD PRESSURE SCREENING COMMUNITY OUTREACH (1956) 269 0 269 25 MEDBILL RESOURCES SPEAKERS COMMUNITY OUTREACH (1956) 114 0 114 11 MENTAL HEALTH & RECOVERY FOR KNOX & LICKING COUNTY IN KIND DEVELOPMENT (1955) 435 0 435 UNKNOWN MENTAL HEALTH & RECOVERY FOR LICKING & KNOX COUNTIES CASH DONATION DEVELOPMENT (1955) 106,199 0 106,199 UNKNOWN MENTAL HEALTH AMERICA YES CLUB IN KIND DONATIONS DEVELOPMENT (1955) 2,615 0 2,615 UNKNOWN MENTAL HEALTH AMERICA OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 1,830 0 1,830 UNKNOWN MENTAL HEALTH AMERICA OF LICKING COUNTY IN KIND DONATIONS DEVELOPMENT (1955) 390 0 390 UNKNOWN MENTAL HEALTH PRESENTATIONS PSYCH OFFICES NEWARK (7430)6,210 0 6,210 UNKNOWN MIDWEST HEALTH SERVICES SPEAKER COMMUNITY OUTREACH (1956) 115 0 115 18 MISSION TRIP DRUGS AND SUPPLIES DEVELOPMENT (1955) 3,044 0 3,044 UNKNOWN MOUND CITY LITTLE LEAGUE CASH DONATIONS DEVELOPMENT (1955) 3,150 0 3,150 UNKNOWN MOVIE NIGHT HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 165 0 165 180 MY PLACE CHILDCARE CENTER SPEAKER COMMUNITY OUTREACH (1956) 260 0 260 70 NEW BEGININGS CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN |
| COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP | NEWARK CATHOLIC COMMUNITY SUPPORT DEVELOPMENT (1955) 354 0 354 UNKNOWN NEWARK CATHOLIC HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 1,200 0 1,200 UNKNOWN NEWARK CATHOLIC HIGH SCHOOL ATHLETIC DEPT. CASH DONATIONS DEVELOPMENT (1955) 650 0 650 UNKNOWN NEWARK CITY SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 356 0 356 UNKNOWN NEWARK CITY SCHOOLS CASH DONATIONS DEVELOPMENT (1955) 950 0 950 UNKNOWN NEWARK DEVELOPMENT PARTNERS COMMUNITY IMPROVEMENT CORPORATION DEVELOPMENT (1955) 11,250 0 11,250 UNKNOWN NEWARK FIREFIGHTERS LOCAL 109 CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN NEWARK GENERALS HOCKEY CLUB CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN NEWARK GRANVILLE SYMPHONY ORCHESTRA CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN NEWARK HIGH SCHOOL CAREER SPEAKER COMMUNITY OUTREACH (1956) 433 0 433 26 NEWARK HIGH SCHOOL SPEAKERS COMMUNITY OUTREACH (1956) 276 0 276 13 NEWARK HIGH SCHOOL ATHLETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 1,150 0 1,150 UNKNOWN NEWARK KIWANIS CLUB CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN NEWARK KIWANIS CLUB IN KIND DONATIONS DEVELOPMENT (1955) 282 0 282 UNKNOWN NEWARK YOUTH SOFTBALL CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN NEWBORN BASICS MATERNAL CHILD (1646) 1,621 0 1,621 119 NEWTON ELEMENTARY IN KIND DONATIONS DEVELOPMENT (1955) 132 0 132 UNKNOWN NORTH NEWARK LITTLE LEAGUE VARSITY AND FARM CASH DONATIONS DEVELOPMENT (1955) 900 0 900 UNKNOWN NORTHRIDGE PTO CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN OLYMPIC ACADEMY OF GYMNASTICS CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN OPENING DAY YOUTH SPORTS CEREMONIES IN KIND DONATIONS COMMUNITY OUTREACH (1956)10,027 0 10,027 2,550 OPERATION FEED IN KIND DONATIONS HUMAN RESOURCES (1951) 2,090 0 2,090 UNKNOWN OSTOMY SUPPORT GROUP IN KIND DONATIONS DEVELOPMENT (1955) 180 0 180 UNKNOWN OSU N CAREER FAIR HUMAN RESOURCES (1951) 162 0 162 100 OUR FUTURES LICKING COUNTY IN KIND DONATIONS DEVELOPMENT (1955) 375 0 375 UNKNOWN PAID STUDENT INTERNSHIPS OTHER HEALTH PROFESSIONAL EDUCATION FISCAL SERVICES (1901) 72,638 0 72,638 16 PAR EXCELLENCE HEALTH FAIR COMMUNITY OUTREACH (1956) 248 0 248 160 PAR EXCELLENCE ACADEMY CASH DONATIONS DEVELOPMENT (1955) 11,000 0 11,000 UNKNOWN PARKINSON'S DISEASE PROCESS IMPROVEMENT (1945)1,045 0 1,045 49 PASTORAL CARE BREAKFAST DEVELOPMENT (1955) 1,204 0 1,204 23 PATASKALA AREA CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 780 0 780 UNKNOWN PATASKALA AREA CHAMBER OF COMMERCE IN KIND DONATIONS DEVELOPMENT (1955) 3,087 0 3,087 65 PATASKALA CHRISTMAS WALK COMMUNITY SUPPORT COMMUNITY OUTREACH (1956) 364 0 364 UNKNOWN PATASKALA RECREATION ASSOCIATION (PRA) CASH DONATIONS DEVELOPMENT (1955) 130 0 130 UNKNOWN PATHWAYS OF CENTRAL OHIO CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN PBJ CONNECTIONS CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN PEDIATRIC DENTAL CLINIC DENTAL CLINIC (1958) 97,344 18,521 78,823 UNKNOWN PELOTONIA CASH DONATIONS DEVELOPMENT (1955) 2,750 0 2,750 UNKNOWN PINK STRIDES TRAIL RUN & WELLNESS WALK IN KIND DONATIONS DEVELOPMENT (1955) 1,002 0 1,002 UNKNOWN POWER HOUSE ELITE CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN PRECEPTING NURSING STUDENTS 4N & 4S 4 SOUTH (1614) 4,089 0 4,089 5 PRECEPTING NURSING STUDENTS ER & URGENT CARE EMERGENCY DEPT (1678) 5,607 0 5,607 5 PRECEPTING NURSING STUDENTS HEALTH PROFESSIONALS ADMIN LMHP (7445) 972 0 972 2 PRECEPTING NURSING STUDENTS HOME HEALTH CARE HOME HEALTH CARE (1978) 326 0 326 1 PRECEPTING NURSING STUDENTS ICU & CCU INTENSIVE CARE (1640) 7,507 0 7,507 7 PRECEPTING NURSING STUDENTS INPATIENT REHAB INPATIENT REHAB (1615)1,166 0 1,166 1 PRECEPTING NURSING STUDENTS MATERNAL CHILD & LABOR AND DELIVERY MATERNAL CHILD (1646) 1,619 0 1,619 2 PRECEPTING NURSING STUDENTS WOUND CLINIC WOUND CLINIC (1677) 4,833 0 4,833 4 PRECEPTING STUDENTS CARDIOLOGY CARDIOLOGY (1712) 4,830 0 4,830 5 PRECEPTING STUDENTS OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY (1700)5,215 0 5,215 2 PRECEPTING STUDENTS PACU/OR SURGERY (1660) 14,658 0 14,658 12 PRECEPTING STUDENTS PHARMACY PHARMACY (1730) 105,408 18,450 86,958 23 PRECEPTING STUDENTS RADIOLOGY RADIOLOGY (1721) 41,021 0 41,021 25 PRECEPTORSHIPS FOR NURSE PRACTICIONERS/PA STUDENTS FP FAMILY PRACTICE EAST (7425)25,081 0 25,081 5 PRECEPTORSHIPS FOR MEDICAL STUDENTS UNKNOWN (0) 34,077 9,000 25,077 17 PRECEPTORSHIPS FOR PEDIATRICS STUDENTS PEDIATRICS (7460) 12,431 0 12,431 5 PRECEPTORSHIPS FOR WOMEN'S HEALTH STUDENTS WOMENS HEALTH CENTER (7455) 12,071 0 12,071 5 PROJECT SEARCH HUMAN RESOURCES (1951) 9,064 0 9,064 9 RED CROSS BLOOD DRIVE PROCESS IMPROVEMENT (1945) 1,344 0 1,344 102 RED DRESS EVENT COMMUNITY OUTREACH (1956) 29,943 0 29,943 288 RELAY FOR LIFE HEALTH INFORMATION TABLE COMMUNITY OUTREACH (1956) 409 0 409 55 RELAY FOR LIFE IN KIND DONATIONS DEVELOPMENT (1955) 332 0 332 UNKNOWN RELAY FOR LIFE SPEAKER ONCOLOGY PC (7405) 590 0 590 330 RESOURCE CENTER/MEDICAL LIBRARY RESOURCE CENTER (1975) 3,120 0 3,120 UNKNOWN REVIEW CLUB SPEAKER COMMUNITY OUTREACH (1956)197 0 197 15 RONALD MCDONALD HOUSE CHARITIES OF CENTRAL OHIO CASH DONATIONS DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN ROTARY CLUB OF GRANVILLE CASH DONATIONS DEVELOPMENT (1955) 1,750 0 1,750 UNKNOWN ROTARY CLUB OF GRANVILLE IN KIND DONATIONS CULINARY SERVICES (1801)1,196 0 1,196 UNKNOWN ROTARY CLUB OF NEWARK IN KIND DONATIONS CULINARY SERVICES (1801)6,732 0 6,732 UNKNOWN ROTARY CLUB OF NEWARK HEATH IN KIND DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN ROTARY CLUB OF PATASKALA CASH DONATIONS DEVELOPMENT (1955) 800 0 800 UNKNOWN SAFE SITTER SEMINAR MATERNAL CHILD (1646) 1,753 0 1,753 22 SAFE SURROUNDINGS SAFE SURROUNDINGS (1647)127,340 29,281 98,059 250 SAINT LUKE'S CHURCH CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN SAINT LUKE'S CHURCH SPEAKER COMMUNITY OUTREACH (1956) 368 0 368 35 SAINT VINCENT HAVEN CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN SALVATION ARMY IN KIND DONATIONS DEVELOPMENT (1955) 1,500 0 1,500 UNKNOWN SALVATION ARMY CHILDREN'S DAY CAMP COMMUNITY OUTREACH (1956) 2,207 0 2,207 28 SALVATION ARMY OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 2,000 0 2,000 UNKNOWN SIBLING PREPARATION CLASS MATERNAL CHILD (1646) 1,338 0 1,338 48 SOUTHWEST LICKING SCHOOLS IN KIND DONATIONS DEVELOPMENT (1955) 1,314 0 1,314 UNKNOWN SOUTHWEST LICKING SCHOOLS SPEAKER COMMUNITY OUTREACH (1956) 196 0 196 200 ST. EDWARD CHURCH COMMUNITY SUPPORT DEVELOPMENT (1955) 278 0 278 UNKNOWN ST. FRANCIS DE SALES SCHOOL & PARISH CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN ST. FRANCIS PARISH FESTIVAL COMMUNITY SUPPORT DEVELOPMENT (1955) 354 0 354 UNKNOWN STATE FARM HEALTH FAIR SCREENINGS COMMUNITY OUTREACH (1956) 346 0 346 51 STUDENT INTERNSHIPS CASE MANAGEMENT CASE MANAGEMENT (1780) 4,015 0 4,015 2 STUDENT INTERNSHIPS COMMUNITY CASE MANAGEMENT COMMUNITY CASE MANAGEMENT (1976) 2,205 0 2,205 3 |
| COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP | STUDENT INTERNSHIPS LABORATORY LAB (1702) 9,220 0 9,220 3 STUDENT INTERNSHIPS PHYSICAL THERAPY & SPEECH THERAPY PHYSICAL THERAPY (1737) 22,810 0 22,810 5 STUDENT NURSE & OTHER HEALTH PROFESSIONALS MANAGEMENT PROCESS PROCESS IMPROVEMENT (1945) 22,828 0 22,828 455 STUDENT VOLUNTEER PROGRAM VOLUNTEERS (1970) 533 0 533 8 SUMMER TEACHER EXTERNSHIP PROGRAM HUMAN RESOURCES (1951) 653 0 653 1 TAXI TOKENS FISCAL SERVICES (1901) 968 0 968 UNKNOWN TECH INTERNATIONAL SPEAKER COMMUNITY OUTREACH (1956) 570 0 570 175 THE CANCER CLIMBER ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN THE ENERGY COOPERATIVE CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN THE ENERGY COOPERATIVE EARTH AND ENERGY DAY COMMUNITY OUTREACH (1956) 595 0 595 400 THE WORKS IN KIND DONATIONS CULINARY SERVICES (1801) 406 0 406 UNKNOWN TOBACCO CESSATION PROGRAM TOBACCO CESSATION (1693) 336,791 0 336,791 416 TOGETHER WE GROW, INC. CASH DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN TOTAL HIP REPLACEMENT PROCESS IMPROVEMENT (1945) 917 0 917 14 TOTAL KNEE REPLACEMENT PROCESS IMPROVEMENT (1945) 801 0 801 17 TYLER'S LIGHT, INC. CASH DONATIONS DEVELOPMENT (1955) 1,317 0 1,317 UNKNOWN UNITED METHODIST CHURCH SPEAKER COMMUNITY OUTREACH (1956) 416 0 416 5 UNITED WAY AGENCIES CASH DONATIONS DEVELOPMENT (1955) 40,800 0 40,800 UNKNOWN UNITED WAY AGENCIES IN KIND DONATIONS HUMAN RESOURCES (1951) 420 0 420 UNKNOWN UNITED WAY WEEK OF CARING PHYSICAL IMPROVEMENTS DEVELOPMENT (1955) 577 0 577 UNKNOWN UTICA ATHETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 150 0 150 UNKNOWN VIC'S MUD BOG SPEAKER/INFO TABLE COMMUNITY OUTREACH (1956) 224 0 224 45 VOLUNTEERS TWIGS & EVENTS VOLUNTEERS (1970) 0 0 0 189 WALK WITH A DOC COMMUNITY OUTREACH (1956) 39,048 0 39,048 260 WASHINGTON SQUARE APARTMENTS IN KIND DONATIONS DEVELOPMENT (1955) 1,167 0 1,167 UNKNOWN WATER'S EDGE ASSEMBLY OF GOD CHURCH SPEAKER COMMUNITY OUTREACH (1956) 754 0 754 12 WATKINS HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN WATKINS HIGH SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN WATKINS HIGH SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 590 0 590 510 WATKINS MEMORIAL CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN WEATHERVANE PLAYHOUSE CASH DONATIONS DEVELOPMENT (1955) 1,250 0 1,250 UNKNOWN WELLNESS CENTER AT C TEC COMMUNITY WELLNESS (1977) 181,358 0 181,358 538 WEST LICKING FIREFIGHTERS ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 12,000 0 12,000 UNKNOWN WILLIAM V FISHER CATHOLIC HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN YMCA SPEAKER COMMUNITY OUTREACH (1956) 385 0 385 18 YOUTH LEAGUE SCHOLARSHIPS DEVELOPMENT (1955) 9,170 0 9,170 101 ZONTA CLUB OF NEWARK CASH DONATIONS DEVELOPMENT (1955) 180 0 180 UNKNOWN ZONTA CLUB OF NEWARK IN KIND DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN MISCELLANEOUS - COMMUNITY HEALTH EDUCATION 883 0 883 197 MISCELLANEOUS - IN-KIND DONATIONS 780 0 780 UNKNOWN MISCELLANEOUS - CASH DONATIONS 100 0 100 UNKNOWN MISCELLANEOUS - WORKFORCE DEVELOPMENT 85 0 85 20 MISCELLANEOUS - COMMUNITY SUPPORT 91 0 91 UNKNOWN MISCELLANEOUS - COMMUNITY BASED CLINICAL SERVICES 35 0 35 5 NUMBER OF PROGRAMS 332 EXPENSES 3,812,768 OFFSETS 153,210 BENEFIT 3,659,558 OUTPUTS 21,299 TRADITIONAL CHARITY CARE EXPENSES $3,902,563 OFFSETS $0 NET BENEFIT $3,902,563 PERSONS 10,023 UPDAID COST OF MEDICAID EXPENSES $65,325,742 OFFSETS $33,949,129 NET BENEFIT $31,276,613 PERSONS 38,257 TOTAL UNDERSERVED EXPENSES $69,228,305 OFFSETS $33,949,129 NET BENEFIT $35,279,176 PERSONS 48,280 GRAND TOTALS EXPENSES $73,041,073 OFFSETS $34,102,339 NET BENEFIT $38,938,734 PERSONS 69,579 |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LICKING MEMORIAL HEALTH SYSTEMS | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311096218 | PARENT COMPANY FOR THE NONPROFIT OPERATION OF HEALTHCARE ORGANIZATIONS | OH | 501(C)(3) | LINE 12D, III-O | N/A | 0 | |
| LICKING MEMORIAL HEALTH FOUNDATION | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311096217 | PROVIDE FUNDING FOR HEALTHCARE PROGRAMS | OH | 501(C)(3) | LINE 12B, II | 0 | LICKING MEMORIAL HEALTH SYSTEMS | |
| LICKING MEMORIAL PROFESSIONAL CORPORATION | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311425530 | HEALTHCARE ORGANIZATION | OH | 501(C)(3) | LINE 11 | 0 | LICKING MEMORIAL HEALTH SYSTEMS | |
| LICKING MEMORIAL TWIGS | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 463190381 | TO SUPPORT THE OPERATIONS OF LICKING MEMORIAL HEALTH SYSTEMS | OH | 501(C)(3) | LINE 12B, II | 0 | LICKING MEMORIAL HEALTH SYSTEMS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |