2016-11-10T11:09:30-06:00 2015-12-31 271235638 MOUNTJOY CHILTON MEDLEY LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2015-01-01 314379519 LICKING MEMORIAL HOSPITAL LICK 2205644528 1320 WEST MAIN STREET NEWARK OH 43055 CYNTHIA L WEBSTER V. P. OF FINANCIAL SERVICES 2205644528 2016-10-31 1 ROBERT M MORELAND CPA P00418596 5027491900 2015 2017-02-10 21:41:12Z ROBERT A MONTAGNESE 1320 WEST MAIN STREET NEWARK OH 43055 228576738 0 X WWW.LMHEALTH.ORG X 1898 OH TO IMPROVE THE HEALTH OF THE COMMUNITY. 13 13 1705 97 0 0 0 0 210220153 222516820 453192 710984 1779535 2402995 212452880 225630799 0 0 0 0 82860488 89459970 0 0 0 87446525 94225421 170307013 183685391 42145867 41945408 164321316 175703832 69652233 92236316 94669083 83467516 X LICKING MEMORIAL HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITY. 0 0 159909307 223382667 LICKING MEMORIAL HOSPITAL (LMH) PROVIDES 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 COST - HEALTH ACTIVITIES AND PROGRAMS FREE-OF-CHARGE TO THE COMMUNITYTHE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED AND MEDICALLY UNDER SERVED.LMH SERVED 8,054 INPATIENTS AND 1,095 NEWBORNS FOR A TOTAL OF 31,179 PATIENT DAYS, AND PROVIDED SERVICES TO 318,899 OUTPATIENTS IN 2015.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 $237,289,000 IN 2015.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 2015, LMH WROTE OFF CHARGES OF APPROXIMATELY $20,294,000 IN BAD DEBTS AND $3,706,000 IN CHARITY CARE. 159909307 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1159 0 1 1705 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OH X DAVID CLAYPOOL 2205644528 1320 WEST MAIN STREET NEWARK OH 43055 BART M WEILER DIRECTOR 1.30 X 0 0 0 BRIAN J MORTELLARO DIRECTOR 1.30 X 0 0 0 CHERI L HOTTINGER DIRECTOR 1.30 X 0 0 0 CRAIG R BALDWIN CHAIRMAN 1.50 1.30 X X 0 0 0 DAVID E DONEY DIRECTOR 1.30 X 0 0 0 DAVID L HILE DIRECTOR 1.30 X 0 0 0 DEBORAH A KOHMAN DIRECTOR 1.30 X 0 0 0 JOYCE L MALAINY TREASURER 1.30 X X 0 0 0 LAUREL B KENNEDY DIRECTOR 1.30 X 0 0 0 MICHAEL A NOBLE DIRECTOR 1.30 X 0 0 0 MICHAEL J MASSARO SECRETARY 1.30 X X 0 0 0 NANCY G NEELY VICE CHAIRMAN 1.30 X X 0 0 0 SHARAD THAKKAR DIRECTOR (BEGAN TERM 4/2015) 1.30 X 0 0 0 C EUGENE BRANSTOOL DIRECTOR (ENDED TERM 4/2015) 1.30 X 0 0 0 CINDY WEBSTER VP FINANCIAL SERVICES 30.00 10.30 X 205151 0 19457 ROBERT MONTAGNESE PRESIDENT & CEO 30.00 10.30 X 611963 0 63213 ANNE PETERSON VP HR AND SUPPORT SERVICES 40.00 X 170794 0 28952 CRAIG CAIRNS VP MEDICAL STAFF AFFAIRS 40.00 X 275698 0 21805 DEBBIE YOUNG VP PATIENT CARE SERVICES 40.00 X 185945 0 29455 SALLIE ARNETT VP INFORMATION SYSTEMS 40.00 X 183706 0 18744 VERONICA LINK VP PR & DEVELOPMENT 12.70 27.30 X 183534 0 29375 1816791 0 211001 46 0 1 0 GE HEALTHCARE IITS 40 IDX DRIVE SOUTH BURLINGTON VT 05403 EQUIPMENT MAINTENANCE 1196204 QUEST DIAGNOSTICS 3 GIRALDA FARMS MADISON NJ 07940 LABORATORY SERVICES 973221 ROBERTSON CONSTRUCTION SEVICES 1801 THORNWOOD DR HEATH OH 43056 CONSTRUCTION 969568 CAREFUSION SOLUTIONS LLC 3750 TORREY VIEW COURT SAN DIEGO CA 92130 DISPENSING SERVICES 954995 ACCUVANT INC 1979 RICHMOND DR LOUISVILLE KY 40205 SOFTWARE MAINTENANCE 703164 40 PATIENT REVENUE 621110 221137495 221137495 MEANINGFUL USE GRANT 621110 753849 753849 HOME HEALTH CARE 621610 625476 625476 222516820 374637 374637 1132746 1132746 0 1970596 178944 1745384 67809 225212 111135 336347 336347 CAFETERIA 722210 1537148 1537148 MISCELLANEOUS 900099 542075 542075 VHA FEES & REBATES 621110 323772 323772 2402995 225630799 223382667 0 2248132 899784 899784 65634598 57815095 7819503 1614252 1458151 156101 16475048 13583705 2891343 4836288 4217449 618839 417913 417913 419229 419229 34481 34481 15111734 13067508 2044226 510169 510169 1460140 1460140 59164 56944 2220 490277 194014 296263 465026 347185 117841 11814992 8820997 2993995 763005 763005 MEDICAL SUPPLIES 38434307 34403176 4031131 BAD DEBT EXPENSE 20294010 20294010 EQUIPMENT RENTAL 3102164 2791321 310843 MISCELLANEOUS 848810 636607 212203 183685391 159909307 23776084 0 9141177 16728930 22151686 23307257 3056383 3588791 2696271 2343652 225060317 132479858 94226466 92580459 22465035 28675789 10584298 8478954 164321316 175703832 21712113 24113205 24980000 32000000 22960120 36123111 69652233 92236316 X 94669083 83467516 94669083 83467516 164321316 175703832 X 41945408 -438355 -52708620 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 1527 1527 0 PART II-B, LINE 1: LICKING MEMORIAL HOSPITAL PAYS $42,430 IN ANNUAL DUES TO OHIO HOSPITAL ASSOCIATION(OHA). OF THE TOTAL DUES PAID, 3.6% OR $1,527 ARE USED BY OHA TO SUPPORT LOBBYING ACTIVITIES OF THE ASSOCIATION. 426393 197 187 426403 429425 188 3220 426393 428882 543 429425 426714 2168 428882 615155 491 188932 426714 1.00000 0 1 1 1802879 1802879 104013207 42072472 61940735 115121152 88175755 26945397 4123079 2231631 1891448 92580459 DEFERRED PENSION AND RETIREE LIABILITY 32325606 ACCRUED INTEREST PAYABLE 48061 ACCRUED MALPRACTICE 3749444 36123111 X 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. THE SYSTEM BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2011. 1 1 X 1 X 1 X 1 1 0 1 1 9755 3549624 3943195 0 0.00000 35013 34909561 16057199 18852362 0.11540 44768 38459185 20000394 18852362 0.11540 19181 2831402 148365 2683037 0.01640 1003 682876 15420 667456 0.00410 165795 165795 0.00100 3315 589093 589093 0.00360 23499 4269166 163785 4105381 0.02510 68267 42728351 20164179 22957743 0.14050 52789 52789 0.00030 43 56384 56384 0.00030 389 132539 132539 0.00080 1000 1000 0.00000 762 29747 29747 0.00020 1194 272459 272459 0.00160 1 20294009 5012620 35070859 39407766 -4336907 X 1 1 1 1 LICKING MEMORIAL HOSPITAL 1320 WEST MAIN STREET NEWARK OH 43055 X X X LICKING MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X 13 1 0 1 1 X WWW.LMHEALTH.ORG X 1 13 1 WWW.LMHEALTH.ORG 0 0 1 X 100.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.LMHEALTH.ORG X WWW.LMHEALTH.ORG X WWW.LMHEALTH.ORG X X X X X 1 X 0 X 1 X 0 0 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 PLANS 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 OUR 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 PROVIDE 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 22D: THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY IN PLACE THAT DISCOUNTS CARE TO THOSE APPLYING FOR AND MEETING THE INCOME LIMITS FOR DISCOUNTED CARE AT A RATE THAT IS GREATER THAN THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE. 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, 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 $ 20,294,010. 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 PROGRAMS AND 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 ACTIVITES THROUGHOUT THE YEAR. ADVOCACY FOR THE HEALTH OF THE COMMUNITY IS NOT ONLY EVIDENT THROUGH THE COMMUNITY CONNECTION PUBLICATIONS, BUT THROUGH VARIOUS HEALTH-RELATED EVENTS AND CLASSES INCLUDING 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 THE COUNTY'S LARGEST EMPLOYER. 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 $4,669,161ALONG THAT SAME LINE, LICKING MEMORIAL PROFESSIONAL CORPORATION, ANOTHER LMHS SUBSIDIARY, PROVIDED SERVICES TO MEDICARE (TRADITIONAL AND HMO) BENEFICIARIES AT A COST SHORTFALL OF $7,597,910 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 ORSOCIAL 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 THE LARGEST EMPLOYER 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 PHYSICIANS SPEAKING 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 INDIVIDUALS WHO HAVE THEIR "FINGERS ON THE PULSE" OF THE COMMUNITY, AND ONE OF THEIR RESPONSIBILITIES AS AMBASSADORS IS TO MAKE THE 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 HEALTH SYSTEMS PRESIDENT & CEO. DEVELOPMENT COUNCIL MEMBERS SERVE AS HOSTS, AND THEY INVITE 20-25 PEOPLE WITH SIMILAR INTERESTS. 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 WE SHARE INFORMATION ABOUT THE HOSPITAL AND THEN ASK FOR FEEDBACK 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 THE COMMUNITY LEADERSHIP REGARDING HOSPITAL ACTIVITIES AND TO 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 ATTENDENCE AT THE CORPORATE BREAKFAST EVENTS.THE HEALTH SYSTEMS' 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.AN AFFILIATED PHYSICIAN GROUP, KNOWN AS THE 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 2015, LMHS PROVIDED $27.6 MILLION OF UNCOMPENSATED CARE AT STANDARD CHARGES, INCLUDING $4.6 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 ABOUT 48,000 PEOPLE WITH A MEDIAN INCOME OF APPROXIMATELY $37,000. THE HOSPITAL SERVES THE COMMUNITY OF NEWARK AND LICKING COUNTY. LICKING COUNTY HAS A POPULATION OF APPROXIMATELY 170,000 (PER US CENSUS BUREAU), A PER CAPITA INCOME OF APPROXIMATELY $27,000 AND AN UNEMPLOYMENT RATE OF 4.3%. PART VI, LINE 5: THROUGH THE MISSION OF "IMPROVING THE HEALTH OF THE COMMUNITY", LMHS PROMOTES HEALTH EDUCATION AND WELLNESS IN VARIOUS 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 TO 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 ACTIVE-FIT 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.THE HEALTH SYSTEMS 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 SUMMER MONTHS WITH AN EKG HEART SCREENING, IN ADDITION TO A HEALTH AND CONCUSSION SCREENING.THE HEALTH SYSTEMS ALSO DEVOTES RESOURCES TO A HEALTH-RELATED COMMUNITY BENEFIT PROJECT EACH YEAR. IN 2013, THE HEALTH SYSTEMS BEGAN UPGRADING THE 12-LEAD EKGS FOR THE LOCAL EMS PROVIDERS. THIS IS A MULTI YEAR PROJECT TO BE CARRIED OUT FROM 2013 THROUGH 2016 FOR A TOTAL CONTRIBUTION OF $845,000. PART VI, LINE 6: LICKING MEMORIAL HEALTH SYSTEMS (THE SYSTEM) IS A NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF OHIO TO PROVIDE AND PROMOTE HEALTH CARE SERVICES IN CENTRAL OHIO.THE SYSTEM 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 SYSTEM'S CHARITABLE PURPOSE. LMPC HAS A SOLE PHYSICIAN SHAREHOLDER, WHO, UNDER A SHARED CONTROL AGREEMENT, ASSIGNED THE VOTING RIGHTS OF THE STOCK TO LMHS. X X X X X 0 1 0 0 0 0 0 0 0 CINDY WEBSTER VP FINANCIAL SERVICES 202967 0 2184 0 0 0 5402 0 14055 0 224608 0 0 0 ROBERT MONTAGNESE PRESIDENT & CEO 552321 0 57194 0 2448 0 35712 0 27501 0 675176 0 0 0 ANNE PETERSON VP HR AND SUPPORT SERVICES 168610 0 2184 0 0 0 4498 0 24454 0 199746 0 0 0 CRAIG CAIRNS VP MEDICAL STAFF AFFAIRS 273504 0 2194 0 0 0 7260 0 14545 0 297503 0 0 0 DEBBIE YOUNG VP PATIENT CARE SERVICES 183761 0 2184 0 0 0 4896 0 24559 0 215400 0 0 0 SALLIE ARNETT VP INFORMATION SYSTEMS 181522 0 2184 0 0 0 4838 0 13906 0 202450 0 0 0 VERONICA LINK VP PR & DEVELOPMENT 181350 0 2184 0 0 0 4833 0 24542 0 212909 0 0 0 PART I, LINE 4B ROBERT MONTAGNESE, PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). A CONTRIBUTION WAS MADE TO THE PLAN ON HIS BEHALF FOR THE 2015 YEAR IN THE AMOUNT OF $19,662. FORM 990, PART VI, SECTION B, LINE 11 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, USING DATA FOR SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS, 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 -20,376,431. CHANGE IN RETIREE BENEFIT PLAN 563,854. NET ASSET TRANSFERS WITH RELATED 501(C)(3) -32,896,043. 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) 165,795 0 165,795 UNKNOWN 20TH CENTURY CLUB CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN 20TH CENTURY CLUB IN KIND DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN ACTIVE FIT PRESENTATIONS COMMUNITY OUTREACH (1956) 27,635 0 27,635 8,213 ACTIVE FIT YOUTH WELLNESS EVENTS COMMUNITY OUTREACH (1956) 33,097 0 33,097 738 AIM AT MELANOMA CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN AMERICAN CANCER SOCIETY CASH DONATIONS DEVELOPMENT (1955) 3,000 0 3,000 UNKNOWN AMERICAN HEART ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 15,000 0 15,000 UNKNOWN AMERICAN RED CROSS IN KIND DONATIONS DEVELOPMENT (1955) 394 0 394 UNKNOWN AMERICAN RED CROSS OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 3,500 0 3,500 UNKNOWN ASK THE DOC AT SHEPHERD HILL OP CHEMICAL DEPENDENCY (1692) 7,179 0 7,179 435 AUTISM SOCIETY OF OHIO IN KIND DONATIONS DEVELOPMENT (1955) 190 0 190 UNKNOWN BABY EXPO DEVELOPMENT (1955) 20,072 0 20,072 175 BEHAVIORAL HEALTH CARE PARTNERS IN KIND DONATIONS DEVELOPMENT (1955) 32,336 0 32,336 UNKNOWN BIG BROTHERS/BIG SISTERS CASH DONATIONS DEVELOPMENT (1955) 7,000 0 7,000 UNKNOWN BIG BROTHERS/BIG SISTERS IN KIND DONATIONS DEVELOPMENT (1955) 9,754 0 9,754 UNKNOWN BOY SCOUTS OF AMERICA SIMON KENTON COUNCIL CASH DONATIONS DEVELOPMENT (1955) 2,000 0 2,000 UNKNOWN BREAST CA AWARENESS DAY FREE MAMMOGRAMS RADIOLOGY (1721) 10,987 0 10,987 38 BREAST FEEDING BASICS MATERNAL CHILD (1646) 9,030 5,900 3,130 515 BREASTFEEDING AND INFANT HEALTH FAIR MATERNAL CHILD (1646) 510 0 510 25 BREASTFEEDING MOTHERS SUPPORT GROUP MATERNAL CHILD (1646) 409 0 409 15 BREASTFEEDING PROMOTION & SUPPORT PROGRAM MATERNAL CHILD (1646) 45,600 0 45,600 285 BROWNSVILLE SENIOR CITIZEN SPEAKERS COMMUNITY OUTREACH (1956) 198 0 198 19 C TEC CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN C TEC IN KIND DONATIONS DEVELOPMENT (1955) 227 0 227 UNKNOWN C TEC SPEAKER COMMUNITY OUTREACH (1956) 1,067 0 1,067 10 C TEC MEDICAL ASSISTANT EXTERNSHIP PROGRAM ADMIN LMHP (7445) 17,264 0 17,264 8 C TEC OUTSTANDING STUDENT AWARD SPONSORSHIP DEVELOPMENT (1955) 500 0 500 UNKNOWN C TEC SENIOR CITIZEN DAY COMMUNITY OUTREACH (1956) 313 0 313 168 CADE AND KATELYN FUND COMMITTEE CASH DONATIONS DEVELOPMENT (1955) 400 0 400 UNKNOWN CAMP A1C COMMUNITY OUTREACH (1956) 15,890 0 15,890 7 CAMP COURAGEOUS COMMUNITY OUTREACH (1956) 10,629 0 10,629 9 CAMP FEELIN' FINE RESPIRATORY THERAPY (1736) 7,186 0 7,186 37 CANCER SURVIVOR PICNIC COMMUNITY SUPPORT DEVELOPMENT (1955) 20,715 0 20,715 300 CAROL STRAWN CENTER CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN CATHOLIC SOCIAL SERVICES IN KIND DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN CBISA SOFTWARE FISCAL SERVICES (1901) 945 0 945 UNKNOWN CENTER FOR DISABILITIES SPEAKERS COMMUNITY OUTREACH (1956) 164 0 164 15 CENTRAL OHIO TECHNICAL COLLEGE CASH DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN CENTRAL OHIO YOUTH BALLET CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN CHAPLAINS FOR CHILDREN SAFE SURROUNDINGS (1647)732 0 732 21 CHEMICAL DEPENDENCY PRESENTATIONS OP CHEMICAL DEPENDENCY (1692)2,964 0 2,964 UNKNOWN CHILDREN'S READING FOUNDATION OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN COLORECTAL CANCER AWARENESS COMMUNITY HEALTH EDUCATION PROCESS IMPROVEMENT (1945) 1,290 0 1,290 8 COMMUNITY BENEFIT REPORTING HOURS FISCAL SERVICES (1901) 4,768 0 4,768 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY BENEFIT) EXECUTIVE ADMIN (1950) 54,856 0 54,856 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY SUPPORT) EXECUTIVE ADMIN (1950) 53,019 0 53,019 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (ECONOMIC DEVELOPMENT) EXECUTIVE ADMIN (1950) 9,765 0 9,765 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (HOUSING REHABILITATION) EXECUTIVE ADMIN (1950) 1,489 0 1,489 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (WORKFORCE DEVELOPMENT) EXECUTIVE ADMIN (1950) 17,023 0 17,023 UNKNOWN COMMUNITY CASE MANAGEMENT SERVICES COMMUNITY CASE MANAGEMENT (1976) 979,424 79,879 899,545 UNKNOWN COMMUNITY HEALTH ASSESSMENT COMMITTEE PROCESS IMPROVEMENT (1945) 1,087 0 1,087 UNKNOWN COMMUNITY LEADERS' ROUNDTABLES DEVELOPMENT (1955) 1,523 0 1,523 89 CORPORATE BREAKFASTS DEVELOPMENT (1955) 6,104 0 6,104 258 COUGHLIN CHEVROLET FAST 5K HEALTH INFORMATION TABLE COMMUNITY OUTREACH (1956) 124 0 124 5 DAWES ARBORETUM CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN DENISON FRESHMAN CAREER FAIR HUMAN RESOURCES (1951) 3,156 0 3,156 700 DINING WITH DIABETES PROCESS IMPROVEMENT (1945) 3,807 0 3,807 72 DONATION OF MEAT TO SALVATION ARMY DEVELOPMENT (1955) 7,509 0 7,509 UNKNOWN DONATION OF NARCAN TO LAW ENFORCEMENT DEVELOPMENT (1955) 1,164 0 1,164 UNKNOWN DONATIONS TO MEDICAL MISSIONARIES IN KIND DONATIONS PURCHASING (1675) 306,558 0 306,558 UNKNOWN DRUG ASSISTANT INDIGENT DRUG RECOVERY ADMIN LMHP (7445) 39,529 0 39,529 851 EMERGENCY SERVICES FOR INDIGENT PATIENTS REFERRALS FISCAL SERVICES (1901) 780,074 0 780,074 UNKNOWN EXCELLENCE IN LEARNING COMMUNITY CO OP (ELCC) CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN FAMILY & FRIENDS INFANT AND CHILD CPR MATERNAL CHILD (1646) 836 110 726 93 FIBROMYALGIA PROCESS IMPROVEMENT (1945) 385 0 385 29 FOOD ALLERGY RESEARCH & EDUCATION, INC. CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN FOOD PANTRY NETWORK CASH DONATIONS DEVELOPMENT (1955) 4,500 0 4,500 UNKNOWN FOOD SAFETY AND CANNING COMMUNITY HEALTH EDUCATION PROCESS IMPROVEMENT (1945)151 0 151 10 FOR YOUR HEALTH 5K AND FUN WALK DEVELOPMENT (1955) 29,586 0 29,586 1,100 FOSTER GRANDPARENT PROGRAM SPEAKERS COMMUNITY OUTREACH (1956)179 0 179 9 FRATERNAL ORDER OF POLICE (FOP) CASH DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN FREEDOM SCHOOL SPEAKERS COMMUNITY OUTREACH (1956) 285 0 285 20 GLENN'S MARKET SCREENINGS COMMUNITY CASE MANAGEMENT (1976) 990 0 990 89 GRANVILLE AREA CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 1,500 0 1,500 UNKNOWN GRANVILLE CHRISTIAN ACADEMY CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN GRANVILLE HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 175 0 175 UNKNOWN GRANVILLE RECREATION DISTRICT CASH DONATIONS DEVELOPMENT (1955) 2,300 0 2,300 UNKNOWN GRANVILLE ROBOTICS BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN H & R BLOCK HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 179 0 179 6 HARRY & DAVID SPEAKER COMMUNITY OUTREACH (1956) 368 0 368 40 HEALTHCARE MEDIA INTERVIEWS COMMUNITY OUTREACH (1956) 1,759 0 1,759 UNKNOWN HEALTHIER FOR LIFE WORKSHOP & REUNION PROCESS IMPROVEMENT (1945) 6,681 0 6,681 123 HEART SAVER CPR AND AED TRAINING PROCESS IMPROVEMENT (1945) 934 0 934 65 HEART TO PLAY PROGRAM SPORTS PHYSICALS (7487) 57,821 0 57,821 629 HEARTBEATS OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN HEATH FIRE DEPARTMENT OPEN HOUSE HEALTH INFORMATION TABLE COMMUNITY OUTREACH (1956) 166 0 166 125 HEATH HIGH SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 110 0 110 UNKNOWN HEATH SERTOMA YOUTH ATHLETIC ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN HONOR FLIGHT PROGRAM IN KIND DONATIONS DEVELOPMENT (1955) 188 0 188 UNKNOWN HOSPICE OF CENTRAL OHIO CASH DONATIONS DEVELOPMENT (1955) 980 0 980 UNKNOWN IMMUNIZATION OF PATIENTS AGES 65 AND OVER FOR TD ADMIN LMHP (7445) 2,762 0 2,762 164 JOHNSTOWN ATHLETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN KENDAL AT GRANVILLE SPEAKER COMMUNITY OUTREACH (1956) 105 0 105 8 KIWANIS CLUB OF GRANVILLE CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP LAKEWOOD ATHLETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 350 0 350 UNKNOWN LAKEWOOD GIRLS SUMMER SOFTBALL CASH DONATIONS DEVELOPMENT (1955) 350 0 350 UNKNOWN LAKEWOOD HIGH SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 2,473 0 2,473 UNKNOWN LCESC JR. HIGH CAREER EXPLORATION HUMAN RESOURCES (1951) 511 0 511 18 LEADERSHIP BY THE MINUTE CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN LIBERTY MIDDLE SCHOOL SPEAKERS BUREAU COMMUNITY OUTREACH (1956) 623 0 623 438 LIBERTY UNITED METHODIST CHURCH SPEAKERS COMMUNITY OUTREACH (1956) 159 0 159 18 LICCO INC. CASH DONATIONS DEVELOPMENT (1955) 250 0 250 UNKNOWN LICCO INC. SPEAKER COMMUNITY OUTREACH (1956) 489 0 489 41 LICKING COUNTY AGING PROGRAM CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LICKING COUNTY AGING PROGRAM SPEAKER COMMUNITY OUTREACH (1956) 1,250 0 1,250 255 LICKING COUNTY CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 11,800 0 11,800 UNKNOWN LICKING COUNTY COALITION FOR HOUSING CASH DONATIONS DEVELOPMENT (1955) 700 0 700 UNKNOWN LICKING COUNTY COALITION FOR HOUSING IN KIND DONATIONS DEVELOPMENT (1955) 2,000 0 2,000 UNKNOWN LICKING COUNTY COALITION OF CARE CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LICKING COUNTY FAMILY YMCA CASH DONATIONS DEVELOPMENT (1955) 10,350 0 10,350 UNKNOWN LICKING COUNTY FOUNDATION IN KIND DONATIONS DEVELOPMENT (1955) 760 0 760 UNKNOWN LICKING COUNTY HEALTH DEPARTMENT CASH DONATIONS DEVELOPMENT (1955) 400 0 400 UNKNOWN LICKING COUNTY HEALTH DEPARTMENT CHLAMYDIA/GC SCREENINGS LAB (1702) 4,723 0 4,723 123 LICKING COUNTY PARK DISTRICT CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN LICKING COUNTY PLAYERS CASH DONATIONS DEVELOPMENT (1955) 750 0 750 UNKNOWN LICKING COUNTY PRAYER PARTNERS CASH DONATIONS DEVELOPMENT (1955) 750 0 750 UNKNOWN LICKING COUNTY SAFETY COUNCIL SPEAKER COMMUNITY OUTREACH (1956) 1,477 0 1,477 150 LICKING COUNTY SHERIFF'S DEPARTMENT CASH DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN LICKING COUNTY SPECIAL OLYMPICS CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN LICKING COUNTY TASK FORCE ON AGING IN KIND DONATIONS DEVELOPMENT (1955) 550 0 550 UNKNOWN LICKING COUNTY TASK FORCE ON AGING SENIOR HEALTH FAIR COMMUNITY OUTREACH (1956) 557 0 557 51 LICKING VALLEY BIDDY LEAGUE FOOTBALL CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN LICKING VALLEY HERITAGE SOCIETY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN LICKING VALLEY HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN LICKING VALLEY HIGH SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 4,579 0 4,579 25 LICKING VALLEY YOUTH SPORTS ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 550 0 550 UNKNOWN LOOK UP CENTER CASH DONATIONS DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN LUNGEVITY FOUNDATION CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN MADISON PUBLIC SCHOOLS CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN MENTAL HEALTH & RECOVERY FOR KNOX & LICKING COUNTY IN KIND DEVELOPMENT (1955) 2,343 0 2,343 100 MENTAL HEALTH & RECOVERY FOR LICKING & KNOX COUNTIES CASH DONATION DEVELOPMENT (1955) 13,555 0 13,555 UNKNOWN MENTAL HEALTH AMERICA YES CLUB IN KIND DONATIONS DEVELOPMENT (1955) 2,275 0 2,275 UNKNOWN MENTAL HEALTH AMERICA OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 300 0 300 UNKNOWN METROPOLITAN HOUSING SPEAKERS COMMUNITY OUTREACH (1956) 308 0 308 67 MIDLAND THEATRE IN KIND DONATIONS FOOD SERVICE (1801) 3,530 0 3,530 UNKNOWN MISCELLANEOUS IN KIND DONATIONS DEVELOPMENT (1955) 113 0 113 1 MISSION TRIP DRUGS AND SUPPLIES DEVELOPMENT (1955) 3,633 0 3,633 UNKNOWN MONROE TOWNSHIP FIRE DEPARTMENT HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 125 0 125 75 MOPAR NATIONALS COMMUNITY SUPPORT POLICE (1842) 403 0 403 UNKNOWN MOUND CITY LITTLE LEAGUE CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN MOVIE NIGHT HEALTH SCREENINGS COMMUNITY OUTREACH (1956) 124 0 124 150 MUSCULAR DYSTROPHY ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN MY PLACE TO BE CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN NATIONAL MULTIPLE SCLEROSIS SOCIETY CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN NEWARK CATHOLIC HIGH SCHOOL ATHLETIC DEPT. CASH DONATIONS DEVELOPMENT (1955) 450 0 450 UNKNOWN NEWARK CITY SCHOOLS CASH DONATIONS DEVELOPMENT (1955) 425 0 425 UNKNOWN NEWARK DEVELOPMENT PARTNERS COMMUNITY IMPROVEMENT CORPORATION DEVELOPMENT (1955) 30,000 0 30,000 UNKNOWN NEWARK DIGITAL ACADEMY SPEAKERS COMMUNITY OUTREACH (1956) 195 0 195 6 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 IN KIND DONATIONS DEVELOPMENT (1955) 134 0 134 UNKNOWN NEWARK HIGH SCHOOL ATHLETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 1,250 0 1,250 UNKNOWN NEWARK KIWANIS CLUB IN KIND DONATIONS DEVELOPMENT (1955) 204 0 204 UNKNOWN NEWARK PUBLIC LIBRARY SPEAKER COMMUNITY OUTREACH (1956) 134 0 134 10 NEWBORN BASICS MATERNAL CHILD (1646) 1,308 130 1,178 90 NORTH NEWARK LITTLE LEAGUE VARSITY AND FARM CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN NORTHRIDGE PTO CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN NORTHRIDGE YOUTH ATHLETIC ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 750 0 750 UNKNOWN OHIO METAL TECHNOLOGIES SPEAKER COMMUNITY OUTREACH (1956) 1,059 0 1,059 43 OHIO STARZ 00 SOFTBALL TEAM CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN OPENING DAY YOUTH SPORTS CEREMONIES IN KIND DONATIONS COMMUNITY OUTREACH (1956) 8,382 0 8,382 2,850 OPERATION FEED IN KIND DONATIONS VOLUNTEERS (1970) 9,249 0 9,249 UNKNOWN OSTEOARTHRITIS COMMUNITY HEALTH EDUCATION PROCESS IMPROVEMENT (1945) 517 0 517 45 OSU SPEAKERS COMMUNITY OUTREACH (1956) 421 0 421 11 OUR FUTURES LICKING COUNTY IN KIND DONATIONS DEVELOPMENT (1955) 1,560 0 1,560 UNKNOWN OWENS CORNING LUNCH AND LEARN SESSIONS COMMUNITY OUTREACH (1956) 308 0 308 15 OXFORD KNEE REPLACEMENT COMMUNITY HEALTH EDUCATION PROCESS IMPROVEMENT (1945) 160 0 160 12 PAID STUDENT INTERNSHIPS OTHER HEALTH PROFESSIONAL EDUCATION FISCAL SERVICES (1901) 64,318 0 64,318 11 PALLIATIVE CARE AND END OF LIFE DECISIONS PROCESS IMPROVEMENT (1945) 137 0 137 8 PAR EXCELLENCE HEALTH FAIR COMMUNITY OUTREACH (1956) 213 0 213 50 PARK NATIONAL BANK SPEAKER COMMUNITY OUTREACH (1956) 422 0 422 34 PARKINSON SUPPORT GROUP SPEAKER COMMUNITY OUTREACH (1956) 453 0 453 57 PATASKALA AREA CHAMBER OF COMMERCE CASH DONATIONS DEVELOPMENT (1955) 360 0 360 UNKNOWN PATASKALA AREA CHAMBER OF COMMERCE IN KIND DONATIONS DEVELOPMENT (1955) 2,959 0 2,959 43 PATASKALA CHRISTMAS WALK COMMUNITY SUPPORT COMMUNITY OUTREACH (1956) 364 0 364 UNKNOWN PATASKALA LIBRARY SPEAKERS COMMUNITY OUTREACH (1956) 148 0 148 250 PATASKALA RECREATION ASSOCIATION (PRA) CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN PATHWAYS OF CENTRAL OHIO SPEAKERS COMMUNITY OUTREACH (1956) 273 0 273 6 PEDIATRIC DENTAL CLINIC DENTAL CLINIC (1958) 96,000 28,542 67,458 UNKNOWN PELOTONIA CASH DONATIONS DEVELOPMENT (1955) 2,900 0 2,900 UNKNOWN PINK STRIDES TRAIL RUN & WELLNESS WALK IN KIND DONATIONS DEVELOPMENT (1955) 1,250 0 1,250 UNKNOWN PLASTIPAK SPEAKERS COMMUNITY OUTREACH (1956) 153 0 153 20 PRECEPTING NURSING STUDENTS 4N & 4S 4 SOUTH (1614) 3,384 0 3,384 2 PRECEPTING NURSING STUDENTS 5S 5 SOUTH (1612) 5,202 0 5,202 3 PRECEPTING NURSING STUDENTS ER & URGENT CARE EMERGENCY DEPT (1678) 5,477 0 5,477 3 PRECEPTING NURSING STUDENTS HOME HEALTH CARE HOME HEALTH CARE (1978) 5,148 0 5,148 4 COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP PRECEPTING NURSING STUDENTS ICU & CCU INTENSIVE CARE (1640) 32,323 0 32,323 17 PRECEPTING NURSING STUDENTS INPATIENT REHAB INPATIENT REHAB (1615) 17,956 0 17,956 4 PRECEPTING NURSING STUDENTS MATERNAL CHILD & LABOR AND DELIVERY MATERNAL CHILD (1646) 11,912 0 11,912 7 PRECEPTING NURSING STUDENTS WOUND CLINIC WOUND CLINIC (1677) 9,460 0 9,460 4 PRECEPTING STUDENTS CARDIOLOGY CARDIOLOGY (1712) 18,642 0 18,642 6 PRECEPTING STUDENTS OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY (1700) 21,816 0 21,816 5 PRECEPTING STUDENTS PACU/OR SURGERY (1660) 30,491 0 30,491 13 PRECEPTING STUDENTS PHARMACY PHARMACY (1730) 108,163 15,420 92,743 9 PRECEPTING STUDENTS RADIOLOGY RADIOLOGY (1721) 82,077 0 82,077 27 PRECEPTORSHIPS FOR NURSE PRACTITIONER/P.A. STUDENTS FP FAMILY PRACTICE EAST (7425) 24,686 0 24,686 4 PRECEPTORSHIPS FOR PEDIATRICS STUDENTS PEDIATRICS (7460) 54,346 0 54,346 10 PRECEPTORSHIPS FOR WOMEN'S HEALTH STUDENTS WOMENS HEALTH CENTER (7455) 34,757 0 34,757 6 RADON: WHAT YOU NEED TO KNOW PROCESS IMPROVEMENT (1945) 132 0 132 17 RED CROSS BLOOD DRIVE PROCESS IMPROVEMENT (1945) 6,659 0 6,659 266 RED DRESS EVENT COMMUNITY OUTREACH (1956) 29,342 0 29,342 303 RELAY FOR LIFE IN KIND DONATIONS DEVELOPMENT (1955) 725 0 725 UNKNOWN RELAY FOR LIFE SPEAKER ONCOLOGY PC (7405) 116 0 116 200 RESOURCE CENTER/MEDICAL LIBRARY RESOURCE CENTER (1975) 4,723 0 4,723 UNKNOWN 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) 5,000 0 5,000 UNKNOWN ROTARY CLUB OF GRANVILLE IN KIND DONATIONS FOOD SERVICE (1801) 914 0 914 UNKNOWN ROTARY CLUB OF NEWARK IN KIND DONATIONS FOOD SERVICE (1801) 3,811 0 3,811 UNKNOWN ROTARY CLUB OF NEWARK HEATH CASH DONATIONS DEVELOPMENT (1955) 17,000 0 17,000 UNKNOWN ROTARY CLUB OF NEWARK HEATH IN KIND DONATIONS DEVELOPMENT (1955) 960 0 960 UNKNOWN ROTARY CLUB OF PATASKALA CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN ROTARY CLUB OF PATASKALA IN KIND DONATIONS FOOD SERVICE (1801) 750 0 750 UNKNOWN SAFE SURROUNDINGS SAFE SURROUNDINGS (1647) 162,010 33,784 128,226 118 SAINT LUKE'S CHURCH CASH DONATIONS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN SAINT VINCENT HAVEN CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN SALVATION ARMY IN KIND DONATIONS DEVELOPMENT (1955) 2,250 0 2,250 UNKNOWN SALVATION ARMY CHILDREN'S DAY CAMP COMMUNITY OUTREACH (1956) 3,088 0 3,088 59 SALVATION ARMY OF LICKING COUNTY CASH DONATIONS DEVELOPMENT (1955) 600 0 600 UNKNOWN SIBLING PREPARATION CLASS MATERNAL CHILD (1646) 536 20 516 44 SKIN CANCER AWARENESS AND SCREENING PROCESS IMPROVEMENT (1945) 2,359 0 2,359 29 SOUTH NEWARK CIVIC ASSOCIATION CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN SOUTHWEST LICKING SCHOOLS CASH DONATIONS DEVELOPMENT (1955) 3,134 0 3,134 UNKNOWN SOUTHWEST LICKING SCHOOLS IN KIND DONATIONS DEVELOPMENT (1955) 1,500 0 1,500 UNKNOWN SOUTHWEST LICKING SCHOOLS SPEAKER COMMUNITY OUTREACH (1956) 286 0 286 185 ST. EDWARD CHURCH COMMUNITY SUPPORT DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN ST. FRANCIS DE SALES SCHOOL & PARISH CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN ST. PAUL'S EVANGELICAL CHURCH IN KIND DONATIONS DEVELOPMENT (1955) 400 0 400 UNKNOWN STUDENT INTERNSHIPS CASE MANAGEMENT CASE MANAGEMENT (1780) 10,175 0 10,175 2 STUDENT INTERNSHIPS COMMUNITY CASE MANAGEMENT COMMUNITY CASE MANAGEMENT (1976) 6,579 0 6,579 6 STUDENT INTERNSHIPS INFORMATION SYSTEMS INFORMATION SYSTEMS (1936) 2,348 0 2,348 1 STUDENT INTERNSHIPS LABORATORY LAB (1702) 46,217 0 46,217 5 STUDENT INTERNSHIPS MEDICAL OFFICE STUDENTS UNKNOWN (0) 14,638 0 14,638 5 STUDENT INTERNSHIPS PHYSICAL THERAPY & SPEECH THERAPY PHYSICAL THERAPY (1737) 38,793 0 38,793 7 STUDENT NURSE & OTHER HEALTH PROFESSIONALS MANAGEMENT PROCESS PROCESS IMPROVEMENT (1945) 13,346 0 13,346 457 STUDENT NURSE & OTHER HEALTH PROFESSIONALS ORIENTATION PROCESS IMPROVEMENT (1945) 3,358 0 3,358 377 STUDENT SUMMER VOLUNTEER PROGRAM VOLUNTEERS (1970) 5,723 0 5,723 8 SUMMER TEACHER EXTERNSHIP PROGRAM HUMAN RESOURCES (1951) 845 0 845 1 TAD SPORTS SPEAKERS COMMUNITY OUTREACH (1956) 191 0 191 10 TAXI TOKENS FISCAL SERVICES (1901) 1,099 0 1,099 UNKNOWN TAYLOR ROAD ELEMENTARY SPEAKER COMMUNITY OUTREACH (1956) 141 0 141 55 THE ENERGY COOPERATIVE EARTH AND ENERGY DAY COMMUNITY OUTREACH (1956) 336 0 336 164 THE WOODLANDS CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN THE WORKS CASH DONATIONS DEVELOPMENT (1955) 12,000 0 12,000 UNKNOWN THE WORKS SPEAKER COMMUNITY OUTREACH (1956) 1,218 0 1,218 50 TINNITUS AND HEARING LOSS COMMUNITY HEALTH EDUCATION PROCESS IMPROVEMENT (1945) 204 0 204 29 TOBACCO CESSATION PROGRAM TOBACCO CESSATION (1693) 287,196 0 287,196 593 TOGETHER WE GROW, INC. CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN TOTAL KNEE REPLACEMENT PROCESS IMPROVEMENT (1945) 289 0 289 34 TRAIL LIFE USA CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN TRINITY EPISCOPAL CHURCH OF NEWARK SPEAKER COMMUNITY OUTREACH (1956) 118 0 118 14 TYLER'S LIGHT, INC. IN KIND DONATIONS DEVELOPMENT (1955) 143 0 143 14 UNITED WAY AGENCIES CASH DONATIONS DEVELOPMENT (1955) 15,750 0 15,750 UNKNOWN UNITED WAY AGENCIES IN KIND DONATIONS HUMAN RESOURCES (1951) 350 0 350 UNKNOWN UNITED WAY DAY OF CARING IN KIND DONATIONS DEVELOPMENT (1955) 3,691 0 3,691 UNKNOWN UTICA ATHETIC BOOSTERS CASH DONATIONS DEVELOPMENT (1955) 200 0 200 UNKNOWN UTICA SERTOMA CLUB CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN VELVET ICE CREAM SPEAKERS COMMUNITY OUTREACH (1956) 553 0 553 230 VICTORY BAPTIST CHURCH IN KIND DONATIONS DEVELOPMENT (1955) 380 0 380 UNKNOWN VILLAGE OF UTICA CASH DONATIONS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN VOLUNTEERS TWIGS & EVENTS VOLUNTEERS (1970) 0 0 0 115 WALK WITH A DOC COMMUNITY OUTREACH (1956) 21,163 0 21,163 78 WATKINS HIGH SCHOOL CASH DONATIONS DEVELOPMENT (1955) 100 0 100 UNKNOWN WATKINS HIGH SCHOOL IN KIND DONATIONS DEVELOPMENT (1955) 125 0 125 UNKNOWN WATKINS HIGH SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 6,383 0 6,383 UNKNOWN WATKINS MEMORIAL CASH DONATIONS DEVELOPMENT (1955) 150 0 150 UNKNOWN WEATHERVANE PLAYHOUSE CASH DONATIONS DEVELOPMENT (1955) 1,250 0 1,250 UNKNOWN WELLNESS CENTER AT C TEC COMMUNITY BENEFIT C TEC (1977) 79,719 0 79,719 221 WELSH HILLS SCHOOL CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN WELSH HILLS SCHOOL SPEAKER COMMUNITY OUTREACH (1956) 200 0 200 30 WEST MAIN STREET BILL BOARD FOR NONPROFITS IN KIND DONATIONS COMMUNITY OUTREACH (1956) 300 0 300 UNKNOWN WILSON MIDDLE SCHOOL WORKFORCE DEVELOPMENT DEVELOPMENT (1955) 195 0 195 25 WYATT ADKINS HEART ORGANIZATION CASH DONATIONS DEVELOPMENT (1955) 50,000 0 50,000 UNKNOWN YMCA SPEAKER COMMUNITY OUTREACH (1956) 516 0 516 52 YOUTH LEAGUE SCHOLARSHIPS DEVELOPMENT (1955) 5,140 0 5,140 59 ZONTA CLUB OF NEWARK CASH DONATIONS DEVELOPMENT (1955) 500 0 500 UNKNOWN MISCELLANEOUS - IN-KIND DONATIONS 551 0 551 25 MISCELLANEOUS - COMMUNITY HEALTH EDUCATION 95 0 95 12 MISCELLANEOUS - CASH DONATIONS 125 0 125 UNKNOWN MISCELLANEOUS - COMMUNITY BASED CLINICAL SERVICES 140 0 140 70 COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP NUMBER OF PROGRAMS 292 EXPENSES 4,541,625 OFFSETS 163,785 NET BENEFIT 4,377,840 PERSONS 24,693 BENEFITS FOR THE UNDERSERVED: TRADITIONAL CHARITY CARE EXPENSE 4,381,611 OFFSETS 3,943,195 NET BENEFIT 438,416 PERSONS 9755 UNPAID COST OF MEDICAID EXPENSES 53,915,363 OFFSETS 23,332,256 NET BENEFIT 30,583,107 PERSONS 35,013 TOTAL UNDERSERVED EXPENSES 58,296,974 OFFSETS 27,275,451 NET BENEFIT 31,021,523 PERSONS 44,768 GRAND TOTALS EXPENSES 62,838,599 OFFSETS 27,439,236 NET BENEFIT 35,399,363 PERSONS 69,461 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) 11 TYPE III - FI N/A 0 LICKING MEMORIAL HEALTH FOUNDATION 1320 WEST MAIN STREET NEWARK OH 43055 311096217 PROVIDE FUNDING FOR HEALTHCARE PROGRAMS OH 501(C)(3) 11 TYPE I LICKING MEMORIAL HEALTH SYSTEMS 0 LICKING MEMORIAL PROFESSIONAL CORPORATION 1320 WEST MAIN STREET NEWARK OH 43055 311425530 HEALTHCARE ORGANIZATION OH 501(C)(3) 9 LICKING MEMORIAL HEALTH SYSTEMS 0 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 11A, I LICKING MEMORIAL HEALTH SYSTEMS 0 0 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1