LODI COMMUNITY HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LODI COMMUNITY HOSPITAL (EIN 34-0718390)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349300839
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T10:17:53-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340718390 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LODI COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LODI | BusinessNameControlTxt |
| Phone | 3309485501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 ELYRIA STREET | AddressLine1Txt |
| City | LODI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44254 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBORAH GORBACH | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3309485501 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALAN J PAPA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 ELYRIA STREET | AddressLine1Txt |
| City | LODI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,765,237 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LODIHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1920 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND LIVES OF THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 163 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $14,121 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,195,707 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,574,232 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$24,640 | PYInvestmentIncomeAmt |
| CY Investment Income | -$38,801 | CYInvestmentIncomeAmt |
| PY Other Revenue | $215,168 | PYOtherRevenueAmt |
| CY Other Revenue | $103,308 | CYOtherRevenueAmt |
| PY Total Revenue | $17,396,235 | PYTotalRevenueAmt |
| CY Total Revenue | $16,652,860 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,289 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $13,760 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,538,906 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,602,844 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,767,572 | PYOtherExpensesAmt |
| CY Other Expenses | $7,473,720 | CYOtherExpensesAmt |
| PY Total Expenses | $15,316,767 | PYTotalExpensesAmt |
| CY Total Expenses | $15,090,324 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,079,468 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,562,536 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,712,071 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,116,607 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,880,306 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,043,938 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,831,765 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,072,669 | NetAssetsOrFundBalancesEOYAmt |
| Mission | LODI COMMUNITY HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH AND LIVES OF THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,272,220 | ExpenseAmt |
| Revenue | $3,064,741 | RevenueAmt |
| Desc | LODI COMMUNITY HOSPITAL IS A 25 BED HOSPITAL OFFERING INPATIENT SERVICES FOR MEDICAL AND SURGICAL PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,002,268 | ExpenseAmt |
| Revenue | $13,505,726 | RevenueAmt |
| Desc | LODI COMMUNITY HOSPITAL OFFERS A VARIETY OF OUTPATIENT SERVICES. OUTPATIENT SERVICES OFFERED TO PATIENTS INCLUDE RADIOLOGY, PHYSICAL THERAPY, CARDIAC, SURGERY, MAMMOGRAPHY, SLEEP CENTER, LAB SERVICES AND EMERGENCY SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,760 | ExpenseAmt |
| Grant | $13,760 | GrantAmt |
| Revenue | $3,765 | RevenueAmt |
| Desc | LODI COMMUNITY HOSPITAL OFFERS COMMUNITY HEALTH AND EDUCATIONAL SERVICES TO THE LOCAL AND SURROUNDING COMMUNITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $12,288,248 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | 0 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 163 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT F WAITKUS | PersonNm |
| Phone | 3304452526 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6801 BRECKSVILLE ROAD RK-85 | AddressLine1Txt |
| City | INDEPENDENCE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ALAN PAPA | ||||||||
| PRESIDENT, COO, DIRECTOR | 5.00 | 50.00 | Yes (X) | Yes (X) | $0 | $463,469 | $28,956 | |
| THOMAS STOVER MD | ||||||||
| DIRECTOR | 5.00 | 50.00 | Yes (X) | $0 | $889,597 | $30,917 | ||
| ANTHONY HAYEK MD | ||||||||
| DIRECTOR | 5.00 | 50.00 | Yes (X) | $0 | $202,994 | $32,140 | ||
| TODD BREAUX MD | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| PAULA BAUER MD | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY BETH C CARROLL | ||||||||
| DIR CHAIR, THRU 10/15 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SONIA ALEMAGNO PHD | ||||||||
| DIR VICE CHAIR THRU 10/15 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THERESA CARTER | ||||||||
| DIRECTOR, CHAIR BEG 10/15 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LAURA CULP | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| LEE GILL | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES RICE | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| LANCE TALMAGE MD | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| KRISTIE VANAUKEN | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| CRAIG M BABBITT | ||||||||
| SECRETARY | 5.00 | 50.00 | Yes (X) | $0 | $390,806 | $32,356 | ||
| DEBORAH GORBACH | ||||||||
| INTERIM TREASURER BEG. 6/15 | 5.00 | 50.00 | Yes (X) | $0 | $256,822 | $19,538 | ||
| SUE J MCCARTHY | ||||||||
| TREASURER THRU 6/15 | 5.00 | 50.00 | Yes (X) | $0 | $254,674 | $18,655 | ||
| DAVE FRIGO | ||||||||
| ASSISTANT TREASURER | 5.00 | 50.00 | Yes (X) | $0 | $225,709 | $22,255 | ||
| DANA KOCSIS | ||||||||
| CHIEF NURSING OFFICER | 50.00 | $165,937 | $0 | $2,543 | Yes (X) | |||
| DAVID PETER MD | ||||||||
| SR VP MEDICAL OFFICER | 5.00 | 50.00 | $0 | $426,492 | $30,477 | Yes (X) | ||
| THOMAS WHELAN | ||||||||
| PRES COMMUNITY/SPECIALTY HOSP | 30.00 | 20.00 | $97,937 | $149,991 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $263,874 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,260,554 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $217,837 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | 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 |
|---|---|---|---|---|---|
| EPMG OF OHIO INC PA | |||||
| 2000 GREEN RD SUITE 300 | ANN ARBOR | MI | 481051571 | ER PHYSICIANS | $581,585 |
| RESPIRATORY SUPPORT SERVICES | |||||
| 328 BOSTON MILLS ROAD | HUDSON | OH | 44236 | CARDIOPULMONARY SERVICES | $389,338 |
| ARAMARK | |||||
| 115 NORTH FIRST STREET | BURBANK | CA | 91502 | LINEN SERVICES | $125,376 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| PO BOX 96485 | CHICAGO | IL | 606936485 | MRI SERVICES | $123,430 |
| CHIPPEWA ROOFING LLC | |||||
| POB BOX 93 | CHIPPEWA LAKE | OH | 44215 | ROOFING REPAIR & REPLACEMENT | $105,950 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $14,121 | GovernmentGrantsAmt |
| Total Contributions | $14,121 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 621990 | $14,375,252 | $14,375,252 |
| MEDICARE/MEDICAID PAYM | 921990 | $2,195,215 | $2,195,215 |
| OTHER PROGRAM SERVICES | 900099 | $3,765 | $3,765 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,574,232 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,534 | TotalRevenueColumnAmt |
| Exclusion | $2,534 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,855 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $71,042 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$27,187 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$27,187 | TotalRevenueColumnAmt |
| Exclusion | -$27,187 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $41,335 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$41,335 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$41,335 | TotalRevenueColumnAmt |
| Exclusion | -$41,335 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CHANGE IN INTEREST-FOU | 900099 | $65,017 | $65,017 |
| CAFETERIA | 900099 | $45,026 | $45,026 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,452 | TotalRevenueColumnAmt |
| Exclusion | $20,452 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $130,495 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,652,860 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,574,232 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $64,507 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,760 | TotalAmt |
| Program Services | $9,760 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,231 | TotalAmt |
| Program Services | $275,231 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,898,258 | TotalAmt |
| Program Services | $5,065,185 | ProgramServicesAmt |
| Management And General | $833,073 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,727 | TotalAmt |
| Program Services | $93,163 | ProgramServicesAmt |
| Management And General | $14,564 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $889,383 | TotalAmt |
| Program Services | $767,610 | ProgramServicesAmt |
| Management And General | $121,773 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,245 | TotalAmt |
| Program Services | $371,302 | ProgramServicesAmt |
| Management And General | $60,943 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,388 | TotalAmt |
| Management And General | $47,388 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $488 | TotalAmt |
| Management And General | $488 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,150,490 | TotalAmt |
| Program Services | $1,829,385 | ProgramServicesAmt |
| Management And General | $321,105 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,111 | TotalAmt |
| Program Services | $86,111 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,684 | TotalAmt |
| Program Services | $283,383 | ProgramServicesAmt |
| Management And General | $98,301 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,362 | TotalAmt |
| Program Services | $79,011 | ProgramServicesAmt |
| Management And General | $12,351 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $880,598 | TotalAmt |
| Program Services | $761,548 | ProgramServicesAmt |
| Management And General | $119,050 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,140 | TotalAmt |
| Program Services | $17,195 | ProgramServicesAmt |
| Management And General | $13,945 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,118 | TotalAmt |
| Management And General | $2,118 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39 | TotalAmt |
| Program Services | $34 | ProgramServicesAmt |
| Management And General | $5 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $790,981 | TotalAmt |
| Program Services | $363,088 | ProgramServicesAmt |
| Management And General | $427,893 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,324 | TotalAmt |
| Program Services | $255,398 | ProgramServicesAmt |
| Management And General | $39,926 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | $1,429,141 | $1,429,141 | |
| MEDICAL SUPPLIES | $595,753 | $595,753 | |
| MGMT FEE TO AGHS | $346,668 | $346,668 | |
| OHIO FRANCHISE FEE | $329,099 | $329,099 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,336 | TotalAmt |
| Program Services | $1,950 | ProgramServicesAmt |
| Management And General | $13,386 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,090,324 | TotalAmt |
| Program Services | $12,288,248 | ProgramServicesAmt |
| Management And General | $2,802,076 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,604 | BOYAmt |
| EOY | $430,926 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,975,983 | BOYAmt |
| EOY | $2,479,420 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,265 | BOYAmt |
| EOY | $48,903 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,203 | BOYAmt |
| EOY | $101,945 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,661,462 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,704,312 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,150,012 | BOYAmt |
| EOY | $6,957,150 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,062,004 | BOYAmt |
| EOY | $1,098,263 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,712,071 | BOYAmt |
| EOY | $11,116,607 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,021,521 | BOYAmt |
| EOY | $953,735 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,033 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,785 | BOYAmt |
| EOY | $1,089,170 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,880,306 | BOYAmt |
| EOY | $2,043,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,143,413 | BOYAmt |
| EOY | $8,413,076 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $688,352 | BOYAmt |
| EOY | $659,593 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,831,765 | BOYAmt |
| EOY | $9,072,669 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,712,071 | BOYAmt |
| EOY | $11,116,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,562,536 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,321,632 | 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $488 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $488 | 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 | PART II-B, LINE 1 (F), GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES: LODI COMMUNITY HOSPITAL IS A DUES PAYING MEMBER OF THE OHIO HOSPITAL ASSOCIATION (OHA). A PORTION OF OUR DUES ($461) IS USED BY OHA FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $688,352 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $52,179 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $80,938 | OtherExpendituresAmt |
| End Year Balance | $659,593 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $705,793 | BeginningYearBalanceAmt |
| Contributions | $291 | ContributionsAmt |
| Investment Earnings Or Losses | $36,620 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $54,352 | OtherExpendituresAmt |
| End Year Balance | $688,352 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $779,774 | BeginningYearBalanceAmt |
| Contributions | $8,901 | ContributionsAmt |
| Investment Earnings Or Losses | $81,322 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $164,204 | OtherExpendituresAmt |
| End Year Balance | $705,793 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $683,304 | BeginningYearBalanceAmt |
| Contributions | $34,659 | ContributionsAmt |
| Investment Earnings Or Losses | $70,646 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$8,835 | OtherExpendituresAmt |
| End Year Balance | $779,774 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $336,802 | BeginningYearBalanceAmt |
| Contributions | $343,021 | ContributionsAmt |
| Investment Earnings Or Losses | $3,481 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $683,304 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| 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 | $98,793 | OtherCostOrOtherBasisAmt |
| Book Value | $98,793 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,113,227 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,957,680 | DepreciationAmt |
| Book Value | $5,155,547 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,705,028 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,288,505 | DepreciationAmt |
| Book Value | $1,416,523 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $744,414 | OtherCostOrOtherBasisAmt |
| Depreciation | $458,127 | DepreciationAmt |
| Book Value | $286,287 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,957,150 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST IN FOUNDATION NET ASSETS | Desc |
| Book Value | $1,098,263 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,098,263 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED MEDICARE SETTLEMENT DUE | $360,791 |
| ACCRUED SELF INSURANCE CLAIMS PAYABLE | $708,379 |
| ASSET RETIREMENT OBLIGATION | $20,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,089,170 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | LODI COMMUNITY HOSPITAL IS A SUBSIDIARY OF AKRON GENERAL HEALTH SYSTEM. AKRON GENERAL HEALTH SYSTEM AND ALL OF ITS SUBSIDIARIES, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF THE CLEVELAND CLINIC FOUNDATION. THE CLEVELAND CLINIC FOUNDATION'S ("THE CLEVELAND CLINIC HEALTH SYSTEM OR "SYSTEM") AUDITED FINANCIAL STATEMENTS ARE REPORTED ON A CONSOLIDATED BASIS, INCLUDING EXEMPT, TAXABLE, AND FOREIGN ENTITIES TO WHICH THE ASC 740-10 LIABILITY RELATES. THE ASC 740-10 FOOTNOTE ON THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE CLEVELAND CLINIC HEALTH SYSTEM READS AS FOLLOWS: AT DECEMBER 31, 2015 AND 2014, THE LIABILITY FOR UNCERTAINTY IN INCOME TAXES WAS $4.1 MILLION AND $9.7 MILLION, RESPECTIVELY. THE SYSTEM DOES NOT EXPECT A SIGNIFICANT INCREASE OR DECREASE IN UNRECOGNIZED TAX BENEFITS WITHIN THE NEXT 12 MONTHS. THE SYSTEM RECOGNIZES INTEREST AND PENALTIES ACCRUED RELATED TO THE LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. | ExplanationTxt |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,107 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $169,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,765,226 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $715,545 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,049,681 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,934,333 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $715,545 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,218,788 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08920 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $139,675 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,974 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $130,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00960 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,184 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,876 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,876 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $216,735 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,974 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $207,761 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01520 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,151,068 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $724,519 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,426,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10440 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,874 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,874 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $493,637 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,017,691 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,877,168 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $140,523 | 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 | LODI COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 ELYRIA ST | AddressLine1Txt |
| City | LODI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.AKRONGENERAL.ORG | WebsiteAddressTxt |
| State License | OH STATE ID 1234AHR | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LODI COMMMUNITY 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 |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.AKRONGENERAL.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.AKRONGENERAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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.AKRONGENERAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.AKRONGENERAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.AKRONGENERAL.ORG | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LODI COMMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: AS DESCRIBED IN THE EXECUTIVE SUMMARY OF ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT, LODI COMMUNITY HOSPITAL (LCH) PARTICIPATED IN A COMMUNITY BASE COLLABORATIVE IN CONDUCTING ITS CHNA. THE COLLABORATIVE WAS COMPOSED OF GOVERNMENTAL AND NONPROFIT AGENCIES. ITS STEERING COMMITTEE SELECTED A GROUP OF COMMUNITY MEMBERS TO RESPOND TO A SELF-ADMINISTERED SURVEY. THE COMMUNITY MEMBERS INCLUDED PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, SUCH AS A REPRESENTATIVE FROM THE RELEVANT COUNTY HEALTH DEPARTMENT, CITY GOVERNMENT, AND/OR OR STATE GOVERNMENT. A LIST OF EACH MEMBER'S ORGANIZATION CAN BE FOUND IN THE EXECUTIVE SUMMARY OF LCH'S CHNA. |
| LODI COMMMUNITY HOSPITAL | PART V, SECTION B, LINE 6A: IN PREPARING ITS OWN COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LODI COMMUNITY HOSPITAL PARTICIPATED IN A COMMUNITY WIDE COLLABORATIVE THAT INCLUDED MEDINA HOSPITAL AND WADSWORTH RITTMAN HOSPITAL. |
| LODI COMMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: IN GENERAL, THE KEY NEEDS IDENTIFIED BY THE 2013 CHNA WERE THE FOLLOWING: FOR ADULTS - CHRONIC DISEASES, MENTAL HEALTH, SUBSTANCE ABUSE, LIFESTYLE FACTORS, ACCESS TO HEALTH CARE, QUALITY OF HEALTH CARE AND ENVIRONMENTAL FACTORS; AND FOR CHILDREN - ENVIRONMENTAL FACTORS, MENTAL HEALTH AND ACCESS TO HEALTH CARE.THE HEALTH NEEDS THAT LCH WILL NOT ADDRESS ARE HIV SCREENINGS FOR ADULTS. IT ALSO WILL NOT ADDRESS ANEMIA AND ELEVATED LEAD LEVELS IN CHILDREN. THESE NEEDS ALREADY ARE BEING ADDRESSED BY THE COUNTY HEALTH DEPARTMENT WHICH HAS THE APPROPRIATE EXPERTISE AND RESOURCES FOR THESE ISSUES. |
| LODI COMMMUNITY HOSPITAL | PART V, SECTION B, LINE 16I: FOR UNINSURED AND UNDERINSURED PATIENTS, OUR FINANCIAL COUNSELORS OR ELIGIBILITY VENDOR STAFF REACH OUT UPON ADMISSION, OR AS SOON AS POSSIBLE THEREAFTER, TO EXPLAIN THE PROGRAMS FOR FREE OR DISCOUNTED CARE AND TO ASSESS ELIGIBILITY FOR MEDICAID AND OTHER VARIOUS PROGRAMS (VETERAN'S ADMINISTRATION, COBRA, OTHER LOCAL PROGRAMS, ETC.).FOR SCHEDULED OUTPATIENT SERVICES, FINANCIAL COUNSELORS ATTEMPT TO CONTACT THE PATIENT PRIOR TO SERVICE TO SCREEN UNINSURED PATIENTS FOR POSSIBLE ASSISTANCE/PAYMENT SOLUTIONS. IF UNABLE TO CONTACT PATIENT PRIOR TO THE SERVICE, WE ATTEMPT TO SCREEN ON THE DAY OF SERVICE OR AS SOON THEREAFTER AS POSSIBLE.FOR UNSCHEDULED EMERGENCY SERVICES, SCREENING MAY BE COMPLETED DURING THE VISIT WHEN PATIENT IS ABLE. OTHERWISE, ATTEMPTS TO CONTACT THE PATIENT ARE MADE BY THE FINANCIAL COUNSELING STAFF.IN EITHER CASE, IF WE ARE UNABLE TO CONTACT THE PATIENT, THE FINANCIAL ASSISTANCE INFORMATION IS ON EACH BILLING STATEMENT SENT TO THE PATIENT.IF THE PATIENT IS DETERMINED TO BE LIKELY ELIGIBLE FOR MEDICAID, THE ELIGIBILITY VENDOR STAFF ASSIST AND REPRESENT THE PATIENT THROUGHOUT THE APPLICATION PROCESS (UPON APPROVAL FROM THE PATIENT). IN ADDITION TO SIGNAGE, INFORMATION EXPLAINING OUR PROGRAMS ARE IN ALL OF OUR REGISTRATION AREAS. OUR WELCOME PACKETS ALSO INCLUDE INFORMATION AS DOES OUR WEBSITE. ALL STATEMENTS MAILED TO PATIENTS INCLUDE A NOTICE THAT OUR FINANCIAL ASSISTANCE APPLICATIONS ARE ON THE BACK OF THE STATEMENT. PHONE NUMBERS ARE PROVIDED FOR ASSISTANCE. |
| LODI COMMMUNITY HOSPITAL | PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY USED THE MEDICARE RATES AND ALL PRIVATE HEALTH INSURANCE WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LODI COMMUNITY CARE CENTER | ||||
| 402 HIGHLAND DRIVE | LODI | OH | 44254 | PHYSICIANS OFFICE |
| 2 - LODI COMMUNITY CARE CENTER | ||||
| 221 ELYRIA ST SUITE 102 | LODI | OH | 44254 | PHYSICIANS OFFICE |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COSTING METHODOLOGY. THE ORGANIZATION USED A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO USED WAS DERIVED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS.PART I, LINE 7(F):COLUMN (F): IN CALCULATING THE PERCENTAGE OF TOTAL EXPENSE REPORTED IN COLUMN (F), TOTAL EXPENSES AS REPORTED ON FORM 990, PART IX, LINE 25, COLUMN (A) WERE REDUCED BY $1,429,141 - THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON THAT LINE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | PART III, SECTION A, LINES 2 AND 3: COSTING METHODOLOGY. BAD DEBTS AS REPORTED ON LINE 2 ARE DERIVED FROM THE GROSS CHARGES WRITTEN OFF AS UNCOLLECTIBLE FOR FINANCIAL REPORTING PURPOSES. THE COST-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2 - RATIO OF PATIENT CARE COST TO CHARGES, WAS APPLIED IN CALCULATING LINE 2. |
| PART III, LINE 4: | THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES.AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, LODI COMMUNITY HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO VARIOUS RESTRICTIONS INCLUDING A PROHIBITION AGAINST ENGAGING IN EXTRAORDINARY COLLECTION PROCEDURES AGAINST AN INDIVIDUAL WITHOUT HAVING FIRST MADE REASONABLE EFFORTS TO DETERMINE THAT INDIVIDUALS ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 8: | LODI COMMUNITY HOSPITAL PROVIDES AN IMPORTANT COMMUNITY BENEFIT THROUGH ITS PARTICIPATION IN THE MEDICARE PROGRAM. BY ABSORBING THIS SHORTFALL, LODI COMMUNITY HOSPITAL PROMOTES THE HEALTH OF THOSE MEMBERS OF THE COMMUNITY RELYING ON MEDICARE AND LESSENS THE BURDEN OF GOVERNMENT BY DOING SO.THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS IS THE COST TO CHARGE RATIO DEVELOPED IN ACCORDANCE WITH THE MEDICARE COST REPORT INSTRUCTIONS. |
| PART III, LINE 9B: | LODI COMMUNITY HOSPITAL'S BAD DEBT COLLECTION POLICY ADDRESSES HOW TO IDENTIFY AND PROCESS PATIENTS' ACCOUNTS FOR QUALIFICATION AS CHARITY CARE OR OTHER FINANCIAL ASSISTANCE. AT REGISTRATION/ADMISSION A SCREENING PROCESS IDENTIFIES THOSE PATIENTS WITHOUT INSURANCE. THOSE PATIENT ACCOUNTS ARE AUTOMATICALLY CHECKED FOR POSSIBLE MEDICAID OR OTHER FINANCIAL ASSISTANCE ELIGIBILITY. WHERE ELEGIBILITY IS ESTABLISHED, THE PATIENT RECEIVES ASSISTANCE AFTER COMPLETING ANY REQUIRED APPLICATIONS. PATIENTS WHO QUALIFY FOR 100% CHARITY CARE WILL HAVE THEIR CHARGES WRITTEN OFF AS SUCH AND NO COLLECTION EFFORTS WILL FOLLOW. PATIENTS THAT QUALIFY FOR A SLIDING SCALE DISCOUNT THROUGH CHARITY CARE WILL HAVE THEIR STATEMENT ADJUSTED ACCORDINGLY. IF THE ADJUSTED BALANCE IS UNPAID, THE ADJUSTED BALANCE GOES TO COLLECTIONS IN ACCORDANCE WITH POLICY FOR ALL BAD DEBT ACCOUNTS. |
| PART VI, LINE 2: | THERE ARE A VARIETY OF NEEDS ASSESSMENT METHODS EMPLOYED BY LODI COMMUNITY HOSPITAL IN DETERMINING THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. FOR MEDICAL STAFFING AND SERVICES, A COMBINATION OF FACTORS INCLUDING THE COMMUNITY'S DEMOGRAPHICS AND HEALTH NEEDS, THE DEMOGRAPHICS OF MEDICAL STAFF (PHYSICIAN AGE, SPECIALTY, ETC...) ARE WEIGHED TO DETERMINE WHERE RESOURCES SHOULD BE CONCENTRATED IN ORDER TO MEET CURRENT AND FUTURE HEALTHCARE NEEDS OF THE COMMUNITY. LODI COMMUNITY HOSPITAL PARTICIPATES IN HEALTHCARE INITIATIVES OF STATE AND LOCAL HEALTH DEPARTMENTS, EITHER SOLELY OR IN CONCERT WITH OTHER HEALTHCARE PROVIDERS, DEPENDING ON THE INITIATIVE. LODI COMMUNITY HOSPITAL HAS WORKED WITH LOCAL CHURCHES AND SOCIAL WELFARE ORGANIZATIONS TO IDENTIFY AND SERVICE HEALTHCARE NEEDS OF PERSONS WHO ARE UNDERSERVED BY GOVERNMENT PROGRAMS OR WHO HAVE FALLEN COMPLETELY THROUGH GOVERNMENT SAFETY NETS. |
| PART VI, LINE 3: | FOR UNINSURED AND UNDERINSURED PATIENTS, OUR FINANCIAL COUNSELORS OR ON-SITE ELIGIBILITY VENDOR STAFF REACH OUT UPON ADMISSION OR PRIOR TO DISCHARGE TO EXPLAIN THE PROGRAMS FOR FREE OR DISCOUNTED CARE AND TO ASSESS ELIGIBILITY FOR MEDICAID AND OTHER VARIOUS PROGRAMS (VETERAN'S ADMINISTRATION, COBRA, OTHER LOCAL PROGRAMS, ETC.).IF THE PATIENT IS DETERMINED TO BE LIKELY ELIGIBLE FOR MEDICAID, THE ELIGIBILITY VENDOR STAFF ASSIST AND REPRESENT THE PATIENT THROUGHOUT THE APPLICATION PROCESS (UPON APPROVAL FROM THE PATIENT). IN ADDITION TO SIGNAGE, BROCHURES EXPLAINING OUR PROGRAMS ARE IN ALL OF OUR REGISTRATION AREAS. OUR WELCOME PACKETS ALSO INCLUDE INFORMATION AS DOES OUR WEBSITE. ALL STATEMENTS MAILED TO PATIENTS INCLUDE A NOTICE THAT OUR FINANCIAL ASSISTANCE APPLICATIONS ARE ON THE BACK OF THE STATEMENT. PHONE NUMBERS ARE PROVIDED FOR ASSISTANCE. FINANCIAL ASSISTANCE APPLICATIONS ARE ON THE BACK OF EVERY PATIENT STATEMENT AS WELL AS MESSAGES INFORMING PATIENTS THAT ASSISTANCE IS AVAILABLE - VIA WEBSITE, AUTOMATED ATTENDANT OR CUSTOMER SERVICE LINE. SUCH MESSAGES ALSO ARE CONSPICUOUSLY POSTED IN PATIENT AREAS AND THROUGHOUT OUR FACILITIES. WE ALSO HAVE FINANCIAL ASSISTANCE INFORMATION SUCH AS CUSTOMER SERVICE PHONE NUMBERS POSTED THROUGHOUT OUR FACILITIES AT PATIENT INTAKE AREAS. IN ADDITION, FINANCIAL COUNSELORS ARE AVAILABLE AT OUR MAIN CAMPUS TO DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE WITH PATIENTS AS THEY DISCHARGE. |
| PART VI, LINE 4: | LODI COMMUNITY HOSPITAL IS LOCATED IN SOUTHERN MEDINA COUNTY AND SERVES THE POPULATION OF 174,915 PEOPLE IN MEDINA. THE MEDIAN AGE OF RESIDENTS IN MEDINA IS 41.3 AND THE MEDIAN HOUSEHOLD INCOME IS AROUND $50,000. THE DOMINANT INDUSTRIES IN THE AREA ARE AGRICULTURE, MANUFACTURING, RETAIL AND GOVERNMENT. LODI COMMUNITY HOSPITAL ALSO SERVES A LARGE AMISH POPULATION. WHILE MEDINA COUNTY'S CURRENT UNEMPLOYMENT RATE IS AT 4.6% THE SURROUNDING COUNTIES' RATES ARE HIGHER; LORAIN IS 6.2% AND CUYAHOGA IS 5.8% WITH THE STATE OF OHIO AT 5%. |
| PART VI, LINE 5: | IN ORDER TO ENSURE THE FURTHERANCE OF LODI COMMUNITY HOSPITAL'S EXEMPT PURPOSE, ITS BOARD OF DIRECTORS CONSISTS OF COMMUNITY MEMBERS - THE MAJORITY OF WHOM ARE INDEPENDENT. THE SIZE OF THE BOARD IS DESIGNED TO BE LARGE ENOUGH TO PROVIDE SUFFICIENT EXPERTISE AND DIVERSITY FOR AN ORGANIZATION OF THIS SIZE WITHOUT BEING TOO LARGE TO MANAGE ITSELF. THE BOARD, AS WELL AS SENIOR MANAGEMENT AND MEDICAL STAFF LEADERS, ARE CHARGED BY POLICY WITH THE EXPECTATION THAT PERSONS IN SUCH POSITIONS WILL ADVOCATE STRONG TIES BETWEEN THE ORGANIZATION AND THE COMMUNITY IT SERVES. AMONG OTHER THINGS THE POLICY CITES THE ASSUMPTION OF BOARD POSITIONS WITH SERVICE ORGANIZATIONS AND COMMUNITY AGENCIES AS WAYS TO PROMOTE SUCH TIES. THROUGH THE HEALTH SYSTEM'S COMMUNITY HEALTH COMMITTEE, LODI COMMUNITY HOSPITAL RECEIVES CONSIDERABLE SUPPORT IN MAINTAINING CONTACTS WITH A DIVERSE CROSS SECTION OF ITS COMMUNITY. THE COMMUNITY HEALTH COMMITTEE SUPPORTS INITIATIVES DESIGNED TO MEET THE NEEDS OF VULNERABLE, DISADVANTAGED POPULATIONS AND THOSE WHO LACK ACCESS TO QUALITY HEALTH CARE. THE MAJORITY OF THE COMMUNITY MEMBERS ARE INDEPENDENT MEMBERS WHOSE FOCUSED MISSION PROVIDES AN IMPORTANT ACCESS POINT FOR GROUPS WITHIN THE COMMUNITY.LODI COMMUNITY HOSPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.LODI COMMUNITY HOSPITAL IS BOUND BY LAW TO REINVEST ANY SURPLUS FROM OPERATIONS INTO ITS FACILITIES AND PROGRAMS IN FURTHERANCE OF ITS EXEMPT PURPOSE, PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. |
| PART VI, LINE 6: | AKRON GENERAL HEALTH SYSTEM IS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION WITH THE MISSION OF IMPROVING THE HEALTH AND LIVES OF PATIENTS AND THE COMMUNITY, AKRON GENERAL HEALTH SYSTEM INCLUDES: AKRON GENERAL MEDICAL CENTER, A 537-BED TEACHING AND RESEARCH MEDICAL CENTER, EDWIN SHAW REHAB, THE AREA'S LARGEST PROVIDER OF REHABILITATION SERVICES, PARTNERS PHYSICIAN GROUP AND LODI COMMUNITY HOSPITAL; AKRON GENERAL PARTNERS, WHICH INCLUDES THE AKRON GENERAL HEALTH & WELLNESS CENTERS, COMMUNITY HEALTH CENTERS AND OTHER COMPANIES, VISITING NURSE SERVICE AND AFFILIATES, THE LARGEST AND MOST COMPREHENSIVE PROVIDER OF HOME HEALTHCARE AND HOSPICE SERVICES IN OHIO, AND THE AKRON GENERAL FOUNDATION.AKRON GENERAL HEALTH SYSTEM BRINGS TOGETHER A NETWORK OF HEALTH CARE FACILITIES AND STAFF WITH A RICH HERITAGE OF EXCEPTIONAL CARE. IT IS AN INTEGRATED HEALTH SYSTEM THAT PROVIDES HIGH-QUALITY HEALTHCARE FOR PATIENTS AND COMMUNITY THROUGHOUT THEIR ENTIRE LIFE - BIRTHS, INPATIENT AND OUTPATIENT SERVICES FOR ADULTS, EMERGENCY CARE, HOME CARE, WELLNESS, DURABLE MEDICAL EQUIPMENT AND HOSPICE SERVICES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALAN PAPA | ||||||||||||||
| PRESIDENT, COO, DIRECTOR | $0 | $383,222 | $0 | $41,200 | $0 | $39,047 | $0 | $5,840 | $0 | $23,116 | $0 | $492,425 | $0 | $0 |
| THOMAS STOVER MD | ||||||||||||||
| DIRECTOR | $0 | $695,123 | $0 | $150,000 | $0 | $44,474 | $0 | $7,678 | $0 | $23,239 | $0 | $920,514 | $0 | $0 |
| ANTHONY HAYEK MD | ||||||||||||||
| DIRECTOR | $0 | $201,928 | $0 | $0 | $0 | $1,066 | $0 | $6,364 | $0 | $25,776 | $0 | $235,134 | $0 | $0 |
| CRAIG M BABBITT | ||||||||||||||
| SECRETARY | $0 | $322,928 | $0 | $35,020 | $0 | $32,858 | $0 | $5,967 | $0 | $26,389 | $0 | $423,162 | $0 | $0 |
| DEBORAH GORBACH | ||||||||||||||
| INTERIM TREASURER BEG. 6/15 | $0 | $225,205 | $0 | $19,780 | $0 | $11,837 | $0 | $1,901 | $0 | $17,637 | $0 | $276,360 | $0 | $0 |
| SUE J MCCARTHY | ||||||||||||||
| TREASURER THRU 6/15 | $0 | $199,770 | $0 | $41,200 | $0 | $13,704 | $0 | $9,790 | $0 | $8,865 | $0 | $273,329 | $0 | $0 |
| DAVE FRIGO | ||||||||||||||
| ASSISTANT TREASURER | $0 | $197,858 | $0 | $16,890 | $0 | $10,961 | $0 | $4,267 | $0 | $17,988 | $0 | $247,964 | $0 | $0 |
| DANA KOCSIS | ||||||||||||||
| CHIEF NURSING OFFICER | $143,567 | $0 | $12,194 | $0 | $10,176 | $0 | $1,798 | $0 | $745 | $0 | $168,480 | $0 | $0 | $0 |
| DAVID PETER MD | ||||||||||||||
| SR VP MEDICAL OFFICER | $0 | $350,226 | $0 | $37,600 | $0 | $38,666 | $0 | $10,600 | $0 | $19,877 | $0 | $456,969 | $0 | $0 |
| THOMAS WHELAN | ||||||||||||||
| PRES COMMUNITY/SPECIALTY HOSP | $74,914 | $49,942 | $10,975 | $7,316 | $12,048 | $92,733 | $1,931 | $148,412 | $6,883 | $4,589 | $106,751 | $302,992 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | FIRST-CLASS TRAVEL IS APPROVED ON AN EXCEPTION BASIS ONLY FOR AN APPROPRIATE BUSINESS PURPOSE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - PERSONS ELIGIBLE TO PARTICPATE IN THE REPORTING ORGANIZATION'S NON-QUALIFIED PLAN HAVE A PORTION OF THEIR COMPENSATION DESIGNATED AS A CONTRIBUTION TO THAT PLAN. THAT PORTION IS GROSSED-UP FOR TAX PURPOSES AND INCLUDED IN THE PROCESS DESCRIBED IN SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. |
| PART I, LINE 4B | LINE 4B: THE FOLLOWING EMPLOYEES PARTICIPATED IN A NONQUALIFIED TAXABLE PLAN WHICH IS NOT FUNDED WITH EMPLOYER CONTRIBUTIONS. CRAIG BABBITT DEBORAH GORBACH SUE J. MCCARTHY TIM STOVER, M.D. ALAN PAPA DAVID PETER, M.D. DAVE FRIGO THOMAS WHELAN PART I, LINE 4B - THE FOLLOWING INDIVIDUALS PARTICIPATE IN A QUALIFIED DEFINED BENEFIT PLAN AND THE ANNUAL INCREASE OR DECREASE IN VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C - RETIREMENT AND OTHER DEFERRED COMPENSATION: ALAN PAPA - $4,760 DECREASE CRAIG BABBITT - $4,633 DECREASE DAVE FRIGO - $4,564 DECREASE DEBBIE GORBACH - $8,202 DECREASE THOMAS STOVER, MD - $272 DECREASE THOMAS WHELAN - $2,920 DECREASE |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | LODI COMMUNITY HOSPITAL HAS ONE MEMBER, AKRON GENERAL MEDICAL CENTER. AKRON GENERAL MEDICAL CENTER IS ORGANIZED IN OHIO AS A NON-PROFIT ORGANIZATION AND IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC 501(C)(3). AKRON GENERAL MEDICAL CENTER IS NOT A PRIVATE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | LODI COMMUNITY HOSPITAL IS GOVERNED BY THE SAME BOARD AS ITS SOLE MEMBER, AKRON GENERAL MEDICAL CENTER (AGMC). THE SOLE MEMBER OF AGMC IS AKRON GENERAL HEALTH SYSTEM. AKRON GENERAL HEALTH SYSTEM HAS THE POWER TO APPOINT THE MEMBERS OF AKRON GENERAL MEDICAL CENTER'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | AKRON GENERAL MEDICAL CENTER IS THE SOLE MEMBER OF LODI COMMUNITY HOSPITAL. AKRON GENERAL HEALTH SYSTEM (AGHS)IS THE SOLE MEMBER OF AKRON GENERAL MEDICAL CENTER. AGHS RESERVES THE FOLLOWING POWERS WITH RESPECT TO LCH, THE POWER: TO ELECT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS, APPOINT CHAIR AND VICE CHAIR OF THE BOARD AND APPOINT AND CONFIRM THE PRESIDENT OF LCH SUBJECT TO CONFIRMATION BY LCH'S BOARD; TO APPROVE ALL VICE PRESIDENTS OF LCH; TO AMEND LCH'S CODE OF REGULATIONS; TO APPROVE EACH ANNUAL OPERATING AND CAPITAL BUDGET AND STRATEGIC PLAN OF LCH; TO APPROVE THE FOLLOWING WHERE THE VALUE EXCEEDS AN AMOUNT PREDETERMINED FOR EACH BY AGHS - CONTRACTS, INVESTMENTS, DONATIONS OF CORPORATE ASSETS AND DEBT OBLIGATIONS; TO APPROVE INDEPENDENT AND INTERNAL AUDITORS, AND ALL ACCOUNTING POLICIES; TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION OR VOLUNTARY DISSOLUTION OF THE CORPORATION; TO APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF MORE THAN 10% IN VALUE OF GROSS PROPERTY AND ASSETS OF THE CORPORATION IN ANY ONE FISCAL YEAR; TO APPROVE THE CREATION OF CONTROLLED OR OWNED SUBSIDIARIES OR AFFILIATES BY THE CORPORATION; TO APPROVE EXECUTIVE COMPENSATION AND BENEFITS; TO APPROVE ALL NEW WRITTEN POLICIES OF LCH. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY EXPERIENCED AND QUALIFIED MEMBERS OF THE FINANCE DIVISION TAX DEPARTMENT. PRIOR TO FILING, KEY SECTIONS OF THE FORM ARE REVIEWED WITH EXPERIENCED AND QUALIFIED MEMBERS OF THE LAW DEPARTMENT. THE ENTIRE RETURN IS ALSO REVIEWED WITH THE CFO, THE AUDIT COMMITTEE CHAIRPERSON AND THE AUDIT COMMITTEE VICE CHAIRPERSON. UPON CONFIRMATION OF SUCCESSFUL E-FILING FROM THE IRS, A COPY OF THE FINAL E-FILED RETURN WILL BE MADE AVAILABLE TO APPROPRIATE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 12C | LODI COMMUNITY HOSPITAL IS AN AFFILIATE OF THE CLEVELAND CLINIC FOUNDATION ("CCF"). IT IS SUBJECT TO THAT ORGANIZATION'S CONFLICT OF INTEREST ("COI") POLICY. CCF HAS ADOPTED A COI POLICY CONSISTENT WITH THE MODEL IRS COI POLICY. IT APPLIES TO DIRECTORS, OFFICERS AND TRUSTEES OF CCF AND ALL ITS AFFILIATES, BOTH EXEMPT AND TAXABLE. UNDER THE BOARD OF DIRECTORS POLICIES AND PROCEDURES FOR DEALING WITH CONFLICT OF INTEREST ISSUES (THE POLICY), A DIRECTOR, OFFICER OR TRUSTEE WHO HAS A CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED CONTRACT, TRANSACTION, OR ARRANGEMENT MUST REFRAIN FROM VOTING ON ANY MATTER RELATING TO THE CONTRACT, TRANSACTION, OR ARRANGEMENT. IN ADDITION, THE DIRECTORS, OFFICERS AND TRUSTEES MUST ANNUALLY DISCLOSE ANY INTERESTS AS DEFINED IN THE POLICY THAT MAY BE CONSIDERED A POTENTIAL CONFLICT OF INTEREST. FAILURE TO TIMELY REPLY IS TO BE ADDRESSED BY THE COMMITTEE UNDER THE POLICY. THE DIRECTORS, OFFICERS AND TRUSTEES HAVE A CONTINUING OBLIGATION TO NOTIFY THE CHIEF GOVERNANCE OFFICER AT ANY TIME DURING THE YEAR IF ANY OF THEIR DISCLOSURES CHANGE OR IF A NEW DISCLOSURE IS REQUIRED UNDER THE POLICY. THE BOARD OF CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) MEETS AT LEAST FOUR TIMES A YEAR AND REVIEWS THE DISCLOSURES, ANY PROPOSED ARRANGEMENTS THAT MAY INVOLVE A POTENTIAL CONFLICT OF INTEREST, AND DOCUMENTS ITS CONCLUSIONS. UNDER THE POLICY, THE INTERESTED PERSONS MAY ATTEND A MEETING AT THE DISCRETION OF THE BOARD OF DIRECTORS, OR THE COMMITTEE, TO PROVIDE INFORMATION OR ANSWER QUESTIONS, BUT SUCH PERSONS MAY NOT BE PRESENT DURING FINAL CONSIDERATION OR VOTING ON THE CONTRACT, TRANSACTION OR ARRANGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE REPORTING ORGANIZATION ITSELF DOES NOT DETERMINE THE COMPENSATION OF ITS TOP MANAGEMENT OFFICIAL OR ITS KEY EMPLOYEES. THE COMPENSATION OF SUCH PERSONS IS DETERMINED BY ITS PARENT ORGANIZATION, AKRON GENERAL HEALTH SYSTEM (AGHS), AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). IN ACCORDANCE WITH AGHS'S EXECUTIVE COMPENSATION POLICY, THE PROCESS FOR DETERMINING THE COMPENSATION OF THE REPORTING ORGANIZATION'S TOP MANAGEMENT PERSONNEL IS MODELED AFTER THE REQUIREMENTS FOUND IN INTERNAL REVENUE CODE SECTION 4958 FOR ESTABLISHING THE PRESUMPTION OF REASONABLE COMPENSATION. THE PROCESS CALLS FOR RECOMMENDATIONS - DEVELOPED BY AN INDEPENDENT COMPENSATION CONSULTANT, BASED ON COMPARABLE MARKET DATA FROM PUBLISHED SURVEYS AND THE FORMS 990 OF COMPARABLE ORGANIZATIONS - THAT ARE WITHIN THE RANGE OF THE TOTAL COMPENSATION AND BENEFITS OF SIMILARLY SITUATED PERSONS AT SIMILARLY SITUATED ORGANIZATIONS. THESE RECOMMENDATIONS ARE REVIEWED BY THE COMPENSATION COMMITTEE OF AGHS'S BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT PERSONS AND THE DELIBERATIONS ARE DOCUMENTED, CONTEMPORANEOUSLY, IN THE COMMITTEE'S MINUTES. WITH THE EXCEPTION OF AGHS'S CEO, THE COMPENSATION FOR THE REPORTING ORGANIZATION'S TOP MANAGEMENT - AS WELL AS ALL PERSONS LISTED IN PART VII AND SCHEDULE J WHO WERE COMPENSATED BY RELATED ORGANIZATIONS - WAS REVIEWED FOR REASONABLENESS USING THIS PROCESS IN 2014. THE COMPENSATION COMMITTEE AND BOARD LEADERSHIP, REQUESTED THAT EXECUTIVE COMPENSATION REVIEW BE DEFERRED UNTIL 2016, AND THEREFORE, NO ADJUSTMENTS TO COMPENSATION WERE MADE IN 2015. DURING 2014, AGHS'S CEO'S CONTRACT WAS PREPARED FOR RENEWAL USING THE PROCESS DESCRIBED ABOVE. IN JANUARY 2015, THE BOARD APPROVED THE RECOMMENDATION OF THE COMPENSATION COMMITTEE AND EXECUTED A NEW THREE-YEAR AGREEMENT WITH THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE REPORTING ORGANIZATION IS A MEMBER OF THE CLEVELAND CLINIC (CCF). CCF MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.CLEVELANDCLINIC.ORG, UNDER THE "ABOUT CLEVELAND CLINIC" SECTION. IN THIS SECTION, THE FINANCIAL STATEMENTS, ANNUAL REPORT, COMMUNITY BENEFIT REPORT, CCF'S CONFLICT OF INTEREST POLICY, AND CORPORATE COMPLIANCE POLICIES ARE AVAILABLE. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 646,343. MANAGEMENT AND GENERAL EXPENSES 2,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 648,843. CLINICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 833,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 833,969. BILLING & COLLECTION FEES: PROGRAM SERVICE EXPENSES 42,535. MANAGEMENT AND GENERAL EXPENSES 31,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,763. LICENSES & REGISTRATION: PROGRAM SERVICE EXPENSES 39,312. MANAGEMENT AND GENERAL EXPENSES 48,074. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,386. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 29,729. MANAGEMENT AND GENERAL EXPENSES 126,551. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 156,280. COURIER: PROGRAM SERVICE EXPENSES 66. MANAGEMENT AND GENERAL EXPENSES 52,808. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,874. TRANSCRIPTION: PROGRAM SERVICE EXPENSES 38,248. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,248. RECRUITING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 24,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,000. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 199,183. MANAGEMENT AND GENERAL EXPENSES 35,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 235,127. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION NET ASSETS -28,759. GRANT FUNDING FOR CAPITAL 9,817. TRANSFER TO/FROM AFFILIATES -2,302,690. |
| FORM 990, PART XII, LINE 2C: | LODI COMMUNITY HOSPITAL IS A SUBSIDIARY OF THE AKRON GENERAL HEALTH SYSTEM. ON NOVEMBER 1, 2015, THE CLEVELAND CLINIC FOUNDATION BECAME THE SOLE MEMBER OF AKRON GENERAL HEALTH SYSTEM. AKRON GENERAL HEALTH SYSTEM, AND ITS SUBSIDIARIES, WERE INCLUDED IN THE CLEVELAND CLINIC FOUNDATION'S AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31ST, 2015. CONSEQUENTLY, THE OVERSIGHT PROCESS FOR THE AUDITED FINANCIAL STATEMENTS WAS CONDUCTED BY THE CLEVELAND CLINIC FOUNDATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AKRON GENERAL HEALTH SYSTEM | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 341546466 | SUPPORTING ORGANIZATION | OH | IRC 501(C)(3) | 11C, FI | NONE | 0 |
| AKRON GENERAL PARTNERS INC | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 201801493 | SUPPORTING ORGANIZATION | OH | IRC 501(C)(3) | 11A | AKRON GENERAL HEALTH SYSTEM | Yes (1) |
| AKRON GENERAL FOUNDATION | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 341127047 | FUNDRAISING | OH | IRC 501(C)(3) | 7 | AKRON GENERAL HEALTH SYSTEM | Yes (1) |
| AKRON GENERAL MEDICAL CENTER | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 340714478 | HOSPITAL | OH | IRC 501(C)(3) | 3 | AKRON GENERAL HEALTH SYSTEM | Yes (1) |
| PARTNERS PHYSICIAN GROUP | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 341843403 | COMMUNITY HEALTH SERVICES | OH | IRC 501(C)(3) | 9 | AKRON GENERAL MEDICAL CENTER | Yes (1) |
| AKRON GENERAL MEDICAL CENTER SELF INSURANCE TRUST FUND | ||||||||||
| 1 AKRON GENERAL AVENUE | AKRON | OH | 44307 | 341243687 | SUPPORTING ORGANIZATION | OH | IRC 501(C)(3) | 11A | AKRON GENERAL MEDICAL CENTER | Yes (1) |
| VISITING NURSE SERVICE INC | ||||||||||
| 1 HOME CARE PLACE | AKRON | OH | 44320 | 340714779 | HOME HEALTH CARE | OH | IRC 501(C)(3) | 9 | AKRON GENERAL HEALTH SYSTEM | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AKRON GENERAL INNOVATIONS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AKRON GENERAL AVENUE | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383928798 | EIN |
| Primary Activities | PARTNERSHIP INVESTMENTS | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AKRON GENERAL MEDICAL CENTER | ||
| S | $91,188 | COST |
| AKRON GENERAL MEDICAL CENTER | ||
| R | $326,317 | COST |
| AKRON GENERAL MEDICAL CENTER | ||
| Q | $677,911 | COST |
| PARTNERS PHYSICIAN GROUP | ||
| Q | $54,729 | COST |
| AKRON GENERAL PARTNERS INC | ||
| R | $163,216 | COST |
| AKRON GENERAL PARTNERS INC | ||
| Q | $177,829 | COST |
| AKRON GENERAL FOUNDATION | ||
| C | $85,943 | COST |
| AKRON GENERAL FOUNDATION | ||
| Q | $73,464 | COST |