2016-11-14T10:17:53-06:00 2015-12-31 990 2015-01-01 340718390 LODI COMMUNITY HOSPITAL LODI 3309485501 225 ELYRIA STREET LODI OH 44254 DEBORAH GORBACH CHIEF FINANCIAL OFFICER 3309485501 2016-11-14 2015 2017-02-10 21:41:12Z ALAN J PAPA 225 ELYRIA STREET LODI OH 44254 16765237 0 X WWW.LODIHOSPITAL.COM X 1920 OH TO IMPROVE THE HEALTH AND LIVES OF THE PEOPLE AND COMMUNITIES WE SERVE. 11 7 163 20 0 0 10000 14121 17195707 16574232 -24640 -38801 215168 103308 17396235 16652860 10289 13760 0 0 7538906 7602844 0 0 0 7767572 7473720 15316767 15090324 2079468 1562536 11712071 11116607 1880306 2043938 9831765 9072669 LODI COMMUNITY HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH AND LIVES OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 2272220 3064741 LODI COMMUNITY HOSPITAL IS A 25 BED HOSPITAL OFFERING INPATIENT SERVICES FOR MEDICAL AND SURGICAL PATIENTS. 10002268 13505726 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. 13760 13760 3765 LODI COMMUNITY HOSPITAL OFFERS COMMUNITY HEALTH AND EDUCATIONAL SERVICES TO THE LOCAL AND SURROUNDING COMMUNITIES. 12288248 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 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 1 1 0 0 1 11 0 1 163 1 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 0 OH X X ROBERT F WAITKUS 3304452526 6801 BRECKSVILLE ROAD RK-85 INDEPENDENCE OH 44131 ALAN PAPA PRESIDENT, COO, DIRECTOR 5.00 50.00 X X 0 463469 28956 THOMAS STOVER MD DIRECTOR 5.00 50.00 X 0 889597 30917 ANTHONY HAYEK MD DIRECTOR 5.00 50.00 X 0 202994 32140 TODD BREAUX MD DIRECTOR 5.00 X 0 0 0 PAULA BAUER MD DIRECTOR 5.00 X 0 0 0 MARY BETH C CARROLL DIR CHAIR, THRU 10/15 5.00 X X 0 0 0 SONIA ALEMAGNO PHD DIR VICE CHAIR THRU 10/15 5.00 X X 0 0 0 THERESA CARTER DIRECTOR, CHAIR BEG 10/15 5.00 X X 0 0 0 LAURA CULP DIRECTOR 5.00 X 0 0 0 LEE GILL DIRECTOR 5.00 X 0 0 0 JAMES RICE DIRECTOR 5.00 X 0 0 0 LANCE TALMAGE MD DIRECTOR 5.00 X 0 0 0 KRISTIE VANAUKEN DIRECTOR 5.00 X 0 0 0 CRAIG M BABBITT SECRETARY 5.00 50.00 X 0 390806 32356 DEBORAH GORBACH INTERIM TREASURER BEG. 6/15 5.00 50.00 X 0 256822 19538 SUE J MCCARTHY TREASURER THRU 6/15 5.00 50.00 X 0 254674 18655 DAVE FRIGO ASSISTANT TREASURER 5.00 50.00 X 0 225709 22255 DANA KOCSIS CHIEF NURSING OFFICER 50.00 X 165937 0 2543 DAVID PETER MD SR VP MEDICAL OFFICER 5.00 50.00 X 0 426492 30477 THOMAS WHELAN PRES COMMUNITY/SPECIALTY HOSP 30.00 20.00 X 97937 149991 0 263874 3260554 217837 1 0 1 0 EPMG OF OHIO INC PA 2000 GREEN RD SUITE 300 ANN ARBOR MI 481051571 ER PHYSICIANS 581585 RESPIRATORY SUPPORT SERVICES 328 BOSTON MILLS ROAD HUDSON OH 44236 CARDIOPULMONARY SERVICES 389338 ARAMARK 115 NORTH FIRST STREET BURBANK CA 91502 LINEN SERVICES 125376 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 606936485 MRI SERVICES 123430 CHIPPEWA ROOFING LLC POB BOX 93 CHIPPEWA LAKE OH 44215 ROOFING REPAIR & REPLACEMENT 105950 5 14121 14121 NET PATIENT SERVICES 621990 14375252 14375252 MEDICARE/MEDICAID PAYM 921990 2195215 2195215 OTHER PROGRAM SERVICES 900099 3765 3765 16574232 2534 2534 43855 71042 -27187 -27187 -27187 41335 -41335 -41335 -41335 CHANGE IN INTEREST-FOU 900099 65017 65017 CAFETERIA 900099 45026 45026 20452 20452 130495 16652860 16574232 0 64507 X 9760 9760 4000 4000 275231 275231 5898258 5065185 833073 107727 93163 14564 889383 767610 121773 432245 371302 60943 47388 47388 488 488 2150490 1829385 321105 86111 86111 381684 283383 98301 91362 79011 12351 880598 761548 119050 31140 17195 13945 2118 2118 39 34 5 790981 363088 427893 295324 255398 39926 PROVISION FOR BAD DEBTS 1429141 1429141 MEDICAL SUPPLIES 595753 595753 MGMT FEE TO AGHS 346668 346668 OHIO FRANCHISE FEE 329099 329099 15336 1950 13386 15090324 12288248 2802076 0 359604 430926 2975983 2479420 45265 48903 119203 101945 16661462 9704312 7150012 6957150 1062004 1098263 11712071 11116607 1021521 953735 1033 858785 1089170 1880306 2043938 X 9143413 8413076 688352 659593 9831765 9072669 11712071 11116607 X 1562536 -2321632 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 488 0 0 0 488 0 PART II-B, LINE 1: 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. 688352 52179 80938 659593 705793 291 36620 54352 688352 779774 8901 81322 164204 705793 683304 34659 70646 -8835 779774 336802 343021 3481 683304 1.00000 0 1 1 98793 98793 10113227 4957680 5155547 5705028 4288505 1416523 744414 458127 286287 6957150 INTEREST IN FOUNDATION NET ASSETS 1098263 1098263 ESTIMATED MEDICARE SETTLEMENT DUE 360791 ACCRUED SELF INSURANCE CLAIMS PAYABLE 708379 ASSET RETIREMENT OBLIGATION 20000 1089170 X PART X, LINE 2: 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. 1 1 X 1 X 1 X 1 1 1 0 0 169107 169107 0.01240 1765226 715545 1049681 0.07680 1934333 715545 1218788 0.08920 139675 8974 130701 0.00960 38184 38184 0.00280 38876 38876 0.00280 216735 8974 207761 0.01520 2151068 724519 1426549 0.10440 25874 25874 0.00170 25874 25874 0.00170 1 493637 3017691 2877168 140523 X 1 1 1 1 LODI COMMUNITY HOSPITAL 225 ELYRIA ST LODI OH 44254 WWW.AKRONGENERAL.ORG OH STATE ID 1234AHR X X X X LODI COMMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.AKRONGENERAL.ORG 1 13 1 WWW.AKRONGENERAL.ORG 0 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X WWW.AKRONGENERAL.ORG X WWW.AKRONGENERAL.ORG X WWW.AKRONGENERAL.ORG X X X X X X 1 0 X X X X 1 X 0 0 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. 2 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 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. X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 ALAN PAPA PRESIDENT, COO, DIRECTOR 0 383222 0 41200 0 39047 0 5840 0 23116 0 492425 0 0 THOMAS STOVER MD DIRECTOR 0 695123 0 150000 0 44474 0 7678 0 23239 0 920514 0 0 ANTHONY HAYEK MD DIRECTOR 0 201928 0 0 0 1066 0 6364 0 25776 0 235134 0 0 CRAIG M BABBITT SECRETARY 0 322928 0 35020 0 32858 0 5967 0 26389 0 423162 0 0 DEBORAH GORBACH INTERIM TREASURER BEG. 6/15 0 225205 0 19780 0 11837 0 1901 0 17637 0 276360 0 0 SUE J MCCARTHY TREASURER THRU 6/15 0 199770 0 41200 0 13704 0 9790 0 8865 0 273329 0 0 DAVE FRIGO ASSISTANT TREASURER 0 197858 0 16890 0 10961 0 4267 0 17988 0 247964 0 0 DANA KOCSIS CHIEF NURSING OFFICER 143567 0 12194 0 10176 0 1798 0 745 0 168480 0 0 0 DAVID PETER MD SR VP MEDICAL OFFICER 0 350226 0 37600 0 38666 0 10600 0 19877 0 456969 0 0 THOMAS WHELAN PRES COMMUNITY/SPECIALTY HOSP 74914 49942 10975 7316 12048 92733 1931 148412 6883 4589 106751 302992 0 0 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 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. 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 1 AKRON GENERAL FOUNDATION 1 AKRON GENERAL AVENUE AKRON OH 44307 341127047 FUNDRAISING OH IRC 501(C)(3) 7 AKRON GENERAL HEALTH SYSTEM 1 AKRON GENERAL MEDICAL CENTER 1 AKRON GENERAL AVENUE AKRON OH 44307 340714478 HOSPITAL OH IRC 501(C)(3) 3 AKRON GENERAL HEALTH SYSTEM 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 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 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 1 AKRON GENERAL INNOVATIONS INC 1 AKRON GENERAL AVENUE AKRON OH 44307 383928798 PARTNERSHIP INVESTMENTS OH C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 AKRON GENERAL MEDICAL CENTER S 91188 COST AKRON GENERAL MEDICAL CENTER R 326317 COST AKRON GENERAL MEDICAL CENTER Q 677911 COST PARTNERS PHYSICIAN GROUP Q 54729 COST AKRON GENERAL PARTNERS INC R 163216 COST AKRON GENERAL PARTNERS INC Q 177829 COST AKRON GENERAL FOUNDATION C 85943 COST AKRON GENERAL FOUNDATION Q 73464 COST