2014-11-12T12:25:46-06:00 2013-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2013-01-01 341893452 UHHSCSAHS - CUYAHOGA INC UHHS 4407402180 6935 TREELINE DRIVE NO J BRECKSVILLE OH 441413393 ALLEN TRACY PRESIDENT 4407402180 2014-10-27 1 BERNIE OSTROWSKI P00366367 6148493000 2013 2015-11-30 17:44:51Z ALLEN TRACY 6935 TREELINE DRIVE NO J BRECKSVILLE OH 441413393 14920171 0 X N/A X 1999 OH SEE SCHEDULE OUHHS/CSAHS-CUYAHOGA, INC (CUYAHOGA) IS AN ORGANIZATION JOINTLY OWNED BY THE SISTERS OF CHARITY HEALTH SYSTEM AND UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. (THE MEMBERS) OPERATED FOR THE EXCLUSIVE BENEFIT OF THE MEMBERS AND THEIR RELATED SUBSIDIARIES. BOTH MEMBERS ARE TAX-EXEMPT 501(C)3 CHARITABLE ORGANIZATIONS. CUYAHOGA PROVIDES ADMINISTRATIVE SUPPORT SERVICES FOR ORGANIZATIONS OPERATED BY THE MEMBERS. 4 4 0 4 0 0 0 0 14196239 14885085 109 94 34917 34992 14231265 14920171 0 0 0 0 6005644 6238974 0 0 0 8370876 8800977 14376520 15039951 -145255 -119780 8267801 7492406 6648361 5992746 1619440 1499660 X UHHS/CSAHS-CUYAHOGA, INC (CUYAHOGA) IS AN ORGANIZATION JOINTLY OWNED BY THE SISTERS OF CHARITY HEALTH SYSTEM AND UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. (THE MEMBERS) OPERATED FOR THE EXCLUSIVE BENEFIT OF THE MEMBERS AND THEIR RELATED SUBSIDIARIES. BOTH MEMBERS ARE TAX-EXEMPT 501(C)3 CHARITABLE ORGANIZATIONS. CUYAHOGA PROVIDES ADMINISTRATIVE SUPPORT SERVICES FOR ORGANIZATIONS OPERATED BY THE MEMBERS. 0 0 15039951 14885085 SEE PART III, LINE 1 MISSION STATEMENT. 15039951 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X MARY KOWTUN 4407402181 6935 TREELINE DRIVE BRECKSVILLE OH 441413393 X X ALLEN TRACY PRESIDENT & CEO 2.00 X X 0 0 0 MELISSA ROGERS CHAIRPERSON 2.00 X X 0 0 0 PAUL TAIT SECRETARY 2.00 X X 0 0 0 JOHN RUSNACZYK TREASURER 2.00 X X 0 0 0 0 0 0 0 0 0 0 MEDICAL INFORMATION TECHNOLOGY PO BOX 74569 CHICAGO IL 60696 IT SUPPORT 1100999 HUMAN ARC 1457 EAST 40TH STREET CLEVELAND OH 44103 COLLECTION SERVICES 452015 REVENUE GROUP 3770 PARK EAST STE 240 POBOX 2212 BEACHWOOD OH 44122 COLLECTION SERVICES 332848 THE HMC GROUP 29065 CLEMENS RD SUITE 200 WESTLAKE OH 44145 COLLECTION SERVICES 286079 CHAMBERLIN EDMONDS PO BOX 572490 MURRAY UT 84157 COLLECTION SERVICES 161227 8 MEMBER REVENUES 561000 14885085 14885085 14885085 94 94 ADMIN BILLINGS 900099 34992 34992 34992 14920171 14885085 0 35086 4631039 4631039 251565 251565 1022827 1022827 333543 333543 23056 23056 42767 42767 338788 338788 339832 339832 2425123 2425123 400695 400695 27074 27074 5525 5525 2376045 2376045 53724 53724 COLLECTION FEES 2336764 2336764 BANK FEES 411507 411507 DUES/SUBSCRIPTIONS 15614 15614 MISCELLANEOUS OTHER EXP 4463 4463 15039951 15039951 0 0 1243837 443499 1206425 2142383 857984 1150293 19123230 15366999 4959555 3756231 8267801 7492406 3032646 3009960 3615715 2982786 6648361 5992746 X 1619440 1499660 1619440 1499660 8267801 7492406 -119780 0 X X 0 1 X 1 0 X X X X 0 0 0 SCHS 341379356 11 1 1 1 0 UHHS 340714775 11 1 1 1 0 2 0 FORM 990, PART I, LINE 11 IN 2013, UHHS/CSAHS-CUYAHOGA, INC FILED A FORM 8940-REQUEST FOR MISCELLANEOUS DETERMINATION TO CHANGE THE TYPE OF ORGANIZATION TO ONE WHO IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF PUBLICLY SUPPORTED ORGANIZATIONS. SCHEDULE A - LINE 11H THE ARTICLES OF THE ORGANIZATION STATE THAT THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS,EDUCATIONAL AND SCIENTIFIC PURPOSES BY CONDUCTING OR SUPPORTING ACTIVITIES EXCLUSIVELY FOR THE BENEFIT OF,TO PERFORM FUNCTIONS OF,OR TO CARRY OUT THE CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF ONE OR MORE HOSPITALS OPERATED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM, INC.(SCHS), UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. (UHHS) OR AN AFFILIATE OF SCHS OR UHHS. 204666 198495 6171 18918564 15168504 3750060 3756231 X 14920171 0 14920171 0 14920171 15039951 0 15039951 0 15039951 PART X, LINE 2: THE COMPANY IS A NONPROFIT, TAX-EXEMPT ORGANIZATION AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS, THE COMPANY IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE AND LOCAL, OR NON-U.S. INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2010. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANY AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO CORPORATE MEMBERS: SISTERS OF CHARITY HEALTH SYSTEM AND UNIVERSITY HOSPITALS HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBERS MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS OF THE GOVERNING BODY, SUCH AS APPROVAL OF BUDGETS, CAPITAL EXPENDITURES AND ACQUISITION OF LAND, MUST BE APPROVED BY THE BOARD OF THE MEMBER ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 AFTER THE 990 RETURN IS REVIEWED INTERNALLY; IT IS SUBMITTED FOR REVIEW TO OUR TAX ADVISORS. THEY REVIEW FOR COMPLETENESS AND COMMUNICATE ANY CONCERNS THAT THEY IDENTIFY WITHIN THE DOCUMENTS AND WORKSHEETS OF THE TAX RETURN. ITEMS IDENTIFIED ARE REVIEWED BY STAFF AND ANY NEEDED CORRECTIONS ARE MADE. THE RETURN IS THEN PROVIDED TO THE PRESIDENT FOR REVIEW AND APPROVAL. IT IS THEN SUBMITTED TO THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS IN PLACE A CONFLICT OF INTEREST POLICY AS WELL AS A NON-RETALIATION POLICY (WHISTLE-BLOWER) MANAGED THROUGH THE COMPLIANCE OFFICER. THE CONFLICT OF INTEREST FORMS ARE SENT OUT ANNUALLY TO ADMINISTRATION, AND OTHER LEADERSHIP EMPLOYEES AS WELL AS BOARD MEMBERS. THE FORMS ARE RETURNED TO ADMINISTRATION. ONCE RETURNED, THEY ARE REVIEWED BY THE COMPLIANCE OFFICER AND CEO TO DETERMINE IF ANYTHING WOULD BE DEEMED A POTENTIAL CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE CEO, COMPLIANCE OFFICER AND EMPLOYEE/INDIVIDUAL MEET TO DISCUSS. THE RESULTS OF THOSE MEETINGS ARE AN AGENDA ITEM AT THE ORGANIZATION'S ADMINISTRATIVE COMPLIANCE COMMITTEE MEETING AND IT IS FURTHER DISCUSSED THERE. ONCE A DECISION IS MADE REGARDING THE CONFLICT, FOLLOW-UP IS MADE BY THE COMPLIANCE OFFICER/CEO WITH THE EMPLOYEE, IF APPROPRIATE. THE ORGANIZATION ALSO DISCUSSES THE RESULTS OF THE CONFLICT OF INTERESTS WITH THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 18 FORMS 990 AND 1023 ARE AVAILABLE TO PUBLIC UPON REQUEST AT THE FINANCIAL SERVICE CENTER LOCATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE FINANCIAL STATEMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO PUBLIC UPON REQUEST AT THE FINANCIAL SERVICE CENTER LOCATION. FORM 990 PART VII LINE 1A ST. JOHN MEDICAL CENTER EMPLOYS THE INDIVIDUALS WHO WORK AT UHHS/CSAHS-CUYAHOGA INC. THEIR SALARIES AND BENEFITS COSTS ARE DIRECTLY EXPENSED BACK TO UHHS/CSAHS-CUYAHOGA INC. ST. JOHN MEDICAL CENTER IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION. SCHEDULE R, PART II UHHS/CSAHS - CUYAHOGA, INC. HAS TWO CORPORATE MEMBERS, UNIVERSITY HOSPITALS HEALTH SYSTEM AND THE SISTERS OF CHARITY OF ST. AUGUSTINE. THE ENTIRE BOARD OF UHHS/CSAHS - CUYAHOGA, INC. ARE EMPLOYEES OF ONE OF THE CORPORATE MEMBERS AND THEREFORE RECEIVE COMPENSATION FROM ONE OF THE CORPORATE MEMBERS. NEITHER CORPORATE MEMBER MEETS THE NECESSARY ELEMENT OF CONTROL TO BE CONSIDERED A RELATED ORGANIZATION AND ARE THEREFORE NOT REPORTED ON SCHEDULE R. ACCORDINGLY, THERE IS NO COMPENSATION REPORTED FOR THE BOARD MEMBERS SINCE THEY ARE NOT COMPENSATED BY THE ORGANIZATION OR A RELATED ORGANIZATION. AS A RESULT, ALL FOUR BOARD MEMBERS HAVE BEEN LISTED ON FORM 990, PART VI, AND LINE B AS NOT LACKING INDEPENDENCE. UHHSCSAHS-CUYAHOGA HOLDING COMPANY INC 6935 TREELINE DRIVE BRECKSVILLE OH 44141 341895400 HOLDING CO OH UHHSCSAHS CUYAHOGA INC C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0