2014-10-29T13:43:16-05:00 2013-12-31 346565596 ERNST & YOUNG LLP 950 MAIN AVENUE 1800 CLEVELAND OH 44113 990 2013-01-01 340714585 THE CLEVELAND CLINIC FOUNDATION CLEV 2164442200 9500 EUCLID AVENUE NO JJ19 CLEVELAND OH 44195 STEVEN C GLASS CHIEF FINANCIAL OFFICER 2164442200 2014-10-29 1 P00089502 2168615000 2013 2015-11-30 17:44:51Z DELOS M COSGROVE 9500 EUCLID AVENUE NO JJ19 CLEVELAND OH 44195 6008512667 0 X WWW.CLEVELANDCLINIC.ORG X 1921 OH PATIENT CARE, RESEARCH & EDUCATION 25 15 33825 2216 30018137 0 231877777 217746821 4265251958 4538959770 105394875 164708228 72709421 205444019 4675234031 5126858838 97452910 120278982 0 0 2439083971 2581260610 1301479 1536158 13311711 1858133257 1884157920 4395971617 4587233670 279262414 539625168 7132666670 7710452150 4408109973 4037471873 2724556697 3672980277 X TO PROVIDE BETTER CARE OF THE SICK, INVESTIGATION OF THEIR PROBLEMS, AND FURTHER EDUCATION OF THOSE WHO SERVE. 0 0 4092841230 120278982 4489785595 SEE PROGRAM SERVICE STATEMENT IN SCHEDULE O. 4092841230 1 1 0 1 0 0 1 0 0 1 1 1 0 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 X 5171 1 1 33825 1 1 1 1 CA CJ GR TU TH KS 0 0 0 1 1 0 0 0 0 0 X 25 15 1 0 1 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 AK CA CO FL GA IL KS KY LA MA MD MN MS NC ND NH NJ NM OH OK OR PA SC TN UT WA WI NY X X ROBERT F WAITKUS 2164452526 6801 BRECKSVILLE ROAD RK-85 INDEPENDENCE OH 44131 COSGROVEDELOS M PRESIDENT, CEO 50.00 X X 4037288 0 -772572 HAHNJOSEPH F CHIEF OF STAFF 50.00 X X 1233144 0 -361213 RICHROBERT E JR BOARD CHAIR 5.00 X X 0 0 0 SCAMINACEJOSEPH M BOARD VICE CHAIR 5.00 X X 0 0 0 AULETTAPATRICK V DIRECTOR 5.00 X 0 0 0 COMMESTHOMAS A DIRECTOR 5.00 X 0 0 0 FEDELIUMBERTO P DIRECTOR 5.00 X 0 0 0 HESSLERDAVID J DIRECTOR 5.00 X 0 0 0 HOOVERCAROLE DIRECTOR 5.00 X 0 0 0 LERNERNORMA DIRECTOR 5.00 X 0 0 0 MACDONALDWILLIAM III DIRECTOR 5.00 X 0 0 0 MALONEDONALD PHYSICIAN 50.00 X 348040 0 4930 MCCARTANPATRICK F DIRECTOR 5.00 X 0 0 0 MILLERPAMELA DIRECTOR 5.00 X 0 0 0 MILLERSAMUEL H DIRECTOR 5.00 X 0 0 0 MOONEYBETH E DIRECTOR 5.00 X 0 0 0 MORINOMARIO DIRECTOR 5.00 X 0 0 0 NANCEFREDERICK DIRECTOR 5.00 X 0 0 0 POLLOCKLARRY DIRECTOR 5.00 X 0 0 0 REIDYWILLIAM J DIRECTOR 5.00 X 0 0 0 ROSSRONALD J DIRECTOR 5.00 X 0 0 0 SANFORDBILL R DIRECTOR 5.00 X 0 0 0 TIMKENWILLIAM AMB DIRECTOR 5.00 X 0 0 0 WEISSMORRY DIRECTOR 5.00 X 0 0 0 WYLLIEROBERT CHIEF MEDICAL OPERATIONS OFFICER 50.00 X 572359 0 108491 DICORLETOPAUL E LERNER INSTITUTE CHAIR 50.00 X 471393 0 -39750 GLASSSTEVEN C CFO & TREASURER 50.00 X 1038559 0 37998 HARRINGTONMICHAEL CAO & CONTROLLER 50.00 X 573562 0 46697 MCHUGHLINDA ASST SECRETARY 50.00 X 372703 0 37400 MEEHANMICHAEL J RECORDING SECRETARY 50.00 X 309906 0 -39031 PEACOCKWILLIAM CHIEF OF OPERATIONS 50.00 X 864044 0 48268 ROWANDAVID SECY AND CHIEF LEGAL OFFICER 50.00 X 930616 0 40926 HARRISONMARC CEO - CCAD 50.00 X 1378336 0 48293 RICETHOMAS PHYSICIAN 50.00 X 3099262 0 -312260 LYTLEBRUCE INSTITUTE CHAIRMAN - HVI 50.00 X 1695068 0 -634366 MIHALJEVICTOMISLAV CHIEF OF STAFF - CCAD 50.00 X 1557102 0 48605 COSTINJOHN STAFF CHAIR - LORAIN INSTITUTE 50.00 X 1464456 0 37149 MARTINDANIEL INSTITUTE CHAIRMAN - COLE EYE INST. 50.00 X 1299772 0 43106 FUNGJOHN J FORMER KEY EMPLOYEE 50.00 X 959030 0 43267 MATSENPAUL FORMER KEY EMPLOYEE 50.00 X 923222 0 43267 23127862 0 -1570795 4225 1 1 0 SIEMENS MEDICAL SOLUTIONS INC PO BOX 121102 DALLAS TX 75312 HEALTHCARE IT & ENGINEERING SERVICES 20206648 TURNER CONSTRUCTION CO 1422 EUCLID AVENUE CLEVELAND OH 44115 CONSTRUCTION SERVICES 11979054 ADCOM COMMUNICATIONS INC 1370 WEST 6TH ST3RD FLR CLEVELAND OH 44113 MARKETING 11901838 SODEXO 1669 PHOENIX PARKWAY 210 COLLEGE PARK GA 30349 LAUNDRY & FOOD SERVICE 9521226 STRATEGIC INVESTMENT GROUP 1001 19TH ST N 16TH FLR ARLINGTON VA 22209 INVESTMENT MANAGEMENT 9300604 466 52456298 2357430 12504 106211184 56709405 17258924 217746821 NET PATIENT SERVICES 621990 3194675253 3194675253 MEDICARE/MEDICAID PAYM 921990 1146723246 1146723246 OTHER PROGRAM SERVICES 900099 142666959 137426012 5240947 PARKING, PHONE & OTHER 812930 20477621 20477621 MANAGEMENT FEES 561000 20320700 7956817 12363883 14095991 3004267 11091724 4538959770 44224288 44224288 3 3 27322817 27322817 9744518 0 9744518 9744518 9744518 997416368 3494960 878348992 2078399 119067376 1416561 120483937 120483937 464223 2357430 1205093 -740870 -740870 41200 21345 19855 19855 INCOME (LOSS) ON INVES 523000 105143245 1321583 103821662 DERIVATIVE INCOME 525990 64077165 64077165 CANCELLATION OF DEBT 900099 382837 382837 -505548 -505548 169097699 5126858838 4489785595 30018137 389308285 27684735 27684735 91344533 91344533 1249714 1249714 11290384 1469784 9820600 1968785 1002297 966488 2032982002 1754555159 271170023 7256820 75907010 65389252 10124883 392875 320704682 277248385 42777307 678990 138407747 119452767 18461566 493414 3886181 3366426 518360 1395 9647388 8360568 1286820 1343969 1343969 490496 490496 1536158 1536158 9761501 9761501 147297206 126175687 19647290 1474229 30836350 26622571 4113117 100662 51213284 44019020 6831102 363162 67296973 58135875 8976431 184667 90646686 78555746 12090940 18446776 15542947 2460530 443299 9195935 7800403 1226603 168929 82882524 71827209 11055315 211638204 183369211 28229437 39556 44809386 38832470 5976916 MEDICAL SUPPLIES 694531869 694531869 BAD DEBT EXPENSE 246034720 246034720 EQUIPMENT RENTAL & MAIN 78999576 68430151 10537386 32039 STATE FRANCHISE FEE 36105701 36105701 49093195 45243534 3704145 145516 4587233670 4092841230 481080729 13311711 117178432 144385551 17665920 40799159 205803380 198702463 603928914 605894804 4617751 5079818 30184514 14830950 64118713 67589481 27218855 26361790 4589682353 2296595647 2284939125 2293086706 1847024922 1977560538 1583726510 1898881254 12000000 12000000 12682300 19999978 321577334 405279658 7132666670 7710452150 543925700 556325843 438188 381156 75985160 91419722 2227589992 2203763294 1074306 556389 96756314 91495953 1462340313 1093529516 4408109973 4037471873 X 2194070444 3084837596 322213362 359383725 208272891 228758956 2724556697 3672980277 7132666670 7710452150 X 539625168 109710575 200606 298887231 X 0 1 X 1 1 1 X X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 11487 1 2875 1 326740 1 40552 1 23466 1 85376 490496 0 SCHEDULE C - PART II-B, LINES 1B-1I PART II-B 1B PAID STAFF OR MANAGEMENT - REPRESENTS BELOW ACTIVITIES CONDUCTED BY MEMBERS OF THE CCF GOVERNMENT RELATIONS OFFICE PART II-B 1D MAILINGS TO MEMBERS, LEGISLATORS, OR THE PUBLIC - REPRESENTS LETTERS SENT TO LEGISLATORS AND ORGANIZATIONS ON VARIOUS HEALTHCARE RELATED TOPICS AND ISSUES PART II-B 1E PUBLICATIONS, OR PUBLISHED OR BROADCAST STATEMENTS - REPRESENTS OPINION AND EDUCATION COLUMNS PUBLISHED IN NEWSPAPERS PART II-B 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES - REPRESENTS PAYMENT TO CERTAIN ORGANIZATIONS FOR LOBBYING SERVICES AS WELL AS PAYMENT OF DUES TO CERTAIN ORGANIZATIONS WHERE A PORTION OF THE DUES ARE USED TO CONDUCT LOBBYING ACTIVITIES PART II-B 1G DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY - REPRESENTS MEETINGS WITH AND TOURS CONDUCTED FOR LEGISLATORS AND/OR THEIR STAFF MEMBERS PART II-B 1H RALLIES, DEMONSTRATIONS, SEMINARS, CONVENTIONS, SPEECHES, LECTURES, OR ANY SIMILAR MEANS - REPRESENTS ORGANIZATION OF AND PARTICIPATION IN TRADE ASSOCIATION MEETINGS AND CONFERENCES PART II-B 1I OTHER ACTIVITIES - REPRESENTS INTERNAL RESEARCH AND EDUCATION ON VARIOUS ISSUES X 1 36.50 0 0 1 1 1 50.00 7500 0 206890438 18444444 24356278 6028347 243662812 174481177 12707046 21848808 2146594 206890438 160993688 11644587 3337378 1494476 174481177 135618081 12450683 15709374 2784450 160993688 111304092 7288623 17025366 135618081 1.00000 0 0 180484224 180484224 2602020090 1214292047 1387728043 73972767 49216187 24756580 1474127516 977423410 496704106 259077756 55664003 203413753 2293086706 HEDGE FUNDS 1230155405 F PRIVATE EQUITY 418676791 F REAL ESTATE 250049058 F 1898881254 UNAMORTIZED FINANCING COSTS 19110552 OTHER ASSETS 132440188 SECURITIES LENDING 91623 PERPETUAL & BENEFICIAL TRUSTS 52908875 INVESTMENT IN AFFILIATES 64590318 DUE FROM AFFILIATES 136138102 405279658 ACCRUED PENSION 439279644 OTHER LIABILITIES 88940880 ACCRUED BENEFITS 166538048 FUTURE GIFT ANNUITY PAYMENTS 8238862 DEFERRED ANNUITY TRUST 846107 INTEREST RATE SWAPS 98402071 UNAMORTIZED BOND PREMIUM 58940123 SECURITIES LENDING 91623 DUE TO AFFILIATES 232252158 1093529516 X PART II, LINE 3: THE CONSERVATION COVENANT REPORTED IN PART II IS RELATED TO WETLANDS LOCATED ON THE CLEVELAND CLINIC HEALTH SYSTEM'S PROPERTY IN TWINSBURG, OHIO. THE EASEMENT IS NOT REQUIRED TO BE REPORTED ON THE BALANCE SHEET SEPARATE FROM THE VALUE OF THE LAND. EXPENSES TO MONITOR, INSPECT, AND PROTECT THIS LAND ARE REFLECTED IN THE STATEMENT OF EXPENSES. PART X, LINE 2: THE CLEVELAND CLINIC HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS ARE REPORTED ON A CONSOLIDATED BASIS, INCLUDING EXEMPT, TAXABLE, AND FOREIGN ENTITIES TO WHICH THE FIN 48 LIABILITY RELATES. THE FIN 48 FOOTNOTE ON THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE CLEVELAND CLINIC HEALTH SYSTEM READS AS FOLLOWS: AT DECEMBER 31, 2013 AND 2012, THE LIABILITY FOR UNCERTAINTY IN INCOME TAXES WAS $10.8 MILLION AND $14.4 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. PART V, LINE 4 THE ENDOWMENT FUNDS OF CLEVELAND CLINIC FOUNDATION ARE USED IN FURTHERANCE OF ITS EXEMPT PURPOSE. SPECIFICALLY, THESE FUNDS ARE USED FOR EDUCATION, RESEARCH, AND PATIENT CARE. 1 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES WHOLLY-OWNED FOREIGN INSURANCE COMPANY 34941842 MIDDLE EAST & NORTH AFRICA 0 8 UNRELATED BUSINESS 3840199 MIDDLE EAST & NORTH AFRICA 0 0 FUNDRAISING 19000 EUROPE 0 0 FUNDRAISING 60000 SOUTH AMERICA 0 0 FUNDRAISING 16000 EAST ASIA & PACIFIC 0 0 FUNDRAISING SOUTH ASIA 0 0 FUNDRAISING CENTRAL AMERICA AND THE CARIBBEAN 0 0 FUNDRAISING NORTH AMERICA 0 0 FUNDRAISING CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 645160951 EUROPE 0 0 INVESTMENT 254744426 NORTH AMERICA 0 0 INVESTMENT 48040324 NORTH AMERICA 0 0 PROGRAM SERVICES WHOLLY-OWNED FOREIGN SUBSIDIARY THAT OPERATES A MEDICAL CLINIC IN TORONTO, CANADA EUROPE 2 2 PROGRAM SERVICES PROMOTION OF HEALTHCARE 21296 0 8 2 2 2 10 38877041 947966997 986844038 NORTH AMERICA RESEARCH 306105 CHECK EAST ASIA & PACIFIC RESEARCH 166523 CHECK EUROPE RESEARCH 111406 CHECK EUROPE RESEARCH 108000 CHECK EUROPE RESEARCH 106210 CHECK EUROPE RESEARCH 98550 CHECK NORTH AMERICA RESEARCH 26548 CHECK EUROPE RESEARCH 24591 CHECK NORTH AMERICA RESEARCH 20598 CHECK EAST ASIA & PACIFIC RESEARCH 18879 CHECK EUROPE RESEARCH 15404 CHECK EUROPE RESEARCH 15330 CHECK EUROPE RESEARCH 13543 CHECK EUROPE RESEARCH 12250 CHECK NORTH AMERICA RESEARCH 10986 CHECK NORTH AMERICA RESEARCH 7000 CHECK RESEARCH EUROPE (INCLUDING ICELAND & GREENLAND) 7 120563 CHECK RESEARCH SOUTH ASIA 1 10000 CHECK RESEARCH SOUTH AMERCIA 1 33775 CHECK RESEARCH EAST ASIA & THE PACIFIC 1 6900 CHECK 1 0 1 1 1 1 PART I, LINE 2: A MAJORITY OF THE RESEARCH GRANTS PROVIDED TO FOREIGN ORGANIZATIONS ARE PART OF AN NIH OR FEDERALLY FUNDED PROGRAM. AS SUCH, THE FOREIGN ORGANIZATION IS REQUIRED TO MEET AND ADHERE TO FEDERAL GRANT REPORTING REQUIREMENTS WITH RESPECT TO THE USE OF THE FUNDS ON AN ON-GOING BASIS IN ORDER TO BE ELIGIBLE TO PARTICIPATE OR CONTINUE TO PARTICIPATE IN THE RESEARCH STUDY. FOR THOSE GRANTS THAT ARE NOT FEDERALLY FUNDED, A CONTRACT EXISTS WITH THE FOREIGN GRANTEE ORGANIZATION THAT ESTABLISHES HOW THE FUNDS ARE TO BE USED AND REQUIRES CERTAIN REPRESENTATIONS AND ACCOUNTING REGARDING THEIR USE. CLEVELAND CLINIC MAINTAINS OVERSIGHT OF THESE GRANTS AND REGULARLY MONITORS THEIR COMPLIANCE WITH EITHER THE FEDERAL REGULATIONS OR THE CONTRACT PROVISIONS. PART I, LINE 3: THE ACCRUAL METHOD IS USED TO ACCOUNT FOR EXPENDITURES. X X X X X X X 1 RR DONNELLEY 111 SOUTH WACKER DRIVE CHICAGO IL 60606 DIRECT MAIL 0 820283 952998 -132715 CONVIO INC 11501 DOMAIN DR STE 200 AUSTIN TX 78758 INTERNET 0 333379 176852 156527 HARRIS CONNECT 1511 ROUTE 22 STE C-25 BREWSTER NY 10509 PHONE SOLICITATION 0 268811 318182 -49371 GRENZEBACH GLIER 401 N MICHIGAN AVE STE 2800 CHICAGO IL 60611 FUNDRAISING CONSULTANT 0 0 88127 -88127 1422473 1536159 -113686 AK AL AR AZ CA CO CT FL GA HI IL KS KY LA MA MD ME MI MN MO MS NC ND NH NJ NM NY OH OK OR PA RI SC TN UT VA WA WV WI CARES GALA 1570244 1350070 220174 138454 160401 273156 179731 HEARTTHROB BALL 983920 851810 132110 25187 104757 70000 201379 2 267489 155550 111939 28773 1200 22055 2821653 2357430 464223 163641 293931 344356 403165 1205093 -740870 41200 21345 1 1.00000 41200 21345 21345 19855 OH 0 THE STATE OF OHIO DOES NOT REQUIRE A LICENSE FOR A RAFFLE CONDUCTED BY AN IRC SECTION 501(C)(3) ORGANIZATION. 0 1 0 0.00000 1.00000 ROBERT F WAITKUS 9500 EUCLID AVE JJ-19 CLEVELAND OH 44195 0 NA 0 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 107621947 107621947 0.02480 323861124 245272818 78588306 0.01810 0 431483071 245272818 186210253 0.04290 26791352 13756 26777596 0.00620 209004987 29744996 179259991 0.04130 8043107 5947782 2095325 0.00050 201362331 132854209 68508122 0.01570 12505700 532328 11973372 0.00280 457707477 169093071 288614406 0.06650 889190548 414365889 474824659 0.10940 46444 46444 0.00000 56966 930 56036 0.00000 366439 366439 0.00010 79483 79483 0.00000 353 353 0.00000 2047989 2047989 0.00040 168659 168659 0.00000 32318 32318 0.00000 0 2798651 930 2797721 0.00050 1 246881061 530034025 552561091 -22527066 X 1 1 1 1 THE CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVENUE CLEVELAND OH 44195 WWW.CLEVELANDCLINIC.ORG OH STATE ID X X X X X X THE CLEVELAND CLINIC FOUNDATION 1 1 X X X X X X X X X 13 1 1 1 X WWW.CLEVELANDCLINIC.ORG X X X X X X X X X 0 0 1 1 250.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 THE CLEVELAND CLINIC FOUNDATION PART V, SECTION B, LINE 3: A THIRD PARTY CONSULTANT WAS ENGAGED TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS TAKEN INTO ACCOUNT VIA INFORMATION INTERVIEW SESSIONS. INTERVIEWS INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; THE LOCAL PUBLIC HEALTH DEPARTMENT; AGENCIES WITH CURRENT DATA OR INFORMATION ABOUT THE HEALTH NEEDS OF THE COMMUNITY; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. THE CLEVELAND CLINIC FOUNDATION PART V, SECTION B, LINE 4: CLEVELAND CLINIC FOUNDATION MAIN CAMPUS COLLABORATED WITH OTHER CLEVELAND CLINIC HEALTH SYSTEM HOSPITALS, INCLUDING: CLEVELAND CLINIC CHILDREN'S HOSPITAL, CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION, EUCLID HOSPITAL, FAIRVIEW HOSPITAL, HILLCREST HOSPITAL, LAKEWOOD HOSPITAL, LUTHERAN HOSPITAL, MARYMOUNT HOSPITAL, MEDINA HOSPITAL, SOUTH POINTE HOSPITAL, AND CLEVELAND CLINIC FLORIDA. THE CLEVELAND CLINIC FOUNDATION PART V, SECTION B, LINE 7: THE CLEVELAND CLINIC FOUNDATION IDENTIFIED THE FOLLOWING HEALTH NEEDS IN THE CHNA THAT HAVE NOT BEEN ADDRESSED: ACCESS TO COMMUNITY SERVICES - THIS NEED RELATES TO THE AVAILABILITY AND AWARENESS OF COMMUNITY SERVICES COVERED BY GOVERNMENTAL AND NON-PROFIT ORGANIZATIONS UNRELATED TO THE CLEVELAND CLINIC. ALTHOUGH IMPORTANT AND MAY IMPACT A PERSON'S HEALTH STATUS, THIS NEED DOES NOT RELATE DIRECTLY TO THE DELIVERY OF HEALTH CARE AND/OR IS A NEED GOVERNMENTAL OR OTHER AGENCIES HAVE THE EXPERTISE NECESSARY TO ADDRESS.ECONOMIC AND COMMUNITY DEVELOPMENT - THIS NEED INCLUDES MORE HOUSING OPTIONS, READILY ACCESSIBLE TRANSPORTATION AND GROCERY STORES, AND BETTER EMPLOYMENT AND CRIME RATES. CLEVELAND CLINIC CANNOT FOCUS OR OTHERWISE ADDRESS THE NEED FOR TRANSPORTATION OR OTHER COMMUNITY SERVICE UNRELATED TO THE DELIVERY OF HEALTHCARE. ALTHOUGH CLEVELAND CLINIC IS NOT DIRECTLY INVOLVED WITH DEVELOPING COMMUNITY INFRASTRUCTURE AND IMPROVING THE ECONOMY, IT DOES AND WILL CONTINUE TO SUPPORT LOCAL CHAMBERS OF COMMERCE AND COMMUNITY DEVELOPMENT ORGANIZATIONS, COLLABORATE WITH LEADERS OF REGIONAL ECONOMIC IMPROVEMENT AND PROVIDE IN-KIND DONATION OF TIME, SKILL AND/OR SPONSORSHIP TO SUPPORT EFFORTS IN THESE AREAS. THE CLEVELAND CLINIC FOUNDATION PART V, SECTION B, LINE 14G: INFORMING THE PUBLIC THAT FINANCIAL ASSISTANCE IS AVAILABLE IS AN IMPORTANT ELEMENT OF OUR FINANCIAL ASSISTANCE PROGRAM AND THE CLEVELAND CLINIC CONTINUOUSLY STRIVES TO IMPROVE ITS COMMUNICATIONS WITH PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE CLEVELAND CLINIC WEBSITE. PATIENT BILLS INCLUDE DETAILED INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGHOUT CCF, INCLUDING IN PATIENT REGISTRATION AREAS, ONLINE, AND WITH FINANCIAL COUNSELORS WHO ARE PRESENT ON-SITE AT EACH CLEVELAND CLINIC HOSPITAL AND OHIO FAMILY HEALTH CENTER TO ASSIST PATIENTS IN QUALIFYING FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS WITH FINANCIAL COUNSELORS. PART V, SECTION B, LINE 18: WE DO NOT ENGAGE IN ANY ACTIVITY IDENTIFIED IN LINE 16 BEFORE ENGAGING IN REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY. WE DO TAKE ALL OF THE ACTIONS LISTED IN LINE 18 AS PART OF OUR FINANCIAL ASSISTANCE PROCESS, I.E. THE COMMUNITY AND PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF ASSISTANCE AS FURTHER DESCRIBED ABOVE, INCLUDING ON THE WEBSITE, THROUGH SIGNAGE AND BROCHURES WHEN PRESENT AT OUR FACILITIES WHICH MAY OCCUR UPON ADMISSION OR PRIOR TO DISCHARGE FOR INPATIENTS, WITH EVERY BILL, AND OUR FINANCE DEPARTMENT DOCUMENTS ITS DETERMINATIONS AS TO WHETHER A PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. 105 BEACHWOOD FAMILY HEALTH & SURGERY CENTER 26900 CEDAR ROAD BEACHWOOD OH 44122 FAMILY HEALTH CENTER RICHARD E JACOBS HEALTH CENTER 33100 CLEVELAND CLINIC BOULEVARD AVON OH 44011 FAMILY HEALTH CENTER STRONGSVILLE FAMILY HEALTH & SURGERY CEN 16761 SOUTH PARK CENTER STRONGSVILLE OH 44136 FAMILY HEALTH CENTER TWINSBURG FAMILY HEALTH & SURGERY CENTER 8701 DARROW ROAD TWINSBURG OH 44087 FAMILY HEALTH CENTER LORAIN FAMILY HEALTH & SURGERY CENTER 5700 COOPER FOSTER PARK ROAD LORAIN OH 44053 FAMILY HEALTH CENTER WILLOUGHBY HILLS FAMILY HEALTH CENTER 2550 2570 SOM CENTER ROAD WILLOUGHBY HILLS OH 44094 FAMILY HEALTH CENTER INDEPENDENCE FAMILY HEALTH CENTER 5001 ROCKSIDE RD CROWN CENTRE II INDEPENDENCE OH 44131 FAMILY HEALTH CENTER WOOSTER FAMILY HEALTH CENTER 1740 CLEVELAND ROAD WOOSTER OH 44691 FAMILY HEALTH CENTER CLEVELAND CLINIC CANCER CENTERS 417 QUARRY LAKES DRIVE SANDUSKY OH 44870 OUTPATIENT PHYSICIAN CLINIC ELYRIA FAMILY HEALTH & SURGERY CENTER 303 CHESTNUT COMMONS DRIVE ELYRIA OH 44035 FAMILY HEALTH CENTER SOLON FAMILY HEALTH CENTER 29800 BAINBRIDGE ROAD SOLON OH 44139 FAMILY HEALTH CENTER BRUNSWICK FAMILY HEALTH CENTER 3574 CENTER ROAD BRUNSWICK OH 44212 FAMILY HEALTH CENTER INDEPENDENCE CANCER CENTER 6100 WEST CREEK ROAD SUITES 15 16 INDEPENDENCE OH 44131 OUTPATIENT PHYSICIAN CLINIC CHAGRIN FALLS FAMILY HEALTH CENTER 551 EAST WASHINGTON STREET CHAGRIN FALLS OH 44022 FAMILY HEALTH CENTER AVON POINTE FAMILY HEALTH CENTER 36901 AMERICAN WAY AVON OH 44011 FAMILY HEALTH CENTER STEPHANIE TUBBS JONES HEALTH CENTER 13944 EUCLID AVENUE EAST CLEVELAND OH 44112 FAMILY HEALTH CENTER NORTH OLMSTED PATIENT TESTING CENTER 24700 LORAIN AVENUE NORTH OLMSTED OH 44070 OUTPATIENT PHYSICIAN CLINIC BEACHWOOD OPHTHALMOLOGY 25101 CHAGRIN BOULEVARD BEACHWOOD OH 44122 OUTPATIENT PHYSICIAN CLINIC AVON LAKE FAMILY HEALTH CENTER 450 AVON-BELDEN ROAD AVON LAKE OH 44012 FAMILY HEALTH CENTER MENTOR MEDICAL OFFICE BUILDING 7060 WAYSIDE DRIVE MENTOR OH 44060 OUTPATIENT PHYSICIAN CLINIC ASHLAND OPHTHALMOLOGYSUGARBUSH EYE AND 21 SUGARBUSH COURT ASHLAND OH 44805 OUTPATIENT PHYSICIAN CLINIC OHIO RENAL CARE GROUP EAST 10205 CARNEGIE AVENUE CLEVELAND OH 44106 DIALYSIS CENTER SPORTS HEALTH AT THE JEWISH COMMUNITY CE 26001 SOUTH WOODLAND ROAD BEACHWOOD OH 44122 OUTPATIENT PHYSICIAN CLINIC MENTOR REHABILITATION AND SPORTS THERAPY 7533 CENTER STREET MENTOR OH 44060 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC CANCER CENTERS 1125 ASPIRA COURT MANSFIELD OH 44906 OUTPATIENT PHYSICIAN CLINIC MIDDLEBURG HEIGHTS ORTHOPAEDICS 7010 ENGLE ROAD SUITE 105 MIDDLEBURG HEIGHTS OH 44130 OUTPATIENT PHYSICIAN CLINIC LAKEWOOD FAMILY HEALTH CENTER 16215 MADISON AVENUE LAKEWOOD OH 44107 FAMILY HEALTH CENTER OHIO RENAL CARE GROUP WEST 14670 SNOW ROAD BROOKPARK OH 44142 DIALYSIS CENTER MADISON MEDICAL OFFICE BUILDING 2999 MCMACKIN ROAD MADISON OH 44057 OUTPATIENT PHYSICIAN CLINIC CLEVELAND EAR NOSE THROAT & ALLERGY CE 6707 POWERS BLVD STE 202 202A PARMA OH 44129 OUTPATIENT PHYSICIAN CLINIC OHIO RENAL CARE GROUP PDHOME DIALYSIS P 11203 STOKES BOULEVARD CLEVELAND OH 44104 DIALYSIS CENTER & DIAGNOSTIC CENTER WILLOUGHBY HILLS BEHAVIORAL HEALTH 2785 SOM CENTER ROAD WILLOUGHBY HILLS OH 44094 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 2001 CROCKER ROAD 520 WESTLAKE OH 44145 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 8254 MAYFIELD ROAD SUITE 1 CHESTERLAND OH 44026 OUTPATIENT PHYSICIAN CLINIC OHIO RENAL CARE GROUP FARNSWORTH 3764 WEST 25TH STREET CLEVELAND OH 44109 DIALYSIS CENTER OHIO RENAL CARE GROUP OF NORTH RANDALL 4750 NORTHFIELD ROAD NORTH RANDALL OH 44128 DIALYSIS CENTER CLEVELAND CLINIC ENT 5400 TRANSPORTATION BLVD STE 8 GARFIELD HEIGHTS OH 44125 OUTPATIENT PHYSICIAN CLINIC OHIO RENAL CARE GROUPSOLON 6020 ENTERPRISE PARKWAY SOLON OH 44139 DIALYSIS CENTER CHARDON REHABILITATION AND SPORTS THERAP 325 CENTER STREET CHARDON OH 44024 OUTPATIENT PHYSICIAN CLINIC WELLINGTON PLACE 4800 CLAGUE ROAD NORTH OLMSTED OH 44070 OUTPATIENT PHYSICIAN CLINIC LORAIN KOLCZUN ORTHOPAEDICS 5800 COOPER FOSTER PARK ROAD LORAIN OH 44053 OUTPATIENT PHYSICIAN CLINIC LORAIN ORTHOPAEDICS 5275 NORTH ABBE ROAD ELYRIA OH 44035 OUTPATIENT PHYSICIAN CLINIC NORTH RIDGEVILLE MEDICAL OFFICE 35105 CENTER RIDGE ROAD NORTH RIDGEVILLE OH 44039 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 20800 ADDINGTON BOULEVARD SUITE 400 FAIRVIEW PARK OH 44126 OUTPATIENT PHYSICIAN CLINIC MOHICAN EYE CENTER - PARK AVENUE VISION 484 PARK AVENUE WEST MANSFIELD OH 44906 OUTPATIENT PHYSICIAN CLINIC CANFIELD ORTHOPAEDICS AND REHABILITATION 3736 BOARDMAN CANFIELD ROAD CANFIELD OH 44406 OUTPATIENT PHYSICIAN CLINIC OBERLIN OPHTHALMOLOGYLAKELAND EYE 309 WEST LORAIN STREET OBERLIN OH 44074 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 7200 CENTER STREET SUITE 200 MENTOR OH 44060 OUTPATIENT PHYSICIAN CLINIC LYNDHURST CAMPUS 1950 RICHMOND ROAD LYNDHURST OH 44124 OUTPATIENT PHYSICIAN CLINIC OUTPATIENT PEDIATRIC PHYSIATRY CLINIC 1912 HAYES AVENUE SANDUSKY OH 44870 OUTPATIENT PHYSICIAN CLINIC SUGARBUSH EYE AND LASER CENTER 1456 PARK AVENUE WEST SUITE P MANSFIELD OH 44906 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC PEDIATRIC CARDIOLOGY 4848 HIGBEE AVENUE NW CANTON OH 44718 OUTPATIENT PHYSICIAN CLINIC MOHICAN EYE CENTER 637 NORTH UNION STREET LOUDONVILLE OH 44842 OUTPATIENT PHYSICIAN CLINIC SUGARBUSH EYE & LASER CENTER 140 HILL STREET BUCYRUS OH 44820 OUTPATIENT PHYSICIAN CLINIC SALOMONE PRACTICE 9500 MENTOR AVENUE MENTOR OH 44060 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 1 MEMORY LANE GARRETTSVILLE OH 44231 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC UROLOGICAL INSTITUTE 20997 LORAIN FAIRVIEW PARK OH 44126 OUTPATIENT PHYSICIAN CLINIC MARYMOUNT REHABILITATION AND SPORTS THER 2525 EAST ROYALTON ROAD BROADVIEW HEIGHTS OH 44147 OUTPATIENT PHYSICIAN CLINIC LORAIN KOLBE ORTHOPAEDICS 3600 KOLBE ROAD SUITE 100 LORAIN OH 44053 OUTPATIENT PHYSICIAN CLINIC ROCKSIDE MEDICAL CENTER 6701 ROCKSIDE ROAD INDEPENDENCE OH 44131 OUTPATIENT PHYSICIAN CLINIC COLUMBUS STAR IMAGING 1550 KENNY ROAD COLUMBUS OH 43212 DIAGNOSTIC CENTER NILES STAR IMAGING 652 YOUNGSTOWN WARREN ROAD NILES OH 44446 DIAGNOSTIC CENTER WILLOUGHBY HILLS REHABILITATION AND SPOR 29017 CHARDON ROAD WILLOUGHBY HILLS OH 44092 OUTPATIENT PHYSICIAN CLINIC ACCESS TO CARE 29000 AURORA ROAD SOLON OH 44139 OUTPATIENT PHYSICIAN CLINIC BOARDMAN STAR IMAGING 7067 TIFFANY BOULEVARD BOARDMAN OH 44512 DIAGNOSTIC CENTER CHARDON ROAD MEDICAL OFFICE BUILDING 34500 CHARDON ROAD WILLOUGHBY HILLS OH 44094 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC CANCER CENTER 509 W MCPHERSON HIGHWAY CLYDE OH 43410 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC FAMILY MEDICINE 11709 LORAIN AVENUE CLEVELAND OH 44111 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC FAMILY MEDICINE ROCKPO 11851 DETROIT AVENUE LAKEWOOD OH 44107 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC FAMILY MEDICINE VALLEY 6605 CENTER ROAD VALLEY CITY OH 44280 OUTPATIENT PHYSICIAN CLINIC CLEVELAND CLINIC STAR IMAGING 1449 BOARDMAN-CANFIELD ROAD YOUNGSTOWN OH 44510 DIAGNOSTIC CENTER CLEVELAND CLINIC UROLOGICAL INSTITUTE 14701 DETROIT RD LAKEWOOD OH 44107 OUTPATIENT PHYSICIAN CLINIC COLE EYE INSTITUTE 2000 AUBURN DRIVE SUITE 100 BEACHWOOD OH 44122 OUTPATIENT PHYSICIAN CLINIC COLUMBUS STAR IMAGING 921 JASONWAY AVENUE COLUMBUS OH 43214 DIAGNOSTIC CENTER COLUMBUS STAR IMAGING 6096 EAST MAIN STREET COLUMBUS OH 44213 DIAGNOSTIC CENTER COMMUNITY HEALTH & WELLNESS CENTER 2390 E 79TH ST CLEVELAND OH 44104 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 26250 EUCLID AVENUE SUITE 611 EUCLID OH 44132 OUTPATIENT PHYSICIAN CLINIC COMMUNITY PEDIATRICS 26300 EUCLID AVENUE EUCLID OH 44132 OUTPATIENT PHYSICIAN CLINIC GASTROENTEROLOGY ASSOCIATES 3700 PARK EAST DRIVE BEACHWOOD OH 44122 OUTPATIENT PHYSICIAN CLINIC GATES MEDICAL CENTER 125 EAST BROAD STREET ELYRIA OH 44035 OUTPATIENT PHYSICIAN CLINIC GRADISEK FAMILY VISION CARE 1142 W 37TH STREET LORAIN OH 44052 OUTPATIENT PHYSICIAN CLINIC HILLCREST HOSPITAL OUTPATIENT REHABILITA 5187 MAYFIELD ROAD SUITES 10 30 LYNDHURST OH 44124 OUTPATIENT PHYSICIAN CLINIC KINDRED HEALTH CARE CLEVELAND 11900 FAIRHILL ROAD CLEVELAND OH 44120 OUTPATIENT PHYSICIAN CLINIC LAKE HEALTH (REGIONAL NEUROSCIENCES) 36001 EUCLID AVENUE WILLOUGHBY OH 44094 OUTPATIENT PHYSICIAN CLINIC LAKEWOOD HOSPITAL TEEN HEALTH CENTER 15644 MADISON AVENUE SUITE LAKEWOOD OH 44107 OUTPATIENT PHYSICIAN CLINIC LAKEWOOD YMCA 16915 DETROIT AVENUE LAKEWOOD OH 44107 OUTPATIENT PHYSICIAN CLINIC MEDINA COMMUNITY RECREATION CENTER 855 WEYMOUTH ROAD MEDINA OH 44256 OUTPATIENT PHYSICIAN CLINIC MERCY MEDICAL CENTER 1320 MERCY DRIVE NW CANTON OH 44708 OUTPATIENT PHYSICIAN CLINIC SHEWBRIDGE PRACTICE 4087 MEDINA ROAD MEDINA OH 44256 OUTPATIENT PHYSICIAN CLINIC SLEEP DISORDERS CENTER 24901 COUNTRY CLUB BOULEVARD NORTH OLMSTED OH 44070 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 3750 ORANGE PLACE BEACHWOOD OH 44122 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 8971 WILCOX DRIVE TWINSBURG OH 44087 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 1825 LORAIN BOULEVARD ELYRIA OH 44035 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 5051 WEST CREEK ROAD INDEPENDENCE OH 44131 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 31222 EASTPOINTE DRIVE MEDINA OH 44256 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 5785 HEISLEY ROAD MENTOR OH 44060 DIAGNOSTIC CENTER SLEEP DISORDERS CENTER 13201 GRANGER ROAD GARFIELD HEIGHTS OH 44125 DIAGNOSTIC CENTER THERAPY SERVICES SOUTH 17800 JEFFERSON PARK DRIVE SUITE 101 MIDDLEBURG HTS OH 44130 OUTPATIENT PHYSICIAN CLINIC THERAPY SERVICES WEST 826 WESTPOINT PKWY SUITE 1200 WESTLAKE OH 44145 OUTPATIENT PHYSICIAN CLINIC THORACIC & CARDIOVASCULAR SURGERY 36100 EUCLID AVENUE SUITE 280 WILLOUGHBY OH 44094 OUTPATIENT PHYSICIAN CLINIC THORACIC & CARDIOVASCULAR SURGERY-PARMA 6681 RIDGE RD SUITE 410 PARMA OH 44129 OUTPATIENT PHYSICIAN CLINIC WELLINGTON MEDICAL OFFICE BUILDING 805 PATRIOT DRIVE UNIT E WELLINGTON OH 44090 OUTPATIENT PHYSICIAN CLINIC WOOSTER MILLTOWN SPECIALTY CENTER 721 EAST MILLTOWN ROAD WOOSTER OH 44691 OUTPATIENT PHYSICIAN CLINIC WOOSTER WOMEN'S HEALTH CENTER 1739 CLEVELAND ROAD WOOSTER OH 44691 OUTPATIENT PHYSICIAN CLINIC YOUNGSTOWN FERTILITY CENTER 3660 STUTZ DRIVE CANFIELD OH 44406 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: CCF PROVIDES MEDICALLY NECESSARY SERVICES TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, GENDER OR COUNTRY OF NATIONAL ORIGIN AND WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. CCF HAS A FINANCIAL ASSISTANCE POLICY THAT IS AMONG THE MOST GENEROUS IN NORTHEAST OHIO. THIS POLICY APPLIES TO ALL CCF FACILITIES, AND THE AMOUNT OF CARE PROVIDED UNDER THE POLICY IS DETERMINED BY NEED AND IS NOT LIMITED OR RATIONED BY BUDGETED AMOUNTS. UNDER THE POLICY, CCF PROVIDES FREE CARE TO INDIVIDUALS WITHOUT INSURANCE WITH INCOMES UP TO 250% OF THE FEDERAL POVERTY LEVEL AND DISCOUNTED CARE ON A SLIDING SCALE UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN ADDITION, THE POLICY CONTAINS A MEDICAL INDIGENCE PROVISION, WHICH PROVIDES ASSISTANCE REGARDLESS OF INCOME LEVEL OR INSURANCE STATUS WHERE MEDICAL COSTS WILL EXCEED 25% OF ANNUAL FAMILY INCOME. UNLIKE THE FINANCIAL ASSISTANCE POLICIES OF MOST HOSPITALS, THE CCF POLICY APPLIES TO BOTH HOSPITAL CHARGES AND CERTAIN PROFESSIONAL FEES FOR SERVICES PROVIDED BY CCF EMPLOYED PHYSICIANS. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM A COST ACCOUNTING SYSTEM. IN OTHER CATEGORIES, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THAT CATEGORY. PART I, LINE 7G: CCF EMPLOYS ITS PHYSICIANS, THEREFORE THE ASSOCIATED COSTS AND CHARGES RELATING TO THESE PHYSICIAN SERVICES ARE INCLUDED IN ALL RELEVANT CATEGORIES OF PART I. PART I, LN 7 COL(F): ADDITIONAL BAD DEBT EXPENSE ADDED FOR PURPOSES OF CALCULATING THE PERCENTAGES BUT NOT REPORTED ON FORM 990 IS $846,341. PART I, LINE 6A SCH H PART I LINE 6A - AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR THE HEALTH SYSTEM AS A WHOLE, WHICH INCLUDES THE PARENT ORGANIZATION AND RELATED AFFILIATES. PART I, LINE 7B THE NET COMMUNITY BENEFIT EXPENSE FIGURE REPORTED FOR UNREIMBURSED MEDICAID IS NET OF CCF'S HCAP BENEFIT OF $ 6,051,223. PART I, LINE 7 NOTE THAT THE TOTAL AMOUNT OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS OF $ 474,824,659 AS REPORTED ON PART I, LINE 7 DIFFERS FROM THE TOTAL COMMUNITY BENEFIT FOR CLEVELAND CLINIC AS REPORTED AS A COMPONENT OF THE OVERALL SYSTEM'S COMMUNITY BENEFIT REPORT. THE AMOUNT DIFFERS IN TWO RESPECTS: 1) IRS DOES NOT CONSIDER COMMUNITY BUILDING ACTIVITIES AS REPORTED IN PART II TO BE COMMUNITY BENEFIT WHERE THESE ACTIVITIES ARE INCLUDED IN COMMUNITY BENEFIT PER CHA GUIDELINES AND 2) THE PROPORTIONATE SHARE OF JOINT VENTURE COMMUNITY BENEFIT IS INCLUDED IN LINE 7. PART II, COMMUNITY BUILDING ACTIVITIES: CLEVELAND CLINIC ADDRESSES VARIOUS COMMUNITY CONCERNS, INCLUDING HEALTH IMPROVEMENT, POVERTY, WORKFORCE DEVELOPMENT, AND ACCESS TO HEALTH CARE. CLEVELAND CLINIC DIRECTS EMPLOYEE TIME AND TALENT TO SERVE ON COMMUNITY COLLABORATION BOARDS, HEALTH ADVOCACY PROGRAMS, AND PHYSICAL IMPROVEMENT PROJECTS TO PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES. PART III, LINE 2: ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS, NOT INCLUDED IN BAD DEBT EXPENSE. PART III, LINE 4: TEXT OF FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS:THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, MAJOR PAYOR SOURCES 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 MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE SYSTEM. PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE CALCULATED USING A COST-TO-CHARGE RATIO.CCF HAS USED THE CHA METHODOLOGY FOR REPORTING COMMUNITY BENEFIT SINCE 2004 AS IT WAS THE EMERGING COMMUNITY BENEFIT REPORTING STANDARD AND NOW HAS BEEN ADOPTED IN LARGE PART BY THE IRS FOR 990 REPORTING PURPOSES. THE CHA MODEL DOES NOT INCLUDE MEDICARE SHORTFALL AS COMMUNITY BENEFIT. PART III, LINE 9B: YES, CLEVELAND CLINIC HAS A WRITTEN DEBT COLLECTION POLICY. IT IS OUR POLICY NOT TO PURSUE COLLECTION PRACTICES AGAINST PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE PROGRAMS OR BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO MAKE SUCH DETERMINATION. IN CERTAIN CASES IT MAY NOT BE EASILY DETERMINED WHETHER OR NOT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE; HOWEVER, IF AFTER COLLECTION PRACTICES HAVE BEGUN IT LATER BECOMES KNOWN THAT A PATIENT QUALIFIES, THE COLLECTION EFFORTS CEASE. ADDITIONALLY, OUR EXTERNAL THIRD-PARTY (COLLECTION) AGENCIES ARE TRAINED ON OUR FINANCIAL ASSISTANCE POLICY AND ASSIST A PATIENT IN NEED BY SUPPLYING OUR APPLICATION FOR FINANCIAL ASSISTANCE. PART III, LINE 5, 6, & 7 IN ADDITION TO THE MEDICARE PROGRAMS REFLECTED IN THE COST REPORTS, CCF INCURS COSTS AND RECEIVES REIMBURSEMENT FOR OTHER MEDICARE ELIGIBLE SERVICES. THE TOTAL REVENUE RECEIVED AND COSTS ASSOCIATED WITH THE ADDITIONAL MEDICARE SERVICES ARE $ 518,491,446 AND $ 828,596,004 RESPECTIVELY. THIS RESULTS IN ADDITIONAL MEDICARE SHORTFALL OF $ 310,104,558 WHICH, ADDED TO THE SHORTFALL OF $ 22,527,066 AS REPORTED ON THE COST REPORTS BRINGS THE TOTAL MEDICARE SHORTFALL TO $ 332,631,624. PART VI, LINE 2: IN ADDITION TO THE CHNA PROCESS, CCF'S INSTITUTES AND DEPARTMENTS MAY GATHER, ANALYZE, AND REVIEW RELEVANT HEALTH STATISTICS AND DEMOGRAPHIC DATA FOR THE COMMUNITY FOR THAT PARTICULAR FACILITY. THE DATA IS USED TO EVALUATE POTENTIAL NEW OR REVISED HEALTH SERVICES THAT CCF MAY PROVIDE TO PARTICULAR GROUPS OF PATIENTS WITHIN THE COMMUNITIES IT SERVES. PART VI, LINE 3: INFORMING THE PUBLIC THAT FINANCIAL ASSISTANCE IS AVAILABLE IS AN IMPORTANT ELEMENT OF OUR FINANCIAL ASSISTANCE PROGRAM AND THE CLEVELAND CLINIC CONTINUOUSLY STRIVES TO IMPROVE ITS COMMUNICATIONS WITH PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE CLEVELAND CLINIC WEBSITE. ALL PATIENT BILLS INCLUDE DETAILED INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY AND AN INSERT DESCRIBING THE FINANCIAL ASSISTANCE PROGRAM IS INCLUDED WITH BILLING STATEMENTS. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGHOUT CCF, INCLUDING IN PATIENT REGISTRATION AREAS, ONLINE, AND WITH FINANCIAL COUNSELORS WHO ARE PRESENT ON-SITE AT EACH CLEVELAND CLINIC HOSPITAL AND OHIO FAMILY HEALTH CENTER TO ASSIST PATIENTS IN QUALIFYING FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS AND WITH FINANCIAL COUNSELORS. PART VI, LINE 4: THE CLEVELAND CLINIC'S COMMUNITY IS DEFINED BOTH BY MISSION AND GEOGRAPHY. THE GEOGRAPHIC COMMUNITY IS DEFINED BY THE HOSPITAL FACILITY'S IMMEDIATELY CONTIGUOUS AREAS AS WELL AS THE BROADER SURROUNDING COUNTIES/REGIONS FROM WHICH THE MAJORITY OF DISCHARGED INPATIENTS RESIDE. ADDITIONALLY, THE COMMUNITY INCLUDES PATIENTS WHO REQUIRE EXPERTISE AND SPECIALIZED SERVICES OF THE CLEVELAND CLINIC. THE COMMUNITY FOR MEDICAL RESEARCH AND EDUCATION IS THE PUBLIC AT LARGE. PART VI, LINE 5: ONE OF THE HALLMARKS OF A CHARITABLE ORGANIZATION IS THAT THE ORGANIZATION SERVES A BROAD, INDEFINITE CHARITABLE CLASS. ONE OF THE KEY INDICATORS THAT AN ORGANIZATION SERVES THE BROADER COMMUNITY IS CONTROL OF THE ORGANIZATION BY INDEPENDENT COMMUNITY LEADERS. CCF AND ITS NORTHEAST OHIO REGIONAL HOSPITAL GOVERNING BOARDS ARE MADE UP OF MEMBERS OF THE COMMUNITY WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF CCF AND ITS SUBORDINATES. TRUSTEES/DIRECTORS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO THE CLEVELAND CLINIC AND THE HEALTH SYSTEM AND ARE NOT COMPENSATED FOR THEIR SERVICES.ANOTHER HALLMARK OF A CHARITABLE ORGANIZATION IS THAT SURPLUS FUNDS ARE USED TO FURTHER CHARITABLE PURPOSES AND ACTIVITIES. SURPLUS FUNDS FOR CCF AND ITS SUBORDINATES ARE REINVESTED AND USED IN CARRYING OUT THE EXEMPT MISSION -- PATIENT CARE, RESEARCH, AND EDUCATION. PART VI, LINE 6: CLEVELAND CLINIC IS THE PARENT ORGANIZATION OF THE HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM CONSISTING OF AN ACADEMIC MEDICAL CENTER, MEDICAL SCHOOL, COMMUNITY HOSPITALS, FAMILY HEALTH CENTERS, VARIOUS ANCILLARY SERVICES, AND A LARGE GROUP OF EMPLOYED PHYSICIANS AND PHYSICIAN RESEARCHERS. 1 A CULTURAL EXCHANGE 12624 LARCHMERE CLEVELAND OH 44120 341759189 501(C)(3) 7500 COMMUNITY SUPPORT ACHIEVEMENT CENTER FOR CHILDREN 4255 NORTHFIELD ROAD HIGHLAND HILLS OH 44128 340714766 501(C)(3) 6500 COMMUNITY SUPPORT ADULT CONGENITAL HEART ASSOCIATION INC 6757 GREENE ST SUITE 335 PHILADELPHIA PA 19119 043447959 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION ALS ASSOCIATION 2500 E 22ND ST SUITE 101 CLEVELAND OH 44115 341595148 501(C)(3) 10000 HEALTHCARE RESEARCH & EDUCATION ALZHEIMERS ASSOCIATION 12200 FAIRHILL ROAD CLEVELAND OH 44120 341311175 501(C)(3) 9100 HEALTHCARE RESEARCH & EDUCATION AMERICAN CANCER SOCIETY 10501 EUCLID AVENUE CLEVELAND OH 441062204 131788491 501(C)(3) 33500 HEALTHCARE RESEARCH & EDUCATION AMERICAN DIABETES ASSOCIATION 1701 N BEAUREGARD STREET ALEXANDRIA VA 22311 131623888 501(C)(3) 45000 HEALTHCARE RESEARCH & EDUCATION AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 590637852 501(C)(3) 180500 HEALTHCARE RESEARCH & EDUCATION AMERICAN JEWISH COMMITTEE 1422 EUCLID AVENUE SUITE 625 CLEVELAND OH 44115 135563393 501(C)(3) 5000 COMMUNITY SUPPORT AMERICAN LIVER FOUNDATION PO BOX 36085 INDIANAPOLIS IN 462360085 362883000 501(C)(3) 16500 HEALTHCARE RESEARCH & EDUCATION AMERICAN LUNG ASSOCIATION 1740 BROADWAY NEW YORK NY 10019 131632524 501(C)(3) 20000 HEALTHCARE RESEARCH & EDUCATION AMERICAN RED CROSS 3747 EUCLID AVENUE CLEVELAND OH 44115 340714622 501(C)(3) 19500 HEALTHCARE RESEARCH & EDUCATION ARTHRITIS FOUNDATION 1330 WEST PEACHTREE STREET NW ATLANTA GA 30309 581341679 501(C)(3) 38500 HEALTHCARE RESEARCH & EDUCATION ASSOCIATION OF INDIAN PHYSICIANS OF NORTHERN OHIO 3249 ROCKY RIVER ROCKY RIVER OH 44111 341407746 501(C)(3) 8170 COMMUNITY SUPPORT AVAMAR FOUNDATION 9225 E MARKET STREET WARREN OH 44484 273247081 501(C)(3) 8800 COMMUNITY SUPPORT BEACHWOOD CHAMBER OF COMMERCE 25550 CHAGRIN BLVD SUITE 201 BEACHWOOD OH 44122 341684237 501(C)(6) 7864 COMMUNITY SUPPORT BENEDICTINE HIGH SCHOOL 2900 MARTIN LUTHER KING JR DR CLEVELAND OH 44704 341619790 501(C)(3) 10000 SUPPORT EDUCATIONAL ACTIVITIES BIG BROTHERS-BIG SISTERS OF LORAIN COUNTY 1917 NORTH RIDGE RD LORAIN OH 44055 341809153 501(C)(3) 5000 COMMUNITY SUPPORT BIKE CLEVELAND PO BOX 609718 CLEVELAND OH 44109 452556898 501(C)(3) 6000 COMMUNITY SUPPORT BLACK PROFESSIONAL ASSOCIATION CHARITABLE FOUNDATION INC PO BOX 5783 CLEVELAND OH 441010783 341496786 501(C)(3) 5000 COMMUNITY SUPPORT BOY SCOUTS OF AMERICA 2241 WOODLAND AVE CLEVELAND OH 441153295 340714322 501(C)(3) 31070 COMMUNITY SUPPORT BOYS AND GIRLS CLUBS OF CLEVELAND 6114 BROADWAY AVENUE CLEVELAND OH 44127 340770686 501(C)(3) 19000 COMMUNITY SUPPORT CARE ALLIANCE 1795 W 25TH STREET SUITE 251 CLEVELAND OH 44113 341748776 501(C)(3) 15000 HEALTHCARE RESEARCH & EDUCATION CHAGRIN FALLS BUSINESS & COMMUNITY PARTNERSHIP 57 EAST WASHINGTON ST CHAGRIN FALLS OH 44022 311564112 501(C)(3) 20000 COMMUNITY SUPPORT CHAGRIN VALLEY JAYCEES CHARITABLE FOUNDATION PO BOX 55 CHAGRIN FALLS OH 44022 320094722 501(C)(3) 14000 COMMUNITY SUPPORT CHOPCHOP KIDS INC 32B CALVIN RD WATERTOWN MA 02472 043505334 501(C)(3) 5000 COMMUNITY SUPPORT CHUMS INCORPORATED 100 HAMLET COURT BRATENAHL OH 44108 800696787 501(C)(3) 5500 COMMUNITY SUPPORT CITY OF INDEPENDENCE 6800 BRECKSVILLE ROAD INDEPENDENCE OH 44131 346001474 501(C)(1) 5000 COMMUNITY SUPPORT CITY OF MAPLE HEIGHTS 5353 LEE ROAD MAPLE HTS OH 44137 346001809 501(C)(1) 8600 COMMUNITY SUPPORT CITY OF TWINSBURG 10075 RAVENNA ROAD TWINSBURG OH 44087 346004070 501(C)(1) 5000 COMMUNITY SUPPORT CLEVELAND BOTANICAL GARDEN 11030 EAST BLVD CLEVELAND OH 44106 340239538 501(C)(3) 8000 COMMUNITY SUPPORT CLEVELAND CENTER FOR ARTS AND TECHNOLOGY 3634 EUCLID AVE SUITE 100 CLEVELAND OH 44115 271193704 501(C)(3) 333333 COMMUNITY SUPPORT CLEVELAND CLINIC EDUCATIONAL FOUNDATION 9500 EUCLID AVENUE CLEVELAND OH 44195 340714553 501(C)(3) 19816233 HEALTHCARE RESEARCH & EDUCATION CLEVELAND COUNCIL ON WORLD AFFAIRS 850 HURON ROAD STE 620 CLEVELAND OH 44115 340720549 501(C)(3) 5000 COMMUNITY SUPPORT CLEVELAND INTERNATIONAL FILM FESTIVAL INC 2510 MARKET AVE CLEVELAND OH 44113 341262368 501(C)(3) 5000 COMMUNITY SUPPORT CLEVELAND LEADERSHIP CENTER 1422 EUCLID AVE SUITE 940 CLEVELAND OH 44115 341927317 501(C)(3) 12250 COMMUNITY SUPPORT CLEVELAND METROPOLITAN BAR ASSOCIATION PO BOX 931891 CLEVELAND OH 44193 262052191 501(C)(3) 10500 COMMUNITY SUPPORT CLEVELAND METROPOLITAN SCHOOL DISTRICT 1380 EAST 6TH ST CLEVELAND OH 44114 346000662 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES CLEVELAND MUSEUM OF ART 11150 EAST BLVD CLEVELAND OH 44106 340714336 501(C)(3) 5000 COMMUNITY SUPPORT CLEVELAND MUSEUM OF NATURAL HISTORY 1 WADE OVAL DRIVE CLEVELAND OH 44106 340714338 501(C)(3) 15000 COMMUNITY SUPPORT CLEVELAND ORCHESTRA 11001 EUCLID AVENUE CLEVELAND OH 44106 340714468 501(C)(3) 10000 COMMUNITY SUPPORT CLEVELAND PLAYHOUSE PO BOX 1989 CLEVELAND OH 44106 340895516 501(C)(3) 10000 COMMUNITY SUPPORT CLEVELAND SOCIETY FOR THE BLIND 1909 EAST 101ST STREET CLEVELAND OH 44106 340714652 501(C)(3) 6000 COMMUNITY SUPPORT CLEVELAND STATE UNIVERSITY 2121 EUCLID AVENUE CLEVELAND OH 441152214 340966056 501(C)(3) 53130 SUPPORT EDUCATIONAL ACTIVITIES COLLEGE NOW GREATER CLEVELAND INC 200 PUBLIC SQUARE SUITE 3820 CLEVELAND OH 441142321 346580096 501(C)(3) 10000 SUPPORT EDUCATIONAL ACTIVITIES COMMUNITY WEST FOUNDATION 20545 CENTER RIDGE ROAD CLEVELAND OH 44116 341456398 501(C)(3) 21000 COMMUNITY SUPPORT CONSERVANCY FOR CUYAHOGA VALLEY NATIONAL PARK 1403 W HINES HILL RD PENINSULA OH 44264 341917257 501(C)(3) 5000 COMMUNITY SUPPORT CORNERSTONE OF HOPE 6600 DAISY AVE INDEPENDENCE OH 44131 341945499 501(C)(3) 18250 COMMUNITY SUPPORT CROHNS & COLITIS FOUNDATION OF AMERICA 23366 COMMERCE 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SUPPORT EUCLID AVENUE CONGREGATIONAL CHURCH 4217 BLUESTONE ROAD CLEVELAND OH 44121 346505904 501(C)(3) 291667 COMMUNITY SUPPORT FAIRFAX RENAISSANCE DEVELOPMENT CORPORATION 8111 QUINCY AVENUE SUITE 100 CLEVELAND OH 44104 341706856 501(C)(3) 104664 COMMUNITY SUPPORT FLASHES OF HOPE INC 6009 LANDERHAVEN DR SUITE 1 MAYFIELD HTS OH 44124 043648694 501(C)(3) 10000 HEALTHCARE RESEARCH & EDUCATION FOUNDATION CENTER 600 SUPERIOR AVE SUITE 2330 CLEVELAND OH 44114 131837418 501(C)(3) 5000 COMMUNITY SUPPORT FRIENDS OF CANCER RESEARCH 1800 M ST NW SUITE 1050 SOUTH TOWER TOWER WASHINGTON DC 20036 521983273 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION GATHERING PLACE 3365 RICHMOND RD BEACHWOOD OH 44122 341879035 501(C)(3) 37800 COMMUNITY SUPPORT GIRL SCOUTS OF AMERICA 19201 VILLAVIEW ROAD CLEVELAND OH 441193074 340714415 501(C)(3) 6600 COMMUNITY SUPPORT GLOBAL CLEVELAND 200 PUBLIC SQ SUITE 100 CLEVELAND OH 44114 275245539 501(C)(3) 25000 COMMUNITY SUPPORT GREATER CLEVELAND FOOD BANK 1557 EAST 27TH STREET CLEVELAND OH 44114 341292848 501(C)(3) 16000 COMMUNITY SUPPORT GREATER CLEVELAND SPORTS COMMISSION 50 PUBLIC SQUARE SUITE 950 CLEVELAND OH 44113 311381131 501(C)(3) 25000 COMMUNITY SUPPORT HEALTH POLICY INSTITUTE OF OHIO 37 WEST BROAD STREET SUITE 350 COLUMBUS OH 43215 300186863 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION HEART 2 HEART COMPANION LLC 601 LAKESIDE AVENUE ROOM 202 CLEVELAND OH 44114 237084455 501(C)(3) 10500 HEALTHCARE RESEARCH & EDUCATION HISPANIC ROUNDTABLE COMMUNITY PROGRAMS 1900 E 9TH STREET SUITE 3200 CLEVELAND OH 44114 200932464 501(C)(3) 5000 COMMUNITY SUPPORT HUMAN RIGHTS CAMPAIGN 6600 DETROIT AVENUE CLEVELAND OH 44102 521243457 501(C)(3) 5000 COMMUNITY SUPPORT HUNGER TASK FORCE OF GREATER CLEVELAND 614 W SUPERIOR AVE 744 CLEVELAND OH 44113 341810545 501(C)(3) 5000 COMMUNITY SUPPORT INNER CITY TENNIS CLINIC PO BOX 32551 CLEVELAND OH 44132 271789893 501(C)(3) 10000 COMMUNITY SUPPORT JOY OUTDOOR EDUCATION CENTER FOUNDATION INC PO BOX 417 CLARKSVILLE OH 45113 310672822 501(C)(3) 5000 COMMUNITY SUPPORT KARAMU HOUSE 2355 EAST 89TH STREET CLEVELAND OH 44106 340714448 501(C)(3) 5000 COMMUNITY SUPPORT KENT STATE UNIVERSITY PO BOX 5190 KENT OH 44242 316402079 501(C)(3) 50500 SUPPORT EDUCATIONAL ACTIVITIES KIDNEY FOUNDATION OF OHIO 2831 PROSPECT AVENUE CLEVELAND OH 44115 340827748 501(C)(3) 12600 HEALTHCARE RESEARCH & EDUCATION LAKELAND COMMUNITY COLLEGE 7700 CLOCKTOWER DRIVE KIRTLAND OH 440945198 341011011 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES LAWRENCE SCHOOL 1551 EAST WALLINGS RD BROADVIEW HEIGHTS OH 44147 341137455 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES LEGAL AID SOCIETY OF CLEVELAND 1223 WEST SIXTH STREET CLEVELAND OH 44113 340866026 501(C)(3) 6000 COMMUNITY SUPPORT LEUKEMIA & LYMPHOMA SOCIETY 902 WESTPOINT PARKWAY 3300 CLEVELAND OH 44145 135644916 501(C)(3) 8500 HEALTHCARE RESEARCH & EDUCATION LIFEBANC 20600 CHAGRIN BLVD SUITE 350 CLEVELAND OH 441225343 341525159 501(C)(3) 22000 HEALTHCARE RESEARCH & EDUCATION LORAIN COUNTY COMMUNITY COLLEGE 1005 NORTH ABBE ROAD SUITE 214 ELYRIA OH 440351691 340930187 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES M C CHATMAN CENTER FOR HUMANITARIAN SERVICES 3582 LUDGATE ROAD SHAKER HTS OH 44120 550834175 501(C)(3) 5000 COMMUNITY SUPPORT MAIN STREET MEDINA 23 PUBLIC SQUARE SUITE 220 MEDINA OH 44256 261802645 501(C)(3) 5000 COMMUNITY SUPPORT MALTZ MUSEUM OF JEWISH HERITAGE 2929 RICHMOND ROAD BEACHWOOD OH 44122 043684531 501(C)(3) 30000 COMMUNITY SUPPORT MARCH OF DIMES FOUNDATION 614 SUPERIOR AVENUE NW CLEVELAND OH 44113 131846366 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION MAYO SOCIETY OF GREATER CLEVELAND PO BOX 19185 CLEVELAND OH 44119 830423217 501(C)(3) 5000 COMMUNITY SUPPORT MEDINA CITY SCHOOLS PO BOX 408 MEDINA OH 44258 346001854 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES MEDWISH INTERNATIONAL PO BOX 181484 CLEVELAND OH 44118 341903712 501(C)(3) 0 4080699 ESTIMATED VALUE IN-KIND EQUIPMENT HEALTHCARE RESEARCH & EDUCATION MEREDITH A COWDEN FOUNDATION 1369 WEBB ROAD LAKEWOOD OH 44107 208666402 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION METRO HEALTH SYSTEM PO BOX 931475 CLEVELAND OH 441930497 346004382 501(C)(1) 192535 HEALTHCARE RESEARCH & EDUCATION MIDTOWN CLEVELAND 5000 EUCLID AVE SUITE 100 CLEVELAND OH 44103 341381334 501(C)(3) 10000 COMMUNITY SUPPORT MUSEUM OF CONTEMPORARY ART CLEVELAND 8501 CARNEGIE AVE CLEVELAND OH 44106 341148828 501(C)(3) 12500 COMMUNITY SUPPORT NAACP 614 SUPERIOR AVE NW 700 CLEVELAND OH 44113 341786675 501(C)(3) 10000 COMMUNITY SUPPORT NAMI GREATER CLEVELAND 2012 WEST 25TH STREET 600 CLEVELAND OH 44113 202254268 501(C)(3) 10600 COMMUNITY SUPPORT NATIONAL CHRISTIAN FOUNDATION OHIO PO BOX 2781 WESTERVILLE OH 43086 581493949 501(C)(3) 9000 COMMUNITY SUPPORT NATIONAL MULTIPLE SCLEROSIS SOCIETY 1422 EUCLID AVE CLEVELAND OH 441151901 340801307 501(C)(3) 10000 HEALTHCARE RESEARCH & EDUCATION NORTH COAST CANCER FOUNDATION 417 QUARRY LAKES DRIVE SANDUSKY OH 44870 341224416 501(C)(3) 100000 HEALTHCARE RESEARCH & EDUCATION NORTH UNION FARMERS MARKET 13212 SHAKER SQUARE SUITE 302 CLEVELAND OH 44120 341812026 501(C)(3) 43500 COMMUNITY SUPPORT OPEN DOORS INC 3311 PERKINS AVE CLEVELAND OH 44114 043697716 501(C)(3) 5150 COMMUNITY SUPPORT PARALLEL INNOVATION LABS 2505 ANTHEM VILLAGE DR SUITE E-179 HENDERSON NV 89052 453656159 501(C)(3) 5000 COMMUNITY SUPPORT PIANO INTERNATIONAL ASSOCIATION OF NORTHERN OHIO 12200 FAIRHILL RD CLEVELAND OH 44120 341774615 501(C)(3) 5000 COMMUNITY SUPPORT PLAYHOUSE SQUARE CENTER 1501 EUCLID AVENUE SUITE 200 CLEVELAND OH 44115 237304942 501(C)(3) 15000 COMMUNITY SUPPORT PRACTICE GREENHEALTH 1901 N MOORE STREET SUITE 509 ARLLINGTON VA 22209 760815736 501(C)(3) 30000 HEALTHCARE RESEARCH & EDUCATION PROJECT LOVE 23611 CHAGRIN BLVD 380 BEACHWOOD OH 44122 341795459 501(C)(3) 20000 COMMUNITY SUPPORT PULSEPOINT FOUNDATION PO BOX 12594 PLEASANTON CA 945882594 452725805 501(C)(3) 25000 HEALTHCARE RESEARCH & EDUCATION RAINEY INSTITUTE 1523 EAST 55TH STREET CLEVELAND OH 44144 346555952 501(C)(3) 12000 SUPPORT EDUCATIONAL ACTIVITIES REBUILDING TOGETHER CLEVELAND INC PO BOX 14274 CLEVELAND OH 441140274 311493982 501(C)(3) 5000 COMMUNITY SUPPORT RECOVERY RESOURCES 3950 CHESTER AVE CLEVELAND OH 44114 341211116 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION REGIONAL TRANSIT AUTHORITY PO BOX 6566 CLEVELAND OH 441019931 341170830 501(C)(3) 125056 COMMUNITY SUPPORT RONALD MCDONALD HOUSE OF CLEVELAND 10415 EUCLID AVENUE CLEVELAND OH 44106 341269123 501(C)(3) 235686 HEALTHCARE RESEARCH & EDUCATION SAINT MARTIN DE PORRES HIGH SCHOOL 6111 LAUSCHE AVE CLEVELAND OH 44103 522401852 501(C)(3) 221371 HEALTHCARE RESEARCH & EDUCATION SAINT VINCENT HEALTH CENTER 232 W 25 STREET ERIE PA 165440001 250965547 501(C)(3) 8000 HEALTHCARE RESEARCH & EDUCATION SALVATION ARMY PO BOX 15 LORAIN OH 44052 240714378 501(C)(3) 12500 COMMUNITY SUPPORT SHAKER SCHOOLS FOUNDATION 15600 PARKLAND DRIVE SHAKER HTS OH 44120 341351470 501(C)(3) 5000 SUPPORT EDUCATIONAL ACTIVITIES SHOES AND CLOTHES FOR KIDS INC 3311 PERKINS AVE SUITE 205 CLEVELAND OH 44114 341554285 501(C)(3) 6000 COMMUNITY SUPPORT SOUTHERN CHRISTIAN LEADERSHIP CONFERENCE PO BOX 92544 ATLANTA GA 30314 580807748 501(C)(3) 10000 COMMUNITY SUPPORT STRONGSVILLE CHAMBER OF COMMERCE 18829 ROYALTON ROAD STRONGSVILLE OH 44136 340892274 501(C)(6) 7880 COMMUNITY SUPPORT SUSAN G KOMEN FOR THE CURE 26210 EMERY ROAD SUITE 307 CLEVELAND OH 44128 341793460 501(C)(3) 36008 HEALTHCARE RESEARCH & EDUCATION THE CHILDREN'S MUSEUM OF CLEVELAND 10730 EUCLID AVENUE CLEVELAND OH 441062200 341360267 501(C)(3) 5000 COMMUNITY SUPPORT THE CLEVELAND POLICE FOUNDATION 1300 ONTARIO STREET CLEVELAND OH 441131648 830509855 501(C)(3) 10000 COMMUNITY SUPPORT THE MARFAN FOUNDATION INC 382 MAIN STREET PORT WASHINGTON NY 110503121 521265361 501(C)(3) 12500 HEALTHCARE RESEARCH & EDUCATION THE MUSICAL ARTS ASSOCIATION 11001 EUCLID AVENUE CLEVELAND OH 44106 340714468 501(C)(3) 5000 COMMUNITY SUPPORT THE VILLAGE AT MARYMOUNT 5200 MARYMOUNT VILLAGE DR GARFIELD HTS OH 44125 205652595 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND 2141 OVERLOOK ROAD CLEVELAND OH 44106 340753561 501(C)(3) 5000 HEALTHCARE RESEARCH & EDUCATION UNITED NEGRO COLLEGE FUND INC 2000 AUBURN DRIVE SUITE 200 CLEVELAND OH 44122 131624241 501(C)(3) 10000 COMMUNITY SUPPORT UNITED WAY OF GREATER CLEVELAND 1331 EUCLID AVENUE CLEVELAND OH 441151854 346516654 501(C)(3) 14100 COMMUNITY SUPPORT UNIVERSITY CIRCLE INCORPORATED 10831 MAGNOLIA DRIVE CLEVELAND OH 44106 340823464 501(C)(3) 5350 COMMUNITY SUPPORT UNIVERSITY OF AKRON 302 E BUTCHEL AVENUE AKRON OH 44325 346002924 501(C)(3) 10000 SUPPORT EDUCATIONAL ACTIVITIES UNIVERSITY SETTLEMENT INC 4800 BROADWAY AVENUE CLEVELAND OH 44127 340714776 501(C)(3) 7500 COMMUNITY SUPPORT URBAN LEAGUE OF CLEVELAND 12001 SHAKER BLVD CLEVELAND OH 44120 340720563 501(C)(3) 5000 COMMUNITY SUPPORT WALK WITH A DOC 495 COOPER ROAD SUITE 411 WESTERVILLE OH 43061 263253701 501(C)(3) 10000 HEALTHCARE RESEARCH & EDUCATION WALLIN ELEMENTARY SCHOOL 2333 CANYON RETREAT DR HENDERSON NV 89044 886000030 501(C)(3) 10000 SUPPORT EDUCATIONAL ACTIVITIES WOMEN OF COLOR FOUNDATION 1667 EAST 40TH ST SUITE 1G1 CLEVELAND OH 441033746 020743542 501(C)(3) 31000 COMMUNITY SUPPORT YOUTH OPPORTUNITIES UNLIMITED 3750 PROSPECT AVE CLEVELAND OH 44115 341381135 501(C)(3) 7500 COMMUNITY SUPPORT 129 6 SCHOLARSHIPS 201 6949472 0 FELLOWSHIPS 2028 84059165 0 LODGING FOR INDIGENT 874 335895 0 PART I, LINE 2: THE CLEVELAND CLINIC FOUNDATION CONTRIBUTES CASH DONATIONS TO VARIOUS TAX EXEMPT ORGANIZATIONS WITHIN THEIR COMMUNITY AND THE UNITED STATES. IN GENERAL, THE CLEVELAND CLINIC FOUNDATION DOES NOT RESTRICT THE USE OF THESE DONATIONS. THE RECEIVING EXEMPT ORGANIZATIONS MAY USE THE DONATIONS AT WILL TO FURTHER THEIR EXEMPT PURPOSES. SCHEDULE I, PART III THE SCHOLARSHIPS AND FELLOWSHIPS LISTED ARE IN FURTHERANCE OF THE CLEVELAND CLINIC FOUNDATION'S MISSION TO INCREASE KNOWLEDGE, AWARENESS, AND QUALITY OF PATIENT CARE AND RESEARCH THROUGH EDUCATION. THE INDIGENT AID LISTED IS PERFORMED IN FURTHERANCE OF CLEVELAND CLINIC FOUNDATION'S MISSION TO PROVIDE BETTER CARE OF THE SICK AND THE INVESTIGATION INTO THEIR PROBLEMS. X X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 COSGROVEDELOS M PRESIDENT, CEO 3625380 0 0 0 411908 0 -786281 0 13709 0 3264716 0 0 0 HAHNJOSEPH F CHIEF OF STAFF 1123623 0 0 0 109521 0 -375039 0 13826 0 871931 0 0 0 MALONEDONALD PHYSICIAN 337226 0 0 0 10814 0 -16367 0 21297 0 352970 0 0 0 WYLLIEROBERT CHIEF MEDICAL OPERATIONS OFFICER 534623 0 0 0 37736 0 94665 0 13826 0 680850 0 0 0 DICORLETOPAUL E LERNER INSTITUTE CHAIR 427423 0 0 0 43970 0 -54994 0 15244 0 431643 0 0 0 GLASSSTEVEN C CFO & TREASURER 947079 0 0 0 91480 0 19231 0 18767 0 1076557 0 0 0 HARRINGTONMICHAEL CAO & CONTROLLER 525403 0 0 0 48159 0 25500 0 21197 0 620259 0 0 0 MCHUGHLINDA ASST SECRETARY 341726 0 0 0 30977 0 18633 0 18767 0 410103 0 0 0 MEEHANMICHAEL J RECORDING SECRETARY 281740 0 0 0 28166 0 -51940 0 12909 0 270875 0 0 0 PEACOCKWILLIAM CHIEF OF OPERATIONS 804579 0 0 0 59465 0 24257 0 24011 0 912312 0 0 0 ROWANDAVID SECY AND CHIEF LEGAL OFFICER 844123 0 0 0 86493 0 25500 0 15426 0 971542 0 0 0 HARRISONMARC CEO - CCAD 902500 0 0 0 475836 0 25500 0 22793 0 1426629 0 0 0 RICETHOMAS PHYSICIAN 773507 0 0 0 2325755 0 -326086 0 13826 0 2787002 0 0 0 LYTLEBRUCE INSTITUTE CHAIRMAN - HVI 1549281 0 0 0 145787 0 -646879 0 12513 0 1060702 0 0 0 MIHALJEVICTOMISLAV CHIEF OF STAFF - CCAD 1056945 0 0 0 500157 0 25500 0 23105 0 1605707 0 0 0 COSTINJOHN STAFF CHAIR - LORAIN INSTITUTE 1326500 0 0 0 137956 0 25500 0 11649 0 1501605 0 0 0 MARTINDANIEL INSTITUTE CHAIRMAN - COLE EYE INST. 1183686 0 0 0 116086 0 25500 0 17606 0 1342878 0 0 0 FUNGJOHN J FORMER KEY EMPLOYEE 872329 0 0 0 86701 0 25500 0 17767 0 1002297 0 0 0 MATSENPAUL FORMER KEY EMPLOYEE 841079 0 0 0 82143 0 25500 0 17767 0 966489 0 0 0 PART I, LINE 1A LISTED BENEFITS THE BENEFITS CHECKED IN PART I, QUESTION 1A, WERE PROVIDED TO CERTAIN PERSONS LISTED IN FORM 990, PART VII, SECTION A ON AN EXCEPTION BASIS ONLY FOR AN APPROPRIATE BUSINESS PURPOSE. ANY REIMBURSEMENT OF THE EXPENSES LISTED MET CLEVELAND CLINIC'S WRITTEN POLICY REGARDING SUBSTANTIATION AND REIMBURSEMENT. WHERE REQUIRED BY IRS RULES AND REGULATIONS, THE LISTED BENEFITS WERE INCLUDED IN TAXABLE INCOME. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THOMAS RICE - PARTICIPATED IN AND RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $2,245,936 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENT THE AMOUNT VESTED IN THE PLAN. DELOS M. COSGROVE - PARTICIPATES IN A SPLIT DOLLAR LIFE INSURANCE PLAN FROM WHICH NO CASH PAYMENTS WERE RECEIVED. FURTHERMORE, DR COSGROVE'S 2013 BASE SALARY INCLUDES A SINGLE, FIXED ANNUAL PAYMENT WHICH IS INTENDED TO OFFSET THE ANNUAL DECREASE IN THE ACTUARIAL VALUE OF HIS SUPPLEMENTAL RETIREMENT PLAN. THE DECREASE IS A RESULT OF DR COSGROVE WORKING BEYOND HIS EXPECTED RETIREMENT AGE AS DEFINED BY THE PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATE IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND THE ANNUAL INCREASE OR DECREASE IN THE ACTUARIAL VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: DELOS M. COSGROVE - $811,781 DECREASE, PAUL E. DICORLETO - $80,494 DECREASE, JOSEPH F. HAHN - $400,539 DECREASE, BRUCE LYTLE - $672,379 DECREASE, DONALD MALONE - $41,867 DECREASE, MICHAEL J. MEEHAN - $77,440 DECREASE, THOMAS RICE - $351,586 DECREASE, AND ROBERT WYLLIE - $69,165 INCREASE. THE FOLLOWING INDIVIDUALS PARTICIPATE IN A QUALIFIED DEFINED BENEFIT PLAN AND THE ANNUAL INCREASE OR DECREASE IN THE ACTUARIAL VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: STEVEN C. GLASS - $6,269 DECREASE, LINDA MCHUGH - $6,867 DECREASE AND WILLIAM PEACOCK - $1,243 DECREASE. A OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756DAY2 2013-05-29 309434915 BOND 2013: REFUND 2004A, 2003A AND FACILITY IMPROVEMENTS 0 0 0 B OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756A3Z3 2012-05-09 519383182 BOND 2012: REFUND 2009, 2003A AND FACILITY IMPROVEMENTS 0 0 0 C OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 677561HU9 2011-11-02 208951439 BOND 2011A: REFUND 2003A SERIES 0 0 0 D OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 NOTAPPLIC 2011-11-02 41120000 BOND 2011B: REFUND 1992A & B AND 1989 SERIES 0 0 0 A 57753 309434915 2129301 20001498 287304115 2013 0 1 1 1 B 6245199 519383182 3825815 411300530 104256837 2012 0 1 1 1 C 5228171 208951439 198466281 2003385 8481773 2011 0 1 1 1 D 5930000 41120000 2302465 735249 38028286 2011 1 0 1 1 A 0 1 1 1 1 1 0.01000 0.00000 0.01000 0 0 1 B 0 1 1 1 1 1 0.00270 0.00080 0.00350 0 0 1 C 0 1 1 1 1 1 0.00450 0.00020 0.00470 0 0 1 D 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 10/15/2013 ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 10/15/2013 A OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 677561FV9 2009-08-25 807007320 BONDS 2009A&B: REFUND 2008B, FACILITY CONSTRUCTION, EQUIPPING AND IMPROVING 0 0 0 B OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756AG22 2008-10-15 451686386 BOND 2008A: REFUND 06A, 04A, AND 01A; FACILITY IMPROVEMENTS 0 0 0 C OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756AJ37 2008-10-15 670000000 BOND 2008B: REFUND 06A, 04A, AND 01A; FACILITY IMPROVEMENTS 0 0 0 A 92146509 807007320 1099225 501164781 304743315 2011 1 0 1 1 B 13845485 451686386 800000 218639952 251263651 2008 1 0 1 1 C 300750000 670000000 1200000 324315217 372706929 2008 1 0 1 1 A 0 1 1 1 1 1 0.01120 0.00040 0.01160 0 0 1 B 0 1 1 1 1 1 0.00510 0.00030 0.00540 0 0 1 C 0 1 1 1 1 1 0.00510 0.00030 0.00540 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D COSGROVE CEO/PRESIDENT INSURANCE PREMIUM PAYMENTS TREATED AS A LOAN X 229247 5079818 0 1 1 5079818 CINTAS CORPORATION ENTITY IN WHICH CCF DIRECTOR, JOE SCAMINACE, IS A DIRECTOR 261434 SUPPLY VENDOR 0 CLEVELAND BROWNS ENTITY IN WHICH FAMILY MEMBER OF NORMA LERNER, CCF DIRECTOR, WAS OWNER 3017533 SPONSORSHIP AGREEMENT - ENTITY IN WHICH FAMILY MEMBER OF NORMA LERNER, CCF DIRECTOR, WAS OWNER AT THE TIME THE AGREEMENT WAS NEGOTIATED 0 CLEVELAND BROWNS ENTITY IN WHICH FAMILY MEMBER OF NORMA LERNER, CCF DIRECTOR, WAS OWNER 592705 MEDICAL SERVICES AGREEMENT - ENTITY IN WHICH FAMILY MEMBER OF NORMA LERNER, CCF DIRECTOR, WAS OWNER AT THE TIME THE AGREEMENT WAS NEGOTIATED 0 KEYBANK NATIONAL ASSOCIATION ENTITY IN WHICH CCF DIRECTORS SERVE AS CHAIRMAN & CEO AND DIRECTOR 366072 BANKING SERVICES -ENTITY IN WHICH BETH MOONEY, CCF DIRECTOR, IS CHAIRMAN AND CEO AND BILL SANFORD, CCF DIRECTOR, IS A DIRECTOR. 0 KEYBANK NATIONAL ASSOCIATION ENTITY IN WHICH CCF DIRECTORS SERVE AS CHAIRMAN & CEO AND DIRECTOR 44700 LEASE AGREEMENT -ENTITY IN WHICH BETH MOONEY, CCF DIRECTOR, IS CHAIRMAN AND CEO AND BILL SANFORD, CCF DIRECTOR, IS A DIRECTOR. 0 GREAT LAKES INTEGRATED ENTITY IN WHICH PATRICK AULETTA, CCF DIRECTOR, IS A DIRECTOR 234168 MARKETING SERVICES 0 LAURA HAHN BRANDON FAMILY MEMBER OF JOSEPH HAHN, CCF CHIEF OF STAFF 89816 EMPLOYMENT AGREEMENT WITH CCF 0 LOREEN KOBILARCSIK FAMILY MEMBER OF LINDA MCHUGH, CCF OFFICER 36036 EMPLOYMENT AGREEMENT WITH CCF 0 ELAINE WYLLIE FAMILY MEMEBER OF ROBERT WYLLIE, CCF DIRECTOR 288926 EMPLOYMENT AGREEMENT WITH CCF 0 TRAVEL TEAM ENTITY IS WHOLLY OWNED BY AN ENTITY OWNED BY ROBERT RICH, CCF DIRECTOR 112421 TRAVEL SERVICES 0 X 25 164398 APPRAISAL X 4008 SALE COMPARABLE GOODS X 37082 SALE COMPARABLE GOODS X 1 2550000 APPRAISAL X 73 6850056 AVERAGE HIGH/LOW X 4 6250000 APPRAISAL X 1 2000 COST X 16 74102 COST X 2 56386 SALE COMPARABLE GOODS X EQUIPMENT 31 1267498 SALE COMPARABLE GOOD X EVENTS/TICKET 3 3394 COST 1 0 1 1 PART I, LINE 32B: THE CLEVELAND CLINIC FOUNDATION WILL AT TIMES HIRE INDEPENDENT THIRD PARTIES TO SELL CERTAIN NON-CASH CONTRIBUTIONS SUCH AS AUCTION ITEMS OR REAL ESTATE. PART III CLEVELAND CLINIC WAS ESTABLISHED IN 1921 WITH THE SAME MISSION THAT CONTINUES TODAY: BETTER CARE FOR THE SICK, INVESTIGATION OF THEIR PROBLEMS AND FURTHER EDUCATION OF THOSE WHO SERVE. CONSISTENT WITH ITS TRIPARTITE MISSION, CLEVELAND CLINIC'S PRIMARY PROGRAM SERVICES ARE FOCUSED ON PATIENT CARE PROVIDED ON A CHARITABLE BASIS, MEDICAL RESEARCH, AND EDUCATION OF BOTH MEDICAL PROFESSIONALS AND THE COMMUNITY. THE FOUNDERS RECOGNIZED THAT IT IS IN THE BEST INTEREST OF PATIENTS TO POOL THE TALENTS OF MEDICAL SPECIALISTS TO DEVELOP, TEACH AND APPLY THE BEST MEDICAL TECHNIQUES. THIS STATEMENT IS NOT INTENDED TO IDENTIFY ALL THE ACTIVITIES BY WHICH CLEVELAND CLINIC FULFILLS ITS CHARITABLE PURPOSES, BUT RATHER IS A SUMMARY OF ITS PRIMARY PROGRAM SERVICES AND CONTRIBUTIONS TO THE COMMUNITY. CLEVELAND CLINIC IS THE PARENT OF THE CLEVELAND CLINIC HEALTH SYSTEM AND REPORTS COMMUNITY BENEFIT ON A SYSTEM-WIDE BASIS, SO THE COMMUNITY BENEFIT NUMBERS REPORTED HERE ARE FOR THE HEALTH SYSTEM. THE COMMUNITY BENEFIT THAT THE CLEVELAND CLINIC HEALTH SYSTEM PROVIDES INCLUDES PATIENT CARE PROVIDED ON A CHARITABLE BASIS, RESEARCH, EDUCATION, MEDICAID SHORTFALL, SUBSIDIZED HEALTH SERVICES AND COMMUNITY OUTREACH PROGRAMS. IN 2013 CLEVELAND CLINIC AND ITS AFFILIATES PROVIDED $652.7 MILLION IN BENEFITS TO THE COMMUNITIES WE SERVE. THE CURRENT EDITION OF ITS COMMUNITY BENEFIT IS AVAILABLE ON OUR WEBSITE AT CLEVELANDCLINIC.ORG. (COMMUNITY BENEFIT AMOUNTS REPORTED IN THIS PROGRAM SERVICE STATEMENT REFER TO OUR 2013 COMMUNITY CONNECTIONS, BASED ON THE CHA REPORTING METHODOLOGY. SEE FORM 990, SCHEDULE H FOR A RECONCILIATION OF SCHEDULE H TO COMMUNITY BENEFIT REPORTING.) I. PATIENT CARE CLEVELAND CLINIC IS DEDICATED TO THE COMMUNITIES WE SERVE, STRIVES TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE TO ALL WHO NEED IT AND SUPPORTS PROGRAMS AND INITIATIVES THAT IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES. THROUGH OUR FINANCIAL ASSISTANCE EFFORTS AND AS A LEADING MEDICAID PROVIDER IN OHIO, WE PROVIDE HEALTHCARE TO THOSE WHO OTHERWISE COULD NOT AFFORD IT. DURING 2013, CLEVELAND CLINIC RECORDED 1,274 TOTAL STAFFED BEDS, 100,679 EMERGENCY VISITS, 97,970 SURGICAL CASES, 55,036 ADMISSIONS, AND MORE THAN 5.1 MILLION TOTAL CLINIC VISITS. IT IS THE POLICY OF CLEVELAND CLINIC TO TREAT ALL PATIENTS WITH COMPASSION, DIGNITY AND RESPECT, REGARDLESS OF THEIR RACE, CREED, OR ABILITY TO PAY. CLEVELAND CLINIC'S PATIENT CARE SERVICES ARE PROVIDED VIA PATIENT-ORIENTED INSTITUTES, WHICH ARE STRUCTURED ON THE BASIS OF ORGAN SYSTEM OR DISEASE. THE INSTITUTES FACILITATE A MULTIDISCIPLINARY APPROACH, AND ARE DESIGNED TO ENHANCE CONVENIENCE FOR PATIENTS AND THE EXCHANGE OF KNOWLEDGE, RESEARCH AND EDUCATIONAL COLLABORATION FOR BETTER PATIENT OUTCOMES. SOME OF THE INSTITUTES ARE: ANESTHESIOLOGY, COLE EYE, DIGESTIVE DISEASE, EMERGENCY SERVICES, ENDOCRINOLOGY & METABOLISM, GLICKMAN UROLOGICAL & KIDNEY, HEAD & NECK, MILLER FAMILY HEART & VASCULAR, IMAGING, MEDICINE, NEUROLOGICAL, NURSING, OB/GYN & WOMEN'S HEALTH, ORTHOPAEDIC & RHEUMATOLOGY, PATHOLOGY & LABORATORY MEDICINE, PEDIATRIC & CHILDREN'S HOSPITAL, RESPIRATORY, TAUSSIG CANCER, AND WELLNESS. NOTABLE ACHIEVEMENTS CLEVELAND CLINIC WAS AGAIN RECOGNIZED FOR ITS QUALITY OF CARE IN U.S. NEWS & WORLD REPORT'S PRESTIGIOUS ANNUAL "AMERICA'S BEST HOSPITALS" SURVEY IN 2013. OVERALL, CLEVELAND CLINIC WAS RANKED 4TH AMONG THE NATION'S NEARLY 5,000 HOSPITALS. CLEVELAND CLINIC WAS RANKED AMERICA'S NUMBER ONE CENTER FOR CARDIAC CARE FOR THE 19TH YEAR IN A ROW. UROLOGY, NEPHROLOGY DIABETES & ENDOCRINOLOGY, GASTROENTEROLOGY AND RHEUMATOLOGY PROGRAMS WERE ALL RANKED SECOND IN THE NATION. FINANCIAL ASSISTANCE THE CLEVELAND CLINIC FINANCIAL ASSISTANCE POLICY NOT ONLY ASSISTS THE POOREST OF THE POOR BY PROVIDING FREE CARE FOR MEDICALLY NECESSARY SERVICES TO UNINSURED PATIENTS WITH INCOMES UP TO 250 PERCENT OF THE FEDERAL POVERTY LEVEL BUT ALSO OFFERS DISCOUNTS ON MEDICALLY NECESSARY SERVICES FOR UNINSURED PATIENTS WHOSE INCOME IS UP TO 400 PERCENT OF THE POVERTY LEVEL. PATIENTS WITH EXCEPTIONAL CIRCUMSTANCES MAY ALSO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THIS POLICY IS DESIGNED TO PREVENT MEDICAL BILLS FROM CAUSING A PATIENT OR FAMILY UNDUE FINANCIAL HARDSHIP. THE CLEVELAND CLINIC HEALTH SYSTEM PROVIDED FINANCIAL ASSISTANCE AT A COST OF $169.8 MILLION IN 2013. II. RESEARCH CLEVELAND CLINIC'S MISSION INCLUDES CONDUCTING RESEARCH TO ADVANCE BIOMEDICAL SCIENCE AND ULTIMATELY IMPROVE PATIENT CARE, PREVENT DISEASE, AND FIND CURES FOR MEDICAL ISSUES. CLEVELAND CLINIC'S LERNER RESEARCH INSTITUTE ("LRI") IS ITS RESEARCH INSTITUTE AND HOME TO A COMPLETE SPECTRUM OF LABORATORY-, TRANSLATIONAL-, AND CLINICAL-BASED RESEARCH. LRI HAS 172 FACULTY-LEVEL SCIENTISTS ORGANIZED IN THE FOLLOWING DEPARTMENTS: BIOMEDICAL ENGINEERING, CANCER BIOLOGY, CELLULAR AND MOLECULAR MEDICINE, GENOMIC MEDICINE, IMMUNOLOGY, MOLECULAR CARDIOLOGY, MOLECULAR GENETICS, NEUROSCIENCES, OPHTHALMIC RESEARCH, PATHOBIOLOGY, QUANTITATIVE HEALTH SCIENCES, STEM CELL BIOLOGY AND REGENERATIVE MEDICINE, AND TRANSLATIONAL HEMATOLOGY AND ONCOLOGY RESEARCH. LRI IS ONE OF THE LEADING NIH-FUNDED RESEARCH INSTITUTES IN THE UNITED STATES AND HAS SPEARHEADED NUMEROUS ADVANCES IN THE DIAGNOSIS AND TREATMENT OF COMPLEX MEDICAL PROBLEMS. SCIENTISTS AND THEIR TEAMS ARE PURSUING A WIDE RANGE OF BIOMEDICAL QUESTIONS AT LRI, INCLUDING THOSE RELATED TO CARDIOVASCULAR, CANCER, NEUROLOGICAL, MUSCULOSKELETAL, AND METABOLIC DISEASES. ALTOGETHER, NEARLY 2,000 SCIENTISTS AND SUPPORT PERSONNEL WORK AT LRI. THIS INCLUDES MORE THAN 200 POSTDOCTORAL FELLOWS, NEARLY 170 GRADUATE STUDENTS AND 200 UNDERGRADUATE STUDENTS. IN ADDITION TO BASIC PRE-CLINICAL RESEARCH, THE CLEVELAND CLINIC AND ITS EMPLOYED PHYSICIANS PARTICIPATE OR ARE PRIMARY INVESTIGATORS IN MANY CLINICAL TRIALS. IN 2013, CLEVELAND CLINIC WAS INVOLVED IN APPROXIMATELY 1000 CLINICAL TRIALS. THE ONGOING COLLABORATION BETWEEN PHYSICIAN INVESTIGATORS AND STUDY VOLUNTEERS IS CENTRAL TO TESTING THE SAFETY AND EFFECTIVENESS OF DRUGS AND MEDICAL PROCEDURES AND HELPS TO SET THE STANDARDS FOR PATIENT CARE. RESEARCH AT CLEVELAND CLINIC IS FUNDED BY EXTERNAL SOURCES, SUCH AS FEDERAL GRANTS, BUT IS ALSO SUBSTANTIALLY SUPPORTED BY THE CLINIC'S OWN INTERNAL RESOURCES. IN 2013, CLEVELAND CLINIC PROVIDED COMMUNITY BENEFIT IN RESEARCH OF $203.7 MILLION, WHICH INCLUDES EXTERNALLY SPONSORED FUNDING OF $133.6 MILLION. THE CLEVELAND CLINIC'S RESEARCH ACTIVITIES ARE INTENDED TO IMPROVE PATIENT CARE AND THE HEALTH OF THE PUBLIC AT LARGE, BY PROVIDING THE LATEST ADVANCES IN MEDICINE DIRECTLY TO PATIENTS AND BY REFINING THE PRACTICE OF MEDICINE THROUGH THE DEVELOPMENT AND PROMULGATION OF NEW TECHNIQUES, DEVICES AND TREATMENT PROTOCOLS. III. EDUCATION ON ITS MAIN CAMPUS, CLEVELAND CLINIC OPERATES A MEDICAL SCHOOL AND RELATED RESEARCH INSTITUTE. THE PRIMARY FOCUS OF CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY (THE "LERNER COLLEGE OF MEDICINE") IS THE TEACHING AND TRAINING OF MEDICAL STUDENTS WHO HAVE A PARTICULAR INTEREST IN RESEARCH. MANY CLEVELAND CLINIC PHYSICIANS SERVE AS FACULTY FOR THE LERNER COLLEGE OF MEDICINE, FURTHERING THE INTEGRATION OF CLINICAL CARE WITH RESEARCH AND EDUCATION. THE LERNER COLLEGE OF MEDICINE CURRENTLY PROVIDES ALL STUDENTS WITH FULL TUITION SCHOLARSHIPS. IN ADDITION TO TRAINING THIS NATION'S FUTURE DOCTORS, CLEVELAND CLINIC SPONSORS A WIDE RANGE OF HIGH QUALITY MEDICAL EDUCATION TRAINING THROUGH ITS EDUCATION INSTITUTE INCLUDING ACCREDITED TRAINING PROGRAMS FOR NURSES AND HEALTH SCIENCE PROFESSIONALS. CLEVELAND CLINIC DEVOTES SUBSTANTIAL RESOURCES TO EDUCATION PROGRAMS, AND, IN 2013, PROVIDED A COMMUNITY BENEFIT OF $230.5 MILLION, WHICH INCLUDES $8.4 MILLION IN EXTERNAL GRANTS, THROUGH SUBSIDY OF MEDICAL EDUCATION PROGRAMS. THESE EDUCATIONAL ACTIVITIES ENSURE RESIDENTS AND PATIENTS IN ALL OF THE CLEVELAND CLINIC'S COMMUNITIES ARE RECEIVING THE HIGHEST STANDARD OF MEDICAL CARE AND HAVE TRAINED HEALTH PROFESSIONALS TO CARE FOR THEM IN THE FUTURE. SOME OF THESE EDUCATION PROGRAMS ARE: GRADUATE MEDICAL EDUCATION CLEVELAND CLINIC MAINTAINS ONE OF THE LARGEST GRADUATE MEDICAL EDUCATION PROGRAMS IN THE COUNTRY. IN 2013, 1,172 RESIDENTS AND FELLOWS TRAINED IN 70 ACCREDITED RESIDENCY TRAINING PROGRAMS, APPROVED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), INCLUDING 155 ADVANCED FELLOWS IN 100 FELLOWSHIP PROGRAMS. PART III - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (CON'T) LERNER COLLEGE OF MEDICINE SINCE ITS INCEPTION IN MAY 2002, THE CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY HAS LINKED ONE OF THE NATION'S TOP HOSPITALS WITH ONE OF THE NATION'S LEADING RESEARCH UNIVERSITIES. THERE WERE MORE THAN 1,923 APPLICANTS FOR 32 POSITIONS IN 2013. THE PROGRAM'S STUDENTS HAVE MATCHED AT SOME OF THE MOST PRESTIGIOUS HOSPITALS THROUGHOUT THE UNITED STATES AND HAVE CONTRIBUTED 85 PUBLICATIONS TO THE WORLD'S STORE OF SCIENTIFIC KNOWLEDGE, AND 39 STUDENTS PARTICIPATED IN PRESENTATIONS AND/OR POSTERS AT LOCAL AND NATIONAL MEETINGS. VISITING MEDICAL STUDENTS VISITING MEDICAL STUDENT EDUCATION REPRESENTS A MAJOR ACADEMIC COMMITMENT BY CLEVELAND CLINIC. IN 2013, OF THE 680 ROTATING MEDICAL STUDENTS, 271 STUDENTS WERE FROM 114 MEDICAL SCHOOLS AROUND THE WORLD. CENTER FOR CONTINUING EDUCATION CLEVELAND CLINIC MAINTAINS ONE OF THE LARGEST CONTINUING MEDICAL EDUCATION (CME) PROGRAMS IN THE COUNTRY AND ENJOYS THE HIGHEST ACCME RANKING: "ACCREDITATION WITH COMMENDATION." IN 2013, THE CENTER FOR CONTINUING EDUCATION OFFERED 1,702 CME PROGRAMS TO 386,252 PARTICIPANTS. OF THAT NUMBER, 913 WERE LIVE COURSES, INCLUDING INTERNATIONAL SUMMITS FOCUSED ON KEY AREAS OF TRANSLATIONAL RESEARCH. ACCORDING TO DATA FROM THE SOCIETY FOR ACADEMIC CONTINUING MEDICAL EDUCATION, CLEVELAND CLINIC IS ONE OF THE LARGEST PROVIDERS OF ONLINE CME AMONG THE NATION'S ACADEMIC MEDICAL CENTERS. THE CENTER'S WEBSITE HAD MORE THAN 434 ACTIVITIES THAT ATTRACTED 146,483 ACTIVITY VIEWERS. IN 2013, THE CENTER ISSUED MORE THAN 295,424 CERTIFICATES FOR LIVE AND ONLINE PROGRAMS COMBINED. JOURNAL CME CONTINUES TO REACH A LARGE NUMBER OF LEARNERS, WITH THE CLEVELAND CLINIC JOURNAL OF MEDICINE (CCJM) PARTICIPANTS RECEIVING MORE THAN 146,800 CERTIFICATES. THE CCJM ENJOYED A CIRCULATION OF MORE THAN 100,000 AND RANKED SECOND IN READERSHIP AMONG JOURNALS DIRECTED TO OFFICE-BASED INTERNISTS AND CARDIOLOGISTS. EACH YEAR, THE ONLINE VERSION IS READ BY MORE THAN 1.8 MILLION PEOPLE AROUND THE WORLD. IN 2013 THE CCJM WEB SITE HAD 2.5 MILLION VISITS FROM 2.1 MILLION UNIQUE VISITORS. CENTER FOR HEALTH SCIENCES EDUCATION CLEVELAND CLINIC IS A MAJOR EDUCATION AND TRAINING SITE FOR A NUMBER OF HEALTH SCIENCE STUDENTS FROM VARIOUS ACADEMIC PROGRAMS THROUGHOUT THE REGION. THE CLEVELAND CLINIC HEALTH SYSTEM CURRENTLY OFFERS 15 IN-HOUSE ALLIED HEALTH PROGRAMS AND HAS 49 AFFILIATED PROGRAMS WITH REGIONAL ACADEMIC INSTITUTIONS. IN 2013, CLEVELAND CLINIC HOSTED MORE THAN 2,100 CLINICAL ROTATIONS FOR HEALTH SCIENCE STUDENTS. CENTER FOR INTERNATIONAL MEDICAL EDUCATION THIS CENTER IS RESPONSIBLE FOR COORDINATING CLEVELAND CLINIC'S INTERNATIONAL EDUCATIONAL INITIATIVES AND FOR ENSURING THE PROVISION OF HIGH QUALITY EDUCATIONAL EXPERIENCES FOR THE GLOBAL MEDICAL COMMUNITY. IN 2013, 750 INTERNATIONAL PHYSICIANS AND MEDICAL STUDENTS TRAVELED TO CLEVELAND CLINIC TO PARTICIPATE IN OBSERVERSHIPS; 200 PHYSICIANS ATTENDED SYMPOSIA HELD AT CLEVELAND CLINIC ON PATIENT EXPERIENCE, CARDIOLOGY, COLORECTAL SURGERY, SPINE SURGERY, GASTROENTEROLOGY, UROLOGY, PEDIATRICS, BREAST CANCER AND OBESITY; AND OUR OWN STAFF TRAVELED TO MORE THAN 15 COUNTRIES TO SHARE CLINICAL AND SURGICAL INNOVATIONS. IV. ADDITIONAL COMMUNITY BENEFIT COMMUNITY EDUCATION EDUCATING THE COMMUNITY HAS ALSO BEEN A PRIORITY AT CLEVELAND CLINIC. OUR CENTER FOR CONSUMER HEALTH INFORMATION EXPANDS KNOWLEDGE THROUGH A VARIETY OF MEDIA TO PATIENTS AND THE NORTHEAST OHIO COMMUNITY. FOLLOWING ARE SOME OF THE PROGRAMS OFFERED IN 2013: HEALTH INFORMATION RESOURCE CENTER: THE ON-CAMPUS PATIENT AND FAMILY HEALTH AND EDUCATION CENTER IS A PLACE WHERE PATIENTS, VISITORS AND EMPLOYEES CAN TAKE ADVANTAGE OF HEALTH INFORMATION RESOURCES. THE CONSUMER HEALTH INFORMATION STAFF ALSO FULFILLS REQUESTS FOR HEALTH INFORMATION MADE IN WRITING, BY EMAIL OR BY PHONE. IN 2013, THE CENTER FULFILLED 9,514 REQUESTS AND SERVED 13,564 PEOPLE WHO CAME INTO THE CENTER FOR INFORMATION. HEALTH TALKS/HEALTH EXCHANGE AND CCTV: THE CENTER FOR CONSUMER HEALTH INFORMATION HOSTED 29 COMMUNITY HEALTH TALKS/HEALTH EXCHANGE PROGRAMS AND MANAGED 3,585 SCHEDULED CLOSED-CIRCUIT TELEVISION WEEKLY PROGRAMS AND APPROXIMATELY 359 WEEKLY ON-DEMAND TELEVISED PROGRAMS. INTERNET SITE: THE CENTER FOR CONSUMER HEALTH INFORMATION WEBSITE (WWW.CLEVELANDCLINIC.ORG/HEALTH) CONTINUES TO BE A SOURCE OF INFORMATION FOR USERS AROUND THE WORLD. THE WEBSITE ALSO FEATURES LIVE WEBCHATS WITH A HEALTH EDUCATOR, ALLOWING THE PUBLIC TO POST QUESTIONS AND HAVE THEM ANSWERED IN REAL TIME. WEBCHATS TAKE PLACE MONDAY THROUGH FRIDAY, FROM 9 AM TO 3:00 PM. BY THE END OF 2013, WE HELD 6,629 WEBCHATS. MEDICAID SHORTFALL THE CLEVELAND CLINIC HEALTH SYSTEM IS A LEADING PROVIDER OF MEDICAID SERVICES IN OHIO. IN MANY STATES, INCLUDING OHIO, MEDICAID PAYMENTS HAVE NOT BEEN SUFFICIENT TO COVER THE COST OF TREATING MEDICAID BENEFICIARIES. IN 2013, THE HEALTH SYSTEM'S UNPAID MEDICAID COSTS WERE $124.0 MILLION (THIS FIGURE IS NET OF AN HCAP BENEFIT OF $17.7 MILLION ). SUBSIDIZED HEALTH SERVICES IN ADDITION TO CHARITY CARE AND COSTS NOT COVERED BY MEDICAID PAYMENTS, ANOTHER CLINICAL COMMUNITY BENEFIT CATEGORY IS "SUBSIDIZED HEALTH SERVICES." THESE SERVICES YIELD LOW OR NEGATIVE MARGINS BUT ARE NEEDED IN THE COMMUNITY. CLEVELAND CLINIC HEALTH SYSTEM PROVIDED SUBSIDIZED HEALTH SERVICES IN 2013 AT A COST OF $16.7 MILLION. COMMUNITY OUTREACH PROGRAMS THE CLEVELAND CLINIC HEALTH SYSTEM IS ACTIVELY ENGAGED IN A BROAD ARRAY OF COMMUNITY OUTREACH PROGRAMS, PROVIDING OR CONTRIBUTING TO MORE THAN 300 SUCH PROGRAMS IN 2013 FOR A TOTAL NET COMMUNITY BENEFIT OF $50.0 MILLION. OUR WELL-ESTABLISHED OUTREACH PROGRAMS RANGE FROM FREE WELLNESS INITIATIVES, HEALTH SCREENINGS, CLINICAL SERVICES AND EDUCATION TO ENROLLMENT ASSISTANCE FOR GOVERNMENT-FUNDED HEALTH PROGRAMS. COMMUNITY OUTREACH PROGRAMS FALL INTO THREE MAIN CATEGORIES: COMMUNITY HEALTH SERVICES, CASH AND IN-KIND DONATIONS, AND COMMUNITY BUILDING. IN 2013, SOME HIGHLIGHTS INCLUDED: - CLEVELAND CLINIC STAFF ACROSS THE SYSTEM PROVIDED NO-COST CLINICAL CARE TO UNDER- AND UNINSURED FAMILIES AT VARIOUS SITES IN THE COMMUNITIES IT SERVES. THE LANGSTON HUGHES HEALTH AND EDUCATION CENTER, IN THE FAIRFAX NEIGHBORHOOD OF THE CITY OF CLEVELAND, PROVIDED MULTI-GENERATIONAL PREVENTION AND WELLNESS SERVICES. - HEALTH FAIRS PROVIDED THOUSANDS OF PEOPLE WITH FREE SCREENINGS FOR DIABETES, CHOLESTEROL, HEART DISEASE, AND PROSTATE AND VARIOUS CANCERS. THE MINORITY MEN'S HEALTH FAIR, CELEBRATING SISTERHOOD, TU FAMILIA AND DOZENS OF COMMUNITY HEALTH FAIRS EDUCATED COMMUNITY MEMBERS ON THE BENEFITS OF PREVENTATIVE CARE. - COMMUNITY EDUCATION CLASSES WERE OFFERED ACROSS THE ENTERPRISE PROVIDING EDUCATION ON CHRONIC DISEASE MANAGEMENT IN THE AREAS OF HEART DISEASE, STROKE, DIABETES AND BRAIN HEALTH. FOR A FULL LIST OF MONTHLY EVENTS, GO TO WWW.CLEVELANDCLINIC.ORG AND SEARCH FOR COMMUNITY EVENTS. - WELLNESS INITIATIVES AND HEALTH LECTURES WERE PROVIDED TO SCHOOLS, FAITH-BASED ORGANIZATIONS AND COMMUNITY CENTERS IN THE AREAS OF PREVENTION AND BEHAVIORAL CHANGE, INCLUDING SMOKING CESSATION, WEIGHT MANAGEMENT, TEEN PARENTING, FAMILY VIOLENCE AND CHILD SAFETY. - COMMUNITY FARMERS MARKETS, URBAN GARDENS AND NUTRITION SEMINARS WERE PROVIDED TO PROMOTE DISEASE PREVENTION AND HEALTHY LIFESTYLES. - REGIONAL LEADERSHIP SUMMITS BROUGHT COMMUNITY LEADERS TOGETHER FOR SOLVING PUBLIC EPIDEMIC HEALTH PROBLEMS SUCH AS HEROIN USE AND OBESITY. - PHYSICAL EDUCATION, TRAINING, AND CONCUSSION AWARENESS WERE PROVIDED TO HIGH SCHOOL STUDENTS BY THE ORTHOPAEDIC AND RHEUMATOLOGIC INSTITUTE. - CLEVELAND CLINIC'S TOMSICH PATHOLOGY & LABORATORY MEDICINE INSTITUTE DONATED SERVICES TO CLEVELAND AREA SAFETY-NET PROVIDERS THE FREE CLINIC AND CARE ALLIANCE. - CLEVELAND CLINIC PHILANTHROPY FOCUSED EFFORTS ON COMMUNITY NEEDS OF CANCER AND BRAIN HEALTH RESEARCH. V. CONCLUSION THE PURPOSE OF THE CLEVELAND CLINIC IS TO BENEFIT HUMANITY THROUGH THE EFFICIENT, EFFECTIVE, AND ETHICAL PRACTICE OF MEDICINE, BY ADVANCING SCIENTIFIC INVESTIGATION AND MEDICAL EDUCATION, BY MAINTAINING THE HIGHEST STANDARDS OF QUALITY, AND BY FOSTERING CREATIVITY AND INNOVATION. FORM 990, PART VI, SECTION A, LINE 2 WILLIAM MACDONALD III AND MORRY WEISS - BUSINESS BILL SANFORD AND LARRY POLLOCK - BUSINESS BETH MOONEY AND BILL SANFORD - BUSINESS FORM 990, PART VI, SECTION A, LINE 4 VARIOUS CHANGES WERE MADE TO THE CLEVELAND CLINIC FOUNDATION CODE OF REGULATIONS TO CONFORM TO MEDICARE CONDITIONS OF PARTICIPATION. IN ADDITION, A CHANGE WAS MADE REGARDING THE TOTAL NUMBER OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 PURSUANT TO NONPROFIT CORPORATION LAW, THERE CAN BE NO SHAREHOLDERS OR OTHER "EQUITY OWNERS" OF A NONPROFIT CORPORATION. MANAGEMENT AND CONTROL RIGHTS ARE HELD AND EXERCISED BY THE "MEMBERS" OF THE NONPROFIT CORPORATION. CCF IS AN OHIO NONPROFIT CORPORATION AND IT HAS BOTH MEMBERS AND TRUSTEES. IT DOES NOT HAVE STOCKHOLDERS. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO NONPROFIT CORPORATION LAW, THE "MEMBERS" OF THE CORPORATION ELECT THE BOARD OF DIRECTORS (TRUSTEES), AND THE BOARD THEN CONDUCTS THE AFFAIRS OF THE CORPORATION. IN ADDITION, ONE NONPROFIT CORPORATION MAY BE THE "MEMBER" OF ANOTHER NONPROFIT CORPORATION. CCF IS AN OHIO NONPROFIT CORPORATION AND IT HAS MEMBERS WHO ELECT THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO NONPROFIT CORPORATION LAW, CERTAIN OF THE DECISIONS OF THE GOVERNING BODIES MUST BE APPROVED BY THE MEMBERS. FOR EXAMPLE, ANY CHANGES TO THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS MUST BE APPROVED BY A VOTE OF THE MEMBERS. 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. IN ADDITION, THE ENTIRE RETURN IS ALSO REVIEWED WITH THE CFO, THE AUDIT COMMITTEE CHAIRPERSON AND THE AUDIT COMMITTEE VICE CHAIRPERSON. THE PAID PREPARER (BIG 4 PUBLIC ACCOUNTING FIRM) CONDUCTS AN IN DEPTH REVIEW OF THE FORM. ANNUALLY, THE 990 FILING IS REVIEWED AND DISCUSSED WITH THE ENTIRE AUDIT COMMITTEE. 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. IN ADDITION TO POSTING ON GUIDESTAR, THE FINAL E-FILED RETURN WILL BE POSTED ON THE ORGANIZATION'S WEBSITE AT WWW.CLEVELANDCLINIC.ORG. FORM 990, PART VI, SECTION B, LINE 12C CCF HAS ADOPTED A CONFLICT OF INTEREST ("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 POLICY AND PROCEDURES FOR DEALING WITH CONFLICT OF INTEREST ISSUES (THE POLICY), A TRUSTEE OR DIRECTOR 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 TRUSTEES, DIRECTORS AND OFFICERS 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 TRUSTEES, OFFICERS AND DIRECTORS 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 CONFLICT OF INTEREST 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 THEIR CONCLUSIONS. UNDER THE POLICY, THE INTERESTED PERSONS MAY ATTEND A MEETING AT THE DISCRETION OF THE BOARD OR COMMITTEE TO PROVIDE INFORMATION OR ANSWER QUESTIONS, BUT THEY MAY NOT BE PRESENT DURING FINAL CONSIDERATION OR VOTING ON THE ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 15 ALL CCF OFFICERS AND KEY EMPLOYEE POSITIONS HAVE THEIR COMPENSATION REVIEWED IN ADVANCE ANNUALLY BY THE COMPENSATION COMMITTEE OF THE CCF BOARD OF DIRECTORS, WHICH IS VESTED WITH BOARD-DELEGATED POWERS TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO COMPENSATION MATTERS. IN REVIEWING AND ESTABLISHING COMPENSATION FOR THESE OFFICERS AND KEY EMPLOYEES, THE COMMITTEE USES A PROCESS WHICH IS INTENDED TO CREATE THE PRESUMPTION IN REGULATION 53.4958-6(A) THAT PAYMENTS OF COMPENSATION TO THESE PERSONS CONSTITUTE REASONABLE COMPENSATION, DEFINED AS AMOUNTS THAT ARE WITHIN THE RANGE OF COMPENSATION PAID BY SIMILARLY SITUATED ORGANIZATIONS TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS. IN THIS PROCESS, NO MEMBER OF THE COMMITTEE WHO HAS A CONFLICT OF INTEREST WITHIN THE MEANING OF REGULATION 53.4958-6(C)(1)(III) WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE IS PERMITTED TO PARTICIPATE IN THE REVIEW AND APPROVAL OF THAT COMPENSATION ARRANGEMENT. IN ESTABLISHING COMPENSATION FOR EMPLOYED PHYSICIANS FOR PHYSICIAN SERVICES, CCF PARTICIPATES IN PRODUCTIVITY AND COMPENSATION SURVEYS WITH SIMILARLY SITUATED ORGANIZATIONS ACROSS THE U.S. IN ADDITION, CCF ENGAGES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT WHO EACH YEAR PROVIDES CCF WITH A CUSTOMIZED COMPENSATION REPORT REGARDING PHYSICIAN COMPENSATION. BY USING THIS DATA, CCF HAS BEEN ABLE TO DEVELOP MARKET-BASED COMPENSATION FOR PHYSICIAN SERVICES. IN ESTABLISHING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES PERFORMING NON-PHYSICIAN SERVICES, THE COMPENSATION COMMITTEE RETAINS AND CONSULTS WITH AN INDEPENDENT COMPENSATION CONSULTANT, WHO PREPARES A CUSTOMIZED REPORT FOR THE COMMITTEE REGARDING AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS. THE COMMITTEE USES THE MARKET-BASED DATA PROVIDED BY THE CONSULTANT, AND WHERE APPROPRIATE, PERFORMANCE REVIEWS AND COMPENSATION RECOMMENDATIONS BY THE CHIEF EXECUTIVE OFFICER AND CHIEF OF STAFF, TO ESTABLISH MARKET-BASED COMPENSATION. AFTER MAKING ITS COMPENSATION DECISIONS, THE COMMITTEE CONTEMPORANEOUSLY DOCUMENTS ITS DELIBERATIONS AND DECISIONS IN CCF'S WRITTEN OR ELECTRONIC BOOKS AND RECORDS. FORM 990, PART VI, SECTION C, LINE 19 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 VI, SECTION C, LINE 18: THE MOST RECENTLY FILED FORM 990 IS AVAILABLE ON THE CCF WEBSITE, WWW.CLEVELANDCLINIC.ORG, UNDER THE "ABOUT CLEVELAND CLINIC" SECTION. ALL OTHER DOCUMENTS WHICH ARE REQUIRED TO BE AVAILABLE TO THE PUBLIC CAN BE OBTAINED UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS 990,491. NET ASSETS RELEASED FROM RESTRICTION USED FOR CAPITAL PURPOSES 792,960. GIFTS AND BEQUESTS 69,767,341. NET INVESTMENT INCOME 27,748,857. NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATIONS -27,981,444. RETIREMENT BENEFITS ADJUSTMENT 225,976,711. NET CHANGE IN UNREALIZED GAINS ON NONTRADING INVESTMENTS -93,292. EQUITY TRANSFERS 2,041,607. COMBINED REPORTING ADJUSTMENT -356,000. 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