2013-11-15T12:17:26-06:00 2012-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2012-01-01 340714612 EMH REGIONAL MEDICAL CENTER EMHR 4403297605 630 EAST RIVER STREET ELYRIA OH 44035 JAMES SIMONE 4403297605 2013-11-15 1 SUSAN MIENCIER P00842339 2483522500 2012 2016-02-25 16:41:14Z DONALD SHELDON 630 EAST RIVER STREET ELYRIA OH 44035 202980669 0 X WWW.EMH-HEALTHCARE.ORG X 1907 OH NON-PROFIT COMMUNITY HEALTH PROVIDING IN AND OUTPATIENT CARE, INCLUDING FULL SERVICE EMERGENCY ROOM TO THE COMMUNITY OF ELYRIA, OHIO AND SURRONDING AREA. 20 19 2157 317 42714 -17354 123279 326373 196589025 193888012 4225375 5486208 1381707 3257730 202319386 202958323 976500 273554 0 0 95822007 93711626 0 0 0 96910656 97647937 193709163 191633117 8610223 11325206 238076263 249208097 121860109 119086454 116216154 130121643 X WE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY THROUGH SAFE, HIGH QUALITY AND COST EFFECTIVE CARE. 0 0 25291954 29878101 CARDIOLOGY - EMH FEATURES LORAIN COUNTY'S LEADING AND NATIONALLY RECOGNIZED CARDIOVASCULAR HEALTH AND REHABILITATION CENTER, WITH SERVICES FOR CORONARY BYPASS SURGERY, ANGIOPLASTY, CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY, CARDIAC REHABILITATION, HEART FAILURE THERAPIES AND OTHER DIAGNOSTIC SERVICES. EMH REGIONAL MEDICAL CENTER RECEIVED FULL CYCLE II ACCREDITATION WITH PCI THROUGH 2010 FROM THE ACCREDITATION REVIEW COMMITTEE OF THE SOCIETY OF CHEST PAIN CENTERS. THE FIRST DESIGNATION WAS GRANTED IN 2004, AND ENSURES THAT EMH MEETS OR EXCEEDS QUALITY OF CARE MEASURES IN ACUTE CARDIAC MEDICINE. EMH IS THE 72ND ACCREDITED CHEST PAIN CENTER IN THE UNITED STATES. ADDITIONALLY, IN 2008, EMH REGIONAL MEDICAL CENTER RECEIVED THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATIONS' NCDR ACTION REGISTRY - GWTG SILVER PERFORMANCE ACHIEVEMENT AWARD - ONE OF ONLY 93 HOSPITALS NATIONWIDE TO DO SO. THE AWARD RECOGNIZES EMH'S COMMITMENT AND SUCCESS IN IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART ATTACK PATIENTS. 45800348 48524472 ROUTINE INPATIENT CARE - INPATIENT CARE AT EMH INCLUDES A VARIETY OF SERVICES, RANGING FROM INTENSIVE CARE UNITS (MEDICAL/SURGICAL) AND THE FAMILY BIRTH CENTER, TO MENTAL HEALTH AND UNIVERSAL CARE. EACH DEPARTMENT IS STAFFED WITH HIGHLY SKILLED AND SPECIALLY EDUCATED HEALTHCARE PROFESSIONALS WHO ARE EQUIPPED TO ADDRESS EACH PATIENT'S NEEDS. 42561749 43088599 SURGICAL SERVICES - HIGHLY TRAINED MEDICAL PHYSICIANS AND SURGEONS TREAT A WIDE VARIETY AND COMPLEXITY OF SURGICAL CASES AT EMH REGIONAL MEDICAL CENTER. SERVICES INCLUDE BOTH INPATIENT AND OUTPATIENT SURGERY, WITH THE MAJORITY PERFORMED ON AN OUTPATIENT BASIS. CONSULTATION WITH SPECIALISTS ENSURE THAT PATIENTS RECEIVE THE MOST COMPREHENSIVE CARE, AND TECHNOLOGICAL INNOVATIONS ALLOW FOR LESS INVASIVE PROCEDURES, WHICH IN TURN ENABLES FASTER HEALING. 54134283 273554 74515606 OTHER PROGRAM SERVICES - ADDITIONAL MEDICAL SERVICES AT EMH ARE COMPREHENSIVE AND INCLUDE: RADIOLOGY/IMAGING, LABORATORY, WOUND CARE, PEDIATRIC AFTER-HOURS CARE, SPORTS MEDICINE/REHABILITATION, OUTPATIENT INFUSION, ORTHOPEDICS, DIABETES EDUCATION, HEALTHY WOMEN/HEALTHY FAMILIES, MENTAL HEALTH, HOME CARE, OCCUPATIONAL MEDICINE, SLEEP STUDIES, SOCIAL WORK AND EMERGENCY SERVICES. 54134283 273554 74515606 167788334 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 83 0 1 2157 1 1 1 0 0 0 0 0 0 0 0 0 X 20 19 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OH X JAMES M SIMONE VP FINANCECFO 4403297605 630 EAST RIVER STREET ELYRIA OH 44035 BECKETT JONATHAN M 2.00 0.00 X 0 0 0 CANNADAY LEE 2.00 0.00 X 0 0 0 HOAGLAND BRIAN 2.00 2.00 X X 0 0 0 LAMB WILLIAM 2.00 0.00 X 0 0 0 MIGGINS LYNN 2.00 0.00 X 0 0 0 OLESEN ROBERT 2.00 0.00 X 0 0 0 REIDY JOAN 2.00 0.00 X 0 0 0 RIGDA PAUL 2.00 0.00 X 0 0 0 RYAN SPENCER 2.00 0.00 X 0 0 0 WALDHEGER PRISCILLA MD 2.00 0.00 X 0 0 0 YOST ROBERT 2.00 0.00 X 0 0 0 FLANIGAN KEVIN 2.00 4.00 X X 0 0 0 SHELDON DONALD 55.00 6.00 X X 0 454579 22688 FRANK RAY 2.00 0.00 X 0 0 0 RAMADUGU ASHOK 2.00 0.00 X 0 0 0 MUSSON JOHN 2.00 0.00 X 0 0 0 PARIKH SANJAY MD 2.00 0.00 X 0 0 0 POND FRED 2.00 0.00 X 0 0 0 YOST JUNE 2.00 0.00 X 0 0 0 INCE DEBBIE 2.00 0.00 X 0 0 0 HAYWOOD TIMOTHY 2.00 0.00 X 0 0 0 SIMONE JAMES M 55.00 7.00 X 0 307097 28839 GARDNER FRANCIS X 55.00 8.00 X 0 237588 10675 COOKSEY JILL 55.00 8.00 X 0 172670 17625 MCDONALD DOUGLAS 55.00 8.00 X 0 221146 23201 MILLER DANIEL N 55.00 8.00 X 0 226542 29889 WRAY CHARLOTTE 55.00 8.00 X 0 168373 25674 GIBBONS TERRI 55.00 0.00 X 140277 0 14974 GRAUER JOHN 55.00 0.00 X 250552 0 1310 ZEOLLA KATHERINE 55.00 0.00 X 165157 0 7021 ROE JAMES 55.00 0.00 X 130722 0 5578 HALLIDAY DON 55.00 0.00 X 131589 0 15516 818297 1787995 202990 27 0 1 0 OWENS & MINOR PO BOX 644783 PHILADELPHIA PA 15264 PURCHASED MEDICAL SERVICES 4620464 MEDTRONIC USA 4642 COLLECTIONS CENTER DR CHICAGO IL 60693 PURCHASED MEDICAL SERVICES 3350154 ZIMMER USA 14235 COLLECTIONS CENTER DR CHICAGO IL 60693 PURCHASED MEDICAL SERVICES 2504678 SIEMENS MED PO BOX 120001 DALLAS TX 75312 PURCHASED MEDICAL SERVICES 1995431 ARAMARK PO BOX 840336 DALLAS TX 75284 PURCHASED MEDICAL SERVICES 1829858 134 68250 258123 326373 NET PATIENT CARE 622110 187704853 187704853 HEALTH FITNESS CENTER 622110 3435681 3435681 ELEC. MEDICAL RECORDS 900099 2704764 2704764 LABORATORY REVENUE 621500 42714 42714 193888012 2951579 2951579 176017 22346 153671 153671 153671 2534629 0 2534629 2534629 2534629 CLINICAL SERVICES 561000 1717141 1717141 CAFETERIA / VENDING 722210 855756 855756 AHA MANAGEMENT FEE 561000 125004 125004 406158 319335 86823 3104059 202958323 196006778 42714 6582458 273554 273554 73441153 66097038 7344115 14842859 13358573 1484286 5427614 4884853 542761 14953947 11215460 3738487 211690 211690 77560 77560 12592135 11561234 1030901 34312 34312 41162905 36637084 4525821 1040989 936890 104099 4221039 2349341 1871698 213209 127925 85284 1833842 1650458 183384 12557610 11301849 1255761 -248997 -248997 REPAIRS AND MAINTENANCE 3650106 3164798 485308 FRANCHISE TAX 2515301 1828439 686862 LEASE / RENTAL 1083827 867061 216766 LAUNDRY 1032983 1032983 715479 715479 191633117 167788334 23844783 0 11231626 13871038 18167628 24980169 2030504 1573211 1569090 813637 236381661 154533885 85762447 81847776 103990603 100595937 15324365 25526329 238076263 249208097 21201078 23845445 42793918 39053425 57865113 56187584 121860109 119086454 X 111781901 125373376 2218834 2366216 2215419 2382051 116216154 130121643 238076263 249208097 X 11325206 5411858 -2831575 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14554 14554 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO CERTAIN HOSPITAL ASSOCIATIONS. A CERTAIN PERCENTAGE OF THOSE DUES ARE USED FOR PURPOSES OF LOBBYING. 4511445 4511445 62589682 39433811 23155871 164042509 111983286 52059223 5238025 3116788 2121237 81847776 INTERCOMPANY RECEIVABLE 25326733 UNAMORTIZED DEFERRED FINANCING COSTS 199596 25526329 PENSION LIABILITY 33743059 SELF-INSURANCE RESERVE 9846176 INTEREST RATE SWAP 5262592 ESTIMATED 3RD PARTY PAYABLE 7335757 56187584 1 1 X 1 X 1 X 1 1 1 0 1 1 12315445 1448050 10867395 0.05670 25620176 16485913 9134263 0.04770 37935621 17933963 20001658 0.10440 1882206 1364646 517560 0.00270 1882206 1364646 517560 0.00270 39817827 19298609 20519218 0.10710 267628 267628 0.00140 267628 267628 0.00140 1 8864315 323904 62833617 62070248 763369 X 1 1 1 1 EMH REGIONAL MEDICAL CENTER

630 EAST RIVER STREET ELYRIA OH 44035

X X X EMH REGIONAL MEDICAL CENTER 1 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X X X X 1 0 1 X 0 0 2 EMH AVON CAMPUS

1997 HEALTHWAY RD AVON OH 44001

IMAGING, LAB REHABILITATION SERVICES & FITNESS CENTER EMH AMHERST CAMPUS

254 CLEVELAND AMHERST OH 44001

IMAGING, LAB, 24 HOUR ER PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS USED FOR CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2.THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE OTHER BENEFITS SECTION (LINE 7E - 7I). PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES PROVIDED INCLUDE NEONATAL INTENSIVE CARE AND INDIVIDUAL PSYCHOLOGY. PART I, L7 COL(F): NO BAD DEBT EXPENSES ARE INCLUDED ON FORM 990, PART IX, LINE 25. PART II: COMMUNITY BUILDING ACTIVITIES INCLUDE HEALTH SCREENS AND PATIENT EDUCATION. COMMUNITY HEALTH SCREENINGS ARE CONDUCTED EVALUATING BLOOD PRESSURE, BLOOD SUGAR, CHOLESTEROL, BODY MASS INDEX, PSA FOR PROSTATE CANCER, SKIN CANCER SCREENINGS.SCREENINGS ARE CONDUCTED FOR LOCAL BUSINESS AND INDUSTRY AND AT LOCAL PUBLIC EVENTS AT SHOPPING MALLS, SALVATION ARMY, UNITED WAY, EL CENTRO EVENTS ETC. PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE FROM CONSOLIDATED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, CHCO ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CHCO ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), CHCO RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.AMOUNTS ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR ASSISTANCE $323,904 IS BASED ON INSURED ACCOUNTS IN BAD DEBT STATUS THAT LATER HAD A CHARITY ADJUSTMENT. PART III, LINE 8: THE MEDICARE COST REPORT ALLOWABLE COSTS WERE USED TO ARRIVE AT AMOUNT REPORTED ON PART III, LINE 6. THESE MEDICARE ALLOWABLE COSTS WERE DETERMINED USING THE COST-TO-CHARGE RATIO. PART III, LINE 9B: EMH WILL PROVIDE MEDICALLY NECESSARY SERVICE(S) FREE OF CHARGE TO ANY NON-MEDICAID OHIO RESIDENT, WHO IS EITHER COVERED BY DISABILITY ASSISTANCE OR HAS A FAMILY INCOME ON THE DATE-OF-SERVICE WHICH IS UP TO 200% OF THE FEDERAL POVERTY GUIDELINES, AND CHARITY DISCOUNTS ARE EXTENDED TO FAMILIES WHOSE INCOME IS BETWEEN 201% AND 300% OF THE FPG BASED ON INCOME AND FAMILY SIZE, DEPENDENT ON THEIR ABILITY TO PAY.IF THE PATIENT'S GUARANTOR(S) IS UNABLE TO MAKE FULL PAYMENT, ASSISTANCE MAY BE PROVIDED UNDER THE EMH CHARITY CARE PROGRAM. FREE CARE WILL BE PROVIDED TO ALL THOSE WHO PROVIDE THE NEEDED DOCUMENTATION ESTABLISHED BY THE OHIO DEPARTMENT OF HUMAN SERVICES, AND WHO HAVE A FAMILY INCOME ON THE DATE OF SERVICE WHICH IS UP TO 200% OF THE FEDERAL POVERTY GUIDELINES, AND CHARITY DISCOUNTS ARE EXTENDED TO FAMILIES WHOSE INCOME IS BETWEEN 201% AND 300% OF THE FPG BASED ON INCOME AND FAMILY SIZE, DEPENDENT ON THEIR ABILITY TO PAY.FREE CARE - OUR CHARITY PROGRAM INCORPORATES OHIO'S FREE CARE REQUIREMENTS. HOSPITAL SERVICES FOR MEDICALLY NECESSARY SERVICES ARE AVAILABLE AT NO CHARGE TO THOSE FAMILIES WHOSE INCOME IS UP TO 200% OF THE FEDERAL POVERTY GUIDELINES, AND CHARITY DISCOUNTS ARE EXTENDED TO FAMILIES WHOSE INCOME IS BETWEEN 201% AND 300 % OF THE FPG BASED ON INCOME AND FAMILY SIZE, DEPENDENT ON THEIR ABILITY TO PAY. THESE GUIDELINES ESTABLISH A THRESHOLD OF INCOME WHICH GROWS AS THE FAMILY SIZE OF THE APPLICANT DOES.APPLYING FOR ASSISTANCE - A RELATIVELY SIMPLE APPLICATION HAS BEEN DESIGNED TO HELP DETERMINE ELIGIBILITY TO BASIC PROGRAMS AND A SPECIAL ABBREVIATED APPLICATION IS USED FOR THE HOMELESS. A PATIENT ACCOUNT REPRESENTATIVE SHALL ASSIST EACH APPLICANT WITH NECESSARY PAPERWORK. THE REPRESENTATIVE WILL ADJUST ACCOUNTS WITH A BALANCE UNDER $2,000. BALANCES $2,000 AND GREATER ARE REFERRED WITH THE APPROPRIATE INFORMATION TO THE PATIENT ACCOUNT ANALYST FOR A FINAL DECISION. ACCOUNTS WITH A BALANCE GREATER THAN $5,000 WILL REQUIRE THE PATIENT ACCOUNT MANAGER APPROVAL. A DECISION ON ELIGIBILITY WILL NORMALLY BE MADE WITHIN FIVE BUSINESS DAYS OF THE APPLICATION. EMH REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 20D: EFFECTIVE 1/1/2011, EMH REGIONAL MEDICAL CENTER BEGAN PROVIDING AN ACROSS THE BOARD (ATB) DISCOUNT TO ALL UNINSURED PATIENTS (33 PERCENT) - A DISCOUNT CONSISTENT WITH ONE A TYPICAL LOCAL HEALTH PLAN WOULD BE GIVEN. IN ADDITION, THE SMALLEST LEVEL OF DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY IS 30% OF THE BALANCE, WHICH IS APPLIED AFTER THE ATB DISCOUNT. IN TOTAL, FAP-ELIGIBLE INDIVIDUALS ARE ELIGIBLE FOR A MINIMUM 53.1% DISCOUNT, APPLIED TO GROSS CHARGES. PART VI, LINE 2: COMMUNITY HEALTH SCREENINGS ARE CONDUCTED EVALUATING BLOOD PRESSURE, BLOOD SUGAR, CHOLESTEROL, BODY MASS INDEX, PSA FOR PROSTATE CANCER, SKIN CANCER SCREENINGS.SCREENINGS ARE CONDUCTED FOR LOCAL BUSINESS AND INDUSTRY AND AT LOCAL PUBLIC EVENTS AT SHOPPING MALLS, SALVATION ARMY, UNITED WAY, EL CENTRO EVENTS ETC.DATA FROM PATIENT ADMISSIONS FROM THE COMMUNITY ARE ALSO EVALUATED. THERE ARE MANY DIABETICS IN OUR COMMUNITY AND WE OFFER FREE DIABETES SEMINARS FOR THE PUBLIC.DATA FROM THE CENTER FOR DISEASE CONTROL INFORMS US OF FLU TRENDS AND THE NEED TO OFFER VACCINATIONS TO OUR PATIENTS. PART VI, LINE 3: NOTICE OF AVAILABILITY OF FREE CARE IS GIVEN TO PATIENTS ON THE ITEMIZED STATEMENT OF ACCOUNT, THEIR FIRST STATEMENT ADVISING THEM OF THE CHARGES AND MONTHLY GUARANTOR STATEMENTS.TO ADVISE OUR CUSTOMERS OF OUR CHARITY PROGRAMS, INCLUDING FREE CARE, SIGNS SHALL BE POSTED IN THE FOLLOWING PLACES:-CENTRAL REGISTRATION-CASHIER'S STATION-PATIENT ACCOUNT REPRESENTATIVE OFFICES-EMERGENCY ROOM LOBBY-ACC LOBBY-GATES LABORATORYTO ENSURE THAT THE MESSAGE IS DELIVERED EVEN IF THE SIGNS ARE MISSED, THIS INFORMATION WILL BE PRINTED ON THE BACK OF EACH "STATEMENT OF ACCOUNT" AND "MONTHLY STATEMENT" FORMS. PART VI, LINE 4: EMH REGIONAL MEDICAL CENTER IN ELYRIA AND AMHERST HOSPITAL IN AMHERST ARE BOTH LOCATED IN LORAIN COUNTY, OHIO. LORAIN COUNTY AMASSES A LAND AREA OF NEARLY 493 SQUARE MILES, WITH APPROXIMATELY 577 PERSONS PER SQUARE MILE. IN 2009, THE POPULATION OF LORAIN COUNTY WAS ESTIMATED AT APPROXIMATELY 305,700, WITH NEARLY 24% OF THOSE PERSONS BEING UNDER 18 YEARS OLD, AND NEARLY 14% AGED 65 YEARS OR OLDER. THE MEDIAN HOUSEHOLD INCOME IN 2008 WAS $52,878 WITH 12.3% OF THE COUNTY'S POPULATION LIVING BELOW THE POVERTY LEVEL. APPROXIMATELY 88% OF THE COUNTY'S POPULATION IS WHITE, WITH THE REMAINING 12% BEING COMPRISED OF BLACK, AMERICAN INDIAN, ASIAN AND HISPANIC ETHNICITY. FEMALES MAKE UP NEARLY 51% PERCENT OF THE COUNTY'S POPULATION.LORAIN COUNTY IS CONSIDERED A RURAL, RUSTBELT COMMUNITY COMPRISED OF MANY CITIES, VILLAGES AND TOWNSHIPS. WHILE SOME CITIES, SUCH AS AVON, AVON LAKE AND NORTH RIDGEVILLE ARE EXPERIENCING BUSTLING GROWTH, OTHERS SUCH AS ELYRIA AND LORAIN HAVE SEEN BUSINESSES CLOSE IN THE PAST SEVERAL YEARS, RESULTING IN JOB LOSS AND PEOPLE LEAVING THE COUNTY. PART VI, LINE 5: EMH HEALTHCARE BELIEVES THAT EDUCATIONAL AND PREVENTATIVE SERVICES ARE IMPERATIVE TO IMPROVING THE HEALTH OF OUR COMMUNITY. AS SUCH, NO-COST HEALTH SCREENINGS ARE HELD THROUGHOUT THE YEAR ON OUR ELYRIA, AMHERST AND AVON CAMPUSES, INCLUDING SKIN CANCER AND PROSTATE CANCER SCREENINGS, ALONG WITH BLOOD PRESSURE, DIABETES, CHOLESTEROL AND BONE DENSITY SCREENINGS. IN JUNE OF 2012, THE CENTER FOR ORTHOPEDICS, A DEPARTMENT OF EMH HEALTHCARE, PROVIDED MORE THAN 700 FREE SPORTS PHYSICALS TO LOCAL STUDENTS REPRESENTING EVERY HIGH SCHOOL IN LORAIN COUNTY AS PART OF THEIR ANNUAL HIGH SCHOOL SPORTS PHYSICAL EVENT. EMH ALSO TRAVELS TO UNDERSERVED NEIGHBORHOODS TO BRING THEIR EDUCATION TO THE COMMUNITY. ONE OF THE LARGEST EVENTS SERVES A COMMUNITY THAT IS MAINLY LATINO, AND THAT IS THE UNITED WAY WEEK OF CARING EVENT AT EL CENTRO IN LORAIN, OHIO. IN PARTNERSHIP WITH EL CENTRO, EMH AND OTHER PROVIDERS OFFER FREE HEALTH SCREENINGS AND HAVE A TEAM OF LABORATORY TECHNICIANS ON-SITE SO THAT RESULTS AND HEALTH EDUCATION CAN BE GIVEN IMMEDIATELY. ANOTHER COMMUNITY OUTREACH PROGRAM IN WHICH EMH PARTICIPATED IN 2012 WAS CALLED "DR. LEARNER." THROUGH A GRANT FROM OUR LOCAL NEWSPAPER, EMH CLINICIANS TRAVELED ON FIVE OCCASIONS TO A LARGE, SOCIO-ECONOMICALLY DEPRIVED ELEMENTARY SCHOOL IN ELYRIA, TO PROVIDE HEALTH AND EXERCISE EDUCATION TO THE STUDENTS. THE STUDENTS WERE ASKED TO SUBMIT QUESTIONS AND THOSE QUESTIONS DICTATED THE HEALTH PRESENTATIONS GIVEN THROUGHOUT THE YEAR. THEY WERE ALSO ENCOURAGED TO TRY HEALTHY FOODS THAT THEY MAY NOT HAVE HAD EXPOSURE TO BEFORE (E.G. MANGOS, ASPARAGUS, ETC.). IN ALL, NEARLY 1,150 MEMBERS OF THE COMMUNITY RECEIVED FREE HEALTH SCREENS OR HEALTH EDUCATION FROM EMH DOCTORS, NURSES OR TECHNICIANS IN 2012.ALSO IN 2012, EMH HEALTHCARE PROFESSIONALS DONATED HUNDREDS OF HOURS OF THEIR TIME TO THE LORAIN COUNTY FREE CLINIC, INCLUDING OUR PRESIDENT AND CHIEF EXECUTIVE OFFICER DONALD SHELDON, M.D. THERE WERE 643 NO-COST ENCOUNTERS WITH PATIENTS OF THE FREE CLINIC IN 2012 THAT WOULD TOTAL $532,529 HAD THOSE ENCOUNTERS BEEN BILLED. VARIOUS HEALTH EDUCATION EVENTS WERE PRESENTED BY EMH HEALTHCARE IN 2012 THAT SUPPORT ITS EXEMPT PURPOSE. THOSE INCLUDE:-COFFEE, TEA & ME -FOUR TIMES EACH YEAR, AN EMH CLINICIAN GIVES AN HOUR-LONG PRESENTATION ON TOPICS RELEVANT TO WOMEN. A HEART-HEALTHY BREAKFAST IS ALSO PROVIDED FREE OF CHARGE.-MALL WALKERS -FROM SEPTEMBER THROUGH MAY, EMH HEALTHCARE SPONSORS A ONCE-MONTHLY FREE HEALTH EDUCATIONAL PROGRAM AT THE MIDWAY MALL IN ELYRIA. AN EMH CLINICIAN PRESENTS HEALTH INFORMATION IN A CASUAL, INFORMAL WAY WHILE ATTENDEES DINE ON FRESH FRUIT, CEREAL BARS, JUICE AND COFFEE.-TO FURTHER ENCOURAGE THE HEALTH AND OVERALL WELLBEING OF ITS MEMBERS, THE EMH CENTER FOR HEALTH AND FITNESS CONTINUED THEIR FREE HEALTH SCREENING PROGRAM IN 2012. A TOTAL OF 110 MEMBERS RECEIVED A FREE CHOLESTEROL AND HDL SCREENING, ALONG WITH EDUCATION PROVIDED BY OUR HEALTHCARE PROFESSIONALS ABOUT HOW TO IMPROVE THEIR NUMBERS IF NECESSARY.LASTLY, EMH UTILIZES SOCIAL MEDIA TO HELP MEMBERS OF THE COMMUNITY MAKE HEALTHY CHOICES AND TO CREATE AWARENESS OF EVENTS, PROGRAMS OR SERVICES TO IMPROVE THEIR OVERALL WELLNESS. THROUGH BOTH FACEBOOK AND TWITTER, EMH PROVIDES HEALTH TIPS AND INFORMATION DIRECTLY FROM OUR PHYSICIANS, NURSES, DIETICIANS AND OTHER HEALTHCARE PROFESSIONALS. WE BELIEVE THAT SOCIAL MEDIA CHANNELS ARE EXCELLENT MEDIUMS TO PROMOTE A MESSAGE OF HEALTH TO THE COMMUNITY AND GENERATE AWARENESS OF UPCOMING EVENTS WHERE PEOPLE CAN TAKE ADVANTAGE OF OUR OUTREACH PROGRAMS. PART VI, LINE 6: EMH REGIONAL MEDICAL CENTER (EMH) OPERATES A FULL-SERVICE ACUTE CARE HOSPITAL AT ITS MAIN CAMPUS IN ELYRIA, OHIO AND PROVIDES FREESTANDING EMERGENCY DEPARTMENT SERVICES AND OTHER ANCILLARY SERVICES ON SEVERAL OTHER CAMPUSES IN LORAIN COUNTY, PRIMARILY AT ITS AVON OHIO CAMPUS AND ITS AMHERST OHIO CAMPUS. APPROXIMATELY 94% OF ADMISSIONS ARE DERIVED FROM THE THREE EMERGENCY DEPARTMENTS OPERATED BY EMH AND FROM DIRECT ADMISSIONS BY PHYSICIANS PRACTICING WITHIN LORAIN COUNTY AND WHO HOLD ADMITTING PRIVILEGES FOR EMH. EMH PROVIDES PATIENT EDUCATION ACTIVITIES AND NUMEROUS HEALTH SCREENINGS THROUGHOUT LORAIN COUNTY. 1 COMPREHENSIVE HEALTHCARE OF OHIO 630 EAST RIVER STREET ELYRIA OH 44035 341492733 501(C)(3) 25000 0 N/A N/A TO PROMOTE HEALTH WITHIN THE COMMUNITY LORAIN COUNTY HEALTH AND DENTISTRY 1205 BROADWAY LORAIN OH 44052 341957404 501(C)(3) 248554 0 N/A N/A TO PROMOTE HEALTH WITHIN THE COMMUNITY 2 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS ARE APPROVED AND PROCESSED BY THE ORGANIZATION'S CEO. 0 1 0 0 0 0 0 0 0 SHELDON DONALD 0 361951 0 0 0 92628 0 14999 0 7689 0 477267 0 0 SIMONE JAMES M 0 258165 0 0 0 48932 0 12500 0 16339 0 335936 0 0 GARDNER FRANCIS X 0 205228 0 0 0 32360 0 9235 0 1440 0 248263 0 0 COOKSEY JILL 0 129329 0 0 0 43341 0 1580 0 16045 0 190295 0 0 MCDONALD DOUGLAS 0 220045 0 0 0 1101 0 12342 0 10859 0 244347 0 0 MILLER DANIEL N 0 193131 0 0 0 33411 0 13595 0 16294 0 256431 0 0 WRAY CHARLOTTE 0 167833 0 0 0 540 0 9625 0 16049 0 194047 0 0 GIBBONS TERRI 139978 0 0 0 299 0 0 0 14974 0 155251 0 0 0 GRAUER JOHN 250000 0 0 0 552 0 0 0 1310 0 251862 0 0 0 ZEOLLA KATHERINE 164972 0 0 0 185 0 0 0 7021 0 172178 0 0 0 PART I, LINE 4B COMPREHENSIVE HEALTHCARE OF OHIO (CHCO), THE PARENT ORGANIZATION, MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF CHCO AND ITS AFFILIATED ENTITIES. THE SERP IS A FUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH IRC SEC. 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. JILL COOKSEY - 457(F) PARTICIPANT FRANCIS GARDNER - 457(F) PARTICIPANT DANIEL MILLER - 457(F) PARTICIPANT DONALD SHELDON - 457(F) PARTICIPANT JAMES SIMONE - 457(F) PARTICIPANT SUPPLEMENTAL INFORMATION PART III PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A COUNTY OF LORAIN OHIO 340714612 543583LF3 2008-07-31 36730000 REFUNDING SERIES 2005 BOND ISSUE 0 1 0 A 36627156 36625 36578616 2008 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 1 DEUTSCHE BANK 1.400000000000 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBER WITH RIGHTS TO GOVERN EMH REGIONAL MEDICAL CENTER IS COMPREHENSIVE HEALTH CARE OF OHIO, INC. IT IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A COMPREHENSIVE HEALTH CARE OF OHIO, INC. IS THE SOLE MEMBER WHICH HAS AUTHORITY TO ELECT THE GOVERNING BODY OF EMH REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS, BUT NOT ALL DECISIONS, OF THE GOVERNING BODY OF EMH REGIONAL MEDICAL CENTER ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, COMPREHENSIVE HEALTH CARE OF OHIO, INC. EXAMPLES OF DECISIONS OF THE GOVERNING BODY OF THE EMH REGIONAL MEDICAL CENTER WHICH ARE SUBJECT TO THE APPROVAL OF THE MEMBER ARE ANNUAL OPERATING BUDGETS, CAPITAL EXPENDITURE BUDGETS, LONG RANGE PLANNING DOCUMENTS, CAPITAL EXPENDITURES INCRURRING DEBT WHICH WOULD REQUIRE MORTGAGE OF ANY PARTS OF THE ASSETS OF EMH REGIONAL MEDICAL CENTER AND AMENDMENT TO THE GOVERNING DOCUMENTS OF EMH REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE CEO, CFO AND IN-HOUSE GENERAL COUNSEL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL DIRECTORS ARE PRESENTED WITH AN ATTESTATION DOCUMENT WHICH STATES THE ESSENCE OF THE CONFLICT OF INTEREST POLICY. EACH DIRECTOR IS REQUIRED TO COMPLETE THE DOCUMENT AND SIGN IT, VERIFYING THAT HE OR SHE IS AWARE OF THE POLICY AND DECLARING ANY POTENTIAL CONFLICTS OF INTEREST WHICH SUCH DIRECTOR MAY HAVE, OR WHICH MAY HAVE DEVELOPED SINCE THE PRIOR YEAR'S ATTESTATION. THE CHAIR OF THE BOARD, OR DESIGNEE, MEETS WITH ANY DIRECTOR WHO HAS INDICATED A POTENTIAL CONFLICT OF INTEREST IN ORDER TO FULLY EXPLORE THE NATURE OF THE POTENTIAL OR EXISTING CONFLICT, WITH THE POTENTIAL THAT SUCH CONFLICT MIGHT PRECLUDE FURTHER SERVICE OF THAT DIRECTOR. ALL ANNUAL ATTESTATIONS ARE MAINTAINED BY THE CEO OF THE ORGANIZATION. THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS INCLUDES AN EXTERNAL ANALYSIS COMPLETED BY TOWERS PERRIN, A NATIONALLY KNOWN BENEFITS AND COMPENSATION CONSULTANT. TOWERS PERRIN GATHERS MARKET RESEARCH DATA FROM THREE PUBLISHED AND RELIABLE HEALTHCARE COMPENSATION SURVEYS. THIS ANALYSIS UTILIZES NATIONAL PAY DATA AND TAKES INTO CONSIDERATION THE SIZE OF THE HEALTHCARE ORGANIZATION, THE RESPECTIVE JOB TITLE, AND TIME IN JOB. THE ANALYSIS IS COMPLETED ANNUALLY. IT INCLUDES RECOMMENDATIONS ON POSITIONING THE CEO AND OTHER TOP MANAGEMENT WITH STAFF WITHIN THE APPROPRIATE PAY RANGE AS WELL AS POSSIBLE PAY RANGE ADJUSTMENTS AND BASE SALARY INCREASE PERCENTAGES FOR THE CURRENT YEAR. RECOMMENDATIONS ARE APPROVED BY A SUBCOMITTEE OF THE BOARD OF DIRECTORS PRIOR TO IMPLEMENTATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2012 BY COMPREHENSIVE HEALTHCARE OF OHIO, THE PARENT ENTITY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS NOT, TO THIS POINT, MADE ITS GOVERNING DOCUMENTS, OTHER THAN THE ORIGINAL ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS AVAILABLE TO ALL EMPLOYEES AND DIRECTORS ON THE ORGANIZATION'S INTRANET SITE, AND HAS BEEN A PART OF THE ORGANIZATION'S WRITTEN POLICY HANDBOOK LONG IN ADVANCE OF THE DEVELOPMENT OF THE INTRANET SITE. FINANCIAL STATEMENTS ARE NOT GENERALLY AVAILABLE TO THE PUBLIC OTHER THAN FINANCIAL INFORMATION WHICH APPEARS ON THE FORM 990 AND OTHER PUBLIC FILINGS REQUIRED BY LAW. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION RELATED CHANGES LIABILITY ADJUSTMENT -2,998,207. INVESTMENT IN PERPETUAL TRUST 166,632. FORM 990, PART XII, LINE 2C: THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. COMPREHENSIVE HEALTH CARE OF OHIO INC 630 EAST RIVER ST ELYRIA OH 44035 341492733 CENTRALIZED MANAGEMENT OH 501(C)(3) LINE 11C, III-FI N/A 0 AMHERST HOSPITAL ASSOCIATION INC 630 EAST RIVER ST ELYRIA OH 44035 340067060 COMMUNITY HOSPITAL OH 501(C)(3) LINE 3 COMPREHESIVE HEALTH CARE OF OHIO INC 1 ELYRIA MEMORIAL HOSPITAL FOUNDATION 630 EAST RIVER ST ELYRIA OH 44035 341492735 FUNDRAISING OH 501(C)(3) LINE 7 COMPREHENSIVE HEALTH CARE OF OHIO INC 1 COMMUNITY HEALTH COLLABORATIVE LLC 18697 BAGLEY ROAD MIDDLEBURG HEIGHTS OH 44130 452450431 HEALTH COLLABORATION OH N/A COMMUNITY HEALTH CONTRACTING ORGANIZATION LLC 18697 BAGLEY ROAD MIDDLEBURG HEIGHTS OH 44130 453023728 HEALTH CARE CONTRACTING OH N/A COMMUNITY HEALTH PURCHASING ORGANIZATION LLC 18697 BAGLEY ROAD MIDDLEBURG HEIGHTS OH 44130 452450431 HEALTH CARE PURCHASING OH N/A COMMUNITY MEDICAL GROUP LLC 18697 BAGLEY ROAD MIDDLEBURG HEIGHTS OH 44130 453023969 HEALTH CARE SERVICES OH N/A COMPREHENSIVE VENTURES UNLIMITED INC 630 EAST RIVER ST ELYRIA OH 44035 341596060 VARIOUS HEALTHCARE ACTIVITIES OH N/A C 0 EMH MEDICAL OFFICE BUILDING IN AVON 1997 HEALTHWAY DR AVON OH 44011 341935407 MEDICAL OFFICE BUILDING OH N/A C 0 EMH SHEFFIELD MEDICAL BUILDING CONDOMINIUM ASSOC 630 EAST RIVER ST ELYRIA OH 44035 260636602 CONDOMINIUM COMPLEX OH N/A C 0 CENTER FOR ORTHOPEDICS INC 630 EAST RIVER ST ELYRIA OH 44035 341665082 PHYSICIAN PRACTICE OH N/A C 0 EMH PROFESSIONAL SERVICES INC 630 EAST RIVER ST ELYRIA OH 44035 341778419 VARIOUS HEALTHCARE ACTIVITIES OH N/A C 0 NORTH OHIO HEART INC 630 EAST RIVER ST ELYRIA OH 44035 272574020 VARIOUS HEALTHCARE ACTIVITIES OH N/A C 0 1 1 1 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 1 COMPREHENSIVE HEALTH CARE OF OHIO INC P 7856408 ACTUAL COST PER FINANCIAL STMTS COMPREHENSIVE HEALTH CARE OF OHIO INC M 14873676 ACTUAL COST PER FINANCIAL STMTS AMHERST HOSPITAL ASSOCIATION INC P 955733 ACTUAL COST PER FINANCIAL STMTS AMHERST HOSPITAL ASSOCIATION INC K 451332 ACTUAL COST PER FINANCIAL STMTS COMPREHENSIVE VENTURES UNLIMITED INC P 1418276 ACTUAL COST PER FINANCIAL STMTS COMPREHENSIVE VENTURES UNLIMITED INC A 105172 ACTUAL COST PER FINANCIAL STMTS COMPREHENSIVE VENTURES UNLIMITED INC M 215193 ACTUAL COST PER FINANCIAL STMTS EMH PROFESSIONAL SERVICES INC P 2189320 ACTUAL COST PER FINANCIAL STMTS EMH PROFESSIONAL SERVICES INC M 389442 ACTUAL COST PER FINANCIAL STMTS CENTER FOR ORTHOPEDICS INC P 2095075 ACTUAL COST PER FINANCIAL STMTS NORTH OHIO HEART INC P 4734588 ACTUAL COST PER FINANCIAL STMTS ELYRIA MEMORIAL HOSPITAL FOUNDATION P 65549 ACTUAL COST PER FINANCIAL STMTS