2012-11-15T12:46:49-06:00 2011-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2011-01-01 341935236 LIMA MEMORIAL PROFESSIONAL CORPORATION LIMA 4192283335 1001 BELLEFONTAINE AVENUE LIMA OH 45804 ERIC D POHJALA 4192283335 2012-11-07 1 BERNIE OSTROWSKI P00366367 6148493000 2011 2016-02-24 21:20:13Z MICHAEL SWICK 1001 BELLEFONTAINE AVENUE LIMA OH 45804 19165083 0 X WWW.DOCLMPC.ORG X 2000 OH WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. 14 1 289 1 14856 0 4776349 6537686 11753185 12608947 0 2702 20150 15748 16549684 19165083 1000 0 0 0 14862808 16897845 0 0 0 6855425 8373290 21719233 25271135 -5169549 -6106052 2956712 3762778 45131223 52043341 -42174511 -48280563 WE ARE HERE TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITIES THROUGH COMPREHENSIVE HEALTH SERVICES. 0 0 20966355 0 12609839 PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF ABILITY TO PAY. 20966355 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 45 0 1 289 1 0 0 0 0 0 0 0 0 0 0 X 14 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X STACEY DEITERING 4199984733 121 W HIGH ST LIMA OH 45801 X CHARLES LYNN THOMPSON MD 20.00 X X 0 247536 64598 ERIC D POHJALA 5.00 X X 0 213079 62137 ROBERT E ARMSTRONG JR 9.00 X X 0 221026 64403 FRANK BALDAUF MD 40.00 X X 152010 0 21110 KERMIT STROH 1.00 X 0 0 0 KHA TRAN MD 40.00 X X 211080 0 29226 CHERYL WAYMAN PA-C 40.00 X X 112439 0 21739 THOMAS FREYTAG MC 40.00 X X 145112 0 4365 S KAYE LEE CNP 40.00 X 93703 0 2811 DAVID LIN MD 40.00 X 652976 0 16501 BONNIE MCNAMARA MD 40.00 X 134290 0 26921 STEVE MILLIGAN JR MD 40.00 X 227202 0 16154 J FRANK OAKS JR MD 40.00 X 244544 0 30228 NATHAN WALTERS MD 40.00 X 267452 0 23999 MICHAEL SWICK 4.00 X 0 341929 116019 LAWRENCE BELL 40.00 X 528731 0 25652 SHABBIR SABIR 40.00 X 378713 0 23822 ABDUL QUAZI 40.00 X 339736 0 25652 ANTHONY BRYM 40.00 X 323528 0 25652 SALIM HANNA 40.00 X 316608 0 22878 4128124 1023570 623867 43 0 1 0 STAFF CARE INC 5001 STATESMAN IRVING TX 750632414 MEDICAL SERVICES 541780 EKG ASSOCIATES II LLC 1005 BELLEFONTAINE AVE STE 340 LIMA OH 45804 MEDICAL SERVICES 235536 EMERGENCY PHYSICIANS OF NW OHIO PO BOX 12490 TOLEDO OH 43606 MEDICAL SERVICES 175280 HYLANT GROUP 811 MADISON AVE TOLEDO OH 45804 INSURANCE SERVICES 155615 MEDICAL DOCTOR ASSOCIATES 145 TECHNOLOGY PARKWAY NOCROSS GA 30092 MEDICAL SERVICES 151025 6 6537686 6537686 PATIENT SERVICE REV. 621110 12608947 12608947 12608947 2702 2702 BILLING SERVICES 561000 14856 14856 PURCHASE DISCOUNTS 621110 892 892 15748 19165083 12609839 14856 2702 2440151 2058987 381164 11911594 9529275 2382319 195822 156658 39164 1517840 1214272 303568 832438 665950 166488 3420246 2736197 684049 102390 81912 20478 1226504 981203 245301 70139 56111 14028 31807 25446 6361 75145 60116 15029 146950 117560 29390 BAD DEBT EXPENSE 3129827 3129827 EDUCATION & REWARDS 87205 69764 17441 MANAGED CARE ORG 82327 82327 RECRUITMENT 750 750 25271135 20966355 4304780 0 534698 608533 1993305 2563750 64506 110737 139039 199990 831851 552083 225164 279768 2956712 3762778 978579 1379389 44152644 50663952 45131223 52043341 X -42174511 -48280563 -42174511 -48280563 2956712 3762778 -6106052 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21551 21551 810300 552083 258217 279768 ADVANCES FROM LIMA MEMORIAL JOINT OPERATING CO. 50213985 PROFESSIONAL LIABILITY RESERVE 449967 50663952 0 1 0 0 0 0 0 0 0 CHARLES LYNN THOMPSON MD 0 237689 0 0 0 9847 0 48126 0 16472 0 312134 0 0 ERIC D POHJALA 0 206958 0 0 0 6121 0 39259 0 22878 0 275216 0 0 ROBERT E ARMSTRONG JR 0 214743 0 0 0 6283 0 41525 0 22878 0 285429 0 0 FRANK BALDAUF MD 137612 0 14398 0 0 0 4638 0 16472 0 173120 0 0 0 KHA TRAN MD 206080 0 5000 0 0 0 6348 0 22878 0 240306 0 0 0 DAVID LIN MD 647976 0 5000 0 0 0 7350 0 9151 0 669477 0 0 0 BONNIE MCNAMARA MD 129290 0 5000 0 0 0 4043 0 22878 0 161211 0 0 0 STEVE MILLIGAN JR MD 222202 0 5000 0 0 0 7003 0 9151 0 243356 0 0 0 J FRANK OAKS JR MD 218419 0 26125 0 0 0 7350 0 22878 0 274772 0 0 0 NATHAN WALTERS MD 265890 0 1562 0 0 0 1121 0 22878 0 291451 0 0 0 MICHAEL SWICK 0 330369 0 0 0 11560 0 93141 0 22878 0 457948 0 0 LAWRENCE BELL 523731 0 5000 0 0 0 7350 0 18302 0 554383 0 0 0 SHABBIR SABIR 364585 0 14128 0 0 0 7350 0 16472 0 402535 0 0 0 ABDUL QUAZI 321720 0 18016 0 0 0 7350 0 18302 0 365388 0 0 0 ANTHONY BRYM 303413 0 20115 0 0 0 7350 0 18302 0 349180 0 0 0 SALIM HANNA 231213 0 85395 0 0 0 0 0 22878 0 339486 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN AN IRC 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN: ERIC D. PAHJALA $4,869 ROBERT ARMSTRONG $5,342 MIKE SWICK $54,591 C. LYNN THOMPSON $13,176 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: RELATED ORGANIZATION, LIMA MEMORIAL JOINT OPERATING COMPANY, DETERMINES THE COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES BY 1)REVIEW AND APPROVAL OF THE COMPENSATION COMMITTEE; 2)UTILIZATION OF AN INDEPENDENT COMPENSATION CONSULTANT; 3)COMPARABLE DATA; AND 4) CONTEMPORANEOUS DOCUMENTATION. SHELDON WICAL DO X 28000 16097 0 1 1 16097 FORM 990, SCHEDULE L, PART II THE LOAN RELATED TO A BUSINESS TRANSACTION WHERE LIMA MEMORIAL PROFESSIONAL CORPORATION PROVIDED A LOAN TO ASSIST WITH THE TRANSITION OF SHELDON WICAL, DO (FORMER SECRETARY OF BOARD) TO LIMA MEMORIAL HEALTH SYSTEM FROM THE PRIOR EMPLOYER. THE CEO, AN OFFICER AND REPRESENTATIVE OF THE BOARD FOR LIMA MEMORIAL PROFESSIONAL CORPORATION, APPROVED THE LOAN TO TERMS OF WHICH WERE CONSISTENT TO THAT OF AN ARMS-LENGTH TRANSACTION. MEMBERS OF THE BOARD ACKNOWLEDGED THIS TRANSACTION AND GAVE AUTHORITY TO THE CEO FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE BOARD REVIEWS AND APPROVES FORM 990. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE ORGANIZATION'S CEO AND OTHER OFFICERS' COMPENSATION INCLUDES: 1) REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE; 2) THE UTILIZATION OF AN INDEPENDENT COMPENSATION CONSULTANT; 3) COMPARABLE DATA; AND 4) CONTEMPORANEOUS DOCUMENTATION. COMPENSATION PAID TO THE CEO, SENIOR VICE PRESIDENT/COO AND VICE PRESIDENT OF FINANCE/CFO ARE PAID AND REVEIEWED BY A RELATED ORGANIZATION. THIS PROCESS WAS LAST COMPLETED IN 2011. FORM 990, PART VI, SECTION C, LINE 18 FORM 1023, FORM 990 AND FORM 990-T ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE CURRENTLY NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII ESTIMATE OF OFFICERS' ALLOCATION OF HOURS WORKED FOR LIMA MEMORIAL PROFESSIONAL CORPORATION RELATED ENTITIES: LIMA MEMORIAL HOSPITAL: -MICHAEL SWICK: 1 -ROBERT E. ARMSTRONG: 1 -ERIC D. POHJALA: 1 -THOMAS FREYTAG, MC: 1 -BARRETT RYDELL: 1 -DEBRA MCCURDY, PHD: 1 -HAROLD WARONKER: 1 -JOHN JOHNSON: 1 -KERMIT STROH: 1 -LAWRENCE D. BELL: 1 -ROBERT L. THOMPSON: 1 LIMA MEMORIAL JOINT OPERATING COMPANY: -MICHAEL SWICK: 34 -ROBERT E. ARMSTRONG: 30 -ERIC D. POHJALA: 34 -C. LYNN THOMPSON, MD: 19 -THOMAS FREYTAG, MC: 1 -BARRETT RYDELL: 1 -DEBRA MCCURDY, PHD: 1 -HAROLD WARONKER: 1 -JOHN JOHNSON: 1 -KERMIT STROH: 1 -LAWRENCE D. BELL: 1 -ROBERT L. THOMPSON: 1 ELM TREE FOUNDATION: -MICHAEL SWICK: 1 -ROBERT E. ARMSTRONG: 1 -ERIC D. POHJALA: 1 FORM 990, PART XI, LINE 2C EXPLANATION: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGE FROM THE PRIOR YEAR. LIMA MEMORIAL HOSPITAL 1001 BELLEFONTAINE AVENUE LIMA OH 45804 344434676 HEALTHCARE OH 501(C)(3) LINE 3 LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL HOSPITAL FOUNDATION 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341707570 SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL OH 501(C)(3) LINE 11A, I LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL HOSPITAL AUXILIARY 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341694632 SUPPORTING ORGANIZATION FOR LIMA MEMORIAL HOSPITAL OH 501(C)(3) LINE 11A, I LIMA MEMORIAL JOINT OPERATING COMPANY 1 LIMA MEMORIAL JOINT OPERATING COMPANY 1001 BELLEFONTAINE AVENUE LIMA OH 45804 341883284 HEALTHCARE OH 501(C)(3) LINE 3 N/A 0 LMHS WOMEN'S HEALTH CO-MANAGEMENT COMPANY LLC 1001 BELLEFONTAINE AVE LIMA OH 45804 271023520 WOMEN'S HEALTH CO-MANAGEMENT OH N/A ELM TREE FOUNDATION 1220 EAST ELM STREET LIMA OH 45804 341417720 RENTAL REAL ESTATE OH N/A C 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 LIMA MEMORIAL JOINT OPERATING COMPANY C 6537686 CASH TRANSACTION LIMA MEMORIAL JOINT OPERATING COMPANY J 270937 LEASE CONTRACT ELM TREE FOUNDATION J 296297 LEASE CONTRACT LIMA MEMORIAL JOINT OPERATING COMPANY P 532565 CASH TRANSACTION