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HealthSpan Integrated Care: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HealthSpan Integrated Care (EIN 34-0922268)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201233189349302093
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T12:14:13-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PRICEWATERHOUSECOOPERS LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340922268EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KAISER FOUNDATION HEALTH PLAN OF OHIOBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% VP - NATIONAL TAX COMPLIANCEInCareOfName
Name ControlKAISNameControl
Phone5102716611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEBORAH STOKESName
TitleSVP, CC & CAOTitle
Phone5102716385Phone
Date Signed2012-11-02DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPATRICIA KENNEDY-SCOTTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Gross Receipts610044588GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1777TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI43951TotalGrossUBI
Net Unrelated Business Txbl Income9372NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year262333ContributionsGrantsPriorYear
Contributions Grants Current Year45581ContributionsGrantsCurrentYear
Program Service Revenue Prior Year587211818ProgramServiceRevenuePriorYear
Program Service Revenue CY558821465ProgramServiceRevenueCY
Investment Income Prior Year2006156InvestmentIncomePriorYear
Investment Income Current Year2840498InvestmentIncomeCurrentYear
Other Revenue Prior Year3752200OtherRevenuePriorYear
Other Revenue Current Year157813OtherRevenueCurrentYear
Total Revenue Prior Year593232507TotalRevenuePriorYear
Total Revenue Current Year561865357TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1785835GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1976805GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year144066609SalariesEtcPriorYear
Salaries Etc Current Year151645515SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year502233248OtherExpensePriorYear
Other Expenses Current Year455827817OtherExpensesCurrentYear
Total Expenses Prior Year648085692TotalExpensesPriorYear
Total Expenses Current Year609450137TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-54853185RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-47584780RevenuesLessExpensesCY
Total Assets BOY260142184TotalAssetsBOY
Total Assets EOY271986191TotalAssetsEOY
Total Liabilities BOY383878920TotalLiabilitiesBOY
Total Liabilities EOY446139061TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-123736736NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-174152870NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense539805021Expense
Grants84315Grants
Revenue558777514Revenue
Descriptionmember health care services and medical training for care improvement Kaiser Foundation Health Plan of Ohio (KFHP of Ohio) provides medical and surgical care, including urgent care services, extended care and home health care, for its members without regards to age, sex, race, religion or national origin or the ability to pay. KFHP of Ohio educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7905437Expense
Grants0Grants
Revenue0Revenue
DescriptionCharitable Care (Medical Financial Assistance and Charitable Coverage) Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. MFA - Health Plan offers financial assistance to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in a Kaiser Permanente facility. CHC - these programs are available to low income adults and children who are not eligible for other public or privately sponsored coverage. More than 1,165 patients received comprehensive care for up to four years through these programs. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1892490Expense
Grants1892490Grants
Revenue0Revenue
DescriptionGrants and Donations The Ohio Health Plan supported approximately 91 nonprofit organizations and enabled them to continue providing programs and services that serve vulnerable populations. Additional information about Ohio Health Plan's charitable activities can be found in Schedule O, Community Benefit Report.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1037012Expense
Grants0Grants
Revenue0Revenue
DescriptionSCH. O, COMMUNITY BENEFIT REPORTDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1037012TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense550639960TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10962494NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1777NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonVP - NATIONAL TAX COMPLIANCENamePerson
Telephone Number5102716385TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Christine Cassel
Director0.5X01845000
Thomas Chapman
Director2.0X019169589109
Daniel Garcia
SVP, Chief Compliance Officer2.0X0122876573604
William Graber
Director1.0X02082690
J Eugene Grigsby III
Director0.5X02109000
George Halvorson
Chairman and CEO5.0X0786191574595X
Judith Johansen
Director0.3X02000750
Kim J Kaiser
Director0.5X01245000
Philip Marineau
Director0.5X02007690
Jenny Ming
Director0.2X01792690
Edward Pei
Director0.5X017300016500
J Neal Purcell
Director0.5X02348580
Cynthia Telles
Director0.5X02046130
Sandra Thompkins
Director0.3X0390310
Margaret E Porfido
Director0.5X0350130
Daniel Beck
VP, Regional Counsel - Ohio30.0014644426853X
Patricia Kennedy-Scott
Region President - Ohio45.00924039153668X
Kathryn Lancaster
EVP & CFO4.002109102289626X
Thomas Meier
SVP, Corporate Treasurer3.00802247110802X
Donald Orndoff
SVP, NFS5.00634274137999X
ROCHELLE ROTH
SENIOR DIRECTOR,QRM5.0019698442093X
Arthur Southam
EVP, Health Plan Operations5.002649224348687X
Deborah Stokes
SVP, CC & CAO4.00720302118018X
Bernard Tyson
President & COO5.002800296482152X
Victoria Zatkin
VP, Off of Brd & Corp Gov Svcs4.0031476884531X
Mark Zemelman
SVP, Gen Counsel & Secretary2.00778576191923X
Donna Lynne
Group President4.001314917222947X
Craig M Faerber
VP, CFO - Ohio30.0030900331524X
Pamela Hara
VP, Quality/Service30.0028567376238X
Joseph M LaGuardia
VP, Mktg, Sls & Bus Devel30.0023873576571X
Thomas Revis
VP, CFO - Ohio30.0042047075326X
Belva Tibbs
VP, Medical Operations30.0035855584200X
Timothy Alberts
VP, Human Resources30.0036238684806X
Heather Bossin
Dir, Financial Services30.0018341758819X
Carolyn Hightower
VP, Regional HP Admin - OH30.0037870482750X
Michelle Richter
Dir, Group Sales and Acct Mgmt30.0020344935038X
Jeffrey Wallace
Dir, Pharmacies30.0016574665144X
Steven Zatkin
Consultant0.0057412176925X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs28148604TotalReportableCompFrmRltdOrgs
Total Other Compensation3210448TotalOtherCompensation
Number Individuals GT100 K82NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LAKE HOSPITAL SYSTEM
PO BOX 714031COLUMBUSOH43271HOSPITAL SERVICES4131149
THE CLEVELAND CLINIC
9500 EUCLID AVECLEVELANDOH44195HOSPITAL SERVICES9193847
OHIO PERMANENTE MEDICAL GROUP
1001 LAKESIDE AVECLEVELANDOH44114MEDICAL SERVICES95556836
THE METROHEALTH SYSTEM
2500 METROHEALTH DRIVECLEVELANDOH44109HOSPITAL SERVICES6267480
KAISER FOUNDATION HOSPITALS
1001 LAKESIDE AVECLEVELANDOH44114HOSPITAL SERVICES59336875
FieldValueIRS element (for citing)
Number Of Contractors GT100 K223NumberOfContractorsGT100K
Related Organizations36803RelatedOrganizations
All Other Contributions8778AllOtherContributions
Total Contributions45581TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MBRS HLTH CARE PRM621400435632521435632521
MEDICARE6214009023302490233024
SUPP CHARGES/PHARM6214002790429027904290
NON-PLAN & IND REV62140096059991664843951
OTHER PROGRAM SERVICE62140040910314091031
FieldValueIRS element (for citing)
Total Program Service Revenue558821465TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2391118TotalRevenueColumn
Exclusion$2,391,118ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real157813Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real157813Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column157813TotalRevenueColumn
Exclusion$157,813ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities48613861Securities
Other14750Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities48179231Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities434630Securities
Other14750Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column449380TotalRevenueColumn
Exclusion$449,380ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column561865357TotalRevenueColumn
Related Or Exempt Function Income558777514RelatedOrExemptFunctionIncome
Unrelated Business Revenue43951UnrelatedBusinessRevenue
Exclusion$2,998,311ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1976805Total
Program Services1976805ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total93670375Total
Program Services81856867ProgramServices
Management And General11813508ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total15580871Total
Program Services13966559ProgramServices
Management And General1614312ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total35443285Total
Program Services29767411ProgramServices
Management And General5675874ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6950984Total
Program Services6914574ProgramServices
Management And General36410ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total42818Total
Management And General42818ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total975766Total
Management And General975766ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total71029Total
Management And General71029ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total81349Total
Program Services81349ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total111742000Total
Program Services109196575ProgramServices
Management And General2545425ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total14962840Total
Program Services25916ProgramServices
Management And General14936924ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1305825Total
Program Services1062557ProgramServices
Management And General243268ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total42959742Total
Program Services34472550ProgramServices
Management And General8487192ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5131483Total
Program Services5128078ProgramServices
Management And General3405ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total948329Total
Program Services585804ProgramServices
Management And General362525ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total179812Total
Management And General179812ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5306838Total
Program Services5306838ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6338913Total
Program Services6338913ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3659244Total
Program Services3659244ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTUAL PAYMENTS154893711154893711
SUPPLIES71227146626542488572898
INTER-REGIONAL CHARGES1773762417264419473205
STATE & LOCAL TAXES61089426108942

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total12154406Total
Program Services9378600ProgramServices
Management And General2775806ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total609450137Total
Program Services550639960ProgramServices
Management And General58810177ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY21275690BOY
EOY21586402EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14804269BOY
EOY15274008EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5705521BOY
EOY5657326EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY859883BOY
EOY662853EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis182167262LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec117636884LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY62993734BOY
EOY64530378EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY153901087BOY
EOY136979074EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY602000BOY
EOY27296150EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY260142184BOY
EOY271986191EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY66199034BOY
EOY53747797EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY9420367BOY
EOY8488470EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY308259519BOY
EOY383902794EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY383878920BOY
EOY446139061EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY4895579BOY
EOY4886800EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-128632315BOY
EOY-179039670EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-123736736BOY
EOY-174152870EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY260142184BOY
EOY271986191EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-47584780ReconcilationRevenueExpenses
Reconcilation Other Changes-2831354ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years190337CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years164696CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years80601CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year262333CurrentTaxYearMinus1Year
Current Tax Year45581CurrentTaxYear
Total743548Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years593239328CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years592918588CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years595429126CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year587211818CurrentTaxYearMinus1Year
Current Tax Year558821465CurrentTaxYear
Total2927620325Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years593429665CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years593083284CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years595509727CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year587474151CurrentTaxYearMinus1Year
Current Tax Year558867046CurrentTaxYear
Total2928363873Total
FieldValueIRS element (for citing)
Public Support Total5092928363873PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6257742CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5406147CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4393255CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2079211CurrentTaxYearMinus1Year
Current Tax Year2548931CurrentTaxYear
Total20685286Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6257742CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5406147CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4393255CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2079211CurrentTaxYearMinus1Year
Current Tax Year2548931CurrentTaxYear
Total20685286Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years599687407CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years598489431CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years599902982CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year589553362CurrentTaxYearMinus1Year
Current Tax Year561415977CurrentTaxYear
Total2949049159Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99299PublicSupportPercentage509
Prior Year Support Percentage0.99149PriorYearSupportPercentage
Investment Income Percentage0.00701InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00851PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$62,150DirectContactLegislatorsAmount
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$4,439RalliesDemonstrationsAmount
Other ActivitiestrueOtherActivities
Other Activities$4,439OtherActivitiesAmount
Total Lobbying Expenditures IIB71028TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchedule C, Part II-B, Line 1A - 1IIdentifier
ExplanationLOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated and benefited from lobbying activities conducted at the regional and national level for the benefit of its enrolled members and for the health care industry as a whole. As an organization generally exempt from income tax under Internal Revenue Code Section 501(c)(3), Health Plan has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in telephone conversations and/or written letters to various federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan has several employees and/or may retain a professional consultant to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed of Federal and State legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the Interest of Health Plan and its members by performing the following activities: (i) Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. (ii) Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. (iii) Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. (iv) Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5961963OtherCostOrOtherBasis
Book Value5961963BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis91062832OtherCostOrOtherBasis
Depreciation45919581Depreciation
Book Value45143251BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis10507387OtherCostOrOtherBasis
Depreciation4650219Depreciation
Book Value5857168BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis46678252OtherCostOrOtherBasis
Depreciation40078316Depreciation
Book Value6599936BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27956828OtherCostOrOtherBasis
Depreciation26988768Depreciation
Book Value968060BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings64530378TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER CURRENT ASSETS231600
STATUTORY DEPOSITS400000
DUE FROM AFFILIATED ORG.26664550
FieldValueIRS element (for citing)
Total Book Value Other Assets27296150TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATED ORGANIZATION$18,914,258
RESERVE FOR PROF & PUBLIC LIAB$34,611,795
RESERVE FOR WORKERS COMP RISK$3,692,261
POST RETIREMENT BENEFITS$183,651,693
OTHER LIABILITIES$2,495,104
SELF INSURED - AUTO & UNEMPLOY$74,974
SUBORDINATED LIABILITIES$101,480,069
MEDICARE LIABILITY RESERVE$24,182,640
PREMIUM DEFICIENCY RESERVE$14,800,000
FieldValueIRS element (for citing)
Total Of Amounts383902794TotalOfAmounts
Total Revenue561865357TotalRevenue
Total Expenses609450137TotalExpenses
Excess Or Deficit For Year-47584780ExcessOrDeficitForYear
Net Unrealized GL On Investments493080NetUnrealizedGLOnInvestments
Other-$3,324,434OtherAmount
Total Adjustments-2831354TotalAdjustments
Excess Or Deficit Per FS-50416134ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt555175195TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments493080NetUnrealizedGainsInvestments
Other Revenues-3848612OtherRevenues
Revenue Not Rptd F990-3355532RevenueNotRptdF990
Revenue Subtotal558530727RevenueSubtotal
Other Revenues Not Included3334630OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3334630RevenueNotRptdOnFinStmt
Total Revenue Per Form990561865357TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt605591329TotExpensesEtcAuditedFinclStmt
Other Expenses Included99447OtherExpensesIncluded
Expenses Not Rptd F99099447ExpensesNotRptdF990
Expenses Subtotal605491882ExpensesSubtotal
Other Expenses Not Included3958255OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt3958255ExpensesNotRptdOnFinStmt
Total Expenses Per Form990609450137TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Schedule D, Part XI, Line 8Change in Other Comprehensive Income $ (2,990,668) Change in Capital Contribution ( 8,779) Gain/Loss on Investments - Tax ( 434,630) Gain/Loss on Investments - Book 510,211 See "note 1" ( 400,568) _______________ TOTAL $ (3,324,434) Note 1: other than temporary impairment (OTTI) of investment recognized for financial statement purposes, which will be tax reported when realized
Schedule D, Part XII, Line 2dBad debt expense - Reclass $ (3,876,906) Gain(Loss) on Investments - Book 510,211 OTTI (400,568) INVESTMENT MANAGEMENT FEES (81,349) _____________ TOTAL $ (3,848,612)
Schedule D, Part XII, Line 4bOTHER REVENUE - RECLASS $ 2,900,000 GAIN(LOSS) ON INVESTMENTS - TAX 434,630 ___________ TOTAL $ 3,334,630
Schedule D, Part XIII, Line 2dChange in Other Comprehensive Income $ 2,990,668 Change in Capital Contribution 8,779 Other Revenue - Reclass (2,900,000) _____________ TOTAL $ 99,447
Schedule D, Part XIII, Line 4bInvestment Management Fees $ 81,349 Bad Debt Expenses - Reclass 3,876,906 ___________ TOTAL $ 3,958,255
Schedule D, Part X, Line 2NOT REQUIREDFIN 48 FOOTNOTE

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (49 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
Akron-Canton Regional Foodbank
350 Opportunity PkwyAkronOH44307341369388501(c)(3)20000Childhood Nutrition
American Diabetes Association
4500 Rockside Rd440IndependenceOH44131131623888501(c)(3)19250Cleveland Step Out
American Heart Association Inc
1689 E 115th StClevelandOH44106135613797501(c)(3)50075Healthy Family Event
Beacon Journal Charity Fund Inc
333 S Main St 319AkronOH44303346543299501(c)(3)10000Orthodontic Treatmnt
Boys and Girls Clubs of Cleveland
6114 Broadway AveClevelandOH44127340770686501(c)(3)15000Healthy Habits
Care Alliance
1530 St Clair AveClevelandOH44114341748776501(c)(3)27167Health Outcomes
Celebrate Westlake
36097 Westminster AveN RdgevilleOH44039341703289501(c)(3)100002011 Eagle Run
City of Twinsburg
10075 Ravenna RdTwinsburgOH44087346004070Government10000Sr Transp Svc
Cleveland Board of Education
1380 E Sixth StClevelandOH44114346000662Government500000Students of Promise
Cleveland Clinic Foundation
9500 Euclid Ave DVBClevelandOH44195340714585501(c)(3)350000Charity Care Service
Cleveland Foodbank Inc
15500 S Waterloo RdClevelandOH44110341292848501(c)(3)35000Children's NutritionMC RC-25
Cleveland Hearing & Speech Center
11635 Euclid AveClevelandOH44106340714648501(c)(3)15000Infant Hearing Prog
Cleveland International Film Festival Inc
2510 Market AveClevelandOH44113341262368501(c)(3)5500Volunteer Grant
Cleveland State Univ Foundation Inc
2121 Euclid Ave MM105ClevelandOH44115341316665501(c)(3)5025Levin College Forum
Community Legal Aid Services Inc
50 S Main St 800AkronOH44308340753560501(c)(3)15000Health Ed Advocacy
Conservancy for Cuyahoga Valley Nat Pk
1403 W Hines Hill RdPeninsulaOH44264341917257501(c)(3)15000Summer Program
Cuyahoga Community College Foundation
700 Carnegie AveClevelandOH44115237320719501(c)(3)11700Presidential Scholarship Luncheon
Diabetes Partnership of Cleveland
3601 S Green Rd 100ClevelandOH44122340762558501(c)(3)19740Swim for Diabetes
Domestic Violence Center
PO Box 5466ClevelandOH44101341278377501(c)(3)11100Mask-or-Aid Ball
Epilepsy Association
2831 Prospect AveClevelandOH44115237198807501(c)(3)20000Proactive Skill Prog
Free Medical Clinic of Greater Cleveland
12202 Euclid AveClevelandOH44106237078501501(c)(3)15000Teen Clinic/Outrch
Gathering Place
23300 Commerce PkBeachwoodOH44122341879035501(c)(3)20000Childrens' Programs
Greater Cleveland Community Shares
3631 Perkins AveClevelandOH44114341493880501(c)(3)5800KP Comm Care Fund
Harvard Community Services Center
18240 HarvardClevelandOH44128237098744501(c)(3)96000HEAL/CHI
Helen Keller International
352 Park Ave So 1200New YorkNY10010135562162501(c)(3)10000ChildSight Ohio
Hospice of the Western Reserve Inc
300 E 185th StClevelandOH44119341256377501(c)(3)10000Bereavement Camp
Ideastream
1375 Euclid AveClevelandOH44115341943865501(c)(3)10000Keeping Kids Fit
Info Line Inc
703 S Main St 211AkronOH44311341170391501(c)(3)15000Diabetic Care Proj
Kidney Foundation of Ohio Inc
2831 Prospect AveClevelandOH44115340827748501(c)(3)6200Gen Oper Donation
Lake County Free Medical Clinic Inc
54 S State St 302PainesvilleOH44077341081191501(c)(3)15790Safety Net Partner
Lake Health District Fund
33 Mill StreetPainesvilleOH44077341598598501(c)(3)21850Community GardensSuite 135A
Legal Aid Society of Cleveland
1223 West Sixth StClevelandOH44113340866026501(c)(3)25000Comm Advocacy Prg
Marymount Hospital Inc
12300 McCracken RdGarfield HghtsOH44125340714458501(c)(3)100000Charity Care Service
Mature Services Incorporated
415 S Portage PathAkronOH44320510148544501(c)(3)17770Brown Bag Med Prg
MobileMed 1 Foundation
19910 Malvern RdShaker HeightsOH44122264038371501(c)(3)50000Providing Health Care
NAMI Greater Cleveland
2012 W 25th St 600ClevelandOH44113202254268501(c)(3)10000Family Education Prog
Neighborhood Family Practice
3569 Ridge RdClevelandOH44102341300581501(c)(3)22119Hispanic Pt Advocate
North Coast Health Ministry
16110 Detroit AveLakewoodOH44107341536257501(c)(3)29140Pt Critical Nds Fund
Ohio Grantmakers Forum
37 W Broad St 800ColumbusOH43215311111842501(c)(3)10000Health Care Reform
Opportunity Parish Ecum Neighborhood Mnstry
941 Princeton StAkronOH44311341046107501(c)(3)15000Safety Net Grant
Planned Parenthood of Northeast Ohio Inc
444 W Exchange StAkronOH44302341015976501(c)(3)22020Teens TalkingtoTeens
PM Foundation Inc
4909 Lorain AveClevelandOH44102346608706501(c)(3)7500Healthy Lifestyles
Providence House Inc
2037 West 32nd StClevelandOH44113341336325501(c)(3)42350Six MonthBed Sponsor
Saint Martin De Porres High School
6111 Lausche AveClevelandOH44103522401852501(c)(3)15484Corp Work Study Prgm
Slavic Village Development
5620 Broadway AveClevelandOH44127341344279501(c)(3)17026Pedal for Health
United Way of Greater Cleveland
1331 Euclid AveClevelandOH44115346516654501(c)(3)25677Inaugural Bike Tour Sponsorship
University Hospitals Health System Inc
11100 Euclid AveClevelandOH44106340714775501(c)(3)30000Centering Pregnancy
Western Stark County Medical Clinic Inc
820 Amherst Rd NEMassillonOH44646341887206501(c)(3)15000Safety Net Grant
YWCA of Greater Cleveland
4019 Prospect AveClevelandOH44103340714800501(c)(3)6675Women's Leadership Conference
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants49TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchedule I, Part I, Question 2Identifier
ExplanationGrantees are required to sign a memorandum of understanding prior to grant funds disbursal. Grantees are required to submit a final report which delineates accomplishments, related to stated objectives, and describe the evaluation method used to assess accomplishmentsExplanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (35 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy Alberts
019580305855001080330676460171600447192075247
Daniel Beck
011299703189701550016635010218017329700
Heather Bossin
016876701030804342044429014390024223600
Christine Cassel
018450000000000018450000
Thomas Chapman
0191695000008910900028080400
Craig M Faerber
0141195060000010780802454506979034052700
Daniel Garcia
056255106400000262140613080122960130236900
William Graber
020826900000000020826900
J Eugene Grigsby III
021090000000000021090000
George Halvorson
0121561305039506016067960613080132870793651000
Pamela Hara
0227427023576034670058449017789036191100
Carolyn Hightower
019202706339201232850655900171600461454090458
Judith Johansen
020007500000000020007500
Patricia Kennedy-Scott
0359537023300403314980135879017789010777070292404
Joseph M LaGuardia
019629209169033274059411017160031530600
Kathryn Lancaster
0630520090795305706290276632012994023987280529003
Philip Marineau
020076900000000020076900
Thomas Meier
03144710339188014858809780801299409130490113944
Jenny Ming
017926900000000017926900
Donald Orndoff
037629702353280226490124482013517077227300
Edward Pei
0173000000001650000018950000
J Neal Purcell
023485800000000023485800
Thomas Revis
05375006954002971800581660171600495796092019
Michelle Richter
015035604852504568018037017001023848700
ROCHELLE ROTH
016720602693402844029508012585023907700
Arthur Southam
07413740117500007328500336623012064029979110688121
Deborah Stokes
0315132033757506759501050240129940838320048521
Cynthia Telles
020461300000000020461300
Belva Tibbs
02159800594140831610664110177890442755066796
Bernard Tyson
08926050129000006176910469158012994032824480587707
Jeffrey Wallace
01501360873206878048143017001023089000
Steven Zatkin
045000542685026936066393010532065104600
Victoria Zatkin
019267508569203640108257001961039929900
Mark Zemelman
03985020259500012057401793380125850970499080051
Donna Lynne
0476108047500003638090208108014839015378640323554

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierExplanationExplanation
Schedule J, part IISteven Zatkin- General counsel to 6/30/10; consultant 3/4/11 to present. Sandra Thompkins- Board of directors to 4/1/11. Schedule J, line 3 Kaiser foundation health plan of ohio relied on kaiser foundation health plan, inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the board or compensation committee - Compensation survey or study - Approval by the board or compensation committee
Schedule J, Line 4aThomas Revis $179,945 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments.
Schedule J, Line 4bTHOMAS REVIS 92,019 BELVA TIBBS 66,796 PATRICIA KENNEDDY-SCOTT 292,404 KATHRYN LANCASTER 529,350 THOMAS MEIER 114,428 ARTHUR SOUTHAM 688,121 DEBORAH STOKES 48,521 BERNARD TYSON 587,707 STEVEN ZATKIN 4,891 MARK ZEMELMAN 81,133 GEORGE HALVORSON 1,500,000 TIMOTHY ALBERTS 75,247 CAROLYN HIGHTOWER 90,458 DONNA LYNNE 323,554 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture.
Schedule J, Line 7The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (51 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 4Changes to governing documentsArticles Four and Seven of the Articles of Incorporation of the Corporation were amended in 2012 to (a) clarify the purpose of the Corporation; (b) make a reference to the Internal Revenue Code (Section 501(c)(3)) consistent with other references in the Articles; and (c) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Certificate of Amendment by Member was filed February 7, 2012; and On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7, President); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section E-9, Executive Vice President or National Senior Vice President); and (e) change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President"; and On June 23, 2011, minor technical amendments were made to the Bylaws of the Corporation to make them more consistent with the Bylaws of Kaiser Foundation Health Plan, Inc. and its Health Plan subsidiaries and with organizational policies and current law. None of the changes were significant; and On December 1, 2011, Article A, Purpose, of the Bylaws of the Corporation was amended to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4).
Form 990, Part VI, Line 6KAISER FOUNDATION HEALTH PLAN, INC IS SOLE MEMBER Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization
Form 990, Part VI, Line 7aKaiser Foundation Health Plan, Inc (KFHP) appoints the Directors (and fills vacancies and has authority to remove Directors). The same 14 individuals who comprise the Board of Directors of KFHP also serve as the 14 Directors of KFHP Colorado, Ohio, Northwest and Mid-Atlantic States
Form 990, Part VI, Line 7bThe following actions of the corporation require approval of the sole member: a. removal of the Chairman of the Board or any President; b. amendment of Article D, Section D-4 of the Bylaws - Election and Term of Office of Directors
Form 990, Part VI, Line 11bForm 990 review process 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal 2. Community benefits details are presented to the community benefit committee of the board for review 3. Executive compensation details are presented to the compensation committee of the board for review 4. The complete tax return is reviewed and signed by a Pricewaterhousecoopers tax advisor 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing
Form 990, Part VI, Line 12cRegularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. The Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment
Form 990, Part VI, Line 15a/bThe executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.
Form 990, Part VI, Line 19Public Inspection Governing documents - are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG and is available upon request. To request copies contact: VP - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612
Form 990, Part VII, Section A, Column BHours for Related Organizations Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.
Form 990, Part XI, Line 5Other changes in net assets or fund balances Change in unrealized gain/loss on investments $ 493,080 Change in Other Comprehensive Income < 2,990,668> Change in Capital Contribution < 8,779> Gain/Loss on investments - Tax < 434,630> Gain/Loss on Investments - Book 510,211 OTTI Losses < 400,568> ______________ TOTAL <$2,831,354>
Form 990, Part III, Line 4a - dExempt purpose achievements - Program Services2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF OHIO Kaiser Foundation Health Plan of Ohio or "Ohio Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Kaiser Foundation Health Plan of Ohio as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, the Ohio Health Plan served 103,499 members and has 1,558 full time administrative, clerical and technical employees. Ohio Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Health Plan fulfills its contractual obligations to group and individual members by contracting with KFH and Ohio Permanente Physicians to provide the required health care services. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, and occupational status or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas it serves. Once enrolled, a member is free to maintain membership regardless of age, health status or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre, Safety Net Partnerships, Community Health Initiatives and Charitable Coverage Programs. In 2007, the KFHP/H Board of Directors refined the focus of the organization Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for under- and uninsured. - Community Health Initiatives - Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provide funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improve health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four key focus areas. THE COMMUNITY BENEFIT PROGRAM IN THE OHIO REGION In 2011, the Ohio Health Plan spent approximately $12.3 million or approximately 2.2% of revenue to support the Community Benefit Program. A breakdown of the 2011 Community Benefit dollars is included in Attachment A. The following identifies many of the signature community benefit programs and services funded by Ohio Health Plan grouped according to the four streams of work. CARE AND COVERAGE FOR LOW-INCOME PEOPLE In 2011, the Ohio Health Plan expended $9.9 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or by a Permanente provider. Charitable Care (Medical Financial Assistance and Charitable Coverage Programs) In the Ohio Region, Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance and Charitable Coverage Programs. In 2011, the Ohio Health Plan spent $7.9 million on under-and uninsured Ohio residents. - Medical Financial Assistance The Ohio Health Plan contributed $1.6 million to assist patients with limited or no resources to pay for care provided in Kaiser Permanente facilities. Each region offers financial assistance to help families and individuals that are unable to meet all or part of the cost of medical care on an immediate and nonrecurring basis. Kaiser Permanente's charity care program also includes discounted charges for uninsured patients below 400% federal income guidelines and aligned contracted collection agency practices with Kaiser Permanente social values. The amount reported under this category is only part of the funds spent by KFH and KFHP for the poor and uninsured. The organization's commitment to charitable care is also reflected in a variety of other programs and initiatives such as the Charitable Coverage Program and grants and donations to community clinics and other safety net providers. Medical Financial Assistance is offered to both members and non members, and eligibility is solely based on income. - Charitable Coverage Transition Plan - The Transition Plan is a 2-year HMO insurance product that provides coverage for low-income individuals (up to 250% FPL) who are not eligible for public programs such as Medicaid or Medicare. Applicants are referred to Kaiser Permanente through a hotline telephone number that connects them to our community partner who assists them through the application process. More than half of the members are new to KP. The plan subsidizes co-pays and premiums, charging $20 per month for individuals and $40 per month for families. They receive comprehensive benefits including prescription drug coverage and hospitalization. Access to Care - Kaiser Permanente participates as an Access to Care safety net provider in Summit County and provides uncompensated, charity care to qualified (non Medicaid eligible) patients. Access to Care is a program of the Healthy Connections Network, a nonprofit organization located in Summit County, Ohio that links uninsured individuals to care. The Network utilizes providers throughout Summit County to provide uncompensated, charity care to qualified patients. The Network serves as the initial point of entry for the patient and makes referrals to partner providers based upon capacity and patient request. Services include primary care visits and some ancillary - lab and imaging services. All specialty care referrals are made back to Healthy Connections Network. Participation in Medicaid and Other Government Sponsored Health Care Programs The Ohio Health Plan has a long history of participation in publicly financed health programs. In 2011, the Ohio Region provided medical coverage and services valued at approximately $1.5 million (in excess of reimbursement) for individuals in the following program: - Care Source Medicaid Program - The Ohio Region does not contract directly with the state as a managed care plan, instead they contract with CareSource, the largest MCO in the state. On behalf of the Ohio Health Plan, Ohio Permanente physicians provide care for CareSource patients. When a patient selects KP as their provider they can access a proscribed list of primary care and ancillary services. In 2011, all physicians and facilities were credentialed as required by state regulations, to see these Medicaid patients. The difference between cost of care and reimbursement from CareSource is reported as Community Benefit. - Medicare-Medicaid Premium Subsidy - In Ohio, state policy does not allow use of state dollars to pay for Medicare monthly premiums, even for low-income persons. Health Plan paid the monthly Medicare premium for dual-eligible Medicare/Medicaid members. This effort supports low-income persons and provides richer Medicare benefits than fee-for-service.
Grants and Donations for Care and CoverageKaiser Permanente renewed support for the Teen Clinic and Teen Outreach Program at the Free Medical Clinic of Greater Cleveland. The Teen Clinic provides comprehensive services and leverages professional and clinical volunteer support to serve young people age 13-21. The Teen Outreach Program provides health and wellness education at The Free Clinic and in community venues throughout Greater Cleveland. Kaiser Permanente made grants to the Cleveland Clinic Foundation and Marymount Hospital to support the provision of charity care services for patients who are uninsured or underinsured. COMMUNITY HEALTH INITIATIVES As an innovator in health, Kaiser Permanente designs, delivers and sustains long-term programs that engage communities in work to improve the conditions in their neighborhoods, workplaces and schools that can support good health, particularly Healthy Eating, Active Living (HEAL). The Ohio Health Plan spent $363,655 on community health initiatives during 2011. Grants and Donations for Community Health Initiatives The Community Health Initiative in Ward 1 Cleveland is in its 6th year. In 2011 focus remained on building sustainable infrastructure and capacity for the institutional home of HEAL, maintaining 10 community gardens and participating in numerous initiatives to change the built environment and impact policy to make healthy and active living the easy choice. HEAL advocacy efforts led the City of Cleveland to include and fund the construction of a walking path into the city's largest park renovation. A grant was made to Harvard Community Services Center, to provide support as the institutional home of Ohio's CHI community. Support was granted to The Lake County General Health District for the Lake County Community Garden Program, which will establish community gardens in Mentor and Concord Township to improve access to fresh fruits and vegetables for residents. The gardens will be part of the Lake County "Action Communities for Health, Innovation, and Environmental Change" (ACHIEVE) initiative, a county-wide partnership to improve physical activity and nutrition among residents of Lake County. SAFETY NET PARTNERSHIPS Through funding, technical assistance, influencing public policy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. The Ohio Health Plan donated $228,346 to support safety net providers through its Thriving Communities Grant Program. Following are three examples: - Care Alliance, an FQHC, undertook the Health Outcomes Improvement Initiative to improve health outcomes of Care Alliance patients. The program, led by a Quality Improvement Registered Nurse, launched wellness programming to help lead to an application for recognition as an NCQA Patient Centered Medical Home. - Kaiser Permanente supported the Community Advocacy Program, a medical-legal partnership which places Legal Aid attorneys at MetroHealth sites to work with physicians to identify and address legal issues that impact health outcomes in patients. - North Coast Health Ministry is a free clinic providing health care services to low-income, uninsured men, women and children living in western Cuyahoga County. Kaiser Permanente's grant will support the Chronic Illness Management Program which seeks to prevent and minimize complications associated with chronic illnesses through a coordinated team of caregivers and leveraging prescription assistance programs to provide medications to patients at no cost. DEVELOPING AND DISSEMINATING KNOWLEDGE Kaiser Permanente aims to improve health by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Ohio Health Plan spent $514,260 to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Educational Theatre Programs (ETP) The Ohio Health Plan's Educational Theatre Programs is based upon a model for promoting health through theatre. KP staff collaborate with the Cleveland Metropolitan School District to train student actors as health education ambassadors and in turn deliver health messages to a broader audience of peers. The program is comprised of three productions: Secrets, focused on HIV/AIDS and other sexually transmitted diseases; The Amazing Food Detective, designed to educate elementary school students about the importance of good nutrition and exercise; and Peace Signs, a conflict resolution, violence prevention, and healthy choices production. Approximately 53 high school students worked as actors in the three productions; and presented 29 performances to 7,054 children and adults. Grants and Donations for Knowledge Dissemination Approximately $70 thousand in grants were awarded for programs related to evidence based medicine, prevention programs and health education. Following are a few examples of community based programs and services funded through the Kaiser Permanente's Thriving Communities Grants Program: Teens Talking to Teens (Triple T) is Planned Parenthood's flagship youth development program supporting the development of healthy lifestyles, responsible decision making, and leadership development amongst adolescents. Grant funds from Kaiser Permanente supported Triple T programs in East Cleveland and Akron. A grant from Kaiser Permanente assisted Providence House in piloting a Trauma Intervention and Therapy Program. Providence House is a crisis nursery offering shelter for at-risk children as well as education, mentoring, case management and aftercare focused on family preservation. The services of The Gathering Place's Children's Programs have been developed based on known data regarding the impact of family illness on children and also on the most widely accepted theories of child development and child mental health. During the grant period, a tool to assess the outcome of children's participation in various programs and services will be refined and piloted. OTHER COMMUNITY BENEFITS The Ohio Health Plan spent approximately $1.3 million to support a variety of other community benefit programs and services to improve community health. Youth and Other Self Sufficiency Programs The Ohio Health Plan supported 56 students in two different programs. The Y.O.U. program offers economically disadvantaged high school students in Ohio with supportive and meaningful employment experiences in the health care field. Employment is during the summer months throughout the organization. INROADS focuses on developing minority college students for leadership roles in corporations and in the community. Student interns typically work two to five summers at Kaiser Permanente with the goal of permanent placement upon graduation from college.
Other Community Grants and DonationsThe Ohio Health Plan awarded 57 grants totaling $758,758 to various community-based organizations to support projects targeted towards children, youth and prevention initiatives. Following is an example of the grants and donations given to community organizations: The Cleveland Metropolitan School District's Students of Promise Program, also known as Closing the Achievement Gap (Program) was created based on the understanding that there should be no 'reason' for Cleveland's African American male students to drop out of high school. 'Reasons' can be affected by family, school or community and may include a lack of connection to the school environment, such as: a perception that school is boring, feeling unmotivated, not getting along with teachers, and not understanding the academic material and the weight of real world events. A comprehensive approach was designed based on using multiple interventions to address the whole student, which includes addressing both the academic and social-emotional learning needs. St. Martin de Porres' unique partnership with the greater Cleveland business community has been identified as a leading indicator of student's persistence rate in college. Each Saint Martin student works in a job-sharing team comprised of four students. Working in a rotating schedule, each team fills one full time equivalent job in a standard Monday-Friday business week schedule. The program sets the tone for student behavior and expectations in the workplace and in the classroom. The program also provides meaningful opportunities for professionals to interact with and mentor their student workers while making a difference in their lives. The Diversity Center has honored men and women of outstanding dedication and community service in our region at the annual Humanitarian Award Dinner. Nominees exhibit an extensive record of involvement in civic, charitable, volunteer, and professional organizations. Each nominee has contributed to the improvement of human relations among diverse groups in Northeast Ohio. Regional Community Benefit Operations The Ohio Health Plan has a dedicated Community Benefit Department with three full time employees to coordinate CB initiatives and support regional community benefit programs and services. ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - OHIO REGION The following chart summarizes the 2011 Community Benefit investments by the Ohio Health Plan. The investments in the community reflected in the chart are unaudited. CARE & COVERAGE Charitable Care & Coverage Programs $ 7,905,437 Government Sponsored Programs 1,455,045 Grants/Donations for Care and Coverage 505,000 Care & Coverage CB Operations 46,155 Subtotal: $ 9,911,637 COMMUNITY HEALTH INITIATIVES Grants/Donations for Community Health Initiatives $ 330,646 Community Health Initiatives CB Operations 33,009 Subtotal: $ 363,655 SAFETY NET PARTNERSHIPS Grants/Donations for Safety Net Partnerships $ 228,346 Subtotal: $ 228,346 KNOWLEDGE DISSEMINATION Medical Research $ 206,120 Educational Theatre Program 153,914 Health Care Training & Education Programs 84,486 Grants/Donations for Knowledge Dissemination 69,740 Subtotal: $ 514,260 OTHER COMMUNITY BENEFITS Self Sufficiency Programs $ 23,966 Grants/Donations for Other Community Benefits 758,758 Other CB Operations 489,363 Subtotal: $ 1,272,087 TOTAL $12,289,985
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Christine Cassel TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Thomas Chapman TITLE:Director HOURS:9
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Daniel Garcia TITLE:SVP, Chief Compliance Officer HOURS:48
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:William Graber TITLE:Director HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:J. Eugene Grigsby III TITLE:Director HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:George Halvorson TITLE:Chairman and CEO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Judith Johansen TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Kim J. Kaiser TITLE:Director HOURS:8
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HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Margaret E Porfido TITLE:Director HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Daniel Beck TITLE:VP, Regional Counsel - Ohio HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Patricia Kennedy-Scott TITLE:Region President - Ohio HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Thomas Meier TITLE:SVP, Corporate Treasurer HOURS:47
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Donald Orndoff TITLE:SVP, NFS HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROCHELLE ROTH TITLE:SENIOR DIRECTOR,QRM HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Arthur Southam TITLE:EVP, Health Plan Operations HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Deborah Stokes TITLE:SVP, CC & CAO HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Bernard Tyson TITLE:President & COO HOURS:45
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Victoria Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Mark Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:48
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Donna Lynne TITLE:Group President HOURS:46
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Craig M. Faerber TITLE:VP, CFO - Ohio HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Pamela Hara TITLE:VP, Quality/Service HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Joseph M LaGuardia TITLE:VP, Mktg, Sls & Bus Devel HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Thomas Revis TITLE:VP, CFO - Ohio HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Belva Tibbs TITLE:VP, Medical Operations HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Timothy Alberts TITLE:VP, Human Resources HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Heather Bossin TITLE:Dir, Financial Services HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Carolyn Hightower TITLE:VP, Regional HP Admin - OH HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Michelle Richter TITLE:Dir, Group Sales and Acct Mgmt HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Jeffrey Wallace TITLE:Dir, Pharmacies HOURS:20
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Steven Zatkin TITLE:Consultant HOURS:

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OHP
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Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

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Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

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Transactions Related Orgs Table TransactionsRelatedOrgsTable (36 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
KAISER FOUNDATION HEALTH PLAN INC
K2735910PER AGREEMENT
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