UNIVERSITY HOSPITALS HEALTH SYSTEM INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: UNIVERSITY HOSPITALS HEALTH SYSTEM INC (EIN 34-1425870)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-11-17
IRS object ID: 201413219349306356
Schema version: 2013v3.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule J
Schedule K
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2014-11-17T13:11:27-06:00	ReturnTs
Tax Period End	2013-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	420714325	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MCGLADREY LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1001 Lakeside Ave Suite 200	AddressLine1
City	Cleveland	City
State	OH	State
ZIP Code	441141152	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	341425870	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Lake Hospital System Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	LAKE	BusinessNameControlTxt
Phone	4403541991	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7590 Auburn Road	AddressLine1
City	Concord	City
State	OH	State
ZIP Code	44077	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL KITTOE	PersonNm
Person Title	Senior VP & CFO	PersonTitleTxt
Phone	4403541991	PhoneNum
Signature	2014-11-17	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ZACHARY FORTSCH	PreparerPersonNm
PTIN	P00052725	PTIN
Phone	2165231900	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Lake Health	BusinessNameLine1

Field	Value	IRS element (for citing)
Principal Officer	Cynthia Moore-Hardy	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7590 Auburn Road	AddressLine1
City	Concord	City
State	OH	State
ZIP Code	44077	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$475,937,349	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.lakehealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1983	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	To provide health care services to the residents of Lake County and neighboring communities in partnership with those who share a commitment to local access, healing with compassion and superior quality.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	3131	TotalEmployeeCnt
Total Volunteers	1010	TotalVolunteersCnt
Total Gross UBI	$1,302,457	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,609,785	PYContributionsGrantsAmt
CY Contributions Grants	$1,399,033	CYContributionsGrantsAmt
PY Program Service Revenue	$348,034,859	PYProgramServiceRevenueAmt
CY Program Service Revenue	$334,131,502	CYProgramServiceRevenueAmt
PY Investment Income	$5,742,827	PYInvestmentIncomeAmt
CY Investment Income	$5,173,201	CYInvestmentIncomeAmt
PY Other Revenue	$7,762,499	PYOtherRevenueAmt
CY Other Revenue	$9,901,395	CYOtherRevenueAmt
PY Total Revenue	$364,149,970	PYTotalRevenueAmt
CY Total Revenue	$350,605,131	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$143,698,287	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$137,000,217	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$206,900,868	PYOtherExpensesAmt
CY Other Expenses	$208,126,992	CYOtherExpensesAmt
PY Total Expenses	$350,599,155	PYTotalExpensesAmt
CY Total Expenses	$345,127,209	CYTotalExpensesAmt
PY Revenues Less Expenses	$13,550,815	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$5,477,922	CYRevenuesLessExpensesAmt
Total Assets BOY	$529,786,022	TotalAssetsBOYAmt
Total Assets EOY	$538,843,712	TotalAssetsEOYAmt
Total Liabilities BOY	$305,994,812	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$278,825,573	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$223,791,210	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$260,018,139	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	It is Lake Hospital System's mission to provide comprehensive health care services to the residents of Lake County and neighboring communities in partnership with those who share a commitment to local access, healing with compassion and superior quality.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$307,806,567	ExpenseAmt
Revenue	$333,068,962	RevenueAmt
Desc	As an independent, community-based hospital system, Lake Hospital System, Inc., DBA Lake Health, has had a long-standing tradition of providing services and programs based on the health care needs of the communities that we serve. We are guided by our mission to provide local access, healing with compassion and superior quality and our core values - respect, innovation, teamwork, stewardship, and integrity. Lake Health's growth as a community-based health care system continues to build on its long history of providing progressive, personalized care that you normally wouldn't expect to find at a community hospital. Guided by a collaborative health needs assessment conducted in cooperation with the Lake County General Health District, Lake Health has developed (refer to Sch O, pg. 70 for additional information)program services and partnerships to address the most pressing health issues. The high priority areas include obesity, inactive lifestyles, and smoking. Lake Health is comprised of 14 facilities in Lake, Geauga, and Cuyahoga counties, which include the following:1. TriPoint Medical Center (full-service, acute care hospital)2. West Medical Center (full-service, acute care hopsital)3. Mentor Campus (outpatient lab and diagnostics, physician offices, cancer services)4. Chardon Campus (urgent care, outpatient lab and diagnostics, physician offices)5. Willowick Campus (urgent care, outpatient lab and diagnostics, physician offices)6. Tyler Blvd. Urgent Care (urgent care, occupational health)7. Madison Campus (free-standing ER, outpatient lab and diagnostics, physician offices, physical therapy)8. Clinic at Madison (walk-in care located in Walmart Supercenter)9. Painesville Quick Care Center (walk-in care)10. Mentor Diagnostics (outpatient imaging)11. Willoughby Hills Diagnostics (outpatient imaging)12. Lyndhurst Diagnostics (outpatient imaging)13. Mentor Physical Therapy (physical therapy)14. Willoughby Physical Therapy (physical therapy)Accessibility is key to our mission. We have contracted with most insurance providers to ensure a vast array of primary care physicians and specialists. Lake Health also operates three full-service emergency departments within Lake County at TriPoint Medical Center in Concord Township, West Medical Center in Willoughby, and the free-standing Madison Emergency Department within the Madison Campus. These emergency departments are open to all persons, regardless of ability to pay. For the twelfth year in a row, we were honored as one of Northcoast 99's "Best Places to Work in Northeast Ohio." Our growth as a hospital system reflects the many ways we are building on our mission and how we aspire to be more than your typical community hospital. We want our patients to receive superior patient care without having to leave the community, and that's why we are committed to bringing the best resources together to provide an expanded level of community care. Lake Health provides services and programs based on the health care needs of the communities we serve. In fact, taking health programs and screenings to where people live, work and play is fundamental to our mission. In 2013, we provided just under $23,844,000 in financial assistance and certain other community benefits at cost through our health system operations in Lake and Geauga counties. This includes over 250 community education programs. We also contributed over $340,000 in 2013 in cash and in-kind donations to civic and community events, programs, and partnerships with a health and wellnes focus. Some of the programs and events are highlighted below. Many of them are facilitated through our Health Promotion Department and/or our community outreach coordinator. Community Programs and Events:-American Heart Walk-Hands-only CPR training-Cardiac Health Education Programs-Baby Talk programs including Childbirth Preparation, Infant Care, Breastfeeding Program, Sibling Program, Infant and Child CPR, TEEN Childbirth Preparation, Caring for Kids, and Car Seat Checks. -Get Healthy Lake County B Fit 4 Life-Healthy Heart Program-LifeCycles for Women lectures-Senior Connection Lunch & Learn programs-Support Groups which include Breast Cancer, Diabetes, Mended Hearts Cardiac, Pulmonary, and Stroke-Participation in the United Way Day of Caring-Women's Health Screening ProjectLake Health joined forces with Lake Metroparks, Lake County YMCA, and the Lake County General Health District again in 2013 to continue B Fit 4 Life (formerly Get Healthy Lake County), a countrywide initiative that features education, prevention, and wellness programs to enhance and improve the quality of life in Lake County and neighboring communities. The initiative includes the B Fit 4 Life Corporate Challenge in which area businesses vie for the most points as their employees exercise their way to better health.	Desc
Total Program Service Expenses	$307,806,567	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	325	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3131	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Chuck Josey VP of Finance	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	4403541991	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7590 Auburn Road	AddressLine1
City	Concord	City
State	OH	State
ZIP Code	44077	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Bruce M Kephart
Chair	0.10	0.00	Yes (X)	Yes (X)	$0	$0	$0
Thomas P Jubeck
Vice Chair	0.10	0.00	Yes (X)	Yes (X)	$0	$0	$0
Michael E Mayher
Treasurer	0.10	0.00	Yes (X)	Yes (X)	$0	$0	$0
Timothy Doyle MD
Secretary	0.10	0.00	Yes (X)	Yes (X)	$0	$0	$0
Kathleen Bates
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
I James Hackenberg Esq
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
Frank Myers DO
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
Susan McGuinness RN PhD
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
John F Platz
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
Robert G Schiebli
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
Paul C Sirko
Trustee	0.10	0.00	Yes (X)		$0	$0	$0
Cynthia Moore-Hardy
President & CEO	40.00	0.00		Yes (X)	$659,251	$0	$106,272
Michael E Kittoe
Senior VP & CFO	38.00	2.00		Yes (X)	$384,494	$0	$30,483
Steven R Karns
Senior VP Administrative Services	40.00	0.00			$267,556	$0	$34,678	Yes (X)
Richard D Cicero
Senior VP Business Development	37.00	3.00			$236,586	$0	$17,484	Yes (X)
Michael Goler MD
Senior VP Medical Affairs	39.00	1.00			$202,795	$0	$41,631	Yes (X)
Mary L Ogrinc
Chief Nursing Officer	40.00	0.00			$242,235	$0	$39,895	Yes (X)
Joyce A Taylor
VP Quality Services	40.00	0.00			$201,596	$0	$25,934		Yes (X)
Cynthia J Racer
VP Clinical Services	40.00	0.00			$169,839	$0	$8,902		Yes (X)
Craig J Ghidotti
VP Human Resources	40.00	0.00			$156,984	$0	$16,070		Yes (X)
Andrea Wasdovich
VP Perioperative & Critical Care Services	40.00	0.00			$163,368	$0	$19,222		Yes (X)
Greg Sanders
Director of LH Foundation	1.00	39.00			$154,528	$0	$9,154		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,839,232	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$349,725	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	84	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
Sodexo Inc & Affiliates
9801 Washingtonian Boulevard	Gaithersburg	MD	20878	Facilities Services	$2,874,651
Crothall Healthcare Inc
955 Chesterbrook Blvd Ste 300	Wayne	PA	19087	Facilities Services	$2,828,448
Siemens Medical Solutions USA Inc
51 Valley Stream Parkway	Malvern	PA	19355	Medical Services	$1,927,288
American Red Cross
3747 Euclid Ave	Cleveland	OH	44115	Medical Services	$1,547,399
Toshiba American Medical Systems Inc
2441 Michelle Drive	Tustin	CA	92780	Medical Services	$1,387,433

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	219	CntrctRcvdGreaterThan100KCnt
Related Organizations	$823,033	RelatedOrganizationsAmt
Government Grants	$576,000	GovernmentGrantsAmt
Noncash Contributions	$300,000	NoncashContributionsAmt
Total Contributions	$1,399,033	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Patient Care	Desc
Business	621110	BusinessCd
Total Revenue Column	$334,131,502	TotalRevenueColumnAmt
Related Or Exempt Func Income	$333,068,962	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,062,540	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$334,131,502	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,096,296	TotalRevenueColumnAmt
Exclusion	$5,096,296	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$230,571	TotalRevenueColumnAmt
Exclusion	$230,571	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,497,126	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,497,126	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,497,126	TotalRevenueColumnAmt
Unrelated Business Revenue	$239,917	UnrelatedBusinessRevenueAmt
Exclusion	$2,257,209	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$125,178,552	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$125,332,218	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$153,666	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$153,666	TotalRevenueColumnAmt
Exclusion	-$153,666	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CMS Incentive Payments	621110	$3,632,101	$3,632,101
Related Sales and Sevices	621110	$886,650	$886,650
Purchase Discounts	621110	$551,522	$551,522

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,333,996	TotalRevenueColumnAmt
Exclusion	$2,333,996	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$7,404,269	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$350,605,131	TotalRevenueColumnAmt
Related Or Exempt Func Income	$333,068,962	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,302,457	UnrelatedBusinessRevenueAmt
Exclusion	$14,834,679	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,163,151	TotalAmt
Management And General	$2,163,151	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$112,686,173	TotalAmt
Program Services	$101,417,556	ProgramServicesAmt
Management And General	$11,268,617	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,064,019	TotalAmt
Program Services	$1,857,617	ProgramServicesAmt
Management And General	$206,402	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$11,791,308	TotalAmt
Program Services	$10,612,177	ProgramServicesAmt
Management And General	$1,179,131	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$8,295,566	TotalAmt
Program Services	$7,466,009	ProgramServicesAmt
Management And General	$829,557	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$4,413,183	TotalAmt
Program Services	$1,765,273	ProgramServicesAmt
Management And General	$2,647,910	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$598,909	TotalAmt
Management And General	$598,909	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$156,204	TotalAmt
Program Services	$4,686	ProgramServicesAmt
Management And General	$151,518	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$950,683	TotalAmt
Management And General	$950,683	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$48,147,905	TotalAmt
Program Services	$38,518,323	ProgramServicesAmt
Management And General	$9,629,582	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,119,383	TotalAmt
Program Services	$2,651,476	ProgramServicesAmt
Management And General	$467,907	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,122,887	TotalAmt
Program Services	$6,904,454	ProgramServicesAmt
Management And General	$1,218,433	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,159,296	TotalAmt
Program Services	$6,935,402	ProgramServicesAmt
Management And General	$1,223,894	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,274,846	TotalAmt
Program Services	$12,847,361	ProgramServicesAmt
Management And General	$1,427,485	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$722,438	TotalAmt
Program Services	$614,072	ProgramServicesAmt
Management And General	$108,366	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$428,705	TotalAmt
Program Services	$364,399	ProgramServicesAmt
Management And General	$64,306	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,606,483	TotalAmt
Program Services	$4,765,511	ProgramServicesAmt
Management And General	$840,972	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$26,588,167	TotalAmt
Program Services	$25,258,759	ProgramServicesAmt
Management And General	$1,329,408	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,806,909	TotalAmt
Program Services	$2,939,284	ProgramServicesAmt
Management And General	$867,625	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$41,423,416	$41,423,416
Bad Debt	$35,636,045	$35,636,045
Hospital Franchise Fee	$4,574,231	$4,574,231
Membership Dues	$733,929	$587,143	$146,786

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$663,373	TotalAmt
Program Services	$663,373	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$345,127,209	TotalAmt
Program Services	$307,806,567	ProgramServicesAmt
Management And General	$37,320,642	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$10,838,946	BOYAmt
EOY	$4,052,187	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$40,867,146	BOYAmt
EOY	$37,957,265	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,072,516	BOYAmt
EOY	$3,683,797	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,595,271	BOYAmt
EOY	$11,417,365	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$496,938,092	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$255,344,247	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$250,066,431	BOYAmt
EOY	$241,593,845	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$201,518,033	BOYAmt
EOY	$225,600,779	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$13,827,679	BOYAmt
EOY	$14,538,474	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$529,786,022	BOYAmt
EOY	$538,843,712	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$33,048,392	BOYAmt
EOY	$27,414,562	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$586,936	BOYAmt
EOY	$689,036	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$225,163,497	BOYAmt
EOY	$213,176,282	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$47,195,987	BOYAmt
EOY	$37,545,693	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$305,994,812	BOYAmt
EOY	$278,825,573	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$223,791,210	BOYAmt
EOY	$260,018,139	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$223,791,210	BOYAmt
EOY	$260,018,139	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$529,786,022	BOYAmt
EOY	$538,843,712	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$5,477,922	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$2,116,389	NetUnrlzdGainsLossesInvstAmt
Investment Expense	$950,683	InvestmentExpenseAmt
Other Changes In Net Assets	$31,914,713	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$13,203	OtherActivitiesAmt
Total Lobbying Expenditures	$13,203	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part II-B, Line 1b	Paid wages of VP, Governmental Affairs and Public Relations, in the context of networking and maintaining relationships with individuals and entities that create, influence, vote, or otherwise determine policy for the healthcare industry and hospitals specifically.
Part II-B, Line 1g	Occurs in the routine course of business for educational, compliance, and policy issues relative to Lake Health for the VP, Governmental Affairs and Public Relations.
Part II-B, Line 1i	Membership dues paid to Hospital industry Associations and Organizations, the percentage of which is reported under IRS rules as lobbying expense.

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,014,355	BeginningYearBalanceAmt
Contributions	$919,340	ContributionsAmt
Investment Earnings Or Losses	$479,684	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$24,327	GrantsOrScholarshipsAmt
Administrative Expenses	$698,398	AdministrativeExpensesAmt
End Year Balance	$4,690,654	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,906,425	BeginningYearBalanceAmt
Contributions	$271,543	ContributionsAmt
Investment Earnings Or Losses	$209,789	InvestmentEarningsOrLossesAmt
Administrative Expenses	$1,373,402	AdministrativeExpensesAmt
End Year Balance	$4,014,355	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,629,760	BeginningYearBalanceAmt
Contributions	$403,229	ContributionsAmt
Investment Earnings Or Losses	-$24,347	InvestmentEarningsOrLossesAmt
Administrative Expenses	$1,102,217	AdministrativeExpensesAmt
End Year Balance	$4,906,425	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,225,581	BeginningYearBalanceAmt
Contributions	$262,613	ContributionsAmt
Investment Earnings Or Losses	$104,682	InvestmentEarningsOrLossesAmt
Administrative Expenses	$963,116	AdministrativeExpensesAmt
End Year Balance	$5,629,760	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,735,829	BeginningYearBalanceAmt
Contributions	$582,250	ContributionsAmt
Investment Earnings Or Losses	$29,764	InvestmentEarningsOrLossesAmt
Administrative Expenses	$2,762,262	AdministrativeExpensesAmt
End Year Balance	$6,585,581	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.02030	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.58090	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.39880	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,956,999	OtherCostOrOtherBasisAmt
Book Value	$12,956,999	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$187,486,379	OtherCostOrOtherBasisAmt
Depreciation	$53,708,980	DepreciationAmt
Book Value	$133,777,399	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,272,115	OtherCostOrOtherBasisAmt
Depreciation	$1,082,115	DepreciationAmt
Book Value	$1,190,000	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$271,368,827	OtherCostOrOtherBasisAmt
Depreciation	$194,768,282	DepreciationAmt
Book Value	$76,600,545	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,853,772	OtherCostOrOtherBasisAmt
Depreciation	$5,784,870	DepreciationAmt
Book Value	$17,068,902	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$241,593,845	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Third Party Settlements	$3,088,822
Workers Compensation Liability	$2,167,321
Deferred Compensation	$2,163,929
Lease Obligation	$2,002,238
Accrued Self-Insurance	$1,118,636
Physician Agreements	$400,000
Interest Rate Swap	$26,604,747

Field	Value	IRS element (for citing)
Total Liability	$37,545,693	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part V, Line 4:	FormAndLineReferenceDesc
Explanation	Lake Health's permanent endowment and temporarily restricted endowment funds are held by the Lake Hospital Foundation, Inc. dba Lake Health Foundation (the "Foundation), a related organization. The Foundation's mission is to secure financial and non-financial support to use in realizing Lake Health's vision of providing health care for the community. The Foundation's sole member is Lake Health.	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investment	TypeOfActivitiesConductedTxt
Region Total Expenditures	$120,000	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continutation Total Office	0	ContinutationTotalOfficeCnt
Continutation Total Employee	0	ContinutationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$120,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$120,000	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent250	Yes (X)	Percent250Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,701,664	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,129,334	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,572,330	NetCommunityBenefitExpnsAmt
Total Expense	0.01610	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$28,327,618	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,764,750	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,562,868	NetCommunityBenefitExpnsAmt
Total Expense	0.05090	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,029,282	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,894,084	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,135,198	NetCommunityBenefitExpnsAmt
Total Expense	0.06700	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$611,416	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$611,416	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,843	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,843	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$340,425	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$340,425	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$956,684	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$956,684	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,985,966	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,894,084	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,091,882	NetCommunityBenefitExpnsAmt
Total Expense	0.06980	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$35,636,045	BadDebtExpenseAmt
Reimbursed By Medicare	$77,301,280	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$82,590,359	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$5,289,079	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (5 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 Mentor Surgery Center LLC
Outpatient surgical center	0.42000	0.00000	0.58000
2 Lake West Medical Specialists LLC
Medical Office Building	0.12000	0.00000	0.88000
3 Concord Medical Campus Physician Building LLC
Medical Office Building	0.51470	0.00000	0.48530
4 Mentor Medical Campus Physician Building LLC
Medical Office Building	0.40390	0.00000	0.39610
5 Lake PHO Inc
Physician services	0.50000	0.00000	0.50000

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd
LakeWest Medical Center
1	36000 Euclid Avenue	Willoughby	OH	44094	Yes (X)	Yes (X)	Yes (X)
TriPoint Medical Center
2	7590 Auburn Rd	Concord	OH	44077	Yes (X)	Yes (X)	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	LakeWest & TriPoint Medical Centers	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.lakehealth.org/about/health-ne	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	0	AllNeedsAddressedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (1)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	250.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (1)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	250.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
Medicaid Medicare	Yes (X)	MedicaidMedicareInd
State Regulation	Yes (X)	StateRegulationInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Attached To Invoice	Yes (X)	AttachedToInvoiceInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
LakeWest & TriPoint Medical Centers	Part V, Section B, Line 3: Lake Health identified community health needs by undergoing a needs assessment process. This process incorporated a comprehensive review by Lake Health's Senior Leadership Team along with secondary and primary data input compiled using the expertise of Dixon Hughes Goodman, LLP ("DHG") and Artower Advisory Services, LLC ("Artower"). The collective Community Health Needs Assessment ("CHNA") team reviewed several sources of quantitative health, as well as social and demographic data specific to Lake Health's service area. Lake Health also took advantage of this opportunity to collaborate with its administrators, physicians, public health agencies, and local organizations in identifying and addressing the needs of the community.
LakeWest & TriPoint Medical Centers	Part V, Section B, Line 4: As allowed by IRS guidelines, Lake Health decided to produce a joint CHNA report for its two Lake County hospitals, West Medical Center and TriPoint Medical Center. Guidelines state that collaborating facilities must define their communities to be the same and conduct a joint CHNA process.
LakeWest & TriPoint Medical Centers	Part V, Section B, Line 7: In acknowledging the wide range of priority health issues that emerged from the CHNA process, Lake Health will focus on those most within its immediate ability to influence.
LakeWest & TriPoint Medical Centers	Part V, Section B, Line 20d: Uninsured patients who do not qualify for Lake Health's financial assistance program are billed for gross charges and are offered a 30% prompt pay discount if payment is received within 30 days of the first patient statement or a payment plan is agreed upon. The maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have insurance covering such care.

Field	Value	IRS element (for citing)
Facility	46	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (46 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
Mentor Medical Campus
9485 Mentor Avenue Suite 101	Mentor	OH	44060	General Medical & Surgical Center-Outpatient
Madison Medical Campus
6270 North Ridge Rd	Madison	OH	44057	General Medical & Emergency Department
Lake County Family Practice
9500 Mentor Avenue Suite 100	Mentor	OH	44060	Physician Office
Willowick Urgent Care
29804 Lakeshore Blvd	Willowick	OH	44095	Urgent Care Center
Lyndhurst Diagnostic Center
5183 Mayfield Rd	Lyndhurst	OH	44124	Diagnostic Center
Tyler Urgent Care
7956 Tyler Blvd	Mentor	OH	44060	Urgent Care Center
LHPG OBGYN Women's Health Specialist
35040 Chardon Rd Bldg VII Suite 205	Willoughby Hills	OH	44094	Physician Office
Willoughby Hills Diagnostic Center
34600 Chardon Rd Unit H	Willoughby Hills	OH	44094	Diagnostic Center
Mentor Diagnostic Center
8401 Mentor Ave Suite B	Mentor	OH	44060	Diagnostic Center
LHPG Mentor IMED
9485 Mentor Avenue Suite 210	Mentor	OH	44060	Physician Office
LHPG Mentor Pediatrics
9485 Mentor Avenue Suite 101	Mentor	OH	44094	Physician Office
LHPG North Coast Family Practice
7580 Auburn Rd Suite 202	Concord	OH	44077	Physician Office
Chardon Urgent Care
510 Fifth Avenue	Chardon	OH	44024	Urgent Care Center
LHPG Madison Family Practice
6270 North Ridge Rd	Madison	OH	44057	Physician Office
LHPG OBGYN - Willow Medical
36001 Euclid Avenue Suite C-10	Willoughby	OH	44094	Physician Office
LHPG Willoughby IMED
36100 Euclid Avenue Suites 240 260	Willoughby	OH	44094	Physician Office
Lake Wellness and Rehabilitation
9170 Mentor Avenue	Mentor	OH	44060	Rehabilitation Clinic
LHPG Willoughby Pediatrics
36100 Euclid Avenue Suite 300	Willoughby	OH	44094	Physician Office
LHPG Madison Pediatrics
6270 North Ridge Rd	Madison	OH	44057	Physician Office
LHPG Willoughby Hills IMED
2747 SOM Center Rd Unit D	Willoughby Hills	OH	44094	Physician Office
LHPG Chardon Family Practice
510 Fifth Avenue Suite 130	Chardon	OH	44024	Physician Office
LHPG Mentor Family Practice
6990 Lindsay Drive 3	Mentor	OH	44060	Physician Office
LHPG Mentor General Surgery
9500 Mentor Avenue Suite 300	Mentor	OH	44060	Physician Office
LHPG Willowick Family Practice
29804 Lakeshore Blvd	Willowick	OH	44095	Physician Office
Madison Quick Clinic
6067 North Ridge Rd	Madison	OH	44057	Quick Clinic
LHPG Plastic Surgery
9500 Mentor Avenue Suite 200	Mentor	OH	44060	Physician Office
LHPG General Surgery
36060 Euclid Avenue Suite 204	Willoughby	OH	44094	Physician Office
LHPG Thomas Family Practice - Mentor
8316 Yellowbrick Rd	Mentor	OH	44060	Physician Office
LHPG Chardon Pediatrics
510 Fifth Avenue Suite 120	Chardon	OH	44024	Physician Office
Lake Wellness and Rehabilitation
34881 Euclid Ave	Willoughby	OH	44094	Rehabilitation Clinic
LHPG Orthopedic Surgery
36060 Euclid Avenue Suite 203	Willoughby	OH	44094	Physician Office
Painesville Quick Clinic
74 S Park Place	Painesville	OH	44077	Quick Clinic
LHPG Thomas Family Practice - Euclid
26151 Euclid Ave	Euclid	OH	44132	Physician Office
LHPG West Cardio Electrophysiology
36100 Euclid Avenue Suite 400	Willoughby	OH	44094	Physician Office
LHPG West IMED
36100 Euclid Avenue Suite 210	Willoughby	OH	44094	Physician Office
Middlefield Quick Clinic
15050 S Springdale Avenue	Middlefield	OH	44062	Quick Clinic
LHPG Mentor OBGYN
9485 Mentor Avenue Suite 202	Mentor	OH	44060	Physician Office
Painesville IMED
1223 Mentor Ave	Painesville	OH	44077	Physician Office
LHPG Sports Medicine & Rehab
36060 Euclid Avenue Suite 105	Willoughby	OH	44094	Physician Office
LHPG Integrative Medicine
9500 Mentor Avenue Suite 360	Mentor	OH	44060	Physician Office
Mentor Medical Physician Building
9485 Mentor Avenue Suites 200 203	Mentor	OH	44060	Physician Office
Hackett Medical Building
8300 Tyler Rd	Mentor	OH	44060	Physician Office
LHPG OBGYN
36001 Euclid Avenue Suite C-7	Willoughby	OH	44094	Physician Office
LHPG Bariatric Surgery
36100 Euclid Avenue Suite 170	Willoughby	OH	44094	Physician Office
LHPG Orthopedic Surgery
7580 Auburn Rd Suite 202	Concord	OH	44077	Physician Office
LHPG Vascular Surgery
36001 Euclid Avenue Suite B-1 B-3	Willoughby	OH	44094	Physician Office

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c:	The following steps will be followed to evaluate patient's requests for consideration under the Uninsured/Uncompensated Care Guidelines: Financial Interview: A hospital representative will discuss with patients their individual financial position and obtain from them information regarding their finances. This information will be recorded on the HCAP application. Patients will be requested to supply copies of their two most recent pay stubs for all family members employed, copies of the previous year's tax return and any other pertinent documentation supporting their financial position. Evaluation Process: The hospital representative will complete the Financial Interview Form. The hospital representative will evaluate the application to determine whether the patient may be eligible for welfare or Medicaid coverage. If this coverage is available, the representative will make arrangements with the patient for completion of the Medicaid eligibility forms. If welfare or Medicaid eligibility is not available, the patient will be sent an application and will be considered for uncompensated care. A copy of the application will be forwarded to the Patient Accounting department. Determination of Eligibility: The Patient Accounting department will review the application and the patient's qualification status under the uninsured/uncompensated care guidelines. If the patient qualifies for uninsured/uncompensated care and services are provided, then the adjustment will be recorded as an adjustment from charges for Lake Hospital's Uninsured/Uncompensated Charity Care. Patients Not Eligible: Patients who are determined not to be eligible under the guidelines will be requested to pay a deposit equal to 50% of the estimated patient responsibility for either the elective inpatient or outpatient services, and to make arrangements for a payment plan to satisfy the remaining balance after services are provided. Eligibility: Each admission represents a separate financial encounter and will be evaluated with new data to determine if a change has taken place. Each outpatient application will be reviewed to determine if there has been any change in financial status. A new application will be required each month.
Part I, Line 7:	A cost-to-charge ratio is used. This ratio takes the total costs, including allocated costs from overhead departments, of providing patient care divided by total gross revenue.
Part I, Line 7g:	Subsidized health services include various free community screening events for health conditions such as blood pressure, cholesterol, bone density, prostate cancer, skin cancer, heart disease and obesity.Part I, Line 7, Column (f):Explanation: An estimated provision for uncollectible accounts is recorded that results in net patient service revenue being reported at the estimated amounts expected to be collected. Patient accounts receivable are reduced by an allowance for uncollectible accounts. The estimation of the allowance for uncollectible accounts is based primarily on the type and age of the patient accounts receivable and the effectiveness of collection efforts. The policy is to reserve a portion of all self-pay receivables, including amounts due from the uninsured and amounts related to co-payments and deductibles, as these charges are recorded. Patient accounts receivable balances and the effectiveness of the reserve policies are reviewed on a monthly basis, and various analytics support the basis for the estimates. Routine hindsight procedures are performed to evaluate historical write-off and collection experience to determine the reasonableness of the process for estimating the allowance for bad debt. Charity care and other community benefits as a percentage of expense is calculated using total expenses from Form 990, Part IX less bad debt expense of $35,636,045 from Part IX.
Part II, Community Building Activities:	Community advisory groups have been in place for 10 years. These distinct groups represent women, seniors and past patients of the system. Each group is made up of approximately 20 members. Quarterly meetings are held in which education is followed by input on specific programs or improvements being considered. The groups are moderated by a third-party facilitator to avoid biasing the groups. The information from these groups has been used to inform Lake Health management on issues ranging from way-finding to program needs. Coalition BuildingLake Health is involved in many community coalitions and partnerships to improve the health of individuals in the service area. Some of these include participation in the Lake County Strategic Plan, ACHIEVE (a community coalition to improve the environment in Lake County), and United Way programs designed to improve health, particularly in vulnerable communities.
Part III, Line 2:	Bad debt is estimated using a hind sight analysis on previous years accounts receivable. Those percentages are then applied to current year accounts receivable by payor to estimate the amount of uncollectible. Anything over 365 days is fully reserved.
Part III, Line 4:	The allowance for uncollectible accounts was approximately $22.8 million and $35.2 million at December 31, 2013 and 2012, respectively. The System's allowance for uncollectible accounts covered approximately 79.6% and 83.5% of combined self-pay and self-pay after insurance patient accounts receivable at December 31, 2013 and 2012, respectively. The System experienced an interruption in the processing of self-pay write-offs during 2012 which resulted in an increase in the provision for uncollectible accounts and a back-log of unprocessed self-pay write-offs at December 31, 2012. Self-pay write-offs were $49.1 million in 2013 compared to $16.3 million in 2012. The higher self-pay write-offs in 2013 and corresponding decrease in the estimated provision for uncollectible accounts was a result of resolving the backlog.
Part III, Line 8:	Based on a cost to charge ratio determined in accordance with Medicare cost report requirements, the costs of providing care to the Medicare population in 2013 was $82,590,359. The payments related to these services were $77,301,280 leaving a Medicare shortfall of $5,289,079 for the year. The Medicare shortfall is a community benefit because providing services to the elderly is a tax-exempt purpose consistent with the Hospital's overall tax exempt status, and the Hospital accepts these patients regardless of its impact on overall profitability.
Part III, Line 9b:	Provisions On Collection Practices For Qualified Patients:Patients who do not have the means to pay for services provided at Lake Hospital System request to be considered under the Uninsured/Uncompensated Charity Care Guidelines. These guidelines define Lake Hospital System's commitment to providing care to patients who are in the greatest financial need. Patients who do not have insurance coverage, or whose out of pocket responsibility is substantial after insurance coverage, or whose income level is at or below 250% of the Federal Income Poverty Guidelines, are eligible to apply for uninsured charity care assistance. The uninsured/uncompensated charity care program does not relieve nor forgive point-of-service copayments that the patient may be required to pay under the terms of their insurance benefit plan. Per visit copayments will be collected at the point of service in compliance with the insurance benefit terms. ProcedureEligibility for Lake's uninsured/uncompensated care is determined by the following two-part test. The Lake Hospital Systems Uninsured/Uncompensated Care Program requires patients to meet at least one condition in both part one and part two: Part One: Insurance Test1. Patient does not have governmental or private insurance coverage; or2. Patient's insurance does not cover the medically necessary service; or3. Patient's insurance benefits are exhausted (i.e. Lifetime Reserve Days, Medicare); or4. Patient has or will obtain medically necessary services from the Hospital for which they do not have the financial means to pay; or5. Patient is responsible for co-payments and deductibles, carries no secondary insurance coverage and only source of income is Social Security.Part Two: Income test (relative to Lake Hospital charges)1. Family income is compared to the Federal Poverty Income Guidelines (family includes patient, patient's spouse, and all of the patient's children, natural or adoptive, under the age of eighteen who live in the home). The schedule shown below will be used to compare family income to a sliding scale based upon the Federal Poverty Income Guidelines. If family income is at or below the designated threshold, the patient is eligible for the percent charity discount associated with that level of income; or 2. The relationship between the patient's medical bills, family income and family assets (including, but not limited to such items as bank accounts, trusts, property, home equity, estate or investments) indicates that the pursuit of payment would adversely affect the well being of the patient and family members, and where the payment of Lake Hospital's bill would result in undue hardship; or3. Patient's family income exceeds 250% of the Federal Income Poverty Guidelines, however patient has supplied information to support exceptional living circumstances (i.e. terminal illness, excessive medical bills and/or medications, etc.) or 100% of incurred charges greater than 25% of annual family income (including bank accounts, trusts and investments, but excluding primary residence). Before Uninsured/Uncompensated Care can be awarded, the following conditions must be met: 1. If Lake Hospital determines that the patient is potentially eligible for medical assistance, the patient must cooperate with Lake Hospital's efforts to establish eligibility for government assistance programs. 2. If Lake Hospital awards Uninsured/Uncompensated Care, it will only cover the services provided under the account number(s) shown on the accompanying application. 3. Proof of income and financial documentation will be requested. (See Hospital Care Assurance Policy.)
Part VI, Line 7, Reports Filed With States	OH
Part VI, Line 2	As an independent, community-based hospital system, Lake Health has had a long-standing tradition of providing services and programs based on the health care needs of the communities we serve. We are guided by our mission to provide local access, healing with compassion and superior quality and our core values - respect, innovation, teamwork, stewardship and integrity. Guided by a collaborative health needs assessment conducted in cooperation with the Lake County General Health District, Lake Health has developed programs, services and partnerships to address the most pressing health issues. The high priority areas include obesity, inactive lifestyles, and smoking. Programs designed to address weight management span from early childhood through mature adults. Get Healthy Lake County is now in its ninth year of operation and has nearly 2,500 members. Our growth as a health system reflects the many ways we are building on our mission and how we aspire to be more than your typical community hospital. We want our patients and their families to receive superior care without having to leave the community. That's why we are committed to offering the best resources to provide an expanded level of care to meet the needs of the community.
Part VI, Line 3	1. Signage posted at facility access points for patients who cannot afford to pay for medical care. 2. Charity/HCAP application forms given to self-pay patients at time of registration. Explanation of assistance provided to complete application if needed. 3. Uninsured inpatients are visited bedside to assist with the completion of the Charity/HCAP application and also to provide application assistance with other programs such as Medicaid, food stamps, etc. 4. Uninsured patients who receive outpatient services are contacted by phone to assist with the Charity/HCAP application and other programs listed above. 5. Charity/HCAP application appears on the back of all patient statements. 6. Charity/HCAP application appears on Lake Health website.
Part VI, Line 4	Lake Health's primary service area is Lake County (population about 230,000) and selected zip codes in its secondary service areas (Cuyahoga, Ashtabula, and Geauga counties with a population in the defined zip codes of 268,113).
Part VI, Line 5	Prior to 1985, Lake Health's facilities were publicly operated as Lake County Memorial Hospitals. However, in 1985 the board of county commissioners and hospital trustees agreed to privatize the hospital to ensure the viability of a technologically progressive hospital system for Lake County residents. County commissioners serve as members of the Lake Hospital Corporation and, as such, appoint the community leaders who serve on the system's governing board. Lake Health has an open medical staff with privileges available to all qualified physicians in the area. Over 550 physicians comprise Lake Health's medical staff. Lake Health's commitment to the community is readily apparent in the Board of Trustees which is comprised solely of community members, appointed by the County Commissioners. All proceeds are reinvested in capital or other programs and services designed to meet the communities we serve. Lake Health provides services and programs based on the health care needs of the communities we serve. In fact, taking health programs and screenings to where people live, work, and play is fundamental to our mission. In 2013, we provided just under $23,844,000 in financial assistance and certain other community benefits at cost through our health system operations in Lake, Geauga, and Cuyahoga counties. This includes community education programs, excluding blood drives. During these community events and health fairs, we performed over 2,268 blood pressure checks, cholesterol screenings, glucose, heel screenings, skin cancer screenings, and prostate cancer screenings for free or at low cost. Lake Health's commitment to health improvement services that provide a demonstrated community benefit can be broadly categorized into three areas: Community Health Education, Community-Based Clinical Services, and Cash and In-Kind Gifts. Some of the programs and events are highlighted below. Community Health EducationLake Health has an extensive community health program that provides health screenings, physician lectures, self-help, and exercise programs in multiple community locations throughout Lake County and surrounding areas. Our support groups help meet educational and emotional needs related to a variety of conditions. We also partner with many local organizations, including the United Way, the American Red Cross, the American Heart Association, the Arthritis Foundation, the Lake County Y, and the Lake Metroparks to inrease awareness of health issues in the community. These programs and services include:A. Community Calendars and Newsletters:The Best of Health MagazineCalendar of Events in the News-HeraldHealth Talks in the News-Herald (weekly)B. Education on Specific Disease Conditions:Senior Connection Lunch and LearnsCommunity Health Lecture SeriesLifeCycles for Women Lecture SeriesRunner's ClinicOrthopedic and Spine Center SymposiumArthritis ExpoKnow Your Numbers (cardiac event)Diabetes Education eventC. Health Promotion and Wellness Programs:B Fit 4 LifeD. Education to the Public about Health Issues:Information through media releasesE. School Health Education Programs:Healthy Heart School ProgramF. Web-based Consumer Health Information:Regarding Health E-NewsletterConstant Contact E-blastsG. Social Media Consumer Health Information:Facebook posts and remindersTwitter posts and remindersYouTube videosI. Self-Help:Boning Up on OsteoporosisWeight 4 Life Weight Management ProgramOne of the many ways Lake Health is building the community is through strong partnerships with others who share our commitment to local access, healing with compassion, and superior quality. Lake Health joined forces with Lake Metroparks, Lake County YMCA, and the Lake County Health District to launch B Fit 4 Life.
Part VI, Line 6	Lake Hospital System, Inc. dba Lake Health is the primary healthcare-providing entity which operates two hospital facilities and several other outpatient, urgent care and physician clinics throughout Lake County and the surrounding community. Lake Health is the sole member of Lake Health Foundation, Inc. dba Lake Health Foundation, a not-for-profit organization which is the fundraising arm of Lake Health. Lake Health is also the sole member of PrimeHealth, Inc. dba Lake Health Physician Grouop ("LHPG") which employs Lake Health's network of physicians. Lake Health is a 50% shareholder in Lake PHO, Inc. dba Lake Health PHO ("the PHO") which is a physician credentialing and membership organization. Physicians must be a member of the PHO in order to practice medicine at a Lake Health hospital or physician clinic. The Lake Health / University Hospitals Seidman Cancer Center is a joint venture between Lake Health and University Hospitals Health System of Cleveland that provides cancer treatment in Mentor, Ohio. Mentor Surgery Center, LLC, Mentor Medical Campus Physician Building, LLC, Lake West Medical Specialists, Inc., and Concord Medical Campus Physicians Building, Inc. are entities in which Lake Health owns a minority stake. These entities lease medical office space at which both Lake Health and non-affiliated practitioners practice.
Part VI, Line 7, List of States Receiving Community Benefit Report:	OH

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Cynthia Moore-Hardy
President & CEO	$609,488	$0	$0	$0	$49,763	$0	$99,703	$0	$6,569	$0	$765,523	$0	$0	$0
Michael E Kittoe
Senior VP & CFO	$367,809	$0	$7,138	$0	$9,547	$0	$24,710	$0	$5,773	$0	$414,977	$0	$0	$0
Steven R Karns
Senior VP Administrative Services	$237,795	$0	$7,554	$0	$22,207	$0	$26,161	$0	$8,517	$0	$302,234	$0	$0	$0
Richard D Cicero
Senior VP Business Development	$225,897	$0	$4,850	$0	$5,839	$0	$11,624	$0	$5,860	$0	$254,070	$0	$0	$0
Michael Goler MD
Senior VP Medical Affairs	$165,220	$0	$15,000	$0	$22,575	$0	$37,733	$0	$3,898	$0	$244,426	$0	$0	$0
Mary L Ogrinc
Chief Nursing Officer	$212,031	$0	$6,000	$0	$24,204	$0	$36,340	$0	$3,555	$0	$282,130	$0	$0	$0
Joyce A Taylor
VP Quality Services	$190,031	$0	$5,482	$0	$6,083	$0	$23,000	$0	$2,934	$0	$227,530	$0	$0	$0
Cynthia J Racer
VP Clinical Services	$168,948	$0	$0	$0	$891	$0	$2,615	$0	$6,287	$0	$178,741	$0	$0	$0
Craig J Ghidotti
VP Human Resources	$156,448	$0	$0	$0	$536	$0	$8,190	$0	$7,880	$0	$173,054	$0	$0	$0
Andrea Wasdovich
VP Perioperative & Critical Care Ser	$162,483	$0	$0	$0	$885	$0	$13,000	$0	$6,222	$0	$182,590	$0	$0	$0
Greg Sanders
Director of LH Foundation	$146,968	$0	$3,000	$0	$4,560	$0	$3,314	$0	$5,840	$0	$163,682	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 1a	Lake Hospital System, Inc.'s CEO received reimbursement for country club dues in 2013 which were included in taxable income.
Part I, Line 4b	Lake Hospital Systems, Inc.'s CEO was credited with a contribution of $66,035 to her 457(f) account in 2013.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
County of Lake Ohio Series 2008
A	346001618	50943PBL2	2008-06-26	$187,820,719	See Part VI	0	0	0
County of Lake Ohio Series 2012
B	346001618	NoneAvail	2012-06-15	$145,275,000	See Part VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$114,200,000	$188,051,290	$2,057,642	$1,808,396	$57,940	$183,896,741	2009	Yes (1)	0	Yes (1)	Yes (1)
B	$1,750,000	$145,275,000		$511,289		$144,763,711	2012	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	Yes (1)	Yes (1)	0	0	0	Yes (1)
B	0	0	Yes (1)	Yes (1)	0	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	0	0	Yes (1)	Yes (1)	0	0	0	Yes (1)
B	0	Yes (1)	0	0	Yes (1)	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Date Rebate Computation Performed	Issuer Name: County of Lake, Ohio Series 2008 Date the Rebate Computation was Performed: 10/01/2012
Schedule K, Part I, Line A, Column (f)	Description of purpose: Construct a hospital; refunding of Series 2004 (issued on 08/15/2004) and Series 2007 (issued on 08/15/2007).
Schedule K, Part I, Line B, column (f)	Description of purpose: Construct a hospital; refunding of Series 2002 (issued on 12/01/2002), Series 2008A (issued on 08/15/2008) and Series 2008B (issued on 08/15/2008).
Schedule K, Part I, Column (e) & Schedule K, Part, II, Line 3: The	difference between issue price in Part I, Column (e) and the total proceeds of issue in Part II, Line 3 is investment income earned on bond escrow before the bond proceeds were expended.

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	Equipment	Desc
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$300,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Column (b):	FormAndLineReferenceDesc
Explanation	is the number of contributions.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section B, line 11	The process followed before filing the Lake Hospital Systems, Inc. Form 990 includes a detailed review completed by an independent outside CPA firm, presentation to and review by the LHS CFO and CEO, presentation and review by the LHS Finance Committee, and presentation to the LHS Board of Trustees.
Form 990, Part VI, Section B, line 12c	The Lake Hospital System, Inc. Board of Trustees completes a conflict of interest questionnaire annually, which is then reviewed by the LHS CFO and Director of the Board of Trustees. Board Members will excuse themselves from the Board Meeting when a topic of potential conflict is presented and return to the meeting following the completion of discussion, motion, and vote. Compliance with the LHS Conflict of Interest Policy is monitored and enforced by the Board Chair, Committee Chairs, and the Director responsible for Board of Trustees matters.
Form 990, Part VI, Section B, line 15	The process for determining compensation of the Lake Hospital System, Inc. CEO, other officers, and key employees includes market research, review, and assessment by an independent consulting firm to make a recommendation to the LHS Board of Directors. The Board reviews the report provided in conjunction with annual performance assessments, and utilizes this information to determine compensation level. In addition, the procedure for other officers and key employees includes review by the CEO. The most recent compensation review took place in February 2012.
Form 990, Part VI, Section C, line 19	Lake Hospital System, Inc. makes its Form 990, Form 990-T, and Form 1023 available to the public upon request. Lake Hospital System, Inc. makes available governing documents, conflict of interest policy, and financial statements to the public upon request, in addition to filing quarterly financial information with Nationally Recognized Municipal Securities Information Repositories for compliance with bond issues and annual financial information with the Attorney General of the State of Ohio. Governing documents for LHS are available through the website of the Ohio Secretary of State.
Form 990, Part IX, line 11g	Medical Services: Program service expenses 38,518,323. Management and general expenses 9,629,582. Fundraising expenses 0. Total expenses 48,147,905.
Form 990, Part XI, line 9:	Net gain from affiliated agencies 518,481. Derivative instruments gain 19,609,107. Net change in unrealized gains on other-than-trading investments 17,513,073. Cash payment on swap -5,312,149. Underwriting support of Foundation -314,107. Foundation capital donations -99,692.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Lake Health IPHE	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7590 Auburn Rd	AddressLine1
City	Concord	City
State	OH	State
ZIP Code	44077	ZIPCode

Field	Value	IRS element (for citing)
Primary Activities	Physician services	PrimaryActivitiesTxt
Legal Domicile State	OH	LegalDomicileStateCd
Total Income	$0	TotalIncomeAmt
End Of Year Assets	$0	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Lake Hospital System Inc	BusinessNameLine1

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd
Lake Health University Hospitals Seidman Cancer Center
9485 Mentor Avenue	Mentor	OH	44060	311565964	Treatment of cancer patients	OH	501(c)(3)	Line 3	Lake Hospital System Inc	Yes (1)
Lake Hospital Foundation
7590 Auburn Rd	Concord	OH	44077	341425872	Fundraising for benefit of Lake Hospital System, Inc.	OH	501(c)(3)	Line 11a, I	Lake Hospital System Inc	Yes (1)
PrimeHealth Inc
7590 Auburn Rd	Concord	OH	44077	341778204	Physician corporation	OH	501(c)(3)	Line 3	Lake Hospital System Inc	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
Mentor Surgery Center LLC
9485 Mentor Avenue	Mentor	OH	44060	341863257	Outpatient Surgery	OH	Lake Hospital System Inc	Related	$406,630	$1,394,081	0	Yes (1)	0.42350
Lake West Medical Specialists LLC
180-A Mentor Avenue	Painesville	OH	44077	341964657	Office Space	OH	Lake Hospital System Inc	Excluded	$13,072	$25,109	0	Yes (1)	0.12000
Concord Medical Campus Physician Building LLC
7580 Auburn Road Suite 103	Concord	OH	44077	260550261	Office Space	OH	Lake Hospital System Inc	Excluded	$172,794	$2,218,967	0	0	0.51470

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1	CityForeignAddress/City	CountryForeignAddress/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Direct Controlling NADirectControllingNACd
Interlake Health Corporation
7590 Auburn Rd	Concord	OH	44077	341510475	Healthcare	OH	Lake Hospital System Inc	C	$373	$186,013	1.00000	Yes (1)
LHS Assurance Ltd
				980456229	Insurance company		Lake Hospital System Inc	C	$3,213,723	$19,636,253	1.00000	Yes (1)	23 Lime Tree Bay Ave Governors Sq	Grand Cayman	CJ	CJ
Lake PHO Inc
7590 Auburn Rd	Concord	OH	44077	341696001	Physician services	OH		C	$241,818	$1,220,369	0.50000	0					N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Concord Medical Campus Physician Building LLC
A	$101,235	Book value
Lake Hospital Foundation
C	$698,398	Book value
LHS Assurance Ltd
C	$500,000	Book value
Lake Health University Hospitals Seidman Cancer Center
J	$849,221	Book value
Mentor Surgery Center LLC
J	$480,804	Book value
Concord Medical Campus Physician Building LLC
K	$1,283,321	Book value
Lake Health Foundation
M	$136,866	Book value
Prime Health Inc
P	$24,201,966	Book value
Mentor Surgery Center LLC
Q	$60,758	Book value
Lake West Medical Specialists
Q	$148,205	Book value