2014-08-06T13:40:27-05:00 2013-09-30 621517792 PERSHING YOAKLEY & ASSOCIATES PC 2963 GULF TO BAY BLVD STE 267 CLEARWATER FL 337594255 990 2012-10-01 592650464 Lakeland Regional Health Systems Inc LAKE 8636871100 1324 Lakeland Hills Boulevard Lakeland FL 33805 Evan C Jones 8636871100 2014-08-06 1 Terry Haefner P01258953 7274427110 2012 2015-11-30 17:44:51Z Elaine C Thompson PhD 1324 Lakeland Hills Boulevard Lakeland FL 33805 24530522 0 X http://lrmc.com. X 1986 FL Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 12 11 68 0 1896047 1792139 706478 0 9922491 18545681 25939570 2726562 4558294 2898162 41126833 24170405 676574 0 0 0 20804680 26215248 0 0 0 5595543 11793739 27076797 38008987 14050036 -13838582 380588445 443463796 71804783 80349870 308783662 363113926 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 0 0 32041576 18819037 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 32041576 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 23 0 1 68 1 1 1 1 CJ CA VI 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Jon Boyette 8636871100 230 S Florida Ave 4th Floor Lakeland FL 33805 A Andy Hernandez 1.00 X 0 0 0 CJ Jack English III 1.00 X 0 0 0 Dale Dreyer 1.00 X 0 0 0 David Duncan 1.00 X 0 0 0 Frank Kendrick 1.00 X 0 0 0 Jack R Harrell Jr 1.00 X 0 0 0 James D Melton III MD 1.00 X 0 0 0 Jay Mulaney MD 1.00 X 0 0 0 Laura J Hawley CFP 1.00 X 0 0 0 Lee Jackson 1.00 X 0 0 0 Weymon P Snuggs III 1.00 X 0 0 0 William Mutz 1.00 X 0 0 0 Robert W Andrews 1.00 X 0 0 0 Elaine Thompson PhD 1.00 50.00 X 0 687068 201054 Evan C Jones 1.00 50.00 X 0 382912 10926 Michael E Campanelli MD 45.00 X 1142014 0 9306 Matthew Smith MD 45.00 X 710627 0 30836 Todd M Hall MD 45.00 X 648178 0 22288 Gameel Hodge MD 45.00 X 528828 0 23598 Arvind B Soni MD 45.00 X 493169 0 30500 Paul A Powers 0.00 X 0 191418 5758 3522816 1261398 334266 42 1 1 0 Vista Staffing Solutions Inc File 50834 Los Angeles CA 900740834 Medical Staffing 278346 C H G Companies Inc PO Box 972651 Dallas TX 75397 Medical 271549 Peterson & Meyers PA PO Box 24628 Lakeland FL 33802 Legal 199029 Women's Imaging Center LLC 2120 Lakeland Hills Blvd Lakeland FL 338052906 Medical 183925 Sterling Capital Management LLC Two Morrocraft Centre 4064 Colony R Charlotte NC 28211 Investment Services 128292 6 Net Patient Services 621990 18151506 18151506 Rental Income 531120 394175 394175 18545681 2413972 2413972 672707 360117 312590 312590 312590 Investment in LSDC/WIC 900099 1892127 1892127 Other Income 900099 725100 725100 Clinical Trials 900099 245874 245874 35061 27482 3920 3659 2898162 24170405 18819037 1896047 3455321 22663434 19105275 3558159 680485 573649 106836 1906843 1607469 299374 964486 813062 151424 459429 387299 72130 60000 50580 9420 1331181 1122186 208995 1519049 1280558 238491 247758 208860 38898 546408 460622 85786 1179190 994057 185133 134764 113606 21158 1320514 1113193 207321 1640731 1383136 257595 Supplies & Pharmaceutic 2114896 1782857 332039 Expense Reimbursement 519431 437880 81551 Dues and Subscriptions 215739 181868 33871 Taxes, Licenses and Fee 130157 109722 20435 374492 315697 58795 38008987 32041576 5967411 0 37507100 27929831 1730502 8448359 356852 994053 32107719 4366473 19599355 27741246 314330629 370960236 5403462 6118784 1660545 1271287 380588445 443463796 1196475 1950019 70608308 78399851 71804783 80349870 X 308206662 362536926 577000 577000 308783662 363113926 380588445 443463796 X -13838582 26136690 42032156 X 0 1 X 1 0 X X X 0 0 0 Lakeland Regional Medical Center Inc 592650456 3 1 1 1 32041576 1 32041576 13078352 13078352 8978127 1689154 7288973 2019744 652216 1367528 8031496 2025103 6006393 27741246 Due to Affiliate 75053345 Employee Compensation and Benefits 3346506 78399851 X 48316000 26136690 333915 26470605 21845395 1329814 995196 2325010 24170405 36680000 827 827 36679173 1329814 1329814 38008987 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Parent, Medical Center, and Foundation have been recognized by the Internal Revenue Service as tax-exempt organizations as described in Section 501(c)(3) of the Internal Revenue Code of 1986. Income earned in furtherance of the organizations' tax-exempt purposes is exempt from federal and state income taxes. Income taxes related to Ventures, a taxable entity, and the Health System's ownership interest in Lakeland Surgical and Diagnostic Center (the Surgical Center) are not material to the Health System. Accounting principles generally accepted in the United States of America require the Health System's management to evaluate tax positions taken by the Health System and recognize a tax liability (or asset) if the Health System has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Health System has analyzed the tax positions and has concluded that as of September 30, 2013, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the consolidated financial statements. The Health System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Health System believes it is no longer subject to income tax examinations for years prior to 2008. Part XI, Line 2d - Other Adjustments: Investment in Women's Imaging Center 333,270. Other Changes 645. Part XI, Line 4b - Other Adjustments: Investment in Lakeland Surgical Diagnostic Center 963,794. Investment in CMS 3,920. Investment in PSSL 27,482. Part XII, Line 2d - Other Adjustments: Other Changes 827. X X X X X 0 1 0 0 0 0 0 0 0 Elaine Thompson PhD 0 680824 0 0 0 6244 0 188319 0 12735 0 888122 0 0 Evan C Jones 0 366194 0 0 0 16718 0 4322 0 6604 0 393838 0 0 Michael E Campanelli MD 1140954 0 0 0 1060 0 0 0 9306 0 1151320 0 0 0 Matthew Smith MD 710602 0 0 0 25 0 17033 0 13803 0 741463 0 0 0 Todd M Hall MD 648128 0 0 0 50 0 15684 0 6604 0 670466 0 0 0 Gameel Hodge MD 528803 0 0 0 25 0 11697 0 11901 0 552426 0 0 0 Arvind B Soni MD 493144 0 0 0 25 0 16697 0 13803 0 523669 0 0 0 Paul A Powers 0 191418 0 0 0 0 0 0 0 5758 0 197176 0 0 Part I, Line 4b Elaine Thompson, Ph.D. - Chief Executive Officer participated in a supplemental nonqualified deferred compensation plan. She had $171,291 of nontaxable benefits accrue during calendar year 2012. This amount is included in Part II Column C. Form 990, Part VI, Section B, line 11 The Form 990 and supporting schedules are reviewed prior to filing by senior management, including the CEO and CFO. Additionally, the compensation schedules are reviewed by the Executive and Physician Compensation Committee of the Board and a copy of the Form 990 and schedules are provided to each member of the Board of Directors before filing with the IRS. Form 990, Part VI, Section B, line 12c Lakeland Regional Medical Center has a conflict of interest policy which is monitored by the Corporate Integrity Services department. All new hires, students, volunteers and contractors are trained on the ethics policy during general orientation. All staff is to comply with ethics training annually as part of their mandatory education requirements. Annually, a certification is required by all managers, directors, and officers who must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Medical Center also has a "Policy of the Board of Directors Regarding Board Members Doing Business" with Lakeland Regional Medical Center or Lakeland Regional Health Systems". All Board Members are annually required to execute a "Corporate Compliance Acknowledgement" and answer a comprehensive "Annual Conflict of Interest Questionnaire". Additionally, all Senior Corporate Management are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire". Form 990, Part VI, Section B, line 15 The Executive and Physician Compensation Committee (the "Committee") of the Board is charged with determining, in advance, all compensation issues for all executive positions including the President & CEO, the CFO and all Vice Presidents of the organization. Only independent and "disinterested" persons may serve as members of the Committee and no member may be employed by the organization or any of its affiliates. Additionally, no physician on the medical staff of the organization may serve as a member of the Committee nor may any member have any business or financial relationships with the organization, either directly or indirectly through family members. The Committee engages an independent nationally recognized human resources management consulting firm which specializes in executive and employee compensation in the health care industry. This firm, among other things: a. Conducts a competitive executive total cash compensation analysis relative to comparable healthcare organizations nationally; and b. Conducts a competitive executive benefits analysis relative to comparable healthcare organizations; and c. Conducts a competitive executive total compensation analysis relative to comparable healthcare organizations; and d. Assists the Committee in ensuring compliance with regulatory requirements; and e. Provides guidance and counsel to the Committee and Board in matters relating to executive compensation; and f. Participates in Committee meetings and presents their findings and recommendations to the committee and to the Board. In determining compensation, the Committee relies on the independent, reliable market data presented by the consulting firm to set all compensation levels and the consulting firm's opinion as to the reasonableness of total compensation to be paid the executives of the organization. The Committee fully documents the basis for all determinations and records, at a minimum, 1) the terms of the compensation agreement and the date on which it was approved; 2) the members of the Committee who were present during the discussion and those who voted on it; 3) the comparability data used and its source; and 4) the basis for the ultimate decision. In fulfilling its responsibility, the Committee has full authority to consult with outside counsel to the organization or Committee engaged counsel, regarding the legality of the compensation and other legal issues which may be relevant to the Committee's responsibilities. Form 990, Part VI, Section C, line 19 The organization's Articles of Incorporation are public records and may be obtained from the State of Florida's Division of Corporations in Tallahassee, Florida. Additionally, the Lease & Transfer Agreement between the organization and the City of Lakeland, Florida, under which the organization operates, is recorded in the Public Records of Polk County, Florida, the county in which the organization is located. Financial statements and similar information, both audited and unaudited, are periodically furnished to the City of Lakeland, Florida, and various regulatory agencies within the State of Florida. The financial statements and information are public records under the pertinent Florida public records law. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfer from Affiliates 42,694,082. Book/Tax Difference LSDC -963,794. Book/Tax Difference WIC 333,270. Book/Tax Difference PSSL -27,482. Book/Tax Difference CMS -3,920. Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Fundraising FL 501(c)(3) 11a - Type 1 Lakeland Regional Health Systems Inc 1 Lakeland Regional Medical Center Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Providing hospital services FL 501(c)(3) 3 Lakeland Regional Health Systems Inc 1 Women's Imaging Center LLC 2120 Lakeland Hills Blvd Lakeland FL 33805 113830470 Medical Imaging Services FL Related -268118 333387 0 1 0.50000 Polk Starlight Sleep Labs LLC 3003 South Florida Ave Ste 203 Lakeland FL 33803 202108795 Medical Services FL Lakeland Regional Health System Inc Related 27482 14405 0 1 0.51000 Lakeland Regional Educational Production Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 200679492 Inactive FL Lakeland Regional Health System Inc C 1.00000 0 Lakeland Regional Health Ventures Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 592650902 Medical Services FL Lakeland Regional Health Systems Inc C 523 580571 1.00000 0 Lakeland Regional Health Ventures Risk Purchasing Group Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 202843126 Inactive FL Lakeland Regional Health System Inc C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 Lakeland Regional Medical Center Inc S 42694082 Cash Value Lakeland Regional Medical Center Inc O 3114775 Cash Value Lakeland Surg & Diagn Center LLP 115 S Missouri Avenue Lakeland FL 33815 593346125 Medical Services FL 0 2162331 5767876 0 1 0.43750