2012-08-13T09:32:43-05:00 2011-09-30 PERSHING YOAKLEY & ASSOCIATES PC 2963 GULF TO BAY BLVD STE 267 CLEARWATER FL 337594255 990 2010-10-01 592650464 Lakeland Regional Health Systems Inc LAKE 8636871100 1324 Lakeland Hills Boulevard Lakeland FL 33805 Evan C Jones 8636871100 2012-08-13 1 Terry Haefner 7274427110 2010 2016-02-24 21:20:13Z Elaine C Thompson PhD 1324 Lakeland Hills Boulevard Lakeland FL 33805 16569158 0 X www.lrmc.com X 1986 FL Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 13 11 62 29 2321780 2193358 444082 0 10052912 11012871 6771156 7206489 6482549 -1651620 23750699 16567740 926896 968815 0 0 21971395 21382678 0 0 0 15824513 5461037 38722804 27812530 -14972105 -11244790 336584304 333161882 281623371 77989963 54960933 255171919 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 0 0 25402599 968815 11012871 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 25402599 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 21 0 1 62 1 1 1 1 CJ CA VI 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Bill Bierschenk 8636871102 230 S Florida Ave Suite 400 Lakeland FL FL 33805 Lee Jackson 1.00 X 0 0 0 Wilton Mack Reavis MD 1.00 X 0 0 0 David Duncan 1.00 X 0 0 0 Robert W Andrew 1.00 X 0 0 0 Jack English III 1.00 X 0 0 0 A Andy Hernandez 1.00 X 0 0 0 Maggie Lazarre 1.00 X 0 0 0 Jack R Harrell Jr 1.00 X 0 0 0 William Mutz 1.00 X 0 0 0 Frank Kendrick 1.00 X 0 0 0 Weymon P Snuggs III 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 Paul A Powers 50.00 X 0 588673 28699 Elaine Thompson PhD 50.00 X 0 662802 2202 Douglas Reintgen MD 50.00 X 1298144 0 25903 Todd Hall MD 50.00 X 623827 0 25063 Michael A Campanelli MD 50.00 X 931177 0 29544 Todd M Lasner MD 50.00 X 886036 0 29544 Donald Sachs MD 50.00 X 828244 0 26446 Jack T Stephens Jr 50.00 X 0 1633041 19160 4567428 2884516 186561 30 1 1 0 Peterson & Myers PA PO Box 24628 Lakeland FL 33802 Legal 282583 Highland Associates PO Box 55469 Birmingham AL 35255 Investment Advisory 234374 UBS Realty Investors LLC 1 N Wacker Drive 36th Floor Chicago IL 60606 Investment Advisory 147644 Stralem and Company Inc 645 Madison Avenue New York NY 10022 Investment Advisory 121919 RODDA Contruction Inc 250 E Highland Drive Lakeland FL 33813 Construction 116732 5 Net Patient Services 621990 10920177 10920177 Rental Income 531120 92694 92694 11012871 7207907 7207907 1418 -1418 -1418 -1418 Investment in LSDC/WIC 900099 2450138 2450138 Other Income 900099 24391 24391 Equity in Earn. Inv Fu 532000 -4126149 -128358 -3997791 -1651620 16567740 11012871 2321780 3233089 968815 968815 19342182 17601386 1740796 590554 537404 53150 886569 806778 79791 563373 512669 50704 294907 268365 26542 73230 66639 6591 576172 524317 51855 440386 400751 39635 233854 212807 21047 264636 240819 23817 119427 108679 10748 197091 179353 17738 578746 526659 52087 1930130 1756418 173712 Equipment Rental/Lease 290916 264734 26182 Supplies & Pharmaceutic 237401 216035 21366 Dues and Subscriptions 90549 82400 8149 Taxes, Licenses and Fee 66899 60878 6021 Miscellaneous 66693 66693 27812530 25402599 2409931 0 48992406 57588698 2182716 2033705 339529 355720 24571621 2621418 17347624 21950203 138917170 115153241 121335635 130138958 4715344 5289818 2753880 651539 336584304 333161882 4719542 1096637 196197065 80706764 76893326 281623371 77989963 X 54383933 254594919 577000 577000 54960933 255171919 336584304 333161882 X -11244790 211455776 X 0 1 1 X 0 X X X 0 0 0 Lakeland Regional Medical Center Inc 592650456 3 1 24433784 1 24433784 9976774 9976774 9763134 930127 8833007 711773 470335 241438 2368522 1220956 1147566 1751418 1751418 21950203 Equity in Investment Funds 95587612 F STRALEM 12227378 F Blackrock 9202941 F PIMCO 13121027 C 130138958 Due to Affiliate 75074267 Employee Compensation and Benefits 1819059 76893326 16567740 27812530 -11244790 -4885732 216341508 211455776 200210986 10796157 -4885732 114740 -4770992 15567149 1000591 1000591 16567740 27812530 0 27812530 0 27812530 Description of Uncertain Tax Positions Under FIN 48: Part X: 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 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, 2011, 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 2007. Part XI, Line 8 - Other Adjustments: Transfer from Affiliates Intercompany Transfer Book/Tax Difference LSDC Book/Tax Difference WIC Explanation for Part XI, Line 8: Book/Tax Difference Lakeland Surgical & Diagnostic Center -1,000,591 Book/Tax Difference Women's Imaging Center 114,740 Transfer from Affiliates 216,806,794 Intercompany Transfer 420,565 Total 216,641,508 Explanation for Part XII, Line 2d: Investment in Women's Imaging Center 114,740 Total 114,740 Explanation for Part XII, Line 4b: Investment in Lakeland Surgical Diagnostic Center 1,000,591 Total 1,000,591 1 Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 237134974 501(c)(3) 968815 To support Fundraising activities. 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Lakeland Regional Health Systems provided support to Lakeland Regional Medical Center Foundation a related 501(c)(3) organization. This assistance was used to support fundraising activities on behalf of Lakeland Regional Medical Center a 501(c)(3) organization that is supported by Lakeland Regional Health Systems. X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 Paul A Powers 0 393350 0 113211 0 82112 0 19160 0 9539 0 617372 0 0 Elaine Thompson PhD 0 169355 0 125000 0 368447 0 0 0 2202 0 665004 0 0 Douglas Reintgen MD 351894 0 0 0 946250 0 19160 0 6743 0 1324047 0 0 0 Todd Hall MD 623802 0 0 0 25 0 19160 0 5903 0 648890 0 0 0 Michael A Campanelli MD 929899 0 0 0 1278 0 19160 0 10384 0 960721 0 0 0 Todd M Lasner MD 883833 0 0 0 2203 0 19160 0 10384 0 915580 0 0 0 Donald Sachs MD 661658 0 165966 0 620 0 18858 0 7588 0 854690 0 0 0 Jack T Stephens Jr 0 533394 0 273680 0 825967 0 19160 0 0 0 1652201 0 405167 Part I, Lines 4a-b Part I, Lines 4a-b: Jack T. Stephens - Former President/CEO participated in a supplemental nonqualified deferred compensation plan. He had $197,485 of benefits accrue during calendar year 2010. He also had $602,653 which was included in his W2 for 2010. This amount is included in Part (B)(iii) other compensation. Of this amount $405,167 was accrued and reported on Form 990 in prior years and has been included in Part II Column F. Paul Powers - Vice President/CFO participated in a supplemental nonqualified deferred compensation plan. He had $82,112 benefits vest during calender year 2010. This amount is included in Part (B)(iii) other compensation. The plan made a cash distribution of $82,112 in calender year 2010. Douglas Reintgen, M.D. - received a severance payment of $861,250 in 2010. 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. The Form and supporting schedules are also reviewed in detail prior to filing by outside legal counsel to the organization. Additionally, the form and 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 Health System 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 whom must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Health Systems also has a "Policy of the Board of Directors Regarding Board Members Doing Business with Lakeland Regional Medical Center or Lakeland Regional Health Systems", that all Board Members are annually required to execute a "Corporate Compliance Acknowledgement", that all Board Members are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire, and that 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 5: Net unrealized losses on investments: -4,885,732. Transfer from Affiliates 216,806,794. Intercompany Transfer 420,565. Book/Tax Difference LSDC -1,000,591. Book/Tax Difference WIC 114,740. Total to Form 990, Part XI, Line 5: 211,455,776. Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Fundraising FL 501(c)(3) 11a - Type 1 Lakeland Regional Medical Center Inc 0 Lakeland Regional Medical Center Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Providing hospital services FL 501(c)(3) 3 1 Women's Imaging Center LLC 2120 Lakeland Hills Blvd Lakeland FL 33805 113830470 Medical Imaging Services FL Related -161440 370537 0 -161440 1 Lakeland Regional Educational Production Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 200679492 Inactive FL C 1.00000 Lakeland Regional Health Ventures Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 592650902 Medical Services FL C 13945 583825 1.00000 Lakeland Regional Health Ventures Risk Purchasing Group Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 202843126 Inactive FL C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 Lakeland Regional Medical Center Inc R 216806795 Book Value Lakeland Regional Medical Center Inc N 3011974 Cash Value Lakeland Surg & Diagn Center LLP 115 S Missouri Avenue Lakeland FL 33815 593346125 Medical Services FL 0 3695299 0 2611578 1