LICKING MEMORIAL HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- LICKING MEMORIAL HOSPITAL (EIN 31-4379519)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-03
- IRS object ID
- 201103079349300905
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-03T09:42:33-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOUNTJOY CHILTON MEDLEY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 S FOURTH ST 2000 MEIDINGER TOWE | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 402023445 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 314379519 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LICK | NameControl |
| Phone | 7403484528 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1 |
| City | NEWARK | City |
| State | OH | State |
| ZIP Code | 43055 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CYNTHIA L WEBSTER | Name |
| Title | V P OF FINANCIAL SERVICES | Title |
| Phone | 7403484528 | Phone |
| Date Signed | 2011-10-31 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VICTORIA D BUSTER CPA | Name |
| Phone | 5027491900 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROBERT A MONTAGNESE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1 |
| City | NEWARK | City |
| State | OH | State |
| ZIP Code | 43055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 168627298 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LMHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1898 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH OF THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1451 | TotalNbrEmployees |
| Total Nbr Volunteers | 164 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 166183433 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 166415478 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 13673 | InvestmentIncomePriorYear |
| Investment Income Current Year | 221728 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1659290 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1393002 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 167856396 | TotalRevenuePriorYear |
| Total Revenue Current Year | 168030208 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 73024990 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 69941046 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 74160052 | OtherExpensePriorYear |
| Other Expenses Current Year | 73162332 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 147185042 | TotalExpensesPriorYear |
| Total Expenses Current Year | 143103378 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 20671354 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 24926830 | RevenuesLessExpensesCY |
| Total Assets BOY | 143479422 | TotalAssetsBOY |
| Total Assets EOY | 130923203 | TotalAssetsEOY |
| Total Liabilities BOY | 74685375 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 65708580 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 68794047 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 65214623 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | LICKING MEMORIAL HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 128518628 | Expense |
| Revenue | 166698593 | Revenue |
| Description | LICKING MEMORIAL HOSPITAL (LMH) PROVIDES HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S RACE, CREED, GENDER, DISABILITY, ETHNICITY, AGE, RELIGION, CITIZENSHIP, NATIONAL ORIGIN OR SOURCES OF PAYMENT FOR CARE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF LMH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. FURTHER, WE BELIEVE OUR PURPOSE IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND EDUCATION. THEREFORE, IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE PROVIDE: - FREE CARE AND/OR SUBSIDIZED CARE - CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST - HEALTH ACTIVITIES AND PROGRAMS FREE-OF-CHARGE TO THE COMMUNITYTHE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED AND MEDICALLY UNDER SERVED.LMH SERVED 7,386 INPATIENTS AND 1,089 NEWBORNS FOR A TOTAL OF 25,904 PATIENT DAYS, AND PROVIDED SERVICES TO 278,049 OUTPATIENTS IN 2010.ADDITIONALLY, LMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, BELOW COST IN MANY CASES. TO THE EXTENT REIMBURSEMENT IS BELOW CHARGES, LMH CONSIDERS THESE AMOUNTS TO BE CONTRACTUAL ADJUSTMENTS, WHICH WILL NEVER BE COLLECTED. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS AMOUNTED TO $116,215,000 IN 2010.UNCOMPENSATED CARE IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES LMH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. THE HOSPITAL ROUTINELY PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO ARE UNWILLING OR UNABLE TO PAY THEIR HOSPITAL BILLS. IN 2010, LMH WROTE OFF CHARGES OF APPROXIMATELY $16,990,000 IN BAD DEBTS AND $15,275,000 IN CHARITY CARE. | Description |
| Total Program Service Expense | 128518628 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 72 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1451 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID CLAYPOOL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7403484528 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1 |
| City | NEWARK | City |
| State | OH | State |
| ZIP Code | 43055 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| PATRICK M JEFFRIES | |||||||
| CHAIRMAN | 1.50 | X | X | 0 | 0 | 0 | |
| LINDA K DALGARN | |||||||
| VICE CHAIRMAN | 1.30 | X | X | 0 | 0 | 0 | |
| JACK E CROCKFORD | |||||||
| TREASURER | 1.30 | X | X | 0 | 0 | 0 | |
| PATRICK D GUANCIALE | |||||||
| SECRETARY | 1.30 | X | X | 0 | 0 | 0 | |
| GUS A ANDREWS | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| MICHAEL D CANTLIN | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| GENE BRANSTOOL | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| KIM FLEMING | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| BONNIE L MANNING | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| ROBERT H MCGAUGHY | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| THOMAS MULLADY | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| RICHARD REED | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| F JENNIFER UTREVIS | |||||||
| DIRECTOR | 1.30 | X | 0 | 0 | 0 | ||
| ROBERT MONTAGNESE | |||||||
| PRESIDENT & CEO | 30.00 | X | 364655 | 0 | 103079 | ||
| CINDY WEBSTER | |||||||
| VICE PRES FINANCIAL SERVIC | 30.00 | X | 120834 | 0 | 18544 | ||
| CRAIG CAIRNS | |||||||
| VP MEDICAL AFFAIRS | 40.00 | 230345 | 0 | 26150 | X | ||
| DEBORAH YOUNG | |||||||
| VP PATIENT CARE | 40.00 | 152863 | 0 | 20769 | X | ||
| SALLIE ARNETT | |||||||
| VP INFO SYSTEMS | 40.00 | 143985 | 0 | 20152 | X | ||
| JEAN GLASER | |||||||
| DIRECTOR OF PHARMACY | 40.00 | 122074 | 0 | 18631 | X | ||
| VERONICA LINK | |||||||
| VP PR & DEVELOPMENT | 14.00 | 131766 | 0 | 19303 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1266522 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 226628 | TotalOtherCompensation |
| Number Individuals GT100 K | 22 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| TURNER CONSTRUCTION | |||||
| 375 HUDSON STREET | NEW YORK | NY | 10014 | CONSTRUCTION | 3378068 |
| MEDICAL DOCTOR ASSOCIATES | |||||
| PO BOX 277185 | ATLANTA | GA | 30384 | PHYSICIAN SERVICES | 1329449 |
| MARSH USA INC | |||||
| 10 WEST BROAD STREET | COLUMBUS | OH | 43215 | INSURANCE SERVICES | 1036759 |
| GE HEALTHCARE IITS USA | |||||
| 40 IDX DRIVE | SOUTH BERLINGTON | VT | 05403 | MEDICAL EQUIPMENT AND MAINTENANCE | 819406 |
| MID OHIO CARDIOLOGY | |||||
| 3705 OLENTANGY RIVER ROAD SUITE 10 | COLUMBUS | OH | 43214 | CARDIOLOGY SERVICES | 777203 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 46 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 166415478 | TotalRevenueColumn |
| Related Or Exempt Function Income | 166415478 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 166415478 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 232719 | TotalRevenueColumn |
| Exclusion | $232,719 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 586099 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 586099 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10991 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -10991 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10991 | TotalRevenueColumn |
| Exclusion | -$10,991 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA | 722210 | 1109887 | $1,109,887 | |
| VHA FEES & REBATES | 621110 | 225883 | 225883 | |
| OTHER SERVICES | 621110 | 57232 | 57232 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1393002 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 168030208 | TotalRevenueColumn |
| Related Or Exempt Function Income | 166698593 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,331,615 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490039 | Total |
| Management And General | 490039 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50299184 | Total |
| Program Services | 45340463 | ProgramServices |
| Management And General | 4958721 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15458290 | Total |
| Program Services | 14066831 | ProgramServices |
| Management And General | 1391459 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3693533 | Total |
| Program Services | 3321968 | ProgramServices |
| Management And General | 371565 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149293 | Total |
| Management And General | 149293 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 435090 | Total |
| Management And General | 435090 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28890 | Total |
| Program Services | 28890 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9800188 | Total |
| Program Services | 6841706 | ProgramServices |
| Management And General | 2958482 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 854332 | Total |
| Program Services | 241277 | ProgramServices |
| Management And General | 613055 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1491928 | Total |
| Program Services | 1491928 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35995 | Total |
| Program Services | 34389 | ProgramServices |
| Management And General | 1606 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 376505 | Total |
| Program Services | 155073 | ProgramServices |
| Management And General | 221432 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1122314 | Total |
| Management And General | 1122314 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11537068 | Total |
| Program Services | 9049907 | ProgramServices |
| Management And General | 2487161 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 809514 | Total |
| Program Services | 809514 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 27085046 | 27085046 | |
| BAD DEBT | 16989615 | 16989615 | |
| EQUIPMENT RENTAL | 1895984 | 1895984 | |
| FRANCHISE FEES/TAXES | 1319157 | 1116554 | 202603 |
| MISCELLANEOUS | -768587 | 49483 | -818070 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143103378 | Total |
| Program Services | 128518628 | ProgramServices |
| Management And General | 14584750 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3803407 | BOY |
| EOY | 3507331 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17226292 | BOY |
| EOY | 5949809 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19557230 | BOY |
| EOY | 17673624 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2336522 | BOY |
| EOY | 2322584 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1107503 | BOY |
| EOY | 2246727 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 183870405 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 99774652 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86529041 | BOY |
| EOY | 84095753 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6461874 | BOY |
| EOY | 8783917 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6457553 | BOY |
| EOY | 6343458 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 143479422 | BOY |
| EOY | 130923203 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10861618 | BOY |
| EOY | 12896301 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29200000 | BOY |
| EOY | 20600000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34623757 | BOY |
| EOY | 32212279 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74685375 | BOY |
| EOY | 65708580 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68794047 | BOY |
| EOY | 65214623 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68794047 | BOY |
| EOY | 65214623 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 143479422 | BOY |
| EOY | 130923203 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 24926830 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -28506256 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $1,960 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1960 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | LICKING MEMORIAL HOSPITAL PAYS $39,207 IN ANNUAL DUES TO OHIO HOSPITAL ASSOCIATION(OHA). OF THE TOTAL DUES PAID, 5% OR $1,960 ARE USED BY OHA TO SUPPORT LOBBYING ACTIVITIES OF THE ASSOCIATION. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 912879 | OtherCostOrOtherBasis |
| Book Value | 912879 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 83507018 | OtherCostOrOtherBasis |
| Depreciation | 28219409 | Depreciation |
| Book Value | 55287609 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2702000 | OtherCostOrOtherBasis |
| Depreciation | 1900283 | Depreciation |
| Book Value | 801717 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 96748508 | OtherCostOrOtherBasis |
| Depreciation | 69654960 | Depreciation |
| Book Value | 27093548 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 84095753 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED PENSION AND RETIREE LIABILITY | $28,288,618 |
| ACCRUED INTEREST PAYABLE | $79,142 |
| ACCRUED MALPRACTICE | $3,844,519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 32212279 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14739 | PersonsServed |
| Total Community Benefit Expense | 7959709 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2241253 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5718456 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04530 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 27082 | PersonsServed |
| Total Community Benefit Expense | 24789356 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13345692 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11443664 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 41821 | PersonsServed |
| Total Community Benefit Expense | 32749065 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15586945 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17162120 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12530 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16556 | PersonsServed |
| Total Community Benefit Expense | 1352197 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 211881 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1140316 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00800 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 891 | PersonsServed |
| Total Community Benefit Expense | 478715 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 460715 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 72006 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 72006 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 400 | PersonsServed |
| Total Community Benefit Expense | 280835 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 280835 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17847 | PersonsServed |
| Total Community Benefit Expense | 2183753 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 229881 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1953872 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 59668 | PersonsServed |
| Total Community Benefit Expense | 34932818 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15816826 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19115992 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13900 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 32 | PersonsServed |
| Total Community Building Expense | 2180 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2180 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 450 | PersonsServed |
| Total Community Building Expense | 34738 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 34738 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 315 | PersonsServed |
| Total Community Building Expense | 4301 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4301 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 421 | PersonsServed |
| Total Community Building Expense | 12195 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12195 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 1218 | PersonsServed |
| Total Community Building Expense | 53414 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 53414 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $7,611,348 | BadDebtExpenseAmount |
| Amount Attributable To | 2683101 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 32043450 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 33441728 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1398278 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WEST MAIN STREET | AddressLine1 |
| City | NEWARK | City |
| State | OH | State |
| ZIP Code | 43055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LICKING MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY LICKING MEMORIAL HEALTH SYSTEMS AND INCLUDES LICKING MEMORIAL HEALTH SYSTEMS, LICKING MEMORIAL HOSPITAL, LICKING MEMORIAL PROFESSIONAL CORPORATION, LICKING MEMORIAL HEALTH FOUNDATION. |
| PART I, LINE 7: THE ORGANIZATION USED THE CBISA SOFTWARE TO DETERMINE THE COST ACCOUNTING METHODOLOGY. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 16989615. |
| PART II: IT IS IMPORTANT TO NOTE THAT ALL ACTIVITIES ASSOCIATED WITH LICKING MEMORIAL HEALTH SYSTEMS REFLECT AND FURTHER THE MISSION OF "IMPROVING THE HEALTH OF THE COMMUNITY." WE DEFINE THE HEALTH OF THE COMMUNITY VERY BROADLY IN ORDER TO INCLUDE ACTIVITIES THAT ARE NOT NECESSARILY HEALTH RELATED BUT ACTIVITIES THAT WE BELIEVE ARE CRITICAL TO A HEALTHY COMMUNITY SUCH AS STRONG SCHOOLS, YOUTH PROGRAMS AND THE ARTS. WE PUBLISH A BI-MONTHLY MAGAZINE THAT IS MAILED TO 55,000 HOUSEHOLDS WHICH HIGHLIGHTS ALL OF OUR COMMUNITY BUILDING ACTIVITIES AND OPPORTUNITIES FOR HEALTH EDUCATION AND SCREENING. |
| PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE FOR LICKING MEMORIAL HEALTH SYSTEMS AND SUBSIDIARIES.IN ADDITION TO CHARITY CARE, THE SYSTEM PROVIDES SERVICES TO PATIENTS WHO ARE UNWILLING TO PAY THEIR BILLS. MANY OF THESE PATIENTS WOULD LIKELY QUALIFY FOR CHARITY CARE IF THEY APPLIED FOR THIS BENEFIT. IN 2010, AND 2009 THE SYSTEM CHARGED $19.7 MILLION AND $20.5 MILLION TO EXPENSE RESPECTIVELY, OF CHARGES RELATED TO THESE PATIENTS.LINE 2 - THE ORGANIZATION USES THE CBISA SOFTWARE FOR COSTING METHODOLOGY, A SOFTWARE PROGRAM ENDORSED BY BOTH THE OHIO HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION.LINE 3 - THE ORGANIZATION EMPLOYED A PATIENT SCORING METHODOLOGY WHICH COMBINES NUMEROUS FINANCIAL INDICATORS TO ARRIVE AT A NUMERIC CREDIT SCORE. THIS SCORE INCLUDES THE PATIENTS ABILITY TO PAY BASED ON THE ESTIMATED HOUSEHOLD INCOME AS WELL AS THE PROBABILITY OF PAYMENT BEING MADE BASED ON HISTORICAL CREDIT INFORMATION. |
| PART III, LINE 8: THE MEDICARE SHORTFALL REPRESENTS AN UNDERPAYMENT OF OUR COST FOR PROVIDING SERVICES TO TRADITIONAL MEDICARE PATIENTS, OUR LARGEST PAYER. SINCE THIS SHORTFALL RELATES TO SUCH A LARGE PORTION OF OUR COMMUNITY, WE FEEL THE COST SHORTFALL IS A RELEVANT FACTOR WHEN CONSIDERING COMMUNITY BENEFIT.WE USE THE MEDICARE COST REPORT FOR COSTING METHODOLOGY FOR CALCULATING THE MEDICARE SHORTFALL.IN ADDITION TO TRADITIONAL MEDICARE SHORTFALLS, THE HOSPITAL PROVIDES SERVICES TO MEDICARE HMO PATIENTS AT OR BELOW COST AS A FURTHER BENEFIT TO OUR COMMUNITY. BY ADOPTING THE SAME METHODOLOGY FOR TRADITIONAL MEDICARE ABOVE, THE MEDICARE HMO SHORTFALL AMOUNTED TO $1,098,587.ALONG THAT SAME LINE, THE LICKING MEMORIAL PROFESSIONAL CORPORATION, ANOTHER LMHS SUBSIDIARY, PROVIDED SERVICES TO MEDICARE (TRADITIONAL AND HMO) BENEFICIARIES AT A COST SHORTFALL OF $4,626,825 USING A CBISA SOFTWARE COSTING METHOD. THE CBISA SOFTWARE IS ENDORSED BY BOTH THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION AS A COSTING METHOD UTILIZED FOR DETERMINING SHORTFALLS. |
| PART III, LINE 9B: THE PATIENT ACCOUNTING DEPARTMENT IS RESPONSIBLE FOR THE COLLECTION OF PATIENTS' ACCOUNTS. THE OBJECTIVE OF THE DEPARTMENT IS TO COLLECT ACCOUNTS DUE THE HOSPITAL WHILE MAINTAINING POSITIVE GUEST RELATIONS.-PRIOR TO OR UPON ADMISSION, PATIENT INFORMATION IS OBTAINED BY THE REGISTRATION DEPARTMENT. THIS INFORMATION IS FORWARDED TO THE PATIENT ACCOUNT REPRESENTATIVE FOR MEDASSIST, INC. UPON ADMISSION.-WHENEVER POSSIBLE, SELF-PAY INPATIENTS ARE INTERVIEWED BY THE PATIENT ACCOUNT REPRESENTATIVE PRIOR TO DISCHARGE. PATIENTS WILL BE SCREENED FOR POSSIBLE STATE OR FEDERAL PROGRAM ELIGIBILITY, SUCH AS MEDICAID ORSOCIAL SECURITY DISABILITY. IF PATIENTS DO NOT MEET THE CRITERIA FOR THESE PROGRAMS, THEY WILL BE INFORMED OF THE UNCOMPENSATED CARE PROGRAMS AVAILABLE.- ALL STATEMENTS CONTAIN INFORMATION AND GUIDELINES FOR UNCOMPENSATED CARE. |
| PART VI, LINE 2: WITH A MISSION OF "IMPROVING THE HEALTH OF THE COMMUNITY," LICKING MEMORIAL HEALTH SYSTEMS CONTINUOUSLY MONITORS AND ASSESSES THE NEEDS OF OUR COMMUNITY. WE DO THIS IN A VARIETY OF WAYS. OUR ENTIRE LEADERSHIP TEAM IS VERY ACTIVE IN THE COMMUNITY, SERVING ON LOCAL, NOT-FOR-PROFIT BOARDS AND IN SERVICE CLUBS SUCH AS ROTARY AND KIWANIS. AS THE LARGEST EMPLOYER IN LICKING COUNTY, THE COMMUNITY LOOKS TO OUR MANAGEMENT STAFF FOR SUPPORT AND INVOLVEMENT IN MOST, IF NOT ALL, MAJOR INITIATIVES. THIS COMMUNITY INVOLVEMENT PROVIDES THE OPPORTUNITY TO COLLECT INFORMATION REGARDING THE NEEDS OF THE DIFFERENT ORGANIZATIONS. SENIOR MANAGEMENT IS VERY RESPONSIVE IN PROVIDING ASSISTANCE WHERE NEEDED AS THIS INFORMATION BECOMES AVAILABLE. THE BOARDS OF DIRECTORS FOR LICKING MEMORIAL HOSPITAL AND LICKING MEMORIAL HEALTH SYSTEMS ARE VERY INTERESTED AND ACTIVELY ENGAGED IN THE COMMUNITY; THEREFORE, THEY ARE A GREAT RESOURCE IN MAKING ADMINISTRATION AWARE OF NEEDS. IN ADDITION, THE BOARD RECEIVES A MONTHLY REPORT AT EACH BOARD MEETING, HIGHLIGHTING ALL OF THE COMMUNITY ACTIVITIES SUPPORTED BY THE HOSPITAL INCLUDING DONATIONS MADE DURING THAT MONTH, HEALTH FAIRS AND HEALTH SCREENINGS, MANAGEMENT AND PHYSICIANS SPEAKING IN THE COMMUNITY, ETC. PROVIDING ALL OF THIS INFORMATION TO THE BOARD ALLOWS THEM TO BE SUPPORTIVE AS ADMINISTRATION RECOMMENDS IMPLEMENTING NEW SERVICES OR ENHANCING EXISTING OFFERINGS.ORGANIZED UNDER THE HOSPITAL CORPORATION IS A 75 MEMBER DEVELOPMENT COUNCIL WHOSE PURPOSE IS TO EDUCATE THE COMMUNITY ABOUT THE HOSPITAL AND TO COMPLETE FUNDRAISING ACTIVITIES IN SUPPORT OF THE ORGANIZATION. THE MEMBERS OF THE DEVELOPMENT COUNCIL ARE COMMUNITY LEADERS REPRESENTING ALL AREAS OF BUSINESS, INDUSTRY AND EDUCATION IN THE COMMUNITY. THESE ARE INDIVIDUALS WHO HAVE THEIR "FINGERS ON THE PULSE" OF THE COMMUNITY, AND ONE OF THEIR RESPONSIBILITIES AS AMBASSADORS IS TO MAKE THE ADMINISTRATION AWARE OF NEEDS IN THE COMMUNITY ESPECIALLY PERTAINING TO HEALTH CARE. AMONG MANY OUTREACH ACTIVITIES OF THE DEVELOPMENT COUNCIL, PROBABLY THE MOST PRODUCTIVE ARE THE COMMUNITY LEADER ROUNDTABLES THAT ARE SPONSORED BY THIS GROUP. THESE ARE LUNCHEONS SCHEDULED MONTHLY WITH THE HEALTH SYSTEMS CEO. DEVELOPMENT COUNCIL MEMBERS SERVE AS HOSTS, AND THEY INVITE 20-25 INDIVIDUALS REPRESENTING SIMILAR INTERESTS. SOME EXAMPLES OF RECENT ROUNDTABLE GROUPS ARE SCHOOL NURSES, SCHOOL ATHLETIC DIRECTORS AND COACHES, REALTORS, FIRE CHIEFS, LOCAL POLITICIANS, ETC. THESE FORUMS ARE ALWAYS VERY INFORMATIVE FOR BOTH THE ATTENDEES AND THE ADMINISTRATION AS WE SHARE INFORMATION ABOUT THE HOSPITAL AND THEN ASK FOR FEEDBACK FROM THE COMMUNITY LEADERS WHO ARE PRESENT. MANY TIMES, IDEAS FOR HOSPITAL INITIATIVES COME FROM THESE EVENTS.ANOTHER ACTIVITY OF THE DEVELOPMENT COUNCIL IS A QUARTERLY CORPORATE BREAKFAST. THESE EDUCATIONAL SESSIONS NORMALLY DRAW 100-125 ATTENDEES FOR BREAKFAST AND PROVIDE AN OPPORTUNITY TO EDUCATE THE COMMUNITY LEADERSHIP REGARDING HOSPITAL ACTIVITIES AND TO PROVIDE AN OPEN FORUM TO DISCUSS HEALTH CARE AND OTHER NEEDS WITHIN THE COMMUNITY. SPEAKERS AT THESE EVENTS HAVE RANGED FROM PHYSICIANS TALKING ABOUT HEART, VASCULAR, ENDOCRINOLOGY, CARING FOR AGING PATIENTS, AND SLEEP MEDICINE, TO OUR DIRECTOR OF PASTORAL CARE TALKING ABOUT HOW HIS DEPARTMENT OF THE HOSPITAL SERVES THE PATIENTS AND THE COMMUNITY. THE HEALTH SYSTEMS' WEBSITE PROVIDES DETAILED INFORMATION ON THE VARIOUS PROGRAMS AVAILABLE AND PROVIDES A MECHANISM FOR COMMUNITY FEEDBACK. ALL REQUESTS COMING THROUGH THE WEBSITE RECEIVE A RESPONSE.AN AFFILIATED PHYSICIAN GROUP, KNOWN AS THE LICKING MEMORIAL PROFESSIONAL CORPORATION, PROVIDES PHYSICIAN INPUT REGARDING THE NEEDS THEY IDENTIFY IN THEIR DAILY PRACTICE AND COMMUNITY INVOLVEMENT. THESE OBSERVATIONS ARE DISCUSSED WITH ADMINISTRATION FOR DEVELOPMENT OF PROGRAMS AND SERVICES TO ADDRESS SUCH NEEDS. |
| PART VI, LINE 3: LICKING MEMORIAL HEALTH SYSTEMS PROVIDES CARE TO THE ENTIRE COMMUNITY REGARDLESS OF ABILITY TO PAY. THAT MESSAGE IS SHARED WITH THE COMMUNITY IN A VARIETY OF WAYS. THE HEALTH SYSTEMS' WEBSITE PROVIDES INFORMATION ON ASSISTANCE IN PAYING HOSPITAL BILLS. IN ADDITION, THE BILLING STATEMENT SENT TO THE PATIENT OR GUARANTOR PROVIDES INSTRUCTIONS FOR ACCESSING CHARITY CARE. ASSISTANCE INFORMATION IS ALSO PROVIDED TO INDIVIDUALS WHO CONTACT THE BILLING OFFICE TO DISCUSS DIFFICULTY IN MAKING PAYMENT. THE HEALTH SYSTEMS CONTRACTS WITH AN ELIGIBILITY COMPANY TO SCREEN AND IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR ASSISTANCE AT CERTAIN POINTS OF SERVICE WITHIN THE ORGANIZATION. WE ALSO EMPLOY THE USE OF EARLY-OUT AGENCIES TO PERFORM SELF-PAY BILLING SERVICES ON OUR BEHALF. THESE AGENCIES ROUTINELY IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR ASSISTANCE AND PROVIDE APPLICATIONS FOR COMPLETION. THE HEALTH SYSTEMS PROVIDES ASSISTANCE TO THOSE WHO ARE ABOVE THE FEDERAL POVERTY LEVEL BY OFFERING DISCOUNTED CARE BASED ON A SLIDING SCALE UP TO 250% OF THE FEDERAL POVERTY LEVEL. IN ADDITION, THE ORGANIZATION PROVIDES FREE OR DISCOUNTED CARE FOR THOSE WHO ARE CONSIDERED TO BE MEDICALLY INDIGENT. THE DEVELOPMENT COUNCIL (AMBASSADORS) HAVE BEEN EDUCATED ABOUT OUR COMMITMENT TO PROVIDE CARE FOR THE ENTIRE COMMUNITY AND THAT MESSAGE IS SHARED IN THE COMMUNITY THROUGH THEIR GRASS ROOTS EFFORTS. |
| PART VI, LINE 4: LICKING MEMORIAL HOSPITAL LOCATED IN NEWARK, OHIO THIRTY THREE MILES EAST OF COLUMBUS. THE CITY OF NEWARK HAS A POPULATION OF ABOUT 50,000 PEOPLE WITH A MEDIAN INCOME OF APPROXIMATELY $41,000. THE HOSPITAL SERVES THE COMMUNITY OF NEWARK AND LICKING COUNTY. LICKING COUNTY HAS A POPULATION OF APPROXIMATELY 166,000 (PER U.S. CENSUS BUREAU), A PER CAPITA INCOME OF APPROXIMATELY $26,000 AND AN UNEMPLOYMENT RATE OF 9.73%. |
| PART VI, LINE 6: THE SYSTEM PROVIDED A VARIETY OF COMMUNITY SERVICES, WHICH INCLUDED PARTICIPATION IN MANY COMMUNITY HEALTH FAIRS THROUGHOUT THE COUNTY TO ENCOURAGE AND ADVANCE HEALTHCARE EDUCATION IN AREA SCHOOLS, CHURCHES AND BUSINESSES; PROVIDED VARIOUS SEMINARS AT NOMINAL CHARGES RELATED TO LAMAZE, CAESARIAN SECTIONS, SIBLING PREPARATION, INFANT AND CHILD CPR, BABYSITTING EDUCATION, AND BREASTFEEDING; PROVIDED SUPPORT GROUPS FOR VICTIMS AND FAMILIES OF CANCER, DIABETES, AND PULMONARY AND HEART DISEASE; PROVIDED ASSISTANCE TO EDUCATORS THROUGH OUR WORK WITH STUDENT NURSES, OCCUPATIONAL THERAPY, AND PHYSICAL THERAPY INTERNS; PROVIDED SPEAKERS TO SCHOOLS, BUSINESSES CIVIC GROUPS AND OTHER ORGANIZATIONS ON HEALTH CARE SUBJECTS. SEE SCHEDULE O FOR A DETAILED LISTING OF VARIOUS PROGRAMS AND INDIVIDUALS SERVED BY THE HEALTH SYSTEM. |
| PART VI, LINE 7: LICKING MEMORIAL HEALTH SYSTEMS (THE SYSTEM) IS A NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF OHIO TO PROVIDE AND PROMOTE HEALTH CARE SERVICES IN CENTRAL OHIO.THE SYSTEM IS THE PARENT ORGANIZATION AND SOLE CORPORATE MEMBER OF LICKING MEMORIAL HOSPITAL (THE HOSPITAL), LICKING MEMORIAL HEALTH FOUNDATION (THE FOUNDATION), AND LICKING MEMORIAL PROFESSIONAL CORPORATION (THE PROFESSIONAL CORPORATION).THE PROFESSIONAL CORPORATION EMPLOYS A STAFF OF PHYSICIANS AND SUPPORT PERSONNEL TO FURTHER THE SYSTEM'S CHARITABLE PURPOSE. THE PROFESSIONAL CORPORATION HAS A SOLE PHYSICIAN SHAREHOLDER, WHO, UNDER A SHARED CONTROL AGREEMENT, ASSIGNED THE VOTING RIGHTS OF THE STOCK TO THE SYSTEM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT MONTAGNESE | |||||||||||||
| 359994 | 0 | 111 | 0 | 4550 | 0 | 89982 | 0 | 13097 | 0 | 467734 | 0 | 0 | 0 |
| CRAIG CAIRNS | |||||||||||||
| 230234 | 0 | 111 | 0 | 0 | 0 | 14138 | 0 | 12012 | 0 | 256495 | 0 | 0 | 0 |
| DEBORAH YOUNG | |||||||||||||
| 152752 | 0 | 111 | 0 | 0 | 0 | 9382 | 0 | 11387 | 0 | 173632 | 0 | 0 | 0 |
| SALLIE ARNETT | |||||||||||||
| 143874 | 0 | 111 | 0 | 0 | 0 | 8837 | 0 | 11315 | 0 | 164137 | 0 | 0 | 0 |
| VERONICA LINK | |||||||||||||
| 131655 | 0 | 111 | 0 | 0 | 0 | 8087 | 0 | 11216 | 0 | 151069 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | ROBERT MONTAGNESE, PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). A CONTRIBUTION WAS MADE TO THE PLAN ON HIS BEHALF FOR THE 2010 YEAR IN THE AMOUNT OF $67,600. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE RETURN IS REVIEWED FIRST BY INTERNAL MANAGEMENT. AFTER INTERNAL MANAGEMENT HAS REVIEWED THE RETURN AND ANY CHANGES ARE MADE A DRAFT IS MADE AVAILABLE FOR REVIEW AND PRESENTATION TO THE BOARD. ONCE THE COMMENTS FROM THE BOARD ARE REVIEWED THE FINAL RETURN IS PREPARED AND SIGNED BY THE VICE PRESIDENT OF FINANCIAL SERVICES. | |
| THE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST STATEMENT ONCE A YEAR. THE ORGANIZATION DOES NOT PERMIT BOARD MEMBERS TO HAVE A CONFLICT OF INTEREST. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE ASKED TO RESIGN FROM THE BOARD. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE ORGANIZATION HAS AN INDEPENDENT COMPENSATION COMMITTEE THAT DETERMINES THE COMPENSATION FOR THE CEO THAT IS THEN APPROVED BY THE BOARD. THE CEO DETERMINES THE COMPENSATION FOR THE OTHER OFFICERS BASED UPON INDEPENDENT SALARY SURVEYS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | ROUNDING 2. NET ASSET TRANSFERS WITH RELATED 501(C)(3) -26,140,758. CHANGE IN RETIREE BENEFIT PLAN -156,321. UNREALIZED GAIN/LOSS 743,370. CHANGE IN MINIMUM PENSION LIABILITY -2,952,549. TOTAL TO FORM 990, PART XI, LINE 5: -28,506,256. | FORM 990, PART XI, LINE 5: |
| THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS OF THE INDEPENDENT AUDITOR. LICKING MEMORIAL HOSPITAL CONTINUES TO BE AUDITED AS PART OF THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED GROUP. LICKING MEMORIAL HOSPITAL IS INCLUDED IN THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS A FINANCE COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. | FORM 990, PAGE 12, PART XII LINE 2C: | |
| COMMUNITY BENEFIT FOR LICKING MEMORIAL HEALTH SYSTEM CONSOLIDATED GROUP | MONETARY INPUTS OUTPUTS EXPENSES OFFSETS BENEFIT PERSONS 12 LEAD EKG PROJECT CARDIOLOGY (1712) 72,006 0 72,006 UNKNOWN 20TH CENTURY CLUB DONATION DEVELOPMENT (1955) 2,000 0 2,000 UNKNOWN AARP SPEAKER PUBLIC RELATIONS (1956) 294 0 294 36 ADAMS MIDDLE SCHOOL JOHNSTOWN SCREENINGS AND HEALTH FAIR PUBLIC RELATIONS (1956) 47 0 47 23 ADD / ADHD PROCESS IMPROVEMENT (1945) 411 0 411 22 ALEXANDRIA BUCKEYE SENIORS SPEAKER PUBLIC RELATIONS (1956) 364 0 364 85 AMERICAN CANCER SOCIETY SPONSORSHIPS DEVELOPMENT (1955) 3,250 0 3,250 UNKNOWN AMERICAN RED CROSS OF LICKING COUNTY EVENT SPONSORSHIPS DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN ANXIETY STRESS MANAGEMENT PROCESS IMPROVEMENT (1945) 473 0 473 57 ART FROM THE HEART DEVELOPMENT (1955) 11,884 0 11,884 389 ARVIN MERITOR SPEAKER PUBLIC RELATIONS (1956) 1,343 0 1,343 118 ASK THE DOC AT SHEPHERD HILL OP CHEMICAL DEPENDENCY (1692) 7,552 0 7,552 1,216 BEATING HOLIDAY STRESS PROCESS IMPROVEMENT (1945) 99 0 99 3 BIG BROTHERS/BIG SISTERS EVENT SPONSORSHIPS DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN BLESSED SACRAMENT SCHOOL SPONSORSHIPS DEVELOPMENT (1955) 400 0 400 UNKNOWN BOEING HEALTH & WELLNESS FAIR SPEAKER COMMUNITY CASE MANAGEMENT (1976) 210 0 210 110 BOY SCOUTS OF AMERICA SIMON KENTON COUNCIL DEVELOPMENT (1955) 850 0 850 UNKNOWN BREAST CA AWARENESS DAY FREE MAMMOGRAMS RADIOLOGY (1721) 8,443 0 8,443 55 BREAST CANCER AWARENESS & SCREENING EDUCATION (1616) 476 0 476 9 BREAST FEEDING BASICS MATERNAL CHILD (1646) 10,980 8,004 2,976 669 BREASTFEEDING PROMOTION & SUPPORT PROGRAM MATERNAL CHILD (1646) 57,600 0 57,600 360 BUSINESS AFTER HOURS INFORMATION TABLE PUBLIC RELATIONS (1956) 267 0 267 200 C TEC ANNUAL RECOGNITION BRUNCH & EVENT SPONSOR DEVELOPMENT (1955) 400 0 400 UNKNOWN C TEC DONATIONS DEVELOPMENT (1955) 10,000 0 10,000 UNKNOWN CAMP FEELIN' FINE RESPIRATORY THERAPY (1736) 6,367 0 6,367 41 CAMP O'BANNON EVENT SPONSOR DEVELOPMENT (1955) 350 0 350 UNKNOWN CANDLEWICK APARTMENTS SPEAKER COMMUNITY CASE MANAGEMENT (1976) 119 0 119 5 CAR SEAT INSTALLATION/EDUCATION MATERNAL CHILD (1646) 153 0 153 26 CAROL STRAWN CENTER SPONSORSHIP DEVELOPMENT (1955) 820 0 820 UNKNOWN CBISA SOFTWARE FISCAL SERVICES (1901) 800 0 800 UNKNOWN CENTER FOR DISABILITY SERVICES EVENT SPONSOR DEVELOPMENT (1955) 350 0 350 UNKNOWN CENTER FOR VISUALLY IMPAIRED SPONSORSHIP DEVELOPMENT (1955) 59 0 59 UNKNOWN CENTRAL OHIO AREA AGENCY ON AGING PUBLIC RELATIONS (1956) 107 0 107 12 CHAPEL GROVE SPEAKER PUBLIC RELATIONS (1956) 298 0 298 55 CHILDHOOD VACCINATIONS PROCESS IMPROVEMENT (1945) 68 0 68 3 CHRISTIAN COMPANIONS OF SECOND CHURCH OF CHRIST PUBLIC RELATIONS (1956) 120 0 120 6 CITY OF HEATH SOFTBALL TEAM SPONSORSHIP DEVELOPMENT (1955) 350 0 350 UNKNOWN CLINICAL EDUCATION OF ECHOSONOGRAPHERS (CARDIOLOGY) CARDIOLOGY (1712) 12,034 0 12,034 7 COLORECTAL AWARENESS EDUCATION (1616) 310 0 310 18 COMMUNITY BENEFIT REPORTING HOURS FISCAL SERVICES (1901) 3,136 0 3,136 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY BENEFIT) EXECUTIVE ADMIN (1950) 14,827 0 14,827 200 COMMUNITY BOARD/COMMITTEE MEETINGS (COMMUNITY SUPPORT) EXECUTIVE ADMIN (1950) 32,568 0 32,568 UNKNOWN COMMUNITY BOARD/COMMITTEE MEETINGS (WORKFORCE DEVELOPMENT) EXECUTIVE ADMIN (1950) 2,199 0 2,199 UNKNOWN COMMUNITY CASE MANAGEMENT SERVICES COMMUNITY CASE MANAGEMENT (1976) 710,404 125,496 584,908 UNKNOWN COMMUNITY HEALTH & RECOVERY BOARD DONATION FOOD SERVICE (1801) 287 0 287 UNKNOWN COMMUNITY HEALTH ASSESSMENT COMMITTEE PROCESS IMPROVEMENT (1945) 483 0 483 UNKNOWN COMPEER SPEAKER PUBLIC RELATIONS (1956) 97 0 97 8 COTC LPN CLASS PUBLIC RELATIONS (1956) 114 0 114 34 COTC RADIOLOGY CLASS PUBLIC RELATIONS (1956) 102 0 102 18 CTEC SPEAKER PUBLIC RELATIONS (1956) 367 0 367 35 CTEC MA EXTERNSHIP PROGRAM EXECUTIVE ADMIN LMHP (7445) 11,960 0 11,960 5 CTEC CLINICAL CAREER CLASS LAB (1702) 59 0 59 22 DAWES ARBORETUM SPONSORSHIP DEVELOPMENT (1955) 700 0 700 UNKNOWN DENISON FRESHMAN CAREER FAIR HUMAN RESOURCES (1951) 1,354 0 1,354 300 DENISON UNIVERSITY EMPLOYEE HEALTH FAIR PUBLIC RELATIONS (1956) 1,732 0 1,732 212 DIABETES AND SMART HOLIDAY EATING PROCESS IMPROVEMENT (1945) 97 0 97 2 DIABETES AWARENESS EDUCATION (1616) 246 0 246 10 DINING WITH DIABETES PROCESS IMPROVEMENT (1945) 240 0 240 163 DONATION OF MEAT TO SALVATION ARMY VOLUNTEERS (1970) 469 0 469 UNKNOWN DONATION OF SUPPLIES TO IMPOVERISHED COUNTRIES PURCHASING (1675) 188,347 0 188,347 UNKNOWN DOWNS SYNDROME ASSOCIATION OF CENTRAL OHIO ANNUAL WORKSHOP PUBLIC RELATIONS (1956) 106 0 106 40 DRUG ASSISTANT INDIGENT DRUG RECOVERY EXECUTIVE ADMIN LMHP (7445) 2,257 0 2,257 83 EMERGENCY SERVICES FOR INDIGENT PATIENTS FISCAL SERVICES (1901) 77,606 0 77,606 UNKNOWN ETNA LIONS CRUISE IN HEALTH FAIR PUBLIC RELATIONS (1956) 266 0 266 24 | FORM 990, PAGE 2 PROGRAM SERVICES |
| FAMILY & FRIENDS INFANT AND CHILD CPR MATERNAL CHILD (1646) 862 385 477 73 FOUR TOWN LA SERTOMA SPEAKER PUBLIC RELATIONS (1956) 173 0 173 16 FUNERAL DIRECTORS CONFERENCE DEVELOPMENT (1955) 243 0 243 22 GIRLS SCOUT TROOP 1931 SPEAKER PUBLIC RELATIONS (1956) 162 0 162 6 GIS RUNNING CLUB DEVELOPMENT (1955) 250 0 250 UNKNOWN GLENN'S MARKET SCREENINGS PUBLIC RELATIONS (1956) 1,456 0 1,456 136 GRANVILLE HIGH SCHOOL SPEAKER PUBLIC RELATIONS (1956) 77 0 77 20 GRANVILLE HIGH SCHOOL SPONSORSHIP DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN GRANVILLE INTERMEDIATE SCHOOL RUNNING CLUB SPEAKER PUBLIC RELATIONS (1956) 116 0 116 135 GRANVILLE PTO AUCTION DONATION DEVELOPMENT (1955) 500 0 500 UNKNOWN GRANVILLE ROTARY CULINARY FESTIVAL SPONSORSHIP DEVELOPMENT (1955) 1,500 0 1,500 UNKNOWN HALLOWEEN ON THE SQUARE VOLUNTEERS (1970) 405 0 405 150 HARTFORD FAIR HEALTH SCREENINGS & HEALTH EDUCATION PUBLIC RELATIONS (1956) 9,448 0 9,448 1,000 HEALTHY EATING AND WEIGHT LOSS EDUCATION (1616) 605 0 605 82 HEART HEALTH & SLEEP DISTURBANCES PROCESS IMPROVEMENT (1945) 310 0 310 35 HEATH FIRE DEPARTMENT OPEN HOUSE PUBLIC RELATIONS (1956) 163 0 163 200 HOSPICE OF CENTRAL OHIO SPONSORSHIPS DEVELOPMENT (1955) 800 0 800 UNKNOWN HOW TO BE A SAFE PATIENT PROCESS IMPROVEMENT (1945) 149 0 149 3 HUMANE SOCIETY CAMPAIGN PUBLIC RELATIONS (1956) 1,145 0 1,145 100 IMMUNIZATION OF PATIENTS AGES 65 AND OVER FOR TD EXECUTIVE ADMIN LMHP (7445) 12,567 0 12,567 469 INSTRUCTIONAL INTERNSHIP LAB STUDENTS LAB (1702) 9,797 0 9,797 2 INTERNSHIP MEDICAL ASSISTANT PROGRAM PAIN CLINIC PAIN MGMT (1690) 1,290 0 1,290 1 KIWANIS MAPLE LEAF 5K PUBLIC RELATIONS (1956) 127 0 127 150 KRANER BEHAVIORAL HEALTH HISTORIC HOME AND OPEN HOUSE DONATION DEVELOPMENT (1955) 250 0 250 UNKNOWN KROGER SPEAKER PUBLIC RELATIONS (1956) 203 0 203 200 LADIES CIRCLE OF UTICA CHURCH OF CHRIST PUBLIC RELATIONS (1956) 394 0 394 12 LAKEWOOD GIRLS SUMMER SOFTBALL SPONSORSHIP DEVELOPMENT (1955) 350 0 350 UNKNOWN LAKEWOOD YOUTH BASEBALL ASSOCIATION SPONSORSHIP FUND DEVELOPMENT (1955) 200 0 200 UNKNOWN LC CHAMBER OF COMMERCE BUSINESS AFTER HOURS SPEAKER PUBLIC RELATIONS (1956) 521 0 521 190 LC MENTAL HEALTH AMERICA EVE ELLIOT EASTER BASKET PROJECT IP PSYCH DETOX (1691) 68 0 68 10 LC UNITED WAY ANNUAL MEETING SPONSORSHIP DEVELOPMENT (1955) 450 0 450 UNKNOWN LCESC JR. HIGH CAREER EXPLORATION HUMAN RESOURCES (1951) 748 0 748 15 LEADS HEADSTART SPEAKER PUBLIC RELATIONS (1956) 118 0 118 8 LEARN, GROW, AND PLAY DAYCARE AND DEVELOPMENT CENTER SPEAKER PUBLIC RELATIONS (1956) 179 0 179 21 LICCO INC. SPONSORSHIP DEVELOPMENT (1955) 250 0 250 UNKNOWN LICKING CO HEALTH DEPT CHLAMYDIA/GC LAB (1702) 5,415 0 5,415 126 LICKING COUNTY AGING PROGRAM SPEAKER PUBLIC RELATIONS (1956) 193 0 193 30 LICKING COUNTY AGING PROGRAM SPONSORSHIPS DEVELOPMENT (1955) 460 0 460 UNKNOWN LICKING COUNTY BOARD OF DEVELOPMENTAL DISABILITIES SPEAKER PUBLIC RELATIONS (1956) 50 0 50 115 LICKING COUNTY CHAMBER OF COMMERCE EVENT SPONSOR DEVELOPMENT (1955) 2,515 0 2,515 UNKNOWN LICKING COUNTY COALITION FOR HOUSING EVENT SPONSOR DEVELOPMENT (1955) 550 0 550 UNKNOWN LICKING COUNTY COALITION OF CARE DONATION DEVELOPMENT (1955) 700 0 700 UNKNOWN LICKING COUNTY FAMILY YMCA EVENT SPONSORSHIPS DEVELOPMENT (1955) 1,350 0 1,350 UNKNOWN LICKING COUNTY HEALTH DEPARTMENT SASS PUBLIC RELATIONS (1956) 1,813 0 1,813 100 LICKING COUNTY HEALTH DEPARTMENT SPEAKER PUBLIC RELATIONS (1956) 400 0 400 15 LICKING COUNTY HEALTH DEPARTMENT DONATION DEVELOPMENT (1955) 400 0 400 UNKNOWN LICKING COUNTY JOB AND FAMILY SERVICES/EMPLOYEE HEALTH & WELLNESS PUBLIC RELATIONS (1956) 161 0 161 50 LICKING COUNTY PRAYER PARTNERS DONATION DEVELOPMENT (1955) 750 0 750 UNKNOWN LICKING COUNTY SETTLERS DONATION DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN LICKING COUNTY SHERIFF''S DEPARTMENT CONTRIBUTION DEVELOPMENT (1955) 292 0 292 UNKNOWN LICKING COUNTY SOIL,WATER AND FARM BUREAU BREAKFAST SCREENINGS PUBLIC RELATIONS (1956) 298 0 298 75 LICKING COUNTY SPECIAL OLYMPICS DEVELOPMENT (1955) 100 0 100 UNKNOWN LICKING COUNTY SPORTS ASSOCIATION SIGN SPONSORSHIP RENEWAL DEVELOPMENT (1955) 350 0 350 UNKNOWN LICKING VALLEY HIGH SCHOOL SPEAKER PUBLIC RELATIONS (1956) 473 0 473 150 LICKING VALLEY HIGH SCHOOL SPONSORSHIPS DEVELOPMENT (1955) 340 0 340 UNKNOWN LICKING VALLEY YOUTH SPORTS ASSOCIATION DEVELOPMENT (1955) 500 0 500 UNKNOWN LOWES SAFETY SATURDAY PUBLIC RELATIONS (1956) 90 0 90 75 MATERNAL CHILD STUDENT PRECEPTORS MATERNAL CHILD (1646) 23,910 0 23,910 12 MENTAL HEALTH AMERICA OF LICKING COUNTY SPONSORSHIPS DEVELOPMENT (1955) 600 0 600 UNKNOWN MILLERSPORT WRESTLING TEAM SPEAKER PUBLIC RELATIONS (1956) 136 0 136 12 MITCHELL RETIREMENT CENTER SPEAKER PUBLIC RELATIONS (1956) 162 0 162 15 MOTHERS OF PRESCHOOLERS PUBLIC RELATIONS (1956) 184 0 184 15 MPW LUNCH AND LEARN PUBLIC RELATIONS (1956) 134 0 134 15 MUSCULAR DYSTROPHY ASSOCIATION SPONSORSHIP DEVELOPMENT (1955) 40 0 40 UNKNOWN NAVIGATING YOUR INSURANCE PROCESS IMPROVEMENT (1945) 129 0 129 3 NEW ALBANY HEALTH AND WELLNESS EXPO PUBLIC RELATIONS (1956) 653 0 653 200 | ||
| NEW LIFE COMMUNITY KIDS FAIR PUBLIC RELATIONS (1956) 214 0 214 25 NEWARK CATHOLIC HIGH SCHOOL SPEAKER PUBLIC RELATIONS (1956) 105 0 105 22 NEWARK CATHOLIC HIGH SCHOOL ATHLETIC DEPT. SPONSORSHIPS DEVELOPMENT (1955) 646 0 646 UNKNOWN NEWARK FIRE FIGHTERS LOCAL 109 DEVELOPMENT (1955) 500 0 500 UNKNOWN NEWARK GENERALS HOCKEY CLUB SPONSORSHIP DEVELOPMENT (1955) 500 0 500 UNKNOWN NEWARK HIGH SCHOOL SPONSORSHIP DEVELOPMENT (1955) 450 0 450 UNKNOWN NEWARK MIDLAND THEATRE SPONSORSHIP DEVELOPMENT (1955) 5,000 0 5,000 UNKNOWN NORTH NEWARK LITTLE LEAGUE VARSITY AND FARM SPONSORSHIP DEVELOPMENT (1955) 600 0 600 UNKNOWN NORTHRIDGE ATHLETIC BOOSTERS DONATION DEVELOPMENT (1955) 500 0 500 UNKNOWN NORTHRIDGE SCHOOL DISTRICT SPEAKER PUBLIC RELATIONS (1956) 917 0 917 700 NUTRITION CLASS COMMUNITY CASE MANAGEMENT (1976) 66 0 66 23 OCCUPATIONAL THERAPY ASSISTANT STUDENT OCCUPATIONAL THERAPY (1700) 16,293 0 16,293 2 ODOT HEALTH FAIR PUBLIC RELATIONS (1956) 784 0 784 140 OHIO CANCER RESEARCH ASSOCIATES DONATION DEVELOPMENT (1955) 4,400 0 4,400 UNKNOWN OP CHEMICAL DEPENDENCY & IP PSYCH STUDENT INTERNSHIPS OP CHEMICAL DEPENDENCY (1692) 11,443 0 11,443 6 OPERATION FEED VOLUNTEERS (1970) 5,020 0 5,020 UNKNOWN OSU ADENA HALL LECTURE COMMUNITY CASE MANAGEMENT (1976) 98 0 98 40 OSU SPEAKER PUBLIC RELATIONS (1956) 715 0 715 8 OWENS CORNING EMPLOYEE HEALTH FAIR PUBLIC RELATIONS (1956) 530 0 530 80 PAR EXCELLENCE ACADEMY SPONSORSHIP DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN PARENTING CLASS MATERNAL CHILD (1646) 724 190 534 44 PARK NATIONAL BANK SPEAKER PUBLIC RELATIONS (1956) 847 0 847 95 PARKINSON SUPPORT GROUP SPEAKER PUBLIC RELATIONS (1956) 218 0 218 65 PATASKALA ELEMENTARY SCHOOL VISIT VOLUNTEERS (1970) 441 0 441 120 PATASKALA HISTORICAL TOWN HALL INC. SPONSORSHIP DEVELOPMENT (1955) 1,394 0 1,394 UNKNOWN PATASKALA STREET FAIR PATASKALA (7404) 1,431 0 1,431 650 PEDIATRIC DENTAL CLINIC DENTAL CLINIC (1958) 96,000 77,641 18,359 UNKNOWN PHYSICIAN MISSION SUPPLIES DONATED KOREA LAB (1702) 319 0 319 50 PINK STRIDES TRAIL RUN & WELLNESS WALK DEVELOPMENT (1955) 386 0 386 150 PRECEPTING NURSING STUDENTS IN GI LAB ENDO DIAGNOSTIC LAB (1676) 1,503 0 1,503 1 PRECEPTING NURSING STUDENTS IN OUTPATIENT CLINIC OUTPATIENT CLINIC (1685) 6,146 0 6,146 2 PRECEPTING NURSING STUDENTS IN THE WOUND CLINIC WOUND CLINIC (1677) 9,198 0 9,198 4 PRECEPTING NURSING STUDENTS ON 4N & 4S 4 SOUTH (1614) 12,301 0 12,301 7 PRECEPTING PHARMACY STUDENTS PHARMACY (1730) 94,275 18,000 76,275 8 PRECEPTING RADIOLOGY STUDENTS RADIOLOGY (1721) 108,290 0 108,290 27 PRECEPTING STUDENTS FOR 5S 5 SOUTH (1612) 9,397 0 9,397 7 PRECEPTORSHIP FOR CERTIFIED NURSE PRACTITIONER STUDENTS FMC EAST (7425) 29,580 0 29,580 9 PRECEPTORSHIP FOR RN STUDENTS ICU, CCU, ER INTENSIVE CARE (1640) 44,453 0 44,453 25 PRECEPTORSHIP FOR ULTRASOUND STUDENT VASCULAR LAB NEURO VASCULAR LAB (1674) 9,082 0 9,082 2 PRECEPTORSHIP IN PACU/OR SURGERY (1660) 22,677 0 22,677 9 PUBLIC HEALTH PARTNERSHIP, INC. THINK PINK DONATION DEVELOPMENT (1955) 400 0 400 UNKNOWN RED CROSS BLOOD DRIVE EDUCATION (1616) 7,973 25 7,948 278 RED DRESS EVENT PUBLIC RELATIONS (1956) 20,624 0 20,624 300 REESE ADULT DAY CARE SPONSORSHIP DEVELOPMENT (1955) 500 0 500 UNKNOWN RESOURCE CENTER RESOURCE CENTER (1975) 14,219 0 14,219 UNKNOWN ROTARY CLUB OF GRANVILLE SPONSORSHIP DEVELOPMENT (1955) 1,500 0 1,500 UNKNOWN ROTARY CLUB OF PATASKALA SPONSORSHIP DEVELOPMENT (1955) 1,000 0 1,000 UNKNOWN SALVATION ARMY FOOD ASSISTANCE FOOD SERVICE (1801) 2,996 0 2,996 UNKNOWN SALVATION ARMY WOMENS LEAGUE SPEAKER PUBLIC RELATIONS (1956) 377 0 377 87 SHERIDAN HIGH SCHOOL VOLLEYBALL TEAM BREAST CANCER AWARENESS PUBLIC RELATIONS (1956) 131 0 131 150 SIBLING PREPARATION CLASS MATERNAL CHILD (1646) 564 140 424 50 SKIN CANCER AWARENESS AND SCREENING PROCESS IMPROVEMENT (1945) 1,293 0 1,293 57 SOUTHWEST LICKING SCHOOLS SPEAKER PUBLIC RELATIONS (1956) 321 0 321 26 SOUTHWEST LICKING SCHOOLS SPONSORSHIP DEVELOPMENT (1955) 200 0 200 UNKNOWN SPIRITUALITY AND HEALING PROCESS IMPROVEMENT (1945) 169 0 169 17 SPORTS PHYSICALS & ECG'S TAMARACK SPORTS PHYSICALS (7487) 41,830 0 41,830 1,072 ST. FRANCIS DE SALES SCHOOL & PARISH SPONSORSHIPS DEVELOPMENT (1955) 100 0 100 UNKNOWN STUDENT INTERNSHIPS RESPIRATORY THERAPY RESPIRATORY THERAPY (1736) 887 0 887 1 STUDENT INTERNSHIPS PHYSICAL THERAPY & SPEECH THERAPY REHAB CENTER (1737) 25,860 0 25,860 5 STUDENT NURSE & OTHER HEALTH PROFESSIONALS MANAGEMENT PROCESS EDUCATION (1616) 10,557 0 10,557 UNKNOWN STUDENT NURSE & OTHER HEALTH PROFESSIONALS ORIENTATION EDUCATION (1616) 6,216 0 6,216 749 STUDENTS TO SHADOW CCM STAFF COMMUNITY CASE MANAGEMENT (1976) 11,363 0 11,363 2 TAXI TOKENS IP PSYCH DETOX (1691) 120 0 120 UNKNOWN TECH INTERNATIONAL SPEAKER PUBLIC RELATIONS (1956) 298 0 298 51 THE ENERGY COOPERATIVE SPEAKER PUBLIC RELATIONS (1956) 608 0 608 2,036 THE WOODLANDS EVENT SPONSORSHIPS DEVELOPMENT (1955) 1,075 0 1,075 UNKNOWN THE WORKS SPONSORSHIPS DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN TOBACCO CESSATION PROGRAM TOBACCO CESSATION (1693) 211,532 0 211,532 2,182 TOPS HEALTHY WEIGHT LOSS GROUP EDUCATION PUBLIC RELATIONS (1956) 603 0 603 83 TREND MAGAZINE WOMEN'S EXPO PUBLIC RELATIONS (1956) 376 0 376 400 UNITED WAY AGENCIES DONATION HUMAN RESOURCES (1951) 1,713 0 1,713 UNKNOWN UNITED WAY CAMPAIGN HUMAN RESOURCES (1951) 3,000 0 3,000 UNKNOWN UNITED WAY DAY OF CARING DEVELOPMENT (1955) 2,180 0 2,180 32 VELVET ICE CREAM SPEAKER PUBLIC RELATIONS (1956) 237 0 237 16 VINEYARD GRACE FELLOWSHIP DONATION LAB (1702) 417 0 417 UNKNOWN VOLUNTEERS TWIGS & EVENTS VOLUNTEERS (1970) 0 0 0 140 WASHINGTON SQUARE APARTMENTS SPEAKER PUBLIC RELATIONS (1956) 56 0 56 20 WATKINS MEMORIAL SPONSORSHIP DEVELOPMENT (1955) 200 0 200 UNKNOWN WEATHERVANE PLAYHOUSE SPONSORSHIP DEVELOPMENT (1955) 2,500 0 2,500 UNKNOWN WEST LICKING FIRE DEPARTMENT SPEAKER & SCREENINGS PUBLIC RELATIONS (1956) 747 0 747 150 WEST MAIN STREET BILL BOARD BEHIND MCN PUBLIC RELATIONS (1956) 500 0 500 UNKNOWN YMCA ACTIVATE OHIO COMMUNITY CASE MANAGEMENT (1976) 281 0 281 95 ZONTA CLUB OF NEWARK DEVELOPMENT (1955) 500 0 500 UNKNOWN NUMBER OF PROGRAMS 213 GRAND TOTALS 2,237,167 229,881 2,007,286 19,065 BENEFITS FOR POOR: TOTAL EXPENSE OFFSETTING REVENUE NET BENEFIT PERSONS TRADITIONAL CHARITY CARE $9,538,335 $2,241,253 $7,297,082 14,739 UNPAID COST OF MEDICAID $31,420,456 $15,565,644 $15,854,812 27,082 GRAND TOTALS $43,195,958 $18,036,778 $25,159,180 60,886 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LICKING MEMORIAL HEALTH SYSTEMS | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311096218 | PARENT COMPANY FOR THE NONPROFIT OPERATION OF HEALTHCARE ORGANIZATIONS | OH | 501(C)(3) | 11 TYPE III - FI | N/A | 0 | |
| LICKING MEMORIAL HEALTH FOUNDATION | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311096217 | PROVIDE FUNDING FOR HEALTHCARE PROGRAMS | OH | 501(C)(3) | 11 TYPE I | 0 | LICKING MEMORIAL HEALTH SYSTEMS | |
| LICKING MEMORIAL PROFESSIONAL CORPORATION | |||||||||||
| 1320 WEST MAIN STREET | NEWARK | OH | 43055 | 311425530 | HEALTHCARE ORGANIZATION | OH | 501(C)(3) | 9 | 0 | LICKING MEMORIAL HEALTH SYSTEMS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Comments