2011-11-15T12:22:55-06:00 2010-12-31 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2010-01-01 340714612 EMH REGIONAL MEDICAL CENTER EMHR 4403297605 630 EAST RIVER STREET ELYRIA OH 44035 JAMES M SIMONE 4403297605 2011-11-14 1 2483522500 2010 2016-02-24 21:20:13Z DONALD SHELDON 630 EAST RIVER STREET ELYRIA OH 44035 309049337 0 X WWW.EMH-HEALTHCARE.ORG X 1907 OH NON-PROFIT COMMUNITY HEALTH PROVIDING IN AND OUT PATIENT CARE INCLUDING FULL SERVICE EMERGENCY ROOM TO THE COMMUNITY OF ELYRIA, OHIO AND SURRONDING AREA. 22 21 2098 323 28383 6318 452755 124618 181512445 185957490 3352455 5333840 1953480 1402913 187271135 192818861 3000 7022430 0 0 84691307 86788049 0 0 0 95506624 98131866 180200931 191942345 7070204 876516 238893375 239835011 110578616 110643132 128314759 129191879 X WE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY THROUGH SAFE, HIGH QUALITY AND COST EFFECTIVE CARE. 0 0 32774305 7022430 36366082 CARDIOLOGY - EMH FEATURES LORAIN COUNTY'S LEADING AND NATIONALLY RECOGNIZED CARDIOVASCULAR HEALTH AND REHABILITATION CENTER, WITH SERVICES FOR CORONARY BYPASS SURGERY, ANGIOPLASTY, CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY, CARDIAC REHABILITATION, HEART FAILURE THERAPIES AND OTHER DIAGNOSTIC SERVICES. EMH REGIONAL MEDICAL CENTER RECEIVED FULL CYCLE II ACCREDITATION WITH PCI THROUGH 2010 FROM THE ACCREDITATION REVIEW COMMITTEE OF THE SOCIETY OF CHEST PAIN CENTERS. THE FIRST DESIGNATION WAS GRANTED IN 2004, AND ENSURES THAT EMH MEETS OR EXCEEDS QUALITY OF CARE MEASURES IN ACUTE CARDIAC MEDICINE. EMH IS THE 72ND ACCREDITED CHEST PAIN CENTER IN THE UNITED STATES. ADDITIONALLY, IN 2008, EMH REGIONAL MEDICAL CENTER RECEIVED THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATIONS' NCDR ACTION REGISTRY - GWTG SILVER PERFORMANCE ACHIEVEMENT AWARD - ONE OF ONLY 93 HOSPITALS NATIONWIDE TO DO SO. THE AWARD RECOGNIZES EMH'S COMMITMENT AND SUCCESS IN IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART ATTACK PATIENTS. 36851922 34095395 ROUTINE INPATIENT CARE - INPATIENT CARE AT EMH INCLUDES A VARIETY OF SERVICES, RANGING FROM INTENSIVE CARE UNITS (MEDICAL/SURGICAL) AND THE FAMILY BIRTH CENTER, TO MENTAL HEALTH AND UNIVERSAL CARE. EACH DEPARTMENT IS STAFFED WITH HIGHLY SKILLED AND SPECIALLY EDUCATED HEALTHCARE PROFESSIONALS WHO ARE EQUIPPED TO ADDRESS EACH PATIENTS'S NEEDS. 26561965 23769065 SURGICAL SERVICES - HIGHLY TRAINED MEDICAL PHYSICIANS AND SURGEONS TREAT A WIDE VARIETY AND COMPLEXITY OF SURGICAL CASES AT EMH REGIONAL MEDICAL CENTER. SERVICES INCLUDE BOTH INPATIENT AND OUTPATIENT SURGERY, WITH THE MAJORITY PERFORMED ON AN OUTPATIENT BASIS. CONSULTATION WITH SPECIALISTS ENSURE THAT PATIENTS RECEIVE THE MOST COMPREHENSIVE CARE, AND TECHNOLOGICAL INNOVATIONS ALLOW FOR LESS INVASIVE PROCEDURES, WHICH IN TURN ENABLES FASTER HEALING. 74125360 92040890 OTHER PROGRAM SERVICES - ADDITIONAL MEDICAL SERVICES AT EMH ARE COMPREHENSIVE AND INCLUDE: RADIOLOGY/IMAGING, LABORATORY, WOUND CARE, PEDIATRIC AFTER-HOURS CARE, SPORTS MEDICINE/REHABILITATION, OUTPATIENT INFUSION, ORTHOPEDICS, DIABETES EDUCATION, HEALTHY WOMEN/HEALTHY FAMILIES, MENTAL HEALTH, HOME CARE, OCCUPATIONAL MEDICINE, SLEEP STUDIES, SOCIAL WORK AND EMERGENCY SERVICES. 74125360 92040890 170313552 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 77 0 1 2098 1 1 1 0 0 0 0 0 0 0 0 0 X 22 21 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OH X JAMES M SIMONE VP FINANCECFO 4403297605 630 EAST RIVER STREET ELYRIA OH 44035 BECKETT JONATHAN M 2.00 X 0 0 0 CANNADAY LEE 2.00 X 0 0 0 HOAGLAND BRIAN 2.00 X 0 0 0 LAMB WILLIAM 2.00 X 0 0 0 MIGGINS LYNN 2.00 X 0 0 0 OLESEN ROBERT 2.00 X 0 0 0 REIDY JOAN 2.00 X 0 0 0 RIGDA PAUL 2.00 X 0 0 0 RYAN SPENCER 2.00 X 0 0 0 WALDHEGER PRISCILLA MD 2.00 X 0 0 0 YOST ROBERT 2.00 X 0 0 0 BRAUSCH JEFF 2.00 X X 0 0 0 FLANIGAN KEVIN 2.00 X X 0 0 0 SHELDON DONALD 55.00 X X 0 416370 21214 D'AMICO LOUIS 2.00 X 0 0 0 FRANK RAY 2.00 X 0 0 0 HAYWOOD TIMOTHY 2.00 X 0 0 0 SPIKE SANDY 2.00 X 0 0 0 MUSSON JOHN 2.00 X 0 0 0 SANJAY PALAKAR MD 2.00 X 0 0 0 POND FRED 2.00 X 0 0 0 YOST JUNE 2.00 X 0 0 0 NORTON BENJAMIN PARTIAL YEAR 2.00 X 0 0 0 SMITH STEPHEN PARTIAL YEAR 2.00 X 0 0 0 SIMONE JAMES M 55.00 X 0 290717 23975 COOKSEY JILL 55.00 X 0 159562 67623 GARDNER FRANCIS X 55.00 X 0 219777 19386 MCDONALD DOUGLAS 55.00 X 0 220492 25102 MILLER DANIEL N 55.00 X 0 237762 24468 WRAY CHARLOTTE 55.00 X 0 154545 19747 GIBBONS TERRIL 55.00 X 140157 0 20540 GRAUER JOHN 55.00 X 217426 0 967 HALLIDAY DONALD 55.00 X 136226 0 19933 WALSH BRIAN 55.00 X 135170 0 28878 ZEOLLA KATERINE 55.00 X 196944 0 14690 825923 1699225 286523 17 0 1 0 ELYRIA ANESTHESIA 860 BROAD STREET ELYRIA OH 44035 PURCHASED MEDICAL SERVICES 1324246 CLEVELAND CLINIC FND PO BOX 931760 CLEVELAND OH 44193 PURCHASED MEDICAL SERVICES 890976 COMMUNITY HOSPITALISTS LLC PO BOX 200466 PITTSBURGH PA 15251 PURCHASED MEDICAL SERVICES 883228 ARUP PO BOX 27964 SALT LAKE CITY UT 84127 PURCHASED MEDICAL SERVICES 609332 DIVERSIFIED CLINICAL SERVICES PO BOX 850001 ORLANDO FL 32888 PURCHASED MEDICAL SERVICES 583553 25 29186 95432 124618 NET PATIENT CARE 622110 182278360 182278360 HEALTH FITNESS CENTER 622110 3650747 3650747 LABORATORY REVENUE 621500 28383 28383 185957490 3130475 3130475 202027 202027 202027 202027 118352983 80858 116230476 2122507 80858 2203365 2203365 CAFETERIA / VENDING 900099 737633 737633 AHA MANAGEMENT FEE 561000 264999 264999 DISCOUNTS / REBATES 900099 77326 77326 120928 120928 1200886 192818861 186271432 28383 6394428 7022430 7022430 68013959 61212563 6801396 13683888 12315499 1368389 5090202 4581182 509020 11444019 8583014 2861005 120779 120779 75560 75560 5332271 4301678 1030593 44398 44398 41177717 36657249 4520468 783228 704905 78323 4102933 2515255 1587678 180747 108448 72299 2065553 1858998 206555 12272491 11045242 1227249 1125897 1125897 BAD DEBT 6340362 6340362 REPAIRS AND MAINTENANCE 3364519 2907518 457001 LAUNDRY 1042989 1042989 LEASE / RENTAL 690984 552787 138197 DUES AND LICENSES 217303 217303 7750116 7175835 574281 191942345 170313552 21628793 0 19722810 11499480 17349425 18994438 1581529 2032554 1514482 1502741 221482104 133363061 89727571 88119043 98249528 108204715 10748030 9482040 238893375 239835011 14078623 19143812 53380344 46526508 43119649 44972812 110578616 110643132 X 124190123 124760056 1973643 2098240 2150993 2333583 128314759 129191879 238893375 239835011 X 876516 604 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10926 10926 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE ORGANIZATION PAYS DUES TO CERTAIN HOSPITAL ASSOCIATIONS. A CERTAIN PERCENTAGE OF THOSE DUES ARE USED FOR PURPOSES OF LOBBYING. 4509220 4509220 61475404 35991992 25483412 144619157 94452787 50166370 10878323 2918282 7960041 88119043 PENSION LIABILITY 22519588 SELF-INSURANCE RESERVE 13587593 INTEREST RATE SWAP 3832113 ESTIMATED 3RD PARTY PAYABLE 5033518 44972812 1 1 X 1 X 1 X 1 1 1 0 1 1 10050495 1073723 8976772 0.05030 20682606 14311330 6371276 0.03570 0 30733101 15385053 15348048 0.08600 0 0 1892012 1415651 476361 0.00270 0 1892012 1415651 476361 0.00270 32625113 16800704 15824409 0.08870 417969 417969 0.00020 417969 417969 0.00020 0 2496940 47309 61179617 60218916 960701 X 1 1 1 ELYRIA CARDIAC CATH LAB LLC OUTPATIENT DIAGNOSTIC CATH LAB PROCEDURES 0.51000 0.00000 0.49000 1 1 EMH REGIONAL MEDICAL CENTER

630 EAST RIVER STREET ELYRIA OH 44035

X X X NA 1 2 EMH AVON CAMPUS

1997 HEALTHWAY RD AVON OH 44001

IMAGING, LAB REHABILITATION SERVICES & FITNESS CENTER EMH WESTLAKE CAMPUS

2211 CROCKER RD WESTLAKE OH 44145

IMAGING PART I, LINE 3C: N/A PART I, LINE 6A: N/A PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS USED FOR CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES PROVIDED INCLUDE NEONATAL INTENSIVE CARE AND INDIVIDUAL PSYCHOLOGY. PART I, L7 COL(F): CALCULATED NET COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL OPERATING EXPENSES (LESS BAD DEBT EXPENSE). THE BAD DEBT EXPENSE EXCLUDED FROM THE DENOMINATOR IS $6,340,362. PART II: COMMUNITY BUILDING ACTIVITIES INCLUDE HEALTH SCREENS AND PATIENT EDUCATION. COMMUNITY HEALTH SCREENINGS ARE CONDUCTED EVALUATING BLOOD PRESSURE, BLOOD SUGAR, CHOLESTEROL, BODY MASS INDEX, PSA FOR PROSTATE CANCER, SKIN CANCER SCREENINGS.SCREENINGS ARE CONDUCTED FOR LOCAL BUSINESS AND INDUSTRY AND AT LOCAL PUBLIC EVENTS AT SHOPPING MALLS, SALVATION ARMY, UNITED WAY, EL CENTRO EVENTS ETC. PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING CHCO'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. COST-TO-CHARGE RATIO USED TO DETERMINE COST REPORTED IN PART III, LINE 2. COST ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR ASSISTANCE ($47,309) BASED ON INSURED ACCOUNTS IN BAD DEBT STATUS THAT LATER HAD A CHARITY ADJUSTMENT. PART III, LINE 8: THE MEDICARE COST REPORT ALLOWABLE COSTS WERE USED TO ARRIVE AT AMOUNT REPORTED ON PART III, LINE 6. THESE MADICARE ALLOWABLE COSTS WERE DETERMINED USING THE COST-TO-CHARGE RATIO. PART III, LINE 9B: EMH WILL PROVIDE MEDICALLY NECESSARY SERVICE(S) FREE OF CHARGE TO ANY NON-MEDICAID OHIO RESIDENT, WHO IS EITHER COVERED BY DISABILITY ASSISTANCE OR HAS A FAMILY INCOME ON THE DATE-OF-SERVICE WHICH IS AT OR BELOW THE FEDERAL POVERTY INCOME GUIDELINES.IF THE PATIENT'S GUARANTOR(S) IS UNABLE TO MAKE FULL PAYMENT, ASSISTANCE MAY BE PROVIDED UNDER THE EMH CHARITY CARE PROGRAM. FREE CARE WILL BE PROVIDED TO ALL THOSE WHO PROVIDE THE NEEDED DOCUMENTATION ESTABLISHED BY THE OHIO DEPARTMENT OF HUMAN SERVICES, AND THE INCOME IS AT OR BELOW THE FEDERAL POVERTY GUIDELINE FOR THE DATE OF SERVICE.FREE CARE - OUR CHARITY PROGRAM INCORPORATES OHIO'S FREE CARE REQUIREMENTS. HOSPITAL SERVICES FOR MEDICALLY NECESSARY SERVICES ARE AVAILABLE AT NO CHARGE TO THOSE FAMILIES WHOSE INCOME IS AT OR LESS THAN THE FEDERAL INCOME GUIDELINES, WHICH ARE UPDATED ANNUALLY AND PUBLISHED EACH SPRING IN THE FEDERAL REGISTER. THESE GUIDELINES ESTABLISH A THRESHOLD OF INCOME WHICH GROWS AS THE FAMILY SIZE OF THE APPLICANT DOES.APPLYING FOR ASSISTANCE - A RELATIVELY SIMPLE APPLICATION HAS BEEN DESIGNED TO HELP DETERMINE ELIGIBILITY TO BASIC PROGRAMS AND A SPECIAL ABBREVIATED APPLICATION IS USED FOR THE HOMELESS. A PATIENT ACCOUNT REPRESENTATIVE SHALL ASSIST EACH APPLICANT WITH NECESSARY PAPERWORK. THE REPRESENTATIVE WILL ADJUST ACCOUNTS WITH A BALANCE UNDER $2,000. BALANCES $2,000 AND GREATER ARE REFERRED WITH THE APPROPRIATE INFORMATION TO THE PATIENT ACCOUNT ANALYST FOR A FINAL DECISION. ACCOUNTS WITH A BALANCE GREATER THAN $5,000 WILL REQUIRE THE PATIENT ACCOUNT MANAGER APPROVAL. A DECISION ON ELIGIBILITY WILL NORMALLY BE MADE WITHIN FIVE BUSINESS DAYS OF THE APPLICATION. PART VI, LINE 2: COMMUNITY HEALTH SCREENINGS ARE CONDUCTED EVALUATING BLOOD PRESSURE, BLOOD SUGAR, CHOLESTEROL, BODY MASS INDEX, PSA FOR PROSTATE CANCER, SKIN CANCER SCREENINGS.SCREENINGS ARE CONDUCTED FOR LOCAL BUSINESS AND INDUSTRY AND AT LOCAL PUBLIC EVENTS AT SHOPPING MALLS, SALVATION ARMY, UNITED WAY, EL CENTRO EVENTS ETC.DATA FROM PATIENT ADMISSIONS FROM THE COMMUNITY ARE ALSO EVALUATED. THERE ARE MANY DIABETICS IN OUR COMMUNITY AND WE OFFER FREE DIABETES SEMINARS FOR THE PUBLIC.DATA FROM THE CENTER FOR DISEASE CONTROL INFORMS US OF FLU TRENDS AND THE NEED TO OFFER VACCINATIONS TO OUR PATIENTS. PART VI, LINE 3: NOTICE OF AVAILABILITY OF FREE CARE IS GIVEN TO PATIENTS ON THE ITEMIZED STATEMENT OF ACCOUNT, THEIR FIRST STATEMENT ADVISING THEM OF THE CHARGES AND MONTHLY GUARANTOR STATEMENTS.TO ADVISE OUR CUSTOMERS OF OUR CHARITY PROGRAMS, INCLUDING FREE CARE, SIGNS SHALL BE POSTED IN THE FOLLOWING PLACES:-CENTRAL REGISTRATION-CASHIER'S STATION-PATIENT ACCOUNT REPRESENTATIVE OFFICES-EMERGENCY ROOM LOBBY-ACC LOBBY-GATES LABORATORYTO ENSURE THAT THE MESSAGE IS DELIVERED EVEN IF THE SIGNS ARE MISSED, THIS INFORMATION WILL BE PRINTED ON THE BACK OF EACH "STATEMENT OF ACCOUNT" AND "MONTHLY STATEMENT" FORMS. PART VI, LINE 4: EMH REGIONAL MEDICAL CENTER IN ELYRIA AND AMHERST HOSPITAL IN AMHERST ARE BOTH LOCATED IN LORAIN COUNTY, OHIO. LORAIN COUNTY AMASSES A LAND AREA OF NEARLY 493 SQUARE MILES, WITH APPROXIMATELY 577 PERSONS PER SQUARE MILE. IN 2009, THE POPULATION OF LORAIN COUNTY WAS ESTIMATED AT APPROXIMATELY 305,700, WITH NEARLY 24% OF THOSE PERSONS BEING UNDER 18 YEARS OLD, AND NEARLY 14% AGED 65 YEARS OR OLDER. THE MEDIAN HOUSEHOLD INCOME IN 2008 WAS $52,878 WITH 12.3% OF THE COUNTY'S POPULATION LIVING BELOW THE POVERTY LEVEL. APPROXIMATELY 88% OF THE COUNTY'S POPULATION IS WHITE, WITH THE REMAINING 12% BEING COMPRISED OF BLACK, AMERICAN INDIAN, ASIAN AND HISPANIC ETHNICITY. FEMALES MAKE UP NEARLY 51% PERCENT OF THE COUNTY'S POPULATION.LORAIN COUNTY IS CONSIDERED A RURAL, RUSTBELT COMMUNITY COMPRISED OF MANY CITIES, VILLAGES AND TOWNSHIPS. WHILE SOME CITIES, SUCH AS AVON, AVON LAKE AND NORTH RIDGEVILLE ARE EXPERIENCING BUSTLING GROWTH, OTHERS SUCH AS ELYRIA AND LORAIN HAVE SEEN BUSINESSES CLOSE IN THE PAST SEVERAL YEARS, RESULTING IN JOB LOSS AND PEOPLE LEAVING THE COUNTY. PART VI, LINE 6: EMH HEALTHCARE BELIEVES THAT EDUCATIONAL AND PREVENTATIVE SERVICES ARE IMPERATIVE TO IMPROVING THE HEALTH OF OUR COMMUNITY. AS SUCH, NO-COST HEALTH SCREENINGS ARE HELD THROUGHOUT THE YEAR ON OUR ELYRIA, AMHERST AND AVON CAMPUSES, INCLUDING SKIN CANCER AND PROSTATE CANCER SCREENINGS, ALONG WITH BLOOD PRESSURE, DIABETES, CHOLESTEROL AND BONE DENSITY SCREENINGS. IN JUNE OF 2010, THE CENTER FOR ORTHOPEDICS - A DEPARTMENT OF EMH HEALTHCARE - PROVIDED APPROXIMATELY 300 FREE SPORTS PHYSICALS TO LOCAL STUDENTS FROM 23 HIGH SCHOOLS AS PART OF THEIR ANNUAL HIGH SCHOOL SPORTS PHYSICAL EVENT. EMH ALSO TRAVELS TO UNDERSERVED NEIGHBORHOODS TO BRING THEIR EDUCATION TO THE COMMUNITY. ONE OF THE LARGEST EVENTS SERVES A COMMUNITY THAT IS MAINLY LATINO, AND THAT IS THE UNITED WAY WEEK OF CARING EVENT AT PRINCIPE DE PAZ CHURCH IN LORAIN, OHIO. IN PARTNERSHIP WITH EL CENTRO, EMH AND OTHER PROVIDERS OFFER FREE HEALTH SCREENINGS AND HAVE A TEAM OF LABORATORY TECHNICIANS ON-SITE SO THAT RESULTS AND HEALTH EDUCATION CAN BE GIVEN IMMEDIATELY. IN ALL, NEARLY 2,600 MEMBERS OF THE COMMUNITY RECEIVED FREE HEALTH SCREENS OR HEALTH EDUCATION FROM EMH DOCTORS, NURSES OR TECHNICIANS IN 2010.ALSO IN 2010, EMH HEALTHCARE PROFESSIONALS DONATED HUNDREDS OF HOURS OF THEIR TIME TO THE LORAIN COUNTY FREE CLINIC, INCLUDING OUR PRESIDENT AND CHIEF EXECUTIVE OFFICER DONALD SHELDON, M.D. THERE WERE 646 NO-COST ENCOUNTERS WITH PATIENTS OF THE FREE CLINIC IN 2010 THAT WOULD TOTAL $470,813 HAD THOSE ENCOUNTERS BEEN BILLED. VARIOUS HEALTH EDUCATION EVENTS WERE PRESENTED BY EMH HEALTHCARE IN 2010 THAT SUPPORT ITS EXEMPT PURPOSE. THOSE INCLUDE:-COFFEE, TEA & ME - FOUR TIMES EACH YEAR, AN EMH PHYSICIAN GIVES AN HOUR-LONG PRESENTATION ON TOPICS RELEVANT TO WOMEN. A HEART-HEALTHY BREAKFAST IS ALSO PROVIDED FREE OF CHARGE.-MALL WALKERS - FROM SEPTEMBER THROUGH MAY, EMH HEALTHCARE SPONSORS A ONCE-MONTHLY FREE HEALTH EDUCATIONAL PROGRAM AT THE MIDWAY MALL IN ELYRIA. AN EMH CLINICIAN PRESENTS HEALTH INFORMATION IN A CASUAL, INFORMAL WAY WHILE ATTENDEES DINE ON FRESH FRUIT, CEREAL BARS, BAGELS, JUICE AND COFFEE.-INDEPENDENT AND/OR ASSISTED LIVING COMMUNITIES - EMH PROVIDES A HEALTH-ORIENTED PRESENTATION MONTHLY AT WESLEYAN MEADOWS IN SHEFFIELD VILLAGE AND QUARTERLY AT WESLEYAN VILLAGE IN ELYRIA ON A VARIETY OF TOPICS RELEVANT TO SENIORS. PRESENTERS HAVE INCLUDED EMH PHYSICIANS, NURSES, EDUCATORS AND PHARMACISTS.-ARTERY EXPLORER - IN 2010, EMH ELYRIA MEDICAL CENTER HOSTED THE ARTERY EXPLORER, AN 18-WHEEL SEMI TRUCK THAT HAS BEEN CONVERTED INTO A MOTION SIMULATOR TO SHOW GUESTS THE EFFECTS OF ATHEROSCLEROSIS. THIS FREE, FIVE MINUTE RIDE TAKES GUESTS ON A 3-D JOURNEY THROUGH THE ARTERIES AND PROVIDES HELPFUL TIPS TO HELP PREVENT THIS POTENTIALLY DEADLY DISEASE. 160 MEMBERS OF THE COMMUNITY VIEWED THE INFORMATIVE VIDEO.LASTLY, AN EXCELLENT TOOL UTILIZED BY EMH HEALTHCARE TO PROVIDE NO-COST HEALTH EDUCATIONAL INFORMATION TO THE COMMUNITY IS OUR QUARTERLY MAGAZINE, HEALTHY OUTLOOK. THIS 16-PAGE NEWSLETTER IS FILLED WITH INFORMATION ABOUT MEDICAL ISSUES THAT ARE AFFECTING THE PEOPLE OF OUR COMMUNITY, SUCH AS HEART DISEASE, WOUND CARE, OBESITY, DIABETES, AND MORE. EACH ISSUE ALSO INCLUDES TWO HEALTHY RECIPES USING A FEATURED INGREDIENT, SUCH AS QUINOA, WHOLE GRAIN, OR A TYPE OF ANTIOXIDANT. THE MAGAZINE IS MAILED TO APPROXIMATELY 108,000 HOUSEHOLDS PER QUARTER. PART VI, LINE 7: EMH REGIONAL MEDICAL CENTER AND AMHERST HOSPITAL COMPRISE THE TWO HOSPITALS IN THE EMH REGIONAL HEALTHCARE SYSTEM, WITH EMH ACCOUNTING FOR 94% OF TOTAL SYSTEM ADMISSIONS. BOTH HOSPITALS ARE LOCATED IN LORAIN COUNTY. ALL HEALTH SCREENING AND PATIENT EDUCATION IS PROVIDED BY EMH AND AMHERST STAFF IN AREAS WITHIN LORAIN COUNTY. 1 COMPREHENSIVE HEALTHCARE OF OHIO 630 EAST RIVER STREET ELYRIA OH 44035 341492733 IRC SEC. 501(C)(3) 7015430 0 N/A N/A TO PROMOTE HEALTH WITHIN THE COMMUNITY 1 0 1 0 0 0 0 0 0 0 SHELDON DONALD 0 362269 0 0 0 54101 0 14491 0 6723 0 437584 0 0 SIMONE JAMES M 0 259639 0 0 0 31078 0 10579 0 13396 0 314692 0 0 COOKSEY JILL 0 146846 0 0 0 12716 0 55020 0 12603 0 227185 0 0 GARDNER FRANCIS X 0 202561 0 0 0 17216 0 9235 0 10151 0 239163 0 0 MCDONALD DOUGLAS 0 219879 0 0 0 613 0 12342 0 12760 0 245594 0 0 MILLER DANIEL N 0 195290 0 0 0 42472 0 11915 0 12553 0 262230 0 0 WRAY CHARLOTTE 0 154063 0 0 0 482 0 7212 0 12535 0 174292 0 0 GIBBONS TERRIL 138437 0 0 0 1720 0 8502 0 12038 0 160697 0 0 0 GRAUER JOHN 216972 0 0 0 454 0 0 0 967 0 218393 0 0 0 HALLIDAY DONALD 128991 0 7000 0 235 0 8480 0 11453 0 156159 0 0 0 WALSH BRIAN 134994 0 0 0 176 0 24128 0 4750 0 164048 0 0 0 ZEOLLA KATERINE 191686 0 5079 0 179 0 9924 0 4766 0 211634 0 0 0 PART I, LINE 4B COMPREHENSIVE HEALTHCARE OF OHIO (CHCO), THE PARENT ORGANIZATION, MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF CHCO AND ITS AFFILIATED ENTITIES. THE SERP IS A FUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH IRC SEC. 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. JILL COOKSEY - 457(F) PARTICIPANT FRANCIS GARDNER - 457(F) PARTICIPANT DANIEL MILLER - 457(F) PARTICIPANT DONALD SHELDON - 457(F) PARTICIPANT JAMES SIMONE - 457(F) PARTICIPANT SUPPLEMENTAL INFORMATION PART III PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SUPPLEMENTAL INFORMATION PART III COUNTY OF LORAIN OHIO 340714612 543583LF3 2008-07-31 36730000 REFUNDING SERIES 2005 BOND ISSUE 0 1 0 36627156 36625 36578616 2008 0 0 1 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 1 DEUTSCHE BANK 1.400000000000 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBER WITH RIGHTS TO GOVERN EMH REGIONAL MEDICAL CENTER IS COMPREHENSIVE HEALTH CARE OF OHIO, INC. IT IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A COMPREHENSIVE HEALTH CARE OF OHIO, INC. IS THE SOLE MEMBER WHICH HAS AUTHORITY TO ELECT THE GOVERNING BODY OF EMH REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS, BUT NOT ALL DECISIONS, OF THE GOVERNING BODY OF EMH REGIONAL MEDICAL CENTER ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, COMPREHENSIVE HEALTH CARE OF OHIO, INC. EXAMPLES OF DECISIONS OF THE GOVERNING BODY OF THE EMH REGIONAL MEDICAL CENTER WHICH ARE SUBJECT TO THE APPROVAL OF THE MEMBER ARE ANNUAL OPERATING BUDGETS, CAPITAL EXPENDITURE BUDGETS, LONG RANGE PLANNING DOCUMENTS, CAPITAL EXPENDITURES INCRURRING DEBT WHICH WOULD REQUIRE MORTGAGE OF ANY PARTS OF THE ASSETS OF EMH REGIONAL MEDICAL CENTER AND AMENDMENT TO THE GOVERNING DOCUMENTS OF EMH REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE CEO, CFO AND IN-HOUSE GENERAL COUNSEL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL DIRECTORS ARE PRESENTED WITH AN ATTESTATION DOCUMENT WHICH STATES THE ESSENCE OF THE CONFLICT OF INTEREST POLICY. EACH DIRECTOR IS REQUIRED TO COMPLETE THE DOCUMENT AND SIGN IT, VERIFYING THAT HE OR SHE IS AWARE OF THE POLICY AND DECLARING ANY POTENTIAL CONFLICTS OF INTEREST WHICH SUCH DIRECTOR MAY HAVE, OR WHICH MAY HAVE DEVELOPED SINCE THE PRIOR YEAR'S ATTESTATION. THE CHAIR OF THE BOARD, OR DESIGNEE, MEETS WITH ANY DIRECTOR WHO HAS INDICATED A POTENTIAL CONFLICT OF INTEREST IN ORDER TO FULLY EXPLORE THE NATURE OF THE POTENTIAL OR EXISTING CONFLICT, WITH THE POTENTIAL THAT SUCH CONFLICT MIGHT PRECLUDE FURTHER SERVICE OF THAT DIRECTOR. ALL ANNUAL ATTESTATIONS ARE MAINTAINED BY THE CEO OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS INCLUDES AN EXTERNAL ANALYSIS COMPLETED BY TOWERS PERRIN, A NATIONALLY KNOWN BENEFITS AND COMPENSATION CONSULTANT. TOWERS PERRIN GATHERS MARKET RESEARCH DATA FROM THREE PUBLISHED AND RELIABLE HEALTHCARE COMPENSATION SURVEYS. THIS ANALYSIS UTILIZES NATIONAL PAY DATA AND TAKES INTO CONSIDERATION THE SIZE OF THE HEALTHCARE ORGANIZATION, THE RESPECTIVE JOB TITLE, AND TIME IN JOB. THE ANALYSIS IS COMPLETED ANNUALLY. IT INCLUDES RECOMMENDATIONS ON POSITIONING THE CEO AND OTHER TOP MANAGEMENT WITH STAFF WITHIN THE APPROPRIATE PAY RANGE AS WELL AS POSSIBLE PAY RANGE ADJUSTMENTS AND BASE SALARY INCREASE PERCENTAGES FOR THE CURRENT YEAR. RECOMMENDATIONS ARE APPROVED BY A SUBCOMITTEE OF THE BOARD OF DIRECTORS PRIOR TO IMPLEMENTATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2010 BY COMPREHENSIVE HEALTHCARE OF OHIO, THE PARENT ENTITY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS NOT, TO THIS POINT, MADE ITS GOVERNING DOCUMENTS, OTHER THAN THE ORIGINAL ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS AVAILABLE TO ALL EMPLOYEES AND DIRECTORS ON THE ORGANIZATION'S INTRANET SITE, AND HAS BEEN A PART OF THE ORGANIZATION'S WRITTEN POLICY HANDBOOK LONG IN ADVANCE OF THE DEVELOPMENT OF THE INTRANET SITE. FINANCIAL STATEMENTS ARE NOT GENERALLY AVAILABLE TO THE PUBLIC OTHER THAN FINANCIAL INFORMATION WHICH APPEARS ON THE FORM 990 AND OTHER PUBLIC FILINGS REQUIRED BY LAW. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 3,183,584. PENSION RELATED CHANGES LIABILITY ADJUSTMENT -3,365,570. UNREALIZED GAIN ON PERPETUAL TRUSTS 182,590. TOTAL TO FORM 990, PART XI, LINE 5: 604. FORM 990, PART XII, LINE 2C THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR FORM 990, PART VII, SECTION A THE AMOUNT OF TIME OFFICERS, DIRECTORS AND KEY EMPLOYEES SPENT WORK FOR COMPREHENSIVE HEALTH CARE OF OHIO IS AS FOLLOWS: JAMES SIMONE - 3 HOURS DONALD SHELDON - 2 HOURS JILL COOKSEY - 3 HOURS FRANCIS GARDNER - 3 HOURS DOUGLAS MCDONALD - 3 HOURS DANIEL MILLER - 3 HOURS CHARLOTTE WRAY - 3 HOURS ELYRIA CARDIAC CATH LAB LLC 630 E RIVER ST ELYRIA OH 44035 202217238 CARDIAC CATHERTERZATION OH -112180 0 N/A COMPREHENSIVE HEALTH CARE OF OHIO INC 630 EAST RIVER STREET ELYRIA OH 44035 341492733 CENTRALIZED MANAGEMENT OH 501(C)(3) 11 N/A 0 AMHERST HOSPITAL ASSOCIATION INC 630 EAST RIVER STREET ELYRIA OH 44035 340067060 COMMUNITY HOSPITAL OH 501(C)(3) 3 COMPREHESIVE HEALTH CARE OF OHIO INC 1 ELYRIA MEMORIAL HOSPITAL FOUNDATION 630 EAST RIVER STREET ELYRIA OH 44035 341492735 FUNDRAISING OH 501(C)(3) 7 COMPREHENSIVE HEALTH CARE OF OHIO INC 1 ELYRIA CARDIAC CATH LAB LLC 630 E RIVER ST ELYRIA OH 44035 202217238 CARDIAC CATHETERIZATION OH N/A RELATED 49191 0 0 0.00000 AVON HOSPITAL JOINT VENTURE LLC 254 CLEVELAND AVE AMHERST OH 44001 272199824 HOSPITAL OH N/A COMPREHENSIVE VENTURES UNLIMITED INC 630 EAST RIVER ST ELYRIA OH 44035 341596060 VARIOUS HEALTHCARE ACTIVITIES OH N/A C EMH MEDICAL OFFICE BUILDING IN AVON 1997 HEALTHWAY DR AVON OH 44011 341935407 MEDICAL OFFICE BUILDING OH N/A C EMH SHEFFIELD MEDICAL BUILDING CONDOMINIUM ASSOC 630 EAST RIVER ST ELYRIA OH 44035 260636602 CONDOMINIUM COMPLEX OH N/A C CENTER FOR ORTHOPEDICS INC 630 EAST RIVER ST ELYRIA OH 44035 341665082 PHYSICIAN PRACTICE OH N/A C EMH MSO INC 630 EAST RIVER ST ELYRIA OH 44035 341783546 PHYSICIAN PRACTICE OH N/A C EMH PROFESSIONAL SERVICES INC 630 EAST RIVER ST ELYRIA OH 44035 341778419 VARIOUS HEALTHCARE ACTIVITIES OH N/A C NORTH OHIO HEART INC 630 EAST RIVER ST ELYRIA OH 44035 272574020 VARIOUS HEALTHCARE ACTIVITIES OH N/A C 1 1 1 0 0 1 1 0 1 1 0 0 1 0 1 1 1 1 COMPREHENSIVE HEALTH CARE OF OHIO INC B 7015430 CASH TRANSACTION COMPREHENSIVE HEALTH CARE OF OHIO INC L 10899000 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE HEALTH CARE OF OHIO INC P 14397825 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE HEALTH CARE OF OHIO INC O 2004209 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE HEALTH CARE OF OHIO INC R 202687 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE VENTURES UNLIMITED INC I 874833 ACTUAL COST PER FINANCIAL STATE. EMH FOUNDATION P 140015 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE HEALTH CARE OF OHIO INC L 4278067 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE VENTURES UNLIMITED INC P 3029536 ACTUAL COST PER FINANCIAL STATE. COMPREHENSIVE VENTURES UNLIMITED INC O 127507 ACTUAL COST PER FINANCIAL STATE. EMH PROFESSIONAL SERVICES INC P 3874749 ACTUAL COST PER FINANCIAL STATE. EMH PROFESSIONAL SERVICES INC O 501551 ACTUAL COST PER FINANCIAL STATE. CENTER FOR ORTHOPEDICS INC G 243400 ACTUAL COST PER FINANCIAL STATE. CENTER FOR ORTHOPEDICS INC P 8114735 ACTUAL COST PER FINANCIAL STATE. CENTER FOR ORTHOPEDICS INC O 907187 ACTUAL COST PER FINANCIAL STATE. 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