2011-08-12T15:15:54-05:00 2010-09-30 PERSHING YOAKLEY & ASSOCIATES PC 2963 GULF TO BAY BLVD STE 267 CLEARWATER FL 337594255 990 2009-10-01 592650464 Lakeland Regional Health Systems Inc LAKE 8636871100 1324 Lakeland Hills Boulevard Lakeland FL 33805 Paul Powers 8636871100 2011-08-12 1 Terry Haefner 7274427110 2009 2016-02-24 21:20:13Z Elaine C Thompson PhD 1324 Lakeland Hills Boulevard Lakeland FL 33805 23782120 0 X www.lrmc.com X 1986 FL Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 12 10 54 0 2423427 2289414 593475 444082 10641995 10052912 6844549 6771156 3480692 6482549 21560711 23750699 696569 926896 0 19774419 21971395 0 0 16086295 15824513 36557283 38722804 -14996572 -14972105 346263201 336584304 279207064 281623371 67056137 54960933 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 0 0 35321173 926896 10052912 Promotion of continued development of high quality, cost effective health care services, including providing cancer diagnostics and treatment. 35321173 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 32 0 1 54 1 1 1 1 CJ CA VI 0 0 0 0 0 0 0 12 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Bill Bierschenk 8636871102 230 S Florida Ave Suite 400 Lakeland FL FL 33805 X Anne Furr 1.00 X 0 0 0 Mack Reavis MD 1.00 X 0 0 0 David Duncan 1.00 X 0 0 0 Robert Andrew 1.00 X 0 0 0 Jack English III 1.00 X 0 0 0 A Andy Hernandez 1.00 X 0 0 0 Maggie Lazarre 1.00 X 0 0 0 Jack Harrell Jr 1.00 X 0 0 0 William Mutz 1.00 X 0 0 0 Frank Kendrick 1.00 X 0 0 0 Weymon P Snuggs III 1.00 X 0 0 0 Jay Mulaney MD 1.00 X 0 0 0 Paul A Powers 50.00 X 0 644219 28613 Jack T Stephens Jr 50.00 X 0 1103697 255350 Douglas Reintgen MD 50.00 X 650530 0 19160 Mathew Smith MD 50.00 X 660683 0 23070 Michael A Campanelli MD 50.00 X 766604 0 29703 Todd M Lasner MD 50.00 X 649185 0 7926 Donald Sachs MD 50.00 X 1273688 0 31665 4000690 1747916 395487 30 0 1 0 Peterson & Myers PA PO Box 24628 Lakeland FL 33802 Legal 421000 Radiology & Imaging Specialists of Lakel 2120 Lakeland Hills Blvd Lakeland FL 33805 Medical Imaging 244263 UBS Realty Investors LLC 142 Trumbull St Hartford CT 06103 Investment Advisory 148631 Sterling Capital Management LLC 4064 Colony Road Suite 300 Charlotte NC 28211 Investment Advisory 119512 4 444082 444082 Net Patient Services 621990 10036360 10036360 Rental Income 531120 16552 16552 10052912 6797519 6797519 5058 31421 -26363 -26363 -26363 Equity in Earn. Inv Fu 532000 3736474 -180475 3916949 Investment in LSDC/WIC 900099 2603902 2603902 Other Income 900099 142173 142173 6482549 23750699 10052912 2423427 10830278 926896 926896 19542882 17784023 1758859 582697 530254 52443 1301200 1184092 117108 544616 495601 49015 324609 295394 29215 105708 96194 9514 770186 700869 69317 504136 458764 45372 385166 350501 34665 317769 289170 28599 134016 121955 12061 163437 148728 14709 9291177 8454971 836206 655256 596283 58973 1593567 1450146 143421 Equipment Rental/Lease 361198 328690 32508 Taxes, Licenses and Fee 161511 146975 14536 Recruitment Fees 140822 128148 12674 Dues and Subscriptions 102114 92924 9190 Repairs & Maintenance 44778 40748 4030 769063 699847 69216 38722804 35321173 3401631 0 76079912 48992406 2337760 2182716 144036 339529 19477665 2130041 11927941 17347624 114052591 138917170 134338133 121335635 4619255 4715344 2763573 2753880 346263201 336584304 4850435 4719542 201711984 196197065 72644645 80706764 279207064 281623371 X 66479137 54383933 577000 577000 67056137 54960933 346263201 336584304 X 0 1 0 X 0 X X X 0 0 0 Lakeland Regional Medical Center Inc 592650456 3 1 35237753 1 35237753 5865030 5865030 6823120 596315 6226805 682777 384790 297987 2639294 1148936 1490358 3467444 3467444 17347624 Equity in Investment Funds 77238622 F STRALEM 11270132 F Blackrock 8993496 F Calamos 23833385 F 121335635 Due to Affiliate 78383157 Employee Compensation and Benefits 2323607 80706764 23750699 38722804 -14972105 5384758 -2507856 2876902 -12095203 28316905 5384758 44405 5429163 22887742 862957 862957 23750699 38722805 0 38722805 0 38722805 Explanation for Part XI, Line 8: Book/Tax Difference Lakeland Surgical & Diagnostic Center -862,957 Book/Tax Difference Women's Imaging Center 44,406 Transfer to Affiliates -1,795,996 Net Assets Released from Restriction 106,692 Total -2,507,856 Explanation for Part XII, Line 2d: Investment in Women's Imaging Center 44,405 Total 44,405 Explanation for Part XII, Line 4b: Investment in Lakeland Surgical Diagostic Center 862,957 Total 862,957 1 Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 237134974 501(c)(3) 926896 To support Fundraising activities. 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Lakeland Regional Health Systems provided support to Lakeland Regional Medical Center Foundation a related 501(c)(3) organization. This assistance was used to support fundraising activities on behalf of Lakeland Regional Medical Center a 501(c)(3) organization that is supported by Lakeland Regional Health Systems. X X X X X 0 1 0 0 0 0 0 0 0 Paul A Powers 0 366793 0 0 0 277426 0 19160 0 9453 0 672832 0 0 Jack T Stephens Jr 0 667650 0 0 0 436047 0 245897 0 9453 0 1359047 0 0 Douglas Reintgen MD 650530 0 0 0 0 0 19160 0 0 0 669690 0 0 0 Mathew Smith MD 660683 0 0 0 0 0 19195 0 3875 0 683753 0 0 0 Michael A Campanelli MD 762604 0 0 0 4000 0 19400 0 10303 0 796307 0 0 0 Todd M Lasner MD 599185 0 0 0 50000 0 0 0 7926 0 657111 0 0 0 Donald Sachs MD 701721 0 0 0 571967 0 21362 0 10303 0 1305353 0 0 0 Part I, Line 4a Jack T. Stephens - President/CEO participated in a supplemental nonqualified deferred compensation plan. He had $415,217 benefits vest during calender year 2009. This amount is included in Part (B)(iii) other compensation. He had an additional $226,737 of nonvested benefits accrue during calendar year 2009. This amount is included in Part II Column C. The plan made a cash distribution of $151,347 in 2009. Paul Powers - Vice President/CFO participated in a supplemental nonqualified deferred compensation plan. He had $234,367 benefits vest during calender year 2009. This amount is included in Part (B)(iii) other compensation. The plan made a cash distribution of $234,367 in calender year 2009. City of Lakeland Florida 596000354 511665HP9 2006-11-02 116566404 2006 Bonds refunded the 1999A & 2002 Bonds and pay the 2006 issuance costs 0 0 116566404 1 111215292 1038389 0 1 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 1 0 0 0 NA 0 Form 990, Part VI, Section B, line 11 The Form 990 and supporting schedules are reviewed prior to filing by senior management, including the CEO and CFO. The Form and supporting schedules are also reviewed in detail prior to filing by outside legal counsel to the organization. Additionally, the form and schedules are reviewed by the Executive and Physician Compensation Committee of the Board and a copy of the Form 990 and schedules are provided to each member of the Board of Directors before filing with the IRS. Form 990, Part VI, Section B, line 12c Lakeland Regional Health System has a conflict of interest policy which is monitored by the Corporate Integrity Services department. All new hires, students, volunteers and contractors are trained on the ethics policy during general orientation. All staff is to comply with ethics training annually as part of their mandatory education requirements. Annually, a certification is required by all managers, directors, and officers whom must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Health Systems also has a "Policy of the Board of Directors Regarding Board Members Doing Business with Lakeland Regional Medical Center or Lakeland Regional Health Systems", that all Board Members are annually required to execute a "Corporate Compliance Acknowledgement", that all Board Members are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire, and that all Senior Corporate Management are annually required to answer a comprehensive "Annual Conflict of Interest Questionnaire". Form 990, Part VI, Section B, line 15 The Executive and Physician Compensation Committee (the "Committee") of the Board is charged with determining, in advance, all compensation issues for all executive positions including the President & CEO, the CFO and all Vice Presidents of the organization. Only independent and "disinterested" persons may serve as members of the Committee and no member may be employed by the organization or any of its affiliates. Additionally, no physician on the medical staff of the organization may serve as a member of the Committee nor may any member have any business or financial relationships with the organization, either directly or indirectly through family members. The Committee engages an independent nationally recognized human resources management consulting firm which specializes in executive and employee compensation in the health care industry. This firm, among other things: a. Conducts a competitive executive total cash compensation analysis relative to comparable healthcare organizations nationally; and b. Conducts a competitive executive benefits analysis relative to comparable healthcare organizations; and c. Conducts a competitive executive total compensation analysis relative to comparable healthcare organizations; and d. Assists the Committee in ensuring compliance with regulatory requirements; and e. Provides guidance and counsel to the Committee and Board in matters relating to executive compensation; and f. Participates in Committee meetings and presents their findings and recommendations to the committee and to the Board. In determining compensation, the Committee relies on the independent, reliable market data presented by the consulting firm to set all compensation levels and the consulting firm's opinion as to the reasonableness of total compensation to be paid the executives of the organization. The Committee fully documents the basis for all determinations and records, at a minimum, 1) the terms of the compensation agreement and the date on which it was approved; 2) the members of the Committee who were present during the discussion and those who voted on it; 3) the comparability data used and its source; and 4) the basis for the ultimate decision. In fulfilling its responsibility, the Committee has full authority to consult with outside counsel to the organization or Committee engaged counsel, regarding the legality of the compensation and other legal issues which may be relevant to the Committee's responsibilities. Form 990, Part VI, Section C, line 19 The organization's Articles of Incorporation are public records and may be obtained from the State of Florida's Division of Corporations in Tallahassee, Florida. Additionally, the Lease & Transfer Agreement between the organization and the City of Lakeland, Florida, under which the organization operates, is recorded in the Public Records of Polk County, Florida, the county in which the organization is located. Financial statements and similar information, both audited and unaudited, are periodically furnished to the City of Lakeland, Florida, and various regulatory agencies within the State of Florida. The financial statements and information are public records under the pertinent Florida public records law. Lakeland Regional Medical Center Foundation Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Fundraising FL 501(c)(3) 11a - Type 1 Lakeland Regional Medical Center Inc Lakeland Regional Medical Center Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 Providing hospital services FL 501(c)(3) 3 Women's Imaging Center LLC 2120 Lakeland Hills Blvd Lakeland FL 33805 113830470 Medical Imaging Services FL Related 481131 533035 0 -149240 1 Lakeland Regional Educational Production Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 200679492 Inactive FL C 1.00000 Lakeland Regional Health Ventures Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 592650902 Medical Services FL C 20272 587709 1.00000 Lakeland Regional Health Ventures Risk Purchasing Group Inc 1324 Lakeland Hills Boulevard Lakeland FL 33805 202843126 Inactive FL C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 Lakeland Regional Medical Center Inc Q 1759941 Lakeland Regional Medical Center Inc N 3415725 Lakeland Surg & Diagn Center LLP 115 S Missouri Avenue Lakeland FL 33815 593346125 Medical Services FL 0 5396193 0 2753142 1