2023-11-06T14:12:18-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 862916134 LHS LEGACY INC LHSL 4403541991 36000 EUCLID AVE WILLOUGHBY OH 44094 BRETT HIMES TREASURER 4409539600 2023-10-31 1 BRETT HIMES 999009999 0 AMY CIMINELLO P00796388 6148493000 2023-10-31 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z BRETT HIMES 36000 EUCLID AVE WILLOUGHBY OH 44094 11128 0 X WWW.LAKEHEALTH.COM X 2021 OH TO OVERSEE AND ENFORCE THE TERMS OF THE MEMBER SUBSTITUTION AGREEMENT IN FURTHERANCE OF THE BEST INTERESTS OF ITS SUPPORTED ORGANIZATION, LAKE HEALTH, AND ITS MISSION TO OPERATE FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. 3 3 0 0 0 0 0 0 0 0 0 11128 0 0 0 11128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11128 2000000 2011128 0 0 2000000 2011128 TO OVERSEE AND ENFORCE THE TERMS OF THE MEMBER SUBSTITUTION AGREEMENT IN FURTHERANCE OF THE BEST INTERESTS OF ITS SUPPORTED ORGANIZATION, LAKE HEALTH, AND ITS MISSION TO OPERATE FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. 0 0 TO OVERSEE AND ENFORCE THE TERMS OF THE MEMBER SUBSTITUTION AGREEMENT IN FURTHERANCE OF THE BEST INTERESTS OF ITS SUPPORTED ORGANIZATION, LAKE HEALTH, AND ITS MISSION TO OPERATE FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X BRETT HIMES 4403541984 3605 WARRENSVILLE CTR RD MSC 9155 SHAKER HEIGHTS OH 44122 X THOMAS JUBECK CHAIRMAN 2.00 X X 0 0 0 MICHAEL MAYHER SECRETARY 2.00 X X 0 0 0 BRETT HIMES TREASURER 2.00 X X 0 0 0 0 0 0 0 0 0 0 0 11128 11128 11128 0 0 11128 0 0 0 0 2000000 2011128 2000000 2011128 0 0 X 2000000 2011128 2000000 2011128 2000000 2011128 11128 0 X 0 1 X 0 0 X X X 1 LAKE HOSPITAL SYSTEM INC 341425870 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 X 1 1 SECTION E, LINE 2A THE BYLAWS STATE LHS LEGACY SHOULD ONLY BE ENTITLED TO OVERSEE AND ENFORCE THE TERMS OF A MEMBER SUBSTITUTION AGREEMENT BY AND BETWEEN LAKE HOSPITAL SYSTEM AND UNIVERSITY HOSPITAL HEALTH SYSTEMS, IN FURTHERANCE OF THE BEST INTEREST OF LAKE HEALTH SYSTEM AND MAKE REASONABLE EXPENDITURES ON BEHALF OF AND GRANTS TO LAKE HEALTH SYSTEM. SCHEDULE A, SECTION E, LINE 2B THE BYLAWS STATE THE PERMITTED ACTIVITIES OF THE LHS LEGACY SHALL BE IN THE DIRECT FURTHERANCE OF THE INTEREST OF LAKE HOSPITAL SYSTEM, AND SUBSTANTIALLY ALL OF SUCH ACTIVITIES IN WHICH, BUT FOR LHS LEGACY'S INVOLVEMENT, LAKE HOSPITAL SYSTEM WOULD NORMALLY BE INVOLVED. FORM 990, PART VI, SECTION A, LINE 6 LAKE HOSPITAL SYSTEM, INC DBA LAKE HEALTH IS THE SOLE MEMBER OF LHS LEGACY, INC. FORM 990, PART VI, SECTION A, LINE 7A LAKE HOSPITAL SYSTEM, INC. DBA LAKE HEALTH HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B LAKE HOSPITAL SYSTEM, INC. DBA LAKE HEALTH HAS THE RIGHT TO MAKE GOVERNANCE DECISIONS SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS OF THE GOVERNING BODY, OR APPROVAL OF THE GOVERNING BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS FOLLOWED BEFORE FILING THE LHS LEGACY, INC FORM 990 INCLUDES A DETAILED REVIEW COMPLETED BY AN INDEPENDENT OUTSIDE CPA FIRM, PRESENTATION TO AND REVIEW BY THE LHS CFO AND CEO, PRESENTATION AND REVIEW BY THE LHS LEGACY FINANCE COMMITTEE, AND PRESENTATION TO THE LHS BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C LHS LEGACY, INC FOLLOWS THE CONFLICT OF INTEREST POLICY OF LAKE HOSPITAL SYSTEM, INC. LAKE HOSPITAL SYSTEM, INC.'S (LHS) BOARD OF TRUSTEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY, WHICH IS THEN REVIEWED BY THE LHS CFO AND A DIRECTOR OF THE BOARD OF TRUSTEES. BOARD MEMBERS WILL EXCUSE THEMSELVES FROM THE BOARD MEETING WHEN A TOPIC OF POTENTIAL CONFLICT IS PRESENTED AND RETURN TO THE MEETING FOLLOWING THE COMPLETION OF DISCUSSION, MOTION, AND VOTE. COMPLIANCE WITH THE LHS CONFLICT OF INTEREST POLICY MONITORED AND ENFORCED BY THE BOARD CHAIR, COMMITTEE CHAIRS, AND THE DIRECTOR RESPONSIBLE FOR BOARD OF TRUSTEE MATTERS. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST UNIVERSITY HOSPITALS HEALTH SYSTEM INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340714775 SUPPORT SYSTEM OH 501(C)(3) LINE 12B, II N/A 0 ELYRIA MEDICAL CENTER FOUNDATION 630 EAST RIVER STREET ELYRIA OH 44035 611579760 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I ELYRIA MEDICAL CENTER 1 ROBINSON MEMORIAL HOSPITAL FOUNDATION 6847 N CHESTNUT STREET PO BOX RAVENNA OH 44266 341510544 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I ROBINSON HEALTH SYSTEM INC 1 SAMARITAN HOSPITAL FOUNDATION 663 EAST MAIN STREET ASHLAND OH 44805 341783215 SUPPORT HOSPITAL OH 501(C)(3) LINE 12C, III-FI SAMARITAN REGIONAL MEDICAL CENTER 1 5805 EUCLID INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 814962989 SUPPORT HOSPITAL OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS HEALTH SYSTEM - HEATHER HILL INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340771884 INACTIVE OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 FUND FOR CURES UK LTD SUITE 1 3RD FLOOR 11-12 ST JAMES LONDON UK GRANT FUNDING UK 501(C)(3) UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 KETTERING MOHICAN AREA MEDICAL CENTER INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340823455 INACTIVE OH 501(C)(3) SAMARITAN REGIONAL HEALTH CENTER 1 UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341567805 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 264827222 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS CONNEAUT MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340714550 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS GENEVA MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340714461 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UH REGIONAL HOSPITALS 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341924226 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 PARMA COMMUNITY GENERAL HOSPITAL 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340827442 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 EMH REGIONAL MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340714612 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS ST JOHN MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341260978 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS MEDICAL GROUP INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 204881619 PHYSICIANS GROUP OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341720429 LAB SERVICES OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS HOME CARE SERVICES INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341527536 HOME CARE OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 ROBINSON HEALTH SYSTEM INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 461382538 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 SAMARITAN REGIONAL HEALTH SYSTEM 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340714535 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS COORDINATED CARE ORGANIZATION 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 900794903 HEALTHCARE OH 501(C)(3) LINE 10 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 COMPREHENSIVE HEALTH CARE OF OHIO INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341492733 INACTINVE OH 501(C)(3) LINE 12B, II UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 UNIVERSITY HOSPITALS GEAUGA MEDICAL CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 340816492 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 LAKE HOSPITAL FOUNDATION INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341425872 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I LAKE HOSPITAL SYSTEM INC 1 PRIMEHEALTH INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341778204 HEALTHCARE OH 501(C)(3) LINE 3 LAKE HOSPITAL SYSTEM INC 1 LAKE HEALTH UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 311565964 HEALTHCARE OH 501(C)(3) LINE 10 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 LAKE HOSPITAL SYSTEM INC 7590 AUBURN ROAD CONCORD OH 44077 341425870 HEALTHCARE OH 501(C)(3) LINE 3 UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 THE AUXILLARY OF LAKE HOSPITAL SYSTEM INC 7590 AUBURN RD CONCORD TWP OH 44077 341605226 PATIENT NEEDS AND PHYSICIAN EQUIPMENT OH 501(C)(3) LINE 3 LAKE HOSPITAL SYSTEM INC 1 LAKE HEALTH UNIVERSITY HOSPITALS SEIDMAN CANCER CENTER PHYSICIANS INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I UNIVERSITY HOSPITALS HEALTH SYSTEM INC 1 PARMA HOSPITAL HEALTH CARE FOUNDATION 7007 POWERS BLVD PARMA OH 44129 341510544 SUPPORT HOSPITAL OH 501(C)(3) LINE 12A, I PARMA COMMUNITY MEDICAL CENTER 1 NEW MANNA CLG LLC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 371848577 SPECIALTY HOSPITAL OH N/A 0 0 CONCORD MEDICAL CAMPUS PHYSICIAN BUILDING LLC 7580 AUBURN RD CONCORD OH 44077 260550261 OFFICE SPACE OH N/A 0 0 SAMARITAN REGIONAL PAIN MANAGEMENT 1025 CENTER STREET ASHLAND OH 44805 462286785 MEDICAL SERVICES OH N/A 0 0 UHHS ENDOSCOPY HOLDINGS LLC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 831284090 MEDICAL SERVICES OH N/A 0 0 UH CANTON-ENDOSCOPY LLC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 830638696 MEDICAL SERVICES OH N/A 0 0 UNIVERSITY SUBURBAN REAL ESTATE LTD 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341397180 REAL ESTATE OH N/A 0 0 UH VALUEHEALTH HOLDINGS LLC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 853503184 HOLDING COMPANY OH N/A 0 0 UH CLINICAL ASSOCIATES LLC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 843169305 MEDICAL SERVICES OH N/A 0 0 COMPREHENSIVE VENTURES UNLIMITED INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341596060 PHYSICIAN ADMINISTRATION OH N/A C 1 EMH MEDICAL OFFICE BUILDING IN AVON INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341935407 REAL ESTATE OH N/A C 1 EMH PROFESSIONAL SERVICES INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341778419 PHYSICIANS GROUP OH N/A C 1 LAKE PHO INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341696001 PHYSICIAN SERVICES OH N/A C 1 LHS ASSURANCE LTD 23 LIME TREE BAY AVENUE GRAND CAYMAN CJ 980456229 INSURANCE COMPANY CJ N/A C 1 NORTH OHIO HEART INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 272574020 PHYSICIANS GROUP OH N/A C 1 POWERS PROFESSIONAL CORPORATION 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341735290 PHYSICIANS GROUP OH N/A C 1 PRL CORPORATION 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341499245 PHYSICIANS GROUP OH N/A C 1 QUALITY CARE NETWORK 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 811081563 MEDICAL MGMT. OH N/A C 1 USHC MANAGEMENT INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341395971 HOLDING COMPANY OH N/A C 1 UHHS PROVIDER & CENTRAL VERIFICATION ORG 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341908517 MEDICAL MGMT. OH N/A C 1 UNIVERSITY HOSPITALS HOLDINGS INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341768931 HOLDING COMPANY OH N/A C 1 UNIVERSITY HOSPITALS PHYSICIAN SERVICES 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341768929 PHYSICIAN ADMINISTRATION OH N/A C 1 UNIVERSITY PRIMARY CARE PRACTICES INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341768928 PHYSICIAN GROUP OH N/A C 1 WESTERN RESERVE ASSURANCE CO LTD SPC PO BOX 1051 GT KY1 CJ 980462740 INSURANCE CJ N/A C 1 UNIVERSITY HOSPITALS ACCOUNTABLE CARE ORGANIZATION INC 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 813836118 ACCOUNT CARE OH N/A C 1 UNIVERSITY HOSPITALS HEALTH CARE ENTERPRISES 3605 WARRENSVILLE CENTER ROAD SHAKER HEIGHTS OH 44122 341510005 MEDICAL MGMT. OH N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0