2023-11-14T08:00:54-06:00 2022-12-31 271235638 MCM CPAS & ADVISORS LLP 101 S FIFTH STREET SUITE 2100 LOUISVILLE KY 40202 990 2022-01-01 311425530 LICKING MEMORIAL PROFESSIONAL CORPORATION LICK 2205644528 1320 WEST MAIN STREET NEWARK OH 430553699 CYNTHIA L WEBSTER V.P. FINANCIAL SERVICES 2205644528 2023-11-10 1 CYNTHIA WEBSTER 999009999 0 THERESA BATLINER CPA P00418596 5027491900 2023-11-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ROBERT MONTAGNESE 1320 WEST MAIN STREET NEWARK OH 430553699 50481959 0 X WWW.LMHEALTH.ORG X 1996 OH TO IMPROVE THE HEALTH OF THE COMMUNITY. 8 8 590 8 0 0 307965 872297 47268229 48894464 164 10723 74210 704475 47650568 50481959 0 0 0 0 77780366 81288050 0 0 0 20085116 21475826 97865482 102763876 -50214914 -52281917 22762276 21796673 22717170 21726483 45106 70190 X LICKING MEMORIAL PROFESSIONAL CORPORATION EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITY. 0 0 96080358 49598939 LMPC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, BELOW COST IN MANY CASES. TO THE EXTENT REIMBURSEMENT IS BELOW CHARGES, LMPC CONSIDERS THESE AMOUNTS TO BE CONTRACTUAL ADJUSTMENTS, WHICH WILL NEVER BE COLLECTED. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS AMOUNTED TO $34,835,000 OF CHARGES IN 2022.UNCOMPENSATED CARE IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES LMPC BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. LMPC ROUTINELY PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO ARE UNWILLING OR UNABLE TO PAY THEIR BILLS. IN 2022, LMPC WROTE OFF CHARGES OF APPROXIMATELY $2,772,000 OF CHARGES IN BAD DEBTS AND $810,000 OF CHARGES IN CHARITY CARE. 96080358 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 590 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DREW LINK 2205644533 1320 WEST MAIN STREET NEWARK OH 43055 ESCHOL CURL JR DIRECTOR 1.30 2.60 X 0 0 0 JOYCE L MALAINY DIRECTOR 1.30 2.60 X 0 0 0 PATRICK D GUANCIALE DIRECTOR 1.30 2.60 X 0 0 0 BRIAN J MORTELLARO DIRECTOR 1.30 2.60 X 0 0 0 DAVID E DONEY DIRECTOR 1.30 2.60 X 0 0 0 NANCY NEELY CHAIR 1.30 2.60 X 0 0 0 CRAIG R BALDWIN SECRETARY/TREASURER 1.30 2.60 X 0 0 0 MICHAEL MASSARO VICE CHAIR 1.30 2.60 X 0 0 0 ROBERT MONTAGNESE PRESIDENT & CEO, EX OFFICIO W/O VOTE 8.00 32.00 X 0 822340 50368 CINDY WEBSTER VP FINANCIAL SERVICES 8.00 32.00 X 0 316539 26619 GREG WALLIS VP PHYSICIAN PRACTICES 40.00 X 252242 0 41728 HASSAN RAJJOUB MD HEART SPECIALIST 40.00 X 1435397 0 54482 ROBERT MUELLER MD ORTHOPEDIC SURGEON 40.00 X 1072389 0 52047 ROY BROWN MD UROLOGIST 40.00 X 942172 0 51173 ANDREW TERLECKY MD ORTHOPEDIC SURGEON 40.00 X 868847 0 50681 KEVIN OUWELEEN MD ORTHOPEDIC SURGEON 40.00 X 853498 0 50577 5424545 1138879 377675 159 0 1 0 0 872297 872297 PHYSICAN SERVICES 621110 48894464 48894464 48894464 10723 10723 INCENTIVE PAYMENTS 900099 704475 704475 704475 50481959 49598939 0 10723 293970 293970 67783030 64541507 3241523 9928476 8678708 1249768 3282574 3035377 247197 6024394 6024394 4071401 3956478 114923 234306 218155 16151 503860 479524 24336 344708 321755 22953 683750 683750 PURCHASED SERVICES REIM 3883420 2933687 949733 EQUIPMENT RENTAL AND MA 2957755 2434791 522964 BAD DEBTS 2772232 2772232 102763876 96080358 6683518 0 3675 3585 1334695 2097329 5078415 4989225 1713899 1286705 7712904 5963873 1688899 1749031 0 509146 12942693 11161652 22762276 21796673 1857949 2235933 20859221 19490550 22717170 21726483 X 45106 70190 45106 70190 22762276 21796673 X -52281917 7001 52300000 X X 0 1 X 1 0 X 1352629 307965 872297 2532891 43922791 46169417 43080642 47342439 49598939 230114228 43922791 46169417 44433271 47650404 50471236 232647119 0 0 0 232647119 8809 13626 1837 164 10723 35159 8809 13626 1837 164 10723 35159 43931600 46183043 44435108 47650568 50481959 232682278 0.99980 0.99990 0.00020 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 366557 326971 39586 7320569 5611956 1708613 25778 24946 832 1749031 TRUSTEE HELD - DEFERRED COMPENSATION 11161652 11161652 DUE TO RELATED ENTITIES 7815167 ACCRUED PENSION AND OTHER RETIREE LIABILITIES 11161652 OPERATING LEASE - RIGHT OF USE 513731 19490550 X PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE SYSTEM, HOSPITAL, PROFESSIONAL CORPORATION, AND FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GAAP REQUIRES THE SYSTEM TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 1 0 0 0 0 0 0 0 HASSAN RAJJOUB MD HEART SPECIALIST 1088999 0 346398 0 0 0 15332 0 39150 0 1489879 0 0 0 ROBERT MUELLER MD ORTHOPEDIC SURGEON 586810 0 485579 0 0 0 14540 0 37507 0 1124436 0 0 0 ROY BROWN MD UROLOGIST 592931 0 349241 0 0 0 14256 0 36917 0 993345 0 0 0 ANDREW TERLECKY MD ORTHOPEDIC SURGEON 570612 0 298235 0 0 0 14096 0 36585 0 919528 0 0 0 KEVIN OUWELEEN MD ORTHOPEDIC SURGEON 619505 0 233993 0 0 0 14062 0 36515 0 904075 0 0 0 ROBERT MONTAGNESE PRESIDENT & CEO, EX OFFICIO W/O VOTE 0 736537 0 82000 0 3803 0 13994 0 36374 0 872708 0 0 CINDY WEBSTER VP FINANCIAL SERVICES 0 314539 0 2000 0 0 0 11799 0 14820 0 343158 0 0 GREG WALLIS VP PHYSICIAN PRACTICES 250242 0 2000 0 0 0 7935 0 33793 0 293970 0 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B ROBERT A. MONTAGNESE, PRESIDENT & CEO, PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). NO CONTRIBUTIONS WERE MADE TO THE PLAN ON HIS BEHALF FOR THE 2022 YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER AND HE HAS ASSIGNED HIS VOTING RIGHTS OVER TO LICKING MEMORIAL HEALTH SYSTEMS. FORM 990, PART VI, SECTION B, LINE 11B 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 FINANCIAL SERVICES. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS FROM RELATED 501(C) (3) ORGANIZATION 52,300,000. FORM 990, PAGE 12, PART XII, LINE 2C: THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS OF THE INDEPENDENT AUDITOR. LMH CONTINUES TO BE AUDITED AS PART OF THE LMHS CONSOLIDATED GROUP. LMPC IS INCLUDED IN THE LMHS CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS A FINANCE COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. 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) LINE 12C, III-FI N/A 0 LICKING MEMORIAL HOSPITAL 1320 WEST MAIN STREET NEWARK OH 43055 314379519 HEALTHCARE ORGANIZATION OH 501(C)(3) LINE 3 LICKING MEMORIAL HEALTH SYSTEMS 0 LICKING MEMORIAL HEALTH FOUNDATION 1320 WEST MAIN STREET NEWARK OH 43055 311096217 PROVIDE FUNDING FOR HEALTHCARE PROGRAMS OH 501(C)(3) LINE 12A, I LICKING MEMORIAL HEALTH SYSTEMS 0 LICKING MEMORIAL TWIGS 1320 WEST MAIN STREET NEWARK OH 43055 463190381 TO SUPPORT THE OPERATIONS OF LICKING MEMORIAL HEALTH SYSTEMS OH 501(C)(3) LINE 12A, I LICKING MEMORIAL HEALTH SYSTEMS 0 0 0 1 0 1 0 0 0 0 0 1 0 1 1 1 1 0 1 1