SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
Lakeland Regional Health Systems Inc
 
Employer identification number

59-2650464
Return Reference Explanation
Form 990, Part VI, Section B, line 11b The Form 990 and supporting schedules are reviewed prior to filing by senior management, including the CEO and CFO. Additionally, the compensation 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 Medical Center 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 who must acknowledge that the policy was read, understood and will be abided by. Lakeland Regional Medical Center also has a "Policy of the Board of Directors Regarding Board Members Doing Business with Lakeland Regional Medical Center or Lakeland Regional Health Systems". All Board Members are annually required to execute a "Corporate Compliance Acknowledgement and answer a comprehensive "Annual Conflict of Interest Questionnaire". Additionally, 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 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 its 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 to 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.
Form 990, Part XI, line 9: Transfer from Affiliates 60,792,813. Book/Tax Difference in Partnerships -471,794. Taxes on UBI Income -651,635. Other Changes 365. Contributed Capital -284,973.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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