SCHEDULE O
(Form 990)

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

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OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
LAKE HOSPITAL FOUNDATION INC
 
Employer identification number

34-1425872
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 LAKE HOSPITAL SYSTEM, INC DBA LAKE HEALTH IS THE SOLE MEMBER OF LAKE HOSPITAL FOUNDATION 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 LAKE HEALTH FOUNDATION 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 LHF FINANCE COMMITTEE, AND PRESENTATION TO THE LHF BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12C THE LAKE HEALTH FOUNDATION 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 LHF CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD CHAIR, COMMITTEE CHAIRS, AND THE DIRECTOR RESPONSIBLE FOR BOARD OF TRUSTEE MATTERS.
FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF LAKE HEALTH FOUNDATION'S EXECUTIVE DIRECTOR INCLUDES MARKET RESEARCH, REVIEW, AND ASSESSMENT BY AN INDEPENDENT CONSULTING FIRM TO MAKE A RECOMMENDATION TO THE LAKE HEALTH CEO AND BOARD OF TRUSTEES. THE CEO REVIEWS THE REPORT IN CONJUNCTION WITH ANNUAL PERFORMANCE ASSESSMENTS IN ORDER TO DETERMINE COMPENSATION LEVEL. A COMPENSATION REVIEW WAS PERFORMED BY UNIVERSITY HOSPITALS COMPENSATION DEPARTMENT WITHIN THE ORGANIZATION'S HUMAN RESOURCES. THE LHF EXECUTIVE DIRECTOR IS PAID BY RELATED ORGANIZATION LAKE HEALTH.
FORM 990, PART VI, SECTION C, LINE 19 LAKE HEALTH FOUNDATION MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104 (D). GOVERNING DOCUMENTS FOR LHF ARE AVAILABLE THROUGH THE WEBSITE OF THE OHIO SECRETARY OF STATE.
FORM 990, PART XI, LINE 9: FUNDING FROM NON-OPS FUNDS -544,054. LOSSES FROM TRUSTS -111,220. GAAP RECLASS FOR ACCRUALS -17,275.
FORM 990, PART XII, LINE 2C: LAKE HEALTH'S BOARD OF TRUSTEES OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2022


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