Civic Intelligence

Forum Health C/O Winter Harbor LLC

990 • Fiscal year 2011 • EIN 31-1560189

Jan 01, 2011 to Dec 31, 2011 • Filed on Jul 11, 2012

Organization ProfileN/A

View Organization Page

1350 E Market Stattn Acct Dept44483-6608
Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on this filing.

Source year 2011

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on this filing.

Source year 2011

Net Margin

Score unavailable

No value available

Net margin requires both revenue and expenses on this filing.

Source year 2011

Top Officer Pay

Score unavailable

No value available

This filing does not contain officer compensation rows.

Source year 2011

Asset Growth

1st percentile

-100%

Faster asset growth than 1% of similar nonprofits.

2011 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2010 to 2011

Revenue Growth

Score unavailable

No value available

No valid filing value is available for this score.

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $148,557,274 (-100%) from 2010

Net Assets

Up

$0

Up $102,612,370 (+100%) from 2010

Liabilities

Down

$0

Down $251,169,644 (-100%) from 2010

Revenue And Expenses
Liabilities / RevenueScore unavailableNet MarginScore unavailable

Revenue

-

No earlier filing loaded for comparison.

Expenses

Down

$4,024,434

Down $13,260,505 (-77%) from 2010

Net Income

-

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset Growth1st percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$300M$200M$100M$0-$100M-$200MAssets 2010: $148,557,274Liabilities 2010: $251,169,644Net Assets 2010: -$102,612,3702010Assets 2011: $0Liabilities 2011: $0Net Assets 2011: $02011Assets 2012: $0Liabilities 2012: $0Net Assets 2012: $02012Assets 2013: $0Liabilities 2013: $0Net Assets 2013: $02013Assets 2014: $0Liabilities 2014: $0Net Assets 2014: $02014Assets 2015: $0Liabilities 2015: $0Net Assets 2015: $02015Assets 2016: $0Liabilities 2016: $0Net Assets 2016: $02016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017Assets 2018: $0Liabilities 2018: $0Net Assets 2018: $02018Assets 2019: $0Liabilities 2019: $0Net Assets 2019: $02019

Highlighted filing

2011

Assets$0
Liabilities$0
Net Assets$0
Open 2011 Filing

Operations Trend

Revenue GrowthScore unavailable

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$20M$15M$10M$5.0M$0Expenses 2010: $17,284,9392010Expenses 2011: $4,024,4342011Revenue 2012: $923Expenses 2012: $923Net Income 2012: $02012Revenue 2013: $0Expenses 2013: $0Net Income 2013: $02013Revenue 2014: $0Expenses 2014: $0Net Income 2014: $02014Revenue 2015: $0Expenses 2015: $0Net Income 2015: $02015Revenue 2016: $0Expenses 2016: $0Net Income 2016: $02016Revenue 2017: $1,419Expenses 2017: $1,419Net Income 2017: $02017Revenue 2018: $0Expenses 2018: $0Net Income 2018: $02018Revenue 2019: $0Expenses 2019: $0Net Income 2019: $02019

Highlighted filing

2011

Revenue-
Expenses$4,024,434
Net Income-
Open 2011 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2011 to Dec 31, 2011
Signed
Jul 11, 2012
Return Version
2011v1.2
Gross Receipts
$2,024,238
Mission and Program Overview

Mission

Forum health was operated exclusively for the benefit of, to perform the functions of, to support, or to carry out the charitable purpose of western reserve care system (wrcs) and trumbull memorial hospital (tmh). On 3/16/09, forum health filed for chapter 11 bankruptcy protection. On 10/1/10, community health systems, inc. Acquired substantially all of the assets of forum health. This entity is no longer active and is awaiting court approval to formally dissolve.

Filing and Contact Details

Filer

EIN
31-1560189
Raw XML AppendixShowing 400 of 657 raw XML fields

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IRS990/Form990PartVIISectionA/Title0INTERIM CEO
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IRS990ScheduleA/SupportedOrgInformation/Name/BusinessNameLine10WESTERN RESERVE CARE SYSTEM
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IRS990ScheduleO/GeneralExplanation/Explanation0CLASSES OF MEMBERS OR STOCKHOLDERS FORUM HEALTH'S SOLE MEMBER IS FORUM HEALTH HOLDING CO. (FHHC). FHHC IS AN OHIO NONPROFIT CORPORATION THAT WAS FORMED AS THE PARENT CORPORATION FOR THE AFFILIATION OF TRUMBULL MEMORIAL HOSPITAL (TMH) AND WESTERN RESERVE CARE SYSTEM (WRCS) INTO A SINGLE INTEGRATED HEALTH SYSTEM. FHHC AND FORUM HEALTH WERE EACH ESTABLISHED AND OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, TO SUPPORT, OR TO CARRY OUT THE CHARITABLE PURPOSES OF TMH AND WRCS. FHHC APPOINTS THE BOARD OF TRUSTEES OF FORUM HEALTH.
IRS990ScheduleO/GeneralExplanation/Explanation1ELECTION OF MEMBERS AND THEIR RIGHTS PERIODICALLY, OR AS VACANCIES ARISE, FORUM HEALTH HOLDING CO., AS THE SOLE MEMBER OF FORUM HEALTH, HAS THE RIGHT TO APPOINT ONE OR MORE MEMBERS OF THE FORUM HEALTH BOARD OF TRUSTEES.
IRS990ScheduleO/GeneralExplanation/Explanation2DECISIONS SUBJECT TO APPROVAL OF MEMBERS SUBJECT TO MATTERS REQUIRING THE CONSENT OF FORUM HEALTH HOLDING CO. (FHHC), AS THE SOLE MEMBER OF FORUM HEALTH, AS SET FORTH BELOW OR UNDER OHIO LAW, THE FORUM HEALTH BOARD OF TRUSTEES HAS FULL AUTHORITY TO OVERSEE AND DIRECT THE OPERATIONS OF FORUM HEALTH. NOTWITHSTANDING THE FOREGOING TO THE CONTRARY, THE FOLLOWING ACTIONS REQUIRE THE APPROVAL OF FHHC: (1) A MERGER OR CONSOLIDATION OF FORUM HEALTH OR OF TRUMBULL MEMORIAL HOSPITAL OR WESTERN RESERVE CARE SYSTEM OR OF ANY HOLDING COMPANY FOR THOSE ENTITIES (EACH A "HOSPITAL PARTY") WITH OR INTO ANOTHER ENTITY IN WHICH FORUM HEALTH OR, AS THE CASE MAY BE, A HOSPITAL PARTY IS NOT A SURVIVING ENTITY; (2) A SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OR BUSINESS OPERATIONS OF FORUM HEALTH OR A HOSPITAL PARTY; (3) THE TRANSFER OF CONTROL OF FORUM HEALTH OR A HOSPITAL PARTY TO ANY OTHER PERSON OR ENTITY; (4) THE DISSOLUTION OR LIQUIDATION OF FORUM HEALTH OR A HOSPITAL PARTY; OR (5) AMENDMENT OF THE ARTICLES OF INCORPORATION OR CODE OF REGULATIONS OF FORUM HEALTH; AND (6) ELECTION OR REMOVAL OF MEMBERS OF THE FORUM HEALTH BOARD OF TRUSTEES.
IRS990ScheduleO/GeneralExplanation/Explanation3ORGANIZATION'S PROCESS TO REVIEW FORM 990 AT THE TIME OF THIS RETURN'S FILING, THE BOARD WAS NOT ACTIVE. ON 10/01/10, COMMUNITY HEALTH SYSTEMS, INC. ACQUIRED SUBSTANTIALLY ALL OF THE ASSETS OF FORUM HEALTH. THIS ENTITY IS NO LONGER ACTIVE.
IRS990ScheduleO/GeneralExplanation/Explanation4ENFORCEMENT OF CONFLICTS POLICY FORUM HEALTH MONITORS FOR ACTUAL AND PROPOSED CONFLICTS OF INTEREST THROUGH ITS CORPORATE COMPLIANCE DEPARTMENT THAT PROVIDES ANNUAL EMPLOYEE EDUCATION ON ITS CONFLICTS OF INTEREST POLICY AND REQUIRES ALL MANAGEMENT EMPLOYEES TO ANNUALLY COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES. FORUM HEALTH HAS DEVELOPED THIS POLICY TO GUIDE THE TRUSTEES (DIRECTORS), OFFICERS, EMPLOYEES AND AFFILIATES ASSOCIATED AND AFFILIATED WITH THE FORUM HEALTH SYSTEM IN AVOIDING CONFLICTS OF INTEREST AND IN IDENTIFYING AND DISCLOSING ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AND TO PROTECT FORUM HEALTH FROM ENTERING INTO ANY ARRANGEMENT THAT BENEFITS OR POTENTIALLY BENEFITS THE PRIVATE INTEREST(S) OF ANY OFFICER, TRUSTEE (DIRECTOR), OR OTHER PERSON AFFILIATED WITH OR IN A POSITION TO EXERT SUBSTANTIAL INFLUENCE OR CONTROL OVER THE AFFAIRS OF THE FORUM HEALTH SYSTEM OR ANY OF ITS CORPORATE ENTITIES. BELOW IS THE CORPORATE CONFLICT OF INTEREST POLICY FOLLOWED BY THE ORGANIZATION. OFFICERS, DIRECTORS OR TRUSTEES, EXECUTIVES, EMPLOYEES, AFFILIATES, AGENTS AND CONTRACTORS, AND INTERESTED PERSONS/INSIDERS OF FORUM HEALTH SYSTEM ENTITIES SHALL NOT ENGAGE IN ACTUAL, POTENTIAL, APPARENT OR INDIRECT CONFLICTS OF INTEREST AS DEFINED IN THIS POLICY. CONFLICTS OF INTEREST PERTAIN TO FINANCIAL OR NON-FINANCIAL INTERESTS. ANY PERSON OR ENTITY HAVING ANY SUCH CONFLICT OF INTEREST HAS A DUTY TO DISCLOSE IT TO THE ORGANIZATION PURSUANT TO THIS POLICY, AS FOLLOWS: TRUSTEES OR DIRECTORS OF ALL FORUM HEALTH ENTITIES WILL ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST FOR THE RECORD TO THE SYSTEM BOARD OF TRUSTEES AND PROMPTLY DISCLOSE ANY CONFLICTS OF INTEREST WHEN RECOGNIZED TO THE BOARD PURSUANT TO THE BOARD'S CONFLICT OF INTEREST PROTOCOLS. THE GENERAL COUNSEL/CORPORATE SECRETARY REVIEWS ALL CONFLICT DISCLOSURES BY MEMBERS OF THE BOARD OF TRUSTEES. MEMBERS OF THE EXECUTIVE, SENIOR LEADERSHIP, AND MANAGEMENT TEAMS PROMPTLY DISCLOSE ANY CONFLICT OF INTEREST TO THE CEO, CHIEF COMPLIANCE OFFICER, OR CHAIR OF THE BOARD OF TRUSTEES. PHYSICIANS, AGENTS AND CONTRACTORS SHALL DISCLOSE ANY FINANCIAL INTEREST, OWNERSHIP INTEREST OR OTHER BUSINESS RELATIONSHIP, DIRECT OR INDIRECT, WITH COMPANIES, AFFILIATES OR PROVIDERS OF PRODUCTS OR SERVICES USED AT FORUM HEALTH, AND/OR FOR PATIENTS SEEN AT A FORUM FACILITY, RELATED TO GRADUATE MEDICAL EDUCATION (TEACHING, PRESENTATIONS OR RESEARCH) AND RELATED TO OR FOR USE IN RESEARCH CONDUCTED AT A FORUM FACILITY AND/OR REVIEWED THROUGH A FORUM IRB. EMPLOYEES DISCLOSE ANY CONFLICTS OF INTEREST TO THEIR SUPERVISORS PROMPTLY WHEN RECOGNIZED. SUPERVISORS CONSULT APPROPRIATE EXECUTIVE OR SENIOR MANAGEMENT AND THE CHIEF COMPLIANCE OFFICER REGARDING ANY CONFLICTS OF INTEREST DISCLOSURES. ADMINISTRATORS AND EMPLOYEES IN A POSITION TO INFLUENCE, AND IN AREAS WHERE CONFLICTS OF INTEREST ARE LIKELY TO ARISE (E.G., PHARMACY, BUSINESS OFFICE, FINANCE, PHYSICIAN CONTRACTING, LEASING, PURCHASING, PURCHASED SERVICES, FACILITIES MANAGEMENT, RESEARCH, AND THE LIKE) DISCLOSE ANY CONFLICTS OF INTEREST TO THE CEO, LEGAL SERVICES AND THE CORPORATE COMPLIANCE OFFICER OR OTHER DESIGNEE AS NOTED AND THROUGH ANNUAL DISCLOSURE PROTOCOLS. DISCLOSED CONFLICTS OF INTEREST: WITHIN THE DISCRETION OF MANAGEMENT, AND SUBJECT TO THE REQUIREMENT OF THE BOARD OF TRUSTEES CONFLICT OF INTEREST POLICY, WHEN A CONFLICT OF INTEREST IS DISCLOSED IN ADVANCE, THE ORGANIZATION TAKES ACTION TO ASSURE THE CONFLICTED PERSON OR ENTITY IS REMOVED FROM THE CONFLICT SITUATION (E.G., RECUSAL FROM VOTING ON THE ISSUE, REMOVAL FROM DECISION MAKING RESPONSIBILITY OVER THE ISSUE, ETC.) OR TO ASSURE DECISION MAKERS ARE AWARE OF THE CONFLICT SO THEY CAN TAKE INTO ACCOUNT THE POSSIBLE COMPETING INTERESTS WHEN MAKING DECISIONS. UNDISCLOSED CONFLICT OF INTEREST: AN UNDISCLOSED CONFLICT OF INTEREST REQUIRES DISCIPLINARY MEASURES CONSISTENT WITH THE DISCIPLINARY POLICY AND PROCEDURE OF FORUM HEALTH AND AS RECOMMENDED BY HUMAN RESOURCES, IN CONSULTATION WITH AND UPON THE APPRO
IRS990ScheduleO/GeneralExplanation/Explanation5COMPENSATION PROCESS FOR TOP OFFICIALS THE FORUM HEALTH BOARD OF TRUSTEES HAS ESTABLISHED A COMPENSATION COMMITTEE FOR THE PURPOSE OF REVIEWING AND APPROVING, ON BEHALF OF THE BOARD OF TRUSTEES, MANAGEMENT RECOMMENDATIONS REGARDING ALL FORMS OF COMPENSATION TO BE PROVIDED TO EACH EXECUTIVE OFFICER AND DIRECTOR OF THE ORGANIZATION. THE COMMITTEE SHALL CONSIST OF A MINIMUM OF THREE MEMBERS OF THE BOARD OF TRUSTEES, ALL OF WHOM SHALL BE "INDEPENDENT" UNDER THE STANDARDS SET FORTH IN THE ORGANIZATION'S CORPORATE GOVERNANCE PRINCIPLES, AS WELL AS UNDER ANY ADDITIONAL OR SUPPLEMENTAL INDEPENDENCE STANDARDS APPLICABLE TO COMPENSATION COMMITTEES ESTABLISHED UNDER ANY APPLICABLE LAW, RULE OR REGULATION. THE COMMITTEE REVIEWS WITH THE ORGANIZATION'S EXECUTIVE MANAGEMENT AND APPROVES ALL FORMS OF COMPENSATION TO BE PROVIDED TO EACH EXECUTIVE OFFICER AND NON-EMPLOYEE DIRECTOR. THE COMMITTEE ALSO REVIEWS WITH THE ORGANIZATION'S EXECUTIVE MANAGEMENT AND APPROVES RECOMMENDATIONS WITH REGARD TO AGGREGATE SALARY AND BONUS BUDGET GUIDELINES FOR ALL OF THE ORGANIZATION'S EMPLOYEES WHO MEET REVIEW CRITERIA. THE COMMITTEE MONITORS SUMMARY DATA ON THE ORGANIZATION'S POPULATION (E.G., TOTAL COMPENSATION COSTS, COMPENSATION BENCHMARK DATA, EMPLOYEE DIVERSITY, TURNOVER LEVELS, ETC.). THE COMMITTEE HAS THE POWER AND AUTHORITY TO RETAIN SUCH COMPENSATION CONSULTANTS, OUTSIDE COUNSEL AND OTHER ADVISORS AS THE COMMITTEE MAY DEEM APPROPRIATE. THE COMMITTEE HOLDS REGULAR MEETINGS AND MAINTAINS WRITTEN MINUTES OF EACH MEETING.
IRS990ScheduleO/GeneralExplanation/Explanation6GOVERNING DOCUMENTS DISCLOSURE EXPLANATION THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
IRS990ScheduleO/GeneralExplanation/Explanation7UNPAID LIABILITIES 104,612,566. TOTAL TO FORM 990, PART XI, LINE 5: 104,612,566.
IRS990ScheduleO/GeneralExplanation/Identifier0CHANGES IN NET ASSETS OR FUND BALANCES:
IRS990ScheduleO/GeneralExplanation/ReturnReference0FORM 990, PART VI, SECTION A, LINE 6
IRS990ScheduleO/GeneralExplanation/ReturnReference1FORM 990, PART VI, SECTION A, LINE 7A
IRS990ScheduleO/GeneralExplanation/ReturnReference2FORM 990, PART VI, SECTION A, LINE 7B
IRS990ScheduleO/GeneralExplanation/ReturnReference3FORM 990, PART VI, SECTION B, LINE 11
IRS990ScheduleO/GeneralExplanation/ReturnReference4FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/GeneralExplanation/ReturnReference5FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/GeneralExplanation/ReturnReference6FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/GeneralExplanation/ReturnReference7FORM 990, PART XI, LINE 5:
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Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2011 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.

Open filing
Assets
$0
Liabilities
$0
Net assets
$0
Revenue
-
Expenses
$4,024,434
Net income
-
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2019Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.00$0.00$0.00
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.00$0.00$0.00
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.00$0.00$0.00
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.00$0.00$0.00
2015Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.00$0.00$0.00
2014Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.00$0.00$0.00
2013Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.00$0.00$0.00
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$0.00$0.00$0.00
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$4.02
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$149$251$103$17.3