Lake Hospital System Inc Self Insurance

990EZ • Fiscal year 2011 • EIN 34-6771096

Jan 01, 2011 to Dec 31, 2011 • Filed on May 08, 2012

Organization Profile N/A

340 S Cleveland Ave Bldg 35043081

Siviq Scores

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

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2011 filings • 501(c)3 • <$500k nonprofits • Source year 2011

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2011 filings • 501(c)3 • <$500k nonprofits • Source year 2011

-87450%

Higher net margin than 1% of similar nonprofits.

2011 filings • 501(c)3 • <$500k nonprofits • Source year 2011

No value available

This filing does not contain officer compensation rows.

Source year 2011

-1.2%

Faster asset growth than 46% of similar nonprofits.

2011 filings • 501(c)3 • <$500k nonprofits • Annualized from 2010 to 2011

No value available

No earlier valid filing was available within the previous three public years.

Source year 2011

Balance Sheet

Liabilities / Assets53rd percentile

Assets

Down

$148,789

Down $1,749 (-1.2%) from 2010

Net Assets

Down

$148,789

Down $1,749 (-1.2%) from 2010

Liabilities

Flat

Flat from 2010

Revenue And Expenses

Liabilities / Revenue56th percentile Net Margin1st percentile

Revenue

No earlier filing loaded for comparison.

Expenses

Down

$1,751

Down $54,013 (-97%) from 2010

Net Income

-$1,749

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset Growth46th percentile

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

Highlighted filing

2011

Assets$148,789

Liabilities$0

Net Assets$148,789

Open 2011 Filing

Operations Trend

Revenue GrowthScore unavailable

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

Highlighted filing

2011

Revenue$2

Expenses$1,751

Net Income-$1,749

Open 2011 Filing

Jump To

Filing Snapshot

Filing Period: Jan 1, 2011 to Dec 31, 2011
Signed: May 8, 2012
Return Version: 2011v1.2

Filing and Contact Details

Filer

EIN: 34-6771096

Raw XML Appendix125 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path	#	Value
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IRS990EZ/AmountOfTaxImposedOnOrgMgr	0	0
IRS990EZ/AmountOfTaxReimbursedByOrg	0	0
IRS990EZ/CashSavingsAndInvestments/BOY	0	150538
IRS990EZ/CashSavingsAndInvestments/EOY	0	148789
IRS990EZ/DidOrgFileForm1120POLThisYear	0	false
IRS990EZ/DoesOrgHaveHospital	0	false
IRS990EZ/EngagedInExcessBenefitTrans	0	false
IRS990EZ/EngageInLobbyingActivities	0	false
IRS990EZ/EngagePoliticalCmpgnActivities	0	false
IRS990EZ/ExcessOrDeficitForYear	0	-1749
IRS990EZ/FeesAndOthPymtToIndContractors	0	1751
IRS990EZ/FiledScheduleA	0	true
IRS990EZ/ForeignFinancialAccount	0	false
IRS990EZ/ForeignOffice	0	false
IRS990EZ/GrossReceipts	0	2
IRS990EZ/GrossReceiptsForPublicUse	0	0
IRS990EZ/InitiationFeesAndCapitalContri	0	0
IRS990EZ/InvestmentIncome	0	2
IRS990EZ/MadeChangesToOrgnzngEtcDoc	0	false
IRS990EZ/MadeLoansToFromOfficers	0	false
IRS990EZ/MaintainAnyDonorAdvisedFunds	0	false
IRS990EZ/MethodOfAccountingCash	0	X
IRS990EZ/NetAssetsOrFundBalances/BOY	0	150538
IRS990EZ/NetAssetsOrFundBalancesBOY	0	150538
IRS990EZ/NetAssetsOrFundBalances/EOY	0	148789
IRS990EZ/NetAssetsOrFundBalancesEOY	0	148789
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/AddressLine1	0	311 SOUTH WACKER DRIVE SUITE 500
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/AddressLine1	1	340 S CLEVELAND AVE BLDG 350
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/City	0	CHICAGO
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/City	1	WESTERVILLE
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/State	0	IL
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/State	1	OH
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/ZIPCode	0	60606
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AddressUS/ZIPCode	1	43081
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AvgHoursPerWkDevotedToPosition	0	2
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/AvgHoursPerWkDevotedToPosition	1	2
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/BusinessName/BusinessNameLine1	0	JPMORGAN CHASE BANK NA
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/Compensation	0	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/Compensation	1	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/ContriToEmplBenefitPlansEtc	0	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/ContriToEmplBenefitPlansEtc	1	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/ExpenseAccountOtherAllowances	0	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/ExpenseAccountOtherAllowances	1	0
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/PersonName	0	DAVID C HILLIARD
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/Title	0	TRUSTEE
IRS990EZ/OfficerDirectorTrusteeKeyEmpl/Title	1	TRUSTEE
IRS990EZ/OperatingSchool	0	false
IRS990EZ/Organization501c3	0	X
IRS990EZ/OrganizationDissolvedEtc	0	false
IRS990EZ/OrganizationHadUBI	0	false
IRS990EZ/OtherChangesInNetAssets	0	0
IRS990EZ/PrimaryExemptPurpose	0	TO PROVIDE PROGRAM SUPPORT FOR LAKE HOSPITAL SYSTEM OF CONCORD, OHIO
IRS990EZ/ProgramServiceAccomplishment/DescriptionProgramServiceAccom	0	TO PROVIDE SUPPORT FOR LAKE HOSPITAL SYSTEM OF CONCORD, OH
IRS990EZ/ProhibitedTaxShelterTrans	0	false
IRS990EZ/RelatedOrgControlledEntity	0	false
IRS990EZ/ScheduleBNotRequired	0	X
IRS990EZ/StatesWhereCopyOfReturnIsFiled	0	OH
IRS990EZ/SubjectToProxyTax	0	false
IRS990EZ/SumOfTotalLiabilities/BOY	0	0
IRS990EZ/SumOfTotalLiabilities/EOY	0	0
IRS990EZ/TanningServicesProvided	0	false
IRS990EZ/TaxImposedUnderIRC4911	0	0
IRS990EZ/TaxImposedUnderIRC4912	0	0
IRS990EZ/TaxImposedUnderIRC4955	0	0
IRS990EZ/TheBooksAreInCareOf/AddressUS/AddressLine1	0	340 S CLEVELAND AVE BLDG 350
IRS990EZ/TheBooksAreInCareOf/AddressUS/City	0	WESTERVILLE
IRS990EZ/TheBooksAreInCareOf/AddressUS/State	0	OH
IRS990EZ/TheBooksAreInCareOf/AddressUS/ZIPCode	0	43081
IRS990EZ/TheBooksAreInCareOf/NameBusiness/BusinessNameLine1	0	JPMORGAN CHASE BANK NA
IRS990EZ/TheBooksAreInCareOf/TelephoneNumber	0	6142481343
IRS990EZ/TotalAssets/BOY	0	150538
IRS990EZ/TotalAssets/EOY	0	148789
IRS990EZ/TotalExpenses	0	1751
IRS990EZ/TotalRevenue	0	2
IRS990EZ/TransactionWithControlEntity	0	false
IRS990EZ/TrnsfrsExemptNonCharRelatedOrg	0	false
IRS990EZ/WebSite	0	N/A
IRS990ScheduleA/CertificationCheckbox	0	X
IRS990ScheduleA/ContribBy35ControlledEntity	0	false
IRS990ScheduleA/ContribByControllingIndividual	0	false
IRS990ScheduleA/ContributionByRelatedParty	0	false
IRS990ScheduleA/SumOfAmounts	0	0
IRS990ScheduleA/SupportedOrgInformation/Amount	0	0
IRS990ScheduleA/SupportedOrgInformation/EIN	0	341425870
IRS990ScheduleA/SupportedOrgInformation/ListedInGoverningDoc	0	true
IRS990ScheduleA/SupportedOrgInformation/Name/BusinessNameLine1	0	LAKE HOSPITAL SYSTEM
IRS990ScheduleA/SupportedOrgInformation/OrganizedInUS	0	true
IRS990ScheduleA/SupportedOrgInformation/SupportedOrganizationNotified	0	false
IRS990ScheduleA/SupportedOrgInformation/TypeOfOrganization	0	7
IRS990ScheduleA/SupportingOrg509a3Type3Other	0	X
IRS990ScheduleA/SupportingOrganization509a3	0	X
IRS990ScheduleA/TotalNumberOfSupportedOrgs	0	1
IRS990ScheduleO/GeneralExplanation/Explanation	0	TRUSTEE REVIEWS ALL UNDERLYING MONETARY AND FACTUAL INFORMATION BEFORE THE IRS FORM 990 IS FILED.
IRS990ScheduleO/GeneralExplanation/Explanation	1	AS TRUSTEE, JPMORGAN CHASE BANK, N.A. MAINTAINS A CLOSE AND CONTINUOUS WORKING RELATIONSHIP WITH THE OFFICERS OF THE SUPPORTED ORGANIZATIONS. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC BUT HAVE BEEN GIVEN AND ARE AVAILABLE TO ALL INTERESTED PARTIES SUCH AS BENEFICIARIES, TRUSTEES, EXECUTORS, ETC. JPMORGAN CHASE BANK, N.A. DOES NOT HAVE A PUBLIC CONFLICT OF INTEREST POLICY; HOWEVER, THE GOVERNING DOCUMENTS AND STATE LAW IMPOSE LIMITATIONS OF TRUSTEE POWERS THAT JPMORGAN CHASE BANK, N.A. STRICTLY FOLLOWS. FINANCIAL STATEMENTS ARE SENT TO EACH CHARITABLE BENEFICIARY FOR REVIEW AND COMMENT. COPIES OF THE TAX RETURNS ARE AVAILABLE TO THE PUBLIC THROUGH SEVERAL INTERNET WEBSITES.
IRS990ScheduleO/GeneralExplanation/Identifier	0	PART VI, SECTION B, LINE 11
IRS990ScheduleO/GeneralExplanation/Identifier	1	DESCRIPTION FOR MAKING DOCUMENTS PUBLIC
IRS990ScheduleO/GeneralExplanation/ReturnReference	0	FORM 990, PAGE 6, PART VI, LINE 19
ReturnHeader/BuildTS	0	2016-02-24 21:20:13Z
ReturnHeader/Filer/EIN	0	346771096
ReturnHeader/Filer/Name/BusinessNameLine1	0	LAKE HOSP SYSTEM SELF-INSURANCE FUND
ReturnHeader/Filer/NameControl	0	LAKE
ReturnHeader/Filer/Phone	0	6142481343
ReturnHeader/Filer/USAddress/AddressLine1	0	340 S CLEVELAND AVE BLDG 350
ReturnHeader/Filer/USAddress/City	0	WESTERVILLE
ReturnHeader/Filer/USAddress/State	0	OH
ReturnHeader/Filer/USAddress/ZIPCode	0	43081
ReturnHeader/Officer/AuthorizeThirdParty	0	true
ReturnHeader/Officer/DateSigned	0	2012-05-08
ReturnHeader/Officer/Name	0	JPMORGAN CHASE BANK NA
ReturnHeader/Officer/Phone	0	6142481343
ReturnHeader/Officer/Title	0	TRUSTEE
ReturnHeader/Preparer/DatePrepared	0	2012-05-08
ReturnHeader/PreparerFirm/PreparerFirmBusinessName/BusinessNameLine1	0	THOMSON REUTERS (TAX & ACCOUNTING)
ReturnHeader/PreparerFirm/PreparerFirmUSAddress/AddressLine1	0	2 EASTON OVAL SUITE 425
ReturnHeader/PreparerFirm/PreparerFirmUSAddress/City	0	COLUMBUS
ReturnHeader/PreparerFirm/PreparerFirmUSAddress/State	0	OH
ReturnHeader/PreparerFirm/PreparerFirmUSAddress/ZIPCode	0	43219
ReturnHeader/Preparer/Name	0	LORI COX
ReturnHeader/Preparer/Phone	0	6144185007
ReturnHeader/ReturnType	0	990EZ
ReturnHeader/TaxPeriodBeginDate	0	2011-01-01
ReturnHeader/TaxPeriodEndDate	0	2011-12-31
ReturnHeader/TaxYear	0	2011
ReturnHeader/Timestamp	0	2012-05-08T11:43:39-06:00

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

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

Open filing

Assets: $148,789
Liabilities: $0
Net assets: $148,789
Revenue: $2
Expenses: $1,751
Net income: -$1,749

	Balance Sheet			Operations
Year	Assets	Liabilities	Net Assets	Revenue	Expenses	Net Income
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.	$1.49	$0.00	$1.49	$0.00	$0.02	$0.02
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.	$1.51	$0.00	$1.51		$0.56