The Cleveland Clinic Foundation Group Return

“The board of each of the cleveland clinic hospitals has delegated authority to an executive committee made up of board members to: (1) to transact all business of the board during the period between meetings of the board, subject to the limitations set forth in the respective bylaws or code of regulations and any limitations otherwise imposed by the boards; (2) to initiate and recommend to the board changes in the respective bylaws or code of regulations of the particular hospital, or any of its affiliated corporations, or when requested to do so by the respective board or an affiliated board, or when the executive committee deems that a change in bylaws or code of regulations is needed; (3) to exercise on behalf of the hospital legal entity, the powers that the hospital legal entity possesses as a sole member of other corporations that are not delegated by the bylaws or code of regulations to other committees of the board; (4) to review hospital performance as compared to enterprise goals; (5) to approve all require hospital annual plans; (6) to establish personal goals and objectives for the president/ceo, and to otherwise establish other corporate goals and objectives as it deems appropriate; (7) to approve all actions related to medical staff credentialing, privileging, disciplinary activity and amendments to medical staff bylaws; and (8) review and approve policies on behalf of the board.”

“Deborah a. Crawford, ccf director & patrick v. Auletta, ccf director - business william m. Peacock iii, ccf officer & timothy l. Longville, ccf officer - business william m. Peacock iii, ccf officer & k. Kelly hancock, dnp, rn, ne-bc, ccf officer - business william m. Peacock iii, kma officer & andrew machado, m.d., ph.d., kma director - business william m. Peacock iii, ccf officer & dennis laraway, ccf officer - business william m. Peacock iii, ccf officer & connor delaney, m.d., ph.d., ccf officer - business timothy longville, ccf officer & connor delaney, m.d., ph.d., ccf officer - business timothy longville, ccf officer & dennis laraway, ccf officer - business dennis laraway, ccf officer & connor delaney, m.d., ph.d., ccf officer - business ronald e. Weinberg, ccf director & stewart a. Kohl, ccf director - business k. Kelly hancock, kma officer & andrew machado, m.d., ph.d., kma director - business larry ruvo, kma officer & camille ruvo, kma officer - family the following individuals may share a business relationship through their association as an officer, director, or trustee of wholly owned related corporations: beri ridgeway, m.d.; david w. Rowan; deborah gordon; dennis laraway; jorge guzman, m.d.; r. Jason oblander; timothy l. Longville; and william m. Peacock iii.”

“Ccf hotel services, llc, a single member disregarded entity of ccf has entered into a management agreement with intercontinental hotels corporation to manage the two hotels owned by ccf hotel services, llc. The cleveland clinic foundation entered into a management agreement with kessler rehabilitation services, inc. As part of a joint venture with hospital holdings corporation (select medical") to manage and operate three inpatient rehabilitation hospital facilities. The cleveland clinic foundation entered into a management agreement with regency hospitals, llc as part of a joint venture with select unit management, inc. (select medical") to manage and operate three long- term acute care facilities.”

“The bylaws of indian river memorial hospital were amended to increase the number of board members to four.”

“Pursuant to nonprofit corporation law, there can be no shareholders or other "equity owners" of a nonprofit corporation. Management and control rights are held and exercised by the "members" of the nonprofit corporation. Ccf is an ohio nonprofit corporation and it has both members and directors. It does not have stockholders. The member of each subordinate in the ccf group is either ccf or an indirect subordinate.”

“Pursuant to nonprofit corporation law, the "members" of the corporation elect the board of directors or board of trustees, and the board then conducts the affairs of the corporation. Nonprofit corporation law permits the use of either "board of trustees or "board of directors." ccf has adopted a practice that a board of directors is generally the fiduciary board for an organization. In addition, one nonprofit corporation may be the "member" of another nonprofit corporation. Ccf is an ohio nonprofit corporation and it has members who elect the directors. The member of each subordinate in the ccf group is either ccf or an indirect subordinate and that member elects the board of the respective subordinate.”

“Pursuant to nonprofit corporation law, certain decisions of the governing bodies must be approved by the members. For example, any changes to the articles of incorporation and code of regulations must be approved by a vote of the members.”

“The form 990 is reviewed by experienced and qualified members of the finance division tax department. Prior to filing, key sections of the form are reviewed with experienced and qualified members of the law department. In addition, the entire return is also reviewed with the cfo, and members of the audit committee. The paid preparer (big 4 public accounting firm) conducts an in depth review of the form. Annually, the 990 filing is discussed with the entire audit committee. Upon confirmation of successful e-filing from the irs, a copy of the final e-filed return will be made available to appropriate members of the governing body. The final e-filed return will be posted on the organization's website at www.clevelandclinic.org.”

“Board members and officers of ccf and its subsidiaries are required to complete a conflict of interest questionnaire annually. The disclosures are reviewed by staff reporting to the chief governance officer and any items that may create a conflict are brought to her attention. If there any disclosure changes during the year or a new disclosure, the policy requires that those individuals inform the chief governance officer. The board of directors audit and conflict of interest committee meets four times per year and reviews the disclosures, any proposed arrangements that may involve a potential conflict of interest, and documents its conclusions. Under the policy, the interested person may attend a meeting at the discretion of the board or committee to provide information or answer questions, but they may not be present during the final consideration or voting on the arrangements.”

“All cleveland clinic officers and significant management executive positions have their compensation reviewed in advance annually by the compensation committee of the cleveland clinic board of directors, which is vested with board-delegated powers to act on behalf of the board with respect to compensation matters. In reviewing and establishing compensation for these officers, the committee uses a process that is intended to create the presumption in regulation 53.4958-6(a) that payments of compensation to these persons constitute reasonable compensation, defined as amounts that are within the range of compensation paid by similarly situated organizations to similarly qualified persons in functionally comparable positions. In this process, no member of the committee who has a conflict of interest within the meaning of regulation 53.4958-9(c)(1)(iii) with respect to the compensation arrangement at issue is permitted to participate in the review and approval of that compensation arrangement. In establishing compensation for employed physicians for physician services, cleveland clinic participates in productivity and compensation surveys with similarly situated organizations across the u.s. In addition, cleveland clinic engages the services of an independent compensation consultant who each year provides cleveland clinic with a customized compensation report regarding physician compensation. By using this data, cleveland clinic has been able to develop market-based compensation for physician services. In establishing compensation for officers and significant management executive employees performing non-physician services, the compensation committee retains and consults with an independent compensation consultant, who prepares a customized report for the committee regarding amounts paid by similarly situated organizations to similarly qualified persons in functionally comparable positions. The committee uses the market-based data provided by the consultant, and, where appropriate, performance reviews and compensation recommendations by the chief executive officer and chief of staff, to establish marked-based compensation. After making its compensation decisions, the committee contemporaneously documents its deliberations and decisions in cleveland clinic's written or electronic books and records.”

“The most recently filed form 990 is available on the ccf website, www.clevelandclinic.org, under the "about us" section. All other documents which are required to be available to the public can be obtained upon request.”

“Cchs makes certain of its key documents available to the public on its website, www.clevelandclinic.org, under the "about cleveland clinic" section. In this section, the financial statements, annual report, community benefit report, ccf's conflict of interest policy, and corporate compliance policies are available.”

“Of the subordinate organizations in the cleveland clinic group exemption, the tax exempt hospital nonprofit corporations have boards that are majority independent. The remaining subordinates are wholly owned subsidiaries many of which have boards comprised in whole or in part by individuals who are officers and/or employees of the parent organization.”

“Cleveland clinic, headquartered in cleveland, ohio, is a nonprofit, tax-exempt academic medical center that integrates clinical and hospital care with research and education. The cleveland clinic foundation is the parent of the cleveland clinic health system ("system"). Cleveland clinic was established in 1921. The system's mission statement is as follows: caring for life, researching for health and educating those who serve. Consistent with its tripartite mission, cleveland clinic's primary program services are focused on patient care provided on a charitable basis, medical research, and education of both medical professionals and the community. The founders recognized that it is in the best interest of patients to pool the talents of medical specialists to develop, teach and apply the best medical techniques. This statement is not intended to identify all the activities by which the system fulfills its charitable purposes, but rather is a summary of its primary program services and contributions to the community. The system defines and measures community benefit (including financial assistance) using the catholic health association ("cha") community benefit model, which recommends reporting community benefit on a cost basis. Using this model, in 2024 cleveland clinic and its affiliates provided $1.49 billion in benefits to the communities served. The community benefit that the system provides includes patient care provided on a charitable basis, research, education, medicaid shortfall, subsidized health services, and community outreach programs. The current community benefit report is available at www.clevelandclinic.org. I. Patient care the system is a world-renowned provider of healthcare services that attracted patients from across the united states and from 178 other countries in 2024. As of december 31, 2024, the system operates 21 hospitals and is the leading provider of healthcare services in northeast ohio. 15 of the hospitals are operated in the northeast ohio area, anchored by the cleveland clinic foundation. The system operates 22 outpatient family health centers, nine ambulatory surgery centers, as well as numerous physician offices, which are located throughout northeast ohio, and specialized cancer centers in sandusky and mansfield, ohio. In florida, the system operates five hospitals, and a clinic located throughout southeast florida, outpatient family health centers in port st. Lucie, stuart and west palm beach, an outpatient family health and ambulatory surgery center in coral springs and numerous physician offices located throughout southeast florida. In addition, the system operates a health and wellness center and a sports medicine clinic in toronto, canada and a specialized neurological clinical center in las vegas, nevada. Pursuant to agreements, the system also provides management services for ashtabula county medical center, located in ashtabula, ohio, and cleveland clinic abu dhabi, a multispecialty hospital offering critical and acute care services that is part of m42 health's network of healthcare facilities located in abu dhabi, united arab emirates. The system is dedicated to the communities it serves striving to provide compassionate, high-quality healthcare to all who need it; and supporting programs and initiatives that improve the health and well-being of our communities. Through its financial assistance efforts and as a leading medicaid provider in ohio, cleveland clinic provides healthcare to those who otherwise could not afford it. In 2024, cleveland clinic recorded 5,454 total staffed beds, 993,993 emergency visits, 319,935 surgical cases, 269,462 admissions, and more than 14 million total clinic visits. It is the policy of the system to treat all patients with compassion, dignity and respect, regardless of their race, creed, or ability to pay. After years of planning, in 2024 the system implemented a new operating model that redefines how cleveland clinic organizes and administers its cl”

“Ohio founded in 1914, akron general is a nonprofit healthcare organization that serves as the hub for cleveland clinic's southern region. The 498 staffed bed teaching and research medical center includes lodi hospital and health & wellness centers. The level 1 trauma center, as designated by the american college of surgeons, offers the technology, expertise, and staffing to treat all injuries regardless of severity. In 2024 u.s. News & world report ranked akron general as the fifth best hospital in ohio and the number one hospital in akron. Akron general was also ranked as high performing in five adult medical specialties and ten common adult procedures and conditions. The american nurses association bestowed the prestigious magnet status designation to akron general. Akron general is accredited by joint commission, also receiving its gold seal of approval stroke care. It is summit county's first accredited chest pain center, meeting strict criteria from the society of chest pain centers and providers. Akron general's mcdowell cancer institute is the only akron cancer hospital to receive an outstanding achievement award from the american college of surgeons commission on cancer. Akron general participates in national cancer institute (nci) sponsored clinical trials, as well as pharmaceutical industry sponsored trials. Membership in six nci cooperative groups provides patients with access to a wide menu of clinical trials. In 2024, akron general was awarded the practice greenhealth environmental excellence award which recognizes superior performance in environmental sustainability. Akron general was nationally recognized for the wellness philosophy - health & wellness center, lifestyles and fitness programs that incorporates integrated outpatient clinical care, prevention, rehabilitation and nutritional counseling. Opened in november 2016, cleveland clinic avon hospital has 126 staffed beds and provides inpatient and outpatient services. The five-story hospital was designed to accommodate future advances in medical care. Avon hospital's features include six operating rooms, an intensive care unit, imaging and radiology, pharmacy and laboratory services, a cardiac catheterization laboratory as well as an expanded emergency department. Avon hospital has obtained an advanced certification for primary stroke by the joint commission. In 2024, avon hospital was awarded the practice greenhealth environmental excellence award which recognizes superior performance in environmental sustainability. In 2022, the american nurses association bestowed the prestigious magnet status to cleveland clinic avon hospital, which is a designation of the highest honor for professional nursing practice. Avon hospital also holds accreditations and awards by the commission on cancer, american heart association/american stroke association, american college of emergency physicians and joint commission accreditation of health organizations cleveland clinic mentor hospital, the system's 21st hospital, is in lake county, ohio and has 34 inpatient beds. The hospital is managed by hillcrest hospital and offers both inpatient and outpatient services including 34 inpatient beds, four operating rooms, an emergency department, outpatient exam and procedure rooms, lab and imaging services. The new facility, which has a flexible modular design that will allow it to adapt to changing community needs, will expand the system's services and care to the residents of lake and geauga counties. Cleveland clinic mercy hospital is a 323 licensed bed hospital serving stark, carroll, wayne, holmes, and tuscarawas counties and parts after becoming a full member of the system, mercy experienced many benefits, including expanding high-quality services, improving technology, providing support and investment to address additional needs in the community, building opportunities for physician collaboration and increasing access to highly specialized services for patients in stark county”

“Opened in 1896, lutheran hospital is a 192 staffed bed hospital offering quality medical care, cutting-edge technology and advanced research and surgery. Lutheran offers expert care in areas such as orthopedics, spine, pain management, general surgery, behavioral health, alcohol and drug recovery, wound care, lab and imaging services, and emergency medicine. In the 2024 u.s. News & world report, lutheran hospital achieved high performing in two adult procedures & conditions. The joint commission, the leading accreditor of healthcare organizations in the united states, has also recognized lutheran hospital as a top performer on key quality measures. Lutheran was awarded the pathway to excellence designation by the american nurses credentialing center (ancc). This designation is earned by healthcare organizations that demonstrate commitment to creating a positive practice environment that empowers and engages staff. In 2024, lutheran hospital was awarded the practice greenhealth environmental excellence award which recognizes superior performance in environmental sustainability. Founded in 1949, marymount hospital is a 263 staffed bed acute care hospital providing advanced health care, guided by the values of service, compassion, dignity, and respect. In 2024, u.s. News & world report recognized marymount hospital as high performing in one adult procedures & conditions. In 2024, marymount was awarded the practice greenhealth environmental excellence award which recognizes superior performance in environmental sustainability. Marymount holds a number of certifications and accreditations including: certification from american college of surgeons commission on cancer; certified as a primary stroke center by the joint commission for hospital accreditation, an accredited hospital program by the joint commission, a behavioral health program accredited by the joint commission, lab accredited by the college of american pathologist (cap) and american association of blood banks, accredited by american college of radiology for mammography and magnetic resonance imaging (mri), and certification by the american association of cardiovascular and pulmonary rehabilitation. Founded in 1944, medina hospital is a 148-staffed bed acute care facility. Medina's clinical centers of excellence include emergency department, orthopedics, and surgery. The hospital features more than 300 physicians covering more than 30 areas of specialization. Medina was awarded the pathway to excellence designation by the american nurses credentialing center (ancc). This designation is earned by healthcare organizations that demonstrate commitment to creating a positive practice environment that empowers and engages staff. In 2024, u.s. News & world report recognized medina hospital as high performing in three adult procedures & conditions. In 2024, medina was awarded the practice greenhealth environmental excellence award which recognizes superior performance in environmental sustainability. Medina hospital currently holds accreditations from the college of american pathologists (cap) for the laboratory and respiratory therapy blood gas lab, an accredited hospital program for oncology from the american college of surgeons commission, and certification from the american college of radiology (acr) for mammography, mri and ultrasound. South pointe hospital is a 172-staffed bed acute care, community teaching hospital which has been servicing the healthcare needs of its community since 1957. South pointe delivers a patient centered model of care which promotes the healing of the mind, body and spirit. In the 2024 u.s. News & world report, south pointe hospital was nationally ranked as high performing in two other adult specialties. South pointe also achieved high performing ratings in two common adult procedures and conditions. The american nurses association bestowed the prestigious magnet status to south pointe. Ancc, a subsidiary of the american nurses association, grants”

“Founded in 1932, indian river hospital has grown from a small community hospital to a 275 staffed bed hospital. Indian river hospital serves as the area's leading provider of comprehensive high-quality health and medical services and improves the health and well-being of the people and that of the communities served. Indian river hospital has been designated as a blue distinction center for cardiac care and knee and hip replacement by florida blue and awarded the joint commission's gold seal of approval. In the 2024 u.s. News & world report, indian river hospital achieved high performing in eight adult procedures and conditions. Indian river was awarded the 2019 readers choice award winner for best hospitals as voted by the hometown news readers of vero beach. Indian river has achieved the gold seal of approval from the joint commission. The american association of critical care nurses ("aacn") recently conferred a bronze-level beacon award for excellence. The award recognizes unit caregivers who successfully improve patient outcomes and align practices with aacn's six healthy work environment standards. Indian river received accreditation from: the american college of radiology; a three-year term in ultrasound by the american college of radiology; computed tomography by the american college of radiology; a cancer program accredited by the american college of surgeons commission on cancer; and is designated as a chest pain center v5 with primary pci accreditation. Martin memorial medical center, inc. Is a not-for-profit, tax-exempt hospital that operates general acute care facilities in stuart, port salerno, and port st. Lucie, florida, with a total of 521 total staffed beds; martin north 244 staffed beds, martin south 100 staffed beds, and tradition 177 staffed beds with associated ancillary service departments. The martin health system's primary mission is to provide quality health care services to citizens of martin, st. Lucie, and eastern okeechobee counties through its acute and ambulatory care facilities. In 2024 u.s. News & world report ranked martin memorial health system as high performing ratings in 11 common adult procedures and conditions. Martin memorial health system is the joint commission accredited, ranking among the top 10 percent of hospitals nationwide. The hospital was also awarded certification by the joint commission for the primary stroke center, orthopedic specialty center and patient blood management program. The robert and carol weissman cancer center at martin health received a three-year accreditation with commendation from the commission on cancer of the american college of surgeons. Cleveland clinic tradition hospital is a fully integrated medical campus that includes diagnostic centers, outpatient surgery and a 24-hour emergency department located in the state-of-the-art hospital. Tradition hospital originally opened in december 2013 and expanded in 2017. Tradition hospital is designed to improve the flow of emergency patients who require extended or overnight stays, along with being equipped with a 177-bed facility that has an 18-bed observation unit, 12-bed post-anesthesia care unit, 12-bed progressive care unit to help patients transition from the icu to a medical-surgical bed and a maternity and neonatal intensive care unit. Founded in 1939 as martin county hospital, martin north hospital's 244 bed facility treats patients with major illnesses or injuries and life-threatening symptoms. The campus is home to the frances langford heart center, the robert and carol weissman cancer center, the back and spine center and a minimally invasive surgery center. In 1992, martin health opened martin south hospital on salerno road in stuart. This 100-bed hospital treats patients with major illnesses or injuries and life-threatening symptoms. This hospital is home to the martin health orthopedic specialty center, a comprehensive program dedicated to helping patients regain independence following orthopedi”

“Iii. Education on its main campus, cleveland clinic operates a medical school and related research institute. The primary focus of cleveland clinic lerner college of medicine of case western reserve university (the "lerner college of medicine") is the teaching and training of medical students who have a particular interest in research. Many cleveland clinic physicians serve as faculty for the lerner college of medicine, furthering the integration of clinical care with research and education. The lerner college of medicine currently provides all students with full tuition scholarships. In addition to training the nation's future doctors, cleveland clinic sponsors a wide range of high-quality medical education training throughout the health system including accredited training programs for nurses and health science professionals. The system devotes substantial resources to education programs, which, in 2024, provided a net community benefit of $357.9 million. These educational activities ensure residents and patients in all the system's communities receive the highest standard of medical care and have trained health professionals to care for them in the future. Some of these education programs include: -graduate medical education: cleveland clinic maintains one of the largest graduate medical education programs in the country. In 2024, 1,549 residents and fellows trained in 115 accredited training programs, approved by the accreditation council for graduate medical education ("acgme"), including 184 advanced fellows in 132 fellowship programs. -lerner college of medicine: since its inception in may 2002, the lerner college of medicine has linked one of the nation's top hospitals with one of the nation's leading research universities. There were 2,295 applicants for 32 positions for the 2024-25 academic year. The program's students have matched at some of the most prestigious hospitals throughout the united states and have contributed 31 publications to the world's store of scientific knowledge based on the 2024 calendar year (which includes published articles and abstract submissions), and 24 students participated in local and national meetings with presentations and posters. -visiting medical students: visiting medical student education represents a major academic commitment by cleveland clinic. In 2024, 720 medical students from 236 medical schools around the world rotated through cleveland clinic. -center for continuing education: cleveland clinic maintains one of the largest continuing medical educations ("cme") programs in the country and enjoys the highest accme ranking: accreditation with commendation. In 2024, the center for continuing education certified 2,763 cme activities that offered over 12,657 cme credits to 629,879 participants. Of that number, 1,928 were live courses that attracted 123,973 participants. Cleveland clinic is one of the largest providers of online cme among the nation's academic medical centers. The center's website had 795 activities that attracted 1,297,621 activity viewers. Journal cme continues to reach a large number of learners, awarding more than 42,710 certificates to cleveland clinic journal of medicine (ccjm) participants. In 2024, the center issued 629,879 certificates for all activities combined. -the ccjm enjoyed a circulation of more than 129,647 copies and ranked no. 4 in readership among journals directed to office-based internists and cardiologists. Each year, the print and online versions are read or accessed by approximately 4.3 million people around the world. In 2024, the ccjm website recorded 7,813,772 page views and 3,781,835 unique visitors to online journals. -center for health sciences education: cleveland clinic is a major education and training site for a number of allied health students from various academic programs throughout the region. The system currently offers 21 in-house allied health programs and has 55 affiliated programs with regional academic institutions. I”

“Donated capital and assets released from restrictions for capital purposes 37,745,603. Gifts and bequests 243,902,878. Transfers of net assets 1,162,946,734. Net investment income 78,179,880. Net assets released from restrictions for operations -154,271,089. Retirement benefits adjustment -998,470. Equity transfers & other transfers 9,805,654.”

“The prior period adjustment in the amount of $810,653,281 is due to various entities that converted and are now included into the cleveland clinic foundation.”