TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) MIHALJEVIC MD TOMISLAV...................................................................... DIRECTOR, PRESIDENT & CEO	50.00 ................. 0.00	X	X			6,205,435	0	51,315
(2) BROOKS MD PETER...................................................................... PHYSICIAN (2022 RETIREE)	0.00 ................. 0.00			X		7,464,421	0	-1,632,555
(3) DONLEY MD BRIAN...................................................................... CEO, CC LONDON (PART YR)	0.00 ................. 50.00		X			0	4,424,918	54,256
(4) ROWAN DAVID...................................................................... SECRETARY, CHIEF GOV OFF & CLO	50.00 ................. 0.00		X			2,288,096	0	47,905
(5) FALCONE MD TOMMASO...................................................................... INTERIM CEO, CCL (PART YR)	0.00 ................. 50.00		X			0	2,213,927	54,256
(6) KOTTKE-MARCHANT MD KANDICE...................................................................... PHYSICIAN (2022 RETIREE)	0.00 ................. 0.00			X		2,926,750	0	-682,117
(7) STREIN STEFAN...................................................................... CHIEF INVESTMENT OFFICER	50.00 ................. 0.00			X		2,010,744	0	49,264
(8) PEACOCK WILLIAM...................................................................... CHIEF OF OPERATIONS	50.00 ................. 0.00		X			1,945,605	0	45,694
(9) SVENSSON MD LARS...................................................................... CHAIR OF HVTI	50.00 ................. 0.00			X		1,840,715	0	51,696
(10) CHANDRA PHD ROHIT...................................................................... CHIEF DIGITAL OFFICER	50.00 ................. 0.00		X			1,828,036	0	51,118
(11) RUGGIERI MD PAUL...................................................................... PHYSICIAN (2022 RETIREE)	0.00 ................. 0.00			X		2,444,796	0	-667,687
(12) DELANEY MD PHD CONOR...................................................................... CEO AND PRESIDENT, CC FLORIDA	0.00 ................. 50.00		X			0	1,685,384	44,753
(13) GLASS STEVEN C...................................................................... CFO & TREASURER (PART YR)	50.00 ................. 0.00		X			1,668,558	0	22,859
(14) SURI MD RAKESH...................................................................... FORMER KEY EMP - CEO CCAD	50.00 ................. 0.00				X	1,629,406	0	45,301
(15) HANCOCK DNP RN NE-BC KELLY...................................................................... CHIEF CAREGIVER OFFICER	50.00 ................. 0.00		X			1,586,716	0	6,058
(16) MERLINO MD JAMES...................................................................... CHIEF CLINICAL TRANSFORMATION OFF	50.00 ................. 0.00		X			1,560,488	0	32,000
(17) GUZMAN MD JORGE...................................................................... CEO CCAD	50.00 ................. 0.00		X			1,518,914	0	47,714

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) RIDGEWAY MD BERI........................................................................ DIRECTOR, CHIEF OF STAFF	50.00 .......................0.00	X	X		1,419,527	50,640
(19) SMEDIRA MD MBA NICHOLAS........................................................................ DIRECTOR, PHYSICIAN	50.00 .......................0.00	X			1,302,287	49,271
(20) HELTON ANTHONY........................................................................ INTERIM CFO	50.00 .......................0.00		X		999,198	37,617
(21) SINGH MD RISHI........................................................................ DIRECTOR, PHYSICIAN	50.00 .......................0.00	X			790,189	45,147
(22) YOUNG MD JAMES P........................................................................ FORMER OFFICER	50.00 .......................0.00			X	724,436	39,181
(23) DAVIS MARLEINA........................................................................ ASST. SECRETARY	50.00 .......................0.00		X		649,318	11,816
(24) KALAYCIO MD MATT........................................................................ DIRECTOR, PHYSICIAN	50.00 .......................0.00	X			573,098	47,233
(25) LONGVILLE TIMOTHY........................................................................ CAO & CONTROLLER	50.00 .......................0.00		X		597,039	-87,983
(26) OBLANDER JASON........................................................................ ASST. SECRETARY	50.00 .......................0.00		X		281,148	21,729
(27) SABANEGH MD EDMUND........................................................................ FORMER OFFICER (RETIRED)	0.00 .......................0.00			X	162,548	2,821
(28) COSGROVE MD DELOS........................................................................ FORMER OFFICER (RETIRED CEO)	0.00 .......................0.00			X	717,864	-565,228
(29) MEEHAN MICHAEL J........................................................................ RECORDING SECRETARY	50.00 .......................0.00		X		365,706	-244,844
(30) MALONE JR MD DONALD........................................................................ PRES, OHIO HOSPITALS & FHCS	50.00 .......................0.00		X		1,338,197	-1,495,693
(31) ERZURUM MD SERPIL........................................................................ CHIEF RESEARCH AND ACADEMIC OFFICER	50.00 .......................0.00		X		1,349,667	-1,571,191
(32) WIEDEMANN MD HERBERT........................................................................ FORMER OFFICER (RETIRED)	0.00 .......................0.00			X	210,113	-796,066
(33) AULETTA PATRICK V........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(34) BENZ MICHAEL........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(35) CRAWFORD DEBORAH........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(36) FEDELI UMBERTO P........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(37) HOOVER CAROLE........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(38) ISHRAK PHD OMAR........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(39) KEMPER RN BETTY........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(40) KILBANE CATHERINE........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(41) KOHL STEWART........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(42) KRAMER RICHARD........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(43) MACDONALD WILLIAM III........................................................................ DIRECTOR (PART YR)	5.00 .......................0.00	X			0	0
(44) MAROONE MICHAEL........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(45) MORINO MARIO........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(46) NANCE FREDERICK........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(47) RICH MELINDA........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(48) ROSS MARK........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(49) SCHULMAN DAN........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(50) SCOTT HAROLD LEE........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(51) STEVENS MARK........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(52) VEGA LORRAINE........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(53) WALDRON JOHN........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(54) WEBER ROBERT........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(55) WEINBERG RONALD........................................................................ DIRECTOR	5.00 .......................0.00	X			0	0
(56) MOONEY BETH E........................................................................ DIRECTOR, BOARD CHAIR	5.00 .......................0.00	X	X		0	0
(57) PETRAS JR MICHAEL J........................................................................ DIR, VICE CHAIR, FINANCE & BUS DEV	5.00 .......................0.00	X	X		0	0
(58) POLLOCK LARRY........................................................................ DIR, V. CHAIR, PHILANTHRPY & STEWARDSHP	5.00 .......................0.00	X	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
QUALIVIS LLC PO BOX 123847 DALLAS,TX75312	PERSONNEL SERVICES	55,814,804
SIEMENS MEDICAL SOLUTIONS INC PO BOX 12102 DALLAS,TX75312	HEALTHCARE IT & ENGINEERING SERVICES	22,551,835
KYNDRYL INC PO BOX 735919 DALLAS,TX75373	INFORMATION TECHNOLOGY SERVICES	22,140,756
ACCENTURE LLP PO BOX 70629 CHICAGO,IL60673	MANAGEMENT CONSULTING & PROFESSIONAL SER	18,458,390
EPIC SYSTEMS CORP PO BOX 88314 MILWUAKE,WI53288	HEALTHCARE IT CONSULTING & SOFTWARE SOLU	15,691,226
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 596

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	261,657,223	263,593,024	529,557,140	444,448,837	325,429,961	1,824,686,185
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3	261,657,223	263,593,024	529,557,140	444,448,837	325,429,961	1,824,686,185
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.						1,824,686,185

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..	261,657,223	263,593,024	529,557,140	444,448,837	325,429,961	1,824,686,185
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	74,797,729	107,975,685	104,905,019	137,076,437	49,537,538	474,292,408
9	Net income from unrelated business activities, whether or not the business is regularly carried on..				692,814		692,814
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	94,283,514	166,735,941	360,583,149	515,964,083	77,092,808	1,214,659,495
11	Total support. Add lines 7 through 10						3,514,330,902

Gross receipts from related activities, etc. (see instructions) ..................

31,607,790,388

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

51.920 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

49.850 %

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2022

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	INCOMELOSS ON INVESTMENTS - 2018 AMOUNT: $ 92,689,670. 2019 AMOUNT: $ 163,697,803. 2020 AMOUNT: $ 351,533,278. 2021 AMOUNT: $ 485,609,324. FOREIGN CURRENCY - 2019 AMOUNT: $ 286,195. 2020 AMOUNT: $ 92,893. 2021 AMOUNT: $ 365,082. DERIVATIVE INCOME - 2018 AMOUNT: $ 1,458,519. 2021 AMOUNT: $ 22,941,199. 2022 AMOUNT: $ 69,244,484. INVESTMENT IN AFFILIATES - 2019 AMOUNT: $ 2,737,082. 2020 AMOUNT: $ 8,956,978. 2021 AMOUNT: $ 6,753,656. 2022 AMOUNT: $ 7,689,997. LIFE INSURANCE TRUST - 2018 AMOUNT: $ 135,325. 2019 AMOUNT: $ 14,861. 2021 AMOUNT: $ 294,822. 2022 AMOUNT: $ 158,327.

Return Reference

Explanation

SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:

INCOMELOSS ON INVESTMENTS - 2018 AMOUNT: $ 92,689,670. 2019 AMOUNT: $ 163,697,803. 2020 AMOUNT: $ 351,533,278. 2021 AMOUNT: $ 485,609,324. FOREIGN CURRENCY - 2019 AMOUNT: $ 286,195. 2020 AMOUNT: $ 92,893. 2021 AMOUNT: $ 365,082. DERIVATIVE INCOME - 2018 AMOUNT: $ 1,458,519. 2021 AMOUNT: $ 22,941,199. 2022 AMOUNT: $ 69,244,484. INVESTMENT IN AFFILIATES - 2019 AMOUNT: $ 2,737,082. 2020 AMOUNT: $ 8,956,978. 2021 AMOUNT: $ 6,753,656. 2022 AMOUNT: $ 7,689,997. LIFE INSURANCE TRUST - 2018 AMOUNT: $ 135,325. 2019 AMOUNT: $ 14,861. 2021 AMOUNT: $ 294,822. 2022 AMOUNT: $ 158,327.

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization THE CLEVELAND CLINIC FOUNDATION

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization THE CLEVELAND CLINIC FOUNDATION		Employer identification number 34-0714585

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization THE CLEVELAND CLINIC FOUNDATION			Employer identification number 34-0714585
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

812,720

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

450,516

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

1,263,236

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C	CLEVELAND CLINIC ENGAGES IN HEALTH CARE RELATED LOBBYING ACTIVITIES IN FURTHERANCE OF ITS EXEMPT PURPOSE AND IN SUPPORT OF ITS MISSION OF CARING FOR LIFE, RESEARCHING FOR HEALTH, AND EDUCATON FOR THOSE WHO SERVE. FUTHER DETAIL ON THE TYPES OF ACTIVITIES IS PROVIDED BELOW. PART II-B, 1B PAID STAFF OR MANAGEMENT - REPRESENTS ACTIVITIES DESCRIBED IN PART II-B LINE 1G CONDUCTED BY MEMBERS OF THE CCF GOVERNMENT RELATIONS OFFICE. PART II-B, 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES - REPRESENTS PAYMENT TO CERTAIN ORGANIZATIONS FOR LOBBYING SERVICES AS WELL AS PAYMENT OF DUES TO CERTAIN TRADE ORGANIZATIONS WHERE A PORTION OF THE DUES ARE USED TO CONDUCT LOBBYING ACTIVITIES. PART II-B, 1G DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY - REPRESENTS MEETINGS WITH AND TOURS CONDUCTED FOR LEGISLATORS AND/OR THEIR STAFF MEMBERS.

Return Reference

Explanation

SCHEDULE C

CLEVELAND CLINIC ENGAGES IN HEALTH CARE RELATED LOBBYING ACTIVITIES IN FURTHERANCE OF ITS EXEMPT PURPOSE AND IN SUPPORT OF ITS MISSION OF CARING FOR LIFE, RESEARCHING FOR HEALTH, AND EDUCATON FOR THOSE WHO SERVE. FUTHER DETAIL ON THE TYPES OF ACTIVITIES IS PROVIDED BELOW. PART II-B, 1B PAID STAFF OR MANAGEMENT - REPRESENTS ACTIVITIES DESCRIBED IN PART II-B LINE 1G CONDUCTED BY MEMBERS OF THE CCF GOVERNMENT RELATIONS OFFICE. PART II-B, 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES - REPRESENTS PAYMENT TO CERTAIN ORGANIZATIONS FOR LOBBYING SERVICES AS WELL AS PAYMENT OF DUES TO CERTAIN TRADE ORGANIZATIONS WHERE A PORTION OF THE DUES ARE USED TO CONDUCT LOBBYING ACTIVITIES. PART II-B, 1G DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY - REPRESENTS MEETINGS WITH AND TOURS CONDUCTED FOR LEGISLATORS AND/OR THEIR STAFF MEMBERS.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.

			Held at the End of the Year
a	Total number of conservation easements ......................	2a	3
b	Total acreage restricted by conservation easements ....................	2b	54.01
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

71.00

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

$ 2,867

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	549,756,555	472,718,962	411,313,487	354,560,827	349,678,997
b	Contributions ...	35,502,175	20,423,929	22,565,740	22,718,792	15,111,719
c	Net investment earnings, gains, and losses	6,879,613	64,802,033	52,756,607	40,731,794	-5,038,774
d	Grants or scholarships ...	36,453,463
e	Other expenditures for facilities and programs ...	14,018,928	8,188,369	13,916,872	6,697,926	5,191,115
f	Administrative expenses ....
g	End of year balance ......	541,665,952	549,756,555	472,718,962	411,313,487	354,560,827

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	182,610,983		182,610,983
b	Buildings ....	4,064,249,309	2,465,368,481	1,598,880,828
c	Leasehold improvements	110,771,080	86,705,251	24,065,829
d	Equipment ....	2,049,653,622	1,419,039,518	630,614,104
e	Other .....	518,117,227	120,007,223	398,110,004
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				2,834,281,748

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) OTHER SECURITIES (HEDGE FUNDS)	3,469,561,896	C
(B) OTHER SECURITIES (PRIVATE EQUITY)	2,987,374,984	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	6,456,936,880

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DUE FROM AFFILIATES				1,239,176,377
(2)PERPETUAL & BENEFICIAL TRUSTS				57,765,657
(3)INVESTMENT IN AFFILIATES				946,399,208
(4)OTHER ASSETS				109,722,499
(5)DEFFERRED ANNUITIES				333,723,968
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,686,787,709

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	539,364
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	2,458,726,604
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART II, LINE 9:	THE CONSERVATION COVENANTS REPORTED IN PART II ARE RELATED TO THREE WETLANDS LOCATED ON THE CLEVELAND CLINIC FOUNDATION'S PROPERTY IN TWINSBURG, OHIO; AKRON, OHIO; AND AVON, OHIO. THESE EASEMENTS ARE NOT REQUIRED TO BE REPORTED ON THE BALANCE SHEET SEPARATE FROM THE VALUE OF THE LAND. EXPENSES TO MONITOR, INSPECT, AND PROTECT THIS LAND ARE REFLECTED IN THE STATEMENT OF EXPENSES.
PART V, LINE 4:	THE ENDOWMENT FUNDS OF THE CLEVELAND CLINIC FOUNDATION ARE USED IN FURTHERANCE OF ITS EXEMPT PURPOSE. SPECIFICALLY, THESE FUNDS ARE USED FOR EDUCATION, RESEARCH, AND PATIENT CARE.
PART X, LINE 2:	THE CLEVELAND CLINIC HEALTH SYSTEM'S ("THE SYSTEM") AUDITED FINANCIAL STATEMENTS ARE REPORTED ON A CONSOLIDATED BASIS, INCLUDING EXEMPT, TAXABLE, AND FOREIGN ENTITIES TO WHICH THE ASC 740-10 LIABILITY RELATES. THE ASC 740-10 FOOTNOTE ON THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE SYSTEM READS AS FOLLOWS: AT DECEMBER 31, 2022 AND 2021, THE LIABILITY FOR UNCERTAINTY IN INCOME TAXES WAS $2.4 MILLION AND $2.0 MILLION, RESPECTIVELY. THE SYSTEM DOES NOT EXPECT A SIGNIFICANT INCREASE OR DECREASE IN UNRECOGNIZED TAX BENEFITS WITHIN THE NEXT 12 MONTHS. THE SYSTEM RECOGNIZES INTEREST AND PENALTIES ACCRUED RELATED TO THE LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA & THE CARIBBEAN	0	0	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	24,120,000
	NORTH AMERICA	2	0	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	49,235,000
	EUROPE	2	33	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	902,205,000
	MIDDLE EAST & NORTH AFRICA	2	73	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	5,652,000
	EAST ASIA AND THE PACIFIC	1	1	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNNED FOREIGN ENTITY	25,000
	EAST ASIA AND THE PACIFIC	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	46,000
	EUROPE	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	2,052,000
	MIDDLE EAST & NORTH AFRICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	6,723,000
	NORTH AMERICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	74,000
	SOUTH ASIA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	3,000
	SOUTH AMERICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	18,000
	MIDDLE EAST & NORTH AFRICA	0	0	FUNDRAISING
	EAST ASIA AND THE PACIFIC	0	0	FUNDRAISING
	CENTRAL AMERICA & THE CARIBBEAN	0	0	FUNDRAISING
	NORTH AMERICA	0	0	FUNDRAISING
	SOUTH ASIA	0	0	FUNDRAISING
	EUROPE	0	0	FUNDRAISING
	EUROPE	0	0	INVESTING		67,525,000
	SUB SAHARAN AFRICA	0	0	INVESTING		101,886,000
	MIDDLE EAST & NORTH AFRICA	0	0	INVESTING		2,419,000
	NORTH AMERICA	0	0	INVESTING		28,426,000
	CENTRAL AMERICA & THE CARIBBEAN	0	0	INVESTING		3,539,268,000
3a	Sub-total ....	7	107			990,058,000
b	Total from continuation sheets to Part I ...	0	0			3,739,619,000
c	Totals (add lines 3a and 3b)	7	107			4,729,677,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022

Schedule F (Form 990) 2022

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement
NORTH AMERICA	RESEARCH	90,000	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	37,340	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	594,000	CHECK AND/OR WIRE
EUROPE	RESEARCH	9,437	CHECK AND/OR WIRE
EUROPE	RESEARCH	6,625	CHECK AND/OR WIRE
MIDDLE EAST & NORTH AFRICA	RESEARCH	45,943	CHECK AND/OR WIRE
EUROPE	RESEARCH	18,952	CHECK AND/OR WIRE
CENTRAL AMERICA & THE CARIBBEAN	RESEARCH	64,800	CHECK AND/OR WIRE
EUROPE	RESEARCH	8,290	CHECK AND/OR WIRE
EUROPE	RESEARCH	395,260	CHECK AND/OR WIRE
EUROPE	RESEARCH	43,890	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	11,010	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	398,753	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	39,800	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	22,048	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	7,449	CHECK AND/OR WIRE
SOUTH AMERICA	RESEARCH	34,500	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	21,247	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	95,028	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	434,310	CHECK AND/OR WIRE
SOUTH AMERICA	RESEARCH	37,770	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	16,398	CHECK AND/OR WIRE

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......	11
3	Enter total number of other organizations or entities .......................	11

Schedule F (Form 990) 2022

Schedule F (Form 990) 2022Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

	(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance
RESEARCH	EAST ASIA & THE PACIFIC	1	6,000	CHECK AND/OR WIRE	0

Schedule F (Form 990) 2022

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2022

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
PART I, LINE 2:	A MAJORITY OF THE RESEARCH GRANTS PROVIDED TO FOREIGN ORGANIZATIONS ARE PART OF A NATIONAL INSTITUTES OF HEALTH OR FEDERALLY FUNDED PROGRAM. AS SUCH, THE FOREIGN ORGANIZATION IS REQUIRED TO MEET AND ADHERE TO FEDERAL GRANT REPORTING REQUIREMENTS WITH RESPECT TO THE USE OF THE FUNDS ON AN ON-GOING BASIS IN ORDER TO BE ELIGIBLE TO PARTICIPATE OR CONTINUE TO PARTICIPATE IN THE RESEARCH STUDY. FOR THOSE GRANTS THAT ARE NOT FEDERALLY FUNDED, A CONTRACT EXISTS WITH THE FOREIGN GRANTEE ORGANIZATION THAT ESTABLISHES HOW THE FUNDS ARE TO BE USED AND REQUIRES CERTAIN REPRESENTATIONS AND ACCOUNTING REGARDING THEIR USE. CLEVELAND CLINIC MAINTAINS OVERSIGHT OF THESE GRANTS AND REGULARLY MONITORS THEIR COMPLIANCE WITH EITHER THE FEDERAL REGULATIONS OR THE CONTRACT PROVISIONS.
PART I, LINE 3:	THE ACCRUAL METHOD IS USED TO ACCOUNT FOR EXPENDITURES.
PART III ACCOUNTING METHOD:

Schedule F (Form 990) 2022

Additional Data

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Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	CLASSY 350 TENTH AVE STE 1300 SAN DIEGO, CA92101	ONLINE FUNDRAISING		No	5,140,998	231,592	4,909,406
	RR DONNELLEY 35 WEST WACKER DR CHICAGO, IL60601	DIRECT MAIL		No	1,936,038	1,348,180	587,858
	TSM DONOR ENGAGEMENT TEAM 155 COMMERCE DR FREEDOM, PA15042	PHONE SOLICITATION		No	108,788	356,699	-247,911







Total . . . . . . . . . . . . . . . . . . . .					7,185,824	1,936,471	5,249,353

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2022

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 VELOSANO (event type)	(b) Event #2 CHILDREN'S DERBY DAY SOIREE (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	5,595,869	1,675,585	279,765	7,551,219
2	Less: Contributions . . . .	4,722,965	498,785	18,000	5,239,750
3	Gross income (line 1 minus line 2) . . . . . .	872,904	1,176,800	261,765	2,311,469

4	Cash prizes . . . . .	0	0	0
5	Noncash prizes . . . .	0	0	15,375	15,375
6	Rent/facility costs . . . .	294,332	49,190	62,500	406,022
7	Food and beverages . . .	185,166	140,899	0	326,065
8	Entertainment . . . .	2,000	2,498	3,140	7,638
9	Other direct expenses . . .	1,272,611	566,374	7,041	1,846,026
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				2,601,126
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-289,657

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2022

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	87,638,725	0	87,638,725	1.170 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1,012,885,308	624,787,068	388,098,240	5.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	0	0		0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	1,100,524,033	624,787,068	475,736,965	6.330 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	32,564,404	847,930	31,716,474	0.420 %
f	Health professions education (from Worksheet 5) . . .	296,333,249	37,525,621	258,807,628	3.440 %
g	Subsidized health services (from Worksheet 6) . . . .	33,117,771	23,693,227	9,424,544	0.130 %
h	Research (from Worksheet 7) .	341,500,386	210,395,842	131,104,544	1.740 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	19,682,082	12,107	19,669,975	0.260 %
j	Total. Other Benefits . .	723,197,892	272,474,727	450,723,165	5.990 %
k	Total. Add lines 7d and 7j .	1,823,721,925	897,261,795	926,460,130	12.320 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense
1	Physical improvements and housing	0	0
2	Economic development	0	0
3	Community support	573,912	0	573,912
4	Environmental improvements	0	0
5	Leadership development and training for community members	0	0
6	Coalition building	0	0
7	Community health improvement advocacy	3,393	0	3,393
8	Workforce development	9,445	0	9,445
9	Other	0	0
10	Total	586,750		586,750

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

154,656,718

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

719,318,559

Enter Medicare allowable costs of care relating to payments on line 5.....

768,456,453

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-49,137,894

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?8Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Facility reporting group
1	THE CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVENUE CLEVELAND,OH44195 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1151AHR	X	X	X	X	X	X
2	CLEVELAND CLINIC REHAB - BEACHWOOD 3025 SCIENCE PARK DRIVE BEACHWOOD,OH44122 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1906	X						A
3	CLEVELAND CLINIC REHABILITATION-AVON 33355 HEALTH CAMPUS BOULEVARD AVON,OH44011 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1522AHR	X						A
4	CLEVELAND CLINIC REHAB - EDWIN SHAW 4389 MEDINA ROAD COPLEY,OH44321 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1905	X						A
5	SELECT SPECIALTY - FAIRHILL 11900 FAIRHILL ROAD CLEVELAND,OH44120 WWW.SELECTMEDICAL.COM OH STATE ID 1468	X						A
6	SELECT SPECIALTY - REGENCY EAST 4200 INTERCHANGE CORPORATE CENTER RD WARRENSVILLE HEIGHTS,OH44128 WWW.SELECTMEDICAL.COM OH STATE ID 1479	X						A
7	SELECT SPECIALTY - REGENCY WEST 6990 ENGLE ROAD MIDDLEBURG HEIGHTS,OH44130 WWW.SELECTMEDICAL.COM OH STATE ID 1478	X						A
8	SELECT SPECIALTY - GATEWAY 2351 E 22ND ST 7TH FL CLEVELAND,OH44115 WWW.SELECTMEDICAL.COM OH STATE ID 1431	X						A

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE CLEVELAND CLINIC FOUNDATION
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE CLEVELAND CLINIC FOUNDATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE CLEVELAND CLINIC FOUNDATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	THE CLEVELAND CLINIC FOUNDATION
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	REPORTING GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 5: DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 6A: CLEVELAND CLINIC FOUNDATION MAIN CAMPUS CONDUCTED ITS CHNA WITH OTHER CLEVELAND CLINIC HEALTH SYSTEM HOSPITALS, INCLUDING: AKRON GENERAL MEDICAL CENTER, AVON HOSPITAL, CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION, EUCLID HOSPITAL, FAIRVIEW HOSPITAL, HILLCREST HOSPITAL, LODI COMMUNITY HOSPITAL, LUTHERAN HOSPITAL, MARYMOUNT HOSPITAL, MEDINA HOSPITAL, MERCY HOSPITAL, SOUTH POINTE HOSPITAL, AND UNION HOSPITAL. COLLABORATIONS WERE ALSO DONE WITH CLEVELAND CLINIC REHAB HOSPITALS - SELECT CLEVELAND HOSPITALS, STATE AND COUNTY HEALTH DEPARTMENTS, AND COMMUNITY BASED ORGANIZATIONS (CBOS).
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 11: THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE CHNA WERE THE FOLLOWING: ACCESS TO HEALTHCARE, BEHAVIORAL HEALTH INCLUDING MENTAL HEALTH AND SUBSTANCE USE, CHRONIC DISEASE PREVENTION AND MANAGEMENT, MATERNAL AND CHILD HEALTH, AND SOCIOECONOMIC ISSUES. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT. IN ADDITION TO THE PRIORITIZED HEALTH NEEDS, THE CHNA IDENTIFIED THREE ADDITIONAL COMMUNITY HEALTH ISSUES PREVALENT IN CONSIDERING COMMUNITY HEALTH: HEALTH EQUITY, SOCIAL DETERMINANTS OF HEALTH, AND MEDICAL EDUCATION AND RESEARCH.
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 13B: PATIENTS WHO DO NOT MEET FINANCIAL CRITERIA FOR ASSISTANCE BASED ON FEDERAL POVERTY LEVEL MAY NONETHELESS QUALIFY FOR ASSISTANCE IF THEIR MEDICAL EXPENSES EXCEED 15% OF THEIR ANNUAL FAMILY INCOME.
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 15E: IN ADDITION TO APPLYING BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION, PATIENTS MAY BE EVALUATED UPON SCHEDULING OR PRIOR TO ADMISSION BY THE CLEVELAND CLINIC FOUNDATION. UNINSURED PATIENTS THAT THE CLEVELAND CLINIC FOUNDATION DETERMINES THROUGH THIRD PARTY VERIFICATION SOURCES TO HAVE ANNUAL FAMILY INCOME UNDER 400% OF THE FEDERAL POVERTY GUIDELINES WILL BE DEEMED ELIGIBLE AND NOTIFIED AS SUCH IN WRITING. IF THE PATIENT BELIEVES THEY QUALIFY FOR ADDITIONAL ASSISTANCE, THEY MAY SUBMIT A COMPLETED APPLICATION FOR CONSIDERATION.
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 16J: INFORMING THE PUBLIC THAT FINANCIAL ASSISTANCE IS AVAILABLE IS AN IMPORTANT ELEMENT OF OUR FINANCIAL ASSISTANCE PROGRAM AND THE CLEVELAND CLINIC CONTINUOUSLY STRIVES TO IMPROVE ITS COMMUNICATIONS WITH PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE CLEVELAND CLINIC WEBSITE. PATIENT BILLS INCLUDE DETAILED INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGHOUT CCF, INCLUDING IN PATIENT REGISTRATION AREAS, ONLINE, AND WITH FINANCIAL COUNSELORS WHO ARE PRESENT ON-SITE AT EACH CLEVELAND CLINIC HOSPITAL AND OHIO FAMILY HEALTH CENTER TO ASSIST PATIENTS IN QUALIFYING FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS WITH FINANCIAL COUNSELORS.
THE CLEVELAND CLINIC FOUNDATION	PART V, SECTION B, LINE 20E: IN ADDITION TO ITEMS LISTED IN 20A-D, THE CLEVELAND CLINIC FOUNDATION NOTIFIES INDIVIDUALS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN COMMUNICATIONS WITH PATIENTS ABOUT APPOINTMENT REMINDERS, IN THEIR DISCHARGE SUMMARY, IN THE ON HOLD MESSAGE IF THEY CALL CUSTOMER SERVICE, AND ON WEB PAGES INCLUDING THE ONLINE BILL PAY PORTAL.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 7: SELECT SPECIALTY - REGENCY WEST, - FACILITY 6: SELECT SPECIALTY - REGENCY EAST, - FACILITY 5: SELECT SPECIALTY - FAIRHILL, - FACILITY 8: SELECT SPECIALTY - GATEWAY, - FACILITY 3: CLEVELAND CLINIC REHABILITATION-AVON, - FACILITY 2: CLEVELAND CLINIC REHAB - BEACHWOOD, - FACILITY 4: CLEVELAND CLINIC REHAB - EDWIN SHAW
GROUP A-FACILITY 7 -- SELECT SPECIALTY - REGENCY WEST PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 7 -- SELECT SPECIALTY - REGENCY WEST PART V, SECTION B, LINE 6A:	SELECT SPECIALTY - REGENCY WEST CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, REGENCY HOSPITAL OF CLEVELAND EAST, CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - BEACHWOOD, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW. SELECT SPECIALTY - WEST ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 7 -- SELECT SPECIALTY - REGENCY WEST PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR SELECT SPECIALTY - REGENCY WEST WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
GROUP A-FACILITY 6 -- SELECT SPECIALTY - REGENCY EAST PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 6 -- SELECT SPECIALTY - REGENCY EAST PART V, SECTION B, LINE 6A:	SELECT SPECIALTY - REGENCY EAST CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, REGENCY HOSPITAL OF CLEVELAND WEST, CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - BEACHWOOD, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW. SELECT SPECIALTY - EAST ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 6 -- SELECT SPECIALTY - REGENCY EAST PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR SELECT SPECIALTY - REGENCY EAST WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
GROUP A-FACILITY 5 -- SELECT SPECIALTY - FAIRHILL PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 5 -- SELECT SPECIALTY - FAIRHILL PART V, SECTION B, LINE 6A:	SELECT SPECIALTY - FAIRHILL CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: REGENCY HOSPITAL OF CLEVELAND WEST, REGENCY HOSPITAL OF CLEVELAND EAST, CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - BEACHWOOD, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW. SELECT SPECIALTY - FAIRHILL ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 5 -- SELECT SPECIALTY - FAIRHILL PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
GROUP A-FACILITY 8 -- SELECT SPECIALTY - GATEWAY PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. SELECT SPECIALTY - GATEWAY BEGAN THE PROCESS OF CONDUCTING A CHNA DURING 2022 UNTIL THE LOCATION CLOSED IN OCTOBER 2022.
GROUP A-FACILITY 8 -- SELECT SPECIALTY - GATEWAY PART V, SECTION B, LINE 6A:	SELECT SPECIALTY - GATEWAY BEGAN TO CONDUCT ITS CHNA PROCESS IN 2022 WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, REGENCY HOSPITAL OF CLEVELAND WEST, REGENCY HOSPITAL OF CLEVELAND EAST, CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - BEACHWOOD, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW. A CHNA WAS NOT COMPLETED AS SELECT SPECIALTY - GATEWAY CLOSED ITS LOCATION IN OCTOBER 2022.
GROUP A-FACILITY 8 -- SELECT SPECIALTY - GATEWAY PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR SELECT SPECIALTY HOSPITAL - GATEWAY WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. SELECT SPECIALTY - GATEWAY CLOSED ITS LOCATION IN OCTOBER 2022, THEREFORE AN IMPLEMENTATION STRATEGY WAS NOT ADOPTED.
GROUP A-FACILITY 3 -- CLEVELAND CLINIC REHABILITATION- AVON PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 3 -- CLEVELAND CLINIC REHABILITATION- AVON PART V, SECTION B, LINE 6A:	CLEVELAND CLINIC REHABILITATION - AVON CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: CLEVELAND CLINIC REHABILITATION - BEACHWOOD, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW, SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, REGENCY HOSPITAL OF CLEVELAND EAST, AND REGENCY HOSPITAL OF CLEVELAND WEST. CC REHAB - AVON ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 3 -- CLEVELAND CLINIC REHABILITATION- AVON PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR CLEVELAND CLINIC REHABILITATION HOSPITAL, AVON WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
GROUP A-FACILITY 4 -- CLEVELAND CLINIC REHAB - EDWIN SHAW PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 4 -- CLEVELAND CLINIC REHAB - EDWIN SHAW PART V, SECTION B, LINE 6A:	CLEVELAND CLINIC REHABILITATION - EDWIN SHAW CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - BEACHWOOD, SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, SELECT SPECIALTY HOSPITAL - CLEVELAND GATEWAY, REGENCY HOSPITAL OF CLEVELAND EAST, AND REGENCY HOSPITAL OF CLEVELAND WEST. CC REHAB - EDWIN SHAW ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 4 -- CLEVELAND CLINIC REHAB - EDWIN SHAW PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR CLEVELAND CLINIC REHABILITATION HOSPITAL, EDWIN SHAW WERE THE FOLLOWING: ACCESS TO HEALTHCARE, ADULT HEALTH, AND COMMUNITY SAFETY. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
GROUP A-FACILITY 2 -- CLEVELAND CLINIC REHAB - BEACHWOOD PART V, SECTION B, LINE 5:	DURING 2022, INPUT FROM THE COMMUNITY WAS RECEIVED THROUGH KEY INFORMANT INTERVIEWS AS WELL AS COMMUNITY ENGAGEMENT SESSIONS WITH COMMUNITY ADVISORY COMMITTEE MEMBERS. CONDUENT HEALTHY COMMUNITIES INSTITUTE INTERVIEWED 20 KEY STAKEHOLDERS FROM A DIVERSE SPECTRUM OF COMMUNITY -BASED ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS. TO PROVIDE ADDITIONAL SUPPORT AND CORROBORATION OF VITAL COMMUNITY INPUT, THE CLEVELAND CLINIC FOUNDATION AND CONDUENT HEALTHY COMMUNITIES INSTITUTE FACILITATED A COMMUNITY ENGAGEMENT SESSION FEATURING COMMUNITY ADVISORY COUNCIL MEMBERS. DURING THE SESSION, CAC MEMBERS OFFERED PERSPECTIVES ON THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, BARRIERS AND CHALLENGES TO IMPROVING HEALTH, IDENTIFIED THE MOST UNDERSERVED POPULATIONS, DISCUSSED POTENTIAL SOLUTIONS TO HEALTH CHALLENGES FACED, AND OFFERED SUCCESS STORIES FROM EXISTING PROGRAM IMPLEMENTATION. A LIST OF EACH PARTICIPANT ORGANIZATION IS IDENTIFIED IN APPENDIX A OF THE HOSPITAL FACILITY'S CHNA.
GROUP A-FACILITY 2 -- CLEVELAND CLINIC REHAB - BEACHWOOD PART V, SECTION B, LINE 6A:	CLEVELAND CLINIC REHABILITATION - BEACHWOOD CONDUCTED ITS CHNA WITH THE CLEVELAND CLINIC HEALTH SYSTEM AND WITH THE FOLLOWING SELECT MEDICAL HOSPITALS: CLEVELAND CLINIC REHABILITATION - AVON, CLEVELAND CLINIC REHABILITATION - EDWIN SHAW, SELECT SPECIALTY HOSPITAL - CLEVELAND FAIRHILL, REGENCY HOSPITAL OF CLEVELAND EAST, AND REGENCY HOSPITAL OF CLEVELAND WEST. CC REHAB - BEACHWOOD ALSO COLLABORATED WITH: STATE AND COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS (CBOS).
GROUP A-FACILITY 2 -- CLEVELAND CLINIC REHAB - BEACHWOOD PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR CLEVELAND CLINIC REHABILITATION HOSPITAL, BEACHWOOD WERE THE FOLLOWING: ACCESS TO HEALTH AND SOCIAL SERVICES, BEHAVIORAL HEALTH, CHRONIC DISEASE PREVENTION AND MANAGEMENT, MATERNAL AND CHILD HEALTH, AND SOCIOECONOMIC CONCERNS. HOW THE FACILITY WILL ADDRESS EACH NEED IS DESCRIBED IN DETAIL IN THE RELEVANT HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY REPORT.
PART V, SECTION B, LINES 7A, 10A, 16A-16C	THE URL LINK TO VIEW THE CHNA, IMPLEMENTATION STRATEGY, FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE FOUND ON THESE RESPECTIVE DIRECT URLS:HTTPS://MY.CLEVELANDCLINIC.ORG/ABOUT/COMMUNITY/REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORTS#2022-CHNAS-TABHTTPS://MY.CLEVELANDCLINIC.ORG/ABOUT/COMMUNITY/REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORTS#OVERVIEW-TABHTTPS://MY.CLEVELANDCLINIC.ORG/PATIENTS/BILLING-FINANCE/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINES 4, 9	SELECT SPECIALTY - GATEWAY HOSPITAL SHUT DOWN OPERATIONS IN OCTOBER 2022. DUE TO THE CLOSURE, THE HOSPITAL FACILITY DID NOT COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022, NOR DID IT ADOPT AN IMPLEMENTATION STRATEGY.

Schedule H (Form 990) 2022

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?120
Name and address		Type of Facility (describe)
1	1 - TWINSBURG FAMILY HEALTH & SURGERY CENTER 8701 DARROW ROAD TWINSBURG,OH44087	FAMILY HEALTH CENTER
2	2 - STRONGSVILLE FAMILY HEALTH & SURGERY CENTE 16761 SOUTH PARK CENTER STRONGSVILLE,OH44136	FAMILY HEALTH CENTER
3	3 - BEACHWOOD FAMILY HEALTH & SURGERY CENTER 26900 CEDAR ROAD BEACHWOOD,OH44122	FAMILY HEALTH CENTER
4	4 - RICHARD E JACOBS HEALTH CENTER 33100 CLEVELAND CLINIC BOULEVARD AVON,OH44011	FAMILY HEALTH CENTER
5	5 - INDEPENDENCE FAMILY HEALTH CENTER 5001 ROCKSIDE RD CROWN CENTRE II INDEPENDENCE,OH44131	FAMILY HEALTH CENTER
6	6 - WILLOUGHBY HILLS FAMILY HEALTH CENTER 2550 2570 SOM CENTER ROAD WILLOUGHBY HILLS,OH44094	FAMILY HEALTH CENTER
7	7 - CLEVELAND CLINIC CANCER CENTERS 417 QUARRY LAKES DRIVE SANDUSKY,OH44870	OUTPATIENT PHYSICIAN CLINIC
8	8 - LORAIN FAMILY HEALTH & SURGERY CENTER 5700 COOPER FOSTER PARK ROAD LORAIN,OH44053	FAMILY HEALTH CENTER
9	9 - WOOSTER FAMILY HEALTH CENTER 1740 CLEVELAND ROAD WOOSTER,OH44691	FAMILY HEALTH CENTER
10	10 - BRUNSWICK FAMILY HEALTH CENTER 3574 CENTER ROAD BRUNSWICK,OH44212	FAMILY HEALTH CENTER
11	11 - CLEVELAND CLINIC CANCER CENTERS 1125 ASPIRA COURT MANSFIELD,OH44906	OUTPATIENT PHYSICIAN CLINIC
12	12 - LAKEWOOD FAMILY HEALTH CENTER 14601 DETROIT AVENUE LAKEWOOD,OH44107	FAMILY HEALTH CENTER
13	13 - SOLON FAMILY HEALTH CENTER 29800 BAINBRIDGE ROAD SOLON,OH44139	FAMILY HEALTH CENTER
14	14 - ELYRIA FAMILY HEALTH & SURGERY CENTER 303 CHESTNUT COMMONS DRIVE ELYRIA,OH44035	FAMILY HEALTH CENTER
15	15 - MENTOR MEDICAL OFFICE 7060 WAYSIDE DRIVE MENTOR,OH44060	OUTPATIENT PHYSICIAN CLINIC
16	16 - AMHERST FAMILY HEALTH CENTER 5172 LEAVITT ROAD LORAIN,OH44053	FAMILY HEALTH CENTER
17	17 - NORTH OHIO GASTROENTEROLOGY 30701 CLEMENS ROAD WESTLAKE,OH44145	OUTPATIENT PHYSICIAN CLINIC
18	18 - CHAGRIN FALLS FAMILY HEALTH CENTER 551 EAST WASHINGTON STREET CHAGRIN FALLS,OH44022	FAMILY HEALTH CENTER
19	19 - SUMMIT GASTROENTEROLOGY ASSOCIATES 3939 S CLEVELAND MASSILLON ROAD BARBERTON,OH44203	OUTPATIENT PHYSICIAN CLINIC
20	20 - LANDERBROOK OFFICE AND ENDOSCOPY CENTER 5900 LANDERBROOK DRIVE MAYFIELD HEIGHTS,OH44124	OUTPATIENT PHYSICIAN CLINIC
21	21 - SHEFFIELD FAMILY HEALTH CENTER 5334 MEADOW LANE CT SHEFFIELD VILLAGE,OH44035	FAMILY HEALTH CENTER
22	22 - STEPHANIE TUBBS JONES HEALTH CENTER 13944 EUCLID AVENUE EAST CLEVELAND,OH44112	FAMILY HEALTH CENTER
23	23 - CLEVELAND CLINIC SUMMIT OPHTHALMOLOGY 1 PARK WEST BOULEVARD STE 150 AKRON,OH44320	OUTPATIENT PHYSICIAN CLINIC
24	24 - AVON POINTE FAMILY HEALTH CENTER 36901 AMERICAN WAY AVON,OH44011	FAMILY HEALTH CENTER
25	25 - CONCORD MEDICAL OUTPATIENT CENTER 7519 FREDLE DRIVE CONCORD,OH44077	OUTPATIENT PHYSICIAN CLINIC
26	26 - CLEVELAND CLINIC ADMINISTRATIVE CAMPUS 3275 SCIENCE PARK DRIVE BLDG 5 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
27	27 - AVON LAKE FAMILY HEALTH CENTER 450 AVON BELDEN ROAD AVON LAKE,OH44012	FAMILY HEALTH CENTER
28	28 - NILES STAR IMAGING 650 YOUNGSTOWN-WARREN ROAD NILES,OH44446	DIAGNOSTIC CENTER
29	29 - CLEVELAND CLINIC FAMILY MEDICINE 19300 DETROIT AVENUE ROCKY RIVER,OH44116	OUTPATIENT PHYSICIAN CLINIC
30	30 - CLEVELAND CLINIC LYNDHURST CAMPUS 1950 RICHMOND ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
31	31 - COLUMBUS STAR IMAGING 921 JASONWAY AVENUE COLUMBUS,OH43214	DIAGNOSTIC CENTER
32	32 - COMMUNITY PEDIATRICS 8254 MAYFIELD ROAD CHESTERLAND,OH44026	OUTPATIENT PHYSICIAN CLINIC
33	33 - MIDDLEBURG HEIGHTS ORTHOPAEDICS 7010 ENGLE ROAD STE 105 MIDDLEBURG HEIGHTS,OH44130	OUTPATIENT PHYSICIAN CLINIC
34	34 - MADISON MEDICAL OFFICE 2999 MCMACKIN ROAD MADISON,OH44057	OUTPATIENT PHYSICIAN CLINIC
35	35 - MENTOR REHABILITATION AND SPORTS THERAPY 7533 CENTER STREET MENTOR,OH44060	OUTPATIENT PHYSICIAN CLINIC
36	36 - CLEVELAND CLINIC COLE EYE OF STREETSBORO ( 9424 STATE ROUTE 14 STREETSBORO,OH44241	OUTPATIENT PHYSICIAN CLINIC
37	37 - OLMSTED TOWNSHIP PRIMARY CARE 27089 BAGLEY ROAD OLMSTED TOWNSHIP,OH44138	OUTPATIENT PHYSICIAN CLINIC
38	38 - WADSWORTH PRIMARY CARE ONE PARK CENTER DRIVE WADSWORTH,OH44281	OUTPATIENT PHYSICIAN CLINIC
39	39 - OHIO RENAL CARE CLEVELAND EAST 2429 MARTIN LUTHER KING JR DR CLEVELAND,OH44104	DIALYSIS CENTER
40	40 - CLEVELAND CLINIC STAR IMAGING 1449 BOARDMAN-CANFIELD ROAD YOUNGSTOWN,OH44512	DIAGNOSTIC CENTER
41	41 - MACEDONIA EXPRESS AND OUTPATIENT CARE 8210 MACEDONIA COMMONS BOULEVARD MACEDONIA,OH44056	OUTPATIENT PHYSICIAN CLINIC
42	42 - MARYMOUNT REHABILITATION AND SPORTS THERAP 2525 EAST ROYALTON ROAD BROADVIEW HEIGHTS,OH44147	OUTPATIENT PHYSICIAN CLINIC
43	43 - NORTH RIDGEVILLE MEDICAL OFFICE 35105 CENTER RIDGE ROAD NORTH RIDGEVILLE,OH44039	OUTPATIENT PHYSICIAN CLINIC
44	44 - CLEVELAND CLINIC URGENT CARE ROCKY RIVER 19895 DETROIT ROAD ROCKY RIVER,OH44116	OUTPATIENT PHYSICIAN CLINIC
45	45 - SUMMIT OPHTHALMOLOGY 1587 BOETTLER ROAD UNIONTOWN,OH44685	OUTPATIENT PHYSICIAN CLINIC
46	46 - ASHLAND OPHTHALMOLOGYSUGARBUSH EYE AND LA 21 SUGARBUSH COURT ASHLAND,OH44805	OUTPATIENT PHYSICIAN CLINIC
47	47 - NEW FAMILY PHYSICIANS LYNDHURST 5187 MAYFIELD ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
48	48 - BRECKSVILLE EXPRESS CARE 8805 BRECKSVILLE ROAD BRECKSVILLE,OH44141	OUTPATIENT PHYSICIAN CLINIC
49	49 - COMMUNITY PEDIATRICS 2001 CROCKER ROAD WESTLAKE,OH44145	OUTPATIENT PHYSICIAN CLINIC
50	50 - OHIO RENAL CARE GROUP WESTLAKE 26024 DETROIT AVENUE WESTLAKE,OH44145	DIALYSIS CENTER
51	51 - SLEEP DISORDERS CENTER 3122 EASTPOINTE DRIVE MEDINA,OH44256	DIAGNOSTIC CENTER
52	52 - SOUTH RUSSELL FAMILY PRACTICE 5192 CHILLICOTHE ROAD SOUTH RUSSELL,OH44022	OUTPATIENT PHYSICIAN CLINIC
53	53 - CLEVELAND CLINIC CHILDRENS STOW 3925 DARROW ROAD STOW,OH44224	OUTPATIENT PHYSICIAN CLINIC
54	54 - DAYTON STAR IMAGING 5529 FAR HILLS AVENUE DAYTON,OH45429	DIAGNOSTIC CENTER
55	55 - CANFIELD ORTHOPAEDICS AND REHABILITATION 3736 BOARDMAN CANFIELD ROAD CANFIELD,OH44406	OUTPATIENT PHYSICIAN CLINIC
56	56 - OHIO RENAL CARE GROUP HERITAGE 1160 E BROAD ST ELYRIA,OH44035	DIALYSIS CENTER
57	57 - OHIO RENAL CARE GROUP LTAC ACUTEWHITE PO 690 WHITE POND DR AKRON,OH44320	DIALYSIS CENTER
58	58 - CHARDON REHABILITATION AND SPORTS THERAPY 325 CENTER STREET CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
59	59 - OHIO RENAL CARE GROUP AMHERST 100 COPPER FOSTER PARK RD AMHERST,OH44001	DIALYSIS CENTER
60	60 - MOHICAN EYE CENTER 484 PARK AVENUE WEST MANSFIELD,OH44906	OUTPATIENT PHYSICIAN CLINIC
61	61 - OHIO RENAL CARE GROUP FARNSWORTH 3280 W 25TH ST CLEVELAND,OH44109	DIALYSIS CENTER
62	62 - VALLEY CITY FAMILY MEDICINE 6605 CENTER ROAD VALLEY CITY,OH44280	OUTPATIENT PHYSICIAN CLINIC
63	63 - OHIO RENAL CARE GROUP SOLON 6020 ENTERPRISE PARKWAY SOLON,OH44139	DIALYSIS CENTER
64	64 - OHIO RENAL CARE GROUP WEST 14670 SNOW ROAD BROOKPARK,OH44142	DIALYSIS CENTER
65	65 - OHIO RENAL CARE GROUP STREETSBORO 9200 STAPLES DR STREETSBORO,OH44241	DIALYSIS CENTER
66	66 - OHIO RENAL CARE GROUP EUCLID 26450 EUCLID AVENUE EUCLID,OH44132	DIALYSIS CENTER
67	67 - DOWNTOWN EXPRESS CARE 315 EUCLID AVENUE STE 2 CLEVELAND,OH44114	OUTPATIENT PHYSICIAN CLINIC
68	68 - OHIO RENAL CARE GROUP MENTOR 8840 TYLER BLVD MENTOR,OH44060	DIALYSIS CENTER
69	69 - OHIO RENAL CARE GROUP GARFIELD HEIGHTS HO 9729 GRANGER RD GARFIELD HTS,OH44125	DIALYSIS CENTER
70	70 - OHIO RENAL CARE GROUP OHIO ACUTES 2500 METROHEALTH DRIVE CLEVELAND,OH44109	DIALYSIS CENTER
71	71 - OHIO RENAL CARE NORTH RANDALL 5035 RICHMOND ROAD BEDFORD HEIGHTS,OH44146	DIALYSIS CENTER
72	72 - CLEVELAND CLINIC EXPRESS CARE 7580 NORTHCLIFF AVENUE BROOKLYN,OH44144	OUTPATIENT PHYSICIAN CLINIC
73	73 - OBERLIN OPHTHALMOLOGY 309 WEST LORAIN STREET OBERLIN,OH44074	OUTPATIENT PHYSICIAN CLINIC
74	74 - BELDEN CENTER 4677 FULTON DRIVE NW CANTON,OH44718	OUTPATIENT PHYSICIAN CLINIC
75	75 - MADISON REHABILITATION AND SPORTS THERAPY 2622 HUBBARD ROAD MADISON,OH44057	OUTPATIENT PHYSICIAN CLINIC
76	76 - OHIO RENAL CARE GROUP HINCKLEY 2583 CENTER RD HINCKLEY,OH44233	DIALYSIS CENTER
77	77 - OHIO RENAL CARE GROUP KENT 401 DEVON PL 100 KENT,OH44240	DIALYSIS CENTER
78	78 - OHIO RENAL CARE GROUP ELYRIA 5316 HOAG DR SHEFFILED,OH44035	DIALYSIS CENTER
79	79 - OHIO RENAL CARE GROUP CUYAHOGA FALLS 320 BROADWAY ST E E CUYAHOGA FALLS,OH44221	DIALYSIS CENTER
80	80 - OHIO RENAL CARE GROUP WADSWORTH 1160 WILLIAMS RESERVE BLVD WADSWORTH,OH44281	DIALYSIS CENTER
81	81 - MOHICAN EYE CENTER 637 NORTH UNION STREET LOUDONVILLE,OH44842	OUTPATIENT PHYSICIAN CLINIC
82	82 - OHIO RENAL CARE GROUP SOUTHPOINT DIALYSIS 4200 WARRENSVILLE CENTER RD STE 100 WARRENSVILLE HTS,OH44122	DIALYSIS CENTER
83	83 - OHIO RENAL CARE GROUP MEDINA 3995 MEDINA RD STE 150 MEDINA,OH44256	DIALYSIS CENTER
84	84 - OHIO RENAL CARE GROUP ASHTABULA 2117 LAKE AVENUE ASHTABULA,OH44004	DIALYSIS CENTER
85	85 - OHIO RENAL CARE GROUP LAKEWOOD 13900 DETROIT RD LAKEWOOD,OH44107	DIALYSIS CENTER
86	86 - OHIO RENAL CARE GROUP MARYMOUNT 12532 ROCKSIDE RD GARFIELD HEIGHTS,OH44125	DIALYSIS CENTER
87	87 - THE LANGSTON HUGHES CENTER CLEVELAND CLINI 2390 E 79TH ST CLEVELAND,OH44104	OUTPATIENT PHYSICIAN CLINIC
88	88 - NEW FAMILY PHYSICIANS WILLOUGHBY HILLS 34500 CHARDON ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC
89	89 - WILLOUGHBY HILLS BEHAVIORAL HEALTH 2785 SOM CENTER ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC
90	90 - CLEVELAND CLINIC DIABETES AND ENDOCRINOLOG 3733 PARK EAST DRIVE STE 105 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
91	91 - STOW-FALLS MEDICAL OUTPATIENT CENTER 857 GRAHAM RD STOW,OH44221	OUTPATIENT PHYSICIAN CLINIC
92	92 - LAKEWOOD MEDICAL OFFICE 16215 MADISON AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
93	93 - CLEVELAND CLINIC SUPERIOR MEDICAL CARE 1959 COOPER FOSTER PARK ROAD AMHERST,OH44053	DIAGNOSTIC CENTER
94	94 - COLE EYE INSTITUTE 2000 AUBURN DRIVE STE 100 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
95	95 - ACCESS TO CARE 29000 AURORA ROAD SOLON,OH44139	OUTPATIENT PHYSICIAN CLINIC
96	96 - ASHTABULA COUNTY MEDICAL CENTER 2422 LAKE AVENUE ASHTABULA,OH44004	OUTPATIENT PHYSICIAN CLINIC
97	97 - BOARDMAN STAR IMAGING 7067 TIFFANY BOULEVARD YOUNGSTOWN,OH44512	DIAGNOSTIC CENTER
98	98 - CHARLESTON AREA MEDICAL CENTER 1201 WASHINGTON STREET EAST STE 100 CHARLESTON,WV25301	OUTPATIENT PHYSICIAN CLINIC
99	99 - LAKEWOOD FAMILY MEDICINE - ROCKPORT 11851 DETROIT AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
100	100 - LAKEWOOD LAKE POINTE LAB DRAW SITE 15800 DETROIT AVENUE LAKEWOOD,OH44107	DIAGNOSTIC CENTER
101	101 - LORAIN ORTHOPAEDICS 5800 COOPER FOSTER PARK ROAD LORAIN,OH44053	OUTPATIENT PHYSICIAN CLINIC
102	102 - SLEEP DISORDERS CENTER 24901 COUNTRY CLUB BOULEVARD NORTH OLMSTED,OH44070	DIAGNOSTIC CENTER
103	103 - SLEEP DISORDERS CENTER 8971 WILCOX DRIVE TWINSBURG,OH44087	DIAGNOSTIC CENTER
104	104 - SLEEP DISORDERS CENTER 5051 WEST CREEK ROAD INDEPENDENCE,OH44131	DIAGNOSTIC CENTER
105	105 - STAR IMAGING DUBLIN 333 W BRIDGE STREET DUBLIN,OH43017	DIAGNOSTIC CENTER
106	106 - WEST VALLEY MEDICAL 20455 LORAIN ROAD 301 FAIRVIEW PARK,OH44126	OUTPATIENT PHYSICIAN CLINIC
107	107 - WILLOUGHBY HILLS REHABILITATION AND SPORTS 29017 CHARDON ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC
108	108 - WOOSTER MILLTOWN SPECIALTY & SURGERY CENTE 721 EAST MILLTOWN ROAD WOOSTER,OH44691	OUTPATIENT PHYSICIAN CLINIC
109	109 - HEALTH SPOT LAKEWOOD HIGH SCHOOL 14100 FRANKLIN BOULEVARD LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
110	110 - LORAIN COUNTY LONG-TERM CARE 1130 TOWER BOULEVARD LORAIN,OH44052	OUTPATIENT PHYSICIAN CLINIC
111	111 - ADVANCED CARDIOVASCULAR CONSULTANTS 531 FIFTH AVENUE CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
112	112 - CHARDON PLAZA MEDICAL OUTPATIENT CENTER 425 WATER STREET CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
113	113 - EL CENTRO COMMUNITY CENTER PRIMARY CARE CL 2800 PEARL AVENUE LORAIN,OH44055	OUTPATIENT PHYSICIAN CLINIC
114	114 - MEDINA COMMUNITY RECREATION CENTER 855 WEYMOUTH ROAD MEDINA,OH44256	OUTPATIENT PHYSICIAN CLINIC
115	115 - NORTH RIDGEVILLE MEDICAL OUTPATIENT CENTER 34960 CENTER RIDGE ROAD NORTH RIDGEVILLE,OH44039	OUTPATIENT PHYSICIAN CLINIC
116	116 - PREMIER LAB CARE 37121 EUCLID AVENUE WILLOUGHBY,OH44094	OUTPATIENT PHYSICIAN CLINIC
117	117 - CANOPY CHILD ADVOCACY CENTER 1711 PAYNE AVENUE CLEVELAND,OH44114	OUTPATIENT PHYSICIAN CLINIC
118	118 - CROSSROADS SLEEP DISORDER CENTER 721 BOARDMAN POLAND ROAD YOUNGSTOWN,OH44512	OUTPATIENT PHYSICIAN CLINIC
119	119 - GREAT LAKES CARE INC 29001 CEDAR ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
120	120 - WEST END PEDIATRICS (CLEVELAND CLINIC CHIL 14701 DETROIT AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	CCF PROVIDES MEDICALLY NECESSARY SERVICES TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, GENDER OR COUNTRY OF NATIONAL ORIGIN AND WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. CCF HAS A FINANCIAL ASSISTANCE POLICY THAT IS AMONG THE MOST GENEROUS IN NORTHEAST OHIO. THIS POLICY APPLIES TO ALL CCF FACILITIES, AND THE AMOUNT OF CARE PROVIDED UNDER THE POLICY IS DETERMINED BY NEED AND IS NOT LIMITED OR RATIONED BY BUDGETED AMOUNTS. UNDER THE POLICY, CCF PROVIDES FREE CARE TO INDIVIDUALS WITHOUT INSURANCE WITH INCOMES UP TO 250% OF THE FEDERAL POVERTY LEVEL AND DISCOUNTED CARE UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN ADDITION, THE POLICY CONTAINS ADDITIONAL WAYS TO QUALIFY BASED ON FINANCIAL OR MEDICAL NEED. UNLIKE THE FINANCIAL ASSISTANCE POLICIES OF MOST HOSPITALS, THE CCF POLICY APPLIES TO BOTH HOSPITAL CHARGES AND CERTAIN PROFESSIONAL FEES FOR SERVICES PROVIDED BY CCF EMPLOYED PHYSICIANS.
PART I, LINE 7:	THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM A COST ACCOUNTING SYSTEM. IN OTHER CATEGORIES, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THAT CATEGORY.
PART I, LINE 7G:	CCF EMPLOYS ITS PHYSICIANS, THEREFORE THE ASSOCIATED COSTS AND CHARGES RELATING TO THESE PHYSICIAN SERVICES ARE INCLUDED IN ALL RELEVANT CATEGORIES OF PART I.
PART I, LN 7 COL(F):	THE PROPORTIONATE SHARE OF TOTAL JV EXPENSES AND BAD DEBT EXPENSES ARE FACTORED IN FOR PURPOSES OF CALCULATING THE PERCENTAGES.
PART I, LINE 6A	SCH H PART I LINE 6A - AN ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR THE HEALTH SYSTEM AS A WHOLE, WHICH INCLUDES THE PARENT ORGANIZATION AND RELATED AFFILIATES.
PART I, LINE 7	THE NET COMMUNITY BENEFIT EXPENSE FIGURE REPORTED FOR UNREIMBURSED MEDICAID IS INCLUSIVE OF CCF'S HCAP ASSESSMENT OF $8,938,778.
PART I, LINE 7	NOTE THAT THE TOTAL AMOUNT OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS OF $926,460,131 AS REPORTED ON PART I, LINE 7 DIFFERS FROM THE COMMUNITY BENEFIT REPORT AS THIS FIGURE REPRESENTS ONLY THE CLEVELAND CLINIC FOUNDATION'S COMMUNITY BENEFIT WHEREAS THE COMMUNITY BENEFIT REPORT REPRESENTS COMMUNITY BENEFIT FOR THE HEALTH SYSTEM.
LINE 2	CLEVELAND CLINIC REHABILITATION AND SELECT FACILITIES HAVE THEIR OWN FINANCIAL ASSISTANCE POLICIES, WHICH COMPLY WITH ALL 501(R) REGULATIONS.
PART I, LINE 7	CLEVELAND CLINIC INCURRED COSTS IN SUPPORT OF ITS INITIAL AND ON-GOING RESPONSE TO THE COVID-19 PANDEMIC. CERTAIN OF THESE COSTS ARE REFLECTED IN THE COMMUNITY BENEFIT AMOUNTS REPORTED ON PART I, LINE 7. SPECIFICALLY, COMMUNITY-BASED CLINICAL SERVICES WERE PROVIDED CONSISTING OF: COVID-19 CLINICS AND SCREENINGS, PUBLIC EDUCATION RELATED TO COVID-19, AND VARIOUS COVID-19 PUBLIC ASSISTANCE PROGRAMS. ADDITIONALLY, CLEVELAND CLINIC INVESTED IN CAPITAL AND EQUIPMENT TO PREPARE FOR THE ANTICIPATED SURGE OF PATIENTS REQUIRING TREATMENT AND HOSPITALIZATION. OVERALL FOR 2022, $31 MILLION OF COVID-19 EXPENSES ARE REPORT IN PART I, LINE 7.
PART II, COMMUNITY BUILDING ACTIVITIES:	CLEVELAND CLINIC ADDRESSES VARIOUS COMMUNITY CONCERNS, INCLUDING HEALTH IMPROVEMENT, POVERTY, WORKFORCE DEVELOPMENT, AND ACCESS TO HEALTH CARE. CLEVELAND CLINIC DEVOTES EMPLOYEE TIME AND TALENT TO PARTICIPATE IN COMMUNITY COLLABORATION BOARDS, HEALTH ADVOCACY PROGRAMS, AND PHYSICAL IMPROVEMENT PROJECTS TO PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.
PART III, LINE 2:	ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS, NOT INCLUDED IN BAD DEBT EXPENSE.
PART III, LINE 4:	SEE EXPLANATION OF IMPLICIT PRICE CONCESSIONS IN FOOTNOTE #3 ON PG. 11 OF THE AUDITED FINANCIAL STATEMENTS, WHICH ARE ATTACHED TO THE FORM 990.
PART III, LINE 8:	MEDICARE ALLOWABLE COSTS ARE CALCULATED USING A COST-TO-CHARGE RATIO.CCF HAS USED THE CHA METHODOLOGY FOR REPORTING COMMUNITY BENEFIT SINCE 2004 AS IT WAS THE EMERGING COMMUNITY BENEFIT REPORTING STANDARD AND NOW HAS BEEN ADOPTED IN LARGE PART BY THE IRS FOR 990 REPORTING PURPOSES. THE CHA MODEL DOES NOT INCLUDE MEDICARE SHORTFALL AS COMMUNITY BENEFIT.
PART III, LINE 9B:	YES, CLEVELAND CLINIC HAS A WRITTEN DEBT COLLECTION POLICY. IT IS OUR POLICY NOT TO PURSUE COLLECTION PRACTICES AGAINST PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE PROGRAMS OR BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO MAKE SUCH DETERMINATION. IN CERTAIN CASES IT MAY NOT BE EASILY DETERMINED WHETHER OR NOT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE; HOWEVER, IF AFTER COLLECTION PRACTICES HAVE BEGUN IT LATER BECOMES KNOWN THAT A PATIENT QUALIFIES, THE COLLECTION EFFORTS CEASE. ADDITIONALLY, OUR EXTERNAL THIRD-PARTY (COLLECTION) AGENCIES ARE TRAINED ON OUR FINANCIAL ASSISTANCE POLICY AND ASSIST A PATIENT IN NEED BY SUPPLYING OUR APPLICATION FOR FINANCIAL ASSISTANCE.
PART III, LINE 5, 6, & 7	IN ADDITION TO THE MEDICARE PROGRAMS REFLECTED IN THE COST REPORTS, CCF INCURS COSTS AND RECEIVES REIMBURSEMENT FOR OTHER MEDICARE ELIGIBLE SERVICES. THE TOTAL REVENUE RECEIVED AND COSTS ASSOCIATED WITH THE ADDITIONAL MEDICARE SERVICES ARE $1,242,196,715 AND $1,615,726,323 RESPECTIVELY. THIS RESULTS IN ADDITIONAL MEDICARE SHORTFALL OF $373,529,608 WHICH, ADDED TO THE SHORTFALL OF $49,137,894 AS REPORTED ON THE COST REPORTS BRINGS THE TOTAL MEDICARE SHORTFALL TO $422,667,502.
PART VI, LINE 2:	IN ADDITION TO THE CHNA PROCESS, CCF'S INSTITUTES AND DEPARTMENTS MAY GATHER, ANALYZE, AND REVIEW RELEVANT HEALTH STATISTICS AND DEMOGRAPHIC DATA FOR THE COMMUNITY FOR THAT PARTICULAR FACILITY'S COMMUNITY. THE DATA IS USED TO EVALUATE POTENTIAL NEW OR REVISED HEALTH SERVICES THAT CCF MAY PROVIDE TO PARTICULAR GROUPS OF PATIENTS WITHIN THE COMMUNITIES IT SERVES.
PART VI, LINE 3:	INFORMING THE PUBLIC THAT FINANCIAL ASSISTANCE IS AVAILABLE IS AN IMPORTANT ELEMENT OF OUR FINANCIAL ASSISTANCE PROGRAM AND THE CLEVELAND CLINIC CONTINUOUSLY STRIVES TO IMPROVE ITS COMMUNICATIONS WITH PATIENTS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE CLEVELAND CLINIC WEBSITE. ALL PATIENT BILLS INCLUDE DETAILED INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY AND AN INSERT DESCRIBING THE FINANCIAL ASSISTANCE PROGRAM IS INCLUDED WITH BILLING STATEMENTS. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGHOUT CCF, INCLUDING IN PATIENT REGISTRATION AREAS, ONLINE, AND WITH FINANCIAL COUNSELORS WHO ARE PRESENT ON-SITE AT EACH CLEVELAND CLINIC HOSPITAL AND OHIO FAMILY HEALTH CENTER TO ASSIST PATIENTS IN QUALIFYING FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND FINANCIAL ASSISTANCE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS AND WITH FINANCIAL COUNSELORS.
PART VI, LINE 4:	THE CLEVELAND CLINIC'S COMMUNITY IS DEFINED BY BOTH MISSION AND GEOGRAPHY. THE GEOGRAPHIC COMMUNITY IS DEFINED BY THE HOSPITAL FACILITY'S IMMEDIATELY CONTIGUOUS AREAS AS WELL AS THE BROADER SURROUNDING COUNTIES/REGIONS FROM WHICH THE MAJORITY OF DISCHARGED INPATIENTS RESIDE. DEMOGRAPHIC DATA BY ZIP CODE WAS ANALYZED TO ENSURE THAT MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS WHO LIVE IN THE GEOGRAPHIC AREAS FROM WHICH THE HOSPITAL DRAWS PATIENTS WERE NOT EXCLUDED FROM THE DEFINED COMMUNITY. ADDITIONALLY, THE COMMUNITY INCLUDES PATIENTS WHO REQUIRE THE EXPERTISE AND SPECIALIZED SERVICES OF THE CLEVELAND CLINIC. THE COMMUNITY FOR MEDICAL RESEARCH AND EDUCATION IS THE PUBLIC AT LARGE. ADDITIONAL DETAIL DESCRIBING THE COMMUNITY THE ORGANIZATION SERVES CAN BE FOUND IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.
PART VI, LINE 5:	ONE OF THE HALLMARKS OF A CHARITABLE ORGANIZATION IS THAT THE ORGANIZATION SERVES A BROAD, INDEFINITE CHARITABLE CLASS. ONE OF THE KEY INDICATORS THAT AN ORGANIZATION SERVES THE BROADER COMMUNITY IS LEADERSHIP BY BOARDS COMPRISED OF INDEPENDENT COMMUNITY LEADERS. CCF AND ITS NORTHEAST OHIO REGIONAL HOSPITAL GOVERNING BOARDS ARE MADE UP OF MEMBERS OF THE COMMUNITY WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF CCF AND ITS AFFILIATES. TRUSTEES/DIRECTORS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO THE CLEVELAND CLINIC AND THE HEALTH SYSTEM AND ARE NOT COMPENSATED FOR THEIR SERVICES.ANOTHER HALLMARK OF A CHARITABLE ORGANIZATION IS THAT SURPLUS FUNDS ARE USED TO FURTHER CHARITABLE PURPOSES AND ACTIVITIES. SURPLUS FUNDS FOR CCF AND ITS AFFILIATES ARE REINVESTED AND USED TO CARRY OUT THE ORGANIZATION'S EXEMPT MISSION -- PATIENT CARE, RESEARCH, AND EDUCATION.
PART VI, LINE 6:	CLEVELAND CLINIC IS THE PARENT ORGANIZATION OF THE HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM CONSISTING OF AN ACADEMIC MEDICAL CENTER, MEDICAL SCHOOL, COMMUNITY HOSPITALS, FAMILY HEALTH CENTERS, VARIOUS ANCILLARY SERVICES, AND A LARGE GROUP OF EMPLOYED PHYSICIANS AND PHYSICIAN RESEARCHERS.
PART VI, LINE 7	THE STATE OF OHIO COLLECTS SCHEDULE H DATA, HOWEVER, NO COMMUNITY BENEFIT REPORT IS FILED IN ANY STATE.

Schedule H (Form 990) 2022

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number
34-0714585

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) ASSOCIATION OF FUNDRAISING PROFESSIONALS GREATER CLEVELAND CHAPTER 3053 NATIONWIDE PKWY BRUNSWICK,OH44212	34-1575857	501(C)(3)	5,600	0			COMMUNITY SUPPORT
(2) AKRON COMMUNITY SERVICE CENTER AND URBAN LEAGUE INC 440 VERNON ODOM BLVD AKRON,OH44307	34-0714520	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(3) ALICE FLAHERTY EXCELLENCE IN NURSING SCHOLARSHIP FUND INC 24179 AMBOUR DR NORTH OLMSTED,OH44070	47-0974372	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(4) ALZHEIMERS ASSOCIATION 12200 FAIRHILL RD CLEVELAND,OH44120	13-3039601	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(5) AMERICAN CANCER SOCIETY 10501 EUCLID AVE CLEVELAND,OH44106	13-1788491	501(C)(3)	32,500	0			COMMUNITY SUPPORT
(6) AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS,TX75231	13-5613797	501(C)(3)	165,000	0			COMMUNITY SUPPORT
(7) AMERICAN LUNG ASSOCIATION 55 WEST WACKER DRIVE CHICAGO,IL60601	13-1632524	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(8) AMERICAN NATIONAL RED CROSS 431 18TH ST NW WASHINGTON,DC20006	53-0196605	501(C)(3)	35,000	0			COMMUNITY SUPPORT
(9) BESSIE ANGELS 17017 MILES RD CLEVELAND,OH44128	47-4200543	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(10) BIG BROTHERS BIG SISTERS 4610 PROSPECT AVE STE 410 CLEVELAND,OH44103	34-1809153	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(11) BIRTHING BEAUTIFUL COMMUNITIES 1416 EAST 105TH ST CLEVELAND,OH44106	47-4453278	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(12) CASE WESTERN RESERVE UNIVERSITY 2040 ADELBERT RD CLEVELAND,OH44106	34-1018992	501(C)(3)	112,750	0			HEALTHCARE RESEARCH & EDUCATION
(13) CATHOLIC CHARITIES CORPORATION 7911 DETROIT AVE CLEVELAND,OH44102	34-1908590	501(C)(3)	42,000	0			COMMUNITY SUPPORT
(14) CATHY'S HOUSE INC PO BOX 811 MEDINA,OH44258	34-1876466	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(15) CITY MISSION 84 W WHEELING ST WASHINGTON,PA15301	34-0760586	501(C)(3)	12,240	0			COMMUNITY SUPPORT
(16) CITY OF AKRON 166 S HIGH ST AKRON,OH44308	34-6000020	501(C)(1)	32,300	0			COMMUNITY SUPPORT
(17) CITY OF MENTOR 8500 CIVIC CENTER BLVD MENTOR,OH44060	34-6001861	501(C)(1)	22,320	0			COMMUNITY SUPPORT
(18) CLEVELAND LEADERSHIP CENTER 1375 EAST 9TH ST STE 1100 CLEVELAND,OH44114	34-1927317	501(C)(4)	10,000	0			COMMUNITY SUPPORT
(19) CLEVELAND METROPOLITAN SCHOOL DISTRICT 1111 SUPERIOR AVE E STE 1800 CLEVELAND,OH44114	34-6000662	501(C)(1)	13,000	0			COMMUNITY SUPPORT
(20) COLORECTAL CANCER ALLIANCE 1025 VERMONT AVE NW STE 1066 WASHINGTON,DC20005	86-0947831	501(C)(3)	33,333	0			COMMUNITY SUPPORT
(21) COMMUNITY PARTNERSHIP ON AGING 1370 VICTORY DR SOUTH EUCLID,OH44121	34-1261538	501(C)(3)	6,838	0			COMMUNITY SUPPORT
(22) COMMUNITY SERVICE ALLIANCE 4001 TRENT AVE CLEVELAND,OH44109	20-1418132	501(C)(3)	5,400	0			COMMUNITY SUPPORT
(23) CUYAHOGA COMMUNITY COLLEGE 700 CARNEGIE AVE CLEVELAND,OH44115	34-0896630	501(C)(1)	10,000	0			COMMUNITY SUPPORT
(24) CUYAHOGA COMMUNITY COLLEGE FOUNDATION 700 CARNEGIE AVE CLEVELAND,OH44115	23-7320719	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(25) OHIO DEPARTMENT OF HEALTH 246 N HIGH ST COLUMBUS,OH43215	34-6000817	501(C)(1)	35,000	0			COMMUNITY SUPPORT
(26) DIGITALC 6815 EUCLID AVE CLEVELAND,OH44103	81-1731053	501(C)(3)	325,000	0			COMMUNITY SUPPORT
(27) ESPERANZA INC 4115 BRIDGE AVE CLEVELAND,OH44113	34-1403492	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(28) FAIRFAX RENAISSANCE DEVELOPMENT CORPORATION 8111 QUINCY AVE STE 100 CLEVELAND,OH44104	34-1706856	501(C)(3)	569,499	0			COMMUNITY SUPPORT
(29) FAMICOS FOUNDATION INC 1325 ANSEL RD CLEVELAND,OH44106	34-1053534	501(C)(3)	28,606	0			COMMUNITY SUPPORT
(30) FIRST LADYS CHARITABLE FOUNDATION PO BOX 340734 COLUMBUS,OH43234	87-1678867	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(31) FRIENDS OF BREAKTHROUGH SCHOOL 3615 SUPERIOR AVE STE 3103A CLEVELAND,OH44114	20-4948838	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(32) GATHERING PLACE 23300 COMMERCE PARK BEACHWOOD,OH44122	34-1879035	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(33) GLOBAL CLEVELAND 1422 EUCLID AVE STE 1652 CLEVELAND,OH44115	27-5245539	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(34) HEALTHCARE ANCHOR NETWORK INC 2202 18TH ST NW STE 317 WASHINGTON,DC20009	86-2147253	501(C)(4)	50,000	0			COMMUNITY SUPPORT
(35) KARAMU HOUSE 2355 E 89TH ST CLEVELAND,OH44106	34-0714448	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(36) KIDNEY FOUNDATION OF OHIO INC 2831 PROSPECT AVE CLEVELAND,OH44115	34-0827748	501(C)(3)	7,500	0			HEALTHCARE RESEARCH & EDUCATION
(37) KOREAN AMERICAN MEDICAL ASSOCIATION OF USA INC 200 SYLVAN AVE STE 22 ENGLEWOOD CLIFFS,NJ07632	82-3304552	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(38) LEGAL AID SOCIETY OF CLEVELAND 1223 W 6TH ST CLEVELAND,OH44113	34-0866026	501(C)(3)	384,000	0			COMMUNITY SUPPORT
(39) LBGT COMMUNITY CENTER OF GREATER CLEVELAND 6705 DETROIT AVE CLEVELAND,OH44102	34-1190920	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(40) LEUKEMIA & LYMPHOMA SOCIETY 3 INTERNATIONAL DR STE 200 RYE BROOK,NY10573	13-5644916	501(C)(3)	125,000	0			COMMUNITY SUPPORT
(41) LORAIN COUNTY COMMUNITY COLLEGE FOUNDATION 1005 N ABBE RD ELYRIA,OH44035	51-0146485	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(42) LORAIN COUNTY FREE CLINIC INC 5040 OBERLIN AVE LORAIN,OH44053	34-1506180	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(43) MAKE-A-WISH FOUNDATION OF OHIO KENTUCKY AND INDIANA INC 2545 FARMERS DRIVE STE 300 COLUMBUS,OH43235	34-1471131	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(44) MARCH OF DIMES INC 1550 CRYSTAL DRIVE STE 1300 ARLINGTON,VA22202	13-1846366	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(45) MEDWISH INTERNATIONAL 17325 EUCLID AVE CLEVELAND,OH44112	34-1903712	501(C)(3)	0	4,845,192	ESTIMATED VALUE	MEDICAL SUPPLIES	COMMUNITY SUPPORT
(46) METRO WEST COMMUNITY DEVELOPMENT ORGANIZATION 3167 FULTON RD 303 CLEVELAND,OH44109	81-4534855	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(47) METRO HEALTH SYSTEM 2500 METROHEALTH DR CLEVELAND,OH44109	34-6004382	501(C)(3)	207,920	0			SUPPORT EDUCATIONAL ACTIVITIES
(48) THE NATIONAL ASSOCIATION OF THE ADVANCEMENT OF COLORED PEOPLE 4805 MT HOPE DR BALTIMORE,MD21215	34-0846628	501(C)(4)	10,000	0			COMMUNITY SUPPORT
(49) NEIGHBORHOOD ALLIANCE 1536 E 30TH ST LORAIN,OH44055	34-0714471	501(C)(3)	20,410	0			COMMUNITY SUPPORT
(50) NEIGHBORHOOD FAMILY PRACTICE 3569 RIDGE RD CLEVELAND,OH44102	34-1300581	501(C)(3)	37,000	0			COMMUNITY SUPPORT
(51) NORTH UNION FARMERS MARKET 13111 SHAKER SQUARE STE 301 CLEVELAND,OH44120	34-1812026	501(C)(3)	18,500	0			COMMUNITY SUPPORT
(52) NORTHEAST OHIO COALITION FOR THE HOMELESS 3631 PERKINS AVE STE 3A-3 CLEVELAND,OH44114	34-1590112	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(53) OHIO MINORITY SUPPLIER DEVELOPMENT COUNCIL 100 E BROAD ST COLUMBUS,OH43215	31-1022688	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(54) URBAN LEAGUE OF GREATER SOUTHWESTERN OHIO INC 3458 READING RD CINCINNATI,OH45229	31-0565428	501(C)(3)	6,500	0			COMMUNITY SUPPORT
(55) ONETEN COALITION INC 126 ATLANTIC ST NORFOLK,VA23514	86-1528485	501(C)(3)	2,250,000	0			COMMUNITY SUPPORT
(56) OROC PO BOX 40332 BAY VILLAGE,OH44140	80-0093560	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(57) REGIONAL TRANSIT AUTHORITY ART PO BOX 6566 CLEVELAND,OH44101	34-1170830	501(C)(1)	125,000	0			COMMUNITY SUPPORT
(58) BENJAMIN ROSE INSTITUTE OF AGING 11890 FAIRHILL RD CLEVELAND,OH44120	34-0714482	501(C)(3)	30,000	0			COMMUNITY SUPPORT
(59) THE SALVATION ARMY 440 W NYACK RD WEST NYACK,NY10994	13-5562351	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(60) SAINT MARTIN DE PORRES HIGH SCHOOL 6111 LAUSCHE AVE CLEVELAND,OH44103	52-2401852	501(C)(3)	40,268	0			COMMUNITY SUPPORT
(61) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION 9500 EUCLID AVE CLEVELAND,OH44195	34-0714553	501(C)(3)	24,141,960	0			COMMUNITY SUPPORT
(62) THE KHNEMU FOUNDATION 966 E 105TH ST CLEVELAND,OH44108	81-2766763	501(C)(3)	17,250	0			COMMUNITY SUPPORT
(63) THE THORACIC SURGERY FOUNDATION 633 N ST CLAIR ST CHICAGO,IL60611	36-3635910	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(64) TIDES CENTER PO BOX 29907 SAN FRANCISCO,CA94129	94-3213100	501(C)(3)	3,000,000	0			HEALTHCARE RESEARCH & EDUCATION
(65) TRANSPLANT HOUSE OF CLEVELAND 2029 E 115TH ST CLEVELAND,OH44106	27-2834616	501(C)(3)	12,400	0			COMMUNITY SUPPORT
(66) UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND 10011 EUCLID AVE CLEVELAND,OH44106	34-0753561	501(C)(3)	113,382	0			COMMUNITY SUPPORT
(67) LEAD SAFE CLEVELAND COALITION 4600 EUCLID AVE CLEVELAND,OH44103	34-6516654	501(C)(3)	7,000,000	0			COMMUNITY SUPPORT
(68) UNITED WAY OF GREATER CLEVELAND 2930 PROSPECT AVE CLEVELAND,OH44115	34-1011104	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(69) VALUES-IN-ACTION FOUNDATION 6700 BETA DRIVE STE 120 MAYFIELD VILLAGE,OH44143	34-1795459	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(70) YOUTH OPPORTUNITIES UNLIMITED 1361 EUCLID AVE CLEVELAND,OH44115	34-1381135	501(C)(3)	15,000	0			COMMUNITY SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) SCHOLARSHIPS	200	8,889,003
(2) FELLOWSHIPS	1563	83,222,062
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	CCF CONTRIBUTES FINANCIAL AND IN-KIND SUPPORT TO OTHER TAX EXEMPT ORGANIZATIONS AND AGENCIES THAT FURTHER THE CCF MISSION OF PATIENT CARE, RESEARCH, AND EDUCATION. THESE ORGANIZATIONS ARE TO USE THE SUPPORT TO STRENGTHEN THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE.
SCHEDULE I, PART III	THE SCHOLARSHIPS AND FELLOWSHIPS LISTED ARE IN FURTHERANCE OF THE CLEVELAND CLINIC FOUNDATION'S MISSION TO INCREASE KNOWLEDGE, AWARENESS, AND QUALITY OF PATIENT CARE AND RESEARCH THROUGH EDUCATION.

Schedule I (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MIHALJEVIC MD TOMISLAV DIRECTOR, PRESIDENT & CEO	(i) (ii)	6,179,863 ------------- 0	0 ------------- 0	25,572 ------------- 0	30,500 ------------- 0	20,815 ------------- 0	6,256,750 ------------- 0	0 ------------- 0
2BROOKS MD PETER PHYSICIAN (2022 RETIREE)	(i) (ii)	1,104,947 ------------- 0	0 ------------- 0	6,359,474 ------------- 0	-1,640,391 ------------- 0	7,836 ------------- 0	5,831,866 ------------- 0	0 ------------- 0
3DONLEY MD BRIAN CEO, CC LONDON (PART YR)	(i) (ii)	0 ------------- 1,760,415	0 ------------- 0	0 ------------- 2,664,503	0 ------------- 30,500	0 ------------- 23,756	0 ------------- 4,479,174	0 ------------- 0
4ROWAN DAVID SECRETARY, CHIEF GOV OFF & CLO	(i) (ii)	2,229,137 ------------- 0	0 ------------- 0	58,959 ------------- 0	30,500 ------------- 0	17,405 ------------- 0	2,336,001 ------------- 0	0 ------------- 0
5FALCONE MD TOMMASO INTERIM CEO, CCL (PART YR)	(i) (ii)	0 ------------- 507,200	0 ------------- 0	0 ------------- 1,706,727	0 ------------- 30,500	0 ------------- 23,756	0 ------------- 2,268,183	0 ------------- 0
6KOTTKE-MARCHANT MD KANDICE PHYSICIAN (2022 RETIREE)	(i) (ii)	219,857 ------------- 0	0 ------------- 0	2,706,893 ------------- 0	-688,164 ------------- 0	6,047 ------------- 0	2,244,633 ------------- 0	0 ------------- 0
7STREIN STEFAN CHIEF INVESTMENT OFFICER	(i) (ii)	1,982,706 ------------- 0	0 ------------- 0	28,038 ------------- 0	30,500 ------------- 0	18,764 ------------- 0	2,060,008 ------------- 0	0 ------------- 0
8PEACOCK WILLIAM CHIEF OF OPERATIONS	(i) (ii)	1,918,635 ------------- 0	0 ------------- 0	26,970 ------------- 0	29,751 ------------- 0	15,943 ------------- 0	1,991,299 ------------- 0	0 ------------- 0
9SVENSSON MD LARS CHAIR OF HVTI	(i) (ii)	1,810,221 ------------- 0	0 ------------- 0	30,494 ------------- 0	30,500 ------------- 0	21,196 ------------- 0	1,892,411 ------------- 0	0 ------------- 0
10CHANDRA PHD ROHIT CHIEF DIGITAL OFFICER	(i) (ii)	1,768,899 ------------- 0	0 ------------- 0	59,137 ------------- 0	30,500 ------------- 0	20,618 ------------- 0	1,879,154 ------------- 0	0 ------------- 0
11RUGGIERI MD PAUL PHYSICIAN (2022 RETIREE)	(i) (ii)	617,215 ------------- 0	0 ------------- 0	1,827,581 ------------- 0	-688,550 ------------- 0	20,863 ------------- 0	1,777,109 ------------- 0	0 ------------- 0
12DELANEY MD PHD CONOR CEO AND PRESIDENT, CC FLORIDA	(i) (ii)	0 ------------- 1,618,880	0 ------------- 0	0 ------------- 66,504	0 ------------- 30,500	0 ------------- 14,253	0 ------------- 1,730,137	0 ------------- 0
13GLASS STEVEN C CFO & TREASURER (PART YR)	(i) (ii)	1,646,187 ------------- 0	0 ------------- 0	22,371 ------------- 0	13,373 ------------- 0	9,486 ------------- 0	1,691,417 ------------- 0	0 ------------- 0
14SURI MD RAKESH FORMER KEY EMP - CEO CCAD	(i) (ii)	623,237 ------------- 0	0 ------------- 0	1,006,169 ------------- 0	27,729 ------------- 0	17,572 ------------- 0	1,674,707 ------------- 0	955,217 ------------- 0
15HANCOCK DNP RN NE-BC KELLY CHIEF CAREGIVER OFFICER	(i) (ii)	1,563,798 ------------- 0	0 ------------- 0	22,918 ------------- 0	-11,560 ------------- 0	17,618 ------------- 0	1,592,774 ------------- 0	0 ------------- 0
16MERLINO MD JAMES CHIEF CLINICAL TRANSFORMATION OFF	(i) (ii)	1,536,530 ------------- 0	0 ------------- 0	23,958 ------------- 0	30,500 ------------- 0	1,500 ------------- 0	1,592,488 ------------- 0	0 ------------- 0
17GUZMAN MD JORGE CEO CCAD	(i) (ii)	1,120,893 ------------- 0	0 ------------- 0	398,021 ------------- 0	30,500 ------------- 0	17,214 ------------- 0	1,566,628 ------------- 0	0 ------------- 0
18RIDGEWAY MD BERI DIRECTOR, CHIEF OF STAFF	(i) (ii)	1,397,213 ------------- 0	0 ------------- 0	22,314 ------------- 0	30,500 ------------- 0	20,140 ------------- 0	1,470,167 ------------- 0	0 ------------- 0
19SMEDIRA MD MBA NICHOLAS DIRECTOR, PHYSICIAN	(i) (ii)	1,274,820 ------------- 0	0 ------------- 0	27,467 ------------- 0	30,500 ------------- 0	18,771 ------------- 0	1,351,558 ------------- 0	0 ------------- 0
20HELTON ANTHONY INTERIM CFO	(i) (ii)	995,518 ------------- 0	0 ------------- 0	3,680 ------------- 0	23,684 ------------- 0	13,933 ------------- 0	1,036,815 ------------- 0	0 ------------- 0
21SINGH MD RISHI DIRECTOR, PHYSICIAN	(i) (ii)	758,229 ------------- 0	0 ------------- 0	31,960 ------------- 0	30,500 ------------- 0	14,647 ------------- 0	835,336 ------------- 0	0 ------------- 0
22YOUNG MD JAMES P FORMER OFFICER	(i) (ii)	701,810 ------------- 0	0 ------------- 0	22,626 ------------- 0	29,734 ------------- 0	9,447 ------------- 0	763,617 ------------- 0	0 ------------- 0
23DAVIS MARLEINA ASST. SECRETARY	(i) (ii)	647,946 ------------- 0	0 ------------- 0	1,372 ------------- 0	-4,287 ------------- 0	16,103 ------------- 0	661,134 ------------- 0	0 ------------- 0
24KALAYCIO MD MATT DIRECTOR, PHYSICIAN	(i) (ii)	547,445 ------------- 0	0 ------------- 0	25,653 ------------- 0	30,500 ------------- 0	16,733 ------------- 0	620,331 ------------- 0	0 ------------- 0
25LONGVILLE TIMOTHY CAO & CONTROLLER	(i) (ii)	584,696 ------------- 0	0 ------------- 0	12,343 ------------- 0	-106,473 ------------- 0	18,490 ------------- 0	509,056 ------------- 0	0 ------------- 0
26OBLANDER JASON ASST. SECRETARY	(i) (ii)	274,359 ------------- 0	0 ------------- 0	6,789 ------------- 0	5,025 ------------- 0	16,704 ------------- 0	302,877 ------------- 0	0 ------------- 0
27SABANEGH MD EDMUND FORMER OFFICER (RETIRED)	(i) (ii)	0 ------------- 0	0 ------------- 0	162,548 ------------- 0	0 ------------- 0	2,821 ------------- 0	165,369 ------------- 0	162,548 ------------- 0
28COSGROVE MD DELOS FORMER OFFICER (RETIRED CEO)	(i) (ii)	216,197 ------------- 0	0 ------------- 0	501,667 ------------- 0	-565,228 ------------- 0	0 ------------- 0	152,636 ------------- 0	202,433 ------------- 0
29MEEHAN MICHAEL J RECORDING SECRETARY	(i) (ii)	329,426 ------------- 0	0 ------------- 0	36,280 ------------- 0	-261,996 ------------- 0	17,152 ------------- 0	120,862 ------------- 0	0 ------------- 0
30MALONE JR MD DONALD PRES, OHIO HOSPITALS & FHCS	(i) (ii)	1,312,175 ------------- 0	0 ------------- 0	26,022 ------------- 0	-1,511,737 ------------- 0	16,044 ------------- 0	-157,496 ------------- 0	0 ------------- 0
31ERZURUM MD SERPIL CHIEF RESEARCH AND ACADEMIC OFFICER	(i) (ii)	1,322,200 ------------- 0	0 ------------- 0	27,467 ------------- 0	-1,572,691 ------------- 0	1,500 ------------- 0	-221,524 ------------- 0	0 ------------- 0
32WIEDEMANN MD HERBERT FORMER OFFICER (RETIRED)	(i) (ii)	210,113 ------------- 0	0 ------------- 0	0 ------------- 0	-796,066 ------------- 0	0 ------------- 0	-585,953 ------------- 0	210,113 ------------- 0

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

PART I, LINE 1A

LISTED BENEFITS THE BENEFITS CHECKED IN PART I, QUESTION 1A, WERE PROVIDED TO CERTAIN PERSONS LISTED IN FORM 990, PART VII, SECTION A ON AN EXCEPTION BASIS ONLY FOR AN APPROPRIATE BUSINESS PURPOSE. ANY REIMBURSEMENT OF THE EXPENSES LISTED MET CLEVELAND CLINIC'S WRITTEN POLICY REGARDING SUBSTANTIATION AND REIMBURSEMENT. WHERE REQUIRED BY IRS RULES AND REGULATIONS, THE LISTED BENEFITS WERE INCLUDED IN TAXABLE INCOME.

PART I, LINES 4A-B

SCHEDULE J, PART I, LINE 4A, SEVERANCE PAYMENTS: EDMUND SABANEGH, M.D. - $163,556 RAKESH SURI, M.D. - $955,217 SCHEDULE J, PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PETER BROOKS, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $6,333,810 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. KANDICE KOTTKE-MARCHANT, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $2,700,175 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. PETER RUGGIERI, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $1,818,287 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: PETER BROOKS, M.D. - $172,481 DELOS COSGROVE, M.D. - $202,433 KANDICE KOTTKE-MARCHANT, M.D. - $94,400 HERBERT WIEDEMANN, M.D. - $210,113 THE FOLLOWING INDIVIDUALS PARTICIPATE IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND/OR A QUALIFIED DEFINED BENEFIT PLAN AND THE ANNUAL INCREASE OR DECREASE IN THE ACTUARIAL VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: PETER BROOKS, M.D. - $1,670,891 DECREASE, DELOS M. COSGROVE, M.D. - $565,228 DECREASE, MARLEINA DAVIS - $34,787 DECREASE, SERPIL ERZURUM, M.D. - $1,603,191 DECREASE, STEVEN C. GLASS - $17,127 DECREASE, KELLY HANCOCK, DNP, R.N., NE-BC - $42,060 DECREASE, KANDICE KOTTKE-MARCHANT, M.D. - $701,357 DECREASE, TIMOTHY LONGVILLE - $136,973 DECREASE, DONALD MALONE, M.D. - $1,542,237 DECREASE, MICHAEL J. MEEHAN - $292,497 DECREASE, JASON OBLANDER - $3,375 DECREASE, WILLIAM PEACOCK $749 DECREASE, PAUL RUGGIERI, M.D. - $719,050 DECREASE, AND HERBERT WIEDEMANN, M.D. - $796,066 DECREASE. FORM 990, PART VII, SECTION A AND SCHEDULE J THE COMPENSATION OF DR. BRIAN DONLEY, DR. TOMMASO FALCONE, AND DR. JORGE GUZMAN AS REPORTED ON PART VII, SECTION A AND SCHEDULE J INCLUDES REGULAR WAGES AND TAXABLE EXPATRIATE BENEFITS.

Schedule J (Form 990) 2022

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number
34-0714585

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756AJ37	10-15-2008	670,000,000	BOND 2008B: REFUND 06A, 04A, AND 01A; FACILITY IMPROVEMENTS		X		X		X
B	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	11-02-2011	41,120,000	BOND 2011B: REFUND 1992A & B AND 1989 SERIES		X		X		X
C	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756DAY2	05-29-2013	309,434,914	BOND 2013: REFUND 2004B, 2003A AND FACILITY IMPROVEMENTS		X		X		X
D	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	12-21-2017	9,305,000	BOND 2017C: REFUND SERIES 2002		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KS0	08-29-2017	939,576,748	BOND 2017A: REFUND 2008A, 2008B, 2009A, 2009B, 2012A		X		X		X
	MARTIN COUNTY HEALTH FACILITIES AUTHORITY	59-6000743	573903FZ9	05-09-2019	259,345,371	BOND 2019AREFINANCE 2012, 2012B & 2015 MHS BONDS & ACQUIRE MEMBERSHIP IN MHS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756CDN5	05-09-2019	351,450,108	BOND 2019BC: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KZ4	05-09-2019	380,150,000	BOND 2019DEF: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561LP5	07-28-2021	82,791,709	BOND 2021A: ACQUIRE MEMBERSHIP IN MERCY HOSPITAL		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MG4	10-05-2021	249,692,662	BOND 2021B: REFUND SERIES 2011A		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		21,125,000		72,270,592		2,115,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,914		9,305,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			2,302,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,200,000		735,249		2,129,301		1,262,472
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	324,315,217		257,297,825		20,001,498		378,404,897
11 Other spent proceeds .............	372,706,929		38,082,286		287,304,115		9,305,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2008		2011		2013		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.460 %		0.070 %		0.120 %		1.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.010 %		0.060 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.470 %		0.130 %		0.120 %		1.510 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X	X			X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference

Explanation

DATE REBATE COMPUTATION PERFORMED

ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 10/15/2018 ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 11/02/2016 ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 05/29/2018 ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/21/2022 ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 08/28/2022

Schedule K (Form 990) 2021

Additional Data

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Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number
34-0714585

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756AJ37	10-15-2008	670,000,000	BOND 2008B: REFUND 06A, 04A, AND 01A; FACILITY IMPROVEMENTS		X		X		X
B	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	11-02-2011	41,120,000	BOND 2011B: REFUND 1992A & B AND 1989 SERIES		X		X		X
C	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756DAY2	05-29-2013	309,434,914	BOND 2013: REFUND 2004B, 2003A AND FACILITY IMPROVEMENTS		X		X		X
D	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	12-21-2017	9,305,000	BOND 2017C: REFUND SERIES 2002		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KS0	08-29-2017	939,576,748	BOND 2017A: REFUND 2008A, 2008B, 2009A, 2009B, 2012A		X		X		X
	MARTIN COUNTY HEALTH FACILITIES AUTHORITY	59-6000743	573903FZ9	05-09-2019	259,345,371	BOND 2019AREFINANCE 2012, 2012B & 2015 MHS BONDS & ACQUIRE MEMBERSHIP IN MHS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756CDN5	05-09-2019	351,450,108	BOND 2019BC: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KZ4	05-09-2019	380,150,000	BOND 2019DEF: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561LP5	07-28-2021	82,791,709	BOND 2021A: ACQUIRE MEMBERSHIP IN MERCY HOSPITAL		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MG4	10-05-2021	249,692,662	BOND 2021B: REFUND SERIES 2011A		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		21,125,000		72,270,592		2,115,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,914		9,305,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			2,302,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,200,000		735,249		2,129,301		1,262,472
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	324,315,217		257,297,825		20,001,498		378,404,897
11 Other spent proceeds .............	372,706,929		38,082,286		287,304,115		9,305,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2008		2011		2013		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.460 %		0.070 %		0.120 %		1.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.010 %		0.060 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.470 %		0.130 %		0.120 %		1.510 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X	X			X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference

Explanation

DATE REBATE COMPUTATION PERFORMED

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
THE CLEVELAND CLINIC FOUNDATION

Employer identification number
34-0714585

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756AJ37	10-15-2008	670,000,000	BOND 2008B: REFUND 06A, 04A, AND 01A; FACILITY IMPROVEMENTS		X		X		X
B	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	11-02-2011	41,120,000	BOND 2011B: REFUND 1992A & B AND 1989 SERIES		X		X		X
C	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756DAY2	05-29-2013	309,434,914	BOND 2013: REFUND 2004B, 2003A AND FACILITY IMPROVEMENTS		X		X		X
D	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	NONEAVAIL	12-21-2017	9,305,000	BOND 2017C: REFUND SERIES 2002		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KS0	08-29-2017	939,576,748	BOND 2017A: REFUND 2008A, 2008B, 2009A, 2009B, 2012A		X		X		X
	MARTIN COUNTY HEALTH FACILITIES AUTHORITY	59-6000743	573903FZ9	05-09-2019	259,345,371	BOND 2019AREFINANCE 2012, 2012B & 2015 MHS BONDS & ACQUIRE MEMBERSHIP IN MHS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756CDN5	05-09-2019	351,450,108	BOND 2019BC: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561KZ4	05-09-2019	380,150,000	BOND 2019DEF: FUND CAPITAL PROJECTS		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561LP5	07-28-2021	82,791,709	BOND 2021A: ACQUIRE MEMBERSHIP IN MERCY HOSPITAL		X		X		X
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MG4	10-05-2021	249,692,662	BOND 2021B: REFUND SERIES 2011A		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		21,125,000		72,270,592		2,115,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,914		9,305,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			2,302,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,200,000		735,249		2,129,301		1,262,472
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	324,315,217		257,297,825		20,001,498		378,404,897
11 Other spent proceeds .............	372,706,929		38,082,286		287,304,115		9,305,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2008		2011		2013		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.460 %		0.070 %		0.120 %		1.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.010 %		0.060 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.470 %		0.130 %		0.120 %		1.510 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X	X			X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference

Explanation

DATE REBATE COMPUTATION PERFORMED

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) GRANT DILLON	FAMILY MEMBER OF WILLIAM PEACOCK, CCF OFFICER	10,408	EMPLOYMENT AGREEMENT WITH CCF		No
(2) JOANNE MCDONALD KILBANE	FAMILY MEMBER OF CATHERINE KILBANE, CCF DIRECTOR	89,874	EMPLOYMENT AGREEMENT WITH CCF		No
(3) LAURA SWEENEY	FAMILY MEMBER OF TIMOTHY LONGVILLE, CCF OFFICER	107,153	EMPLOYMENT AGREEMENT WITH CCF		No
(4) MICHAEL PETRAS	FAMILY MEMBER OF MICHAEL PETRAS, JR., CCF DIRECTOR AND OFFICER	48,501	EMPLOYMENT AGREEMENT WITH CCF		No
(5) RYAN OAKEY	FAMILY MEMBER OF WILLIAM PEACOCK, CCF OFFICER	78,072	EMPLOYMENT AGREEMENT WITH CCF		No
(6) VICTORIA JAVOR	FAMILY MEMBER OF KELLY HANCOCK, DNP, RN, NE-BC, CCF OFFICER	99,996	EMPLOYMENT AGREEMENT WITH CCF		No
(7) ROBERT SYTO	FAMILY MEMBER OF BERI RIDGEWAY, M.D., CCF OFFICER AND DIRECTOR	58,774	EMPLOYMENT AGREEMENT WITH CCF		No
(8) AMANDA HANCOCK	FAMILY MEMBER OF KELLY HANCOCK, DNP, RN, NE-BC, CCF OFFICER	34,197	EMPLOYMENT AGREEMENT WITH CCF		No
(9) AMY MERLINO	FAMILY MEMBER OF JAMES MERLINO, M.D., CCF OFFICER	582,917	EMPLOYMENT AGREEMENT WITH CCF		No
(10) ADRIENNE DELANEY	FAMILY MEMBER OF CONOR DELANEY, M.D., PH.D.,CCF OFFICER	32,156	EMPLOYMENT AGREEMENT WITH CCF		No
(11) JIM HALLORAN	FAMILY MEMBER OF KELLY HANCOCK, DNP, RN, NE-BC, CCF OFFICER	18,228	EMPLOYMENT AGREEMENT WITH CCF		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	3	30,970	APPRAISAL
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		73,056	SALE COMPARABLE GOODS
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	104	14,743,496	AVERAGE HIGH/LOW
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	2	654	COST
20 Drugs and medical supplies .	X	6	524,655	COST
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( EVENT TICKETS )	X	1	12,750	COST
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 32B:	THE CLEVELAND CLINIC FOUNDATION WILL AT TIMES HIRE INDEPENDENT THIRD PARTIES TO SELL CERTAIN NON-CASH CONTRIBUTIONS SUCH AS AUCTION ITEMS OR REAL ESTATE.

Schedule M (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Return Reference	Explanation
FORM 990, PART III, PROGRAM SERVICE STATEMENT	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. CLEVELAND CLINIC WAS ESTABLISHED IN 1921. WHEN THE CLINIC CELEBRATED ITS CENTENNIAL YEAR A NEW MISSION STATEMENT WAS UNVEILED: CARING FOR LIFE, RESEARCHING FOR HEALTH AND EDUCATING THOSE WHO SERVE. THE NEW MISSION STATEMENT STAYS TRUE TO THE PAST, ENCOMPASSES THE PRESENT, AND OUTLINES THE FUTURE OF THE ORGANIZATION. 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 CLEVELAND CLINIC HEALTH SYSTEM FULFILLS ITS CHARITABLE PURPOSES, BUT RATHER IS A SUMMARY OF ITS PRIMARY PROGRAM SERVICES AND CONTRIBUTIONS TO THE COMMUNITY. THE CLEVELAND CLINIC HEALTH SYSTEM DEFINES AND MEASURES COMMUNITY BENEFIT (INCLUDING FINANCIAL ASSISTANCE) USING THE CATHOLIC HEALTH ASSOCIATION ("CHA") COMMUNITY BENEFIT MODEL, WHICH RECOMMENDS REPORTING FINANCIAL ASSISTANCE ON A COST BASIS. USING THIS MODEL, IN 2022 CLEVELAND CLINIC AND ITS AFFILIATES PROVIDED $1.42 BILLION IN BENEFITS TO THE COMMUNITIES SERVED. THE COMMUNITY BENEFIT THAT THE CLEVELAND CLINIC HEALTH 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 CLEVELANDCLINIC.ORG. (COMMUNITY BENEFIT AMOUNTS REPORTED IN THIS PROGRAM SERVICE STATEMENT REFER TO THE CLEVELAND CLINIC'S 2022 COMMUNITY CONNECTIONS, BASED ON THE CHA REPORTING METHODOLOGY.) COVID-19 ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DECLARED THE NOVEL CORONAVIRUS DISEASE (COVID-19) OUTBREAK A GLOBAL PANDEMIC. THE GOVERNORS OF OHIO AND FLORIDA DECLARED A STATE OF EMERGENCY FOR THEIR RESPECTIVE STATES RELATED TO THE COVID-19 OUTBREAK ON MARCH 9, 2020, AND A NATIONAL STATE OF EMERGENCY IN THE U.S. WAS DECLARED ON MARCH 13, 2020. THE SYSTEM HAS ENGAGED IN VARIOUS COMMUNITY HEALTH IMPROVEMENT INITIATIVES INCLUDING: HEALTH EDUCATION AND CLINICAL SERVICES FOR COMMUNITY RESIDENTS REGARDING VIRUS IMPACT, TESTING, AND VACCINE DISTRIBUTION IN NEIGHBORHOODS, WELLNESS INITIATIVES TO RESIDENTS, SCHOOLS, AND COMMUNITY BASED ORGANIZATIONS IN THE AREAS OF DISEASE PREVENTION, DONATIONS OF PERSONAL PROTECTIVE EQUIPMENT TO COMMUNITY BASED ORGANIZATIONS SUPPORTED SAFETY ISSUES, AND ADMINSTRATION OF COVID-19 VACCINES IN UNDERSERVED AREAS AND COMMUNITIES WITH MINORITY POPULATIONS AND LARGE NUMBERS OF RESIDENTS AGED 60 YEARS OR OLDER TO HELP ADDRESS HEALTH DISPARITIES. I. PATIENT CARE THE CLEVELAND CLINIC HEALTH SYSTEM (SYSTEM) IS A WORLD-RENOWNED PROVIDER OF HEALTHCARE SERVICES THAT ATTRACTED PATIENTS FROM ACROSS THE UNITED STATES AND FROM 131 OTHER COUNTRIES IN 2022. AS OF DECEMBER 31, 2022, THE SYSTEM OPERATES 20 HOSPITALS AND IS THE LEADING PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST OHIO. FOURTEEN OF THE HOSPITALS ARE OPERATED IN THE NORTHEAST OHIO AREA, ANCHORED BY THE CLEVELAND CLINIC FOUNDATION. THE SYSTEM OPERATES 21 OUTPATIENT FAMILY HEALTH CENTERS, 9 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. IN MARCH 2022, CLEVELAND CLINIC LONDON HOSPITAL OPENED FOR PATIENTS. 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 MUBADALA DEVELOPMENT COMPANY'S NETWORK OF HEALTHCARE FACILITIES LOCATED IN ABU DHABI, UNITED ARAB EMIRATES. CLEVELAND CLINIC HEALTH 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 2022, CLEVELAND CLINIC RECORDED 1,298 TOTAL STAFFED BEDS, 115,829 EMERGENCY VISITS, 81,924 SURGICAL CASES, 50,840 ADMISSIONS, AND MORE THAN 12.8 MILLION TOTAL CLINIC VISITS. IT IS THE POLICY OF CLEVELAND CLINIC HEALTH SYSTEM TO TREAT ALL PATIENTS WITH COMPASSION, DIGNITY AND RESPECT, REGARDLESS OF THEIR RACE, CREED, OR ABILITY TO PAY. CLEVELAND CLINIC'S PATIENT CARE SERVICES ARE PROVIDED VIA PATIENT-ORIENTED INSTITUTES, WHICH ARE STRUCTURED ON THE BASIS OF ORGAN SYSTEM OR DISEASE. THE INSTITUTES FACILITATE A MULTIDISCIPLINARY APPROACH, AND ARE DESIGNED TO ENHANCE CONVENIENCE FOR PATIENTS AND THE EXCHANGE OF KNOWLEDGE, RESEARCH AND EDUCATIONAL COLLABORATION FOR BETTER PATIENT OUTCOMES. SOME OF THE INSTITUTES ARE: ANESTHESIOLOGY & PAIN MANAGEMENT; BARIATRIC & METABOLIC; CANCER CENTER/TAUSSIG CANCER; CLEVELAND CLINIC CHILDREN'S AND PEDIATRIC INSTITUTE, COMMUNITY CARE; DERMATOLOGY & PLASTIC SURGERY INSTITUTE; DIGESTIVE DISEASE & SURGERY INSTITUTE; EMERGENCY SERVICES INSTITUTE; ENDOCRINOLOGY & METABOLISM INSTITUTE; EYE INSTITUTE (COLE); GENOMICS; HEAD & NECK INSTITUTE; HEART, VASCULAR & THORACIC INSTITUTE (SYDELL AND ARNOLD MILLER FAMILY); IMAGING INSTITUTE; NEUROLOGICAL INSTITUTE; NURSING INSTITUTE (STANLEY SHALOM ZIELONY); OB/GYN & WOMEN'S HEALTH INSTITUTE; ORTHOPAEDIC & RHEUMATOLOGIC INSTITUTE; PATHOLOGY & LABORATORY MEDICINE; RESPIRATORY INSTITUTE; AND UROLOGY & KIDNEY INSTITUTE (GLICKMAN); WELLNESS & PREVENTIVE MEDICINE. NOTABLE ACHIEVEMENTS CLEVELAND CLINIC WAS AGAIN RECOGNIZED FOR ITS QUALITY OF CARE IN U.S. NEWS & WORLD REPORT'S PRESTIGIOUS ANNUAL AMERICA'S BEST HOSPITALS SURVEY IN 2022. OVERALL, CLEVELAND CLINIC WAS AMONG THE NATION'S BEST HOSPITALS, EARNING THE NO. 4 RANKING. FOR THE 28TH CONSECUTIVE YEAR, CLEVELAND CLINIC RANKED BEST IN THE NATION FOR CARDIOLOGY AND HEART SURGERY, EARNING THE NO. 1 SPOT. 11 CLEVELAND CLINIC SPECIALTIES ALSO RANKED IN THE TOP 10. OF THESE, SIX PLACED IN THE TOP 5 INCLUDING: CARDIOLOGY & HEART SURGERY; UROLOGY; GASTROENTEROLOGY & GASTROINTESTINAL SURGERY; RHEUMATOLOGY; GERIATRICS & GYNECOLOGY. CLEVELAND CLINIC WAS NATIONALLY RANKED IN 13 ADULT SPECIALTIES AND 9 CHILDREN'S SPECIALTIES. CLEVELAND CLINIC WAS ALSO RATED HIGH PERFORMING IN EIGHTEEN PROCEDURES AND CONDITIONS. CLEVELAND CLINIC HAS ACHIEVED THE DISTINGUISHED MAGNET RECOGNITION. MAGNET STATUS IS THE HIGHEST NATIONAL RECOGNITION AWARDED TO A HOSPITAL OR MEDICAL CENTER FOR EXCELLENCE IN NURSING. AMERICAN NURSES CREDENTIALING CENTER, A SUBSIDIARY OF THE AMERICAN NURSES ASSOCIATION, GRANTS MAGNET STATUS WHEN A HEALTHCARE ORGANIZATION REFLECTS NURSING PROFESSIONALISM, TEAMWORK AND SUPERIORITY IN PATIENT CARE. FEWER THAN 400 OF THE COUNTRY'S 6,000-PLUS HOSPITALS HAVE EARNED THIS PRESTIGIOUS HONOR. FOR THE TWELFTH TIME IN THE PAST 14 YEARS, CLEVELAND CLINIC HAS BEEN RECOGNIZED AS ONE OF THE WORLD'S MOST ETHICAL COMPANIES. CLEVELAND CLINIC IS ONE OF JUST FIVE HEALTHCARE PROVIDERS WORLDWIDE ON THE 2022 LIST BY THE ETHISPHERE INSTITUTE, WHICH DESCRIBES ITSELF AS "ADVANCING THE STANDARDS OF ETHICAL BUSINESS PRACTICES THAT FUEL CORPORATE CHARACTER, MARKETPLACE TRUST AND BUSINESS SUCCESS".
FORM 990, PART III, PROGRAM SERVICE STATEMENT (CONTINUED)	CLEVELAND CLINIC RECEIVED THE ENVIRONMENTAL EXCELLENCE AWARD FROM PRACTICE GREENHEALTH. PRACTICE GREENHEALTH RECOGNIZES ORGANIZATIONS WITHIN THE HEALTHCARE SECTOR THAT SUPPORT AND CREATE BETTER, SAFER, AND GREENER WORKPLACES AND COMMUNITIES. IN 2022, CLEVELAND CLINIC AND ITS FACILITIES RECEIVED: THE TOP 25 ENVIRONMENTAL EXCELLENCE AWARD, THE CIRCLE OF EXCELLENCE AWARD AND THE GREENING THE OR RECOGNITION AWARD. THESE AWARDS RECOGNIZE SUPERIOR PERFORMANCE IN ENVIRONMENTAL SUSTAINABILITY, COVERING A RANGE OF DIFFERENT SUSTAINABILITY PROGRAMS AND ACTIVITIES. WINNERS HAVE ALSO MADE SUBSTANTIVE PROGRESS ON MERCURY ELIMINATION. FINANCIAL ASSISTANCE THE CLEVELAND CLINIC FINANCIAL ASSISTANCE PROGRAM REPRESENTS THE COST OF PROVIDING FREE OR DISCOUNTED MEDICALLY NECESSARY OR EMERGENCY CARE TO PATIENTS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS. THE SYSTEM'S FINANCIAL ASSISTANCE POLICY PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED PATIENTS WITH INCOMES UP TO 400 PERCENT OF THE FEDERAL POVERTY LEVEL AND WHO MEET CERTAIN OTHER ELIGIBILITY CRITERIA BY STATE. THIS POLICY COVERS BOTH HOSPITAL CARE AND SERVICES PROVIDED BY THE SYSTEM'S EMPLOYED PHYSICIANS. PATIENTS WITH SPECIAL MEDICAL OR EXCEPTIONAL CIRCUMSTANCES MAY ALSO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY IS DESIGNED TO PREVENT MEDICAL BILLS FROM CAUSING A PATIENT OR FAMILY UNDUE FINANCIAL HARDSHIP. THE CLEVELAND CLINIC HEALTH SYSTEM PROVIDED FINANCIAL ASSISTANCE AT A COST OF $210.8 MILLION IN 2022. II. RESEARCH CLEVELAND CLINIC'S MISSION INCLUDES CONDUCTING RESEARCH TO ADVANCE BIOMEDICAL SCIENCE AND ULTIMATELY IMPROVE PATIENT CARE, PREVENT DISEASE, AND FIND CURES FOR MEDICAL ISSUES. THE CLEVELAND CLINIC HEALTH SYSTEM'S RESEARCH ACTIVITIES ARE INTENDED TO IMPROVE PATIENT CARE AND THE HEALTH OF THE PUBLIC AT LARGE, BY PROVIDING THE LATEST ADVANCES IN MEDICINE DIRECTLY TO PATIENTS AND BY REFINING THE PRACTICE OF MEDICINE THROUGH THE DEVELOPMENT AND PROMULGATION OF NEW TECHNIQUES, DEVICES, AND TREATMENT PROTOCOLS. CLEVELAND CLINIC'S LERNER RESEARCH INSTITUTE ("LRI") IS ITS RESEARCH INSTITUTE LOCATED ON THE MAIN CAMPUS AND HOME TO A COMPLETE SPECTRUM OF LABORATORY-, TRANSLATIONAL-, AND CLINICAL-BASED RESEARCH. LRI HAS APPROXIMATELY 237 FACULTY-LEVEL SCIENTISTS ORGANIZED IN THE FOLLOWING DEPARTMENTS: BIOMEDICAL ENGINEERING, CANCER BIOLOGY, CARDIOVASCULAR AND METABOLIC SCIENCES, COMPUTATIONAL LIFE SCIENCES, GENOMIC MEDICINE, IMMUNOTHERAPY & PRECISION IMMUNO-ONCOLOGY, INFECTION BIOLOGY, INFLAMMATION AND IMMUNITY, NEUROSCIENCES, OPHTHALMIC RESEARCH, QUANTITATIVE HEALTH SCIENCES, AND TRANSLATIONAL HEMATOLOGY AND ONCOLOGY RESEARCH. LRI IS ONE OF THE LEADING NIH-FUNDED RESEARCH INSTITUTES IN THE UNITED STATES AND HAS SPEARHEADED NUMEROUS ADVANCES IN THE DIAGNOSIS AND TREATMENT OF COMPLEX MEDICAL PROBLEMS. SCIENTISTS AND THEIR TEAMS ARE PURSUING A WIDE RANGE OF BIOMEDICAL QUESTIONS AT LRI, INCLUDING THOSE RELATED TO CARDIOVASCULAR, CANCER, NEUROLOGICAL, MUSCULOSKELETAL, AND METABOLIC DISEASES. ALTOGETHER, NEARLY 1,700 SCIENTISTS AND SUPPORT PERSONNEL WORK AT LRI. THIS INCLUDES APPROXIMATELY 268 RESEARCH FELLOWS, 162 GRADUATE STUDENTS AND 146 UNDERGRADUATE STUDENTS. IN ADDITION TO BASIC PRE-CLINICAL RESEARCH, THE CLEVELAND CLINIC, ITS AFFILIATES, AND EMPLOYED PHYSICIANS PARTICIPATE OR ARE PRIMARY INVESTIGATORS IN MANY CLINICAL TRIALS. IN 2022, CLEVELAND CLINIC WAS INVOLVED IN APPROXIMATELY 3,600 ACTIVE INSTITUTIONAL REVIEW BOARD APPROVED HUMAN SUBJECTS' RESEARCH STUDIES. THE ONGOING COLLABORATION BETWEEN PHYSICIAN INVESTIGATORS AND STUDY VOLUNTEERS IS CENTRAL TO TESTING THE SAFETY AND EFFECTIVENESS OF DRUGS AND MEDICAL PROCEDURES AND HELPS TO SET THE STANDARDS FOR PATIENT CARE. RESEARCH AT CLEVELAND CLINIC IS FUNDED BY EXTERNAL SOURCES, SUCH AS FEDERAL GRANTS, BUT IS ALSO SUBSTANTIALLY SUPPORTED BY THE CLINIC'S OWN INTERNAL RESOURCES. IN 2022, CLEVELAND CLINIC PROVIDED COMMUNITY BENEFIT IN RESEARCH AT A SUBSIDIZED COST OF MORE THAN $129 MILLION, WHICH INCLUDED EXTERNALLY- SPONSORED FUNDING OF $227.6 MILLION. 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. CLEVELAND CLINIC HEALTH SYSTEM DEVOTES SUBSTANTIAL RESOURCES TO EDUCATION PROGRAMS, WHICH, IN 2022, PROVIDED A NET COMMUNITY BENEFIT OF $338.2 MILLION. THESE EDUCATIONAL ACTIVITIES ENSURE RESIDENTS AND PATIENTS IN ALL OF THE CLEVELAND CLINIC HEALTH SYSTEM'S COMMUNITIES ARE RECEIVING 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 2022, 1,101 RESIDENTS AND FELLOWS TRAINED IN 84 ACCREDITED TRAINING PROGRAMS, APPROVED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), INCLUDING 149 ADVANCED FELLOWS IN 90 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 1,687 APPLICANTS FOR 32 POSITIONS FOR THE 2022-23 ACADEMIC YEAR. THE PROGRAM'S STUDENTS HAVE MATCHED AT SOME OF THE MOST PRESTIGIOUS HOSPITALS THROUGHOUT THE UNITED STATES AND HAVE CONTRIBUTED 143 PUBLICATIONS TO THE WORLD'S STORE OF SCIENTIFIC KNOWLEDGE BASED ON 2022 CALENDAR YEAR (WHICH INCLUDES PUBLISHED ARTICLES AND ABSTRACT SUBMISSIONS), AND 30 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 2022, 230 MEDICAL STUDENTS FROM 118 MEDICAL SCHOOLS AROUND THE WORLD ROTATED THROUGH CLEVELAND CLINIC. -CENTER FOR CONTINUING EDUCATION: CLEVELAND CLINIC MAINTAINS ONE OF THE LARGEST CONTINUING MEDICAL EDUCATION (CME) PROGRAMS IN THE COUNTRY AND ENJOYS THE HIGHEST ACCME RANKING: ACCREDITATION WITH COMMENDATION. IN 2022, THE CENTER FOR CONTINUING EDUCATION CERTIFIED 2,327 CME ACTIVITIES THAT OFFERED OVER 12,986 CME CREDITS TO 394,938 PARTICIPANTS. OF THAT NUMBER, 1,561 WERE LIVE COURSES THAT ATTRACTED 124,447 PARTICIPANTS. CLEVELAND CLINIC IS ONE OF THE LARGEST PROVIDERS OF ONLINE CME AMONG THE NATION'S ACADEMIC MEDICAL CENTERS. THE CENTER'S WEBSITE HAD 718 ACTIVITIES THAT ATTRACTED 2,544,522 ACTIVITY VIEWERS. JOURNAL CME CONTINUES TO REACH A LARGE NUMBER OF LEARNERS, AWARDING MORE THAN 29,300 CERTIFICATES TO CLEVELAND CLINIC JOURNAL OF MEDICINE (CCJM) PARTICIPANTS. IN 2022, THE CENTER ISSUED 394,938 CERTIFICATES FOR ALL ACTIVITIES COMBINED. -THE CCJM ENJOYED A CIRCULATION OF MORE THAN 128,725 COPIES AND RANKED NO. 2 IN READERSHIP AMONG JOURNALS DIRECTED TO OFFICE-BASED INTERNISTS AND CARDIOLOGISTS. EACH YEAR, THE PRINT AND ONLINE VERSIONS ARE READ OR ACCESSED BY APPROXIMATELY 3.3 MILLION PEOPLE AROUND THE WORLD. IN 2022, THE CCJM WEBSITE RECORDED 4,675,274 PAGE VIEWS FROM 5,668,522 UNIQUE VISITORS. -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 CLEVELAND CLINIC HEALTH SYSTEM CURRENTLY OFFERS 15 IN-HOUSE ALLIED HEALTH PROGRAMS AND HAS 39 AFFILIATED PROGRAMS WITH REGIONAL ACADEMIC INSTITUTIONS. IN 2022, CLEVELAND CLINIC HEALTH SYSTEM HOSTED MORE THAN 368,702 CLINICAL ROTATION HOURS FOR OVER 952 HEALTH SCIENCE STUDENTS. -CENTER FOR INTERNATIONAL MEDICAL EDUCATION: THE CENTER FOR INTERNATIONAL MEDICAL EDUCATION (CIME) IS RESPONSIBLE FOR COORDINATING CLEVELAND CLINIC'S INTERNATIONAL EDUCATIONAL INITIATIVES AND FOR ENSURING THE PROVISION OF HIGH QUALITY EDUCATIONAL EXPERIENCES FOR THE GLOBAL MEDICAL COMMUNITY. IV. ADDITIONAL COMMUNITY BENEFIT PATIENT CARE PROVIDED ON A CHARITABLE BASIS, RESEARCH, AND EDUCATION DESCRIBED ABOVE ARE INTEGRAL COMPONENTS OF THE COMMUNITY BENEFIT THE CLEVELAND CLINIC HEALTH SYSTEM ANNUALLY REPORTS TO THE COMMUNITY. THE OTHER COMPONENTS OF THE CLEVELAND CLINIC'S COMMUNITY BENEFIT ARE:
FORM 990, PART III, PROGRAM SERVICE STATEMENT (CONTINUED)	MEDICAID SHORTFALL THE CLEVELAND CLINIC HEALTH SYSTEM IS A LEADING PROVIDER OF MEDICAID SERVICES IN OHIO. IN MANY STATES, INCLUDING OHIO, MEDICAID PAYMENTS HAVE NOT BEEN SUFFICIENT TO COVER THE COST OF TREATING MEDICAID BENEFICIARIES. IN 2022, THE HEALTH SYSTEM'S UNPAID MEDICAID COSTS WERE $615 MILLION (THIS FIGURE INCLUDES AS HCAP ASSESSMENT OF $6.7 MILLION). SUBSIDIZED HEALTH SERVICES IN ADDITION TO FINANCIAL ASSISTANCE AND COSTS NOT COVERED BY MEDICAID PAYMENTS, ANOTHER CLINICAL COMMUNITY BENEFIT CATEGORY IS "SUBSIDIZED HEALTH SERVICES." THESE SERVICES YIELD LOW OR NEGATIVE MARGINS BUT ARE NEEDED IN THE COMMUNITY. CLEVELAND CLINIC PROVIDED SUBSIDIZED HEALTH SERVICES IN 2022 AT A COST OF $57.8 MILLION. COMMUNITY OUTREACH PROGRAMS THE CLEVELAND CLINIC HEALTH SYSTEM IS ACTIVELY ENGAGED IN A BROAD ARRAY OF COMMUNITY OUTREACH PROGRAMS, PROVIDING OR CONTRIBUTING TO OUTREACH ACTIVITIES FOR A TOTAL NET COMMUNITY BENEFIT OF $68.7 MILLION, PARTIALLY OFFSET BY EXTERNAL FUNDING. THESE PROGRAMS ARE DESIGNED TO SERVE THE VULNERABLE AND AT-RISK POPULATIONS, AS WELL AS BROADER POPULATION IN OUR COMMUNITIES. OUR RESPONSIVE OUTREACH PROGRAMS RANGE FROM FREE WELLNESS INITIATIVES, HEALTH SCREENINGS, CLINICAL SERVICES, EDUCATION, AND YOUTH WORKFORCE DEVELOPMENT TO ENROLLMENT ASSISTANCE FOR GOVERNMENT-FUNDED HEALTH PROGRAMS. OUTREACH PROGRAMS ADDRESS DOCUMENTED HEALTH NEEDS OF OUR COMMUNITIES, ALIGN WITH OUR COMMUNITY HEALTH NEEDS ASSESSMENTS AND FALL INTO THREE MAIN CATEGORIES: COMMUNITY HEALTH SERVICES, CASH AND IN-KIND DONATIONS, AND COMMUNITY BUILDING. IN 2022, SOME HIGHLIGHTS INCLUDED: -PLEDGED $50 MILLION IN JANUARY 2022 TO LEAD SAFE CLEVELAND COALITION, IN ADDITION TO THE PREVIOUSLY COMMITTED $2.5 MILLION TO ADVANCE LEAD POISONING PREVENTION EFFORTS WITH UNITED WAY. THE FIVE-YEAR FINANCIAL COMMITTMENT WILL HELP SUPPORT THE COLLABORATION TO REMOVE HARMFUL SOURCES OF LEAD EXPOSURE FROM LOCAL HOMES. -HEALTH EDUCATION AND CLINICAL SERVICES FOR COMMUNITY RESIDENTS ON COVID-19 IMPACT AND TESTING. ESTABLISHED COVID-19 VACCINATION CLINIC TO HELP ENSURE THAT THOSE WHO ARE AT HIGHER RISK OF INFECTION AND DEATH FROM THE VIRUS INCLUDING BLACK, HISPANIC AND UNDERSERVED COMMUNITIES HAVE ACCESS TO THE VACCINE. INCLUDED PARTNERSHIPS WITH HEALTH DEPARTMENTS AND COMMUNITY BASED ORGANIZATIONS. -FAITH BASED FORUMS FOR KEY COMMUNITY LEADERS ON COVID-19 EDUCATION AND ACCESS. -WELLNESS INITIATIVES TO RESIDENTS, SCHOOLS AND COMMUNITY BASED ORGANIZATIONS IN THE AREAS OF DISEASE PREVENTION, INCLUDING COVID-19 PROTOCOL, PERSONAL SAFETY, BEHAVIORAL HEALTH, STRESS MANAGEMENT, NUTRITION IMPROVEMENT AND EXERCISE. -COMMUNITY FARMERS MARKETS, URBAN GARDENS AND A MOBILE FOOD PANTRY PROVIDED ACCESS TO FRESH LOCAL PRODUCTS AND SUPPLEMENTAL FOOD PROGRAMS TO ADDRESS FOOD INSECURITY ISSUES. -NO-COST CLINICAL CARE TO UNDER- AND UNINSURED FAMILIES AT COMMUNITY SITES, INCLUDING LANGSTON HUGHES HEALTH & EDUCATION CENTER IN THE FAIRFAX NEIGHBORHOOD. CARE INCLUDES MULTIGENERATIONAL WELLNESS CLASSES, CANCER SCREENING AND CHRONIC DISEASE MANAGEMENT SERVICES. -COLLABORATIVE INITIATIVES WITH COMMUNITY NONPROFIT ORGANIZATIONS AND LOCAL GOVERNMENTS ADDRESSED CRITICAL POPULATION ISSUES. TASKFORCE STRATEGIES FOCUSED ON DECREASING OPIOID PRESCRIPTIONS USE AND OVERDOSE DEATHS. PROVIDED METHODS TO DECREASE INFANT MORTALITY INCLUDING PROACTIVE CENTERING PROGRAMS. -WORKFORCE DEVELOPMENT PROGRAMS TO MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS TO ENHANCE GRADUATION RATES, PURSUE SECONDARY EDUCATION AND OBTAIN EMPLOYMENT. -PARTNERSHIP WITH CITY OF CLEVELAND, MEIJER, FAIRFAX RENAISSANCE DEVELOPMENT CORPORATION AND FAIRMOUNT PROPERTIES ON A $52.8 MILLION DEVELOPMENT THAT WILL INCLUDE A NEW 40,000-SQUARE-FOOT GROCERY MARKET AND 196 APARTMENT UNITS IN THE FAIRFAX NEIGHBORHOOD OF CLEVELAND. -AMONG 12 U.S. HEALTH SYSTEMS TO SIGN THE "IMPACT PURCHASING COMMITMENT," DESIGNED BY THE HEALTHCARE ANCHOR NETWORK. CLEVELAND CLINIC IDENTIFIES QUALIFIED DIVERSE SUPPLIERS, INCLUDING MINORITY- AND WOMEN-OWNED BUSINESSES, AS WELL AS LOCALLY OWNED, EMPLOYEE-OWNED, COOPERATIVELY OWNED OR NONPROFIT-OWNED ENTERPRISES. -CONNECTING PATIENTS WITH HEALTH AND SOCIAL ORGANIZATIONS TO REDUCE BARRIERS TO CARE THROUGH THE UNITE US PROGRAM. -EXPANDING ACCESS TO MENTAL HEALTH, VISION AND PRIMARY CARE SERVICES TO LOCAL YOUTH THROUGH SCHOOL-BASED PROGRAMS. V. CONCLUSION THE PURPOSE OF THE CLEVELAND CLINIC HEALTH SYSTEM IS TO BENEFIT HUMANITY THROUGH THE EFFICIENT, EFFECTIVE, AND ETHICAL PRACTICE OF MEDICINE, BY ADVANCING SCIENTIFIC INVESTIGATION AND MEDICAL EDUCATION, BY MAINTAINING THE HIGHEST STANDARDS OF QUALITY, AND BY FOSTERING CREATIVITY AND INNOVATION.
FORM 990, PART VI, SECTION A, LINE 2	DEBORAH CRAWFORD, CCF DIRECTOR & PATRICK V. AULETTA, CCF DIRECTOR - BUSINESS STEVEN C. GLASS, CCF OFFICER & TIMOTHY LONGVILLE, CCF OFFICER - BUSINESS WILLIAM PEACOCK, CCF OFFICER & KELLY HANCOCK, CCF OFFICER - BUSINESS WILLIAM PEACOCK, CCF OFFICER & TIMOTHY LONGVILLE, CCF OFFICER - BUSINESS
FORM 990, PART VI, SECTION A, LINE 3	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 FOUR LONG TERM ACUTE CARE FACILITIES.
FORM 990, PART VI, SECTION A, LINE 6	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.
FORM 990, PART VI, SECTION A, LINE 7A	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. 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.
FORM 990, PART VI, SECTION A, LINE 7B	PURSUANT TO NONPROFIT CORPORATION LAW, CERTAIN OF THE 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.
FORM 990, PART VI, SECTION B, LINE 11B	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.
FORM 990, PART VI, SECTION B, LINE 12C	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 HIS 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 CONFLICT OF INTEREST AND MANAGING INNOVATIONS 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.
FORM 990, PART VI, SECTION B, LINE 15	ALL CCF OFFICERS AND SIGNIFICANT MANAGEMENT EXECUTIVE POSITIONS HAVE THEIR COMPENSATION REVIEWED IN ADVANCE ANNUALLY BY THE COMPENSATION COMMITTEE OF THE CCF 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 534958-9(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, CCF PARTICIPATES IN PRODUCTIVITY AND COMPENSATION SURVEYS WITH SIMILARLY SITUATED ORGANIZATIONS ACROSS THE U.S. IN ADDITION, CCF ENGAGES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT WHO EACH YEAR PROVIDES CCF WITH A CUSTOMIZED COMPENSATION REPORT REGARDING PHYSICIAN COMPENSATION. BY USING THIS DATA, CCF 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 CCF'S WRITTEN OR ELECTRONIC BOOKS AND RECORDS.
FORM 990, PART VI, SECTION C, LINE 18	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.
FORM 990, PART VI, SECTION C, LINE 19	CCF MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.CLEVELANDCLINIC.ORG, UNDER THE "ABOUT US" SECTION. IN THIS SECTION, THE FINANCIAL STATEMENTS, ANNUAL REPORT, COMMUNITY BENEFIT REPORT, CCF'S CONFLICT OF INTEREST POLICY, AND CORPORATE COMPLIANCE POLICIES ARE AVAILABLE.
FORM 990, PART XI, LINE 9:	DONATED CAPITAL AND ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL PURPOSES -13,250,921. GIFTS AND BEQUESTS 282,494,498. TRANSFERS OF NET ASSETS -59,323,311. NET INVESTMENT INCOME -40,320,412. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS -67,284,530. RETIREMENT BENEFITS ADJUSTMENT 62,091,872. EQUITY TRANSFERS & OTHER TRANSFERS -2,204,179.
FORM 990, PART XI, LINE 8	THE PRIOR PERIOD ADJUSTMENT IN THE AMOUNT OF $42,923,403 IS DUE TO THE ADDITION OF SINGLE MEMBER LIMITED LIABILITY COMPANIES (SMLLCS) TREATED AS DISREGARDED ENTITIES WITHIN THE CLEVELAND CLINIC FOUNDATION.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) ADVANCED INFUSION SERVICES LTD 1 HOME CARE PLACE AKRON,OH44320 34-1847339	INFUSION SERVICES	OH	-215	197,827	VISITING NURSE SERVICE INC
(2) AKRON GENERAL MEDICAL CENTER OUTPATIENT PHARMACY LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 84-2380272	HEALTH CARE SERVICES	OH	-789,563	2,537,614	AKRON GENERAL HEALTH SYSTEM
(3) AUTISM EYES LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3070150	AUTISM DETECTION PLATFORM	DE	-319,748	1,234,213	THE CLEVELAND CLINIC FOUNDATION
(4) CARNEGIE89TH GARAGE AND SERVICE CENTER 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 20-5693261	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(5) CARNEGIE96TH RESEARCH BUILDING LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 11-3706542	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(6) CC CHINA LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 20-5776477	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(7) CC WEB SOLUTIONS LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 26-3222020	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(8) CCF AMBULATORY SURGERY CENTERS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1939710	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(9) CCF HOTEL SERVICES LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-0666034	HOTEL OPERATIONS	OH	-2,889,193	102,148,965	THE CLEVELAND CLINIC FOUNDATION
(10) CHV HOME MEDICAL EQUIPMENT CO LLC 1 HOME CARE PLACE AKRON,OH44320 20-4760456	DURABLE MEDICAL EQUIPMENT	OH	4,395	-4,696,426	VISITING NURSE SERVICE INC
(11) CLEVELAND CLINIC CARE COORDINATION LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-5282492	HEALTH CARE SERVICES	OH	0	-942,441	THE CLEVELAND CLINIC FOUNDATION
(12) CLEVELAND CLINIC FLORIDA CONCIERGE MEDICINE LLC 1301 EAST BROWARD BLVD STE 330 FT LAUDERDALE,FL33301 82-3186835	HEALTH CARE SERVICES	FL	11,417	-502,949	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(13) CLEVELAND CLINIC FLORIDA HOME HEALTHCARE LLC 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 83-2250064	HEALTH CARE SERVICES	FL	41	-41	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(14) CLEVELAND CLINIC FLORIDA NAPLES LLC 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 31-1741150	INACTIVE	FL	0	0	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(15) CLEVELAND CLINIC GLOBAL SOLUTIONS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-3666730	HEALTH CARE SERVICES & IP LICENSING	OH	-28,890	17,043,222	THE CLEVELAND CLINIC FOUNDATION
(16) CLEVELAND CLINIC GLOBAL SOLUTIONS II LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 87-1180623	HEALTH CARE SERVICES & IP LICENSING	OH	-2,445,769	2,543,274	THE CLEVELAND CLINIC FOUNDATION
(17) CLEVELAND CLINIC MEDICARE ACO LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 47-1281189	HEALTH CARE SERVICES	OH	693,030	2,393,206	THE CLEVELAND CLINIC FOUNDATION
(18) CLEVELAND CLINIC OBGYN SPECIALTIES LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1938153	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(19) CLEVELAND CLINIC OHIO REGIONAL PHYSICIANS LLC 1330 MERCY DRIVE NW SUITE 506 CANTON,OH44708 92-1359067	HEALTH CARE SERVICES	OH	0	-5,867	THE CLEVELAND CLINIC FOUNDATION
(20) CLEVELAND CLINIC RISK RETENTION GROUP LLC 701 EAST BAY STREET SUITE 514 CHARLESTON,SC29403 87-2395525	RISK RETENTION GROUP	SC	0	0	THE CLEVELAND CLINIC FOUNDATION
(21) CLEVELAND CLINIC WELLNESS ENTERPRISE LLC 1950 RICHMOND ROAD LYNDHURST,OH44124 26-3859233	HEALTH CARE SERVICES	OH	487,787	-36,300,279	THE CLEVELAND CLINIC FOUNDATION
(22) CLINIC MEDICAL SERVICES COMPANY LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1932969	HEALTH CARE SERVICES	OH	82,876,498	0	THE CLEVELAND CLINIC FOUNDATION
(23) CLINIC REGIONAL PHYSICIANS LLC 25875 SCIENCE PARK DR BEACHWOOD,OH44122 26-2636530	HEALTH CARE SERVICES	OH	27,676	-457,738	THE CLEVELAND CLINIC FOUNDATION
(24) EDWIN SHAW REHAB LLC 330 BROADWAY STREET EAST CUYAHOGA FALLS,OH44221 27-0119182	REHABILITATION FACILITY	OH	-18,405	1,365,046	AKRON GENERAL MEDICAL CENTER
(25) INTELLIS EPM LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 27-0645368	MEDICAL TECHNOLOGY	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(26) IRMCF#1 LLC 1000 36TH STREET VERO BEACH,FL32960 59-0760215	REAL ESTATE HOLDINGS	FL	0	0	INDIAN RIVER HOSPITAL FOUNDATION INC
(27) IVHR LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-4657632	MEDICAL TECHNOLOGY	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(28) MARTIN SURGICAL VENTURES LLC 333 THIRD STREET N STE 200 ST PETERSBURG,FL33701 32-0496475	SURGICAL VENTURE	FL	-849,036	1,745,722	MARTIN MEMORIAL MEDICAL CENTER INC
(29) MEDINA HEALTH VENTURES LLC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1533871	INACTIVE	OH	0	0	MEDINA HOSPITAL
(30) MERCY PROFESSIONAL CARE CORPORATION 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 34-1873008	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(31) MERIDIA MEDICAL GROUP LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 34-1898545	INACTIVE	OH	6,963	-10,166	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(32) MITRIA MEDICAL LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3447663	MEDICAL TECHNOLOGY	DE	1,113,383	719,151	THE CLEVELAND CLINIC FOUNDATION
(33) MONTROSE SLEEP CENTER LLC 4125 MEDINA ROAD AKRON,OH44333 20-0494491	HEALTH CARE SERVICES	OH	-591,623	3,013,969	AKRON GENERAL PARTNERS INC
(34) NEUROOPERATIVE MONITORING LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 30-0746215	INACTIVE	OH	0	0	AKRON GENERAL PARTNERS INC
(35) NORTHEAST OHIO NEUROLOGICAL ASSOCIATES LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 20-0442351	HEALTH CARE SERVICES	OH	0	0	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(36) OBVF VII LLC 10000 CEDAR AVE CLEVELAND,OH44106 86-1185460	MEDICAL TECHNOLOGY	OH	-309,461	25,512,327	THE CLEVELAND CLINIC FOUNDATION
(37) OBVF VIII LLC 10000 CEDAR AVE CLEVELAND,OH44106 87-1129899	MEDICAL TECHNOLOGY	OH	-309,461	25,512,327	THE CLEVELAND CLINIC FOUNDATION
(38) OHIO STAR IMAGING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(39) OPTOQUEST LLC 10000 CEDAR AVENUE CLEVELAND,OH44106 26-3589643	SCIENTIFIC RESEARCH	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(40) PSMA LLC 10000 CEDAR AVE CLEVELAND,OH44106 83-4269973	COMMERCIALIZE TECHNOLOGY	DE	-19,596	191,896	THE CLEVELAND CLINIC FOUNDATION
(41) PSVW LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-1614376	REAL ESTATE HOLDINGS	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(42) REJ HOLDINGS LLC 3050 SCIENCE PARK DRIVE BEACHWOOD,OH44122 27-3245990	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(43) SCIENCE PARK CLEVELAND LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 20-8726513	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(44) SPC BUILDINGS 1 & 3 LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 26-1357176	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(45) TATARA VASCULAR LLC 10000 CEDAR AVE CLEVELAND,OH44106 47-4282964	MEDICAL TECHNOLOGY	DE	540	178	THE CLEVELAND CLINIC FOUNDATION
(46) THE BRENTWOOD CENTER OF EXCELLENCE LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 20-1476092	HEALTH CARE SERVICES	OH	0	0	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(47) TREASURE COAST INTEGRATED HEALTHCARE LLC PO BOX 9010 STUART,FL34995 82-0708813	HEALTH CARE SERVICES	FL	0	0	MARTIN MEMORIAL MEDICAL CENTER INC
(48) TUSCARAWAS AMBULATORY SURGERY CENTER LLC 659 BOULEVARD DOVER,OH44622 34-0000100	INACTIVE	OH	170,542	2,763,195	THE UNION HOSPITAL ASSOCIATION
(49) UNION HOSPITAL MEDICAL SERVICES LLC 659 BOULEVARD DOVER,OH44622 27-0273520	HEALTH CARE SERVICES	OH	11,929	-3,308,517	THE UNION HOSPITAL ASSOCIATION
(50) UNION PHYSICIAN SERVICES LLC 659 BOULEVARD DOVER,OH44622 26-4215547	HEALTH CARE SERVICES	OH	10,417,520	-140,797,685	THE UNION HOSPITAL ASSOCIATION
(51) VERO RADIOLOGY SERVICES LLC 3725 11TH CIRCLE VERO BEACH,FL32960 59-2755370	RADIOLOGY SERVICES	FL	-1,332,778	14,786,200	INDIAN RIVER MEMORIAL HOSPITAL INC
(52) WOOSTER CLINIC LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1855775	HEALTH CARE SERVICES	OH	58,060,394	0	THE CLEVELAND CLINIC FOUNDATION

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)AUXILIARY BOARD OF FAIRVIEW GENERAL HOSPITAL 18101 LORAIN AVENUE CLEVELAND,OH44111 23-7108198	SUPPORT FAIRVIEW HOSPITAL	OH	501(C)(3)	TYPE III, OTHER	N/A		No
(2)CLEVELAND CLINIC PHILANTHROPY (UK) LTD SUITE 1 3RD FLOOR 11-12TH ST JAM LONDON SW1Y4LB UK 98-1571304	SUPPORT FOR HEALTHCARE EDUCATION AND RESEARCH IN THE UK	UK	501(C)(3)	LINE 7	N/A	Yes
(3)COMMUNITY WEST FOUNDATION 800 SHARON DRIVE STE C WESTLAKE,OH44145 34-1456398	ADVANCE THE HEALTH AND WELL-BEING OF THE COMMUNITY	OH	501(C)(3)	LINE 7	N/A		No
(4)HOSPITAL AUXILIARY OF THE IRMH INC 1000 36TH STREET VERO BEACH,FL32960 59-1003707	SUPPORT THE INDIAN RIVER HOSPITAL	FL	501(C)(3)	TYPE III, FUNCTIONAL	N/A		No
(5)MARTIN MEMORIAL HOSPITAL AUXILIARY INC PO BOX 9033 STUART,FL34995 23-7115443	PROMOTE QUALITY HEALTH CARE FOR MARTIN & ST. LUCIE COUNTIES	FL	501(C)(3)	LINE 10	N/A		No
(6)THE UNIFY PROJECT 1151 NORTH MARGINAL ROAD CLEVELAND,OH44114 82-3605707	SUPPORT CHARITABLE PURPOSES OF HOSPITALS & UNIVERSITIES	OH	501(C)(3)	LINE 3	N/A		No
(7)THREE ARCHES FOUNDATION 14601 DETROIT AVENUE STE 240 LAKEWOOD,OH44107 34-6519834	SUPPORT THE CLEVELAND CLINIC FOUNDATION	OH	501(C)(3)	TYPE III, OTHER	N/A		No
(8)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 659 BOULEVARD DOVER,OH44622 34-0000100	PHYSICIAN HOSPITAL AND ORGANIZATION	OH	501(C)(3)	LINE 3	N/A		No
(9)UNION HOSPITAL AUXILIARY 659 BOULEVARD DOVER,OH44622 34-1204928	SUPPORT THE UNION HOSPITAL ASSOCIATION	OH	501(C)(3)	LINE 10	N/A		No
(10)WO WALKER CENTER INC 10700 EUCLID AVENUE CLEVELAND,OH44106 91-1818256	HEALTH CARE SERVICES	OH	501(C)(3)	TYPE III, FUNCTIONAL	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) AACP INDIA VENTURE INVESTORS D LP 1 EMBARCADERO 16TH FL SAN FRANCISCO,CA94111 83-1009352	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	-6,367	8,184,464		No			No	61.690 %
(2) AKRON SURGICAL ASSOCIATES LLC 4125 MEDINA ROAD AKRON,OH44333 01-0672877	AMBULATORY SURGERY CENTER	OH	AKRON GENERAL PARTNERS INC	RELATED	846,198	843,376		No			No	51.000 %
(3) ALTOS HYBRID CC LLC 2882 SAND HILL ROAD SUITE 100 MENLO PARK,CA94025 85-3546949	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	4,039	8,530,936		No			No	100.000 %
(4) BEXP II (PARALLEL) LP 5914 W COURTYARD DRIVE SUITE 340 AUSTIN,TX78730 87-3188834	ALTERNATIVE INVESTMENT	TX	THE CLEVELAND CLINIC FOUNDATION	RELATED	9,018,784	52,100,322		No			No	29.260 %
(5) CCAW JV LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3867549	MEDICAL SERVICES & TELE HEALTH	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	-966,500	258,261		No		Yes		51.000 %
(6) CCFMHS RENAL CARE COMPANY LTD 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1863789	MEDICAL SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	RELATED	1,116,592	11,792,143		No			No	60.000 %
(7) EXCELERATE STRATEGIC HEALTH SOURCING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 46-1810992	HEALTH CARE OP & MGMT	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	1,295,634	500,866		No	979,496	Yes		51.000 %
(8) KEROGEN ENERGY FUND II CO-INVESTMENT FUND A LP 1 NEXUS WAY CAMANA BAY KY1-9005 CJ 98-1231373	ALTERNATIVE INVESTMENT	CJ	THE CLEVELAND CLINIC FOUNDATION	RELATED	8,854	3,190,815		No			No	58.830 %
(9) MEDICAL CENTER AT HOBE SOUND LLC PO BOX 9033 STUART,FL34996 65-0748232	RENTAL OF MEDICAL OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	55,325	2,249,047		No		Yes		99.000 %
(10) MEDICAL CENTER AT ST LUCIE WEST LLC PO BOX 9033 STUART,FL34996 65-0504863	RENTAL OF MEDICAL OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	6,535	135,810		No		Yes		99.000 %
(11) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 1050 FORRER BLVD KETTERING,OH45420 81-0687167	SURGERY CENTER	OH	THE CLEVELAND CLINIC FOUNDATION	RELATED	-53,101	1,102,350		No			No	60.000 %
(12) PARAMETRIC GLOBAL LOW BETA VRP FUND LLC 3600 MINNESOTA DRIVE SUITE 325 MINNEAPOLIS,MN55435 85-0959525	ALTERNATIVE INVESTMENT	MN	THE CLEVELAND CLINIC FOUNDATION	RELATED	3,886,627	188,495,811		No			No	95.340 %
(13) SPROTT PRIVATE RESOURCE STREAMING AND ROYALTY 200 BAY STREET SUITE 2600 TORONTO M5J-2J1 CA 98-1654634	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	13,803	16,009,274		No			No	100.000 %
(14) STUART SURGERY CENTER LLC 2096 SE OCEAN BLVD STUART,FL34996 82-2542219	SURGERY CENTER	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	978,920	1,223,323		No		Yes		77.630 %
(15) TRADITION SURGERY CENTER LLC 10080 INNOVATION WAY SUITE 101 PORT ST LUCIE,FL34987 36-4837780	SURGERY CENTER	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	368,026	-274,470		No		Yes		51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) 33 GROSVENOR PLACE LIMITED 33 GROSVENOR PLACE LONDON SW1X 7HY UK	LEASE HOLDING COMPANY	JE	CLEVELAND CLINIC UK HOLDINGS LTD	C	-12,864,110	657,971,741	100.000 %	Yes
(2) ABCON THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 85-3703323	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(3) AXONEURAL THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 85-1131595	THERAPEUTIC TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		217,604	100.000 %	Yes
(4) BERING HEALTH INC 10000 CEDAR AVE CLEVELAND,OH44106 92-0570284	BRIDGE VIRTUAL & IN-PERSON CARE	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(5) CASHEL NEURAL INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4625105	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	89,271	92,338	100.000 %	Yes
(6) CCAW EMPLOYMENT CO LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-5164677	MANAGEMENT SERVICES	DE	CCAW JV LLC	C	2,033,043		51.000 %	Yes
(7) CCF (SHANGHAI) CONSULTING CO LTD LEVEL 40 ONE MUSEUM PLACE 669 ZINZ SHANGHAI 200041 CH	ADVISORY SERVICES	CH	CLEVELAND CLINIC GLOBAL SOLUTIONS LLC	C	1,037	2,231	100.000 %	Yes
(8) CCF BOLTON INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4596571	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C					No
(9) CCHS INDEMNITY CO LTD 23 LIME TREE BAY BOX 1051 GRAND CAYMAN KY1-1102 CJ 98-0207086	INSURANCE COMPANY	CJ	THE CLEVELAND CLINIC FOUNDATION	C	-35,862,047	238,719,872	100.000 %	Yes
(10) CERAXIS HEALTH INC 10000 CEDAR AVE CLEVELAND,OH44106 86-3324076	STYLUS TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		1,623,099	80.000 %	Yes
(11) CLEVELAND CLINIC CANADA-TORONTO INC 181 BAY STREET BOX 818 TORONTO M5J 2T3 CA	HEALTH CARE SERVICES	CA	THE CLEVELAND CLINIC FOUNDATION	C	437,859	15,441,902	100.000 %	Yes
(12) CLEVELAND CLINIC EMR INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4856025	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C		1,101,761		Yes
(13) CLEVELAND CLINIC HEALTH SYSTEM PHYSICIAN ORGANIZATION 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1877409	CONTRACTING ORGANIZATION	OH	CLINIC MEDICAL SOLUTIONS INC	C	11,321,768	7,085,305		Yes
(14) CLEVELAND CLINIC LONDON LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	HOSPITAL OPERATING COMPANY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C	-240,492,664	596,090,612	100.000 %	Yes
(15) CLEVELAND CLINIC SAUDI ARABIA (A LIMITED LIABILITY COMPANY) PO BOX 340340 RIYADH 11333 SA	MEDICAL SERVICES	SA	THE CLEVELAND CLINIC FOUNDATION	C	-533	609,029	100.000 %	Yes
(16) CLEVELAND CLINIC UK FINANCING PLC 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	FINANCING ENTITY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C	-261,580	941,904,507	100.000 %	Yes
(17) CLEVELAND CLINIC UK HOLDINGS LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	HOLDING COMPANY	UK	THE CLEVELAND CLINIC FOUNDATION	C	-19,722,442	1,888,786,682	100.000 %	Yes
(18) CLINIC MEDICAL SOLUTIONS INC 18101 LORAIN AVENUE CLEVELAND,OH44111 34-1695388	HEALTH CARE SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	C	9,812,931	3,905,292		Yes
(19) CMCD INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256599	REAL ESTATE	OH	MEDINA HOSPITAL	C		311,040	100.000 %	Yes
(20) CSC CONDOMINIUM ASSOCIATION INC PO BOX 9033 STUART,FL34995 59-2320501	CONDOMINIUM ASSOCIATION	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	214,323	395,413	83.700 %	Yes
(21) INFUSEON THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1776182	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		151,850	100.000 %	Yes
(22) ION-VAC INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1560044	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		20,799	100.000 %	Yes
(23) MARTIN MEMORIAL PHYSICIAN CORPORATION INC PO BOX 9010 STUART,FL34995 65-0556041	PHYSICIAN OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	115,397,996	85,023,435	100.000 %	Yes
(24) MCZ INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256598	LEASING	OH	MEDINA HOSPITAL	C	9,097	500	100.000 %	Yes
(25) MEDICAL & FINANCIAL MANAGEMENT INC PO BOX 9033 STUART,FL34995 59-2843163	BILLING AND COLLECTIONS	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	4,168,475	1,082,474	100.000 %	Yes
(26) MEDICAL CAMPUS MANAGEMENT INC PO BOX 9033 STUART,FL34995 65-0605328	MANAGEMENT SERVICES	FL	MEDICAL & FINANCIAL MANAGEMENT INC	C	7,125	124,360	100.000 %	Yes
(27) MEDINVEST INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-3978297	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(28) MERIDIA HEALTH VENTURES INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1533871	INACTIVE	OH	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	C			100.000 %	Yes
(29) MERLOT ORTHOPEDIX INC 10000 CEDAR AVE CLEVELAND,OH44106 11-3779414	MEDICAL DEVICE MANUFACTURING	DE	THE CLEVELAND CLINIC FOUNDATION	C		31,389	55.000 %	Yes
(30) METHOD AI INC 10000 CEDAR AVE CLEVELAND,OH44106 86-2997632	ROBOTIC SURGERY TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		515,838	53.420 %	Yes
(31) MOBIUS CARE INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 88-3418504	IBS TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		399,775	100.000 %	Yes
(32) NEOMEDICS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 02-0656818	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(33) NEW COS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4828042	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	450,522	853,835	100.000 %	Yes
(34) PINE FALLS CONDOMINIUM ASSOCIATES INC 6100 WEST CREEK SUITE 25 INDEPENDENCE,OH44131 34-1617589	CONDOMINIUM ASSOCIATION	OH	THE CLEVELAND CLINIC FOUNDATION	C				Yes
(35) TETONIC BIOTECH INC 10000 CEDAR AVE CLEVELAND,OH44106 85-3689997	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(36) UNION CARE CORPORATION 659 BOULEVARD DOVER,OH44622 34-1556177	HEALTH CARE SERVICES	OH	THE UNION HOSPITAL ASSOCIATION	C			100.000 %	Yes
(37) UNION PHARMACEUTICAL CARE INC 659 BOULEVARD DOVER,OH44622 04-3588229	RETAIL PHARMACY SALES	OH	THE UNION HOSPITAL ASSOCIATION	C	17,923	68,300	100.000 %	Yes
(38) ZEHNA THERAPEUTICS LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3850618	MICROBIOME TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		1,838,227	100.000 %	Yes
(39) CHARITABLE REMAINDER TRUST (13)		OH	THE CLEVELAND CLINIC FOUNDATION	T			100.000 %	Yes

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) CLEVELAND CLINIC CANADA - TORONTO INC	A	100,000	FMV
(2) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	B	24,141,960	FMV
(3) CCAW JV LLC	D	426,773	FMV
(4) CERAXIS HEALTH INC	D	61,146	FMV
(5) CLEVELAND CLINIC LONDON LTD	D	1,881,000	FMV
(6) CLEVELAND CLINIC PHILANTHROPY (UK) LTD	D	151,000	FMV
(7) EXCELERATE STRATEGIC HEALTH SOURCING LLC	D	2,131,000	FMV
(8) CCHS INDEMNITY CO LTD	E	9,237,000	FMV
(9) ION-VAC INC	E	897,223	FMV
(10) CLEVELAND CLINIC MEDICAL SERVICES INC	J	451,488	FMV
(11) FAIRVIEW HOSPITAL	J	51,752	FMV
(12) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	J	1,718,859	FMV
(13) AKRON GENERAL MEDICAL CENTER	K	327,995	FMV
(14) CLEVELAND CLINIC AVON HOSPITAL	K	4,329,392	FMV
(15) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	K	2,441,187	FMV
(16) FAIRVIEW HOSPITAL	K	1,254,355	FMV
(17) LUTHERAN HOSPITAL	K	248,200	FMV
(18) MARYMOUNT HOSPITAL INC	K	1,308,055	FMV
(19) MEDINA HOSPITAL	K	1,370,563	FMV
(20) AKRON GENERAL MEDICAL CENTER	L	1,030,268	FMV
(21) CLEVELAND CLINIC AVON HOSPITAL	L	165,761	FMV
(22) CLEVELAND CLINIC FLORIDA REGIONAL HEALTH SYSTEM NONPROFIT CORPORATION	L	554,598	FMV
(23) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	L	1,348,768	FMV
(24) CLEVELAND CLINIC MERCY HOSPITAL	L	55,881	FMV
(25) FAIRVIEW HOSPITAL	L	799,449	FMV
(26) LUTHERAN HOSPITAL	L	84,609	FMV
(27) MARYMOUNT HOSPITAL INC	L	203,331	FMV
(28) AKRON GENERAL MEDICAL CENTER	M	515,277	FMV
(29) CLEVELAND CLINIC AVON HOSPITAL	M	540,591	FMV
(30) CLEVELAND CLINIC MEDICAL SERVICES INC	M	10,967,000	FMV
(31) CLEVELAND CLINIC MERCY HOSPITAL	M	219,635	FMV
(32) EUCLID HOSPITAL	M	540,387	FMV
(33) FAIRVIEW HOSPITAL	M	668,242	FMV
(34) HILLCREST HOSPITAL	M	941,062	FMV
(35) LODI COMMUNITY HOSPITAL	M	127,532	FMV
(36) LUTHERAN HOSPITAL	M	250,892	FMV
(37) MARYMOUNT HOSPITAL INC	M	533,155	FMV
(38) MEDINA HOSPITAL	M	554,478	FMV
(39) SOUTH POINTE HOSPITAL	M	476,351	FMV
(40) CCHS INDEMNITY CO LTD	P	90,875,710	FMV
(41) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	Q	575,873	FMV

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: CARING FOR LIFE, RESEARCHING FOR HEALTH AND EDUCATING THOSE WHO SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	30
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	23
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	47,067
6	Total number of volunteers (estimate if necessary) .............	6	391
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	49,936,678
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	444,448,837	325,429,961
9	Program service revenue (Part VIII, line 2g) .........	6,845,081,523	7,330,742,260
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	210,613,557	29,380,610
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	555,905,882	-101,945,782
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	8,056,049,799	7,583,607,049
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	123,691,865	138,878,583
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	3,888,815,052	4,338,264,562
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	2,301,099	1,936,471
b	Total fundraising expenses (Part IX, column (D), line 25) 22,898,444
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,838,188,433	3,192,549,659
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	6,852,996,449	7,671,629,275
19	Revenue less expenses. Subtract line 18 from line 12.......	1,203,053,350	-88,022,226
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	15,457,099,264	15,354,669,845
21	Total liabilities (Part X, line 26).............	6,934,332,854	7,217,745,829
22	Net assets or fund balances. Subtract line 21 from line 20.....	8,522,766,410	8,136,924,016

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 6,856,784,552 including grants of $ 138,878,583 ) (Revenue $ 7,330,742,260 )
	SEE PROGRAM SERVICE STATEMENT IN SCHEDULE O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses6,856,784,552

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	48,399,015	8,324,229	-6,833,720

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	5,239,750
d	Related organizations		1d	4,065
e	Government grants (contributions)		1e	178,259,375

f	All other contributions, gifts, grants, and similar amounts not included above		1f	141,926,771

g	Noncash contributions included in lines 1a - 1f:$		1g	15,385,581

h Total. Add lines 1a-1f.......		325,429,961

		Business Code
2a	NET PATIENT SERVICES	620000	3,777,270,861	3,764,896,789	12,374,072
b	MEDICARE/MEDICAID PAYM	921990	2,648,041,943	2,648,041,943
c	OTHER PROGRAM SERVICES	900099	834,801,217	817,052,669	17,748,548
d	PARKING, PHONE & OTHER	720000	53,919,787		18,839,525	35,080,262
e	MANAGEMENT FEES	561000	14,476,263	14,476,263
f	All other program service revenue.		2,232,189	1,257,656	974,533
g	Total. Add lines 2a–2f .....		7,330,742,260

3 Investment income (including dividends, interest, and othersimilar amounts) ......			19,054,939			19,054,939
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			22,731,874			22,731,874
		(ii) Personal	(i) Real
6a	Gross rents		7,750,725	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		7,750,725	6c
d	Net rental income or (loss).......			7,750,725			7,750,725
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,271,694,581	7a
b	Less: cost or other basis and sales expenses	780,620	1,260,588,290	7b
c	Gain or (loss)	-780,620	11,106,291	7c
d	Net gain or (loss).........			10,325,671			10,325,671
8a	Gross income from fundraising events (not including $ 5,239,750of contributions reported on line 1c). See Part IV, line 18 ....
			8a	2,311,469
b	Less: direct expenses ...		8b	2,601,126
c	Net income or (loss) from fundraising events..			-289,657			-289,657
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	DERIVATIVE INCOME		525990	69,244,484			69,244,484
b	INVESTMENT IN AFFILIAT		523000	7,689,997			7,689,997
c	LIFE INSURANCE TRUST		525990	158,327			158,327
d	All other revenue ....			-209,231,532			-209,231,532
e	Total. Add lines 11a–11d ......			-132,138,724
12	Total revenue. See instructions.....			7,583,607,049	7,245,725,320	49,936,678	-37,484,910

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	44,328,668	44,328,668
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	92,111,065	92,111,065
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	2,438,850	2,438,850
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	25,435,624	4,932,355	20,503,269
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	2,170,376	1,008,870	1,161,506
7	Other salaries and wages........	3,455,202,034	2,979,039,591	463,221,730	12,940,713
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	218,023,345	187,998,275	29,229,304	795,766
9	Other employee benefits .......	411,332,356	354,820,286	55,145,280	1,366,790
10	Payroll taxes ...........	226,100,827	194,895,181	30,312,212	893,434
11	Fees for services (non-employees):
a	Management ......	4,113,453	3,561,983	551,470
b	Legal .........	6,664,168	5,770,736	893,432
c	Accounting ...........	2,929,998		2,929,998
d	Lobbying ...........	1,263,236	1,263,236
e	Professional fundraising services. See Part IV, line 17	1,936,471			1,936,471
f	Investment management fees ......	24,019,734		24,019,734
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	247,018,778	210,944,176	33,116,577	2,958,025
12	Advertising and promotion ....	31,703,244	26,851,559	4,250,296	601,389
13	Office expenses .......	81,975,972	70,325,799	10,990,111	660,062
14	Information technology ......	177,757,664	153,916,852	23,831,085	9,727
15	Royalties ..	3,699,988	3,203,949	496,039
16	Occupancy ...........	113,669,052	98,430,008	15,239,044
17	Travel ............	19,711,698	16,701,960	2,642,649	367,089
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	9,792,976	8,272,969	1,312,895	207,112
20	Interest ...........	92,503,923	80,102,383	12,401,540
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	278,503,935	241,165,334	37,337,636	965
23	Insurance ...	55,304,104	47,889,758	7,414,346
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	1,618,341,064	1,618,330,673		10,391
b	BAD DEBT EXPENSE	154,656,718	154,656,718
c	STATE FRANCHISE FEE	107,932,926	107,932,926
d	EQUIPMENT RENTAL & MAIN	77,890,986	67,372,872	10,442,457	75,657
e	All other expenses	83,096,042	78,517,520	4,503,669	74,853
25	Total functional expenses. Add lines 1 through 24e	7,671,629,275	6,856,784,552	791,946,279	22,898,444
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			498,384,430	1	273,957,294
2	Savings and temporary cash investments .........			7,153,308	2	554,427,938
3	Pledges and grants receivable, net ......			179,673,788	3	256,102,721
4	Accounts receivable, net .............			902,116,044	4	1,052,654,289
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			180,286,471	7	314,099,563
8	Inventories for sale or use ............			152,339,876	8	165,271,912
9	Prepaid expenses and deferred charges ......			83,503,134	9	112,946,287
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	6,925,402,221
b	Less: accumulated depreciation	10b	4,091,120,473	2,736,246,027	10c	2,834,281,748
11	Investments—publicly traded securities .			1,290,508,941	11	78,386,405
12	Investments—other securities. See Part IV, line 11 .....			6,598,260,675	12	6,456,936,880
13	Investments—program-related. See Part IV, line 11 ..			280,879,313	13	419,977,896
14	Intangible assets ...............			138,116,773	14	148,839,203
15	Other assets. See Part IV, line 11 ...........			2,409,630,484	15	2,686,787,709
16	Total assets. Add lines 1 through 15 (must equal line 33)...			15,457,099,264	16	15,354,669,845

17	Accounts payable and accrued expenses .....	871,240,899	17	1,057,506,342
18	Grants payable ...	-1,014,299	18	2,419,921
19	Deferred revenue .........	58,283,283	19	66,850,015
20	Tax-exempt bond liabilities .........	3,350,190,802	20	3,287,410,144
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..	326,159,025	24	344,832,803
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	2,329,473,144	25	2,458,726,604
26	Total liabilities. Add lines 17 through 25..	6,934,332,854	26	7,217,745,829

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	7,325,709,216	27	7,280,501,987
28	Net assets with donor restrictions ...........	1,197,057,194	28	856,422,029
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	8,522,766,410	32	8,136,924,016
33	Total liabilities and net assets/fund balances ........	15,457,099,264	33	15,354,669,845

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No