TY 2023 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	6,966,584	55,218
(2) RIDGEWAY MD BERI...................................................................... DIR, EXEC VP, CHIEF OF STAFF	50.00 ................. 0.00	X	X	1,712,183	52,833
(3) AULETTA PATRICK V...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(4) BENZ K MICHAEL...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(5) CRAWFORD DEBORAH A...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(6) FEDELI UMBERTO P...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(7) GWIN BONNIE W...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(8) HOOVER CAROLE...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(9) ISHRAK PHD OMAR...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(10) KEMPER RN BETTY...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(11) KILBANE ESQ CATHERINE M...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(12) KOHL STEWART...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(13) KRAMER RICHARD...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(14) MAROONE MICHAEL...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(15) MORINO MARIO...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(16) NANCE ESQ FREDERICK R...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0
(17) RICH MELINDA R...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0

(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) ROSS MARK........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(19) SCHULMAN DAN........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(20) SCOTT JR HAROLD LEE........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(21) STEVENS MARK........................................................................ DIRECTOR (PART YR)	5.00 .......................0.00	X				0	0	0
(22) VEGA LORRAINE........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(23) WALDRON JOHN........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(24) WEBER ESQ ROBERT C........................................................................ DIRECTOR (PART YR)	5.00 .......................0.00	X				0	0	0
(25) WEINBERG RONALD........................................................................ DIRECTOR	5.00 .......................0.00	X				0	0	0
(26) MOONEY BETH E........................................................................ DIRECTOR, BOARD CHAIR	5.00 .......................0.00	X	X			0	0	0
(27) PETRAS JR MICHAEL........................................................................ DIR, V. CHAIR, FINANCE & BUS DEV	5.00 .......................0.00	X	X			0	0	0
(28) POLLOCK LARRY........................................................................ DIR, V. CHAIR, PHILAN & STEWARDSHIP	5.00 .......................0.00	X	X			0	0	0
(29) FALCONE MD TOMMASO........................................................................ INTERIM CEO CC LONDON (PART YR)	0.00 .......................50.00		X			0	2,504,315	57,102
(30) ROWAN DAVID........................................................................ SEC, EXEC VP, CHIEF LEGAL OFF	50.00 .......................0.00		X			2,402,885	0	51,446
(31) LARAWAY DENNIS........................................................................ EXEC VP, CFO & TREASURER (PART YR)	50.00 .......................0.00		X			2,285,205	0	44,424
(32) CHANDRA PHD ROHIT........................................................................ CHIEF DIGITAL OFFICER	50.00 .......................0.00		X			2,170,811	0	48,184
(33) PEACOCK WILLIAM........................................................................ EXEC VP, CHIEF OF OPERATIONS	50.00 .......................0.00		X			2,148,691	0	52,167
(34) MALONE JR MD DONALD........................................................................ EXEC VP, PRES OF NEO MARKET	50.00 .......................0.00		X			1,451,184	0	672,846
(35) HANCOCK DNP RN NE-BC KELLY........................................................................ EXEC VP, CHIEF CAREGIVER OFFICER	50.00 .......................0.00		X			1,927,793	0	63,222
(36) ERZURUM MD SERPIL........................................................................ EXEC VP, CHIEF RESEARCH & ACADEMIC	50.00 .......................0.00		X			1,496,956	0	358,841
(37) DELANEY MD PHD CONOR........................................................................ EXEC VP, PRESIDENT OF FLA MKT	0.00 .......................50.00		X			0	1,714,711	47,750
(38) GUZMAN MD JORGE........................................................................ CEO CCAD; EXEC VP, PRES NEO MKT	50.00 .......................0.00		X			1,658,345	0	51,452
(39) LORENZ MD ROBERT........................................................................ PRES, CC LONDON (PART YR)	0.00 .......................50.00		X			0	1,583,789	53,730
(40) MERLINO MD JAMES........................................................................ CHIEF CLINICAL TRANSFORMATION OFFICER	50.00 .......................0.00		X			1,349,005	0	33,875
(41) DAVIS MARLEINA T........................................................................ ASST. SECRETARY	50.00 .......................0.00		X			787,881	0	57,019
(42) LONGVILLE TIMOTHY........................................................................ VP CHIEF ACCOUNTING OFFICER	50.00 .......................0.00		X			598,378	0	73,975
(43) HELTON ANTHONY........................................................................ INTERIM CFO (PART YR)	50.00 .......................0.00		X			534,169	0	40,955
(44) MEEHAN ESQ MICHAEL J........................................................................ RECORDING SECRETARY	50.00 .......................0.00		X			490,656	0	37,859
(45) OBLANDER JASON........................................................................ ASST. SECRETARY	50.00 .......................0.00		X			263,397	0	27,490
(46) BOLWELL MD BRIAN........................................................................ PHYSICIAN (2023 RETIREE)	50.00 .......................0.00			X		4,384,158	0	-126,231
(47) VIDIMOS MD ALLISON........................................................................ PHYSICIAN (2023 RETIREE)	50.00 .......................0.00			X		3,027,736	0	82,911
(48) SVENSSON MD LARS........................................................................ INSTITUTE CHIEF - HVTI	50.00 .......................0.00			X		2,284,287	0	55,511
(49) STREIN STEFAN........................................................................ CHIEF INVESTMENT OFFICER	50.00 .......................0.00			X		2,163,476	0	53,501
(50) DEYLING MD CYNTHIA........................................................................ RETIRED PHYSICIAN	0.00 .......................0.00			X		2,043,898	0	137,968
(51) DONLEY MD BRIAN........................................................................ FORMER OFFICER	0.00 .......................0.00				X	0	1,406,418	0
(52) WIEDEMANN MD HERBERT........................................................................ FORMER OFFICER (RETIRED)	0.00 .......................0.00				X	210,113	0	-12,930
(53) GLASS STEVEN C........................................................................ FORMER OFFICER	0.00 .......................0.00				X	135,862	0	6,514
(54) SURI MD RAKESH........................................................................ FORMER KEY EMPLOYEE (RETIRED)	0.00 .......................0.00				X	562,170	0	7,025

(A) Name and business address	(B) Description of services	(C) Compensation
QUALIVIS LLC PO BOX 674913 DALLAS,TX75267	PERSONNEL SERVICES	115,425,612
SIEMENS MEDICAL SOLUTIONS INC PO BOX 121102 DALLAS,TX75312	HEALTHCARE IT & ENGINEERING SERVICES	27,741,803
MEDIA STORM LLC PO BOX 321 NORWALK,CT06856	ADVERTISING AND MARKETING SERVICES	20,488,595
TOWNE PARK LLC 555 E N LANE STE 5020 CONSHOHOCKEN,PA19428	PARKING SERVICES	19,757,599
GILBANE BUILDING CO 950 MAIN AVE 1410 CLEVELAND,OH44113	CONSTRUCTION SERVICES	14,170,826
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 619

- 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

2023

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	263,593,024	529,557,140	444,448,837	325,429,961	431,017,785	1,994,046,747
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	263,593,024	529,557,140	444,448,837	325,429,961	431,017,785	1,994,046,747
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.						1,994,046,747

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..	263,593,024	529,557,140	444,448,837	325,429,961	431,017,785	1,994,046,747
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	107,975,685	104,905,019	137,076,437	49,537,538	130,784,811	530,279,490
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.)..	166,735,941	360,583,149	515,964,083	77,092,808	264,631,706	1,385,007,687
11	Total support. Add lines 7 through 10						3,910,026,738

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

34,010,457,379

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 2023 (line 6, column (f) divided by line 11, column (f)) .........

51.000 %

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

51.920 %

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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 - 2019 AMOUNT: $ 163,697,803. 2020 AMOUNT: $ 351,533,278. 2021 AMOUNT: $ 485,609,324. 2023 AMOUNT: $ 244,432,456. FOREIGN CURRENCY - 2019 AMOUNT: $ 286,195. 2020 AMOUNT: $ 92,893. 2021 AMOUNT: $ 365,082. 2023 AMOUNT: $ 57,129. DERIVATIVE INCOME - 2021 AMOUNT: $ 22,941,199. 2022 AMOUNT: $ 69,244,484. 2023 AMOUNT: $ 2,252,093. INVESTMENT IN AFFILIATES - 2019 AMOUNT: $ 2,737,082. 2020 AMOUNT: $ 8,956,978. 2021 AMOUNT: $ 6,753,656. 2022 AMOUNT: $ 7,689,997. 2023 AMOUNT: $ 17,890,028. LIFE INSURANCE TRUST - 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 - 2019 AMOUNT: $ 163,697,803. 2020 AMOUNT: $ 351,533,278. 2021 AMOUNT: $ 485,609,324. 2023 AMOUNT: $ 244,432,456. FOREIGN CURRENCY - 2019 AMOUNT: $ 286,195. 2020 AMOUNT: $ 92,893. 2021 AMOUNT: $ 365,082. 2023 AMOUNT: $ 57,129. DERIVATIVE INCOME - 2021 AMOUNT: $ 22,941,199. 2022 AMOUNT: $ 69,244,484. 2023 AMOUNT: $ 2,252,093. INVESTMENT IN AFFILIATES - 2019 AMOUNT: $ 2,737,082. 2020 AMOUNT: $ 8,956,978. 2021 AMOUNT: $ 6,753,656. 2022 AMOUNT: $ 7,689,997. 2023 AMOUNT: $ 17,890,028. LIFE INSURANCE TRUST - 2019 AMOUNT: $ 14,861. 2021 AMOUNT: $ 294,822. 2022 AMOUNT: $ 158,327.

Schedule A (Form 990) 2023

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

2023

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) (2023)

Schedule B (Form 990) (2023) 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) (2023)

Schedule B (Form 990) (2023)

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) (2023)

Schedule B (Form 990) (2023)

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) (2023)

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

right arrow

Complete if the organization is described below. 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

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

966,190

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

Yes

500,695

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

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

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

1,466,885

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 EDUCATING 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 EDUCATING 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) 2022

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.
right arrow

Attach to Form 990.
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

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

87.00

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

$ 38,585

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	541,665,952	549,756,555	472,718,962	411,313,487	354,560,827
b	Contributions ...	3,521,110,524	35,502,175	20,423,929	22,565,740	22,718,792
c	Net investment earnings, gains, and losses	182,574,046	6,879,613	64,802,033	52,756,607	40,731,794
d	Grants or scholarships ...		36,453,463
e	Other expenditures for facilities and programs ...	100,585,264	14,018,928	8,188,369	13,916,872	6,697,926
f	Administrative expenses ....
g	End of year balance ......	4,144,765,258	541,665,952	549,756,555	472,718,962	411,313,487

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

100.000 %

Term endowment right arrow

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 .....	183,961,863		183,961,863
b	Buildings ....	4,189,139,372	2,563,533,291	1,625,606,081
c	Leasehold improvements	111,724,528	90,122,791	21,601,737
d	Equipment ....	2,143,787,022	1,453,952,866	689,834,156
e	Other .....	640,837,595	115,596,721	525,240,874
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				3,046,244,711

Schedule D (Form 990) 2022

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)	1,779,668,176	C
(B) OTHER SECURITIES (PRIVATE EQUITY)	1,708,600,511	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	3,488,268,687

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				1,397,320,243
(2)PERPETUAL & BENEFICIAL TRUSTS				35,148,313
(3)INVESTMENT IN AFFILIATES				1,157,739,897
(4)OTHER ASSETS				151,476,683
(5)DEFERRED ANNUITIES				418,652,728
(6)FEDERAL INCOME TAXES				7,980
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				3,160,345,844

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
DEFERRED ANNUITY TRUST	4,396,647
OTHER LIABILITIES	60,775,829
FUTURE GIFT ANNUITY PAYMENTS	11,437,617
INTEREST RATE SWAP	30,459,036
ACCRUED PENSION	660,862,447
DUE TO AFFILIATES	1,768,257,344
ACCRUED BENEFITS	235,742,061


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	2,771,930,981
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) 2022

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; COPLEY, 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: UNCERTAIN INCOME TAX POSITIONS WERE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2023 AND 2022. THE SYSTEM DOES NOT EXPECT A SIGNIFICANT INCREASE OR DECREASE IN UNRECOGNIZED TAX BENEFITS WITHIN THE NEXT 12 MONTHS. THE SYSTEM RECOGNIZES ACCRUED INTEREST AND PENALTIES RELATED TO THE LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS.

Schedule D (Form 990) 2022

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 arrow

Attach to Form 990. Right arrow

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

OMB No. 1545-0047

2023

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	52,120,000
	NORTH AMERICA	2	0	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	49,235,000
	EUROPE	4	27	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	1,062,764,000
	MIDDLE EAST & NORTH AFRICA	2	98	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNED FOREIGN ENTITY	5,650,000
	EAST ASIA AND THE PACIFIC	1	0	PROGRAM SERVICES	INVESTMENT IN WHOLLY-OWNNED FOREIGN ENTITY	25,000
	CENTRAL AMERICA & THE CARIBBEAN	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	10,000
	EAST ASIA AND THE PACIFIC	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	117,000
	EUROPE	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	696,000
	MIDDLE EAST & NORTH AFRICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	6,813,000
	NORTH AMERICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	416,000
	SOUTH AMERICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	21,000
	SOUTH ASIA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	47,000
	SUB-SAHARAN AFRICA	0	0	PROGRAM SERVICES	TRAVEL FOR EDUCATION/PATIENT CARE	1,000
	MIDDLE EAST & NORTH AFRICA	0	0	FUNDRAISING
	EAST ASIA AND THE PACIFIC	0	0	FUNDRAISING
	SOUTH AMERICA	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		82,836,000
	SUB-SAHARAN AFRICA	0	0	INVESTING		102,160,000
	MIDDLE EAST & NORTH AFRICA	0	0	INVESTING		2,419,000
	NORTH AMERICA	0	0	INVESTING		41,132,000
	CENTRAL AMERICA & THE CARIBBEAN	0	0	INVESTING		3,761,112,000
3a	Sub-total ....	9	125			1,170,617,000
b	Total from continuation sheets to Part I ...	0	0			3,996,957,000
c	Totals (add lines 3a and 3b)	9	125			5,167,574,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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
SOUTH AMERICA	RESEARCH	21,781	CHECK AND/OR WIRE
EUROPE	RESEARCH	208,425	CHECK AND/OR WIRE
EUROPE	RESEARCH	56,208	CHECK AND/OR WIRE
EUROPE	RESEARCH	6,888	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	324,000	CHECK AND/OR WIRE
SOUTH AMERICA	RESEARCH	50,817	CHECK AND/OR WIRE
SOUTH AMERICA	RESEARCH	19,838	CHECK AND/OR WIRE
SOUTH AMERICA	RESEARCH	64,576	CHECK AND/OR WIRE
MIDDLE EAST & NORTH AFRICA	RESEARCH	77,235	CHECK AND/OR WIRE
CENTRAL AMERICA & THE CARIBBEAN	RESEARCH	44,125	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	54,000	CHECK AND/OR WIRE
EUROPE	RESEARCH	7,188	CHECK AND/OR WIRE
EUROPE	RESEARCH	5,836	CHECK AND/OR WIRE
EUROPE	RESEARCH	257,164	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	33,000	CHECK AND/OR WIRE
EUROPE	RESEARCH	74,130	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	502,588	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	15,600	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	13,898	CHECK AND/OR WIRE
EAST ASIA & THE PACIFIC	RESEARCH	62,754	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	39,912	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	32,873	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	170,170	CHECK AND/OR WIRE
NORTH AMERICA	RESEARCH	219,423	CHECK AND/OR WIRE
EUROPE	RESEARCH	187,007	CHECK AND/OR WIRE
EUROPE	RESEARCH	7,030	CHECK AND/OR WIRE
CENTRAL AMERICA & THE CARIBBEAN	RESEARCH	6,900	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 .......	19
3	Enter total number of other organizations or entities .......................	8

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 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.

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

Schedule F (Form 990) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

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.

Schedule F (Form 990) 2023

Additional Data

Software ID:
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

2023

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	6,108,240	264,933	5,843,307
	RR DONNELLEY 35 WEST WACKER DR CHICAGO, IL60601	DIRECT MAIL		No	1,714,891	1,351,566	363,325
	TSM DONOR ENGAGEMENT TEAM 155 COMMERCE DR FREEDOM, PA15042	PHONE SOLICITATION		No	49,858	217,513	-167,655







Total . . . . . . . . . . . . . . . . . . . .					7,872,989	1,834,012	6,038,977

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) 2023

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 . . . . .	7,594,939	1,317,540	301,138	9,213,617
2	Less: Contributions . . . .	7,477,944	1,252,800	232,777	8,963,521
3	Gross income (line 1 minus line 2) . . . . . .	116,995	64,740	68,361	250,096

4	Cash prizes . . . . .	0	0	3,700	3,700
5	Noncash prizes . . . .	0	179	0	179
6	Rent/facility costs . . . .	325,028	49,663	35,100	409,791
7	Food and beverages . . .	209,721	151,411	34,772	395,904
8	Entertainment . . . .	18,535	14,861	0	33,396
9	Other direct expenses . . .	1,496,830	651,214	10,354	2,158,398
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				3,001,368
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-2,751,272

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) 2023

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) 2023

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.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

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? . . . . . .

Yes

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) . . .	92,419,889	0	92,419,889	1.110 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1,068,267,384	667,439,688	400,827,696	4.800 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	0	0
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	1,160,687,273	667,439,688	493,247,585	5.910 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	18,351,065	3,146,878	15,204,187	0.180 %
f	Health professions education (from Worksheet 5) . . .	294,802,940	37,766,370	257,036,570	3.080 %
g	Subsidized health services (from Worksheet 6) . . . .	29,728,087	23,816,100	5,911,987	0.070 %
h	Research (from Worksheet 7) .	358,830,674	227,911,422	130,919,252	1.570 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	18,572,503	0	18,572,503	0.220 %
j	Total. Other Benefits . .	720,285,269	292,640,770	427,644,499	5.120 %
k	Total. Add lines 7d and 7j .	1,880,972,542	960,080,458	920,892,084	11.030 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			724	0	724	0 %
2	Economic development			23,573	0	23,573	0 %
3	Community support			170,707	0	170,707	0 %
4	Environmental improvements			0	0		0 %
5	Leadership development and training for community members			13,174	300	12,874	0 %
6	Coalition building			95,946	0	95,946	0 %
7	Community health improvement advocacy			28,576	0	28,576	0 %
8	Workforce development			1,054,658	0	1,054,658	0.010 %
9	Other				0
10	Total			1,387,358	300	1,387,058	0.010 %

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. ......

162,243,546

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).....

774,376,734

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

835,565,375

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

-61,188,641

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) 2023

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?7Name, 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	SELECT SPECIALTY - FAIRHILL 11900 FAIRHILL ROAD CLEVELAND,OH44120 WWW.SELECTMEDICAL.COM OH STATE ID 1468	X						A
3	CLEVELAND CLINIC REHAB - BEACHWOOD 3025 SCIENCE PARK DRIVE BEACHWOOD,OH44122 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1906	X						A
4	CLEVELAND CLINIC REHABILITATION-AVON 33355 HEALTH CAMPUS BOULEVARD AVON,OH44011 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1522AHR	X						A
5	CLEVELAND CLINIC REHAB - EDWIN SHAW 4389 MEDINA ROAD COPLEY,OH44321 WWW.CLEVELANDCLINIC.ORG OH STATE ID 1905	X						A
6	SELECT SPECIALTY - REGENCY WEST 6990 ENGLE ROAD MIDDLEBURG HEIGHTS,OH44130 WWW.SELECTMEDICAL.COM OH STATE ID 1478	X						A
7	SELECT SPECIALTY - REGENCY EAST 4200 INTERCHANGE CORPORATE CENTER RD WARRENSVILLE HEIGHTS,OH44128 WWW.SELECTMEDICAL.COM OH STATE ID 1479	X						A

Schedule H (Form 990) 2023

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) 2023

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) 2023

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) 2023

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) 2023

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) 2023

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) 2023

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) 2023

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) 2023

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 ("CAC"). 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, AND ONLINE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS.
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 6: SELECT SPECIALTY - REGENCY WEST, - FACILITY 7: SELECT SPECIALTY - REGENCY EAST, - FACILITY 2: SELECT SPECIALTY - FAIRHILL, - FACILITY 4: CLEVELAND CLINIC REHABILITATION-AVON, - FACILITY 3: CLEVELAND CLINIC REHAB - BEACHWOOD, - FACILITY 5: CLEVELAND CLINIC REHAB - EDWIN SHAW
GROUP A-FACILITY 6 -- 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 ("CAC"). 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 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 6 -- 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 7 -- 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 ("CAC"). 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 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 7 -- 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 2 -- 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 ("CAC"). 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 -- 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 2 -- 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 4 -- 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 ("CAC"). 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 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 4 -- 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 5 -- 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 ("CAC"). 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 -- 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, 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 5 -- 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 3 -- 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 ("CAC"). 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 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 3 -- CLEVELAND CLINIC REHAB - BEACHWOOD PART V, SECTION B, LINE 11:	THE KEY NEEDS IDENTIFIED FOR CLEVELAND CLINIC REHAB - BEACHWOOD 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.
PART V, SECTION B, LINES 7A, 10A, 16A-16C	THE URL LINK TO VIEW THE CHNA CAN BE FOUND DIRECTLY AT: HTTPS://MY.CLEVELANDCLINIC.ORG/ABOUT/COMMUNITY/REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORTS#2022-CHNAS-TABTHE URL LINK TO VIEW THE IMPLEMENTATION STRATEGY CAN BE FOUND DIRECTLY AT: HTTPS://MY.CLEVELANDCLINIC.ORG/ABOUT/COMMUNITY/REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORTS#OVERVIEW-TABTHE URL LINK TO VIEW THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND DIRECTLY AT: HTTPS://MY.CLEVELANDCLINIC.ORG/PATIENTS/BILLING-FINANCE/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2023

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?124
Name and address		Type of Facility (describe)
1	1 - TWINSBURG FAMILY HEALTH & SURGERY CENTER 8701 DARROW ROAD TWINSBURG,OH44087	FAMILY HEALTH CENTER
2	2 - BEACHWOOD FAMILY HEALTH & SURGERY CENTER 26900 CEDAR ROAD BEACHWOOD,OH44122	FAMILY HEALTH CENTER
3	3 - STRONGSVILLE FAMILY HEALTH & SURGERY CENTE 16761 SOUTH PARK CENTER STRONGSVILLE,OH44136	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 - LORAIN FAMILY HEALTH & SURGERY CENTER 5700 COOPER FOSTER PARK ROAD LORAIN,OH44053	FAMILY HEALTH CENTER
7	7 - WILLOUGHBY HILLS FAMILY HEALTH CENTER 2550 2570 SOM CENTER ROAD WILLOUGHBY HILLS,OH44094	FAMILY HEALTH CENTER
8	8 - CLEVELAND CLINIC CANCER CENTERS 417 QUARRY LAKES DRIVE SANDUSKY,OH44870	OUTPATIENT PHYSICIAN CLINIC
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 - LAKEWOOD FAMILY HEALTH CENTER 14601 DETROIT AVENUE LAKEWOOD,OH44107	FAMILY HEALTH CENTER
12	12 - CLEVELAND CLINIC CANCER CENTERS 1125 ASPIRA COURT MANSFIELD,OH44906	OUTPATIENT PHYSICIAN CLINIC
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 - AMHERST FAMILY HEALTH CENTER 5172 LEAVITT ROAD LORAIN,OH44053	FAMILY HEALTH CENTER
16	16 - CHAGRIN FALLS FAMILY HEALTH CENTER 551 EAST WASHINGTON STREET CHAGRIN FALLS,OH44022	FAMILY HEALTH CENTER
17	17 - NORTH OHIO GASTROENTEROLOGY 30701 CLEMENS ROAD WESTLAKE,OH44145	OUTPATIENT PHYSICIAN CLINIC
18	18 - WEST VALLEY MEDICAL 20455 LORAIN ROAD 301 FAIRVIEW PARK,OH44126	OUTPATIENT PHYSICIAN CLINIC
19	19 - SHEFFIELD FAMILY HEALTH CENTER 5334 MEADOW LANE CT SHEFFIELD VILLAGE,OH44035	FAMILY HEALTH CENTER
20	20 - SUMMIT GASTROENTEROLOGY ASSOCIATES 3939 S CLEVELAND MASSILLON ROAD BARBERTON,OH44203	OUTPATIENT PHYSICIAN CLINIC
21	21 - STOW-FALLS MEDICAL OUTPATIENT CENTER 857 GRAHAM RD STOW,OH44221	OUTPATIENT PHYSICIAN CLINIC
22	22 - AVON POINTE FAMILY HEALTH CENTER 36901 AMERICAN WAY AVON,OH44011	FAMILY HEALTH CENTER
23	23 - MENTOR MEDICAL OFFICE 7060 WAYSIDE DRIVE MENTOR,OH44060	OUTPATIENT PHYSICIAN CLINIC
24	24 - CONCORD MEDICAL OUTPATIENT CENTER 7519 FREDLE DRIVE CONCORD,OH44077	OUTPATIENT PHYSICIAN CLINIC
25	25 - MIDDLEBURG HEIGHTS FAMILY HEALTH CENTER 17840 BAGLEY ROAD MIDDLEBURG HEIGHTS,OH44130	FAMILY HEALTH CENTER
26	26 - CLEVELAND CLINIC ADMINISTRATIVE CAMPUS 3275 SCIENCE PARK DRIVE BLDG 5 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
27	27 - SUMMIT OPHTHALMOLOGY 1587 BOETTLER ROAD UNIONTOWN,OH44685	OUTPATIENT PHYSICIAN CLINIC
28	28 - STEPHANIE TUBBS JONES HEALTH CENTER 13944 EUCLID AVENUE EAST CLEVELAND,OH44112	FAMILY HEALTH CENTER
29	29 - AVON LAKE FAMILY HEALTH CENTER 450 AVON BELDEN ROAD AVON LAKE,OH44012	FAMILY HEALTH CENTER
30	30 - MADISON MEDICAL OFFICE 2999 MCMACKIN ROAD MADISON,OH44057	OUTPATIENT PHYSICIAN CLINIC
31	31 - OLMSTED TOWNSHIP PRIMARY CARE 27089 BAGLEY ROAD OLMSTED TOWNSHIP,OH44138	OUTPATIENT PHYSICIAN CLINIC
32	32 - COMMUNITY PEDIATRICS 8254 MAYFIELD ROAD CHESTERLAND,OH44026	OUTPATIENT PHYSICIAN CLINIC
33	33 - COLUMBUS STAR IMAGING 921 JASONWAY AVENUE COLUMBUS,OH43214	DIAGNOSTIC CENTER
34	34 - MIDDLEBURG HEIGHTS ORTHOPAEDICS 7010 ENGLE ROAD STE 105 MIDDLEBURG HEIGHTS,OH44130	OUTPATIENT PHYSICIAN CLINIC
35	35 - WADSWORTH PRIMARY CARE ONE PARK CENTER DRIVE WADSWORTH,OH44281	OUTPATIENT PHYSICIAN CLINIC
36	36 - NILES STAR IMAGING 650 YOUNGSTOWN-WARREN ROAD NILES,OH44446	DIAGNOSTIC CENTER
37	37 - BOARDMAN STAR IMAGING 7067 TIFFANY BOULEVARD YOUNGSTOWN,OH44512	DIAGNOSTIC CENTER
38	38 - CLEVELAND CLINIC COLE EYE OF STREETSBORO ( 9424 STATE ROUTE 14 STREETSBORO,OH44241	OUTPATIENT PHYSICIAN CLINIC
39	39 - OHIO RENAL CARE CLEVELAND EAST 2429 MARTIN LUTHER KING JR DR CLEVELAND,OH44104	DIALYSIS CENTER
40	40 - CLEVELAND CLINIC URGENT CARE ROCKY RIVER 19895 DETROIT ROAD ROCKY RIVER,OH44116	OUTPATIENT PHYSICIAN CLINIC
41	41 - ASHLAND OPHTHALMOLOGYSUGARBUSH EYE AND LA 21 SUGARBUSH COURT ASHLAND,OH44805	OUTPATIENT PHYSICIAN CLINIC
42	42 - MACEDONIA EXPRESS AND OUTPATIENT CARE 8210 MACEDONIA COMMONS BOULEVARD MACEDONIA,OH44056	OUTPATIENT PHYSICIAN CLINIC
43	43 - MARYMOUNT REHABILITATION AND SPORTS THERAP 2525 EAST ROYALTON ROAD BROADVIEW HEIGHTS,OH44147	OUTPATIENT PHYSICIAN CLINIC
44	44 - LAKEWOOD MEDICAL OFFICE 16215 MADISON AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
45	45 - CLEVELAND CLINIC FAMILY MEDICINE 19300 DETROIT AVENUE ROCKY RIVER,OH44116	OUTPATIENT PHYSICIAN CLINIC
46	46 - WILLOUGHBY HILLS BEHAVIORAL HEALTH 2785 SOM CENTER ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC
47	47 - BRECKSVILLE EXPRESS CARE 8805 BRECKSVILLE ROAD BRECKSVILLE,OH44141	OUTPATIENT PHYSICIAN CLINIC
48	48 - SOUTH RUSSELL FAMILY PRACTICE 5192 CHILLICOTHE ROAD SOUTH RUSSELL,OH44022	OUTPATIENT PHYSICIAN CLINIC
49	49 - OHIO RENAL CARE GROUP WESTLAKE 26024 DETROIT AVENUE WESTLAKE,OH44145	DIALYSIS CENTER
50	50 - NEW FAMILY PHYSICIANS WILLOUGHBY HILLS 34500 CHARDON ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC
51	51 - SLEEP DISORDERS CENTER 3122 EASTPOINTE DRIVE MEDINA,OH44256	DIAGNOSTIC CENTER
52	52 - LAKEWOOD FAMILY MEDICINE - ROCKPORT 11851 DETROIT AVENUE LAKEWOOD,OH44107	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 - NORTH RIDGEVILLE MEDICAL OUTPATIENT CENTER 34960 CENTER RIDGE ROAD NORTH RIDGEVILLE,OH44039	OUTPATIENT PHYSICIAN CLINIC
56	56 - NORTH RIDGEVILLE MEDICAL OFFICE 35105 CENTER RIDGE ROAD NORTH RIDGEVILLE,OH44039	OUTPATIENT PHYSICIAN CLINIC
57	57 - CHARDON REHABILITATION AND SPORTS THERAPY 325 CENTER STREET CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
58	58 - OHIO RENAL CARE GROUP HERITAGE 1160 E BROAD ST ELYRIA,OH44035	DIALYSIS CENTER
59	59 - CLEVELAND CLINIC EXPRESS CARE 7580 NORTHCLIFF AVENUE BROOKLYN,OH44144	OUTPATIENT PHYSICIAN CLINIC
60	60 - OHIO RENAL CARE GROUP LTAC ACUTEWHITE PO 690 WHITE POND DR AKRON,OH44320	DIALYSIS CENTER
61	61 - CANFIELD ORTHOPAEDICS AND REHABILITATION 3736 BOARDMAN CANFIELD ROAD CANFIELD,OH44406	OUTPATIENT PHYSICIAN CLINIC
62	62 - WEST END PEDIATRICS (CLEVELAND CLINIC CHIL 14701 DETROIT AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
63	63 - CROSSROADS SLEEP DISORDER CENTER 721 BOARDMAN POLAND ROAD YOUNGSTOWN,OH44512	OUTPATIENT PHYSICIAN CLINIC
64	64 - OHIO RENAL CARE GROUP AMHERST 100 COPPER FOSTER PARK RD AMHERST,OH44001	DIALYSIS CENTER
65	65 - CLEVELAND CLINIC SUPERIOR MEDICAL CARE 1959 COOPER FOSTER PARK ROAD AMHERST,OH44053	DIAGNOSTIC CENTER
66	66 - OHIO RENAL CARE GROUP FARNSWORTH 3280 W 25TH ST CLEVELAND,OH44109	DIALYSIS CENTER
67	67 - CHARDON PLAZA MEDICAL OUTPATIENT CENTER 425 WATER STREET CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
68	68 - VALLEY CITY FAMILY MEDICINE 6605 CENTER ROAD VALLEY CITY,OH44280	OUTPATIENT PHYSICIAN CLINIC
69	69 - OHIO RENAL CARE GROUP WEST 14670 SNOW ROAD BROOKPARK,OH44142	DIALYSIS CENTER
70	70 - OHIO RENAL CARE GROUP EUCLID 26450 EUCLID AVENUE EUCLID,OH44132	DIALYSIS CENTER
71	71 - OHIO RENAL CARE GROUP MENTOR 8840 TYLER BLVD MENTOR,OH44060	DIALYSIS CENTER
72	72 - CLEVELAND CLINIC LYNDHURST CAMPUS 1950 RICHMOND ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
73	73 - OHIO RENAL CARE GROUP GARFIELD HEIGHTS HO 9729 GRANGER RD GARFIELD HTS,OH44125	DIALYSIS CENTER
74	74 - OHIO RENAL CARE GROUP STREETSBORO 9200 STAPLES DR STREETSBORO,OH44241	DIALYSIS CENTER
75	75 - LORAIN ORTHOPAEDICS 5800 COOPER FOSTER PARK ROAD LORAIN,OH44053	OUTPATIENT PHYSICIAN CLINIC
76	76 - OHIO RENAL CARE GROUP SOLON 6020 ENTERPRISE PARKWAY SOLON,OH44139	DIALYSIS CENTER
77	77 - OHIO RENAL CARE GROUP OHIO ACUTES 2500 METROHEALTH DRIVE CLEVELAND,OH44109	DIALYSIS CENTER
78	78 - BELDEN CENTER 4677 FULTON DRIVE NW CANTON,OH44718	OUTPATIENT PHYSICIAN CLINIC
79	79 - OHIO RENAL CARE NORTH RANDALL 5035 RICHMOND ROAD BEDFORD HEIGHTS,OH44146	DIALYSIS CENTER
80	80 - OHIO RENAL CARE GROUP ELYRIA 5316 HOAG DR SHEFFILED,OH44035	DIALYSIS CENTER
81	81 - MOHICAN EYE CENTER 484 PARK AVENUE WEST MANSFIELD,OH44906	OUTPATIENT PHYSICIAN CLINIC
82	82 - MOHICAN EYE CENTER 637 NORTH UNION STREET LOUDONVILLE,OH44842	OUTPATIENT PHYSICIAN CLINIC
83	83 - OHIO RENAL CARE GROUP KENT 401 DEVON PL 100 KENT,OH44240	DIALYSIS CENTER
84	84 - MADISON REHABILITATION AND SPORTS THERAPY 2622 HUBBARD ROAD MADISON,OH44057	OUTPATIENT PHYSICIAN CLINIC
85	85 - OHIO RENAL CARE GROUP CUYAHOGA FALLS 320 BROADWAY ST E E CUYAHOGA FALLS,OH44221	DIALYSIS CENTER
86	86 - CLEVELAND CLINIC FAMILY MEDICINE - NORDONI 2055 ALEXANDRIA WAY MACEDONIA,OH44056	OUTPATIENT PHYSICIAN CLINIC
87	87 - OHIO RENAL CARE GROUP WADSWORTH 1160 WILLIAMS RESERVE BLVD WADSWORTH,OH44281	DIALYSIS CENTER
88	88 - MEDINA COMMUNITY RECREATION CENTER 855 WEYMOUTH ROAD MEDINA,OH44256	OUTPATIENT PHYSICIAN CLINIC
89	89 - WOOSTER MILLTOWN SPECIALTY & SURGERY CENTE 721 EAST MILLTOWN ROAD WOOSTER,OH44691	OUTPATIENT PHYSICIAN CLINIC
90	90 - THE LANGSTON HUGHES CENTER CLEVELAND CLINI 2390 E 79TH ST CLEVELAND,OH44104	OUTPATIENT PHYSICIAN CLINIC
91	91 - OHIO RENAL CARE GROUP HINCKLEY 2583 CENTER RD HINCKLEY,OH44233	DIALYSIS CENTER
92	92 - OHIO RENAL CARE GROUP SOUTHPOINT DIALYSIS 4200 WARRENSVILLE CENTER RD STE 100 WARRENSVILLE HTS,OH44122	DIALYSIS CENTER
93	93 - OHIO RENAL CARE GROUP MEDINA 3995 MEDINA RD STE 150 MEDINA,OH44256	DIALYSIS CENTER
94	94 - OBERLIN OPHTHALMOLOGY 309 WEST LORAIN STREET OBERLIN,OH44074	OUTPATIENT PHYSICIAN CLINIC
95	95 - HEALTH SPOT LAKEWOOD HIGH SCHOOL 14100 FRANKLIN BOULEVARD LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
96	96 - OHIO RENAL CARE GROUP MARYMOUNT 12532 ROCKSIDE RD GARFIELD HEIGHTS,OH44125	DIALYSIS CENTER
97	97 - LORAIN COUNTY LONG-TERM CARE 1130 TOWER BOULEVARD LORAIN,OH44052	OUTPATIENT PHYSICIAN CLINIC
98	98 - PARMA ROCKSIDE LABORATORY SERVICE CENTER 1440 ROCKSIDE ROAD PARMA,OH44134	OUTPATIENT PHYSICIAN CLINIC
99	99 - OHIO RENAL CARE GROUP LAKEWOOD 13900 DETROIT RD LAKEWOOD,OH44107	DIALYSIS CENTER
100	100 - OHIO RENAL CARE GROUP ASHTABULA 2117 LAKE AVENUE ASHTABULA,OH44004	DIALYSIS CENTER
101	101 - ADVANCED CARDIOVASCULAR CONSULTANTS 531 FIFTH AVENUE CHARDON,OH44024	OUTPATIENT PHYSICIAN CLINIC
102	102 - ASHTABULA COUNTY MEDICAL CENTER 2422 LAKE AVENUE ASHTABULA,OH44004	OUTPATIENT PHYSICIAN CLINIC
103	103 - CHARLESTON AREA MEDICAL CENTER 1201 WASHINGTON STREET EAST STE 100 CHARLESTON,WV25301	OUTPATIENT PHYSICIAN CLINIC
104	104 - CLEVELAND CLINIC DIABETES AND ENDOCRINOLOG 3733 PARK EAST DRIVE STE 105 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
105	105 - CLEVELAND CLINIC STAR IMAGING 1449 BOARDMAN-CANFIELD ROAD YOUNGSTOWN,OH44512	DIAGNOSTIC CENTER
106	106 - CLEVELAND CLINIC SUMMIT OPHTHALMOLOGY 1 PARK WEST BOULEVARD STE 150 AKRON,OH44320	OUTPATIENT PHYSICIAN CLINIC
107	107 - COLE EYE INSTITUTE 2000 AUBURN DRIVE STE 100 BEACHWOOD,OH44122	OUTPATIENT PHYSICIAN CLINIC
108	108 - COMMUNITY PEDIATRICS 2001 CROCKER ROAD WESTLAKE,OH44145	OUTPATIENT PHYSICIAN CLINIC
109	109 - DOWNTOWN EXPRESS CARE 315 EUCLID AVENUE STE 2 CLEVELAND,OH44114	OUTPATIENT PHYSICIAN CLINIC
110	110 - EL CENTRO COMMUNITY CENTER PRIMARY CARE CL 2800 PEARL AVENUE LORAIN,OH44055	OUTPATIENT PHYSICIAN CLINIC
111	111 - GREAT LAKES CARE INC 29001 CEDAR ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
112	112 - LAKEWOOD CITY SCHOOL DISTRICT 13701 LAKE AVENUE LAKEWOOD,OH44107	OUTPATIENT PHYSICIAN CLINIC
113	113 - LAKEWOOD LAKE POINTE LAB DRAW SITE 15800 DETROIT AVENUE LAKEWOOD,OH44107	DIAGNOSTIC CENTER
114	114 - LANDERBROOK OFFICE AND ENDOSCOPY CENTER 5900 LANDERBROOK DRIVE MAYFIELD HEIGHTS,OH44124	OUTPATIENT PHYSICIAN CLINIC
115	115 - MENTOR REHABILITATION AND SPORTS THERAPY 7533 CENTER STREET MENTOR,OH44060	OUTPATIENT PHYSICIAN CLINIC
116	116 - NEW FAMILY PHYSICIANS LYNDHURST 5187 MAYFIELD ROAD LYNDHURST,OH44124	OUTPATIENT PHYSICIAN CLINIC
117	117 - NOMS AMBULATORY ENDOSCOPY CENTER 5319 HOAG DRIVE ELYRIA,OH44035	OUTPATIENT PHYSICIAN CLINIC
118	118 - PREMIER LAB CARE 37121 EUCLID AVENUE WILLOUGHBY,OH44094	OUTPATIENT PHYSICIAN CLINIC
119	119 - SLEEP DISORDERS CENTER 24901 COUNTRY CLUB BOULEVARD NORTH OLMSTED,OH44070	DIAGNOSTIC CENTER
120	120 - SLEEP DISORDERS CENTER 8971 WILCOX DRIVE TWINSBURG,OH44087	DIAGNOSTIC CENTER
121	121 - SLEEP DISORDERS CENTER 5051 WEST CREEK ROAD INDEPENDENCE,OH44131	DIAGNOSTIC CENTER
122	122 - STAR IMAGING DUBLIN 333 W BRIDGE STREET DUBLIN,OH43017	DIAGNOSTIC CENTER
123	123 - THERAPY SERVICES WEST - BLDG 11 800 WESTPOINT PARKWAY WESTLAKE,OH44145	OUTPATIENT PHYSICIAN CLINIC
124	124 - WILLOUGHBY HILLS REHABILITATION AND SPORTS 29017 CHARDON ROAD WILLOUGHBY HILLS,OH44094	OUTPATIENT PHYSICIAN CLINIC

Schedule H (Form 990) 2023

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 $9,920,086.
PART I, LINE 7	NOTE THAT THE TOTAL AMOUNT OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS OF $920,892,085 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.
PART I, LINE 2	CLEVELAND CLINIC REHABILITATION AND SELECT FACILITIES HAVE THEIR OWN FINANCIAL ASSISTANCE POLICIES, WHICH COMPLY WITH ALL 501(R) REGULATIONS.
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 #2 ON PG. 21 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 $1,431,313,561 AND $1,865,606,781 RESPECTIVELY. THIS RESULTS IN ADDITIONAL MEDICARE SHORTFALL OF $434,293,220 WHICH, ADDED TO THE SHORTFALL OF $61,188,642 AS REPORTED ON THE COST REPORTS BRINGS THE TOTAL MEDICARE SHORTFALL TO $495,481,861.
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 AND ONLINE. A DESCRIPTION OF THE POLICY IS ALSO INCLUDED IN OUR INSURANCE AND BILLING INFORMATION PATIENT BROCHURE, WHICH IS AVAILABLE AT REGISTRATION DESKS.
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) 2023

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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

2023

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) AATS FOUNDATION 800 CUMMINGS CENTER 350-V BEVERLY,MA01915	23-7288866	501(C)(3)	20,000	0			HEALTHCARE RESEARCH & EDUCATION
(2) AMERICAN CANCER SOCIETY 10501 EUCLID AVENUE CLEVELAND,OH44106	13-1788491	501(C)(3)	387,000	0			COMMUNITY SUPPORT
(3) AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVENUE DALLAS,TX75231	13-5613797	501(C)(3)	225,000	0			COMMUNITY SUPPORT
(4) AMERICAN LUNG ASSOCIATION 55 WEST WACKER DRIVE CHICAGO,IL60601	13-1632524	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(5) ASHBURY COMMUNITY SERVICE INC 11011 ASHBURY AVE CLEVELAND,OH44106	30-0100675	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(6) BELLAIRE-PURITAS DEVELOPMENT CORPORATION 14703 PURITAS AVENUE CLEVELAND,OH44135	34-1685259	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(7) BENJAMIN ROSE INSTITUTE ON AGING 11890 FAIRHILL ROAD CLEVELAND,OH44120	34-0714482	501(C)(3)	54,000	0			COMMUNITY SUPPORT
(8) BESSIES ANGELS INC 17017 MILES ROAD CLEVELAND,OH44128	47-4200543	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(9) BIKE CLEVELAND 3000 BRIDGE AVENUE STE 1 CLEVELAND,OH44113	45-2556898	501(C)(3)	6,000	0			COMMUNITY SUPPORT
(10) BIKUR CHOLIM OF CLEVELAND 1845 SOUTH TAYLOR ROAD CLEVELAND HEIGHTS,OH44118	34-1809885	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(11) BIRTHING BEAUTIFUL COMMUNITIES 1416 EAST 105TH STREET CLEVELAND,OH44106	47-4453278	501(C)(3)	150,000	0			HEALTHCARE RESEARCH & EDUCATION
(12) BOYS & GIRLS CLUB OF MARTIN COUNTY INC PO BOX 910 HOBE SOUND,FL33475	65-0253002	501(C)(3)	43,374	0			COMMUNITY SUPPORT
(13) BOYS & GIRLS CLUBS OF BROWARD COUNTY INC 877 NW 61ST STREET FORT LAUDERDALE,FL33309	59-1108790	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(14) CANOPY CHILD ADVOCACY CENTER PO BOX 5386 CLEVELAND,OH44101	84-3398528	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(15) CASE WESTERN RESERVE UNIVERSITY 2040 ADELBERT ROAD CLEVELAND,OH44106	34-1018992	501(C)(3)	22,900	0			COMMUNITY SUPPORT
(16) CHILDREN'S HEART FOUNDATION 5 REVERE DRIVE STE 200 NORTHBROOK,IL60062	36-4077528	501(C)(3)	7,500	0			COMMUNITY SUPPORT
(17) CHILDREN'S HUNGER ALLIANCE 1105 SCHROCK ROAD 505 COLUMBUS,OH43229	23-7303509	501(C)(3)	130,000	0			COMMUNITY SUPPORT
(18) CHILDREN'S INSTITUTE INC 2121 W TEMPLE STREET LOS ANGELES,CA90026	95-1641424	501(C)(3)	12,500	0			COMMUNITY SUPPORT
(19) CITY MISSION 84 W WHEELING STREET WASHINGTON,PA15301	34-0760586	501(C)(3)	107,040	0			HEALTHCARE RESEARCH & EDUCATION
(20) CITY OF AKRON 166 S HIGH STREET AKRON,OH44308	34-6000020	501(C)(1)	5,900	0			COMMUNITY SUPPORT
(21) CLEVELAND FURNITURE BANK 13360 SMITH ROAD MIDDLEBURG HEIGHTS,OH44130	56-2610534	501(C)(3)	9,540	0			COMMUNITY SUPPORT
(22) CLEVELAND LEADERSHIP CENTER 1240 HURON ROAD E ST 450 CLEVELAND,OH44115	34-1927317	501(C)(3)	11,000	0			COMMUNITY SUPPORT
(23) CLEVELAND METROPOLITAN SCHOOL DISTRICT 1111 SUPERIOR AVE E STE 1800 CLEVELAND,OH44114	34-3740643	501(C)(1)	10,000	0			COMMUNITY SUPPORT
(24) COLLEGE NOW GREATER CLEVELAND INC 1500 W 3RD STREET STE 125 CLEVELAND,OH44113	34-6580096	501(C)(3)	120,000	0			COMMUNITY SUPPORT
(25) COLORECTAL CANCER ALLIANCE 1025 VERMONT AVENUE NW STE 1066 WASHINGTON,DC20005	86-0947831	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(26) CROHNS & COLITIS FOUNDATION INC 733 THIRD AVENUE STE 510 NEW YORK,NY10017	13-6193105	501(C)(3)	73,500	0			COMMUNITY SUPPORT
(27) CUYAHOGA COMMUNITY COLLEGE FOUNDATION 700 CARNEGIE AVENUE CLEVELAND,OH44115	23-7320719	501(C)(3)	27,000	0			COMMUNITY SUPPORT
(28) DIAPER BANK OF GREATER CLEVELAND 12200 FAIRHILL ROAD CLEVELAND,OH44120	84-1957545	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(29) DIGITALC 6815 EUCLID AVENUE CLEVELAND,OH44103	81-1731053	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(30) EL CENTRO DE SERVICIOS SOCIALES INC 2800 PEARL AVENUE LORAIN,OH44055	34-1165756	501(C)(3)	27,500	0			COMMUNITY SUPPORT
(31) ENVIRONMENTAL HEALTH WATCH FOREMAN 4600 EUCLID AVENUE CLEVELAND,OH44103	34-1443935	501(C)(3)	11,749	0			COMMUNITY SUPPORT
(32) FAIRFAX RENAISSANCE DEVELOPMENT CORPORATION 8111 QUINCY AVENUE STE 100 CLEVELAND,OH44104	34-1706856	501(C)(3)	410,000	0			COMMUNITY SUPPORT
(33) FAMICOS FOUNDATION INC 1325 ANSEL ROAD CLEVELAND,OH44106	34-1053534	501(C)(3)	22,500	0			COMMUNITY SUPPORT
(34) FEEDING MEDINA COUNTY 650 W SMITH ROAD STE C-8 MEDINA,OH44256	45-4049528	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(35) GATHERING PLACE 23300 COMMERCE PARK BEACHWOOD,OH44122	34-1879035	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(36) GILDA'S CLUB OF SOUTH FLORIDA INC 4850 W PROSPECT ROAD FORT LAUDERDALE,FL33309	65-0528626	501(C)(3)	30,000	0			COMMUNITY SUPPORT
(37) GIRLS ON THE RUN OF GREATER SUMMIT 8929 BRECKSVILLE ROAD BRECKSVILLE,OH44141	47-0991498	501(C)(3)	5,460	0			COMMUNITY SUPPORT
(38) GREATER CLEVELAND FOOD BANK INC 15500 SOUTH WATERLOO ROAD CLEVELAND,OH44110	34-1292848	501(C)(3)	25,736	0			COMMUNITY SUPPORT
(39) GREATER CLEVELAND PARTNERSHIP 1240 HURON ROAD E STE 300 CLEVELAND,OH44115	34-0149250	501(C)(6)	10,000	0			COMMUNITY SUPPORT
(40) GREATER CLEVELAND SPORTS COMMISSION 334 EUCLID AVE STE 100 CLEVELAND,OH44114	31-1381131	501(C)(3)	163,200	0			COMMUNITY SUPPORT
(41) HAUS OF TRANSCENDENT 908 HERRICK ROAD CLEVELAND,OH44108	92-1577766	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(42) HEALTHY LAKEWOOD FOUNDATION PO BOX 770230 LAKEWOOD,OH44107	83-2537125	501(C)(3)	500,000	0			COMMUNITY SUPPORT
(43) HITCHCOCK CENTER FOR WOMEN INC 1227 ANSEL ROAD CLEVELAND,OH44108	34-1264097	501(C)(3)	2,500,000	0			COMMUNITY SUPPORT
(44) HOPE RECOVERY COMMUNITY 200 HIGHLAND DRIVE MEDINA,OH44256	83-2330980	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(45) HUNGER NETWORK OF GREATER CLEVELAND 4415 EUCLID AVENUE STE 110 CLEVELAND,OH44103	34-1810545	501(C)(3)	6,500	0			COMMUNITY SUPPORT
(46) JOSETTE BEDDELL MEMORIAL FOUNDATION 2005 MARKET AVENUE N STE 3 CANTON,OH44714	27-2164164	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(47) JOURNEY CENTER FOR SAFETY AND HEALING PO BOX 5466 CLEVELAND,OH44101	34-1278377	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(48) LAKE COUNTY FREE CLINIC INC 89 CHESTER STREET PAINESVILLE,OH44077	34-1081191	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(49) LEGAL AID SOCIETY OF CLEVELAND 1223 WEST SIXTH STREET CLEVELAND,OH44113	34-0866026	501(C)(3)	384,000	0			COMMUNITY SUPPORT
(50) LESBIAN GAY BISEXUAL TRANSGENDER COMMUNITY CENTER 6705 DETROIT AVENUE CLEVELAND,OH44102	34-1190920	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(51) LIFEACT 210 BELL STREET CHAGRIN FALLS,OH44022	34-1724365	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(52) LORAIN COUNTY FREE CLINIC INC 5040 OBERLIN AVENUE LORAIN,OH44053	34-1506180	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(53) MARCH OF DIMES INC 1550 CRYSTAL DRIVE STE 1300 ARLINGTON,VA22202	13-1846366	501(C)(3)	30,000	0			COMMUNITY SUPPORT
(54) MEDWISH INTERNATIONAL 17325 EUCLID AVENUE CLEVELAND,OH44112	34-1903712	501(C)(3)	0	7,710,008	FAIR MARKET VALUE	MEDICAL SUPPLIES	COMMUNITY SUPPORT
(55) MOBILE SCHOOL PANTRY INC SOUTH FLORIDA PO BOX 223126 HOLLYWOOD,FL33022	32-0420453	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(56) MUSICAL ARTS ASSOCIATION 11001 EUCLID AVENUE CLEVELAND,OH44106	34-0714468	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(57) NATIONAL ARBOR DAY FOUNDATION 211 N 12TH STREET STE 501 LINCOLN,NE68508	23-7169265	501(C)(3)	25,025	0			COMMUNITY SUPPORT
(58) NATIONAL KIDNEY FOUNDATION INC 30 EAST 33RD STREET NEW YORK,NY10016	13-1673104	501(C)(3)	11,000	0			HEALTHCARE RESEARCH & EDUCATION
(59) NATIONAL ORGANIZATION FOR ARTS IN HEALTH 3157 THIRD AVENUE SAN DIEGO,CA92103	82-0682604	501(C)(3)	7,000	0			COMMUNITY SUPPORT
(60) NATIONAL MULTIPLE SCLEROSIS SOCIETY 733 THIRD AVENUE NEW YORK,NY10017	13-5661935	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(61) NEAR WESTSIDE MULTISERVICE CORPORATION 4115 BRIDGE AVENUE CLEVELAND,OH44113	23-7061949	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(62) NORTH UNION FARMERS MARKET 13111 SHAKER SQUARE STE 301 CLEVELAND,OH44120	34-1812026	501(C)(3)	18,500	0			COMMUNITY SUPPORT
(63) OBERLIN COMMUNITY SERVICES COUNCIL 285 SOUTH PROFESSOR STREET OBERLIN,OH44074	34-0907948	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(64) OHIO MINORITY SUPPLIER DEVELOPMENT COUNCIL 100 EAST BROAD STREET STE 2460 COLUMBUS,OH43215	31-1022688	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(65) OHIOGUIDESTONE 343 WEST BAGLEY ROAD 4TH FLOOR BEREA,OH44017	34-0720558	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(66) OLD BROOKLYN COMMUNITY DEVELOPMENT CORPORATION 4274 PEARL ROAD CLEVELAND,OH44109	34-1177633	501(C)(3)	6,500	0			COMMUNITY SUPPORT
(67) OUTRUN OVARIAN CANCER PO BOX 40332 BAY VILLAGE,OH44140	80-0093560	501(C)(3)	10,000	0			HEALTHCARE RESEARCH & EDUCATION
(68) PACE CENTER FOR GIRLS INC 6745 PHILIPS INDUSTRIAL BOULEVARD JACKSONVILLE,FL32256	59-2414492	501(C)(3)	33,750	0			COMMUNITY SUPPORT
(69) PANCREATIC CANCER ACTION NETWORK INC 1500 ROSECRANS AVENUE STE 200 MANHATTAN BEACH,CA90266	33-0841281	501(C)(3)	7,500	0			COMMUNITY SUPPORT
(70) PARKINSON'S FOUNDATION INC 200 SE 1ST STREET STE 800 MIAMI,FL33131	13-1866796	501(C)(3)	10,500	0			COMMUNITY SUPPORT
(71) PIANO INTERNATIONAL ASSOC OF NORTHERN OH 20600 CHAGRIN BOULEVARD STE 610 SHAKER HEIGHTS,OH44122	34-1774615	501(C)(3)	25,000	0			HEALTHCARE RESEARCH & EDUCATION
(72) PREGNANT WITH POSSIBILITIES RESOURCE CENTER 16004 BROADWAY AVENUE MAPLE HEIGHTS,OH44137	47-2882533	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(73) PROVIDENCE HOUSE INC 2050 W 32ND STREET CLEVELAND,OH44113	34-1336325	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(74) REGINA HEALTH CENTER 5232 BROADVIEW ROAD RICHFIELD,OH44286	34-1722394	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(75) RONALD MCDONALD HOUSE CHARITIES OF NORTHEAST OHIO INC 10415 EUCLID AVENUE CLEVELAND,OH44106	34-1269123	501(C)(3)	179,505	0			COMMUNITY SUPPORT
(76) SAY YES CLEVELAND SCHOLARSHIP INC 1422 EUCLID AVE STE 1300 CLEVELAND,OH44115	83-3463932	501(C)(3)	100,000	0			COMMUNITY SUPPORT
(77) SENIOR COLLABORATIVE OF INDIAN RIVER COUNTY INC 1836 14TH AVENUE STE 204 VERO BEACH,FL32962	83-1714542	501(C)(3)	5,500	0			COMMUNITY SUPPORT
(78) SHAPE CLEVELAND 5193 CHELTENHAM BOULEVARD LYNDHURST,OH44124	82-2181305	501(C)(3)	23,358	0			COMMUNITY SUPPORT
(79) SISTERS HAVEN 21330 AVALON DRIVE ROCKY RIVER,OH44116	88-2562122	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(80) SPECIAL OLYMPICS FLORIDA INC 1915 DON WICKHAM DRIVE CLERMONT,FL34711	23-7181560	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(81) ST EDWARD HIGH SCHOOL 13500 DETROIT AVENUE LAKEWOOD,OH44107	34-0737808	501(C)(3)	11,000	0			COMMUNITY SUPPORT
(82) ST MARTIN DE PORRES HIGH SCHOOL 6111 LAUSCHE AVENUE CLEVELAND,OH44103	52-2401852	501(C)(3)	108,432	0			COMMUNITY SUPPORT
(83) THE CENTERS FOR FAMILIES AND CHILDREN 4500 EUCLID AVENUE CLEVELAND,OH44103	23-7084455	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(84) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION 9500 EUCLID AVE CLEVELAND,OH44195	34-0714553	501(C)(3)	25,944,669	0			HEALTHCARE RESEARCH & EDUCATION
(85) THE HAVEN HOME LLC 6114 FRANCIS AVENUE CLEVELAND,OH44127	82-2847184	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(86) THE MALTZ MUSEUM OF JEWISH HERITAGE 2929 RICHMOND ROAD BEACHWOOD,OH44122	04-3684531	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(87) THE MARFAN FOUNDATION INC 22 MANHASSET AVENUE PORT WASHINGTON,NY11050	52-1265361	501(C)(3)	15,000	0			HEALTHCARE RESEARCH & EDUCATION
(88) THE NORTHEAST OHIO HISPANIC CHAMBER OF COMMERCE 2511 CLARK AVENUE CLEVELAND,OH44109	34-1555659	501(C)(6)	85,000	0			COMMUNITY SUPPORT
(89) THE SALVATION ARMY 440 WEST NYACK ROAD WEST NYACK,NY10994	13-5562351	501(C)(3)	20,000	0			COMMUNITY SUPPORT
(90) THE WORD CHURCH 18909 S MILES ROAD WARRENSVILLE HEIGHTS,OH44128	03-0415420	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(91) TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA 3451 WALNUT STREET STE 305 PHILADELPHIA,PA19104	23-1352685	501(C)(3)	9,188	0			COMMUNITY SUPPORT
(92) TYKES & TEENS INC 3577 SW CORPORATE PARKWAY PALM CITY,FL34990	65-0570899	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(93) UNITED AGAINST POVERTY INC 1400 27TH STREET VERO BEACH,FL32960	11-3697936	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(94) UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND 10011 EUCLID AVENUE CLEVELAND,OH44106	34-0753561	501(C)(3)	121,222	0			COMMUNITY SUPPORT
(95) UNITED WAY OF MARTIN COUNTY INC PO BOX 362 STUART,FL34995	23-7273540	501(C)(3)	16,000	0			COMMUNITY SUPPORT
(96) UNITED WAY OF SUMMIT AND MEDINA 37 NORTH HIGH STREET STE A AKRON,OH44308	34-1169257	501(C)(3)	25,000	0			COMMUNITY SUPPORT
(97) URBAN LEAGUE OF BROWARD COUNTY INC 560 NW 27TH AVENUE FORT LAUDERDALE,FL33311	59-1564384	501(C)(3)	22,500	0			COMMUNITY SUPPORT
(98) USA WORLD CONGRESS OF PEDIATRIC CARDIOLOGY AND CARDIAC SURGERY 7301 2ND AVENUE SOUTH ST PETERSBURG,FL33707	82-1564296	501(C)(3)	10,000	0			HEALTHCARE RESEARCH & EDUCATION
(99) VILLAGE PROJECT PO BOX 40023 BAY VILLAGE,OH44140	61-1705980	501(C)(3)	7,000	0			COMMUNITY SUPPORT
(100) WEST PARK KAMMS NEIGHBORHOOD DEVELOPMENT 17407 LORAIN AVENUE CLEVELAND,OH44111	34-1254542	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(101) YOUNG LATINO NETWORK 3167 FULTON ROAD STE 305B CLEVELAND,OH44109	27-0554602	501(C)(3)	10,000	0			COMMUNITY SUPPORT
(102) YOUNG MENS CHRISTIAN ASSOCIATION OF CLEVELAND 1301 EAST 9TH STREET CLEVELAND,OH44114	34-0714728	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(103) ZEEBEE'S HEARTSAVERS LLC 2490 LEE BOULEVARD CLEVELAND HEIGHTS,OH44118	88-3781671	501(C)(3)	15,000	0			COMMUNITY SUPPORT
(104) ZELIE'S HOME PO BOX 25612 GARFIELD HEIGHTS,OH44125	85-1358110	501(C)(3)	10,000	0			COMMUNITY SUPPORT

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

100

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) 2023

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	197	9,048,309
(2) FELLOWSHIPS	1603	88,742,115
(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) 2023

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
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

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) 2023

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)	5,349,125 ------------- 0	0 ------------- 0	1,617,459 ------------- 0	33,000 ------------- 0	22,218 ------------- 0	7,021,802 ------------- 0	0 ------------- 0
2BOLWELL MD BRIAN PHYSICIAN (2023 RETIREE)	(i) (ii)	1,335,356 ------------- 0	0 ------------- 0	3,048,802 ------------- 0	-140,451 ------------- 0	14,220 ------------- 0	4,257,927 ------------- 0	0 ------------- 0
3VIDIMOS MD ALLISON PHYSICIAN (2023 RETIREE)	(i) (ii)	753,250 ------------- 0	0 ------------- 0	2,274,486 ------------- 0	81,411 ------------- 0	1,500 ------------- 0	3,110,647 ------------- 0	0 ------------- 0
4FALCONE MD TOMMASO INTERIM CEO CC LONDON (PART YR)	(i) (ii)	0 ------------- 580,016	0 ------------- 0	0 ------------- 1,924,299	0 ------------- 33,000	0 ------------- 24,102	0 ------------- 2,561,417	0 ------------- 0
5ROWAN DAVID SEC, EXEC VP, CHIEF LEGAL OFF	(i) (ii)	2,018,906 ------------- 0	0 ------------- 0	383,979 ------------- 0	33,000 ------------- 0	18,446 ------------- 0	2,454,331 ------------- 0	0 ------------- 0
6SVENSSON MD LARS INSTITUTE CHIEF - HVTI	(i) (ii)	2,097,270 ------------- 0	0 ------------- 0	187,017 ------------- 0	33,000 ------------- 0	22,511 ------------- 0	2,339,798 ------------- 0	0 ------------- 0
7LARAWAY DENNIS EXEC VP, CFO & TREASURER (PART YR)	(i) (ii)	2,242,360 ------------- 0	0 ------------- 0	42,845 ------------- 0	28,435 ------------- 0	15,989 ------------- 0	2,329,629 ------------- 0	0 ------------- 0
8CHANDRA PHD ROHIT CHIEF DIGITAL OFFICER	(i) (ii)	2,043,958 ------------- 0	0 ------------- 0	126,853 ------------- 0	33,000 ------------- 0	15,184 ------------- 0	2,218,995 ------------- 0	0 ------------- 0
9STREIN STEFAN CHIEF INVESTMENT OFFICER	(i) (ii)	1,925,842 ------------- 0	0 ------------- 0	237,634 ------------- 0	33,000 ------------- 0	20,501 ------------- 0	2,216,977 ------------- 0	0 ------------- 0
10PEACOCK WILLIAM EXEC VP, CHIEF OF OPERATIONS	(i) (ii)	1,855,324 ------------- 0	0 ------------- 0	293,367 ------------- 0	35,148 ------------- 0	17,019 ------------- 0	2,200,858 ------------- 0	0 ------------- 0
11DEYLING MD CYNTHIA RETIRED PHYSICIAN	(i) (ii)	86,108 ------------- 0	0 ------------- 0	1,957,790 ------------- 0	137,968 ------------- 0	0 ------------- 0	2,181,866 ------------- 0	0 ------------- 0
12MALONE JR MD DONALD EXEC VP, PRES OF NEO MARKET	(i) (ii)	1,285,018 ------------- 0	0 ------------- 0	166,166 ------------- 0	655,521 ------------- 0	17,325 ------------- 0	2,124,030 ------------- 0	0 ------------- 0
13HANCOCK DNP RN NE-BC KELLY EXEC VP, CHIEF CAREGIVER OFFICER	(i) (ii)	1,649,814 ------------- 0	0 ------------- 0	277,979 ------------- 0	44,568 ------------- 0	18,654 ------------- 0	1,991,015 ------------- 0	0 ------------- 0
14ERZURUM MD SERPIL EXEC VP, CHIEF RESEARCH & ACADEMIC	(i) (ii)	1,238,000 ------------- 0	0 ------------- 0	258,956 ------------- 0	357,341 ------------- 0	1,500 ------------- 0	1,855,797 ------------- 0	0 ------------- 0
15RIDGEWAY MD BERI DIR, EXEC VP, CHIEF OF STAFF	(i) (ii)	1,400,510 ------------- 0	0 ------------- 0	311,673 ------------- 0	33,000 ------------- 0	19,833 ------------- 0	1,765,016 ------------- 0	0 ------------- 0
16DELANEY MD PHD CONOR EXEC VP, PRESIDENT OF FLA MKT	(i) (ii)	0 ------------- 1,483,711	0 ------------- 0	0 ------------- 231,000	0 ------------- 33,000	0 ------------- 14,750	0 ------------- 1,762,461	0 ------------- 0
17GUZMAN MD JORGE CEO CCAD; EXEC VP, PRES NEO MKT	(i) (ii)	1,018,850 ------------- 0	0 ------------- 0	639,495 ------------- 0	33,000 ------------- 0	18,452 ------------- 0	1,709,797 ------------- 0	0 ------------- 0
18LORENZ MD ROBERT PRES, CC LONDON (PART YR)	(i) (ii)	0 ------------- 596,791	0 ------------- 0	0 ------------- 986,998	0 ------------- 33,000	0 ------------- 20,730	0 ------------- 1,637,519	0 ------------- 0
19DONLEY MD BRIAN FORMER OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 1,406,418	0 ------------- 0	0 ------------- 0	0 ------------- 1,406,418	0 ------------- 0
20MERLINO MD JAMES CHIEF CLINICAL TRANSFORMATION OFFICE	(i) (ii)	1,099,554 ------------- 0	0 ------------- 0	249,451 ------------- 0	33,000 ------------- 0	875 ------------- 0	1,382,880 ------------- 0	0 ------------- 0
21DAVIS MARLEINA T ASST. SECRETARY	(i) (ii)	751,620 ------------- 0	0 ------------- 0	36,261 ------------- 0	39,865 ------------- 0	17,154 ------------- 0	844,900 ------------- 0	0 ------------- 0
22LONGVILLE TIMOTHY VP CHIEF ACCOUNTING OFFICER	(i) (ii)	542,583 ------------- 0	0 ------------- 0	55,795 ------------- 0	55,119 ------------- 0	18,856 ------------- 0	672,353 ------------- 0	0 ------------- 0
23HELTON ANTHONY INTERIM CFO (PART YR)	(i) (ii)	471,163 ------------- 0	0 ------------- 0	63,006 ------------- 0	35,936 ------------- 0	5,019 ------------- 0	575,124 ------------- 0	0 ------------- 0
24SURI MD RAKESH FORMER KEY EMPLOYEE (RETIRED)	(i) (ii)	0 ------------- 0	0 ------------- 0	562,170 ------------- 0	0 ------------- 0	7,025 ------------- 0	569,195 ------------- 0	564,754 ------------- 0
25MEEHAN ESQ MICHAEL J RECORDING SECRETARY	(i) (ii)	450,485 ------------- 0	0 ------------- 0	40,171 ------------- 0	31,183 ------------- 0	6,676 ------------- 0	528,515 ------------- 0	0 ------------- 0
26OBLANDER JASON ASST. SECRETARY	(i) (ii)	260,647 ------------- 0	0 ------------- 0	2,750 ------------- 0	8,719 ------------- 0	18,771 ------------- 0	290,887 ------------- 0	0 ------------- 0
27WIEDEMANN MD HERBERT FORMER OFFICER (RETIRED)	(i) (ii)	210,113 ------------- 0	0 ------------- 0	0 ------------- 0	-12,930 ------------- 0	0 ------------- 0	197,183 ------------- 0	210,113 ------------- 0
28GLASS STEVEN C FORMER OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	135,862 ------------- 0	6,514 ------------- 0	0 ------------- 0	142,376 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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: RAKESH SURI, M.D. - $564,754 SCHEDULE J, PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: BRIAN BOLWELL, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $2,931,218 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. CYNTHIA DEYLING, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $1,957,790 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. ALLISON VIDIMOS, M.D. - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $2,199,177 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: BRIAN BOLWELL, M.D. - $22,641 CYNTHIA DEYLING, M.D. - $86,108 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: BRIAN BOLWELL, M.D., $173,451 DECREASE, MARLEINA DAVIS - $6,865 INCREASE, CYNTHIA DEYLING, M.D., $137,968 INCREASE, SERPIL ERZURUM, M.D. - $325,758 INCREASE, STEVEN C. GLASS - $6,514 INCREASE, KELLY HANCOCK, DNP, R.N., NE-BC - $11,568 INCREASE, ANTHONY HELTON - $2,936 INCREASE, TIMOTHY LONGVILLE - $22,119 INCREASE, DONALD MALONE, M.D. - $622,521 INCREASE, JASON OBLANDER - $692 INCREASE, WILLIAM PEACOCK $2,148 INCREASE, ALLISON VIDIMOS, M.D. - $48,411 INCREASE, AND HERBERT WIEDEMANN, M.D. - $12,930 DECREASE. FORM 990, PART VII, SECTION A AND SCHEDULE J THE COMPENSATION OF DR. BRIAN DONLEY, DR. TOMMASO FALCONE, DR. JORGE GUZMAN AND DR. ROBERT LORENZ AS REPORTED ON PART VII, SECTION A AND SCHEDULE J INCLUDES REGULAR WAGES AND TAXABLE EXPATRIATE BENEFITS.

Schedule J (Form 990) 2023

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

OMB No. 1545-0047

2023

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	309,434,915	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
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MH2	09-26-2023	300,000,000	BOND 2023: FUND VARIOUS CAPITAL PROJECTS OF THE SYSTEM		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		22,930,000		72,325,902		2,645,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,915		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) 2023

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 ....	0.450 %		0.060 %		0.120 %		1.480 %
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 .............	0.460 %		0.120 %		0.120 %		1.490 %
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) 2023

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: 10/15/2023 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: 05/29/2023
SCHEDULE K, PART I	THE TOTAL BOND PROCEEDS OF BOND SERIES 2021A DOES NOT MATCH THE BOND ISSUANCE AMOUNT REPORTED IN PART I. THIS IS DUE TO INVESTMENT EARNINGS.

Schedule K (Form 990) 2023

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

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	309,434,915	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
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MH2	09-26-2023	300,000,000	BOND 2023: FUND VARIOUS CAPITAL PROJECTS OF THE SYSTEM		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		22,930,000		72,325,902		2,645,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,915		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) 2023

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 ....	0.450 %		0.060 %		0.120 %		1.480 %
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 .............	0.460 %		0.120 %		0.120 %		1.490 %
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) 2023

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: 10/15/2023 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: 05/29/2023
SCHEDULE K, PART I	THE TOTAL BOND PROCEEDS OF BOND SERIES 2021A DOES NOT MATCH THE BOND ISSUANCE AMOUNT REPORTED IN PART I. THIS IS DUE TO INVESTMENT EARNINGS.

Schedule K (Form 990) 2023

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

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	309,434,915	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
	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	677561MH2	09-26-2023	300,000,000	BOND 2023: FUND VARIOUS CAPITAL PROJECTS OF THE SYSTEM		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	342,425,000		22,930,000		72,325,902		2,645,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	670,000,000		41,120,000		309,434,915		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) 2023

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 ....	0.450 %		0.060 %		0.120 %		1.480 %
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 .............	0.460 %		0.120 %		0.120 %		1.490 %
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) 2023

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: 10/15/2023 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: 05/29/2023
SCHEDULE K, PART I	THE TOTAL BOND PROCEEDS OF BOND SERIES 2021A DOES NOT MATCH THE BOND ISSUANCE AMOUNT REPORTED IN PART I. THIS IS DUE TO INVESTMENT EARNINGS.

Schedule K (Form 990) 2023

Additional Data

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

OMB No. 1545-0047

2023

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. ........................... $

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

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) 2023

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) ADRIENNE JAROCKI	FAMILY MEMBER OF CONOR DELANEY, M.D., PH.D., CCF OFFICER	62,186	EMPLOYMENT AGREEMENT WITH CCF		No
(2) AMANDA HANCOCK	FAMILY MEMBER OF K. KELLY HANCOCK, DNP, RN, NE-BC, CCF OFFICER	69,097	EMPLOYMENT AGREEMENT WITH CCF		No
(3) AMY MERLINO	FAMILY MEMBER OF JAMES MERLINO, M.D., CCF OFFICER	628,750	EMPLOYMENT AGREEMENT WITH CCF		No
(4) GRANT DILLON	FAMILY MEMBER OF WILLIAM M. PEACOCK, III, CCF OFFICER	19,550	EMPLOYMENT AGREEMENT WITH CCF		No
(5) JIM HALLORAN	FAMILY MEMBER OF KELLY HANCOCK, CCF OFFICER	51,493	EMPLOYMENT AGREEMENT WITH CCF		No
(6) JOANNE MCDONALD KILBANE	FAMILY MEMBER OF CATHERINE KILBANE, ESQ.,CCF DIRECTOR	92,411	EMPLOYMENT AGREEMENT WITH CCF		No
(7) LAURA SWEENEY	FAMILY MEMBER OF TIMOTHY L. LONGVILLE, CCF OFFICER	95,985	EMPLOYMENT AGREEMENT WITH CCF		No
(8) ROBERT SYTO	FAMILY MEMBER OF BERI RIDGEWAY, M.D., CCF OFFICER & DIRECTOR	61,659	EMPLOYMENT AGREEMENT WITH CCF		No
(9) RYAN OAKLEY	FAMILY MEMBER OF WILLIAM M. PEACOCK, III, CCF OFFICER	82,872	EMPLOYMENT AGREEMENT WITH CCF		No
(10) VICTORIA JAVOR	FAMILY MEMBER OF K. KELLY HANCOCK, DNP, RN, NE-BC, CCF OFFICER	103,365	EMPLOYMENT AGREEMENT WITH CCF		No
(11) AYLIN OZDEMIR-LORENZ	FAMILY MEMBER OF ROBERT LORENZ, M.D., CCF OFFICER	55,135	EMPLOYMENT AGREEMENT WITH CCF		No
(12) MICHELLE MILLER	FAMILY MEMBER OF MARK ROSS, CCF DIRECTOR	27,236	EMPLOYMENT AGREEMENT WITH CCF		No
(13) PETER DELANEY	FAMILY MEMBER OF CONOR DELANEY, M.D., PH.D., CCF OFFICER	33,633	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) 2023

Additional Data

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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

2023

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	2	32,725	APPRAISAL
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		152,789	SALE COMPARABLE GOODS
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	98	8,487,539	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 .	X	2	1,601,100	APPRAISAL
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	1	2,609	COST
20 Drugs and medical supplies .	X	2	179,722	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) (2023)

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) (2023)

Additional Data

Software ID:
Software Version:

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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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

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 (SYSTEM). CLEVELAND CLINIC WAS ESTABLISHED IN 1921. THE SYSTEM'S MISSION STATEMENT, UPDATED IN 2021 AS THE CLINIC CELEBRATED ITS CENTENNIAL YEAR, IS AS FOLLOWS: CARING FOR LIFE, RESEARCHING FOR HEALTH AND EDUCATING THOSE WHO SERVE. THE 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 THE SYSTEM FULFILLS ITS CHARITABLE PURPOSES, BUT RATHER IS A SUMMARY OF ITS PRIMARY PROGRAM SERVICES AND CONTRIBUTIONS TO THE COMMUNITY. THE SYSTEM DEFINES AND MEASURES COMMUNITY BENEFIT (INCLUDING FINANCIAL ASSISTANCE) USING THE CATHOLIC HEALTH ASSOCIATION ("CHA") COMMUNITY BENEFIT MODEL, WHICH RECOMMENDS REPORTING COMMUNITY BENEFIT ON A COST BASIS. USING THIS MODEL, IN 2023 CLEVELAND CLINIC AND ITS AFFILIATES PROVIDED $1.48 BILLION IN BENEFITS TO THE COMMUNITIES SERVED. THE COMMUNITY BENEFIT THAT THE SYSTEM PROVIDES INCLUDES PATIENT CARE PROVIDED ON A CHARITABLE BASIS, RESEARCH, EDUCATION, MEDICAID SHORTFALL, SUBSIDIZED HEALTH SERVICES, AND COMMUNITY OUTREACH PROGRAMS. THE CURRENT COMMUNITY BENEFIT REPORT IS AVAILABLE AT WWW.CLEVELANDCLINIC.ORG. I. PATIENT CARE THE SYSTEM IS A WORLD-RENOWNED PROVIDER OF HEALTHCARE SERVICES THAT ATTRACTED PATIENTS FROM ACROSS THE UNITED STATES AND FROM 131 OTHER COUNTRIES IN 2023. AS OF DECEMBER 31, 2023, THE SYSTEM OPERATES 21 HOSPITALS AND IS THE LEADING PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST OHIO. FIFTEEN OF THE HOSPITALS ARE OPERATED IN THE NORTHEAST OHIO AREA, ANCHORED BY THE CLEVELAND CLINIC FOUNDATION. THE SYSTEM OPERATES 22 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. 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. THE SYSTEM IS DEDICATED TO THE COMMUNITIES IT SERVES STRIVING TO PROVIDE COMPASSIONATE, HIGH-QUALITY HEALTHCARE TO ALL WHO NEED IT; AND SUPPORTING PROGRAMS AND INITIATIVES THAT IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES. THROUGH ITS FINANCIAL ASSISTANCE EFFORTS AND AS A LEADING MEDICAID PROVIDER IN OHIO, CLEVELAND CLINIC PROVIDES HEALTHCARE TO THOSE WHO OTHERWISE COULD NOT AFFORD IT. IN 2023, CLEVELAND CLINIC RECORDED 1,273 TOTAL STAFFED BEDS, 124,200 EMERGENCY VISITS, 86,488 SURGICAL CASES, 53,933 ADMISSIONS, AND MORE THAN 13.6 MILLION TOTAL CLINIC VISITS. IT IS THE POLICY OF THE SYSTEM TO TREAT ALL PATIENTS WITH COMPASSION, DIGNITY AND RESPECT, REGARDLESS OF THEIR RACE, CREED, OR ABILITY TO PAY. AFTER YEARS OF PLANNING, IN 2023 THE SYSTEM IMPLEMENTED A NEW OPERATING MODEL THAT REDEFINES HOW CLEVELAND CLINIC ORGANIZES AND ADMINISTERS ITS CLINICAL SERVICES. THE SYSTEM IS A COMPLEX GLOBAL ORGANIZATION. THIS NEW FRAMEWORK PREPARES CLEVELAND CLINIC FOR FUTURE GROWTH BY SIMPLIFYING ITS STRUCTURE, MAKING IT REPRODUCIBLE AND ENSURING THAT CLEVELAND CLINIC OPERATES OPTIMALLY, EFFICIENTLY AND UNIFORMLY EVERYWHERE IT SERVES PATIENTS. THAT CREATES THE BEST ENVIRONMENT FOR ITS CAREGIVERS TO PROVIDE CARE. A KEY FEATURE OF THE OPERATING MODEL INCLUDES 11 CLINICAL INSTITUTES, WHICH OVERSEE SPECIFIC TYPES OF SPECIALIZED CARE. EACH INSTITUTE'S LEADERSHIP DIRECTS A GLOBAL COMMUNITY OF CAREGIVERS, ENSURING COLLABORATION, EXCELLENCE AND CONSISTENCY OF CARE ACROSS ALL LOCATIONS. 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. THE INSTITUTES ARE CANCER; HEART, VASCULAR AND THORACIC; MEDICAL SPECIALTY; DIGESTIVE DISEASE; PRIMARY CARE; INTEGRATED SURGICAL; INTEGRATED HOSPITAL BASED CARE; NEUROLOGICAL; DIAGNOSTICS; OBSTETRICS & GYNECOLOGY AND CHILDREN'S. 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 2023. OVERALL, CLEVELAND CLINIC WAS AMONG THE NATION'S BEST HOSPITALS. FOR THE 29TH CONSECUTIVE YEAR, CLEVELAND CLINIC RANKED BEST IN THE NATION FOR CARDIOLOGY AND HEART SURGERY, EARNING THE NO. 1 SPOT. SEVEN CLEVELAND CLINIC SPECIALTIES ALSO RANKED IN THE TOP 10. OF THESE, THREE PLACED IN THE TOP 5 INCLUDING: CARDIOLOGY & HEART SURGERY; UROLOGY; RHEUMATOLOGY. CLEVELAND CLINIC WAS NATIONALLY RANKED IN 12 ADULT SPECIALTIES AND 9 CHILDREN'S SPECIALTIES. CLEVELAND CLINIC WAS ALSO RATED HIGH PERFORMING IN TWENTY 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 THIRTEENTH TIME IN FIFTEEN 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 2023 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". 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 2023, 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 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 SYSTEM PROVIDED FINANCIAL ASSISTANCE AT A COST OF $261.3 MILLION IN 2023.
FORM 990, PART III, PROGRAM SERVICE STATEMENT (CONTINUED)	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 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 241 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, 1,832 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 2023, CLEVELAND CLINIC WAS INVOLVED IN 3,719 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 2023, CLEVELAND CLINIC PROVIDED COMMUNITY BENEFIT IN RESEARCH AT A SUBSIDIZED COST OF MORE THAN $135.0 MILLION, WHICH IS NET OF GRANTS AND OTHER EXTERNAL FUNDING OF $231.7 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. THE SYSTEM DEVOTES SUBSTANTIAL RESOURCES TO EDUCATION PROGRAMS, WHICH, IN 2023, PROVIDED A NET COMMUNITY BENEFIT OF $350.8 MILLION. THESE EDUCATIONAL ACTIVITIES ENSURE RESIDENTS AND PATIENTS IN ALL THE 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 2023, 1,129 RESIDENTS AND FELLOWS TRAINED IN 87 ACCREDITED TRAINING PROGRAMS, APPROVED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), INCLUDING 148 ADVANCED FELLOWS IN 109 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 1,690 APPLICANTS FOR 32 POSITIONS FOR THE 2023-24 ACADEMIC YEAR. THE PROGRAM'S STUDENTS HAVE MATCHED AT SOME OF THE MOST PRESTIGIOUS HOSPITALS THROUGHOUT THE UNITED STATES AND HAVE CONTRIBUTED 88 PUBLICATIONS TO THE WORLD'S STORE OF SCIENTIFIC KNOWLEDGE BASED ON THE 2023 CALENDAR YEAR (WHICH INCLUDES PUBLISHED ARTICLES AND ABSTRACT SUBMISSIONS), AND 55 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 2023, 598 MEDICAL STUDENTS FROM 264 MEDICAL SCHOOLS AROUND THE WORLD ROTATED THROUGH CLEVELAND CLINIC. -CENTER FOR CONTINUING EDUCATION: CLEVELAND CLINIC MAINTAINS ONE OF THE LARGEST CONTINUING MEDICAL EDUCATIONS (CME) PROGRAMS IN THE COUNTRY AND ENJOYS THE HIGHEST ACCME RANKING: ACCREDITATION WITH COMMENDATION. IN 2023, THE CENTER FOR CONTINUING EDUCATION CERTIFIED 2,589 CME ACTIVITIES THAT OFFERED OVER 13,082 CME CREDITS TO 517,408 PARTICIPANTS. OF THAT NUMBER, 1,791 WERE LIVE COURSES THAT ATTRACTED 121,570 PARTICIPANTS. CLEVELAND CLINIC IS ONE OF THE LARGEST PROVIDERS OF ONLINE CME AMONG THE NATION'S ACADEMIC MEDICAL CENTERS. THE CENTER'S WEBSITE HAD 751 ACTIVITIES THAT ATTRACTED 2,374,097 ACTIVITY VIEWERS. JOURNAL CME CONTINUES TO REACH A LARGE NUMBER OF LEARNERS, AWARDING MORE THAN 27,149 CERTIFICATES TO CLEVELAND CLINIC JOURNAL OF MEDICINE (CCJM) PARTICIPANTS. IN 2023, THE CENTER ISSUED 517,408 CERTIFICATES FOR ALL ACTIVITIES COMBINED. -THE CCJM ENJOYED A CIRCULATION OF MORE THAN 129,647 COPIES AND RANKED NO. 3 IN READERSHIP AMONG JOURNALS DIRECTED TO OFFICE-BASED INTERNISTS AND CARDIOLOGISTS. EACH YEAR, THE PRINT AND ONLINE VERSIONS ARE READ OR ACCESSED BY APPROXIMATELY 3.7 MILLION PEOPLE AROUND THE WORLD. IN 2023, THE CCJM WEBSITE RECORDED 4,369,060 PAGE VIEWS AND 4,593,414 UNIQUE VISITORS TO ONLINE JOURNALS. -CENTER FOR HEALTH SCIENCES EDUCATION: CLEVELAND CLINIC IS A MAJOR EDUCATION AND TRAINING SITE FOR A NUMBER OF ALLIED HEALTH STUDENTS FROM VARIOUS ACADEMIC PROGRAMS THROUGHOUT THE REGION. THE SYSTEM CURRENTLY OFFERS 15 IN-HOUSE ALLIED HEALTH PROGRAMS AND HAS 42 AFFILIATED PROGRAMS WITH REGIONAL ACADEMIC INSTITUTIONS. IN 2023, SYSTEM HOSTED MORE THAN 374,481 CLINICAL ROTATION HOURS FOR OVER 997 HEALTH SCIENCE STUDENTS. -CENTER FOR INTERNATIONAL MEDICAL EDUCATION: THE CENTER FOR INTERNATIONAL MEDICAL EDUCATION 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 SYSTEM ANNUALLY REPORTS TO THE COMMUNITY. THE OTHER COMPONENTS OF THE CLEVELAND CLINIC'S COMMUNITY BENEFIT ARE: MEDICAID SHORTFALL THE 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 2023, THE HEALTH SYSTEM'S UNPAID MEDICAID COSTS WERE $640.9 MILLION (THIS FIGURE INCLUDES AN HCAP ASSESSMENT OF $7.1 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 2023 AT A COST OF $21.5 MILLION. COMMUNITY OUTREACH PROGRAMS THE 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 $43.4 MILLION, PARTIALLY OFFSET BY EXTERNAL FUNDING. THESE PROGRAMS ARE DESIGNED TO SERVE THE VULNERABLE AND AT-RISK POPULATIONS, AS WELL AS THE 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.
FORM 990, PART III, PROGRAM SERVICE STATEMENT (CONTINUED)	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 2023, SOME HIGHLIGHTS INCLUDED: -WELLNESS INITIATIVES TO RESIDENTS, SCHOOLS AND COMMUNITY-BASED ORGANIZATIONS IN THE AREAS OF DISEASE PREVENTION, 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 AND PROVIDED METHODS TO DECREASE INFANT MORTALITY INCLUDING PROACTIVE CENTERING PROGRAMS. -WORKFORCE DEVELOPMENT PROGRAMS CONDUCTED FOR 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 INCLUDE A NEW 40,000-SQUARE-FOOT GROCERY MARKET 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 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	WILLIAM M. PEACOCK III, CCF OFFICER & TIMOTHY L. LONGVILLE, CCF OFFICER - BUSINESS DEBORAH CRAWFORD, CCF OFFICER & PATRICK V. AULETTA, CCF DIRECTOR - BUSINESS WILLIAM M. PEACOCK III, CCF OFFICER & K. KELLY HANCOCK, DNP, RN, NE-BC, 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 4	CCF ADOPTED A NEW CODE OF REGULATIONS. SIGNIFICANT CHANGES INCLUDED: SPLIT OF BOARD OF GOVERNORS AND MEDICAL EXECUTIVE COMMITTEE; REMOVAL OF REPRESENTATIVES FROM BOARD OF GOVERNORS TO BOARD OF DIRECTORS OR BOARD OF TRUSTEES; COMPOSITION OF BOARD OF GOVERNORS; REMOVAL OF BOARD OF GOVERNORS RESPONSIBILITY TO BE INVOLVED IN SELECTION PROCESS FOR CEO OR CHIEF OF STAFF.
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 CLEVELAND CLINIC" SECTION. IN THIS SECTION, THE FINANCIAL STATEMENTS, ANNUAL REPORT, COMMUNITY BENEFIT REPORT, CCF'S CONFLICT OF INTEREST POLICY, AND CORPORATE COMPLIANCE POLICIES ARE AVAILABLE.
FORM 990, PART XI, LINE 9:	DONATED CAPITAL AND ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL PURPOSES 1,218,394. GIFTS AND BEQUESTS 123,280,081. TRANSFERS OF NET ASSETS -643,112,543. NET INVESTMENT INCOME 80,081,781. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS -105,576,001. RETIREMENT BENEFITS ADJUSTMENT 2,351,686. EQUITY TRANSFERS & OTHER TRANSFERS 225,717.
FORM 990, PART XI, LINE 8	THE PRIOR PERIOD ADJUSTMENT IN THE AMOUNT OF $466,986,350 IS DUE TO VARIOUS ENTITIES THAT CONVERTED AND ARE NOW INCLUDED INTO 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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

OMB No. 1545-0047

2023

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) AKRON GENERAL MEDICAL CENTER OUTPATIENT PHARMACY LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 84-2380272	HEALTH CARE SERVICES	OH	8,366,404	2,998,457	AKRON GENERAL HEALTH SYSTEM
(2) CCF AMBULATORY SURGERY CENTERS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1939710	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(3) CCF HOTEL SERVICES LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-0666034	HOTEL OPERATIONS	OH	38,283,816	90,839,260	THE CLEVELAND CLINIC FOUNDATION
(4) CLEVELAND CLINIC CARE COORDINATION LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-5282492	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(5) CLEVELAND CLINIC FLORIDA CONCIERGE MEDICINE LLC 1301 EAST BROWARD BLVD STE 330 FT LAUDERDALE,FL33301 82-3186835	HEALTH CARE SERVICES	FL	2,823,507	426,046	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(6) CLEVELAND CLINIC FLORIDA HOME HEALTHCARE LLC 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 83-2250064	HEALTH CARE SERVICES	FL	0	0	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(7) CLEVELAND CLINIC FLORIDA NAPLES LLC 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 31-1741150	INACTIVE	FL	0	0	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(8) CLEVELAND CLINIC GLOBAL SOLUTIONS II LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 87-1180623	HEALTH CARE SERVICES	OH	951,425	2,703,224	THE CLEVELAND CLINIC FOUNDATION
(9) CLEVELAND CLINIC GLOBAL SOLUTIONS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-3666730	HEALTH CARE SERVICES	OH	72,967,780	82,117,710	THE CLEVELAND CLINIC FOUNDATION
(10) CLEVELAND CLINIC MEDICARE ACO LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 47-1281189	HEALTH CARE SERVICES	OH	12,358,313	5,605,939	THE CLEVELAND CLINIC FOUNDATION
(11) CLEVELAND CLINIC OHIO REGIONAL PHYSICIANS LLC 1330 MERCY DRIVE NW SUITE 506 CANTON,OH44708 92-1359067	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(12) CLEVELAND CLINIC RISK RETENTION GROUP LLC 701 EAST BAY STREET SUITE 514 CHARLESTON,SC29403 87-2395525	RISK RETENTION GROUP	SC	586,945	17,830,260	THE CLEVELAND CLINIC FOUNDATION
(13) CLEVELAND CLINIC WELLNESS ENTERPRISE LLC 1950 RICHMOND ROAD LYNDHURST,OH44124 26-3859233	HEALTH CARE SERVICES	OH	2,959,292	379,314	THE CLEVELAND CLINIC FOUNDATION
(14) CLINIC MEDICAL SERVICES COMPANY LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1932969	HEALTH CARE SERVICES	OH	86,544,307	0	THE CLEVELAND CLINIC FOUNDATION
(15) EDWIN SHAW REHAB LLC 330 BROADWAY STREET EAST CUYAHOGA FALLS,OH44221 27-0119182	REHABILITATION FACILITY	OH	8,999	1,353,149	AKRON GENERAL MEDICAL CENTER
(16) INTELLIS EPM LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 27-0645368	MEDICAL TECHNOLOGY	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(17) IRMCF#1 LLC 1000 36TH STREET VERO BEACH,FL32960 59-0760215	REAL ESTATE HOLDINGS	FL	0	0	INDIAN RIVER HOSPITAL FOUNDATION INC
(18) IVHR LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-4657632	MEDICAL TECHNOLOGY	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(19) MARTIN SURGICAL VENTURES LLC 333 THIRD STREET N STE 200 ST PETERSBURG,FL33701 32-0496475	SURGICAL VENTURE	FL	1,498,119	1,669,736	MARTIN MEMORIAL MEDICAL CENTER INC
(20) MEDICAL CENTER AT HOBE SOUND LLC PO BOX 9033 STUART,FL34995 65-0748232	RENTAL REAL ESTATE	OH	218,492	676,390	MARTIN MEMORIAL MEDICAL CENTER INC
(21) MEDICAL CENTER AT ST LUCIE WEST LLC PO BOX 9033 STUART,FL34995 65-0504863	RENTAL REAL ESTATE	OH	1,487,289	2,663,257	MARTIN MEMORIAL MEDICAL CENTER INC
(22) MEDINA HEALTH VENTURES LLC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1533871	INACTIVE	OH	0	0	MEDINA HOSPITAL
(23) MERCY PROFESSIONAL CARE LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 34-1873008	HEALTH CARE SERVICES	OH	17,173,657	2,337,183	THE CLEVELAND CLINIC FOUNDATION
(24) MONTROSE SLEEP CENTER LLC 4125 MEDINA ROAD AKRON,OH44333 20-0494491	HEALTH CARE SERVICES	OH	1,469,129	3,657,627	AKRON GENERAL PARTNERS INC
(25) NEUROOPERATIVE MONITORING LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 30-0746215	INACTIVE	OH	0	0	AKRON GENERAL PARTNERS INC
(26) NORTHEAST OHIO NEUROLOGICAL ASSOCIATES LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 20-0442351	HEALTH CARE SERVICES	OH	0	0	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(27) OBVF VII LLC 10000 CEDAR AVE CLEVELAND,OH44106 86-1185460	GRANT RECEIVING ORGANIZATION	OH	698,882	29,666,340	THE CLEVELAND CLINIC FOUNDATION
(28) OBVF VIII LLC 10000 CEDAR AVE CLEVELAND,OH44106 87-1129899	GRANT RECEIVING ORGANIZATION	OH	81,245	15,179,404	THE CLEVELAND CLINIC FOUNDATION
(29) OPTOQUEST LLC 10000 CEDAR AVENUE CLEVELAND,OH44106 26-3589643	SCIENTIFIC RESEARCH	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(30) PSMA LLC 10000 CEDAR AVE CLEVELAND,OH44106 83-4269973	COMMERCIALIZE TECHNOLOGY	DE	0	383,146	THE CLEVELAND CLINIC FOUNDATION
(31) PSVW LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-1614376	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(32) REJ HOLDINGS LLC 3050 SCIENCE PARK DRIVE BEACHWOOD,OH44122 27-3245990	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(33) TASC ANESTHESIA LLC 659 BOULEVARD DOVER,OH44622 02-0611167	INACTIVE	OH	0	0	THE UNION HOSPITAL ASSOCIATION
(34) TATARA VASCULAR LLC 10000 CEDAR AVE CLEVELAND,OH44106 47-4282964	MEDICAL TECHNOLOGY	DE	0	118	THE CLEVELAND CLINIC FOUNDATION
(35) 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
(36) TREASURE COAST INTEGRATED HEALTHCARE LLC PO BOX 9010 STUART,FL34995 82-0708813	HEALTH CARE SERVICES	FL	0	0	CLEVELAND CLINIC FLORIDA REGIONAL HEALTH SYSTEM
(37) TUSCARAWAS AMBULATORY SURGERY CENTER LLC 659 BOULEVARD DOVER,OH44622 34-0000100	INACTIVE	OH	0	2,763,195	THE UNION HOSPITAL ASSOCIATION
(38) UNION HOSPITAL MEDICAL SERVICES LLC 659 BOULEVARD DOVER,OH44622 27-0273520	HEALTH CARE SERVICES	OH	0	0	THE UNION HOSPITAL ASSOCIATION
(39) UNION PHYSICIAN SERVICES LLC 659 BOULEVARD DOVER,OH44622 26-4215547	HEALTH CARE SERVICES	OH	22,614,541	81,910,053	THE UNION HOSPITAL ASSOCIATION
(40) VERO RADIOLOGY SERVICES LLC 3725 11TH CIRCLE VERO BEACH,FL32960 59-2755370	RADIOLOGY SERVICES	FL	18,070,527	14,281,324	INDIAN RIVER MEMORIAL HOSPITAL INC
(41) WOOSTER CLINIC LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1855775	HEALTH CARE SERVICES	OH	61,463,996	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)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
(2)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
(3)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
(4)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
(5)THREE ARCHES FOUNDATION 14601 DETROIT AVENUE STE 240 LAKEWOOD,OH44107 34-6519834	SUPPORT THE LAKEWOOD COMMUNITY	OH	501(C)(3)	TYPE III, OTHER	N/A		No
(6)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 659 BOULEVARD DOVER,OH44622 34-0000100	PHYSICIAN HOSPITAL AND ORGANIZATION	OH	501(C)(3)	LINE 3	N/A		No
(7)UNION HOSPITAL AUXILIARY 659 BOULEVARD DOVER,OH44622 34-1204928	SUPPORT THE UNION HOSPITAL ASSOCIATION	OH	501(C)(3)	LINE 10	N/A		No
(8)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) 2023

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) AKRON SURGICAL ASSOCIATES LLC 4125 MEDINA ROAD AKRON,OH44333 01-0672877	AMBULATORY SURGERY CENTER	OH	AKRON GENERAL PARTNERS INC	RELATED	1,189,868	1,728,975		No			No	51.000 %
(2) CCAW JV LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3867549	MEDICAL SERVICES & TELE HEALTH	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	-1,318,794	2,032,779		No			No	51.000 %
(3) CCFMHS RENAL CARE COMPANY LTD 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1863789	MEDICAL SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	RELATED	2,911,026	12,413,325		No			No	60.000 %
(4) EXCELERATE STRATEGIC HEALTH SOURCING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 46-1810992	GROUP PURCHASING ORG	DE	THE CLEVELAND CLINIC FOUNDATION	UNRELATED	1,478,162	5,016,943		No	809,077	Yes		51.000 %
(5) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 1050 FORRER BLVD KETTERING,OH45420 81-0687167	SURGERY CENTER	OH	MERCY MEDICAL CENTER	RELATED	305,747	1,605,913		No			No	61.000 %
(6) STUART SURGERY CENTER LLC 2096 SE OCEAN BLVD STUART,FL34996 82-2542219	SURGERY CENTER	FL	MARTIN SURGICAL VENTURES LLC	RELATED	1,423,428	1,480,355		No		Yes		87.680 %
(7) TRADITION SURGERY CENTER LLC 10080 INNOVATION WAY SUITE 101 PORT ST LUCIE,FL34987 36-4837780	SURGERY CENTER	FL	MARTIN SURGICAL VENTURES LLC	RELATED	698,145	1,720,825		No		Yes		60.570 %
(8) VISIONAIR SOLUTIONS LLC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4828042	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	354,110			No			No	8.000 %
(9) KEROGEN ENERGY FUND II CO-INVESTMENT FUND A LP 190 ELGIN AVENUE GEORGE TOWN,GRAND CAYMANKY1-9005 CJ 98-1231373	ALTERNATIVE INVESTMENT	CJ	THE CLEVELAND CLINIC FOUNDATION	RELATED	-57,706	3,060,051		No			No	58.910 %
(10) ALTOS HYBRID CC LLC 250 CALIFORNIA DR FLOOR 4 BURLINGAME,CA940104113 85-3546949	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	-386,206	10,194,645		No			No	100.000 %
(11) SPROTT PRIVATE RESOURCE STREAMING AND ROYALTY 200 BAY STREET SUITE 2600 TORONTOM5J 2J1 CA 98-1654634	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	48,031	20,154,891		No			No	100.000 %
(12) AACP INDIA VENTURE INVESTORS D LP ONE EMBARCADERO CENTER 16TH FLOOR SAN FRANCISCO,CA94111 83-1009352	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	-56,622	8,207,057		No			No	61.690 %
(13) SABAL STRATEGIC OPPORTUNITIES (PARALLEL) FUND II LP 2211 MICHELSON DRIVE SUITE 620 IRVINE,CA92612 93-2330465	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	493	8,153,985		No			No	56.600 %
(14) SSO II CO-INVEST (PARALLEL) LP 2211 MICHELSON DRIVE SUITE 620 IRVINE,CA92612 93-4239123	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	18	18,931		No			No	86.960 %
(15) SRE OPPORTUNITY FUND IV SELECT LP 980 N MICHIGAN AVE SUITE 1700 CHICAGO,IL60611 86-2718615	ALTERNATIVE INVESTMENT	IL	THE CLEVELAND CLINIC FOUNDATION	RELATED	-557,592	11,369,139		No			No	55.560 %
(16) PARAMETRIC GLOBAL LOW BETA VRP FUND LLC C/O PWC-MSIM TAX 12TH FLOOR 1 NORTH CHICAGO,IL60606 85-0959525	ALTERNATIVE INVESTMENT	IL	THE CLEVELAND CLINIC FOUNDATION	RELATED	17,569,673	159,998,181		No			No	94.090 %

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 000000000	LEASE HOLDING COMPANY	JE	CLEVELAND CLINIC UK HOLDINGS LTD	C	18,945,650	608,922,962	100.000 %	Yes
(2) AUTISM EYES INC 10000 CEDAR AVE CLEVELAND,OH44106 84-3070150	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		154,866	100.000 %	Yes
(3) AXONEURAL THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 85-1131595	THERAPEUTIC TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		128,081	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		448,513	100.000 %	Yes
(5) CASHEL NEURAL INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4625105	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	1,134	29,514	100.000 %	Yes
(6) CCAW EMPLOYMENT CO LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-5164677	MANAGEMENT SERVICES	DE	CCAW JV LLC	C	2,737,265		51.000 %	Yes
(7) CCF (SHANGHAI) CONSULTING CO LTD LEVEL 40 ONE MUSEUM PLACE 669 ZINZ SHANGHAI 200041 CH 000000000	ADVISORY SERVICES	CH	CLEVELAND CLINIC GLOBAL SOLUTIONS LLC	C	149,899	9,585		Yes
(8) 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	127,082,726	303,436,883	100.000 %	Yes
(9) CERAXIS HEALTH INC 10000 CEDAR AVE CLEVELAND,OH44106 86-3324076	STYLUS TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		1,258,110	80.000 %	Yes
(10) CLEVELAND CLINIC CANADA-TORONTO INC 181 BAY STREET BOX 818 TORONTO M5J 2T3 CA 000000000	HEALTH CARE SERVICES	CA	THE CLEVELAND CLINIC FOUNDATION	C	24,172,997	20,355,621	100.000 %	Yes
(11) CLEVELAND CLINIC EMR INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4856025	HEALTH CARE SERVICES	OH	CLINIC MEDICAL SOLUTIONS INC	C		1,094,191		Yes
(12) CLEVELAND CLINIC HEALTH SYSTEM PHYSICIAN ORGANIZATION 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1877409	CONTRACTING ORGANIZATION	OH	CLINIC MEDICAL SOLUTIONS INC	C	11,900,613	14,568,427		Yes
(13) CLEVELAND CLINIC LONDON LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK 000000000	HOSPITAL OPERATING COMPANY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C	185,598,626	567,065,768	100.000 %	Yes
(14) CLEVELAND CLINIC SAUDI ARABIA (A LIMITED LIABILITY COMPANY) PO BOX 340340 RIYADH 11333 SA 000000000	MEDICAL SERVICES	SA	THE CLEVELAND CLINIC FOUNDATION	C		968,734	100.000 %	Yes
(15) CLEVELAND CLINIC UK FINANCING PLC 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK 000000000	FINANCING ENTITY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C		843,470,228	100.000 %	Yes
(16) CLEVELAND CLINIC UK HOLDINGS LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK 000000000	HOLDING COMPANY	UK	THE CLEVELAND CLINIC FOUNDATION	C	81,868	1,841,696,812	100.000 %	Yes
(17) CLINIC MEDICAL SOLUTIONS INC 18101 LORAIN AVENUE CLEVELAND,OH44111 34-1695388	HEALTH CARE SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	C	9,450,590	4,300,824		Yes
(18) CMCD INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256599	REAL ESTATE	OH	MEDINA HOSPITAL	C		311,040	100.000 %	Yes
(19) CSC CONDOMINIUM ASSOCIATION INC PO BOX 9033 STUART,FL34995 59-2843163	CONDOMINIUM ASSOCIATION	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	225,352	334,666	83.700 %	Yes
(20) INFUSEON THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1776182	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		120,014	100.000 %	Yes
(21) ION-VAC INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1560044	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(22) MARTIN MEMORIAL PHYSICIAN CORPORATION INC PO BOX 9010 STUART,FL34995 65-0556041	PHYSICIAN OFFICES	FL	MARTIN MEMORIAL HEALTH SYSTEMS INC	C	113,482,732	87,240,135	100.000 %	Yes
(23) MCZ INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256598	LEASING	OH	MEDINA HOSPITAL	C	9,097	500	100.000 %	Yes
(24) MEDICAL & FINANCIAL MANAGEMENT INC PO BOX 9033 STUART,FL34995 59-2320501	BILLING AND COLLECTIONS	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C					No
(25) MEDICAL CAMPUS MANAGEMENT INC PO BOX 9033 STUART,FL34995 65-0605328	MANAGEMENT SERVICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C					No
(26) MEDINVEST INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-3978297	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(27) MERIDIA HEALTH VENTURES INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1533871	INACTIVE	OH	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	C			100.000 %	Yes
(28) MERLOT ORTHOPEDIX INC 10000 CEDAR AVE CLEVELAND,OH44106 11-3779414	MEDICAL DEVICE MANUFACTURING	DE	THE CLEVELAND CLINIC FOUNDATION	C		31,389	55.000 %	Yes
(29) METHOD AI INC 10000 CEDAR AVE CLEVELAND,OH44106 86-2997632	ROBOTIC SURGERY TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		2,145,681	66.030 %	Yes
(30) MITRIA MEDICAL INC 10000 CEDAR AVE CLEVELAND,OH44106 84-3447663	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		380,023	100.000 %	Yes
(31) MOBIUS CARE INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 88-3418504	IBS TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		1,794,312	100.000 %	Yes
(32) NEOMEDICS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 02-0656818	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(33) PINE FALLS CONDOMINIUM ASSOCIATES INC 6100 WEST CREEK SUITE 25 INDEPENDENCE,OH44131 34-1617589	CONDOMINIUM ASSOCIATION	OH	THE CLEVELAND CLINIC FOUNDATION	C				Yes
(34) TETONIC BIOTECH INC 10000 CEDAR AVE CLEVELAND,OH44106 85-3689997	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(35) UNION CARE CORPORATION 659 BOULEVARD DOVER,OH44622 34-1556177	HEALTH CARE SERVICES	OH	THE UNION HOSPITAL ASSOCIATION	C					No
(36) UNION PHARMACEUTICAL CARE INC 659 BOULEVARD DOVER,OH44622 04-3588229	RETAIL PHARMACY SALES	OH	THE UNION HOSPITAL ASSOCIATION	C	7,409		100.000 %		No
(37) ZEHNA THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 84-3850618	MICROBIOME TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		927,648	100.000 %	Yes
(38) SSO FUND (CAYMAN) LP PO BOX 309 UGLAND HOUSE CHURCH STR GRAND CAYMAN KY1-1104 CJ 85-0807404	INVESTING	CJ	THE CLEVELAND CLINIC FOUNDATION	C	4,935,096	23,251,087	51.410 %		No
(39) CC ELLINGTON STRUCTURED CREDIT FUND LTD 53 FOREST AVENUE SUITE 301 OLD GREENWICH 6870 CJ 98-1557643	INVESTING	CJ	THE CLEVELAND CLINIC FOUNDATION	C	40,541,810	380,240,719	100.000 %		No
(40) CLEVELAND CLINIC PHILANTHROPY (UK) LTD SUITE 1 7TH FLOOR 50 BROADWAY LONDON SW1H0BL UK	PUBLIC HEALTH BENEFIT	UK	THE CLEVELAND CLINIC FOUNDATION	C	9,287,340	15,069,070	100.000 %		No
(41) WHALE ROCK LONG OPPORTUNITIES FUND IV C/O MC CORPORATE SERVICES LIMITED GRAND CAYMAN CJ 98-1748551	INVESTING	CJ	THE CLEVELAND CLINIC FOUNDATION	C	497,335,644	1,257,742,245	97.510 %		No
(42) CHARITABLE REMAINDER TRUSTS (15)		OH	THE CLEVELAND CLINIC FOUNDATION	T			100.000 %		No

Schedule R (Form 990) 2023

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	27,223,119	FMV
(3) CERAXIS HEALTH INC	D	65,291	FMV
(4) CLEVELAND CLINIC LONDON LTD	D	1,892,083	FMV
(5) CLEVELAND CLINIC PHILANTHROPY (UK) LTD	D	375,386	FMV
(6) EXCELERATE STRATEGIC HEALTH SOURCING LLC	D	2,451,334	FMV
(7) CCAW JV LLC	E	230,865	FMV
(8) CCHS INDEMNITY CO LTD	E	12,654,054	FMV
(9) ION-VAC INC	E	354,793	FMV
(10) NEW COS INC	E	273,854	FMV
(11) CLEVELAND CLINIC MEDICAL SERVICES INC	J	451,488	FMV
(12) FAIRVIEW HOSPITAL	J	484,463	FMV
(13) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	J	1,409,703	FMV
(14) AKRON GENERAL MEDICAL CENTER	K	199,853	FMV
(15) CLEVELAND CLINIC AVON HOSPITAL	K	4,337,445	FMV
(16) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	K	3,485,477	FMV
(17) FAIRVIEW HOSPITAL	K	1,602,343	FMV
(18) LUTHERAN HOSPITAL	K	354,147	FMV
(19) MARYMOUNT HOSPITAL INC	K	1,484,308	FMV
(20) MEDINA HOSPITAL	K	1,359,796	FMV
(21) AKRON GENERAL MEDICAL CENTER	L	226,370	FMV
(22) CLEVELAND CLINIC FLORIDA REGIONAL HEALTH SYSTEM NONPROFIT CORPORATION	L	597,652	FMV
(23) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	L	1,006,165	FMV
(24) CLEVELAND CLINIC MERCY HOSPITAL	L	53,968	FMV
(25) FAIRVIEW HOSPITAL	L	611,203	FMV
(26) MARYMOUNT HOSPITAL INC	L	176,324	FMV
(27) AKRON GENERAL MEDICAL CENTER	M	483,476	FMV
(28) CLEVELAND CLINIC AVON HOSPITAL	M	743,881	FMV
(29) CLEVELAND CLINIC MEDICAL SERVICES INC	M	12,001,000	FMV
(30) CLEVELAND CLINIC MERCY HOSPITAL	M	529,891	FMV
(31) EUCLID HOSPITAL	M	529,891	FMV
(32) FAIRVIEW HOSPITAL	M	811,917	FMV
(33) HILLCREST HOSPITAL	M	785,232	FMV
(34) LUTHERAN HOSPITAL	M	295,301	FMV
(35) MARYMOUNT HOSPITAL INC	M	616,341	FMV
(36) MEDINA HOSPITAL	M	445,639	FMV
(37) MENTOR HOSPITAL	M	230,012	FMV
(38) SOUTH POINTE HOSPITAL	M	388,225	FMV
(39) CCHS INDEMNITY CO LTD	P	89,197,573	FMV
(40) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	Q	657,322	FMV

Schedule R (Form 990) 2023

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) 2023

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) 2023

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	26
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	22
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	48,824
6	Total number of volunteers (estimate if necessary) .............	6	430
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	58,365,078
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) .........	325,429,961	431,017,785
9	Program service revenue (Part VIII, line 2g) .........	7,330,742,260	8,115,749,217
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	29,380,610	95,656,390
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-101,945,782	315,873,692
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	7,583,607,049	8,958,297,084
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	138,878,583	141,164,972
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)	4,338,264,562	4,860,199,970
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	1,936,471	1,834,012
b	Total fundraising expenses (Part IX, column (D), line 25) 23,353,343
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	3,192,549,659	3,515,291,245
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	7,671,629,275	8,518,490,199
19	Revenue less expenses. Subtract line 18 from line 12.......	-88,022,226	439,806,885
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	15,354,669,845	15,892,710,603
21	Total liabilities (Part X, line 26).............	7,217,745,829	7,575,057,911
22	Net assets or fund balances. Subtract line 21 from line 20.....	8,136,924,016	8,317,652,692

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 7,624,932,615 including grants of $ 141,164,972 ) (Revenue $ 8,115,749,217 )
	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 expenses7,624,932,615

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	43,055,823	7,209,233	2,084,657

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	8,963,521
d	Related organizations		1d	122
e	Government grants (contributions)		1e	209,877,008

f	All other contributions, gifts, grants, and similar amounts not included above		1f	212,177,134

g	Noncash contributions included in lines 1a - 1f:$		1g	10,469,234

h Total. Add lines 1a-1f.......		431,017,785

		Business Code
2a	NET PATIENT SERVICES	620000	4,164,253,272	4,152,094,196	12,159,076
b	MEDICARE/MEDICAID PAYM	921990	2,840,899,797	2,840,899,797
c	OTHER PROGRAM SERVICES	900099	1,037,787,369	1,014,346,970	23,440,399
d	PARKING, PHONE & OTHER	720000	58,575,864		21,956,526	36,619,338
e	MANAGEMENT FEES	561000	10,854,460	10,854,460
f	All other program service revenue.		3,378,455	2,569,378	809,077
g	Total. Add lines 2a–2f .....		8,115,749,217

3 Investment income (including dividends, interest, and othersimilar amounts) ......			76,791,553			76,791,553
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			44,280,840			44,280,840
			(i) Real	(ii) Personal
6a	Gross rents	6a	9,712,418
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	9,712,418
d	Net rental income or (loss).......			9,712,418			9,712,418
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	1,027,232,896
b	Less: cost or other basis and sales expenses	7b	1,008,338,881	29,178
c	Gain or (loss)	7c	18,894,015	-29,178
d	Net gain or (loss).........			18,864,837			18,864,837
8a	Gross income from fundraising events (not including $ 8,963,521of contributions reported on line 1c). See Part IV, line 18 ....
			8a	250,096
b	Less: direct expenses ...		8b	3,001,368
c	Net income or (loss) from fundraising events..			-2,751,272			-2,751,272
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
11a	INCOME ON HEDGE FUNDS		901101	244,432,456			244,432,456
b	INVESTMENT IN AFFILIAT		523000	17,890,028			17,890,028
c	DERIVATIVE INCOME		525990	2,252,093			2,252,093
d	All other revenue ....			57,129			57,129
e	Total. Add lines 11a–11d ......			264,631,706
12	Total revenue. See instructions.....			8,958,297,084	8,020,764,801	58,365,078	448,149,420

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	40,822,056	40,822,056
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	97,790,424	97,790,424
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	2,552,492	2,552,492
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	30,981,083	4,926,336	26,054,747
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	908,754	766,378	142,376
7	Other salaries and wages........	3,866,644,203	3,332,324,579	520,540,645	13,778,979
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	247,813,312	213,582,261	33,361,461	869,590
9	Other employee benefits .......	457,349,127	394,257,417	61,569,877	1,521,833
10	Payroll taxes ...........	256,503,491	221,035,666	34,531,363	936,462
11	Fees for services (non-employees):
a	Management ......	4,687,229	4,056,218	631,011
b	Legal .........	6,326,468	5,474,778	851,690
c	Accounting ...........	2,850,814		2,850,814
d	Lobbying ...........	1,466,885	1,466,885
e	Professional fundraising services. See Part IV, line 17	1,834,012			1,834,012
f	Investment management fees ......	21,427,998		21,427,998
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	215,830,646	184,809,055	29,055,847	1,965,744
12	Advertising and promotion ....	34,790,387	29,449,297	4,683,599	657,491
13	Office expenses .......	80,706,776	69,147,090	10,865,018	694,668
14	Information technology ......	226,614,543	196,096,379	30,507,612	10,552
15	Royalties ..	9,073,816	7,852,268	1,221,548
16	Occupancy ...........	101,242,864	87,612,749	13,629,655	460
17	Travel ............	27,303,749	22,967,697	3,675,723	660,329
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	11,288,241	9,472,474	1,519,661	296,106
20	Interest ...........	110,888,487	95,960,306	14,928,181
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	234,277,562	202,738,110	31,539,233	219
23	Insurance ...	68,149,284	58,974,798	9,174,486
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	1,904,665,927	1,904,661,647		4,280
b	BAD DEBT EXPENSE	162,243,546	162,243,546
c	STATE FRANCHISE FEE	109,225,991	109,225,991
d	EQUIPMENT RENTAL	87,981,179	76,109,314	11,844,322	27,543
e	All other expenses	94,248,853	88,556,404	5,597,374	95,075
25	Total functional expenses. Add lines 1 through 24e	8,518,490,199	7,624,932,615	870,204,241	23,353,343
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 ........			273,957,294	1	241,659,399
2	Savings and temporary cash investments .........			554,427,938	2	486,517,843
3	Pledges and grants receivable, net ......			256,102,721	3	216,632,994
4	Accounts receivable, net .............			1,052,654,289	4	1,082,626,026
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 ...........			314,099,563	7	111,967,362
8	Inventories for sale or use ............			165,271,912	8	174,985,539
9	Prepaid expenses and deferred charges ......			112,946,287	9	115,259,560
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	7,269,450,380
b	Less: accumulated depreciation	10b	4,223,205,669	2,834,281,748	10c	3,046,244,711
11	Investments—publicly traded securities .			78,386,405	11	3,157,884,408
12	Investments—other securities. See Part IV, line 11 .....			6,456,936,880	12	3,488,268,687
13	Investments—program-related. See Part IV, line 11 ..			419,977,896	13	463,109,031
14	Intangible assets ...............			148,839,203	14	147,209,199
15	Other assets. See Part IV, line 11 ...........			2,686,787,709	15	3,160,345,844
16	Total assets. Add lines 1 through 15 (must equal line 33)...			15,354,669,845	16	15,892,710,603

17	Accounts payable and accrued expenses .....	1,057,506,342	17	1,034,028,426
18	Grants payable ...	2,419,921	18
19	Deferred revenue .........	66,850,015	19	70,433,576
20	Tax-exempt bond liabilities .........	3,287,410,144	20	3,437,375,689
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 ..	344,832,803	24	261,289,239
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	2,458,726,604	25	2,771,930,981
26	Total liabilities. Add lines 17 through 25..	7,217,745,829	26	7,575,057,911

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	7,280,501,987	27	6,241,699,040
28	Net assets with donor restrictions ...........	856,422,029	28	2,075,953,652
	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 ...........	8,136,924,016	32	8,317,652,692
33	Total liabilities and net assets/fund balances ........	15,354,669,845	33	15,892,710,603

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