<strong>Cleveland</strong> <strong>Clinic</strong> <strong>Health</strong> <strong>System</strong>Notes to Consolidated Financial Statements (continued)12. Pensions and Other Postretirement Benefits (continued)The incremental effects of adopting the provisions of SFAS No. 158 on the <strong>System</strong>’sconsolidated balance sheet at December 31, 2007, are presented in the following table. Theadoption of SFAS No. 158 had no effect on the <strong>System</strong>’s consolidated statement of operationsand changes in net assets for the year ended December 31, 2007, or for any prior periodpresented, and it will not effect the <strong>System</strong>’s operating results in future periods. Had the <strong>System</strong>not been required to adopt SFAS No. 158 at December 31, 2007, it would have recognized anadditional minimum liability pursuant to the provisions of SFAS No. 87. The effect ofrecognizing the additional minimum liability is included in the table below in the column labeled“Prior to Adopting SFAS No. 158” (in thousands).Prior toAdoptingSFAS No. 158Effect ofAdoptingSFAS No. 158As Reported atDecember 31,2007Intangible pension asset $ 6,571 $ (6,571) $ –Accrued benefit liability 248,494 135,200 383,694Change in unrestricted net assets (168,300) (141,771) (310,071)Included in unrestricted net assets at December 31, 2007, are the following amounts that havenot yet been recognized in net periodic pension cost: unrecognized prior service costs of $35.0million and unrecognized actuarial losses of $275.1 million. The prior service cost and actuarialloss included in unrestricted net assets and expected to be recognized in net periodic pension costduring the fiscal year-ended December 31, 2008 is $2.2 million and $21.0 million, respectively.30
<strong>Cleveland</strong> <strong>Clinic</strong> <strong>Health</strong> <strong>System</strong>Notes to Consolidated Financial Statements (continued)12. Pensions and Other Postretirement Benefits (continued)The following table sets forth the funded status of the <strong>System</strong>’s postretirement benefit plans as ofSeptember 30, 2007 and 2006 (the measurement date), and the amounts recognized in the<strong>System</strong>’s December 31, 2007 and 2006, consolidated balance sheets for the defined benefit andother postretirement benefit plans (in thousands):Defined BenefitPension Plans Other Postretirement2007 2006 2007 2006Change in projected benefit obligation:Projected benefit obligation at beginning of year $ 1,002,910 $ 942,367 $ 74,338 $ 70,280Service cost (credit) 49,909 47,348 (989) 130Interest cost 61,835 55,771 4,340 3,977Actuarial (gain) loss (38,047) (10,117) 7,682 14,444Plan amendments – 7,047 – (10,296)Benefits paid (37,276) (39,506) (6,320) (4,812)Federal subsidy – – 844 615Projected benefit obligation at end of year 1,039,331 1,002,910 79,895 74,338Change in plan assets:Fair value of plan assets at beginning of year 677,944 578,306 – –Actual gain on plan assets 86,898 43,612 – –<strong>System</strong> contributions 4,845 95,532 – –Benefits paid (37,276) (39,506) – –Fair value of plan assets at end of year 732,411 677,944 – –Underfunded status of plan (306,920) (324,966) (79,895) (74,338)Unrecognized net actuarial loss (gain) – 377,962 – (13,401)Unrecognized prior service cost – 7,093 – 30,056Contributions in the fourth quarter 1,770 652 1,351 1,306Cumulative minimum pension liability adjustment – (263,026) – –Accrued benefit liability $ (305,150) $ (202,285) $ (78,544) $ (56,377)Prepaid benefit cost $ – $ 110,426 $ – $ –Intangible asset – 7,032 – –Accrued benefit liability (305,150) (319,743) (78,544) (56,377)Net liability recognized in balance sheets $ (305,150) $ (202,285) $ (78,544) $ (56,377)31
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NEW ISSUEBOOK ENTRY ONLYSee “RATI
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TABLE OF CONTENTSINTRODUCTORY STATE
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OFFERING CIRCULARRelating to$452,34
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Security and Sources of Payment for
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Upon issuance of the Series 2008A B
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(ii) acquisition of magnetic resona
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$147,200,000 Term Bonds Due January
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that the redemption is conditional
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Use of Certain Terms in Other Secti
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County BondsThe Cleveland Clinic an
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The Cleveland Clinic regularly revi
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ESTIMATED SOURCES AND USES OF FUNDS
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DEBT SERVICE COVERAGEThe following
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MedicareGeneralApproximately 29% of
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there is no assurance that the Obli
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Medicare Conditions of Participatio
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fiscal year’s budget that are in
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Federal Regulatory and Contractual
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Stark-type statutes have fewer exce
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party or for any services rendered
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typically in a position to refer pa
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OhioOhio Certificate of Need Progra
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performance demonstration programs
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manifest injustice would otherwise
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and properties owned or operated by
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plan of reorganization, with one ex
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percentage may be composed wholly o
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The Internal Revenue Service Form 9
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Charity Care, Underinsured and Unin
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• Proposals to eliminate the tax-
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acting in the capacity of underwrit
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Frederick R. Nance, Regional Managi
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FINANCIAL POSITION — D. BALANCE S
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The CommissionBecause the Series 20
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APPENDIX ACLEVELAND CLINIC HEALTH S
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TABLE OF CONTENTSPageINTRODUCTION .
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This Appendix to the Offering Circu
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A. ORIGINS AND FUNDAMENTAL MISSIONT
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C. GOVERNANCE OF THE CLEVELAND CLIN
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Voting Members of theBoard of Trust
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Voting Members of theBoard of Trust
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Principal Operating Officers. The d
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In addition to the broad range of o
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The main campus also includes a com
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GovernanceThe Cleveland Clinic is t
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E. UTILIZATIONThe following tables
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Statistical Information. The follow
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I. COLLABORATIVE PROGRAMSIn additio
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Clinic’s charity care policy, see
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statements filed with Digital Assur
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(g) the loan of cash or other non-O
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under this caption shall be deemed
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Supplemental Indenture to which suc
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emedy thereunder, unless the Noteho
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purchase or other acquisition or re
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limitation, (A) the Special Funds a
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(b) Default in the payment of the p
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Fund Requirements, in the order of
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(g) to evidence the appointment of
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THE LEASEThe Lease contains various
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(a) Failure by the Cleveland Clinic
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APPENDIX DPROPOSED FORM OF OPINION
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PROPOSED TEXT OF LEGAL OPINION OFSQ
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October __, 2008Page 32008A Bonds c