TY 2021 Form 990 Schedule R

Instrumentl eFile RenderObject ID: 202223149349305002 - Rendered 2024-04-29 TIN: 34-0714585

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

THE CLEVELAND CLINIC FOUNDATION

Employer identification number

34-0714585

Part I

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) ZEHNA THERAPEUTICS LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3850618	MICROBIOME TECHNOLOGY	DE	-1,394,025	5,231,169	THE CLEVELAND CLINIC FOUNDATION
(2) WOOSTER CLINIC LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1855775	HEALTH CARE SERVICES	OH	64,660,353	0	THE CLEVELAND CLINIC FOUNDATION
(3) VISIONAIR SOLUTIONS LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3881050	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(4) VERO RADIOLOGY SERVICES LLC 3725 11TH CIRCLE VERO BEACH,FL32960 59-2755370	RADIOLOGY SERVICES	FL	5,256,915	14,399,982	INDIAN RIVER MEMORIAL HOSPITAL INC
(5) UNION PHYSICIAN SERVICES LLC 659 BOULEVARD DOVER,OH44622 26-4215547	HEALTH CARE SERVICES	OH	26,176,327	-113,750,345	THE UNION HOSPITAL ASSOCIATION
(6) UNION HOSPITAL MEDICAL SERVICES LLC 659 BOULEVARD DOVER,OH44622 27-0273520	HEALTH CARE SERVICES	OH	0	-3,272,687	THE UNION HOSPITAL ASSOCIATION
(7) TUSCARAWAS AMBULATORY SURGERY CENTER LLC 659 BOULEVARD DOVER,OH44622 34-0000100	HEALTH CARE SERVICES	OH	1,140,335	532,877	THE UNION HOSPITAL ASSOCIATION
(8) TREASURE COAST INTEGRATED HEALTHCARE LLC PO BOX 9010 STUART,FL34995 82-0708813	HEALTH CARE SERVICES	FL	0	0	MARTIN MEMORIAL MEDICAL CENTER INC
(9) 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
(10) TATARA VASCULAR LLC 10000 CEDAR AVE CLEVELAND,OH44106 47-4282964	MEDICAL TECHNOLOGY	DE	-814	717	THE CLEVELAND CLINIC FOUNDATION
(11) SPC BUILDINGS 1 & 3 LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 26-1357176	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(12) SCIENCE PARK CLEVELAND LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 20-8726513	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(13) REJ HOLDINGS LLC 3050 SCIENCE PARK DRIVE BEACHWOOD,OH44122 27-3245990	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(14) PSVW LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-1614376	REAL ESTATE HOLDINGS	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(15) PSMA LLC 10000 CEDAR AVE CLEVELAND,OH44106 83-4269973	COMMERCIALIZE TECHNOLOGY	DE	-44,453	195,402	THE CLEVELAND CLINIC FOUNDATION
(16) OPTOQUEST LLC 10000 CEDAR AVENUE CLEVELAND,OH44106 26-3589643	SCIENTIFIC RESEARCH	OH	-19	0	THE CLEVELAND CLINIC FOUNDATION
(17) OHIO STAR IMAGING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(18) OBVF VIII LLC 10000 CEDAR AVE CLEVELAND,OH44106 87-1129899	MEDICAL TECHNOLOGY	OH	115,800	11,884,950	THE CLEVELAND CLINIC FOUNDATION
(19) OBVF VII LLC 10000 CEDAR AVE CLEVELAND,OH44106 86-1185460	MEDICAL TECHNOLOGY	OH	115,800	11,884,950	THE CLEVELAND CLINIC FOUNDATION
(20) NORTHEAST OHIO NEUROLOGICAL ASSOCIATES LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 20-0442351	HEALTH CARE SERVICES	OH	0	0	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(21) NEUROOPERATIVE MONITORING LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 30-0746215	INACTIVE	OH	0	0	AKRON GENERAL PARTNERS INC
(22) MONTROSE SLEEP CENTER LLC 4125 MEDINA ROAD AKRON,OH44333 20-0494491	HEALTH CARE SERVICES	OH	27,563	2,326,382	AKRON GENERAL PARTNERS INC
(23) MITRIA MEDICAL LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3447663	MEDICAL TECHNOLOGY	DE	-1,435,234	1,519,901	THE CLEVELAND CLINIC FOUNDATION
(24) MERIDIA MEDICAL GROUP LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 34-1898545	INACTIVE	OH	0	-3,204	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION
(25) MEDINA HEALTH VENTURES LLC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1533871	INACTIVE	OH	0	0	MEDINA HOSPITAL
(26) MARTIN SURGICAL VENTURES LLC 333 THIRD STREET N STE 200 ST PETERSBURG,FL33701 32-0496475	SURGICAL VENTURE	FL	0	896,686	MARTIN MEMORIAL MEDICAL CENTER INC
(27) IVHR LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-4657632	MEDICAL TECHNOLOGY	OH	0	-2,825	THE CLEVELAND CLINIC FOUNDATION
(28) IRMCF#1 LLC 1000 36TH STREET VERO BEACH,FL32960 59-0760215	REAL ESTATE HOLDINGS	FL	0	0	INDIAN RIVER HOSPITAL FOUNDATION INC
(29) INTELLIS EPM LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 27-0645368	MEDICAL TECHNOLOGY	OH	0	-508	THE CLEVELAND CLINIC FOUNDATION
(30) EDWIN SHAW REHAB LLC 330 BROADWAY STREET EAST CUYAHOGA FALLS,OH44221 27-0119182	REHABILITATION FACILITY	OH	-2,558	1,345,584	AKRON GENERAL MEDICAL CENTER
(31) CLINIC REGIONAL PHYSICIANS LLC 25875 SCIENCE PARK DR BEACHWOOD,OH44122 26-2636530	HEALTH CARE SERVICES	OH	0	-430,272	THE CLEVELAND CLINIC FOUNDATION
(32) CLINIC MEDICAL SERVICES COMPANY LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1932969	HEALTH CARE SERVICES	OH	78,473,181	0	THE CLEVELAND CLINIC FOUNDATION
(33) CLEVELAND CLINIC WELLNESS ENTERPRISE LLC 1950 RICHMOND ROAD LYNDHURST,OH44124 26-3859233	HEALTH CARE SERVICES	OH	2,390,076	-35,762,589	THE CLEVELAND CLINIC FOUNDATION
(34) CLEVELAND CLINIC RISK RETENTION GROUP LLC 701 EAST BAY STREET SUITE 514 CHARLESTON,SC29403 87-2395525	RISK RETENTION GROUP	SC	0	0	THE CLEVELAND CLINIC FOUNDATION
(35) CLEVELAND CLINIC OBGYN SPECIALTIES LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1938153	HEALTH CARE SERVICES	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(36) CLEVELAND CLINIC MEDICARE ACO LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 47-1281189	HEALTH CARE SERVICES	OH	225,935	3,334,984	THE CLEVELAND CLINIC FOUNDATION
(37) CLEVELAND CLINIC GLOBAL SOLUTIONS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 26-3666730	HEALTH CARE SERVICES & IP LICENSING	OH	-43,908	-43,748	THE CLEVELAND CLINIC FOUNDATION
(38) CLEVELAND CLINIC GLOBAL SOLUTIONS II LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 87-1180623	HEALTH CARE SERVICES & IP LICENSING	OH	0	40	THE CLEVELAND CLINIC FOUNDATION
(39) CLEVELAND CLINIC FLORIDA NAPLES LLC 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 31-1741150	INACTIVE	FL	0	0	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(40) 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)
(41) CLEVELAND CLINIC FLORIDA CONCIERGE MEDICINE LLC 1301 EAST BROWARD BLVD STE 330 FT LAUDERDALE,FL33301 82-3186835	HEALTH CARE SERVICES	FL	614,445	-408,531	CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION)
(42) CLEVELAND CLINIC CARE COORDINATION LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 45-5282492	HEALTH CARE SERVICES	OH	0	-942,441	THE CLEVELAND CLINIC FOUNDATION
(43) CHV HOME MEDICAL EQUIPMENT CO LLC 1 HOME CARE PLACE AKRON,OH44320 20-4760456	DURABLE MEDICAL EQUIPMENT	OH	7,621	-4,691,858	VISITING NURSE SERVICE INC
(44) CCF HOTEL SERVICES LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-0666034	HOTEL OPERATIONS	OH	11,709,216	106,009,145	THE CLEVELAND CLINIC FOUNDATION
(45) CCF AMBULATORY SURGERY CENTERS LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1939710	HEALTH CARE SERVICES	OH	14,211,646	0	THE CLEVELAND CLINIC FOUNDATION
(46) CC WEB SOLUTIONS LLC 6801 BRECKSVILLE RD INDEPENDENCE,OH44131 26-3222020	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(47) CC CHINA LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 20-5776477	INACTIVE	OH	0	0	THE CLEVELAND CLINIC FOUNDATION
(48) CARNEGIE96TH RESEARCH BUILDING LLC 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 11-3706542	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(49) CARNEGIE89TH GARAGE AND SERVICE CENTER 6801 BRECKSVILLE ROAD RK1-85 INDEPENDENCE,OH44131 20-5693261	INACTIVE	DE	0	0	THE CLEVELAND CLINIC FOUNDATION
(50) AUTISM EYES LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3070150	AUTISM DETECTION PLATFORM	DE	-49,500	202,143	THE CLEVELAND CLINIC FOUNDATION
(51) AKRON GENERAL MEDICAL CENTER OUTPATIENT PHARMACY LLC 1 AKRON GENERAL AVENUE AKRON,OH44307 84-2380272	HEALTH CARE SERVICES	OH	854,395	1,510,581	AKRON GENERAL HEALTH SYSTEM
(52) ADVANCED INFUSION SERVICES LTD 1 HOME CARE PLACE AKRON,OH44320 34-1847339	INFUSION SERVICES	OH	-316	197,626	VISITING NURSE SERVICE INC

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)AUXILIARY BOARD OF FAIRVIEW GENERAL HOSPITAL 18101 LORAIN AVENUE CLEVELAND,OH44111 23-7108198	SUPPORT FAIRVIEW HOSPITAL	OH	501(C)(3)	TYPE III, OTHER	N/A		No
(2)CLEVELAND CLINIC PHILANTHROPY (UK) LTD SUITE 1 3RD FLOOR 11-12TH ST JAM LONDON,GREATER LONDONSW1Y4LB UK 98-1571304	SUPPORT FOR HEALTHCARE EDUCATION AND RESEARCH IN THE UK	UK	501(C)(3)	LINE 7	N/A	Yes
(3)COMMUNITY WEST FOUNDATION 800 SHARON DRIVE STE C WESTLAKE,OH44145 34-1456398	ADVANCE THE HEALTH AND WELL-BEING OF THE COMMUNITY	OH	501(C)(3)	LINE 7	N/A		No
(4)HOSPITAL AUXILIARY OF THE IRMH INC 1000 36TH STREET VERO BEACH,FL32960 59-1003707	SUPPORT THE INDIAN RIVER HOSPITAL	FL	501(C)(3)	TYPE III, FUNCTIONAL	N/A		No
(5)MARTIN MEMORIAL HOSPITAL AUXILIARY INC PO BOX 9033 STUART,FL34995 23-7115443	PROMOTE QUALITY HEALTH CARE FOR MARTIN & ST. LUCIE COUNTIES	FL	501(C)(3)	LINE 10	N/A		No
(6)THE UNIFY PROJECT 1151 NORTH MARGINAL ROAD CLEVELAND,OH44114 82-3605707	SUPPORT CHARITABLE PURPOSES OF HOSPITALS & UNIVERSITIES	OH	501(C)(3)	LINE 3	N/A		No
(7)THREE ARCHES FOUNDATION 14601 DETROIT AVENUE STE 240 LAKEWOOD,OH44107 34-6519834	SUPPORT THE CLEVELAND CLINIC FOUNDATION	OH	501(C)(3)	TYPE III, OTHER	N/A		No
(8)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 659 BOULEVARD DOVER,OH44622 34-0000100	PHYSICIAN HOSPITAL AND ORGANIZATION	OH	501(C)(3)	LINE 3	N/A		No
(9)UNION HOSPITAL AUXILIARY 659 BOULEVARD DOVER,OH44622 34-1204928	SUPPORT THE UNION HOSPITAL ASSOCIATION	OH	501(C)(3)	LINE 10	N/A		No
(10)WO WALKER CENTER INC 10700 EUCLID AVENUE CLEVELAND,OH44106 91-1818256	HEALTH CARE SERVICES	OH	501(C)(3)	TYPE III, FUNCTIONAL	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) AACP INDIA VENTURE INVESTORS D LP 1 EMBARCADERO 16TH FL SAN FRANCISCO,CA94111 83-1009352	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED		7,842,029		No	229,912		No	61.690 %
(2) AKRON SURGICAL ASSOCIATES LLC 4125 MEDINA ROAD AKRON,OH44333 01-0672877	AMBULATORY SURGERY CENTER	OH	AKRON GENERAL PARTNERS INC	RELATED	1,177,940	1,483,563		No			No	51.000 %
(3) ALTOS HYBRID CC LLC 2882 SAND HILL ROAD SUITE 100 MENLO PARK,CA94025 85-3546949	ALTERNATIVE INVESTMENT	CA	THE CLEVELAND CLINIC FOUNDATION	RELATED	377	3,941,380		No	332		No	100.000 %
(4) CCAW JV LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-3867549	MEDICAL SERVICES & TELE HEALTH	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	-2,271,236	1,041,712		No			No	51.000 %
(5) CCFMHS RENAL CARE COMPANY LTD 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1863789	MEDICAL SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	RELATED	2,184,856	16,166,954		No			No	60.000 %
(6) EXCELERATE STRATEGIC HEALTH SOURCING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 46-1810992	HEALTH CARE OP & MGMT	DE	THE CLEVELAND CLINIC FOUNDATION	RELATED	1,300,962	4,259,351		No	946,568	Yes		51.000 %
(7) KEROGEN ENERGY FUND II CO-INVESTMENT FUND A LP 1 NEXUS WAY CAMANA BAY,CAYMAN ISLANDSKY1-9005 CJ 98-1231373	ALTERNATIVE INVESTMENT	CJ	THE CLEVELAND CLINIC FOUNDATION	RELATED	838,869	1,336,809		No			No	58.330 %
(8) MEDICAL CENTER AT HOBE SOUND LTD PO BOX 9033 STUART,FL34996 65-0748232	RENTAL OF MEDICAL OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	80,654	2,201,040		No			No	100.000 %
(9) MEDICAL CENTER AT ST LUCIE WEST LTD PO BOX 9033 STUART,FL34996 65-0504863	RENTAL OF MEDICAL OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	630,677	9,539,212		No			No	100.000 %
(10) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 1050 FORRER BLVD KETTERING,OH45420 81-0687167	SURGERY CENTER	OH	CLEVELAND CLINIC MERCY HOSPITAL	RELATED	1,043,279	2,518,325		No			No	60.000 %
(11) PARAMETRIC GLOBAL LOW BETA VRP FUND LLC 3600 MINNESOTA DRIVE SUITE 325 MINNEAPOLIS,MN55435 85-0959525	ALTERNATIVE INVESTMENT	MN	THE CLEVELAND CLINIC FOUNDATION	RELATED	15,543,700	240,344,859		No	16,961,717		No	97.730 %
(12) STATE STREET MSCI CANADA SMALL CAP INDEX NON-LENDING COMMON TRUST FUND 1 IRON STREET BOSTON,MA02210 82-6649803	ALTERNATIVE INVESTMENT	MA	THE CLEVELAND CLINIC FOUNDATION	RELATED	847,426			No	114,968		No	59.090 %
(13) STUART SURGERY CENTER LLC 2096 SE OCEAN BLVD STUART,FL34996 82-2542219	SURGERY CENTER	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	954,215	1,042,113		No		Yes		78.000 %
(14) TRADITION SURGERY CENTER LLC 10080 INNOVATION WAY SUITE 101 PORT ST LUCIE,FL34987 36-4837780	SURGERY CENTER	FL	MARTIN MEMORIAL MEDICAL CENTER INC	RELATED	369,422	1,342,585		No		Yes		51.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) 33 GROSVENOR PLACE LIMITED 33 GROSVENOR PLACE LONDON SW1X 7HY UK	LEASE HOLDING COMPANY	JE	CLEVELAND CLINIC UK HOLDINGS LTD	C	-34,848	736,041,482	100.000 %	Yes
(2) ABCON THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 85-3703323	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C			100.000 %	Yes
(3) AXONEURAL THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 85-1131595	THERAPEUTIC TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		-35	100.000 %	Yes
(4) CASHEL NEURAL INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4625105	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	384,926	48,531	100.000 %	Yes
(5) CCAW EMPLOYMENT CO LLC 10000 CEDAR AVE CLEVELAND,OH44106 84-5164677	MANAGEMENT SERVICES	DE	CCAW JV LLC	C	1,670,999		51.000 %	Yes
(6) CCF (SHANGHAI) CONSULTING CO LTD LEVEL 40 ONE MUSEUM PLACE 669 ZINZ SHANGHAI 200041 CH	ADVISORY SERVICES	CH	CLEVELAND CLINIC GLOBAL SOLUTIONS LLC	C	-13,516	17,948	100.000 %	Yes
(7) CCF BOLTON INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4596571	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	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	-1,831,246	264,635,730	100.000 %	Yes
(9) CERAXIS HEALTH INC 10000 CEDAR AVE CLEVELAND,OH44106 86-3324076	STYLUS TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		1,324,439	80.000 %	Yes
(10) CLEVELAND CLINIC CANADA-TORONTO INC 181 BAY STREET BOX 818 TORONTO M5J 2T3 CA	HEALTH CARE SERVICES	CA	THE CLEVELAND CLINIC FOUNDATION	C	1,526,848	21,798,919	100.000 %	Yes
(11) CLEVELAND CLINIC EMR INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4856025	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C		1,102,091		Yes
(12) CLEVELAND CLINIC HEALTH SYSTEM PHYSICIAN ORGANIZATION 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1877409	CONTRACTING ORGANIZATION	OH	CLINIC MEDICAL SOLUTIONS INC	C	13,053,784	10,154,179		Yes
(13) CLEVELAND CLINIC LONDON LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	HOSPITAL OPERATING COMPANY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C	79,397,050	629,324,022	100.000 %	Yes
(14) CLEVELAND CLINIC SAUDI ARABIA (A LIMITED LIABILITY COMPANY) PO BOX 340340 RIYADH 11333 SA	MEDICAL SERVICES	SA	THE CLEVELAND CLINIC FOUNDATION	C	64,010	5,960,142	100.000 %	Yes
(15) CLEVELAND CLINIC UK FINANCING PLC 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	FINANCING ENTITY	UK	CLEVELAND CLINIC UK HOLDINGS LTD	C		943,255,409	100.000 %	Yes
(16) CLEVELAND CLINIC UK HOLDINGS LTD 11-12 ST JAMESS SQUARE STE1 3RD LONDON SW1Y 4LB UK	HOLDING COMPANY	UK	THE CLEVELAND CLINIC FOUNDATION	C	-280,269	1,830,315,159	100.000 %	Yes
(17) CLINIC MEDICAL SOLUTIONS INC 18101 LORAIN AVENUE CLEVELAND,OH44111 34-1695388	HEALTH CARE SERVICES	OH	THE CLEVELAND CLINIC FOUNDATION	C	12,193,049	19,984,336		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 59-2320501	CONDOMINIUM ASSOCIATION	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	186,013	331,587		Yes
(20) INFUSEON THERAPEUTICS INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1776182	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	15,000	231,199	100.000 %	Yes
(21) ION-VAC INC 10000 CEDAR AVE CLEVELAND,OH44106 46-1560044	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C		21,243	100.000 %	Yes
(22) MARTIN MEMORIAL PHYSICIAN CORPORATION INC PO BOX 9010 STUART,FL34995 65-0556041	PHYSICIAN OFFICES	FL	MARTIN MEMORIAL MEDICAL CENTER INC	C	106,411,586	78,978,145		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 59-2843163	BILLING AND COLLECTIONS	FL	MARTIN MEMORIAL HEALTH SYSTEM	C	3,919,672	1,350,173	100.000 %	Yes
(25) MEDICAL CAMPUS MANAGEMENT INC PO BOX 9033 STUART,FL34995 65-0605328	MANAGEMENT SERVICES	FL	MEDICAL & FINANCIAL MANAGEMENT INC	C	7,153	110,083	100.000 %	Yes
(26) MEDINVEST INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-3978297	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(27) MERCY PROFESSIONAL CARE CORPORATION 1320 MERCY DRIVE NW CANTON,OH44708 34-1873008	PHYSICIAN OFFICES	OH	CLEVELAND CLINIC MERCY HOSPITAL	C	25,212,869	5,815,168	100.000 %	Yes
(28) MERIDIA HEALTH VENTURES INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1533871	INACTIVE	OH	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	C			100.000 %	Yes
(29) MERLOT ORTHOPEDIX INC 10000 CEDAR AVE CLEVELAND,OH44106 11-3779414	MEDICAL DEVICE MANUFACTURING	DE	THE CLEVELAND CLINIC FOUNDATION	C		34,573	55.000 %	Yes
(30) METHOD AI INC 10000 CEDAR AVE CLEVELAND,OH44106 86-2997632	ROBOTIC SURGERY TECHNOLOGY	DE	THE CLEVELAND CLINIC FOUNDATION	C		2,121,080	53.420 %	Yes
(31) NEOMEDICS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 02-0656818	INACTIVE	OH	CLINIC MEDICAL SOLUTIONS INC	C			100.000 %	Yes
(32) NEW COS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4828042	SCIENTIFIC RESEARCH	DE	THE CLEVELAND CLINIC FOUNDATION	C	239,652	632,650	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			100.000 %	Yes
(36) UNION PHARMACEUTICAL CARE INC 659 BOULEVARD DOVER,OH44622 04-3588229	RETAIL PHARMACY SALES	OH	THE UNION HOSPITAL ASSOCIATION	C	4,344	30,458	100.000 %	Yes
(37) CHARITABLE REMAINDER TRUSTS (13)		OH	THE CLEVELAND CLINIC FOUNDATION	T			100.000 %	Yes

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

Yes

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

Yes

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

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

Yes

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

Yes

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) CLEVELAND CLINIC CANADA - TORONTO INC	A	100,000	FMV
(2) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	B	21,971,306	FMV
(3) CLEVELAND CLINIC LONDON LTD	D	1,997,000	FMV
(4) CCAW JV LLC	D	283,000	FMV
(5) EXCELERATE STRATEGIC HEALTH SOURCING LLC	D	1,854,000	FMV
(6) CLEVELAND CLINIC PHILANTHROPY (UK) LTD	D	110,000	FMV
(7) CCHS INDEMNITY CO LTD	E	43,977,000	FMV
(8) CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION	J	284,346	FMV
(9) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	J	1,749,280	FMV
(10) CLEVELAND CLINIC MEDICAL SERVICES INC	J	448,271	FMV
(11) FAIRVIEW HOSPITAL	J	796,433	FMV
(12) MEDINA HOSPITAL	J	57,546	FMV
(13) PARTNERS PHYSICIAN GROUP	J	114,833	FMV
(14) AKRON GENERAL MEDICAL CENTER	K	78,586	FMV
(15) CLEVELAND CLINIC AVON HOSPITAL	K	4,494,237	FMV
(16) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	K	3,573,493	FMV
(17) FAIRVIEW HOSPITAL	K	1,034,756	FMV
(18) LUTHERAN HOSPITAL	K	508,271	FMV
(19) MARYMOUNT HOSPITAL INC	K	1,495,376	FMV
(20) MEDINA HOSPITAL	K	1,300,808	FMV
(21) AKRON GENERAL MEDICAL CENTER	L	5,359,500	FMV
(22) CLEVELAND CLINIC AVON HOSPITAL	L	1,137,196	FMV
(23) CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION	L	265,523	FMV
(24) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	L	6,334,350	FMV
(25) FAIRVIEW HOSPITAL	L	3,244,897	FMV
(26) LUTHERAN HOSPITAL	L	872,200	FMV
(27) MARYMOUNT HOSPITAL INC	L	1,198,166	FMV
(28) MEDINA HOSPITAL	L	1,376,813	FMV
(29) AKRON GENERAL HEALTH SYSTEM	L	369,848	FMV
(30) CLEVELAND CLINIC FLORIDA REGIONAL HEALTH SYSTEM NONPROFIT CORPORATION	L	2,822,000	FMV
(31) CLINIC MEDICAL SOLUTIONS INC	L	1,347,915	FMV
(32) THE UNION HOSPITAL ASSOCIATION	L	133,125	FMV
(33) AKRON GENERAL MEDICAL CENTER	M	420,614	FMV
(34) CLEVELAND CLINIC AVON HOSPITAL	M	680,303	FMV
(35) CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION	M	1,848,764	FMV
(36) CLEVELAND CLINIC MEDICAL SERVICES INC	M	10,665,000	FMV
(37) FAIRVIEW HOSPITAL	M	616,506	FMV
(38) LODI COMMUNITY HOSPITAL	M	137,399	FMV
(39) LUTHERAN HOSPITAL	M	304,728	FMV
(40) MARYMOUNT HOSPITAL INC	M	732,498	FMV
(41) MEDINA HOSPITAL	M	848,246	FMV
(42) CCHS INDEMNITY CO LTD	P	56,895,270	FMV
(43) THE CLEVELAND CLINIC EDUCATIONAL FOUNDATION	Q	85,420	FMV

Schedule R (Form 990) 2021

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2021

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