2024-08-15T13:24:07-05:00 2023-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-10-01 590675143 FLAGLER HOSPITAL INC FLAG 9048254400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 ROBERT W THORNTON TREASURER 9048194069 2024-08-14 1 1 AMY CIMINELLO P00796388 6148493000 2024-08-14 2022 2024-08-08 14:25:15Z UF HEALTH FLAGLER HOSPITAL ROBERT W THORNTON 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 334833250 0 X WWW.FLAGLERHOSPITAL.ORG X 1906 FL BECOME A TOTAL CARE ENTERPRISE THAT ADVANCES THE PHYSICAL, SOCIAL, AND ECONOMIC HEALTH OF THE COMMUNITIES WE SERVE. 8 4 2472 139 0 0 2764564 292560 315098629 329173875 -901190 204163 4023262 4032308 320985265 333702906 1209987 796885 0 0 125553537 136251228 0 0 0 219382940 227292181 346146464 364340294 -25161199 -30637388 422455902 367496059 310040476 303785190 112415426 63710869 PROVIDE THE BEST PATIENT EXPERIENCE WITH THE BEST STAFF. 0 0 279129286 796885 329173875 SINCE ITS FOUNDING IN 1889, OUR PRIVATE, NOT-FOR-PROFIT FACILITY HAS GROWN INTO A DIVERSE CLINICAL ENTERPRISE THAT IS CONSISTENTLY RECOGNIZED NATIONALLY FOR CLINICAL EXCELLENCE BY HEALTHGRADES, TRUVEN, AND OTHER COMPARATIVE QUALITY DATA ORGANIZATIONS. HOSPITAL SERVICES ARE PROVIDED TO INPATIENTS AND OUTPATIENTS, INCLUDING CHARITY CARE TO THE INDIGENT AND OTHER PATIENTS. PLEASE SEE SCHEDULE H FOR DETAILS ON COMMUNITY BENEFITS. 279129286 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 582 0 1 2472 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DEBORAH COSTABILE 9048195259 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 CHRIS KAMEINSKI CHAIRMAN/ BOARD MEMBER 1.00 0.00 X X 0 0 0 TIMOTHY MOREY MD VICE-CHAIRMAN/ BOARD MEMBER 1.00 40.00 X X 0 699898 51375 BOB THORNTON TREASURER 1.00 40.00 X X 0 520133 46072 BILL YOUNG SECRETARY/ BOARD MEMBER 1.00 0.00 X X 0 0 0 RAY MATUZA BOARD MEMBER 1.00 0.00 X 0 0 0 SUSAN PONDER-STANSEL BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID NELSON MD BOARD MEMBER 1.00 40.00 X 0 1566779 51184 JAMES KELLY JR BOARD MEMBER 1.00 40.00 X 0 939771 37867 WILLIAM ABARE EDD TREASURER - PART YEAR 1.00 0.00 X X 0 0 0 ANDREW CRENSHAW BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 JOHN DELANEY BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 FRED FRANKLIN JR SECRETARY - PART YEAR 1.00 0.00 X X 0 0 0 STUART SOROKA BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 KAREN TAYLOR BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 LEN TUCKER BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 LEN WEEKS BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 CARLTON DEVOOGHT PRESIDENT/CEO 40.00 2.00 X 525791 0 27637 DAVID RICE MD END 923 EVP/CHIEF PHYSICIAN EXECUTIVE 40.00 2.00 X 543835 0 55463 DR TODD BATENHORST VP, INTERIM CHIEF MEDICAL OFFICER 40.00 2.00 X 421170 0 42104 ANGIE METCALF END 923 CHIEF ADMINISTRATIVE OFFICER 40.00 1.00 X 310851 0 7752 DONNA WAGNER VP CHIEF NURSING OFFICER 40.00 2.00 X 205163 0 1224 KEVIN SWEENY VP, CHIEF OF STAFF 40.00 2.00 X 210844 0 5837 MELISSA CECIL VP, CHIEF INFORMATION OFFICER 40.00 2.00 X 248063 0 10413 TOM BAILEY INTERIM CHIEF FINANCIAL OFFICER 40.00 2.00 X 125608 0 8709 JILL BERRY VP, CHIEF LEGAL OFFICER 40.00 2.00 X 235614 0 18225 BRENDA BAKER END 1222 CHIEF FINANCIAL OFFICER 40.00 2.00 X 373907 0 19500 VINCENT JOHNSON END 1222 CHIEF OPERATING OFFICER 40.00 2.00 X 407504 0 45084 DONALD R CRIST VP OF OPERATIONS 40.00 2.00 X 257086 0 15613 JOHN FRANKS END 923 EVP, AMBULATORY ENTERPRISE 40.00 2.00 X 242998 0 5213 MICHAEL HALL ADMINISTRATOT, CLINICAL SERVICES 40.00 2.00 X 200052 0 30207 JOHN WAGNER END 1222 EVP REVENUE CYCLE 40.00 1.00 X 235417 0 33896 SIBEL MIGLINO INTERIM VP OF HUMAN RESOURCES 40.00 2.00 X 144982 0 24168 FAITH M JONES RN 40.00 0.00 X 170220 0 22375 LYLE KOLNIK CLINICAL PHARMACIST 40.00 0.00 X 168453 0 0 KENISHA S ELLIOTT RN 40.00 0.00 X 196597 0 5853 SHARON R MCDADE CHARGE RN 40.00 0.00 X 190663 0 5945 JASON BARRETT FORMER PRESIDENT/CEO 0.00 0.00 X 379229 0 0 MIGUEL MACHADO FORMER CHIEF MEDICAL OFFICER 0.00 0.00 X 357040 0 106 REGINA R MANGUS FORMER EVP ADVANCEMENT & STRATEGY 0.00 0.00 X 344823 0 10751 6495910 3726581 582573 185 1 1 0 STELLAR GROUP 2900 HARTLEY RD JACKSONVILLE FL 32257 CONSTRUCTION/ENGINEERING 9745865 MCKESSON DRUG CO PO BOX 409521 ATLANTA GA 30384 MEDICAL SERVICES 9385654 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 FOOD MANAGEMENT 9009874 GREAT-WEST FINANCIAL PO BOX 173764 DENVER CO 80217 EMPLOYEE BENEFIT CONSULTING 7678089 TRIMEDX INC PO BOX 636129 CINCINNATI OH 45263 MEDICAL SERVICES 5436861 258 292560 292560 NET PATIENT SERVICE REVENUE 623000 315222145 315222145 ANCILLARY SERVICES 623000 13950951 13950951 OSC REVENUE 623000 779 779 329173875 1119194 1119194 3610911 148721 3462190 3462190 3462190 360712 554319 -360712 -554319 -915031 -915031 148092 66592 81500 81500 NON OPERATING REV OTHER 561499 304273 304273 PATIENT RECORD TRANSCRIPTION 561000 184345 184345 488618 333702906 329173875 0 4236471 X 796885 796885 5250008 5250008 109066680 94658205 14408475 2382181 2374394 7787 11802436 11260544 541892 7749923 6417207 1332716 3565108 3521731 43377 253500 253500 712711 712711 73523771 57296496 16227275 1210921 3186 1207735 4039417 1752135 2287282 9141285 9141285 9145251 3512203 5633048 195546 96666 98880 8027859 5862561 2165298 21652269 21652269 3441783 3441783 MEDICAL SUPPLIES 52550277 52439813 110464 BAD DEBT EXPENSE 19943570 19943570 RADIOLOGY SUPPLIES 2359265 2359265 MINOR EQUIPMENT 1156916 887345 269571 16372732 15947080 425652 364340294 279129286 85211008 0 8039519 6654645 29789894 13732246 36369359 31101190 4757540 7682515 7356939 7651030 3204964 6105048 556506846 323881921 232571997 232624925 64597127 31139868 4194542 3365755 7766026 6484726 23807995 20954111 422455902 367496059 49518104 51421020 3600224 3475269 216846979 52990000 10366624 166761634 29708545 29137267 310040476 303785190 X 112415426 63710869 112415426 63710869 422455902 367496059 X -30637388 4950180 -23017349 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 712711 0 0 712711 0 PART II-B, LINE 1: DURING THE TAX YEAR, THE ORGANIZATION ENGAGED A PROFESSIONAL LOBBYIST TO MONITOR LEGISLATION DIRECTLY AFFECTING NOT-FOR-PROFIT HOSPITALS/RURAL COMMUNITY PROVIDERS. 4064275 4064275 4064275 4064275 4064225 50 4064275 4064200 25 4064225 4655297 4573 595670 4064200 0.00000 1.00000 0.00000 0 1 1 46912035 46912035 209710773 126271875 83438898 6790854 5649474 1141380 228077596 183068532 45009064 65015588 8892040 56123548 232624925 DUE FROM AFFILIATES 13378443 LONG-TERM RECOVERIES 6120645 RIGHT OF USE ASSETS 1455023 20954111 CAPITAL LEASE LIABILITY 16086538 MEDICARE ACCELERATED PAYMENTS 13050729 29137267 318916430 4950180 -19885377 -14935197 333851627 -148721 -148721 333702906 344603638 206914 206914 344396724 19943570 19943570 364340294 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF FOUR INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENTS ARE ALL DONOR-RESTRICTED AND INTERNALLY CONTROLLED. FLAGLER HEALTH CARE FOUNDATION, A RELATED ORGANIZATION, HOLDS THESE ENDOWMENTS FOR BENEFIT OF FLAGLER HOSPITAL, INC. INVESTMENTS CONTAIN AMOUNTS TO BE HELD IN PERPETUITY, THE DIVIDEND AND INTEREST INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTHCARE SERVICES, AND THE REMAINING INVESTMENT INCOME, GAINS, AND LOSSES ARE TO ADJUST THE CORPUS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -19,943,570. COST OF GOODS SOLD 66,592. EXPENSE ACCOUNTS INCLUDED IN REVENUE -8,399. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -148,721. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 148,721. COST OF GOODS SOLD 66,592. EXPENSE ACCOUNTS INCLUDED IN REVENUE -8,399. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 19,943,570. 1 1 X 1 X 1 X 1 1 1 0 1 1 7140519 80349 7060170 0.02050 26829879 21796902 5032977 0.01460 33970398 21877251 12093147 0.03510 13 4613 3903014 2186519 1716495 0.00500 31 1009 1100183 1100183 0.00320 1 195476 195476 0.00060 5 277 251080 251080 0.00070 50 5899 5449753 2186519 3263234 0.00950 50 5899 39420151 24063770 15356381 0.04460 1 1323 806438 806438 1 22 4979 4979 0.00000 2 45 306153 306153 0.00090 4 1390 1117570 806438 311132 0.00090 1 19943570 88199112 103960299 -15761187 X 1 1 1 1 FLAGLER HOSPITAL INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 WWW.FLAGLERHEALTH.ORG X X X FLAGLER HOSPITAL 1 0 1 1 X X X X X X X X X 23 1 0 0 1 X HTTPS://TINYURL.COM/2FAF2U4H X X 1 23 1 HTTPS://TINYURL.COM/2FAF2U4H 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X HTTPS://TINYURL.COM/BDWDTN68 X HTTPS://TINYURL.COM/BDWDTN68 X HTTPS://TINYURL.COM/BDWDTN68 X X X X X X 1 X 0 X X X X 1 X 0 0 FLAGLER HOSPITAL PART V, SECTION B, LINE 2: UF HEALTH (TAX EXEMPT) ACQUIRED FLAGLER HOSPITAL ON SEPTEMBER 1, 2023. FLAGLER HOSPITAL PART V, SECTION B, LINE 5: FLAGLER HOSPITAL CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. SEVENTEEN (17) PHONE INTERVIEWS WERE CONDUCTED DURING FEBRUARY AND MARCH 2023. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT INTERVIEWS. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN THE SERVICE AREA, WHO SPOKE ABOUT ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. FOCUS WAS PLACED ON ORGANIZATIONS WHO SERVE AND REPRESENT DIVERSE COMMUNITY GROUPS RELATED TO RACE, AGE, ETHNICITY, LANGUAGE, CULTURE AND SOCIAL NEEDS.THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN THE PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT FOR THE STAKEHOLDERS. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN.DURING THE INTERVIEWS, PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE ISSUES, CHALLENGES AND BARRIERS RELATIVE TO THE IDENTIFIED HEALTH NEEDS (WHAT MAKES EACH HEALTH NEED A SIGNIFICANT ISSUE IN THE COMMUNITY? WHAT ARE THE CHALLENGES PEOPLE FACE IN ADDRESSING THESE NEEDS?), ALONG WITH IDENTIFYING KNOWN RESOURCES TO ADDRESS THESE HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS. THE IDENTIFIED SIGNIFICANT COMMUNITY NEEDS WERE PRIORITIZED WITH INPUT FROM THE COMMUNITY. INTERVIEWS WITH COMMUNITY STAKEHOLDERS WERE USED TO GATHER INPUT ON THE SIGNIFICANT NEEDS. THE FOLLOWING CRITERIA WERE USED TO PRIORITIZE THE SIGNIFICANT NEEDS: THE PERCEIVED SEVERITY OF A HEALTH OR COMMUNITY ISSUE AS IT AFFECTS THE HEALTH AND LIVES OF THOSE IN THE COMMUNITY. IMPROVING OR WORSENING OF AN ISSUE IN THE COMMUNITY. AVAILABILITY OF RESOURCES TO ADDRESS THE NEED. THE LEVEL OF IMPORTANCE THE HOSPITAL SHOULD PLACE ON ADDRESSING THE ISSUE. THE STAKEHOLDER INTERVIEWEES WERE SENT A LINK TO AN ELECTRONIC SURVEY (SURVEYMONKEY) IN ADVANCE OF THE INTERVIEW. THE STAKEHOLDERS WERE ASKED TO RANK EACH IDENTIFIED NEED. THE PERCENTAGE OF RESPONSES WERE NOTED AS THOSE THAT IDENTIFIED THE NEED AS HAVING SEVERE OR VERY SEVERE IMPACT ON THE COMMUNITY, HAD WORSENED OVER TIME, AND HAD A SHORTAGE OR ABSENCE OF RESOURCES AVAILABLE IN THE COMMUNITY. NOT ALL RESPONDENTS ANSWERED EVERY QUESTION, THEREFORE, THE RESPONSE PERCENTAGES WERE CALCULATED BASED ON RESPONDENTS ONLY AND NOT ON THE ENTIRE SAMPLE SIZE. MENTAL HEALTH, HOUSING AND HOMELESSNESS, AND SUBSTANCE USE HAD THE HIGHEST SCORES FOR SEVERE AND VERY SEVERE IMPACT ON THE COMMUNITY. MENTAL HEALTH, HOUSING AND HOMELESSNESS, AND SUBSTANCE USE WERE THE TOP THREE NEEDS THAT HAD WORSENED OVER TIME. MENTAL HEALTH AND HOUSING AND HOMELESSNESS HAD THE HIGHEST SCORES FOR INSUFFICIENT RESOURCES AVAILABLE TO ADDRESS THE NEED.COMMUNITY INPUT WAS OBTAINED FROM INTERVIEWS WITH COMMUNITY STAKEHOLDERS FROM COMMUNITY AGENCIES AND ORGANIZATIONS THAT REPRESENT MEDICALLY UNDERSERVED, LOW-INCOME, AND/OR MINORITY POPULATIONS. FLAGLER HOSPITAL PART V, SECTION B, LINE 7D: FLAGLER HOSPITAL UTILIZED A VARIETY OF APPROACHES TO INFORM THE COMMUNITY ON THE RESULTS OF THE 2023 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. FLAGLER HOSPITAL INVESTED IN PRINTING 50 HARD COPIES OF THE PUBLICATION. THESE COPIES WERE PROVIDED TO ALL ST. JOHNS COUNTY COMMUNITY STAKEHOLDERS AND DISPLAYED ON-SITE AT EACH MEMBER AGENCY. IN ADDITION TO THESE MODALITIES, THE CHNA WAS POSTED ON THE HOSPITAL WEBSITE AND CONTINUES TO BE USED AS A CORNERSTONE AND STRATEGIC PLAN FOR ALL COMMUNITY PARTNERSHIPS AND INVESTMENTS IN COMMUNITY HEALTH IMPROVEMENT. FLAGLER HOSPITAL PART V, SECTION B, LINE 11: THE IMPLEMENTATION STRATEGY DETAILS HOW FLAGLER HOSPITAL PLANS TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2023 CHNA. THE HOSPITAL WILL BUILD ON PREVIOUS CHNA EFFORTS AND EXISTING INITIATIVES, WHILE ALSO CONSIDERING NEW STRATEGIES AND EFFORTS TO IMPROVE HEALTH.THE FOLLOWING CRITERIA WERE USED TO DETERMINE THE SIGNIFICANT HEALTH NEEDS FLAGLER HOSPITAL WILL ADDRESS IN THE IMPLEMENTATION STRATEGY: EXISTING INFRASTRUCTURE: THERE ARE PROGRAMS, SYSTEMS, STAFF, AND SUPPORT RESOURCES IN PLACE TO ADDRESS THE ISSUE. ESTABLISHED RELATIONSHIPS: THERE ARE ESTABLISHED RELATIONSHIPS WITH COMMUNITY PARTNERS TO ADDRESS THE ISSUE. ONGOING INVESTMENT: EXISTING RESOURCES ARE COMMITTED TO THE ISSUE. STAFF TIME AND FINANCIAL RESOURCES FOR THIS ISSUE ARE COUNTED AS PART OF OUR COMMUNITY BENEFIT EFFORT. FOCUS AREA: HAS ACKNOWLEDGED COMPETENCIES AND EXPERTISE TO ADDRESS THE ISSUE AND THE ISSUE FITS WITH THE ORGANIZATIONAL MISSION. THE NEED WAS IDENTIFIED AS A PRIORITY IN THE PREVIOUS IMPLEMENTATION STRATEGY.HOSPITAL LEADERS EXAMINED THE IDENTIFIED HEALTH NEEDS ACCORDING TO THESE CRITERIA. AS A RESULT OF THE APPLICATION OF THE ABOVE CRITERIA, FLAGLER HOSPITAL CHOSE TO FOCUS ON: ACCESS TO CARE CHRONIC DISEASE (INCLUDING OVERWEIGHT AND OBESITY) HOUSING AND HOMELESSNESS MENTAL HEALTHSTRATEGIES TO ADDRESS PRIORITIZED HEALTH NEEDSFOR EACH HEALTH NEED THE HOSPITAL PLANS TO ADDRESS, THE IMPLEMENTATION STRATEGY DESCRIBES THE FOLLOWING: ACTIONS THE HOSPITAL INTENDS TO TAKE, INCLUDING PROGRAMS AND RESOURCES IT PLANS TO COMMIT; ANTICIPATED IMPACTS OF THESE ACTIONS; AND PLANNED COLLABORATION BETWEEN THE HOSPITAL AND OTHER ORGANIZATIONS.TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, FLAGLER HOSPITAL WILL NOT DIRECTLY ADDRESS PREVENTIVE PRACTICES AND SUBSTANCE USE AS PRIORITY HEALTH NEEDS. THE HOSPITAL HAS INSUFFICIENT RESOURCES TO EFFECTIVELY ADDRESS ALL THE IDENTIFIED NEEDS, AND, IN SOME CASES, THE NEEDS ARE CURRENTLY ADDRESSED BY OTHERS IN THE COMMUNITY. KNOWING THAT THERE ARE NOT SUFFICIENT RESOURCES TO ADDRESS ALL THE COMMUNITY HEALTH NEEDS, FLAGLER HOSPITAL CHOSE TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. FLAGLER HOSPITAL PART V, SECTION B, LINE 15E: CONTACT INFORMATION IS IN THE PLAIN LANGUAGE SUMMARY LOCATED ON THE HOSPITAL WEBSITE: HTTPS://STJOHNS.UFHEALTH.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY/ THERE ARE MANY WAYS TO FIND INFORMATION ABOUT THE FAP APPLICATION PROCESS, OR GET COPIES OF THE FAP OR FAP APPLICATION FORM. TO APPLY FOR FINANCIAL ASSISTANCE YOU MAY: DOWNLOAD THE INFORMATION ONLINE AT FLAGLERHOSPITAL.ORG, KEY WORDS FINANCIAL ASSISTANCE REQUEST THE INFORMATION IN WRITING BY MAIL OR BY VISITING UF HEALTH ST JOHNS FLAGLER HOSPITAL BUSINESS OFFICE AT 100 WHETSTONE PLACE, SUITE 100 ST. AUGUSTINE, FL 32086 REQUEST THE INFORMATION BY CALLING (904) 819-4539 AVAILABILITY OF TRANSLATIONSTHE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND THE PLAIN LANGUAGE SUMMARY ARE OFFERED IN ENGLISH AND SPANISH. FLAGLER HOSPITAL MAY ELECT TO FURNISH TRANSLATION AIDS, TRANSLATION GUIDES, OR PROVIDE ASSISTANCE THROUGH USE OF QUALIFIED BILINGUAL INTERPRETER BY REQUEST. FOR INFORMATION ABOUT FLAGLER HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND TRANSLATION SERVICES, PLEASE CALL A REPRESENTATIVE AT (904) 819-4539. 1 1 - FLAGLER OUTPATIENT LAB 156-316 ST HWY 312 260-264 ST AUGUSTINE FL 32086 OUTPATIENT LAB SATELLITE DRAW STATION PART I, LINE 7: EXPENSES WERE CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $19,943,570. PART II, COMMUNITY BUILDING ACTIVITIES: FLAGLER HOSPITAL DONATED PAID STAFF TIME FOR EMPLOYEES WHO SERVED ON VARIOUS BOARDS FOR COMMUNITY EVENTS AND COMMITTEES WHICH OFFERED COMMUNITY SUPPORT, COALITION BUILDING WITH OTHER AGENCIES AND HEALTH AND WELFARE PROVIDERS, AND COMMUNITY HEALTH IMPROVEMENTS ADVOCACY.THROUGH A PARTNERSHIP WITH THE HOSPITAL, THE ST. JOHNS COUNTY SCHOOL DISTRICT CREATED THE FLAGLER HOSPITAL ACADEMY OF MEDICAL AND HEALTH CAREERS AT PEDRO MENENDEZ HIGH SCHOOL IN 2007-2008, THAT CONTINUES TO SUPPORT STUDENTS TODAY. IN ADDITION, FLAGLER HOSPITAL STARTED A NEW HEALTH ACADEMY AT TOCOI CREEK HIGH SCHOOL IN JANUARY OF 2023. THE ACADEMIES ARE OPEN TO STUDENTS THROUGHOUT THE SCHOOL SYSTEM. THEY FOCUS ON PROVIDING SKILLS AND EXPERIENCE NECESSARY TO ATTAIN ENTRY LEVEL JOBS IN HEALTH, MEDICAL AND RELATED FIELDS, AND PROVIDES ACADEMIC PREPARATION TO CONTINUE TRAINING THROUGH CLINICAL EXPERIENCE, COMMUNITY COLLEGE AND UNIVERSITY PROGRAMS. THIS PAST FISCAL YEAR THE ACADEMIES HAD 45 STUDENTS ENROLLED AND ROTATING THROUGH VARIOUS DEPARTMENTS AT THE HOSPITAL FOR TRAINING. THE LIFE INSTITUTE WORKS CLOSELY WITH THE SCHOOL DISTRICT TO ADMINISTER THE ACADEMY. FOUR $1,000 SCHOLARSHIPS WERE DONATED TO STUDENTS IN THE PROGRAM FOR FURTHER EDUCATION, GIVEN WITH NO EXPECTATION OF THE STUDENT HAVING TO WORK FOR FLAGLER HOSPITAL UPON COMPLETION OF SCHOOL. IN ADDITION TO THE HEALTH ACADEMIES, FLAGLER HOSPITAL ALSO ADMINISTERS AND OVERSEES THE YOUTH LEADERSHIP ST. JOHNS PROGRAM. THE MISSION OF YOUTH LEADERSHIP ST. JOHNS (YLSJ) IS TO DEVELOP A CORPS OF INFORMED, COMMITTED AND QUALIFIED YOUNG PEOPLE CAPABLE OF PROVIDING DYNAMIC LEADERSHIP IN THEIR SCHOOLS, CAREERS AND COMMUNITIES AS THEY MATURE INTO ADULTHOOD. STUDENTS IN THE YOUTH LEADERSHIP ST. JOHNS PROGRAM MUST COMMIT TO A HIGH STANDARD OF ATTENDANCE AND PARTICIPATION IN THE RETREAT AND PROGRAM SESSIONS. IN FY23 WE HAD 22 STUDENTS PARTICIPATE IN THE PROGRAM. THE OFFICE ON HOMELESSNESS RECOGNIZES AND DESIGNATES LOCAL ENTITIES TO SERVE AS LEAD AGENCIES FOR LOCAL PLANNING EFFORTS TO COORDINATE HOMELESS ASSISTANCE CONTINUUM OF CARE SYSTEMS. THE PURPOSE OF THE LOCAL CONTINUUM OF CARE IS TO HELP COMMUNITIES ENVISION, PLAN AND IMPLEMENT COORDINATED, LONG-TERM SOLUTIONS TO ADDRESS HOMELESSNESS. UF HEALTH ST. JOHNS, FORMERLY KNOWN AS FLAGLER HOSPITAL, BECAME THE LEAD AGENCY FOR THE ST. JOHNS COUNTY CONTINUUM OF CARE IN DECEMBER OF 2017. THE OBJECTIVE OF THE COC IS TO IMPROVE THE OVERALL QUALITY OF LIFE FOR HOMELESS INDIVIDUALS AND/OR FAMILIES THROUGH COORDINATION WITH COMMUNITY AGENCIES TO PROVIDE QUALITY SERVICES AND PROGRAMS INCLUDING BOTH FACILITIES (I.E. HOMELESS SHELTERS, TRANSITIONAL HOUSING, ECT.) AS WELL AS PREVENTION AND RE-HOUSING INITIATIVES (I.E. RENTAL AND FINANCIAL ASSISTANCE PROGRAMS) OR OUTREACH ACTIVITIES INCLUDING THE COMPETITIVELY AWARDED CHALLENGE GRANT, EMERGENCY SOLUTIONS GRANT (ESG) AND TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) GRANTS. THESE SERVICES WILL PROVIDE THE HOMELESS POPULATION THE ASSISTANCE NEEDED TO GAIN SELF-SUFFICIENCY AND MAKE SUITABLE LIVING CONDITIONS AVAILABLE. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE SYSTEM'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE SYSTEM RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: THE MEDICARE REVENUE AND ALLOWABLE COSTS ON LINES 5 AND 6, RESPECTIVELY, WERE TAKEN FROM THE MEDICARE COST REPORT. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE REIMBURSEMENT ALLOWED, BEFORE REDUCTION OF CO-PAY AMOUNTS, LESS SEQUESTRATION AND ANY OTHER REDUCTIONS ASSOCIATED WITH VALUE BASED PURCHASING REDUCTIONS AS PER THE COST REPORT WORKSHEETS E PART A AND B. MEDICARE ALLOWABLE COSTS RELATING TO PAYMENTS ARE TAKEN FROM THE PART A AND PART B EXPENSES AS DETERMINED BY THE COST REPORT STEP DOWN AND COST APPORTIONMENT METHODOLOGY ON WORKSHEETS D-1 AND D PART V, PLUS THE 65% REDUCTION APPLIED TO MEDICARE BAD DEBTS. THE ENTIRE SHORTFALL IS REPORTED AS COMMUNITY BENEFIT. WE DO NOT RECEIVE ENOUGH IN MEDICARE REIMBURSEMENTS TO COVER OUR COSTS ASSOCIATED WITH THE PROVISION OF THESE SERVICES, YET WE CONTINUE TO PROVIDE MEDICARE SERVICES TO OUR COMMUNITY REGARDLESS OF THE REIMBURSEMENT LEVELS. THEREFORE, WE FEEL JUSTIFIED IN REPORTING THIS AS PART OF OUR COMMUNITY BENEFIT. PART III, LINE 9B: 1. FLAGLER HOSPITAL BUSINESS OFFICE STAFF REVIEW UNPAID PATIENT ACCOUNTS ON A REGULAR BASIS TO IDENTIFY THOSE ACCOUNTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ATTEMPTS TO CLASSIFY THESE PARTICULAR INDIVIDUALS START AT THE TIME THAT THEY ARE STILL IN-HOUSE. PATIENTS ARE ALSO CONTACTED AFTER DISCHARGE THROUGH PHONE CALLS OR MAIL. COMPLIANT INDIVIDUALS WHO MEET THE HOSPITAL'S FINANCIAL ASSISTANCE GUIDELINES ARE GRANTED THE APPROPRIATE DISCOUNT BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES. MANY PATIENTS DUE TO FAILURE TO PRODUCE THE APPROPRIATE DOCUMENTATION RECEIVE A REDUCED NON-COMPLIANT HOSPITAL ADJUSTMENT. THESE PARTICULAR INDIVIDUALS MAY HAVE RECEIVED A HIGHER WRITE-OFF IF THEY WERE IN FACT COMPLIANT. 2. REGARDLESS OF THE PATIENTS FINANCIAL CLASS OR STATUS, IF A BILL REMAINS UNPAID FOR MORE THAN 120 DAYS FROM THE DATE IT WAS FIRST MAILED TO THE PATIENT, AND REASONABLE COLLECTION ATTEMPTS HAVE FAILED, THE DEBT IS SENT TO A PRIMARY BAD DEBT COLLECTION AGENCY FOR FURTHER COLLECTION EFFORTS. PART VI, LINE 2: SECONDARY DATA WERE COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL DETERMINANTS OF HEALTH, ACCESS TO HEALTH CARE, BIRTH CHARACTERISTICS, LEADING CAUSES OF DEATH, COVID-19, ACUTE AND CHRONIC DISEASE, HEALTH BEHAVIORS, MENTAL HEALTH, SUBSTANCE USE AND PREVENTIVE PRACTICES. WHERE AVAILABLE, THESE DATA ARE PRESENTED IN THE CONTEXT OF FLORIDA.ANALYSIS OF SECONDARY DATA INCLUDES AN EXAMINATION AND REPORTING OF HEALTH DISPARITIES FOR SOME HEALTH INDICATORS. THE REPORT INCLUDES BENCHMARK COMPARISON DATA THAT MEASURE THE DATA FINDINGS AS COMPARED TO HEALTHY PEOPLE 2030 OBJECTIVES, WHERE APPROPRIATE. HEALTHY PEOPLE 2030 IS A NATIONAL INITIATIVE TO IMPROVE THE PUBLIC'S HEALTH BY PROVIDING MEASURABLE OBJECTIVES THAT ARE APPLICABLE AT NATIONAL, STATE, AND LOCAL LEVELS. FLAGLER HOSPITAL WAS RECOGNIZED AS A HEALTHY PEOPLE 2030 CHAMPION IN MARCH 2023.SEVENTEEN (17) PHONE INTERVIEWS WERE CONDUCTED DURING FEBRUARY AND MARCH 2023. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT INTERVIEWS. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN ST. JOHNS COUNTY, WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. FOCUS WAS PLACED ON ORGANIZATIONS WHO SERVE AND REPRESENT DIVERSE COMMUNITY GROUPS RELATED TO RACE, AGE, ETHNICITY, LANGUAGE, CULTURE AND SOCIAL NEEDS. DURING THE INTERVIEWS, PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE ISSUES, CHALLENGES AND BARRIERS RELATIVE TO THE IDENTIFIED HEALTH NEEDS (WHAT MAKES EACH HEALTH NEED A SIGNIFICANT ISSUE IN THE COMMUNITY? WHAT ARE THE CHALLENGES PEOPLE FACE IN ADDRESSING THESE NEEDS?), ALONG WITH IDENTIFYING KNOWN RESOURCES TO ADDRESS THESE HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS.BIEL CONSULTING, INC. CONDUCTED THE CHNA. DR. MELISSA BIEL WAS JOINED BY SEVANNE SARKIS, JD, MHA, MED, AND DENISE FLANAGAN, BA. BIEL CONSULTING, INC. IS AN INDEPENDENT CONSULTING FIRM THAT HAS OVER 25 YEARS OF EXPERIENCE CONDUCTING HOSPITAL CHNAS AND WORKING WITH HOSPITALS ON DEVELOPING, IMPLEMENTING, AND EVALUATING COMMUNITY BENEFIT PROGRAMS. PART VI, LINE 3: THE HOSPITAL COMMUNICATES ITS CHARITY CARE POLICY, OR PATIENT-FRIENDLY SUMMARY THEREOF, IN THE FOLLOWING WAYS:- POSTED ON THE FLAGLER HOSPITAL WEBSITE - POSTED AT THE RECEPTION DESKS IN ALL REGISTRATION AREAS - POSTED AT ALL FINANCIAL COUNSELORS' DESKSWHEN UNINSURED OR UNDERINSURED PATIENTS ARE ADMITTED TO THE HOSPITAL, THEY ARE SCREENED FOR FINANCIAL ASSISTANCE. AT THE TIME OF SCREENING, THE PATIENT IS PROVIDED A FINANCIAL ASSISTANCE APPLICATION TO COMPLETE. THEY ARE THEN ASKED TO SUBMIT THE REQUIRED FINANCIAL DOCUMENTS (I.E., BANK STATEMENTS, PAY STUBS, TAX RETURNS, ETC.). THOSE PATIENTS DISCHARGED PRIOR TO SCREENING ARE CALLED BY THE BUSINESS OFFICE AND ARE SCREENED OVER THE PHONE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED FOR VERIFICATION. UNINSURED PATIENTS TREATED IN THE EMERGENCY DEPARTMENT WHO MEET CERTAIN CRITERIA ARE SCREENED BY PHONE BY THE BUSINESS OFFICE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED. A SEPARATE SCREENING IS PERFORMED TO DETERMINE ELIGIBILITY FOR COUNTY PROGRAMS AND MEDICAID. IN ADDITION, THE HOSPITAL UTILIZES A THIRD-PARTY VENDOR TO SCREEN SELF-PAY PATIENTS FOR POSSIBLE DISCOUNTS AND FINANCIAL ASSISTANCE OPTIONS. PART VI, LINE 4: ST. JOHNS COUNTY IS PART OF THE JACKSONVILLE METROPOLITAN AREA AND ENCOMPASSES APPROXIMATELY 680 SQUARE MILES OF LAND IN NORTHEAST FLORIDA, SITUATED BETWEEN THE ST. JOHNS RIVER AND MORE THAN 40 MILES OF BEACHES ALONG THE ATLANTIC COAST. ACCORDING TO THE U.S. CENSUS BUREAU, THE POPULATION OF ST. JOHNS COUNTY IS 265,724. FROM 2016 TO 2021, THE POPULATION INCREASED BY 21.7%, WHICH WAS MORE THAN TRIPLE THE STATE RATE OF GROWTH (7%). POPULATION BY GENDER: THE AREA POPULATION IS 51.1% FEMALE AND 48.9% MALE. POPULATION BY AGE: CHILDREN AND YOUTH, AGES 0-19, MAKE UP 24.2% OF THE POPULATION, 55.7% ARE ADULTS, AGES 20-64, AND 20.1% OF THE POPULATION ARE SENIOR ADULTS, AGES 65 AND OLDER. THE POPULATION IN THE COUNTY HAS A HIGHER PERCENTAGE OF CHILDREN, AGES 5-19, AND ADULTS, AGES 45-64, AND A LOWER PERCENTAGE OF ADULTS, AGES 20-44, THAN FOUND AT THE STATE LEVEL.RACE AND ETHNICITY: THE MAJORITY POPULATION IN THE COUNTY ARE NON-HISPANIC WHITE RESIDENTS (80.9%). 7.6% OF THE POPULATION ARE HISPANIC OR LATINO RESIDENTS, 5.1% OF THE POPULATION ARE BLACK OR AFRICAN AMERICAN RESIDENTS, AND 3% OF THE POPULATION ARE ASIAN RESIDENTS. RESIDENTS WHO ARE MULTIRACIAL (TWO-OR-MORE RACES) MAKE UP 2.8% OF THE POPULATION, WHILE NATIVE HAWAIIAN OR PACIFIC ISLANDER RESIDENTS AND AMERICAN INDIAN OR ALASKAN NATIVE RESIDENTS EACH MAKE UP 0.1% OF THE POPULATION. THOSE WHO IDENTIFY AS A RACE OR ETHNICITY NOT LISTED REPRESENT 0.4% OF THE POPULATION. THE COUNTY HAS A HIGHER POPULATION OF WHITE RESIDENTS, AND A LOWER POPULATION OF HISPANIC OR LATINO RESIDENTS AND BLACK OR AFRICAN AMERICAN RESIDENTS, WHEN COMPARED TO THE STATE POPULATION.SOCIAL AND ECONOMIC FACTORS RANKING: COUNTY HEALTH RANKINGS RANK COUNTIES ACCORDING TO HEALTH FACTORS DATA. SOCIAL AND ECONOMIC INDICATORS ARE EXAMINED AS A CONTRIBUTOR TO THE HEALTH OF A COUNTY'S RESIDENTS. FLORIDA'S 67 COUNTIES ARE RANKED ACCORDING TO SOCIAL AND ECONOMIC FACTORS WITH 1 BEING THE COUNTY WITH THE BEST FACTORS TO 67 FOR THE COUNTY WITH THE POOREST FACTORS. THIS RANKING EXAMINES: HIGH SCHOOL GRADUATION RATES, UNEMPLOYMENT, CHILDREN IN POVERTY, SOCIAL SUPPORT, AND OTHERS. ST. JOHNS COUNTY IS RANKED FIRST AMONG FLORIDA COUNTIES, ACCORDING TO SOCIAL AND ECONOMIC FACTORS. PART VI, LINE 5: THE GOVERNING BOARD OF THE HOSPITAL IS MADE UP OF PRIMARLY COMMUNITY MEMBERS THAT RESIDE IN ST. JOHNS COUNTY AND ARE FAMILIAR WITH THE NEEDS AND SERVICES PROVIDED THROGUH THE COUNTY. EACH BOARD MEMBER IS PROVIDED WITH A COPY OF THE CHNA TO FAMILIARIZE THEMSELVES WITH THE MOST UP-TO-DATE ASSESSMENT. FLAGLER HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILAGES TO ALL QUALIFYING PHYSICIANS WHO REQUEST TO BE CREDENTIALED WITH THE HOSPITAL. PART VI, LINE 6: AS OF SEPTEMBER 1, 2023, THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WITH SHANDS TEACHING HOSPITAL AND CLINICS, INC. DBA UF SHANDS. 1 JACKSONVILLE FC INC 2850 HODGES BLVD JACKSONVILLE FL 32224 592881219 501(C)(3) 6000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE M2 32081 LLC 48 GULFSTREAM WAY PONTE VEDRA BEACH FL 32081 843846475 232000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE PALM COAST REGIONAL CHAMBER OF COMMERCE 145 CITY PLACE SUITE 301 PALM COAST FL 32164 852141868 501(C)(6) 10000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE PALM COAST MUSIC FESTIVAL INC 1 FLORIDA PARK DRIVE SUITE 103 PALM COAST FL 32137 842655852 501(C)(6) 12000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE K9S FOR WARRIORS INC 114 CAMP K9 RD PONTE VEDRA FL 32081 275219467 501(C)(3) 80000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST JOHNS COUNTY CHAMBER OF COMMERCE 100 SOUTHPARK BLVD STE 405/406 ST AUGUSTINE FL 32086 590432275 501(C)(6) 61665 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE GOOD LAD SOCCER 409 SPANISH CREEK DR PONTE VEDRA BEACH FL 32081 832249321 9200 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE SHE IS FIERCE LLC 24 S DIXIE HWY ST AUGUSTINE FL 32084 474695657 40000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ROSCOLUSA LLC 1611 WOODLAND ST NASHVILLE TN 37206 462971411 45000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST FRANCIS HOUSE 70 WSHINGTON ST ST AUGUSTINE FL 32084 592475614 501(C)(3) 5940 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE EPIC BEHAVIORAL HEALTHCARE 17 ST JOHNS MEDICAL PARK DR ST AUGUSTINE FL 32086 591502582 501(C)(3) 154000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST JOHNS COUNCIL ON AGING (SJCCOA) 180 MARINE ST ST AUGUSTINE FL 32084 591525829 501(C)(3) 52500 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE GOOD SAMARITAN HEALTH CENTERS INC 268 HERBERT ST ST AUGUSTINE FL 32084 522125419 501(C)(3) 7179 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST AUGUSTINE SONGWRITERS FASTIVAL 4109 STONE HALL BLVD HERMITAGE TN 37076 821824607 15000 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE FLAGLER CO EDUCATION FOUNDATION DIRECT SUPPORT 1769 EAST MOODY BLVD BLDG 2 BUNNELL FL 32110 593006312 501(C)(3) 5500 0 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE 7 8 PART I, LINE 2: THE FLAGLER HEALTH CARE FOUNDATION, A SUPPORTING ORGANIZATION OF THE HOSPITAL, REPORTS ITS FINANCIAL ACTIVITIES TO THE CFO OF FLAGLER HOSPITAL. THE HOSPITAL HAS A COMMUNITY BENEFITS GROUP THAT WORKS WITH ST. JOHNS COUNTY TO DETERMINE GRANT RECIPIENTS AND MONITOR THE USE OF FUNDS. X 1 0 X X X X 1 1 0 0 0 0 0 1 0 DAVID NELSON MD BOARD MEMBER 0 1201967 0 360000 0 4812 0 28609 0 22575 0 1617963 0 0 JAMES KELLY JR BOARD MEMBER 0 710988 0 146900 0 81883 0 21350 0 16517 0 977638 0 0 TIMOTHY MOREY MD VICE-CHAIRMAN/ BOARD MEMBER 0 590551 0 104535 0 4812 0 28609 0 22766 0 751273 0 0 DAVID RICE MD END 923 EVP/CHIEF PHYSICIAN EXECUTIVE 543835 0 0 0 0 0 0 0 55463 0 599298 0 0 0 BOB THORNTON TREASURER 0 391616 0 72400 0 56117 0 21350 0 24722 0 566205 0 0 CARLTON DEVOOGHT PRESIDENT/CEO 525791 0 0 0 0 0 0 0 27637 0 553428 0 0 0 DR TODD BATENHORST VP, INTERIM CHIEF MEDICAL OFFICER 393695 0 27475 0 0 0 0 0 42104 0 463274 0 0 0 VINCENT JOHNSON END 1222 CHIEF OPERATING OFFICER 372390 0 0 0 35114 0 0 0 45084 0 452588 0 0 0 BRENDA BAKER END 1222 CHIEF FINANCIAL OFFICER 357268 0 0 0 16639 0 0 0 19500 0 393407 0 0 0 JASON BARRETT FORMER PRESIDENT/CEO 0 0 0 0 379229 0 0 0 0 0 379229 0 0 0 MIGUEL MACHADO FORMER CHIEF MEDICAL OFFICER 10703 0 0 0 346337 0 0 0 106 0 357146 0 0 0 REGINA R MANGUS FORMER EVP ADVANCEMENT & STRATEGY 138104 0 0 0 206719 0 0 0 10751 0 355574 0 0 0 ANGIE METCALF END 923 CHIEF ADMINISTRATIVE OFFICER 310251 0 0 0 600 0 0 0 7752 0 318603 0 0 0 DONALD R CRIST VP OF OPERATIONS 249840 0 0 0 7246 0 0 0 15613 0 272699 0 0 0 JOHN WAGNER END 1222 EVP REVENUE CYCLE 221156 0 0 0 14261 0 0 0 33896 0 269313 0 0 0 MELISSA CECIL VP, CHIEF INFORMATION OFFICER 248063 0 0 0 0 0 0 0 10413 0 258476 0 0 0 JILL BERRY VP, CHIEF LEGAL OFFICER 226928 0 8686 0 0 0 0 0 18225 0 253839 0 0 0 JOHN FRANKS END 923 EVP, AMBULATORY ENTERPRISE 236070 0 0 0 6928 0 0 0 5213 0 248211 0 0 0 MICHAEL HALL ADMINISTRATOT, CLINICAL SERVICES 194336 0 0 0 5716 0 0 0 30207 0 230259 0 0 0 KEVIN SWEENY VP, CHIEF OF STAFF 210844 0 0 0 0 0 0 0 5837 0 216681 0 0 0 DONNA WAGNER VP CHIEF NURSING OFFICER 205163 0 0 0 0 0 0 0 1224 0 206387 0 0 0 KENISHA S ELLIOTT RN 168347 0 28250 0 0 0 0 0 5853 0 202450 0 0 0 SHARON R MCDADE CHARGE RN 168344 0 17684 0 4635 0 0 0 5945 0 196608 0 0 0 FAITH M JONES RN 142873 0 22305 0 5042 0 0 0 22375 0 192595 0 0 0 SIBEL MIGLINO INTERIM VP OF HUMAN RESOURCES 144982 0 0 0 0 0 0 0 24168 0 169150 0 0 0 LYLE KOLNIK CLINICAL PHARMACIST 159445 0 1060 0 7948 0 0 0 0 0 168453 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES GROSS UP PAYMENTS FOR THE VALUE OF THE DISABILITY INSURANCE POLICY PREMIUMS TO CERTAIN OFFICERS, REPORTED ON THE OFFICERS' FORM W-2. PART I, LINES 4A-B JASON BARRETT AND REGINA MANGUS RECEIVED SEVERANCE PAYMENTS OF $379,229 AND 150,577 RESPECTIVELY. THE ORGANIZATION CONTRIBUTED $224,419 IN TOTAL TO A 457(F) PLAN FOR DAVID RICE, VINCENT JOHNSON, DON CHRIST, MELISSA CECIL, JILL BERRY & CARLTON DEVOUGHT. PART I, LINE 7 BONUSES ARE BASED ON PERFORMANCE METRICS SET AT THE BEGINNING OF THE PERFORMANCE YEAR. THE BOARD HAS APPROVAL RIGHTS FOR THE FINAL AMOUNT PAID AT THE END OF THE PERFORMANCE YEAR. A ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 592146640 2017-09-28 71400000 SEE PART VI 0 0 0 A 18071639 71400000 338361 592158 53517222 16952259 2019 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 PART I, LINE A, COLUMN F: CURRENT REFUNDING OF SERIES 2010A AND SERIES 2010B BONDS, FINANCING OF FACILITIES IMPROVEMENT PROJECTS AND EQUIPMENT ACQUISITIONS. PART I, LINE B, COLUMN F: CURRENT REFUNDING OF SERIES 2012B AND ADVANCE REFUNDING OF SERIES 2017A BONDS, EXTINGUISHING THE 2014 BANK LOAN, FINANCING OF FACILITIES IMPROVEMENT PROJECTS AND EQUIPMENT ACQUISITIONS. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED TO INCLUDE THAT THE SOLE MEMBER OF THE ORGANIZATION IS SHANDS TEACHING HOSPITAL AND CLINICS, INC. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS SHANDS TEACHING HOSPITAL AND CLINICS, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT AND REVIEWED AND APPROVED BY INTERNAL MANAGEMENT AND SHARED WITH EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL TRUSTEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS THAT DEVELOP AFTER SUBMISSION MUST BE DISCLOSED IN WRITING TO BOARD OF TRUSTEES. EXISTING CONFLICTS OF INTEREST MAY REQUIRE ABSTAINING FROM DISCUSSING OR VOTING UPON MATTERS RELATED TO OR AFFECTED BY THE CONFLICT, OR RECUSING ONESELF FROM PARTICIPATING IN RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PACKAGE FOR THE CEO POSITION IS SET AND APPROVED BY THE COMPENSATION COMMITTEE, WHICH CONSISTS OF THE CURRENT AND PAST CHAIRPERSONS OF THE HOSPITAL, FLAGLER HEALTH CARE SYSTEM, AND FLAGLER HEALTH SERVICES BOARDS. INDEPENDENT SALARY SURVEYS ARE OBTAINED FROM INDUSTRY EXPERTS TO DETERMINE COMPENSATION AND BENEFITS. THOSE INDEPENDENT SALARY SURVEYS ARE ALSO USED TO DEVELOP COMPENSATION PACKAGES FOR THE SENIOR MANAGEMENT TEAM. THE COMPENSATION COMMITTEE EVALUATES THE DATA, THEN DEBATES AND DOCUMENTS ITS RECOMMENDATION OF REASONABLE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 40,519,152. MANAGEMENT AND GENERAL EXPENSES 15,692,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 56,211,310. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 16,777,344. MANAGEMENT AND GENERAL EXPENSES 535,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,312,461. FORM 990, PART XI, LINE 9: TRANSFERS TO AFFILIATES -23,017,349. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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