2022-05-16T14:04:33-05:00 2021-06-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2020-07-01 592142859 SHANDS JACKSONVILLE MEDICAL CENTER INC SHAN 9042440411 655 West 8th Street Jacksonville FL 32209 Dean C Cocchi Chief Financial Officer 2022-05-16 true Dean C Cocchi 999009999 MALLORY FAIRLESS P01321579 3128997000 2020 2022-09-23 18:48:47Z UF HEALTH JACKSONVILLE Russell Armistead CEO beginning Aug 2021 655 West 8th Street Jacksonville FL 32209 894154627 false X UFHEALTHJAX.ORG X 1981 FL The mission at Shands Jacksonville Medical Center, Inc. ("SJMC") is to heal, comfort, educate and discover. We dedicate our work to improving the lives of our patients, and the community, through innovations in healthcare. 9 5 5951 238 82593 0 23696942 76124567 841754379 807692433 575393 1670863 5976695 8878612 872003409 894366475 37702291 40241052 0 341366271 374115448 0 0 488122779 409958167 867191341 824314667 4812068 70051808 664920656 750537278 457236321 475423266 207684335 275114012 The mission at Shands Jacksonville Medical Center, Inc. is to heal, to comfort, to educate and to discover. We dedicate our work to improving life through innovations in healthcare. Our commitment is to provide constant attention to the needs of our patients, community and each other. false false 641274666 40241052 812932044 SHANDS JACKSONVILLE MEDICAL CENTER, INC. PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE MEDICAL CENTER, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE THESE ESSENTIAL MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT BY PROVIDING HEALTHCARE SERVICES AND HEALTH EDUCATION. THE FOLLOWING SERVICES AND ACTIVITIES ARE PROVIDED WHERE THE NEED AND AN INDIVIDUAL'S INABILITY TO PAY COEXIST: FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY. (CONTINUED IN SCHEDULE O) 641274666 true true false true false true true false false true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true false false false true 78 0 true 5951 true true true false false false false false false false false false true false X 9 5 true false false false true true true true true false false true true true true true true false true false FL X Patricia Rausch 9042440411 655 WEST 8TH STREET JACKSONVILLE FL 32209 David R Nelson Chairman / SVP for Health Affairs at Univ of FL 2.0 48.0 X X 0 1095464 30325 Leon L Haley Jr MD CEO / Dean of Univ of FL College of Medicine 20.0 30.0 X X 0 1042641 34000 Audrey Moran Esq Director 2.0 2.0 X 0 0 0 Chandana Lall MD Director / Professor of Radiology at Univ of FL 2.0 48.0 X 0 706235 24389 David Mann Director 0.5 0.5 X 0 0 0 Kelly Gray-Eurom MD Director / Chief Quality Officer 2.0 48.0 X 0 420554 36777 Kendall Spencer Director 0.5 0.5 X 0 0 0 Marsha Powers Director 0.5 0.5 X 0 0 0 Michelle M Boynton Director 0.5 0.5 X 0 0 0 Dean Cocchi Treasurer / CFO 47.5 2.5 X 461004 0 34042 Jon DeBardeleben Asst. Secretary / VP Senior Counsel 47.5 2.5 X 281874 0 24556 Patricia Rausch Assistant Treasurer / Controller 49.5 0.5 X 217577 0 20381 Randall C Jenkins Secretary / SVP of General Council of Univ of FL 5.0 45.0 X 0 497302 47819 Robert Templin Asst. Secretary 49.5 0.5 X 184323 0 28126 Ann-Marie Knight VP Comm Engage (Chief Diversity Officer) 50.0 0 X 229120 0 19598 David Vukich MD CMO / Dean for Hospital Affairs of Univ of FL 2.0 48.0 X 0 515702 59337 Gregory Miller EVP COO 40.0 8.0 X 645339 0 28295 Lesli A Ward VP Chief HRO 48.0 2.0 X 0 323746 34721 Patrice Jones VP Chief Nursing Officer 48.0 0 X 376223 0 17799 Rita James VP of Ambulatory Services 2.0 48.0 X 0 211745 31314 Thanh Hogan VP Clinical Operations 48.0 0 X 356057 0 20215 Wayne A Marshall VP UFH North 48.0 0 X 355988 0 34006 Cynthia Gerdick VP Assoc Nursing 48.0 0 X 210361 0 11810 Jun Santos Registered Nurse 40.0 0 X 221674 0 30212 Robert Hervey Dir of Support Services 48.0 0 X 253976 0 32373 Robert Phillips Dir Div Information Technology 48.0 0 X 223185 0 22564 Steven L Wylie Dir Business Development 48.0 0 X 228758 0 25440 4245459 4813389 648099 383 false true false UF PR HOUSESTAFF 653-1 West 8th Street JACKSONVILLE FL 32209 MEDICAL STAFFING SERVICES 24160963 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICES 12204035 CROTHALL HEALTHCARE FKA PROFESSIONAL SERVICES 13028 COLLECTION CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING AND OTHER MANAGEMENT SERVICES 6820310 MORRISONS MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICES 6657808 SOUND PHYSICIANS OF FLORIDA II PO BOX 742936 LOS ANGELES CA 90074 MEDICAL STAFFING SERVICES 5975744 96 2685 276986 74012552 1832344 76124567 PATIENT SERVICE REVENUE 622110 806856457 806856457 Ancillary and Contract Services 622110 835976 835976 0 0 0 0 807692433 1873567 1873567 2838397 2838397 0 2838397 2838397 202704 0 -202704 -202704 -202704 632097 -414552 217545 217545 LABORATORY REVENUE 621500 82593 82593 Affiliate IT Services 900099 1815900 1815900 PARKING REVENUE 812930 500466 500466 3423711 3423711 0 0 5822670 894366475 812932044 82593 5227271 X 40241052 40241052 3117263 3117263 0 0 0 297069559 240388068 56681491 11061580 10906712 154868 40768554 40466431 302123 22098492 17709500 4388992 304901 12644 292257 212500 212500 93220 93220 123509251 38657646 84851605 0 2710467 2710467 5303613 3033848 2269765 11340865 7711788 3629077 42420436 28845896 13574540 267003 225599 41404 292689 212580 80109 7100395 4828268 2272127 31678767 21541561 10137206 3923043 3719132 203911 AHCA ASSESSMENT 7296248 7296248 MEDICAL SUPPLIES 172282482 171833009 449473 Postage and Courier 300677 74752 225925 RECRUITING EXPENSE 254774 253284 1490 666836 606181 60655 0 824314667 641274666 183040001 0 152570111 150525812 32257956 80677077 10163107 9456598 107616839 125685896 0 0 0 0 18538838 18233027 2981977 2876872 694438417 460164829 211175195 234273588 0 0 129616633 128808408 664920656 750537278 142273954 170923764 1858438 5541115 212388548 204540011 0 0 15939812 13588482 84775569 80829894 457236321 475423266 X 204064983 271544660 3619352 3569352 207684335 275114012 664920656 750537278 70051808 -2622132 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 93220 93220 93220 93220 641194243 644780696 641287463 644873916 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 70978 92319 107823 93220 364340 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 X 1 5.56 0 1 0 1 false 0.0 0 true 0 54300 0 0 false 4541933 4541933 365160814 218126466 147034348 1579589 1392572 187017 298907129 240645791 58261338 24248952 24248952 234273588 DEPOSITS AND OTHER 16034450 DUE FROM AFFILIATES 112773958 128808408 3RD PARTY SETTLEMENT 52972522 OTHER LIABILITIES 14122692 NOTES PAYABLE TO STHC 425043 Pension Expense per GASB 75 -7880515 Long Term Medicare Advance 21190152 80829894 X Schedule D, Part II, Line 9 Conservation easements financial reporting The easement is not recorded as part of the organization's financial statements. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Company and its subsidiaries are exempt from federal income taxes pursuant to Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code and from state income taxes pursuant to Chapter 220 of the Florida Statutes. true true X true X true X true true false true true 23952316 23952316 0.0291 0 0.0 66618192 30275594 36342598 0.0441 0 0 90570508 30275594 60294914 0.0731 376990 376990 0.0005 49492162 24582239 24909923 0.0302 0 0.0 0 0.0 0 0.0 0 0 49869152 24582239 25286913 0.0307 0 0 140439660 54857833 85581827 0.1038 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 143005704 129206512 13799192 X true true 1 1 SHANDS JACKSONVILLE MEDICAL CENTER INC 655 W 8TH STREET JACKSONVILLE FL 32209 UFHEALTHJAX.ORG 4063 X X X X SHANDS JACKSONVILLE MEDICAL CENTER INC 1 false false true X X X X X X X X X 18 true true true true X https://ufhealthjax.org/community/community-health-needs-assessment.aspx X true 18 true https://ufhealthjax.org/community/community-health-needs-assessment.aspx false true X 100.0 200.0 X X X true true X X X true X HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX X HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX X HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Once the significant health needs were identified, this list was prioritized for implementation planning and strategizing. To prioritize the significant needs, 68 community members engaged in three rounds of voting and discussion on May 17, 2018. In the first round, prioritization participants had three votes; in the second round, two; and in the third and final round, one. Prioritization participants were asked to consider how each significant need fared against four criteria: 1. Importance of the problem to the community 2. Opportunity to impact multiple problems 3. Opportunity to intervene at a prevention level 4. Ability to address disparities As a part of the prioritization session, participants were presented findings from the primary and secondary data for each significant health need identified. After each round of voting, participants discussed results and eliminated health topics with no votes or the lowest number of votes. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Shands Jacksonville Medical Center, Inc.. The primary data used in this assessment consist of (1) key informant interviews conducted by phone by HCI, (2) focus group discussions facilitated by HCI and the Partnership, and (3) a community survey distributed through online and on paper submissions. Twenty-nine key informant interviews were conducted by phone from March 13, 2018, through April 23, 2018. Participants were selected for their knowledge about community health needs, barriers, strengths and opportunities, including the needs of vulnerable and underserved populations as required by IRS regulations. People with public health expertise; the ability to speak on the needs of low-income, underserved, or minority populations; and the ability to speak on the broad interests of the community were asked to participate in key informant interviews. Of the 29 key informant interviews conducted, 21 interviews were with community experts who either served or represented underserved communities. Twenty-two focus groups with a total of 212 participants were facilitated by HCI or by the Partnership from March 28 through April 25, 2018. Participants were selected for their knowledge about community health needs and barriers. The focus groups were split almost evenly into two categories: (1) focus groups of hospital staff associated with UF Health Jacksonville and UF Health North, and (2) focus groups of community members with wide backgrounds, including persons with disabilities, veterans, persons of limited income, communities of color, faith communities, and more. Of the 22 focus groups conducted, 10 of the focus groups included community members of underserved communities or community advocates for underserved communities. The community survey was primarily distributed online through SurveyMonkey from March 26 through April 16, 2018. The survey was also made available on paper, though paper distribution was limited. The survey elicited responses from 697 community members in Duval County. The survey was a convenience sample survey, and thus the results are not representative of the community population as a whole. Another limitation is that the survey was only made available in English. Survey respondents were asked about their views on the community's health needs, barriers and most impacted populations. Secondary data used for this assessment were collected and analyzed from HCI's community indicator database. The database, maintained by researchers and analysts at HCI, includes over 150 community indicators from 29 state and national data sources, such as the Florida Department of Health, Florida Behavioral Risk Factor Surveillance System and American Community Survey. HCI carefully evaluates sources based on the following three criteria: (1) the source has a validated methodology for data collection and analysis, (2) the source has scheduled, regular publication of findings, and (3) the source has data values for small geographic areas, such as counties and postal codes that are available for all county-level locations in Florida or the United States, as appropriate per the source's geographic area of coverage. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Shands Jacksonville Medical Center, Inc.. The Community Health Needs Assessment was conducted with Baptist Health, Brooks Rehabilitation, Clay County Health Department, Duval County Health Department, Mayo Clinic, Nassau County Health Department, Putnam County Health Department, St. Vincent's HealthCare, and Wolfson Children's Hospital, which came together and formed the Jacksonville Metropolitan Community Benefit Partnership. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Shands Jacksonville Medical Center, Inc.. The Community Health Needs Assessment was conducted with Clay County Health Department, Duval County Health Department, Nassau County Health Department and Putnam County Health Department. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Shands Jacksonville Medical Center, Inc.. BEHAVIORAL HEALTH Mental Health First Aid - Mental Health First Aid, or MHFA, is an evidenced-based training to give non-mental health professionals practical training on how to identify, communicate with and connect people suffering with mental health issues to local resources. The training teaches the skills needed to reach out and provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis. CANCER 1. Tobacco Cessation Program - This program provides education about health promoting behaviors, assists with food insecurity and provides job training resources. The program is offered through the Total Care Clinic, which provides comprehensive care to underserved and uninsured Jacksonville community members. 2. Employee Smoking Cessation Program - This program's purpose is to help employees, spouses and dependents over 18 stop smoking by providing resources, free cessation counseling and prescription medication consultations. While focused on employees, this education benefits the community at large, as households in the community enhance their understanding of smoking related risks and understand better how to stop smoking. 3. Big Step - This program is a four-week smoking cessation program open to the public. Some topics include yoga, relaxation and meditation as aids to smoking cessation. 4. Smoke-Free UF Health - UF Health Jacksonville will maintain all of its facilities as smoke-free. POVERTY Humana Health-Smart - This program provides education about health promoting behaviors, assists with food insecurity, and provides job training resources. VULNERABLE POPULATIONS 1. Humana Health-Smart - Program provides education about health promoting behaviors, assists with food insecurity and provides job training resources to low-income, minority seniors. 2. HIV Telemedicine Project - Program provides access to specialty care for persons living with HIV. 3. Epilepsy Wellness Center Support Group - A monthly support group for seizure/epilepsy patients, caregivers and the community. 4. Comprehensive Multiple Sclerosis Program - Program provides educational sessions, financial assistance, medical coverage coordination and support groups for caregivers, patients and the community. OBESITY & PHYSICAL ACTIVITY Diabetes Rapid Access Program - This program provides diabetes self-management education thus enabling community members with skills to self-manage their disease. The program is open to community members who visit the Total Care Clinic or wellness centers. The Total Care Clinic and wellness centers provide care to underserved and uninsured community members who qualify for City Contract coverage. MATERNAL, FETAL & INFANT HEALTH 1. Little Miracles - Community program that provides pregnancy tests, prenatal and infant care access assistance and maternity and childbirth education. Nurses schedule first prenatal and newborn care appointment within the UF Health Jacksonville network. 2. Healthy Start - Community based, nurse led, prenatal case management for high risk women. Inter-conception case management for three to six months post-delivery. Program provides childbirth classes, breastfeeding classes, parenting classes and assistance with Medicaid enrollment. 3. Nurse Family Partnership - Evidence-based program that provides nurse-led, prenatal case management, infant health and development home visitation until child turns two. 4. Trauma Prevention Program - Community program that educates children and parents in the Jacksonville community on important safety topics in an effort to reduce the number and severity of injuries. NEEDS UF HEALTH JACKSONVILLE WILL NOT ADDRESS No entity can address all of the health needs present in its community. UF Health Jacksonville is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization so that it can continue to provide a wide range of community benefits. This implementation strategy does not include specific plans to address the ACCESS health priority that was identified in the 2018 Community Health Needs Assessment. UF Health Jacksonville provides access to a wide array of health care services for uninsured, Medicaid, and other patients and will continue to provide such access as resources permit. UF Health Jacksonville is recognized as the region's safety-net provider for Medicaid and uninsured individuals, and operates the Community Clinics Department (which provides a variety of services and programs including free/low-cost primary care, medications, self-management support and care management), the Community Obstetrics Initiatives (which strive to improve birth outcomes), the Telemedicine Clinic, and others programs and services. While many of the programs and initiatives described above improve the access for vulnerable populations, this implementation strategy does not include specific access-related initiatives because the availability of future resources to support them is highly uncertain. 9 UF Health North 15255 Max Leggett Pkwy Jacksonville FL 32218 Hospital Campus and Outpatient Clinic Faculty Clinic 653-2 W 8th Street Jacksonville FL 32209 Outpatient Clinic UF Health Proton Therapy Institute 2015 N Jefferson Street Jacksonville FL 32206 Outpatient Clinic Emerson Clinic 4555 Emerson Expressway Jacksonville FL 32207 Outpatient Clinic UF Health Oncology 15255 Max Leggett Pkwy Jacksonville FL 32218 Oncology Center UF Health Oncology Baymeadows 7751 Baymeadows Rd Suite 205 Jacksonville FL 32256 Oncology Center UF Health Oncology LaVilla 425 N Lee St suite 201 Jacksonville FL 32202 Oncology Center UF Health Oncology Fernandina 1699 S 14th St Unit 2 Fernandina Beach FL 32034 Oncology Center UF Health Oncology Orange Park 2141 Loch Rane Blvd Suite 16 Orange Park FL 32073 Oncology Center Schedule H, Part I, Line 6a Community benefit report prepared by related organization Shands Teaching Hospitals and Clinics Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The organization used the cost to charge ratio to compute the cost of financial assistance reported in part I, line 7. A direct cost methodology was used for all other amounts. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, THE ORGANIZATION DIRECTLY REDUCES THE AMOUNT OF PATIENT SERVICE REVENUE REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS BY THE AMOUT OF BAD DEBT EXPENSE. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The organization reports $0 bad debt expense because bad debts are included in net patient revenue. Therefore, the amount of bad debts attributable to patients eligible under the organization's financial assistance policy is also $0. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The provision for bad debts is based on management's assessment of historical and expected net collections, considering business and economic conditions, trends in federal and state governmental health care coverage, and other collection indicators. Throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon these trends. The results of these reviews are then used to make any modification to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. Patient accounts receivable are written off after collection efforts have been followed under the Company's policies. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The amounts reported on lines 5 and 6 were derived from the FYE 2021 Medicare Cost Report. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Patients may qualify for different levels of financial assistance. If they qualify for 100% financial assistance there are no collection efforts. For less than 100% financial assistance, collection efforts are consistent with those used for all self-pay account balances, which includes sending invoices for 120 days and then turning account balances over to a collection agency. Schedule H, Part V, Section B, Line 16a FAP website - SHANDS JACKSONVILLE MEDICAL CENTER, INC.: Line 16a URL: HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX; Schedule H, Part V, Section B, Line 16b FAP Application website - SHANDS JACKSONVILLE MEDICAL CENTER, INC.: Line 16b URL: HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - SHANDS JACKSONVILLE MEDICAL CENTER, INC.: Line 16c URL: HTTP://UFHEALTHJAX.ORG/PATIENT-CARE/FINANCIAL-ASSISTANCE.ASPX; Schedule H, Part VI, Line 2 Needs assessment Community benefit is a planned, managed, organized , and measured approach to a health care organization's participation in meeting identified community health needs. It implies collaboration with a "community" to "benefit" its residents, particularly the poor and undeserved groups, by improving health status and quality of life. Community Benefits projects and services are identified by health care organizations in response to findings of a community heath assessment, strategic and/or clinical priorities, and partner areas of attention. Community benefit categories include financial assistance, community health services, health professions education, research and donations. SJMC has a long history of providing community benefits and has quantified those benefits using national guidelines developed by the Catholic Health Association in collaboration with the Voluntary Hospital Association. IN RESPONSE TO THE COVID-19 PANDEMIC, UF HEALTH JACKSONVILE ACTIVATED ITS COMMAND CENTER TO MANAGE OPERATIONS AND COMMUNICATIONS. THE HOSPITAL RESPONDED QUICKLY TO COMMUNITY HEALTH NEEDS RELATED TO COVID-19, ADMITTING ITS FIRST PATIENT WITH COVID-19 IN MARCH 2020. ELECTIVE PROCEDURES WERE HALTED IN THE EARLY MONTHS OF THE PANDEMIC IN ORDER TO PROTECT PATIENTS AND PROVIDERS. CERTAIN PROCEDURES, SUCH AS NON-EMERGENCY APPOINTMENTS WERE MOVED TO A TELEMEDICINE PLATFORM TO FURTHER SAFEGUARD AGAINST THE SPREAD OF COVID-19. THE HOSPITAL PRIORITIZED THE COLLECTION AND DISTRIBUTION OF MASKS AND OTHER PERSONAL PROTECTIVE EQUIPMENT TO FRONTLINE WORKERS, TO ENSURE THAT FRONTLINE HEALTH CARE PERSONNEL WOULD HAVE THE EQUIPMENT NEEDED TO STAY SAFE AND TO PROVIDE THE BEST POSSIBLE CARE TO PATIENTS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The eligibility for Financial Assistance under federal, state or local government programs is determined under the organization's Financial Assistance Program. Ideally, eligibility is obtained upon admission or before discharge. The organization provides notice of the Financial Assistance Program via the patient's billing statements. Information about the organization's Financial Assistance Program is also available on the organization's website. Education is also provided through distribution of the plain language summary, hospital staff, signage throughout the hospital and referrals from community organizations Schedule H, Part VI, Line 4 Community information This hospital serves Duval County, Florida and other nearby locations. According to the U.S. Census Bureau's 2016 population estimates, the hospital's service area had a population of 926,255. Residents of 32202, 32206, 32208, 32209, 32211, 32212, 32227, 32234 and 32254 have the highest socioeconomic need of all ZIP codes within the service area, based on indicators of income, poverty, unemployment, occupation, educational attainment, and linguistic barriers. Schedule H, Part VI, Line 5 Promotion of community health We have a community-based Board, operate emergency rooms, have open medical staff and use excess funds to invest in patient care needs. In addition to satisfying regulatory requirements of the federal and state agencies and local funders, the community needs assessment represents an unprecedented effort and key opportunity to bring together hospital data, population health, health- related quality of life indicators and community member input to provide a more detailed and complete profile of community health needs. The long term goal to achieve regional collaboration that will serve as an opportunity for optimal leverage of resources, setting ( and managing) regional health priorities, and developing regional collective impact strategies among all health-related stakeholders. Schedule H, Part VI, Line 6 Affiliated health care system Shands Jacksonville Medical Center, Inc. ("SJMC") is affiliated with the following organizations: Shands Jacksonville Foundation, Inc., Shands Jacksonville Healthcare, Inc., Shands Jacksonville Community Services, Inc., Shands Jacksonville Affiliates Inc., and Shands Jacksonville Properties Inc. In strategic partnership with these affiliates, Shands Jacksonville Medical Center, Inc. works to heal, comfort, educate and to discover through quality health care, elimination of health disparities, medical education, innovation and research. The organization understands its responsibility to the health of its community and the affiliates provide critical support in delivering constant attention to the needs of patients and the community. true UNIVERISTY OF FLORIDA JACKSONVILLE PHYSICIANS INC 653 WEST 8TH STREET JACKSONVILLE FL 32209 591867557 501(C)(3) 39387953 0 N/A N/A GENERAL SUPPORT WOLFSON CHILDREN'S HOSPITAL 800 PRUDENTIAL DRIVE JACKSONVILLE FL 32207 591452787 501(C)(3) 705443 0 N/A N/A GENERAL SUPPORT Shands Jacksonville Foundation 655 WEST 8TH STREET Jacksonville FL 32209 592622323 501(C)(3) 85000 0 N/A N/A General Support 3 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Funds included in the grant paid to University of Florida Jacksonville Physicians, Inc. are monitored to ensure funds are spent in accordance with the existing written agreement. The amount is based on negotiations between in-house counsel, VP of Finance and/or CFOs, President, Dean and/or CEO of each organization. If spending patterns change during the fiscal year, amounts can be reviewed and amended. Funds paid to WOLFSON CHILDREN'S HOSPITAL are agreed upon in the written agreement. SJMC monitors the funding and ensures that proper allocation of funds are paid subsequent to each fiscal year based on financial performance. Funds paid to Shands Jacksonville Foundation, a related organization, are monitored throughout the year to ensure the funds are spent in accordance with the written agreement. false false false false false false false true false Leon L Haley Jr MD CEO / Dean of Univ of FL College of Medicine 0 925329 0 112500 0 4812 0 14949 0 19051 0 1076641 0 0 David R Nelson Chairman / SVP for Health Affairs at Univ of FL 0 1064652 0 26000 0 4812 0 9406 0 20919 0 1125789 0 0 Kelly Gray-Eurom MD Director / Chief Quality Officer 0 399527 0 17355 0 3672 0 15924 0 20853 0 457331 0 0 Chandana Lall MD Director / Professor of Radiology at Univ of FL 0 594898 0 100000 0 11337 0 15083 0 9306 0 730624 0 0 Dean Cocchi Treasurer / CFO 384455 0 56250 0 20299 0 16868 0 17174 0 495046 0 0 0 Jon DeBardeleben Asst. Secretary / VP Senior Counsel 222646 0 20340 0 38888 0 13316 0 11240 0 306430 0 0 0 Randall C Jenkins Secretary / SVP of General Council of Univ of FL 0 493632 0 0 0 3670 0 26032 0 21787 0 545121 0 0 Patricia Rausch Assistant Treasurer / Controller 178660 0 10774 0 28143 0 13223 0 7158 0 237958 0 0 0 Robert Templin Asst. Secretary 182932 0 0 0 1391 0 11205 0 16921 0 212449 0 0 0 Thanh Hogan VP Clinical Operations 260320 0 30600 0 65137 0 14129 0 6086 0 376272 0 0 0 Rita James VP of Ambulatory Services 0 201745 0 10000 0 0 0 6242 0 25072 0 243059 0 0 Patrice Jones VP Chief Nursing Officer 327170 0 38160 0 10893 0 16904 0 895 0 394022 0 0 0 Ann-Marie Knight VP Comm Engage (Chief Diversity Officer) 200063 0 17550 0 11507 0 5495 0 14103 0 248718 0 0 0 Wayne A Marshall VP UFH North 271005 0 31800 0 53183 0 16948 0 17058 0 389994 0 0 0 Gregory Miller EVP COO 472997 0 70350 0 101992 0 16793 0 11502 0 673634 0 0 0 David Vukich MD CMO / Dean for Hospital Affairs of Univ of FL 0 498942 0 5000 0 11760 0 37914 0 21423 0 575039 0 0 Lesli A Ward VP Chief HRO 0 286461 0 25470 0 11815 0 22800 0 11921 0 358467 0 0 Cynthia Gerdick VP Assoc Nursing 188524 0 11149 0 10688 0 10798 0 1012 0 222171 0 0 0 Robert Hervey Dir of Support Services 214946 0 12922 0 26108 0 15374 0 16999 0 286349 0 0 0 Robert Phillips Dir Div Information Technology 194834 0 11649 0 16702 0 11099 0 11465 0 245749 0 0 0 Jun Santos Registered Nurse 191536 0 14730 0 15408 0 13483 0 16729 0 251886 0 0 0 Steven L Wylie Dir Business Development 214905 0 12859 0 994 0 12170 0 13270 0 254198 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Leon L. Haley, Jr, MD, CEO of SJMC, is paid by the University of Florida, a related organization. In accordance with the organization's bylaws, the compensation committee of Shands Jacksonville Medical Center has the power and authority to review and approve CEO compensation annually. The following methods are utilized in reviewing compensation of the top management official: -Approval by the compensation committee -Independent compensation consultant -Form 990 of other organizations -Compensation study Schedule J, Part I, Line 7 Non-fixed payments In order to recruit and retain key talent, SJMC offers short and long term incentive plans for certain employees listed in Part VII, section A, line 1A. For calendar year 2020, the incentive plans were targeted in the areas of financial performance, clinical quality, and employee and patient satisfaction. A Florida Development Finance Corporation 593270584 34061QAJ6 2013-11-21 63606897 2013A Refund 2005 & 2008 Bonds and Capital Financing false false false B Florida Development Finance Corporation 593270584 34061QAK3 2013-11-21 59405000 2013B Refund Series 2005 & 2008 Bonds false false false C City of Jacksonville Florida 596000344 000000000 2015-06-29 20000000 2015 Capital Financing false false false D Florida Development Finance Corporation 593270584 34061QAL1 2015-12-10 87267800 2015 Capital Financing of North Campus false false false A 7540000 0 63612989 6430092 0 0 1097897 0 0 34000000 22085000 0 2013 true false true true B 23120000 0 59405000 0 0 0 680000 0 0 0 58725000 0 2013 true false true true C 11154990 0 20000000 0 0 0 50000 0 0 19950000 0 0 2015 false false true true D 0 0 87267800 0 0 0 1358192 0 0 85909608 0 0 2018 false false true true A false true false false 0.0 0.0 0.0 false false false B false true false false 0.0 0.0 0.0 false false false C false false false false 0.0 0.0 0.0 false false false D false false false false 0.0 0.0 0.0 false false false A true false false false false false false false false B true false false false true false false false false C false true false true true true Compass Bank 10.0 false false false false false D false true false true false true Bank of America Merrill Lynch 5.0 false false false false false A false B false C false D false Schedule K, Part VI Part III Line 9, Part IV Line 7, and Part V While the organization does not currently have an approved written policy, it does maintain procedures that include annual arbitrage reporting and routine reviews and determinations of private business use. Schedule K, Part II, Line 3 2013A Bond Total proceeds of the 2013 bond issue reported on Schedule K Part II Line 3 exceed the issue price reported on Schedule K Part I Col (e) due to earnings on the reserve fund. Schedule K, Part IV, Line 2c COLUMN C Issuer name: City of Jacksonville Florida The calculation for computing no rebate due was performed on 06/29/2020 Schedule K, Part IV, Line 2c COLUMN D Issuer name: Florida Development Finance Corporation The calculation for computing no rebate due was performed on 12/10/2020 A Florida Development Finance Corporation 593270584 000000000 2019-09-20 20000000 2019 Capital Financing false false false A 3362000 0 20000000 0 0 0 279205 0 0 19720795 0 0 2019 false false true true A false false false false 0.0 0.0 0.0 false false false A false true false false true true Banco Bilbao Viscaya Argentaria SA 10.0 false false false false false A false Form 990, Part VI, Line 15a COMPENSATION OF TOP MANAGEMENT OFFICIAL The filing organization does not compensate the top management official of the organization; therefore, Line 15a has been answered "no" in accordance with the Form 990 instructions. Leon L. Haley, Jr, MD is paid by the University of Florida, a RELATED ORGANIZATION, WHICH DETERMINED THE APPROPRIATE COMPENSATION DURING THE TAX YEAR. SJMC'S COMPENSATION COMMITTEE ENGAGES MERCER, AN INDEPENDENT FIRM ENGAGED IN THE DEVELOPMENT OF COMPENSATION SURVEYS ON EXECUTIVE PAY LEVELS ACROSS DIFFERENT INDUSTRIES, TO PROVIDE COMPETITIVE DATA AND GUIDANCE ON DETERMINING APPROPRIATE AND REASONABLE RANGES AND SALARIES. MERCER ANNUALLY REVIEWS ALL ASPECTS OF EXECUTIVE COMPENSATION-INCLUDING ALL ELEMENTS OF SUPPLEMENTAL BENEFITS- TO ENSURE THAT THEY ARE REASONABLE TOTAL REMUNERATION LEVELS. SJMC'S COMPENSATION COMMITTEE USES THE MERCER COMPARABILITY DATA TO REVIEW AND APPROVE COMPENSATION FOR MANY OF THE ORGANIZATION'S OFFICERS INCLUDING THE TOP MANAGEMENT OFFICIAL. The compensation committee, according to the bylaws, has the power and authority of the independent board to review and approve CEO compensation annually. THE REVIEW IS DONE ANNUALLY AND WAS LAST CONDUCTED IN Fiscal Year 2021. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE DOCUMENTS THE DECISIONS AND DETERMINATIONS IN COMMITTEE MINUTES. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee shall consist of the same individuals serving on the Executive Committee of Shands Jacksonville Healthcare, Inc., the sole member of SJMC. These Executive Committee members consist of the following individuals: 1. THE CHAIR OF THE BOARD. 2. THE VICE PRESIDENT FOR HEALTH AFFAIRS OF THE UNIVERSITY OF FLORIDA. 3. DEAN OF THE COLLEGE OF MEDICINE OF THE JACKSONVILLE REGIONAL CAMPUS, UNIVERSITY OF FLORIDA. 4. THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. 5. FOUR DIRECTORS WHO ARE NOT EMPLOYEES OF THE CORPORATION OR OF THE UNIVERSITY OF FLORIDA OR ANY OF ITS COLLEGES, ALL OF WHOM SHALL BE APPOINTED BY THE CHAIR OF THE BOARD. 6. ONE CATEGORY TWO DIRECTOR (OR TWO CATEGORY TWO DIRECTORS IF THE SAME PERSON SERVES AS THE CHAIR OF THE CORPORATION AND VICE PRESIDENT FOR HEALTH AFFAIRS OF THE UNIVERSITY). THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY AND RESPONSIBILITY TO (I) MAKE REFERRALS OF SUBSTANTIVE ISSUES TO THE APPROPRIATE BOARD COMMITTEES AND TO COORDINATE THE PRESENTATION OF COMMITTEE FINDINGS AND RECOMMENDATIONS TO THE BOARD OF DIRECTORS, (II) MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS ON MATTERS OF POLICY THAT ARE NOT BEING CONSIDERED BY OTHER COMMITTEES, (III) ADVISE THE BOARD OF DIRECTORS CONCERNING AFFAIRS OF THE CORPORATION, AND (IV) TRANSACT ALL BUSINESS OF THE BOARD OF DIRECTORS DURING THE PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, EXCEPT THAT IT MAY NOT: 1.ELECT OR REMOVE OFFICERS OR REMOVE DIRECTORS; 2.CREATE OR ABOLISH ANY COMMITTEES; 3.AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF THE BYLAWS; 4.MODIFY IN ANY RESPECT OR CAUSE TO BE VIOLATED POLICIES ADOPTED BY THE BOARD OF DIRECTORS; 5.TAKE ANY ACTION THAT IS REQUIRED BY LAW, OR ARTICLE IV, SECTION 3 OF THE BYLAWS, TO BE TAKEN BY THE MEMBER. The Executive Committee shall keep minutes of its meetings and shall inform the Board of Directors, at the next regularly scheduled Board meeting, of all of its actions. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Jon Debardeleben; Greg Miller; Leon L Haley, JR, MD; Dean Cocchi - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders The sole member of the Corporation shall be Shands Jacksonville Healthcare, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the Corporation shall be Shands Jacksonville Healthcare, Inc. The directors shall be the same individuals from time to time as the Board of Directors of Shands Jacksonville Healthcare, Inc., subject to the right of the mayor of the city of Jacksonville to nominate a director. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The following actions require approval by the Member: a) The adoption of annual operating and capital budgets; b) The merger or dissolution, or the sale, lease, exchange or other disposition of all or substantially all of the assets; c) The acquisition of an interest in real or personal property, outside of approved budgetary authority, at a price or involving an annual economic obligation in excess of Five Hundred Thousand Dollars ($500,000.00); d) The conveyance or disposition of an interest in real or personal property involving fair market value, net book value, or an annual economic benefit exceeding Five Hundred Thousand Dollars ($500,000.00); e) The establishment of a long range or strategic plan; f) The incurrence of long-term indebtedness; g) The election or removal with or without cause of the Chief Executive Officer; h) The amendment of bylaws or articles of incorporation; or i) Such other matters where member or shareholder action is required by law. Form 990, Part VI, Line 11b Review of form 990 by governing body A complete copy of the Form 990 is provided to the Board of Directors, Chief Executive Officer, Secretary and Treasurer of the corporation before the return is filed. Form 990, Part VI, Line 12c Conflict of interest policy The Corporate Compliance Department's Conflicts of Interest policy covers any director, officer, member of a board committee or key staff member who has a direct or indirect financial interest as defined by the policy. The individuals covered under the policy are required to disclose a conflict of interest or a potential conflict of interest when it arises. The Deliberative Body, as defined by the policy, reviews and monitors conflicts of interests annually and as they arise. Any individual who has a conflict of interest is prohibited from participating in the Deliberative Body's deliberations and decision in the transaction. Form 990, Part VI, Line 15b Process to establish compensation of other employees The organization's compensation committee engages Mercer, an independent firm engaged in the development of compensation surveys on executive pay levels across different industries, to provide competitive data and guidance on determining appropriate and reasonable ranges and salaries. Mercer annually reviews all aspects of executive compensation-including all elements of supplemental benefits- to ensure that they are reasonable total remuneration levels. The compensation committee uses the Mercer comparability data to review and approve compensation for many of the organization's officers and key employees. The review is done annually and was last conducted in fiscal year 2020. The compensation committee documents the decisions and determinations in committee minutes. Form 990, Part VI, Line 19 Required documents available to the public The conflicts of interest policy, governing documents and financial statements are available upon request. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REVENUE - Total Revenue: 3423711, Related or Exempt Function Revenue: 3423711, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Professional Fees - Total Expense: 46100483, Program Service Expense: 11386464, Management and General Expenses: 34714019, Fundraising Expenses: ; Purchased Services - Total Expense: 77408768, Program Service Expense: 27271182, Management and General Expenses: 50137586, Fundraising Expenses: ; Continued from Part III (CONTINUED FROM PART III) UF HEALTH JACKSONVILLE IS A 695 BED NOT-FOR-PROFIT ACADEMIC MEDICAL CENTER AFFILIATED WITH THE UNIVERSITY OF FLORIDA. THERE ARE MORE THAN 370 NATIONALLY RECOGNIZED FACULTY PHYSICIANS WORKING WITH OVER 300 UNIVERSITY OF FLORIDA FULL-TIME RESIDENTS AT UF HEALTH JACKSONVILLE. FOR FISCAL YEAR ENDED JUNE 30, 2021, THE HOSPITAL SERVED 25,475 INPATIENT ADMISSIONS, EXCLUDING OBSERVATION CASES, AND 578,112 OUTPATIENT VISITS. UF HEALTH JACKSONVILLE HAS A LEVEL 1 TRAUMA CENTER. THE FLORIDA POISON INFORMATION CENTER IS ALSO LOCATED ON CAMPUS, COVERING 42 COUNTIES AND APPROXIMATELY 160 - 200 CALLS EACH DAY. UF HEALTH JACKSONVILLE TOGETHER WITH OUR UNIVERSITY OF FLORIDA COLLEAGUES AND AFFILIATES HAS DEVELOPED SEVERAL CENTERS OF EXCELLENCE. THESE CENTERS BRING TOGETHER INTERDISCIPLINARY TEAMS USING ALL THE RESOURCES OF THE ACADEMIC MEDICAL CENTER. UF HEALTH JACKSONVILLE IS A LEADER IN PROVIDING BOTH UNIQUE AND ESSENTIAL CLINICAL PROGRAMS AND SERVICES, AS WELL AS IN PROMOTING GOOD HEALTH WITH PREVENTATIVE CARE, SCREENINGS AND HEALTH EDUCATION PROGRAMS THAT REACH RESIDENTS WHERE THEY LIVE AND WORK. THE HOSPITAL HOSTS HEALTH FAIRS, SUPPORT GROUPS AND OTHER SPECIAL EVENTS AND PERFORMED BLOOD PRESSURE, HIV, CHOLESTEROL, STROKE ASSESSMENT, PREGNANCY, BLOOD SUGAR AND GLAUCOMA SCREENINGS. UF HEALTH JACKSONVILLE ALSO HAS AN ACTIVE COMMUNITY ENGAGEMENT DEPARTMENT COMMITTED TO IMPROVING COMMUNITY HEALTH, EDUCATING THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS, ADVOCATING FOR HEALTH AND OTHER HEALTH NEEDS AND CONTRIBUTING TO QUALITY OF LIFE PRIORITIES OF OUR COMMUNITY INCLUDING JACKSONVILLE'S URBAN CORE. IN MARCH 2020 THE HOSPITAL BEGAN EFFORTS TO CARE FOR COVID-19 PATIENTS AND PROVIDE UPDATES TO THE COMMUNITY TO COMBAT THE GLOBAL PANDEMIC. 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