2021-04-13T09:31:26-05:00 2020-06-30 366055558 GRANT THORNTON LLP 200 S ORANGE AVENUE SUITE 2050 ORLANDO FL 32801 990 2019-07-01 593238634 H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL INC HLEE 8137454673 12902 MAGNOLIA DRIVE TAMPA FL 33612 YVETTE TREMONTI EVP/CFAO 8137457862 2021-04-13 1 MICHELE N MELCHIOR P00488037 4074815100 2019 2022-09-23 18:48:47Z DR PATRICK HWU 12902 MAGNOLIA DRIVE TAMPA FL 33612 1369166220 0 X WWW.MOFFITT.ORG X 1994 FL TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 16 16 4488 803 0 0 24718713 41081644 1236041531 1326798964 5597 77248 1417973 1203231 1262183814 1369161087 10589432 7680013 0 0 354689002 384677848 0 0 0 652006010 688222848 1017284444 1080580709 244899370 288580378 274999134 286006622 60183806 87159124 214815328 198847498 X THE PRIMARY PURPOSE OF THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. ("HOSPITAL") IS TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 0 0 927748035 7680013 1326143307 H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE HOSPITAL, INC. (THE "HOSPITAL") IS LOCATED ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA IN TAMPA, FL. SINCE OPENING IN 1986, THE HOSPITAL HAS BEEN GUIDED BY ONE MISSION, "TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER." MOFFITT IS A LEADING NATIONAL CANCER INSTITUTE (NCI) COMPREHENSIVE CANCER CENTER - ONE OF ONLY 49 IN THE NATION TO HOLD THIS DISTINCTION. MOFFITT IS A TOP 10 CANCER HOSPITAL AND HAS BEEN NATIONALLY RANKED BY U.S. NEWS & WORLD REPORT SINCE 1999. WITH MORE THAN 5,700 EMPLOYEES, MOFFITT HAS AN ECONOMIC IMPACT ON FLORIDA OF $2.1 BILLION.RESEARCH IS CRITICAL TO MOFFITT'S MISSION. MUCH OF OUR CLINICAL TRIALS AND STUDIES ARE DONE THROUGH COLLABORATION BETWEEN MOFFITT RESEARCHERS AND PHYSICIANS WHO FOCUS ON COMPREHENSIVE CANCER TREATMENT. THE CLINICAL TRIALS AND STUDIES EXPLORE NEW MEDICAL DISCOVERIES OR NEW WAYS TO USE EXISTING TREATMENTS TO IMPROVE PATIENT CARE. EVERY PARTICIPANT HELPS TAKE US ONE STEP CLOSER TO THAT NEXT BIG BREAKTHROUGH IN CANCER TREATMENT.REIMBURSEMENT IS ALSO CRITICAL TO THE HOSPITAL'S OPERATIONS; HOWEVER, MOFFITT RECOGNIZES ITS RESPONSIBILITY TO PROVIDE SERVICES AND EDUCATION TO THOSE NEEDING SPECIALIZED RESEARCH CAPABILITIES. PATIENTS WHO MEET MOFFITT'S MEDICAL AND SURGICAL PROTOCOLS AND DO NOT HAVE THE ABILITY TO PAY WILL BE TREATED, IF SUCH PROTOCOLS ARE NOT AVAILIABLE IN THEIR COMMUNITY.IT IS THIS COMMITTMENT THAT GUIDES THE HOSPITAL TO:1) PROVIDE CARE FOR PATIENTS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST2) PROVIDE FREE CHARITY CARE FOR THOSE WHO CANNOT PAY3) PROVIDE ONCOLOGY SPECIALIZATION TO THE STATE OF FLORIDA THROUGH INVOLVEMENT IN INVESTIGATIONAL PROTOCOLS, EDUCATION OF FUTURE PHYSICIANS AND CONTINUING PROFESSIONAL EDUCATION FOR PHYSICIANS AND OTHER ALLIED HEALTH CARE PROFESSIONALS4) TAKE A LEADERSHIP ROLE IN CANCER PREVENTION AND SCREENING ACTIVITIES THE HOSPITAL IS A CRITICAL RESOURCE FOR THE STATE OF FLORIDA, WHICH RANKS SECOND IN THE NATION IN BOTH CANCER INCIDENCE AND MORTALITY MOFFITT IS LICENSED FOR 218 BEDS AND DEVOTES MORE THAN 2 MILLION SQUARE FEET TO RESEARCH AND PATIENT CARE. ADDITIONALLY, MOFFITT PROVIDES A WIDE ARRAY OF OUTREACH AND EDUCATIONAL ACTIVITIES FOR THE GENERAL PUBLIC AND SELECT UNDERSERVED POPULATIONS. IN FISCAL YEAR 2020, THE HOSPITAL RECORDED 473,227 OUTPATIENT VISITS AND 9,453 ADMISSIONS. 927748035 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 107 0 1 4488 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X YVETTE M LYONS TREMONTI 8137457862 12902 MAGNOLIA DRIVE TAMPA FL 33612 X JOHN A KOLOSKY HOSPITAL PRESIDENT 23.00 33.00 X 0 998205 960228 YVETTE M LYONS TREMONTI EVP-CFAO & ASST TREASURER 20.00 38.00 X 0 964941 321875 G DOUGLAS LETSON EVP-PHYS IN CHIEF 15.00 40.00 X 960289 0 256848 L DAVID DE LA PARTE EVP-GENERAL COUNSEL;ASST SEC 20.00 38.00 X 0 794823 328756 ROBERT KEENAN VP-QUALITY/CMO 55.00 0.00 X 756041 0 138931 W MICHAEL ALBERTS FORMER DIRECTOR, VP-MED AFFAIRS 0.00 50.00 X 0 339064 375867 SACHIN APTE ASSOC CHIEF MEDICAL OFFICER 50.00 0.00 X 594564 0 97596 BRYAN MCIVER DEPUTY PHYSICIAN IN CHIEF 50.00 0.00 X 594669 0 97379 JANE FUSILERO VP-PATIENT CARE SVS/CNO 55.00 0.00 X 550151 0 55467 STUART G WASSERMAN DIR CLINICAL PHYSICS 50.00 0.00 X 335032 0 234632 EDUARDO G MOROS SR MBR PHYSICIST-RAD ONC 50.00 0.00 X 377511 0 188842 VLADIMIR FEYGELMAN SR MBR PHYSICIST-RAD ONC 50.00 0.00 X 268350 0 291698 JOANNA WEISS VP FINANCE 15.00 40.00 X 0 418125 138073 CYNTHIA TERRANO VP PAYER STRATEGIES 35.00 20.00 X 448738 0 81135 MATTHEW BEDNAR VP-AMBULATORY OPS/VIRTUAL CARE 55.00 0.00 X 328642 0 80716 S DOMINIC SERAPHIN VP STRAT ALLIANCE & NETWK TO 5/15/20 15.00 40.00 X 0 338688 50737 KEN KOMORNY CHIEF PHARMACY OFFICER 55.00 0.00 X 219782 0 27546 MARILYN COSTACHE CHIEF RISK OFFICER 1.00 54.00 X 0 187528 46554 BETH A HOUGHTON DIRECTOR, CHAIR 1.00 1.00 X X 0 0 0 THE HON MARK A PIZZO ESQ DIRECTOR, VICE CHAIR 1.00 1.00 X X 0 0 0 JOSEPH CABALLERO DIRECTOR, SEC/TREAS 1.00 2.00 X X 0 0 0 MICHAEL BICE DIRECTOR 1.00 0.00 X 0 0 0 ROLAND DANIELS DIRECTOR 1.00 0.00 X 0 0 0 VALERIE GODDARD DIRECTOR 1.00 1.00 X 0 0 0 ROBERT HORTON DIRECTOR 1.00 0.00 X 0 0 0 JACQUELINE LEWIS DIRECTOR 1.00 0.00 X 0 0 0 JO MANION DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER MOFFITT DIRECTOR 1.00 0.00 X 0 0 0 KEVIN PLUMMER DIRECTOR 1.00 0.00 X 0 0 0 NICOLAS PORTER DIRECTOR 1.00 0.00 X 0 0 0 MARY ANNE REILLY DIRECTOR 1.00 0.00 X 0 0 0 BETH SIMONETTI DIRECTOR 1.00 0.00 X 0 0 0 SUPRIYA TANEJA DIRECTOR 1.00 0.00 X 0 0 0 HAL WALKER DIRECTOR 1.00 0.00 X 0 0 0 5433769 4041374 3772880 338 1 1 0 NATIONAL MARROW DONOR PROGRAM 3001 BROADWAY ST NE 500 MINNEAPOLIS MN 55413 DONOR SEARCH SERVICES 6769650 ASSOC REGIONAL & UNIV PATH 500 CHIPETA WAY TAMPSALT LAKE CITYA UT 84108 LABORATORY SERVICES 1873348 UNIVERSITY DIAGNOSTIC INST 3301 ALUMNI DR TTAMPA FL 33612 MRI SERVICES 1557063 THE CHARTIS GROUP LLC 220 W KINZIE ST FL3 CHICAGOCHICAGO IL 60654 CONSULTING SERVICES 1038670 AMN HEALTHCARE INC 12400 HIGH BLUFF DR SAN DIEGO CA 92130 TEMPORARY LABOR SERVICES 912030 38 2386899 23768936 14925809 600077 41081644 NET PATIENT SERVICE REVENUE 900099 1288248349 1288248349 SPECIALTY PHARMACY 900099 36358451 36358451 OUTPATIENT PHARMACY 900099 800000 800000 CORE LAB REVENUE 900099 516447 516447 QUALITY IMPROVEMENT PROGRAM 900099 386928 386928 488789 488789 1326798964 129458 0 129458 129458 129458 82381 5133 77248 77248 77248 CAFETERIA COMMISSIONS 900099 319447 319447 REBATES 900099 306432 306432 INTEREST FROM INS COMPANIES 524114 268568 268568 179326 48285 131041 1073773 1369161087 1326047249 0 2032194 X 7680013 7680013 3723267 3462638 260629 303997145 231132580 72864565 12827473 9805635 3021838 43021297 37936763 5084534 21108666 16265308 4843358 5487503 5487503 190972 190972 441210 441210 60366453 30133254 30233199 6319006 19113 6299893 63260387 45023668 18236719 26444154 26444154 16856357 5546363 11309994 660605 353444 307161 7313835 7313835 38812433 14362628 24449805 1217250 1217250 MEDICAL SUPPLIES 426054312 426052765 1547 ALLOC OF INTERCO EXP 0 68842029 -68842029 BAD DEBT EXPENSE - PATI 14290715 14290715 HCCB ASSESSMENT 12935724 12935724 7571932 3905395 3666537 1080580709 927748035 152832674 0 2675 2675 14399110 21036632 169052931 152243038 19092902 30123202 3474413 8209490 230369210 179430692 52308372 50938518 11607530 11932320 5061200 11520748 274999134 286006622 43356947 45591695 3104 10187 16823755 41557242 60183806 87159124 X 209855164 193690975 4960164 5156523 214815328 198847498 274999134 286006622 X 288580378 -304548208 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 16518 1 17829 0 1 665073 1 31098 1 35601 766119 0 PART II-B, LINE 1: THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS THREE NON-PROFIT SUBSIDIARY CORPORATIONS ("CORPORATION") WERE CREATED TO GOVERN AND OPERATE THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE ("INSTITUTE") PURSUANT TO SECTION 1004.43, FLORIDA STATUTES. AMONG OTHER THINGS, SECTION 1004.43 FLORIDA STATUTES PROVIDES: (1) THAT THE CORPORATION SHALL ENTER INTO AN AGREEMENT WITH THE STATE BOARD OF EDUCATION FOR THE UTILIZATION OF FACILITIES ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA; (2) THAT THE CORPORATION SUBMIT ANNUAL POST AUDITS OF ITS FINANCIAL ACCOUNTS TO THE AUDITOR GENERAL OF THE STATE OF FLORIDA AND THE BOARD OF GOVERNORS FOR THEIR REVIEW; AND (3) THAT THE CORPORATION'S CEO REPORT TO THE BOARD OF GOVERNORS OR ITS DESIGNEE AND PROVIDE COPIES OF THE INSTITUTE'S ANNUAL REPORT TO THE GOVERNOR OF THE STATE OF FLORIDA, THE CABINET, THE PRESIDENT OF THE SENATE, THE SPEAKER OF THE HOUSE AND THE CHAIR OF THE BOARD OF GOVERNORS. ALTHOUGH THE CORPORATION IS A PRIVATE ENTITY, IT IS NONETHELESS SUBJECT TO THE STATE OF FLORIDA'S PUBLIC RECORDS AND THE PUBLIC MEETINGS LAWS. THE CORPORATION ALSO RELIES ON ANNUAL APPROPRIATIONS BY THE LEGISLATURE OF THE STATE OF FLORIDA AND GRANTS FROM VARIOUS LOCAL, STATE AND FEDERAL AGENCIES FOR OPERATION AND MAINTENANCE OF ITS FACILITIES AND FOR SPECIFIC RESEARCH AND CLINICAL PROGRAMS. FOR THESE REASONS, THE CORPORATION FROM TIME TO TIME ENGAGES LOBBYISTS AND OTHER CONSULTANTS: (1) TO ASSIST IT IN COMPLYING WITH ITS REPORTING REQUIREMENTS TO THE STATE OF FLORIDA UNDER SECTION 1004.43, FLORIDA STATUTES; (2) TO MONITOR LEGISLATIVE AND EXECUTIVE BRANCH ACTION AT LOCAL, STATE AND FEDERAL LEVELS OF GOVERNMENT WHICH IMPACT ITS OPERATION AND THE FULFILLMENT OF ITS MISSION; AND (3) TO INFLUENCE LEGISLATION IN FURTHERANCE OF ITS MISSION IN THE AREAS OF CANCER RESEARCH AND TREATMENT, THE TEACHING AND TRAINING OF HEALTH CARE PROFESSIONALS AND COMMUNITY EDUCATION AND OUTREACH ACTIVITIES. THE CORPORATION DOES NOT ENGAGE IN ANY ACTIVITIES TO SUPPORT OR OPPOSE ANY CANDIDATE FOR PUBLIC OFFICE. PART II-B, LINE 1I, OTHER ACTIVITIES THE OTHER ACTIVITIES AMOUNT LISTED ON LINE 1I IS COMPRISED OF EXPENSES RELATED TO ORCHESTRATING CONTACT BETWEEN GRASSROOTS SUPPORTERS (WHO ARE VOLUNTEERS) AND ELECTED OFFICIALS TO PROMOTE THE INSTITUTION'S LEGISLATIVE OBJECTIVES. 281110 281110 0 229051168 179149582 49901586 1036932 1036932 50938518 HCCB ASSESSMENT 19056262 OPERATING LEASE LIABILITY 4097292 ESTIMATED THIRD PARTY PAYABLES 18403688 41557242 X PART X, LINE 2: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. DID NOT HAVE ANY UNCERTAIN POSITIONS IN ITS AUDITED FINANCIAL STATEMENTS. THE ASC-740 FOOTNOTE READS AS FOLLOWS: MOFFITT RECOGNIZES A TAX POSITION AFTER DETERMINING THAT A RELEVANT TAX AUTHORITY WOULD MORE LIKELY THAN NOT (GREATER THAN 50% LIKELIHOOD) SUSTAIN THE POSITION FOLLOWING AN AUDIT AND RECORDS THESE BENEFITS AT THE AMOUNT MOST LIKELY TO BE REALIZED, ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 25839913 25839913 0.02390 30868849 3891959 26976890 0.02500 56708762 3891959 52816803 0.04890 966325 966325 0.00090 3774836 3774836 0.00350 17116 17116 0.00000 4758277 4758277 0.00440 61467039 3891959 57575080 0.05330 3037 3037 0.00000 1561 1561 0.00000 16462 16462 0.00000 21060 21060 0.00000 1 3189652 293750557 325541577 -31791020 X 1 1 1 1 H LEE MOFFITT CANCER CENTER & RESEARCH 12902 MAGNOLIA DRIVE TAMPA FL 33612 WWW.MOFFITT.ORG 4334 X H LEE MOFFITT CANCER CENTER & RESEARCH 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PART V, SECTION B, LINE 10A X 1 18 1 WWW.MOFFITT.ORG/PUBLICATIONS/COMMUNITY-BENEFIT 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X PART V, SECTION B, LINE 16C X PART V, SECTION B, LINE 16C X PART V, SECTION C X X X X X X X 1 X 0 X X X X X 0 X X X 0 0 H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 5: MOFFITT RECOGNIZES THAT THE COMMUNITY'S HEALTH IS AFFECTED BY MULTIPLE FACTORS. THE CURRENT CHNA USED A COLLABORATIVE APPROACH WITH MOFFITT RESEARCH FACULTY AND COMMUNITY STAKEHOLDERS, ANALYZING AN ARRAY OF CLINICAL, SOCIAL AND HEALTH-RELATED DATA. THE DATA COLLECTED INCORPORATED THREE DIFFERENT SOURCES: 1) PUBLICALLY-AVAILABLE DATA ON SOCIAL, ECONOMIC, AND HEALTH ISSUES2) PHONE INTERVIEWS WITH COMMUNITY STAKEHOLDERS3) ONLINE SURVEY OF COMMUNITY RESIDENTS MOFFITT HIRED CARNAHAN GROUP, INC. TO PERFORM COMMUNITY STAKEHOLDER PHONE INTERVIEWS. A TOTAL OF 39 EXTERNAL COMMUNITY STAKEHOLDERS AND 13 INTERNAL MOFFITT STAFF INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 28, 2019 AND MARCH 7, 2019. YOUGOV, INC. WAS HIRED AS A CONSULTANT TO IMPLEMENT AN ONLINE COMMUNITY SURVEY. THE RESPONSES WERE WEIGHTED BASED ON CENSUS DATA TO REFLECT THE AREA POPULATION. THE SURVEY WAS AVAILABLE IN BOTH ENGLISH AND SPANISH. THERE WERE 740 PARTICIPANTS FROM THE PRIMARY SERVICE AREA. WE WOULD LIKE TO ACKNOWLEDGE EACH OF THE FOLLOWING ORGANIZATIONS AND MOFFITT DEPARTMENTS WHO PARTICIPATED IN AN INTERVIEW FOR THIS ASSESSMENT. THEY CONTRIBUTED IMMEASURABLE VALUE IN THE FORMATION OF THIS REPORT, PROVIDING PROFESSIONAL KNOWLEDGE, EXPERT INFORMATION, AND INFORMED PUBLIC POLICY DIRECTION. WE THANK ALL PARTICIPANTS, WHETHER BY PHONE OR ONLINE, FOR THEIR GENEROUS TIME AND CONTRIBUTIONS TO THIS ASSESSMENT.COMMUNITY STAKEHOLDER ORGANIZATIONS INCLUDE ALLEGANY FRANCISCAN MINISTRIES - TAMPA BAY REGION, GULF COAST NORTH AREA HEALTH EDUCATION CENTER, AMERICAN CANCER SOCIETY, HAITIAN ASSOCIATION, ANGELS CARE CENTER OF ELOISE, HILLSBOROUGH COUNTY HEALTH CARE PLAN, BAYCARE, HISPANIC SERVICES COUNCIL-HEALTHY LIVING PROGRAMS, CATHOLIC MOBILE MEDICAL SERVICES, INDIGENT HEALTH CARE, CITY OF ST. PETERSBURG, LAKE WALES FREE CLINIC, COMMUNITY HEALTH CENTERS OF PINELLAS, LAKELAND REGIONAL HOSPITAL, CRISIS CENTER, METROPOLITAN MINISTRIES, DESOTO COUNTY BOARD OF COUNTY COMMISSIONERS, PREMIER COMMUNITY HEALTHCARE GROUP, DIVISION OF HUMAN SERVICES, PASCO COUNTY, ST. PETERSBURG FREE CLINIC, FACES OF COURAGE FOUNDATION, SUNCOAST COMMUNITY HEALTH CENTERS, FAMILY HEALTHCARE FOUNDATION, TAMPA FAMILY HEALTH CENTERS, FARMWORKER SELF HELP, TAMPA GENERAL HOSPITAL, FLORIDA DEPARTMENT OF HEALTH-HILLSBOROUGH COUNTY, TAMPA YMCA, FLORIDA DEPARTMENT OF HEALTH-PASCO COUNTY, UNITED WAY SUNCOAST, FLORIDA DEPARTMENT OF HEALTH-PINELLAS COUNTY, UNIVERSITY AREA COMMUNITY DEVELOPMENT CORPORATION, FLORIDA DEPARTMENT OF HEALTH-POLK COUNTY, USF & LATINOS UNIDOS POR UN NUEVO AMANECER, INC., FOUNDATION FOR A HEALTHY ST. PETE, USF COLLEGE OF PUBLIC HEALTH, GOOD SAMARITAN HEALTH CLINIC, AND USF OFFICE OF COMMUNITY ENGAGEMENT & PARTNERSHIPS.MOFFITT DEPARTMENTS INCLUDE BREAST PROGRAM DIVISION, MOFFITT PROGRAM FOR OUTREACH, WELLNESS, EDUCATION, AND RESOURCES, CLINIC ADMINISTRATION, NURSING PRACTICE, EDUCATION & CLINICAL EFFECTIVENESS, CLINICAL TRIALS CORE, PATIENT AND ADVISORY EXECUTIVE PROGRAM, HOSPITAL ADMINISTRATION, SOCIAL WORK, INTERNATIONAL & EXECUTIVE REFERRAL SERVICES, TAMPA BAY COMMUNITY CANCER NETWORK, MARKETING, AND U54 PARTNERSHIP. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 6A: IN OCTOBER 2015, MOFFITT COLLABORATED WITH THE FLORIDA DEPARTMENT OF HEALTH, HILLSBOROUGH COUNTY, TO ESTABLISH HEALTHY HILLSBOROUGH. HEALTHY HILLSBOROUGH IS A COMMITTEE OF LOCAL HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND FEDERALLY QUALIFIED HEALTH CENTERS. THE PURPOSE OF HEALTHY HILLSBOROUGH IS TO COMPLETE A COMPREHENSIVE CHNA AND TO IDENTIFY OPPORTUNITIES FOR COLLABORATION TO COLLECTIVELY IMPACT AND IMPROVE THE HEALTH OF HILLSBOROUGH COUNTY. HOSPITAL FACILITIES WITH WHICH MOFFITT COLLABORATED ARE:-FLORIDA HOSPITAL -SHRINER'S HOSPITAL FOR CHILDREN - TAMPA-SOUTH FLORIDA BAPTIST HOSPITAL-ST. JOSEPH'S HOSPITALS-TAMPA GENERAL HOSPITALIN 2019, THE HEALTHY HILLSBOROUGH COMMITTEE EXTENDED THE PARTNERSHIP TO THE COUNTY HEALTH DEPARTMENTS IN PINELLAS, PASCO, AND POLK TO COLLABORATE ON THE CHNA. THE FOUR COUNTY COLLABORATION IS CALLED ALL4HEALTHFL. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 6B: IN ADDITION TO THE HOSPITALS LISTED ABOVE, MOFFITT ALSO PARTNERED WITH OTHER HEALTH ORGANIZATIONS TO DETERMINE THE NEEDS OF THE COMMUNITY. THOSE ORGANIZATIONS ARE AS FOLLOWS:-FLORIDA DEPARTMENT OF HEALTH HILLSBOROUGH COUNTY-SUNCOAST COMMUNITY HEALTH CENTERS-TAMPA FAMILY HEALTH CENTERS H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, TEN MAJOR HEALTH NEEDS WERE IDENTIFIED WITHIN THE COMMUNITY. THESE TEN NEEDS CAN BE GROUPED INTO FOUR BASIC CATEGORIES:-ACCESS TO CARE (HEALTHCARE NAVIGATION, TRANSPORTATION, SOCIAL DETERMINANT OF HEALTH)-HEALTH BEHAVIORS (SMOKING, PHYSICIAL INACTIVITY, ALCOHOL USE, OBESITY, HPV VACCINATION)-CANCER SCREENING-CANCER BELIEFSON MAY 6, 2019, A MEETING WAS HELD WITH MOFFITT STAFF AND COMMUNITY PARTNERS TO REVIEW THE NEEDS ASSESSMENT RESULTS AND TO PRESENT THE IDENTIFIED PRIORITY AREAS. THERE WERE SEVEN COMMUNITY PARTNERS FROM HEALTH CLINICS, ACADEMIA, AND COMMUNITY-BASED ORGANIZATIONS AND 16 MOFFITT STAFF MEMBERS, REPRESENTING A VARIETY OF DEPARTMENTS IN ATTENDANCE. THE IDENTIFIED HEALTH NEEDS WERE PLACED ON SEPARATE WALL CHARTS AND DISPLAYED THROUGHOUT THE MEETING ROOM. EACH PARTICIPANT HAD UP TO FIVE "STICKY DOTS" THEY COULD USE TO VOTE ON THEIR PERCEIVED MOST-PRESSING HEALTH NEEDS. THE PRIORITIZING CRITERIA WERE BASED ON ALIGNMENT TO MOFFITT'S MISSION AND RESOURCES, THE ABILITY AND FEASIBILITY TO ADDRESS A PARTICULAR HEALTH NEED, AND THE RESULTING IMPACT AND BENEFIT TO THE COMMUNITY. EACH PARTICIPANT COULD PLACE ALL OR PART OF THEIR ALLOTTED DOTS ON A SINGLE NEED OR ALLOCATE THEM TO MULTIPLE NEEDS ACCORDING TO THEIR OWN PERCEPTIONS. FOLLOWING THE INITIAL VOTE, PARTICIPANTS REGROUPED TO DISCUSS HOW THE VOTES WERE DISTRIBUTED. BASED ON THE DISCUSSION, THE GROUP DECIDED ON THE TOP FOUR PRIORITIES TO ADDRESS IN THE 2020-2022 IMPLEMENTATION PLAN: HEALTHCARE NAVIGATION, TRANSPORTATION, CANCER SCREENING, AND HPV VACCINATION.TO DATE SOME OF THE HIGHLIGHTS IN EXECUTING THE 2020-2022 IMPLEMENTATION PLAN HAVE BEEN IN THE FOLLOWING AREAS.HEALTHCARE NAGIVATION: 1. MOFFITT PATIENT NAVIGATORS OFFER INDIVIDUALIZED ASSISTANCE TO PATIENTS, FAMILIES AND CAREGIVERS TO HELP OVERCOME SYSTEM BARRIERS AND WORK DIRECTLY WITH THE CLINICAL TEAM TO COORDINATE CARE. MOFFITT INCREASED THE NUMBER OF PATIENTS RECEIVING NAVIGATION SERVICES WITHIN THE FOLLOWING CLINICS: *ADOLESCENT & YOUNG ADULT/SARCOMA - 31 PATIENTS *HEAD AND NECK ONCOLOGY - 99 PATIENTS *THORACIC ONCOLOGY - 38 PATIENTS *GENITOURINARY ONCOLOGY - 96 PATIENTS *NEURO-ONCOLOGY - 48 PATIENTS 2. NAVIGATED PATIENTS HAD FAVORABLE SATISFACTION SCORES (95.7) ON THE QUESTION "DEGREE TO WHICH YOUR CARE WAS COORDINATED AMONG YOUR CAREGIVERS." 3. TREATMENT RETENTION RATE AMONG NAVIGATED PATIENTS INCREASED (52%) COMPARED TO FY19 (37%).TRANSPORTATION: 1. THE M-POWER OUTREACH TEAM PARTNERS WITH SUNCOAST COMMUNITY HEALTHCARE CENTER TO PROVIDE TRANSPORTATION SERVICES FOR UNINSURED WOMEN TO RECEIVE A BREAST CANCER SCREENING AT MOFFITT THROUGH ITS VOUCHER PROGRAM. THESE EVENTS ARE KNOWN AS COMMUNITY DAYS. THERE WERE TWO COMMUNITY DAY EVENTS WITH A TOTAL OF 10 WOMEN WHO WERE SCREENED CANCER SCREENING: 1. THE MOFFITT PROGRAM FOR OUTREACH, WELLNESS, EDUCATION AND RESOURCES (M-POWER) HOSTED 113 HEALTH EDUCATION WORKSHOPS IN THE AREAS OF CANCER PREVENTION, EARLY DETECTION AND SCREENING, REACHING 1,605 ADULTS. 2. THE TAMPA BAY COMMUNITY CANCER NETWORK (TBCCN) IS A COLLABORATIVE NETWORK OF ACADEMIC AND COMMUNITY-BASED ORGANIZATIONS. TBCCN HOSTED 9 OUTREACH EVENTS FOCUSED ON CANCER DISPARITIES AND RESEARCH, REACHING 288 ADULTS. 3. THE LUNG AND THORACIC TUMOR EDUCATION (LATTE) PROGRAM HOSTED 2 OUTREACH EVENTS FOCUSED ON LUNG CANCER ADVOCACY, SUPPORT, EDUCATION, AND COMMUNITY OUTREACH, REACHING 35 ADULTS. 4. MOFFITT OFFERS COMMUNITY MEMBERS OPPORTUNITIES TO RECEIVE A CANCER SCREENING AT NO COST TO HELP IMPROVE SCREENING BEHAVIORS. *SCREENING VOUCHERS WERE UTILIZED BY 479 UNINSURED INDIVIDUALS WHO MEET SPECIFIC CRITERIA FOR LUNG, BREAST, PROSTATE AND COLORECTAL CANCER SCREENINGS. *MOLE PATROL, THE MOBILE SKIN CANCER SCREENING PROGRAM, TRAVELED TO EIGHT COMMUNITY EVENTS AND SCREENED 1,042 INDIVIDUALS. *THE DEPARTMENT OF HEAD AND NECK-ENDOCRINE ONCOLOGY PARTICIPATED IN TWO COMMUNITY EVENTS AND PROVIDED SCREENINGS TO 258 INDIVIDUALS BY EXAMINING AN INDIVIDUAL'S HEAD, NECK AND ORAL CAVITY. *THE SURVIVORSHIP CLINIC PHYSICIANS PROMOTE CANCER SCREENING AMONG THEIR AGE-ELIGIBLE PATIENTS AND THERE WERE 52 PATIENTS WHO PARTICIPATED IN EITHER A BREAST, PROSTATE, OR LUNG CANCER SCREENING.HPV VACCINATION: 1. MOFFITT ORGANIZED THE FLORIDA LEADERSHIP SUMMIT TO ELIMINATE HPV-RELATED CANCERS SUMMIT ON MARCH 4, 2020. THIS EVENT TARGETED PROVIDERS AND HEALTH CARE PROFESSIONALS TO INCREASE AWARENESS AND LEVERAGE EXPERTISE TO CREATE STRATEGIES AND IDENTIFY RESOURCES ASSOCIATED WITH HPV-RELATED CANCER ELIMINATION, VACCINATION AND CERVICAL CANCER SCREENING. THERE WERE 141 ATTENDEES, REPRESENTING 40 FLORIDA CITIES, 23 FLORIDA COUNTIES AND PUERTO RICO. FOUR STRATEGIC THEMES TO ADDRESS HPV-RELATED CANCERS WERE IDENTIFIED: INDIVIDUAL ACTIONS, PRACTICE/SYSTEMS CHANGES, PROVIDER/PATIENT/PARENT COMMUNICATIONS AND DATA NEEDS.AS NOTED, MOFFITT IS NOT ABLE TO ADDRESS ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED AND BASED ON THE AFOREMENTIONED CRITERIA (RESOURCES, ALIGNMENT TO MISSION, ABILITY & FEASIBILITY TO ADDRESS THE NEED, AND THE RESULTING IMPACT AND BENEFIT TO THE COMMUNITY) THE FOLLOWING SIGNIFICANT HEALTH NEEDS DO NOT ALIGN WITH THOSE CRITERIA AND ARE NOT BEING ADDRESSED BY MOFFITT: -SOCIAL DETERMINANT OF HEALTH-HEALTH BEHAVIORS-CANCER BELIEFS H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 13B: PATIENTS WHO ARE MEDICALLY NEEDY MAY STILL APPLY FOR FINANCIAL ASSISTANCE, BUT WILL PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE IF THEY CANNOT MEET THEIR SHARE OF COST AS DETERMINED BY THE FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES. THE LEVEL OF ASSISTANCE WILL BE DETERMINED BY WHICH INCOME LEVEL THE PATIENT'S SHARE OF COST FALLS ON THE FEDERAL POVERTY GUIDELINES. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 13H: CRITERIA USED TO DETERMINE ELIGIBILITY NOT ONLY INCLUDES INCOME LEVEL, ASSET LEVEL, INSURANCE OR UNDERINSURANCE STATUS AND RESIDENCEY, BUT MAY ALSO INCLUDE INFORMATION RELATED TO EMPLOYMENT STATUS, NUMBER OF DEPENDENTS IN HOUSEHOLD AND FINANCIAL SUPPORT BY ANY OTHER PERSON OR PROGRAM. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 15E: METHOD BY WHICH PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE: A. PATIENTS THAT REQUEST FINANCIAL ASSISTANCE OR WHO HAVE BEEN IDENTIFIED AS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE REFERRED TO THE CENTER'S FINANCIAL COUNSELORS. B. PATIENTS MAY CONTACT THE MOFFITT CANCER CENTER BUSINESS OFFICE AT 12902 MAGNOLIA DRIVE, MCB-BO, TAMPA, FLORIDA 33612, OR CALL 1-800-456-3434 EXT. 8422 OR THE DIRECT NUMBER AT 813-745-8422 FOR INFORMATION AND ASSISTANCE REGARDING THE FINANCIAL ASSISTANCE APPLICATION. C. PATIENTS WILL BE INFORMED OF THE PROCESS AND PROCEDURES INVOLVED FOR A FINANCIAL ASSISTANCE APPLICATION EITHER BEFORE RECEIVING SERVICES OR DURING THE BILLING AND COLLECTION PROCESS. D. THE PATIENT AND/OR THE PATIENT'S FAMILY WILL BE ADVISED OF ALL DOCUMENTATION REQUIRED TO MAKE A DETERMINATION AS TO ELIGIBILITY FOR FINANCIAL ASSISTANCE. E. A FINANCIAL COUNSELOR WILL INTERVIEW THE PATIENT OR THE PATIENT'S RELATIVES WHO ARE LEGALLY RESPONSIBLE FOR THE PATIENT'S SUPPORT IN COMPLIANCE WITH HIPAA GUIDELINES. DURING THE INTERVIEW, THE FINANCIAL COUNSELOR WILL GATHER INFORMATION ABOUT THE PATIENT'S CIRCUMSTANCES AND ABILITY TO PAY AND, IF REQUESTED, MAY ASSIST THE PATIENT OR PATIENT'S FAMILY IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. F. A PATIENT AND/OR A PATIENT'S FAMILY MAY ALSO MEET WITH THE CENTER'S PHARMACY REPRESENTATIVE TO APPLY FOR AVAILABLE ASSISTANCE PROGRAMS FOR PHARMACEUTICAL CARE. G. A REQUEST FOR FINANCIAL ASSISTANCE AND A DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE SHOULD OCCUR PRIOR TO RENDERING NON-EMERGENT MEDICALLY NECESSARY SERVICES. HOWEVER, THE DETERMINATION MAY BE DONE AT ANY POINT IN THE COLLECTION PROCESS. H. IF THE MARITAL STATUS OF A MINOR CANNOT BE DETERMINED, OR WHERE THERE IS NOT SUFFICIENT DOCUMENTATION TO CONFIRM A MINOR'S EMANCIPATION, ELIGIBILITY OF FINANCIAL ASSISTANCE WILL BE BASED ON THE INCOME AND ASSETS OF THE PARENT/PARENTS OR LEGAL GUARDIAN OF THE MINOR. DOCUMENTATION PROVIDED FOR THE FINANCIAL ASSISTANCE APPLICATION MUST BE CONSISTENT WITH ALL OTHER DOCUMENTATION PRESENTED FOR REVIEW. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 16J: REFERENCE TO THE POLICY IS ADDED TO THE BILLING INVOICE STATING THAT A MOFFITT REPRESENTATIVE CAN HELP EVALUATE ELIGIBILITY FOR FINANCIAL ASSISTANCE IF THE PATIENT IS UNABLE TO PAY. HOSPITAL'S BILLING AND COLLECTIONS AREA OF ITS WEBSITE ALSO STATES THAT IF A PATIENT IS UNDERINSURED OR UNABLE TO PAY, A PATIENT ACCOUNT REPRESENTATIVE OR A SOCIAL WORKER WILL HELP IDENTIFY ASSISTANCE PROGRAMS THAT OFFER HELP IN MEETING FINANCIAL OBLIGATIONS. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 20E: MOFFITT HOSPITAL DID NOT INITIATE ANY OF THE ACTIONS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 19. HOWEVER, IF THE HOSPITAL HAD UNDERTAKEN ANY OF THE LISTED ACTIONS, IT WOULD HAVE FIRST NOTIFIED PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY ON ADMISSION, PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE PATIENTS REGARDING THEIR BILLS. MOFFITT HOSPITAL DOCUMENTS ITS DETERMINATION OF WHETHER PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. CONTINUOUS EFFORT IS MADE TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE, SUCH AS ASSISTING WITH THE APPLICATION PROCESS TO DETERMINE ELIGIBILITY AS WELL AS IDENTIFYING OTHER PROGRAMS THAT MAY PROVIDE ASSISTANCE. H LEE MOFFITT CANCER CENTER & RESEARCH PART V, SECTION B, LINE 21D: THE CANCER CENTER IS A SPECIALTY HOSPITAL AND THEREFORE, DOES NOT PROVIDE EMERGENCY MEDICAL TREATMENT WITHIN THE MEANING OF SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). IF, HOWEVER, AN INDIVIDUAL SEEKING SUCH CARE ENTERS THE CANCER CENTER'S FACILITY, THE CANCER CENTER WITHOUT DISCRIMINATION WILL STABILIZE THE PATIENT AND ASSIST THE PATIENT AND/OR THE PATIENT'S FAMILY IN OBTAINING TRANSPORTATION FOR THE PATIENT TO A LOCAL HOSPITAL EQUIPPED FOR EMERGENCY MEDICAL CARE. PART V, SECTION B, LINE 16C WEBSITE ADDRESS FULL URL: HTTPS://MOFFITT.ORG/PATIENT-FAMILY/INSURANCE-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ PART I, LINE 3C: CHARITY ADJUSTMENTS ARE PROVIDED BY THE CANCER CENTER AS FOLLOWS:A. PATIENTS WHO HAVE FAMILY INCOME AND ASSETS AT OR BELOW 200% OF THEFEDERAL POVERTY GUIDELINES FOR THE PATIENT'S FAMILY SIZE SHALL BEENTITLED TO 100% FINANCIAL ASSISTANCE ON QUALIFYING BALANCES.B. PATIENTS WHO HAVE FAMILY INCOME AND ASSETS BETWEEN 201%-400% OF THEFEDERAL POVERTY GUIDELINE FOR THE PATIENT'S FAMILY SIZE SHALL BECLASSIFIED AS "SELF PAY TIER 1" STATUS AND ARE ENTITLED TO FINANCIALASSISTANCE OF 65% ON QUALIFYING BALANCES.C. PATIENTS WHO ARE MEDICALLY NEEDY MAY STILL APPLY FOR FINANCIALASSISTANCE, BUT WILL PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE IFTHEY CANNOT MEET THEIR SHARE OF COST AS DETERMINED BY THE FLORIDADEPARTMENT OF CHILDREN AND FAMILIES. THE LEVEL OF ASSISTANCE WILL BEDETERMINED BY WHICH INCOME LEVEL THE PATIENT'S SHARE OF COST FALLS ON THEFEDERAL POVERTY GUIDELINES. PART I, LINE 7: METHODOLOGY USED TO CALCULATE CHARITY CARE, MEDICAID, AND OTHER MEANS-TESTED EXPENSES IS COST TO CHARGE RATIO, USING PATIENT EXPENSES TO GROSS CHARGES, WHILE THE DIRECT COST METHOD IS USED TO DETERMINE OTHER COMMUNITY BENEFITS/PROGRAMS EXPENSES. PART I, LN 7 COL(F): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A FOR THE HOSPITAL IS $1,080,580,709. THE TOTAL BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $14,290,715. AFTER BAD DEBT WAS DEDUCTED FROM THE TOTAL EXPENSES THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN F WAS $1,066,289,994. PART II, COMMUNITY BUILDING ACTIVITIES: MOFFITT PARTICIPATES IN THE CHAPTERS HEALTH BIOETHICS COMMITTEE MEETINGSWHICH IS COMPRISED OF HEALTHCARE PROFESSIONALS FROM THE COMMUNITY THATHAVE EXPERIENCE DEALING WITH HEALTHCARE RELATED ETHICS ISSUES. THECOMMITTEE OVERSEES ETHICS ISSUES FOR CHAPTERS HOSPICE SYSTEM.MOFFITT HAS DEVELOPED A MENTORING PROGRAM CALLED "VOLUNTEEN" WHERE HIGH SCHOOL STUDENTS CAN VOLUNTEER AT MOFFITT. THE PROGRAM IS DESIGNED TO EXPOSE TEENS TO HEALTHCARE CAREERS, EDUCATE THEM ON THE IMPORTANCE OF PROVIDING HEALTHCARE TO THE COMMUNITY, AND HOW MOFFITT AND OTHER HEALTHCARE ORGANIZATIONS PLAY A ROLE IN MEETING THE NEEDS OF THE COMMUNITY. THE VOLUNTEERS ARE GUIDED THROUGH VARIOUS DEPARTMENTSTHROUGHOUT THE ORGANIZATION AND RECEIVE HANDS ON EXPERIENCE IN THE AREASASSIGNED. IN FY20, THERE WERE 100 STUDENTS WHO VOLUNTEERED FOR OVER 2,500 HOURS.MOFFITT PARTICIPATED IN THE BIG BROTHERS BIG SISTERS SCHOOL TO WORK PROGRAM THAT PROVIDES ONE-ON-ONE MENTORING IN THE WORKPLACE FOR HIGH SCHOOL JUNIORS AND SENIORS TO HELP IMPROVE GRADUATION RATES. MOFFITT TEAM MEMBERS MENTORED 25 STUDENTS, TOTALING 222 HOURS. PART III, LINE 2: THE METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE WAS CALCULATING THE COST TO CHARGE RATIO, USING PATIENT EXPENSES TO GROSS CHARGES, AND APPLYING IT TO THE BAD DEBT PROVISION IN PART III, LINE 4. PART III, LINE 4: ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANSOF THE PROVISION FOR BAD DEBTS. ACCOUNTS ARE WRITTEN OFF WHEN DEEMED TOBE UNCOLLECTIBLE AND ARE DEDUCTED FROM THE PATIENT'S ACCOUNTS RECEIVABLE BALANCE.THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'SASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS ANDECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTHCARECOVERAGE AND OTHER COLLECTION INDICATORS. ONE TOOL USED IN MANAGEMENT'SASSESSMENT IS A DETAILED REVIEW OF HISTORICAL COLLECTIONS AND WRITE-OFFSAT THE CANCER CENTER THAT REPRESENT A MAJORITY OF THE CANCER CENTER'SREVENUES AND ACCOUNTS RECEIVABLE. THE RESULTS OF THE DETAILED REVIEW OFHISTORICAL COLLECTIONS AND WRITE-OFFS EXPERIENCE, ADJUSTED FOR CHANGES INTRENDS AND CONDITIONS, ARE USED TO EVALUATE THE ALLOWANCE AMOUNT FOR THECURRENT PERIOD. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT OF MEDICAREALLOWABLE COSTS IS THE STEP-DOWN METHOD WHICH DISALLOWS CERTAIN COSTS TOBE CONSIDERED AS COSTS RELATED TO PATIENT CARE. MEDICARE SHORTFALLS WHICHARE COSTS INCURRED BY THE HOSPITAL TO PROVIDE QUALITY CARE AND TREATMENT OF ITS PATIENTS SHOULD BE TREATED AS COMMUNITY BENEFIT. TO NOT INCUR THESE COST WOULD POTENTIALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERVICE PROVIDED TO THE ELDERLY OR DISABLED. PART III, LINE 9B: PATIENTS ARE SCREENED DURING THE ADMISSIONS PROCESS TO ASSESS THE NEEDFOR FINANCIAL ASSISTANCE. HOWEVER, IF AT ANY POINT IN THE COLLECTIONPROCESS IT IS DETERMINED THAT THE PATIENT MAY BE UNABLE TO MEET HIS ORHER OBLIGATION, THE PATIENT WILL BE SENT AN APPLICATION FOR FINANCIALASSISTANCE OR CHARITY ADJUSTMENT. IF PATIENT DOES NOT EXPRESS THEINABILITY TO PAY PRIOR TO BILLING, AN INVOICE IS SENT TO THE PATIENTWHICH INCLUDES CONTACT INFORMATION FOR A PATIENT SERVICE REPRESENTATIVEIF THE PATIENT NEEDS FINANCIAL ASSISTANCE. A HOSPITAL REPRESENTATIVE WILLMAKE EVERY EFFORT TO WORK WITH THE PATIENT TO DETERMINE WHETHER FINANCIALASSISTANCE IS NEEDED. IF THE PATIENT DOES NOT STATE THE NEED OR DOES NOTQUALIFY FOR FINANCIAL ASSISTANCE THEREAFTER, AND PAYMENTS ARE NOT MADE ASAGREED, THE HOSPITAL REPRESENTATIVE MAY OFFER REASONABLE PAYMENT PLANS TOHELP PATIENTS MEET THEIR FINANCIAL OBLIGATIONS. PART VI, LINE 2: MOFFITT CANCER CENTER IS HEAVILY INVOLVED IN THE COMMUNITY WITHOUTREACH/EDUCATION EFFORTS (E.G., M-POWER OUTREACH TEAM), COMMUNITY-BASEDPARTICIPATORY RESEARCH, PARTICIPATION IN COMMUNITY COMMITTEES ORCOALITIONS (E.G., HEALTHY HILLSBOROUGH) AND PARTNERSHIPS WITHFEDERALLY-QUALIFIED HEALTH CENTERS AND FREE CLINICS. THESE EFFORTS ENSURETHE ORGANIZATION IS CONTINUOUSLY ASSESSING THE HEALTH CARE NEEDS OF THECOMMUNITY. MOFFITT'S CHNA REPORT EXPLAINS THE PROCESS OF ASSESSING THENEEDS OF THE COMMUNITY. WE ENGAGED COMMUNITY MEMBERS THROUGH AN ONLINE SURVEY, AS WELL AS, PUBLIC HEALTH PROFESSIONALS VIA TELEPHONE INTERVIEWS DURING THE COMPLETION OF THE NEEDS ASSESSMENT. THE REPORT CAN BE FOUND ON OUR WEBSITE. AS WELL, MOFFITT'S COMMUNITY OUTREACH, ENGAGEMENT, AND EQUITY TEAM DEVELOPED A CATCHMENT AREA PROFILE THAT HIGHLIGHTS CANCER RELEVANT DATA COLLECTED FOR CHNA INCLUDING INCIDENCE, RISK FACTORS, AND PREVENTION BEHAVIORS TO HELP STAKEHOLDERS MAKE INFORMED DECISIONS ABOUT THEIR RESEARCH, EDUCATION, AND OUTREACH PRIORITIES RELATED TO MOFFITT'S 15-COUNTY CATCHMENT AREA. PART VI, LINE 3: PUBLICATION OF THE POLICY: A. THE CENTER HAS PLACED SIGNAGE IN THE ADMISSION AREAS OF THE HOSPITALINFORMING PATIENTS OF FINANCIAL ASSISTANCE AND MAKES ITS POLICY, THEFINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THEPOLICY WIDELY AVAILABLE ON ITS WEBSITE. INDIVIDUALS WITH ACCESS TO THEINTERNET CAN ACCESS, DOWNLOAD, VIEW, AND PRINT A HARD COPY OF THISPOLICY, THE FINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGESUMMARY OF THIS POLICY FROM THE WEBSITE: I. WITHOUT REQUIRING SPECIAL COMPUTER HARDWARE OR SOFTWARE (OTHER THANSOFTWARE THAT IS READILY AVAILABLE TO MEMBERS OF THE PUBLIC WITHOUTPAYMENT OF ANY FEE); II. WITHOUT PAYING A FEE TO THE CENTER; AND III. WITHOUT CREATING AN ACCOUNT OR BEING OTHERWISE REQUIRED TO PROVIDEPERSONALLY-IDENTIFIABLE INFORMATION. B. THE CENTER PROVIDES INDIVIDUALS WHO ASK HOW TO ACCESS A COPY OF THEPOLICY, THE FINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGESUMMARY OF THE POLICY ONLINE WITH THE DIRECT WEBSITE ADDRESS, OR URL, OFTHE WEB PAGE WHERE THE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, ANDTHE PLAIN LANGUAGE SUMMARY OF THE POLICY ARE POSTED. C. THE CENTER WILL MAKE PAPER COPIES OF THIS POLICY, THE FINANCIALASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICYAVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH BY MAIL AND IN PUBLICLOCATIONS AT THE CENTER, INCLUDING ANY ADMISSIONS AREAS. D. THE CENTER WILL NOTIFY AND INFORM PATIENTS WHO RECEIVE CARE AT THECENTER ABOUT THIS POLICY NOT ONLY BY SIGNAGE IN THE ADMISSION AREAS BUTALSO BY OFFERING A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY OF THEFINANCIAL ASSISTANCE POLICY AS PART OF THE INTAKE OR DISCHARGE PROCESS.IN ADDITION, THE CANCER CENTER REPRESENTATIVE WILL ALSO GUIDE A PATIENTTO THE WEBSITE OR URL WHERE COPIES OF THIS POLICY, THE FINANCIALASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICY MAYBE OBTAINED. THE CENTER ALSO INCLUDES A CONSPICUOUS WRITTEN NOTICE ONBILLING STATEMENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THEAVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY ALONG WITH THETELEPHONE NUMBER OF THE OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATIONRELATED TO THE POLICY AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS. E. AT ANY TIME DURING THE PATIENT'S TREATMENT THE PATIENT MAY REQUEST ACOPY OF THIS POLICY, THE FINANCIAL ASSISTANCE APPLICATION, OR THE PLAINLANGUAGE SUMMARY OF THIS POLICY. F. IF A MEMBER OF THE WORKFORCE BECOMES AWARE OF THE PATIENT'S NEED FORFINANCIAL ASSISTANCE DURING THE ADMISSION PROCESS, THE PATIENT SERVICEREPRESENTATIVE WILL PROVIDE THE PATIENT WITH THE NECESSARY INFORMATIONNEEDED TO APPLY FOR FINANCIAL ASSISTANCE. G. THE CENTER WILL ALSO TRANSLATE THIS POLICY, THE FINANCIAL ASSISTANCEAPPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICY INTO THEPRIMARY LANGUAGES SPOKEN BY ALL SIGNIFICANT POPULATIONS SERVED BY THECENTER. PART VI, LINE 4: MOFFITT PRIMARILY SERVES THE TAMPA BAY AREA, WHICH IS COMPRISED OFHILLSBOROUGH, PINELLAS, PASCO, AND POLK COUNTIES IN WEST CENTRAL FLORIDA.THIS PRIMARY SERVICE AREA HAS OVER 3.7 MILLION RESIDENTS: 59.7% WHITERESIDENTS, 12.5% BLACK RESIDENTS, AND 21.6% HISPANICS. SLIGHTLY LESS THAN HALF (43.2%) OF THE PRIMARY SERVICE AREA'S HOUSEHOLD INCOME DISTRIBUTION IS UNDER $50,000. ABOUT 13% OF INDIVIDUALS IN THE PRIMARY SERVICE AREA ARE BELOW THE POVERTY LEVEL. PART VI, LINE 5: MOFFITT'S CHNA IMPLEMENTATION PLAN OUTLINES THE ORGANIZATIONAL EFFORTS INPROMOTING THE HEALTH OF OUR COMMUNITY AND ADDRESSING CANCER PREVENTIONAND EARLY DETECTION. THE M-POWER OUTREACH TEAM IS DEDICATED TO ADDRESSTHE CANCER NEEDS OF UNDERSERVED POPULATIONS THROUGH EDUCATION, COMMUNITYCOLLABORATIONS, AND NAVIGATION OF SERVICES. IN FISCAL YEAR 2020, THE M-POWER TEAM HELD 113 CANCER EDUCATIONAL WORKSHOPS, SERVING 1,605 INDIVIDUALS (78% HISPANIC OR AFRICAN AMERICAN/BLACK), AS WELL AS, ATTENDED 76 HEALTH FAIRS AND OTHER OUTREACH EVENTS, SERVING 5,707 INDIVIDUALS. ADDITIONALLY, FUNDS ARE USED TO PROVIDE SCREENING VOUCHERS FOR UNINSURED INDIVIDUALS TO RECEIVE A BREAST, LUNG, COLORECTAL, OR PROSTATE SCREENING AT NO COST TO THE PATIENT. IN FISCAL YEAR 2020, 479 UNINSURED MEN AND WOMEN UTILIZED A SCREENING VOUCHER. MOFFITT HEALTHY KIDZ ORGANIZED STEM (SCIENCE, TECHNOLOGY, ENGINEERING AND MATHEMATICS) EVENTS TO PROMOTE CAREERS IN HEALTHCARE AND EDUCATE ON CANCER PREVENTION AMONG MIDDLE AND HIGHSCHOOL STUDENTS. IN FISCAL YEAR 2020, THE PROGRAM HOSTED 18 STEM EVENTS.THE TAMPA BAY COMMUNITY CANCER NETWORK (TBCCN) IS A COLLABORATIVE NETWORK OF ACADEMIC AND COMMUNITY-BASED ORGANIZATIONS FOCUSED ON CANCER DISPARITIES OUTREACH AND RESEARCH. TBCCN HOSTED 9 OUTREACH EVENTS, REACHING 288 PEOPLE. PART VI, LINE 6: TO FURTHER THE MISSION OF CONTRIBUTING TO THE PREVENTION AND CURE OFCANCER, MOFFITT CANCER CENTER COLLABORATES WITH RESPECTED ACADEMIC,HOSPITAL SYSTEMS, REGIONAL CARE CENTERS AND PHYSICIANS GROUPS KNOWN ASTHE MOFFITT ONCOLOGY NETWORK. WHOLLY COMMITTED TO MOFFITT'S MODEL OF PATIENT-CENTERED, INTEGRATED CANCER CARE, THE MOFFITT ONCOLOGY NETWORK IS HELPING MOFFITT DEVELOP A PREMIER CANCER CARE DELIVERY SYSTEM, FOCUSED SOLELY ON PROVIDING PATIENTS THE BEST PERSONALIZED CANCER CARE. THE MOFFITT ONCOLOGY NETWORK IMPLEMENTS MOFFITT'S CLINICAL CARE MODEL, INCLUDING MULTIDISCIPLINARY CANCER CARE, PEER REVIEW, CLINICAL PATHWAYS AND QUALITY ASSURANCE.THE COMMUNITY HEALTH NEEDS ASSESSMENT DETERMINED OPPORTUNITIES THAT CANBE ADDRESSED BY THE CANCER CENTER AS A WHOLE. THE CANCER CENTER'SNON-HOSPITAL FACILITIES DEDICATED TO SERVING INDIVIDUALS WHO ARE IN NEEDOF FINANCIAL ASSISTANCE, HELPING TO DEVELOP AND FUND COMMUNITY PROGRAMSAND PERFORM TRANSLATIONAL RESEARCH TO BENEFIT THE COMMUNITY, INCLUDEMOFFITT FOUNDATION, MOFFITT MEDICAL GROUP, AND MOFFITT RESEARCH. MOFFITTFOUNDATION SOLICITS FUNDS TO SUPPORT THE WORK OF THE CANCER CENTER.DONATIONS MAINTAINED BY THE FOUNDATION MAY BE USED FOR A SPECIFICPROGRAMOR MAY BE USED TO FURTHER THE OVERALL NEEDS OF THE COMMUNITY.MOFFITT MEDICAL GROUP EMPLOYS PHYSICIANS THAT STAFF THE HOSPITAL ANDPROVIDE CLINICAL RESEARCH TO THE CANCER CENTER HEALTH CARE SYSTEM. THESEPHYSICIANS PROVIDE MEDICAL SERVICES TO THOSE PATIENTS THAT QUALIFY FORFINANCIAL ASSISTANCE. IN ADDITION, PHYSICIANS PARTICIPATE IN COMMUNITYRELATED PROGRAMS PROVIDING EDUCATION AND TRAINING. MOFFITT'S CANCERRESEARCH FACILITY PERFORMS STUDIES AND INVESTIGATIONS TO GENERATEGENERALIZABLE KNOWLEDGE AVAILABLE TO THE PUBLIC. THE RESEARCH FACILITY ISALSO THE PARENT COMPANY OF THE CANCER CENTER HEALTH CARE SYSTEM THATPLANS, DEVELOPS, AND IMPLEMENTS COMMUNITY BENEFIT PROGRAMS TO ADDRESSCOMMUNITY NEEDS SEPARATELY FROM, AS WELL AS IN COLLABORATION WITH, THEHOSPITAL. COMMUNITY BENEFIT EXPENSES PERFORMED BY RELATED ENTITIES:MOFFITT MEDICAL GROUP ENTITY:FINANCIAL ASSISTANCE AT COST WAS $1,949,759PERCENT OF TOTAL MMG ENTITY EXPENSE: .8867%PERCENT OF COMBINED EXPENSE: .128%HEALTH PROFESSIONS EDUCATION WAS $11,668,157PERCENT OF TOTAL MMG ENTITY EXPENSE: 5.31%PERCENT OF COMBINED EXPENSE: .77%BAD DEBT EXPENSE AT COST: $654,508MOFFITT RESEARCH ENTITY:RESEARCH NET COMMUNITY BENEFIT EXPENSE WAS $1,803,029PERCENT OF TOTAL PARENT/RESEARCH EXPENSE: .76%PERCENT OF COMBINED EXPENSE: .12% 1 H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 592451713 501(C)(3) 7680013 INTERCOMPANY SUPPORT 1 PART I, LINE 2: THE SCHEDULE I, PART II, THE GRANT LISTED AS INTERCOMPANY SUPPORT IS ONLY MADE TO A RELATED ORGANIZATION TO SUPPORT ITS OPERATIONS. THE ORGANIZATION MAY ALSO, FROM TIME TO TIME, GIVE DONATIONS OR SPONSORSHIPS TO OTHER ORGANIZATIONS THAT ALIGN WITH OUR MISSION. THE ORGANIZATIONS ARE VETTED AND APPROVED BEFORE THE GRANT OR SPONSORSHIP IS GIVEN AND UNLESS OTHERWISE NOTED, THESE AMOUNTS ARE GRANTED FOR GENERAL PURPOSES AND DO NOT REQUIRE SPECIFIC MONITORING AS TO USE. X 0 1 0 1 0 0 0 1 1 0 0 JOHN A KOLOSKY HOSPITAL PRESIDENT 0 637453 0 272161 0 88591 0 935088 0 32263 0 1965556 0 0 YVETTE M LYONS TREMONTI EVP-CFAO & ASST TREASURER 0 628335 0 264605 0 72001 0 292033 0 36369 0 1293343 0 0 G DOUGLAS LETSON EVP-PHYS IN CHIEF 630149 0 267799 0 62341 0 228820 0 34724 0 1223833 0 0 0 L DAVID DE LA PARTE EVP-GENERAL COUNSEL;ASST SEC 0 528721 0 223021 0 43081 0 301619 0 34961 0 1131403 0 0 ROBERT KEENAN VP-QUALITY/CMO 554265 0 194252 0 7524 0 119902 0 31200 0 907143 0 0 0 W MICHAEL ALBERTS FORMER DIRECTOR, VP-MED AFFAIRS 0 331634 0 0 0 7430 0 354578 0 22747 0 716389 0 0 SACHIN APTE ASSOC CHIEF MEDICAL OFFICER 514535 0 78319 0 1710 0 72322 0 30592 0 697478 0 0 0 BRYAN MCIVER DEPUTY PHYSICIAN IN CHIEF 492386 0 97691 0 4592 0 78499 0 31676 0 704844 0 0 0 JANE FUSILERO VP-PATIENT CARE SVS/CNO 381520 0 135102 0 33529 0 37088 0 26538 0 613777 0 0 0 STUART G WASSERMAN DIR CLINICAL PHYSICS 269405 0 57459 0 8168 0 202486 0 33968 0 571486 0 0 0 EDUARDO G MOROS SR MBR PHYSICIST-RAD ONC 371816 0 500 0 5195 0 161250 0 30565 0 569326 0 0 0 VLADIMIR FEYGELMAN SR MBR PHYSICIST-RAD ONC 263031 0 500 0 4819 0 272969 0 19816 0 561135 0 0 0 JOANNA WEISS VP FINANCE 0 288869 0 103951 0 25305 0 106450 0 39633 0 564208 0 0 CYNTHIA TERRANO VP PAYER STRATEGIES 327645 0 116291 0 4802 0 62756 0 30130 0 541624 0 0 0 MATTHEW BEDNAR VP-AMBULATORY OPS/VIRTUAL CARE 240949 0 87156 0 537 0 49070 0 38562 0 416274 0 0 0 S DOMINIC SERAPHIN VP STRAT ALLIANCE & NETWK TO 5/15/20 0 215818 0 83637 0 39233 0 19613 0 41301 0 399602 0 0 KEN KOMORNY CHIEF PHARMACY OFFICER 196956 0 20073 0 2753 0 1225 0 27201 0 248208 0 0 0 MARILYN COSTACHE CHIEF RISK OFFICER 0 157636 0 29559 0 333 0 18962 0 28377 0 234867 0 0 PART I, LINE 1A HOSPITAL PAYS MEMBERSHIP DUES TO A SOCIAL CLUB FOR G.D. LETSON. THE AMOUNT PAID IS INCLUDED IN G.D. LETSON'S TAXABLE WAGES. PART I, LINE 1B: PAYMENTS MADE FOR SOCIAL CLUB DUES ARE INITIALLY APPROVED BY EXECUTIVE LEADERSHIP AND HUMAN RESOURCES AND REVIEWED/APPROVED BY THE JOINT EXECUTIVE COMPENSATION AND BENEFITS COMMITTEE (JE&BC), APPOINTED BY THE BOARD TO APPROVE SUCH PAYMENTS AND ASSOCIATED AMOUNTS. PART I, LINE 3 FOR TAX YEAR 2019 JOHN KOLOSKY, HOSPITAL'S PRESIDENT, IS PAID BY A RELATED ORGANIZATION. THE COMPENSATION IS ESTABLISHED BY RELYING ON AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, AN EXECUTIVE COMPENSATION COMMITTEE, AND THE APPROVAL BY THE BOARD OR THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. PART I, LINE 4B TO BE ELIGIBLE TO PARTICIPATE IN THE 457(F) NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), PARTICIPANTS MUST ELECT TO CONTRIBUTE AT LEAST 10% ACROSS THE 403(B) AND 457(B) PLANS, AND ARE VESTED AFTER 10 YEARS OF SERVICE. LUMP SUM DISTRIBUTIONS FROM THE ACCOUNT ARE MADE UPON NORMAL RETIREMENT OR TERMINATION. BELOW ARE INDIVIDUALS LISTED ON HOSPITAL'S 2019 FORM 990 PART VII, SECTION A, THAT PARTICIPATED IN THE 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AND THEIR RESPECTIVE AMOUNTS OF COMPENSATION CONSTRUCTIVELY RECEIVED IN TAX YEAR 2019 FROM THE PLAN: WILLIAM M. ALBERTS-$1,500 MATTHEW BEDNAR-$0 LOUIS D. DE LA PARTE-$38,187 VLADIMIR FEYGELMAN-$1,500 JANE FUSILERO-$26,654 ROBERT KEENAN-$0 JOHN A. KOLOSKY-$56,144 G. DOUGLAS LETSON-$54,918 YVETTE M. LYONS TREMONTI-$47,887 EDUARDO G. MOROS-$1,500 CYNTHIA TERRANO-$0 STUART G. WASSERMAN-$135 JOANNA WEISS-$18,056 PART I, LINE 6 IN GENERAL, INCENTIVE COMPENSATION IS BASED ON MOFFITT'S ACHIEVEMENT AGAINST SPECIFIC ORGANIZATIONAL GOALS RELATED TO NET OPERATING INCOME AND ON DIVISION OR INDIVIDUAL GOALS. NET OPERATING INCOME MUST MEET OR EXCEED A CERTAIN THRESHOLD IN ORDER TO TRIGGER A PAYOUT FOR THE ORGANIZATIONAL GOAL COMPONENTS. X EQUIPMENT 2 600077 PURCHASE PRICE 0 0 0 0 PART I, COLUMN (B): THE NUMBER ON LINE 25(B) REPRESENTS THE NUMBER OF ITEMS CONTRIBUTED, NOT THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING DIRECTORS AND OFFICERS, THAT JOINTLY SERVE ON THE HOSPITAL AND A FOR-PROFIT RELATED ENTITY, QUALIFY AS HAVING A BUSINESS RELATIONSHIP. HOSPITAL & M2GEN, CORP.: LOUIS D. DE LA PARTE - OFFICER YVETTE LYONS TREMONTI - OFFICER HOSPITAL & MOFFITT TECHNOLOGIES CORPORATION: JOHN A. KOLOSKY - OFFICER LOUIS D. DE LA PARTE - OFFICER YVETTE LYONS TREMONTI - OFFICER HOSPITAL & ONCOBAY INC.: LOUIS D. DE LA PARTE - OFFICER YVETTE LYONS TREMONTI - OFFICER FORM 990, PART VI, SECTION A, LINE 6 H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. IS THE SOLE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF THE HOSPITAL, H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. SHALL HAVE THE POWER TO APPROVE, DISAPPROVE OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OR OFFICER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AS THE SOLE MEMBER OF THE CORPORATION SHALL ALSO HAVE THE FOLLOWING POWERS: A. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; B. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE BYLAWS OF THE CORPORATION; C. APPROVE, DISAPPROVE OR RECOMMEND THE SELECTION OF A QUALIFIED AUDIT FIRM AND THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; D. APPROVE OR DISAPPROVE THE TRANSFER, SALE, LEASE OR DISPOSITION OF ANY ASSET OF THE CORPORATION IN EXCESS OF TWO HUNDRED THOUSAND DOLLARS ($200,000.00); E. APPROVE OR DISAPPROVE THE CONFERRING OF ANY LIEN OR SECURITY INTEREST IN ASSETS OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000.00), WHETHER SAME SHALL BE IN CONNECTION WITH EITHER PUBLIC OR PRIVATE FINANCING, OR OTHERWISE; F. APPROVE OR DISAPPROVE ALL DONATIONS OR CHARITABLE CONTRIBUTIONS BY THE CORPORATION IN EXCESS OF TWENTY THOUSAND DOLLARS ($20,000.00) PER CONTRIBUTION OR ANNUAL CONTRIBUTION EXCEEDING FIFTY THOUSAND DOLLARS ($50,000.00) IN THE AGGREGATE; G. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION OF THE CORPORATION'S MISSION AND PHILOSOPHY STATEMENT; AND H. APPROVE OR DISAPPROVE CAPITAL EXPENDITURES BY THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000.00) PER EXPENDITURE OR ONE MILLION DOLLARS ($1,000,000.00) IN THE AGGREGATE ANNUALLY. I. APPROVE, DISAPPROVE OR REMOVE ANY MEMBER OF THE BOARD OR OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B LINE 11B, PRIOR TO ELECTRONICALLY FILING FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX), A COPY OF THE RETURN IS PROVIDED TO THE GOVERNING BODY, GIVING EACH BOARD MEMBER TIME TO REVIEW THE RETURN. BOARD MEMBERS HAVE THE OPPORTUNITY TO ASK QUESTIONS RELATED TO THE INFORMATION PROVIDED ON THE RETURN. THE HOSPITAL'S FORM 990 IS ALSO PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW. BASED ON THE REVIEW ANY SUGGESTED COMMENTS OR CHANGES ARE DISCUSSED PRIOR TO SIGNING. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS A PRESENTATION IS MADE TO HOSPITAL BOARD MEMBERS TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROCEDURES FOR DISCLOSING ANY POTENTIAL CONFLICTS. EACH DIRECTOR, OFFICER, COMMITTEE MEMBER, AND KEY EMPLOYEE SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ATTACHED TO THE POLICY. ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, OR KEY EMPLOYEE WHO REASONABLY BELIEVES THAT HE OR SHE MAY HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST DISCLOSE THE EXISTENCE OF AND THE MATERIAL FACTS OF THE NATURE OF HIS/HER INTEREST ON THE FORM. THE FORM IS SUBMITTED TO THE CORPORATE COMPLIANCE OFFICE, WHICH REVIEWS THE FORMS, GATHERS ADDITIONAL RELEVANT INFORMATION WHERE NECESSARY, AND PREPARES A SUMMARY OF THE DISCLOSURES TO BE REVIEWED BY THE CONFLICT OF INTEREST WORK GROUP. IF A DIRECTOR OR COMMITTEE MEMBER DISCLOSES THAT HE/SHE HAS A POTENTIAL CONFLICT OF INTEREST AT A BOARD OR COMMITTEE MEETING, SUCH DIRECTOR OR COMMITTEE MEMBER MUST DISCLOSE THE NATURE OF THE INTEREST AND ANY RELATED INFORMATION AND RESPOND TO QUESTIONS AS MAY BE REQUIRED BY THE REMAINING MEMBERS. BASED ON THE INFORMATION DISCLOSED, THE REMAINING BOARD MEMBERS WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER AN ALTERNATIVE TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT IS EQUALLY ADVANTAGEOUS. IF AN ALTERNATIVE TRANSACTION IS NOT EQUALLY ADVANTAGEOUS THE DIRECTOR OR COMMITTEE MEMBER WHO IS THE SUBJECT OF THE CONFLICT SHALL NOT VOTE ON, NOR USE HIS/HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 MOFFITT'S BOARD OF DIRECTORS HAS AN ESTABLISHED SUB-COMMITTEE, THE JOINT EXECUTIVE COMPENSATION & BENEFITS COMMITTEE (JEC&BC) THAT IS MADE UP ENTIRELY OF INDEPENDENT, OUTSIDE DIRECTORS. THIS COMMITTEE IS CHARGED WITH THE OVERSIGHT OF THE PERFORMANCE AND COMPENSATION OF MOFFITT AND ITS SUBSIDIARIES' EXECUTIVES AND DISQUALIFIED PERSONS. THESE POSITIONS INCLUDE THE CEO, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND DEPARTMENT CHAIRPERSONS. TO ACCOMPLISH ITS MISSION, THE COMMITTEE CAN AS NEEDED AND DOES AT ITS DISCRETION, ENGAGE OUTSIDE INDEPENDENT, OUTSIDE ADVISORS INCLUDING, BUT NOT LIMITED TO ATTORNEYS AND COMPENSATION CONSULTANTS. ON AN ANNUAL BASIS THE JEC&BC ENGAGES A NATIONALLY KNOWN, THIRD PARTY CONSULTING FIRM TO PROVIDE A DETAILED STUDY OF THE CASH COMPENSATION FOR EACH EXECUTIVE, DISQUALIFIED PERSON AND INDIVIDUAL IN KEY POSITIONS. THE CONSULTANT USES A VARIETY OF PUBLISHED SURVEYS COMPILED BY INDEPENDENT FIRMS TO PROVIDE THE SOURCE DATA FOR THE STUDY. USING FUNCTIONALLY COMPARABLE POSITIONS IN OTHER SIMILARLY SIZED, NOT-FOR-PROFIT AND FOR-PROFIT HEALTHCARE, ACADEMIC AND RESEARCH ORGANIZATIONS, THE CONSULTING FIRM PRODUCES A STUDY THAT COMPARES EACH DESIGNATED POSITION TO ITS APPROPRIATE MARKET EQUIVALENT. THE RESULTING DATA IS PROVIDED TO THE DIRECTOR OF COMPENSATION, WHO IS NOT INCLUDED IN THE EXECUTIVE OR DISQUALIFIED PERSON CATEGORIES, FOR USE IN THE FORMULATION OF RECOMMENDATIONS FOR COMPENSATION CHANGES TO MAINTAIN MARKET COMPETITIVENESS OR TO REWARD PERFORMANCE. THESE RECOMMENDATIONS ALONG WITH THE CONSULTANT'S COMPARABILITY DATA ARE PRESENTED TO THE JEC&BC FOR IT TO CONFIRM ITS REASONABLENESS, MAKE MODIFICATIONS AS IT DEEMS NECESSARY AND PROVIDE FINAL APPROVAL. EVERY THIRD YEAR THE INDEPENDENT CONSULTANT ANALYZES THE TOTAL EXECUTIVE COMPENSATION PROGRAM, USING THE SAME METHODOLOGY AS DESCRIBED ABOVE, THAT INCLUDES THE VALUE OF ALL BENEFITS AND PERQUISITES (CASH AND NON-CASH) PROVIDED AS COMPENSATION TO THE EXECUTIVES AND DISQUALIFIED PERSONS. THE PURPOSE OF THE ANALYSIS IS TO PROVIDE AN OPINION ON THE REASONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION COMPONENTS AND THE AGGREGATE COMPENSATION TOTAL. THIS MORE COMPREHENSIVE ANALYSIS IS PROVIDED TO THE JEC&BC FOR THEIR USE IN THE ANNUAL REVIEW PROCESS. MINUTES ARE KEPT AT EACH OF THESE ANNUAL MEETINGS DETAILING THE RECOMMENDATIONS PRESENTED AND THE DECISIONS MADE BY THE COMMITTEE. THESE MINUTES ARE PUBLISHED TO THE COMMITTEE AT THE NEXT MEETING AND REPORTED BACK TO THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES AVAILABLE ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO THE PUBLIC THROUGH DAC BOND, A THIRD PARTY VENDORS' WEBSITE AND MOFFITT'S WEBSITE. IN ADDITION, FORM 990 IS MADE AVAILABLE ON GUIDESTAR AS WELL AS MOFFITT'S WEBSITE. ALL ORGANIZING AND GOVERNING DOCUMENTS SUCH AS FORM 1023, CONFLICTS OF INTEREST POLICY, AND BYLAWS AS WELL AS FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: EMPLOYEES WHO ARE LISTED ON MOFFITT HOSPITAL'S FORM 990 ARE EMPLOYEES WHOSE W-2'S WERE ISSUED BY MOFFITT INSTITUTE, THE COMMON PAYMASTER AND RELATED ENTITY. PROCEDURES TO REPORT COMPENSATION OF EMPLOYEES ON FORM 990 PART VII AND ON SCHEDULE J ARE IN ACCORDANCE WITH IRS INSTRUCTIONS FOR EACH RESPECTIVE SECTION. FORM 990, PART IX, COLUMN D: THERE ARE NO FUNDRAISING EXPENSES BECAUSE THE CONTRIBUTIONS ARE FROM RELATED AND NON-RELATED ORGANIZATIONS. H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. HANDLES ALL FUNDRAISING ACTIVITIES FOR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS SUBSIDIARIES. FORM 990, PART XI, LINE 9: CHANGES IN NET ASSETS PREDOMINANTLY RELATES TO THE CLOSE OUT OF INTERCOMPANY ACCOUNTS PAYABLE AND RECEIVABLES (DUE TO/DUE FROM) IN THE AMOUNT OF ($304,548,208) TO NET ASSETS. H LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 592451713 PARENT-RESEARCH FL 501(C)(3) LINE 7 N/A 0 H LEE MOFFITT CANCER CTR & RESEARCH INSTITUTE FOUNDATION INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238636 FUNDRAISING FL 501(C)(3) LINE 7 H LEE MOFFITT CANCER CTR & RES INST INC 0 H LEE MOFFITT CC&RI LIFETIME CANCER SCREENING CENTER INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238640 PRACTICE MANAGEMENT FL 501(C)(3) LINE 10 H LEE MOFFITT CANCER CTR & RES INST INC 0 MOFFITT TECHNOLOGIES CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 300332914 TECHNOLOGY MANAGEMENT FL H LEE MOFFITT CANCER CTR & RES INST INC C 0 M2GEN CORP 10902 N MCKINLEY DRIVE TAMPA FL 33612 208486180 DATABASE MANAGEMENT FL H LEE MOFFITT CANCER CTR & RES INST INC C 0 ONCOBAY CLINICAL INC 10902 N MCKINLEY DRIVE TAMPA FL 33612 843412796 RESEARCH & PRODUCT DEVELOPMENT FL H LEE MOFFITT CANCER CTR & RES INST INC C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0