SOUTH LAKE HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH LAKE HOSPITAL INC (EIN 59-3322533)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-11
- IRS object ID
- 201712239349300431
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-11T10:23:40-04:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593322533 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LAKE HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 3523944071 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 DON WICKHAM DRIVE | AddressLine1Txt |
| City | CLERMONT | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 347111979 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LANCE SEWELL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3523944071 | PhoneNum |
| Signature | 2017-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2017-08-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN MOORE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 DON WICKHAM DR | AddressLine1Txt |
| City | CLERMONT | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 347111979 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $213,951,957 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOUTHLAKEHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES IN SOUTH LAKE COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 1693 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $2,464,908 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$823,331 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,541,618 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,195,819 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $161,834,810 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $174,728,190 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,540,861 | PYInvestmentIncomeAmt |
| CY Investment Income | $988,663 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,381,988 | PYOtherRevenueAmt |
| CY Other Revenue | $4,558,915 | CYOtherRevenueAmt |
| PY Total Revenue | $171,299,277 | PYTotalRevenueAmt |
| CY Total Revenue | $189,471,587 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $56,994 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $250,216 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $75,219,981 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $83,754,642 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $79,149,563 | PYOtherExpensesAmt |
| CY Other Expenses | $89,753,358 | CYOtherExpensesAmt |
| PY Total Expenses | $154,426,538 | PYTotalExpensesAmt |
| CY Total Expenses | $173,758,216 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,872,739 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $15,713,371 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $298,931,701 | TotalAssetsBOYAmt |
| Total Assets EOY | $309,369,465 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $111,757,267 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $106,269,065 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $187,174,434 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $203,100,400 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES IN SOUTH LAKE COUNTY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $142,685,483 | ExpenseAmt |
| Grant | $250,216 | GrantAmt |
| Revenue | $175,762,180 | RevenueAmt |
| Desc | OPERATION OF NOT-FOR-PROFIT HOSPITAL PROVIDING INPATIENT, OUTPATIENT, & EMERGENCY CARE FOR RESIDENTS OF SOUTHERN LAKE COUNTY FLORIDA. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. TOTAL PATIENT DAYS FOR THE FISCAL YEAR WAS APPROXIMATELY 39,000. | Desc |
| Total Program Service Expenses | $142,685,483 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 148 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1693 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LANCE SEWELL CFO | PersonNm |
| Phone | 3522417104 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 DON WICKHAM DRIVE | AddressLine1Txt |
| City | CLERMONT | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 347111979 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| LUSHANTHA GUNASEKERA MD | |||||||||
| BOARD MEMBER | 42.00 | Yes (X) | $0 | $715,261 | $34,418 | ||||
| MILDRED BEAM | |||||||||
| VICE PRESIDE | 2.00 | Yes (X) | $0 | $554,690 | $83,023 | 55.00 | Yes (X) | ||
| CARY D'ORTONA | |||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $226,748 | $45,118 | 55.00 | Yes (X) | ||
| SUSAN MCLEAN | |||||||||
| BOARD PRESID | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| ROBERT E BERENS JR | |||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DAVID BATMAN | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN MOORE | |||||||||
| HOSPITAL PRE | 55.00 | $0 | $312,061 | $65,652 | 1.00 | Yes (X) | |||
| LANCE SEWELL | |||||||||
| CFO | 55.00 | $0 | $179,606 | $40,099 | 1.00 | Yes (X) | |||
| PAUL JOHNS | |||||||||
| COO | 55.00 | $0 | $154,720 | $34,834 | Yes (X) | ||||
| LINDA WALTON | |||||||||
| CNO | 55.00 | $0 | $108,665 | $26,975 | Yes (X) | ||||
| PAREKATTIL SIJO MD | |||||||||
| PHYSICIAN | 40.00 | $522,405 | $0 | $28,663 | Yes (X) | ||||
| JEROME STURM MD | |||||||||
| PHYSICIAN | 40.00 | $515,538 | $0 | $25,877 | Yes (X) | ||||
| BRAHMBHATT JAMIN MD | |||||||||
| PHYSICIAN | 40.00 | $494,092 | $0 | $24,944 | Yes (X) | ||||
| ANDREW KAREN MD | |||||||||
| PHYSICIAN | 40.00 | $416,420 | $0 | $23,578 | Yes (X) | ||||
| JACOB SINDU MD | |||||||||
| PHYSICIAN | 40.00 | $203,698 | $0 | $26,163 | Yes (X) | ||||
| SHERRIE SITARIK | |||||||||
| VICE PRESIDE | 0.00 | $0 | $325,552 | $5,356 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,152,153 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,577,303 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $464,700 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ORIGIN DBA SHIFTWISE | |||||
| 2501 SW 1ST AVE SUITET 200 | PORTLAND | OR | 972014752 | NURSE STAFFING | $3,095,159 |
| ROBINS & MORTON GROUP | |||||
| 400 SHADES CREEK PKWY | BIRMINGHAM | AL | 352094454 | CONSTRUCTION SV | $2,128,629 |
| OB HOSPITALIST GROUP | |||||
| 10 CENTIMETERS DRIVE | MAULDIN | SC | 296623278 | HEALTHCARE SVS | $1,498,403 |
| AVI FOOD SYSTEMS | |||||
| 2590 ELM ROAD NE | WARREN | OH | 444832904 | MGMT FOOD SVCS | $1,412,013 |
| BIG TEN LLC | |||||
| 2020 OAKLEY SEAVER DR | CLERMONT | FL | 347111902 | MGMT SURGICAL | $1,094,270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 47 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,229,796 | RelatedOrganizationsAmt |
| All Other Contributions | $3,966,023 | AllOtherContributionsAmt |
| Noncash Contributions | $3,900,000 | NoncashContributionsAmt |
| Total Contributions | $9,195,819 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $174,728,190 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $174,728,190 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $174,728,190 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,061,545 | TotalRevenueColumnAmt |
| Exclusion | $1,061,545 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $536,035 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $431,233 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $104,802 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $104,802 | TotalRevenueColumnAmt |
| Exclusion | $104,802 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,939,985 | SecuritiesAmt |
| Other | $36,270 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,046,204 | SecuritiesAmt |
| Other | $2,933 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$106,219 | SecuritiesAmt |
| Other | $33,337 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$72,882 | TotalRevenueColumnAmt |
| Exclusion | -$72,882 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| NATIONAL TRAINING CENTER | 623000 | $2,464,908 | $2,464,908 | ||
| FOOD AND BEVERAGE | 722210 | $955,215 | $955,215 | ||
| EHR HOSPITAL | 621990 | $923,317 | $923,317 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,673 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $110,673 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,454,113 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $189,471,587 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $175,762,180 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,464,908 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,048,680 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,216 | TotalAmt |
| Program Services | $250,216 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,938,791 | TotalAmt |
| Program Services | $60,294,316 | ProgramServicesAmt |
| Management And General | $6,644,475 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,689,363 | TotalAmt |
| Program Services | $1,518,210 | ProgramServicesAmt |
| Management And General | $171,153 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,592,961 | TotalAmt |
| Program Services | $9,519,761 | ProgramServicesAmt |
| Management And General | $1,073,200 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,533,527 | TotalAmt |
| Program Services | $4,092,538 | ProgramServicesAmt |
| Management And General | $440,989 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,151 | TotalAmt |
| Management And General | $1,151 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,511 | TotalAmt |
| Management And General | $450,511 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,914 | TotalAmt |
| Management And General | $316,914 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,887,699 | TotalAmt |
| Program Services | $15,057,569 | ProgramServicesAmt |
| Management And General | $12,830,130 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $298,170 | TotalAmt |
| Program Services | $77,814 | ProgramServicesAmt |
| Management And General | $220,356 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,665,007 | TotalAmt |
| Program Services | $17,830,754 | ProgramServicesAmt |
| Management And General | $834,253 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,606 | TotalAmt |
| Program Services | $82,975 | ProgramServicesAmt |
| Management And General | $17,631 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,992,466 | TotalAmt |
| Program Services | $2,781,796 | ProgramServicesAmt |
| Management And General | $210,670 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,511 | TotalAmt |
| Program Services | $124,170 | ProgramServicesAmt |
| Management And General | $34,341 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,891,669 | TotalAmt |
| Management And General | $4,891,669 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,558,684 | TotalAmt |
| Program Services | $10,744,953 | ProgramServicesAmt |
| Management And General | $813,731 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $691,682 | TotalAmt |
| Management And General | $691,682 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $15,579,038 | $15,579,038 | |
| REPAIRS AND MAINTENANCE | $2,622,350 | $2,252,690 | $369,660 |
| PROVIDER FEES | $1,813,641 | $1,813,641 | |
| RECRUITING | $817,210 | $817,210 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $908,049 | TotalAmt |
| Program Services | $665,042 | ProgramServicesAmt |
| Management And General | $243,007 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,758,216 | TotalAmt |
| Program Services | $142,685,483 | ProgramServicesAmt |
| Management And General | $31,072,733 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,234,584 | BOYAmt |
| EOY | $47,416,181 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,597,131 | BOYAmt |
| EOY | $18,818,308 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,485,863 | BOYAmt |
| EOY | $1,340,941 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,731,861 | BOYAmt |
| EOY | $2,877,304 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,271,353 | BOYAmt |
| EOY | $1,636,063 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $248,067,714 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $97,537,859 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,479,059 | BOYAmt |
| EOY | $150,529,855 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,260,571 | BOYAmt |
| EOY | $73,199,039 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,005 | BOYAmt |
| EOY | $313,378 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,570,655 | BOYAmt |
| EOY | $7,570,655 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,223,619 | BOYAmt |
| EOY | $5,667,741 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,931,701 | BOYAmt |
| EOY | $309,369,465 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,376,914 | BOYAmt |
| EOY | $22,048,908 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $442,725 | BOYAmt |
| EOY | $540,173 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,652,993 | BOYAmt |
| EOY | $80,045,604 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,928,603 | BOYAmt |
| EOY | $1,726,701 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,356,032 | BOYAmt |
| EOY | $1,907,679 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,757,267 | BOYAmt |
| EOY | $106,269,065 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,563,306 | BOYAmt |
| EOY | $201,571,679 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,611,128 | BOYAmt |
| EOY | $1,528,721 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,174,434 | BOYAmt |
| EOY | $203,100,400 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,931,701 | BOYAmt |
| EOY | $309,369,465 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $15,713,371 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $136,389 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | -$152,745 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $228,951 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | Yes (true) | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $11,450 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,649 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $16,099 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS MEMBERSHIP DUES TO A STATE HEALTHCARE ORGANIZATION. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THE STATE HEALTHCARE ORGANIZATION PARTICIPATES. ADDITIONALLY, THE DIRECTOR OF GOVERNMENT RELATIONS SPENDS APPROXIMATALY 10% OF HER TIME LOBBYING FOR THE ORGANIZATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,611,128 | BeginningYearBalanceAmt |
| Contributions | $271,064 | ContributionsAmt |
| Grants Or Scholarships | $250,215 | GrantsOrScholarshipsAmt |
| Other Expenditures | $103,256 | OtherExpendituresAmt |
| End Year Balance | $1,528,721 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,531,728 | BeginningYearBalanceAmt |
| Contributions | $387,542 | ContributionsAmt |
| Grants Or Scholarships | $56,714 | GrantsOrScholarshipsAmt |
| Other Expenditures | $251,428 | OtherExpendituresAmt |
| End Year Balance | $1,611,128 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,421,671 | BeginningYearBalanceAmt |
| Contributions | $181,257 | ContributionsAmt |
| Grants Or Scholarships | $25,456 | GrantsOrScholarshipsAmt |
| Other Expenditures | $45,744 | OtherExpendituresAmt |
| End Year Balance | $1,531,728 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,322,778 | BeginningYearBalanceAmt |
| Contributions | $230,518 | ContributionsAmt |
| Grants Or Scholarships | $67,250 | GrantsOrScholarshipsAmt |
| Other Expenditures | $64,375 | OtherExpendituresAmt |
| End Year Balance | $1,421,671 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,372,263 | BeginningYearBalanceAmt |
| Contributions | $227,295 | ContributionsAmt |
| Grants Or Scholarships | $80,246 | GrantsOrScholarshipsAmt |
| Other Expenditures | $196,534 | OtherExpendituresAmt |
| End Year Balance | $1,322,778 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $752,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $16,195,071 | OtherCostOrOtherBasisAmt |
| Book Value | $16,947,071 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $148,784,631 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,300,871 | DepreciationAmt |
| Book Value | $103,483,760 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,020,454 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,640,390 | DepreciationAmt |
| Book Value | $3,380,064 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,295,438 | OtherCostOrOtherBasisAmt |
| Depreciation | $50,596,598 | DepreciationAmt |
| Book Value | $21,698,840 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,020,120 | OtherCostOrOtherBasisAmt |
| Book Value | $5,020,120 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $150,529,855 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY SETTLEMENTS | $1,572,776 |
| RAC RESERVE | $202,693 |
| OTHER LIABILITIES | $132,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,907,679 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $186,043,035 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $136,389 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $681,448 | OtherRevenueAmt |
| Revenue Not Reported | $817,837 | RevenueNotReportedAmt |
| Revenue Subtotal | $185,225,198 | RevenueSubtotalAmt |
| Other Revenues Not Included | $4,246,389 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,246,389 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $189,471,587 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $174,104,727 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $596,726 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $596,726 | ExpensesNotReportedAmt |
| Expenses Subtotal | $173,508,001 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $250,215 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $250,215 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $173,758,216 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | CAPTAIN HOMER N. ALLEN FUND FOR NURSING SCHOLARSHIPS PROVIDES SUPPORT FOR SCHOLARSHIPS FOR RESIDENTS OF SOUTH LAKE COUNTY AND/OR EMPLOYEES OF SOUTH LAKE HOSPITAL WHO WISH TO FURTHER THEIR EDUCATION IN THE FIELD OF NURSING. OTHER RESTRICTED FUNDS ARE AVAILABLE FOR THE ACQUISITION OF FIXED ASSETS AND OTHER OPERATING USES. ORLANDO HEALTH FOUNDATION (AN AFFILIATE OF ORLANDO HEALTH, A RELATED ORGANIZATION) HOLDS AND ADMINISTERS CERTAIN DONOR RESTRICTED FUNDS ON BEHALF OF SOUTH LAKE HOSPITAL. THE AMOUNT HELD WAS 742,567 AS OF SEPTEMBER 30, 2016. |
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2016 AND 2015 OR FOR THE YEARS THEN ENDED. FOR FEDERAL INCOME TAX PURPOSES THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | RENTAL EXPENSES 431,233 NET ASSETS RELEASED FROM RESTRICTIONS 250,215 |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | CAPITAL CONTRIBUTIONS 4,093,644 CONTRIBUTED SERVICES 152,745 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSE 431,233 EQUITY ADJUSTMENT 165,493 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | SCHOLARSHIPS RELEASED FROM RESTRICTION 250,215 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,016,926 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,016,926 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02880 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,718,640 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,534,637 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,184,003 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06990 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,735,566 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,534,637 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,200,929 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09870 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,380,214 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,380,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00790 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $150,077 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $60,744 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $244,964 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,964 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $264,505 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $264,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,039,760 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $60,744 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,979,016 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,775,326 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,595,381 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,179,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $16,243,880 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $12,182,910 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $43,167,715 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $43,796,059 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$628,344 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LAKE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 DON WICKHAM DRIVE | AddressLine1Txt |
| City | CLERMONT | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 347111979 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SOUTHLAKEHOSPITAL.COM | WebsiteAddressTxt |
| State License | 4180 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SURG CTR, REHAB, MRI, HH | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH LAKE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SOUTHLAKEHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.SOUTHLAKEHOSPITAL.COM | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWSOUTHLAKEHOSPITALCOM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWSOUTHLAKEHOSPITALCOM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWWSOUTHLAKEHOSPITALCOM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 5 | CONSUMER SURVEY THE SURVEY WAS DISTRIBUTED BOTH IN HARD COPY (1,407) AND ELECTRONICALLY VIA SURVEYMONKEY (291) WITH A TOTAL OF 1,698 RESPONSES. WHILE MOST RESPONDENTS COMPLETED THE SURVEY IN ENGLISH, 331 WERE COMPLETED IN SPANISH, SIX IN FRENCH AND THREE IN CREOLE. AFTER DATA SCREENING, 1,235 RESPONSES WERE ANALYZED. PROVIDER SURVEY THIS SURVEY, DISTRIBUTED ELECTRONICALLY, INCLUDED RESPONSES FROM 145 PARTICIPANTS. THE QUESTIONS WERE MOSTLY OPEN-ENDED AND EXPLORED RESPONDENTS' VIEWS ON THE COMMUNITY'S DEFICITS GIVEN A HOLISTIC DEFINITION OF A HEALTHY COMMUNITY, ISSUES RELATED TO HEALTHCARE SERVICES AND FORCES OF CHANGE IN THE COMMUNITY. STAKEHOLDER IN-DEPTH INTERVIEWS INTERVIEWS WERE CONDUCTED WITH 16 COMMUNITY STAKEHOLDERS. EACH INTERVIEW LASTED AN AVERAGE OF 65 MINUTES. COMMUNITY CONVERSATIONS SIX COMMUNITY CONVERSATION SESSIONS TOOK PLACE WITH A TOTAL OF 102 PARTICIPANTS. THESE CONVERSATIONS EMPLOYED THE WORLD CAFE/CROSS POLLINATION METHOD. EACH PARTICIPANT WAS SEATED AT A TABLE WITH OTHER PARTICIPANTS. EACH TABLE ENGAGED IN CONVERSATION, WRITING DOWN KEY THOUGHTS AND IDEAS ON CARDS OR SKETCHING THEM OUT ON PAPER. AFTER 20-30 MINUTES, PARTICIPANTS WERE ASKED TO CHANGE TABLES, CARRYING THOUGHTS FROM THEIR PREVIOUS TABLE TO THEIR NEW GROUP. THROUGHOUT THE PROCESS, A "TABLE HOST" STAYED BEHIND AT EACH TABLE TO SHARE THE INSIGHTS OF THEIR PREVIOUS DISCUSSION WITH THE NEW ARRIVALS. AFTER THESE SMALL-GROUP ROUNDS, ALL PARTICIPANTS CONVENED FOR A LARGE-GROUP CONVERSATION AND COLLECTIVE KNOWLEDGE WAS HARVESTED. HOSPITAL-SPECIFIC PRIORITIZATION AN INTERNAL ASSESSMENT TEAM CONVENED AT SOUTH LAKE HOSPITAL AND INCLUDED CASE MANAGEMENT, NURSING, MEDICAL STAFF, ADMINISTRATION, FINANCE, EDUCATION, AND OTHER CLINICAL AND NON-CLINICAL STRATEGY INDIVIDUALS. |
| FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 6A | FOUR NOT-FOR-PROFIT HOSPITALS-ORLANDO HEALTH, SOUTH LAKE HOSPITAL, IN AFFILIATION WITH ORLANDO HEALTH, FLORIDA HOSPITAL AND ASPIRE HEALTH PARTNERS -ALONGSIDE THE FLORIDA DEPARTMENT OF HEALTH IN LAKE, ORANGE, OSCEOLA AND SEMINOLE COUNTIES COLLABORATED IN 2015 AND 2016 TO CREATE A CHNA FOR LAKE, ORANGE, OSCEOLA AND SEMINOLE COUNTIES. |
| FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 6B | SEE RESPONSE TO 6A. |
| FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 11 | SOUTH LAKE HOSPITAL WILL INVOLVE NUMEROUS DEPARTMENTS THROUGHOUT THE ORGANIZATION AND COMMUNITY PARTNERS TO USE BEST-PRACTICES TO STRATEGICALLY ADDRESS THE NEEDS IN THE SOUTH LAKE COMMUNITY WHICH ARE HIGHLIGHTED IN THE 2016 IMPLEMENTATION PLAN. SOUTH LAKE HOSPITAL WILL FOCUS PREVENTION, DETECTION AND EDUCATION EFFORTS IN THE SPECIFIC NEEDS LISTED BELOW: HEART DISEASE DIABETES CHILDHOOD/STUDENT OBESITY INFANT MORTALITY THE SOUTH LAKE HOSPITAL CHNA IDENTIFIED ADDITIONAL NEEDS IN THE SERVICE AREA THAT ARE NOT ADDRESSED AS A PRIORITY IN THIS CURRENT IMPLEMENTATION STRATEGY PLAN. IN CONSIDERING WHAT NEEDS TO NOT ADDRESS, THE SLH COMMITTEE WEIGHED THE LEVEL AT WHICH THESE NEEDS ARE ALREADY BEING ADDRESSED BY OTHER COMMUNITY PARTNERS, THE HOSPITAL AND/OR WHETHER THE HOSPITAL HAD THE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THESE NEEDS INCLUDED THE FOLLOWING: MENTAL ILLNESS/DEPRESSION POVERTY SUBSTANCE ABUSE INAPPROPRIATE ER VISITS POOR ACCESS TO FOOD/NUTRITION CANCER HIV/AIDS DENTAL CARE BOTH THE 2016 CHNA AND IMPLEMENTATION PLAN ARE LOCATED ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING ADDRESS: HTTP://WWW.SOUTHLAKEHOSPITAL.COME/ABOUT-US/COMMUNITY-OUTREACH |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| NATIONAL TRAINING CENTER | ||||
| 1935 DON WICKHAM DRIVE | CLERMONT | FL | 347111979 | WELLNESS CENTER |
| SOUTH LAKE SURGICAL CENTER | ||||
| 1935 DON WICKHAM DRIVE | CLERMONT | FL | 347111979 | OUTPATIENT SURGERY |
| SOUTH LAKE HOME HEALTH AGENCY | ||||
| 1935 DON WICKHAM DRIVE | CLERMONT | FL | 347111979 | HOME HEALTH |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | IF TOTAL OF ALL OPEN BILLS ACCOUNTS FOR MORE THAN 25% OF THEIR ANNUAL INCOME, DISCOUNT WILL BE APPLIED TO REACH THE 25% MARK, PROVIDED PATIENT'S INCOME DOES NOT EXCEED 400% OF THE FPG. |
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | SUBSIDIZED HEALTH SERVICES REPRESENT THE OPERATIONAL COSTS FOR THE FREE CLINIC TO CARE FOR INDIGENT PATIENTS OF SOUTH LAKE COUNTY. |
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 173,758,217 ADD: EXPENSES REPORTED IN PART VIII 431,233 DENOMINATOR FOR COLUMN (F) 174,189,450 |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I, LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. THE AMOUNT INCLUDED ON PART III LINE 3 IS BASED ON HISTORICAL DATA FOR THOSE INDIVIDUALS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY; HOWEVER, FAILED TO COMPLETE THE APPLICATION PROCESS. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | SEE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | BOTH DISCOUNTS AND PAYMENTS TO ACCOUNTS WILL REDUCE THE BAD DEBT EXPENSE, SHOULD THE ACCOUNT BE REPORTED AS BAD DEBT. THAT IS TO SAY, DISCOUNTS APPLIED TO ACCOUNTS ARE NOT REVERSED PRIOR TO DECLARING, ADJUSTING AND/OR WRITING OFF ACCOUNTS AS BAD DEBT. ALL ACCOUNTS WHICH ARE ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT ARE REVIEWED TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF SUFFICIENT DOCUMENTATION WAS NOT PROVIDED BY THE ACCOUNT HOLDER, SOUTH LAKE USES PREDICTIVE ANALYTICS TO DETERMINE IF THE ACCOUNT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. THE PREDICTIVE ANALYTICS DESIGNED TO ASSESS FINANCIAL ASSISTANCE FOR ACCOUNTS ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT USES DATA DERIVED FROM THIRD PARTIES WHICH INCLUDE, BUT ARE NOT LIMITED TO DEMOGRAPHIC VERIFICATION, INCOME VERIFICATION, HOUSEHOLD SIZE VERIFICATION, PAYMENT HISTORY INFORMATION, PROPERTY OWNERSHIP INFORMATION, OCCUPATION INFORMATION, VEHICLE OWNERSHIP HISTORY AND VALUES AND HOME OWNERSHIP HISTORY AND VALUES. ONCE THIS DATA LOGIC IS APPLIED, IT BECOMES APPARENT IF THE ACCOUNT QUALIFIES FOR FINANCIAL ASSISTANCE. IF THE ACCOUNT DOES QUALIFY, PREVIOUS UNINSURED DISCOUNTS, BAD DEBT ADJUSTMENTS AND/OR WRITE OFFS ARE REVERSED AND THE NEW BALANCE REFLECTED IS RECLASSIFIED AS FINANCIAL ASSISTANCE OR CHARITY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | SOUTH LAKE COMPLETED ITS ASSESSMENT AS PART OF OUR STRATEGY, PLANNING AND BUDGETING PROCESS AND HAS PROCESSES IN PLACE TO ENSURE THE ORGANIZATION IS REACTIVE TO THE COMMUNITY'S HEALTH NEEDS. EXAMPLES OF HOW SOUTH LAKE RESPONDS TO COMMUNITY NEEDS ARE AS FOLLOWS: 1. GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE; 2. PARTNERSHIP WITH LOCAL AREA GROUPS AND ASSOCIATES TO ATTEND TO THE HEALTH CARE NEEDS OF THE SOUTH LAKE COMMUNITY; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH FAIRS, COMMUNITY FITNESS, WELLNESS EVENTS AND OTHER OUTREACH EVENTS; AND 4. TRANSITION SERVICES POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS TO PREVENT UNNECESSARY ADMISSIONS AND POTENTIAL RE-ADMISSIONS. SOUTH LAKE MEETS THE NEEDS OF THE COMMUNITY THROUGH ITS EDUCATION, RESEARCH AND PATIENT CARE PROGRAMS. THE SPECIFIC NEEDS TARGETED BY THESE PROGRAMS HAVE BEEN IDENTIFIED BY THE EXPERIENCE OF COMMUNITY HOSPITAL ADVISORY COUNCILS, NEIGHBORHOOD OUTREACH AND THROUGH COMMUNITY NEEDS ASSESSMENTS THAT IDENTIFIED HEALTH PROBLEMS IN THE COMMUNITIES SERVED BY THE HOSPITAL. SOUTH LAKE SPONSORS A VARIETY OF PROGRAMS FOR AT-RISK POPULATIONS, FEDERALLY-DESIGNED MEDICALLY UNDERSERVED AREAS AND SPECIAL NEEDS GROUPS, AS WELL AS FOR THE BROADER COMMUNITY. DURING THE FISCAL YEAR 2016, THE ORGANIZATION, ALONG WITH THE EFFORTS OF IMPACT PARTNERS, LLC, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT. THE CHNA CAN BE FOUND AT HTTP://WWW.SOUTHLAKEHOSPITAL.COM/ABOUT-US/COMMUNITY-OUTREACH. THE IMPLEMENTATION STRATEGY PLAN CAN ALSO BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTP://WWW.SOUTHLAKEHOSPITAL.COM/ABOUT-US/COMMUNITY-OUTREACH |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SOUTH LAKE FOLLOWS AN ESTABLISHED PROCESS TO INFORM ALL PATIENTS OF ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES. DURING PREADMISSION, AT REGISTRATION OR AT BEDSIDE, UNINSURED PATIENTS ARE INFORMED OF THE HOSPITAL'S CHARITY CARE POLICY AND OTHER FINANCIAL ASSISTANCE. FINANCIAL INFORMATION IS SECURED FOR ALL UNINSURED PATIENTS TO SCREEN FOR POSSIBLE ENROLLMENT IN FEDERAL, STATE AND LOCAL PROGRAMS. SOUTH LAKE HAS CONTRACTED DEDICATED ORGANIZATIONS THAT ASSIST THE PATIENT WITH THEIR ENROLLMENT PROCESS ALL THE WAY TO APPROVAL OR DENIAL BY THE RESPECTIVE AGENCIES. FOR UNINSURED PATIENTS THAT ARE DENIED COVERAGE OR DO NOT MEET THE COVERAGE CRITERION FOR A RESPECTIVE AGENCY, SOUTH LAKE THEN SCREENS THE PATIENT FOR CHARITY ELIGIBILITY. IT IS SOUTH LAKE'S OBJECTIVE TO PROVIDE CHARITY CARE TO OUR PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | SOUTH LAKE CURRENTLY OPERATES IN THE CENTRAL FLORIDA REGION, WHICH HAS OVER TWO MILLION RESIDENTS AND THOUSANDS OF INTERNATIONAL VISITORS ANNUALLY. SOUTH LAKE'S PRIMARY SERVICE AREA IS COMPRISED OF ORANGE AND LAKE COUNTIES. THE MEDIAN HOUSEHOLD INCOME IN THE AREA IS 53,840. APPROXIMATELY 19% OF THE SERVICE AREA IS OVER 64 WHILE APPROXIMATELY 23% IS 0-12. COMMUNITY OUTREACH ACTIVITIES INCLUDE SPEAKER'S BUREAU, SUPPORT/EDUCATION GROUPS, WELLNESS ACTIVITIES, HEALTH FAIRS, CLINICAL SCREENINGS AND ASSESSMENTS, MEDICAL EDUCATION, RESEARCH, WOMEN, CHILDREN AND SENIOR HEALTH INITIATIVES, PUBLIC PROGRAM ENROLLMENT ASSISTANCE AND POST-ACUTE CARE FOR HOMELESS AND UNINSURED, SPONSORSHIPS, SCHOOL INITIATIVES, DONATED MEETING SPACE AND SPIRITUAL CARE. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | SOUTH LAKE HOSPITAL, INC. FURTHERS ITS EXEMPT PURPOSE BY REINVESTING SURPLUS FUNDS IN THE HOSPITAL, EXTENDING ADMITTING PRIVILEGES TO QUALIFYING PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS, OPERATING A FREE CLINIC FOR RESIDENTS OF SOUTH LAKE WHO MEET CERTAIN INDIGENT GUIDELINES, OPERATING THE NATIONAL TRAINING CENTER FOR THE OVERALL HEALTH OF THE COMMUNITY AND ENCOURAGING OVERALL COMMUNITY INVOLVEMENT IN THE GOVERNING BODY OF THE ORGANIZATION. GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | SOUTH LAKE HOSPITAL, INC. (HOSPITAL) IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHICH ALSO INCLUDES ORLANDO HEALTH (OH), SOUTH LAKE HOSPITAL FOUNDATION (FOUNDATION), AND SOUTH LAKE COUNTY HOSPITAL DISTRICT (DISTRICT). THE HOSPITAL, LOCATED IN CLERMONT, FL, IS A NOT-FOR-PROFIT HOSPITAL PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHERN LAKE COUNTY, FL AND SURROUNDING AREAS. OH PROVIDES TRAUMA AND ACUTE CARE TO PATIENTS THROUGHOUT THE CENTRAL FLORIDA AREA AND OFFERS PEDIATRIC AND ADULT PATIENT SERVICES. THE FOUNDATION WAS FOUNDED AND OPERATES TO SUPPORT THE SERVICES OF SOUTH LAKE HOSPITAL. THE FOUNDATION OFFERS SUPPORT TO PATIENTS OF SOUTH LAKE HOSPITAL AS WELL AS THE CHILDREN IN THE COMMUNITY FOR WELLNESS. THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | NURSING SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 18 | RecipientCnt |
| Cash Grant | $250,216 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | NURSING SCHOLARSHIP POLICY IS TO PROVIDE TUITION REIMBURSEMENT FOR ANY APPLICANT WHO MEETS CERTAIN CRITERIA REGARDING EMPLOYMENT, GRADES AND QUALIFICATIONS AS WELL AS SUPERVISORY RECOMMENDATIONS. PROOF OF GRADE AND PAYMENT MUST BE PRESENTED AT THE TIME OF REIMBURSEMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LUSHANTHA GUNASEKERA MD | ||||||||||||
| BOARD MEMBER | $397,236 | $316,309 | $1,716 | $11,262 | $23,156 | $749,679 | ||||||
| MILDRED BEAM | ||||||||||||
| VICE PRESIDENT | $385,939 | $120,441 | $48,310 | $67,226 | $15,797 | $637,713 | $47,395 | |||||
| CARY D'ORTONA | ||||||||||||
| TREASURER | $188,360 | $28,991 | $9,397 | $21,962 | $23,156 | $271,866 | $9,238 | |||||
| JOHN MOORE | ||||||||||||
| HOSPITAL PRESIDENT | $224,970 | $56,931 | $30,160 | $42,227 | $23,425 | $377,713 | $28,985 | |||||
| LANCE SEWELL | ||||||||||||
| CFO | $149,721 | $18,607 | $11,278 | $15,935 | $24,164 | $219,705 | $11,147 | |||||
| PAUL JOHNS | ||||||||||||
| COO | $131,192 | $16,315 | $7,213 | $11,409 | $23,425 | $189,554 | $6,748 | |||||
| PAREKATTIL SIJO MD | ||||||||||||
| PHYSICIAN | $470,909 | $50,998 | $498 | $28,663 | $551,068 | |||||||
| JEROME STURM MD | ||||||||||||
| PHYSICIAN | $311,484 | $199,976 | $4,078 | $25,877 | $541,415 | |||||||
| BRAHMBHATT JAMIN MD | ||||||||||||
| PHYSICIAN | $474,627 | $19,066 | $399 | $24,944 | $519,036 | |||||||
| ANDREW KAREN MD | ||||||||||||
| PHYSICIAN | $328,593 | $87,484 | $343 | $23,578 | $439,998 | |||||||
| JACOB SINDU MD | ||||||||||||
| PHYSICIAN | $200,743 | $2,955 | $26,163 | $229,861 | ||||||||
| SHERRIE SITARIK | ||||||||||||
| VICE PRESIDENT/CEO | $325,552 | $5,356 | $330,908 | |||||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY THE RELATED ORGANIZATION AND PROVIDER OF MANAGEMENT SERVICES, ORLANDO HEALTH INC. (OH), TO ESTABLISH COMPENSATION OF THE PRESIDENT AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY OH INCLUDES AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | MILDRED BEAM 0 63,914 0 CARY D'ORTONA 0 13,300 0 JOHN MOORE 0 33,386 0 LANCE SEWELL 0 10,758 0 PAUL JOHNS 0 9,380 0 LINDA WALTON 0 9,324 0 SHERRIE SITARIK 325,552 0 0 |
| SCHEDULE J, PART III | THE 457F DEFERRED COMPENSATION PLAN IS A RETENTION PLAN WHEREBY 7% OF THE EXECUTIVE'S BASE SALARY IS DEPOSITED INTO A LINCOLN ACCOUNT. EACH YEAR'S DEPOSIT IS SUBJECT TO A THREE YEAR VESTING SCHEDULE. UPON VESTING THE ACCOUNT IS TAXED AND PAID OUT LESS ANY 403B DEDUCTIONS. IF THE EXECUTIVE VOLUNTARILY SEPARATES FOR ANY REASON, ALL UNVESTED AMOUNTS ARE FORFEITED. BONUS PLAN DEPARTMENT DIRECTORS, AS WELL AS THE OFFICERS, RECEIVE AN INCENTIVE FOR THE ACHIEVEMENT OF CERTAIN FINANCIAL, PERSONNEL, CUSTOMER SATISFACTION, AND QUALITY GOALS. PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE BASED ON VARIOUS ORGANIZATIONAL GOALS OF WHICH RELATIVE VALUE UNIT (RVU) EXPECTATIONS MAKE UP ONE OF THE COMPONENTS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2Txt | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|---|
| SOUTH LAKE COUNTY HOSP HLTH DIST | |||||||||
| A | BOARD OF TRUSTEES | 590571600 | 838640DL1 | 2010-01-06 | $52,335,000 | CONSTRUCTION/RENOVATION | false | Yes (true) | false |
| SOUTH LAKE COUNTY HOSP HLTH DIST | |||||||||
| B | BOARD OF TRUSTEES | 590571600 | 838640DX5 | 2010-06-03 | $34,330,000 | REDEMPTION OF 1999 BONDS | false | Yes (true) | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Refunding EscrowRefundingEscrowAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $3,170,000 | $51,998,222 | $5,199,822 | $998,399 | $45,800,001 | 2011 | false | false | false | Yes (true) | |
| B | $4,600,000 | $33,956,621 | $680,262 | 2010 | Yes (true) | false | Yes (true) | Yes (true) | $33,276,360 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | Yes (true) | Yes (true) | false | false | false | Yes (true) |
| B | false | Yes (true) | Yes (true) | Yes (true) | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | false |
| B | false |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT BERENS JR | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $388,916 | TransactionAmt |
| Transaction | BANK OFFICER; CASH | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | ROBERT E. BERENS, JR., CURRENTLY SERVING AS SECRETARY OF THE GOVERNING BOARD, IS A VICE PRESIDENT AT SEACOAST NATIONAL BANK AND OWNS LESS THAN 1% OF THE BANK'S STOCK. THE BANK HOLDS A CD VALUED AT APPROXIMATELY 389,000 FOR THE FILING ENTITY. | ExplanationTxt |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,900,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | APPRAISAL | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 1 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | ORLANDO HEALTH (OH) PROVIDES THE HOSPITAL'S PRESIDENT, CFO, COO AND CNO PURSUANT TO A MANAGEMENT AGREEMENT WITH THE HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 7A | FIFTY PERCENT OF THE BOARD MEMBERS ARE APPOINTED BY OH WHILE THE REMAINING MEMBERS ARE APPOINTED BY SOUTH LAKE MEMORIAL HOSPITAL, INC. ON BEHALF OF SOUTH LAKE COUNTY HOSPITAL DISTRICT ("DISTRICT"), A RELATED ORGANIZATION. THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL. NEITHER RELATED ORGANIZATION HAS TECHNICAL CONTROL OF THE HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE BOARD CHAIR REVIEWS THE FORM 990 WITH THE CFO IN DETAIL PAYING PARTICULAR ATTENTION TO ANY NEW SCHEDULES AND THE RECONCILIATION TO THE AUDITED FINANCIAL STATEMENTS PRIOR TO FILING WITH THE IRS. THE PUBLIC INSPECTION COPY (WITHOUT CONTRIBUTORS' NAMES AND ADDRESSES) IS THEN ELECTRONICALLY CIRCULATED TO THE CURRENT VOTING BOARD MEMBERS BY SURVEY MONKEY AS AN ATTACHMENT, PRIOR TO FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY, THE COMPLIANCE OFFICER FOR OH PROVIDES A QUESTIONNAIRE TO THE LEADERSHIP, BOARD OF DIRECTORS, DISTRICT BOARD OF TRUSTEES AND MEDICAL STAFF LEADERSHIP FOR DISCLOSURE IN REGARDS TO POTENTIAL CONFLICTS OF INTEREST. THE OH COMPLIANCE OFFICER EVALUATES EACH QUESTIONNAIRE AND WILL REQUEST ADDITIONAL INFORMATION SHOULD IT BE REQUIRED. ANY VOTING RIGHTS OR COMPENSATION RECEIVED IN RELATION TO ANY COMPETING ENTITIES IS QUESTIONED AS WELL AS OWNERSHIP IN ANY VENDOR STOCK DIRECTLY. IF ANY CONFLICT OF INTEREST OCCURS, THAT INDIVIDUAL IS RECUSED FROM THAT PORTION OF THE MEETING REGARDING THE CONFLICTED TRANSACTION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH CONTINUING DISCLOSURE AGREEMENT WITH DIGITAL ASSURANCE CORPORATION (DAC). GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE SUNSHINE LAW. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICE 6,704,854 1,214,754 0 REFERENCE LAB 1,223,106 0 0 PROFESSIONAL FEES 4,974,213 0 0 OTHER FEES 669,215 10,979 0 PURCHASED SERVICES 680,717 7,458,219 0 COURIER 30,822 1,348 0 CONSULTING FEES 3,689 1,226,624 0 COLLECTION 283,433 2,918,206 0 UBTI - OTHER FEES 487,520 0 0 |
| FORM 990, PART XI, LINE 9 | NET ASSETS RELEASED FROM RESTRICTIONS 84,721 CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 144,230 TOTAL 228,951 TOTAL CHANGE IN NET ASSETS IS DETAILED ABOVE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ORLANDO HEALTH | ||||||||||
| 1414 KUHL AVENUE | ORLANDO | FL | 328062008 | 591726273 | HEALTHCARE | FL | 501C3 | 3 | NA | false |
| SOUTH LAKE COUNTY HOSPITAL DISTRICT | ||||||||||
| 1900 DON WICKHAM DRIVE | CLERMONT | FL | 347111979 | 590571600 | LEVY TAX | FL | 501C3 | 6 | NA | false |
| SOUTH LAKE HOSPITAL FOUNDATION | ||||||||||
| 1935 DON WICKHAM DRIVE | CLERMONT | FL | 347111915 | 900805455 | FUNDRAISIN | FL | 501C3 | 7 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE PURCHASING ALLIANCE LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1417 S KUHL AVENUE SUITE 100 | AddressLine1Txt |
| City | ORLANDO | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 328062010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454843489 | EIN |
| Primary Activities | PURCHASING | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OH | BusinessNameLine1Txt |
| Business Name Line2 | ORLANDO HEALTH INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $688,398 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $377,143 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0.08420 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R | FormAndLineReferenceDesc |
| Explanation | HEALTHCARE PURCHASING ALLIANCE, INC. IS OWNED 7% BY THE FILING ENTITY WITH THE REMAINING 93% OWNED BY ORLANDO HEALTH, INC., A RELATED ORGANIZATION. | ExplanationTxt |