2015-08-13T07:39:53-05:00 2014-09-30 420714325 MCGLADREY LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2013-10-01 590624371 Holmes Regional Medical Center Inc HOLM 3214345150 3300 Fiske Blvd Rockledge FL 32955 Joseph G Felkner Exec VP/CFO 3214345150 2015-08-03 1 Wayne Harder P00294296 3126343400 2013 2016-03-07 17:11:31Z Steven P Johnson 3300 Fiske Blvd Rockledge FL 32955 531294627 0 X WWW.HEALTH-FIRST.ORG X 1931 FL Our team positively changing the health and well-being of you and your family through excellent and compassionate health care. 19 11 0 1091 2867174 1751342 1886596 958727 496117576 525943658 948615 -452573 5700787 3477767 504653574 529927579 1142122 1076569 0 0 227151391 217879001 0 0 0 226400706 226029196 454694219 444984766 49959355 84942813 630530922 686590294 328707789 342168741 301823133 344421553 X Our team positively changing the health and well-being of you and your family through excellent and compassionate health care. 0 0 352992818 1076569 525943658 Holmes Regional Medical Center (HRMC) features 514 beds and more than500 highly skilled medical staff members. As the region's premiertertiary referral hospital, HRMC offers all patients cutting-edgelife-saving technology.The Heart Center at HRMC offers comprehensive cardiac services and performs more cardiac procedures than all other hospitals in Brevard County. As the only state-accredited Level II trauma center serving Brevard and Indian River Counties, HRMC's trauma center offers 24/7 trauma care and rapid patient transport via First Flight, a Health First operated aero-medical helicopter. Additionally, the birth suites at HRMC includes Brevard's first Level II neonatal ICU for newborns with medical conditions requiring intensive care.HRMC is also the first hospital in Brevard to offer state-of-the-art robotics-assisted surgery for urology, prostate, and gynecological procedures and is currently the only hospital in Brevard to offer anterior hip replacement surgery and reverse shoulder surgery. As a primary stroke center, HRMC offers life-changing interventional neuro-radiology services for advanced stroke treatment. Palm Bay Hospital (PBH) features 152 beds and 195 highly skilled physicians. Focused on cutting-edge technology, PBH offers patients extensive digital diagnostic radiology including digital mammography, x-ray, MRI, CT, ultrasound, nuclear medicine and tele radiology. PBH is the first hospital in Brevard to offer thoracic endograph surgery. PBH also offers a full spectrum of healthcare services, including cardiopulmonary, surgery, rehabilitation, intensive care, emergency and endoscopy services. HRMC and PBH provide high-quality medical services to the community of Brevard County regardless of race, creed, gender, national origin, handicap, age or ability to pay. It is recognized that not all individuals possess the ability to purchase essential medical services and further, that our mission is to serve the community with respect to providing health care services and health care education such as "Healthy Happenings" seminars and support groups for the public.In keeping with this hospital's commitment, to serve all members of its community:1) Free care and/or subsidized care is provided where the need and/or inability to pay exists;2) Care is provided at below cost to persons covered by governmental programs;3) Free healthcare activities and programs are provided to the community. These activities include: wellness programs, communityeducation programs, special programs for elderly, handicapped, and mentally underserved along with a variety of broad community support activities.For a copy of our Health First Community Benefit Report see:Http://hfwww1.health-first.org/about_us/gives_back/community_report.cfm 352992818 1 1 0 0 0 0 0 0 0 0 1 0 1 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 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 19 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Arthur Craig Springer II 3214345150 3300 Fiske Blvd Rockledge FL 32955 James C Shaw Chairman 1.00 3.00 X X 0 7719 0 Catherine A Ford Vice Chairman 1.00 3.00 X X 0 10007 0 Richard McNeight Secretary 1.00 3.00 X X 0 0 0 Martin W Isenman MD Treasurer 1.00 3.00 X X 0 2184 0 Pamela A Gatto Director 1.00 3.00 X 0 2402 0 Eugene S Cavallucci Esq Director 1.00 3.00 X 0 13592 0 James Dwight Director 1.00 3.00 X 0 6456 0 Frances U Pickett Director 1.00 3.00 X 0 4663 0 William C Potter Esq Director 1.00 3.00 X 0 0 0 Kevin B Steele Director 1.00 4.00 X 0 0 0 Christopher S Rehak MD Medical Staff President 1.00 0.00 X 0 0 0 Cathy Eddy Director 1.00 3.00 X 0 0 0 Donald F Hagen MD Director 1.00 3.00 X 0 0 0 Kevin S Pruett Director 1.00 3.00 X 0 0 0 Bryan R Roub Director 1.00 3.00 X 0 0 0 Tamar Ahmed MD Medical Staff President 1.00 0.00 X 0 0 0 Alan Prestwood Director (in-coming) 1.00 3.00 X 0 0 0 James Ridenour Director (in-coming) 1.00 3.00 X 0 0 0 Norberto Schechtmann MD Medical Staff President (out-going) 1.00 40.00 X 0 420713 16657 James S Mitchell III Exec VP COO HF Inc. 1.00 40.00 X 0 910024 19245 Joseph G Felkner EVP/CFO 1.00 42.00 X X 0 696970 21175 David E Mathias SVP/Corporate Counsel 1.00 41.00 X 0 527625 23956 Sean J Gregory President HRMC 40.00 1.00 X X 0 577075 16156 Steven P Johnson President/CEO HF 1.00 44.00 X X 0 1625823 21847 Robert R Wright President Community Hosp (out-going) 13.00 28.00 X 0 609378 23206 Judith A Gizinski COO PBH 40.00 1.00 X 0 209524 22194 Matthew E Troup COO HRMC 40.00 0.00 X 0 300668 14869 Charles T Behl Lead Pharmacist 40.00 0.00 X 0 154981 21562 Tia Marie Rossana Pharmacist 40.00 0.00 X 0 181735 12366 Joseph Albert Gurri VP Med Affairs HRMC 40.00 0.00 X 0 388299 21507 Marcia S Minnich-Barnes Pharmacist 40.00 0.00 X 0 149050 18724 Kelly R Breedlove Interim CNO Admin Dir Nursing 40.00 0.00 X 0 167113 19970 Nicholas E Pellegrino Director 0.00 0.00 X 0 107803 0 Brian J Bussen Director 0.00 0.00 X 0 101110 0 A Thomas Hollingsworth PhD Director 0.00 0.00 X 0 85981 0 Robert C Galloway SVP CFO 0.00 0.00 X 0 115009 0 Jerry Senne President/CEO HRMC 0.00 0.00 X 0 794805 0 0 8170709 273434 0 1 1 0 Health First Inc 3300 Fiske Blvd Rockledge FL 32955 Management Support 445466640 Health First Physicians Inc 3300 Fiske Blvd Rockledge FL 32955 Physician Services 124088 2 551051 407676 958727 Patient Service 621110 319155950 318032955 1122995 Medicare/Medicaid 621110 193591991 193591991 Pro Health 713940 9760600 9760600 Related Company Rent 531120 2382382 2382382 Reference Lab 621500 1052735 1052735 525943658 154274 154274 1720715 616467 1104248 1104248 691444 412804 143734 750581 -606847 -606847 -606847 Cafeteria 722210 673473 673473 1700046 1700046 2373519 529927579 523767928 2867174 2333750 1076569 1076569 2253574 2253574 164106112 131088133 33017979 3371146 2912091 459055 35068655 26934462 8134193 13079514 10897198 2182316 1707499 33590 1673909 361474 361474 29951622 17178242 12773380 907314 30185 877129 6073575 4348891 1724684 10943185 814235 10128950 12370582 10731596 1638986 133137 29489 103648 82883 10585 72298 10539672 8732524 1807148 27957876 20212534 7745342 3029918 3029918 Medical Supplies 99030518 99030518 0 Maintenance & Repair 7296857 6136628 1160229 Florida Indigent Tax 5987696 5987696 0 Licenses and Taxes 235629 51838 183791 9419759 6755814 2663945 444984766 352992818 91991948 0 159661156 220470661 57281654 59048574 12572464 13676063 1828185 1737173 671471782 408181171 272937785 263290611 114017540 114888199 828133 775217 11404005 12703796 630530922 686590294 55701407 74135392 76145574 69313234 196860808 198720115 328707789 342168741 X 299224421 341562520 2598712 2859033 301823133 344421553 630530922 686590294 X 84942813 -42344393 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22416868 22416868 374207342 166257881 207949461 1328670 933059 395611 269747488 240990231 28757257 3771414 3771414 263290611 Healthcare Related Joint Venture 11688529 C Demand Note - Health First Inc 100050164 C Demand Note - Health First Fdn 290473 C Other Temporarily Restricted Assets 2859033 C 114888199 Inter-Company Payable 36217635 Other Noncurrent Liabilities 1196926 Tax-exempt Bonds Held By Health First Inc. 161305554 198720115 X Part X, Line 2: FASB ASC 740 Footnote: The Company is exempt from Federal and State income taxes applicable under Section 501(a), as an organization described in section 501(c)(3), of the Internal Revenue Code and Section 220.13 of the Florida statutes, respectively. Accordingly, no provision for income taxes is made in the accompanying financial statements. ASC topic 740, Income Taxes, prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC topic 740 provides guidance for recognition threshold and measurement of a tax position taken or expected to be taken in a tax return. 1 1 X 1 X 0 1 1 0 1 1 34018561 8099343 25919218 0.05820 54248440 37819625 16428815 0.03690 5987696 293697 5693999 0.01280 94254697 46212665 48042032 0.10790 43926 0 43926 0.00010 1618887 0 1618887 0.00360 1095937 0 1095937 0.00250 1097523 0 1097523 0.00250 3856273 3856273 0.00870 98110970 46212665 51898305 0.11660 1 10797793 5296602 135190928 153823256 -18632328 X 1 1 1 Doctor's GI Partnership Inc Out-Patient Surgery 0.80000 0.00000 0.20000 2 Health First Quick Care LLC Emergent Care Clinic 0.51000 0.00000 0.49000 2 1 Holmes Regional Medical Center 1350 South Hickory Street Melbourne FL 32901 X X X X 2 Palm Bay Hospital 1425 Malabar Road NE Palm Bay FL 32907 X X X Holmes Regional Medical Center 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 0 0 1 1 X X X 1 0 X X 1 X 0 0 Palm Bay Hospital Inc 2 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 0 0 1 1 X X X 1 0 X X 1 X 0 0 Holmes Regional Medical Center Part V, Section B, Line 3: Part V, Sec B, Line 3:The Health Council of East Central Florida held phone interviews with the following persons who represent the community:Lisa Gurri, Brevard Health AllianceJennifer Floyd, Healthy Start Coalition of Brevard County, Inc.Christine Michaels, Melbourne/Palm Bay Chamber of CommerceHoward Tipton, Brevard County Manager's OfficeAra Deumedjian, MD, Brevard Medical SocietyDr. Kristi Van Sickle, FitDr. Jenny Gessler, Women's CenterLisa Rice, Brevard WorkforceKristin Bakke, Lead BrevardCindy Kane, Corporate Relations, Harris Corp.Shawna Kelsch, Reduce Obesity in Central Florida KidsKay Heimmer, Prevent! of BrevardIan Golden, Brevard County Housing & Human ServicesMaria Stahl, Brevard Co. Health DepartmentDr. Lana Saal, Brevard Public SchoolsJohnette Gindling, Space Coast Health FoundationPaul Ringenberger, Space Coast Volunteers In MedicineDr. John McPherson, Fire Rescue Medical DirectorDr. Rochelle Jones, The Coalition Of The Hungry & Homeless of Brevard County, Inc.Teresa Miles, Children's Home SocietyRob Rains, United Way of Brevard Palm Bay Hospital, Inc. Part V, Section B, Line 3: Part V, Sec B, Line 3:The Health Council of East Central Florida held phone interviews with the following persons who represent the community:Lisa Gurri, Brevard Health AllianceJennifer Floyd, Healthy Start Coalition of Brevard County, Inc.Christine Michaels, Melbourne/Palm Bay Chamber Of CommerceHoward Tipton, Brevard County Manager's OfficeAra Deumedjian, MD, Brevard Medical SocietyDr. Kristi Van Sickle, FitDr. Jenny Gessler, Women's CenterLisa Rice, Brevard WorkforceKristin Bakke, Lead BrevardCindy Kane, Corporate Relations, Harris Corp.Shawna Kelsch, Reduce Obesity In Central Florida KidsKay Heimmer, Prevent! Of BrevardIan Golden, Brevard County Housing & Human ServicesMaria Stahl, Brevard Co. Health DepartmentDr. Lana Saal, Brevard Public SchoolsJohnette Gindling, Space Coast Health FoundationPaul Ringenberger, Space Coast Volunteers in MedicineDr. John McPherson, Fire Rescue Medical DirectorDr. Rochelle Jones, the Coalition Of The Hungry & Homeless Of Brevard County, Inc.Teresa Miles, Children's Home SocietyRob Rains, United Way of Brevard Holmes Regional Medical Center Part V, Section B, Line 4: Part V, Sec B, Line 4: Cape Canaveral Hospital & Viera Hospital Palm Bay Hospital, Inc. Part V, Section B, Line 4: Part V, Sec B, Line 4: Cape Canaveral Hospital & Viera Hospital Holmes Regional Medical Center Part V, Section B, Line 7: Part V, Sec B, Line 7: Cancer - Due to existing cancer programs at Health First including Health First Holmes Regional Medical Center, Health First Cape Canaveral Hospital, Hospice Of Health First, and Health First Cancer Care Medical Group. Coronary Heart Disease - Due to risk factors of high blood pressure, high cholesterol and diabetes are same as those associated with cerebrovascular disease and cardiovascular disease and will be addressed in those implementation strategies.Binge drinking, youth substance abuse & youth cigarette smoking - These are being addressed through efforts of several community partners including Circles Of Care, Brevard Tobacco Initiative, And Prevent! Of Brevard Palm Bay Hospital, Inc. Part V, Section B, Line 7: Part V, Sec B, Line 7: Cancer - Due to existing cancer programs at Health First including Health First Holmes Regional Medical Center, Health First Cape Canaveral Hospital, Hospice Of Health First, and Health First Cancer Care Medical Group. Coronary Heart Disease - Due to risk factors of high blood pressure, high cholesterol and diabetes are same as those associated with cerebrovascular disease and cardiovascular disease and will be addressed in those implementation strategies.Binge drinking, youth substance abuse & youth cigarette smoking - These are being addressed through efforts of several community partners including Circles Of Care, Brevard Tobacco Initiative, And Prevent! Of Brevard Holmes Regional Medical Center Part V, Section B, Line 11: Health First does make provision for providing discounted care to low income individuals through processes and formularies which include consideration of individuals incomes in comparison to FPG. Discounts range from expected token payments (such as $100) to a 60% discount of billed charges. Palm Bay Hospital, Inc. Part V, Section B, Line 11: Health First does make provision for providing discounted care to low income individuals through processes and formularies which include consideration of individuals incomes in comparison to FPG. Discounts range from expected token payments (such as $100) to a 60% discount of billed charges. Holmes Regional Medical Center Part V, Section B, Line 14g: Part V, Sec B, Line 14g: Signage is posted in the emergency room, waiting rooms, & admissions, that the financial assistance policy is available upon request. Palm Bay Hospital, Inc. Part V, Section B, Line 14g: Part V, Sec B, Line 14g: Signage is posted in the emergency room, waiting rooms, & admissions, that the financial assistance policy is available upon request. Holmes Regional Medical Center Part V, Section B, Line 20d: Individuals that do not have insurance are eligible for a 60% prompt pay discount. This discount is approximately the average negotiated commercial insurance rate for those services at the hospital facility. Palm Bay Hospital, Inc. Part V, Section B, Line 20d: Individuals that do not have insurance are eligible for a 60% prompt pay discount. This discount is approximately the average negotiated commercial insurance rate for those services at the hospital facility. 2 Pro-Health Fitness Centers 1350 South Hickory Street Melbourne FL 32901 Health and Wellness Center Family Pharmacy 1350 South Hickory Street Melbourne FM 32901 Pharmacy Part I, Line 3c: Health First does make provision for providing discounted care to low income individuals through processes and formularies which include consideration of individuals incomes in comparison to FPG. Discounts range from expected token payments (such as $100) to a 60% discount of billed charges.Part I, Line 5b:Financial assistance expenses did not exceed the budgeted amount.Part I, Line 6a:The Community Benefit Report is prepared by Health First, Inc., the parent company to the organization. The community benefits of this organization are included within that report. Part I, Line 7: The organization calculated the cost amounts noted in Part I, Line 7 by utilizing the cost to charge ratio on worksheet S-10 on the medicare cost report. The cost addresses all patient segments reported on, including, but not limited to impatient, outpatient, Medicaid, uninsured, and Medicare. Part II, Community Building Activities: Community building activities are primarily subsidized by Health First, Inc. (Parent) and therefore are not reported at each individual hospital. The needs identified are, in part, based on the community needs assessment. Health First, Inc. utilized hours of paid physicians and nurses to support the community while on payroll. In addition, an amount in excess of $1.5M was contributed to various local organizations, primarily supporting the various community public health needs. Health First, Inc. also supported the economic development needs, provided other community support, participated in environmental improvements, coalition building projects, supported a community health improvement advocacy, and supported the local workforce development program. Health First, Inc. and its employees also actively support the local United Way in excess of $180k. Part III, Line 4: Bad Debt at cost is calculated by multiplying actual bad debt write-offs by the filing organization's cost-to-charge ratio.The organization used a cost to charge ratio to determine the cost amount of the bad debt expense. Worksheet 2, ratio of patient care cost to charges, as provided in the IRS instructions was used to validate the cost to charge ratio which approximates internal cost calculation.The organization provides uninsured accounts with a discount for prompt payment. The discount is not collected, nor pursued, and therefore not included in net patient revenue. The remaining balance is pursued, and if not collected, reported as a bad debt expense.The organization does not issue a standalone financial statement; however, it is included as a part of the Health First, Inc. consolidated financial statements. The footnote from the Health First, Inc. consolidated financial statements is as follows: The provision for bad debts and allowance for uncollectible accounts are based upon management's assessment of historical and expected net collections and historical write-off experience by payor and aging category, considering the business and economic conditions, trends in health care coverage, and other collection indicators. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added.The method the organization used to determine the amount that could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy if sufficient information had been available to make a determination of their eligibility is based on a collection scoring system. The scoring system attributed a recover score to each patient. It was then determined that patients below a certain score would typically qualify for charity care if they were to provide sufficient information. Part III, Line 8: The Organization derived its costing methodology used to determine the Medicare allowable costs reported in the organization's Medicare cost report by using cost report worksheets. Medicare costs are determined through the Medicare cost finding process which allocates general service center costs to revenue departments. Routine and ICU costs are determined based on an average cost per day multiplied by the number of Medicare allowable days. Medicare ancillary costs are determined by the ratio of department costs to department charges then the resulting % is applied to Medicare allowable charges. The methodology described in the instructions to Schedule H, Part III, Section B, Line 6 does not take into account all costs incurred by the hospital and does not represent the total community benefit conferred in this area. The reasons Medicare shortfall should be treated as community benefit are: absent the Medicare program, it is likely many of the individuals would qualify for financial assistance or other needs-based government programs; by accepting payment below cost to treat these individuals, the burdens of government are relieved with respect to these individuals; there is a significant possibility that continued reduction in reimbursement may actually create difficulties in access for these individuals; and the amount spent to cover Medicare shortfall is money not available to cover financial assistance and other community benefit needs. Part III, Line 9b: The organization applies the following procedures in its collection practices for those who may qualify for financial assistance:1. Patients or guarantors desiring to apply for financial assistance will be required to complete a Health First financial assistance application. The application process may begin at pre-admission or at any time thereafter. For financial assistance approval on elective procedures, please refer to policy addendum below.2. Income guidelines for qualification for financial assistance will be based on the Federal Poverty Guideline as furnished annually by the department of HRS.3. AHCA guidelines and documentation requirements will be used in establishing qualification for financial assistance. This documentation may include, but not be limited to, the following:a. Completed and signed financial assistance applicationb. Proof of household incomec. Credit bureau report and/or asset check4. Patients who are eligible for Medicaid will not be required to complete a financial assistance application.5. The financial assistance application and supporting documentation will be reviewed for propriety when determining eligibility for financial assistance.6. A notification letter will be sent to the guarantor or patient to communicate eligibility for financial assistance or denial.7. Patients who do not provide information necessary to completely and accurately assess their financial situation and/or who do not cooperate with efforts to secure other third party coverage will not be eligible for financial assistance.8. Patients who are uninsured and do not qualify for full or partial financial assistance will be eligible for Health First's prompt pay discount for self pay patients (PBS 5.12).9. All approved financial assistance applications will be valid for a period of 90 days. Approved tumor clinic applications are valid for a period of one year. Form 990, Schedule H: Part III, Section A, Line 1:The filing organization reports bad debt in accordance with generally accepted accounting principles (GAAP). Healthcare Financial Management Association Statement 15 is followed to the extent that it aligns with the guidelines set forth by GAAP. Part VI, Line 2: Health First, Inc. (Parent), on behalf of its member hospital organizations, partners with the Health Council of East Central Florida in assessing the health care needs of our community. The most recent community needs assessment report is available athttp://www.cflhealthymeasures.org./ Part VI, Line 3: It is the policy of Health First to grant financial assistance to eligible individuals who are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for health care services due to their limited financial resources. It is also the Health First policy to provide, without discrimination, care for emergency medical conditions (as defined by federal law known as "EMTALA") to individuals regardless of their eligibility for financial assistance under this policy.Information about Health First's financial assistance program shall be made available to patients and guarantors by various means, including the publication of notices in patient bills and by posting notices in the emergency and admitting departments, and at other public places the Health First facility may elect. Written summary information describing the policy along with financial assistance contact information will be made available to each patient in all emergency and admitting departments. The policy will also be posted on the Health First website. Such information shall be provided in the primary language spoken by the general populations served by the Health First facility.Any Health First associate or member of the medical staff may refer patients for financial assistance. A patient or a family member, close friend or associate of the patient may also make a request for financial assistance on behalf of the patient. Part VI, Line 4: Brevard County, also known as the Space Coast, stretches over 70 miles along the Atlantic coast best known as the location of the Kennedy Space Center, the "Space Coast" is also home to Port Canaveral, the world's busiest passenger cruise port. The county is unofficially divided into three sections, North County, comprising of Titusville, Mims, and Port St. John; Central Brevard, which includes Viera, Cocoa, Rockledge, Merritt Island, and Cocoa Beach; and South County, including Melbourne, Palm Bay, Grant, Valkaria and the South Beaches, which stretch to the border of Brevard and Indian River Counties.The population of Brevard County was 543,376 (based on July 2010 U.S. Census Data) and has grown to 554,117 in 2014. The county is over 82% White, 10% African American, and 8% other races. Hispanics/Latinos comprise 9%. The average household size is 2.33 persons. The population distribution is as follows: 19% under the age of 18, 59% from ages 18 to 64, and 22% who are 65 years of age or older. The median age is 46.5 years. In 2014, 9% of the residents lived in poverty compared with 12% statewide. There were 17.36% receiving SNAP benefits in 2012. According to the U.S. Bureau of Labor Statistics, the unemployment rate was 6.9% in November 2013. Statistics reveal that 90% of Brevard County residents have a high school diploma, compared with 86% statewide.The economy in Brevard County has taken a hit in recent years as has the economy in Florida. In 2010, the Brooking Institution reported that Brevard County ranked in the bottom fifth of the nation's top metro areas based on unemployment, gross metropolitan product, housing prices and foreclosed properties. There are seven acute care hospitals serving patients in Brevard County, Parrish Medical Center located in North County, Cape Canaveral Hospital, Viera Hospital and Wuesthoff Rockledge in Central County and Holmes Regional Medical Center, Wuesthoff Melbourne and Palm Bay Hospital in South County. Part VI, Line 5: The governing body of Holmes Regional Medical Center, Inc. is comprised of persons who primarily reside in the organization's primary service area and are neither employees nor contractors nor family members of the organization nor its key employees.The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments.The organization does apply resources throughout the year to support improvements in patient care, medical education and training. The organization spent more than $1.6M to support local students via training, education, and scholarship.Holmes Regional Medical Center, Inc. partnered with local organizations in the community that supported thousands of uninsured or underinsured Brevard residents who are otherwise unable to pay for healthcare services in excess of $1M in the year.The emergency departments at Holmes Regional Medical Center, Inc had more than 73,000 visits and the emergency department located at the Palm Bay Community Hospital (a department of Holmes Regional Medical Center, Inc.) had more than 42,000 visits during the year regardless of ability to pay. In addition, the organization participates in several government-sponsored health care programs including but not limited to Medicare, Medicaid, Champus, and Tricare.The Heart Center at Holmes performs more cardiac procedures than all other hospitals in Brevard and provides patients with all-private rooms. As the only state-accredited Level II trauma center in Brevard and Indian River Counties, Holmes Trauma Center offers 24/7 trauma care and rapid patient transport via first flight aeromedical helicopter. Additionally, the birth suites mother/baby unit offers Brevard's first Level II neonatal ICU for our tiniest patients.Holmes is also proud to be the first hospital in Brevard to offer state-of-the-art robotics-assisted surgery for urology, prostate, and gynecological conditions, advanced anterior hip replacement and reverse shoulder surgeries. Holmes is currently the only hospital in Brevard to offer life-changing interventional neuro-radiology procedures for advanced stroke treatment.Holmes Regional Medical Center, Inc. reinvests their net operating income to sustain its mission and prepare for the future. Part VI, Line 6: The roots of Health First run deep in Brevard, dating back to 1931 when Brevard Hospital first opened in Melbourne with 27 beds. Now known as Holmes Regional Medical Center (HRMC), the hospital is Brevard's largest, with 514 beds. Cape Canaveral Hospital (CCH) opened in 1962 with 44 beds, and has since grown to 150 beds. Palm Bay Hospital (PBH) opened in 1992 as a satellite of HRMC with 60 beds and has since grown to 152 beds. Viera Hospital (VH) opened in April of 2011 with 84 beds.Health First was formed when CCH, HRMC, and PBH joined together in August 1995 to create a truly integrated not-for-profit healthcare delivery system and fulfill a common mission of improving the health of our community. The first new services added in the Health First Family were Health First Physicians, opening in late 1995, and Health First Health Plans, opening in January 1996. Since then, we've also added Holmes Regional Trauma Center, Viera Hospital in April of 2011, Vitalwatch - electronic intensive care unit and many other services to our family.Other services include outpatient centers; the county's only trauma center; home care; specialized programs for cancer, diabetes, heart, stroke, and rehabilitative services; central Brevard's largest medical group; three fitness centers; and Medicare advantage, commercial POS, and commercial HMO health plans.Working together in a seamless system, Health First is devoted to integrating quality healthcare services with state-of-the-art technology. Health First also works together with other organizations and physicians in our community.Our associates are also actively building a healthier community through volunteering for organizations dedicated to preventing and treating health concerns such as cancer, diabetes, and heart disease. We're also proud of our associate giving program, supporting a variety of services and a patient and family care fund. Part VI, Line 7:Not applicable. Neither the filing organization nor any related organization files a community benefit report with any state other than the extent to which community benefit information is included in other reporting requirements, such as information provided to the Florida Hospital Association. 1 Brevard Health Alliance 3661 Babcock St Melbourne FL 32901 900068515 501(c)(3) 342081 Financial assistance to further advance the goals and mission of Brevard Health Alliance. Health First Foundation 3300 Fiske Blvd Rockledge FL 32955 593528774 501(c)(3) 48053 General support Brevard County Board of Commissioners 400 Fortenberry Rd Merritt Island FL 32952 596000523 657920 Health services to Brevard County's Medicaid & underinsured population Eastern Florida State College 1519 Clearlake Road Cocoa FL 32955 590920675 501(c)(3) 28515 General Support 4 0 Part I, Line 2: The Holmes Regional Medical Center Board monitors usage by each entity to assure funds raised are used appropriately. 1 0 0 0 0 0 0 0 0 Norberto Schechtmann MD Medical Staff President (out-going) 0 414347 0 0 0 6366 0 0 0 16657 0 437370 0 0 James S Mitchell III Exec VP COO HF Inc. 0 652202 0 0 0 257822 0 4242 0 15003 0 929269 0 0 Joseph G Felkner EVP/CFO 0 605323 0 0 0 91647 0 4274 0 16901 0 718145 0 0 David E Mathias SVP/Corporate Counsel 0 465350 0 0 0 62275 0 7800 0 16156 0 551581 0 0 Sean J Gregory President HRMC 0 489059 0 0 0 88016 0 0 0 16156 0 593231 0 0 Steven P Johnson President/CEO HF 0 1204481 0 0 0 421342 0 7800 0 14047 0 1647670 0 0 Robert R Wright President Community Hosp (out-going) 0 234240 0 0 0 375138 0 4729 0 18477 0 632584 0 0 Judith A Gizinski COO PBH 0 205956 0 0 0 3568 0 5882 0 16312 0 231718 0 0 Matthew E Troup COO HRMC 0 295908 0 0 0 4760 0 0 0 14869 0 315537 0 0 Charles T Behl Lead Pharmacist 0 153144 0 0 0 1837 0 4827 0 16735 0 176543 0 0 Tia Marie Rossana Pharmacist 0 181580 0 0 0 155 0 5774 0 6592 0 194101 0 0 Joseph Albert Gurri VP Med Affairs HRMC 0 373880 0 0 0 14419 0 3169 0 18338 0 409806 0 0 Marcia S Minnich-Barnes Pharmacist 0 147379 0 0 0 1671 0 2274 0 16450 0 167774 0 0 Kelly R Breedlove Interim CNO Admin Dir Nursing 0 163811 0 0 0 3302 0 3213 0 16757 0 187083 0 0 Nicholas E Pellegrino Director 0 487 0 0 0 107316 0 0 0 0 0 107803 0 82700 Brian J Bussen Director 0 8211 0 0 0 92899 0 0 0 0 0 101110 0 62971 A Thomas Hollingsworth PhD Director 0 8119 0 0 0 77862 0 0 0 0 0 85981 0 54675 Robert C Galloway SVP CFO 0 14516 0 0 0 100493 0 0 0 0 0 115009 0 0 Jerry Senne President/CEO HRMC 0 67220 0 0 0 727585 0 0 0 0 0 794805 0 0 Part I, Line 4a The following individuals received a severance payment for their service to Holmes Regional Medical Center, Inc.: Robert R. Wright $193,948 Jerry Senne $161,836 Form 990, Schedule J: Compensation is paid by Health First, Inc. EIN:59-3336894 and reimbursed by Holmes Regional Medical Center, Inc. Salary and benefit expenses disclosed in part IX is allocated to this entity. Amounts reported in Column F represent deferred compensation previously reported on prior years' Form 990. The filing organization relied on Health First for establishing the top management official's compensation. See Core 990, part VI, Section B, Line 15 on Schedule O for further information regarding the process utilized. Form 990, Part VI, Section A, line 6 The sole member of Holmes Regional Medical Center, Inc. is Health First, Inc., a Florida not-for-profit corporation that serves as the corporate parent of the health system. Form 990, Part VI, Section A, line 7a Health First, Inc. (HFI), a section 501(c)(3) exempt organization and the parent of the exempt healthcare system, is the sole corporate member of the filing organization. Form 990, Part VI, Section A, line 7b Per the bylaws and the laws of the state of Florida, the administrative power of the corporation shall be vested in the Board of Directors which shall have charge, control and management of property, affairs and funds of the corporation. The Board of Directors shall not take any action with respect to the following without approval of the member: -Change in the mission, purpose or scope of the corporation and its operation; -Incurrence of debt or guarantee the debt of another; -Approval of the sale, lease, purchase, conveyance or other disposition of any real or personal property having a total capitalized cost in excess of $1,000,000; -Approval of the sale, lease, purchase, conveyance or other disposition of all or substantially all the assets of the organization; -Approval of annual operating and capital expenditure budgets and any material deviations therefrom; -Appointment or engagement of auditors, legal counsel or consultants; -Creation, acquisition, sale, purchase, dissolution or other disposition of any affiliated or controlled entity or joint venture or any interest in such entity; -Relocation, implementation or discontinuation of a major program service. -Capital expenditures and capital leases exceeding $1,000,000 in total. Form 990, Part VI, Section B, line 11 After review and approval by the Chief Financial Officer the Form 990 is sent to each member of the Board of Directors electronically for their review and approval prior to filing. Form 990, Part VI, Section B, line 12c A copy of the Conflict of Interest policy is provided to all associates, including management, in which they review and electronically attest that they have agreed to the terms noted in the policy on an annual basis. In addition, Senior Leadership and BOD members on an annual basis are required to complete a Conflict of Interest questionnaire prepared and monitored by the Chief Compliance Officer. The questionnaire requires an attestation stating that the individual is free of conflicts should they not report anything of concern. These forms are tracked and kept on file. Should a conflict arise, the Chief Compliance Officer investigates the issue and determines a course of action to ensure enforcement of the policy. Form 990, Part VI, Section B, line 15 The salaries of our CEO and other Health First executives are reviewed and recommended annually to the Board of Trustees and approved in executive session by the full Board of Health First. Health First contracts annually with a highly respected national consulting firm, to provide these recommendations to ensure that our executives are compensated fairly and competitively when compared with similar roles in other healthcare organizations nationally. The Compensation Committee is independent for Internal Revenue Code Section 4958 for the individuals whose salary is reviewed. Minutes are kept for all Board of Directors and Compensation Committee meetings. The process is documented contemporaneously in the Board and Committee meetings. Form 990, Part VI, Section C, line 19 Quarterly and annually consolidated financials and consolidated statistical information is filed electronically on www.dacbond.com and is available to the public. In addition, any requests made to the Chief Financial Officer for the above referenced items are provided upon request in a timely manner. A copy of the conflicts of interest policy is available upon request to the Compliance Officer. Documents are available for the same period of disclosure as provided in Section 6104(d). Form 990, Part XI, line 9: Transfer of net assets to a related tax-exempt -42,604,715. Change in temporarily restricted net assets 260,322. FORM 990, PART XII, QUESTION 2C, AUDITED FINANCIAL STATEMENT: The Audit Committee of Health First reviews and approves the annual audit and compliance audit plans then makes its report to the Health First Board of Directors. The Audit Committee is responsible for the selection of the independent auditors. There was no change from prior year. FORM 990, PART IV, QUESTION 24A, BONDS ISSUED AFTER DECEMBER 31, 2002: The filing organization is part of an obligated group that had more than $100,000 in bonds issued after December 31, 2002 that were outstanding on the last day of its tax year. The filing organization's share of these obligations is reported on Part X, Line 20 of Health First, Inc. The parent of the obligated group, is filing Schedule K on behalf of itself and all members of the obligated group. FORM 990, PART V, QUESTION 2A, NUMBER OF EMPLOYEES: Employees at Holmes Regional Medical Center, Inc. are included in the Form 941 filed by Health First, Inc. Ein: 59-3336894 Cape Canaveral Hospital Inc 3300 Fiske Blvd Rockledge FL 32955 592477479 Hospital FL 501(c)(3) Line 3 Health First Inc 1 Hospice of Health First Inc 3300 Fiske Blvd Rockledge FL 32955 591911574 Healthcare FL 501(c)(3) Line 9 Health First Inc 1 Health First Foundation Inc 3300 Fiske Blvd Rockledge FL 32955 593528774 Fundraising FL 501(c)(3) Line 7 Health First Inc 1 Health First Inc 3300 Fiske Blvd Rockledge FL 32955 593336894 Support Org FL 501(c)(3) Line 11c, III-FI N/A 0 Viera Hospital Inc 3300 Fiske Blvd Rockledge FL 32955 264019868 Hospital FL 501(c)(3) Line 3 Health First Inc 1 Health First Quickcare LLC 3300 Fiske Blvd Rockledge FL 32955 900520186 Healthcare FL Holmes Regional Medical Center Related -14322 49141 0 0 0.51000 Doctors GI Partnership Ltd 3300 Fiske Blvd Rockledge FL 32955 593758988 Healthcare FL Holmes Regional Medical Center Related 607444 1268181 0 1 0.80000 Doctor's Surgical Partnership Ltd 3300 Fiske Blvd Rockledge FL 32955 593490279 Healthcare FL Health First Inc Related 0 0 Cape Health Properties Inc 3300 Fiske Blvd Rockledge FL 32955 593086711 Real Estate FL Cape Canaveral Hospital Inc C 0 Health First Medical Management Inc 3300 Fiske Blvd Rockledge FL 32955 593348252 Health Care FL Health First Holding Corp C 0 Health First Physicians Inc 3300 Fiske Blvd Rockledge FL 32955 593346397 Health Care FL Health First Holding Corp C 0 Holmes Regional Enterprises Inc 3300 Fiske Blvd Rockledge FL 32955 592109953 Real Estate FL Health First Holding Corp C 0 Health First Health Plans Inc 3300 Fiske Blvd Rockledge FL 32955 593315064 Health Care FL Health First Holding Corp C 0 Health First Insurance Inc 3300 Fiske Blvd Rockledge FL 32955 453131932 Health Care FL Health First Holding Corp C 0 Health First Holding Company & Subs 3300 Fiske Blvd Rockledge FL 32955 593509709 Holding Corp. FL Health First Inc C 0 0 1 1 0 0 0 0 1 0 1 1 1 1 0 0 1 1 0 0 Cape Canaveral Hospital Inc J 86463 Cape Canaveral Hospital Inc L 733060 Health First Foundation Inc C 551051 Health First Foundation Inc J 69738 Viera Hospital Inc L 330740 Viera Hospital Inc M 74456 Viera Hospital Inc Q 89550 Cape Canaveral Hospital Inc Q 342912 Hospice of Health First Inc Q 118664 Form 990, Schedule R, Part V, Schedule R Disclosures: All transactions reported in this section are based upon corporate books and records which are kept according to Generally Accepted Accounting Standards.