CAPE CANAVERAL HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CAPE CANAVERAL HOSPITAL INC (EIN 59-2477479)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-13
- IRS object ID
- 201422259349300532
- Schema version
- 2012v2.1
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-13T08:19:03-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 SWACKER DRIVE STE 800 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592477479 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cape Canaveral Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAPE | NameControl |
| Phone | 3214345150 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 Fiske Blvd | AddressLine1 |
| City | Rockledge | City |
| State | FL | State |
| ZIP Code | 329554305 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joseph G Felkner | Name |
| Title | Exec VP/CFO | Title |
| Phone | 3214345150 | Phone |
| Date Signed | 2014-07-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wayne Harder | Name |
| PTIN | P00294296 | PTIN |
| Phone | 3126343400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Steven P Johnson | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 Fiske Blvd | AddressLine1 |
| City | Rockledge | City |
| State | FL | State |
| ZIP Code | 329554305 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 107651408 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HEALTH-FIRST.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | Our team positively changing the health and well-being of you and your family through excellent and compassionate health care.Cape Canaveral Hospital is a full-service, not-for-profit hospital with services including a 21-bed level II emergency department, a certified baby-friendly mother/baby unit, fully equipped surgical services, a state-of-the-art cancer program and a full-service laboratory. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 623 | TotalNbrVolunteers |
| Total Gross UBI | 69921 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -85649 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 170500 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 51188 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 108176841 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 106736870 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 48338 | InvestmentIncomePriorYear |
| Investment Income Current Year | -38646 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1036848 | OtherRevenuePriorYear |
| Other Revenue Current Year | 822743 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 109432527 | TotalRevenuePriorYear |
| Total Revenue Current Year | 107572155 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4887276 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 23229 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 55301918 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 54688236 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 45544694 | OtherExpensePriorYear |
| Other Expenses Current Year | 43170798 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 105733888 | TotalExpensesPriorYear |
| Total Expenses Current Year | 97882263 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3698639 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9689892 | RevenuesLessExpensesCY |
| Total Assets BOY | 155087950 | TotalAssetsBOY |
| Total Assets EOY | 159736167 | TotalAssetsEOY |
| Total Liabilities BOY | 82864809 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 82704118 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 72223141 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 77032049 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Our team positively changing the health and well-being of you and your family through excellent and compassionate health care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 82941579 | Expense |
| Grants | 23229 | Grants |
| Revenue | 106666949 | Revenue |
| Description | Cape Canaveral Hospital, Inc. (CCH ) features 150 beds and has 279 highly skilled medical staff members. The women's diagnostic center features state-of-the-art, personalized services including digital mammography, ultrasound, stereotactic breast biopsy, and MRI breast imaging and is accredited by theAmerican College of Radiology and the US Food and Drug Administration. The facility also operates a 7 suite operating room and 2 suite cath lab available for both inpatient and outpatient procedures.Additionally, Cape Canaveral Hospital includes a 21-bed Level II emergency department and an adjoining six-story medical plaza that includes physician's offices, a conference center, pre-operative testing, outpatient registration for laboratory testing and same-day surgery, as well as a health resource center for the community. Cape Canaveral Hospital provides quality medical healthcare regardless of race, creed, gender, national origin, handicap, age or ability to pay, although reimbursement for services rendered is critical to the operation and stability of Cape Canaveral Hospital, Inc.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 healthcare 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, community education programs, special programs for elderly, handicapped, and mentally underserved along with a variety of broad community support activities.See our Health First Community Benefit video @www.health-first.org/cr2013 | Description |
| Total Program Service Expense | 82941579 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joseph G Felkner | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3214345150 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 Fiske Blvd | AddressLine1 |
| City | Rockledge | City |
| State | FL | State |
| ZIP Code | 32955 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| James C Shaw | |||||||||
| Chairman | 1.00 | 3.00 | X | X | 0 | 9110 | 27650 | ||
| Catherine A Ford | |||||||||
| Vice Chairman | 1.00 | 3.00 | X | X | 0 | 10640 | 16050 | ||
| Eugene S Cavallucci Esq | |||||||||
| Secretary | 1.00 | 3.00 | X | X | 0 | 6313 | 19850 | ||
| Kevin B Steele | |||||||||
| Treasurer | 1.00 | 4.00 | X | X | 0 | 0 | 22800 | ||
| Robert R Wright | |||||||||
| President Community Hosp | 13.00 | 28.00 | X | X | 0 | 521533 | 26132 | ||
| Nicholas E Pellegrino | |||||||||
| Immediate Past Chairman | 1.00 | 3.00 | X | 0 | 1487 | 15300 | |||
| A Thomas Hollingsworth PhD | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 10552 | 15150 | |||
| Brian J Bussen | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 9110 | 14300 | |||
| James Dwight | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 0 | |||
| Cathy Eddy | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 0 | |||
| Pamela A Gatto | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 4804 | 9150 | |||
| Donald F Hagen MD | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 10000 | |||
| Martin W Isenman MD | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 0 | |||
| Richard McNeight | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 0 | |||
| Frances Pickett | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 0 | |||
| William C Potter Esq | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 1000 | 20550 | |||
| Kevin S Pruett | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 800 | 15200 | |||
| Bryan R Roub | |||||||||
| Director | 1.00 | 3.00 | X | 0 | 0 | 10000 | |||
| Steven P Johnson | |||||||||
| President/CEO HF | 1.00 | 44.00 | X | X | 0 | 1320804 | 13203 | ||
| Robert Bashore MD | |||||||||
| Medical Staff President | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| Todd F Bibens | |||||||||
| Director of Clinical Nursing | 40.00 | 0.00 | 0 | 154098 | 12161 | X | |||
| Rodney R Moore | |||||||||
| VP Medical Management | 40.00 | 0.00 | 0 | 357509 | 7603 | X | |||
| Wesley C Ott | |||||||||
| COO Cape Canaveral Hospital | 40.00 | 0.00 | 0 | 172781 | 20716 | X | |||
| Ronald C McGrier Jr | |||||||||
| Pharmacy Manager | 40.00 | 0.00 | 0 | 148091 | 8994 | X | |||
| Tracy L Lott Longobardi | |||||||||
| Director of Clinical Nursing | 40.00 | 0.00 | 0 | 139149 | 18761 | X | |||
| Tony Hernandez III Esq | |||||||||
| Chairman (Out-going) | 1.00 | 1.00 | 0 | 18830 | 4950 | X | |||
| Judith A George | |||||||||
| Secretary/Treasurer (Out-going) | 1.00 | 2.00 | 0 | 76519 | 1150 | X | |||
| James E Carter MD | |||||||||
| Director (Out-going) | 1.00 | 1.00 | 0 | 66643 | 54800 | X | |||
| George W Lewis | |||||||||
| Director (Out-going) | 1.00 | 1.00 | 0 | 68713 | 6750 | X | |||
| Alphonse Pecoraro Jr MD | |||||||||
| Medical Staff President (Out-going) | 1.00 | 0.00 | 0 | 356566 | 17851 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3455052 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 389071 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Health First Inc | |||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | Management Support | 84683896 |
| Holmes Regional Medical Center Inc | |||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | Hospital Services | 865859 |
| Cape Health Properties Inc | |||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | Real Estate Services | 149628 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Related Organizations | 51188 | RelatedOrganizations |
| Total Contributions | 51188 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Patient Services | 621110 | 74774689 | 74774689 | |
| Medicare/Medicaid | 621110 | 31805805 | 31805805 | |
| Reference Lab | 621500 | 69921 | 69921 | |
| Medical Monitoring | 900099 | 65815 | 65815 | |
| Related Company Rent | 531120 | 20640 | 20640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 106736870 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40607 | TotalRevenueColumn |
| Exclusion | $40,607 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 324 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 324 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 324 | TotalRevenueColumn |
| Exclusion | $324 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 79253 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -79253 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -79253 | TotalRevenueColumn |
| Exclusion | -$79,253 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Cafeteria | Description |
| Business Code | 722210 | BusinessCode |
| Total Revenue Column | 641672 | TotalRevenueColumn |
| Exclusion | $641,672 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 180747 | TotalRevenueColumn |
| Exclusion | $180,747 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 822419 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107572155 | TotalRevenueColumn |
| Related Or Exempt Function Income | 106666949 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 69921 | UnrelatedBusinessRevenue |
| Exclusion | $784,097 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23229 | Total |
| Program Services | 23229 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 702758 | Total |
| Management And General | 702758 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40794355 | Total |
| Program Services | 37328908 | ProgramServices |
| Management And General | 3465447 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 874235 | Total |
| Program Services | 836011 | ProgramServices |
| Management And General | 38224 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8977697 | Total |
| Program Services | 7262627 | ProgramServices |
| Management And General | 1715070 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3339191 | Total |
| Program Services | 2984702 | ProgramServices |
| Management And General | 354489 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 883848 | Total |
| Management And General | 883848 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107136 | Total |
| Management And General | 107136 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 854 | Total |
| Management And General | 854 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6095638 | Total |
| Program Services | 4437551 | ProgramServices |
| Management And General | 1658087 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140011 | Total |
| Program Services | 7684 | ProgramServices |
| Management And General | 132327 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1120124 | Total |
| Program Services | 881200 | ProgramServices |
| Management And General | 238924 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1846149 | Total |
| Program Services | 14746 | ProgramServices |
| Management And General | 1831403 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2116202 | Total |
| Program Services | 1976229 | ProgramServices |
| Management And General | 139973 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322175 | Total |
| Program Services | 304394 | ProgramServices |
| Management And General | 17781 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20023 | Total |
| Program Services | 7471 | ProgramServices |
| Management And General | 12552 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3597500 | Total |
| Program Services | 3542664 | ProgramServices |
| Management And General | 54836 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7594472 | Total |
| Program Services | 5640227 | ProgramServices |
| Management And General | 1954245 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 797018 | Total |
| Management And General | 797018 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 12618012 | 12606471 | 11541 |
| Maintenance & Repair | 2426115 | 2269611 | 156504 |
| Florida Indigent Tax | 1223284 | 1223284 | 0 |
| Licenses & Taxes | 75412 | 30605 | 44807 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2186825 | Total |
| Program Services | 1563965 | ProgramServices |
| Management And General | 622860 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97882263 | Total |
| Program Services | 82941579 | ProgramServices |
| Management And General | 14940684 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59193698 | BOY |
| EOY | 65450734 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9507647 | BOY |
| EOY | 10967934 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 218125 | BOY |
| EOY | 1386958 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2320511 | BOY |
| EOY | 2990048 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 328325 | BOY |
| EOY | 310621 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 165959942 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 116422011 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53745266 | BOY |
| EOY | 49537931 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27985910 | BOY |
| EOY | 28155765 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 576875 | BOY |
| EOY | 617517 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1211593 | BOY |
| EOY | 318659 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155087950 | BOY |
| EOY | 159736167 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6276356 | BOY |
| EOY | 4910470 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37306293 | BOY |
| EOY | 15072940 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39282160 | BOY |
| EOY | 62720708 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82864809 | BOY |
| EOY | 82704118 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71089984 | BOY |
| EOY | 75819600 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1133157 | BOY |
| EOY | 1212449 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72223141 | BOY |
| EOY | 77032049 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155087950 | BOY |
| EOY | 159736167 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9689892 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4880984 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 71173 | OtherCostOrOtherBasis |
| Book Value | 71173 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87458817 | OtherCostOrOtherBasis |
| Depreciation | 46926627 | Depreciation |
| Book Value | 40532190 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 865174 | OtherCostOrOtherBasis |
| Depreciation | 723267 | Depreciation |
| Book Value | 141907 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 77440431 | OtherCostOrOtherBasis |
| Depreciation | 68772117 | Depreciation |
| Book Value | 8668314 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 124347 | OtherCostOrOtherBasis |
| Book Value | 124347 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 49537931 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Demand Note - Health First Inc. | 20762347 | C |
| Demand Note - Health First Foundation | 719672 | C |
| Other Temporarily Restricted Net Assets | 1212449 | C |
| Investment In Joint Ventures - Coastal Health | 2167884 | C |
| Investment In Joint Affiliates - Cape Health Properties | 3293413 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 28155765 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Other Current Liabilities | $7,903,677 |
| Intercompany Payable | $6,764,342 |
| Other Noncurrent Liabilities | $1,952,624 |
| Tax-exempt bonds held by Health First, Inc. | $46,100,065 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 62720708 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X, Line 2: | ReturnReference |
| Explanation | FIN 48 footnote: The Company is exempt from Federal and State income taxes 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 attributes for the Financial Statement recognition and measurement of a tax position taken or expected to be taken in a tax return. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4963990 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1382423 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3581567 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03660 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9374259 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4723857 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4650402 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04750 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1223284 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1223284 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01250 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15561533 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6106280 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9455253 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09660 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5434 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5434 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 429266 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 429266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 517475 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27860 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 489615 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23229 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 23229 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 975404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27860 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 947544 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16536937 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6134140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10402797 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10630 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,829,239 | BadDebtExpenseAmount |
| Amount Attributable To | 876737 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 27081948 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 31819331 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4737383 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cape Canaveral Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W Cocoa Beach Cswy | AddressLine1 |
| City | Cocoa Beach | City |
| State | FL | State |
| ZIP Code | 32931 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Acute Care Hospital | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cape Canaveral Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Health First Aging Institute | ||||
| 701 W Cocoa Beach Cswy | Cocoa Beach | FL | 32931 | Elder Care |
| Health First Home Care | ||||
| 701 W Cocoa Beach Cswy | Cocoa Beach | FL | 32931 | In-Home Care |
Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| 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 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 its current cost accounting system. The cost accounting system addresses all patient segments reported on, including, but not limited to inpatient, outpatient, Medicaid, uninsured, and Medicare. | |
| Part II: 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 $195k. | |
| 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. | |
| 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 V, Section 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 | Cape Canaveral Hospital |
| Part V, Section B, Line 4: Holmes Regional Medical Center, Palm Bay Hospital, Viera Hospital | Cape Canaveral Hospital |
| Part V, Section 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. | Cape Canaveral Hospital |
| 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. | Cape Canaveral Hospital |
| Part V, Section B, Line 14g: Signage is posted in the emergency room, waiting rooms, & admissions, that the financial assistance policy is available upon request. | Cape Canaveral Hospital |
| 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. | Cape Canaveral Hospital |
| 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 at http://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 bemade available to patients and guarantors by various means, including thepublication of notices in patient bills and by posting notices in theemergency and admitting departments, and at other public places the HealthFirst facility may elect. Written summary information describing thepolicy along with financial assistance contact information will be madeavailable to each patient in all emergency and admitting departments. Thepolicy will also be posted on the Health First website. Such informationshall 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 referpatients for financial assistance. a patient or a family member, closefriend or associate of the patient may also make a request for financialassistance 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 Titusville, Mims, and Port St. John; Central Brevard, which includes Viera, Cocoa, Rockledge, Merritt Island, and Cocoa Beach; and South County, which includes Melbourne, Palm Bay, Grant, Valkaria and the South Beaches which stretch to the line between Brevard and Indian River Counties. According to July 2013 US census data, the population of Brevard County was 543,376 in 2010 and has grown to an estimated population of 550,823 in 2013. The county is over 84% white, 11% African American, and 5% other races. Hispanics/Latinos comprise 9%.The average household size is 2.43 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 45 years. In 2012, 12.5% of the residents live in poverty compared with 15.6% 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 theeconomy in Florida. In 2010, the brooking institution reported thatBrevard County ranked in the bottom fifth of the nation's top metro areasbased on unemployment, gross metropolitan product, housing prices andforeclosed 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 HolmesRegional Medical Center, Wuesthoff Melbourne and Palm Bay Hospital inSouth County. | |
| Part VI, Line 5: The governing body of Cape Canaveral Hospital, Inc. is comprised of persons who primarily reside in the organization's primary service area and are neither employees nor contractors nor family membersof the organization nor its key employees.The organization extends medical staff privileges to all qualifiedphysicians in its community for some or all of its departments.The organization does apply resources throughout the year to supportimprovements in patient care, medical education and training. The organization spent more than $420k to support local students via training, education, and scholarship.The emergency department at Cape Canaveral Hospital, Inc. had more than27,000 visits during the year regardless of ability to pay. In additionthe organization participates in several government sponsored health careprograms, including, but not limited to, Medicare, Medicaid, Champus, andTricare.Cape Canaveral Hospital, Inc. reinvest their net operating income tosustain 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 August1995 to create a truly integrated not-for-profit healthcare deliverysystem and fulfill a common mission of improving the health of ourcommunity. The first new services added in the Health First Family wereHealth First Physicians, opening in late 1995, and Health First HealthPlans, opening in January 1996. Since then, we've also added, HolmesRegional 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 traumacenter; home care; specialized programs for cancer, diabetes, heart,stroke, and rehabilitative services; Central Brevard's largest medicalgroup; three fitness centers; and Medicare advantage, commercial POS, andcommercial HMO health plans.Working together in a seamless system, Health First is devoted tointegrating quality healthcare services with state-of-the-art technology.Health First also works together with other organizations and physiciansin our community.Our associates are also actively building a healthier community throughvolunteering for organizations dedicated to preventing and treating healthconcerns such as cancer, diabetes, and heart disease. We're also proud ofour associate's charitable giving plan, EAGLES (Every Associate's GiftLeaves Everlasting Spirit), that promotes tissue and organ donorawareness, provides dental services for Brevard Health Alliance patients,and supports the Bright Star center for grieving children & families.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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Health First Foundation Inc | |||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593528774 | 501(c)(3) | 20229 | General Support |
| Health Council of East Central Florida | |||||||
| 2461 W State Road 426 Suite 2041 | Oviedo | FL | 32765 | 592227752 | 501(c)(3) | 3000 | General Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The Cape Canaveral Hospital Board monitors usage by each entity to assure funds are raised and used appropriately. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert R Wright | ||||||||||||||
| President Community Hosp | 0 | 389982 | 0 | 0 | 0 | 131551 | 0 | 7600 | 0 | 18532 | 0 | 547665 | 0 | 13995 |
| Steven P Johnson | ||||||||||||||
| President/CEO HF | 0 | 1081750 | 0 | 0 | 0 | 239054 | 0 | 0 | 0 | 13203 | 0 | 1334007 | 0 | 21758 |
| Todd F Bibens | ||||||||||||||
| Director of Clinical Nursing | 0 | 153294 | 0 | 0 | 0 | 804 | 0 | 4932 | 0 | 7229 | 0 | 166259 | 0 | 0 |
| Rodney R Moore | ||||||||||||||
| VP Medical Management | 0 | 112034 | 0 | 0 | 0 | 245475 | 0 | 2335 | 0 | 5268 | 0 | 365112 | 0 | 0 |
| Wesley C Ott | ||||||||||||||
| COO Cape Canaveral Hospital | 0 | 167524 | 0 | 0 | 0 | 5257 | 0 | 3853 | 0 | 16863 | 0 | 193497 | 0 | 0 |
| Ronald C McGrier Jr | ||||||||||||||
| Pharmacy Manager | 0 | 147836 | 0 | 0 | 0 | 255 | 0 | 2294 | 0 | 6700 | 0 | 157085 | 0 | 0 |
| Tracy L Lott Longobardi | ||||||||||||||
| Director of Clinical Nursing | 0 | 138447 | 0 | 0 | 0 | 702 | 0 | 4363 | 0 | 14398 | 0 | 157910 | 0 | 0 |
| Tony Hernandez III Esq | ||||||||||||||
| Chairman (Out-going) | 0 | 8193 | 0 | 0 | 0 | 10637 | 0 | 4950 | 0 | 0 | 0 | 23780 | 0 | 5625 |
| Judith A George | ||||||||||||||
| Secretary/Treasurer (Out-going) | 0 | 9762 | 0 | 0 | 0 | 66757 | 0 | 1150 | 0 | 0 | 0 | 77669 | 0 | 51025 |
| James E Carter MD | ||||||||||||||
| Director (Out-going) | 0 | 9803 | 0 | 0 | 0 | 56840 | 0 | 4800 | 0 | 0 | 0 | 71443 | 0 | 51825 |
| George W Lewis | ||||||||||||||
| Director (Out-going) | 0 | 8675 | 0 | 0 | 0 | 60038 | 0 | 6750 | 0 | 0 | 0 | 75463 | 0 | 49425 |
| Alphonse Pecoraro Jr MD | ||||||||||||||
| Medical Staff President (Out-going) | 0 | 354856 | 0 | 0 | 0 | 1710 | 0 | 0 | 0 | 17851 | 0 | 374417 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Lines 4a-b | The following individuals received severance payments for their service to Health First, Inc.: Rodney Moore, $244,344 Health First, Inc has a non-qualified SERP for certain executives. The SERP was terminated during the 2012 tax year, and all amounts deferred were paid out. The payouts are included in column B(iii), and there is no representation per column C as the payout was made in the same year. Amounts reported as deferred in prior years have now been paid out with the closure of the plan and are included with column B(iii) and represented per column F due to prior deferral. Below are the 2012 deferred amounts: Robert Wright, $2,613 Steven Johnson, 183,012 | |
| Part III | Compensation is paid by Health First, Inc. EIN: 59-3336894 and reimbursed by Cape Canaveral Hospital, 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, number 15 for further information regarding the process utilized. James E. Carter received payments of $50,000 from Health First, Inc. reported in Box 3 of 1099-MISC. This compensation is not reported on Schedule J, Part II. | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The sole member of Cape Canaveral Hospital, 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 long-term 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 of 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. -The repeal, amendment, or restatement of articles of incorporation and bylaws of the corporation; and -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. | |
| Form 990, Part VI, Section B, line 12c | A copy of the conflict of interest policy is provided to all BOD members, officers, management, and associates in which they review and sign that they have agreed to the terms noted in the policy on an annual basis. In addition, all management, officers, and BOD members on an annual basis are required to fill out a conflict of interest questionnaire prepared and monitored by the Chief Compliance Officer. The questionnaire requires an attestation in regards to stating 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 compensation process is determined by the parent company. The parent company's process is as follows: the salaries of our CEO and other health executives are reviewed and recommended annually to the Board of Directors 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 | 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. | |
| Form 990, Part XI, line 9: | Transfer of net assets to a related tax-exempt -4,960,276. Change in temporarily restricted net assets 79,292. | Changes in Net Assets or Fund Balances: |
| 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 Cape Canaveral Hospital, Inc. are included in the Form 941 filed by Health First, Inc. EIN: 59-3336894. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Health First Inc | |||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593336894 | Support Org | FL | 501(c)(3) | Line 11c, III-FI | N/A | 0 | |
| Holmes Regional Medical Center Inc | |||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 590624371 | Hospital | FL | 501(c)(3) | Line 3 | 1 | Health First Inc | |
| Hospice of Health First Inc | |||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 591911574 | Healthcare | FL | 501(c)(3) | Line 9 | 1 | Health First Inc | |
| Health First Foundation Inc | |||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593528774 | Fundraising | FL | 501(c)(3) | Line 7 | 1 | Health First Inc | |
| Viera Hospital Inc | |||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 264019868 | Hospital | FL | 501(c)(3) | Line 3 | 1 | Health First Inc | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Cape Health Properties Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593086711 | Real Estate | FL | Cape Canaveral Hospital Inc | C | 1.00000 | 0 |
| Health First Medical Management Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593348252 | Health Care | FL | Health First Holding Corp Inc | C | 0 | |
| Health First Physicians Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593346397 | Health Care | FL | Health First Holding Corp Inc | C | 0 | |
| Holmes Regional Enterprises Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 592109953 | Real Estate | FL | Health First Holding Corp Inc | C | 0 | |
| Health First Health Plans Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593315064 | Health Care | FL | Health First Holding Corp Inc | C | 0 | |
| Health First Insurance Inc | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 453131932 | Health Care | FL | Health First Holding Corp Inc | C | 0 | |
| Health First Holding Company & Subs | ||||||||||
| 3300 Fiske Blvd | Rockledge | FL | 32955 | 593509709 | Holding Corp. | FL | Health First Inc | C | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Health First Foundation Inc | |
| C | 51188 |
| Holmes Regional Medical Center Inc | |
| K | 68061 |
| Cape Health Properties Inc | |
| K | 132583 |
| Health First Health Plans Inc | |
| L | 19134152 |
| Viera Hospital Inc | |
| L | 64798 |
| Holmes Regional Medical Center Inc | |
| M | 797798 |
| Health First Physicians Inc | |
| P | 80783 |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Form 990, Schedule R, Part V, Schedule R Disclosures: | ReturnReference |
| Explanation | All transactions reported in this section are based upon corporate books and records which are kept according to Generally Accepted Accounting Standards. | Explanation |