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UNIVERSITY COMMUNITY HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
UNIVERSITY COMMUNITY HOSPITAL INC (EIN 59-1113901)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-10
IRS object ID
201443149349303089
Schema version
2013v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-10T18:34:13-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN591113901EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1University Community Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlUNIVBusinessNameControlTxt
Phone8139716000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13100 East Fletcher AvenueAddressLine1
CityTampaCity
StateFLState
ZIP Code336134688ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLynn AddiscottPersonNm
Person TitleAssistant SecretaryPersonTitleTxt
Phone8139716000PhoneNum
Signature2014-11-10SignatureDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Florida Hospital TampaBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerBrian AdamsPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13100 East Fletcher AvenueAddressLine1
CityTampaCity
StateFLState
ZIP Code336134688ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$510,079,091GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.floridahospital.com/tampaWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionThe provision of medical care to the community through the operation of two hospitals and a long-term acute care facility.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee4340TotalEmployeeCnt
Total Volunteers415TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$610,870PYContributionsGrantsAmt
CY Contributions Grants$527,038CYContributionsGrantsAmt
PY Program Service Revenue$494,364,487PYProgramServiceRevenueAmt
CY Program Service Revenue$504,175,518CYProgramServiceRevenueAmt
PY Investment Income$3,906,893PYInvestmentIncomeAmt
CY Investment Income$2,213,894CYInvestmentIncomeAmt
PY Other Revenue$4,787,098PYOtherRevenueAmt
CY Other Revenue$3,162,641CYOtherRevenueAmt
PY Total Revenue$503,669,348PYTotalRevenueAmt
CY Total Revenue$510,079,091CYTotalRevenueAmt
PY Grants And Similar Paid$170,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$103,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$191,769,202PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$209,311,681CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$267,493,533PYOtherExpensesAmt
CY Other Expenses$266,981,462CYOtherExpensesAmt
PY Total Expenses$459,432,735PYTotalExpensesAmt
CY Total Expenses$476,396,643CYTotalExpensesAmt
PY Revenues Less Expenses$44,236,613PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$33,682,448CYRevenuesLessExpensesAmt
Total Assets BOY$809,175,286TotalAssetsBOYAmt
Total Assets EOY$790,329,557TotalAssetsEOYAmt
Total Liabilities BOY$357,443,758TotalLiabilitiesBOYAmt
Total Liabilities EOY$278,602,074TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$451,731,528NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$511,727,483NetAssetsOrFundBalancesEOYAmt
MissionAdventist Health System Sunbelt Healthcare Corporation and all of its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$415,653,348ExpenseAmt
Grant$103,500GrantAmt
Revenue$507,338,159RevenueAmt
DescOperation of Florida Hospital Tampa, a 381-bed general acute care hospital, Florida Hospital Carrollwood, a 120-bed general acute care hospital, Florida Hospital Pepin Heart Institute, a 94-bed facility, and a 50-bed Long-Term Acute Care Hospital. Combined these facilities generated 25,453 patient admissions, 138,462 patient days, and 158,613 outpatient visits during the current tax year.Desc
Total Program Service Expenses$415,653,348TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document327IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4340EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Tim WiddisonBusinessNameLine1
FieldValueIRS element (for citing)
Phone8139716000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13100 East Fletcher AvenueAddressLine1
CityTampaCity
StateFLState
ZIP Code336134688ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Robert Anderson
Chairman2.000.00Yes (X)$0$0$0
Michael Schultz
Vice Chairman2.0050.00Yes (X)$0$1,430,716$157,109
Art Berard
Director1.000.00Yes (X)$0$0$0
Scott Bronleewe MD
Director1.000.00Yes (X)$0$0$0
Jack Butcher
Director1.000.00Yes (X)$0$0$0
Jon Courson
Director1.000.00Yes (X)$0$0$0
Henry Ennis Jr
Director1.000.00Yes (X)$0$0$0
John Harding
CEO/Director50.000.00Yes (X)$0$1,028,752$125,824Yes (X)
Lars Houmann
Director1.0050.00Yes (X)$0$1,670,927$240,916
David Jimenez
Director (Beg 9/12/13)1.000.00Yes (X)$0$0$0
Arthenia Joyner
Director1.000.00Yes (X)$0$0$0
Ken Lightfoot
Director1.000.00Yes (X)$0$0$0
Mary Mahon
Director1.000.00Yes (X)$0$0$0
Fred Meyer
Director1.000.00Yes (X)$0$0$0
Eric Newman
Director1.000.00Yes (X)$0$0$0
Brendan O'Malley MD
Director50.000.00Yes (X)$240,168$0$43,699
Thaddeus Parker IV
Director1.000.00Yes (X)$0$0$0
Sharad Patel MD
Director9.400.00Yes (X)$62,833$0$0
Tom Pepin
Director1.000.00Yes (X)$0$0$0
Charlie Robbins
Director1.000.00Yes (X)$0$0$0
Robert Rosequist MD
Director (end 1/24/13)1.000.00Yes (X)$0$93,825$0
Basil Scaglione
Director1.000.00Yes (X)$0$0$0
Kurt Stonesifer MD
Director1.000.00Yes (X)$0$0$0
Jose Vivero
Director1.000.00Yes (X)$0$0$0
Janice Hagensicker
Regional CFO (End 8/13)50.000.00$0$679,929$71,520Yes (X)
Vadym Didenko
CFO - Medical Center (Beg 9/13)50.000.00$0$416,531$75,310Yes (X)
Richard Tibbitts
COO - Medical Center50.000.00$0$454,297$51,305Yes (X)
Brad Bjornstad MD
CMO - Medical Center50.000.00$0$392,038$53,292Yes (X)
Kathleen Miller
CNO - Medical Center50.000.00$0$275,500$40,859Yes (X)
Joel Johnson
CEO-Carrollwood50.000.00$0$509,357$76,166Yes (X)
Shane Cox
CFO - Carrollwood50.000.00$0$223,278$33,511Yes (X)
Robin McGuinness
CNO - Carrollwood50.000.00$0$187,650$38,758Yes (X)
Brigitte Shaw
COO - Pepin Heart Hosp50.000.00$0$315,173$65,428Yes (X)
Alexander Rosemurgy MD
Physician45.000.00$793,990$0$50,404Yes (X)
Sharona Ross MD
Physician45.000.00$465,573$0$37,618Yes (X)
Michael Harris MD
Physician45.000.00$448,380$0$33,679Yes (X)
James Orlowski MD
Physician45.000.00$389,663$0$43,129Yes (X)
Charles Lambert MD
Physician45.000.00$376,237$0$19,951Yes (X)
Marvin Kurtz
Former CFO - Med Ctr0.000.00$0$100,219$7,154Yes (X)
Mary Whillock
Former - CNO Carrollwood0.000.00$0$123,271$14,246Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,776,844TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,901,463TotReportableCompRltdOrgAmt
Total Other Compensation$1,279,878TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K123IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
Crothall Healthcare Inc
13028 Collections Center DriveChicagoIL60693Housekeeping$6,799,997
Hyperbaric & Wound Care Inc
7171 N Dale Mabry HwyTampaFL33614Management Services$3,724,414
General Electric Meds Systems Inc
15724 COLLECTIONS CENTER DRChicagoIL60693Service Contract - Med Equip$3,353,869
Select Medical Corp
4714 Gettysburg RoadMechanicsburgPA17055Management Services$1,768,176
Cross Country Staffing
PO Box 404674AtlantaGA30384Staffing$1,645,070
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K89CntrctRcvdGreaterThan100KCnt
Related Organizations$434,210RelatedOrganizationsAmt
Government Grants$92,828GovernmentGrantsAmt
Total Contributions$527,038TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue900099$498,974,174$498,974,174
Cafeteria900099$2,303,055$2,303,055
Research Fees900099$746,625$746,625
Medical Office Building531120$642,399$642,399
Gift Shop900099$404,390$404,390

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,104,875TotalRevenueColumnAmt
Related Or Exempt Func Income$1,104,875RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$504,175,518TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,206,193TotalRevenueColumnAmt
Exclusion$1,206,193ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$930,339SecuritiesAmt
Other$77,362OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$930,339SecuritiesAmt
Other$77,362OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,007,701TotalRevenueColumnAmt
Exclusion$1,007,701ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEHR RevenueDesc
Business900099BusinessCd
Total Revenue Column$3,162,641TotalRevenueColumnAmt
Related Or Exempt Func Income$3,162,641RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,162,641OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$510,079,091TotalRevenueColumnAmt
Related Or Exempt Func Income$507,338,159RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,213,894ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$103,500TotalAmt
Program Services$103,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,461,179TotalAmt
Program Services$346,700ProgramServicesAmt
Management And General$5,114,479ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$152,622,524TotalAmt
Program Services$129,159,143ProgramServicesAmt
Management And General$23,463,381ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,695,155TotalAmt
Program Services$3,038,863ProgramServicesAmt
Management And General$656,292ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$35,076,673TotalAmt
Program Services$29,358,715ProgramServicesAmt
Management And General$5,717,958ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,456,150TotalAmt
Program Services$10,243,828ProgramServicesAmt
Management And General$2,212,322ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$815,838TotalAmt
Management And General$815,838ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$145,519TotalAmt
Management And General$145,519ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$671,721TotalAmt
Management And General$671,721ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$57,328,376TotalAmt
Program Services$44,681,896ProgramServicesAmt
Management And General$12,646,480ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,784,878TotalAmt
Management And General$3,784,878ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,725,211TotalAmt
Program Services$8,483,435ProgramServicesAmt
Management And General$2,241,776ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$21,009,050TotalAmt
Program Services$17,921,176ProgramServicesAmt
Management And General$3,087,874ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,518,116TotalAmt
Program Services$7,518,116ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$775,400TotalAmt
Program Services$775,400ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,582,789TotalAmt
Program Services$7,582,789ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$35,561,772TotalAmt
Program Services$35,561,772ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,640,659TotalAmt
Program Services$4,455,882ProgramServicesAmt
Management And General$184,777ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$94,676,512$94,676,512
Repairs & Maintenance$13,095,385$13,095,385
State Tax Indigent Asse$6,673,815$6,673,815
Bad Debt Expense$748,809$748,809

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,227,612TotalAmt
Program Services$1,227,612ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$476,396,643TotalAmt
Program Services$415,653,348ProgramServicesAmt
Management And General$60,743,295ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,935BOYAmt
EOY$14,426EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$125,911,520BOYAmt
EOY$126,984,598EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$74,223,344BOYAmt
EOY$73,279,527EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$12,355,633BOYAmt
EOY$12,781,077EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$11,785,039BOYAmt
EOY$9,998,420EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$608,174,092LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$111,444,145LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$468,700,490BOYAmt
EOY$496,729,947EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$25,000BOYAmt
EOY$25,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$15,998,496BOYAmt
EOY$15,158,496EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$100,165,829BOYAmt
EOY$55,358,066EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$809,175,286BOYAmt
EOY$790,329,557EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$35,979,461BOYAmt
EOY$38,811,615EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$173,090EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$321,464,297BOYAmt
EOY$239,617,369EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$357,443,758BOYAmt
EOY$278,602,074EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$434,397,567BOYAmt
EOY$490,253,055EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,847,319BOYAmt
EOY$20,816,354EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$486,642BOYAmt
EOY$658,074EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$451,731,528BOYAmt
EOY$511,727,483EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$809,175,286BOYAmt
EOY$790,329,557EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$33,682,448ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$16,412NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$26,329,919OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$86,255OtherActivitiesAmt
Total Lobbying Expenditures$86,255TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationDues were paid to the American Hospital Association and Florida Hospital Association. 2 Outside Consultants were used during 2013 for lobbying on behalf of the filing organization with respect to legislative matters impacting the delivery of health as follows: 1. Mike Fasano - $16,923 2. RSA Consultants - $48,000ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$15,352,543BeginningYearBalanceAmt
Contributions$1,108,676ContributionsAmt
Investment Earnings Or Losses$858,180InvestmentEarningsOrLossesAmt
Other Expenditures$1,360,318OtherExpendituresAmt
End Year Balance$15,959,081EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,206,168BeginningYearBalanceAmt
Contributions$1,019,381ContributionsAmt
Investment Earnings Or Losses$642,968InvestmentEarningsOrLossesAmt
Other Expenditures$2,515,974OtherExpendituresAmt
End Year Balance$15,352,543EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,247,486BeginningYearBalanceAmt
Contributions$426,688ContributionsAmt
Investment Earnings Or Losses$194,446InvestmentEarningsOrLossesAmt
Other Expenditures$662,452OtherExpendituresAmt
End Year Balance$16,206,168EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,242,118BeginningYearBalanceAmt
Contributions$10,131,589ContributionsAmt
Investment Earnings Or Losses$32,188InvestmentEarningsOrLossesAmt
Other Expenditures-$892,786OtherExpendituresAmt
Administrative Expenses$51,195AdministrativeExpensesAmt
End Year Balance$16,247,486EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,117,631BeginningYearBalanceAmt
Contributions$2,259,714ContributionsAmt
Investment Earnings Or Losses-$144,735InvestmentEarningsOrLossesAmt
Other Expenditures$3,990,492OtherExpendituresAmt
End Year Balance$5,242,118EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.03000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.97000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,506,000OtherCostOrOtherBasisAmt
Book Value$24,506,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$399,485,882OtherCostOrOtherBasisAmt
Depreciation$49,785,826DepreciationAmt
Book Value$349,700,056BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$120,777,537OtherCostOrOtherBasisAmt
Depreciation$59,166,477DepreciationAmt
Book Value$61,611,060BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,404,673OtherCostOrOtherBasisAmt
Depreciation$2,491,842DepreciationAmt
Book Value$60,912,831BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$496,729,947TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
Due from Affiliates$12,402,176
Other Current Receivables$1,128,249
Board Designated Funds$18,408,376
Interest in VHA, Inc.$200,000
Interest in UCH Foundation$21,474,428
Receivable from Third Parties$1,744,837
FieldValueIRS element (for citing)
Total Book Value Other Assets$55,358,066TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
Capital Lease Obligations$1,924,104
Payable to Third Parties$5,537,071
Credit Balances in A/R$5,076,205
Other Noncurrent Liabilities$16,217,991
Other Current Liabilities$713,322
Interco. Alloc. of Tax Exempt Bond Proceeds$204,900,351
Due to Affiliates$5,248,325
FieldValueIRS element (for citing)
Total Liability$239,617,369TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:University Community Hospital Foundation, Inc. (UCHF), a related organization formed and maintained exclusively to further the exempt purpose of University Community Hospital, Inc. (the Hospital), held assets in temporary endowment and permanent endowment funds during the current tax year. UCHF's endowment consists of individual donor restricted endowment funds and pledges receivable where the assets have been designated for endowment established to support various purposes benefiting the Hospital and its patients.
Part X, Line 2:The Hospital is part of a consolidated audited financial statement. The consolidated audited financial statement includes the following FIN 48 footnote - The Division follows the Income Taxes Topic of the ASC (ASC 740), which prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,655,482TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,655,482NetCommunityBenefitExpnsAmt
Total Expense0.03710TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,559,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,317,322DirectOffsettingRevenueAmt
Net Community Benefit Expns$35,241,696NetCommunityBenefitExpnsAmt
Total Expense0.07400TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$81,214,500TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,317,322DirectOffsettingRevenueAmt
Net Community Benefit Expns$52,897,178NetCommunityBenefitExpnsAmt
Total Expense0.11110TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,477TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,477NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,477TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,477NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$81,229,977TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,317,322DirectOffsettingRevenueAmt
Net Community Benefit Expns$52,912,655NetCommunityBenefitExpnsAmt
Total Expense0.11110TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$36,162,957BadDebtExpenseAmt
Bad Debt Expense Attributable$2,671,716BadDebtExpenseAttributableAmt
Reimbursed By Medicare$114,580,466ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$124,254,415CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$9,673,949MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities3HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndResearch FacilityResearchFacilityIndEmergency Room24 HrsEmergencyRoom24HrsInd
Florida Hospital Tampa
13100 E Fletcher AvenueTampaFL33613www.floridahospital.com/tampa4035Yes (X)Yes (X)Yes (X)Yes (X)
Florida Hospital Carrollwood
27171 N Dale Mabry HwyTampaFL33614www.floridahospital.com/carrollwood4179Yes (X)Yes (X)Yes (X)
FL Hosp at Connerton LTAC Hospital
39441 Health Center DriveLand OLakesFL34637www.floridahospital.com/connerton4499Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNumCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtRpt Available Upon RequestRptAvailableUponRequestIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndPrioritize Health NeedsPrioritizeHealthNeedsIndOther Needs AddressedOtherNeedsAddressedIndAll Needs AddressedAllNeedsAddressedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareIndFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctExplained BasisExplainedBasisIndIncome LevelIncomeLevelIndAsset LevelAssetLevelIndMedical IndigencyMedicalIndigencyIndInsurance StatusInsuranceStatusIndUninsured DiscountUninsuredDiscountIndMedicaid MedicareMedicaidMedicareIndState RegulationStateRegulationIndApp Financial Asst ExplnAppFinancialAsstExplnIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndAvailable On RequestAvailableOnRequestIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndOther Method UsedOtherMethodUsedIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
Florida Hospital Tampa
1Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)0Yes (1)Yes (X)https://www.floridahospital.comYes (X)Yes (X)Yes (X)Yes (X)00Yes (1)Yes (1)200.000000000000Yes (1)400.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (X)00
Florida Hospital Carrollwood
2Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)0Yes (1)Yes (X)https://www.floridahospital.comYes (X)Yes (X)Yes (X)Yes (X)00Yes (1)Yes (1)200.000000000000Yes (1)400.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (X)00
FL Hosp at Connerton LTAC Hospital
30Yes (1)Yes (1)200.000000000000Yes (1)400.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Florida Hospital TampaPart V, Section B, Line 3: University Community Hospital, Inc. d/b/a Florida Hospital Tampa, (FHT or the Hospital) is a 475-bed hospital facility located in Hillsborough County in Florida. The Hospital's primary service area is nestled in Hillsborough County and is primarily comprised of seven zip codes surrounding the Hospital. Several of the primary service area zip codes include communities that are fundamentally underserved. The Hospital's primary service area includes diverse micro-communities which vary in income, education level, and living conditions and are ethnically and culturally diverse. In conducting its 2013 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data collection efforts included key informant/stakeholder interviews, community member interviews, community surveys, and congregational surveys. Key stakeholders were identified to ensure broad representation of the community. Many of the key informants were selected because of their direct ties to the underserved and impoverished communities in the Hospital's primary service area. Key stakeholders included representatives from the local Haitian community, the Florida Council of Churches, the Hillsborough County Public Health Department, the Hillsborough County Sheriff's Department, Hillsborough County schools, a local free clinic for uninsured patients, the University Area Community Development Center, WIC, and a free clinic operated for the University of South Florida. FHT also gathered primary data through the utilization of two distinct survey instruments. The first one was developed by the Congregational Health Network sub-committee and was administered to four partners within the Hospital's congregational network. The second survey was a community member survey which was based upon the Congregational Health Network survey but included fewer questions. Various sources of secondary data were reviewed to understand the larger issues plaguing the Hospital's primary service area. As part of its efforts to ensure broad community-based input into the CHNA process, the Hospital established a Community Health Needs Assessment Committee (CHNAC). The CHNAC was intended to represent the needs of the general community with a particular focus on including representatives of the medically underserved, low-income and minority populations. Many of the same community groups that participated in the key stakeholder interviews were also represented on the CHNAC.
Florida Hospital CarrollwoodPart V, Section B, Line 3: University Community Hospital, Inc., d/b/a Florida Hospital Carrollwood (FHCW or the Hospital), is a 120-bed community hospital specializing in Spine and Orthopedic Surgery, General Surgery, Cardiac Services, Neurological Services, General Medicine, Wound Healing, ENT, Diabetes Management, Metabolic and Bariatric Weight Loss Surgery, as well as other services that meet the Hospital's mission of healing the mind, body, and spirit. The Hospital's core service area is comprised of seven zip codes located in Hillsborough County, Florida. The total population in the Hospital's core service area is approximately 212,000. Median income in the Hospital's core service area is approximately $49,000 and about 14% of the population lives below the federal poverty level. In conducting its 2013 Community Health Needs Assessment (CHNA), primary and secondary data was collected through interviews and surveys along with secondary data from local, regional, and national health-related sources. As part of its efforts to ensure broad community-based input into the CHNA process, the Hospital established a Community Health Needs Assessment Committee (CHNAC). FHCW relied heavily on stakeholder input from the CHNAC, whose members represented a broad cross-section of the community, including vulnerable populations. In addition, FHCW turned to two specific local groups that have first-hand experience with the healthcare needs of the low-income population in the Hospital's community : The Judeo-Christian Coalition and Egypt Lake Elementary School. The Judeo Christian Coalition is the oldest, largest, and most dominant free clinic in Hillsborough County. Egypt Lake Elementary School is among the poorest in the Hillsborough County School District. The school has very high numbers of children in the free and reduced-fee lunch programs. In order to ensure input from representatives of low-income, minority and medically underserved populations, key informants/stakeholder were identified for interviews. Stakeholders who participated in the CHNA interview process included, among others, representatives from the Judeo Christian Coalition, Egypt Lake Elementary School, The Florida Department of Health, Suncoast United Way, Florida Association of Physicians of Indian Descent, several local churches, the University of South Florida Department of Public Health, and Tampa Family Health Center. In addition to key stakeholder interviews, FHCW selected CHNAC members who represented the broad needs of the community, including low-income, minority and underserved populations. The CHNAC consisted of 28 members and represented organizations such as the Hillsborough County Sheriff's Office, the University of South Florida Department of Public Health, the University Area Community Development Corporation, the local Haitian community, along with numerous church organizations.
Florida Hospital TampaPart V, Section B, Line 5d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Florida Hospital CarrollwoodPart V, Section B, Line 5d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Florida Hospital TampaPart V, Section B, Line 6i: As a part of its Community Health Needs Assessment, the filing organization conducted an extensive and thorough analysis and prioritization of its significant identified health needs. Please see our discussion in Part V, Section B, line 7.The filing organization adopted its initial Community Health Needs Assessment by 12/31/13 and was in the process of developing its community health needs implementation strategy. The filing organization's implementation strategy will be documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) will describe how the filing organization plans to meet its identified prioritized health needs or will identify the health need as one the filing organization does not intend to specifically address and provide an explanation as to why the filing organization does not intend to address that health need. In accordance with Proposed Regulation Section 1.501(r)-3(e)(2), the filing organization's CHP will be adopted no later than May 15, 2014.
Florida Hospital CarrollwoodPart V, Section B, Line 6i: The filing organization adopted its initial Community Health Needs Assessment by 12/31/13 and was in the process of developing its community health needs implementation strategy. The filing organization's implementation strategy will be documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) will describe how the filing organization plans to meet its identified prioritized health needs or will identify the health need as one the filing organization does not intend to specifically address and provide an explanation as to why the filing organization does not intend to address that health need. In accordance with Proposed Regulation Section 1.501(r)-3(e)(2), the filing organization's CHP will be adopted no later than May 15, 2014.
Florida Hospital TampaPart V, Section B, Line 7: University Community Hospital, Inc. d/b/a Florida Hospital Tampa (FHT or the Hospital), formed a Community Health Needs Assessment Committee (CHNAC) to review primary and secondary data collected and to formulate the determination of health priorities. The CHNA assessment process employed the use of qualitative and quantitative methods derived from public health. This mixed method and interdisciplinary approach proved to be very successful in beginning to understand the diverse community serviced by FHT. The Hospital's findings from primary data (community interviews and surveys) and from secondary data (pre-existing regional health related data) guided the selection process for determining the top health needs of the Hospital's community. Based upon the primary and secondary data collected, a total of eleven health needs were initially identified. Discussions were held concerning the feasibility of addressing each of the health needs based on available resources and partners. The CHNAC represented the broad community including low-income, minority and underserved populations. The initial eleven health needs identified were as follows: mental health, lack of education and awareness, obesity, pediatric asthma, maternal and child health, lack of access to primary care, diabetes, rate of uninsured, teen pregnancy, respiratory related diseases, and heart disease. The CHNA narrowed down the initial eleven healthy priorities to four health priorities based upon how the CHNA perceived these conditions could be addressed by partnering with the Hospital. Upon final health needs priority selection, the CHNAC chose the following four health priorities:Mental health;Diabetes;Lack of access to Primary Care; andLack of education and awareness.
Florida Hospital CarrollwoodPart V, Section B, Line 7: University Community Hospital, Inc., d/b/a Florida Hospital Carrollwood (FHCW or the Hospital), formed a Community Health Needs Assessment Committee (CHNAC) to review primary and secondary data collected and to formulate the determination of health priorities using a systematic approach that relied heavily on a decision tree priority selection process. The decision tree format assisted the CHNAC in focusing on those needs that the Hospital would have the ability to influence through the implementation or expansion of programs, services, or other actions, and that may be the focus of other community resources/organizations that may be already addressing the need in some way. The CHNAC used a Priority Selection Report tool to assist in the review of data collected and prioritization of the top areas of significant community need for the Hospital's community. Based upon the primary and secondary data collected, eleven health issues were initially identified for the Hospital's core service area. Based upon discussions and collaborative interactions, such as creating inventories of needs resources throughout the community, the CHNAC collectively determined that the top eleven health needs for FHCW were: Respiratory conditions, UTI, Gastrointestinal distress, Chest pain, Lack of access to free/affordable healthcare, Lack of primary care physicians/lack of access to primary care, Lack of access to specialized care, Diabetes, Lack of utilization, Mental Health, and High cholesterol/hypertension. In further prioritizing the eleven initially identified top health issues, the CHNAC considered the level of community need, the ability of the Hospital to provide services related to the need, the work already going on in the community, and the ability to collaborate with community partners. Through extensive dialogue and analysis, the CHNAC narrowed the list of issues to five, focusing on those upon which the Hospital could have the greatest positive impact. Upon final health needs priority selection, the CHNAC chose the following five priorities:Lack of Primary Care/Access to Primary Care Lack of Education High Cholesterol/Hypertension DiabetesAsthma/Respiratory Diseases. The CHNAC did not choose the following issues for the reasons stated below. Mental Health the Hospital does not provide mental health services and other community agencies are providing these services. Poverty/Unemployment The University Area Community Development Corporation is working to rejuvenate very low-income areas of the Tampa area. They are part of the CHNAC and are supported by the Hospital.Uninsured The Hospital and the Congregational Health Network will continue to support the area's free clinics and Federally Qualified Health Centers. The University of South Florida has received federal funding for Health Navigators to help Tampa residents enroll in insurance offered on the Federal Insurance Marketplace. This will help increase the coverage level of our community.
Florida Hospital TampaPart V, Section B, Line 14g: The filing organziation has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Florida Hospital CarrollwoodPart V, Section B, Line 14g: The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
FL Hosp. at Connerton LTAC HospitalPart V, Section B, Line 14g: The filing organziation has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Florida Hospital TampaPart V, Section B, Line 20d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Florida Hospital CarrollwoodPart V, Section B, Line 20d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
FL Hosp. at Connerton LTAC HospitalPart V, Section B, Line 20d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Supplemental Schedule to Schedule H, Part V, Section B: Hospital 3Disclosure Statement Pursuant to Internal Revenue Service (IRS) Notice 2014-3:The filing organization operates three separately licensed hospital facilities. Two of these hospital facilities are general acute-care hospitals that offer general medical and surgical services and operate 24/7 emergency departments. The third facility, d/b/a Florida Hospital at Connerton Long Term Acute Care Hospital, is a long-term acute care facility that offers long-term care services for individuals with complex medical conditions, and does not operate an emergency department. Pursuant to IRS Notice 2014-3, the filing organization is seeking an excusal from its failure to conduct a community health needs assessment (CHNA) for Florida Hospital Connerton Long Term Acute Care Hospital for its tax year ended December 31, 2013. The failure was not willful or egregious. Additionally, steps are underway to correct the failure and this disclosure is being made in accordance with Section 6 of the Proposed Revenue Procedure set forth in IRS Notice 2014-3 as follows:(1) A description of the failure: The filing organization is a subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a healthcare system known as Adventist Health System (AHS). As noted above, the filing organization operates two acute-care hospitals and one long-term acute care facility. In its 2013 tax year, the filing organization conducted two separate CHNAs for its two acute-care hospitals following extensive and detailed policies and procedures adopted and implemented by AHS on a system-wide basis. The failure to conduct a CHNA for the long-term care facility was the result of a determination (although later discovered to be erroneous) that because the long-term care facility did not operate an emergency department or provide traditional acute-care hospital services, it was not a hospital for purposes of Prop. Reg. Section 1.501(r)-1. The failure was not due to gross negligence, reckless disregard, or willful neglect. The filing organization was under the good-faith belief that a CHNA was not required for its long-term acute care facility. A CHNA was conducted for each of the other two general acute-care hospitals operated by the filing organization and both were made publicly available by posting the CHNAs on the filing organization's website by December 31, 2013. The filing organization is subject to an AHS system-wide policy that sets forth the requirements, and general processes and procedures to be followed by all AHS hospital facilities with respect to CHNAs and implementation strategies. (2) A description of the discovery: The filing organization's failure to conduct a CHNA for its long-term acute care facility was discovered in October of 2014 during the Form 990 preparation process. In the process of gathering hospital license numbers for purposes of reporting on Form 990, Schedule H, Part V, Section A, it was discovered that the license-type assigned to the long-term acute care facility was as a hospital. Further investigation followed and it was determined that the long-term acute care facility was licensed as a hospital under the State of Florida statutes. Accordingly, a CHNA should have been conducted for the long-term acute care facility for its 2013 tax year. (3) A description of the correction made: The correction of the failure to conduct a CHNA for the filing organization's long-term acute care facility for its 2013 tax year is to commence a CHNA process immediately, following the policies and procedures established by AHS. The filing organization will make every effort to complete the documentation of the CHNA in the form of a CHNA report, obtain Board of Director approval of the CHNA report, and make the CHNA report available to the public by posting it on the filing organization's web-site by December 31, 2014. All future CHNAs will be conducted by the long-term acute care facility in a timely fashion in accordance with the requirements set forth in IRC Section 501(r)(3).(4) A description of policies and procedures: As noted above, complete and extensive policies and procedures are currently in place for the AHS system of hospitals that set forth AHS's policy on compliance with IRC Section 501(r)(3). These policies mandate that CHNAs will be conducted by each AHS hospital facility and provide the general steps and processes that should be followed in the conduct of a CHNA. There is also an AHS system-wide policy that addresses the public posting requirements of each AHS hospital's CHNA. The filing organization's failure to conduct a CHNA for its long-term acute care facility was not due to incorrect or inadequate policies and procedures, but rather was due to the issue of the qualification of the long-term acute care facility as a hospital for purposes of IRC Section 501(r)(3).
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
UCH Wound Healing Institute
3000 Medical Park Dr Ste 430TampaFL33613Wound Care
Brandon Wound Care Clinic
205 S Moon Ave Ste 106BrandonFL33511Wound Care
UCH Home Health Care
13601 Bruce B Downs Blvd Ste 110TampaFL33613Home Health
Carrollwood Occupational Health Clinic
7001 N Dale Mabry HwyTampaFL33613Occupational Health

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The filing organization is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC serves as a parent organization to 24 tax-exempt 501(c)(3) hospital organizations that operate 44 hospitals in ten states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "Adventist Health System" (AHS).All hospital organizations within AHS collect, calculate, and report the community benefits they provide to the communities they serve. AHS organizations exist solely to improve and enhance the local communities they serve. AHS has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. On an annual basis, the community benefits of all AHS organizations are consolidated and reported in the AHS Annual Report document prepared by Adventist Health System Sunbelt Healthcare Corporation (59-2170012).
Part I, Line 7:The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part III, Line 2:The amount of bad debt expense, reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
Part III, Line 3:Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Charity Care Policy:Self-pay patients are required to complete a Patient Financial Assistance Application Short Form (PFAA). If the PFAA is not completed after reasonable attempts to obtain it are exhausted, patient information is processed through a Scorer product. The Scorer product utilizes publicly available data, such as credit reports, to assess an individual patient's financial viability. Patients who earn a certain score on the Scorer product are considered to qualify as non-state charity patients. An amount up to $1,000 of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered to be non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the Scorer product is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Charity Care Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for charity care. However, not all patients will cooperate with such efforts and a charity care eligibility determination can not be made. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered to be community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 8:Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
Part III, Line 9b:At the time of patient registration, non-elective self-pay patients are informed of the filing organization's financial assistance policy and told that they will be required to submit necessary financial data in order to potentially receive any discounts. Under the filing organization's financial assistance policy, percentage discounts are applied to a patient's account based upon amounts generally billed to individuals who have insurance covering such care.Under the filing organization's policies, payment plans for partial charity accounts will be individually developed with the patient. Partial charity accounts result when a financial assistance eligibility determination allows for a percentage reduction but leaves the patient with a self-pay balance. If the patient complies with the agreed-upon payment plan, the filing organization does not pursue any collection action with respect to the patient. The filing organization does not pursue collection of amounts from patients determined to qualify for a 100% reduction in charges under its financial assistance policy.
Part III, Line 4:Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 6 and 7. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
Supplemental Schedule to Schedule H, Part III, Section B:Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are reported as a community benefit to the elderly and are included in the consolidated Adventist Health System (AHS or the Company) Community Benefits Report contained in the AHS Annual Report document. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients as reported in the AHS Community Benefit Report are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(9,673,949)- Difference in costing methodology: (3,051,051)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (23,400,375) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $(36,125,375) As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
Part VI, Line 2:As reported in Schedule H, Part V, Section B, Lines 1-8, the two licensed acute care hospitals operated by the filing organization conducted their initial community health needs assessments (CHNAs) during the current year. Their initial CHNAs were adopted by the Hospitals' boards by December 31, 2013, the end of each of the Hospital's taxable year in which it conducted its CHNA. Each Hospital's initial CHNA complied with the guidance set forth by the IRS in Proposed Regulation Section 1.501(r)-3. In addition to the CHNA discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of its community.Such practices and processes involve the following:1. Hospital operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's communities.
Part VI, Line 3:The filing organization has a process in place whereby patients are informed about each Hospital's Financial Assistance Policy. Signage is posted in the Emergency Rooms indicating that financial assistance is available for those self-pay patients meeting eligibility requirements. After EMTALA medical screening and stabilization requirements are met, registration personnel will secure financial information on as many self-pay patients as possible at the time of service. For those who appear to qualify for Medicaid or under each Hospital's Financial Assistance Policy, the financial counselors will continue to work with those patients until final account resolution is achieved. All other self-pay patients are covered under this process. At any time during the process that data is provided showing that a patient qualifies for assistance under the Financial Assistance Policy the discounts extended under that policy will be applied.As part of the billing process, each Hospital includes the Application for Financial Assistance along with the initial patient bill. Each Hospital's Financial Assistance Application is also available to patients on the Hospital's web-site in both an English and Spanish version. Additionally, each Hospital's financial counselors are available to work with every patient during the first 120 days of the billing process to assist the patient with completing Financial Assistance Applications and investigating other potential sources of third-party assistance. The determination of a patient's eligibility for financial assistance is made on a case-by-case basis. Various factors are considered in that determination. Each individual patient who is identified as potentially being eligible to receive financial assistance is seen by a financial counselor at each Hospital. The financial counselor will work with the patient to make sure that other sources of assistance (public or otherwise) have been sought to the fullest extent possible. When other forms of assistance are not available or have been exhausted, each Hospital will gather certain financial information from the patient to determine the patient's ability to pay based upon level of income.
Part VI, Line 4:The filing organization currently operates 2 hospital facilities, Florida Hospital Tampa and Florida Hospital Carrollwood, a Heart Hospital, and a Long Term Acute Care Hospital on three campuses in and around the Tampa Bay Area. Combined, these facilities are a major healthcare provider caring for close to 200,000 patients each year residing in Hillsborough, Pasco and surrounding Counties. Florida Hospital Tampa (FHT), located in Hillsborough County in close proximity to the University of South Florida, is licensed for 381 acute-care beds. FHT is home to six Centers of Excellence that focus resources on major disease areas including cardiac treatment, women's health, stroke, pediatrics, diabetes management and orthopaedics. Florida Hospital Carrollwood (FHCW), also located in Hillsborough County, is licensed for 120 beds and offers comprehensive medical and surgical care, many specialized services, as well as a wide range of radiological procedures available for diagnosis and treatment of injuries and illnesses. Diagnostic imaging services offered include x-rays, ultrasound, mammography, nuclear medicine, CT Scan and special procedures. UCHCW's five-story medical tower also houses a six-suite surgery unit that offers advanced technologies in gynecologic, vascular surgery and joint replacement procedures.Florida Hospital Pepin Heart Institute (FHPHI), located adjacent to FHT, is licensed for 94 beds. Officially opening its doors on April 3, 2006, FHPHI became the Southeast's first all-digital cardiovascular specialty facility. This free-standing heart hospital is filled with the advancements in technology, techniques, and revolutionary patient-centered care and is raising expectations when it comes to the diagnosis, treatment, and study of cardiovascular disease. Most importantly, FHPHI is filled with a team of physicians, nurses, technicians, and staff who have worked together for more than 20 years to create one of the most successful heart programs in the Tampa Bay Area. FHPHI's physicians and clinical specialists have built a comprehensive cardiovascular program with the experience of providing over 76,000 angioplasty procedures and over 11,000 open heart surgeries.Florida Hospital at Connerton Long Term Acute Care Hospital (LTAC), located in Pasco County is licensed for 50 beds. This facility is designed to serve individuals who have medically complex illnesses, requiring additional weeks of specialized hospital care. The filing organization (UCH) is a crucial community and regional asset. UCH provides necessary medical services to the already large and rapidly expanding Tampa Area. With the exception of the LTAC, each facility is located in Tampa, Florida and primarily serves patients residing in Hillsborough County which is located on the west coast of central Florida. Hillsborough County, Florida has a population of approximately 1.3 million with approximately 12% of the population over the age of 65. Hillsborough County has an estimated 65% of its residents having a high school diploma or higher. It is estimated that 13% of the individuals residing in Hillsborough County live below the poverty level. Approximately 49.2% of the Hospital's patients during the current tax year were Medicare patients, about 12.5% were Medicaid patients, about 7.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In 2013, about 60% of the combined hospital's in-patients were admitted through the Emergency Department.
Part VI, Line 5:The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ" and embodies the filing organzation's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its communities through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $347,103 of benefit with respect to the faith-based and spiritual needs of the community in conjunction with its operation of its community hospitals. The filing organization also provides benefits to its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $58,201,066 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.The filing organization values the communities it serves, and pledges to provide each community with needed educational, preventative, diagnostic, treatment and rehabilitative services. The filing organization is continually improving and updating its range of services as necessary to meet community needs. The filing organization's community outreach efforts are focused on health education, wellness information, physician referral, and screening services. Each month, the filing organization offers a variety of health and wellness classes taught by members of its medical staff and other health care professionals. The filing organization also maintains a speakers' bureau whereby qualified speakers are provided to community groups to deliver the latest information on health, wellness, and prevention. Because prevention and early detection are key components of maintaining good health for individuals of all ages, UCH regularly conducts a variety of free and low-cost health screening events. Such screenings include cholesterol, blood pressure checks, body fat and osteoporosis screenings.
Part VI, Line 6:University Community Hospital, Inc. is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 44 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AHS subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AHS as a whole. The reader is directed to visit the web-site of AHS at www.adventisthealthsystem.com to learn more about the mission and operations of AHS and to access AHS's annual report that contains financial data as well as community benefit reporting for the entire system.
Part VI, Line 7:The filing organization does not file a community benefit report with any state.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
American Cancer Society Inc
2006 W Kennedy BlvdTampaFL33606590657320501(c)(3)$13,500General Support
American Heart Association Inc
7272 Greenville AvenueDallasTX75231135613797501(c)(3)$15,000General Support
Junior Achievement of West Central Florida Inc
13805 58th Street NClearwaterFL33760591098499501(c)(3)$25,000General Support
Tampa Bay Partnership For Regional Economic Development
4300 W Cypress Street Ste 700TampaFL33607593248071501(c)(6)$50,000General Support
University Community Hospital Foundation Inc
3100 E Fletcher AvenueTampaFL33613592554889501(c)(3)General Support$61,950Fair Market ValueContributed Facilities
University Community Hospital Foundation Inc
3100 E Fletcher AvenueTampaFL33613592554889501(c)(3)$25,000General Support
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationGrants are generally made only to related organizations that are exempt from Federal Income Tax under 501(c)(3), or to other non-profit community organizations. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Michael Schultz
Vice Chairman$0$662,144$0$193,658$0$574,914$0$114,208$0$42,901$0$1,587,825$0$107,872
John Harding
CEO/Director$0$493,063$0$143,873$0$391,816$0$99,338$0$26,486$0$1,154,576$0$82,377
Lars Houmann
Director$0$911,606$0$302,898$0$456,423$0$197,919$0$42,997$0$1,911,843$0$166,425
Brendan O'Malley MD
Director$197,598$0$41,370$0$1,200$0$26,528$0$17,171$0$283,867$0$0$0
Janice Hagensicker
Regional CFO (End 8/13)$0$336,676$0$84,387$0$258,866$0$42,561$0$28,959$0$751,449$0$28,362
Vadym Didenko
CFO - Medical Center (Beg 9/13)$0$258,006$0$39,300$0$119,225$0$33,822$0$41,488$0$491,841$0$10,863
Richard Tibbitts
COO - Medical Center$0$271,778$0$40,762$0$141,757$0$26,482$0$24,823$0$505,602$0$8,294
Brad Bjornstad MD
CMO - Medical Center$0$297,434$0$47,466$0$47,138$0$35,493$0$17,799$0$445,330$0$13,930
Kathleen Miller
CNO - Medical Center$0$216,001$0$33,879$0$25,620$0$13,079$0$27,780$0$316,359$0$0
Joel Johnson
CEO-Carrollwood$0$284,594$0$70,937$0$153,826$0$40,559$0$35,607$0$585,523$0$33,447
Shane Cox
CFO - Carrollwood$0$183,307$0$29,904$0$10,067$0$11,842$0$21,669$0$256,789$0$0
Robin McGuinness
CNO - Carrollwood$0$160,363$0$23,191$0$4,096$0$9,234$0$29,524$0$226,408$0$0
Brigitte Shaw
COO - Pepin Heart Hosp$0$246,967$0$41,398$0$26,808$0$30,683$0$34,745$0$380,601$0$16,207
Alexander Rosemurgy MD
Physician$604,596$0$186,169$0$3,225$0$27,560$0$22,844$0$844,394$0$0$0
Sharona Ross MD
Physician$356,780$0$108,373$0$420$0$16,272$0$21,346$0$503,191$0$0$0
Michael Harris MD
Physician$370,662$0$76,518$0$1,200$0$13,136$0$20,543$0$482,059$0$0$0
James Orlowski MD
Physician$388,435$0$28$0$1,200$0$21,100$0$22,029$0$432,792$0$0$0
Charles Lambert MD
Physician$375,009$0$28$0$1,200$0$0$0$19,951$0$396,188$0$0$0
Marvin Kurtz
Former CFO - Med Ctr$0$0$0$0$0$100,219$0$4,618$0$2,536$0$107,373$0$0
Mary Whillock
Former - CNO Carrollwood$0$108,304$0$0$0$14,967$0$5,825$0$8,421$0$137,517$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aThe filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of AHS. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC that provide services and are on the management team of the filing organization. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to Vice Presidents and above and is usually limited to one business trip per year beyond the annual AHS President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AHS has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval of the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: A nominal discretionary spending amount was provided in the current year to all eligible executives who attend the annual AHS President's Council business meeting ($500 per executive) or the annual AHS CFO Conference business meeting ($300 per executive). Other discretionary spending accounts may be provided in connection with other AHS sponsored conferences but typically do not exceed $200 per participant. With respect to the AHS President's council meeting, eligible executives may include AHSSHC Vice Presidents and above and all AHSSHC subsidiary organization CEOs and Regional CFOs. The payment provided to each executive was considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements.
Part I, Line 3The individual who serves as the CEO of the filing organization is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for that individual's role in serving as the CEO. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives of the community, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AHS and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AHS will not exceed the 40th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Lines 4a-bPart I, Line 4a: During the year ending December 31, 2013, Mary Whillock and Marvin Kurtz received severance payments in the amounts of $12,585 and $100,385 respectively. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AHS. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including deferred compensation benefits taxable under Internal Revenue Code (IRC) Section 457(f), to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AHS entities and Vice Presidents of all AHS entities whose base salary is at least $218,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-Day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-Day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AHS active employment inclusive of income from all other Seventh-Day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to the SERP and by the individual's year of entry to the AHS Executive FLEX Benefit Program. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distributions Contrib. Distributions* Payment ------------------------------------------------------- Brad Bjornstad, MD $ 39,144 $ 16,354 $0 $0 Vadym Dedinko $ 19,972 $ 11,678 $0 $0 Janice Hagensicker $ 46,211 $ 28,375 $174,831 $0 John Harding $ 85,488 $ 94,098 $277,917 $0 Lars Houmann $184,069 $186,831 $232,784 $0 Joel Johnson $ 26,709 $ 35,530 $106,949 $0 Michael Schultz $117,859 $124,294 $397,783 $0 Richard Tibbits $ 30,132 $ 9,863 $ 98,801 $0 Brigitte Shaw $ 16,834 $ 17,989 $0 $0 Kathleen Miller $ 14,956 * Including Investment Earnings

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Jon L Courson III
Family member of Board Member$28,795Employee Compensation0
Cardiac Surgery Associates of Tampa
>5% owned by Board Member$406,403Surgical Services0
Ravindra Patel MD
Family member of Board Member$353,253Surgical Services0
Advanced Cardiac Management LLC
>5% owned by Board Member$1,200,792Physician Services0
Reliance Laboratory Partners LLC
>5% owned by Board Member$107,607Lab Cytology Services0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Jon Courson and Eric Newman - Family Relationship Mary Mahon and Jose Vivero - Business Relationship Art Bernard and Fred Meyer - Business Relationship
Form 990, Part VI, Section A, line 4Article XI of the filing organization's Bylaws were amended in 2013 to provide that, for the period from January 1, 2013 to December 31, 2014, the President shall carry out such duties as assigned by the Member, who designee shall be the Executive Vice President of the Florida Division of Adventist Health System.
Form 990, Part VI, Section A, line 6University Community Hospital, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7aThe sole member of the filing organization is AHSSHC. AHSSHC appoints all voting members to the Board of Directors of UCH. Regular directors are nominated by the Board of Directors of UCH but must be appointed by the member.
Form 990, Part VI, Section A, line 7bAHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: 1) The approval or disapproval of the Bylaws of the filing organization; 2) To set limits and terms for the borrowing of funds in excess of $100,000; 3) The approval or disapproval of single expenditures and/or the purchase or sale of real property in excess of one million dollars; 4) To direct the placement of funds and capital of the filing organization; 5) To establish general guiding policies; and 6) To approve the identity of an auditing firm and election of the fiscal year for the filing organization.
Form 990, Part VI, Section B, line 11The filing organization's current year Form 990 was reviewed by the Board Vice Chairman, Regional CFO, CEO and by the CFO prior to its filing with the IRS. The review conducted by these individuals did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12cThe Conflict of Interest Policy of the filing organization applies to members of its Board of Trustees/Directors, its officers, executive employees, physician employees, and officers of the medical staff (to be known as Interested Persons). In connection with any actual or possible conflict of interests, any member of the Board of Trustees/Directors of the filing organization or any other Interested Person of the filing organization must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Trustees/Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Interested Person, the remaining members of the Board of Trustees/Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Trustees/Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section C, line 19The filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Each year, AHS publishes an annual report document that includes a financial report for the relevant year as well as a community benefit report. The financial report and community benefit report are presented on a consolidated basis and represent all of the activities, results of operations, and financial position at year-end of the entire AHS system. In addition, the audited consolidated financial statements of AHS and of the AHS "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Part VII, Section AFor those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Adventist Health System.
Form 990, Part IX, line 11gAHS Management Fees: Program service expenses 0. Management and general expenses 4,763,628. Fundraising expenses 0. Total expenses 4,763,628. EHR Management Fees: Program service expenses 0. Management and general expenses 2,015,382. Fundraising expenses 0. Total expenses 2,015,382. Billing & Collection Services: Program service expenses 0. Management and general expenses 5,867,470. Fundraising expenses 0. Total expenses 5,867,470. Payments to Healthcare Professionals: Program service expenses 23,718,100. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,718,100. Miscellaneous Purchased Services: Program service expenses 11,055,076. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,055,076. Environmental Services: Program service expenses 1,955,465. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,955,465. Recruiting: Program service expenses 1,534,452. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,534,452. Professional Fees: Program service expenses 6,418,803. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,418,803.
Form 990, Part XI, line 9:Allocation from Tax-Exempt Parent with respect to debt 745,294. Transfer to Tax Exempt Parent -1,988,350. Change in Interest in Foundation 2,711,925. Pension Related Changes 21,621,340. Investment in Tax Exempt Affiliate 2,540,043. Donated Property/Gifts 699,667.
Part X, Line 2The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Boudreaux Realty LLC
401 East Jackson St Ste 2700TampaFL33602461450437Real EstateFL$51,000University Community Hospital Inc
Mason Florida Investments LLC
401 East Jackson St Ste 2700TampaFL33602591113901Real EstateFLUniversity Community Hospital Inc

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (105 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Adventist Bolingbrook Hospital
500 Remington BlvdBolingbrookIL60440651219504Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Adventist Care Centers - Courtland Inc
730 Courtland StreetOrlandoFL32804205774723Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Adventist GlenOaks Hospital
701 Winthrop AvenueGlendale HeightsIL60139363208390Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Adventist Hinsdale Hospital
120 North Oak StreetHinsdaleIL60521362276984Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Adventist Hlth Mid-America Inc
9100 W 74th StreetShawnee MissionKS66204521347407Hlthcare Related ServicesKS501(c)(3)Line 11a, IAdventist Hlth SystemSunbelt Inc0
Adventist Hlth Partners Inc
1000 Remington Blvd Ste 200BolingbrookIL60440364138353Operate out-patient physician clinicsIL501(c)(3)Line 3AHS Midwest Management Inc0
Adventist Hlth System Affiliated Benefit Trust
900 Hope WayAltamonte SpringsFL32714266422966Promotion of HlthcareFL501(c)(3)Line 11a, IAdventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope WayAltamonte SpringsFL32714592170012Management ServicesFL501(c)(3)Line 11a, I0N/A
Adventist Hlth SystemGeorgia Inc
1035 Red Bud RoadCalhounGA30701581425000Operation of Hospital & Related ServicesGA501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth SystemSunbelt Inc
900 Hope WayAltamonte SpringsFL32714591479658Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth SystemTexas Inc
602 Courtland StreetOrlandoFL32804742578952Leasing Personnel to Affiliated HospitalTX501(c)(3)Line 11c, III-FIAdventist Hlth System Sunbelt Hlthcare Corp0
Adventist University of Health Sciences Inc (630 Year End)
671 Lake Winyah DriveOrlandoFL32803593069793Education/Operation of SchoolFL501(c)(3)Line 2Adventist Hlth SystemSunbelt Inc0
AHS Midwest Management Inc
1000 Remington Blvd Ste 200BolingbrookIL60440363354567Operation of Physician Practice MgmtIL501(c)(3)Line 11a, IAdventist Hlth SystemSunbelt Inc0
AHSCentral Texas Inc
1301 Wonder World DriveSan MarcosTX78666742621825Provide Office Space - Medical ProfessionalsTX501(c)(3)Line 11c, III-FIAdventist Hlth System Sunbelt Hlthcare Corp0
Apopka Hlth Care Properties Inc
305 E Oak StreetApopkaFL32703510605694Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Battle Creek Adventist Hospital
1000 Remington Blvd Ste 200BolingbrookIL60440381359189InactiveMI501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Bolingbrook Hospital Foundation
1000 Remington Blvd N Entrance 2ndBolingbrookIL60440900494445Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Bradford Heights Hlth & Rehab Center Inc
950 Highpoint DriveHopkinsvilleKY42240205782342Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Burleson Nursing & Rehab Center Inc
301 Huguley BlvdBurlesonTX76028205782243Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Caldwell Hlth Care Properties Inc
1333 West MainPrincetonKY42445510605680Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Cedar Crag Terrace Inc (630 Year End) (11-72213)
Rt 5 Box 900ManchesterKY40962611120442Operation of Home for the elderly-disabledKY501(c)(3)Line 7Memorial Hospital Inc0
Central Texas Hlthcare Collaborative
1301 Wonder World DriveSan MarcosTX78666453739929Support Operation of HospitalTX501(c)(3)Line 11a, IAdventist Hlth SystemSunbelt Inc0
Central Texas Medical Center Foundation
1301 Wonder World DriveSan MarcosTX78666742259907Fund-raising for Tax-exempt hospitalTX501(c)(3)Line 7Adventist Hlth SystemSunbelt Inc0
Chickasaw Hlth Care Properties Inc
250 S Chickasaw TrailOrlandoFL32825510605681Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue WestDurandWI54736391365168Operation of Hospital & Related ServicesWI501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Cobb Medical Associates LLC
3949 South Cobb Drive SESmyrnaGA30080582617089Operation of Physician Practices & Medical ServicesGA501(c)(3)Line 3Emory-Adventist Inc0
Courtland Hlth Care Properties Inc
730 Courtland StreetOrlandoFL32804510605682Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Creekwood Place Nursing & Rehab Center Inc
683 E Third StreetRussellvilleKY42276205782260Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Dairy Road Hlth Care Properties Inc
7350 Dairy RoadZephyrhillsFL33540510605684Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
East Orlando Hlth & Rehab Center Inc
250 S Chickasaw TrailOrlandoFL32825205774748Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Emory-Adventist Inc
3949 South Cobb DriveSmyrnaGA30080582171011Operation of Hospital & Related SvcsGA501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Fletcher Hospital Inc
100 Hospital DriveHendersonvilleNC28792560543246Operation of Hospital & Related SvcsNC501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
FLNC Inc
3355 E Semoran BlvdApopkaFL32703205774761Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Florida Hospital Healthcare Partners Inc (130-123113)
301 Memorial Medical ParkwayDaytona BeachFL32117462354804Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Florida Hospital Medical Group Inc
900 Winderley PlaceMaitlandFL32751593214635Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Florida Hospital Physician Group Inc (21-123113)
14055 Riveredge Drive Ste 250TampaFL33637462021581Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Florida Hospital Waterman Inc
1000 Waterman WayTavaresFL32778593140669Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Florida Hospital Zephyrhills Inc
7050 Gall BlvdZephyrhillsFL33541592108057Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Foundation for Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480868859Fund-raising for Tax-exempt hospitalKS501(c)(3)Line 11a, IShawnee Mission Medical Center Inc0
GlenOaks Hospital Foundation
701 Winthrop AvenueGlendale HeightsIL60139363926044Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas AveTarpon SpringsFL34689592106043Fund-raising for Tax-exempt hospital/foundationFL501(c)(3)Line 11c, III-FITarpon Springs Hospital Foundation Inc0
Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689593690149Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 11c, III-FITarpon Springs Hospital Foundation Inc0
Hinsdale Hospital Foundation
7 Salt Creek Lane Suite 203HinsdaleIL60521521466387Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
In-Motion Rehab Inc
602 Courtland Street Ste 200OrlandoFL32804208023411Therapy services to tax exempt nursing homesKS501(c)(3)Line 11b, IISunbelt Hlth Care Centers Inc0
Jellico Community Hospital Inc
188 Hospital LaneJellicoTN37762620924706Operation of Hospital & Related ServicesTN501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Johnson County Community Care Corporation (11-5613)
11801 South FreewayBurlesonTX76028452793120Support Operation of HospitalTX501(c)(3)Line 11a, IAdventist Hlth SystemSunbelt Inc0
La Grange Memorial Hospital Foundation
5101 S Willow Springs RdLa GrangeIL60525300247776Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Memorial Hlth Systems Foundation Inc
770 West Granada BlvdOrmond BeachFL32174311771522Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 7Memorial Hlth Systems Inc0
Memorial Hlth Systems Inc
301 Memorial Medical ParkwayDaytona BeachFL32117590973502Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Memorial Hospital - West Volusia Inc
701 West Plymouth AvenueDelandFL32720593256803Operation of Hospital & Related ServicesFL501(c)(3)Line 3Memorial Hlth Systems Inc0
Memorial Hospital Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592951990Operation of Hospital & Related ServicesFL501(c)(3)Line 3Memorial Hlth Systems Inc0
Memorial Hospital Inc
210 Marie Langdon DriveManchesterKY40962610594620Operation of Hospital & Related ServicesKY501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Merriam Hlth Care Properties Inc
9700 West 62nd StreetMerriamKS66203364595806Lease to Related OrganizationKS501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Metroplex Adventist Hospital Inc
2201 S Clear Creek RoadKilleenTX76549742225672Operation of Hospital & Related ServicesTX501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Metroplex Clinic Physicians Inc
2201 S Clear Creek RoadKilleenTX76549113762050Physician Hlthcare services to the communityTX501(c)(3)Line 3Metroplex Adventist Hospital Inc0
Metroplex Hospital Inc
900 Hope WayAltamonte SpringsFL32714461256516Future Operation of Hospital & Related SvcsFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Midwest Hlth Foundation
120 North Oak StreetHinsdaleIL60521352230515Support of subsidiary FoundationsIL501(c)(3)Line 11b, II0N/A
Mills Hlth & Rehab Center Inc
500 Beck LaneMayfieldKY42066205782320Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Mission Strategies of Georgia Inc
3949 S Cobb DriveSmyrnaGA30080900866024Provision of support to the nursing home divisionGA501(c)(3)Line 11b, IISunbelt Hlth Care Centers Inc0
Mission Strategies Inc
602 Courtland Street Ste 200OrlandoFL32804205982365Provision of support to the nursing home divisionKS501(c)(3)Line 11b, IISunbelt Hlth Care Centers Inc0
Missouri Adventist Hlth Inc
9100 W 74th StreetShawnee MissionKS66204431224729Support Hlth Care ServicesMO501(c)(3)Line 11d, III-OAdventist Hlth Mid-America Inc0
North Regional EMS Inc
188 Hospital LaneJellicoTN37762262653616EMS ServicesTN501(c)(3)Line 9Jellico Community Hospital Inc0
Ormond Beach Memorial Hospital Auxiliary Inc
301 Memorial Medical ParkwayDaytona BeachFL32117591721962Volunteer support servicesFL501(c)(3)Line 11c, III-FIMemorial Hlth Systems Inc0
Overland Park Nursing & Rehab Center Inc
6501 West 75th StreetOverland ParkKS66204205774821Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Paragon Hlth Care Properties Inc
950 Highpoint DriveHopkinsvilleKY42240510605686Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Pasco-Pinellas Hillsborough Community Hlth System Inc
2400 Bedford RoadOrlandoFL32803208488713Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Portercare Adventist Hlth System (630 Year End)
2525 S Downing StreetDenverCO80210840438224Operation of Hospital & Related ServicesCO501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
Portland Nursing & Rehab Center Inc (11-6513)
215 Highland Circle DrivePortlandTN37148205774842Operation of Home for the Aged/Hlthcare DeliveryTN501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Princeton Hlth & Rehab Center Inc
1333 West MainPrincetonKY42445205782272Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Princeton Professional Services Inc
601 E Rollins StreetOrlandoFL32803591191045Provision of Hlthcare ServicesFL501(c)(3)Line 9Adventist Hlth System Sunbelt Hlthcare Corp0
Quality Circle for Hlthcare Inc
900 Hope WayAltamonte SpringsFL32714263789368Hlthcare Quality ServicesFL501(c)(3)Line 11a, IAdventist Hlth System Sunbelt Hlthcare Corp0
Resource Personnel Inc
602 Courtland Street Ste 200OrlandoFL32804208040875Provide administrative support to tax exempt nursing homesFL501(c)(3)Line 11b, IISunbelt Hlth Care Centers Inc0
Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
2525 South Downing StreetDenverCO80210840745018Fund-raising for Tax-exempt hospitalCO501(c)(3)Line 7PorterCare Adventist Hlth System0
Rollins Brook Community Care Corp
2201 S Clear Creek RoadKilleenTX76549461656773InactiveTX501(c)(3)Line 11a, IAdventist Hlth SystemSunbelt Inc0
Russellville Hlth Care Properties Inc
683 East Third StreetRussellvilleKY42276510605691Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
San Marcos Hlth Care Properties Inc
1900 Medical ParkwaySan MarcosTX78666510605693Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
San Marcos Nursing & Rehab Center Inc
1900 Medical ParkwaySan MarcosTX78666205782224Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Shawnee Mission Hlth Care Inc
6501 West 75th StreetOverland ParkKS66204480952508Lease to Related OrganizationKS501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480637331Operation of Hospital & Related ServicesKS501(c)(3)Line 3Adventist Hlth Mid-America Inc0
South Central Nursing Homes Properties Inc
900 Hope WayAltamonte SpringsFL32714593686109Management SupportGA501(c)(3)Line 11d, III-OSouth Central Inc0
South Central Nursing Homes Inc
602 Courtland StreetOrlandoFL32804611242373Management SupportKY501(c)(3)Line 11d, III-OSouth Central Inc0
South Central Properties III Inc
900 Hope WayAltamonte SpringsFL32714593692860Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties IV Inc
900 Hope WayAltamonte SpringsFL32714593692862Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties VI Inc
900 Hope WayAltamonte SpringsFL32714593692857Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties Inc
900 Hope WayAltamonte SpringsFL32714593651692Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Inc
602 Courtland StreetOrlandoFL32804593689740Management SupportGA501(c)(3)Line 11c, III-FI0N/A
South Pasco Hlth Care Properties Inc
38250 A AvenueZephyrhillsFL33542510605679Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Southwest Volusia Hlth Services Inc
1055 Saxon BlvdOrange CityFL32763593281591Medical Office Building for HospitalFL501(c)(3)Line 11a, ISouthwest Volusia Hlthcare Corp0
Southwest Volusia Hlthcare Corp
1055 Saxon BlvdOrange CityFL32763593149293Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Specialty Physicians of Central Texas Inc
1301 Wonder World DriveSan MarcosTX78666208814408Physician Hlthcare services to the communityTX501(c)(3)Line 3Adventist Hlth SystemSunbelt Inc0
Spring View Hlth & Rehab Center Inc
718 Goodwin LaneLeitchfieldKY42754205782288Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Sunbelt Hlth & Rehab Center - Apopka Inc
305 East Oak StreetApopkaFL32703205774856Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Sunbelt Hlth Care Centers Inc
602 Courtland Street Ste 200OrlandoFL32804581473135Management ServicesTN501(c)(3)Line 11b, IIAdventist Hlth System Sunbelt Hlthcare Corp0
SunSystem Development Corp
900 Hope WayAltamonte SpringsFL32714592219301Fund Raising for Affiliated Tax-Exempt HospitalsFL501(c)(3)Line 7Adventist Hlth System Sunbelt Hlthcare Corp0
Tarpon Springs Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689590898901Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)University Community Hospital IncYes (1)
Tarrant County Hlth Care Properties Inc
301 Huguley BlvdBurlesonTX76028510605677Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Taylor Creek Hlth Care Properties Inc
718 Goodwin LaneLeitchfieldKY42754510605678Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
The Volunteer Auxiliary of Florida Hospital - Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592486582Volunteer support servicesFL501(c)(3)Line 11c, III-FIMemorial Hospital Flagler Inc0
Trinity Nursing & Rehab Center Inc
9700 West 62nd StreetMerriamKS66203205774890Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
University Community Hospital Foundation Inc
3100 E Fletcher AveTampaFL33613592554889Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 11a, IUniversity Community Hospital IncYes (1)
University Community Hospital Specialty Care Inc
3100 E Fletcher AveTampaFL33613593231322InactiveFL501(c)(3)Line 11a, IUniversity Community Hospital IncYes (1)
University Community Hospital Inc
3100 E Fletcher AveTampaFL33613591113901Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare Corp0
West Kentucky Hlth Care Properties Inc
500 Beck LaneMayfieldKY42066510605676Lease to Related OrganizationGA501(c)(3)Line 11c, III-FISunbelt Hlth Care Centers Inc0
Zephyr Haven Hlth & Rehab Center Inc
38250 A AvenueZephyrhillsFL33542205774930Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0
Zephyrhills Hlth & Rehab Center Inc
7350 Dairy RoadZephyrhillsFL33540205774967Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 9Sunbelt Hlth Care Centers Inc0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Appalachian Therapy Services LLC
100 Hospital DriveHendersonvilleNC28792202463851Therapy StaffingNCN/A
Clear Creek MOB Ltd
2201 S Clear Creek RdKilleenTX76549742609195Real EstateTXN/A
Endoscopy Center at Porter LLC
1001 South Park DriveLittletonCO80120205855038Medical ServicesCON/A
Florida Hospital DMERT LLC
2450 Maitland Center Pkwy Ste 200MaitlandFL32751202392253Medical EquipmentFLN/A
Florida Hospital Home Infusion
2450 Maitland Center Pkwy Ste 200MaitlandFL32751593142824Home Infusion ServicesFLN/A
KCCCSMMC Cancer Center LLC (11-4813)
9100 W 74th StreetShawnee MissionKS66204270909763Equipment RentalKSN/A
PAHSUSP Surgery Centers LLC
15305 Dallas Pkwy Ste 1600 LB 28AddisonTX75010263057950Medical ServicesCON/A
San Marcos MRI LP
1330 Wonder World Dr Ste 202San MarcosTX78666770597972Imaging & TestingTXN/A
Shawnee Mission Open MRI LLC
9100 W 74th Street Box 2923Shawnee MissionKS66201270011796Imaging & TestingKSN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1Province Or StateForeignAddress/ProvinceOrStateCountryForeignAddress/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1OwnershipOwnershipPct
Altamonte Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803592855792Condo AssociationFLN/AC0
Apopka Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803593000857Condo AssociationFLN/AC0
CC MOB Inc
2201 S Clear Creek RoadKilleenTX76549742616875Real Estate RentalTXN/AC0
Central Texas Medical Associates
1301 Wonder World DriveSan MarcosTX78666742729873Physician ClinicsTXN/AC0
Central Texas Provider's Network
1301 Wonder World DriveSan MarcosTX78666742827652Physician Hospital Org.TXN/AC0
Florida Hospital Flagler Medical Offices Association Inc
60 Memorial Medical ParkwayPalm CoastFL32164262158309Condo AssociationFLN/AC0
Florida Hospital Healthcare System Inc
602 Courtland StreetOrlandoFL32804593215680PHO/TPAFLN/AC0
Florida Medical Plaza Condo Association Inc
601 East Rollins StreetOrlandoFL32803592855791Condo AssociationFLN/AC0
Florida Memorial Health Network Inc
770 W Granada Blvd Ste 317Ormond BeachFL32174593403558Physician Hospital Org.FLN/AC0
Huguley Alliance Foundation
11801 South FreewayFort WorthTX76115752642209InactiveTXN/AC0
Kissimmee Multispecialty Clinic Condominium Association Inc
201 Hilda Street Suite 30KissimmeeFL34741593539564Condo AssociationFLN/AC0
Midwest Management Services Inc
9100 West 74th StreetShawnee MissionKS66204480901551Real Estate RentalKSN/AC0
Metroplex Adventist Hospital CRNA (11-111113)
2201 S Clear Creek RoadKilleenTX76549260760794Support hospital - provide allied health professionalsTXN/AC0
North American Health Services Inc & Subs
111 N Orlando AvenueWinter ParkFL32789621041820Lessor/Holding Co.TNN/AC0
Ormond Professional Condo Association (430 Year End)
770 W Granada Blvd Ste 101Ormond BeachFL32174592694434Condo AssociationFLN/AC0
Park Ridge Property Owner's Association Inc
1 Park Place Naples RoadFletcherNC28732030380531Condo AssociationNCN/AC0
Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs
2525 S Downing StreetDenverCO80210840956175Healthcare ServicesCON/AC0
San Marcos Regional MRI Inc
1301 Wonder World DriveSan MarcosTX78666770597968Holding CompanyTXN/AC0
The Garden Retirement Community Inc
602 Courtland Street Ste 200OrlandoFL32804593414055Real Estate RentalFLN/AC0
University Community Health Insurance Company SPC Ltd (11-32813)
Captive InsuranceCYes (1)C/O AON Insurance Managers PO BoxGrand CaymanCJCJUniversity Community Hospital Inc1.00000
UCH Services Inc (11-61213)
3100 East Fletcher AveTampaFL33613593508454Management CompanyFLCYes (1)University Community Hospital Inc1.00000
Winter Park Medical Office Building I Condo Assoc Inc
200 Lakemont AveWinter ParkFL32792452228478Physician ClinicsFLN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Pasco-Pinellas Hillsborough Community Health System Inc
Q$2,380,163Cost
Tarpon Springs Hospital Foundation Inc
Q$3,888,189Cost
University Community Hosp Foundation Inc
Q$1,087,679Cost
University Community Hosp Foundation Inc
B$61,950Cost
University Community Hosp Foundation Inc
B$25,000Actual Amount Given
University Community Hosp Foundation Inc
C$434,210Actual Amount Received
Adventist Health System Sunbelt Healthcare Corp
B$1,988,350Actual Amount Given
Adventist Health System Sunbelt Healthcare Corp
M$4,658,186% of facility's operating exp.
Adventist Health System Sunbelt Healthcare Corp dba AHS IS
M$16,745,093% of facility's operating exp.
Adventist Health System Sunbelt Inc dba Florida Hospital
P$238,596Cost
Adventist Health SystemSunbelt Inc
M$2,015,382% of Facility's EHR Revenue
Florida Hospital Zephyrhills Inc
Q$175,140Cost
Adventist Health System Sunbelt Healthcare Corp
P$17,865,847cost