Mid-Florida Medical Services Inc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Mid-Florida Medical Services Inc (EIN 59-2486580)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-07-30
- IRS object ID
- 201302119349300750
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-30T11:04:17-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621517792 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERSHING YOAKLEY & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2963 GULF TO BAY BLVD STE 267 | AddressLine1 |
| City | CLEARWATER | City |
| State | FL | State |
| ZIP Code | 337594255 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592486580 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mid-Florida Medical Services Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MID- | NameControl |
| Phone | 8632971899 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Ave F NE | AddressLine1 |
| City | Winter Haven | City |
| State | FL | State |
| ZIP Code | 33881 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Lance W Anastasio | Name |
| Title | President | Title |
| Phone | 8632971899 | Phone |
| Date Signed | 2013-07-30 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Terry Haefner | Name |
| PTIN | P01258953 | PTIN |
| Phone | 7274427110 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Lance W Anastasio | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Ave F NE | AddressLine1 |
| City | Winter Haven | City |
| State | FL | State |
| ZIP Code | 33881 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16225873 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mfms.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | To improve the health of the people in the community by providing the highest quality and most effective care and services--and return value to the people in our community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 9 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4108140 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16225873 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4108140 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16225873 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 315000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 195000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3495325 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4004358 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2939575 | OtherExpensePriorYear |
| Other Expenses Current Year | 2552059 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6749900 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6751417 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2641760 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9474456 | RevenuesLessExpensesCY |
| Total Assets BOY | 124143500 | TotalAssetsBOY |
| Total Assets EOY | 133176868 | TotalAssetsEOY |
| Total Liabilities BOY | 21059718 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22735044 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 103083782 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 110441824 | NetAssetsOrFundBalancesEOY |
| Mission Description | To improve the health of the people we serve, by providing the highest quality and most effective care and services--and to return value to the people in our communities. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6576861 | Expense |
| Grants | 195000 | Grants |
| Revenue | 16225873 | Revenue |
| Description | Mid-Florida Medical Services, Inc., ("Mid-Florida"), is a not-for-profit corporation located in Polk County, Florida. Mid-Florida serves as the holding company for Winter Haven Hospital, Inc., ("The Hospital"). Mid-Florida's purpose is to provide strategic direction to the Hospital by identifying health trends and community needs that the Hospital may be able to meet. The all-volunteer governing board of Mid-Florida is comprised of the Executive Committee of the Hospital board and several additional at-large board members experienced in healthcare.Mid-Florida Medical Services, Inc. is the holding company for Physician Service Entities in various specialties. | Description |
| Total Program Service Expense | 6576861 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 9 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lance Anastasio | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8632931121 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Avenue F NE | AddressLine1 |
| City | Winter Haven | City |
| State | FL | State |
| ZIP Code | 33881 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Mark Bostick | ||||||||
| Chairman | 2.00 | X | 0 | 0 | 0 | |||
| Brian Swain | ||||||||
| 1st Vice Chairman | 2.00 | X | 0 | 0 | 0 | |||
| Richard Straughn | ||||||||
| 2nd Vice Chairman | 2.00 | X | 0 | 0 | 0 | |||
| Robert C Carter | ||||||||
| 3rd Vice Chairman | 2.00 | X | 0 | 0 | 0 | |||
| Don Ingram | ||||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | |||
| Eileen Holden | ||||||||
| Assistant Secretary | 2.00 | X | 0 | 0 | 0 | |||
| Williams Burns | ||||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | |||
| William H Murrell | ||||||||
| Assistant Treasurer | 2.00 | X | 0 | 0 | 0 | |||
| Lance Anastasio | ||||||||
| President & CEO | 40.00 | 531933 | 0 | 27356 | X | |||
| David MacDougall | ||||||||
| Vice President,CFO | 40.00 | 298995 | 0 | 36819 | X | |||
| David Libby | ||||||||
| Vice President | 40.00 | 183925 | 0 | 22627 | X | |||
| Andrea Kaye Hixon | ||||||||
| Vice President | 40.00 | 210374 | 0 | 11566 | X | |||
| Mary Jo Schreiber | ||||||||
| Vice President | 40.00 | 215718 | 0 | 13988 | X | |||
| Joel Thomas | ||||||||
| Vice President | 40.00 | 153080 | 0 | 31405 | X | |||
| John Parman | ||||||||
| Corporate Attorney | 40.00 | 0 | 177066 | 23464 | X | |||
| Donald Gale | ||||||||
| Vice President | 40.00 | 132364 | 0 | 25650 | X | |||
| Celestino Vega | ||||||||
| Vice President | 40.00 | 316531 | 0 | 36909 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2042920 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 177066 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 229784 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Income From Subsid | 532000 | 11722438 | 11722438 |
| Administrative Salary | 561000 | 2433296 | 2433296 |
| Medical Services | 621990 | 1845139 | 1845139 |
| Lease Income | 531120 | 225000 | 225000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16225873 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16225873 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16225873 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 195000 | Total |
| Program Services | 195000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1876178 | Total |
| Program Services | 1876178 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1876701 | Total |
| Program Services | 1876701 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41515 | Total |
| Program Services | 41515 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32235 | Total |
| Program Services | 32235 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177729 | Total |
| Program Services | 177729 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7500 | Total |
| Management And General | 7500 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2685 | Total |
| Program Services | 2685 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28902 | Total |
| Management And General | 28902 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28971 | Total |
| Program Services | 28971 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12752 | Total |
| Management And General | 12752 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64282 | Total |
| Program Services | 64282 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Professional Fees | 2092282 | 2089999 | 2283 |
| Bad Debts | 179135 | 179135 | |
| Bank Fees | 42288 | 42288 | |
| Medical Supplies | 12431 | 12431 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80831 | Total |
| Management And General | 80831 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6751417 | Total |
| Program Services | 6576861 | ProgramServices |
| Management And General | 174556 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57086 | BOY |
| EOY | 85387 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 270456 | BOY |
| EOY | 223762 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2512797 | BOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2566766 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1459548 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 803872 | BOY |
| EOY | 1107218 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116706218 | BOY |
| EOY | 128428655 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3793071 | BOY |
| EOY | 3331846 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124143500 | BOY |
| EOY | 133176868 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 208605 | BOY |
| EOY | 306468 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20851113 | BOY |
| EOY | 22428576 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21059718 | BOY |
| EOY | 22735044 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101251417 | BOY |
| EOY | 108420706 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 865966 | BOY |
| EOY | 1054719 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 966399 | BOY |
| EOY | 966399 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103083782 | BOY |
| EOY | 110441824 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124143500 | BOY |
| EOY | 133176868 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9474456 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2116414 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Winter Haven Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 590724462 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $6,576,861 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 6576861 | SumOfAmounts |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 229417 | OtherCostOrOtherBasis |
| Book Value | 229417 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1159280 | OtherCostOrOtherBasis |
| Depreciation | 719721 | Depreciation |
| Book Value | 439559 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 109741 | OtherCostOrOtherBasis |
| Depreciation | 109741 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1068328 | OtherCostOrOtherBasis |
| Depreciation | 630086 | Depreciation |
| Book Value | 438242 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1107218 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investment in Winter Haven Hospital | 113371998 | F |
| Investment in Mid-Florida Medical Services Fnd | 15056657 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 128428655 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Deferred Compensation 457(b) Plan Liability | $3,331,846 |
| Accrued Pension Liability | $16,163,846 |
| Due to Affiliates | $2,932,884 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 22428576 | TotalOfAmounts |
| Total Revenue | 16225873 | TotalRevenue |
| Total Expenses | 6751417 | TotalExpenses |
| Excess Or Deficit For Year | 9474456 | ExcessOrDeficitForYear |
| Other | -$2,116,414 | OtherAmount |
| Total Adjustments | -2116414 | TotalAdjustments |
| Excess Or Deficit Per FS | 7358042 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16046742 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 16046742 | RevenueSubtotal |
| Other Revenues Not Included | 179131 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 179131 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16225873 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 6572286 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 6572286 | ExpensesSubtotal |
| Other Expenses Not Included | 179131 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 179131 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 6751417 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | All of the affiliate organizations are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and from state income taxes under the provisions of Chapter 220.13 of the Florida Income Tax Code. Accordingly, no provision for income taxes is made in the accompanying consolidated financial statements. The IRC provides for taxation of unrelated business income under certain circumstances. During the years ended September 30, 2012 and 2011, Mid-Florida performed lab and laundry services for other hospitals, clinics and other health care providers in the community, which generated unrelated business income and resulted in no unrelated business income taxes. There are no significant gross deferred tax assets or liabilities at September 30, 2012 or 2011. Mid-Florida files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: the tax-exempt status of each entity, the continued tax-exempt status of bonds, and various positions relative to potential sources of unrelated business taxable income. |
| Part XI, Line 8 - Other Adjustments: | Additional Pension Liability -2,116,414. | |
| Part XII, Line 4b - Other Adjustments: | Bad Debts Netted with Revenues 179,131. | |
| Part XIII, Line 4b - Other Adjustments: | Bad Debts Netted with Revenues 179,131. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Florida Clinical Practice Association | |||||||
| PO Box 100205 | Gainesville | FL | 326100205 | 561680273 | 501(c)(3) | 120000 | To support medical research. |
| University of Florida Foundation Inc | |||||||
| PO Box 103594 | Gainesville | FL | 326103594 | 590974739 | 501(c)(3) | 75000 | To support medical research. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Mid-Florida Medical Services provided support to Florida Clinical Practice Association and the University of Florida Foundation for medical research. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lance Anastasio | |||||||||||||
| 465292 | 0 | 46900 | 0 | 19741 | 0 | 16270 | 0 | 11086 | 0 | 559289 | 0 | 0 | 0 |
| David MacDougall | |||||||||||||
| 267662 | 0 | 27300 | 0 | 4033 | 0 | 15404 | 0 | 21415 | 0 | 335814 | 0 | 0 | 0 |
| David Libby | |||||||||||||
| 161292 | 0 | 16500 | 0 | 6133 | 0 | 11855 | 0 | 10772 | 0 | 206552 | 0 | 0 | 0 |
| Andrea Kaye Hixon | |||||||||||||
| 184023 | 0 | 18700 | 0 | 7651 | 0 | 11144 | 0 | 422 | 0 | 221940 | 0 | 0 | 0 |
| Mary Jo Schreiber | |||||||||||||
| 194000 | 0 | 19400 | 0 | 2318 | 0 | 13988 | 0 | 0 | 0 | 229706 | 0 | 0 | 0 |
| Joel Thomas | |||||||||||||
| 136412 | 0 | 14100 | 0 | 2568 | 0 | 10287 | 0 | 21118 | 0 | 184485 | 0 | 0 | 0 |
| John Parman | |||||||||||||
| 0 | 175680 | 0 | 0 | 0 | 1386 | 0 | 12659 | 0 | 10805 | 0 | 200530 | 0 | 0 |
| Donald Gale | |||||||||||||
| 130354 | 0 | 0 | 0 | 2010 | 0 | 14977 | 0 | 10673 | 0 | 158014 | 0 | 0 | 0 |
| Celestino Vega | |||||||||||||
| 269985 | 0 | 27900 | 0 | 18646 | 0 | 15481 | 0 | 21428 | 0 | 353440 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Executive Director of Accounting and CFO of Mid-Florida Medical Services, Inc. intially reviewed Form 990. After their review was completed, the final Form 990 was then presented and made available to all Board Members including all voting members of the governing body. | |
| Form 990, Part VI, Section B, line 12c | The Chairman of the Board of Directors inquires at least annually if there are any conflicts of interest. In addition all officers, directors, trustees and key employees are required to sign a conflict of interest statement annually. | |
| Form 990, Part VI, Section B, line 15 | The Executive Compensation Committee of the Board of Directors sets compensation for the President and Vice Presidents of the hospital. The Executive Compensation Committee consists of four Board members, all of whom are independent. The Executive Compensation Committee has used the consulting firm of Sullivan and Cotter to advise them about executive compensation and to provide them with comparability data. Minutes of the Executive Compensation Committee meetings are kept and retained at the Hospital. | |
| Form 990, Part VI, Section C, line 19 | The financial statements of Mid-Florida Medical Services, Inc. are made available to the public upon request. The organization's governing documents and conflict of interest policy are not made available to the public. | |
| Form 990, Part XI, line 5: | Additional Pension Liability -2,116,414. Total to Form 990, Part XI, Line 5: -2,116,414. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets |
|---|---|---|---|---|---|---|---|---|
| Mid-Florida Critical Care Physician Services LLC | ||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 421765832 | Medical Services | FL | -117 | 96 |
| Mid-Florida OBGYN Hospitalist Physician Services LLC | ||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 421765830 | Medical Services | FL | 832 | 27 |
| Mid-Florida Oncology Physician Services LLC | ||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 611558556 | Medical Services | FL | 181406 | 29477 |
| Mid-Florida Urology Physician Services LLC | ||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 611558558 | Medical Services | FL | 1165067 | 601276 |
| Mid-Florida Physician Services LLC | ||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 611558557 | Medical Services | FL | 0 | 0 |
| Mid-Florida Interventional Cardiology Physician Services LLC | ||||||||
| 800 Ave F NE | Winter Haven | FL | 33881 | 800641119 | Medical Services | FL | 497946 | 93295 |
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Mid-Florida Medical Services Foundation Inc | |||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 030406130 | Fundraising | FL | 501(c)(3) | 11A - Type 1 | 0 |
| Winter Haven Hospital Inc | |||||||||
| 200 Ave F NE | Winter Haven | FL | 33881 | 590724462 | Medical Services | FL | 501(c)(3) | 3 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Winter Haven Hospital | ||
| I | 225000 | Cost |
| Winter Haven Hospital | ||
| N | 2433296 | Cost |