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CAPE CANAVERAL HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CAPE CANAVERAL HOSPITAL INC (EIN 59-2477479)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-14
IRS object ID
201302269349302010
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

FieldValueIRS element (for citing)
Timestamp2013-08-14T11:52:57-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line17351 OFFICE PARK PLAddressLine1
CityMELBOURNECity
StateFLState
ZIP Code32940ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN592477479EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAPE CANAVERAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAPENameControl
Phone3214345150Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code329554305ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOSEPH G FELKNERName
TitleEXEC VP/CFOTitle
Phone3214345150Phone
Date Signed2013-07-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHERESA A BURDINE CPAName
PTINP00362629PTIN
Phone3217516200Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVEN P JOHNSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code329554305ZIPCode
FieldValueIRS element (for citing)
Gross Receipts109432527GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEALTH-FIRST.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionOUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.CAPE CANAVERAL HOSPITAL IS A FULL-SERVICE, NOT-FOR-PROFIT HOSPITAL WITH SERVICES INCLUDING A 21-BED LEVEL II EMERGENCY DEPARTMENT, A CERTIFIED BABY-FRIENDLY MOTHER/BABY UNIT, FULLY EQUIPPED SURGICAL SERVICES, A STATE-OF-THE-ART CANCER PROGRAM AND A FULL-SERVICE LABORATORY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers600TotalNbrVolunteers
Total Gross UBI90377TotalGrossUBI
Net Unrelated Business Txbl Income-65406NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year274356ContributionsGrantsPriorYear
Contributions Grants Current Year170500ContributionsGrantsCurrentYear
Program Service Revenue Prior Year116372331ProgramServiceRevenuePriorYear
Program Service Revenue CY108176841ProgramServiceRevenueCY
Investment Income Prior Year-7951InvestmentIncomePriorYear
Investment Income Current Year48338InvestmentIncomeCurrentYear
Other Revenue Prior Year1117242OtherRevenuePriorYear
Other Revenue Current Year1036848OtherRevenueCurrentYear
Total Revenue Prior Year117755978TotalRevenuePriorYear
Total Revenue Current Year109432527TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4580295GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4887276GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year59231104SalariesEtcPriorYear
Salaries Etc Current Year55301918SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year49519635OtherExpensePriorYear
Other Expenses Current Year45544694OtherExpensesCurrentYear
Total Expenses Prior Year113331034TotalExpensesPriorYear
Total Expenses Current Year105733888TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4424944RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3698639RevenuesLessExpensesCY
Total Assets BOY153393690TotalAssetsBOY
Total Assets EOY155087950TotalAssetsEOY
Total Liabilities BOY84306278TotalLiabilitiesBOY
Total Liabilities EOY82864809TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY69087412NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY72223141NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense89385292Expense
Grants4887276Grants
Revenue108086464Revenue
DescriptionCAPE CANAVERAL HOSPITAL, INC. (CCH) FEATURES 150 BEDS AND HAS 240 HIGHLY SKILLED MEDICAL STAFF MEMBERS. CAPE CANAVERAL HOSPITAL IS CERTIFIED AS A "BABY-FRIENDLY HOSPITAL" BY THE WORLD HEALTH ORGANIZATION AND UNICEF. THE WOMEN'S DIAGNOSTIC CENTER FEATURES STATE-OF-THE-ART, PERSONALIZED SERVICES INCLUDING DIGITAL MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, AND MRI BREAST IMAGING AND IS ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY AND THE US FOOD AND DRUG ADMINISTRATION. ADDITIONALLY, CAPE CANAVERAL HOSPITAL INCLUDES A 21-BED LEVEL II EMERGENCY DEPARTMENT AND AN ADJOINING SIX-STORY MEDICAL PLAZA THAT INCLUDES PHYSICIAN'S OFFICES, A CONFERENCE CENTER, PRE-OPERATIVE TESTING, OUTPATIENT REGISTRATION FOR LABORATORY TESTING AND SAME-DAY SURGERY, AS WELL AS A HEALTH RESOURCE CENTER FOR THE COMMUNITY. CAPE CANAVERAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY, ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF CAPE CANAVERAL HOSPITAL, INC. IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION SUCH AS "HEALTHY HAPPENINGS" SEMINARS AND SUPPORT GROUPS FOR THE PUBLIC.IN 2011, CAPE CANAVERAL HOSPITAL'S CHAPLAIN, DEVELOPED AND CONTINUED ON A LOCAL CHURCH-BASED HEALTH MINISTRY KNOWN AS FAITH COMMUNITY NURSING. INITIAL FUNDING OVER A THREE-YEAR PERIOD HELPED ESTABLISH NURSES TO WORK WITHIN TWO AREA CHURCHES. THE NURSES, HIRED BY EACH CHURCH, PROVIDE EDUCATION AND OTHER RESOURCES TO HELP CONGREGANTS LEAD HEALTHIER LIFESTYLES AND AVOID UNNECESSARY MEDICAL SERVICES. IN KEEPING WITH THIS HOSPITAL'S COMMITMENT, TO SERVE ALL MEMBERS OF ITS COMMUNITY:1) FREE CARE AND/OR SUBSIDIZED CARE IS PROVIDED WHERE THE NEED AND/OR INABILITY TO PAY EXISTS; 2) CARE IS PROVIDED AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS; 3) FREE HEALTHCARE ACTIVITIES AND PROGRAMS ARE PROVIDED TO THE COMMUNITY. THESE ACTIVITIES INCLUDE: WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR ELDERLY, HANDICAPPED, AND MENTALLY UNDERSERVED ALONG WITH A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.FOR A COPY OF OUR COMMUNITY BENEFIT REPORT SEE: HTTP://WWW.HEALTH-FIRST.ORG/CR/2013-CR/INDEX.CFM?UTM_SOURCE=WWWHOMEPGBANNER&UTM_MEDIUM=HPBANNER&UTM_CAMPAIGN=CR2013HFWWWHOMEPAGEBANNERDescription
Total Program Service Expense89385292TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DWAIN STILSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3214345150TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code32955ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
TONY HERNANDEZ III ESQ
CHAIRMAN1.00XX069080
KEVIN B STEELE
VICE CHAIRMAN1.00XX0021900
JUDITH A GEORGE
SECRETARY/TREASURER1.00XX01236714400
NICHOLAS E PELLEGRINO
IMMEDIATE PAST CHAIRMAN1.00X0014950
JAMES E CARTER MD
DIRECTOR1.00X0801815400
A THOMAS HOLLINGSWORTH PHD
DIRECTOR1.00X01353716900
GEORGE W LEWIS
DIRECTOR1.00X01128014700
ALPHONSE PECORARO JR MD
MEDICAL STAFF PRESIDENT1.00X035216320413
ROBERT R WRIGHT
PRESIDENT13.00XX0120740362878
RODNEY R MOORE
VP MEDICAL AFFAIRS CCH40.00028941934271X
WESLEY C OTT
VP OPERATIONS CCH40.00016672221119X
SUZANNE CLARK WOODS
VP NURSING CCH40.0001630309624X
JOHN SCOTT WARNER
PHARMACIST40.0001523808829X
SCOTT R SCHIFFER
HOME HEALTH PER VISIT PT40.00014274919893X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2525976TotalReportableCompFrmRltdOrgs
Total Other Compensation275277TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL329554305MANAGEMENT SUPPORT88327921
HOLMES REGIONAL MEDICAL CENTER INC
3300 FISKE BLVDROCKLEDGEFL329554305HOSPITAL SERVICES563253
CAPE HEALTH PROPERTIES
3300 FISKE BLVDROCKLEDGEFL329554305REAL ESTATE SERVICES129049
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations170500RelatedOrganizations
Total Contributions170500TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES6211107738186377381863
MEDICARE/MEDICAID6211103061060030610600
REFERENCE LAB6215009037790377
MEDICAL MONITORING9000997215372153
RELATED COMPANY RENT5311202184821848
FieldValueIRS element (for citing)
Total Program Service Revenue108176841TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column37473TotalRevenueColumn
Exclusion$37,473ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real334Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real334Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column334TotalRevenueColumn
Exclusion$334ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other10865Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other10865Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column10865TotalRevenueColumn
Exclusion$10,865ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFETERIADescription
Business Code722210BusinessCode
Total Revenue Column649018TotalRevenueColumn
Exclusion$649,018ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column387496TotalRevenueColumn
Exclusion$387,496ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1036514TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column109432527TotalRevenueColumn
Related Or Exempt Function Income108086464RelatedOrExemptFunctionIncome
Unrelated Business Revenue90377UnrelatedBusinessRevenue
Exclusion$1,085,186ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4887276Total
Program Services4887276ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1582884Total
Management And General1582884ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total39923452Total
Program Services36677321ProgramServices
Management And General3246131ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1022738Total
Program Services753833ProgramServices
Management And General268905ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9407662Total
Program Services7938103ProgramServices
Management And General1469559ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3365182Total
Program Services2988734ProgramServices
Management And General376448ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1118737Total
Management And General1118737ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total112500Total
Program Services1188ProgramServices
Management And General111312ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1708Total
Management And General1708ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5782199Total
Program Services4292939ProgramServices
Management And General1489260ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total133755Total
Program Services10265ProgramServices
Management And General123490ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1139148Total
Program Services875777ProgramServices
Management And General263371ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2107558Total
Program Services11950ProgramServices
Management And General2095608ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2078984Total
Program Services1832535ProgramServices
Management And General246449ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total314862Total
Program Services300240ProgramServices
Management And General14622ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total10468Total
Program Services792ProgramServices
Management And General9676ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3499130Total
Program Services3108763ProgramServices
Management And General390367ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8136321Total
Program Services6558816ProgramServices
Management And General1577505ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1147032Total
Management And General1147032ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES140504801403562714853
MAINTENANCE & REPAIR23686482249020119628
FLORIDA INDIGENT TAX12448341244834
LICENSES & TAXES925065321939287

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2205824Total
Program Services1564060ProgramServices
Management And General641764ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total105733888Total
Program Services89385292ProgramServices
Management And General16348596ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY52380949BOY
EOY59193698EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11719683BOY
EOY9507647EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY107685BOY
EOY218125EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2427966BOY
EOY2320511EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY337976BOY
EOY328325EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis164424965LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec110679699LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57119935BOY
EOY53745266EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY27454405BOY
EOY27985910EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY736527BOY
EOY576875EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1108564BOY
EOY1211593EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY153393690BOY
EOY155087950EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6080814BOY
EOY6276356EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY32874556BOY
EOY37306293EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY45350908BOY
EOY39282160EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY84306278BOY
EOY82864809EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY67407988BOY
EOY71089984EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1679424BOY
EOY1133157EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY69087412BOY
EOY72223141EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY153393690BOY
EOY155087950EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3698639ReconcilationRevenueExpenses
Reconcilation Other Changes-562910ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis71173OtherCostOrOtherBasis
Book Value71173BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis87095068OtherCostOrOtherBasis
Depreciation43588418Depreciation
Book Value43506650BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis865174OtherCostOrOtherBasis
Depreciation678784Depreciation
Book Value186390BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis76190813OtherCostOrOtherBasis
Depreciation66412497Depreciation
Book Value9778316BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis202737OtherCostOrOtherBasis
Book Value202737BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings53745266TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
HEALTHCARE RELATED JOINT VENTURES5412749C
DEMAND NOTE - HEALTH FIRST INC20721740C
DEMAND NOTE - HEALTH FIRST FDN718264C
OTHER TEMPORARILY RESTRICTED1133157C
FieldValueIRS element (for citing)
Total Of Book Value Program Related27985910TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER CURRENT LIABILITIES$6,104,182
INTER-COMPANY PAYABLE$7,781,306
OTHER NONCURRENT LIABILITIES$1,316,647
TAX-EXEMPT BONDS HELD BY HEALTH FIRST INC.$24,080,025
FieldValueIRS element (for citing)
Total Of Amounts39282160TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationFIN 48 FOOTNOTE: THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(A), AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), OF THE INTERNAL REVENUE CODE AND SECTION 220.13 OF THE FLORIDA STATUTES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. ASC TOPIC 740, INCOME TAXES, PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC TOPIC 740 PROVIDES GUIDANCE FOR RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6161890TotalCommunityBenefitExpense
Direct Offsetting Revenue1817183DirectOffsettingRevenue
Net Community Benefit Expense4344707NetCommunityBenefitExpense
Percent Of Total Expense0.04110PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8286784TotalCommunityBenefitExpense
Direct Offsetting Revenue4284914DirectOffsettingRevenue
Net Community Benefit Expense4001870NetCommunityBenefitExpense
Percent Of Total Expense0.03780PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1244834TotalCommunityBenefitExpense
Net Community Benefit Expense1244834NetCommunityBenefitExpense
Percent Of Total Expense0.01180PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense15693508TotalCommunityBenefitExpense
Direct Offsetting Revenue6102097DirectOffsettingRevenue
Net Community Benefit Expense9591411NetCommunityBenefitExpense
Percent Of Total Expense0.09070PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense9862TotalCommunityBenefitExpense
Net Community Benefit Expense9862NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense399971TotalCommunityBenefitExpense
Net Community Benefit Expense399971NetCommunityBenefitExpense
Percent Of Total Expense0.00380PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense533425TotalCommunityBenefitExpense
Net Community Benefit Expense533425NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense63582TotalCommunityBenefitExpense
Net Community Benefit Expense63582NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1006840TotalCommunityBenefitExpense
Net Community Benefit Expense1006840NetCommunityBenefitExpense
Percent Of Total Expense0.00950PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16700348TotalCommunityBenefitExpense
Direct Offsetting Revenue6102097DirectOffsettingRevenue
Net Community Benefit Expense10598251NetCommunityBenefitExpense
Percent Of Total Expense0.10020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,922,205BadDebtExpenseAmount
Amount Attributable To910458AmountAttributableTo
Amount Reimbursed By Medicare26325686AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare34889233CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8563547MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAPE CANAVERAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1701 W COCOA BEACH CSWYAddressLine1
CityCOCOA BEACHCity
StateFLState
ZIP Code32931ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherACUTE CARE HOSPITALOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CAPE CANAVERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted0UsesFPGDiscounted
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HEALTH FIRST AGING INSTITUTE
701 W COCOA BEACH CSWYCOCOA BEACHFL32931ELDER CARE
HEALTH FIRST HOME CARE
701 W COCOA BEACH CSWYCOCOA BEACHFL32931IN-HOME CARE

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: THE ORGANIZATION CALCULATED THE COST AMOUNTS NOTED IN PART I, LINE 7 BY UTILIZING ITS CURRENT COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS REPORTED ON, INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, MEDICAID, UNINSURED, AND MEDICARE.PART I, LINE 3C:HEALTH FIRST DOES MAKE PROVISION FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THROUGH PROCESSES AND FORMULARIES WHICH INCLUDE CONSIDERATION OF INDIVIDUALS INCOMES IN COMPARISON TO FPG. DISCOUNTS RANGE FROM EXPECTED TOKEN PAYMENTS (SUCH AS $100) TO A 60% DISCOUNT OF BILLED CHARGES.PART I, LINE 6A:THE COMMUNITY BENEFIT REPORT IS PREPARED BY HEALTH FIRST, INC., THE PARENT COMPANY TO THE ORGANIZATION. THE COMMUNITY BENEFITS OF THIS ORGANIZATION ARE INCLUDED WITHIN THAT REPORT.
PART II: COMMUNITY BUILDING ACTIVITIES ARE PRIMARILY SUBSIDIZED BY HEALTH FIRST, INC. (PARENT) AND THEREFORE ARE NOT REPORTED AT EACH INDIVIDUAL HOSPITAL. THE NEEDS IDENTIFIED ARE, IN PART, BASED ON THE COMMUNITY NEEDS ASSESSMENT. HEALTH FIRST, INC. UTILIZED HOURS OF PAID PHYSICIANS AND NURSES TO SUPPORT THE COMMUNITY WHILE ON PAYROLL. IN ADDITION, AN AMOUNT IN EXCESS OF $1.4M WAS CONTRIBUTED TO VARIOUS LOCAL ORGANIZATIONS PRIMARILY SUPPORTING THE VARIOUS COMMUNITY PUBLIC HEALTH NEEDS. HEALTH FIRST, INC. ALSO SUPPORTED THE ECONOMIC DEVELOPMENT NEEDS, PROVIDED OTHER COMMUNITY SUPPORT, PARTCIPATED IN ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING PROJECTS, SUPPORTED A COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND SUPPORTED THE LOCAL WORKFORCE DEVELOPMENT PROGRAM. HEALTH FIRST, INC. AND ITS EMPLOYEES ALSO ACTIVELY SUPPORT THE LOCAL UNITED WAY IN EXCESS OF $220K.
PART III, LINE 4: BAD DEBT AT COST IS CALCULATED BY MULTIPLYING ACTUAL BAD DEBT WRITE-OFFS BY THE FILING ORGANIZATION'S COST-TO-CHARGE RATIO.THE ORGANIZATION USED A COST TO CHARGE RATIO TO DETERMINE THE COST AMOUNT OF THE BAD DEBT EXPENSE. WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, AS PROVIDED IN THE IRS INSTRUCTIONS WAS USED TO VALIDATE THE COST TO CHARGE RATIO WHICH APPROXIMATES INTERNAL COST CALCULATION. THE ORGANIZATION PROVIDES UNINSURED ACCOUNTS WITH A DISCOUNT FOR PROMPT PAYMENT. THE DISCOUNT IS NOT COLLECTED, NOR PURSUED, AND THEREFORE NOT INCLUDED IN NET PATIENT REVENUE. THE REMAINING BALANCE IS PURSUED, AND IF NOT COLLECTED, REPORTED AS A BAD DEBT EXPENSE.THE ORGANIZATION DOES NOT ISSUE A STAND ALONE FINANCIAL STATEMENT; HOWEVER, IT IS INCLUDED AS A PART OF THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS. THE FOOTNOTE FROM THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS IS AS FOLLOWS: THE PROVISION FOR BAD DEBTS AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR AND AGING CATEGORY, CONSIDERING THE BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED.THE METHOD THE ORGANIZATION USED TO DETERMINE THE AMOUNT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY IS BASED ON A COLLECTION SCORING SYSTEM. THE SCORING SYSTEM ATTRIBUTED A RECOVER SCORE TO EACH PATIENT. IT WAS THEN DETERMINED THAT PATIENTS BELOW A CERTAIN SCORE WOULD TYPICALLY QUALIFY FOR CHARITY CARE IF THEY WERE TO PROVIDE SUFFICIENT INFORMATION.
PART III, LINE 8: THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. ROUTINE AND ICU COSTS ARE DETERMINED BASED ON AN AVERAGE COST PER DAY MULTIPLIED BY THE NUMBER OF MEDICARE ALLOWABLE DAYS. MEDICARE ANCILLARY COSTS ARE DETERMINED BY THE RATIO OF DEPARTMENT COSTS TO DEPARTMENT CHARGES THEN THE RESULTING % IS APPLIED TO MEDICARE ALLOWABLE CHARGES.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: THE ORGANIZATION APPLIES THE FOLLOWING PROCEDURES IN ITS COLLECTION PRACTICES FOR THOSE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE:1. PATIENTS OR GUARANTORS DESIRING TO APPLY FOR FINANCIAL ASSISTANCE WILL BE REQUIRED TO COMPLETE A HEALTH FIRST FINANCIAL ASSISTANCE APPLICATION. THE APPLICATION PROCESS MAY BEGIN AT PRE-ADMISSION OR AT ANY TIME THEREAFTER. FOR FINANCIAL ASSISTANCE APPROVAL ON ELECTIVE PROCEDURES, PLEASE REFER TO POLICY ADDENDUM BELOW.2. INCOME GUIDELINES FOR QUALIFICATION FOR FINANCIAL ASSISTANCE WILL BE BASED ON THE FEDERAL POVERTY GUIDELINE AS FURNISHED ANNUALLY BY THE DEPARTMENT OF HRS.3. AHCA GUIDELINES AND DOCUMENTATION REQUIREMENTS WILL BE USED IN ESTABLISHING QUALIFICATION FOR FINANCIAL ASSISTANCE. THIS DOCUMENTATION MAY INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING:A. COMPLETED AND SIGNED FINANCIAL ASSISTANCE APPLICATIONB. PROOF OF HOUSEHOLD INCOMEC. CREDIT BUREAU REPORT AND/OR ASSET CHECK4. PATIENTS WHO ARE ELIGIBLE FOR MEDICAID WILL NOT BE REQUIRED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION.5. THE FINANCIAL ASSISTANCE APPLICATION AND SUPPORTING DOCUMENTATION WILL BE REVIEWED FOR PROPRIETY WHEN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.6. A NOTIFICATION LETTER WILL BE SENT TO THE GUARANTOR OR PATIENT TO COMMUNICATE ELIGIBILITY FOR FINANCIAL ASSISTANCE OR DENIAL.7. PATIENTS WHO DO NOT PROVIDE INFORMATION NECESSARY TO COMPLETELY AND ACCURATELY ASSESS THEIR FINANCIAL SITUATION AND/OR WHO DO NOT COOPERATE WITH EFFORTS TO SECURE OTHER THIRD PARTY COVERAGE WILL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE.8. PATIENTS WHO ARE UNINSURED AND DO NOT QUALIFY FOR FULL OR PARTIAL FINANCIAL ASSISTANCE WILL BE ELIGIBLE FOR HEALTH FIRST'S PROMPT PAY DISCOUNT FOR SELF PAY PATIENTS.9. ALL APPROVED FINANCIAL ASSISTANCE APPLICATIONS WILL BE VALID FOR A PERIOD OF 90 DAYS. APPROVED TUMOR CLINIC APPLICATIONS ARE VALID FOR A PERIOD OF ONE YEAR.
PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGN WITH THE GUIDELINES SET FORTH BY GAAP.
PART V, SECTION B, LINE 10: HEALTH FIRST DOES MAKE PROVISION FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THROUGH PROCESSES AND FORMULARIES WHICH INCLUDE CONSIDERATION OF INDIVIDUALS INCOMES IN COMPARISON TO FPG. DISCOUNTS RANGE FROM EXPECTED TOKEN PAYMENTS (SUCH AS $100) TO A 60% DISCOUNT OF BILLED CHARGES.CAPE CANAVERAL HOSPITAL
PART V, SECTION B, LINE 19D: INDIVIDUALS THAT DO NOT HAVE INSURANCE ARE ELIGIBLE FOR A 60% PROMPT PAY DISCOUNT. THIS DISCOUNT IS APPROXIMATELY THE AVERAGE NEGOTIATED COMMERCIAL INSURANCE RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY.CAPE CANAVERAL HOSPITAL
PART VI, LINE 2: HEALTH FIRST, INC. (PARENT), ON BEHALF OF ITS MEMBER HOSPITAL ORGANIZATIONS, PARTNERS WITH THE HEALTH COUNCIL OF EAST CENTRAL FLORIDA IN ASSESSING THE HEALTH CARE NEEDS OF OUR COMMUNITY. THE MOST RECENT COMMUNITY NEEDS ASSESSMENT REPORT IS AVAILABLE AT HTTP://WWW.CFLHEALTHYMEASURES.ORG./
PART VI, LINE 3: IT IS THE POLICY OF HEALTH FIRST TO GRANT FINANCIAL ASSISTANCE TO ELIGIBLE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR HEALTH CARE SERVICES DUE TO THEIR LIMITED FINANCIAL RESOURCES. IT IS ALSO THE HEALTH FIRST POLICY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS (AS DEFINED BY FEDERAL LAW KNOWN AS "EMTALA") TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY.INFORMATION ABOUT HEALTH FIRST'S FINANCIAL ASSISTANCE PROGRAM SHALL BEMADE AVAILABLE TO PATIENTS AND GUARANTORS BY VARIOUS MEANS, INCLUDING THEPUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN THEEMERGENCY AND ADMITTING DEPARTMENTS, AND AT OTHER PUBLIC PLACES THE HEALTHFIRST FACILITY MAY ELECT. WRITTEN SUMMARY INFORMATION DESCRIBING THEPOLICY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION WILL BE MADEAVAILABLE TO EACH PATIENT IN ALL EMERGENCY AND ADMITTING DEPARTMENTS. THEPOLICY WILL ALSO BE POSTED ON THE HEALTH FIRST WEBSITE. SUCH INFORMATIONSHALL BE PROVIDED IN THE PRIMARY LANGUAGE SPOKEN BY THE GENERAL POPULATIONS SERVED BY THE HEALTH FIRST FACILITY.ANY HEALTH FIRST ASSOCIATE OR MEMBER OF THE MEDICAL STAFF MAY REFERPATIENTS FOR FINANCIAL ASSISTANCE. A PATIENT OR A FAMILY MEMBER, CLOSEFRIEND OR ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIALASSISTANCE ON BEHALF OF THE PATIENT.
PART VI, LINE 4: BREVARD COUNTY, ALSO KNOWN AS THE SPACECOAST, STRETCHES OVER 70 MILES ALONG THE ATLANTIC COAST, WITH A POPULATION OF MORE THAN 550,000 AND MORE THAN 250,000 HOUSING UNITS (BASED ON JULY 2010 US CENSUS DATA). BEST KNOWN AS THE LOCATION OF THE KENNEDY SPACE CENTER, THE "SPACECOAST" IS ALSO HOME TO PORT CANAVERAL, THE WORLD'S SECOND BUSIEST PASSENGER CRUISE PORT. THE COUNTY IS UNOFFICIALLY DIVIDED INTO THREE SECTIONS, NORTH COUNTY, COMPRISING TITUSVILLE, MIMS, AND PORT ST. JOHN; CENTRAL BREVARD, WHICH INCLUDES COCOA, ROCKLEDGE, MERRITT ISLAND, AND COCOA BEACH; AND SOUTH COUNTY, WHICH INCLUDES MELBOURNE, PALM BAY, GRANT, VALKARIA AND THE SOUTH BEACHES WHICH STRETCH TO THE LINE BETWEEN BREVARD AND INDIAN RIVER COUNTIES. BREVARD COUNTY GREW BY 12.6% BETWEEN 2000 AND 2010 TO 543,376 PEOPLE. DURING THIS SAME TIME PERIOD, THE HISPANIC POPULATION DOUBLED AND THE AFRICAN AMERICAN POPULATION GREW BY 37%. THE COUNTY IS OVER 78% WHITE, 10% AFRICAN AMERICAN, 8% HISPANIC AND THE REMAINDER, A MIXTURE OF OTHER RACES.OF THE HOUSEHOLDS IN BREVARD COUNTY, OVER 26% HAVE CHILDREN UNDER THE AGEOF 18 LIVING WITH THEM, 53% ARE MARRIED COUPLES LIVING TOGETHER, 10% HAVEA FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT AND 33% ARE NON-FAMILIES.THE POPULATION DISTRIBUTION IS AS FOLLOWS: 19% UNDER THE AGE OF 18, 8%FROM 18 TO 24, 23% FROM 25 TO 44, 28% FROM 45 TO 64, AND 22% WHO ARE65 YEARS OF AGE OR OLDER. THE MEDIAN AGE IS 42.8 YEARS.IN 2010, 8% OF THE RESIDENTS WERE LIVING IN POVERTY COMPARED WITH 13%STATEWIDE. 87% OF THE RESIDENTS HAD A HIGH SCHOOL DEGREE, COMPARED WITH85% STATEWIDE.THE ECONOMY IN BREVARD COUNTY HAS TAKEN A HIT IN RECENT YEARS AS HAS THEECONOMY IN FLORIDA. IN 2010, THE BROOKING INSTITUTION REPORTED THATBREVARD COUNTY RANKED IN THE BOTTOM FIFTH OF THE NATION'S TOP METRO AREASBASED ON UNEMPLOYMENT, GROSS METROPOLITAN PRODUCT, HOUSING PRICES ANDFORECLOSED PROPERTIES. BY MARCH 2012, ALMOST 80,000 PEOPLE IN THE COUNTY WERE RECEIVING FOOD STAMPS.THERE ARE 7 ACUTE CARE HOSPITALS SERVING PATIENTS IN BREVARD COUNTY:PARRISH MEDICAL CENTER LOCATED IN NORTH COUNTY; CAPE CANAVERAL HOSPITAL,VIERA HOSPITAL AND WUESTHOFF ROCKLEDGE IN CENTRAL COUNTY; AND HOLMESREGIONAL MEDICAL CENTER, WUESTHOFF MELBOURNE AND PALM BAY HOSPITAL INSOUTH COUNTY.
PART VI, LINE 5: THE GOVERNING BODY OF CAPE CANAVERAL HOSPITAL, INC. IS COMPRISED OF PERSONS WHO PRIMARILY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS NOR FAMILY MEMBERSOF THE ORGANIZATION NOR ITS KEY EMPLOYEES.THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIEDPHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS.THE ORGANIZATION DOES APPLY RESOURCES THROUGHOUT THE YEAR TO SUPPORTIMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND TRAINING. THE ORGANIZATION SPENT MORE THAN $390K TO SUPPORT LOCAL STUDENTS VIA TRAINING, EDUCATION, AND SCHOLARSHIP.THE EMERGENCY DEPARTMENT AT CAPE CANAVERAL HOSPITAL, INC. HAD MORE THAN26,000 VISITS DURING THE YEAR REGARDLESS OF ABILITY TO PAY. IN ADDITIONTHE ORGANIZATION PARTICIPATES IN SEVERAL GOVERNMENT SPONSORED HEALTH CAREPROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, CHAMPUS, ANDTRICARE.CAPE CANAVERAL HOSPITAL, INC. REINVEST THEIR NET OPERATING INCOME TOSUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.
PART VI, LINE 6: THE ROOTS OF HEALTH FIRST RUN DEEP IN BREVARD, DATING BACK TO 1931 WHEN BREVARD HOSPITAL FIRST OPENED IN MELBOURNE WITH 27 BEDS. NOW KNOWN AS HOLMES REGIONAL MEDICAL CENTER (HRMC), THE HOSPITAL IS BREVARD'S LARGEST, WITH 514 BEDS. CAPE CANAVERAL HOSPITAL (CCH) OPENED IN 1962 WITH 44 BEDS, AND HAS SINCE GROWN TO 150 BEDS. PALM BAY HOSPITAL (PBH) OPENED IN 1992 AS A SATELLITE OF HRMC WITH 60 BEDS AND HAS SINCE GROWN TO 152 BEDS. VIERA HOSPITAL (VH) OPENED IN APRIL OF 2011 WITH 84 BEDS.HEALTH FIRST WAS FORMED WHEN CCH, HRMC, AND PBH JOINED TOGETHER IN AUGUST1995 TO CREATE A TRULY INTEGRATED NOT-FOR-PROFIT HEALTHCARE DELIVERYSYSTEM AND FULFILL A COMMON MISSION OF IMPROVING THE HEALTH OF OURCOMMUNITY. THE FIRST NEW SERVICES ADDED IN THE HEALTH FIRST FAMILY WEREHEALTH FIRST PHYSICIANS, OPENING IN LATE 1995, AND HEALTH FIRST HEALTHPLANS, OPENING IN JANUARY 1996. SINCE THEN, WE'VE ALSO ADDED, HOLMESREGIONAL TRAUMA CENTER, VIERA HOSPITAL IN APRIL OF 2011, VITALWATCH - ELECTRONIC INTENSIVE CARE UNIT AND MANY OTHER SERVICES TO OUR FAMILY.OTHER SERVICES INCLUDE OUTPATIENT CENTERS; THE COUNTY'S ONLY TRAUMACENTER; HOME CARE; SPECIALIZED PROGRAMS FOR CANCER, DIABETES, HEART,STROKE, AND REHABILITATIVE SERVICES; CENTRAL BREVARD'S LARGEST MEDICALGROUP; THREE FITNESS CENTERS; AND MEDICARE ADVANTAGE, COMMERCIAL POS, ANDCOMMERCIAL HMO HEALTH PLANS.WORKING TOGETHER IN A SEAMLESS SYSTEM, HEALTH FIRST IS DEVOTED TOINTEGRATING QUALITY HEALTHCARE SERVICES WITH STATE-OF-THE-ART TECHNOLOGY.HEALTH FIRST ALSO WORKS TOGETHER WITH OTHER ORGANIZATIONS AND PHYSICIANSIN OUR COMMUNITY.OUR ASSOCIATES ARE ALSO ACTIVELY BUILDING A HEALTHIER COMMUNITY THROUGHVOLUNTEERING FOR ORGANIZATIONS DEDICATED TO PREVENTING AND TREATING HEALTHCONCERNS SUCH AS CANCER, DIABETES, AND HEART DISEASE. WE'RE ALSO PROUD OFOUR ASSOCIATE'S CHARITABLE GIVING PLAN, EAGLES (EVERY ASSOCIATE'S GIFTLEAVES EVERLASTING SPIRIT), THAT PROMOTES TISSUE AND ORGAN DONORAWARENESS, PROVIDES DENTAL SERVICES FOR BREVARD HEALTH ALLIANCE PATIENTS,AND SUPPORTS THE BRIGHT STAR CENTER FOR GRIEVING CHILDREN & FAMILIES.PART VI, LINE 7: NOT APPLICABLE. NEITHER THE FILING ORGANIZATION NOR ANY RELATED ORGANIZATION FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO THE FLORIDA HOSPITAL ASSOCIATION.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
HEALTH FIRST FOUNDATION INC
3300 FISKE BLVDROCKLEDGEFL32955593528774501(C)(3)15819GENERAL SUPPORT
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955593336894501(C)(3)4823694GENERAL SUPPORT
BREVARD COMMUNITY COLLEGE NURSING PROGRAM
1519 CLEARLAKE ROADCOCOAFL3292259092067511547763EXPAND ASSOCIATE NURSING PROGRAM

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE CAPE CANAVERAL HOSPITAL BOARD MONITORS USAGE BY EACH ENTITY TO ASSURE FUNDS RAISED ARE USED APPROPRIATELY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALPHONSE PECORARO JR MD
0350453000171000020413037257600
ROBERT R WRIGHT
0247816000959587043818019060012702810629608
RODNEY R MOORE
02845170004902012931021340032369000
WESLEY C OTT
0163268000345406282014837018784100
SUZANNE CLARK WOODS
015998600030440688302741017265400
JOHN SCOTT WARNER
01513990009810764201187016120900
SCOTT R SCHIFFER
01426690008006522013371016264200

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BHEALTH FIRST, INC HAS A NON-QUALIFIED SERP FOR CERTAIN EXECUTIVES. BELOW ARE THE 2011 DEFERRED AMOUNTS: ROBERT R. WRIGHT $ 31,515
PART IIICOMPENSATION IS PAID BY HEALTH FIRST, INC. EIN: 59-3336894 AND REIMBURSED BY CAPE CANAVERAL HOSPITAL, INC. SALARY AND BENEFIT EXPENSES DISCLOSED IN PART IX IS ALLOCATED TO THIS ENTITY. AMOUNTS REPORTED IN COLUMN F REPRESENT DEFERRED COMPENSATION PREVIOUSY REPORTED ON PRIOR YEARS' FORM 990. THE FILING ORGANIZATION RELIED ON HEALTH FIRST FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, NUMBER 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF CAPE CANAVERAL HOSPITAL, INC. IS HEALTH FIRST, INC., A FLORIDA NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE CORPORATE PARENT OF THE HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7AHEALTH FIRST, INC. (HFI), A SECTION 501(C)(3) EXEMPT ORGANIZATION AND THE PARENT OF THE EXEMPT HEALTHCARE SYSTEM, IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BPER THE BYLAWS AND THE LAWS OF THE STATE OF FLORIDA, THE ADMINISTRATIVE POWER OF THE CORPORATION SHALL BE VESTED IN THE BOARD OF DIRECTORS WHICH SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION. THE BOARD OF DIRECTORS SHALL NOT TAKE ANY ACTION WITH RESPECT TO THE FOLLOWING WITHOUT APPROVAL OF THE MEMBER: -CHANGE IN THE MISSION, PURPOSE OR SCOPE OF THE CORPORATION AND ITS OPERATION; -INCURRENCE OF DEBT OR GUARANTEE THE DEBT OF ANOTHER; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF ANY REAL OR PERSONAL PROPERTY HAVING FMV IN EXCESS OF $250,000; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; -APPROVAL OF THE ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS AND ANY MATERIAL DEVIATONS THEREFROM; -APPOINTMENT OR ENGAGEMENT OF AUDITORS, LEGAL COUNSEL OR CONSULTANTS; -APPROVAL OF CHANGES OF HUMAN RESOURCE, EMPLOYEE BENEFITS, ACCOUNTING, FINANCIAL AND OTHER POLICIES OR PROCEDURES; -APPROVAL OF STRATEGIC AND LONG-RANGE PLANS, MAJOR FUND RAISING PROGRAMS AND FINANCIAL COMMITMENTS NOT BUDGETED; -CREATION, ACQUISITION, SALE, PURCHASE, DISSOLUTION OR OTHER DISPOSITION OF ANY AFFILIATED OR CONTROLLED ENTITY OR JOINT VENTURE OR ANY INTEREST IN SUCH ENTITY; -RELOCATION, IMPLEMENTATION OR DISCONTINUATION OF A MAJOR PROGRAM SERVICE; -THE APPROVAL OF MANAGED CARE AGREEMENTS; -THE REPEAL, AMENDMENT, OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; AND -CAPITAL EXPENDITURES AND CAPITAL LEASES EXCEEDING $500,000 ANNUALLY OR $1,000,000 IN TOTAL.
FORM 990, PART VI, SECTION B, LINE 11AFTER REVIEW AND APPROVAL BY THE CHIEF FINANCIAL OFFICER THE FORM 990 IS SENT TO EACH MEMBER OF THE BOARD OF DIRECTORS ELECTRONICALLY FOR THEIR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CA COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL BOD MEMBERS, OFFICERS, MANAGEMENT, AND ASSOCIATES IN WHICH THEY REVIEW AND SIGN THAT THEY HAVE AGREED TO THE TERMS NOTED IN THE POLICY ON AN ANNUAL BASIS. IN ADDITION, ALL MANAGEMENT, OFFICERS, AND BOD MEMBERS ON AN ANNUAL BASIS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE PREPARED AND MONITORED BY THE CHIEF COMPLIANCE OFFICER. THE QUESTIONNAIRE REQUIRES AN ATTESTATION STATING THAT THE INDIVIDUAL IS FREE OF CONFLICTS SHOULD THEY NOT REPORT ANYTHING OF CONCERN. THESE FORMS ARE TRACKED AND KEPT ON FILE. SHOULD A CONFLICT ARISE, THE CHIEF COMPLIANCE OFFICER INVESTIGATES THE ISSUE AND DETERMINES A COURSE OF ACTION TO ENSURE ENFORCEMENT OF THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION PROCESS IS DETERMINED BY THE PARENT COMPANY. THE PARENT COMPANY'S PROCESS IS AS FOLLOWS: THE SALARIES OF OUR CEO AND OTHER HEALTH EXECUTIVES ARE REVIEWED AND RECOMMENDED ANNUALLY TO THE BOARD OF DIRECTORS AND APPROVED IN EXECUTIVE SESSION BY THE FULL BOARD OF HEALTH FIRST. HEALTH FIRST CONTRACTS ANNUALLY WITH A HIGHLY RESPECTED NATIONAL CONSULTING FIRM TO PROVIDE THESE RECOMMENDATIONS TO ENSURE THAT OUR EXECUTIVES ARE COMPENSATED FAIRLY AND COMPETITIVELY WHEN COMPARED WITH SIMILAR ROLES IN OTHER HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION COMMITTEE IS INDEPENDENT FOR INTERNAL REVENUE CODE SECTION 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED. MINUTES ARE KEPT FOR ALL BOARD OF DIRECTORS AND COMPENSATION COMMITTEE MEETINGS. THE PROCESS IS DOCUMENTED CONTEMPORANEOUSLY IN THE BOARD AND COMMITTEE MEETINGS.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: QUARTERLY AND ANNUALLY CONSOLIDATED FINANCIALS AND CONSOLIDATED STATISTICAL INFORMATION IS FILED ELECTRONICALLY ON WWW.DACBOND.COM AND IS AVAILABLE TO THE PUBLIC. IN ADDITION, ANY REQUESTS MADE TO THE CHIEF FINANCIAL OFFICER FOR THE ABOVE REFERENCED ITEMS ARE PROVIDED UPON REQUEST IN A TIMELY MANNER. A COPY OF THE CONFLICTS OF INTEREST POLICY IS AVAILABLE UPON REQUEST TO THE COMPLIANCE OFFICER.
PART VII, SECTION A, COLUMN B:AVERAGE HOURS PER WEEK DEVOTED TO POSITIONS WITH RELATED ORGANIZATIONS: JAMES E. CARTER, MD 1 HOUR HEALTH FIRST, INC. JUDITH A. GEORGE 1 HOUR HEALTH FIRST, INC & VIERA HOSPITAL, INC. A. THOMAS HOLLINGSWORTH 1 HOUR HEALTH FIRST, INC & VIERA HOSPITAL, INC. GEORGE W. LEWIS 1 HOUR HEALTH FIRST, INC. NICHOLAS E. PELLEGRINO 1 HOUR HEALTH FIRST, INC. KEVIN STEELE 1 HOUR HEALTH FIRST, INC & HEALTH FIRST FOUNDATION, INC. ROBERT R. WRIGHT 28 HOURS HOLMES REGIONAL MEDICAL CENTER, INC., VIERA HOSPITAL, INC., HOSPICE OF HEALTH FIRST, INC., & HEALTH FIRST, INC. TONY HERNANDEZ III, ESQ. 1 HOUR HEALTH FIRST, INC.
FORM 990, PART XI, LINE 5:TRANSFER OF NET ASSETS TO A RELATED TAX-EXEMPT -16,643. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -546,267. TOTAL TO FORM 990, PART XI, LINE 5: -562,910.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, QUESTION 2C, AUDITED FINANCIAL STATEMENT:THE AUDIT COMMITTEE OF HEALTH FIRST REVIEWS AND APPROVES THE ANNUAL AUDIT AND COMPLIANCE AUDIT PLANS THEN MAKES ITS REPORT TO THE HEALTH FIRST BOARD OF DIRECTORS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITORS. THERE WAS NO CHANGE FROM PRIOR YEAR.
FORM 990, PART IV, QUESTION 24A, BONDS ISSUED AFTER DECEMBER 31, 2002:THE E-FILING ORGANIZATION IS PART OF AN OBLIGATED GROUP THAT HAD MORE THAN $100,000 IN BONDS ISSUED AFTER DECEMBER 31, 2002 THAT WERE OUTSTANDING ON THE LAST DAY OF ITS TAX YEAR. THE FILING ORGANIZATION'S SHARE OF THESE OBLIGATIONS IS REPORTED ON PART X, LINE 20 OF HEALTH FIRST, INC. THE PARENT OF THE OBLIGATED GROUP, IS FILING SCHEDULE K ON BEHALF OF ITSELF AND ALL MEMBERS OF THE OBLIGATED GROUP.
FORM 990, PART V, QUESTION 2A, NUMBER OF EMPLOYEES:EMPLOYEES AT CAPE CANAVERAL HOSPITAL, INC. ARE INCLUDED IN THE FORM 941 FILED BY HEALTH FIRST, INC. EIN: 59-3336894.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955593336894SUPPORT ORGFL501(C)(3)LINE 11C, III-FIN/A0
HOLMES REGIONAL MEDICAL CENTER INC
3300 FISKE BLVDROCKLEDGEFL32955590624371HOSPITALFL501(C)(3)LINE 3N/A1
HOSPICE OF HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955591911574HOSPITALFL501(C)(3)LINE 9N/A1
HEALTH FIRST FOUNDATION INC
3300 FISKE BLVDROCKLEDGEFL32955593528774FUNDRAISINGFL501(C)(3)LINE 7N/A1
VIERA HOSPITAL INC
3300 FISKE BLVDROCKLEDGEFL32955264019868HOSPITALFL501(C)(3)LINE 3N/A1

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnership
CAPE HEALTH PROPERTIES INC
3300 FISKE BLVDROCKLEDGEFL32955593086711REAL ESTATEFLCAPE CANAVERAL HOSPITAL INCC1.00000
HEALTH FIRST MEDICAL MANAGEMENT INC
3300 FISKE BLVDROCKLEDGEFL32955593348252HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST PHYSICIANS INC
3300 FISKE BLVDROCKLEDGEFL32955593346397HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HOLMES REGIONAL ENTERPRISES INC
3300 FISKE BLVDROCKLEDGEFL32955592109953REAL ESTATEFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST HEALTH PLANS INC
3300 FISKE BLVDROCKLEDGEFL32955593315064HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST INSURANCE INC
3300 FISKE BLVDROCKLEDGEFL32955453131932HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST HOLDING COMPANY & SUBS
3300 FISKE BLVDROCKLEDGEFL32955593509709HOLDING CORP.FLHEALTH FIRST INCC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
HEALTH FIRST FOUNDATION INC
C170500
HOLMES REGIONAL MEDICAL CENTER INC
J65443
CAPE HEALTH PROPERTIES INC
J129049
HEALTH FIRST HEALTH PLANS INC
K19337075
VIERA HOSPITAL INC
K100163
HOLMES REGIONAL MEDICAL CENTER INC
L563253

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferenceFORM 990, SCHEDULE R, PART V, SCHEDULE R DISCLOSURES:ReturnReference
ExplanationALL TRANSACTIONS REPORTED IN THIS SECTION ARE BASED UPON CORPORATE BOOKS AND RECORDS WHICH ARE KEPT ACCORDING TO GENERALLY ACCEPTED ACCOUNTING STANDARDS.Explanation