2013-08-14T11:52:57-05:00 2012-09-30 420714325 MCGLADREY LLP 7351 OFFICE PARK PL MELBOURNE FL 32940 990 2011-10-01 592477479 CAPE CANAVERAL HOSPITAL INC CAPE 3214345150 3300 FISKE BLVD ROCKLEDGE FL 329554305 JOSEPH G FELKNER 3214345150 2013-07-19 1 THERESA A BURDINE CPA P00362629 3217516200 2011 2016-02-25 16:41:14Z STEVEN P JOHNSON 3300 FISKE BLVD ROCKLEDGE FL 329554305 109432527 0 X WWW.HEALTH-FIRST.ORG X 1984 FL OUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.CAPE CANAVERAL HOSPITAL IS A FULL-SERVICE, NOT-FOR-PROFIT HOSPITAL WITH SERVICES INCLUDING A 21-BED LEVEL II EMERGENCY DEPARTMENT, A CERTIFIED BABY-FRIENDLY MOTHER/BABY UNIT, FULLY EQUIPPED SURGICAL SERVICES, A STATE-OF-THE-ART CANCER PROGRAM AND A FULL-SERVICE LABORATORY. 9 7 0 600 90377 -65406 274356 170500 116372331 108176841 -7951 48338 1117242 1036848 117755978 109432527 4580295 4887276 0 0 59231104 55301918 0 0 0 49519635 45544694 113331034 105733888 4424944 3698639 153393690 155087950 84306278 82864809 69087412 72223141 X OUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE. 0 0 89385292 4887276 108086464 CAPE 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=CR2013HFWWWHOMEPAGEBANNER 89385292 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DWAIN STILSON 3214345150 3300 FISKE BLVD ROCKLEDGE FL 32955 X TONY HERNANDEZ III ESQ 1.00 X X 0 6908 0 KEVIN B STEELE 1.00 X X 0 0 21900 JUDITH A GEORGE 1.00 X X 0 12367 14400 NICHOLAS E PELLEGRINO 1.00 X 0 0 14950 JAMES E CARTER MD 1.00 X 0 8018 15400 A THOMAS HOLLINGSWORTH PHD 1.00 X 0 13537 16900 GEORGE W LEWIS 1.00 X 0 11280 14700 ALPHONSE PECORARO JR MD 1.00 X 0 352163 20413 ROBERT R WRIGHT 13.00 X X 0 1207403 62878 RODNEY R MOORE 40.00 X 0 289419 34271 WESLEY C OTT 40.00 X 0 166722 21119 SUZANNE CLARK WOODS 40.00 X 0 163030 9624 JOHN SCOTT WARNER 40.00 X 0 152380 8829 SCOTT R SCHIFFER 40.00 X 0 142749 19893 0 2525976 275277 0 0 1 0 HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 MANAGEMENT SUPPORT 88327921 HOLMES REGIONAL MEDICAL CENTER INC 3300 FISKE BLVD ROCKLEDGE FL 329554305 HOSPITAL SERVICES 563253 CAPE HEALTH PROPERTIES 3300 FISKE BLVD ROCKLEDGE FL 329554305 REAL ESTATE SERVICES 129049 3 170500 170500 PATIENT SERVICES 621110 77381863 77381863 MEDICARE/MEDICAID 621110 30610600 30610600 REFERENCE LAB 621500 90377 90377 MEDICAL MONITORING 900099 72153 72153 RELATED COMPANY RENT 531120 21848 21848 108176841 37473 37473 334 0 334 334 334 10865 0 10865 10865 10865 CAFETERIA 722210 649018 649018 387496 387496 1036514 109432527 108086464 90377 1085186 4887276 4887276 1582884 1582884 39923452 36677321 3246131 1022738 753833 268905 9407662 7938103 1469559 3365182 2988734 376448 1118737 1118737 112500 1188 111312 1708 1708 5782199 4292939 1489260 133755 10265 123490 1139148 875777 263371 2107558 11950 2095608 2078984 1832535 246449 314862 300240 14622 10468 792 9676 3499130 3108763 390367 8136321 6558816 1577505 1147032 1147032 MEDICAL SUPPLIES 14050480 14035627 14853 MAINTENANCE & REPAIR 2368648 2249020 119628 FLORIDA INDIGENT TAX 1244834 1244834 LICENSES & TAXES 92506 53219 39287 2205824 1564060 641764 105733888 89385292 16348596 0 52380949 59193698 11719683 9507647 107685 218125 2427966 2320511 337976 328325 164424965 110679699 57119935 53745266 27454405 27985910 736527 576875 1108564 1211593 153393690 155087950 6080814 6276356 32874556 37306293 45350908 39282160 84306278 82864809 X 67407988 71089984 1679424 1133157 69087412 72223141 153393690 155087950 X 3698639 -562910 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 71173 71173 87095068 43588418 43506650 865174 678784 186390 76190813 66412497 9778316 202737 202737 53745266 HEALTHCARE RELATED JOINT VENTURES 5412749 C DEMAND NOTE - HEALTH FIRST INC 20721740 C DEMAND NOTE - HEALTH FIRST FDN 718264 C OTHER TEMPORARILY RESTRICTED 1133157 C 27985910 OTHER CURRENT LIABILITIES 6104182 INTER-COMPANY PAYABLE 7781306 OTHER NONCURRENT LIABILITIES 1316647 TAX-EXEMPT BONDS HELD BY HEALTH FIRST INC. 24080025 39282160 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FIN 48 FOOTNOTE: THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(A), AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), OF THE INTERNAL REVENUE CODE AND SECTION 220.13 OF THE FLORIDA STATUTES. 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. 1 1 X 1 X 0 1 1 0 1 1 6161890 1817183 4344707 0.04110 8286784 4284914 4001870 0.03780 1244834 1244834 0.01180 15693508 6102097 9591411 0.09070 9862 9862 0.00010 399971 399971 0.00380 533425 533425 0.00500 63582 63582 0.00060 1006840 1006840 0.00950 16700348 6102097 10598251 0.10020 1 1922205 910458 26325686 34889233 -8563547 X 1 1 1 1 CAPE CANAVERAL HOSPITAL

701 W COCOA BEACH CSWY COCOA BEACH FL 32931

X X X ACUTE CARE HOSPITAL CAPE CANAVERAL HOSPITAL 1 1 1 200.000000000000 0 1 X X X X 1 1 X X X X 1 0 1 X 0 0 2 HEALTH FIRST AGING INSTITUTE

701 W COCOA BEACH CSWY COCOA BEACH FL 32931

ELDER CARE HEALTH FIRST HOME CARE

701 W COCOA BEACH CSWY COCOA BEACH FL 32931

IN-HOME CARE 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. CAPE CANAVERAL HOSPITAL 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. 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. 1 HEALTH FIRST FOUNDATION INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593528774 501(C)(3) 15819 GENERAL SUPPORT HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593336894 501(C)(3) 4823694 GENERAL SUPPORT BREVARD COMMUNITY COLLEGE NURSING PROGRAM 1519 CLEARLAKE ROAD COCOA FL 32922 590920675 115 47763 EXPAND ASSOCIATE NURSING PROGRAM PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE CAPE CANAVERAL HOSPITAL BOARD MONITORS USAGE BY EACH ENTITY TO ASSURE FUNDS RAISED ARE USED APPROPRIATELY. 1 0 1 0 0 0 0 0 0 0 ALPHONSE PECORARO JR MD 0 350453 0 0 0 1710 0 0 0 20413 0 372576 0 0 ROBERT R WRIGHT 0 247816 0 0 0 959587 0 43818 0 19060 0 1270281 0 629608 RODNEY R MOORE 0 284517 0 0 0 4902 0 12931 0 21340 0 323690 0 0 WESLEY C OTT 0 163268 0 0 0 3454 0 6282 0 14837 0 187841 0 0 SUZANNE CLARK WOODS 0 159986 0 0 0 3044 0 6883 0 2741 0 172654 0 0 JOHN SCOTT WARNER 0 151399 0 0 0 981 0 7642 0 1187 0 161209 0 0 SCOTT R SCHIFFER 0 142669 0 0 0 80 0 6522 0 13371 0 162642 0 0 PART I, LINE 4B HEALTH FIRST, INC HAS A NON-QUALIFIED SERP FOR CERTAIN EXECUTIVES. BELOW ARE THE 2011 DEFERRED AMOUNTS: ROBERT R. WRIGHT $ 31,515 SUPPLEMENTAL INFORMATION PART III COMPENSATION IS PAID BY HEALTH FIRST, INC. EIN: 59-3336894 AND REIMBURSED BY CAPE CANAVERAL HOSPITAL, INC. SALARY AND BENEFIT EXPENSES DISCLOSED IN PART IX IS ALLOCATED TO THIS ENTITY. AMOUNTS REPORTED IN COLUMN F REPRESENT DEFERRED COMPENSATION 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. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF CAPE CANAVERAL HOSPITAL, INC. IS HEALTH FIRST, INC., A FLORIDA NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE CORPORATE PARENT OF THE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A HEALTH FIRST, INC. (HFI), A SECTION 501(C)(3) EXEMPT ORGANIZATION AND THE PARENT OF THE EXEMPT HEALTHCARE SYSTEM, IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B PER THE BYLAWS AND THE LAWS OF THE STATE OF FLORIDA, THE ADMINISTRATIVE POWER OF THE CORPORATION SHALL BE VESTED IN THE BOARD OF DIRECTORS WHICH SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION. THE BOARD OF DIRECTORS SHALL NOT TAKE ANY ACTION WITH RESPECT TO THE FOLLOWING WITHOUT APPROVAL OF THE MEMBER: -CHANGE IN THE MISSION, PURPOSE OR SCOPE OF THE CORPORATION AND ITS OPERATION; -INCURRENCE OF 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 11 AFTER REVIEW AND APPROVAL BY THE CHIEF FINANCIAL OFFICER THE FORM 990 IS SENT TO EACH MEMBER OF THE BOARD OF DIRECTORS ELECTRONICALLY FOR THEIR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL BOD MEMBERS, OFFICERS, MANAGEMENT, AND ASSOCIATES IN WHICH THEY REVIEW AND SIGN THAT THEY HAVE AGREED TO THE TERMS NOTED IN THE POLICY ON AN ANNUAL BASIS. IN ADDITION, ALL MANAGEMENT, OFFICERS, AND BOD MEMBERS ON AN ANNUAL BASIS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE PREPARED AND MONITORED BY THE CHIEF COMPLIANCE OFFICER. THE QUESTIONNAIRE REQUIRES AN ATTESTATION STATING THAT THE INDIVIDUAL IS FREE OF CONFLICTS SHOULD THEY NOT REPORT ANYTHING OF CONCERN. THESE FORMS ARE TRACKED AND KEPT ON FILE. SHOULD A CONFLICT ARISE, THE CHIEF COMPLIANCE OFFICER INVESTIGATES THE ISSUE AND DETERMINES A COURSE OF ACTION TO ENSURE ENFORCEMENT OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PROCESS IS DETERMINED BY THE PARENT COMPANY. THE PARENT COMPANY'S PROCESS IS AS FOLLOWS: THE SALARIES OF OUR CEO AND OTHER HEALTH EXECUTIVES ARE REVIEWED AND RECOMMENDED ANNUALLY TO THE BOARD OF DIRECTORS AND APPROVED IN EXECUTIVE SESSION BY THE FULL BOARD OF HEALTH FIRST. HEALTH FIRST CONTRACTS ANNUALLY WITH A HIGHLY RESPECTED NATIONAL CONSULTING FIRM TO PROVIDE THESE RECOMMENDATIONS TO ENSURE THAT OUR EXECUTIVES ARE COMPENSATED FAIRLY AND COMPETITIVELY WHEN COMPARED WITH SIMILAR ROLES IN OTHER HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION COMMITTEE IS INDEPENDENT FOR INTERNAL REVENUE CODE SECTION 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED. MINUTES ARE KEPT FOR ALL BOARD OF DIRECTORS AND COMPENSATION COMMITTEE MEETINGS. THE PROCESS IS DOCUMENTED CONTEMPORANEOUSLY IN THE BOARD AND COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: QUARTERLY AND ANNUALLY CONSOLIDATED FINANCIALS AND CONSOLIDATED STATISTICAL INFORMATION IS FILED ELECTRONICALLY ON WWW.DACBOND.COM AND IS AVAILABLE TO THE PUBLIC. IN ADDITION, ANY REQUESTS MADE TO THE CHIEF FINANCIAL OFFICER FOR THE ABOVE REFERENCED ITEMS ARE PROVIDED UPON REQUEST IN A TIMELY MANNER. A COPY OF THE CONFLICTS OF INTEREST POLICY IS AVAILABLE UPON REQUEST TO THE COMPLIANCE OFFICER. 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. CHANGES IN NET ASSETS OR FUND BALANCES: 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. 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. HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593336894 SUPPORT ORG FL 501(C)(3) LINE 11C, III-FI N/A 0 HOLMES REGIONAL MEDICAL CENTER INC 3300 FISKE BLVD ROCKLEDGE FL 32955 590624371 HOSPITAL FL 501(C)(3) LINE 3 N/A 1 HOSPICE OF HEALTH FIRST INC 3300 FISKE BLVD ROCKLEDGE FL 32955 591911574 HOSPITAL FL 501(C)(3) LINE 9 N/A 1 HEALTH FIRST FOUNDATION INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593528774 FUNDRAISING FL 501(C)(3) LINE 7 N/A 1 VIERA HOSPITAL INC 3300 FISKE BLVD ROCKLEDGE FL 32955 264019868 HOSPITAL FL 501(C)(3) LINE 3 N/A 1 CAPE HEALTH PROPERTIES INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593086711 REAL ESTATE FL CAPE CANAVERAL HOSPITAL INC C 1.00000 HEALTH FIRST MEDICAL MANAGEMENT INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593348252 HEALTH CARE FL HEALTH FIRST HOLDING CORP C HEALTH FIRST PHYSICIANS INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593346397 HEALTH CARE FL HEALTH FIRST HOLDING CORP C HOLMES REGIONAL ENTERPRISES INC 3300 FISKE BLVD ROCKLEDGE FL 32955 592109953 REAL ESTATE FL HEALTH FIRST HOLDING CORP C HEALTH FIRST HEALTH PLANS INC 3300 FISKE BLVD ROCKLEDGE FL 32955 593315064 HEALTH CARE FL HEALTH FIRST HOLDING CORP C HEALTH FIRST INSURANCE INC 3300 FISKE BLVD ROCKLEDGE FL 32955 453131932 HEALTH CARE FL HEALTH FIRST HOLDING CORP C HEALTH FIRST HOLDING COMPANY & SUBS 3300 FISKE BLVD ROCKLEDGE FL 32955 593509709 HOLDING CORP. FL HEALTH FIRST INC C 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 HEALTH FIRST FOUNDATION INC C 170500 HOLMES REGIONAL MEDICAL CENTER INC J 65443 CAPE HEALTH PROPERTIES INC J 129049 HEALTH FIRST HEALTH PLANS INC K 19337075 VIERA HOSPITAL INC K 100163 HOLMES REGIONAL MEDICAL CENTER INC L 563253 FORM 990, SCHEDULE R, PART V, SCHEDULE R DISCLOSURES: ALL TRANSACTIONS REPORTED IN THIS SECTION ARE BASED UPON CORPORATE BOOKS AND RECORDS WHICH ARE KEPT ACCORDING TO GENERALLY ACCEPTED ACCOUNTING STANDARDS.