2013-08-12T13:56:55-05:00 2012-09-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2011-10-01 590694358 NAPLES COMMUNITY HOSPITAL INC % MICHAEL E STEPHENS CFO NAPL 2396246338 PO BOX 413029 NAPLES FL 341013029 MICHAEL STEVENS 2013-08-09 true 2673303000 2011 2016-02-24 21:20:13Z MICHAEL E STEPHENS PO BOX 413029 NAPLES FL 341013029 502697878 false X N/A X 1957 FL THROUGH THE PROVISION OF CHARITABLE HEALTHCARE, OUR MISSION IS TO PROMOTE, MAINTAIN AND RESTORE HEALTH FOR THOSE WE SERVE. 20 11 3796 1041 28581 -790 5173672 9972258 444235124 440613486 5852166 5811853 12378411 10713308 467639373 467110905 12500 5000 0 0 193758219 187224119 0 0 16777 242785919 248987023 436556638 436216142 31082735 30894763 580430393 598720213 245108380 246237138 335322013 352483075 X NAPLES COMMUNITY HOSPITAL, INC. (THE "HOSPITAL") IS A NOT-FOR-PROFIT CORPORATION LOCATED IN COLLIER COUNTY, FLORIDA. THE HOSPITAL CONSISTS OF NAPLES COMMUNITY HOSPITAL, A 359-BED FACILITY, AND NORTH NAPLES HOSPITAL, A 325-BED FACILITY, LOCATED IN SW FLORIDA. THE HOSPITAL IS A SUBSIDIARY OF NCH HEALTHCARE SYSTEM, INC. ("NCHS"), A NOT-FOR-PROFIT CORPORATION. NAPLES COMMUNITY HOSPITAL, INC. PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. THE HOSPITAL ALSO PROVIDES HEALTH ENHANCING EDUCATIONAL PROGRAMS IN ADDITION TO MEDICAL CARE FOR THE BETTERMENT OF THE COMMUNITY. ANY EXCESS REVENUE OVER EXPENSES IS USED TO FUND THE REPLACEMENT AND IMPROVEMENT OF FACILITIES AND TECHNOLOGY ALONG WITH PROGRAMS TO IMPROVE ACCESS TO NEEDED HEALTHCARE SERVICES TO ALL THOSE IN OUR COMMUNITY. false false 375507854 5000 450480621 HEALTHCARE SERVICES- NAPLES COMMUNITY HOSPITAL, INC. ("NCH") PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. FROM ITS TWO HOSPITALS, CANCER TREATMENT CENTERS, WOUND CARE CENTERS, AND OUTPATIENT REHABILITATION CENTERS, NCH PROVIDED $70,576,201 OF CHARITY CARE TO PATIENTS WHO WERE UNABLE TO PAY AND NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PROGRAM. ADDITIONALLY, NCH WROTE OFF $42,053,481 CLASSIFIED AS BAD DEBTS, MUCH OF WHICH REPRESENTED SERVICES DELIVERED TO INDIGENT PATIENTS, WHO DID NOT RECEIVE A CHARITY CARE DETERMINATION IN ACCORDANCE WITH THE STATE'S CRITERIA. THE SERVICES OFFERED AT NCH ARE EXTENSIVE AND INCLUDE MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC, REHABILITATIVE, PSYCHIATRIC, DIAGNOSTIC, AND EMERGENCY TREATMENT. A TOTAL OF 535 ACTIVE AND ASSOCIATE PHYSICIANS, 2,748 FULL-TIME EQUIVALENT EMPLOYEES, AND 1,041 VOLUNTEERS COMPRISE THE OUTSTANDING MEDICAL TEAM WORKING TOGETHER TO PROVIDE THESE SERVICES. THE TWO HOSPITALS ARE COMPROMISED OF 598 ACUTE CARE BEDS, A 54 BED REHABILITATIVE UNIT, 9 NICU BEDS, AND A 23 BED PSYCHIATRIC UNIT. ADDITIONAL SPECIALTY SERVICES FOR THE CARE OF CERTAIN CRITICAL AND LIFE THREATENING MEDICAL CONDITIONS INCLUDE THE MEDICAL INTENSIVE CARE UNIT, SURGICAL INTENSIVE CARE UNIT, CARDIAC CARE UNIT, CARDIAC CATHERIZATION UNIT, AND INTERMEDIATE CARE UNIT. OTHER SPECIALTIES INCLUDE ONCOLOGY, DIAGNOSTIC SERVICES (CARDIO-DIAGNOSTICS, MAMMOGRAPHY, COMPUTERIZED TOPOGRAPHIC SCANNING (CT), AND MAGNETIC RESONANCE IMAGING (MRI), AND SPECIAL PROCEDURES SUCH AS BIOPSY, ANGIOGRAPHY, AND ANGIOPLASTY). DURING THE 2012 FISCAL YEAR, NCH HAD 31,536 INPATIENT ADMISSIONS RESULTING IN 137,460 DAYS OF CARE. ADDITIONALLY, 89,174 PATIENTS WERE TREATED IN OUR EMERGENCY CARE CENTERS. NAPLES COMMUNITY HOSPITAL, INC. RECEIVES VOLUNTEER ASSISTANCE FOR OPERATING ITS HOSPITALITY, GIFT, AND RETAIL SHOPS. NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES HEALTH ENHANCING EDUCATIONAL PROGRAMS IN ADDITION TO MEDICAL CARE. THESE PROGRAMS INCLUDE: WHITAKER WELLNESS CENTER, BETTER BREATHERS CLUB, MENDED HEARTS, DIABETES EDUCATION PROGRAM, CHILDBIRTH CLASSES, HEALTH FAIRS, AND CAREER DAYS. IN ADDITION, NCH SUPPORTS THE FOLLOWING: NURSES IN THE COLLIER COUNTY PUBLIC SCHOOL SYSTEM, AND ATHLETIC TRAINERS AT THE LOCAL HIGH SCHOOLS AND SPORTING EVENTS. 375507854 true true false false false false false false false true true false false true true false false true false false false false false false true false true true false false true true false false false false false false false true true true true false false false false true false false false false true 452 5 true 3796 true true true false false false false true true false false false false X 20 11 true false false false true true true true true false false true true true true true true true true false FL X X MICHAEL E STEPHENS CFO 2396244005 350 SEVENTH STREET NORTH NAPLES FL 341023029 X Mariann MacDonald 0.5 X X 0 0 0 Thomas J Gazdic 0.5 X X 0 0 0 Kay Gow 0.5 X X 0 0 0 John Lewis MD 0.5 X X 0 0 0 William Allyn 0.5 X Michelle Barrett 0.5 X 76340 0 26643 Kenneth Bookman MD 0.5 X 0 510833 32942 Alberto M de la Rivaherrera MD 0.5 X 0 0 0 Michael Feuer 0.5 X 0 0 0 Terrance Flynn 0.5 X 0 0 0 Elizabeth Foster RN 0.5 X 74687 0 12334 Daniel Gill 0.5 X 0 0 0 Joann Jenner 0.5 X 90335 0 13002 Kim Ciccarelli Kantor 0.5 X Hermes Koop MD 0.5 X Frank Linsalata 0.5 X Robert Moses 0.5 X 0 0 0 Wayne Mullican 0.5 X 0 0 0 Joseph I Perkovich 0.5 X 0 0 0 Ken Plunkitt MD 0.5 X 0 0 0 Ambassador Francis Rooney 0.5 X 0 0 0 Gregory Russo 0.5 X Scot C Schultz MD 0.5 X Norman Thomson MD 0.5 X Gregory Wilkerson RN 0.5 X 65831 0 11869 Allen S Weiss MD 40.0 X X 743591 0 -44450 Kevin D Cooper 40.0 X 436945 0 18855 Phillip Dutcher 40.0 X 439343 0 10436 Aurora Estevez MD 40.0 X 461501 0 18972 Vicki D Orr 40.0 X 424437 0 33205 Elizabeth Martin 40.0 X 57090 0 15137 John McGirl 40.0 X 0 0 0 Helen Thompson 40.0 X 0 0 0 Michele Thoman 40.0 X 304944 0 33338 Michael Riley 40.0 X 235572 0 31876 James K Martin 1.0 X 0 271716 31045 Zachary Bostock 1.0 X 0 72597 94 Gary Parsons MD 1.0 X 0 334411 15652 Renee M Thigpen 40.0 X 152206 0 29231 Bedalin Helvink MD 40.0 X 239795 0 32873 Brian D Wilson 40.0 X 178960 0 16602 Patricia Read 40.0 X 170967 0 23063 James Bates 40.0 X 170140 0 30793 Noble Arrington 40.0 X 162661 0 29082 Gail Dolan 0.0 X 186320 0 0 Susan Wolff 0.0 X 278047 0 16978 Brian Settle 0.0 X 271317 0 22380 5221029 1189557 461952 175 true true false CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64141 IT SUPPORT 12069111 PRECYSE SOLUTIONS LLC DEPT 1736 PO BOX 11407 BIRMINGHAM AL 35246 MEDICAL RECORDS SUPP 4122153 AMN HEALTHCARE INC 2735 Collection Center Dr CHICAGO IL 60693 AGENCY LABOR 3568130 SODEXHO INC PO BOX 536922 ATLANTA GA 303536922 FOOD/ENVIRONMENTAL 2656274 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 303844674 AGENCY LABOR 1788512 82 358660 9613598 2576747 9972258 NET PATIENT SERVICE REVENUES 622110 440613486 440613486 440613486 4938847 9996 4928851 31881 31881 0 823495 122 823373 823373 823373 36090791 43800 35229739 63727 861052 -19927 841125 841125 297600 358660 293385 4215 4215 0 0 DIETARY SERVICES 900099 2334182 2334182 WELLNESS CENTER 900099 3065182 3065182 SCHOOL NURSE 900099 2451496 2451496 2034860 2016275 18585 9885720 467110905 450480621 28581 6629445 0 5000 5000 0 0 3930192 0 3930192 0 0 153949707 131550025 22386442 13240 4995880 4268979 726375 526 12901477 11024312 1875167 1998 11446863 9781344 1664506 1013 647634 553403 94231 0 907117 775131 131986 0 383209 327452 55757 0 0 0 0 36915420 31544226 5371194 0 1928170 1647621 280549 0 102833009 87870808 14962201 0 12493797 10675950 1817847 0 0 8877974 7586229 1291745 0 247172 211208 35964 0 0 0 7940731 6785355 1155376 0 0 26866943 22957803 3909140 0 6837641 5842764 994877 0 OTHER MISC. 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350 7TH STREET NORTH NAPLES FL 34102

X X X NAPLES COMMUNITY HOSPITAL 1 true true 200. true 400. true X X X X X X X X true true X X X X X true false X X X true X false false SUPPLEMENTAL DISCLOSURES PART I, LINE 3C N/A PART I, LINE 6A NAPLES COMMUNITY HOSPITAL, INC. IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("NCHS"). NCHS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND INCLUDES THIS REPORT WITH ITS FORM 990 TAX RETURN FILING. THE COMMUNITY BENEFIT REPORT PREPARED INCLUDES ALL ORGANIZATIONS OF THE SYSTEM, INCLUDING NAPLES COMMUNITY HOSPITAL, INC. BAD DEBT EXPENSE, COSTING METHODOLOGY USED PART I, LINE 7 THE BAD DEBT EXPENSE AMOUNT INCLUDED ON FORM 990, PART IX, COLUMN 25(A) WAS $42,053,481 FOR THE YEAR ENDED SEPTEMBER 30, 2012. THIS AMOUNT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES REPORTED ON THE SCHEDULE H, PART I, LINE 7 TABLE. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. BAD DEBT EXPENSE PART III, SECTION A, LINE 4 UNCOMPENSATED CARE REPRESENTS EITHER CHARGES FOREGONE OR CHARGES IN EXCESS OF PAYMENT RECEIVED FOR SERVICES PROVIDED TO PATIENTS WHO ARE NOT COVERED UNDER CONTRACTS WITH THIRD-PARTY PAYORS. THE MAJOR COMPONENTS OF UNCOMPENSATED CARE ARE CATEGORIZED AS CHARITY, WELFARE, AND BAD DEBT. CHARITY CARE REPRESENTS SERVICES AND SUPPLIES FURNISHED AT NO CHARGE TO PATIENTS WHO HAVE QUALIFIED UNDER THE INCOME CRITERIA PROMULGATED BY THE STATE OF FLORIDA. PATIENTS WHO WOULD OTHERWISE BE DEEMED AS CHARITY CARE CAN SOMETIMES QUALIFY UNDER THE COLLIER COUNTY WELFARE PROGRAM. PAYMENTS UNDER THE COUNTY WELFARE PROGRAM ARE LIMITED BY THE AMOUNT APPROPRIATED BY THE COUNTY. FINALLY, BAD DEBTS REPRESENT CHARGES DEEMED UNCOLLECTIBLE DUE TO EITHER (A) A PATIENT'S INABILITY TO QUALIFY AS CHARITY, WELFARE, OR MEDICAID, YET CLEAR FINANCIAL INDICATIONS EXIST THAT DEMONSTRATE AN INABILITY TO PAY, OR (B) A PATIENT'S REFUSAL TO PAY FOR SERVICES PROVIDED AND THE HOSPITAL'S DECISION TO CEASE FURTHER COLLECTION EFFORTS. THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON THE COST TO CHARGE RATIO. COSTING METHODOLOGY, MEDICARE SHORTFALL PART III, SECTION B, LINE 8 THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF NAPLES COMMUNITY HOSPITAL, INC. AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, NAPLES COMMUNITY HOSPITAL, INC. VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. COLLECTION PRACTICES PART III, LINE 9B NAPLES COMMUNITY HOSPITAL, INC. PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET SPECIFIC CRITERIA UNDER THE STATE'S CHARITY CARE GUIDELINES. BECAUSE NAPLES COMMUNITY HOSPITAL, INC. DOES NOT PURSUE COLLECTION OF ACCOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS REVENUE. NEEDS ASSESSMENT PART VI, LINE 2 THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IN VARIOUS WAYS. IN 2012, WE PARTICIPATED IN THE COLLIER COUNTY COMMUNITY ASSESSMENT DESIGN GROUP. THIS GROUP PARTNERED KEY PARTICIPANTS FROM THE COUNTY INCLUDING THE COLLIER COUNTY HEALTH DEPARTMENT, PHYSICIANS REGIONAL MEDICAL CENTER, AND NAPLES COMMUNITY HOSPITAL. THE INITIAL PROJECT OF THE GROUP WAS TO DESIGN AND IMPLEMENT THE COMMUNITY THEMES AND STRENGTHS SURVEY AND THE FORCES OF CHANGE ASSESSMENT. A SURVEY WAS PREPARED AND SENT OUT TO HEALTH CARE LEADERS, COMMUNITY FOCUS GROUPS AND HEALTH CARE STAFF. IDENTIFIED PROBLEM AREAS SURVEYED WERE SUFFICIENT JOB EMPLOYMENT AND ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, ROADWAYS SAFE FOR BICYCLISTS AND PEDESTRIANS, PRIMARY CARE RESOURCES, ACCESS TO AFFORDABLE HEALTHY FOOD, AND ACCESS TO LONG-TERM CARE BEDS. IN ADDITION, COMMUNITY ISSUES IN COLLIER COUNTY AND FLORIDA SUCH AS COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, HEALTH OF ELDERLY, ACCESS TO CARE, DISABILITIES, AND UNINTENTIONAL INJURIES. THE GROUP WAS ABLE TO FOCUS ON SOLUTIONS TO SOME OF THE ISSUES DISCUSSED AS WELL AS CREATE OPPORTUNITIES TO BETTER SERVE THE COMMUNITY'S NEEDS. INFORMATION REGARDING PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 NAPLES COMMUNITY HOSPITAL, INC. RECOGNIZES ITS RESPONSIBILITY TO COMMUNICATE ITS FINANCIAL POLICIES AND EXPECTATIONS TO PATIENTS. THE HOSPITAL INFORMS AND EDUCATES PATIENTS BY PROVIDING PATIENTS WITH THE NCH HEALTHCARE SYSTEM PATIENT RIGHTS AND RESPONSIBILITIES. INCLUDED IN THESE RIGHTS IS THE RIGHT TO BE GIVEN, UPON REQUEST, FULL MEDICAL INFORMATION AND FINANCIAL COUNSELING. IN ADDITION, A PATIENT REPRESENTATIVE WILL CONTACT PATIENTS PRIOR TO SERVICES TO EVALUATE THE PATIENT'S ABILITY TO PAY. THIS PROCESS INCLUDES OBTAINING THE PATIENT'S CURRENT FINANCIAL INFORMATION, OBTAINING A CREDIT REPORT AND REVIEWING THE PATIENT'S PAYMENT HISTORY WITH NAPLES COMMUNITY HOSPITAL, INC. PERSONS REQUIRING ASSISTANCE WITH THE UNFUNDED PORTION OF THEIR BILLS ARE ENCOURAGED TO REQUEST A CHARITY EVALUATION. NCH ALSO PROVIDES ASSISTANCE FOR PATIENTS TO APPLY FOR MEDICAID COVERAGE OR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS WHICH MAY ASSIST WITH PAYMENT FOR MEDICAL SERVICES. COMMUNITY INFORMATION PART VI, LINE 4 NAPLES COMMUNITY HOSPITAL, INC. SERVES A DIVERSE AND SEASONAL COMMUNITY. THE POPULATION IS APPROXIMATELY 384,431. THE MEDIAN AGE OF RESIDENTS IS 46.9. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IS $60,167. THE UNEMPLOYMENT RATE IS APPROXIMATELY 8.5%. THE PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS APPROXIMATELY 12.2%. INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 NAPLES COMMUNITY HOSPITAL, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. THE TYPES OF PROGRAMS/RESOURCES PROVIDED INCLUDE: HEALTH SEMINARS, COMMUNITY HEALTH FAIRS & TESTING, RN'S EDUCATING FUTURE PATIENTS, SUPPORTING THE NEIGHBORHOOD HEALTH CLINIC, PHYSICIAN LED ACCESS NETWORK OF COLLIER COUNTY, HEART PROGRAMS, CANCER SURVIVAL AWARENESS, SUPPORT OF PATIENT FAMILIES, THE SPIRIT OF WOMEN, DR. JOHN BRIGGS WELLNESS CENTER, AS WELL AS THE SHARING OF SPACE AT NO COST TO NEEDY, NOT-FOR-PROFIT ORGANIZATIONS. THE ORGANIZATION ALSO SPONSORS AND SUPPORTS THE CLINICAL NURSING SCHOOLS IN OUR COMMUNITY. THE ORGANIZATION'S CIVIC INVOLVEMENT INCLUDES MEMBERS OF NCH MANAGEMENT SERVING ON COMMUNITY BOARDS IN VARIOUS CAPACITIES. THE HOSPITALS HAVE ALWAYS PROVIDED EXEMPLARY PASTORAL CARE SERVICES. NCH IS ENCOURAGING THEIR OWN HEALTHCARE PROFESSIONAL BY SPONSORING CAREER DAYS, JOB SHADOWING, AND LECTURES AT LOCAL MIDDLE AND HIGH SCHOOLS ON THE MANY OPPORTUNITIES IN THE HEALTHCARE FIELD. FOR ADDITIONAL COMMUNITY ACTIVITIES THAT NAPLES COMMUNITY HOSPITAL, INC. SUPPORTS, PLEASE REFER TO FORM 990, SCHEDULE O, PART III, PROGRAM SERVICES. AFFILIATED HEALTHCARE SYSTEM INFORMATION PART VI, LINE 6 NAPLES COMMUNITY HOSPITAL, INC. IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. NCH HEALTHCARE SYSTEM, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. IN ADDITION TO NAPLES COMMUNITY HOSPITAL, INC., THE NCH HEALTHCARE SYSTEM ALSO INCLUDES THE FOLLOWING NON-PROFIT ORGANIZATIONS: > MARCO ISLAND HOSPITAL, INC., OPERATES AN 11 1/2-HOUR/7-DAYS A WEEK URGENT CARE FACILITY AND SERVICES PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. DURING FYE 09/30/12, 7,837 PATIENTS WERE TREATED. OF THESE PATIENTS, 10.64% WERE CLASSIFIED AS MEDICAID, CHARITY, OR BAD DEBTS. > COLLIER HEALTH CARE, INC. OWNS AND LEASES HEALTHCARE FACILITIES IN NAPLES AND IMMOKALEE, FLORIDA. THIS ORGANIZATION ALSO OPERATES CHILDREN'S MEDICAL SERVICES, A PROGRAM SERVING CHRONICALLY ILL AND SPECIAL NEEDS CHILDREN UNDER TITLE V AND THE FLORIDA KIDCARE PROGRAM THROUGH TITLE XXI. > NCHMD, INC. OWNS AND OPERATES PHYSICIAN MEDICAL PRACTICES IN COLLIER AND LEE COUNTY, FLORIDA. FACILITY INFORMATION SCHEDULE H, PART V, 11H ANOTHER FACTOR NAPLES COMMUNITY HOSPITAL, INC. USES IN DETERMINING AMOUNTS CHARGED TO PATIENTS IS FAMILY SIZE. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI FL, X X X X X true true false false false false false true false Kenneth Bookman MD 0 442816 0 51517 0 16500 0 9800 0 23142 0 543775 0 0 Allen S Weiss MD 665923 0 61168 0 16500 0 -60708 0 16258 0 699141 0 0 0 Kevin D Cooper 385077 0 35368 0 16500 0 9800 0 9055 0 455800 0 0 0 Gail Dolan 0 0 21785 0 164535 0 0 0 0 0 186320 0 0 0 Phillip Dutcher 403975 0 35368 0 0 0 9800 0 636 0 449779 0 0 0 Aurora Estevez MD 407533 0 37468 0 16500 0 9800 0 9172 0 480473 0 0 0 Vicki D Orr 372569 0 35368 0 16500 0 9800 0 23405 0 457642 0 0 0 Michele Thoman 281576 0 23368 0 0 0 9800 0 23538 0 338282 0 0 0 Michael Riley 216123 0 19449 0 0 0 8901 0 22975 0 267448 0 0 0 James K Martin 0 256416 0 15300 0 0 0 7669 0 23376 0 302761 0 0 Gary Parsons MD 0 317843 0 68 0 16500 0 6733 0 8919 0 350063 0 0 Bedalin Helvink MD 239727 0 68 0 0 0 9731 0 23142 0 272668 0 0 0 Brian D Wilson 178892 0 68 0 0 0 4532 0 12070 0 195562 0 0 0 Patricia Read 161776 0 4703 0 4488 0 6756 0 16307 0 194030 0 0 0 James Bates 166641 0 3499 0 0 0 6975 0 23818 0 200933 0 0 0 Noble Arrington 155109 0 4550 0 3002 0 6600 0 22482 0 191743 0 0 0 Susan Wolff 190096 0 24716 0 63235 0 9800 0 7178 0 295025 0 0 0 Brian Settle 178264 0 23766 0 69287 0 9800 0 12580 0 293697 0 0 0 Renee M Thigpen 142015 0 4198 0 5993 0 6245 0 22986 0 181437 0 0 0 DETAIL OF SEVERANCE PAYMENTS FORM 990, SCHEDULE J, PART I, LINE 4A GAIL DOLAN, COO, NORTH NAPLES HOSPITAL, RESIGNED 08/30/10 AND RECEIVED A SEVERANCE PAYMENT OF $164,535 FOR CALENDAR YEAR 2011. BRIAN SETTLE, CHIEF HUMAN RESOURCES OFFICER, RESIGNED 9/30/11 AND RECEIVED A SEVERANCE PAYMENT OF $52,786 FOR CALENDAR YEAR 2011. SUSAN WOLFF, CHIEF INFORMATION OFFICER, RESIGNED 9/30/11 AND RECEIVED A SEVERANCE PAYMENT OF $49,908 FOR CALENDAR YEAR 2011. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION FORM 990, SCHEDULE J, LINE 4B IN 1996, THE NCH HEALTHCARE SYSTEM, INC. BOARD OF TRUSTEES APPROVED A RECOMMENDATION OF THE EXECUTIVE COMPENSATION COMMITTEE THAT CERTAIN EXECUTIVES OF THE NCH HEALTHCARE SYSTEM WOULD BE PROVIDED WITH A SERP THAT WAS SUPPORTED THROUGH THE USE OF LIFE INSURANCE PROGRAMS. DUE TO CHANGES IN THE IRS TAX CODE, EFFECTIVE OCTOBER 1, 2003, THE FUNDING MECHANISM FOR ACTIVE EMPLOYEES WAS CHANGED FROM USING LIFE INSURANCE TO FUNDING RABBI TRUSTS. HOWEVER, THE PLAN DESIGN WAS NOT CHANGED. THE TRUST IS OWNED BY NCH AND IS SUBJECT TO THE RISK OF CREDITORS OF NCH. CONSEQUENTLY, DEPOSITS MADE TO THE TRUSTS REMAIN AS ASSETS OF NCH UNTIL THE PARTICIPANT VESTS IN ACCORDANCE WITH THE PLAN. THE SERP HAS BEEN DISCONTINUED WITH THE EXCEPTION OF DR. ALLEN WEISS, PRESIDENT & CEO, WHO IS NO LONGER RECEIVING CONTRIBUTIONS TO THE PLAN, BUT WHOSE PLAN CONTINUES TO REALIZE INVESTMENT INCOME/LOSSES ON PREVIOUS CONTRIBUTIONS WHICH HAVE BEEN REPORTED ON PRIOR YEAR FORMS 990. THE ACCOUNT OF ALLEN S. WEISS, M.D. REALIZED INVESTMENT LOSS OF $70,508 FOR THE CALENDAR YEAR 2011. THIS INVESTMENT LOSS IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. PROVISIONS OF NON-FIXED PAYMENTS FORM 990, SCHEDULE J, LINE 7 NCH MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE NCH COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. COLLIER CTY INDSTL DEVLMT ATHRTY- SERIES 2010 591695679 2010-12-30 30000000 NEW CAPITAL EQUIPMENT false false false COLLIER CTY INDSTRL DEVLMT ATHRTY- SERIES 2011 PUB 591695679 194641AK2 2011-04-01 102115000 REFINANCE 93/96 BONDS & NEW CAP EQ false false false COLLIER CTY INDSTRL DEVLMT AUTH- SERIES 2011 BQ 591695679 2011-10-31 46340000 REFINANCE 02/04 BONDS false false false 0 0 30044258 5926055 0 0 159198 0 0 23914747 0 44258 false false false true 0 0 100976009 10286265 0 0 1414549 0 0 40032448 49222562 20185 true false false true 0 0 46343027 0 0 0 180000 0 0 0 46160000 3027 2011 true false true true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false 0 false false false 0 false true false false false 0 false false false 0 false true false true false 0 false false false 0 false true X SEE SCHEDULE O FOR ADDITIONAL SUPPLEMENTAL INFORMATION 0 KATHRYN HOUSER FAMILY MEMBER OF TRUSTEE 72481 PAYMENT OF COMPENSATION false DIANNE GARRISON FAMILY MEMBER OF TRUSTEE 135148 PAYMENT OF COMPENSATION false GULF COAST CARDIOTHORACIC COMMON TRUSTEE/PARTNER 225525 PURCHASE OF MEDICAL SERVICES false CANDACE S SETTLE FAMILY MEMBER OF OFFICER 30894 PAYMENT OF COMPENSATION false MANHATTEN KRAFT CONSTRUCTION COMPAN COMMON TRUSTEE/PARTNER 1459664 CONSTRUCTION- OR EXPANSION false JODI S COOPER FAMILY MEMBER OF OFFICER 144444 PAYMENT OF COMPENSATION false JAMES ORR MD FAMILY MEMBER OF OFFICER 457898 RECEIPT OF RENTAL INCOME false MEGAN RILEY FAMILY MEMBER OF OFFICER 10181 PAYMENT OF COMPENSATION false ALYSSA THIGPEN FAMILY MEMBER OF OFFICER 17224 PAYMENT OF COMPENSATION false ASHLEY THIGPEN MESSIER FAMILY MEMBER OF OFFICER 25185 PAYMENT OF COMPENSATION false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS FORM 990, SCHEDULE L, PART IV KATHRYN HOUSER, RN AND DIANNE GARRISON, RN ARE SIBLINGS OF BOARD TRUSTEE JOANN JENNER. BOARD TRUSTEE SCOT C. SCHULTZ, M.D. IS A PARTNER OF GULF COAST CARDIOTHORACIC. CANDACE S. SETTLE, PHYSICAL THERAPIST ASSISTANT, IS THE SPOUSE OF FORMER OFFICER BRIAN SETTLE, CHIEF HUMAN RESOURCES OFFICER. AMBASSADOR FRANCIS ROONEY, TRUSTEE, IS AN OWNER OF MANHATTEN KRAFT CONSTRUCTION COMPANY. JODI S. COOPER, DIRECTOR OF THE LABORATORY, IS THE SPOUSE OF OFFICER KEVIN D. COOPER, GENERAL COUNSEL/CHIEF OF STAFF. JAMES ORR, M.D. IS THE SPOUSE OF VICKI D. ORR, CFO/ASSISTANT TREASURER. HE HAS A MINORITY EQUITY INTEREST IN 21ST CENTURY ONCOLOGY WHICH PAYS NCH RENTAL INCOME FOR THE LUTGERT EAST BUILDING. MEGAN RILEY IS THE DAUGHTER OF MICHAEL RILEY, CHIEF STRATEGY OFFICER. ALYSSA THIGPEN AND ASHLEY THIGPEN MESSIER ARE THE DAUGHTERS OF RENEE M. THIGPEN, INTERIM CHIEF HUMAN RESOURCES OFFICER. X 577126 FMV X 3 2250 FMV X 11 1992831 FMV X FGCU BASKETBALL SEAT PRESIDENTS BOX FOR 16 1 1500 FMV X PARLOR MEETING 1 3040 FMV 0 false true false DETAIL OF BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 ALBERTO M. DE LA RIVAHERRERA, M.D. AND JOHN LEWIS, M.D. ARE MINORITY PARTNERS OF SOUTHWEST FLORIDA EMERGENCY MANAGEMENT, INC. GOVERNING BODY AND MANAGEMENT FORM 990, PART VI, SECTION A, LINE 6, 7A,B THE BOARD OF DIRECTORS OF NCH HEALTHCARE SYSTEM, INC., SOLE MEMBER OF THIS ORGANIZATION, ELECTS THIS ORGANIZATION'S DIRECTORS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11 INFORMATION RELATED TO NAPLES COMMUNITY HOSPITAL INC.'S ("NCH") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW AND RETURN PREPARATION. THE 2010 FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2012 WAS REVIEWED AND APPROVED BY THE CHAIRMAN OF THE NCH FINANCE COMMITTEE, SENIOR LEADERSHIP TEAM AND OUTSIDE COUNSEL FOR THE BOARD PRIOR TO FILING WITH THE IRS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12 ANNUALLY, ALL NCH OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. COMPENSATION PROCESS FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY NCH PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). WRITTEN EMPLOYMENT CONTRACTS ARE ALSO UTILIZED. DOCUMENTS AVAILABILITY TO PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NAPLES COMMUNITY HOSPITAL, INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: WWW.NCHMD.ORG. DETAIL OF OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 TRANSFERS TO RELATED ORGANIZATIONS $(22,299,146) CHANGE IN NET UNREALIZED GAINS AND LOSSES 8,565,445 ------------ TOTAL OTHER CHANGES IN NET ASSETS $(13,733,701) SUPPLEMENTAL INFORMATION REGARDING TAX EXEMPT BONDS FORM 990, SCHEDULE K, PART II, LINE 3 FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2010, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $44,258 IN INVESTMENT EARNINGS. FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2011 PUBLIC, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $1,159,176 IN NET ORIGINAL ISSUE DISCOUNTS AND $20,185 IN INVESTMENT EARNINGS. FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2011 BQ, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $3,027 IN INVESTMENT EARNINGS. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mariann MacDonald TITLE:Chairwoman HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas J. Gazdic TITLE:1st Vice Chairman/Treasurer HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kay Gow TITLE:2nd Vice Chairwoman HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John Lewis, M.D. TITLE:Secretary HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:William Allyn TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michelle Barrett TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kenneth Bookman, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Alberto M. de la Rivaherrera, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Feuer TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Terrance Flynn TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Elizabeth Foster, R.N. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel Gill TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Joann Jenner TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kim Ciccarelli Kantor TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Hermes Koop, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Frank Linsalata TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Moses TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Wayne Mullican TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Joseph I. Perkovich TITLE:Former Chairman HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ken Plunkitt, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ambassador Francis Rooney TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gregory Russo TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Scot C. Schultz, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Norman Thomson, M.D. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gregory Wilkerson, R.N. TITLE:Trustee HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Allen S. Weiss, M.D. TITLE:President/CEO/Trustee HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kevin D. Cooper TITLE:General Counsel/Chief of Staff HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Phillip Dutcher TITLE:COO, NCH Healthcare System Inc HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Aurora Estevez, M.D. TITLE:Chief Medical Officer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Vicki D. Orr TITLE:CFO/Assistant Treasurer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Elizabeth Martin TITLE:Assistant Secretary HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John McGirl TITLE:Chief Human Resources Officer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Helen Thompson TITLE:Chief Information Officer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michele Thoman TITLE:CHIEF NURSING OFFICER HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Riley TITLE:Chief Strategy Officer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James K. Martin TITLE:Chief Development Officer HOURS:44 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Zachary Bostock TITLE:Chief Administrative Officer HOURS:44 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gary Parsons, M.D. TITLE:Chief Medical Officer NCHMD HOURS:44 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Renee M. Thigpen TITLE:Interim Chief HR Officer HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Brian D. Wilson TITLE:Physician/Bonita Health HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Patricia Read TITLE:Admisitrative Director HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Noble Arrington TITLE:Controller HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Susan Wolff TITLE:Former Chief Information Offic HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Brian Settle TITLE:Former Chief Human Resources HOURS: NCH HEALTHCARE SYSTEM INC PO BOX 413029 NAPLES FL 34101 592314655 HOLDING CO FL 501 (C)(3) 11,B NA false NCHMD INC PO BOX 413029 NAPLES FL 34101 331075317 HEALTHCARE FL 501 (C)(3) 9 NCH SYSTEM false COLLIER HEALTH CARE INC PO BOX 413029 NAPLES FL 34101 650244276 HEALTHCARE FL 501 (C)(3) 3 NCH SYSTEM false COMMUNITY HOME SERVICES INC PO BOX 413029 NAPLES FL 34101 592440516 SUPPORT ORG FL 501 (C)(3) 11,B NCH SYSTEM false MARCO ISLAND HOSPITAL INC 40 HEATHWOOD DRIVE MARCO ISLAND FL 34145 592315435 HEALTHCARE FL 501 (C)(3) 3 NCH SYSTEM false COUNSELING & EMPLOYEE ASSISTANCE PROGRAM 350 7TH STREET NORTH NAPLES FL 34102 650374989 EMPLOYEE ASSIST FL NCH SYSTEM C CORP HEALTH RESOURCES CORPORATION 350 7TH STREET NORTH NAPLES FL 34102 592568003 HOLDING COMPANY FL NCH SYSTEM C CORP AMBULATORY SURGICAL CARE CENTER INC 350 7TH STREET NORTH NAPLES FL 34102 592568029 OUTPAT. SURGERY FL HRC C CORP COMMUNITY HOME CARE INC 350 7TH STREET NORTH NAPLES FL 34102 592372966 HOME HEALTH FL HRC C CORP COMMUNITY IMAGING INC 350 7TH STREET NORTH NAPLES FL 34102 592446336 RADIOLOGY LAB FL HRC C CORP GULFCOAST LINEN SERVICE INC 350 7TH STREET NORTH NAPLES FL 34102 650214546 LINEN SERVICE FL HRC C CORP true true true false false false false true true true true true true true true true true true