STRATEGY STUDIO / PUBLIC DATA EXPLORER

WINTER HAVEN HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WINTER HAVEN HOSPITAL INC (EIN 59-0724462)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-07-30
IRS object ID
201322119349300752
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)
Timestamp2013-07-30T11:04:52-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN621517792EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12963 GULF TO BAY BLVD STE 267AddressLine1
CityCLEARWATERCity
StateFLState
ZIP Code337594255ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN590724462EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Winter Haven Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWINTNameControl
Phone8632931121Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Ave F NEAddressLine1
CityWinter HavenCity
StateFLState
ZIP Code33881ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLance AnastasioName
TitlePresidentTitle
Phone8632931121Phone
Date Signed2013-07-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTerry HaefnerName
PTINP01258953PTIN
Phone7274427110Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLance AnastasioNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 Ave F NEAddressLine1
CityWinter HavenCity
StateFLState
ZIP Code33881ZIPCode
FieldValueIRS element (for citing)
Gross Receipts307507443GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.winterhavenhospital.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1926YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTo provide hospital and healthcare services.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees2664TotalNbrEmployees
Total Nbr Volunteers236TotalNbrVolunteers
Total Gross UBI846078TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5121071ContributionsGrantsPriorYear
Contributions Grants Current Year4836497ContributionsGrantsCurrentYear
Program Service Revenue Prior Year256334293ProgramServiceRevenuePriorYear
Program Service Revenue CY283688378ProgramServiceRevenueCY
Investment Income Prior Year3891619InvestmentIncomePriorYear
Investment Income Current Year1919217InvestmentIncomeCurrentYear
Other Revenue Prior Year594724OtherRevenuePriorYear
Other Revenue Current Year1411654OtherRevenueCurrentYear
Total Revenue Prior Year265941707TotalRevenuePriorYear
Total Revenue Current Year291855746TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year127611178SalariesEtcPriorYear
Salaries Etc Current Year134880756SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year133704661OtherExpensePriorYear
Other Expenses Current Year151332423OtherExpensesCurrentYear
Total Expenses Prior Year261315839TotalExpensesPriorYear
Total Expenses Current Year286213179TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4625868RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5642567RevenuesLessExpensesCY
Total Assets BOY248636308TotalAssetsBOY
Total Assets EOY258162407TotalAssetsEOY
Total Liabilities BOY145206541TotalLiabilitiesBOY
Total Liabilities EOY144790410TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY103429767NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY113371997NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo improve the health of the people we serve, by providing the highest quality and most effective care and services - and to return value to the people in our communities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense198747160Expense
Revenue284352403Revenue
DescriptionSee Schedule O for Program Service AccomplishmentsDescription
Total Program Service Expense198747160TotalProgramServiceExpense
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 Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 With1096387NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2664NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
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 Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Line1Dave MacDougallBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8632971899TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 Avenue F NEAddressLine1
CityWinter HavenCity
StateFLState
ZIP Code33881ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Mark Bostick
Chairman2.00X000
Brian K Swain
1st Vice Chairman2.00X000
Richard Straughn
2nd Vice Chairman2.00X000
Robert C Carter
3rd Vice Chairman2.00X000
Don Ingram
Secretary2.00X000
Eileen Holden
Assistant Secretary2.00X000
William G Bill Burns
Treasurer2.00X000
William H Murrell
Assistant Treasurer2.00X000
Eric Adamson
Trustee2.00X000
AlbertAl Cassidy
Trustee2.00X000
Kelly Gray-Eurom MD
Trustee2.00X000
Cindy Price
Trustee2.00X000
David K Speyerer MD
Trustee2.00X000
Chip Tucker
Trustee2.00X000
Lance Anastasio
President/Chief Executive Officer40.00053193327356X
David MacDougall
Vice President/Chief Financial Officer40.00029899536819X
Kaye Hixon
Vice President40.00021037411566X
David Libby
Vice President40.00018392522627X
John Parman
Vice President/Corporate Attorney40.00177066023464X
Mary Jo Schreiber
Vice President40.00021571813988X
Joel Thomas
Vice President40.00015308031405X
Celestino Vega
Vice President40.00031653136909X
Majd Alsamman
Medical Director39.60324433017625X
Joseph Lynch
Physician Intensivist39.80340392023445X
Kenneth L Gibbs
Physician40.60398366022726X
George Winny
Medical Director40.00240035033646X
Takkallapelli D Tao
Psychiatrist34.70221839020774X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1702131TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1910556TotalReportableCompFrmRltdOrgs
Total Other Compensation322350TotalOtherCompensation
Number Individuals GT100 K68NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sodexo Inc & Affiliates
PO Box 536922AtlantaGA303536922Management Services3840611
Doster Construction Co Inc
8529 South Park Circle Suite 130OrlandoFL32819Construction3312624
Florida Clinical Practice
PO Box 100247GainesvilleFL32610Physicians1390990
OB Hospitalist Group LLC
10 Centimeters DriveMauldinSC29662Physicians1286600
Pece of Mind Environmental Inc
1575 Aber RoadOrlandoFL32807Demolition1233573
FieldValueIRS element (for citing)
Number Of Contractors GT100 K50NumberOfContractorsGT100K
Related Organizations1012860RelatedOrganizations
Government Grants3814364GovernmentGrants
All Other Contributions9273AllOtherContributions
Total Contributions4836497TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Services621990171800346171800346
Medicare/Medicaid Paym621990106290706106290706
Other Services62199048731842974842$1,898,342
Medicare/Medicaid Paym621500488018488018
Lab Outreach621500236124236124
FieldValueIRS element (for citing)
Total Program Service Revenue283688378TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1744050TotalRevenueColumn
Unrelated Business Revenue10541UnrelatedBusinessRevenue
Exclusion$1,733,509ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real694686Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real58452Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real636234Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column636234TotalRevenueColumn
Exclusion$636,234ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities15737630Securities
Other30782Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities15609108Securities
Other-15863Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities128522Securities
Other46645Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column175167TotalRevenueColumn
Exclusion$175,167ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Other Revenue621990664025664025
Contract Rev - Linen812300111395111395
FieldValueIRS element (for citing)
Total Other Revenue775420TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column291855746TotalRevenueColumn
Related Or Exempt Function Income281729919RelatedOrExemptFunctionIncome
Unrelated Business Revenue846078UnrelatedBusinessRevenue
Exclusion$4,443,252ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total115358095Total
Program Services87913991ProgramServices
Management And General27444104ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4725094Total
Program Services3491955ProgramServices
Management And General1233139ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6479620Total
Program Services35081ProgramServices
Management And General6444539ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8317947Total
Program Services6184810ProgramServices
Management And General2133137ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2433296Total
Management And General2433296ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1455926Total
Management And General1455926ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total297560Total
Management And General297560ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total311323Total
Management And General311323ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12795706Total
Program Services5571009ProgramServices
Management And General7224697ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total526962Total
Program Services62301ProgramServices
Management And General464661ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1610038Total
Program Services83112ProgramServices
Management And General1526926ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4577967Total
Management And General4577967ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total330075Total
Program Services180748ProgramServices
Management And General149327ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total122301Total
Program Services48380ProgramServices
Management And General73921ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3309337Total
Management And General3309337ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14674600Total
Management And General14674600ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3719903Total
Management And General3719903ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies52157242486398033517439
Bad Debt3786950037869500
Equipment Rental & Main942708838286935598395
Indigent Fund26716612671661

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3041938Total
Program Services2166116ProgramServices
Management And General875822ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total286213179Total
Program Services198747160ProgramServices
Management And General87466019ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY11871BOY
EOY10998EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY26717156BOY
EOY23838313EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY42081796BOY
EOY44930528EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5930240BOY
EOY6330268EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4888590BOY
EOY5502957EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis283321458LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec180273175LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY109070457BOY
EOY103048283EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY48931109BOY
EOY50754821EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11005089BOY
EOY23746239EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY248636308BOY
EOY258162407EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28965683BOY
EOY33506904EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY80808817BOY
EOY77634964EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6363826BOY
EOY3377701EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY2700000BOY
EOY2700000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY26368215BOY
EOY27570841EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY145206541BOY
EOY144790410EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY103429767BOY
EOY113371997EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY103429767BOY
EOY113371997EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY248636308BOY
EOY258162407EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5642567ReconcilationRevenueExpenses
Reconcilation Other Changes4299663ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

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 Basis4164198OtherCostOrOtherBasis
Book Value4164198BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis93333724OtherCostOrOtherBasis
Depreciation48307404Depreciation
Book Value45026320BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4147652OtherCostOrOtherBasis
Depreciation3249245Depreciation
Book Value898407BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis164002690OtherCostOrOtherBasis
Depreciation115581883Depreciation
Book Value48420807BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17673194OtherCostOrOtherBasis
Depreciation13134643Depreciation
Book Value4538551BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings103048283TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Other Receivables4343004
Deferred Loan Origination Costs, Net720148
Other Long-Term Assets, Net130057
Construction in Progress16190416
Estimated Insurance Recoveries2362614
FieldValueIRS element (for citing)
Total Book Value Other Assets23746239TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Professional Liability and Workmens Comp$10,705,868
Other Liabilities$1,544,756
Swap Agreements$14,720,466
Estimated Third Party Settlements$599,751
FieldValueIRS element (for citing)
Total Of Amounts27570841TotalOfAmounts
Total Revenue291855746TotalRevenue
Total Expenses286213179TotalExpenses
Excess Or Deficit For Year5642567ExcessOrDeficitForYear
Net Unrealized GL On Investments4785359NetUnrealizedGLOnInvestments
Other-$485,696OtherAmount
Total Adjustments4299663TotalAdjustments
Excess Or Deficit Per FS9942230ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt259597515TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments4785359NetUnrealizedGainsInvestments
Other Revenues1990386OtherRevenues
Revenue Not Rptd F9906775745RevenueNotRptdF990
Revenue Subtotal252821770RevenueSubtotal
Other Revenues Not Included39033976OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt39033976RevenueNotRptdOnFinStmt
Total Revenue Per Form990291855746TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt247707533TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal247707533ExpensesSubtotal
Other Expenses Not Included38505646OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt38505646ExpensesNotRptdOnFinStmt
Total Expenses Per Form990286213179TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Hospital is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and from state income taxes under the provisions of Chapter 220.13 of the Florida Income Tax Code. Accordingly, no provision for income taxes is made in the accompanying consolidated financial statements. The IRC provides for taxation of unrelated business income under certain circumstances. During the years ended September 30, 2012 and 2011, the Hospital performed lab and laundry services for other hospitals, clinics and other health care providers in the community, which generated unrelated business income and resulted in no unrelated business income taxes. There are no significant gross deferred tax assets or liabilities at September 30, 2012 or 2011. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the tax-exempt status of each entity, the continued tax-exempt status of bonds, and various positions relative to potential sources of unrelated business taxable income. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. There were no unrecognized tax benefits identified and recorded as a liability as of September 30, 2012 and 2011.
Part XI, Line 8 - Other Adjustments:Change in Value of Swap Liability -528,333. Transfer to Mid-Florida Medical Services Foundation, Inc. -167,539. Income from Investments in Partnerships 210,176. Total to Schedule D, Part XI, Line 8: -485,696.
Part XII, Line 2d - Other Adjustments:Investment in Subsidiary 1,780,210. Investment Income from Partnerships 210,176.
Part XII, Line 4b - Other Adjustments:Revenue Netted with Expenses 636,143. Change in Value of Swap 528,333. Bad Debts Netted with Revenues 37,869,500.
Part XIII, Line 4b - Other Adjustments:Expenses Netted With Revenue 636,146. Bad Debts Netted with Revenue 37,869,500.

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 Care1FPGReferenceDiscountedCare
Pcent300XPcent300
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 Expense7172196TotalCommunityBenefitExpense
Net Community Benefit Expense7172196NetCommunityBenefitExpense
Percent Of Total Expense0.02890PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense31920951TotalCommunityBenefitExpense
Direct Offsetting Revenue24947145DirectOffsettingRevenue
Net Community Benefit Expense6973806NetCommunityBenefitExpense
Percent Of Total Expense0.02810PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1890708TotalCommunityBenefitExpense
Direct Offsetting Revenue913837DirectOffsettingRevenue
Net Community Benefit Expense976871NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense40983855TotalCommunityBenefitExpense
Direct Offsetting Revenue25860982DirectOffsettingRevenue
Net Community Benefit Expense15122873NetCommunityBenefitExpense
Percent Of Total Expense0.06090PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense304445TotalCommunityBenefitExpense
Net Community Benefit Expense304445NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense282232TotalCommunityBenefitExpense
Net Community Benefit Expense282232NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense77797TotalCommunityBenefitExpense
Net Community Benefit Expense77797NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense664474TotalCommunityBenefitExpense
Net Community Benefit Expense664474NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense41648329TotalCommunityBenefitExpense
Direct Offsetting Revenue25860982DirectOffsettingRevenue
Net Community Benefit Expense15787347NetCommunityBenefitExpense
Percent Of Total Expense0.06350PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense182766TotalCommunityBuildingExpense
Net Community Building Expense182766NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense250000TotalCommunityBuildingExpense
Net Community Building Expense250000NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense432766TotalCommunityBuildingExpense
Net Community Building Expense432766NetCommunityBuildingExpense
Percent Of Total Expense0.00170PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$7,347,863BadDebtExpenseAmount
Amount Reimbursed By Medicare68479418AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare82725251CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-14245833MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalEr24 HoursEr24Hours
Winter Haven Hospital Inc
1200 Ave F NEWinter HavenFL33881XX
Regency Center for Women and Infants
2101 Avenue O NEWinter HavenFL33880X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
Winter Haven Hospital Inc
111200.0000000000001300.0000000000001X11X101X00
Regency Center for Women and Infants
211200.0000000000001300.0000000000001X11X101X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Blood Banks of Mid-Florida Medical Svcs
460 First Street NorthWinter HavenFL33881Blood Bank
Family Health Center - Auburndale
2028 Highway 92 WestAuburndaleFL33823Outpatient Physician Clinic
Family Health Center - Bartow
1625 North Carpenter AveBartowFL33830Outpatient Physician Clinic
Family Health Center - Dundee
5999 Dundee Road Suite 750DundeeFL33884Outpatient Physician Clinic
Family Health Center - Haines City
36245 Highway 27Haines CityFL33844Outpatient Physician Clinic
Family Health Center - Lake Wales
201 SR 60 WestLake WalesFL33853Outpatient Physician Clinic
Family Health Center - Winter Haven
100 Avenue I NEWinter HavenFL33881Outpatient Physician Clinic
Family Health Center - SE Winter Haven
6035 Cypress Gardens BlvdWinter HavenFL33884Outpatient Physician Clinic
Center for Behavioral Health - Polk Co
1201 First Street SouthWinter HavenFL33880Outpatient Beh Hlth Center

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 7: Charity Care and Means-Tested Government Programs costs (lines a through d) are determined using a Cost-to-Charge ratio. Other Benefits were calculated based on actual cost (lines e through j).
Part I, L7 Col(f): There is $37,869,500 of bad debt expense which is included in Form 990, Part IX, Line 24. This amount was removed in the calculation of the Percent of Total Expense on Schedule H Line 7f.
Part II: The Hospital helps build the community in two major ways as mentioned above. First, if the hospital finds that there is a shortage in a certain health care specialty, it works to recruit those types of physicians to the area. In the past, the hospital has commissioned a Manpower study to determine what the community's needs are. Additionally, the hospital subsidizes the cost of anesthesia for women giving birth at the Regency Center for Women and Infants. This benefits the community by allowing those who are less fortunate to have access to anesthesia services.
Part III, Line 4: The organization's financial statements do not include a footnote that describes bad debt expense. Bad debt expense at cost was calculated by multiplying bad debt expense by the Cost to Charge Ratio.Although the Hospital has excluded Bad Debt Expense from the calculation of community benefit found in Schedule H Part I in accordance with IRS instructions, Winter Haven Hospital considers bad debt as a community benefit because a large percentage of the Hospital's bad debt is believed to be undocumented charity care. Hospital bad debt is different from other businesses' bad debt because hospitals continue to provide life saving services to people who cannot or will not pay.
Part III, Line 8: A large percentage of the local community is elderly which results in a large amount of the Medicare Shortfall. Winter Haven Hospital considers this a community benefit because it is committed to providing first class care to the elderly even though it is at a loss due to underpayment by the federal government. The hospital uses the Cost to Charge ratio method.
Part III, Line 9b: At any time in the collection process the account can be determined to meet the criteria of medical indigency as defined by the Federal Poverty Guidelines and all further collection efforts may be suspended. Documentation of such criteria will be retained in the files.
Part V, Section B, Line 19d: The hospital facility used the average of all of the commercial insurance rates for services at this hospital facility. In addition to this decrease, the hospital provides a discount for prompt payment.Winter Haven Hospital, Inc.
Part V, Section B, Line 19d: The hospital facility used the average of all of the commercial insurance rates for services at this hospital facility. In addition to this decrease, the hospital provides a discount for prompt payment.Regency Center for Women and Infants
Part VI, Line 2: The hospital assesses the health care needs of the community by participating in several community organizations that develop community strategic plans such as Winter Haven's "Our Future by Design". The Hospital also works with the Polk County Health Department in order to conduct studies and help set priorities. Additionally, the Hospital works with and utilizes several community health surveys conducted by Polk Healthcare Alliance.
Part VI, Line 3: All self-pay patients are screened for funding sources (Medicaid, Polk Health Care, Charity, etc.) at the time of admission or in the pre-admission process. The Hospital's Financial Counselors review the patient's family size, income, and estimated hospital bill to determine if the patient is eligible for any assistance. If he or she is not, the hospital offers a variety of payment plans to help accommodate the patient.
Part VI, Line 4: Winter Haven is the second largest of 17 municipalities located in Polk County Florida. Over 3.5 million people live within 50 miles of Winter Haven Hospital, with 660,000 living within 25 miles. Of Polk County's citizens, 18% are under 15 years old, 10% are aged 15-24, 35% are 25-54, 10% are 54-64, and 27% are over 65 years old.
Part VI, Line 5: Besides the previously mentioned benefits, the Hospital also benefits the community by providing the following:1. Scholarships to high school students2. Timely initiatives to address the community's emerging problems. (For instance, after the Polk Healthcare Alliance identified that African American infants die at a rate of 4 times the rate of white infants, the hospital developed the Pre Natal Passport which assists pregnant women in tracking their care and worked closely with the Healthy Start Coalition to provide education and portable cribs to new moms that can't afford them.)3. A corporate culture that motivates its employees to volunteer in the community4. An active Speakers Bureau that provides free lectures to the community on health related topics5. Free meeting space for a variety of support groups such as epilepsy, grief, caregivers, lupus, leukemia, brain injury, AIDS, Alzheimers, and domestic violence6. Sponsorship and fund raising for many other community organizations and events, such as: American Heart Association "Heart Walk" and the American Cancer Society "Relay for Life"7. Numerous free and/or at cost health screenings at health fairs in the community, with each fair specializing in men, women, cardiac or diabetic health issues. These screenings include screens for blood pressure, stress assessments, breast exams, prostate cancer, diet and exercise.
Part VI, Line 6: The Hospital is affiliated with the University of Florida Medical School and continually draws on its expertise. Emergency Department physicians and the physician director of the Cancer Center and the Center for Robotics and Urology are from the University of Florida. The University of Florida staff plays a significant role in providing continuing education for medical and nursing staff. This continuing education allows the hospital to improve the way it cares for patients.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (13 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
Lance Anastasio
0465292046900019741016270011086055928900
David MacDougall
026766202730004033015404021415033581400
Kaye Hixon
0184023018700076510111440422022194000
David Libby
016129201650006133011855010772020655200
John Parman
17568000013860126590108050200530000
Mary Jo Schreiber
01940000194000231801398800022970600
Joel Thomas
013641201410002568010287021118018448500
Celestino Vega
0269985027900018646015481021428035344000
Majd Alsamman
316601040000383201690907160342058000
Joseph Lynch
329106000112860122880111570363837000
Kenneth L Gibbs
37300200025364064040163220421092000
George Winny
23835800016770122840213620273681000
Takkallapelli D Tao
145312075060014670101550106190242613000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Polk County Industrial Development Authority
591292108NoneAvail2009-03-2619000000Capital Expenditures000
Polk County Industrial Development Authority
591292108NoneAvail2010-05-1326100000Capital Expenditures000
Polk County Industrial Development Authority
5912921087311B2AA52010-05-1326100000Capital Expenditures000
Polk County Industrial Development Authority
59129210873112BAB32010-05-1314600000Capital Expenditures000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Total ProceedsTotalProceedsCapitalized InterestCapitalizedInterestIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount UnspentAmountUnspent
19000000108131225654187743460011
2610000047721708682472861710011200515
261000002649892423932210011595689
1460000091351447001445429410011016

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedgeBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2
NA
010000NA000
Morgan Stanley
011100NA00024.500000000000
Morgan
011100NA00024.500000000000Stanley/Goldman
Goldman Sachs
011100NA00030.250000000000
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Program Service StatementForm 990, Part III, Line 4aCommunity Benefit Report for Year Ended 9/30/12 Statement of Program Service Accomplishments The Community Benefit contributions of Winter Haven Hospital and the Winter Haven Hospital Foundation include programs and activities that improve access to healthcare and improve health in our communities. Winter Haven Hospital is a not-for-profit organization that is the leading healthcare provider in eastern Polk County, dedicated to the mission of improving the health of the people we serve, by providing the highest quality and most effective care and services and to return value to the people in our communities. Our history of fulfilling this mission and providing access to medical excellence close to home began in 1926. Since that time we have remained dedicated to meeting the healthcare needs of individuals and businesses in central Florida. This statement of program service accomplishments is organized using the HERO methodology; Healthcare, Education, Research, Outreach. Healthcare Established in 1926, Winter Haven Hospital serves as the major medical center for eastern Polk County and the U.S. Highway 27/Ridge corridor. Since that time, the local population has grown substantially with over 609,000 people living within 25 miles of the hospital and over 3 million within 50 miles. The hospital is a division of Mid-Florida Medical Services, Inc., a 501(c)(3), not-for-profit organization, which is governed by an independent Board of Trustees made up of local business and civic leaders who serve without pay. With 527 licensed beds, Winter Haven Hospital's main campus is the larger of the two inpatient facilities in our healthcare system, followed by our Regency Center for Women and Infants. With approximately 2,500 employees, Winter Haven Hospital is the largest private employer in eastern Polk County. The hospital is fully accredited by the Joint Commission and has more than 300 board-certified physicians on its medical staff representing every major specialty. Winter Haven Hospital is affiliated with the University of Florida College of Medicine/Shands Healthcare in the areas of emergency medicine, oncology and urology. The hospital is also a member of the American Hospital Association, Florida Hospital Association, the Premier Alliance, and the West Central Florida Hospital Council. Hospital based services include: - The Bostick Heart Center - The Cassidy Cancer Center - Three 12-bed intensive care units for medical, surgical and coronary care - A nationally recognized Stroke Center - The nationally accredited Joy-Fuller Rehabilitation Center - The Regency Center for Women and Infants - Center for Robotic Surgery With community based facilities located throughout eastern Polk County, Winter Haven Hospital offers numerous specialty programs and units: - State-of-the-art OB/GYN women's facility - Level II neonatal intensive care - Comprehensive physical rehabilitation inpatient and outpatient centers accredited by the Commission on Accreditation of Rehabilitation Facilities, which are also state-designated for brain injury - Three cardiac catheterization laboratories - Clinical lab and regional Blood Bank - Ambulatory Surgery and Diagnostic Center including new operating rooms, endoscopy procedure rooms and prep and recovery areas - Emergency Department - Seven primary care offices (Auburndale, Bartow, Dundee, Haines City, Lake Wales, Winter Haven (two)) - Inpatient Center for Psychiatry/outpatient behavioral health services - Diabetes Care Center With approximately 18,000 total admissions last year, over 1,600 births and over 61,000 emergency and urgent care visits, Winter Haven Hospital continually seeks to fulfill its mission: To improve the health of the people we serve, by providing the highest quality and most effective care and services and to return value to the people in our communities. Winter Haven Hospital's Regency Center for Women and Infants has received the Healthgrades Maternity Care Excellence award every year since 2010. The Regency was just presented with its fourth award. The Joy-Fuller Rehabilitation Center earned its seventh-consecutive 3-year Commission on Accreditation of Rehabilitation Facilities in December 2010. The Bostick Heart Care Center was given a three-star rating by Consumer Reports magazine for 4 years running with the latest published in April 2013. This designation for the Bostick Heart Center's heart-bypass program ranks it as among the top 50 such programs in the nation. Only two other Florida hospitals were given this designation. 2012 also marked the fifth year in a row that the Bostick Heart Center received the top rating of 3 stars from the Society of Thoracic Surgeons. In December 2008 the Hospital was awarded Magnet Status which is the highest level of recognition from the American Nurses Credentialing Center. Characteristics that define nursing services in a Magnet organization emphasize high-quality patient care, clinical autonomy and responsibility, participatory decision-making, strong nurse leaders, effective use of resources, and high levels of job satisfaction. The hospital is in the process of a quadrennial re-certification process for Magnet status. The hospital was one of 60 hospitals to achieve the Gold Elite Award from the American Stroke Association acknowledging at least 2 years of 85% or higher adherence to all performance measures for stroke care with the most recent award coming in January 2012. The hospital program for the continuum of stroke was initially certified by the Joint Commission in July 2005. The program received its second Joint Commission designation in December 2007 and its fourth designation in December 2011. Winter Haven Hospital is committed to the highest quality of compassionate patient care by adhering to the following nursing philosophy: - We believe there is a potential inherent in every human being for self-actualization that can be empowered through the caring nurse-patient relationship. - We value diversity of human experience and expression by accepting the person not only as he or she is now, but as what he or she may become. - We believe that we have an ethical and social responsibility to both individuals and society to protect human dignity and preserve humanity. - We are committed to teamwork and collaboration in which individuals engage in genuine communication, put aside individual and discipline agendas, and put the patient and the patient's social support systems first. - We actualize these beliefs by promoting and rewarding clinical, administrative, research, and education activities which maintain an exceptional caring relationship with those we are privileged to serve. Winter Haven Hospital meets the organizational description for tax exemption as evidenced by: - Operating a 24-hour emergency room that is open to all persons regardless of the ability to pay. - Having an open medical staff with privileges available to all qualified physicians in the area. - Having a governing body comprised of independent persons representative of the community. - Participating in Medicare, Medicaid, Champus, and other government sponsored healthcare programs. - Providing charity care to the indigent as more fully described below. Winter Haven Hospital offers financial assistance policies that help the low income and uninsured members of the community. All self-pay patients are screened for funding sources at the time of admission or in the pre-admission process. Patients are screened for qualification with federal, state, or county funded programs or the hospital's charity care policy. If the patient qualifies, the Financial Counseling staff assists the patient in the application process. If he or she does not qualify, the hospital offers a variety of payment plans to help accommodate the patient. Uninsured patients receive an automatic 40% discount on their bills. The hospital's charity care policy complies with Florida's Agency for Health Care Administration charity guidelines which enables us to provide healthcare to patients that are unable to pay due to financial hardship. This policy includes: - 100 % write-off of charges for families whose income for the 12 months preceding the determination is below 200% of the current federal poverty guidelines. - A sliding scale write-off of charges for families whose income for the 12 months preceding the determination is between 201% and 300% of the current federal poverty guidelines. - A sliding scale write-off of charges for catastrophic cases where the bill exceeds 25% of family annual income.
Additionally, the hospital offers discounts for patients who are underinsured and whose insurance has minimal benefits and/or limited coverage. In order to ensure that everyone in the community has access to quality care, the hospital subsidizes the cost of various critical community healthcare needs such as: - Anesthesia for Medicaid and indigent patients at its Regency Center for Women and Infants - The cost of OB/GYN Hospitalists for Medicaid and indigent patients without a primary obstetrician - The outpatient mental health programs offered at the Hospital's Center for Behavioral Health. - Discounted mammograms during the month of October for National Breast Cancer Awareness Month. The mammograms are given every Tuesday of the month between 1-4 pm. - Operation and subsidization of a pre-natal clinic for Medicaid expecting mothers. Education: Community education - Working directly with the community to promote better health by educating them on a variety of topics taught by physicians or other licensed medical professionals, including but not limited to nutrition lectures, diabetes, stroke awareness, safe babysitting and behavioral disorders. A comprehensive listing of our education programs and support groups is inserted in the Lakeland Ledgers Inside Polk Magazine entitled "You + Your Health". Some examples of our community education offerings include: - Health Connection - A service available to the community providing physician referrals, health information, and referrals to the many Hospital sponsored programs and events. - Speaker's Bureau - The Hospital provides speakers to community organizations on a range of medical topics at no charge. The hospital's Center for Behavioral Health offers lectures on mental health topics open to the public free of charge. - Medical Library - The hospital maintains a medical library that is open to the public. The library is available at the main campus of Winter Haven Hospital as well as an additional library at the Regency Medical Center and offers books, tapes and online clinical research tools. The Medical library also has an onsite Research Information Specialist who is trained by the National Library of Medicine and the Medical Library Association to assist with internet research. - Diabetes Self-Management Education - The hospital offers low cost education for people with or at risk for developing Diabetes. The classes help these individuals gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. Endowed Chair in Nursing - The Hospital is also committed to improving the education of nurses in the local area. In 2010, the Winter Haven Hospital Foundation made a substantial donation to Polk State College to create an endowed chair in nursing. This donation helped to underwrite a new teaching position at Polk State College and augment the college's efforts to add a bachelor's degree in nursing program. Watson Caring Science Institute & Jean Watson International Caritas Consortium - The hospital became an official Watson Caring Science Institute Affiliate in 2010. The Watson Caring Science Institute is a non-profit foundation that advances philosophies, theories, and practices of human caring. Additionally, the hospital became the first hospital to begin data collection for the International Watson Caritas Comparative Database which is a database that collects and evaluates nurse caring behavior. In April 2011, the hospital had the privilege of hosting the International Caritas Consortium. The consortium is a forum for sharing original scholarship, discussing caring research, and mentoring Caritas Coaches. Attendants come from all over the world to join in the forum. In April 2012, Mary Jo Schreiber, Vice President of Nursing, presented the hospital's work with caring theory to the International Caritas Consortium as well as at the July 2012 World Caring Conference. Beth Koon, Manager of Quality Improvement Customer Engagement, presented a 3 hour workshop Blending Social Work Ethics with Caring Science at the NASW Florida Chapter Conference in June 2012 and at the International Caritas Consortium in October 2012. Research: Research Council - The multidisciplinary team helps to identify and review potential research projects for Winter Haven Hospital. Additionally, they track research currently in progress and ensure that all policy, procedures and federal mandates are followed. Institutional Review Board - The purpose of the Institutional Review Board is to review, approve or disapprove the initiation of, and conduct periodic review of, biomedical research involving human subjects. The primary purpose of such review is to ensure the protection of the rights and welfare of human subjects. It further serves as liaison between physicians, investigators, and all other interested parties, and ensures compliance with applicable federal laws and regulations regarding biomedical research involving human subjects. The Institutional Review Board includes engagement of physicians, nurses, board members, administration, pharmacy and three seats for members of the community. Research Studies - The Hospital's commitment to constant improvement has lead to its involvement in several research studies. A few examples from 2012 include the use of Bio-Inert Matrix Wrap for a more effective and efficient vasovasostomy (Vasectomy Reversal) as well as a study to compare various approaches to Percutanous Coronary Intervention for women. Annual Nursing Research Seminar - The hospital invites nurses from around central Florida to its exceptional Research Seminar where nationally known speakers educate and challenge the staff. In 2012, over 70 nurses from various hospitals attended the annual nursing research seminar. Memory Clinic - In 2012, the Hospital's Center for Behavioral Health launched a memory clinic in collaboration with the University of South Florida Applied Neuroscience Lab. The Memory Clinic assists elderly pre-dementia patients to delay onset of memory loss. Robotics - In 2010, the hospital formed its Center for Robotics with initial focus on improving patient outcomes in the area of urology and gynecological surgery. In 2011 and 2012, the hospital hosted the Ramses Robotic Surgery Conference to showcase to other physicians across the county the patient care benefits of an effective robotic surgery program. In 2012, the Robotics institute and Center for Urology opened its new state-of-the-art treatment center in downtown Winter Haven to treat patients with prostate cancer, enlarged prostate, kidney cancer, bladder cancer, male infertility and many other disorders. Outreach: Community health screenings - Numerous free and/or at cost health screenings were performed at health fairs in the community, with each fair specializing in women, cardiac or diabetic health issues. These screenings include screens for blood pressure, stress assessments, breast exams, prostate cancer, diet and exercise. Community Partnerships Our community partners are critical to helping us improve the health and well-being of eastern Polk County. Together, we combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of working with the following community partners: I. Polk Healthcare Alliance - A senior hospital employee serves as the liaison with the Polk Healthcare Alliance. As a member of a five person Executive Committee for the Polk Healthcare Alliance, the liaison reviews progress toward the organization's Community Health Improvement Plan (CHIP). II. Haley Center - The Hospital was instrumental in the development of a free clinic in Winter Haven called the Haley Center. The First Baptist Church of Winter Haven asked for assistance and the health departments, the hospital, the county's Community Health and Social Services Department and others came together to ensure the free clinic's success. It has been operational since December 2005 and the hospital provides free lab, X-ray and pulmonary function testing. Haley Center and Hospital volunteer staff have helped share their expertise with the Parkview Christian Church (Baptist) in Haines City which is now providing free services in its community.
III. We Care - The Hospital participates in the Polk County Medical Association's We Care program. Through a network of 215 medical specialists, We Care helps provide specialty medical care for low income, uninsured residents of Polk County. A member of the hospital's leadership team serves on the board of trustees of We Care. IV. Angel Care Center of Eloise - The Hospital participates in the local church based program called the Angel Care Center of Eloise. This center offers a free diabetic clinic the second Wednesday of each month for persons whose income does not exceed 200 percent of the federal poverty level, who are not eligible for Medicaid or Medicare and who do not have private medical insurance. Hospital volunteers also provide their time to assist with free medical attention. V. Polk Health Care Plan - The Hospital participates in and accepts the Polk Healthcare Plan. Polk HealthCare Plan is a public/private partnership that allows for a comprehensive managed health care program for eligible Polk County residents. The Plan provides an integrated system of health care and social services through a wide range of primary and preventive medical care, specialty medical care, hospitalization, diagnostic testing, ancillary services and pharmaceuticals. In essence, the Plan functions as a County-operated HMO for qualified Polk County residents. A senior hospital employee attends the Citizen Oversight Committee, an advisory body on health issues for the Polk Healthcare Plan. The hospital joined with Polk Healthcare and other area hospitals to participate in an initiative that increases primary care services to low income residents of Polk County. A member of the hospital's board of trustees serves on the board of the Citizen Oversight Committee. VI. Physician Recruitment - The hospital has a full-time physician recruiter and actively recruits physicians in primary care and specialty care areas where it has identified a community need. The hospital also works closely with physician groups to assist them in recruiting new physicians to our area. VII. Regency Prenatal Care Center - The Winter Haven Hospital's Regency Center for Women and Infants offers an obstetrician on site 24 hours a day, 7 days a week for low income patients who do not have a private physician. In August 2012, the Regency opened the Prenatal Care Center to serve low income women who would not otherwise received proper prenatal care. Sponsored community events - Winter Haven Hospital and its employees provided sponsorship and fund raising for these and many other community organizations and events: I. Heart Smart Days: A luncheon, health fair and lecture series focused on heart health education II. Citrus Classic: Features a 5k run, three-mile walk and Kindergarten Dash. III. Heart Walk: A three-mile walk benefiting the American Heart Association. IV. Relay for Life: An 18-24 hour relay walk benefiting the American Cancer Society. V. Baby-to-be and Up-to-three: A fun and informative health fair for expecting parents and young children which includes exhibits, child ID fingerprinting, fire safety, bike helmet fittings, and free immunizations for children. VI. Neighborhood Services Center: The Hospital maintains a Neighborhood Services Center and employs a full time director in order to coordinate speakers, entertainment and health fairs primarily for senior citizens. VII. One Team One Goal: The One Team One Goal campaign provides employees with the opportunity to make a pledge to any combination of seven different charities and funds, including three Winter Haven Hospital Foundation funds and three external charities. VIII. Tennis for Tumors: The Hospital's Cassidy Cancer Center sponsored an annual tennis tournament dedicated to support advanced technology through research and grants and to raise community awareness of childhood brain tumors. The Hospital also sponsors and offers free meeting space for a variety of support groups such as cancer, epilepsy, grief, caregivers, lupus, leukemia, brain injury, AIDS, Alzheimer's, and domestic violence. Peer Recovery Program - The Hospital facilitates the Peer Recovery Program which provides education, socialization, employment skills, and support to consumers who have a mental health diagnosis. Membership and participation is free and open to everyone in the community. Community Leadership - The Hospital enables its leaders to participate in organizations that benefit the well being of the community including for example: The United Way, Girls, Inc., the Women's Resource Center, the Chamber of Commerce for several local communities, and the American Heart Association. Volunteer Services Department The hospital has an active and important volunteer department with over 290 active members serving throughout the hospital for over 42,000 hours. The hospital volunteers have spent hours serving the community with a Patient I.D. Fair, HIM Bake Off, Polk Heartwalk, Heart Smart Day and the Women's Health Fair. They also provide special Christmas stockings for infants going home on Christmas and sponsor the Christmas Angel Tree program. Community Benefit Quantification The following financial information represents a quantification of Winter Haven Hospital's community benefit for the fiscal year ended September 30, 2012. This quantification was developed using the principals set forth under IRS Schedule H. The hospital will file IRS Schedule H with its 2011 Form 990 as required by IRS regulations for fiscal year ending September 30, 2012. 2012 Charity and Medicaid Cases: Charity Medicaid Emergency Department 4,890 10,029 Inpatient 481 2,242 Other 1,358 1,675 Total 6,729 13,946 Charity Care and Certain Other Community at Cost: Charity Care - at cost $ 7,172,196 Direct Community Based Healthcare Programs $ 328,950 Unreimbursed Cost of Medicaid Programs $ 6,973,806 Unreimbursed Cost of County Indigent Care Program $ 647,920 Donations and Community Groups $ 77,798 Education/Health Fairs $ 149,249 Enrollment Assistance in Government Programs $ 155,197 Health Professionals Education $ 282,232 Total Charity Care and Certain Other Community Benefits at Cost $ 15,787,348 Community Building Activities: Physician Recruitment $ 182,766 Subsidized Cost of Regency Anesthesia $ 250,000 Total Community Building Activities $ 432,766 Total Quantifiable Community Benefit $ 16,220,114 The Community Benefit Quantification shown above does not include the following additional important demonstrations of the Hospital's community support: Cost of Uncompensated Care to Patients above the Poverty Line $ 7,347,863 Shortfall of Medicare Funding for Patient Care* $ 14,245,833 Scholarship for Workforce Development $ 37,024 Total $ 21,630,720 *From Medicare Cost Report Excludes Medicare Advantage (HMO, PPO, etc.) shortfall of $3,625,158
Form 990, Part VI, Section A, line 2Mark Bostick and William H. Murrell, Board Members, have a family relationship.
Form 990, Part VI, Section A, line 6The sole member of Winter Haven Hospital, Inc. is Mid-Florida Medical Services, Inc.
Form 990, Part VI, Section A, line 7aThe Trustees of the Winter Haven Hospital, Inc. shall be elected by the Sole Member, Mid Florida Medical Services, Inc., at its annual meeting each year for staggered three year terms.
Form 990, Part VI, Section A, line 7bAs stated in the Bylaws of Winter Haven Hospital - The Board of Trustees shall not, without the prior approval of the Sole Member of the Corporation: 1. Amend the Bylaws or the Articles of Incorporation of Winter Haven Hospital. 2. Approve a plan of dissolution of Winter Haven Hospital. 3. Approve a plan of merger or consolidation of Winter Haven Hospital with another Corporation. 4. Organize or acquire, or authorize or approve the organization or acquisition of any subsidiary or affiliate of the Corporation.
Form 990, Part VI, Section B, line 11The Executive Director of Accounting and CFO of Winter Haven Hospital intially reviewed Form 990. After their review was completed, the final Form 990 was then presented and made available to all Board Members including all voting members of the governing body.
Form 990, Part VI, Section B, line 12cThe Chairman of the Board of Directors inquires at least annually if there are any conflicts of interest. In addition all officers, directors, trustees and key employees are required to sign a conflict of interest statement annually.
Form 990, Part VI, Section B, line 15The Executive Compensation Committee of the Board of Directors sets compensation for the President and Vice Presidents of the hospital. The Executive Compensation Committee consists of four Board members, all of whom are independent. The Executive Compensation Committee has used the consulting firm of Sullivan and Cotter to advise them about executive compensation and to provide them with comparability data. Minutes of the Executive Compensation Committee meetings are kept and retained at the Hospital.
Form 990, Part VI, Section C, line 19The financial statements of Winter Haven Hospital are made availabe to the public upon request. The organization's governing documents and conflict of interest policy are not made available to the public.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 5:Net unrealized gains on investments: 4,785,359. Change in Value of Swap Liability -528,333. Transfer to Mid-Florida Medical Services Foundation, Inc. -167,539. Income from Investments in Partnerships 210,176. Total to Form 990, Part XI, Line 5: 4,299,663.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Mid-Florida Medical Services Inc
200 Ave F NEWinter HavenFL33881592486580Support OrganizationFL501(c)(3)509(a)(3) - Type 1N/A0
Mid-Florida Medical Services Foundation Inc
200 Ave F NEWinter HavenFL33881030406130FundraisingFL501(c)(3)509(a)(3) - Type 10
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
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 Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Mid-Florida Medical Services Foundation Inc
Q167539Cost
Mid-Florida Medical Services Foundation Inc
C1012860Cost
Mid-Florida Medical Services Foundation Inc
L509018Cost
mid-Florida Medical Services Foundation Inc
P1103931Cost