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HOLMES REGIONAL MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOLMES REGIONAL MEDICAL CENTER (EIN 59-0624371)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-14
IRS object ID
201332269349302058
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

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

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

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

Filer Filer

FieldValueIRS element (for citing)
EIN590624371EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOLMES REGIONAL MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLMNameControl
Phone3214245150Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code32955ZIPCode

Officer Officer

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

Preparer Preparer

FieldValueIRS element (for citing)
NameTHERESA A BURDINE CPAName
PTINP00362629PTIN
Phone3217516200Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code32955ZIPCode
FieldValueIRS element (for citing)
Gross Receipts525925752GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEALTH-FIRST.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1931YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionOUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.THE ORGANIZATION OPERATES 2 NOT-FOR-PROFIT HOSPITALS: HOLMES REGIONAL MEDICAL CENTER, A 514-BED HOSPITAL WITH MORE THAN 500 PHYSICIANS ON STAFF, AND PALM BAY HOSPITAL, A 152-BED HOSPITAL THAT SERVES RESIDENTS OF PALM BAY AND NEIGHBORING COMMUNITIES. THE HOSPITALS OFFER SERVICES INCLUDING CANCER, HEART, EMERGENCY AND TRAUMA, LABORATORY, ORTHOPEDICS, AND WOMEN AND CHILDREN'S PROGRAMS. THROUGH OUR SERVICES, COMMUNITY CLASSES, SUPPORT GROUPS, AND OTHER EVENTS, WE'RE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY AND PROVIDING CONVENIENT ACCESS TO HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers1074TotalNbrVolunteers
Total Gross UBI2085450TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1364259ContributionsGrantsPriorYear
Contributions Grants Current Year1456339ContributionsGrantsCurrentYear
Program Service Revenue Prior Year515057860ProgramServiceRevenuePriorYear
Program Service Revenue CY517426910ProgramServiceRevenueCY
Investment Income Prior Year151397InvestmentIncomePriorYear
Investment Income Current Year-2713833InvestmentIncomeCurrentYear
Other Revenue Prior Year7021483OtherRevenuePriorYear
Other Revenue Current Year6149167OtherRevenueCurrentYear
Total Revenue Prior Year523594999TotalRevenuePriorYear
Total Revenue Current Year522318583TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year23450210GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY31278335GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year232313776SalariesEtcPriorYear
Salaries Etc Current Year226467613SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year246176877OtherExpensePriorYear
Other Expenses Current Year229727758OtherExpensesCurrentYear
Total Expenses Prior Year501940863TotalExpensesPriorYear
Total Expenses Current Year487473706TotalExpensesCurrentYear
Revenues Less Expenses Prior Year21654136RevenuesLessExpensesPriorYear
Revenues Less Expenses CY34844877RevenuesLessExpensesCY
Total Assets BOY602313369TotalAssetsBOY
Total Assets EOY615097426TotalAssetsEOY
Total Liabilities BOY361024786TotalLiabilitiesBOY
Total Liabilities EOY338584666TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY241288583NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY276512760NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR TEAM POSITIVELY CHANGING THE HEALTH AND WELL-BEING OF YOU AND YOUR FAMILY THROUGH EXCELLENT AND COMPASSIONATE HEALTH CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense416866858Expense
Grants31278335Grants
Revenue515963169Revenue
DescriptionHOLMES REGIONAL MEDICAL CENTER (HRMC) FEATURES 514 BEDS AND MORE THAN 500 HIGHLY SKILLED MEDICAL STAFF MEMBERS. AS THE REGION'S PREMIER TERTIARY REFERRAL HOSPITAL, HOLMES OFFERS ALL PATIENTS CUTTING-EDGE, LIFE-SAVING TECHNOLOGY. THE HEART CENTER AT HOLMES OFFERS COMPREHENSIVE CARDIAC SERVICES AND PERFORMS MORE CARDIAC PROCEDURES THAN ALL OTHER HOSPITALS IN BREVARD COUNTY. AS THE ONLY STATE-ACCREDITED LEVEL II TRAUMA CENTER SERVING BREVARD AND INDIAN RIVER COUNTIES, HRMC'S TRAUMA CENTER OFFERS 24/7 TRAUMA CARE AND RAPID PATIENT TRANSPORT VIA FIRST FLIGHT, A HEALTH FIRST OPERATED AERO-MEDICAL HELICOPTER. ADDITIONALLY, THE BIRTH SUITES AT HRMC INCLUDES BREVARD'S FIRST LEVEL II NEONATAL ICU FOR NEWBORNS WITH MEDICAL CONDITIONS REQUIRING INTENSIVE CARE. HRMC IS ALSO THE FIRST HOSPITAL IN BREVARD TO OFFER STATE-OF-THE-ART ROBOTICS-ASSISTED SURGERY FOR UROLOGY, PROSTATE, AND GYNECOLOGICAL PROCEDURES AND IS CURRENTLY THE ONLY HOSPITAL IN BREVARD TO OFFER ANTERIOR HIP REPLACEMENT SURGERY AND REVERSE SHOULDER SURGERY. AS A PRIMARY STROKE CENTER, HRMC OFFERS LIFE-CHANGING INTERVENTIONAL NEURO-RADIOLOGY SERVICES FOR ADVANCED STROKE TREATMENT.PALM BAY HOSPITAL (PBH) FEATURES 152 BEDS AND 195 HIGHLY SKILLED PHYSICIANS. FOCUSED ON CUTTING-EDGE TECHNOLOGY, PALM BAY HOSPITAL OFFERS PATIENTS EXTENSIVE DIGITAL DIAGNOSTIC RADIOLOGY INCLUDING DIGITAL MAMMOGRAPHY, X-RAY, MRI, CT, ULTRASOUND, NUCLEAR MEDICINE AND TELE RADIOLOGY.PBH IS THE FIRST HOSPITAL IN BREVARD TO OFFER THORACIC ENDOGRAPH SURGERY. PBH ALSO OFFERS A FULL SPECTRUM OF HEALTHCARE SERVICES, INCLUDING CARDIOPULMONARY, SURGERY, REHABILITATION, INTENSIVE CARE, EMERGENCY AND ENDOSCOPY SERVICES.HRMC AND PALM BAY HOSPITAL (PBH) PROVIDE HIGH-QUALITY MEDICAL SERVICES TO THE COMMUNITY OF BREVARD COUNTY REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION SUCH AS "HEALTHY HAPPENINGS" SEMINARS AND SUPPORT GROUPS FOR THE PUBLIC.IN KEEPING WITH THIS HOSPITAL'S COMMITMENT, TO SERVE ALL MEMBERS OF ITS COMMUNITY:1) FREE CARE AND/OR SUBSIDIZED CARE IS PROVIDED WHERE THE NEED AND/OR INABILITY TO PAY EXISTS; 2) CARE IS PROVIDED AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS; 3) FREE HEALTHCARE ACTIVITIES AND PROGRAMS ARE PROVIDED TO THE COMMUNITY. THESE ACTIVITIES INCLUDE: WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR ELDERLY, HANDICAPPED, AND MENTALLY UNDERSERVED ALONG WITH A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.FOR A COPY OF OUR HEALTH FIRST COMMUNITY BENEFIT REPORT SEE:HTTP://WWW.HEALTH-FIRST.ORG/CR/2013CR/INDEX.CFMUTM_SOURCE=WWWHOMEPGBANNER&UTM_MEDIUM=HPBANNER&UTM_CAMPAIGN=CR2013HFWWWHOMEPAGEBANNERDescription
Total Program Service Expense416866858TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
JAMES C SHAW
DIRECTOR1.00X0023400
PAMELA A GATTO
VICE CHAIRMAN1.00X0415615600X
WILLIAM C POTTER ESQ
CHAIRMAN1.00X080017800X
BRIAN J BUSSEN
DIRECTOR1.00X0761712800
EUGENE S CAVALLUCCI ESQ
SECRETARY/TREASURER1.00X0673817000X
CATHERINE A FORD
DIRECTOR1.00X01166219800
NORBERTO SCHECHTMANN MD
MEDICAL STAFF PRESIDENT1.00X0078175
JUDY KILLEBREW INCOMING
PRESIDENT/CEO (HRMC)40.00X023259219225X
CHRISTOPHER S REHAK MD
MEDICAL STAFF PRESIDENT1.00X000
ROBERT R WRIGHT INCOMING
PRESIDENT (PBH)13.00X0120740362878X
JERRY SENNE OUTGOING
PRESIDENT/CEO (HRMC)40.00X02405861219592X
JUDITH A GIZINSKI OUTGOING
PRESIDENT (PBH)40.00X019730472831X
JACQUELINE B LINAS MD
MEDICAL STAFF PRESIDENT (OUT-GOING)1.00X000
JAMES STUART MITCHELL III
EVP/COO (INCOMING)1.00000X
JOSEPH G FELKNER INCOMING
EVP/CFO1.00000X
ROBERT C GALLOWAY OUTGOING
SVP/CFO1.00056090845572X
DAVID E MATHIAS ESQ
SVP/CORPORATE COUNSEL1.00048698554645X
DAVID SCOTT GETTINGS
VP CHIEF MEDICAL OFFICER40.00032392223235X
BONNIE RUDOLPH
CNO HEALTH FIRST VP HRMC40.00019802514989X
CHARLES BEHL
LEAD PHARMACIST40.00017281721174X
TIA MARIE ROSSANA
PHARMACIST40.00017204314272X
HENRY BETHEA POWELL
PHARMACIST40.00015863219962X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6147465TotalReportableCompFrmRltdOrgs
Total Other Compensation752950TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955MANAGEMENT SUPPORT435606275
CAPE HEALTH PROPERTIES INC
3300 FISKE BLVDROCKLEDGEFL32955REAL ESTATE SERVICES163532
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations841794RelatedOrganizations
Government Grants614545GovernmentGrants
Total Contributions1456339TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE621110334223136334223136
MEDICARE/MEDICAID621110171441909171441909
PRO HEALTH71394096894809689480
REFERENCE LAB62150014637411463741
RELATED COMPANY RENT531120608644608644
FieldValueIRS element (for citing)
Total Program Service Revenue517426910TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column179623TotalRevenueColumn
Exclusion$179,623ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1826716Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real675909Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1150807Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1150807TotalRevenueColumn
Unrelated Business Revenue621709UnrelatedBusinessRevenue
Exclusion$529,098ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other37804Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2931260Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-2893456Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2893456TotalRevenueColumn
Exclusion-$2,893,456ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFETERIADescription
Business Code722210BusinessCode
Total Revenue Column2697672TotalRevenueColumn
Exclusion$2,697,672ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2300688TotalRevenueColumn
Exclusion$2,300,688ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4998360TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column522318583TotalRevenueColumn
Related Or Exempt Function Income515963169RelatedOrExemptFunctionIncome
Unrelated Business Revenue2085450UnrelatedBusinessRevenue
Exclusion$2,813,625ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total31278335Total
Program Services31278335ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2843369Total
Management And General2843369ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total165300377Total
Program Services151027062ProgramServices
Management And General14273315ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4298117Total
Program Services2999686ProgramServices
Management And General1298431ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total39722639Total
Program Services32097785ProgramServices
Management And General7624854ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total14303111Total
Program Services12843109ProgramServices
Management And General1460002ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3458741Total
Management And General3458741ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total279696Total
Program Services6288ProgramServices
Management And General273408ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total2770Total
Management And General2770ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25807764Total
Program Services19124583ProgramServices
Management And General6683181ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total543364Total
Program Services28444ProgramServices
Management And General514920ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5432453Total
Program Services4435658ProgramServices
Management And General996795ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8925334Total
Program Services9142ProgramServices
Management And General8916192ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total12034385Total
Program Services10890771ProgramServices
Management And General1143614ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total99965Total
Program Services45084ProgramServices
Management And General54881ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total64150Total
Program Services16169ProgramServices
Management And General47981ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total13503417Total
Program Services11917673ProgramServices
Management And General1585744ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total33623121Total
Program Services22534567ProgramServices
Management And General11088554ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4918536Total
Management And General4918536ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES939753579390503670321
MAINTENANCE & REPAIR90031058483760519345
FLORIDA INDIGENT TAX63073316307331
LICENSES AND TAXES15542147366108055

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total11592848Total
Program Services8869009ProgramServices
Management And General2723839ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total487473706Total
Program Services416866858ProgramServices
Management And General70606848ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY107504459BOY
EOY138307220EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY61102396BOY
EOY55871945EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY10576517BOY
EOY10642466EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1824381BOY
EOY1935631EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis657959623LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec368685090LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY311442063BOY
EOY289274533EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY107404391BOY
EOY109524493EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1441788BOY
EOY1120878EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1017374BOY
EOY8420260EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY602313369BOY
EOY615097426EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY30811674BOY
EOY61212817EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY78325863BOY
EOY84814868EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY251887249BOY
EOY192556981EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY361024786BOY
EOY338584666EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY239424424BOY
EOY274178004EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1864159BOY
EOY2334756EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY241288583BOY
EOY276512760EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY602313369BOY
EOY615097426EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses34844877ReconcilationRevenueExpenses
Reconcilation Other Changes379300ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis22416868OtherCostOrOtherBasis
Book Value22416868BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis370778000OtherCostOrOtherBasis
Depreciation141266917Depreciation
Book Value229511083BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1285332OtherCostOrOtherBasis
Depreciation762629Depreciation
Book Value522703BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis262738890OtherCostOrOtherBasis
Depreciation226655544Depreciation
Book Value36083346BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis740533OtherCostOrOtherBasis
Book Value740533BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings289274533TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
HEALTHCARE RELATED JOINT VENTURE7199740C
DEMAND NOTE - HEALTH FIRST INC99629317C
DEMAND NOTE - HEALTH FIRST FDN360680C
OTHER TEMPORARILY RESTRICTED ASSETS2334756C
FieldValueIRS element (for citing)
Total Of Book Value Program Related109524493TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
INTER-COMPANY PAYABLE$36,119,067
OTHER NONCURRENT LIABILITIES$1,159,075
TAX-EXEMPT BONDS HELD BY HEALTH FIRST INC.$155,278,839
FieldValueIRS element (for citing)
Total Of Amounts192556981TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

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

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense29863490TotalCommunityBenefitExpense
Direct Offsetting Revenue10664241DirectOffsettingRevenue
Net Community Benefit Expense19199249NetCommunityBenefitExpense
Percent Of Total Expense0.03910PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense53348160TotalCommunityBenefitExpense
Direct Offsetting Revenue35108388DirectOffsettingRevenue
Net Community Benefit Expense18239772NetCommunityBenefitExpense
Percent Of Total Expense0.03710PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense6307331TotalCommunityBenefitExpense
Direct Offsetting Revenue281272DirectOffsettingRevenue
Net Community Benefit Expense6026059NetCommunityBenefitExpense
Percent Of Total Expense0.01230PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense89518981TotalCommunityBenefitExpense
Direct Offsetting Revenue46053901DirectOffsettingRevenue
Net Community Benefit Expense43465080NetCommunityBenefitExpense
Percent Of Total Expense0.08850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense33865TotalCommunityBenefitExpense
Net Community Benefit Expense33865NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1567350TotalCommunityBenefitExpense
Net Community Benefit Expense1567350NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1003287TotalCommunityBenefitExpense
Net Community Benefit Expense1003287NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1564100TotalCommunityBenefitExpense
Net Community Benefit Expense1564100NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4168602TotalCommunityBenefitExpense
Net Community Benefit Expense4168602NetCommunityBenefitExpense
Percent Of Total Expense0.00850PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense93687583TotalCommunityBenefitExpense
Direct Offsetting Revenue46053901DirectOffsettingRevenue
Net Community Benefit Expense47633682NetCommunityBenefitExpense
Percent Of Total Expense0.09700PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$9,818,019BadDebtExpenseAmount
Amount Attributable To4644231AmountAttributableTo
Amount Reimbursed By Medicare140904860AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare166706806CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-25801946MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 DOCTOR'S GI PARTNERSHIP INC
OUT-PATIENT SURGERY0.400000.000000.60000
2 HEALTH FIRST QUICK CARE LLC
EMERGENT CARE CLINIC0.510000.000000.49000
FieldValueIRS element (for citing)
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
HOLMES REGIONAL MEDICAL CENTER
11350 SOUTH HICKORY STREETMELBOURNEFL32901XXXX
PALM BAY HOSPITAL
21425 MALABAR ROAD NEPALM BAYFL32907XXX
HEALTHSOUTH OF SEA PINES LP
3101 EAST FLORIDA AVENUEMELBOURNEFL32901XACUTE REHAB

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedExplains BasisExplainsBasisIncome LevelIncomeLevelInsurance StatusInsuranceStatusMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsitePosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossChargesFPG Discount PercentFPGDiscountPercentUninsured DiscountUninsuredDiscountNo Emergency PolicyNoEmergencyPolicy
HOLMES REGIONAL MEDICAL CENTER
111200.00000000000001XXXX11XXXX101X00
PALM BAY HOSPITAL INC
211200.00000000000001XXXX11XXXX101X00
HEALTH SOUTH OF SEA PINES LP
311200.00000000000011X10100X00300.000000000000XX

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PRO-HEALTH FITNESS CENTERS
1350 SOUTH HICKORY STREETMELBOURNEFL32901HEALTH AND WELLNESS CENTER
FAMILY PHARMACY
1350 SOUTH HICKORY STREETMELBOURNEFL32901PHARMACY

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: THE ORGANIZATION CALCULATED THE COST AMOUNTS NOTED IN PART I, LINE 7 BY UTILIZING ITS CURRENT COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS REPORTED ON, INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, MEDICAID, UNINSURED, AND MEDICARE.PART I, LINE 2:HEALTH SOUTH OF SEA PINES' FINANCIAL ASSISTANCE POLICY IS APPLIED UNIFORMLY TO MOST HEALTH SOUTH OF SEA PINES' FACILITIES.PART I, LINE 3B:HEALTHSOUTH OF SEA PINES APPLIES A 300% OF FPG TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.PART I, LINE 3C:HEALTH FIRST DOES MAKE PROVISION FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THROUGH PROCESSES AND FORMULARIES WHICH INCLUDE CONSIDERATION OF INDIVIDUALS INCOMES IN COMPARISON TO FPG. DISCOUNTS RANGE FROM EXPECTED TOKEN PAYMENTS (SUCH AS $100) TO A 60% DISCOUNT OF BILLED CHARGES.PART I, LINE 5B:HEALTHSOUTH OF SEA PINES FINANCIAL ASSISTANCE EXPENSES DID NOT EXCEED THE BUDGETED AMOUNT.PART I, LINE 6A:THE COMMUNITY BENEFIT REPORT IS PREPARED BY HEALTH FIRST, INC., THE PARENT COMPANY TO THE ORGANIZATION. THE COMMUNITY BENEFITS OF THIS ORGANIZATION ARE INCLUDED WITHIN THAT REPORT.HEALTHSOUTH OF SEA PINES DOES NOT PREPARE A COMMUNITY BENEFIT REPORT.
PART II: COMMUNITY BUILDING ACTIVITIES ARE PRIMARILY SUBSIDIZED BY HEALTH FIRST, INC. (PARENT) AND THEREFORE ARE NOT REPORTED AT EACH INDIVIDUAL HOSPITAL. THE NEEDS IDENTIFIED ARE, IN PART, BASED ON THE COMMUNITY NEEDS ASSESSMENT. HEALTH FIRST, INC. UTILIZED HOURS OF PAID PHYSICIANS AND NURSES TO SUPPORT THE COMMUNITY WHILE ON PAYROLL. IN ADDITION, AN AMOUNT IN EXCESS OF $1.4M WAS CONTRIBUTED TO VARIOUS LOCAL ORGANIZATIONS PRIMARILY SUPPORTING THE VARIOUS COMMUNITY PUBLIC HEALTH NEEDS. HEALTH FIRST, INC. ALSO SUPPORTED THE ECONOMIC DEVELOPMENT NEEDS, PROVIDED OTHER COMMUNITY SUPPORT, PARTICIPATED IN ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING PROJECTS, SUPPORTED A COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND SUPPORTED THE LOCAL WORKFORCE DEVELOPMENT PROGRAM. HEALTH FIRST, INC. AND ITS EMPLOYEES ALSO ACTIVELY SUPPORT THE LOCAL UNITED WAY IN EXCESS OF $220K.
PART III, LINE 4: BAD DEBT AT COST IS CALCULATED BY MULTIPLYING ACTUAL BAD DEBT WRITE-OFFS BY THE FILING ORGANIZATION'S COST-TO-CHARGE RATIO.THE ORGANIZATION USED A COST TO CHARGE RATIO TO DETERMINE THE COST AMOUNT OF THE BAD DEBT EXPENSE. WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, AS PROVIDED IN THE IRS INSTRUCTIONS WAS USED TO VALIDATE THE COST TO CHARGE RATIO WHICH APPROXIMATES INTERNAL COST CALCULATION.THE ORGANIZATION PROVIDES UNINSURED ACCOUNTS WITH A DISCOUNT FOR PROMPT PAYMENT. THE DISCOUNT IS NOT COLLECTED, NOR PURSUED, AND THEREFORE NOTINCLUDED IN NET PATIENT REVENUE. THE REMAINING BALANCE IS PURSUED, AND IFNOT COLLECTED, REPORTED AS A BAD DEBT EXPENSE.THE ORGANIZATION DOES NOT ISSUE A STAND ALONE FINANCIAL STATEMENT; HOWEVER, IT IS INCLUDED AS A PART OF THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS. THE FOOTNOTE FROM THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS IS AS FOLLOWS: THE PROVISION FOR BAD DEBTS AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR AND AGING CATEGORY, CONSIDERING THE BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED.THE METHOD THE ORGANIZATION USED TO DETERMINE THE AMOUNT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY IS BASED ON A COLLECTION SCORING SYSTEM. THE SCORING SYSTEM ATTRIBUTED A RECOVER SCORE TO EACH PATIENT. IT WAS THEN DETERMINED THAT PATIENTS BELOW A CERTAIN SCORE WOULD TYPICALLY QUALIFY FOR CHARITY CARE IF THEY WERE TO PROVIDE SUFFICIENT INFORMATION.
PART III, LINE 8: THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. ROUTINE AND ICU COSTS ARE DETERMINED BASED ON AN AVERAGE COST PER DAY MULTIPLIED BY THE NUMBER OF MEDICARE ALLOWABLE DAYS. MEDICARE ANCILLARY COSTS ARE DETERMINED BY THE RATIO OF DEPARTMENT COSTS TO DEPARTMENT CHARGES THEN THE RESULTING % IS APPLIED TO MEDICARE ALLOWABLE CHARGES.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: THE ORGANIZATION APPLIES THE FOLLOWING PROCEDURES IN ITS COLLECTION PRACTICES FOR THOSE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE:1. PATIENTS OR GUARANTORS DESIRING TO APPLY FOR FINANCIAL ASSISTANCE WILLBE REQUIRED TO COMPLETE A HEALTH FIRST FINANCIAL ASSISTANCE APPLICATION. THE APPLICATION PROCESS MAY BEGIN AT PRE-ADMISSION OR AT ANY TIME THEREAFTER. FOR FINANCIAL ASSISTANCE APPROVAL ON ELECTIVE PROCEDURES,PLEASE REFER TO POLICY ADDENDUM BELOW.2. INCOME GUIDELINES FOR QUALIFICATION FOR FINANCIAL ASSISTANCE WILL BEBASED ON THE FEDERAL POVERTY GUIDELINE AS FURNISHED ANNUALLY BY THEDEPARTMENT OF HRS.3. AHCA GUIDELINES AND DOCUMENTATION REQUIREMENTS WILL BE USED INESTABLISHING QUALIFICATION FOR FINANCIAL ASSISTANCE. THIS DOCUMENTATIONMAY INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING:A. COMPLETED AND SIGNED FINANCIAL ASSISTANCE APPLICATIONB. PROOF OF HOUSEHOLD INCOMEC. CREDIT BUREAU REPORT AND/OR ASSET CHECK4. PATIENTS WHO ARE ELIGIBLE FOR MEDICAID WILL NOT BE REQUIRED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION.5. THE FINANCIAL ASSISTANCE APPLICATION AND SUPPORTING DOCUMENTATION WILLBE REVIEWED FOR PROPRIETY WHEN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.6. A NOTIFICATION LETTER WILL BE SENT TO THE GUARANTOR OR PATIENT TOCOMMUNICATE ELIGIBILITY FOR FINANCIAL ASSISTANCE OR DENIAL.7. PATIENTS WHO DO NOT PROVIDE INFORMATION NECESSARY TO COMPLETELY ANDACCURATELY ASSESS THEIR FINANCIAL SITUATION AND/OR WHO DO NOT COOPERATEWITH EFFORTS TO SECURE OTHER THIRD PARTY COVERAGE WILL NOT BE ELIGIBLE FORFINANCIAL ASSISTANCE.8. PATIENTS WHO ARE UNINSURED AND DO NOT QUALIFY FOR FULL OR PARTIALFINANCIAL ASSISTANCE WILL BE ELIGIBLE FOR HEALTH FIRST'S PROMPT PAYDISCOUNT FOR SELF PAY PATIENTS.9. ALL APPROVED FINANCIAL ASSISTANCE APPLICATIONS WILL BE VALID FOR A PERIOD OF 90 DAYS. APPROVED TUMOR CLINIC APPLICATIONS ARE VALID FOR A PERIOD OF ONE YEAR.HEALTHSOUTH OF SEA PINES' COLLECTION POLICY DOES NOT CONTAIN PROVISIONS ON THE COLLECTION PRACTICES
PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.
PART V, SECTION B, LINE 10: HEALTH FIRST DOES MAKE PROVISION FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THROUGH PROCESSES AND FORMULARIES WHICH INCLUDE CONSIDERATION OF INDIVIDUALS INCOMES IN COMPARISON TO FPG. DISCOUNTS RANGE FROM EXPECTED TOKEN PAYMENTS (SUCH AS $100) TO A 60% DISCOUNT OF BILLED CHARGES.HOLMES REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 11H: OTHER FACTOR USED IN DETERMINING AMOUNTS CHARGED TO THE PATIENTS IS NUMBER OF DEPENDENTS.HEALTH SOUTH OF SEA PINES, L.P.
PART V, SECTION B, LINE 19D: INDIVUDALS THAT DO NOT HAVE INSURANCE ARE ELIGIBLE FOR A 60% PROMPT PAY DISCOUNT. THE DISCOUNT IS APPROXIMATELY THE AVERAGE NEGOTIATED COMMERICIAL INSURANCE RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY.HOLMES REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 19D: INDIVUDALS THAT DO NOT HAVE INSURANCE ARE ELIGIBLE FOR A 60% PROMPT PAY DISCOUNT. THE DISCOUNT IS APPROXIMATELY THE AVERAGE NEGOTIATED COMMERICIAL INSURANCE RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY.PALM BAY HOSPITAL, INC
PART V, SECTION B, LINE 19D: HEALTHSOUTH SEA PINES BILLS 45% OF GROSS CHARGES TO THE INDIVIDUALS WHO DON'T HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.HEALTH SOUTH OF SEA PINES, L.P.
PART VI, LINE 2: HEALTH FIRST, INC. (PARENT), ON BEHALF OF ITS MEMBER HOSPITAL ORGANIZATIONS, PARTNERS WITH THE HEALTH COUNCIL OF EAST CENTRAL FLORIDA IN ASSESSING THE HEALTH CARE NEEDS OF OUR COMMUNITY. THE MOST RECENT COMMUNITY NEEDS ASSESSMENT REPORT IS AVAILABLE AT HTTP://WWW.CFLHEALTHYMEASURES.ORG./
PART VI, LINE 3: IT IS THE POLICY OF HEALTH FIRST TO GRANT FINANCIAL ASSISTANCE TO ELIGIBLE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR HEALTH CARE SERVICES DUE TO THEIR LIMITED FINANCIAL RESOURCES. IT IS ALSO THE HEALTH FIRST POLICY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS (AS DEFINED BY FEDERAL LAW KNOWN AS "EMTALA") TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY.INFORMATION ABOUT HEALTH FIRST'S FINANCIAL ASSISTANCE PROGRAM SHALL BEMADE AVAILABLE TO PATIENTS AND GUARANTORS BY VARIOUS MEANS, INCLUDING THEPUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN THEEMERGENCY AND ADMITTING DEPARTMENTS, AND AT OTHER PUBLIC PLACES THE HEALTHFIRST FACILITY MAY ELECT. WRITTEN SUMMARY INFORMATION DESCRIBING THE POLICY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION WILL BE MADEAVAILABLE TO EACH PATIENT IN ALL EMERGENCY AND ADMITTING DEPARTMENTS. THEPOLICY WILL ALSO BE POSTED ON THE HEALTH FIRST WEBSITE. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGE SPOKEN BY THE GENERAL POPULATIONS SERVED BY THE HEALTH FIRST FACILITY.ANY HEALTH FIRST ASSOCIATE OR MEMBER OF THE MEDICAL STAFF MAY REFERPATIENTS FOR FINANCIAL ASSISTANCE. A PATIENT OR A FAMILY MEMBER, CLOSEFRIEND OR ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIALASSISTANCE ON BEHALF OF THE PATIENT.
PART VI, LINE 4: BREVARD COUNTY, ALSO KNOWN AS THE SPACECOAST, STRETCHES OVER 70 MILES ALONG THE ATLANTIC COAST, WITH A POPULATION OF MORE THAN 550,000 AND MORE THAN 250,000 HOUSING UNITS (BASED ON JULY 2010 US CENSUS DATA). BEST KNOWN AS THE LOCATION OF THE KENNEDY SPACE CENTER, THE "SPACECOAST" IS ALSO HOME TO PORT CANAVERAL, THE WORLD'S SECOND BUSIEST PASSENGER CRUISE PORT. THE COUNTY IS UNOFFICIALLY DIVIDED INTO THREE SECTIONS, NORTH COUNTY, COMPRISING TITUSVILLE, MIMS, AND PORT ST. JOHN; CENTRAL BREVARD, WHICH INCLUDES COCOA, ROCKLEDGE, MERRITT ISLAND, AND COCOA BEACH; AND SOUTH COUNTY, WHICH INCLUDES MELBOURNE, PALM BAY, GRANT, VALKARIA AND THE SOUTH BEACHES WHICH STRETCH TO THE LINE BETWEEN BREVARD AND INDIAN RIVER COUNTIES.BREVARD COUNTY GREW BY 12.6% BETWEEN 2000 AND 2010 TO 543,376 PEOPLE. DURING THIS SAME TIME PERIOD, THE HISPANIC POPULATION DOUBLED AND THE AFRICAN AMERICAN POPULATION GREW BY 37%. THE COUNTY IS OVER 78% WHITE, 10% AFRICAN AMERICAN, 8% HISPANIC AND THE REMAINDER, A MIXTURE OF OTHER RACES.OF THE HOUSEHOLDS IN BREVARD COUNTY, OVER 26% HAVE CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM, 53% ARE MARRIED COUPLES LIVING TOGETHER, 10% HAVE A FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT AND 33% ARE NON-FAMILIES. THE POPULATION DISTRIBUTION IS AS FOLLOWS: 19% UNDER THE AGE OF 18, 8% FROM 18 TO 24, 23% FROM 25 TO 44, 28% FROM 45 TO 64, AND 22% WHO ARE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE IS 42.8 YEARS.IN 2010, 8% OF THE RESIDENTS WERE LIVING IN POVERTY COMPARED WITH 13% STATEWIDE. 87% OF THE RESIDENTS HAD A HIGH SCHOOL DEGREE, COMPARED WITH 85% STATEWIDE.THE ECONOMY IN BREVARD COUNTY HAS TAKEN A HIT IN RECENT YEARS AS HAS THE ECONOMY IN FLORIDA. IN 2010, THE BROOKING INSTITUTION REPORTED THAT BREVARD COUNTY RANKED IN THE BOTTOM FIFTH OF THE NATION'S TOP METRO AREAS BASED ON UNEMPLOYMENT, GROSS METROPOLITAN PRODUCT, HOUSING PRICES AND FORECLOSED PROPERTIES. BY MARCH 2012, ALMOST 80,000 PEOPLE IN THE COUNTY WERE RECEIVING FOOD STAMPS.THERE ARE 7 ACUTE CARE HOSPITALS SERVING PATIENTS IN BREVARD COUNTY: PARRISH MEDICAL CENTER LOCATED IN NORTH COUNTY; CAPE CANAVERAL HOSPITAL, VIERA HOSPITAL AND WUESTHOFF ROCKLEDGE IN CENTRAL COUNTY; AND HOLMES REGIONAL MEDICAL CENTER, WUESTHOFF MELBOURNE AND PALM BAY HOSPITAL IN SOUTH COUNTY.
PART VI, LINE 5: THE GOVERNING BODY OF HOLMES REGIONAL MEDICAL CENTER, INC. IS COMPRISED OF PERSONS WHO PRIMARILY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS NOR FAMILY MEMBERS OF THE ORGANIZATION NOR ITS KEY EMPLOYEES.THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS.THE ORGANIZATION DOES APPLY RESOURCES THROUGHOUT THE YEAR TO SUPPORT IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND TRAINING. THE ORGANIZATION SPENT MORE THAN $1.5M TO SUPPORT LOCAL STUDENTS VIA TRAINING, EDUCATION, AND SCHOLARSHIP.HOLMES REGIONAL MEDICAL CENTER, INC. PARTNERED WITH LOCAL ORGANIZATIONS IN THE COMMUNITY THAT SUPPORTED THOUSANDS OF UNINSURED OR UNDERINSURED BREVARD RESIDENTS WHO ARE OTHERWISE UNABLE TO PAY FOR HEALTHCARE SERVICES IN EXCESS OF $1M IN THE YEAR.THE EMERGENCY DEPARTMENTS AT HOLMES REGIONAL MEDICAL CENTER INC HAD MORETHAN 64,000 VISITS AND THE EMERGENCY DEPARTMENT LOCATED AT THE PALM BAYCOMMUNITY HOSPITAL (A DEPARTMENT OF HOLMES REGIONAL MEDICAL CENTER, INC.)HAD MORE THAN 39,000 VISITS DURING THE YEAR REGARDLESS OF ABILITY TO PAY.IN ADDITION, THE ORGANIZATION PARTICIPATES IN SEVERAL GOVERNMENT SPONSOREDHEALTH CARE PROGRAMS INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID,CHAMPUS AND TRICARE.THE HEART CENTER AT HOLMES PERFORMS MORE CARDIAC PROCEDURES THAN ALL OTHERHOSPITALS IN BREVARD AND PROVIDES PATIENTS WITH ALL-PRIVATE ROOMS. AS THEONLY STATE-ACCREDITED LEVEL II TRAUMA CENTER IN BREVARD AND INDIAN RIVERCOUNTIES, HOLMES TRAUMA CENTER OFFERS 24/7 TRAUMA CARE AND RAPID PATIENTTRANSPORT VIA FIRST FLIGHT AEROMEDICAL HELICOPTER. ADDITIONALLY THE BIRTHSUITES MOTHER/BABY UNIT OFFERS BREVARD'S FIRST LEVEL II NEONATAL ICU FOROUR TINIEST PATIENTS.HOLMES IS ALSO PROUD TO BE THE FIRST HOSPITAL IN BREVARD TO OFFER STATE-OF-THE-ART ROBOTICS-ASSISTED SURGERY FOR UROLOGY, PROSTATE, GYNECOLOGICAL CONDITIONS, ADVANCED ANTERIOR HIP REPLACEMENT AND REVERSE SHOULDER SURGERIES. HOLMES IS CURRENTLY THE ONLY HOSPITAL IN BREVARD TO OFFER LIFE-CHANGING INTERVENTIONAL NEURO-RADIOLOGY PROCEDURES FOR ADVANCED STROKE TREATMENT.HOLMES REGIONAL MEDICAL CENTER, INC. REINVEST THEIR NET OPERATING INCOME TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.
PART VI, LINE 6: THE ROOTS OF HEALTH FIRST RUN DEEP IN BREVARD, DATING BACK TO 1931 WHEN BREVARD HOSPITAL FIRST OPENED IN MELBOURNE WITH 27 BEDS. NOW KNOWN AS HOLMES REGIONAL MEDICAL CENTER (HRMC), THE HOSPITAL IS BREVARD'S LARGEST, WITH 514 BEDS. CAPE CANAVERAL HOSPITAL (CCH) OPENED IN 1962 WITH 44 BEDS, AND HAS SINCE GROWN TO 150 BEDS. PALM BAY HOSPITAL (PBH) OPENED IN 1992 AS A SATELLITE OF HRMC WITH 60 BEDS AND HAS SINCE GROWN TO 152 BEDS. VIERA HOSPITAL (VH) OPENED IN APRIL OF 2011 WITH 84 BEDS.HEALTH FIRST WAS FORMED WHEN CCH, HRMC, AND PBH JOINED TOGETHER IN AUGUST1995 TO CREATE A TRULY INTEGRATED NOT-FOR-PROFIT HEALTHCARE DELIVERY SYSTEM AND FULFILL A COMMON MISSION OF IMPROVING THE HEALTH OF OUR COMMUNITY. THE FIRST NEW SERVICES ADDED IN THE HEALTH FIRST FAMILY WERE HEALTH FIRST PHYSICIANS, OPENING IN LATE 1995, AND HEALTH FIRST HEALTH PLANS, OPENING IN JANUARY 1996. SINCE THEN, WE'VE ALSO ADDED, HOLMES REGIONAL TRAUMA CENTER, VIERA HOSPITAL IN APRIL OF 2011, VITALWATCH - ELECTRONIC INTENSIVE CARE UNIT AND MANY OTHER SERVICES TO OUR FAMILY.OTHER SERVICES INCLUDE OUTPATIENT CENTERS; THE COUNTY'S ONLY TRAUMACENTER; HOME CARE; SPECIALIZED PROGRAMS FOR CANCER, DIABETES, HEART,STROKE, AND REHABILITATIVE SERVICES; CENTRAL BREVARD'S LARGEST MEDICALGROUP; THREE FITNESS CENTERS; AND MEDICARE ADVANTAGE, COMMERCIAL POS, ANDCOMMERCIAL HMO HEALTH PLANS.WORKING TOGETHER IN A SEAMLESS SYSTEM, HEALTH FIRST IS DEVOTED TO INTEGRATING QUALITY HEALTHCARE SERVICES WITH STATE-OF-THE-ART TECHNOLOGY.HEALTH FIRST ALSO WORKS TOGETHER WITH OTHER ORGANIZATIONS AND PHYSICIANS IN OUR COMMUNITY.OUR ASSOCIATES ARE ALSO ACTIVELY BUILDING A HEALTHIER COMMUNITY THROUGHVOLUNTEERING FOR ORGANIZATIONS DEDICATED TO PREVENTING AND TREATING HEALTHCONCERNS SUCH AS CANCER, DIABETES, AND HEART DISEASE. WE'RE ALSO PROUD OFOUR ASSOCIATE'S CHARITABLE GIVING PLAN, EAGLES (EVERY ASSOCIATE'S GIFTLEAVES EVERLASTING SPIRIT), THAT PROMOTES TISSUE AND ORGAN DONOR AWARENESS, PROVIDES DENTAL SERVICES FOR BREVARD HEALTH ALLIANCE PATIENTS,AND SUPPORTS THE BRIGHT STAR CENTER FOR GRIEVING CHILDREN & FAMILIES.PART VI, LINE 7: NOT APPLICABLE. NEITHER THE FILING ORGANIZATION NOR ANY RELATED ORGANIZATION FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO THE FLORIDA HOSPITAL ASSOCIATION.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
BREVARD HEALTH ALLIANCE
3661 BABCOCK STMELBOURNEFL32901900068515501(C)(3)1307474FINANCIAL ASSISTANCE TO FURTHER ADVANCE THE GOALS AND MISSION OF BREVARD HEALTH ALLIANCE.
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955593336894501(C)(3)29714235GENERAL SUPPORT
HEALTH FIRST FOUNDATION INC
3300 FISKE BLVDROCKLEDGEFL32955593528774501(C)(3)46828GENERAL SUPPORT
BREVARD COMMUNITY COLLEGE NURSING PROGRAM
1519 CLEARLAKE ROADCOCOAFL32955590920675115209798EXPAND ASSOCIATE NURSING PROGRAM

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (11 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
JUDY KILLEBREW INCOMING
0231095000149704027015198025181700
ROBERT R WRIGHT INCOMING
0247816000959587043818019060012702810629608
JERRY SENNE OUTGOING
0370870000203499101982520213400262545302007884
JUDITH A GIZINSKI OUTGOING
01933620003942057730015101027013500
ROBERT C GALLOWAY OUTGOING
0331571000229337028880016692060648000
DAVID E MATHIAS ESQ
02646400002223450405530140920541630041486
DAVID SCOTT GETTINGS
03163980007524010700012535034715700
BONNIE RUDOLPH
019257100054540794507044021301400
CHARLES BEHL
0171092000172507737013437019399100
TIA MARIE ROSSANA
01718990001440871605556018631500
HENRY BETHEA POWELL
015825000038208220011742017859400

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BHEALTH FIRST, INC HAS A NON-QUALIFIED SERP FOR CERTAIN EXECUTIVES. BELOW ARE THE 2011 DEFERRED AMOUNTS: JERRY SENNE $ 185,460 JUDITH A. GIZINSKI $ 47,788 ROBERT R. WRIGHT $ 31,515 ROBERT C. GALLOWAY $ 15,730 DAVID E. MATHIAS $ 27,981
PART IIICOMPENSATION IS PAID BY HEALTH FIRST, INC. EIN:59-3336894 AND REIMBURSED BY HOLMES REGIONAL MEDICAL CENTER, INC. SALARY AND BENEFIT EXPENSES DISCLOSED IN PART IX IS ALLOCATED TO THIS ENTITY. AMOUNTS REPORTED IN COLUMN F REPRESENT DEFERRED COMPENSATION PREVIOUSY REPORTED ON PRIOR YEARS' FORM 990. THE FILING ORGANIZATION RELIED ON HEALTH FIRST FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, LINE 15 DISCLOSURE ON SCHEDULE O FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF HOLMES REGIONAL MEDICAL CENTER, INC. IS HEALTH FIRST, INC., A FLORIDA NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE CORPORATE PARENT OF THE HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7AHEALTH FIRST, INC. (HFI), A SECTION 501(C)(3) EXEMPT ORGANIZATION AND THE PARENT OF THE EXEMPT HEALTHCARE SYSTEM, IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BPER THE BYLAWS AND THE LAWS OF THE STATE OF FLORIDA, THE ADMINISTRATIVE POWER OF THE CORPORATION SHALL BE VESTED IN THE BOARD OF DIRECTORS WHICH SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION. THE BOARD OF DIRECTORS SHALL NOT TAKE ANY ACTION WITH RESPECT TO THE FOLLOWING WITHOUT APPROVAL OF THE MEMBER: -CHANGE IN THE MISSION, PURPOSE OR SCOPE OF THE CORPORATION AND ITS OPERATION; -INCURRENCE OF DEBT OR GUARANTEE THE DEBT OF ANOTHER; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF ANY REAL OR PERSONAL PROPERTY HAVING FMV IN EXCESS OF $250,000; -APPROVAL OF THE SALE, LEASE, PURCHASE, CONVEYANCE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; -APPROVAL OF THE ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS AND ANY MATERIAL DEVIATONS THEREFROM; -APPOINTMENT OR ENGAGEMENT OF AUDITORS, LEGAL COUNSEL OR CONSULTANTS; -APPROVAL OF CHANGES OF HUMAN RESOURCE, EMPLOYEE BENEFITS, ACCOUNTING, FINANCIAL AND OTHER POLICIES OR PROCEDURES; -APPROVAL OF STRATEGIC AND LONG-RANGE PLANS, MAJOR FUND RAISING PROGRAMS AND FINANCIAL COMMITMENTS NOT BUDGETED; -CREATION, ACQUISITION, SALE, PURCHASE, DISSOLUTION OR OTHER DISPOSITION OF ANY AFFILIATED OR CONTROLLED ENTITY OR JOINT VENTURE OR ANY INTEREST IN SUCH ENTITY; -RELOCATION, IMPLEMENTATION OR DISCONTINUATION OF A MAJOR PROGRAM SERVICE; -THE APPROVAL OF MANAGED CARE AGREEMENTS; -THE REPEAL, AMENDMENT, OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; AND -CAPITAL EXPENDITURES AND CAPITAL LEASES EXCEEDING $500,000 ANNUALLY OR $1,000,000 IN TOTAL.
FORM 990, PART VI, SECTION B, LINE 11AFTER REVIEW AND APPROVAL BY THE CHIEF FINANCIAL OFFICER THE FORM 990 IS SENT TO EACH MEMBER OF THE BOARD OF DIRECTORS ELECTRONICALLY FOR THEIR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CA COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL BOD MEMBERS, OFFICERS, MANAGEMENT, AND ASSOCIATES IN WHICH THEY REVIEW AND SIGN THAT THEY HAVE AGREED TO THE TERMS NOTED IN THE POLICY ON AN ANNUAL BASIS. IN ADDITION, ALL MANAGEMENT, OFFICERS, AND BOD MEMBERS ON AN ANNUAL BASIS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE PREPARED AND MONITORED BY THE CHIEF COMPLIANCE OFFICER. THE QUESTIONNAIRE REQUIRES AN ATTESTATION STATING THAT THE INDIVIDUAL IS FREE OF CONFLICTS SHOULD THEY NOT REPORT ANYTHING OF CONCERN. THESE FORMS ARE TRACKED AND KEPT ON FILE. SHOULD A CONFLICT ARISE, THE CHIEF COMPLIANCE OFFICER INVESTIGATES THE ISSUE AND DETERMINES A COURSE OF ACTION TO ENSURE ENFORCEMENT OF THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION PROCESS IS DETERMINED BY THE PARENT COMPANY. THE PARENT COMPANY'S PROCESS IS AS FOLLOWS: THE SALARIES OF OUR CEO AND OTHER HEALTH EXECUTIVES ARE REVIEWED AND RECOMMENDED ANNUALLY TO THE BOARD OF DIRECTORS AND APPROVED IN EXECUTIVE SESSION BY THE FULL BOARD OF HEALTH FIRST. HEALTH FIRST CONTRACTS ANNUALLY WITH A HIGHLY RESPECTED NATIONAL CONSULTING FIRM TO PROVIDE THESE RECOMMENDATIONS TO ENSURE THAT OUR EXECUTIVES ARE COMPENSATED FAIRLY AND COMPETITIVELY WHEN COMPARED WITH SIMILAR ROLES IN OTHER HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION COMMITTEE IS INDEPENDENT FOR INTERNAL REVENUE CODE SECTION 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED. MINUTES ARE KEPT FOR ALL BOARD OF DIRECTORS AND COMPENSATION COMMITTEE MEETINGS. THE PROCESS IS DOCUMENTED CONTEMPORANEOUSLY IN THE BOARD AND COMMITTEE MEETINGS. FORM 990, PART VI, SECTION B, LINE 16B: A FORMAL POLICY HAS BEEN PREPARED AND IS IN THE PROCESS OF BEING ADOPTED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: QUARTERLY AND ANNUALLY CONSOLIDATED FINANCIALS AND CONSOLIDATED STATISTICAL INFORMATION IS FILED ELECTRONICALLY ON WWW.DACBOND.COM AND IS AVAILABLE TO THE PUBLIC. IN ADDITION, ANY REQUESTS MADE TO THE CHIEF FINANCIAL OFFICER FOR THE ABOVE REFERENCED ITEMS ARE PROVIDED UPON REQUEST IN A TIMELY MANNER. A COPY OF THE CONFLICTS OF INTEREST POLICY IS AVAILABLE UPON REQUEST TO THE COMPLIANCE OFFICER.
PART VII, SECTION A, COLUMN B:AVERAGE HOURS PER WEEK DEVOTED TO POSITIONS WITH RELATED ORGANIZATIONS: BRIAN J. BUSSEN 1 HOUR HEALTH FIRST, INC & VIERA HOSPITAL, INC. EUGENE S. CAVALLUCCI 1 HOUR HEALTH FIRST, INC. CATHERINE A. FORD 1 HOUR HEALTH FIRST, INC. ROBERT C. GALLOWAY 40 HOURS HEALTH FIRST, INC. PAMELA A. GATTO 1 HOUR HEALTH FIRST, INC & VIERA HOSPITAL, INC. JUDITH A. GIZINSKI 1 HOUR HEALTH FIRST, INC. DAVID E. MATHIAS 40 HOURS HEALTH FIRST, INC. WILLIAM C. POTTER, ESQ 1 HOUR HEALTH FIRST, INC. ROBERT R. WRIGHT 28 HOURS CAPE CANAVERAL HOSPITAL, INC., HOSPICE OF HEALTH FIRST, INC., VIERA HOSPITAL, INC. & HEALTH FIRST, INC. JERRY SENNE 1 HOUR HEALTH FIRST INC. JAMES C. SHAW 1 HOUR HEALTH FIRST, INC. JAMES STUART MITCHELL, III 40 HOURS HEALTH FIRST, INC. JOSEPH G. FELKNER 40 HOURS HEALTH FIRST, INC.
FORM 990, PART XI, LINE 5:TRANSFER OF NET ASSETS TO A RELATED TAX-EXEMPT -91,298. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 470,598. TOTAL TO FORM 990, PART XI, LINE 5: 379,300.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, QUESTION 2C, AUDITED FINANCIAL STATEMENTS:THE AUDIT COMMITTEE OF HEALTH FIRST REVIEWS AND APPROVES THE ANNUAL AUDIT AND COMPLIANCE AUDIT PLANS THEN MAKES ITS REPORT TO THE HEALTH FIRST BOARD OF DIRECTORS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITORS. THERE WAS NO CHANGE FROM PRIOR YEAR.
FORM 990, PART IV, QUESTION 24A, BONDS ISSUED AFTER DECEMBER 31, 2002:THE FILING ORGANIZATION IS PART OF AN OBLIGATED GROUP THAT HAD MORE THAN $100,000 IN BONDS ISSUED AFTER DECEMBER 31, 2002 OUTSTANDING ON THE LAST DAY OF ITS TAX YEAR. THE FILING ORGANIZATION'S SHARE OF THESE OBLIGATIONS IS REPORTED ON PART X, LINE 20. HEALTH FIRST, INC., THE PARENT OF THE OBLIGATED GROUP, IS FILING SCHEDULE K ON BEHALF OF ITSELF AND ALL MEMBERS OF THE OBLIGATED GROUP.
FORM 990, PART V, QUESTION 2A, NUMBER OF EMPLOYEES:EMPLOYEES AT HOLMES REGIONAL MEDICAL CENTER, INC. ARE INCLUDED IN THE FORM 941 FILED BY HEALTH FIRST, INC. EIN: 59-3336894.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
CAPE CANAVERAL HOSPITAL INC
3300 FISKE BLVDROCKLEDGEFL32955592477479HOSPITALFL501(C)(3)LINE 3N/A1
HOSPICE OF HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955591911574HEALTHCAREFL501(C)(3)LINE 9N/A1
HEALTH FIRST FOUNDATION INC
3300 FISKE BLVDROCKLEDGEFL32955593528774FUNDRAISINGFL501(C)(3)LINE 7N/A1
HEALTH FIRST INC
3300 FISKE BLVDROCKLEDGEFL32955593336894SUPPORT ORGFL501(C)(3)LINE 11C, III-FIN/A0
VIERA HOSPITAL INC
3300 FISKE BLVDROCKLEDGEFL32955264019868HOSPITALFL501(C)(3)LINE 3N/A1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTH FIRST QUICKCARE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13300 FISKE BLVDAddressLine1
CityROCKLEDGECity
StateFLState
ZIP Code32955ZIPCode
FieldValueIRS element (for citing)
EIN900520186EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateFLLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOLMES REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income16197ShareOfTotalIncome
Share Of EOY Assets41164ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.51000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
CAPE HEALTH PROPERTIES INC
3300 FISKE BLVDROCKLEDGEFL32955593086711REAL ESTATEFLCAPE CANAVERAL HOSPITAL INCC
HEALTH FIRST MEDICAL MANAGEMENT INC
3300 FISKE BLVDROCKLEDGEFL32955593348252HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST PHYSICIANS INC
3300 FISKE BLVDROCKLEDGEFL32955593346397HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HOLMES REGIONAL ENTERPRISES INC
3300 FISKE BLVDROCKLEDGEFL32955592109953REAL ESTATEFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST HEALTH PLANS INC
3300 FISKE BLVDROCKLEDGEFL32955593315064HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST INSURANCE INC
3300 FISKE BLVDROCKLEDGEFL32955453131932HEALTH CAREFLHEALTH FIRST HOLDING CORPC
HEALTH FIRST HOLDING COMPANY & SUBS
3300 FISKE BLVDROCKLEDGEFL32955593509709HOLDING CORP.FLHEALTH FIRST INCC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
HEALTH FIRST FOUNDATION INC
C841794
CAPE CANAVERAL HOSPITAL INC
I65443
HEALTH FIRST FOUNDATION INC
I67214
HEALTH FIRST PHYSICIANS INC
I320463
CAPE CANAVERAL HOSPITAL INC
K563253
HEALTH FIRST HEALTH PLANS INC
K73721858
HEALTH FIRST FOUNDATION INC
L61826
HOSPICE OF HEALTH FIRST INC
P63872
VIERA HOSPITAL INC
K269227
CAPE HEALTH PROPERTIES INC
O163532
VIERA HOSPITAL INC
P192318

Form990 Schedule R Part VII Form990ScheduleRPartVII

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