2012-07-31T12:16:56-07:00 2011-09-30 KPMG LLP 300 N Greene St Suite 400 Greensboro NC 27401 990 2010-10-01 593458145 FLORIDA HEALTH SCIENCES CENTER INC FLOR 8138447000 PO BOX 1289 TAMPA FL 33601 Steve Short 8138444805 2012-07-31 1 Donald E Rich Jr 3364337071 2012-08-01 2010 2016-02-24 21:20:13Z TAMPA GENERAL HOSPITAL Ronald Hytoff PO Box 1289 Tampa FL 33601 1252545629 0 X http://www.tgh.org X 1997 FL Tampa General Hospital is committed to providing the residents of West Central Florida with excellent and compassionate health care ranging from the simplest to most complex medical services. As a teaching facility, Tampa General partners with academic and community institutions to support both its teaching and research missions. As the region's leading safety net hospital, Tampa General Hospital reaffirms its commitment to providing high quality health services to all residents. 15 12 7680 570 975752 336981 19358442 3709264 1022143197 1087657580 20202430 28124526 169433 175685 1061873502 1119667055 0 786179 0 0 432731950 488057589 0 0 0 558975042 588175038 991706992 1077018806 70166510 42648249 1151470936 1171706038 760070818 758365271 391400118 413340767 Tampa General Hospital is committed to providing the residents of West Central Florida with excellent and compassionate health care ranging from the simplest to most complex medical services. As a teaching facility, Tampa General partners with academic and community institutions to support both its teaching and research missions. As the region's leading safety net hospital, Tampa General Hospital reaffirms its commitment to providing high quality health services to all residents. 0 0 838204305 1040575895 Hospital Patient Services: Tampa General Hospital, a leading safety net, private not-for-profit hospital, is one of the most comprehensive medical facilities in West Central Florida serving a dozen counties with a population in excess of 4 million. As one of the largest hospitals in Florida, Tampa General is licensed for 1,018 beds, and with over 7,000 employees, is one of the region's largest employers. TGH is the area's only Level 1 Trauma center and one of just four burn centers in Florida. With five medical helicopters, we are able to transport critically injured or ill patients from 23 surrounding counties to receive the advanced care they need. The hospital is home to one of the leading organ transplant centers in the country, having performed more than 6,000 adult solid organ transplants, including the state's first successful heart transplant in 1985. TGH is a state-certified comprehensive stroke center, and its 32-bed Neuroscience Intensive Care Unit is the largest on the west coast of Florida. Other outstanding centers include cardiovascular, orthopedics, high risk and normal obstetrics, urology, ENT, endocrinology, and the Children's Medical Center, which features a nine-bed pediatric intensive care unit and one of just three outpatient pediatric dialysis units in the state. Services for outpatients are provided in a variety of locations. A range of diagnostic and therapeutic outpatient services are provided on the TGH campus. In addition, TGH provides outpatient rehabilitation services in an offsite facility and primary and specialty physician services in various offsite clinics. As the region's leading safety net hospital, Tampa General is committed to providing area residents with excellent and compassionate health care ranging from the simplest to the most complex medical services. TGH provides medical services to those unable to pay through various means, including the Hillsborough County Health Plan and the State Medicaid program. In addition, TGH provides trauma care on a regional basis as well as other services at no charge to eligible patients through its charity care program. Statistics: Total patient days: 279,188, Emergency room visits: 84,140, Deliveries: 5,489, and Surgeries: 28,867. 28512872 0 15692159 Residents' teaching program (the revenues and expenses disclosed in this section include direct graduate medical education only): Tampa General Hospital has been affiliated with the University of South Florida ("USF") College of Medicine since the school was created in the early 1970s. Tampa General Hospital is the primary teaching affiliate of the Morsani College of Medicine at the University of South Florida. In excess of 300 residents rotate through the hospital each year. The Medicare program funds 209 residents, with the remaining slots funded solely by the hospital. These residents are assigned to Tampa General Hospital for specialty training in areas ranging from general internal medicine to neurosurgery. In addition, medical, nursing and physical therapy students all receive part of their training at the Tampa General Hospital on an annual basis. In excess of 200 medical students rotate through Tampa General Hospital during their third and fourth year of medical school. Faculty of the Morsani College of Medicine at the University of South Florida admit and care for patients at Tampa General Hospital as do community physicians, many of whom also serve as USF adjunct clinical faculty. 1271945 0 794802 Clinical Research: As the region's only Level 1 Trauma Center and the primary teaching hospital for the Morsani College of Medicine at the University of South Florida, Tampa General Hospital is uniquely poised to conduct cutting-edge clinical trials advancing the state of medicine every day. The Office of Clinical Research (OCR) is committed to supporting investigators, sponsors, and patients participating in clinical trials. We provide strategic services, education and training, and comprehensive review processes designed to fulfill the potential of clinical investigators and their research staff. TGH is actively engaged in clinical trials with university physicians and private physicians. During fiscal year 2011, the OCR provided oversight for a total of 426 active studies including 124 newly approved studies. In addition to the OCR administrative services, the TGH Center for Outpatient Research Excellence (CORE) provides coordination services that begin before site initiation and continue for the duration of the study. Pre-study services include study placement, coordination of pre-study site visit, regulatory work, laboratory and radiology research pricing, and arrangements for special services. Study coordination services include recruitment, screening, subject enrollment, study visits/procedures, investigational drug services, administration and accountability, packaging and shipping, source documentation, case report form completion, and long term record storage. 2346005 786179 30594724 Tampa General Hospital's Other Program Services includes cafeteria and vending sales, parking garage revenues, pharmacy sales to employees, net assets released from restrictions, and other miscellaneous revenue. 2346005 786179 30594724 870335127 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 451 0 1 7680 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X Steve Short CFO 8138447000 PO Box 1289 Tampa FL 33601 Thomas L Bernasek MD 1 X 28441 0 0 John Brabson 1 X 0 0 0 Margarita Cancio MD 1 X 123378 0 0 Phillip S Dingle 1 X 0 0 0 Owen Fredrick Dobbins 1 X 0 0 0 John McKibbon 1 X 0 0 0 Eugene McNichols 1 X 0 0 0 Shelton Quarles 1 X 0 0 0 Dana L Shires MD 1 X 0 0 0 John T Sinnott MD 1 X 0 0 0 David A Straz Jr 1 X 0 0 0 Joseph Taggart 1 X 0 0 0 John T Touchton Jr 1 X 0 0 0 Erika Wallace 1 X 0 0 0 James W Warren 1 X 0 0 0 John H Bond Jr 50 X 401430 0 31493 Mark W Campbell 50 X 231343 0 29706 Janet H Davis 50 X 320870 0 30454 Robin W DeLaVergne 50 X 387160 0 27997 Cheryl A Eagan 50 X 299200 0 26270 Anthony D Escobio 50 X 218327 0 31074 Sally H Houston 50 X 508458 0 37685 Ronald A Hytoff 50 X 2776767 0 146964 Kathi K Katz 50 X 372897 0 7640 Elizabeth J Lindsay-Wood 50 X 421676 0 36146 Marcos F Lorenzo 50 X 584148 0 45500 Veronica B Martin 50 X 215350 0 19219 Jean M Mayer 50 X 477026 0 39662 Deana L Nelson 50 X 930875 0 69671 Maureen Ogden 50 X 349675 0 31993 Judith M Ploszek 50 X 527038 0 43224 David K Robbins 50 X 257441 0 32507 Chris A Roederer 50 X 361956 0 29562 Steve L Short 50 X 820337 0 64416 Amy J Paratore 50 X 325212 0 33656 Richard L Paula 50 X 211295 0 7725 Maja G Gift 50 X 186655 0 24857 John P Dunn 50 X 206270 0 5135 Lucila E Ramiro 50 X 239887 0 9290 George A Gadea 50 X 229760 0 13595 Emma C Ocampo 50 X 229476 0 13589 Sarah J Poblete 50 X 205200 0 5129 Ginger K Oliver 50 X 232983 0 6234 12680531 0 900393 332 1 1 0 USF & UMSA PO Box 917492 Orlando FL 32891 Physicians/Residents 43572755 FLORIDA BLOOD SERVICE INC 10100 Dr Martin Luther King Jr St St Petersburg FL 33716 Blood Services/Products 15648023 LIFELINK OF FLORIDA 409 BAYSHORE BLVD Tampa FL 33606 Organ Acquisition 12414069 SKANSKA USA BUILDING INC 4950 W Kennedy Blvd Tampa FL 33609 Construction 10302785 EPIC SYSTEMS CORPORATION 1979 Milky Way Verona WI 53593 Software Training 6791316 245 0 0 0 443491 3193151 72622 0 3709264 Medicaid, Medicare, Other Government, Commerical 622000 1026426930 1026426930 0 0 Disproportionate Share Revenue 622000 29841124 29841124 0 0 Sales to Employees/Pharmacy 446110 6982750 6982750 0 0 24406776 23431024 975752 0 1087657580 15287047 0 0 15287047 721871 0 0 721871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144299062 695120 132498642 379932 11800420 315188 12115608 0 0 12115608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Rental Income -Towers 900099 175685 0 0 175685 0 0 0 0 175685 1119667055 1086681828 975752 28300211 786179 786179 0 0 0 0 0 0 13957805 6041149 7916656 0 0 0 0 0 370734465 300557701 70176764 0 27096441 21677153 5419288 0 49140583 39312466 9828117 0 27128295 21702636 5425659 0 4100843 276546 3824297 0 2816188 0 2816188 0 312005 0 312005 0 108530 108530 0 0 1067607 0 1067607 0 108860607 92405497 16455110 0 3552194 110191 3442003 0 255157078 237032129 18124949 0 33495244 0 33495244 0 0 0 0 0 14891650 9783814 5107836 0 1187570 452270 735300 0 0 0 0 0 260130 153826 106304 0 18541483 12181754 6359729 0 30654 0 30654 0 36816557 24622934 12193623 0 20501542 20501542 0 Bad Debt 68656371 68656371 0 0 Assessments 12959747 12959747 0 0 Dues and Memberships 1976689 237087 1739602 0 Property Taxes 377698 237506 140192 0 Recruitment Expenses 521890 73864 448026 0 1982761 464235 1518526 0 1077018806 870335127 206683679 0 19345 20995 92692910 84821859 668135 525141 109180812 124762316 24215498 19216950 3118449 4440248 707559863 261808204 409316535 445751659 328048125 452507031 145546901 1439652 7249258 6645152 31414968 31575035 1151470936 1171706038 161085002 159913627 463191 325831 375232875 370082645 4570553 4094132 218719197 223949036 760070818 758365271 X 373098119 399778462 18301999 13562305 0 0 391400118 413340767 1151470936 1171706038 X 42648249 -20707600 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 100 0 0 1 422249 0 0 422349 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Tampa General Hospital's lobbying activities focus on communicating the hospital's special status and challenges to elected officials at the County, State, and Federal levels. Given TGH's large share of indigent care in the region, efforts are primarily focused on maintaining existing funding and seeking additional government support to ensure TGH can continue to deliver quality care to its patients. 812385 31507 397 0 10464 0 833825 797412 15675 821 0 1523 0 812385 762812 34373 3539 0 3312 0 797412 0 1 0 0 1 1 0 43896417 43896417 0 379912109 95533686 284378423 0 5569247 5245838 323409 0 235117737 159425196 75692541 0 43064353 1603484 41460869 445751659 Deposits 1439652 F 1439652 Accrued Claims Payable Malpractice 66910503 Accrued Retirement Benefits 71901691 Due to Third Party Payor 59867081 Accrued Supplemental Retirement Benefits 17935700 Accrued Postretirement Benefits 4075614 Accrued Workers Compensation 2335000 2006 Bond Arbitrage Payable 923447 223949036 1119667055 1077018806 42648249 -18355660 0 0 0 -1363259 -19718919 22929330 1099948136 -18355660 0 0 0 -18355660 1118303796 0 1363259 1363259 1119667055 1077018806 0 0 0 0 0 1077018806 0 0 0 1077018806 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Permanently restricted funds were available for hospital construction projects, equipment, and educational initiatives. SchD_P10_S00_L02 Schedule D, Part X, Line 2 TGH has been recognized by the Internal Revenue Service as a tax-exempt organization described in Section 501(c)(3) of the Internal Revenue Code. Accordingly, income earned in the furtherance of TGH's tax-exempt purpose is exempt from federal and state income taxes. TGH applies Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740 for Income Taxes which clarifies the accounting for uncertainty in income tax positions and provides guidance when tax positions are recognized in an entity's financial statements and how the value of these positions are determined. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 This amount represents contributions in the amount of $1,363,259 received from the Tampa General Hospital Foundation and other governmental grants that is not included in the audited financial statements as revenue, but as a change in net assets. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Contributions of $1,363,259 received from the Foundation and other related organizations are included in Part VIII but are not reported in the audited financial statements as revenue. Central America and the Caribbean 1 2 Program Services Provides professional and general liability services in support of Florida Health Science Center Inc. 492171 1 2 492171 0 0 1 0 0 0 SchF_P01_S00_L03 Schedule F, Part I, Line 3 Florida Health Sciences Center Ltd, which was formed in Cayman Islands began operations June 1, 2010, provides professional and general liability services to Florida Health Sciences Center Inc. 1 1 X 1 X 1 X 1 1 1 0 1 1 62740119 20870413 41869706 0.042 193394604 184343279 9051325 0.009 32281860 21650338 10631522 0.011 0 0 288416583 226864030 61552553 0.062 1114356 1114356 0.001 28512872 15692159 12820713 0.013 7146530 7146530 0.007 1271945 794802 477143 0 1317607 1317607 0.001 0 0 39363310 16486961 22876349 0.022 0 0 327779893 243350991 84428902 0.084 1 13834259 0 232088164 253874948 -21786784 X 1 1 1 1 Florida Health Sciences Center Inc dba Tampa General Hospital

PO Box 1289 Tampa FL 33601

X X X X X Florida Health Sciences Center Inc dba Tampa General Hospital 1 1 1 200 1 400 1 X X X X X 1 1 X X X X 1 X X 1 X X X X X X 1 X X X 0 1 9 Genesis OB GYN at Healthpark

5802 N 30th Street Tampa FL 33610

Outpatient OB/GYN clinic. Family Care Center Kennedy

2501 W Kennedy Blvd Tampa FL 33609

Family care clinic. Pediatrics Clinic at Healthpark

5802 N 30th Street Tampa FL 33610

Pediatrics outpatient clinic. Specialty Center at Healthpark

5802 N 30th Street Tampa FL 33610

Specialty outpatient clinic. Family Care Center Healthpark

5802 N 30th Street Tampa FL 33610

Family care outpatient clinic. TGH Outpatients Rehabilitation Services

509 S Armenia Ave Suite 301 Tampa FL 33609

Outpatient rehabilitation clinic. TGH Community Health Education

740 S Village Circle Tampa FL 33606

Community health education center. Transplant Abdominal Clinic

409 Bayshore Blvd Tampa FL 33606

Transplant clinic. Heart and Lung Transplant Clinic

5 Tampa General Hospital Suite 300 Tampa FL 33606

Heart and lung transplant clinic. SchH_P01_S00_L06a Schedule H, Part I, Line 6a The hospital's community benefit report can be accessed at www.tgh.org SchH_P01_S00_L07 Schedule H, Part I, Line 7 The hospital's cost accounting system was used to calculate the amounts reported in line 7. For the purpose of computing subsidized services, both direct and indirect costs were considered. For research, only direct costs were considered. SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f Bad debt of $68,656,371, included in the expense total, is not included in the total operating expense of $1,077,018,806 which was used to calculate the Table 7 percentages. SchH_P01_S00_L07g Schedule H, Part I, Line 7g Physician Clinics were included in the subsidized health services calculation resulting in a community benefit expense of $3,208,589. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 Receivables are reported net of an allowance for bad debt and contractual adjustment estimates. Although the aggregate amount of receivables may include balances due from patients and third party payers, amounts due from third-party payers for retroactive adjustments of items, such as final settlements or appeals, are reported separately in the financial statements. The adequacy of the allowance for bad debts is evaluated regularly, with adjustments to increase or decrease the allowance by adjustments in the provision for bad debts. As expected payments are determined to be uncollectible, they are written off against the allowance for bad debts. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The $21.8 million shortfall reported at Pt. III line 7 should be considered a community benefit in that much of the shortfall in Medicare payments relates to the costs associated with the TGH liver, heart, kidney, lung and pancreas organ transplant programs, and medical education programs, which are a significant benefit to all patients in these programs and the community as a whole. Medicare revenues and cost are from the 2011 Medicare cost report cost to charge ratio, adjusted for increases in total expenses and total charges from 2010 to 2011, adjusted for the revenues and costs associated with subsidized health services and graduate medical education reported separately in Part I lines 7g and 7f. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Each self pay patient is evaluated to determine if covered by Medicaid, Hillsborough County and/or charity assistance. The financial information provided by this evaluation determines into which category a patient resides. Patients who do not qualify for government assistance are then evaluated in accordance with hospital policy for Charity and Discounted Care. Patient balances will either qualify for a total write-off or a discount based on the patient's household income and family size in relation to the Federal Poverty Limitations. SchH_P05_S0B_L11 Schedule H, Part V, Section B, Line 11 Tampa General Hospital assesses the patient's household expenses as a basis for calculating amounts charged to patients. SchH_P05_S0B_L13 Schedule H, Part V, Section B, Line 13 A pamphlet is given to patients who we believe may qualify or who ask. SchH_P05_S0B_L15 Schedule H, Part V, Section B, Line 15 Working with patients on reasonable extended payment terms. SchH_P05_S0B_L16 Schedule H, Part V, Section B, Line 16 Working with patients on reasonable extended payment terms. SchH_P05_S0B_L19 Schedule H, Part V, Section B, Line 19 Sometimes the hospital uses the Medicaid rate. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 We assess total charges to international patients coming for highly specialized elective care. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 Tampa General Hospital (TGH) is a 1,018 bed academic medical center located in Hillsborough County, Florida. TGH serves a 12 county region that includes a population in excess of 3,300,000 people. This population has a broad range of health care needs, and TGH identifies these needs using a variety of approaches, including analysis of population demographics, consumer survey data, inpatient and outpatient utilization of services by the population, state, local, & national data on health status, and other factors impacting the need for health care programs and services. Each of these will be described in more detail below. Utilization Data: The state of Florida collects data on inpatient hospitalizations for all hospitals in the state. Analysis of this data allows TGH to identify patterns of inpatient utilization by the age of the patient, diagnosis, and location of residence. This data can be coupled with the demographic data to determine the need for new or expanded inpatient programs. For example, the data can be used to determine population utilization rates by diagnosis and age cohort. If the rates are increasing and the population cohort is growing, services may need to be increased to meet future demand. Analysis of this data is a critical step in all TGH program development. State, Local, & National Data: There are many sources of data available from local, state, and the federal government that assist TGH in identifying community needs. The inpatient utilization data identified above is an example of data available from the state of Florida. One critical source of information available from the federal government is found in the Healthy People 2010 goals. The Healthy People 2010 goals are based on a nationwide assessment of community health status. These goals provide a roadmap for local communities to use in developing programs based at health promotion and prevention. They also identify specific population access issues that can help in program design. TGH has designed community education, screenings, and programs specifically in support of the Healthy People 2010 goals related to cancer, heart disease and stroke, immunizations, nutrition, and tobacco use. Consumer Survey Data: The most complete needs assessment data that TGH utilizes to design community programs is the annual National Research Consumer Health Report. The Report is based on surveys of the residents of the Tampa-St. Petersburg-Clearwater, Florida CBSA. The 2008-2009 report, which was the basis of TGH's Fiscal Year 2011 programming, was based on a sample of 3,034 households in the CBSA. Questions in the survey asked consumers to rate their health status, whether they had been diagnosed in the past 12 months with one or more conditions, whether they were insured, and what type of preventive activities they engaged in during the past 12 months. The demographic characteristics of the respondents was also collected, which allowed the data to be analyzed by age and income. Analysis of the report provided TGH data to support the development of screenings for hypertension and cholesterol, programs on nutrition and obesity, smoking cessation, diabetes, sleep disorders and osteoporosis. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 For Fiscal Year 2011, the costs associated with charity care, unreimbursed Medicaid, and the unreimbursed costs of other means-tested government programs care exceeded $61 million. These include patients who qualify for free care under TGH's charity care policy or are enrolled in programs for low-income or underinsured individuals sponsored by state and local governments. While TGH received reimbursement for some of these patients the amounts are not sufficient to cover the costs of care provided. Free care is provided to patients who qualify based on an evaluation of their income and assets. Individuals with an income that is less than or equal to 200% of the Federal Poverty Level (FPL) are eligible for charity or free care as are individuals whose income is less than 400% of the FPL but whose hospital charges are greater than 25% of their annual income. Financial counselors work with individuals who seek care and are uninsured. Assistance is provided to enroll eligible individuals in government programs such as Medicaid, Medicare Disability or the Hillsborough County Health Plan as well as determining whether they qualify for charity or discounted care. TGH's financial assistance (charity care and discounted care) policy is available to consumers at TGH.org as well as in the hospital admissions area. The information is written in both English and Spanish and the English version is reproduced below. Financial Assistance (Charity and Discounted Care) Tampa General Hospital provides necessary medical care regardless of a patient's ability to pay for services. Patients, who are admitted and are uninsured or underinsured, may qualify for financial assistance and/or discounted care. Uninsured patients who are seeking non-emergent care are given these guidelines and an estimate of charges upon inquiry, prior to admission. (FS 395.301 7.8) Qualifying for assistance is based upon the Federal Poverty Income Guidelines. Our Financial Counseling staff is available to assist patients throughout the qualifying process. Charity eligibility will be considered for six months from the date of eligibility. The following guidelines are used to determine the amount of financial assistance a patient receives. A patient's assets and medical expenses are taken into consideration when determining the level of assistance. Patients will be asked to provide information to the TGH financial counselors in order to determine eligibility for charity or discounted care. * Charity: You will not be billed if your income is between 0 and 200% of the Federal Poverty Level (FPL). * Charity Catastrophic: You will not be billed if your income is under 400% FPL and your hospital charges are greater than 25% of your annual income. * Uninsured Discount Tier 1: Your hospital bill will be discounted by 70% if your annual income is between 200 and 300% of the FPL. * Uninsured Discount Tier 2: Your hospital bill will be discounted by 60% if your income is between 300 and 400% of the FPL. * Insured/Recently Uninsured: If your income is greater than 400% of the FPL and you are recently uninsured you may qualify for a discount equivalent to that of your most recent insurance carrier. * Prompt Payment: If your income is greater than 400% of the FPL, you may qualify for a prompt pay discount. Providing false information to defraud a hospital for the purpose of obtaining goods or services is a misdemeanor in the second degree and punishable under Florida Statute 817.50. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Tampa General Hospital's primary service area is Hillsborough County, Florida. Seventy percent of the inpatients who are treated at TGH are residents of Hillsborough County. The remaining 30% come from an 11 county region of West Central Florida, as well as other areas of Florida and the United States. The entire region benefits from the warm climate of Florida and is a popular destination for retirees as well as others looking to escape the harsher climates of the Midwest and Eastern parts of the United States. Hillsborough County is a growing area. With a current population of over a million (1,230,000), the County is projected to grow by 9% over the next five years (1,340,000). This growth rate is more than double that of the entire nation. The average age of Hillsborough County population is 35.1 years which is almost identical to the US as a whole 36.7. Individuals over 65 years of age comprise 11.8% of the population while 23.9% of the population is less than 18 years of age. The County's population is racially and ethnically diverse with 17% of the population Black or African American and 25% of the population either White or Black Hispanic. Household income in Hillsborough County averages $47,129 somewhat less than the US average ($50,221) while per capita income is slightly higher ($27,252 v. $27,041). It is estimated that approximately 15.2% of the families in the County are below the federal poverty level. The current recession has impacted Hillsborough County as unemployment rates are in excess of 11.8%. The eleven county regions that comprise TGH's secondary service area have a very different demographic profile. The region extends north of Hillsborough County to Citrus County and south to Charlotte County. The secondary service area includes the following Florida Counties: Pasco, Hernando, Citrus, Polk, Pinellas, Highlands, Desoto, Manatee, Sarasota, Charlotte, and Hardee. The secondary service area has a current population in excess of 3.3 million. Projected grow is expected to be less than the primary service area and is estimated to be 7.1% over the next five years. By 2015, the population of the secondary service area is projected to be 3,556,776. The secondary service area population is older than that of the primary service area with an average age of 45.1 years. Over 24.5% of the secondary service area population is over the age of 65. Many of the secondary service area counties are popular retirement areas for residents of colder parts of the United States. The secondary service area is slightly less diverse than the primary service area. Less than 8% of the secondary service area is Black or African American (7.8%) and 15.6% consider themselves Latino or Hispanic. The average household and per capita income of the secondary service area is less than that of both the primary service area and the US as a whole. Household income averages $39,729 almost $7,400 less than that of the primary service area. This is a reflection of the large senior population many of whom are on fixed incomes. Per capita income for the secondary service area is slightly less than that of the primary service area ($23,737 v. $27,252). Less than 16.9% of the families in the secondary service have incomes below the federal poverty level. Unemployment in the secondary service area varies from approximately 10.5% to 15.7%. Educational levels in both the primary and secondary service area are somewhat different than the US as a whole. The percentage of the population with Masters Degrees or above in both the primary and secondary service area are less than the national average of 7% for the population over 25. In the primary service area approximately 19% of the population has a Bachelors degree compared to less than 15% in the secondary service area and 17% for the United States as a whole. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Tampa General Hospital's commitment to the health of the community it serves is exemplified by its mission statement. The key elements of TGH's mission include the provision of services ranging from the simplest to the most complex to all of the residents of West Central Florida, a commitment to research and education with its physician and medical school partners and recognition of its role in the community as the safety net provider. The TGH Board of Directors reaffirms this mission during the annual review and adoption of the TGH strategic plan. The Board also authorizes the use of surplus funds through the annual budget process to fund enhancements to services, the physical plant, infrastructure and financial support for training physicians, nurses and other health care providers, health education to the community and support of other not-for-profit organizations in the community with complimentary goals and missions. The 15 member board is composed of independent community leaders as well as members of the TGH medical staff. The board bylaws specify that its membership will include the elected medical chief of staff, a representative of the University of South Florida and the chairman of the TGH Foundation. TGH utilizes its surplus funds for the development of inpatient services and to subsidize outpatient services for underserved members of the community. TGH operates a number of outpatient clinics that provide primary and specialty care for the uninsured and under-insured. Services include adult primary and specialty care, pediatrics, and high risk obstetrics. While many of these patients have some funding either through Medicaid or the Hillsborough County Health Plan, the revenue from these sources is insufficient to cover the costs of providing the services. In fiscal year 2011, TGH's clinics provided 156,557 patient visits. The TGH medical staff is open to any physician that meets the requirements of the medical staff bylaws and rules and regulations. The medical staff is composed of community physicians with private practices and physicians on the faculty of the USF Health Morsani Florida College of Medicine (USFHMCOM). Both the community and USFHMCOM physicians are involved in research and training. Many of the community physicians hold clinical appointments with the USFHMCOM and all staff physicians may participate in research. In FY2011, the TGH Office of Clinical Research supported 426 research studies at a net cost of $794 thousand. These studies received funding from a variety of public and private agencies, including the Department of Defense and the National Institute of Child Health Development and were led by both community and university physician principal investigators. The research centered on a range of topics, including a Phase III study of effective drug cocktails for HIV positive patients to an evidenced-based clinical decision support system to predict survival and life expectancy of hospice patients. These research initiatives have immediate benefits to the patients who participate in them as well as long term benefits to the community. TGH is considered a statutory teaching hospital under Florida Law. This designation is only available to hospitals that have made a significant commitment to graduate medical education. In fiscal year 2011, TGH funded over 300 full time equivalent residents and fellows in over 40 specialties. The Medicare program funds 209 residents, with the remaining slots funded solely by the hospital out of surplus funds. In addition to a robust medical education program, TGH is also committed to the training of nurses, pharmacists, and other clinical staff. TGH provides financial support for nursing education at both the University of South Florida and the University of Tampa. Students and residents in a variety of clinical programs (pharmacy, pastoral care, and other programs) rotate through TGH or in some cases are assigned to TGH for their training. Finally, TGH sponsors continuing medical education (CME) for physicians in the community and in outlying areas. In fiscal year 2011, TGH CME sponsorships provided CME education to 794 physicians, none of whom were on the TGH medical staff. The cost of CME sponsorships exceeded $150,000. In all cases, surplus funds are dedicated to the educational mission of TGH. Tampa General's commitment to improving the health status of the community is evident in the vast array of educational programs, screenings and support groups it provides to the community. In fiscal year 2011, TGH provided 149 free programs and screenings to 5280 members of the community. Educational programs focused on everything from preventing the flu, to smoking cessation to stress management. Programs were provided in a variety of locations. For example, programs of particular interest to seniors were provided at several senior living facilities within the primary service area including Sun City, University Village, Horizon Bay, Riverview Senior Center and Brandon Community Center. In fiscal year 2011, TGH participated in three programs in collaboration with its community partners. Health & Fit for life is a program for kids and their parents that focus on making healthy food choices and increasing exercise as a way of maintaining and controlling weight. Health & Fit was designed with More Health, a community based health education program for children in Hillsborough & Pinellas Counties. This program was provided at the University Area Community Development Center. Living Healthy and Matter of Balance are both multi-week programs aimed at individuals with chronic illnesses or balance concerns. These programs were provided in conjunction with the Florida's West Coast Area Agency on Aging. Screenings provided during fiscal year 2011 ranged from blood pressure and diabetes to screenings for memory loss, hearing, peripheral vascular disease and abdominal aortic aneurysms. TGH has a dedicated staff responsible for developing programs as well as identifying high risk areas within the county that might benefit most from screenings and health prevention and promotion programs. TGH nurses volunteer their time to help with these programs and screenings as part of their clinical ladder. In addition to providing educational programs and screenings, TGH also provides financial support to other community not-for-profit organizations. This funding is another way that TGH utilizes its surplus funds to support the community health and well being. In fiscal year 2011, TGH provided financial support to over 80 not-for-profit organizations. This support ranged from donations under $1,000 to commitments in excess of $250,000. Three organizations in particular receive significant support from TGH: More Health Inc., Ronald McDonald Mobile Health Van and Tampa Community Health Center. For more than 20 years, TGH has been the largest single sponsor of More Health, Inc. More Health provides health education in Hillsborough and Pinellas County public and private school. Innovative, hands on instruction for all grades is a key feature of More Health and more than a million children have benefited from the education provided by More Health. TGH, in conjunction with the USF Health Morsani College of Medicine and the Ronald McDonald Foundation supports a mobile medical van that provides medical and dental services to underserved children in the region. TGH also provides financial support to Tampa Community Health Center (TCHC). TCHC is a federally qualified health center that provides significant amounts of service to underserved populations in Hillsborough County. TGH's donation allows them to expand primary care and other services. In addition TGH supports a variety of other not-for-profits including the American Heart Association, March of Dimes, Ronald McDonald Foundation, Wheels of Success, the Epilepsy Foundation, Joshua House, the Spring and many others. In addition to financial support, many TGH employees volunteer their time and participate in fundraising events like the Heart Walk for the American Heart Association. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 NOT APPLICABLE SchH_P06_S00_L07 Schedule H, Part VI, Line 7 FL 1 More Health Inc 3821 Henderson Blvd Tampa FL 33629 593397472 501(c)3 200000 Support mission to promote healthy choices to students in surrounding counties. Tampa Family Health Center Inc 2103 N Rome Ave Tampa FL 33607 592420282 501 (c) (3) 225000 Support local health program centers. University of South Florida 4202 E Fowler Ave Tampa FL 33620 593102112 501(c)3 60000 Support USF in the provison of healthcare service to schools to low income areas. Ronald McDonald House 28 Columbia Dr Tampa FL 33606 591835985 501(c)3 55000 Support mission to provide programs to directly improve the health and well being of children. University of Tampa 401 W Kennedy Blvd Tampa FL 33606 590624459 501(c)3 52002 Support provisions of healthcare services. Tampa Bay Partnership 4300 W Cypress St Suite 700 Tampa FL 33607 593414776 501(c)3 50000 Support of One Bay: Healthy Communities. The Tampa Tribune 200 S Parker St Tampa FL 33606 541967824 40000 Sponsor event for womens retreat that provides screening and health education. University of South Florida 4202 E Fowler Ave Tampa FL 33620 593102112 501(c)3 38177 Support provisions of healthcare services. American Heart Association 11207 Blue Heron Blvd N Suite P St Petersburg FL 33716 135613797 501(c)3 36000 Support various local sponsorship events. Gasparilla Distance Classic Association Inc 106 Columbia Dr A7 Tampa FL 33606 591943559 501(c)3 10000 Sponsorship for individuals and the set up of a medical tent for screening runners. Lifelink Legacy Fund 409 Bayshore Blvd Tampa FL 33606 593040982 501(c)3 10000 Support mission to reach people regarding the need for organ and tissue transplants. Moffitt Cancer Center Foundation 12902 Magnolia Dr Tampa FL 33612 593238636 501(c)3 10000 Support mission for Moffitt Cancer Center Foundation. 10 2 SchI_P01_S00_L02 Schedule I, Part I, Line 2 Tampa General Hospital monitors the charitable contributions donated through out the year. We have a select staff whose purpose is to promote health throughout the community with the help of local charities. The staff works closely with the charities to ensure that the funds are directly beneficial to the community. X X 1 1 X X X X X X 0 1 0 0 0 1 0 1 0 Amy J Paratore 150348 0 57848 0 117016 0 20106 0 13551 0 358869 0 25361 0 Anthony D Escobio 145676 0 66340 0 6311 0 20583 0 10490 0 249400 0 0 0 Cheryl A Eagan 200590 0 94095 0 4515 0 16808 0 9461 0 325469 0 0 0 Chris A Roederer 246850 0 112484 0 2622 0 20062 0 9501 0 391519 0 0 0 David K Robbins 170070 0 77798 0 9573 0 18936 0 13571 0 289948 0 0 0 Deana L Nelson 443470 0 231525 0 255880 0 64373 0 5297 0 1000545 0 0 0 Elizabeth J Lindsay-Wood 274103 0 126000 0 21573 0 22472 0 13674 0 457822 0 0 0 Emma C Ocampo 207452 0 16000 0 6024 0 21719 0 13589 0 264784 0 0 0 George A Gadea 198747 0 16000 0 15013 0 17361 0 13595 0 260716 0 0 0 Ginger K Oliver 40072 0 0 0 192911 0 4209 0 2024 0 239216 0 0 0 Janet H Davis 163941 0 72356 0 84573 0 23014 0 7440 0 351324 0 0 0 Jean M Mayer 236590 0 107593 0 132843 0 33171 0 6490 0 516687 0 0 0 John H Bond Jr 160729 0 72657 0 168044 0 17931 0 13562 0 432923 0 46347 0 John P Dunn 165782 0 20000 0 20488 0 18137 0 5135 0 229542 0 0 0 Judith M Ploszek 275811 0 123441 0 127786 0 38087 0 5136 0 570261 0 0 0 Kathi K Katz 237070 0 108000 0 27827 0 19282 0 7640 0 399819 0 0 0 Lucila E Ramiro 211166 0 16000 0 12721 0 22026 0 9290 0 271203 0 0 0 Maja G Gift 155690 0 20000 0 10965 0 17294 0 7563 0 211512 0 0 0 Marcos F Lorenzo 255766 0 117532 0 210850 0 36150 0 9350 0 629648 0 0 0 Mark W Campbell 146367 0 66340 0 18636 0 16160 0 13547 0 261050 0 0 0 Maureen Ogden 179068 0 53087 0 117520 0 22558 0 9435 0 381668 0 0 0 Richard L Paula 160232 0 50625 0 438 0 0 0 7725 0 219020 0 0 0 Robin W DeLaVergne 221522 0 101231 0 64407 0 18681 0 9315 0 415156 0 2664 0 Ronald A Hytoff 872208 0 520169 0 1384390 0 132726 0 14237 0 2923730 0 0 0 Sally H Houston 360652 0 145922 0 1884 0 28235 0 9450 0 546143 0 0 0 Sarah J Poblete 189634 0 15000 0 566 0 11845 0 5129 0 222174 0 0 0 Steve L Short 435694 0 231525 0 153118 0 50821 0 13595 0 884753 0 0 0 Veronica B Martin 152551 0 57116 0 5683 0 11663 0 7556 0 234569 0 0 0 Margarita Cancio MD 123378 0 0 0 0 0 0 0 0 0 123378 0 Thomas L Bernasek MD 28441 0 0 0 0 0 0 0 0 0 28441 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a TGH pays membership dues for the University Club of Tampa for Mr. Ronald Hytoff. These membership dues were not treated as taxable compensation to the recipient. Any international travel by an executive is booked with a first class ticket. SchJ_P01_S00_L03 Schedule J, Part I, Line 3 Within the framework of applicable law, Tampa General Hospital will establish and maintain compensation goals, policies, and programs that enable the hospital to recruit, develop, and retain the most qualified and talented staff. Tampa General Hospital strives to effect a strategic investment in the people who support the hospital's mission. Compensation goals, policies, and programs are guided by and reflect our values and principles, which are consistent with the high quality of the hospital's achievement in the furtherance of medical science. Differences in pay will not be based upon such factors as race, religion, gender, national origin, ancestry, age, marital status, or disability. To ensure that TGH is paying reasonable compensation and not violating the private inurement prohibition, the Compensation Committee of the Board of Directors annually reviews and sets the compensation of officers, the executive group and key employees. The Committee utilizes the outside consulting firm of Towers Watson to provide expert information regarding industry-wide compensation norms. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Tampa General Hospital provides the executive staff with a supplemental retirement plan (SERP). Participants of this plan are listed on Statement 4 column C3 (Officers). As these participants become vested, the incremental amount of vested benefits is included on Form W-2; however, distributions are not made until either the participant retires or leaves the organization. The compensation reported in the 2010 W-2s includes this following vested amounts: Ronald A. Hytoff: $1,278,662; Deana Nelson: $228,123; Marcos Lorenzo: $181,775; John Bond: $144,329; Ginger Oliver: $120,087; Steve Short: $116,880; Maureen Ogden: $115,882; Jean Mayer: $109,974; Judith Ploszek: $109,364; Amy Paratore: $100,205; Janet Davis: $73,934; Robin DeLaVergne: $55,195; and Mark Campbell: $5,865. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 A portion of the bonuses and incentive is based achieving certain financial targets. The remaining bonuses are based on the achievement of certain quality indicators and other non-financial metrics. SchJ_P01_S00_L07 Schedule J, Part I, Line 7 A portion of the bonuses and incentive is based achieving certain financial targets. The remaining bonuses are based on the achievement of certain quality indicators and other non-financial metrics. Hillsborough County Industrial Development Authority 591293512 43233ACA2 2003-05-29 208601867 Hospital Expansion and Refunding 1992 Bond Issue 0 0 0 Hillsborough County Industrial Development Authority 591293512 43233ACT1 2006-09-28 190910329 Hospital Expansion 0 0 0 20480000 0 230607013 14042506 0 0 2872749 0 4592749 110846006 98253003 0 2007 1 0 1 1 2595000 0 202380091 0 0 0 2184896 0 0 199158479 0 1036716 2009 0 0 1 1 0 1 0 0 0 0.002 0 0.002 1 0 1 0 0 0 0.0018 0 0.0018 1 0 0 0 1 Societe Generale 6 1 0 0 0 0 0 1 Transamerica Life 2.25 1 0 0 SchK_P01_S00_L00e Schedule K, Part I, Column e Issue price from Part I, column E does not agree with the Part II, line 3 due to interest earned. SchK_P04_S00_L04c Schedule K, Part IV, Line 4c The original agreement between Tampa General Hospital and Societe Generale had a maturity date of October 1, 2013. On July 7, 2010, the original agreement was terminated. DeLaVergne & Company Business owned by spouse of Robin DelaVergne, FHSC Vice President 285394 Real Estate Commission 0 Suntrust Mr. Owen Fredrick Dobbins, a FHSC trustee, is a local officer for Suntrust Bank 256329 Suntrust performs a custodial function for FHSC, Inc. The above fees represent the amount FHSC paid Suntrust as a custodian of invested funds in an arm's length transaction 0 Florida Orthopedic Institute Dr. Thomas L Bernasek is a FHSC trustee and shareholder and surgeon at Florida Orthopedic Institute 2178866 Florida Orthopedic Institute provides professional medical services for FHSC 0 SchL_P04_S00_L00 Schedule L, Part IV DelaVergne & Company, a real estate brokerage firm, is owned by Robin DelaVergne's spouse and son. TGH engages DelaVergne & Company for commercial real estate services which are paid at fair market value. Robin DelaVergne is a senior vice president. Mr. Dobbins is a director of FHSC and an employee of Suntrust Bank. FHSC has some commercial bank accounts with Suntrust. Dr. Thomas L Bernasek is a surgeon and shareholder of Florida Orthopedic. FHSC conducts business transactions with both. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a USF designates one individual to participate in FHSC's board. In addition, the Chairman of the Board of the Tampa General Hospital Foundation is also a member of FHSC's board. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b The Hillsborough County Hospital Authority has the right to approve amendments to FHSC's Articles of Incorporation. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The IRS Form 990 is prepared by the Finance Department and sent to Tampa General Hospital's tax accountants for review. Following the revisions made at the suggestion of Tampa General Hospital's tax accountants, the IRS Form 990 is provided to the Chief Financial Officer (CFO) and the President/Chief Executive Officer (CEO) for comment and recommended changes. The Finance Department makes all appropriate revisions. The CFO reviews the Form 990 with the Audit Committee and considers any changes recommended by the Audit Committee. Any agreed-upon changes are incorporated and the draft Form 990, along with the Mission Statement, is distributed to the Board of Directors for review and approval. Upon approval by the Board, the Form 990 is filed with the IRS. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The monitoring and enforcing of the conflict of interest policy is a joint effort between Corporate Compliance and Human Resources. All new hires are required to review, complete, and sign the conflict of interest (COI) statement. The leadership group and all Board members are required to review, complete, and sign the COI annually. In addition, existing employees are required as part of their annual performance evaluation to review, complete, and sign the COI. All the COIs are reviewed by Human Resources. If there is a COI disclosed on the form, additional information is requested from the employee and in some cases Corporate Compliance is included where additional input or guidance is needed by Human Resources. Employees are also advised to disclose COIs that may arise during the course of the year. Employees and other TGH healthcare partners can similarly report COIs to Corporate Compliance using the compliance line, email, phone, etc. Periodically, in newsletters issued by Corporate Compliance, reference is made to COI. It is the responsibility of Corporate Compliance to initate investigations of allegations of COIs. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 Within the framework of applicable law, Tampa General Hospital has established and maintained compensation goals, policies, and programs that enable the hospital to recruit, develop, and retain the most qualified and talented staff. Tampa General Hospital strategically invests in the people who support the hospital's mission. Compensation goals, policies, and programs are guided by and reflect our values and principles, which are consistent with the high quality of the hospital's achievement in the furtherance of medical science. Differences in pay will not be based upon such factors as race, religion, gender, national origin, ancestry, age, marital status, or disability. To ensure that TGH is paying reasonable compensation and not violating the private inurement prohibition, the Compensation Committee of the Board of Directors annually reviews and sets the compensation of officers, the executive group and key employees. The Committee utilizes the outside consulting firm of Towers Watson to provide expert information regarding industry-wide compensation norms. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital ("TGH") will make the following documents available to the public: (1) Articles of Incorporation and Amendments thereto; (2) Bylaws; (3) Conflict of Interest Policy; (4) Audited Financial Statements; (5) IRS Form 990 and IRS Form 1023; and (6) Community Benefits Report. The preceding documents will be available to the public either through (a) the website at www.tgh.org or (b) upon request made to the TGH Public Relations Office, after payment of reasonable copying fee. F990_P11_S00_L05 Form 990, Part XI, Line 5 Form 990, Part XI, Line 5 - Unrealized gains and losses of $(18,355,660); actuarial pension change of $(1,354,775); related entity and other government contributions entered as revenue for tax purposes of $(1,363,259); and other changes of $366,094 Tampa General Hospital Foundation Inc PO Box 1289 Tampa FL 33601 237354477 Fundraising to support TGH's mission FL 501(c)(3) Line 7 N/A 0 Tampa General Hospital Auxiliary Inc P O Box 1289 Tampa FL 33601 590810712 Support Tampa General Hospital FL 501(c)(3) Line 11c - Type III N/A 0 Florida Health Sciences Center LTD c/o Marsh Management Svcs 23 Lime Tree Bay Av Bd 4 Fl 2 Georgetown Grand Cayman CJ KY1-1102 980695992 Professional liability & general liability coverage to TGH on a claims made basis. CJ Florida Health Scences Center Inc C 0 83517355 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 Tampa General Hospital Foundation Inc c 801127 Donated amounts based on hospital needs. Tampa General Hospital Foundation Inc n 445310 Based on benefit & salary of shared employees. Florida Health Sciences Center LTD q 97443538 Based on cost of investments. Florida Health Sciences Center LTD r 20819211 Based on cost of services. Extension already filed and approved by the IRS