2012-05-14T16:41:00-05:00 2011-06-30 ERNST & YOUNG US LLP 75 BEATTIE PLACE SUITE 800 GREENVILLE SC 29601 990 2010-07-01 593238634 H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL INC HLEE 8137454673 12902 MAGNOLIA DRIVE TAMPA FL 33612 Janene Culumber 8137451329 2012-05-14 0 EMILY STANCIL 8642425740 2010 2016-02-24 21:20:13Z JOHN A KOLOSKY 12902 MAGNOLIA DRIVE TAMPA FL 33612 566276475 0 X WWW.MOFFITT.ORG X 1994 FL TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 15 12 2726 735 0 0 7551785 3536511 514831626 559022885 3009349 959849 3050462 2657769 528443222 566177014 141450 0 0 0 189234730 173558237 0 0 0 270869961 336105911 460246141 509664148 68197081 56512866 325027437 129567820 44109244 35515073 280918193 94052747 X THE PRIMARY PURPOSE OF THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. IS TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 0 0 436872599 558846427 H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE HOSPITAL, INC. (THE "HOSPITAL") IS LOCATED ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA IN TAMPA, FL. SINCE OPENING IN 1986, THE HOSPITAL HAS BEEN GUIDED BY ONE MISSION, "TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER." MOFFITT IS A LEADING NATIONAL CANCER INSTITUTE (NCI) COMPREHENSIVE CANCER CENTER - ONE OF ONLY 40 IN THE NATION TO HOLD THIS DISTINCTION. TO HELP FURTHER ITS MISSION, THE HOSPITAL HAS ESTABLISHED A NETWORK OF STRATEGIC PARTNERS COMPOSED OF 14 AFFILIATE HOSPITALS WITHIN THE STATE PLUS ONE IN GEORGIA AND ANOTHER IN PENNSYLVANIA. THE NETWORK ALSO INCLUDES MORE THAN 400 COMMUNITY ONCOLOGISTS.REIMBURSEMENT IS CRITICAL TO THE HOSPITAL'S OPERATIONS; HOWEVER, MOFFITT RECOGNIZES ITS RESPONSIBILITY TO PROVIDE SERVICES AND EDUCATION TO THOSE NEEDING SPECIALIZED RESEARCH CAPABILITIES. PATIENTS WHO MEET MOFFITT'S MEDICAL AND SURGICAL PROTOCOLS AND DO NOT HAVE THE ABILITY TO PAY WILL BE TREATED, IF SUCH PROTOCOLS ARE NOT AVAILIABLE IN THEIR COMMUNITY.IT IS THIS COMMITTMENT THAT GUIDES THE HOSPITAL TO:(1) PROVIDE CARE FOR PATIENTS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST(2) PROVIDE FREE CHARITY CARE FOR THOSE WHO CANNOT PAY(3) PROVIDE ONCOLOGY SPECIALIZATION TO THE STATE OF FLORIDA THROUGH INVOLVEMENT IN INVESTIGATIONAL PROTOCOLS, EDUCATION OF FUTURE PHYSICIANS AND CONTINUING PROFESSIONAL EDUCATION FOR PHYSICIANS AND OTHER ALLIED HEALTH CARE PROFESSIONALS(4) TAKE A LEADERSHIP ROLE IN CANCER PREVENTION AND SCREENING ACTIVITIES THE HOSPITAL IS A CRITICAL RESOURCE FOR THE STATE OF FLORIDA, WHICH RANKS SECOND IN THE NATION IN BOTH CANCER INCIDENCE AND MORTALITY. THE MOFFITT ORGANIZATION HAS MORE THAN 4,600 EMPLOYEES. IT IS LICENSED FOR 206 BEDS AND INCLUDES THE MOFFITT MEDICAL CLINIC, A FREESTANDING OUTPATIENT TREATMENT CENTER LOCATED IN SOUTH TAMPA, AND A FREESTANDING LIFETIME CANCER SCREENING AND PREVENTION CENTER PROVIDING A WIDE ARRAY OF OUTREACH AND EDUCATIONAL ACTIVITIES FOR THE GENERAL PUBLIC AND SELECT UNDERSERVED POPULATIONS.IN FISCAL YEAR 2011, THE HOSPITAL RECORDED 328,311 OUTPATIENT VISITS AND 8,921 INPATIENT ADMISSIONS. 436872599 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 0 0 0 0 1 150 0 2726 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X JANENE CULUMBER 8137451329 12902 MAGNOLIA DRIVE TAMPA FL 33612 X BETH A HOUGHTON 1.00 X X 0 0 0 THE HONORABLE MARK A PIZZO 1.00 X X 0 0 0 THE HONORABLE H LEE MOFFITT 1.00 X X 0 0 0 W MICHAEL ALBERTS 55.00 X X 205414 217993 44228 KAREN A ARNOLD 1.00 X 0 0 0 JOSEPH CABALLERO 1.00 X 0 0 0 MUNYA CHIURA PHD 1.00 X 0 0 0 JULIE DJEU 1.00 X 0 286155 25870 HARVEY M GREENBERG MD 1.00 X 0 0 0 DWAYNE HAWKINS 1.00 X 0 0 0 RONALD A HURST 1.00 X 0 0 0 STEPHEN K KLASKO MD 1.00 X 0 0 0 THE HONORABLE GWEN MILLER 1.00 X 0 0 0 ORLANDO NIEVES 1.00 X 0 0 0 MARY ANNE REILLY 1.00 X 0 0 0 JOHN A KOLOSKY 33.00 X 0 725119 43330 WILLIAM S DALTON 1.00 X 0 1314151 67154 LOUIS D DE LA PARTE 22.00 X 0 465035 39330 ALAN F LIST 33.00 X 309464 336120 43267 NICOLAS C PORTER 33.00 X 0 574354 39695 YVETTE LYONS TREMONTI 33.00 X 0 302801 37774 BRAULIO VICENTE 40.00 X 358349 0 42361 JANENE CULUMBER 22.00 X 0 394396 34904 JANE FUSILERO 55.00 X 0 0 0 BRENDA S GORDON 55.00 X 249376 0 22775 MARYBETH REARDON 55.00 X 272353 0 26606 SCOTT D ELDREDGE 55.00 X 186385 0 23458 GENE WETZSTEIN 55.00 X 185010 0 34753 VLADIMIR FEYGELMAN 55.00 X 223775 0 30470 KENNETH M FORSTER 55.00 X 252484 0 39642 BRIAN K NORIEGA 55.00 X 209039 0 31500 SIRIPORN SARANGKASIRI 55.00 X 212077 0 21071 STUART G WASSERMAN 55.00 X 241048 0 33449 DEAN R HEAD 0.00 X 0 206862 26423 MARK F HULSE 0.00 X 0 285574 33600 THOMAS A SELLERS 0.00 X 0 561879 47650 W J WILSON 22.00 X 108994 177270 26240 PHILIP E JOHNSON 55.00 X 199812 0 24757 3213580 5847709 840307 165 1 1 0 LAB CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 450161 ERNST & YOUNG US LLP 200 PLAZA DRIVE SECAUCUS NJ 07094 AUDIT AND TAX SERVICES 269738 CUMMINS POWER SOUTH LLC 5125 HWY 85 ATLANTA GA 30349 CONSTRUCTION SERVICES 232448 THERMACIRC LLC 425 MAPLEWOOD DRIVE OLDSMAR FL 34677 EQUIPMENT SERVICES 192940 LIBERTY PARTNERS GROUP LLP 1050 K ST NW STE 315 WASHINGTON DC 20001 CONSULTING SERVICES 150413 10 1295659 14926 2225926 141036 3536511 NET PATIENT SERVICE RE 900099 542240459 542240459 OUTPATIENT PHARMACY 900099 15338615 15338615 LODGING PROGRAM 721000 457405 457405 CONFERENCE PLANNING 611710 385679 385679 MOFFITT SOUTH 900099 195402 195402 405325 225879 179446 559022885 983206 983206 76104 99461 -23357 -23357 -23357 CAFETERIA 722210 2207557 2207557 GIFT SHOP 453220 240421 240421 INT FROM INS CO 524114 140147 140147 69644 2988 66656 2657769 566177014 558846427 0 3794076 3056621 2906934 149687 230506 219218 11288 133995080 127433153 6561927 8127873 7729840 398033 17892320 17016108 876212 10255837 9753594 502243 172575 172575 578518 578518 9422431 8001294 1421137 97676 97676 172953377 171857727 1095650 10643253 10643253 4530483 4416437 114046 322303 251893 70410 713527 713527 11785762 11489079 296683 INTERCOMPANY SERVICES 82464333 33258403 49205930 PURCHASED SERVICES 21983735 21352707 631028 BAD DEBT EXPENSE 11357223 11357223 HCCB ASSESSMENT 5291978 5291978 CAFETERIA FOOD SERVICES 1710694 1710694 2078043 1436596 641447 509664148 436872599 72791549 0 12625 11874 1157383 817776 57914955 78688695 8433711 8871679 7113030 1887878 142616444 107799938 230340629 34816506 20055104 4473412 325027437 129567820 41148192 31800791 833333 2961052 2880949 44109244 35515073 X 278802193 91987172 2116000 2065575 280918193 94052747 325027437 129567820 X 56512866 -243378312 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 46322 1 1779 0 1 519795 0 1 10622 578518 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS THREE NON-PROFIT SUBSIDIARY CORPORATIONS ("CORPORATION") WERE CREATED TO GOVERN AND OPERATE THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE ("INSTITUTE") PURSUANT TO SECTION 1004.43, FLORIDA STATUTES. AMONG OTHER THINGS, SECTION 1004.43 FLORIDA STATUTES PROVIDES: (1) THAT THE CORPORATION SHALL ENTER INTO AN AGREEMENT WITH THE STATE BOARD OF EDUCATION FOR THE UTILIZATION OF FACILITIES ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA; (2) THAT THE CORPORATION SUBMIT ANNUAL POST AUDITS OF ITS FINANCIAL ACCOUNTS TO THE AUDITOR GENERAL OF THE STATE OF FLORIDA AND THE BOARD OF GOVERNORS FOR THEIR REVIEW; AND (3) THAT THE CORPORATION'S CEO REPORT TO THE BOARD OF GOVERNORS OR ITS DESIGNEE AND PROVIDE COPIES OF THE INSTITUTE'S ANNUAL REPORT TO THE GOVERNOR OF THE STATE OF FLORIDA, THE CABINET, THE PRESIDENT OF THE SENATE, THE SPEAKER OF THE HOUSE AND THE CHAIR OF THE BOARD OF GOVERNORS. ALTHOUGH THE CORPORATION IS A PRIVATE ENTITIY, IT IS NONETHELESS SUBJECT TO THE STATE OF FLORIDA'S PUBLIC RECORDS AND THE PUBLIC MEETINGS LAWS. THE CORPORATION ALSO RELIES ON ANNUAL APPROPRIATIONS BY THE LEGISLATURE OF THE STATE OF FLORIDA AND GRANTS FROM VARIOUS LOCAL, STATE AND FEDERAL AGENCIES FOR OPERATION AND MAINTENANCE OF ITS FACILITIES AND FOR SPECIFIC RESEARCH AND CLINICAL PROGRAMS. FOR THESE REASONS, THE CORPORATION FROM TIME TO TIME ENGAGES LOBBYISTS AND OTHER CONSULTANTS: (1) TO ASSIST IT IN COMPLYING WITH ITS REPORTING REQUIREMENTS TO THE STATE OF FLORIDA UNDER SECTION 1004.43, FLORIDA STATUTES; (2) TO MONITOR LEGISLATIVE AND EXECUTIVE BRANCH ACTION AT LOCAL, STATE AND FEDERAL LEVELS OF GOVERNMENT WHICH IMPACT ITS OPERATION AND THE FULFILLMENT OF ITS MISSION; AND (3) TO INFLUENCE LEGISLATION IN FURTHERANCE OF ITS MISSION IN THE AREAS OF CANCER RESEARCH AND TREATMENT, THE TEACHING AND TRAINING OF HEALTH CARE PROFESSIONALS AND COMMUNITY EDUCATION AND OUTREACH ACTIVITIES. THE CORPORATION DOES NOT ENGAGE IN ANY ACTIVITIES TO SUPPORT OR OPPOSE ANY CANDIDATE FOR PUBLIC OFFICE. Part IV, Supplemental Information: OTHER ACTIVITIES, LINE 1i: THE OTHER ACTIVITIES AMOUNT LISTED ON LINE 1i IS COMPRISED OF EXPENSES RELATED TO ORGANIZING VOLUNTEERS TO VISIT LEGISLATORS. 281110 281110 0 141796085 107518828 34277257 539249 539249 34816506 HCCB ASSESSMENT 2880949 2880949 Description of Uncertain Tax Positions Under FIN 48: Part X: The Cancer Center recognizes uncertain tax positions when it is more likely than not (i.e., greater than 50% likelihood of receiving benefit) and records these benefits at the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. The Cancer Center has no significant unrecognized tax benefits and does not believe that there will be any material changes in the Cancer Center's unrecognized tax position over the next 12 months. 1 1 X 1 X 1 X 1 1 1 0 1 1 5027 20508725 20508725 0.04120 3352 40725452 18478842 22246610 0.04460 45 271422 192620 78802 0.00010 8424 61505599 18671462 42834137 0.08590 108741 4323 104418 0.00020 5 434 1311900 0 1311900 0.00260 1 1483 51096 0 51096 0.00010 6 1917 1471737 4323 1467414 0.00290 6 10341 62977336 18675785 44301551 0.08880 1 3746027 116681166 131031128 -14349962 X 1 1 1 1 H LEE MOFFITT CANCER CENTER & RESEARCH

12902 MAGNOLIA DRIVE TAMPA FL 33612

X H LEE MOFFITT CANCER CENTER & RESEARCH 1 1 1 200.000000000000 1 300.000000000000 1 X X X X X 1 1 X X 1 X 1 X X X X 0 X X X X 0 0 Part I, Line 3c: CHARITY ADJUSTMENTS ARE PROVIDED BY THE CANCER CENTER AS FOLLOWS:A. PATIENTS WHO HAVE FAMILY INCOME AND ASSETS AT OR BELOW 200% FO THE FEDERAL POVERTY GUIDELINE FOR THE PATIENT'S FAMILY SIZE SHALL BE ENTITLED TO CHARITY ADJUSTMENTS OF 100% ON QUALIFYING BALANCES.B. PATIENTS, WHO HAVE FAMILY INCOME AND ASSETS BETWEEN 201%-300% OF THE FEDERAL POVERTY GUIDELINE FOR THE PATIENT'S FAMILY SIZE, SHALL BE ENTITLED TO CHARITY ADJUSTMENTS OF 70% ON QUALIFYING BALANCES.C. PATIENTS, WHO HAVE FAMILY INCOME AND ASSETS BETWEEN 301%-400% OF THE FEDERAL POVERTY GUIDELINE FOR THE PATIENT'S FAMILY SIZE, SHALL BE ENTITLED TO CHARITY ADJUSTMENTS OF 60% ON QUALIFYING BALANCES.PART I, LINE 4: CHARITY CARE IS PROVIDED TO THOSE CLASSIFIED AS MEDICALLY INDIGENT IF A PATIENT'S MEDICAL BILLS/CHARGES EXCEED 25% OF PATIENT'S AND FAMILY'S GROSS ANNUAL INCOME AND ASSETS. OUTSTANDING MEDICAL BALANCES FROM FACILITIES OTHER THAN THE CANCER CENTER CAN AND WILL BE USED IN THIS DETERMINATION. MEDICALLY INDIGENT PATIENTS SHALL BE ENTITLED TO CHARITY ADJUSTMENTS OF 100% ON QUALIFYING BALANCES. PART I, LINE 5A & 5B: THE ANNUAL BUDGETED AMOUNT FOR CHARITY CARE IS AN ESTIMATE USED FOR FINANCIAL BUDGETING PURPOSES AND DOES NOT LIMIT THE CANCER CENTER FROM PROVIDING CARE TO QUALIFYING PATIENTS. Part I, Line 6a: OUR ANNUAL COMMUNITY BENEFIT REPORT WAS MAILED TO SEVERAL COMMUNITY ORGANIZATIONS WITH WHOM WE ARE ASSOCIATED. THE REPORT IS ALSO MADE AVAILABLE TO THE PUBLIC UPON REQUEST. Part I, Line 7: COST METHODOLOGY FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IS THE COST-TO-CHARGE RATIO USED FOR THE CHARITY CARE AND MEANS TESTED PROGRAMS AND DIRECT COST METHOD FOR THE OTHER BENEFITS/PROGRAMS. Part I, Line 7g: CALCULATION OF SUBSIDIZED HEATH SERVICES RELATES TO HOSPITAL'S SKIN CANCER MOLE PATROL UNIT. PHYSICIAN CLINICS WERE NOT INCLUDED IN THE CALCULATION. Part I, L7 Col(f): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A FOR HOSPITAL $509,664,148. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $11,357,223. AFTER BAD DEBT WAS DEDUCTED FROM THE TOTAL EXPENSES THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN F WAS $498,306,925. Part III, Line 4: ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS ARE WRITTEN OFF WHEN DEEMED TO BE UNCOLLECTIBLE AND ARE DEDUCTED FROM THE PATIENT'S ACCOUNTS RECEIVABLE BALANCE.THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. ONE TOOL USED IN MANAGEMENT'S ASSESSMENT IS A DETAILED REVIEW OF HISTORICAL COLLECTIONS AND WRITE-OFFS AT THE CANCER CENTER THAT REPRESENT A MAJORITY OF THE CANCER CENTER'S REVENUES AND ACCOUNTS RECEIVABLE. THE RESULTS OF THE DETAILED REVIEW OF HISTORICAL COLLECTIONS AND WRITE-OFFS EXPERIENCE, ADJUSTED FOR CHANGES IN TRENDS AND CONDITIONS, ARE USED TO EVALUATE THE ALLOWANCE AMOUNT FOR THE CURRENT PERIOD.PART III, LINE 2: THE RATIO OF PATIENT COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS REPORTED ON LINE 2. DISCOUNTS ARE NOT NETTED AGAINST BAD DEBT EXPENSE BUT RATHER ARE CONSIDERED AJUSTMENTS TO REVENUE.PART III, LINE 3: AN AMOUNT OF BAD DEBT SHOULD BE INCLUDED IN COMMUNITY BENEFIT; HOWEVER, AT THIS TIME A THOROUGH ASSESSMENT/ANALYSIS HAS NOT BEEN MADE TO DETERMINE THE AMOUNT THAT SHOULD BE CONSIDERED CHARITY CARE. Part III, Line 8: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS IS THE STEP DOWN METHOD WHICH DISALLOWS CERTAIN COSTS TO BE CONSIDERED AS COSTS RELATED TO PATIENT CARE. MEDICARE SHORTFALLS WHICH ARE COSTS INCURRED BY THE HOSPITAL TO PROVIDE QUALITY CARE AND TREATMENT OF ITS PATIENTS SHOULD BE TREATED AS COMMUNITY BENEFIT. TO NOT INCUR THESE COST WOULD POTENTIALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERVICE PROVIDED. Part III, Line 9b: PATIENTS ARE SCREENED DURING THE ADMISSIONS PROCESS (PRIOR TO THE COLLECTION PROCESS)TO ASSESS THE NEED FOR FINANCIAL ASSISTANCE. HOWEVER, IF AT ANY POINT IN THE COLLECTION PROCESS IT IS DETERMINED THAT THE PATIENT MAY BE UNABLE TO MEET ITS OBLIGATION, THE PATIENT WILL BE SENT AN APPLICATION FOR FINANCIAL ASSISTANCE OR CHARITY ADJUSTMENT. BASED ON PATIENT'S ELIGIBILITY THE QUALIFYING AMOUNT WILL NO LONGER BE BILLED. H LEE MOFFITT CANCER CENTER & RESEARCH Part V, Section B, Line 13g: LANGUAGE IS ADDED TO THE BILLING INVOICE STATING THAT A MOFFITT REPRESENTATIVE CAN HELP EVALUATE ELIGIBILITY FOR FINANCIAL ASSISTANCE IF THE PATIENT IS UNABLE TO PAY.IF A PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATION BECAUSE THEY ARE UNINSURED OR UNDERINSURED OR IF THE PATIENT EXPRESSES THE INABILITY TO PAY, MOFFITT'S REPRESENTATIVES OR AGENTS WORKS WITH THE PATIENT TO DETERMINE THE NEED FOR FINANCIAL ASSISTANCE H LEE MOFFITT CANCER CENTER & RESEARCH Part V, Section B, Line 15e: A DETERMINATION OF WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE WILL BE MADE IF A PATIENT EXPRESSES THE INABILITY TO PAY THEIR OBLIGATION EITHER BEFORE, DURING OR AFTER TREATMENT. IF THE PATIENT DOES NOT EXPRESS THE INABILITY TO PAY PRIOR TO BILLING, AN INVOICE IS SENT TO THE PATIENT WHICH HAS LANGUAGE REGARDING THE NEED FOR FINANCIAL ASSISTANCE. A HOSPITAL REPRESENTATIVE WILL MAKE EVERY EFFORT TO WORK WITH THE PATIENT TO DETERMINE WHETHER FINANCIAL ASSISTANCE IS NEEDED. IF THE PATIENT DOES NOT STATE THE NEED FOR FINANCIAL ASSISTANCE OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE THEREAFTER AND PAYMENTS ARE NOT MADE AS AGREED, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY. H LEE MOFFITT CANCER CENTER & RESEARCH Part V, Section B, Line 16e: THE HOSPITAL REFERS PATIENT ACCOUNTS TO A COLLECTION AGENCY. COLLECTION AGENCY MAKES EVERY EFFORT TO CONTACT THE PATIENT BY MAIL OR TELEPHONE. THE COLLECTION AGENCY FOLLOWS HOSPITAL'S FINANCIAL ASSISTANCE POLICY, IN THE EVENT THE PATIENT EXPRESSES THE INABILITY TO PAY. H LEE MOFFITT CANCER CENTER & RESEARCH Part V, Section B, Line 18c: THE HOSPITAL WAS NOT EQUIPPED FOR EMERGENCY MEDICAL CARE SERVICES. HOWEVER, IF HOSPITAL PERSONNEL IDENTIFIED A PATIENT NEEDING EMERGENCY MEDICAL TREATMENT, WITHOUT DISCRIMINATION THE HOSPITAL WOULD STABILIZE THE PATIENT UNTIL SUCH TIME THAT THE PAIENT COULD BE TRANSFERRED TO A FACILITY WITH EMERGENCY MEDICAL SERVICES. H LEE MOFFITT CANCER CENTER & RESEARCH Part V, Section B, Line 19d: HOSPITAL USES A 50% DISCOUNTED RATE OF BILLED CHARGES. Part VI, Line 2: IN RESPONSE TO AN URGENT NEED TO CREATE SOLUTIONS FOR THE DEVELOPMENT OF EFFECTIVE CANCER INTERVENTIONS AND EFFECTIVE PENETRATION WITHIN THE COMMUNITY, THE CANCER CENTER IN COLLABORATION WITH LOCAL COMMUNITY-BASED HEALTH CENTERS, SOCIAL SERVICES AGENCIES, FAITH-BASED GROUPS, ADULT EDUCATION AND LITERACY GROUPS, AND LOCAL MEDIA FORMED A NETWORK. THIS NETWORK AIMS TO ADDRESS CRITICAL ACCESS, PREVENTION AND CANCER CONTROL ISSUES THAT IMPACT MEDICALLY UNDERSERVED, LOW-LITERACY AND LOW-INCOME POPULATIONS IN THE COMMUNITY. Part VI, Line 3: DURING THE PATIENT ADMISSION/REGISTRATION PROCESS, PATIENTS WILL MEET WITH A HOSPITAL PATIENT SERVICE REPRESENTATIVE WHO OBTAINS DEMOGRAPHIC AND FINANCIAL, I.E. INSURANCE, INFORMATION. WHEN THE PATIENT SERVICE REPRESENTATIVE DETERMINES A PATIENT HAS NO INSURANCE COVERAGE AND WILL NOT LIKELY BE ABLE TO PAY FOR ANTICIPATED SERVICES, THE PATIENT SERVICE REPRESENTATIVE WILL DETERMINE THE PATIENT'S ELIGIBLITY FOR RELEVANT STATE, COUNTY, AND FEDERAL PROGRAMS. IF THE PATIENT DOES NOT QUALIFY FOR ELIGIBLE FUNDING THE PATIENT SERVICE REPRESENTATIVE WILL WORK WITH THE PATIENT TO COMPLETE A FINANCIAL STATEMENT FOR DETERMINATION OF CHARITY CARE OR PARTIAL CARE ELIGIBILITY. Part VI, Line 4: THE HOSPITAL IS THE ONLY FLORIDA BASED NCI DESIGNATED CANCER CENTER, PRIMARILY SERVICING SEVEN COUNTIES, HILLSBOROUGH, PASCO, PINELLAS, POLK, HERNANDO, SARASOTA, AND MANATEE. IN HILLSBOROUGH COUNTY, MINORITIES, MAINLY COMPRISING OF AFRICAN-AMERICAN AND HISPANICS, MADE UP 40% OF THE POPULATION IN 2011 WITH MEDIAN HOUSEHOLD INCOME RANGING FROM $24k TO $38k. FOR ALL SEVEN COUNTIES HISPANIC AND AFRICAN-AMERICAN'S WERE 26% OF THE POPULATION FOR 2011 WITH A MEDIAN HOUSEHOLD INCOME RANGING BETWEEN $41k AND $52k. FOR THE MONTH OF JUNE 2011 UNEMPLOYMENT FOR ALL SEVEN COUNTIES RANGED FROM 10.6% TO 13.7%. Part VI, Line 6: THE HOSPITAL IS INTERNATIONALLY RECOGNIZED FOR ITS FOCUS ON TOTAL CANCER CARE AND TRANSLATIONAL RESEARCH AND HAS GROWN TO BE THE THIRD-LARGEST CANCER CENTER IN THE U.S. BASED ON OUTPATIENT VISITS. IT HAS CREATED ALLIANCES WITH 14 STATEWIDE HEALTH CARE SYSTEMS TO FURTHER IMPROVE THE DELIVERY OF CANCER CARE AND ACCESS TO CLINICAL TRIALS. THE MAJORITY OF THE HOSPITAL'S BOARD MEMBERS RESIDE AND ARE CONSIDERED COMMUNITY LEADERS IN THE SERVICE AREA. Part VI, Line 7: AFFILIATES OF THE HOSPITAL DEDICATED TO SERVING INDIVIDUALS WHO ARE IN NEED OF FINANCIAL ASSISTANCE, HELPING TO DEVELOP AND FUND COMMUNITY PROGRAMS AND PERFORM TRANSLATIONAL RESEARCH TO BENEFIT THE COMMUNITY, INCLUDE MOFFITT FOUNDATION, MOFFITT MEDICAL GROUP, AND MOFFITT RESEARCH. MOFFITT FOUNDATION SOLICITS FUNDS TO SUPPORT THE WORK OF THE CANCER CENTER. DONATIONS MAINTAINED BY THE FOUNDATION MAY BE USED FOR A SPECIFIC PROGRAM OR MAY BE USED TO FURTHER THE OVERALL NEEDS OF THE COMMUNITY. MOFFITT MEDICAL GROUP EMPLOYS PHYSICIANS THAT STAFF THE HOSPITAL AND PROVIDE CLINICAL RESEARCH TO THE CANCER CENTER HEALTH CARE SYSTEM. THESE PHYSICIANS PROVIDE MEDICAL SERVICES TO THOSE PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. IN ADDITON, PHYSICIANS PARTICIPATE IN COMMUNITY RELATED PROGRAMS PROVIDING EDUCATION AND TRAINING. MOFFITT'S CANCER RESEARCH FACILITY PERFORMS STUDIES AND INVESTIGATIONS TO GENERATE GENERALIZABLE KNOWLEDGE AVAILABLE TO THE PUBLIC. THE RESEARCH FACILITY IS ALSO THE PARENT COMPANY OF THE CANCER CENTER HEALTH CARE SYSTEM THAT PLANS, DEVELOPS, AND IMPLEMENTS COMMUNITY BENEFIT PROGRAMS TO ADDRESS COMMUNITY NEEDS SEPARATELY FROM, AS WELL AS IN COLLABORATION WITH, THE HOSPITAL.COMMUNITY BENEFIT EXPENSES PERFORMED BY OUR AFFILIATED ENTITIES:FINANCIAL ASSISTANCE AT COST WAS $2,147,738PERCENT OF TOTAL AFFILIATE EXPENSE: 2.564%PERCENT OF COMBINED EXPENSE: .29%COMMUNITY HEALTH IMPROVEMENT WAS $28,800PERCENT OF TOTAL AFFILIATE EXPENSE: .03%PERCENT OF COMBINED EXPENSE: <.01%HEALTH PROFESSIONS EDUCATION WAS $3,447,355PERCENT OF TOTAL AFFILIATE EXPENSE: 4.115%PERCENT OF COMBINED EXPENSE: .47%RESEARCH NET COMMUNITY BENEFIT EXPENSE WAS $24,004,727PERCENT OF TOTAL AFFILIATE EXPENSE: 17.62%PERCENT OF COMBINED EXPENSE: 3.27% X X 0 1 0 1 0 0 0 0 0 0 0 W MICHAEL ALBERTS 122593 189001 62188 0 20633 28992 9380 16223 11771 12846 226565 247062 0 0 JULIE DJEU 0 259379 0 8482 0 18294 0 25602 0 1615 0 313372 0 0 JOHN A KOLOSKY 0 542940 0 128752 0 53427 0 25603 0 23633 0 774355 0 0 WILLIAM S DALTON 0 863378 0 297504 0 153269 0 25603 0 49305 0 1389059 0 0 LOUIS D DE LA PARTE 0 369700 0 93553 0 1782 0 25603 0 17862 0 508500 0 0 ALAN F LIST 182499 292416 120000 14108 6965 29596 0 25602 12860 12244 322324 373966 0 0 NICOLAS C PORTER 0 410483 0 104026 0 59845 0 25603 0 21393 0 621350 0 0 YVETTE LYONS TREMONTI 0 240532 0 49238 0 13031 0 24353 0 23246 0 350400 0 0 BRAULIO VICENTE 287224 0 56351 0 14774 0 19600 0 29884 0 407833 0 0 0 JANENE CULUMBER 0 320465 0 60000 0 13931 0 19600 0 21275 0 435271 0 0 BRENDA S GORDON 200573 0 38484 0 10319 0 19206 0 10829 0 279411 0 0 0 MARYBETH REARDON 207247 0 42436 0 22670 0 19353 0 13409 0 305115 0 0 0 SCOTT D ELDREDGE 160900 0 17090 0 8395 0 11629 0 15249 0 213263 0 0 0 GENE WETZSTEIN 159074 0 18946 0 6990 0 11992 0 24524 0 221526 0 0 0 VLADIMIR FEYGELMAN 213946 0 9032 0 797 0 23518 0 8746 0 256039 0 0 0 KENNETH M FORSTER 241906 0 7846 0 2732 0 25603 0 16967 0 295054 0 0 0 BRIAN K NORIEGA 203534 0 3605 0 1900 0 13278 0 19281 0 241598 0 0 0 SIRIPORN SARANGKASIRI 206572 0 3605 0 1900 0 13278 0 8851 0 234206 0 0 0 STUART G WASSERMAN 211372 0 22144 0 7532 0 14987 0 20442 0 276477 0 0 0 DEAN R HEAD 0 166491 0 32003 0 8368 0 16609 0 16267 0 239738 0 0 MARK F HULSE 0 228134 0 46001 0 11439 0 15750 0 24715 0 326039 0 0 THOMAS A SELLERS 0 436097 0 104972 0 20810 0 25602 0 29757 0 617238 0 0 W J WILSON 104905 126581 0 46534 4089 4155 8449 11039 5374 6106 122817 194415 0 0 PHILIP E JOHNSON 183888 0 6347 0 9577 0 12364 0 13329 0 225505 0 0 0 Part I, Line 1b PAYMENTS MADE FOR HEALTH OR SOCIAL CLUB DUES, INITIATION FEES OR PERSONAL SERVICES ARE APPROVED BY THE JOINT EXECUTIVE COMPENSATION AND BENEFITS COMMITTEE (JEC&BC). PAYMENTS ARE A FIXED AMOUNT BASED ON JOB CLASSIFICATION AND IS DOCUMENTED IN MINUTES OF THE COMMITTEE AND REPORTED BACK TO THE BOARD. Part I, Line 4b THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AND AMOUNTS LISTED ARE INCLUDED IN THEIR TOTAL COMPENSATION, RESPECTIVELY: YVETTE M. LYONS TREMONTI - $4,737.49 NICOLAS C. PORTER - $25,999.79 JOHN A. KOLOSKY - $41,138.42 WILLIAM S. DALTON - $87,104.55 Supplemental Information Part III Schedule J, Part I, Line 3: HOSPITAL'S PRESIDENT AND CEO ARE PAID BY A RELATED ORGANIZATION WHICH ESTABLISHES THEIR COMPENSATION BY RELYING ON AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, AN EXECUTIVE COMPENSATION COMMITTEE, AND THE APPROVAL BY THE BOARD OR THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. LISA WETZSTEIN SEE PART V 17978 SEE PART V 0 STORR OFFICE SEE PART V 694706 SEE PART V 0 Form 990, Schedule L, Part IV INTERESTED PERSON: LISA WETZSTEINRELATIONSHIP: FAMILY MEMBER OF GENE WETZSTEINTRANSACTION DESCRIPTION: COMPENSATIONINTERESTED PERSON: STORR OFFICE ENVIRONMENTS (STORR OFFICE)RELATIONSHIP: KAREN ARNOLD, DIRECTOR, IS KEY EMPLOYEE FOR STORR OFFICETRANSACTION DESCRIPTION: COMPENSATION FOR GOODS AND SERVICES X EQUIPMENT 3 9071 PURCHASE PRICE X SOFTWARE 2 131965 PURCHASE PRICE 0 0 0 0 Method for Determining Number of Contributors: Part I, Column (b): THE NUMBER OF CONTRIBUTORS REPORTED REFLECTS THE NUMBER OF ITEMS CONTRIBUTED. Form 990, Part VI, Section A, line 2 THE FOLLOWING DIRECTORS AND OFFICERS, THAT JOINTLY SERVE ON THE HOSPITAL AND A FOR-PROFIT RELATED ENTITY, QUALIFY AS HAVING A BUSINESS RELATIONSHIP. HOSPITAL & MOFFITT GENETICS CORPORATION: H. LEE MOFFITT - DIRECTOR WILLIAM S. DALTON - OFFICER LOUIS D. DE LA PARTE - OFFICER JANENE J. CULUMBER - OFFICER HOSPITAL & MOFFITT TECHNOLOGIES CORPORATION: WILLIAM S. DALTON - OFFICER JOHN A. KOLOSKY - OFFICER LOUIS D. DE LA PARTE - OFFICER JANENE J. CULUMBER - OFFICER Form 990, Part VI, Section A, line 6 H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. IS THE SOLE MEMBER OF THE HOSPITAL. Form 990, Part VI, Section A, line 7a AS THE SOLE MEMBER OF THE HOSPITAL, H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. SHALL HAVE THE POWER TO APPROVE, DISAPPROVE OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OR OFFICER OF THE HOSPITAL. Form 990, Part VI, Section A, line 7b THE SOLE MEMBER OF THE CORPORATION SHALL HAVE THE FOLLOWING POWERS: A. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; B. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE BYLAWS OF THE CORPORATION; C. APPROVE, DISAPPROVE OR RECOMMEND THE SELECTION OF A QUALIFIED AUDIT FIRM AND THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; D. EITHER APPROVE OR DISAPPROVE THE TRANSFER, SALE, LEASE OR DISPOSITION OF ANY ASSET OF THE CORPORATION IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000.00); E. APPROVE OR DISAPPROVE THE CONFERRING OF ANY LIEN OR SECURITY INTEREST IN ASSETS OF THE CORPORATION IN EXCESS OF FIVE HUNDRED THOUSAND DOLLARS ($500,000.00), WHETHER SAME SHALL BE IN CONNECTION WITH EITHER PUBLIC OR PRIVATE FINANCING, OR OTHERWISE; F. APPROVE OR DISAPPROVE ALL DONATIONS OR CHARITABLE CONTRIBUTIONS BY THE CORPORATION IN EXCESS OF TEN THOUSAND DOLLARS ($10,000.00) PER CONTRIBUTION OR ANNUAL CONTRIBUTION EXCEEDING TWENTY FIVE THOUSAND DOLLARS ($25,000.00) IN THE AGGREGATE; G. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION OF THE CORPORATION'S MISSION AND PHILOSOPHY STATEMENT; AND H. APPROVE OR DISAPPROVE CAPITAL EXPENDITURES BY THE CORPORATION IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000.00) PER EXPENDITURE OR TWO HUNDRED FIFTY THOUSAND DOLLARS ($250,000.00) IN THE AGGREGATE ANNUALLY. Form 990, Part VI, Section B, line 11 PRIOR TO PROVIDING FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, TO THE HOSPITAL BOARD OF DIRECTORS FOR REVIEW, THE CHIEF FINANCIAL OFFICER REVIEWS THE RETURN. SUGGESTED COMMENTS OR CHANGES ARE DISCUSSED AND ANY NECESSARY CORRECTIONS ARE MADE. PRIOR TO ELECTRONICALLY FILING FORM 990, MOFFITT HOSPITAL PROVIDES A COPY OF THE RETURN TO THE GOVERNING BODY, GIVING EACH BOARD MEMBER TIME TO REVIEW THE RETURN. BOARD MEMBERS HAVE THE OPPORTUNITY TO ASK QUESTIONS RELATED TO THE INFORMATION PROVIDED ON THE RETURN. Form 990, Part VI, Section B, line 12c ON AN ANNUAL BASIS A PRESENTATION IS MADE TO HOSPITAL BOARD MEMBERS TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROCEDURES FOR DISCLOSING ANY POTENTIAL CONFLICTS. EACH DIRECTOR, OFFICER, COMMITTEE MEMBER, AND KEY EMPLOYEE SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ATTACHED TO THE POLICY. ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, OR KEY EMPLOYEE WHO REASONABLY BELIEVES THAT HE OR SHE MAY HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST DISCLOSE THE EXISTENCE OF AND THE MATERIAL FACTS OF THE NATURE OF HIS/HER INTEREST ON THE FORM. THE FORM IS SUBMITTED TO THE CORPORATE COMPLIANCE OFFICE, WHICH REVIEWS THE FORMS, GATHERS ADDITIONAL RELEVANT INFORMATION WHERE NECESSARY, AND PREPARES A SUMMARY OF THE DISCLOSURES TO BE REVIEWED BY THE CONFLICT OF INTEREST WORK GROUP. IF A DIRECTOR OR COMMITTEE MEMBER DISCLOSES THAT HE/SHE HAS A POTENTIAL CONFLICT OF INTEREST AT A BOARD OR COMMITTEE MEETING, SUCH DIRECTOR OR COMMITTEE MEMBER MUST DISCLOSE THE NATURE OF THE INTEREST AND ANY RELATED INFORMATION AND RESPOND TO QUESTIONS AS MAY BE REQUIRED BY THE REMAINING MEMBERS. BASED ON THE INFORMATION DISCLOSED, THE REMAINING BOARD MEMBERS WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER AN ALTERNATIVE TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT IS EQUALLY ADVANTAGEOUS. IF AN ALTERNATIVE TRANSACTION IS NOT EQUALLY ADVANTAGEOUS THE DIRECTOR OR COMMITTEE MEMBER WHO IS THE SUBJECT OF THE CONFLICT SHALL NOT VOTE ON, NOR USE HIS/HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO THE TRANSACTION. Form 990, Part VI, Section B, line 15 MOFFITT'S BOARD OF DIRECTORS HAS AN ESTABLISHED SUB-COMMITTEE, THE JOINT EXECUTIVE COMPENSATION & BENEFITS COMMITTEE (JEC&BC) THAT IS MADE UP ENTIRELY OF INDEPENDENT, OUTSIDE DIRECTORS. THIS COMMITTEE IS CHARGED WITH THE OVERSIGHT OF THE PERFORMANCE AND COMPENSATION OF MOFFITT EXECUTIVES AND DISQUALIFIED PERSONS. THESE POSITIONS INCLUDE THE CEO, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND DEPARTMENT CHAIRPERSONS. TO ACCOMPLISH ITS MISSION, THE COMMITTEE CAN AS NEEDED AND DOES AT ITS DISCRETION, ENGAGE OUTSIDE INDEPENDENT, OUTSIDE ADVISORS INCLUDING, BUT NOT LIMITED TO ATTORNEYS AND COMPENSATION CONSULTANTS. ON AN ANNUAL BASIS THE JEC&BC ENGAGES A NATIONALLY KNOWN, THIRD PARTY CONSULTING FIRM TO PROVIDE A DETAILED STUDY OF THE CASH COMPENSATION FOR EACH EXECUTIVE, DISQUALIFIED PERSON AND INDIVIDUAL IN KEY POSITIONS. THE CONSULTANT USES A VARIETY OF PUBLISHED SURVEYS COMPILED BY INDEPENDENT FIRMS TO PROVIDE THE SOURCE DATA FOR THE STUDY. USING FUNCTIONALLY COMPARABLE POSITIONS IN OTHER SIMILARLY SIZED, NOT-FOR-PROFIT AND FOR-PROFIT HEALTHCARE, ACADEMIC AND RESEARCH ORGANIZATIONS, THE CONSULTING FIRM PRODUCES A STUDY THAT COMPARES EACH DESIGNATED MOFFITT POSITION TO ITS APPROPRIATE MARKET EQUIVALENT. THE RESULTING DATA IS PROVIDED TO THE DIRECTOR OF COMPENSATION, WHO IS NOT INCLUDED IN THE EXECUTIVE OR DISQUALIFIED PERSON CATEGORIES, FOR USE IN THE FORMULATION OF RECOMMENDATIONS FOR COMPENSATION CHANGES TO MAINTAIN MARKET COMPETITIVENESS OR TO REWARD PERFORMANCE. THESE RECOMMENDATIONS ALONG WITH THE CONSULTANT'S COMPARABILITY DATA ARE PRESENTED TO THE JEC&BC FOR IT TO CONFIRM ITS REASONABLENESS, MAKE MODIFICATIONS AS IT DEEMS NECESSARY AND PROVIDE FINAL APPROVAL. EVERY THIRD YEAR THE INDEPENDENT CONSULTANT ANALYZES THE TOTAL EXECUTIVE COMPENSATION PROGRAM, USING THE SAME METHODOLOGY AS DESCRIBED ABOVE, THAT INCLUDEDS THE VALUE OF ALL BENEFITS AND PREREQUISITES (CASH AND NON-CASH) PROVIDED AS COMPENSATION TO THE EXECUTIVES AND DISQUALIFIED PERSONS. THE PURPOSE OF THE ANALYSIS IS TO PROVIDE AN OPINION ON THE REASONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION COMPONENTS AND THE AGGREGATE COMPENSATION TOTAL. THIS MORE COMPREHENSIVE ANALYSIS IS PROVIDED TO THE JEC&BC FOR THEIR USE IN THE ANNUAL REVIEW PROCESS. MINUTES ARE KEPT AT EACH OF THESE ANNUAL MEETINGS DETAILING THE RECOMMENDATIONS PRESENTED AND THE DECISIONS MADE BY THE COMMITTEE. THESE MINUTES ARE PUBLISHED TO THE COMMITTEE AT THE NEXT MEETING AND REPORTED BACK TO THE FULL BOARD. Form 990, Part VI, Section C, line 19 MOFFITT HOSPITAL MAKES AVAILABLE TO THE PUBLIC THROUGH THIRD PARTY VENDORS' WEBSITES, ITS FORM 990 AND AUDITED FINANCIAL STATEMENTS. FORM 990 IS MADE AVAILABLE ON GUIDESTAR WHILE THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE ON DACBOND. ALL ORGANIZING AND GOVERNING DOCUMENTS SUCH AS FORM 1023, CONFLICTS OF INTEREST POLICY, AND BYLAWS AS WELL AS FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VI, Section B, Line 14: THE ORGANIZATION HAS A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY WITH WHICH IT COMPLIES; HOWEVER, THE POLICY WAS NOT APPROVED BY THE BOARD OR A COMMITTEE BY THE FISCAL YEAR END. Form 990, Part VII, Section A, Line 1a: EMPLOYEES WHO ARE LISTED ON HOSPITAL'S 2010 FORM 990 ARE EMPLOYEES WHOSE 2010 W-2'S WERE ISSUED BY MOFFITT INSTITUTE, THE COMMON PAYMASTER RELATED ENTITY. AFTER SIGNIFICANT ANALYSIS A DETERMINATION WAS MADE TO REPORT EMPLOYEES BY ENTITY RATHER THAN BY THE ORGANIZATION WHICH ISSUED THE W-2, A MORE CONSERVATIVE APPROACH SINCE KEY EMPLOYEES HAVE THE POTENTIAL OF BEING EXCLUDED DUE TO THE FACT THAT THESE EMPLOYEES ARE NOT KEY EMPLOYEES OF THE ISSUING ENTITY. PROCEDURES TO REPORT COMPENSATION OF EMPLOYEES ON FORM 990 PART VII AND ON SCHEDULE J ARE IN ACCORDANCE WITH IRS INSTRUCTIONS FOR EACH RESPECTIVE SECTION. Form 990, Part VII, Section A, Line 1a: GENE WETZSTEIN WAS PROMOTED TO DIRECTOR OF PHARMACY SINCE PHILIP JOHNSON TRANSFERRED TO THE POSITION, HOSPITAL'S DIRECTOR OF ADVOCACY WHICH NO LONGER QUALIFIES HIM AS A KEY EMPLOYEE. JANE FUSILERO WAS HIRED AS VP-PATIENT CARE/CNO WHICH WAS PREVIOUSLY HELD BY MARYBETH REARDON WHO TRANSFERRED TO THE POSITION, HOSPITAL'S EXEC ADV NURSING EXCELLENCE. WILLIAM DALTON WHO WAS PRESIDENT OF HOPSITAL UNTIL FEBRUARY 10, 2011, REMAINS PRESIDENT/CEO AND CENTER DIRECTOR FOR THE PARENT. JOHN KOLOSKY WHO WAS EXECUTIVE VICE PRESIDENT/CHIEF OPERATING OFFICER FOR HOSPITAL BECAME PRESIDENT FEBRUARY 11, 2011. Form 990, Part VII, Section A, Line 1b: DIRECTORS ESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS JOSEPH CABALLERO H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. 1HR BETH HOUGHTON: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE INC. 1HR THE HONORABLE H. LEE MOFFITT: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 1HR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 1HR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 1HR MOFFITT GENETICS CORPORATION 1HR THE HONORABLE MARK A. PIZZO: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 1HR FORM 990, PART VII, SECTION A, LINE 1B: CURRENT & FORMER OFFICERS ESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS JANENE J. CULUMBER: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 17HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 5HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 5HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 5HRS WILLIAM S. DALTON: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 33HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 10HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 11HRS LOUIS D. DE LA PARTE: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 17HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 5HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 5HRS MOFFITT TECHNOLOGIES CORPORATION 1HR MOFFITT GENETICS CORPORATION 5HRS JOHN A. KOLOSKY: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 17HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 4HRS MOFFITT TECHNOLOGIES CORPORATION 1HR ALAN F. LIST: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 7HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 15HRS NICOLAS C. PORTER: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 17HRS H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, FOUNDATION, INC. 5HRS YVETTE M. LYONS TREMONTI: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 22HRS BRAULIO VICENTE: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE LIFETIME CANCER SCREENING, INC. 15HRS DEAN R. HEAD (FORMER): H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 55HRS MARK F. HULSE (FORMER): H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 55HRS THOMAS A. SELLERS (FORMER): H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 55HRS W. J. WILSON (FORMER): H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. 33HRS Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: TRANSFER TO TAX EXEMPT AFFILIATES -XXX-XX-XXXX. INTEREST IN NET ASSETS OF FOUNDATION -50425. Total to Form 990, Part XI, Line 5: -XXX-XX-XXXX. H LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 592451713 PARENT-RESEARCH FL 501(c)(3) Line 7 N/A 0 H LEE MOFFITT CANCER CTR & RESEARCH INSTITUTE FOUNDATION INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238636 FUNDRAISING FL 501(c)(3) Line 7 N/A 0 H LEE MOFFITT CC&RI LIFETIME CANCER SCREENING CENTER INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238640 PRACTICE MANAGEMENT FL 501(c)(3) Line 9 N/A 0 MOFFITT TECHNOLOGIES CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 300332914 TECHNOLOGY MANAGEMENT FL N/A C MOFFITT GENETICS CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 208486180 DATABASE MANAGEMENT FL N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0