STRATEGY STUDIO / PUBLIC DATA EXPLORER

WINTER HAVEN HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WINTER HAVEN HOSPITAL INC (EIN 59-0724462)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-06
IRS object ID
201232199349300643
Schema version
2010v3.4
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)
Timestamp2012-08-06T12:35:45-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12963 GULF TO BAY BLVD STE 267AddressLine1
CityCLEARWATERCity
StateFLState
ZIP Code337594255ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN590724462EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameLance AnastasioName
TitlePresidentTitle
Phone8632931121Phone
Date Signed2012-08-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTerry HaefnerName
Phone7274427110Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 Ave F NEAddressLine1
CityWinter HavenCity
StateFLState
ZIP Code33881ZIPCode
FieldValueIRS element (for citing)
Gross Receipts286373695GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.winterhavenhospital.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1926YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTo provide hospital and healthcare services.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees2689TotalNbrEmployees
Total Nbr Volunteers328TotalNbrVolunteers
Total Gross UBI817149TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3447508ContributionsGrantsPriorYear
Contributions Grants Current Year5121071ContributionsGrantsCurrentYear
Program Service Revenue Prior Year271607748ProgramServiceRevenuePriorYear
Program Service Revenue CY256334293ProgramServiceRevenueCY
Investment Income Prior Year2735788InvestmentIncomePriorYear
Investment Income Current Year3891619InvestmentIncomeCurrentYear
Other Revenue Prior Year-2596543OtherRevenuePriorYear
Other Revenue Current Year594724OtherRevenueCurrentYear
Total Revenue Prior Year275194501TotalRevenuePriorYear
Total Revenue Current Year265941707TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year127607606SalariesEtcPriorYear
Salaries Etc Current Year127611178SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year147668177OtherExpensePriorYear
Other Expenses Current Year133704661OtherExpensesCurrentYear
Total Expenses Prior Year275275783TotalExpensesPriorYear
Total Expenses Current Year261315839TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-81282RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4625868RevenuesLessExpensesCY
Total Assets BOY250298873TotalAssetsBOY
Total Assets EOY248636308TotalAssetsEOY
Total Liabilities BOY146056152TotalLiabilitiesBOY
Total Liabilities EOY145206541TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY104242721NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY103429767NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo improve the health of the people we serve, by providing the highest quality and most effective care and services - and to return value to the people in our communities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense178424589Expense
Revenue256384765Revenue
DescriptionThe Community Benefit contributions of Winter Haven Hospital and the Winter Haven Hospital Foundation include programs and activities that improve access to healthcare and improve health in our communities. Winter Haven Hospital is a not-for-profit organization that is the leading healthcare provider in eastern Polk County, dedicated to the mission of improving the health of the people we serve, by providing the highest quality and most effective care and services - and to return value to the people in our communities. Our history of fulfilling this mission and providing access to medical excellence close to home began in 1926. Since that time we have remained dedicated to meeting the healthcare needs of individuals and businesses in central Florida.This statement of program service accomplishments is organized using the HERO methodology; Healthcare, Education, Research, Outreach.HealthcareEstablished in 1926, Winter Haven Hospital serves as the major medical center for eastern Polk County and the U.S. Highway 27/Ridge corridor. Since that time, the local population has grown substantially with over 660,000 people living within 25 miles of the hospital and over 3 million within 50 miles. The hospital is a division of Mid-Florida Medical Services, a locally owned and operated 501(C)(3), not-for-profit organization, which is governed by an independent Board of Trustees made up of local business and civic leaders who serve without pay. With 527 licensed beds, Winter Haven Hospital main campus is the larger of the two inpatient facilities in our healthcare system, followed by our Regency Center for Women and Infants. With approximately 2,400 employees, Winter Haven Hospital is the largest private employer in eastern Polk County. The hospital is fully accredited by the Joint Commission and has more than 300 board-certified physicians on its medical staff representing every major specialty. Winter Haven Hospital is affiliated with the University of Florida College of Medicine/Shands Healthcare in the areas of emergency medicine, oncology and urology. The hospital is also a member of the American Hospital Association, Florida Hospital Association, the Premier Alliance, and the West Central Florida Hospital Council.Hospital based services include:- The Bostick Heart Center- The Cassidy Cancer Center- Three 12-bed intensive care units for medical, surgical and coronary care- A Nationally recognized Stroke Center- The Nationally accredited Joy-Fuller Rehabilitation Center- The Regency Center for Women and Infants- Center for Robotic SurgeryWith community based facilities located throughout eastern Polk County, Winter Haven Hospital offers numerous specialty programs and units:- State-of-the-art OB/GYN women's facility- Level II neonatal intensive care- Comprehensive physical rehabilitation inpatient and outpatient centers accredited by the Commission on Accreditation of Rehabilitation Facilities, which are also state-designated for brain injury- Three cardiac catheterization laboratories- Clinical lab and regional Blood Bank- Ambulatory Surgery and Diagnostic Center including new operating rooms, endoscopy procedure rooms and prep and recovery areas. - Emergency Department- Seven primary care offices (Auburndale, Bartow, Dundee, Haines City, Lake Wales, Winter Haven (two))- Inpatient Center for Psychiatry/outpatient behavioral health services - Diabetes Care CenterWith approximately 17,000 total admissions last year, over 1,600 births and over 60,000 emergency and urgent care visits, Winter Haven Hospital continually seeks to fulfill its mission: To improve the health of the people we serve, by providing the highest quality and most effective care and services - and to return value to the people in our communities.Winter Haven Hospital's Regency Center for Women and Infants received the Premier Quality award for being one of the best Women's Hospitals in the country. Also in June 2011, Heathgrades awarded the Regency the Maternity Care Excellence Award.The Joy-Fuller Rehabilitation Center earned its seventh-consecutive 3-year Commission on Accreditation of Rehabilitation Facilities in December 2010. It is the only CARF-accredited inpatient rehabilitation center in Polk, Highlands and Hardee Counties. The Bostick Heart Care Center was given a three-star rating by Consumer Reports magazine for 3 years running with the latest published in April 2012. This designation for the Bostick Heart Center's heart-bypass program ranks it as among the top 50 such programs in the nation. Only two other Florida hospitals were given this designation. 2011 also marked the fourth year in a row that the Bostick Heart Center received the top rating of 3 stars from the Society of Thoracic Surgeons. In December 2008 the Hospital was awarded Magnet Status which is the highest level of recognition from the American Nurses Credentialing Center. Characteristics that define nursing services in a Magnet organization emphasize high-quality patient care, clinical autonomy and responsibility, participatory decision-making, strong nurse leaders, effective use of resources, and high levels of job satisfaction.The hospital was one of 60 hospitals to achieve the Gold Elite Award from the American Stroke Association acknowledging at least 2 years of 85% or higher adherence to all performance measures for stroke care with the most recent award coming in January 2009. The hospital program for the continuum of stroke care was initially certified by the Joint Commission in July 2005. The program received its second Joint Commission designation in December 2007 and its fourth designation in December 2011.Winter Haven Hospital is committed to the highest quality of compassionate patient care by adhering to the following nursing philosophy:- We believe there is a potential inherent in every human being for self-actualization that can be empowered through the caring nurse-patient relationship.- We value diversity of human experience and expression by accepting the person not only as he or she is now, but as what he or she may become.- We believe that we have an ethical and social responsibility to both individuals and society to protect human dignity and preserve humanity.- We are committed to teamwork and collaboration in which individuals engage in genuine communication, put aside individual and discipline agendas, and put the patient and the patient's social support systems first.- We actualize these beliefs by promoting and rewarding clinical, administrative, research, and education activities which maintain an exceptional caring relationship with those we are privileged to serve.Winter Haven Hospital meets the organizational description for tax exemption as evidenced by:- Operating a 24 hour emergency room that is open to all persons regardless of the ability to pay.- Having an open medical staff with privileges available to all qualified physicians in the area.- Having a governing body comprised of independent persons representative of the community.- Participating in Medicare, Medicaid, Champus, and other government sponsored healthcare programs.- Providing charity care to the indigent as more fully described below.Winter Haven Hospital offers financial assistance policies that help the low income and uninsured members of the community. All self-pay patients are screened for funding sources at the time of admission or in the pre-admission process. Patients are screened for qualification with federal, state, or county funded programs or the hospital's charity care policy. If the patient qualifies, the Financial Counseling staff assists the patient in the application process. If he or she does not qualify, the hospital offers a variety of payment plans to help accommodate the patient. Uninsured patients receive an automatic 40% discount on their bills. The hospital's charity care policy complies with Florida's Agency for Health Care Administration charity guidelines which enables us to provide healthcare to patients that are unable to pay due to financial hardship. This policy includes:- 100% write-off of charges for families whose income for the 12 months preceding the determination is below 200% of the current Federal poverty guidelines.- A sliding scale write-off of charges for families whose income for the 12 months preceding the determination is between 201% and 300% of the current Federal poverty guidelines.- A sliding scale write-off of charges for catastrophic cases where the bill exceeds 25% of family annual income.Description
Total Program Service Expense178424589TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other 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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096373NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2689NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Dave MacDougallBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8632971899TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Richard Straughn
2nd Vice Chairman2.00XX000
Mark Bostick
Chairman2.00XX000
Charles W McPherson
Assistant Treasurer2.00X000
Todd Dantzler
Secretary2.00XX000
David K Speyerer
Trustee2.00X000
Chip Tucker
Trustee2.00X000
Tommy Oakley
3rd Vice Chairman2.00XX000
Albert Cassidy
Trustee2.00X000
Kelly Gray-Eurom MD
Trustee2.00X000
Brian K Swain
1st Vice Chairman2.00XX000
William G Burns
Treasurer2.00XX000
Eric Adamson
Trustee2.00X000
Ben Hill Griffin III
Trustee2.00X000
Eileen Holden
Trustee2.00X000
William H Murrell
Trustee2.00X000
Robert C Carter
Assistant Secretary2.00X000
Lance Anastasio
President and CEO40.00X048634028804
David MacDougall
Vice President & CFO40.00X025210939684
David Libby
Vice President40.00016305222843X
Mary Jo Schreiber
Vice President40.00018205113077X
Iftikhar Rasul MD
Psychiatrist40.00257207038425X
George Winney MD
Psychiatrist40.00251799041660X
Joseph Lynch MD
Physician Intensivist40.00336839022807X
Majd Alsamman MD
Medical Director40.00377685023169X
Takkallapelli D Tao MD
Vice President40.00233066021106X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1456596TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1083552TotalReportableCompFrmRltdOrgs
Total Other Compensation251575TotalOtherCompensation
Number Individuals GT100 K60NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sodexo Inc & Affiliates
PO Box 536922AtlantaGA303536922Management Services4504805
Doster Construction Co Inc
8529 South Park Circle Suite 130OrlandoFL32819Construction1898894
OB Hospitalist Group LLC
10 Centimeters DriveMauldinSC29662Physicians1386902
Florida Clinical Practice
PO Box 100247GainesvilleFL32610Physicians1045212
Winter Haven Cardiovascular
PO Box 3130OcalaFL344783130Physicians820753
FieldValueIRS element (for citing)
Number Of Contractors GT100 K34NumberOfContractorsGT100K
Related Organizations2026657RelatedOrganizations
Government Grants3087899GovernmentGrants
All Other Contributions6515AllOtherContributions
Total Contributions5121071TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Patient Services621990152549553152549553
Medicare/Medicaid Paym6219909830982998309829
Other Services62199047756083028653240$1,746,715
Medicare/Medicaid Paym621500492178492178
Lab Outreach621500207125207125
FieldValueIRS element (for citing)
Total Program Service Revenue256334293TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2044467TotalRevenueColumn
Unrelated Business Revenue2817UnrelatedBusinessRevenue
Exclusion$2,041,650ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real488050Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real58587Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real429463Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column429463TotalRevenueColumn
Exclusion$429,463ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities22211132Securities
Other9421Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities20298802Securities
Other74599Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1912330Securities
Other-65178Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1847152TotalRevenueColumn
Exclusion$1,847,152ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Contract Rev - Linen812300114789114789
Other Revenue6219905047250472
FieldValueIRS element (for citing)
Total Other Revenue165261TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column265941707TotalRevenueColumn
Related Or Exempt Function Income253938507RelatedOrExemptFunctionIncome
Unrelated Business Revenue817149UnrelatedBusinessRevenue
Exclusion$6,064,980ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total110635493Total
Program Services84344118ProgramServices
Management And General26291375ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3845887Total
Program Services2862620ProgramServices
Management And General983267ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4989283Total
Program Services337915ProgramServices
Management And General4651368ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8140515Total
Program Services5987889ProgramServices
Management And General2152626ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1549429Total
Management And General1549429ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1235672Total
Management And General1235672ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total235977Total
Management And General235977ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total334637Total
Management And General334637ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9560317Total
Program Services4522173ProgramServices
Management And General5038144ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total563614Total
Program Services53471ProgramServices
Management And General510143ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1358868Total
Program Services118762ProgramServices
Management And General1240106ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4671529Total
Management And General4671529ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total316448Total
Program Services176394ProgramServices
Management And General140054ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total99367Total
Program Services45344ProgramServices
Management And General54023ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3808105Total
Management And General3808105ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total16974009Total
Management And General16974009ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3648211Total
Management And General3648211ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies48132847449773633155484
Bad Debt2668680226686802
Equipment Rental & Main909599041010134994977
Indigent Fund26772992677299
Contract Labor16816571473145208512

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1073883Total
Program Services60281ProgramServices
Management And General1013602ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total261315839Total
Program Services178424589ProgramServices
Management And General82891250ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY11656BOY
EOY11871EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY24635048BOY
EOY26717156EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY40535320BOY
EOY42081796EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5090948BOY
EOY5930240EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5022175BOY
EOY4888590EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis275491506LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec166421049LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY110236585BOY
EOY109070457EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY56358300BOY
EOY48931109EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8408841BOY
EOY11005089EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY250298873BOY
EOY248636308EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28616785BOY
EOY28965683EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY82644483BOY
EOY80808817EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY9245650BOY
EOY6363826EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY2700000BOY
EOY2700000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY22849234BOY
EOY26368215EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY146056152BOY
EOY145206541EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY104242721BOY
EOY103429767EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY104242721BOY
EOY103429767EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY250298873BOY
EOY248636308EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4625868ReconcilationRevenueExpenses
Reconcilation Other Changes-5438822ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4164198OtherCostOrOtherBasis
Book Value4164198BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis93058725OtherCostOrOtherBasis
Depreciation45508624Depreciation
Book Value47550101BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4146612OtherCostOrOtherBasis
Depreciation2977748Depreciation
Book Value1168864BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis156448777OtherCostOrOtherBasis
Depreciation107466682Depreciation
Book Value48982095BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17673194OtherCostOrOtherBasis
Depreciation10467995Depreciation
Book Value7205199BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings109070457TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Professional Liability and Workmens Comp$9,945,341
Other Liabilities$2,230,741
Swap Agreements$14,192,133
FieldValueIRS element (for citing)
Total Of Amounts26368215TotalOfAmounts
Total Revenue265941707TotalRevenue
Total Expenses261315839TotalExpenses
Excess Or Deficit For Year4625868ExcessOrDeficitForYear
Net Unrealized GL On Investments-2932754NetUnrealizedGLOnInvestments
Other-$2,506,068OtherAmount
Total Adjustments-5438822TotalAdjustments
Excess Or Deficit Per FS-812954ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt260926858TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2932754NetUnrealizedGainsInvestments
Other Revenues726497OtherRevenues
Revenue Not Rptd F990-2206257RevenueNotRptdF990
Revenue Subtotal263133115RevenueSubtotal
Other Revenues Not Included2808592OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2808592RevenueNotRptdOnFinStmt
Total Revenue Per Form990265941707TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt260727062TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal260727062ExpensesSubtotal
Other Expenses Not Included588777OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt588777ExpensesNotRptdOnFinStmt
Total Expenses Per Form990261315839TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Hospital is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and from state income taxes under the provisions of Chapter 220.13 of the Florida Income Tax Code. Accordingly, no provision for income taxes is made in the accompanying consolidated financial statements. The IRC provides for taxation of unrelated business income under certain circumstances. During the years ended September 30, 2011 and 2010, the Hospital performed lab and laundry services for other hospitals, clinics and other health care providers in the community, which generated unrelated business income and resulted in no unrelated business income taxes. There are no significant gross deferred tax assets or liabilities at September 30, 2011 or 2010. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the tax-exempt status of each entity, the continued tax-exempt status of bonds, and various positions relative to potential sources of unrelated business taxable income. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. There were no unrecognized tax benefits identified and recorded as a liability as of September 30, 2011 and 2010.
Part XI, Line 8 - Other Adjustments:Change in Value of Swap Liability -2,213,896. Transfer to Mid-Florida Medical Services Foundation, Inc. -286,253. Income from Investments in Partnerships -5,919.
Part XII, Line 2d - Other Adjustments: Investment in Subsidiary 726,497 Part XII, Line 4b - Other Adjustments: Change in Value of Swap Liability 2,213,896 Income from Investment Partnerships 5,919 Expenses Netted with Revenues 588,777 Total 2,808,592 Part XIII, Line 4b - Other Adjustments: Expenses Netted with Revenues 588,777

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense9987961TotalCommunityBenefitExpense
Net Community Benefit Expense9987961NetCommunityBenefitExpense
Percent Of Total Expense0.04260PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense34362268TotalCommunityBenefitExpense
Direct Offsetting Revenue25863917DirectOffsettingRevenue
Net Community Benefit Expense8498351NetCommunityBenefitExpense
Percent Of Total Expense0.03620PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1998401TotalCommunityBenefitExpense
Direct Offsetting Revenue970886DirectOffsettingRevenue
Net Community Benefit Expense1027515NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense46348630TotalCommunityBenefitExpense
Direct Offsetting Revenue26834803DirectOffsettingRevenue
Net Community Benefit Expense19513827NetCommunityBenefitExpense
Percent Of Total Expense0.08320PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense318469TotalCommunityBenefitExpense
Net Community Benefit Expense318469NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense328365TotalCommunityBenefitExpense
Net Community Benefit Expense328365NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense63330TotalCommunityBenefitExpense
Net Community Benefit Expense63330NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense710164TotalCommunityBenefitExpense
Net Community Benefit Expense710164NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense47058794TotalCommunityBenefitExpense
Direct Offsetting Revenue26834803DirectOffsettingRevenue
Net Community Benefit Expense20223991NetCommunityBenefitExpense
Percent Of Total Expense0.08630PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense242933TotalCommunityBuildingExpense
Net Community Building Expense242933NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense250000TotalCommunityBuildingExpense
Net Community Building Expense250000NetCommunityBuildingExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense492933TotalCommunityBuildingExpense
Net Community Building Expense492933NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$6,050,427BadDebtExpenseAmount
Amount Reimbursed By Medicare65764787AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare84150685CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-18385898MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

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

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

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

Hospital Facility NumberHospitalFacilityNumber
Winter Haven Hospital Inc
1
Regency Medical Center
2

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanation
Part I, Line 7: Charity Care and Means-Tested Government Programs costs (lines a through d) are determined using a Cost-to-Charge ratio. Other Benefits were calculated based on actual cost (lines e through j).
Part I, L7 Col(f): There is $26,686,802 of bad debt expense which is included in Form 990, Part IX, Line 25. This amount was removed in the calculation of the Percent of Total Expense on Schedule H Line 7f.
Part II: The Hospital helps build the community in two major ways as mentioned above. First, if the hospital finds that there is a shortage in a certain health care specialty, it works to recruit those types of physicians to the area. In the past, the hospital has commissioned a Manpower study to determine what the community's needs are. Additionally, the hospital subsidizes the cost of anesthesia for women giving birth at the Regency Center for Women and Infants. This benefits the community by allowing those who are less fortunate to have access to anesthesia services.
Part III, Line 4: The organization's financial statements do not include a footnote that describes bad debt expense. Bad debt expense at cost was calculated by multiplying bad debt expense by the Cost to Charge Ratio.Although the Hospital has excluded Bad Debt Expense from the calculation of community benefit found in Schedule H Part 1 in accordance with IRS instructions, Winter Haven Hospital considers Bad Debt as a community benefit because a large percentage of a Hospital's bad debt is really undocumented charity care. Hospital Bad Debt is different from other businesses' bad debt because hospitals continue to provide life saving services to people who cannot or will not pay.
Part III, Line 8: A large percentage of the local community is elderly which results in a large amount of Medicare Shortfall. Winter Haven Hospital considers this a community benefit because it is committed to providing first class care to the elderly even though it is at a loss due to underpayment by the federal government. The hospital uses the Cost to Charge ratio method.
Part III, Line 9b: At any time in the collection process the account can be determined to meet the criteria of medical indigency as defined by the Federal Poverty Guidelines and all further collection efforts may be suspended. Documentation of such criteria will be retained in the files.
Part VI, Line 2: The hospital assesses the health care needs of the community by participating in several community organizations that develop community strategic plans such as Winter Haven's "Our Future by Design". The Hospital also works with the Polk County Health Department in order to conduct studies and help set priorities. Additionally, the Hospital works with and utilizes several community health surveys conducted by Polk Healthcare Alliance.
Part VI, Line 3: All self-pay patients are screened for funding sources (Medicaid, Polk Health Care, Charity, etc.) at the time of admission or in the pre-admission process. The Hospital's Financial Counselors review the patient's family size, income, and estimated hospital bill to determine if the patient is eligible for any assistance. If he or she is not, the hospital offers a variety of payment plans to help accommodate the patient.
Part VI, Line 4: Winter Haven is the second largest of 17 municipalities located in Polk County Florida. Over 3.5 million people live within 50 miles of Winter Haven Hospital, with 719,851 living within 25 miles. Of Polk County's citizens, 18% are under 15 years old, 10% are aged 15-24, 35% are 25-54, 10% are 54-64, and 27% are over 65 years old.
Part VI, Line 6: Besides the previously mentioned benefits, the Hospital also benefits the community by providing the following:1. Scholarships to high school students2. Timely initiatives to address the community's emerging problems. (For instance, after the Polk Healthcare Alliance identified that African American infants die at a rate of 4 times the rate of white infants, the hospital developed the Pre Natal Passport which assists pregnant women in tracking their care and worked closely with the Healthy Start Coalition to provide education and portable cribs to new moms that can't afford them.)3. A corporate culture that motivates its employees to volunteer in the community.4. An active Speakers Bureau that provides free lectures to the community.5. Free meeting space for a variety of support groups such as epilepsy, grief, caregivers, lupus, leukemia, brain injury, AIDS, Alzheimers, and domestic violence.6. Sponsorship and fund raising for many other community organizations and events, such as: American Heart Association "Heart Walk" and the American Cancer Society "Relay for Life".7. Numerous free and/or at cost health screenings at health fairs in the community, with each fair specializing in men, women, cardiac or diabetic health issues. These screenings include screens for blood pressure, stress assessments, breast exams, prostate cancer, diet and exercise.
Part VI, Line 7: The Hospital is affiliated with the University of Florida Medical School and continually draws on its expertise. Emergency Department physicians and the physician director of the Cancer Center are from the University of Florida. The University of Florida staff plays a significant role in providing continuing education for medical and nursing staff. This continuing education allows the hospital to improve the way it cares for patients.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Lance Anastasio
046585000020490017129011675051514400
David MacDougall
02482530003856017145022539029179300
David Libby
01568560006196011497011346018589500
Mary Jo Schreiber
0176378000567301307700019512800
Iftikhar Rasul MD
1526600103190013570106050278200295632000
George Winney MD
211485039130011840137080279520293459000
Joseph Lynch MD
33076100060780110630117440359646000
Majd Alsamman MD
29604000081645016987061820400854000
Takkallapelli D Tao MD
14314908845001467099020112040254172000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 1aReturnReference
ExplanationLance Anastasio, President and CEO was provided social club dues for membership in the Lake Region Country Club in the amount of $543. This membership was used to entertain and hold meetings with business associates, board members and employee relations. However, the payment for his social club dues ceased in January 2010. The full amount of $543 was included in taxable wages.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

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

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Total ProceedsTotalProceedsCapitalized InterestCapitalizedInterestIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundAmount UnspentAmountUnspent
1900000072311205775187942251011
26100000170868242406151000671688517
26100000264989242393551000831595656
146000001447001430370010008151600

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

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

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2
NA
0100NA00
Morgan Stanley
0110NA0024.50000000000010
Morgan
0110NA0024.50000000000010Stanley/Goldman
Goldman Sachs
0110NA0030.25000000000010

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Program Service AccomplishmentsContinuation of Form 990, Part III, Line 4aAdditionally, the hospital offers discounts for patients who are underinsured and whose insurance has minimal benefits and/or limited coverage. In order to ensure that everyone in the community has access to quality care, the hospital subsidizes the cost of various critical community healthcare needs such as: - Anesthesia for Medicaid and indigent patients at its Regency Center for Women and Infants - The cost of OB/GYN Hospitalists for Medicaid and indigent patients without a primary Obstetrician - The outpatient mental health programs offered at the Hospital's Center for Behavioral Health. Education: Community education - Working directly with the community to promote better health by educating them on a variety of topics taught by physicians or other licensed medical professionals, including but not limited to nutrition lectures, diabetes, stroke awareness, safe babysitting and behavioral disorders. A comprehensive listing of our education programs and support groups is published and distributed to 85,000 residents semi-annually in a publication entitled Here's to Your Health and can be found on our website www.winterhavenhospital.org. Some examples of our community education offerings include: - Health Connection - A service available to the community providing physician referrals, health information, and referrals to the many Hospital sponsored programs and events. - Speaker's Bureau - The Hospital provides speakers to community organizations on a range of medical topics at no charge. The hospital's Center for Behavioral Health offers lectures on mental health topics open to the public free of charge. - Medical Library - The hospital maintains a medical library that is open to the public. The library is available at the main campus of Winter Haven Hospital as well as an additional library at the Regency Medical Center and offers books, tapes and online clinical research tools. The Medical library also has an onsite Research Information Specialist who is trained by the National Library of Medicine and the Medical Library Association to assist with internet researches. - Diabetes Self-Management Education - The hospital offers low cost education for people with or at risk for developing Diabetes. The classes help these individuals gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. Endowed Chair in Nursing - The Hospital is also committed to improving the education of nurses in the local area. In 2010, the Winter Haven Hospital Foundation made a substantial donation to Polk State College to create an endowed chair in nursing. This donation helped to underwrite a new teaching position at Polk State College and augment the college's efforts to add a bachelor's degree in nursing program. Watson Caring Science Institute & Jean Watson International Caritas Consortium - The hospital became an official Watson Caring Science Institute Affiliate in 2010. The Watson Caring Science Institute is a non-profit foundation that advances philosophies, theories, and practices of human caring. Additionally, the hospital became the first hospital to begin data collection for the International Watson Caritas Comparative Database which is database that collects and evaluates nurse caring behavior. In April 2011, the hospital had the privilege of hosting the International Caritas Consortium. The consortium is a forum for sharing original scholarship, discussing caring research, and mentoring Caritas Coaches. Attendants come from all over the world to join in the forum. Research: Research Council - The multidisciplinary team helps to identify and review potential research projects for Winter Haven Hospital. Additionally, they track research currently in progress and ensure that all policy, procedures and federal mandates are followed. Institutional Review Board - The purpose of the Institutional Review Board is to review, approve or disapprove the initiation of, and conduct periodic review of, biomedical research involving human subjects. The primary purpose of such review is to ensure the protection of the rights and welfare of human subjects. It further will serve as liaison between physicians, investigators, and all other interested parties, and ensure compliance with applicable federal laws and regulations regarding biomedical research involving human subjects. The Institutional Review Board includes engagement of physicians, nurses, board members, administration, pharmacy and three seats for members of the community. Research Studies - The Hospital's commitment to constant improvement has lead to its involvement in several research studies. A few examples from 2011 include research on the prevalence of postpartum depression in community hospitals as well as research on Coronary Intervention in women and new uses of Cardiac Stents. Annual Nursing Research Seminar - The hospital invites nurses from around central Florida to its exceptional Research Seminar where nationally known speakers educate and challenge the staff. In 2010, over 80 nurses from various hospitals attended the annual nursing research seminar. Memory Clinic - In 2012, the Hospital's Center for Behavioral Health launched a memory clinic in collaboration with the University of South Florida Polytechnic Applied Neuro Lab. The Memory Clinic assists elderly pre-dementia patients to delay onset of memory loss. Robotics - In 2010, the Hospital formed its Center for Robotics with initial focus on improving patient outcomes in the area of urology and gynecological surgery. In 2011, the hospital hosted the Ramses Robotic Surgery Conference to show care to other physicians across the county the patient care benefits of an effective robotic surgery program. Outreach: Community health screenings - Numerous free and/or at cost health screenings were performed at Health fairs in the community, with each fair specializing in women, cardiac or diabetic health issues. These screenings include screens for blood pressure, stress assessments, breast exams, prostate cancer, diet and exercise. Community Partnerships Our community partners are critical to helping us improve the health and well-being of eastern Polk County. Together, we combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of working with the following community partners: I. Polk Healthcare Alliance - A senior hospital employee serves as the liaison with the Polk Healthcare Alliance. As a member of a five person Executive Committee for the Polk Healthcare Alliance, the Liaison reviews progress toward the organization's Community Health Improvement Plan (CHIP). II. The Polk County Health Department - The Hospital jointly collaborated with the Polk County Health Department for the provision of maternity services to Medicaid patients. The Hospital guaranteed their access to maternity services by subsidizing and arranging for obstetrical physician services. The Polk County Health Department was selected to receive $1,950,000 over three years from the state Low Income Pool (LIP) program. These funds provide payments to health care safety net providers who serve the uninsured. Partnering with others they are seeking to link uninsured and underinsured individuals to healthcare coverage and a medical home. They are also seeking to expand access to primary care physicians and medications. Finally, they are assisting people with chronic health conditions in managing their diseases. They are working closely with hospital emergency departments to help ensure that low income individuals find a medical home. The funds were available up through July 2011. III. Haley Center - The Hospital was instrumental in the development of a free clinic in Winter Haven called the Haley Center. The First Baptist Church of Winter Haven asked for assistance and the health departments, the hospital, the country's Community Health and Social Services Department and others came together to ensure the free clinic's success. It has been operational since December 2005 and the hospital provides free Lab, X-ray and pulmonary function testing. Haley Center and Hospital volunteer staff has helped share their expertise with the Parkview Christian Church (Baptist) in Haines City which is now providing free services in their community.
Program Service AccomplishmentsContinuation of Form 990, Part III, Line 4aIV. We Care - The Hospital participates in the Polk County Medical Association's We Care program. Through a network of 215 medical specialists, We Care helps provide specialty medical care for low income, uninsured residents of Polk County. V. Angel Care Center of Eloise- The Hospital participates in the local church based program called the Angel Care Center of Eloise. This center offers a free diabetic clinic the second Wednesday of each month for persons whose income doesn't exceed 200 percent of the federal poverty level, who are not eligible for Medicaid or Medicare and who do not have private medical insurance. Hospital volunteers also provide their time to assist with free medical attention. VI. Polk Health Care Plan - The Hospital participates and accepts the Polk Healthcare Plan. Polk HealthCare Plan is a public/private partnership that allows for a comprehensive managed health care program for eligible Polk County residents. The Plan provides an integrated system of health care and social services through a wide range of primary and preventive medical care, specialty medical care, hospitalization, diagnostic testing, ancillary services and pharmaceuticals. In essence, the Plan functions as a County-operated HMO for qualified Polk County residents. A senior hospital employee attends the Citizen Oversight Committee, an Advisory body on health issues for the Polk Healthcare Plan. In 2010, the hospital joined with Polk Healthcare and another area hospital to start an initiative that would bring an additional $1 million worth of primary care services to low income residents of Polk County. VII. Physician Recruitment - The hospital has a full-time physician recruiter and actively recruits physicians in primary care and specialty care areas where it has identified a community need. The hospital also works closely with physician groups to assist them in recruiting new physicians to our area. Sponsored community events - Winter Haven Hospital and its employees provided sponsorship and fund raising for these and many other community organizations and events: I. Heart Smart Days: A luncheon, health fair and lecture series focused on heart health education II. Citrus Classic: Features a 5k run, three-mile walk and Kindergarten Dash. III. Heart Walk: A three-mile walk benefiting the American Heart Association. IV. Relay for Life: An 18-24 hour relay walk benefiting the American Cancer Society. V. Baby-to-be and Up-to-three: A fun and informative health fair for expecting parents and young children which includes exhibits, child ID fingerprinting, fire safety, bike helmet fittings, and free immunizations for children. VI. Just Culture Community Seminar: The hospital sponsored a seminar hosted by world-renowned expert Sidney Dekker which was part of the Hospital's ongoing effort to heighten awareness about safety issues in the work place. VII. Neighborhood Services Center: The Hospital maintains a Neighborhood Services Center and employs a full time director in order to coordinate speakers, entertainment and health fairs primarily for senior citizens. VIII. One Team One Goal: The One Team One Goal campaign provides employees with the opportunity to make a pledge to any combination of seven different charities and funds, including two Winter Haven Hospital Foundation funds and five external charities. The hospital also sponsors and offers free meeting space for a variety of support groups such as cancer, epilepsy, grief, caregivers, lupus, leukemia, brain injury, AIDS, Alzheimers, and domestic violence. Peer Recovery Program - The Hospital facilitates the Peer Recovery Program which provides education, socialization, employment skills, and support to consumers who have a mental health diagnosis. Membership and participation is free and open to everyone in the community. Community Leadership - The Hospital enables its leaders to participate in organizations that benefit the well being of the community including for example: The United Way, Girls, Inc., the Women's Resource Center, and the Chamber of Commerce for several local communities, and the American Heart Association. Volunteer Services Department The hospital has an active and important volunteer department with over 317 active members serving throughout the hospital for over 27,450 hours. The hospital volunteers have spent hours serving the community with a Patient I.D. Fair, HIM Bake Off, Polk Heartwalk, Heart Smart Day and the Women's Health Fair. They also provide special Christmas stockings for infants going home on Christmas and sponsor the Christmas Angel Tree program. Community Benefit Quantification The following financial information represents a quantification of Winter Haven Hospital's community benefit for the fiscal year ended September 30, 2011. This quantification was developed using the principals set forth under IRS Schedule H. The hospital will file IRS Schedule H with its 2010 Form 990 as required by IRS regulations for Fiscal Year ending September 30, 2011. 2011 Charity and Medicaid Cases: Charity Medicaid Emergency Department 5,206 8,967 Inpatient 532 2,171 Other 1,001 1,649 Total 6,739 12,787 Charity Care and Certain Other Community Benefits at Cost: Charity Care - at cost $ 9,987,961 Direct Community Based Healthcare Programs $ 440,419 Unreimbursed Cost of Medicaid Programs $ 8,498,351 Unreimbursed Cost of County Indigent Care Program $ 587,096 Donations and Community Groups $ 63,330 Education/Health Fairs $ 176,569 Enrollment Assistance in Government Programs $ 141,900 Health Professionals Education $ 328,365 Total Charity Care and Certain Other Community Benefits at Cost $ 20,223,991 Community Building Activities: Physician Recruitment $ 242,933 Subsidized Cost of Regency Anesthesia $ 250,000 Total Community Building Activities $ 492,933 Total Quantifiable Community Benefit $ 20,716,924 The Community Benefit Quantification shown above does not include the following additional important demonstrations of the Hospital's community support - Cost of Uncompensated Care to Patients above the poverty line $ 6,050,427 - Shortfall of Medicare Funding for Patient Care* $ 18,385,898 - Scholarship for Workforce Development $ 42,039 Total $ 24,478,364 *From Medicare Cost Report Excludes other Medicare (HMO, PPO, etc.) shortfall of $10,596,128
Form 990, Part VI, Section A, line 2Mark Bostick and William H. Murrell, Board Members, have a family relationship.
Form 990, Part VI, Section A, line 6The sole member of Winter Haven Hospital, Inc. is Mid-Florida Medical Services, Inc.
Form 990, Part VI, Section A, line 7aThe Trustees of the Winter Haven Hospital, Inc. shall be elected by the Sole Member, Mid Florida Medical Services, Inc., at its annual meeting each year for staggered three year terms.
Form 990, Part VI, Section A, line 7bAs stated in the Bylaws of Winter Haven Hospital - The Board of Trustees shall not, without the prior approval of the Sole Member of the Corporation: 1. Amend the Bylaws or the Articles of Incorporation of Winter Haven Hospital. 2. Approve a plan of dissolution of Winter Haven Hospital. 3. Approve a plan of merger or consolidation of Winter Haven Hospital with another Corporation. 4. Organize or acquire, or authorize or approve the organization or acquisition of any subsidiary or affiliate of the Corporation.
Form 990, Part VI, Section B, line 11The Executive Director of Accounting and CFO of Winter Haven Hospital intially reviewed Form 990. After their review was completed, the final Form 990 was then presented and made available to all Board Members including all voting members of the governing body.
Form 990, Part VI, Section B, line 12cThe Chairman of the Board of Directors inquires at least annually if there are any conflicts of interest. In addition all officers, directors, trustees and key employees are required to sign a conflict of interest statement annually.
Form 990, Part VI, Section B, line 15The Executive Compensation Committee of the Board of Directors sets compensation for the President and Vice Presidents of the hospital. The Executive Compensation Committee consists of four Board members, all of whom are independent. The Executive Compensation Committee has used the consulting firm of Sullivan and Cotter to advise them about executive compensation and to provide them with comparability data. Minutes of the Executive Compensation Committee meetings are kept and retained at the Hospital.
Form 990, Part VI, Section C, line 19The financial statements of Winter Haven Hospital are made availabe to the public upon request. The organization's governing documents and conflict of interest policy are not made available to the public.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 5:Net unrealized losses on investments: -2,932,754. Change in Value of Swap Liability -2,213,896. Transfer to Mid-Florida Medical Services Foundation, Inc. -286,253. Income from Investments in Partnerships -5,919. Total to Form 990, Part XI, Line 5: -5,438,822.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Mid-Florida Medical Services Inc
200 Ave F NEWinter HavenFL33881592486580Support OrganizationFL501(c)(3)509(a)(3) - Type 1N/A0
Mid-Florida Medical Services Foundation Inc
200 Ave F NEWinter HavenFL33881030406130FundraisingFL501(c)(3)509(a)(3) - Type 10
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Mid-Florida Medical Services Foundation Inc
Q286252Cost
Mid-Florida Medical Services Foundation Inc
C2056202Cost
Mid-Florida Medical Services Foundation Inc
L464681Cost
mid-Florida Medical Services Foundation Inc
P1959379Cost