2024-06-05T07:28:27-05:00 2023-09-30 593040705 RIVERO GORDIMER & COMPANY PA P O BOX 172359 TAMPA FL 33672 990 2022-10-01 237354477 TAMPA GENERAL HOSPITAL FOUNDATION INC TAMP 8138447250 P O BOX 1289 RM H-149 TAMPA FL 33601 FRANN LEPPLA CHIEF PHILANTHROPY OFFICER 8138447250 2024-05-31 1 FRANN LEPPLA 999009999 1 SAM A LAZZARA P01342929 8138757774 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z FRANN LEPPLA P O BOX 1289 RM H-149 TAMPA FL 33601 28935810 0 X WWW.TGH.ORG/FOUNDATION X 1974 FL TO SUPPORT AND PROMOTE THE PROGRAM SERVICES OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. 27 26 0 179 0 0 15790978 22721569 4615 3759 1068655 1348270 493156 270595 17357404 24344193 13107165 11691113 0 0 0 0 0 0 166156 197640 215616 13304805 11906729 4052599 12437464 43744733 54853377 2608193 2412051 41136540 52441326 X THE TAMPA GENERAL HOSPITAL FOUNDATION EXCLUSIVELY OPERATES FOR THE PURPOSE OF RAISING FUNDS TO SUPPORT THE RESEARCH, EDUCATION AND SERVICE MISSION OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. TAMPA GENERAL IS A 1,007 BED, PRIVATE, NOT-FOR-PROFIT, SAFETY NET HOSPITAL AND ONE OF THE MOST COMPREHENSIVE MEDICAL FACILITIES IN WEST CENTRAL FLORIDA SERVING A DOZEN COUNTIES WITH A POPULATION IN EXCESS OF 4 MILLION. 0 0 1952065 1952065 JOHN AND SUSAN SYKES CENTER OF EXCELLENCE IN COLORECTAL CANCER - TAMPA GENERAL FOUNDATION PROVIDES SUPPORT TO THE TAMPA GENERAL HOSPITAL CANCER INSTITUTE BY SUPPORTING THE GROWTH ACROSS THE FIELD OF ONCOLOGY. 1721126 1721126 MUMA CHILDREN'S HOSPITAL EXPANSION FUND - TAMPA GENERAL FOUNDATION PROVIDES SUPPORT TO THE HOSPITAL IN ITS MISSION TO CARE FOR EVERYONE, EVERY DAY. 1052700 1052700 NEONATAL INTENSIVE CARE PROGRAM SERVES OUR YOUNGEST POPULATION AND THEIR FAMILIES BY PROVIDING FUNDING FOR EDUCATION, EQUIPMENT PURCHASES AND OTHER PROGRAMMATIC NEEDS. 6965222 6965222 3759 FUNDED OPERATIONAL, EDUCATIONAL AND/OR CAPITAL PURCHASES SUPPORT TO FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. SPECIFIC GRANTS INCLUDED NURSING SCHOLARSHIPS, SMALL CAPITAL EQUIPMENT TO IMPROVE PATIENT SERVICES, HOSPITAL EMPLOYEE EMERGENCY ASSISTANCE AND SUPPORT OF HOSPITAL COMMUNITY OUTREACH, EDUCATIONAL SEMINARS AND REHAB PROGRAMS. 6965222 6965222 3759 11691113 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 100 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 27 26 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X FRANN LEPPLA 8138447250 PO BOX 1289 ROOM H-149 TAMPA FL 336011289 TAMMY KING PT MHS DPT SECRETARY 2.00 X X 0 0 0 MATHEW WASH TREASURER 2.00 X X 0 0 0 NATALIE GOODWIN ASSISTANT TREASURER 2.00 X X 0 0 0 JOSEPH WILLIAMS VICE CHAIRMAN 2.00 X X 0 0 0 GORDON GILLETTE CHAIRMAN 2.00 X X 0 0 0 JEFFRIE VAN LOVEREN MEMBER AT LARGE 1.00 X 0 0 0 SUPRIYA TANEJA MEMBER AT LARGE 1.00 X 0 0 0 FRANK HANCOCK MEMBER AT LARGE 1.00 X 0 0 0 RAVIENDER BUKKAPATNAM MD MEMBER AT LARGE 1.00 X 0 0 0 JOHN COURIS EX OFFICIO 1.00 X 0 2113230 41496 T COREY NEIL EX OFFICIO 1.00 X 0 0 0 BETHANY PAGLIARULO TRUSTEE 1.00 X 0 0 0 TAPAN PADHYA MD TRUSTEE 1.00 X 0 0 0 TOM LONCAR TRUSTEE 1.00 X 0 0 0 CHRISTOPHER KETCHEY MD TRUSTEE 1.00 X 0 0 0 TEALE TAGGART SMITH TRUSTEE 1.00 X 0 0 0 DIANNE JACOB TRUSTEE 1.00 X 0 0 0 J WADE KIRKLAND JR TRUSTEE 1.00 X 0 0 0 ERIC EBBERT TRUSTEE 1.00 X 0 0 0 RON WEISSER TRUSTEE 1.00 X 0 0 0 PATRICIA J EMMANUEL MD TRUSTEE 1.00 X 0 0 0 JUDETTE LOUIS MD MPH TRUSTEE 1.00 X 0 0 0 BRUCE ZWIEBEL MD TRUSTEE 1.00 X 0 0 0 DUANE DRAPER TRUSTEE 1.00 X 0 0 0 WAYNE LEWIS TRUSTEE 1.00 X 0 0 0 KRISHNA NALLAMSHETTY MD TRUSTEE 1.00 X 0 0 0 CHIP SCOTT WHITWORTH TRUSTEE 1.00 X 0 0 0 FRANN LEPPLA SVP/ CHIEF PHILANTHROPY OFF 50.00 X 0 464699 37906 0 2577929 79402 0 0 1 0 0 824062 21897507 318598 22721569 EDUCATIONAL FEES 900099 3759 3759 3759 1507440 1507440 4432447 4591617 -159170 -159170 -159170 186059 824062 0 186059 186059 MANAGEMENT FEE 900099 84536 84536 84536 24344193 3759 0 1618865 10795563 10795563 895550 895550 24000 24000 20141 20141 161856 161856 7600 3300 4300 2000 2000 19 19 11906729 11691113 49460 166156 1637199 3264626 10758556 16679335 1309 1278 50 31 31348928 34909385 43744733 54853377 101735 98829 526920 731507 1979538 1581715 2608193 2412051 X 8945806 8341326 32190734 44100000 41136540 52441326 43744733 54853377 X 12437464 1834988 -2967666 X X 0 1 X 1 0 X X X 1 FLORIDA HEALTH SCIENCES CENTER DBA 593458145 3 1 11691113 0 1 11691113 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART IV, SECTION D, LINE 3 EVERY GRANT, GIFT AND NEW FUND ESTABLISHED BY THE FOUNDATION DIRECTLY CORRELATES TO THE NEEDS OF THE SUPPORTED ORGANIZATION. NO GIFT IS SOLICITED FOR ANYTHING OTHER THAN THE SUPPORTED ORGANIZATION'S NEEDS. EACH RESTRICTED FUND IS ASSIGNED TO THE TGH VICE PRESIDENT WHO THEN DESIGNATES A FUND OFFICER. THE FUND OFFICER MUST BE EMPLOYED BY TGH AS A MEDICAL STAFF MEMBER, VICE PRESIDENT, DEPARTMENT MANAGER OR DIRECTOR. THE FUND OFFICER AND VICE PRESIDENT ARE DIRECTLY AND SOLELY RESPONSIBLE FOR MEETING THE REQUIREMENTS OF THE FUND PURPOSE. DISBURSEMENTS FROM THE FUND MAY ONLY BE MADE WHEN A PROPERLY COMPLETED CHECK REQUEST FORM WITH SUPPORTING DOCUMENTATION HAS BEEN SUBMITTED BY THE FUND OFFICER, APPROVED BY THE ASSIGNED VICE PRESIDENT AND REVIEWED BY THE FOUNDATION EXECUTIVE DIRECTOR TO ENSURE THAT THE REQUEST MEETS THE ORIGINALLY ESTABLISHED FUND CRITERIA. PART IV, SECTION E, LINE 2A THE FOUNDATION IS A SUPPORTING ORGANIZATION WHICH IS ORGANIZED AND OPERATED EXCLUSIVELY TO PROMOTE, SUPPORT, AND ENHANCE THE MISSION AND SERVICES OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL (TGH) (EIN 59-3458145). PART IV, SECTION E, LINE 2B IF THE FOUNDATION DID NOT OPERATE TO RAISE THE FUNDS TO SUPPORT TGH'S RESEARCH, EDUCATION, AND SERVICE MISSION, TGH WOULD HAVE TO CONDUCT THESE ACTIVITIES ITSELF. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1677495 144675 1822170 1338921 338574 1677495 1521211 15622 197952 1338881 1241725 279486 1521211 1133621 108360 256 1241725 1.00000 0 0 1309 1278 31 31 FUNDS HELD FOR THE BENEFIT OF OTHERS 1581715 1581715 X 29100470 1834988 2941430 4776418 24324052 20141 20141 24344193 17795684 2941430 2967666 5909096 11886588 20141 20141 11906729 PART V, LINE 4: ENDOWMENT FUNDS SUPPORT THE MISSION OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL, INCLUDING RESEARCH, EDUCATION, AND HEALTHCARE DELIVERY. PART X, LINE 2: THE FOUNDATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. INCOME EARNED IN FURTHERANCE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THE FOUNDATION IS NOT AWARE OF ANY TAX POSITIONS IT HAS TAKEN THAT ARE SUBJECT TO A SIGNIFICANT DEGREE OF UNCERTAINTY. TAX YEARS AFTER JUNE 30, 2020 REMAIN SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. PART XII, LINE 2D - OTHER ADJUSTMENTS: ALLOWANCE OF UNCOLLECTIBLE PLEDGES 2,967,666. GOLF 717742 662392 55350 GALA 245550 114841 130709 1 46829 46829 1010121 824062 186059 186059 1 FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 1952065 0 CANCER INSTITUTE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 1721126 0 EVERY ONE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 1052700 0 NEONATAL INTENSIVE CARE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 1011694 0 BURN ICU RENOVATIONS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 840093 0 FUND FOR THE FUTURE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 504774 0 RESPIRATORY THERAPY AND EDUC FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 500150 0 TAMPAWELL FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 184993 0 TONY SALGADO PATHOLOGY TRUST FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 181119 0 PETSMART FACILITY DOG FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 358675 0 EVENT SUPPORT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 175000 0 DEBARTOLO FAMILY ORTHO CENTER FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 155000 0 CARDIOVASCULAR SUPPORT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 134775 0 INTERVENTIONAL CENTER OF EXEL FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 119107 0 HOME BASE SUPPORT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 112089 0 CLINICAL RESEARCH VACCINE TRIAL FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 93907 0 GENESIS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 93241 0 AEROMED SUPPLIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 90000 0 EMPLOYEE WELLNESS CENTER FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 85247 0 NEONATAL EXPOSURE PROGRAM FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 82512 0 COMPLEX SPINE SURGERY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 81340 0 WOMEN'S LEADERSHIP FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 72809 0 DEBARTOLO GLOBAL EMERGING DISEASE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 49765 0 CYSTIC FIBROSIS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 36644 0 TGH CHILDREN'S HOSP ENDOWMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 24377 0 PHARMACY EDUCATION FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 24294 0 OTHER EVENTS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 24230 0 CHILD LIFE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 18815 0 TRAUMA EDUCATION DEVELOPMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 18613 0 WOMEN & CHILDREN SERVICE LINE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 18143 0 BURN CAMP HOPETAKE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 13025 0 OPERATION SANTA CAMPAIGN FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 12169 0 NICU FAMILY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 11733 0 PEDIATRIC TRAUMA SURGERY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 11301 0 HELP A HEART FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 11170 0 BURN CENTER EDUC AND RESEARCH FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 10478 0 HOOKED ON HOPE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9848 0 INTEGRATIVE MEDICINE PROGRAM FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9035 0 COVID SWABS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 8742 0 TEAM MEMBER RESILIENCY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 8401 0 TRAUMA CENTER FAMILY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 8232 0 PET THERAPY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 7183 0 MICHAEL HAGGARD FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 5300 0 IMAGING FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 5264 0 BURN SURVIVORS CONNECT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 578485 0 AGENCY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 205000 0 NETWORK EXPANSION FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 62900 0 VARIOUS ASSISTANCES 1 EMPLOYEE SCHOLARSHIP FUND 7 9501 PATIENT HARDSHIP 2 64188 TRANSPLANT ASSISTANCE 44 43769 ONCOLOGY PATIENT ASSISTANCE 51 40417 GEDI TRAVEL EXPENSES 32 40719 NURSING SCHOLARSHIPS 24 113206 NURSE WEEK AWARDS 92 87415 TGH EXEC HEALTH AMBASSADOR 12 69184 EMPLOYEE EMERGENCY ASSISTANCE 140 427151 PART I, LINE 2: THE FOUNDATION EXECUTIVE COMMITTEE ESTABLISHES A RESTRICTED FUND AFTER A CAREFUL REVIEW OF THE FUND'S SPECIFIC PURPOSE AND ANTICIPATED APPROVED EXPENDITURES. EACH RESTRICTED FUND IS ASSIGNED TO A TAMPA GENERAL HOSPITAL (TGH) VICE PRESIDENT WHO THEN DESIGNATES A FUND OFFICER. THE FUND OFFICER MUST BE EMPLOYED BY TGH AS A MEDICAL STAFF MEMBER, VICE PRESIDENT, DEPARTMENT MANAGER OR DIRECTOR. THE FUND OFFICER AND VICE PRESIDENT ARE DIRECTLY AND SOLELY RESPONSIBLE FOR MEETING THE REQUIREMENTS OF THE FUND PURPOSE. DISBURSEMENTS FROM THE FUND MAY ONLY BE MADE WHEN A PROPERLY COMPLETED CHECK REQUEST FORM WITH SUPPORTING DOCUMENTATION HAS BEEN SUBMITTED BY THE FUND OFFICER, APPROVED BY THE ASSIGNED VICE PRESIDENT AND REVIEWED BY THE FOUNDATION EXECUTIVE DIRECTOR TO ENSURE THAT THE REQUEST MEETS THE ORIGINALLY ESTABLISHED FUND CRITERIA. ALL LEVELS OF APPROVAL MUST BE OBTAINED BEFORE A CHECK IS PRODUCED. THE EXECUTIVE DIRECTOR AND BOARD TREASURER OR ASSISTANT TREASURER PERFORM A FINAL REVIEW OF THE DOCUMENTATION PRIOR TO SIGNING PRINTED CHECKS. 0 0 0 0 0 0 0 0 0 JOHN COURIS EX OFFICIO 0 1231255 0 881975 0 0 0 15250 0 26246 0 2154726 0 0 FRANN LEPPLA SVP/ CHIEF PHILANTHROPY OFF 0 314765 0 149934 0 0 0 13205 0 24701 0 502605 0 0 PART I, LINE 3 TAMPA GENERAL HOSPITAL (TGH) PAYS THE COMPENSATION FOR THE CEO, OFFICERS, EXECUTIVE GROUP AND KEY EMPLOYEES. TGH UTILIZES COMPENSATION COMMITTEES, INDEPENDENT COMPENSATION CONSULTANTS, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THESE INDIVIDUALS. X 1 5000 RETAIL PRICING X 11 276185 MARKET PRICING X 3 955 RETAIL PRICING X MEALS/TICKETS TO EVENTS 22 21519 RETAIL PRICING X GIFT CARDS/PRIZES 17 9719 RETAIL PRICING X TOYS/GAMES 4 3001 RETAIL PRICING X OFFICE SUPPLIES 1 2000 RETAIL PRICING X SERVICES 1 220 RETAIL PRICING 0 1 0 FORM 990, PART VI, SECTION A, LINE 7A TWO TRUSTEES ARE APPOINTED FROM TAMPA GENERAL HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE FINANCE COMMITTEE. ONCE SATISFIED WITH THE RETURN, IT WAS PRESENTED TO THE BOARD OF TRUSTEES AT A BOARD MEETING FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C EACH FOUNDATION TRUSTEE, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS IS REQUIRED TO SIGN AN "ANNUAL DISCLOSURE STATEMENT (CONFLICT OF INTEREST AND IRS MATTERS)." ON THE FORM THE PERSON AFFIRMS THAT HE/SHE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE FOUNDATION IS A CHARITABLE, TAX EXEMPT ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. ADDITIONALLY, HE/SHE DISCLOSES ALL KNOWN POTENTIAL OR ACTUAL CONFLICTS. UPON COMPLETION, THE ANNUAL DISCLOSURE STATEMENT IS PROVIDED TO THE FOUNDATION'S EXECUTIVE DIRECTOR, WITH A COPY TO LEGAL COUNSEL. TO ENSURE THAT THE FOUNDATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED AT LEAST ANNUALLY AND ON A CHANGE OF CIRCUMSTANCE. THE MINUTES OR OTHER RECORDS OF THE BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS CONTAIN THE NAMES OF ANY PERSONS WHO ABSTAIN FROM VOTING DUE TO A REAL OR POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 TAMPA GENERAL HOSPITAL FOUNDATION, INC. HAS ADOPTED THE FOLLOWING PROCEDURES FROM FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL ("TGH") AND DEPENDS ON TGH TO PROVIDE THE ANALYSIS DESCRIBED. WITHIN THE FRAMEWORK OF APPLICABLE LAW, TAMPA GENERAL HOSPITAL HAS ESTABLISHED AND MAINTAINED COMPENSATION GOALS, POLICIES, AND PROGRAMS THAT ENABLE THE HOSPITAL TO RECRUIT, DEVELOP, AND RETAIN THE MOST QUALIFIED AND TALENTED STAFF. TAMPA GENERAL HOSPITAL STRATEGICALLY INVESTS IN THE PEOPLE WHO SUPPORT THE HOSPITAL'S MISSION. COMPENSATION GOALS, POLICIES, AND PROGRAMS ARE GUIDED BY AND REFLECT OUR VALUES AND PRINCIPLES, WHICH ARE CONSISTENT WITH THE HIGH QUALITY OF THE HOSPITAL'S ACHIEVEMENT IN THE FURTHERANCE OF MEDICAL SCIENCE. DIFFERENCES IN PAY WILL NOT BE BASED UPON SUCH FACTORS AS RACE, RELIGION, GENDER, NATIONAL ORIGIN, ANCESTRY, AGE, MARITAL STATUS, OR DISABILITY. TO ENSURE THAT TGH IS PAYING REASONABLE COMPENSATION AND NOT VIOLATING THE PRIVATE INUREMENT PROHIBITION, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS AND SETS THE COMPENSATION OF OFFICERS, THE EXECUTIVE GROUP, AND KEY EMPLOYEES. THE COMMITTEE UTILIZES THE OUTSIDE CONSULTING FIRM OF MERCER TO PROVIDE EXPERT INFORMATION REGARDING INDUSTRY-WIDE COMPENSATION NORMS. IN ADDITION, THE HOSPITAL UTILIZES AN OUTSIDE CONSULTING FIRM TO REVIEW THE COMPENSATION ARRANGEMENTS OF EMPLOYED PHYSICIANS FOR COMPLIANCE WITH ALL APPLICABLE LAWS. FORM 990, PART VI, SECTION C, LINE 19 TAMPA GENERAL HOSPITAL FOUNDATION, INC. WILL MAKE THE FOLLOWING DOCUMENTS AVAILABLE TO THE PUBLIC: (1) ARTICLES OF INCORPORATION AND AMENDMENTS THERETO; (2) BYLAWS; (3) CONFLICT OF INTEREST POLICY; (4) AUDITED FINANCIAL STATEMENTS; AND (5) IRS FORM 990. THE FOREGOING DOCUMENTS WILL BE AVAILABLE TO THE PUBLIC UPON REQUEST AND AFTER PAYMENT OF REASONABLE COPYING FEES. FORM 990, PART XI, LINE 9: ALLOWANCE FOR UNCOLLECTIBLE PLEDGES -2,967,666. FORM 990, PART XII, LINE 2C THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FL HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL 1 TAMPA GENERAL CIRCLE TAMPA FL 33606 593458145 1,007 BED PRIVATE, NOT-FOR-PROFIT HOSPITAL FL 501(C)(3) 3 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0