2023-08-10T15:06:06-05:00 2022-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2021-10-01 821562462 FLAGLER HOME CARE LLC FLAG 9048242501 301 HEALTH PARK BLVD 327 ST AUGUSTINE FL 32086 TOM BAILEY INTERIM CFO 9048194069 2023-08-09 1 TOM BAILEY 999009999 AMY CIMINELLO P00796388 6148493000 2023-08-09 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z FLAGLER HOME HEALTH TOM BAILEY 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 1630364 0 X WWW.FLAGLERHOSPITAL.ORG/MEDICAL-SERVICES/HOME-CAR X 2017 FL TO RESPECTFULLY AND COMPASSIONATELY MEET THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES BY LISTENING, PLANNING, EDUCATING, AND DELIVERING THE HIGHEST QUALITY OF INDIVIDUALIZED HOME HEALTH CARE. 7 0 0 0 0 0 0 0 839299 1630364 0 0 0 0 839299 1630364 0 0 0 0 0 0 0 0 0 1723938 1963181 1723938 1963181 -884639 -332817 1516960 2088064 1769666 47116 -252706 2040948 TO RESPECTFULLY AND COMPASSIONATELY MEET THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES BY LISTENING, PLANNING, EDUCATING, AND DELIVERING THE HIGHEST QUALITY OF INDIVIDUALIZED HOME HEALTH CARE. 0 0 1789532 0 1630364 FLAGLER HOME CARE PROVIDES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, SKILLED NURSING, HOME AIDE AND MEDICAL SOCIAL SERVICES TO THE PUBLIC. 1789532 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X DEBORAH COSTABILE 9048194756 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 X CARLTON DEVOOGHT PRESIDENT/CEO 1.00 41.00 X X 0 491592 25957 DONNA WAGNER VP CNO 1.00 41.00 X X 0 217093 1224 TOM BAILEY INTERIM CFO/ ADMINISTRATOR 0.06 40.00 X X 0 0 0 DAVID RICE MD EVP/CHIEF PHYSICIAN EXECUTIVE 0.06 40.00 X 0 597634 35023 JILL BERRY VP, CHIEF LEGAL OFFICER 0.06 40.00 X X 0 163902 18681 JASON P BARRETT PRESIDENT/CEO (PART YEAR) 0.06 40.00 X X 0 798855 42957 MIGUEL A MACHADO CMO 0.06 40.00 X X 0 558904 2403 BRENDA BAKER CFO (PART YEAR) 40.00 0.00 X 0 248536 13000 SUZANNE EDWARDS ADMINISTRATOR 40.00 0.00 X 103463 0 0 DIANA TWOMBLY RN 40.00 0.00 X 109733 0 0 213196 3076516 139245 2 0 1 0 0 HOME HEALTH SERVICES 621610 1630364 1630364 1630364 1630364 1630364 0 0 124499 10908 113591 774 774 52474 46379 6095 12188 12188 30374 30374 94066 94066 11482 11482 LEASED EMPLOYEES 1625791 1585994 39797 DUES & SUBSCRIPTIONS 10329 10329 BANKING FEES 1204 1204 1963181 1789532 173649 0 197180 386324 844814 1249393 19301 12880 4716 0 141880 57798 95564 84082 355385 355385 1516960 2088064 73372 22164 29642 24952 1666652 0 1769666 47116 X -252706 2040948 -252706 2040948 1516960 2088064 X -332817 2626471 X X 0 1 X 1 1 0 X 1121268 1303838 1763195 839299 1630364 6657964 1121268 1303838 1763195 839299 1630364 6657964 0 2904 2904 2904 2904 6655060 1121268 1303838 1763195 839299 1630364 6657964 0.99960 0.00000 X 83666 27483 56183 58214 30315 27899 84082 0 1 0 0 0 0 0 0 0 JASON P BARRETT PRESIDENT/CEO (PART YEAR) 0 586206 0 171900 0 40749 0 0 0 42957 0 841812 0 0 DAVID RICE MD EVP/CHIEF PHYSICIAN EXECUTIVE 0 451880 0 145754 0 0 0 0 0 35023 0 632657 0 0 MIGUEL A MACHADO CMO 0 467904 0 91000 0 0 0 0 0 2403 0 561307 0 0 CARLTON DEVOOGHT PRESIDENT/CEO 0 392215 0 99377 0 0 0 0 0 25957 0 517549 0 0 BRENDA BAKER CFO (PART YEAR) 0 182284 0 65977 0 275 0 0 0 13000 0 261536 0 0 DONNA WAGNER VP CNO 0 188350 0 28383 0 360 0 0 0 1224 0 218317 0 0 JILL BERRY VP, CHIEF LEGAL OFFICER 0 163402 0 500 0 0 0 0 0 18681 0 182583 0 0 PART I, LINE 3 A RELATED ORGANIZATION, FLAGLER HOSPITAL, CONDUCTS THE COMPENSATION REVIEW. THE REVIEW INCLUDES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEYS, AND APPROVAL BY THE COMPENSATION COMMITTEE. PART I, LINE 4B A RELATED ORGANIZATION CONTRIBUTED $151,000 TO A 457(F) PLAN FOR DAVID RICE, CARLTON DEVOOGHT AND MIGUEL MACHADO. FORM 990, PART VI, SECTION A, LINE 6 FLAGLER HOME CARE LLC HAS TWO MEMBERS: FLAGLER HOME CARE LLC HAS TWO MEMBERS: FLAGLER HEALTH NETWORK, LLC AND ST. JOHN'S COUNTY WELFARE FEDERATION. FLAGLER HEALTH NETWORK IS A DISREGARDED ENTITY OF FLAGLER HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A FLAGLER HEALTH NETWORK HAS THE POWER TO APPOINT FOUR OF THE FIVE MANAGERS OF FLAGLER HOME CARE. THE PRESIDENT OF FLAGLER HOSPITAL HAS THE POWER TO APPOINT ALL OF THE MANAGERS OF FLAGLER HEALTH NETWORK. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATIONS MEMBERS HAVE THE POWER TO REMOVE MANAGERS WITH OR WITHOUT CAUSE BY A VOTE OF SEVENTY-FIVE PERCENT OF THE ISSUED AND OUTSTANDING VOTING INTERESTS. ANY AMENDMENTS TO THE GOVERNING DOCUMENTS ALSO REQUIRES APPROVAL FROM THE MEMBERS BY A VOTE OF SEVENTY-FIVE PERCENT OF THE ISSUED AND OUTSTANDING VOTING INTERESTS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTANT AND REVIEWED AND APPROVED BY INTERNAL MANAGEMENT AND SHARED WITH EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL MEMBERS OF THE BOARD OF MANAGERS, ALL OFFICERS, AND ANY OTHER KEY MEMBERS ON STAFF. ON AN ANNUAL BASIS, ALL INDIVIDUALS SUBJECT TO THE CONFLICT OF INTEREST POLICY SHALL SIGN A STATEMENT ACKNOWLEDGING UNDERSTANDING OF THIS POLICY, AND SHALL COMPLETE AND RETURN A DISCLOSURE FORM TO THE BOARD OF MANAGERS, UPON ELECTION, APPOINTMENT, OR ENTERING THE DUTIES OF HIS OR HER OFFICE. THE BOARD WILL REVIEW ALL POTENTIAL CONFLICTS AND MAKE A DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT EXISTS. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST, WHETHER FINANCIAL OR PERSONAL, SHALL ABSTAIN FROM DISCUSSING OR VOTING ON MATTERS THAT MAY BE RELATED TO OR AFFECTED BY SUCH CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. FORM 990, PART VII SUZANNE EDWARDS AND DIANA TWOMBLY'S COMPENSATION IS PAID BY A RELATED ORGANIZATION AS A CENTRAL PAYMASTER, HOWEVER, 100% OF THEIR RESPONSIBILITIES ARE FOR FLAGLER HOME CARE, LLC. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE 2,626,471. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 3B THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT BEEN COMPLETED YET FOR THE YEAR-END 9/30/22, BUT PLANS TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN THE RELEVANT OMB GUIDANCE. FLAGLER HOSPITAL INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 590675143 HOSPITAL FL 501(C)(3) LINE 3 N/A 0 FLAGLER HEALTH CARE FOUNDATION INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 592440537 SUPPORTING ORGANIZATION FL 501(C)(3) LINE 12A, I FLAGLER HOSPITAL 1 CF MANAGEMENT ADMINISTRATIVE COMPANY LLC 30 TURIN TERRACE ST AUGUSTINE FL 32092 843559295 HEALTHCARE FL N/A 0 1 FLAGLER PROFESSIONAL HEALTH CARE SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 364860252 HEALTHCARE FL N/A C 1 FLAGLER HEALTH SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 592484352 REAL ESTATE LEASING FL N/A C 1 ANDERSON GIBBS CONDOMINIUM 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 593223458 PROPERTY MANAGEMENT FL N/A C 1 HEALTH PARK OWNERS ASSOCIATION 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 592869538 PROPERTY MANAGEMENT FL N/A C 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0