2022-08-15T11:51:02-05:00 2021-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-10-01 821562462 FLAGLER HOME CARE LLC FLAG 9048242501 301 HEALTH PARK BLVD NO 327 ST AUGUSTINE FL 32086 BRENDA BAKER CFO 9048194069 2022-08-12 1 BRENDA BAKER 999009999 AMY CIMINELLO P00796388 6148493000 2022-08-10 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z FLAGLER HOME HEALTH BRENDA BAKER 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 839299 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. 5 1 0 1 0 0 0 0 1763195 839299 0 0 0 0 1763195 839299 0 0 0 0 0 0 0 0 0 1646242 1723938 1646242 1723938 116953 -884639 2232456 1516960 1600523 1769666 631933 -252706 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 1564977 839299 FLAGLER HOME CARE PROVIDES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, SKILLED NURSING, HOME AIDE AND MEDICAL SOCIAL SERVICES TO THE PUBLIC. 1564977 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 1 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X MIKE O'DONNELL 9048195259 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 JASON BARRETT MANAGER/BOARD/PRESIDENT- F 1.00 51.00 X X 0 571702 93601 MIGUEL MACHADO MD MANAGER/BOARD 0.06 50.00 X 0 459453 25539 CARLTON A DEVOOGHT MANAGER/BOARD 0.06 50.00 X 0 390240 57721 MURRAY S MARSH MANAGER/BOARD/CFO-FLAGLER (TO NOV 2020) 1.00 51.00 X X 0 335995 77933 GINA MANGUS MANAGER/BOARD 0.06 50.00 X 0 214311 54279 DR LARRY LAKE MANAGER/BOARD 0.06 0.00 X 0 0 0 BRENDA BAKER MANAGER/BOARD/CFO 0.06 51.00 X X 0 0 0 0 1971701 309073 0 0 1 0 AEGIS THERAPIES PO BOX 936652 ATLANTA GA 31193 THERAPY SERVICES 352957 1 HOME HEALTH SERVICES 621610 839299 839299 839299 839299 839299 0 0 101340 5500 95840 460 460 26937 19280 7657 25112 25112 28991 28991 72781 72781 11535 11535 LEASED EMPLOYEES 1441612 1415144 26468 DUES & SUBSCRIPTIONS 11746 11746 BANKING FEES 2951 2951 473 473 1723938 1564977 158961 0 240529 197180 1522233 844814 7210 19301 0 4716 141880 46316 107099 95564 355385 355385 2232456 1516960 74153 73372 229337 29642 1297033 1666652 1600523 1769666 X 631933 -252706 631933 -252706 2232456 1516960 -884639 0 X X 0 1 X 1 1 0 X 1121268 1303838 1763195 839299 5027600 1121268 1303838 1763195 839299 5027600 0 2904 2904 2904 2904 5024696 1121268 1303838 1763195 839299 5027600 X 83666 21982 61684 58214 24334 33880 95564 DUE TO FLAGLER HOSPITAL, INC. 1666652 1666652 0 1 0 0 0 0 0 0 0 JASON BARRETT MANAGER/BOARD/PRESIDENT- F 0 557143 0 0 0 14559 0 92300 0 1301 0 665303 0 0 MIGUEL MACHADO MD MANAGER/BOARD 0 454453 0 5000 0 0 0 18300 0 7239 0 484992 0 0 CARLTON A DEVOOGHT MANAGER/BOARD 0 385240 0 5000 0 0 0 37800 0 19921 0 447961 0 0 MURRAY S MARSH MANAGER/BOARD/CFO-FLAGLER (TO NOV 20 0 323036 0 5000 0 7959 0 62050 0 15883 0 413928 0 0 GINA MANGUS MANAGER/BOARD 0 204715 0 5000 0 4596 0 31443 0 22836 0 268590 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 $35,000 TO A 457(F) PLAN FOR JASON BARRETT. CARLTON DEVOOGHT PARTICIPATES IN A 457(F) PLAN THAT IS OFFERED THROUGH A RELATED ORGANIZATION. THE AMOUNT ACCRUED FOR THE PLAN WAS $22,500 DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 FLAGLER HOME CARE LLC HAS TWO MEMBERS: FLAGLER HEALTH NETWORK, LLC AND ST. JOHN'S COUNTY WELFARE FEDERATION, D/B/A BAYVIEW HOME HEALTH OF ST. AUGUSTINE. 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 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 9/30/21, 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 1 1 0 0