2022-08-15T11:54:59-05:00 2021-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-10-01 592440537 FLAGLER HEALTH CARE FOUNDATION INC FLAG 9048254400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 BRENDA BAKER CFO 9048194069 2022-08-12 1 BRENDA BAKER 999009999 AMY CIMINELLO P00796388 6148493000 2022-08-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BRENDA BAKER 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 2918875 0 X WWW.FLAGLERHOSPITAL.ORG/OUR-FOUNDATION X 1984 FL THE FOUNDATION OPERATES AS A SUPPORTING ORGANIZATION FOR FLAGLER HOSPITAL. 11 11 0 13 0 0 1870414 915166 88242 90081 2527442 1913628 -27646 0 4458452 2918875 796578 1059964 0 0 0 0 0 0 51822 788848 539069 1585426 1599033 2873026 1319842 48346259 56503561 439520 285209 47906739 56218352 FLAGLER HEALTH CARE FOUNDATION, INC. OPERATES AS A SUPPORTING ORGANIZATION FOR FLAGLER HOSPITAL AND MANAGES INVESTMENTS AND HOLDS LAND FOR THE BENEFIT OF THE HOSPITAL. 0 0 1059964 1059964 0 THE FOUNDATION PROVIDED $1,059,964 OF FINANCIAL ASSISTANCE TO FLAGLER HOSPITAL, EDUCATION FOR EMPLOYEES, AND ASSISTANCE FOR HOSPITAL EMPLOYEE EMERGENCIES. 0 0 90081 LAND LEASE TO FLAGLER HOPSITAL. 1059964 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MIKE O'DONNELL 9048194756 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 DR GREGORY OXFORD CHAIRMAN 1.00 0.00 X X 0 0 0 RAY MATUZA BOARD MEMBER 1.00 1.00 X 0 0 0 MARK BAILEY BOARD MEMBER 1.00 0.00 X 0 0 0 JANE BOLES BOARD MEMBER 1.00 0.00 X 0 0 0 SUZANNE BROWN BOARD MEMBER 1.00 0.00 X 0 0 0 ANDREW DIFEO BOARD MEMBER 1.00 0.00 X 0 0 0 MICHELLE GROBMAN BOARD MEMBER 1.00 0.00 X 0 0 0 MELISSA KAUTTU BOARD MEMBER 1.00 0.00 X 0 0 0 MARY LOCKE BOARD MEMBER 1.00 0.00 X 0 0 0 BRADLEY COOPER BOARD MEMBER 1.00 0.00 X 0 0 0 CLINT PYLE BOARD MEMBER 1.00 0.00 X 0 0 0 JASON BARRETT CEO (TO MARCH 2022) 1.00 41.00 X 0 571702 0 CARLTON DEVOOGHT CEO (FROM MARCH 2022) 1.00 41.00 X 0 390240 0 BRENDA BAKER CFO 1.00 41.00 X 0 0 0 GINA MANGUS EXECUTIVE DIRECTOR 20.00 20.00 X 0 214311 0 0 1176253 0 0 0 1 0 0 915166 915166 RENTS TO AFFILIATES 531390 90081 90081 90081 1392966 1392966 520662 0 520662 520662 520662 2918875 90081 0 1913628 1050032 1050032 9932 9932 134489 134489 72983 72983 3097 3097 4495 369 4126 27315 27315 41176 5170 36006 LEASED EMPLOYEES 243525 243525 SPECIAL EVENTS 8593 8593 DUES & SUBSCRIPTIONS 2188 2188 BANK FEES 1208 1208 1599033 1059964 487247 51822 514454 1004500 1841634 1883717 74166 9387 335233 0 335233 335233 45580772 53270724 48346259 56503561 311538 165385 86458 80423 41524 39401 439520 285209 X 40764484 48981851 7142255 7236501 47906739 56218352 48346259 56503561 1319842 6991771 0 X X 0 1 X 1 0 X X 1 FLAGLER HOSPITAL INC 590675143 3 1 1050032 0 1 1050032 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4064225 50 4064275 4064200 25 4064225 4655297 4573 595670 4064200 4391344 271053 7100 4655297 4009627 381717 4391344 0.00000 1.00000 0.00000 0 0 220739 220739 114494 114494 335233 DUE TO AFFILIATES 39401 39401 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF FOUR INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENTS ARE ALL DONOR-RESTRICTED AND INTERNALLY CONTROLLED. FLAGLER HEALTH CARE FOUNDATION HOLDS THESE ENDOWMENTS FOR THE BENEFIT OF FLAGLER HOSPITAL, INC., A RELATED ORGANIZATION. INVESTMENTS CONTAIN AMOUNTS TO BE HELD IN PERPETUITY, THE DIVIDEND AND INTEREST INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTHCARE SERVICES, AND THE REMAINING INVESTMENT INCOME, GAINS, AND LOSSES ARE TO ADJUST THE CORPUS. 1 FLAGLER HOSPITAL INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 590675143 501(C)(3) 1050032 OPERATIONAL SUPPORT 1 0 EDUCATION ASSISTANCE 15 6872 EMPLOYEE EMERGENCY ASSISTANCE 7 3060 PART I, LINE 2: THE ORGANIZATION SUPPORTS FLAGLER HOSPITAL, INC. IN ITS EXEMPT PURPOSE. GRANTS TO ORGANIZATIONS ARE MADE PREDOMINANTLY TO FLAGLER HOSPITAL, THE FOUNDATION'S SUPPORTED ORGANIZATION. THE FOUNDATION RECEIVES APPLICATIONS FOR VARIOUS GRANTS GIVEN ANNUALLY. THESE APPLICATIONS ARE REVIEWED AND APPROVED BY AN OBJECTIVE COMMITTEE BASED ON NEED PARAMETERS. 0 1 0 0 0 0 0 0 0 JASON BARRETT CEO (TO MARCH 2022) 0 557143 0 0 0 14559 0 0 0 0 0 571702 0 0 CARLTON DEVOOGHT CEO (FROM MARCH 2022) 0 385240 0 5000 0 0 0 0 0 0 0 390240 0 0 GINA MANGUS EXECUTIVE DIRECTOR 0 204715 0 5000 0 4596 0 0 0 0 0 214311 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 JASON BARRETT PARTICIPATES IN A SECTION 457(F) PLAN THAT IS OFFERED THROUGH A RELATED ORGANIZATION. THE AMOUNT ACCRUED FOR THE PLAN WAS $35,000 DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 2 MARY LOCKE, BOARD MEMBER, HAS A FAMILY RELATIONSHIP WITH JASON BARRETT, HOSPITAL CEO. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS FLAGLER HOSPITAL, INC., A FLORIDA NOT-FOR-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER APPOINTS MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER RESERVES THE RIGHT TO AMEND THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS, AS WELL AS OTHER CORPORATE ACTIONS SET FORTH IN THE FOUNDATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT AND REVIEWED AND APPROVED BY INTERNAL MANAGEMENT AND SHARED WITH ALL MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL TRUSTEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS THAT DEVELOP AFTER SUBMISSION MUST BE DISCLOSED IN WRITING TO BOARD OF TRUSTEES. EXISTING CONFLICTS OF INTEREST MAY REQUIRE ABSTAINING FROM DISCUSSING OR VOTING UPON MATTERS RELATED TO OR AFFECTED BY THE CONFLICT, OR RECUSING ONESELF FROM PARTICIPATING IN RELATED MATTERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FLAGLER HOSPITAL INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 590675143 HEALTH CARE SERVICES FL 501(C)(3) LINE 3 N/A 0 FLAGLER HOME CARE LLC 301 HEALTH PARK BLVD STE 327 ST AUGUSTINE FL 32086 821562462 SUPPORTING ORGANIZATION FL 501(C)(3) LINE 10 FLAGLER HEALTH NETWORK LLC 1 CF MANAGEMENT ADMINISTRATIVE COMPANY LLC 30 TURIN TERRACE ST AUGUSTINE FL 32092 843559295 HEALTHCARE FL N/A 0 1 FLAGLER HEALTH SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 592484352 REAL ESTATE LEASING 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 ANDERSON GIBBS CONDOMINIUM ASSOCIATION 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 593223458 PROPERTY MANAGEMENT FL N/A C 1 FLAGLER PROFESSIONAL HEALTH CARE SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 364860252 HEALTHCARE FL N/A C 1 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0