2021-08-13T14:16:46-05:00 2020-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2019-10-01 590675143 FLAGLER HOSPITAL INC FLAG 9048254400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 BRENDA BAKER CFO 9048194069 2021-08-13 1 AMY CIMINELLO P00796388 6148493000 2021-08-13 2019 2022-09-23 18:48:47Z BRENDA BAKER 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 309841695 0 X WWW.FLAGLERHOSPITAL.ORG X 1906 FL PROVIDE EXCELLENT HEALTHCARE SERVICES AND BE RECOGNIZED AS A LEADING PROVIDER IN NORTHEAST FL. 15 14 2159 203 87251 19143 203237 19743314 276063850 292017958 5590379 5707158 8296590 -7872274 290154056 309596156 215890 670520 0 0 103245582 114387238 0 0 272742 171660533 191256815 275122005 306314573 15032051 3281583 377017933 544176873 180910033 340483793 196107900 203693080 PROVIDE THE BEST PATIENT EXPERIENCE WITH THE BEST STAFF. 0 0 226532935 670520 292020933 SINCE ITS FOUNDING IN 1889, OUR PRIVATE, NOT-FOR-PROFIT FACILITY HAS GROWN INTO A DIVERSE CLINICAL ENTERPRISE THAT IS CONSISTENTLY RECOGNIZED NATIONALLY FOR CLINICAL EXCELLENCE BY HEALTHGRADES, TRUVEN, AND OTHER COMPARATIVE QUALITY DATA ORGANIZATIONS. HOSPITAL SERVICES ARE PROVIDED TO INPATIENTS AND OUTPATIENTS, INCLUDING CHARITY CARE TO THE INDIGENT AND OTHER PATIENTS. PLEASE SEE SCHEDULE H FOR DETAILS ON COMMUNITY BENEFITS. 226532935 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 436 0 1 2159 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JASON BARRETT 9048194400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 JASON P BARRETT PRESIDENT/CEO 40.00 2.00 X 733976 0 89950 MIGUEL A MACHADO CMO 40.00 0.00 X 486168 0 24244 CARLTON DEVOOGHT SEVP/CAO 40.00 2.00 X 448457 0 53028 MURRAY S MARSH JR SEVP/CAO (TO NOV 2020) 40.00 2.00 X 393750 0 74798 TODD BATENHORST EVP 40.00 2.00 X 377670 0 61184 MICHAEL C SANDERS CHIEF MEDICAL INFORMATICS 40.00 0.00 X 368455 0 17950 JOSEPH GORDY FORMER CEO 20.00 0.00 X 354763 0 9202 JEFFREY A HURLEY CHRO 40.00 0.00 X 277311 0 73640 NANGELA PULSFUS EVP/COO 40.00 0.00 X 256891 0 53544 DONALD R CRIST VP OF OPERATIONS 40.00 0.00 X 262240 0 42636 WILLIAM RIEGER CIO 40.00 0.00 X 246970 0 32194 MARY K MANTESE FORMER CHIEF NURSING OFFIC 0.00 0.00 X 231149 0 5770 MICHAEL HALL ADMINISTRATOR 40.00 0.00 X 198928 0 25801 LAWRENCE SMITH ADMINISTRATOR 40.00 0.00 X 172023 0 44873 DONNA WAGNER ADMINISTRATOR 40.00 0.00 X 172506 0 7742 MICHELLE ANDRADE ADMINISTRATOR 40.00 0.00 X 161458 0 13884 ANGELA CHRISTENSEN ADMINISTRATOR 40.00 0.00 X 161179 0 13266 WILLIAM KOPF CHAIRMAN 1.00 0.00 X X 0 0 0 TODD NEVILLE VICE-CHAIRMAN 1.00 0.00 X X 0 0 0 MATT BAKER DIRECTOR 1.00 0.00 X 0 0 0 STUART SOROKA MD SECRETARY 1.00 0.00 X X 0 0 0 RAY MATUZA DIRECTOR 1.00 0.00 X 0 0 0 SUSAN PONDER-STANSEL DIRECTOR 1.00 0.00 X 0 0 0 BRAD RUNK DIRECTOR 1.00 0.00 X 0 0 0 KAREN TAYLOR DIRECTOR 1.00 0.00 X 0 0 0 LEN TUCKER DIRECTOR 1.00 0.00 X 0 0 0 LEN WEEKS DIRECTOR 1.00 0.00 X 0 0 0 CHRIS KAMIENSKI DIRECTOR 1.00 0.00 X 0 0 0 ASHFAQ KUDIA DIRECTOR 1.00 0.00 X 0 0 0 FRED FRANKLIN DIRECTOR 1.00 0.00 X 0 0 0 FERRIS GEORGE DIRECTOR 1.00 0.00 X 0 0 0 BILL ABARE TREASURER 1.00 0.00 X X 0 0 0 5303894 0 643706 71 1 1 0 FIRST CITY HOSPITALIST GROUP 400 HEALTH PARK BLVD SAINT AUGUSTINE FL 32086 MEDICAL 2605975 FIRST COAST HEART & VAS 3901 UNIVERSITY BLVD JACKSONVILLE FL 32216 MEDICAL 2177601 CANCER SPECIALISTS OF NORTH FLORIDA 7015 AC SKINNER PARKWAY JACKSONVILLE FL 32256 MEDICAL 2156234 J GREG DENT MD & ASSOCIATES 400 HEALTH PARK BLVD SAINT AUGUSTINE FL 32086 MEDICAL 1194013 CARDIOTHORACIC & VASCULAR SURGICAL ASSOC 1824 KING STREET JACKSONVILLE FL 32204 MEDICAL 961865 67 762133 18981181 19743314 NET PATIENT SERVICE REVENUE 623000 285696578 285696578 ANCILLARY SERVICES 623000 3563869 3563869 OSC REVENUE 623000 2757511 2757511 292017958 3231200 3231200 3126316 206005 2920311 2920311 2920311 2406087 69871 0 0 2406087 69871 2475958 2475958 89247 39534 49713 49713 PATIENT RECORD TRANSCRIPTION 900099 173734 173734 QUEST LAB TESTS 541380 84276 84276 SEMA LAB TESTS 541380 2975 2975 -11103283 -11103283 -10842298 309596156 292017958 87251 -2252367 X 670520 670520 3069834 3069834 88150342 76576991 11573351 2469721 2469721 13711481 426952 13284529 6985860 6068679 917181 824316 824316 100200 100200 441069 441069 54289377 31124270 23165107 1162504 416604 745900 1619119 174289 1444830 6244539 6244539 3569229 2012868 1518936 37425 503326 459261 44065 4998909 3917659 1078954 2296 23646959 18532188 5103911 10860 5723165 4902709 820456 MEDICAL SUPPLIES 40362961 40321466 41495 BAD DEBT EXPENSE 18472242 18472242 OSC EXPENSES 4175906 4134039 41867 UBI TAX 8870 8870 25114124 18313328 6578635 222161 306314573 226532935 79508896 272742 19476367 76525346 1186741 47647636 30988752 31287663 1591431 2994049 8258147 8250382 2726030 3316810 475324630 259566142 170975322 215758488 82144919 88140228 4531474 3827559 5752310 3981867 24439604 24439604 24946836 38007241 377017933 544176873 31777039 48876867 3951082 3813234 123382433 222665098 5619315 13049464 16180164 52079130 180910033 340483793 X 196107900 203693080 196107900 203693080 377017933 544176873 3281583 4303597 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 441069 0 0 441069 0 PART II-B, LINE 1: DURING THE TAX YEAR, THE ORGANIZATION ENGAGED A PROFESSIONAL LOBBYIST TO MONITOR LEGISLATION DIRECTLY AFFECTING NOT-FOR-PROFIT HOSPITALS/RURAL COMMUNITY PROVIDERS. 4064200 25 4064225 4655297 4573 595670 4064200 4391344 271053 7100 4655297 4009626 381717 4391344 3581146 225328 203153 4009626 0.00000 1.00000 0.00000 0 1 1 39402783 39402783 174923609 103611294 71312315 6331399 5316950 1014449 202815670 145191798 57623872 51851169 5446100 46405069 215758488 DUE FROM AFFILIATES 31100300 LONG-TERM RECOVERIES 6906941 38007241 CAPITAL LEASE LIABILITY 15812950 MEDICARE ACCELERATED PAYMENTS 36266180 52079130 295673050 4303597 -18472242 -14168645 309841695 -245539 -245539 309596156 288087870 245539 245539 287842331 18472242 18472242 306314573 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, A RELATED ORGANIZATION, HOLDS THESE ENDOWMENTS FOR BENEFIT OF FLAGLER HOSPITAL, INC. 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -18,472,242. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD -39,534. RENTAL EXPENSES -206,005. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 39,534. RENTAL EXPENSES 206,005. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 18,472,242. 1 1 X 1 X 1 X 1 1 0 1 1 6805505 865889 5939616 0.02060 21794415 16529206 5265209 0.01830 28599920 17395095 11204825 0.03890 14 33090 2740904 683988 2056916 0.00710 14 1975 1009533 1009533 0.00350 9202987 9202987 0.03200 1 209777 209777 0.00070 7 915 319299 319299 0.00110 36 35980 13482500 683988 12798512 0.04440 36 35980 42082420 18079083 24003337 0.08330 2 1259 706476 495176 211300 0.00070 1 22 1933 1933 0.00000 3 1281 708409 495176 213233 0.00070 1 18472242 1276152 90827914 94301466 -3473552 X 1 1 1 1 FLAGLER HOSPITAL INC 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 WWW.FLAGLERHOSPITAL.ORG X X X FLAGLER HOSPITAL 1 0 0 1 X X X X X X X X X 17 1 0 1 1 X SEE PART V X SEE PART V X X 1 17 1 SEE PART V 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X X 1 X 0 0 FLAGLER HOSPITAL PART V, SECTION B, LINE 5: THE YEAR-LONG PROCESS FOR THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN IN JULY 2016 AND UTILIZED A COMMUNITY-WIDE STRATEGIC PLANNING PROCESS CALLED "MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS OR "MAPP", WHICH WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS PLANNED BY THE HEALTH LEADERSHIP COUNCIL AS A COLLECTION OF DATA GATHERED TO IDENTIFY AND ANALYZE HEALTH STATUS, HEALTH FACTORS AND HEALTH OUTCOMES WITHIN THE COMMUNITY. USING MAPP GUIDELINES, FOCUS GROUPS WERE FORMED TO DETERMINE HOW RESIDENTS FELT ABOUT THE QUALITY OF LIFE IN ST. JOHNS COUNTY. THESE FOCUS GROUPS WERE FACILITATED BY LEADERS OF THE HEALTH LEADERSHIP COUNCIL WITH THE INTENT OF COVERING A VARIETY OF GEOGRAPHIC AND DEMOGRAPHIC SECTORS OF THE COUNTY. SECOND, A SURVEY WAS DISPERSED COUNTY-WIDE AND MADE AVAILABLE ONLINE. THIS DATA AND DATA FROM THE NATIONAL AND STATE COUNTY HEALTH RANKINGS AND HEALTHY PEOPLE 2020, SERVED AS A BASIS FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). NOTE: THE COMPLETE "COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN" IS PUBLISHED AND AVAILABLE ON THE FLAGLER HOSPITAL WEBSITE: HTTPS://WWW.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX IN TOTAL, FLAGLER HOSPITAL AND THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL FACILITATED 8 COMMUNITY FOCUS GROUPS WITH A TOTAL OF 50 PARTICIPANTS TO GAIN A BETTER UNDERSTANDING OF PERCEPTIONS OF COMMUNITY STRENGTHS, NEEDS AND HEALTH CONCERNS. A COMMUNITY-WIDE SURVEY WAS USED TO GATHER RESIDENTS' THOUGHTS AND CONCERNS ABOUT THE QUALITY OF LIFE AND HEALTHCARE SERVICES IN ST. JOHNS COUNTY, FL. THIS SURVEY WAS MADE WIDELY AVAILABLE TO RESIDENTS BOTH THROUGH WEB-BASED SURVEYS AND PAPER-BASED SURVEYS AVAILABLE AT 42 LOCATIONS THROUGHOUT ST. JOHNS COUNTY. MARKETING TOOLS TO INCREASE RESIDENT PARTICIPATION CONSISTED OF SOCIAL MEDIA, PRESS-RELEASES, AND COMMUNITY WORD-OF-MOUTH WITH THE HELP OF THE COUNCIL. PAPER SURVEYS WERE COLLECTED AND MANUALLY ENTERED IN THE WEB-BASED DATABASE. A TOTAL OF 2,721 SURVEYS WERE COLLECTED (1,776 PAPER SURVEYS AND 945 WEB-BASED SURVEYS). MORE THAN 1% OF ST. JOHNS COUNTY RESIDENTS RESPONDED TO THIS SURVEY (2,614). THIS REFLECTS AN ACCURACY RATE OF 2% AT A 95% CONFIDENCE LEVEL AND MORE THAN TWICE THE NUMBER OF SURVEYS COLLECTED IN THE PREVIOUS CYCLES (1,189 RESPONSES WERE COLLECTED DURING 2014 CYCLE).A NEW SURVEY AND RESULTING REPORT WERE CREATED IN DECEMBER OF 2020 WHICH WILL BE SHOWN IN TAX YEAR 2021. THE WEBSITE FOR THIS REPORT IS SHOWN HERE FOR REFERENCE: HTTPS://WWW.FLAGLERHEALTH.ORG/COMMUNITY-HEALTH-IMPROVEMENT/COMMUNITY-BENEFIT-PLANNING/ST-JOHNS-COUNTY-HEALTH-NEEDS-ASSESSMENT/ FLAGLER HOSPITAL PART V, SECTION B, LINE 6B: ANASTASIA MOSQUITO CONTROL DISTRICT- SJCAZALEA HEALTHBETTY GRIFFIN CENTERCHILDREN'S HOME SOCIETY OF FLORIDACLINTON HEALTH MATTERS INITIATIVECOMMUNITY HOSPICE AND PALLIATIVE CARECOMMUNITY MANAGEMENT & CONSULTINGEPIC BEHAVIORAL HEALTHCAREFLAGLER HOSPITALFLORIDA ARMY RESERVE NATIONAL GUARDFLORIDA DEPARTMENT OF HEALTH IN ST. JOHNS COUNTYGOOD SAMARITAN HEALTH CENTERS/WILDFLOWER CLINICHEALTH PLANNING COUNCIL OF NORTHEAST FLORIDAST JOHNS RIVER RURAL HEALTH NETWORKNEW MT. MORIAH CHRISTIAN MINISTRYNORTHEAST FLORIDA HEALTHY START COALITIONPACT PREVENTION COALITION OF ST. JOHNS COUNTYST. JOHNS COUNTY HEALTH AND HUMAN SERVICESST. AUGUSTINE BEACH POLICE DEPARTMENTST. AUGUSTINE YOUTH SERVICESST. JOHNS COUNTY ADMINISTRATIONST. JOHNS COUNTY BOARD OF COUNTY COMMISSIONERSST. JOHNS COUNTY COUNCIL ON AGINGST. JOHNS COUNTY EMERGENCY MANAGEMENTSJC HEALTH AND HUMAN SERVICES ADVISORY COUNCILST. JOHNS COUNTY MEDICAL SOCIETYST. JOHNS COUNTY SCHOOL DISTRICTSJC HEAD START PROGRAM/EARLY CHILDHOOD SERVICESST. JOHNS COUNTY SHERIFF'S OFFICEST. JOHNS RIVER STATE COLLEGEST. VINCENT'S MOBILE HEALTH OUTREACH MINISTRYSTEWART MARCHMAN - ACT BEHAVIORAL HEALTHCARETHE SONTAG FOUNDATIONTOBACCO FREE ST. JOHNSYMCA OF FLORIDA'S FIRST COAST FLAGLER HOSPITAL PART V, SECTION B, LINE 7D: FLAGLER HOSPITAL UTILIZED A VARIETY OF APPROACHES TO INFORM THE COMMUNITY ON THE RESULTS OF THE 2017 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. FLAGLER HOSPITAL INVESTED IN PRINTING 300 HARD COPIES OF THE 147-PAGE PUBLICATION. THESE COPIES WERE PROVIDED TO ALL ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL MEMBERS AND DISPLAYED ON-SITE AT EACH MEMBER AGENCY. FLAGLER HOSPITAL ALSO PRINTED 50 LARGE-FONT VERSIONS OF THE CHNA FOR VISUALLY IMPAIRED COMMUNITY MEMBERS THAT WERE DISTRIBUTED TO THE ST. JOHNS COUNTY COUNCIL ON AGING AND LOCAL LIBRARIES. FLAGLER HOSPITAL PART V, SECTION B, LINE 11: REDUCE PERCENTAGE OF LOW BIRTH WEIGHT INFANTSTHE PERCENTAGE OF LOW BIRTHWEIGHT INFANTS IN ST. JOHNS COUNTY CONTINUES TO BE A DISPARITY AMONG COMMUNITY POPULATIONS. FOR THIS REASON, REDUCING THE PERCENTAGE OF LOW BIRTHWEIGHT INFANTS IN ST. JOHNS COUNTY WAS SELECTED AS A STRATEGIC OBJECTIVE CRITICAL ACTIONS INCLUDE THE FORMATION OF A FETAL INFANT MORTALITY REVIEW TEAM AND COORDINATED EFFORTS AMONG COMMUNITY PARTNERS TOWARDS INCREASING THE PERCENTAGE OF WOMEN RECEIVING FIRST TRIMESTER PRENATAL CARE. FLAGLER HOSPITAL'S DIRECTOR OF MATERNITY SERVICES, NEONATAL INTENSIVE CARE MANAGER AND MATERNITY COORDINATOR CONTINUE TO SERVE ON THE ST. JOHNS INFANT MORTALITY TASK FORCE. THE TASK FORCE MEETS QUARTERLY TO ANALYZE MORTALITY RATES FOR NORTHEAST FLORIDA AND DETERMINE LEADING CAUSES FOR LOW BIRTH WEIGHT TO ACHIEVE BETTER OUTCOMES FOR ST. JOHNS COUNTY. THIS TASK FORCE IS PART OF THE NE FLORIDA HEALTHY START COALITION, INC. THE TASK FORCE IS CURRENTLY WORKING TO PROMOTE HEALTHY PREGNANCY AND PREGNANCY BODY MASS INDEX LEVELS, REDUCE TOBACCO USAGE AMONG PREGNANT WOMEN AND HELP INCREASE AWARENESS OF THE IMPORTANCE OF INCREASING THE INTERVAL TIME BETWEEN PREGNANCIES FOR HEALTHY OUTCOMES. FLAGLER HOSPITAL OFFERS FREE PRE-NATAL YOGA CLASSES TO HELP MOMS STAY IN OPTIMUM HEALTH FOR DELIVERY (OPEN TO ALL ST. JOHNS COUNTY MOMS, EVEN IF THEY DON'T PLAN TO DELIVER AT FLAGLER HOSPITAL). REDUCE CHRONIC DISEASE MORBIDITY AND MORTALITYCHRONIC DISEASE WAS RESPONSIBLE FOR OVER 55.6% OF ALL DEATHS IN ST. JOHNS COUNTY IN 2016. CANCER IS THE LEADING CAUSE OF DEATH IN ST. JOHNS COUNTY, WITH BREAST, COLON AND LUNG CANCER IDENTIFIED AS BEING THE MOST COMMON TYPES AMONG RESIDENTS. AMONG SURVEY RESPONDENTS, 17.9% REPORTED CANCER AS THE MOST CONCERNING HEALTH PROBLEM, RANKING FIFTH AMONG ALL RESPONDENTS. TO RAISE AWARENESS ABOUT THE BENEFITS OF PREVENTION AND EARLY DETECTION OF CANCER, FLAGLER HOSPITAL PARTICIPATED IN OVER 25 HEALTH FAIRS, PROVIDING ST. JOHNS COUNTY RESIDENTS WITH UP-TO-DATE SCREENING GUIDELINES AND THE BENEFITS OF A HEALTHY LIFESTYLE. FURTHER, A THREE YEAR FLAGLER CANCER INSTITUTE COMMUNITY NEEDS ASSESSMENT WAS COMPLETED, WHICH IDENTIFIED THE FOLLOWING AREAS OF NEED WITHIN THE COMMUNITY: MAMMOGRAPHY SCREENING RATES, AGE-ADJUSTED CANCER DEATH RATE FOR BLACK ST. JOHNS COUNTY RESIDENTS, AND TIME BETWEEN LUNG CANCER DIAGNOSES TO TREATMENT.CANCER PREVENTION PROGRAMS INCLUDED PRESENTATIONS FOR LOCAL CHURCHES AND CIVIC GROUPS, LUNG CANCER AWARENESS EVENTS, COLORECTAL CANCER PREVENTION AND AWARENESS EVENTS AND A SKIN CANCER PREVENTION PROGRAM. IN ADDITION, FLAGLER HOSPITAL PARTNERED WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS GOOD SAMARITAN WILDFLOWER CLINIC, AMERICAN CANCER SOCIETY, LUNG CANCER ALLIANCE, PINK UP THE PACE AND UNITY OUTREACH TO PROMOTE CANCER AWARENESS AND EARLY DETECTION THROUGHOUT THE COMMUNITY.BREAST CANCER: FROM 2014-2016, THE BREAST CANCER AGE-ADJUSTED DEATH RATE WAS 22.4/100,000. THIS RATE IS LOWER THAN STATE AND REGIONAL AVERAGES, AND IDENTICAL TO THE PEER COUNTY STATE AVERAGE. IN ORDER TO REDUCE THE TIME FRAME BETWEEN BREAST CANCER DIAGNOSIS AND TREATMENT, A BREAST CANCER PATIENT NAVIGATOR (BCPN) WAS ADDED TO THE FLAGLER HOSPITAL CANCER INSTITUTE CARE TEAM AND HELPS PATIENTS MOVE THROUGH THE PROCESS OF BREAST CANCER ALL THE WAY THROUGH DIAGNOSIS, SURGERY, TREATMENT AND RECOVERY. THE BREAST CANCER PATIENT NAVIGATOR HELPS PATIENTS FROM THE TIME THERE IS A SUSPICION OF BREAST CANCER UNTIL TREATMENT IS CONCLUDED. OUR PATIENT NAVIGATOR NURSE IS A CERTIFIED BREAST CARE NURSE CBCN AND IS DEDICATED TO THE FOLLOWING: PROVIDING PATIENTS WITH KNOWLEDGEABLE AND COMPASSIONATE SUPPORT; FACILITATING COMMUNICATION BETWEEN THE PATIENT AND PHYSICIANS IN ORDER TO DECREASE FRAGMENTATION OF CARE; AND PROVIDING PATIENTS AND FAMILY MEMBERS WITH INFORMATION ON COMMUNITY-BASED RESOURCES.IN THIS FISCAL YEAR, THE BCPN GUIDED OVER 150 PATIENTS THROUGH THEIR CANCER TREATMENT. THE BREAST CANCER PATIENT NAVIGATOR PARTICIPATES IN MANY COMMUNITY EVENTS, EDUCATING WOMEN ON THE BENEFITS OF EARLY DETECTION AND THE IMPORTANCE OF PERFORMING SELF-EXAMINATIONS. FLAGLER HOSPITAL CONTINUES TO SUPPORT LOCAL NON-PROFIT ORGANIZATIONS THAT FOCUS ON THE PREVENTION AND EARLY DETECTION OF BREAST CANCER IN ST. JOHNS COUNTY. ON AUGUST 24, 2019 FLAGLER HOSPITAL PARTNERED WITH GOOD SAMARITAN HEALTH CENTERS (WILDFLOWER CLINIC) TO HELP ST. JOHNS COUNTY WOMEN OVERCOME ONE OF THE BARRIERS TO RECEIVING A SCREENING MAMMOGRAM. THROUGH THIS PROGRAM, 21 PATIENTS RECEIVED FREE SCREENING MAMMOGRAMS, FUNDED BY PINK UP THE PACE.THE DAY OF THE EVENT, EACH PATIENT WAS SCREENED BY THE WILDFLOWER CLINIC TO HELP FACILITATE ADDITIONAL TESTS AND TREATMENT, IF NEEDED. THROUGH THIS PROGRAM, 21 WOMEN RECEIVED A SCREENING MAMMOGRAM. OF THE 21 MAMMOGRAMS GIVEN, ONE OF THE FOLLOW-UPS LED TO A BREAST CANCER DIAGNOSIS.IN ADDITION, FLAGLER HOSPITAL'S CANCER EDUCATION AND SUPPORT CENTER FACILITATES A BREAST CANCER SUPPORT GROUP THAT MEETS ON A MONTHLY BASIS. A FREE MAMMOGRAM DAY WAS NOT HELD IN 2020 DUE TO THE PANDEMIC.LUNG CANCER: REALIZING THAT CIGARETTE SMOKING IS THE NUMBER ONE RISK FACTOR FOR LUNG CANCER, FLAGLER HOSPITAL CONTINUES TO MAINTAIN A SMOKE FREE FACILITY, INCLUDING PARKING LOTS AND LEASED PROPERTIES. FLAGLER HOSPITAL ALSO IMPLEMENTED A TOBACCO SCREENING PROTOCOL THROUGHOUT THE HOSPITAL. UPON ADMISSION, EACH PATIENT IS ASKED IF THEY SMOKE OR USE TOBACCO IN ANY OTHER FORM. THIS INFORMATION IS USED TO TRIGGER A CONSULT FROM THE CARDIOPULMONARY DEPARTMENT, FROM A MEMBER OF THE "QUIT TEAM". QUIT TEAM MEMBERS VERIFY THE PATIENTS WHO USE TOBACCO AND PROVIDE COUNSELING ON TOBACCO CESSATION. IF THE PATIENT IS INTERESTED IN QUITTING, THEY ARE GIVEN INFORMATION ON FREE TOBACCO CESSATION PROGRAMS OFFERED THROUGH FLAGLER HOSPITAL. THE QUIT TEAM ALSO EDUCATED FLAGLER STAFF AND MEDICAL PERSONNEL ON THE IMPORTANCE OF THE MESSAGE THAT CESSATION OPPORTUNITIES ARE BOTH VALUABLE AND EFFICACIOUS. FLAGLER HOSPITAL PARTNERS WITH NORTHEAST FLORIDA AREA HEALTH EDUCATION CENTER TO PROVIDE ACCESS TO THE "QUIT SMOKING NOW" SMOKING CESSATION PROGRAM. QUIT SMOKING NOW IS A FREE COURSE THAT CONSISTS OF GROUP SESSIONS FACILITATED BY THE CARDIOPULMONARY DEPARTMENT AND HELD IN THE FLAGLER HOSPITAL WELLNESS CENTER. CLASSES TAKE PLACE ONE PER WEEK FOR 1 HOUR, OVER A SIX-WEEK PERIOD. THROUGHOUT 2019, FLAGLER HOSPITAL OFFERED SIX FREE QUIT SMOKING NOW CLASSES. IN TOTAL, 78 QUIT SMOKING NOW PARTICIPANTS ENROLLED AND 36 OF THE PARTICIPANTS QUIT SMOKING. IN 2019, 37,500 OF FLAGLER HOSPITAL PATIENTS WERE SCREENED FOR TOBACCO USE, 3,000 PATIENTS WERE COUNSELED OR ADVISED TO QUIT, 84 DIRECT REFERRALS WERE MADE TO AHEC AND THE FLORIDA QUIT LINE AND 3,700 TOBACCO USERS WERE PROVIDED WITH CESSATION MATERIALS. IN ADDITION TO THE QUIT SMOKING NOW SMOKING CESSATION PROGRAM, FLAGLER HOSPITAL HOSTED A LUNG CANCER AWARENESS EVENT. SHINE A LIGHT ON LUNG CANCER WAS HELD IN THE CANCER EDUCATION AND SUPPORT CENTER ON NOVEMBER 4, 2019. THIS IS A NATIONAL EVENT HELD AT DIFFERENT LOCATIONS ACROSS THE NATION. THE GOAL IS TO BRING ATTENTION, COMPASSION, HOPE AND SUPPORT TO ALL INDIVIDUALS IMPACTED BY LUNG CANCER. THE ADMINISTRATOR OF COMMUNITY HEALTH IMPROVEMENT SERVES ON THE BOARD OF DIRECTORS OF THE TOBACCO FREE ST. JOHNS PARTNERSHIP, A COMMUNITY-WIDE LOCALLY ORGANIZED GROUP COLLECTIVELY WORKING TOWARDS ELIMINATING INITIATION AND USE OF TOBACCO AMONG ST. JOHNS COUNTY RESIDENTS, SUPPORTING POLICY CHANGE AND EDUCATING DECISION MAKERS ABOUT THE IMPACT OF TOBACCO ON THE LIVES OF ST. JOHNS COUNTY RESIDENTS AND VISITORS. SEE LATER PART OF SCHEDULE H, PART V FOR CONTINUATION. FLAGLER HOSPITAL PART V, SECTION B, LINE 15E: CONTACT INFORMATION IS IN THE PLAIN LANGUAGE SUMMARY LOCATED ON THE HOSPITAL WEBSITE: HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY.ASPX: THERE ARE MANY WAYS TO FIND INFORMATION ABOUT THE FAP APPLICATION PROCESS, OR GET COPIES OF THE FAP OR FAP APPLICATION FORM. TO APPLY FOR FINANCIAL ASSISTANCE YOU MAY: DOWNLOAD THE INFORMATION ONLINE AT FLAGLERHOSPITAL.ORG, KEY WORDS FINANCIAL ASSISTANCE REQUEST THE INFORMATION IN WRITING BY MAIL OR BY VISITING THE FLAGLER HOSPITAL BUSINESS OFFICE AT 100 WHETSTONE PLACE, SUITE 100 ST. AUGUSTINE, FL 32086 REQUEST THE INFORMATION BY CALLING (904) 819-4539 AVAILABILITY OF TRANSLATIONSTHE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND THE PLAIN LANGUAGE SUMMARY ARE OFFERED IN ENGLISH AND SPANISH. FLAGLER HOSPITAL MAY ELECT TO FURNISH TRANSLATION AIDS, TRANSLATION GUIDES, OR PROVIDE ASSISTANCE THROUGH USE OF QUALIFIED BILINGUAL INTERPRETER BY REQUEST. FOR INFORMATION ABOUT FLAGLER HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND TRANSLATION SERVICES, PLEASE CALL A REPRESENTATIVE AT (904) 819-4539. PART V, SECTION B, LINE 11 CONTINUED: REDUCE SUBSTANCE ABUSEJUST AS WAS FOUND IN THE 2014 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, THE ISSUE OF SUBSTANCE ABUSE WAS LISTED AS THE #1 IMPORTANT HEALTH PROBLEMS BY SURVEY RESPONDENTS IN THE 2017 CHNA. THIS INCLUDES BINGE DRINKING, UNDERAGE DRINKING, CIGARETTE AND MARIJUANA AND OTHER DRUG USE. FLAGLER HOSPITAL'S DIRECTOR OF BEHAVIORAL HEALTH SERVICES WORKS CLOSELY WITH EPIC COMMUNITY SERVICES (EPIC WAS CREATED TO PROVIDE SUBSTANCE ABUSE PREVENTION, INTERVENTION, OUTPATIENT TREATMENT AND AFTERCARE SERVICES), PACT, (PREVENTION, ACTION, CHOICES AND TEAMWORK) PREVENTION SERVICES (WHICH ADVOCATES FOR PREVENTION FOR YOUTH), TOBACCO FREE ST. JOHNS AND OTHER GROUPS SUCH AS LAW ENFORCEMENT ON THIS ISSUE. ST. JOHNS COUNTY CONTINUES TO RANK IN THE TOP 5 COUNTIES IN FLORIDA FOR BINGE DRINKING. THE ST. JOHNS COUNTY BEHAVIORAL HEALTH CONSORTIUM CONTINUES TO WORK TOWARDS FINDING A WAY TO GET THESE IMPORTANT HEALTH SERVICES AVAILABLE FOR REFERRAL IN OUR SERVICE AREA. FLAGLER HOSPITAL CONTINUES TO PROVIDE A YEARLY $150,000 DONATION IN SUPPORT OF EPIC BEHAVIORAL HEALTHCARE'S 16-BED RECOVERY CENTER. THE EPIC RECOVERY CENTER (ERC) OPENED IN JANUARY, 2014, FILLING THE NEED FOR AN INPATIENT TREATMENT CENTER IN ST. JOHNS COUNTY. THE ERC OFFERS SEVERAL TYPES OF SUBSTANCE USE DISORDER TREATMENT SERVICES INCLUDING DETOXIFICATION, OUTPATIENT THERAPY, RESIDENTIAL TREATMENT, AND THE MARS (MEDICALLY-ASSISTED RECOVERY SERVICES) PROGRAM. IN THE PAST 7.5 YEARS, THE ERC HAS HAD 5,495 ADMISSIONS AND IN THE PAST FEW YEARS, 43% OF ALL DETOX ADMISSIONS WERE RELATED TO OPIATE USE.THE MAJORITY OF EPIC RECOVERY CENTER'S PATIENTS LIVE IN POVERTY (78%), HAVE NO INSURANCE, OR INSURANCE WITH POOR BEHAVIORAL HEALTH BENEFITS, WHICH MAKES FLAGLER HOSPITAL'S SUPPORT ESSENTIAL TO PROVIDING THIS MUCH NEEDED SERVICE TO THE COMMUNITY. THE EPIC RECOVERY CENTER HAS BECOME THE CORNERSTONE OF THE ADDICTION TREATMENT SYSTEM OF CARE IN ST. JOHNS COUNTY SERVING SOME OF THE MOST VULNERABLE FLORIDIANS UNINSURED, HOMELESS, THOSE INVOLVED IN THE CHILD WELFARE SYSTEM, CRIMINALLY JUSTICE INVOLVED, AND/OR SUFFERING FROM MULTIPLE CHRONIC HEALTH CONDITIONS. INCREASE ACCESS TO DENTAL CAREACCESS TO DENTAL CARE HAS LONG BEEN AN ISSUE IN ST. JOHNS COUNTY, AS IT IS ACROSS THE STATE. RESPONDENTS OF THE 2017 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTED DENTAL/ORAL CARE AS ONE OF THE TOP HEALTH SERVICE THAT IS DIFFICULT TO OBTAIN. A MAJOR THEME OF ALL FOCUS GROUPS WAS A NEED FOR IMPROVED ACCESS TO DENTAL CARE. TO ADDRESS THIS NEED, FLAGLER HOSPITAL, THE WILDFLOWER CLINIC, AND THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL WORKED TOGETHER TO PROVIDE SOLUTIONS. DURING THE ASSESSMENT YEAR 765 DENTAL CASES CAME TO THE FLAGLER HOSPITAL EMERGENCY DEPARTMENT FOR DENTAL CARE, HIGHLIGHTING THE NEED. THE GOOD SAMARITAN WILDFLOWER CLINIC IS THE ONLY CLINIC OFFERING BOTH FREE DENTAL AND FREE HEALTH CARE IN ST. JOHNS COUNTY. FLAGLER CONTINUES TO BE A MAJOR CORPORATE SPONSOR OF THE WILDFLOWER CLINIC AND WORKS CLOSELY WITH THE CLINIC TO SHORTEN THE TIME BETWEEN THE INITIAL CRISES (FLAGLER ER VISIT) AND FOLLOW UP CARE. WITH THE HELP OF GRANTS FROM FLAGLER HOSPITAL, AND OTHER COMMUNITY ORGANIZATIONS, THE WILDFLOWER CLINIC STAFF HAS BEGUN OFFERING REGULAR DENTAL WALK-IN CLINICS EVERY WEEK. WITH CONTINUED COLLABORATION BETWEEN THE WILDFLOWER CLINIC AND FLAGLER HOSPITAL'S EMERGENCY DEPARTMENT ON COORDINATING CARE BETWEEN UNINSURED ST. JOHNS COUNTY RESIDENTS, FLAGLER HOSPITAL EMERGENCY ROOM VISITS FOR DENTAL EMERGENCIES HAVE CONTINUED TO DROP BY OVER 10% EACH FISCAL YEAR. DURING 2020 WILDFLOWER CLINIC SAW 387 PATIENTS THE CLINIC WAS CLOSED FOR A CONSIDERABLE AMOUNT OF TIME DUE TO THE PANDEMIC BUT IS REOPENED AND SEEING PATIENTS WEEKLY. BUILDING ON THIS SUCCESSFUL PARTNERSHIP, FH+ AND WILDFLOWER CONTINUE TO OPTIMIZE THIS TRANSITION AND FOLLOW-UP PROCESS FROM THE HOSPITAL EMERGENCY ROOM TO THE WILDFLOWER DENTAL CLINIC.INCREASE ACCESS TO MENTAL HEALTH CAREWITH DEPRESSION AND ANXIETY RANKED AS THE #2 HEALTH PROBLEMS IN ST. JOHNS COUNTY, THE 2017 CHNA REVEALED THAT ACCESS TO MENTAL HEALTH SERVICES CONTINUES TO BE AN ISSUE. IN ADDITION, MENTAL HEALTH COUNSELING WAS REPORTED TO BE THE #2 MOST DIFFICULT TO OBTAIN SERVICE BY SURVEY RESPONDENTS.IN RESPONSE TO AN IDENTIFIED CRITICAL NEED FOR OUTPATIENT MENTAL HEALTH SERVICES IN ST. JOHNS COUNTY, FLAGLER HOSPITAL INTRODUCED AN INTENSIVE OUTPATIENT PROGRAM. THIS PROGRAM WAS SPECIFICALLY DESIGNED TO SUPPORT PATIENTS AFTER BEING RELEASED FROM INPATIENT CARE. THE PROGRAM'S PRIMARY GOAL OF IMPROVING QUALITY OF LIFE AND REDUCE SYMPTOMS TO PREVENT RELAPSE IS ACCOMPLISHED THROUGH GROUP THERAPY, MEDICATION AND SYMPTOM MANAGEMENT AND INDIVIDUAL PSYCHOTHERAPY. ALL NEW PATIENTS PARTICIPATE IN A FORMAL CLINICAL EVALUATION PERFORMED BY A MULTI-DISCIPLINARY TEAM. THIS EVALUATION HELPS THE TEAM DEVELOP A TREATMENT PLAN THAT REFLECTS EACH PATIENT'S INDIVIDUAL STRENGTHS, LIMITATIONS AND GOALS FOR TREATMENT. EVERY PATIENT'S GOALS ARE REVIEWED AND UPDATED WEEKLY IN TEAM MEETINGS AND INDIVIDUAL SESSIONS. MEDICAL STAFF FROM THE INTENSIVE OUTPATIENT PROGRAM ATTENDS COMMUNITY EVENTS TO RAISE AWARENESS ABOUT MENTAL HEALTH AND TO INFORM THE COMMUNITY ON AVAILABLE RESOURCES. A SCHOLARSHIP IS AVAILABLE FOR EACH SESSION, TO ENSURE THAT ACCESS TO MENTAL HEALTH SERVICES IS NEVER DEPENDENT UPON A PATIENT'S ABILITY TO PAY. FLAGLER HOSPITAL IS COMMITTED TO COLLABORATION WITH COMMUNITY PARTNERS TO ADDRESS EACH NEED IDENTIFIED DURING THE 2017 CHNA. TO INCREASE ACCESS TO MENTAL HEALTH CARE, THIS COLLABORATION CENTERS ON COORDINATION AND LINKAGE OF MENTAL HEALTH SERVICES BETWEEN FLAGLER HOSPITAL AND COMMUNITY OUTPATIENT PROVIDERS. FLAGLER HOSPITAL CONTINUES TO WORK WITH ST AUGUSTINE YOUTH SERVICES TO SUPPORT THE COUNTY-WIDE MOBILE CRISIS RESPONSE TEAM (MCRT). THE TEAM'S MISSION IS TO PROVIDE AN ASSESSMENT AT THE FIRST SIGNS OF CHILD BEHAVIORAL RISK TO PREVENT SERIOUS MENTAL ISSUES FROM DEVELOPING. THE TEAM ALSO PROVIDES IMMEDIATE ACCESS TO MENTAL HEALTH SERVICES AND ALLOW THE OPPORTUNITY FOR FAMILIES TO SELECT A SOLUTION THAT WORKS BEST FOR THEM. THE ULTIMATE GOAL OF THE MOBILE CRISIS RESPONSE TEAM PROGRAM IS TO DIVERT CHILDREN FROM COSTLY EMERGENCY SERVICES AND ESTABLISH GREATER COORDINATION OF CARE THAT WILL SERVE THE FAMILY BEYOND THE INITIAL CRISIS. THE MCRT CONSISTS OF THREE STATE LICENSED CLINICIANS, A CERTIFIED CASE MANAGER AND A STATE LICENSED REGISTERED NURSE. TO DATE THE MCRT HAS RESPONDED TO AND PROVIDED ASSESSMENTS AND WRAPAROUND SERVICES FOR OVER 1,900 ST JOHNS COUNTY YOUTH. 81% OF BAKER ACTS WERE DIVERTED. WITH HOSPITAL VISITS AVERAGING $3,900, THE MCRT ASSESSMENTS SAVED OUR COMMUNITY OVER $7.4 MILLION. PART V, SECTION B, LINE 11 CONTINUED: INCREASE USE OF AVAILABLE TRANSPORTATIONFROM THE FOCUSES GROUPS CONDUCTED AS PART OF THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS OF "A NEED FOR TRANSPORTATION" WAS OBSERVED AS A PRIMARY THEME FROM FOCUSES GROUPS. FURTHERMORE, SURVEY RESULTS SHOWED A POSITIVE INCREASE IN THE PERCENTAGE OF RESPONDENTS THAT RANKED TRANSPORTATION AS A BARRIER TO CARE, FROM 7.9% IN 2011 TO 9.7% IN 2014 AND 12.2% IN 2017.TRANSPORTATION HAS BEEN A FOCUS IN ST. JOHNS COUNTY FOR OVER 16 YEARS. THE 2005 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED IMPROVING ACCESS TO HEALTH SERVICES IN OUTLYING AREAS OF ST. JOHNS COUNTY THROUGH COORDINATION OF PUBLIC TRANSPORTATION AS A HIGH-PRIORITY COMMUNITY NEED. SINCE THAT TIME, A COMMUNITY-WIDE EFFORT TO IMPROVE PUBLIC TRANSPORTATION IN ST. JOHNS COUNTY HAS PICKED UP MOMENTUM. THE ST. JOHNS COUNTY COUNCIL ON AGING, INC. (COA) SERVES AS THE COMMUNITY TRANSPORTATION COORDINATOR FOR ST. JOHNS COUNTY. THE COA PROVIDES DOOR-TO-DOOR NON-EMERGENCY MEDICAL TRANSPORTATION SERVICES TO AMBULATORY AND WHEELCHAIR BOUND CLIENTS WITHIN THE ST. JOHNS COUNTY SERVICE AREA. THE SUNSHINE BUS COMPANY (A DIVISION OF THE COA) IS ST. JOHNS COUNTY'S PUBLIC BUS SERVICE. SINCE ITS INCEPTION IN 2006, THE SUNSHINE BUS COMPANY HAS CONTINUED TO EXPANDED SERVICES TO BETTER SERVE THE COMMUNITY, WITH THE ADDITION OF NEW ROUTES AND AN INCREASED NUMBER OF DAILY TRIPS. THE 2017 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT FEEDBACK SHOWED THE CONTINUED NEED FOR A FOCUS ON TRANSPORTATION. IN 2019, FLAGLER HOSPITAL SUPPORTED THE STRATEGIC OBJECTIVE OF "INCREASE USE OF AVAILABLE TRANSPORTATION OPTIONS" BY PARTNERING WITH THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL TO PROVIDE TRANSPORTATION TRAINING TO 14 COMMUNITY ORGANIZATIONS. THIS EDUCATION IS OFFERED TO BOTH COMMUNITY MEMBERS, AND HEALTHCARE PROVIDERS, IN EFFORT TO RAISE AWARENESS AND INCREASE UTILIZATION. IN ADDITION TO SUPPORTING PUBLIC TRANSPORTATION INITIATIVES, FLAGLER HEALTH+ HAS ALSO PARTNERED WITH UBER HEALTH TO PROVIDE TRANSPORTATION TO AND FROM DOCTORS' APPOINTMENTS. THIS SERVICE IS AVAILABLE TO COMMUNITY RESIDENTS, REGARDLESS OF WHETHER OR NOT THE DOCTOR IS AFFILIATED WITH FLAGLER HEALTH+. IN FY20, CARE CONNECT PAID FOR OVER $12,000 IN UBER OR TAXI RIDES TO MEDICAL APPOINTMENTS FOR THE COMMUNITY.CARE CONNECT CONNECTING PEOPLE TO RESOURCESCARE CONNECT+ IS A PROGRAM OF THE HOSPITAL THAT WAS STARTED IN 2017. THIS COMMUNITY ALLIANCE WAS ESTABLISHED TO CONNECT AREA RESIDENTS IN NEED WITH AVAILABLE SERVICE AND ADDRESS SOCIAL DETERMINANTS OF HEALTH IN A COORDINATED WAY THROUGHOUT ALL OF ST JOHNS COUNTY. BY ALIGNING COMMUNITY RESOURCES INTO A SINGLE ACCESS POINT, CARE CONNECT INCREASES COORDINATION AND ACCESS OF AVAILABLE RESOURCES. THE PROGRAM HELPS CONNECT PEOPLE TO PRIMARY CARE SERVICE, DENTAL SERVICE, PRESCRIPTION ASSISTANCE, RENTAL AND UTILITY ASSISTANCE, TRANSPORTATION ASSISTANCE, HOMELESS PREVENTION SERVICES, ACCESS TO LOCAL FOOD BANKS AND COMMUNITY RESOURCE NAVIGATION AND CASE MANAGEMENT SERVICES. RATHER THAN SIMPLY REFER PEOPLE TO SERVICES, CARE CONNECT COMMUNITY HEALTH ASSOCIATES, FOLLOW EACH CLIENT UNTIL ALL NEEDS HAVE BEEN MET. IF SERVICES ARE NOT AVAILABLE IN THE COMMUNITY, CARE CONNECT TRACKS GAPS IN SERVICE TO DEVELOP THOSE SERVICES WITH COMMUNITY PARTNERS. CARE CONNECT INCREASES ACCESS TO HEALTH PROVIDERS, DENTAL PROVIDERS, MENTAL HEALTH PROVIDERS, SOCIAL SERVICES AND TRANSPORTATION THROUGH A COORDINATED HUB. IN FISCAL YEAR 2020, 680 CLIENTS ENTERED THE CARE CONNECT HUB AND WERE MATCHED WITH SERVICES.IN SEPTEMBER, 2019, FLAGLER HEALTH+ IMPLEMENTED AN INNOVATIVE MODEL TO INCREASE ACCESS TO BEHAVIORAL HEALTH PROVIDERS FOR STUDENTS ACROSS ST. JOHNS COUNTY THROUGH A PARTNERSHIP WITH THE ST. JOHNS COUNTY SCHOOL DISTRICT. THE B.R.A.V.E. PROGRAM STANDS FOR BEING RESILIENT AND VOICING EMOTIONS. THROUGH BRAVE, CARE CONNECT+ SERVES AS THE HUB FOR STUDENT HEALTH REFERRALS FOR ALL 39 SCHOOLS IN THE ST JOHNS SCHOOL DISTRICT. DURING FY 2020, THERE WAS A 66% DECREASE IN THE LENGTH OF TIME FROM REFERRAL TO FIRST APPOINTMENT AND A 160% INCREASE IN THE NUMBER OF STUDENTS CONNECTED TO A BEHAVIORAL HEALTH PROVIDER. DURING THE SPRING AND SUMMER MONTHS OF 2020, WHEN THE COVID PANDEMIC AFFECTED IN-PERSON PROVIDER APPOINTMENTS, CARE CONNECT FINANCIALLY AND ADMINISTRATIVELY SUPPORTED THE LAUNCH OF A TELEMEDICINE PLATFORM WITH PROVIDERS TO MAINTAIN STUDENT AND ADULT MENTAL HEALTH APPOINTMENTS. PART V, SECTION B, LINE 7A: HTTPS://WWW.FLAGLERHEALTH.ORG/PATIENTS-VISITORS/ PART V, SECTION B, LINE 7B: HTTP://STJOHNS.FLORIDAHEALTH.GOV/PROGRAMS-AND-SERVICES/COMMUNITY-HEALTH-PLANNING-AND-STATISTICS/COMMUNITY-HEALTH-ASSESSMENTS/2017-CHA.HTML PART V, SECTION B, LINE 10A: HTTPS://WWW.FLAGLERHEALTH.ORG/PATIENTS-VISITORS/ PART V, SECTION B, LINE 16A: HTTPS://WWW.FLAGLERHEALTH.ORG/FINANCIAL-SERVICES/CHARITY-CARE-FINANCIAL-ASSISTANCE-POLICY/ PART V, SECTION B, LINE 16B: HTTPS://WWW.FLAGLERHEALTH.ORG/FINANCIAL-SERVICES/FINANCIAL-COUNSELING-CHARITY-CARE-POLICY/ PART V, SECTION B, LINE 16C: HTTPS://WWW.FLAGLERHEALTH.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY/ 1 1 - FLAGLER OUTPATIENT LAB 156-316 ST HWY 312 260-264 ST AUGUSTINE FL 32086 OUTPATIENT LAB SATELLITE DRAW STATION PART I, LINE 7: EXPENSES WERE CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $18,472,242. OF THIS TOTAL, FLAGLER HOSPITAL'S PORTION OF BAD DEBT EXPENSE IS $18,472,242 AND OUTPATIENT SURGERY CENTER OF ST. AUGUSTINE, LLC'S PORTION OF BAD DEBT EXPENSE IS $0. PART II, COMMUNITY BUILDING ACTIVITIES: HEALTH PROFESSIONS EDUCATIONFLAGLER HOSPITAL DONATED PAID STAFF HOURS IN ONE-ON-ONE PROGRAMS TO PRECEPT NURSING STUDENTS AND ARNP STUDENTS FROM JACKSONVILLE UNIVERSITY, ST. JOHNS RIVER STATE COLLEGE, UNIVERSITY OF CENTRAL FLORIDA, UNIVERSITY OF FLORIDA, DAYTONA STATE COLLEGE. ADDITIONALLY, STUDENTS IN THE FIELDS OF EMT TRAINING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, MEDICAL ASSISTING, LAB SCIENCES, SOCIAL WORK, HEALTH INFORMATION MANAGEMENT, CARDIOVASCULAR TECHNOLOGY, RADIOLOGY, NUCLEAR MEDICINE AND MENTAL HEALTH WERE TRAINED WITH ONE-ON-ONE CONTACT WITH STAFF AT FLAGLER HOSPITAL.FLAGLER HOSPITAL HAS TWO FULL TIME STAFF MEMBERS DEDICATED TO OFFERING CONTINUING MEDICAL EDUCATION TO ALL PHYSICIANS AND CLINICAL PROVIDERS IN THE ST. JOHNS COUNTY COMMUNITY, REGARDLESS OF THEIR AFFILIATION WITH THE HOSPITAL. THIS HELPS ENSURE THAT OUR LOCAL RESIDENTS HAVE ACCESS TO PHYSICIANS AND CLINICAL PROVIDERS WHO ARE UP TO DATE ON THE LATEST ADVANCEMENTS IN MEDICAL CARE. THE CME COORDINATOR FACILITATED 39 PROGRAMS CONSISTING OF GRAND ROUNDS, MEDICAL SOCIETY MEETINGS, WEBCASTS AND ONLINE COMPUTER ACTIVITIES FOR PHYSICIANS AND CLINICAL PROVIDERS DURING THIS FY.RESEARCHFLAGLER HOSPITAL EMPLOYS TWO FULL-TIME EMPLOYEES TO MANAGE A CANCER PATIENT DATABASE, LOG INFORMATION THAT CAN BE USED TO DETECT CANCER EARLIER, IMPROVE TREATMENTS AND ULTIMATELY, INCREASE CANCER SURVIVAL RATE. REGISTRARS DETERMINE A PATIENT'S ELIGIBILITY FOR THE CANCER REGISTRY, RECORD THE PATIENT'S DIAGNOSIS, AND TRACK THEIR TREATMENT PLAN. BY COLLECTING, TRACKING AND EVALUATING THIS DATA, WE ARE ABLE TO ADVANCE OUR KNOWLEDGE ON RISK FACTORS FOR CERTAIN CANCERS. BECAUSE DATA ENTERED IN THE CANCER REGISTRY IS AVAILABLE TO THE PUBLIC, OUTCOMES AND TREATMENT PLANS FOR PATIENTS IN ST. JOHNS COUNTY HAVE AN IMPACT NATION-WIDE. FINANCIAL AND IN-KIND CONTRIBUTIONSFLAGLER HOSPITAL MADE FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALING $235,715 TO MANY AREA NON-PROFIT ORGANIZATIONS THAT FOCUS ON PROVIDING HEALTH PROGRAMS TARGETING COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH THE ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. ONE OF THE BIGGEST DETERMINANTS OF HEALTH THAT COMMUNITY ORGANIZATIONS HAVE INFLUENCE ON IS ACCESS TO HEALTHCARE. DURING THIS LAST FISCAL YEAR, FLAGLER HOSPITAL GAVE A $50,000 GRANT TO THE ST. JOHNS COUNCIL ON AGING TO PROVIDE STAFF TO ASSIST SENIOR CITIZENS IN ST. JOHNS COUNTY IN APPLYING FOR FREE OR REDUCED RATE PRESCRIPTION DRUGS FROM PHARMACEUTICAL COMPANIES. THIS PROGRAM CONTINUES TO SERVE OVER 300 SENIORS. BECAUSE THE GRANT PROVIDED PAID STAFF TO RUN THIS PROGRAM, COUNCIL ON AGING VOLUNTEERS WERE ABLE TO FOCUS OVER 600 VOLUNTEER HOURS ON COUNSELING, CLIENT NOTIFICATION AND DOCTOR'S OFFICE VISITS TO HELP EXPEDITE PAPERWORK. FLAGLER HOSPITAL ALSO DONATED MEETING ROOMS AND IN SOME CASES FOOD/CATERING CHARGES FOR VARIOUS NON-PROFIT, SUPPORT AND SELF-HELP GROUPS IN THE COMMUNITY. THIS TOTALED OVER $3,000 USING A $3/HOUR CHARGE FOR EACH MEETING SPACE, A FIGURE BASED ON THE SQUARE FOOTAGE OF THE HOSPITAL. COMMUNITY BUILDING ACTIVITIESFLAGLER HOSPITAL DONATED PAID STAFF TIME FOR EMPLOYEES WHO SERVED ON VARIOUS BOARDS FOR COMMUNITY EVENTS AND COMMITTEES WHICH OFFERED COMMUNITY SUPPORT, COALITION BUILDING WITH OTHER AGENCIES AND HEALTH AND WELFARE PROVIDERS, AND COMMUNITY HEALTH IMPROVEMENTS ADVOCACY. THROUGH A PARTNERSHIP WITH THE HOSPITAL, THE ST. JOHNS COUNTY SCHOOL DISTRICT CREATED THE FLAGLER HOSPITAL ACADEMY OF MEDICAL AND HEALTH CAREERS AT PEDRO MENENDEZ HIGH SCHOOL IN 2007-2008. IT IS OPEN TO STUDENTS THROUGHOUT THE SCHOOL SYSTEM. IT FOCUSES ON PROVIDING SKILLS AND EXPERIENCE NECESSARY TO ATTAIN ENTRY LEVEL JOBS IN HEALTH, MEDICAL AND RELATED FIELDS, AND PROVIDES ACADEMIC PREPARATION TO CONTINUE TRAINING THROUGH CLINICAL EXPERIENCE, COMMUNITY COLLEGE AND UNIVERSITY PROGRAMS. NOW IN ITS 13TH YEAR, THE ACADEMY HAD 50 THIRD YEAR STUDENTS ROTATING THROUGH VARIOUS DEPARTMENTS AT THE HOSPITAL FOR TRAINING, FOR A COMBINED TOTAL OF 1600 HOURS. STUDENTS SHADOWED IN THE LAB, RADIOLOGY, PHARMACY, OPERATING ROOM, PHYSICAL AND OCCUPATIONAL THERAPY, IN ADDITION TO MULTIPLE NURSING UNITS. COMMUNITY SUPPORTST JOHNS VOLUNTEERS IS A PROGRAM THAT IS NOW HOUSED WITHIN THE COMMUNITY HEALTH IMPROVEMENT DEPARTMENT. DURING THIS FISCAL YEAR, ST JOHNS VOLUNTEERS WAS RUN AS A PROGRAM OF CARE CONNECT. IN JUNE 2019, THE NON-PROFIT STATUS WAS DISSOLVED AND THE PROGRAM WAS ABSORBED BY FLAGLER HOSPITAL. ST JOHNS VOLUNTEERS HOSTS A WEBSITE THAT CONNECTS VOLUNTEERS TO NON-PROFIT VOLUNTEER OPPORTUNITIES IN THE COUNTY. ST JOHNS VOLUNTEERS HAS 77 NONPROFIT PARTNERS AND 2,890 USERS AND OVER 150 VOLUNTEER OPPORTUNITIES AS OF APRIL 2021. COMMUNITY BENEFIT OPERATIONSFLAGLER HOSPITAL HAS A FULL TIME ADMINISTRATOR OF COMMUNITY HEALTH IMPROVEMENT TO COORDINATE HOSPITAL-WIDE COMMUNITY BENEFIT FUNCTIONS IN ACCORDANCE WITH NATIONAL STANDARDS AND PUBLIC REPORTING REQUIREMENTS. THE ADMINISTRATOR OF COMMUNITY HEALTH IMPROVEMENT USES CBISA SOFTWARE TO TRACK AND REPORT COMMUNITY BENEFIT ACTIVITIES AND PROVIDE AN ANNUAL REPORT ON COMMUNITY BENEFIT NUMBERS TO THE DIRECTOR OF ACCOUNTING FOR THE HOSPITAL'S 990 H. COMMUNITY HEALTH IMPROVEMENT SERVICESIN ADDITION TO NEEDS ASSESSED BY THE HEALTH LEADERSHIP COUNCIL, FLAGLER HOSPITAL IS IN A POSITION TO KNOW THE OTHER HEALTH ISSUES WHICH COST THE COMMUNITY AND ITS CITIZENS THE MOST TIME AND MONEY. WHILE DEATH FROM DIABETES IS ON THE DECLINE, INCIDENCE OF DIABETES IS RISING, DUE TO OBESITY CAUSED BY DIET AND LIFESTYLE. FLAGLER HOSPITAL CONTINUED TO PARTNER WITH THE WILDFLOWER CLINIC, A NON-PROFIT DEDICATED TO PROVIDING FREE MEDICAL AND DENTAL CARE TO QUALIFYING ST. JOHNS COUNTY RESIDENTS, TO ESTABLISH WILDFLOWER CHRONIC CARE CLINIC (CCC). THE CHRONIC CARE CLINIC PROVIDES INVALUABLE CARE TO UNINSURED, CHRONICALLY ILL, LOW-INCOME RESIDENTS OF ST. JOHNS COUNTY. THE FLAGLER CCC FOCUSES ON CHRONIC DISEASE MANAGEMENT, WITH AN EMPHASIS ON DIABETES MANAGEMENT. THIS CLINIC IS AVAILABLE TO ANY PATIENT WITH AN UNMANAGED, CHRONIC CONDITION WHO MEETS THE GOOD SAMARITAN HEALTH CENTERS PATIENT QUALIFICATIONS. PATIENTS RECEIVE SERVICES FREE OF CHARGE.THE CHRONIC CARE CLINIC IS STAFFED WITH A NURSE PRACTITIONER, WHO IS AVAILABLE BY PHONE, PAGER, AND EMAIL, 24 HOURS A DAY/7 DAYS A WEEK. ALL CHRONIC CARE CLINIC PATIENTS ARE PROVIDED WITH HER CONTACT INFORMATION AND INSTRUCTED TO CONTACT HER DIRECTLY IF THEY HAVE ANY QUESTIONS OR CONCERNS BETWEEN VISITS, ESPECIALLY IF THEY ARE NOT FEELING WELL. THROUGH TELEMEDICINE OR ADDITIONAL VISITS BETWEEN SCHEDULED APPOINTMENTS, THE NURSE PRACTITIONER CAN ADD OR ADJUST MEDICATIONS, ORDER LAB WORK, AND MANAGE ANY SITUATIONS FOR WHICH A PATIENT MAY HAVE OTHERWISE RESORTED TO THE FLAGLER HOSPITAL EMERGENCY CARE CENTER FOR A NON-EMERGENT VISIT. BY PAIRING 24-HOUR ACCESS TO A NURSE PRACTITIONER WITH ACCESS TO MEDICATIONS THAT WOULD BE OTHERWISE UNAFFORDABLE AND EDUCATION ABOUT THEIR CHRONIC ILLNESSES, THE WILDFLOWER CHRONIC CARE CLINIC HAS EFFECTIVELY KEPT COUNTLESS PATIENTS FROM SEEKING CARE IN THE FLAGLER HOSPITAL EMERGENCY CARE CENTER. DURING THE LAST FISCAL YEAR, FLAGLER HOSPITAL HAS PROVIDED THE WILDFLOWER CLINIC WITH $388,962 IN FREE LABORATORY SERVICES.THE HEART CENTER AT FLAGLER HOSPITAL PROVIDES A CRITICAL SERVICE TO RESIDENTS OF ST. JOHNS COUNTY AND THE SURROUNDING AREAS. FLAGLER HOSPITAL'S STATE-OF-THE-ART HEALTHCARE ENCOMPASSES THE ENTIRE CONTINUUM OF CARE FOR HEART PATIENTS, INCLUDING CLOSE COLLABORATION WITH ST. JOHNS COUNTY FIRE RESCUE, INCLUDING TRANSMISSION OF EKGS DIRECTLY FROM AMBULANCE TO HOSPITAL, CARDIAC CATH LABS, WORLD-CLASS PHYSICIANS AND STAFF, QUALITY ASSURANCE PLANS, AND COMMUNITY OUTREACH AND EDUCATION PROGRAMS. ONCE A PATIENT IS DISCHARGED WITH A DIAGNOSIS OF HEART FAILURE, A NURSE CARE COORDINATOR FOLLOWS UP WITH THE PATIENT TO REVIEW DISCHARGE MEDICATIONS, VITAL SIGNS, THE IMPORTANCE OF WEIGHT MANAGEMENT AND FLUID RESTRICTIONS. ONCE IN THE HOME, THE NURSE PRACTITIONER REVIEWS THE FOODS THAT ARE IN THE PATIENT'S HOMES AND DISCUSSES HOW THAT FOOD SHOULD BE USED IN THE DIET OR NOT USED AT ALL. SHE USES CUPS THAT ARE IN THE PATIENT'S HOUSE TO SHOW HOW MUCH FLUID SHOULD GO IN AND HOW MANY A DAY SHOULD BE USED. THIS OFFERS THE PATIENT A PRACTICAL APPROACH TO CARING FOR THEMSELVES AT HOME. THIS SERVICE COMES AT NO CHARGE TO THE PATIENT AND HELPS THEM UNDERSTAND WHAT THE DOCTOR EXPECTS FROM THEM. THIS SERVICE GOES BEYOND HOSPITAL EDUCATION AND IS TRUE COMMUNITY/ HOME EDUCATION. FLAGLER HOSPITAL MAINTAINS A CANCER RESOURCE CENTER, OPEN TO ALL IN THE COMMUNITY, ALONG WITH A WIG AND PROSTHESIS CLOSET. THERE IS A FREE COMPUTER KIOSK FOR THE DISSEMINATION OF HEALTH INFORMATION. IT IS STAFFED BY OUR CANCER EDUCATION AND SUPPORT COORDINATOR AND VOLUNTEERS EACH WEEKDAY FROM 9:00 UNTIL 4:00. PART III, LINE 3: BASED ON COMPILED HOSPITAL BAD DEBT DATA FOR FY20, WE ARE ESTIMATING THAT 50% OF THE 3,447 PATIENT ACCOUNTS THAT WENT TO BAD DEBT AND SCORED BETWEEN 201% - 400% OR THAT WERE NOT SCORED WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF PATIENT WOULD HAVE COMPLIED WITH THE HOSPITALS FINANCIAL ASSISTANCE POLICY OR HAD BEEN ABLE TO BE PRESUMPTIVELY SCORED. 50% OF THE CHARGES MULTIPLIED BY THE AVERAGE AGB (24%) EQUAL THE ESTIMATED COST. PART III, LINE 4: SEE AUDITED FINANCIAL STATEMENTS PAGES 8, 10 PART III, LINE 8: THE MEDICARE REVENUE AND ALLOWABLE COSTS ON LINES 5 AND 6, RESPECTIVELY, WERE TAKEN FROM THE MEDICARE COST REPORT. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE REIMBURSEMENT ALLOWED, BEFORE REDUCTION OF CO-PAY AMOUNTS, LESS SEQUESTRATION AND ANY OTHER REDUCTIONS ASSOCIATED WITH VALUE BASED PURCHASING REDUCTIONS AS PER THE COST REPORT WORKSHEETS E PART A AND B. MEDICARE ALLOWABLE COSTS RELATING TO PAYMENTS ARE TAKEN FROM THE PART A AND PART B EXPENSES AS DETERMINED BY THE COST REPORT STEP DOWN AND COST APPORTIONMENT METHODOLOGY ON WORKSHEETS D-1 AND D PART V, PLUS THE 65% REDUCTION APPLIED TO MEDICARE BAD DEBTS. THE ENTIRE SHORTFALL IS REPORTED AS COMMUNITY BENEFIT. WE DO NOT RECEIVE ENOUGH IN MEDICARE REIMBURSEMENTS TO COVER OUR COSTS ASSOCIATED WITH THE PROVISION OF THESE SERVICES, YET WE CONTINUE TO PROVIDE MEDICARE SERVICES TO OUR COMMUNITY REGARDLESS OF THE REIMBURSEMENT LEVELS. THEREFORE, WE FEEL JUSTIFIED IN REPORTING THIS AS PART OF OUR COMMUNITY BENEFIT. PART III, LINE 9B: 1.) FLAGLER HOSPITAL BUSINESS OFFICE STAFF REVIEW UNPAID PATIENT ACCOUNTS ON A REGULAR BASIS TO IDENTIFY THOSE ACCOUNTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ATTEMPTS TO CLASSIFY THESE PARTICULAR INDIVIDUALS START AT THE TIME THAT THEY ARE STILL IN-HOUSE. PATIENTS ARE ALSO CONTACTED AFTER DISCHARGE THROUGH PHONE CALLS OR MAIL. COMPLIANT INDIVIDUALS WHO MEET THE HOSPITAL'S FINANCIAL ASSISTANCE GUIDELINES ARE GRANTED THE APPROPRIATE DISCOUNT BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES. MANY PATIENTS DUE TO FAILURE TO PRODUCE THE APPROPRIATE DOCUMENTATION RECEIVE A REDUCED NON-COMPLIANT HOSPITAL ADJUSTMENT. THESE PARTICULAR INDIVIDUALS MAY HAVE RECEIVED A HIGHER WRITE-OFF IF THEY WERE IN FACT COMPLIANT. 2.) REGARDLESS OF THE PATIENTS' FINANCIAL CLASS OR STATUS, IF A BILL REMAINS UNPAID FOR MORE THAN 120 DAYS FROM THE DATE IT WAS FIRST MAILED TO THE PATIENT, AND REASONABLE COLLECTION ATTEMPTS HAVE FAILED, THE DEBT IS SENT TO A PRIMARY BAD DEBT COLLECTION AGENCY FOR FURTHER COLLECTION EFFORTS. PART VI, LINE 2: ST. JOHNS COUNTY IS FORTUNATE TO HAVE STRONG AND PROACTIVE LEADERSHIP WITHIN ITS PUBLIC HEALTH SYSTEM, AND A HISTORY OF SUCCESSFUL COLLABORATION. CHAMPIONED BY FLAGLER HOSPITAL AND THE FLORIDA DEPARTMENT OF HEALTH IN ST. JOHNS COUNTY, THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL WAS ESTABLISHED IN 2010 FOR THE SPECIFIC PURPOSE OF BRINGING TOGETHER KEY LEADERS FROM THE LOCAL COMMUNITY TO ASSESS AND ADDRESS THE HEALTH NEEDS OF OUR RESIDENTS. IN MAY 2014, THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL ACHIEVED NATIONAL ROLE MODEL STATUS, WHEN IT WAS SELECTED BY THE UNIVERSITY OF KENTUCKY (UK) COLLEGE OF PUBLIC HEALTH TO BE INCLUDED IN A NATION-WIDE STUDY OF HIGHLY SUCCESSFUL PUBLIC HEALTH COLLABORATIVE. THE PURPOSE OF THE UK STUDY WAS TO IDENTIFY, COMPARE AND CONTRAST EXCEPTIONAL MODELS OF COLLABORATION INVOLVING COMMUNITY HOSPITALS, PUBLIC HEALTH DEPARTMENTS AND OTHER STAKEHOLDERS, WHO SHARE A COMMITMENT TO IMPROVING COMMUNITY HEALTH, AND TO DETERMINE THE KEY LESSONS LEARNED FROM THEIR EXPERIENCES. THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL WAS ONE OF ONLY TWELVE COLLABORATIVES SELECTED BY THE UK STUDY TEAM FROM OVER 150 NATIONAL APPLICATIONS. FLAGLER HOSPITAL'S CEO, VP OF MARKETING AND STRATEGY, AND ADMINISTRATOR OF COMMUNITY HEALTH IMPROVEMENT, ALONG WITH REPRESENTATIVES FROM 41 OTHER AGENCIES PARTICIPATED IN THIS HIGHLY COLLABORATIVE EFFORT WITH FLAGLER HOSPITAL IN THE FOREFRONT OF EVERY PHASE FROM DEVELOPING SURVEY QUESTIONS, CREATING SURVEY TOOLS, IDENTIFYING FOCUS GROUPS, ANALYZING DATA, ESTABLISHING ACTION PLANS AND REVIEWING RESULTS. SEE NARRATIVE ON PART V FOR PART V, SECTION B, LINE 6B FOR A LISTING OF THE MEMBERSHIP ORGANIZATIONS AND REPRESENTATIVES.TO IMPLEMENT THE FINDINGS AND GOALS DETERMINED THROUGH THE CHNA, THE MAPP PROCESS USES A THREE YEAR CYCLE WITH EACH IDENTIFIED NEED HAVING AN "OWNER" TO TRACK PROGRESS. WHILE VARIOUS MEMBERS OF THE HEALTH LEADERSHIP COUNCIL TOOK "OWNERSHIP" OF VARIOUS ASPECTS OF THE HEALTH NEEDS ASSESSMENT'S IMPLEMENTATION, FLAGLER HOSPITAL PARTICIPATES IN EACH PART OF IMPLEMENTATION. THE SHARED VISION AND COMMON VALUES OF MEMBERS PROVIDE A FRAMEWORK FOR PURSUING THE LONG RANGE GOALS, SO FLAGLER HOSPITAL IS PROUD TO PARTNER WITH MANY MEMBERS OF THE HEALTH LEADERSHIP COUNCIL, IN ORDER TO BROADEN COMMUNITY PARTICIPATION. FLAGLER HOSPITAL ACKNOWLEDGES AND AGREES WITH THE SPECIFIED GOALS OF THE CHNA. A COMMUNITY BALANCED SCORECARD WAS CREATED TO TRACK AND EVALUATE EACH OF THE STRATEGIC OBJECTIVES AND ACTS AS THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE CRITERIA AND RATIONALE FOR EACH OF THE OBJECTIVES AND GOALS IS CONTAINED ON PAGE 133 OF THE PUBLISHED "2017 COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN". PART VI, LINE 3: THE HOSPITAL COMMUNICATES ITS CHARITY CARE POLICY, OR PATIENT-FRIENDLY SUMMARY THEREOF, IN THE FOLLOWING WAYS:- POSTED ON THE FLAGLER HOSPITAL WEBSITE - POSTED AT THE RECEPTION DESKS IN ALL REGISTRATION AREAS - POSTED AT ALL FINANCIAL COUNSELORS' DESKSWHEN UNINSURED OR UNDERINSURED PATIENTS ARE ADMITTED TO THE HOSPITAL, THEY ARE SCREENED FOR FINANCIAL ASSISTANCE. AT THE TIME OF SCREENING, THE PATIENT IS PROVIDED A FINANCIAL ASSISTANCE APPLICATION TO COMPLETE. THEY ARE THEN ASKED TO SUBMIT THE REQUIRED FINANCIAL DOCUMENTS (I.E., BANK STATEMENTS, PAY STUBS, TAX RETURNS, ETC.). THOSE PATIENTS DISCHARGED PRIOR TO SCREENING ARE CALLED BY THE BUSINESS OFFICE AND ARE SCREENED OVER THE PHONE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED FOR VERIFICATION. UNINSURED PATIENTS TREATED IN THE EMERGENCY DEPARTMENT WHO MEET CERTAIN CRITERIA ARE SCREENED BY PHONE BY THE BUSINESS OFFICE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED. A SEPARATE SCREENING IS PERFORMED TO DETERMINE ELIGIBILITY FOR COUNTY PROGRAMS AND MEDICAID. IN ADDITION, THE HOSPITAL UTILIZES A THIRD-PARTY VENDOR TO SCREEN SELF-PAY PATIENTS FOR POSSIBLE DISCOUNTS AND FINANCIAL ASSISTANCE OPTIONS. FOR DETAILS, PLEASE SEE THE RESPONSE TO PART I, LINE 3C ABOVE. PART VI, LINE 4: ST. JOHNS COUNTY IS PART OF THE JACKSONVILLE METROPOLITAN AREA AND ENCOMPASSES APPROXIMATELY 680 SQUARE MILES OF LAND IN NORTHEAST FLORIDA, SITUATED BETWEEN THE ST. JOHNS RIVER AND MORE THAN 40 MILES OF BEACHES ALONG THE ATLANTIC COAST. AT THE TIME OF PUBLICATION FOR THIS REPORT, THE U.S. CENSUS BUREAU 2019 POPULATION ESTIMATE FOR ST. JOHNS COUNTY, FL IS 264,762. SINCE 2010, ST. JOHNS COUNTY IS ASCRIBED AS THE HEALTHIEST COUNTY OF 67 COUNTIES IN FLORIDA FOR OVERALL HEALTH FACTORS AND HEALTH OUTCOMES IN THE 2020 COUNTY HEALTH RANKINGS REPORT. ST. JOHNS COUNTY SCHOOL DISTRICT RANKS FIRST OF 67 DISTRICTS IN FLORIDA IN TOTAL FLORIDA COMPREHENSIVE ASSESSMENT TEST POINTS. THE CITY OF ST. AUGUSTINE, THE COUNTY SEAT AND NATION'S "OLDEST CITY," ATTRACTED ABOUT 6.3 MILLION VISITORS TO THE COUNTY IN 2017.POPULATION AND AGE DISTRIBUTIONST. JOHNS COUNTY'S POPULATION NEARLY TRIPLED BETWEEN THE YEARS 1990 AND 2016, THIS BEING A POPULATION INCREASE OF OVER 180%. GROWTH FOR ST. JOHNS COUNTY IS OCCURRING AT A RATE THREE TIMES FASTER THAN FLORIDA AND ALMOST SIX TIMES FASTER THAN THE NATION. THE U.S. CENSUS BUREAU ESTIMATES ST. JOHNS COUNTY'S POPULATION FOR 2016 TO BE 235,087 (51.2% FEMALE), AN ESTIMATED 3.7% HIGHER THAN THE 2015 ESTIMATE. ST. JOHNS COUNTY, FL WAS ASCRIBED THE 15TH FASTEST GROWING COUNTY AMONG THE 100 FASTEST GROWING COUNTIES WITH 10,000 OR MORE POPULATION IN THE NATION BETWEEN 2010 AND 2016. USING 2016 ESTIMATES, THE U.S. BUREAU OF ECONOMIC AND BUSINESS RESEARCH PROJECTS ST. JOHNS COUNTY'S POPULATION WILL GROW TO 287,027 BY 2025.ST. JOHNS COUNTY AND FLORIDA HAVE SIMILAR POPULATION AGE DISTRIBUTIONS. HOWEVER, WHEN COMPARED TO THE STATE, ST. JOHNS COUNTY HAS A SLIGHTLY HIGHER PROPORTION OF PEOPLE WITHIN THE GROUP OF PEOPLE FROM 10 YEARS OF AGE TO 19 YEARS OF AGE AND THE ALSO WITHIN THE GROUP OF PEOPLE FROM 35 YEARS OF AGE TO 69 YEARS OF AGE. COMPARING THE 2010 AND 2016 POPULATION AGE DISTRIBUTION ESTIMATES REVEALS AN AGING POPULATION; BETWEEN 2010 AND 2016, ST. JOHNS COUNTY EXPERIENCED HIGHEST POPULATION GROWTH AMONG PEOPLE 65 YEARS OF AGE TO 69 YEARS OF AGE (2.4%), FOLLOWED BY PEOPLE 50 YEARS OF AGE TO 54 YEARS OF AGE (1.1%) AND 40 YEARS OF AGE TO 44 YEARS OF AGE (1.0%). ACCORDING TO THE U.S. CENSUS BUREAU, APPROXIMATELY 19.3% OF ST. JOHNS COUNTY'S POPULATION WAS 65 YEARS OF AGE OR OLDER IN 2016, A SLIGHTLY LOWER PROPORTION THAN THE STATE (19.9%) BUT HIGHER THAN THE NATION (15.2%).VULNERABLE POPULATIONS PERSONS WITH ACCESS AND FUNCTIONAL NEEDS INCLUDE PERSONS WITH PHYSICAL, COGNITIVE, OR DEVELOPMENTAL DISABILITIES, PERSONS WITH LIMITED ENGLISH PROFICIENCY, GEOGRAPHICALLY OR CULTURALLY ISOLATED PERSONS, AND MEDICALLY OR CHEMICALLY DEPENDENT PERSONS. RECENT DISASTERS HAVE SHOWN THE NEED TO BETTER DEVELOP STRATEGIES FOR MEETING THE NEEDS OF MOST AT-RISK POPULATIONS TO PREVENT ADVERSE HEALTH OUTCOMES DURING OR FOLLOWING A DISASTER. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 INVESTING IN KIDS (INK) 40 ORANGE ST ST AUGUSTINE FL 32084 841452282 501(C)(3) 16200 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE BOYS AND GIRLS CLUB OF NE FLORIDA 555 W 25TH STREET JACKSONVILLE FL 32206 596167630 501(C)(3) 12500 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ROSCOLUSA SONGWRITERS FESTIVAL 1611 WOODLAND ST NASHVILLE TN 37206 462971411 N/A 20000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE UNIVERSITY OF NORTH FLORIDA FOUNDATION INC 1 UNF DRIVE HICKS HALL NO 2900 JACKSONVILLE FL 32224 237167701 501(C)(3) 39000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST JOHNS COUNTY CHAMBER OF COMMERCE 100 SOUTHPARK BLVD ST AUGUSTINE FL 32086 590432275 501(C)(6) 35000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE SHE IS FIERCE 24 SOUTH DIXIE HIGHWAY ST AUGUSTINE FL 32084 474695657 501(C)(3) 15000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE GOOD SAMARITAN HEALTH CENTERS INC 268 HERBERT ST ST AUGUSTINE FL 32084 522125419 501(C)(3) 10000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE EPIC BEHAVIORAL HEALTH 17 ST JOHNS MEDICAL PARK DR ST AUGUSTINE FL 32086 591502582 501(C)(3) 150000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST JOHNS COUNCIL ON AGING 180 MARINE ST ST AUGUSTINE FL 32084 591525829 501(C)(3) 50000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE 5 2 PART I, LINE 2: THE FLAGLER HEALTH CARE FOUNDATION, A SUPPORTING ORGANIZATION OF THE HOSPITAL, REPORTS ITS FINANCIAL ACTIVITIES TO THE CFO OF FLAGLER HOSPITAL. THE HOSPITAL HAS A COMMUNITY BENEFITS GROUP THAT WORKS WITH ST. JOHNS COUNTY TO DETERMINE GRANT RECIPIENTS AND MONITOR THE USE OF FUNDS. X 1 0 X X X X X 1 1 0 0 0 0 0 1 0 JASON P BARRETT PRESIDENT/CEO 522980 0 208465 0 2531 0 89950 0 0 0 823926 0 0 0 MIGUEL A MACHADO CMO 429417 0 56751 0 0 0 17950 0 6294 0 510412 0 0 0 CARLTON DEVOOGHT SEVP/CAO 367607 0 80850 0 0 0 36950 0 16078 0 501485 0 0 0 MURRAY S MARSH JR SEVP/CAO (TO NOV 2020) 339422 0 54328 0 0 0 60950 0 13848 0 468548 0 0 0 TODD BATENHORST EVP 346142 0 31528 0 0 0 55950 0 5234 0 438854 0 0 0 MICHAEL C SANDERS CHIEF MEDICAL INFORMATICS 328248 0 40207 0 0 0 17950 0 0 0 386405 0 0 0 JOSEPH GORDY FORMER CEO 254763 0 0 0 100000 0 9202 0 0 0 363965 0 0 0 JEFFREY A HURLEY CHRO 235393 0 41198 0 720 0 56987 0 16653 0 350951 0 0 0 NANGELA PULSFUS EVP/COO 219936 0 36235 0 720 0 37466 0 16078 0 310435 0 0 0 DONALD R CRIST VP OF OPERATIONS 220395 0 28825 0 13020 0 23302 0 19334 0 304876 0 0 0 WILLIAM RIEGER CIO 221864 0 25106 0 0 0 12860 0 19334 0 279164 0 0 0 MARY K MANTESE FORMER CHIEF NURSING OFFIC 114813 0 0 0 116336 0 0 0 5770 0 236919 0 0 0 MICHAEL HALL ADMINISTRATOR 173582 0 24626 0 720 0 9723 0 16078 0 224729 0 0 0 LAWRENCE SMITH ADMINISTRATOR 144226 0 19866 0 7931 0 30188 0 14685 0 216896 0 0 0 DONNA WAGNER ADMINISTRATOR 153288 0 18498 0 720 0 7742 0 0 0 180248 0 0 0 MICHELLE ANDRADE ADMINISTRATOR 138980 0 14354 0 8124 0 7590 0 6294 0 175342 0 0 0 ANGELA CHRISTENSEN ADMINISTRATOR 141406 0 19081 0 692 0 7235 0 6031 0 174445 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES GROSS UP PAYMENTS FOR THE VALUE OF THE DISABILITY INSURANCE POLICY PREMIUMS TO CERTAIN OFFICERS, REPORTED ON THE OFFICERS' FORM W-2. PART I, LINES 4A-B MARY MANTESE RECEIVED A SEVERANCE PAYMENT OF $116,336. THE ORGANIZATION CONTRIBUTED $35,000 TO A 457(F) PLAN FOR JASON BARRETT. PART I, LINE 7 BONUSES ARE BASED ON PERFORMANCE METRICS SET AT THE BEGINNING OF THE PERFORMANCE YEAR. THE BOARD HAS APPROVAL RIGHTS FOR THE FINAL AMOUNT PAID AT THE END OF THE PERFORMANCE YEAR. A ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 592146640 2017-09-28 71400000 SEE PART VI 0 0 0 A 71400000 338361 592158 53517222 16952259 2019 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 PART I, LINE A, COLUMN F: CURRENT REFUNDING OF SERIES 2010A AND SERIES 2010B BONDS, FINANCING OF FACILITIES IMPROVEMENT PROJECTS AND EQUIPMENT ACQUISITIONS. PART I, LINE B, COLUMN F: CURRENT REFUNDING OF SERIES 2012B AND ADVANCE REFUNDING OF SERIES 2017A BONDS, EXTINGUISHING THE 2014 BANK LOAN, FINANCING OF FACILITIES IMPROVEMENT PROJECTS AND EQUIPMENT ACQUISITIONS. PART II, LINE 11, COLUMN B: BOND PROCEEDS APPLIED TOWARD CURRENT REFUNDING OF SERIES 2012A AND SERIES 2012B BONDS IN FULL . THOMPSON BAKER AGENCY INC MATT BAKER, CHAIRMAN, IS MAJORITY SHAREHOLDER OF THOMPSON BAKER AGENCY INC 284892 INSURANCE PAYMENTS 0 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 EACH BOARD MEMBER 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 B, LINE 15 THE COMPENSATION PACKAGE FOR THE CEO POSITION IS SET AND APPROVED BY THE COMPENSATION COMMITTEE, WHICH CONSISTS OF THE CURRENT AND PAST CHAIRPERSONS OF THE HOSPITAL, FLAGLER HEALTH CARE SYSTEM, AND FLAGLER HEALTH SERVICES BOARDS. INDEPENDENT SALARY SURVEYS ARE OBTAINED FROM INDUSTRY EXPERTS TO DETERMINE COMPENSATION AND BENEFITS. THOSE INDEPENDENT SALARY SURVEYS ARE ALSO USED TO DEVELOP COMPENSATION PACKAGES FOR THE SENIOR MANAGEMENT TEAM. THE COMPENSATION COMMITTEE EVALUATES THE DATA, THEN DEBATES AND DOCUMENTS ITS RECOMMENDATION OF REASONABLE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 14,252,118. MANAGEMENT AND GENERAL EXPENSES 14,299,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,551,981. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,262,423. MANAGEMENT AND GENERAL EXPENSES 7,814,616. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,077,039. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 14,607,672. MANAGEMENT AND GENERAL EXPENSES 685,016. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,292,688. OTHER FEES: PROGRAM SERVICE EXPENSES 2,057. MANAGEMENT AND GENERAL EXPENSES 365,612. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 367,669. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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