2020-08-17T17:43:08-05:00 2019-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2018-10-01 590675143 FLAGLER HOSPITAL INC FLAG 9048254400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 MURRAY S MARSH JR CFO 9048254400 2020-08-17 1 AMY CIMINELLO P00796388 6148493000 2020-08-17 108.208.76.253 2020-08-17 17:42:51 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2CF7C5A78B789059D0734872C4021BB0B9EC4A92 2018 2020-09-23 17:36:50Z JASON BARRETT 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 339872379 0 X WWW.FLAGLERHOSPITAL.ORG X 1906 FL PROVIDE EXCELLENT HEALTHCARE SERVICES AND BE RECOGNIZED AS A LEADING PROVIDER IN NORTHEAST FL. 15 14 2113 256 5016532 1502142 612845 203237 262425152 276063850 7275677 5590379 7646875 8296590 277960549 290154056 367618 215890 0 0 104629630 103245582 0 0 50241 157531506 171660533 262528754 275122005 15431795 15032051 352538512 377017933 171304933 180910033 181233579 196107900 PROVIDE THE BEST PATIENT EXPERIENCE WITH THE BEST STAFF. 0 0 213318854 215890 276063850 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. 213318854 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 1 431 0 1 2113 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X MURRAY MARSH JR 9048254400 400 HEALTH PARK BLVD ST AUGUSTINE FL 32086 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 DIRECTOR 1.00 0.00 X 0 0 0 JAMES GRIMES MD DIRECTOR 1.00 0.00 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 SUSAN YARIAN MD DIRECTOR 1.00 0.00 X 0 0 0 CHRIS KAMIENSKI DIRECTOR 1.00 0.00 X 0 0 0 FRED FRANKLIN DIRECTOR 1.00 0.00 X 0 0 0 BILL ABARE DIRECTOR 1.00 0.00 X 0 0 0 JASON P BARRETT PRESIDENT/CEO 40.00 2.00 X 608690 0 96457 MURRAY S MARSH JR CFO 40.00 2.00 X 318325 0 72747 CARLTON DEVOOGHT CAO 40.00 0.06 X 319015 0 45259 DONALD R CRIST VP OF OPERATIONS 40.00 0.50 X 239518 0 42204 MICHAEL HALL ADMINISTRATOR 40.00 0.50 X 181578 0 25260 ANGELA CHRISTENSEN ADMINISTRATOR 40.00 0.50 X 158942 0 14491 NANGELA PULSFUS ADMINISTRATOR 40.00 0.50 X 187932 0 46867 DONNA WAGNER ADMINISTRATOR 40.00 0.50 X 163912 0 9060 MICHAEL C SANDERS CHIEF MEDICAL INFORMATICS 40.00 0.00 X 349731 0 17600 MIGUEL A MACHADO EVP, CHIEF MEDICAL OFFICER 40.00 0.06 X 454437 0 23348 JULIA CLICK EVP, CHIEF HUMAN RESOURCES 40.00 0.00 X 254336 0 50994 GREGORY A GIBSON PHYSICIAN 40.00 0.00 X 229901 0 27410 JEFFREY A HURLEY DIRECTOR OF RISK MANAGEMENT 40.00 0.00 X 246088 0 71591 JOSEPH GORDY CEO - PART YEAR 40.00 0.00 X 416078 0 27112 MARY K MANTESE FORMER CHIEF NURSING OFFICER 0.00 0.00 X 136171 0 0 4264654 0 570400 63 1 1 0 FIRST COAST HEART & VAS 3901 UNIVERSITY BLVD JACKSONVILLE FL 32216 MEDICAL 4064258 FIRST CITY HOSPITALIST GROUP 400 HEALTH PARK BLVD SAINT AUGUSTINE FL 32086 MEDICAL 2382267 CANCER SPECIALISTS OF NORTH FLORIDA 7015 AC SKINNER PARKWAY JACKSONVILLE FL 32256 MEDICAL 1303210 J GREG DENT MD & ASSOCIATES 400 HEALTH PARK BLVD SAINT AUGUSTINE FL 32086 MEDICAL 937983 CARDIOTHORACIC & VASCULAR SURGICAL ASSOC 1824 KING STREET JACKSONVILLE FL 32204 MEDICAL 849715 58 203237 203237 NET PATIENT SERVICE REVENUE 623000 274303626 274303626 ANCILLARY SERVICES 623000 1760224 1760224 276063850 4964577 4964577 2887483 222515 2664968 2664968 2664968 50027051 26344 49427593 0 599458 26344 625802 625802 156882 68215 88667 88667 OSC REVENUE 623000 4857967 4857967 PATIENT RECORD TRANSCRIPTION 900099 165733 165733 QUEST LAB TESTS 541380 158565 158565 360690 360690 5542955 290154056 276063850 5016532 8870437 X 215890 215890 2960512 2960512 81715069 70922305 10792764 2980771 2980771 9332397 171855 9160542 6256833 5430443 826390 699890 699890 120100 120100 177896 177896 44677947 28228716 16449231 1065244 312877 752367 3286628 1192631 2093997 5195793 5195793 4711014 2846801 1864213 608856 84495 524361 4123416 3240965 876057 6394 21923437 17231821 4647769 43847 4254314 3433437 820877 MEDICAL SUPPLIES 42849927 42849697 230 BAD DEBT EXPENSE 16795867 16795867 OSC EXPENSES 4335891 3704455 631436 INDIGENT TAX 3034882 3034882 13799431 13621717 177714 275122005 213318854 61752910 50241 13712041 19476367 17819961 1186741 28028631 30988752 2310761 1591431 7636048 8258147 1869555 2726030 406872520 235897198 155978378 170975322 76248181 82144919 6826129 4531474 2166825 5752310 24439604 24439604 15502398 24946836 352538512 377017933 33718337 31777039 3587819 3951082 129847529 123382433 4151248 5619315 0 16180164 171304933 180910033 X 181233579 196107900 181233579 196107900 352538512 377017933 15032051 -157730 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 521833 0 0 521833 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. 4655297 4573 595670 4064200 4391344 271053 7100 4655297 4009626 381717 4391344 3581146 225328 203153 4009626 3895387 -314241 3581146 0.00000 1.00000 0.00000 0 1 1 11240781 11240781 163614449 95447245 68167204 6271085 5143797 1127288 192129609 131048437 61081172 33616596 4257719 29358877 170975322 DUE FROM AFFILIATES 15957533 LONG-TERM RECOVERIES 8989303 24946836 CAPITAL LEASE LIABILITY 16180164 16180164 273349933 -157730 -16759227 -16916957 290266890 177896 -290730 -112834 290154056 258475612 290730 290730 258184882 177896 16759227 16937123 275122005 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF THREE 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 -16,759,227. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD -68,215. RENTAL EXPENSES -222,515. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 68,215. RENTAL EXPENSES 222,515. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 16,759,227. 1 1 X 1 X 1 X 1 1 0 1 1 6992916 741773 6251143 0.02420 20135809 16529206 3606603 0.01400 27128725 17270979 9857746 0.03820 13 6072 2022518 2022518 0.00780 15 1817 557163 557163 0.00220 7537314 7537314 0.02920 1 209323 209323 0.00080 11 417367 417367 0.00160 40 7889 10743685 10743685 0.04160 40 7889 37872410 17270979 20601431 0.07980 2 6587 592531 560792 31739 0.00010 1 22 15396 15396 0.00010 1 25 3399 3399 0.00000 4 6634 611326 560792 50534 0.00020 1 16759197 939298 87939779 90857801 -2918022 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 COMMUNTIY 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 RESIDENT'S 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). FLAGLER HOSPITAL PART V, SECTION B, LINE 6B: ANASTASIA MOSQUITO CONTROL DISTRICT- SJC AZALEA HEALTH BETTY GRIFFIN CENTER CHILDREN'S HOME SOCIETY OF FLORIDA CLINTON HEALTH MATTERS INITIATIVE COMMUNITY HOSPICE AND PALLIATIVE CARE COMMUNITY MANAGEMENT & CONSULTING EPIC BEHAVIORAL HEALTHCARE FLAGLER HOSPITAL FLORIDA ARMY RESERVE NATIONAL GUARD FLORIDA DEPARTMENT OF HEALTH IN ST. JOHNS COUNTY GOOD SAMARITAN HEALTH CENTERS/WILDFLOWER CLINIC HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA ST JOHNS RIVER RURAL HEALTH NETWORK NEW MT. MORIAH CHRISTIAN MINISTRY NORTHEAST FLORIDA HEALTHY START COALITION PACT PREVENTION COALITION OF ST. JOHNS COUNTY ST. JOHNS COUNTY HEALTH AND HUMAN SERVICES ST. AUGUSTINE BEACH POLICE DEPARTMENT ST. AUGUSTINE YOUTH SERVICES ST. JOHNS COUNTY ADMINISTRATION ST. JOHNS COUNTY BOARD OF COUNTY COMMISSIONERS ST. JOHNS COUNTY COUNCIL ON AGING ST. JOHNS COUNTY EMERGENCY MANAGEMENT SJC HEALTH AND HUMAN SERVICES ADVISORY COUNCIL ST. JOHNS COUNTY MEDICAL SOCIETY ST. JOHNS COUNTY SCHOOL DISTRICT SJC HEAD START PROGRAM/EARLY CHILDHOOD SERVICES ST. JOHNS COUNTY SHERIFF'S OFFICE ST. JOHNS RIVER STATE COLLEGE ST. VINCENT'S MOBILE HEALTH OUTREACH MINISTRY STEWART MARCHMAN - ACT BEHAVIORAL HEALTHCARE THE SONTAG FOUNDATION TOBACCO FREE ST. JOHNS YMCA 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 186 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. FLAGLER HOSPITAL, IN PARTNERSHIP WITH THE WILDFLOWER CLINIC, HELD A FREE MAMMOGRAM DAY ON SATURDAY, OCTOBER 18, 2018. THIS EVENT WAS OPEN TO ALL UNINSURED ST. JOHNS COUNTY WOMEN BETWEEN THE AGES OF 40-64. AT THIS EVENT 29 WOMEN RECEIVED MAMMOGRAMS, HEALTH SCREENINGS, AND INFORMATION ON AVAILABLE COMMUNITY RESOURCES. IN OCTOBER, FOR INSURED WOMEN WHOSE SCHEDULE MAY NOT PERMIT THEM TO GET A MAMMOGRAM DURING NORMAL BUSINESS HOURS, FLAGLER HOSPITAL OPENED THE FLAGLER IMAGING CENTER ON A THURSDAY EVENING AND A SATURDAY MORNING, WHERE A TOTAL OF 29 MAMMOGRAMS WERE COMPLETED. IN ADDITION, FLAGLER HOSPITAL'S CANCER EDUCATION AND SUPPORT CENTER FACILITATES A BREAST CANCER SUPPORT GROUP THAT MEETS ON A MONTHLY BASIS. COLON CANCER: THE ANNUAL COLORECTAL CANCER AWARENESS DAY WAS HELD ON MARCH 4, 2018. THE EVENT WAS COORDINATED BY THE FLAGLER HOSPITAL CANCER EDUCATION AND SUPPORT CENTER TO PROVIDE INFORMATION ON COLORECTAL CANCER PREVENTION AND SCREENING STRATEGIES. THIS EVENT TOOK PLACE IN THE CANCER EDUCATION AND SUPPORT CENTER AND OVER 85 PEOPLE VISITED THE EVENT AND ANSWERED THE OPTIONAL SURVEY.THE INFORMATION PROVIDED WAS BASED ON THE NATIONAL COMPREHENSIVE CANCER NETWORK (NCCN) COLORECTAL SCREENING GUIDELINES.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. IN ADDITION TO THE QUIT SMOKING NOW SMOKING CESSATION PROGRAM, FLAGLER HOSPITAL HOSTED TWO LUNG CANCER AWARENESS EVENTS. SHINE A LIGHT ON LUNG CANCER WAS HELD IN THE CANCER EDUCATION AND SUPPORT CENTER ON NOVEMBER 17, 2018. 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. LASTLY, THE GREAT AMERICAN SMOKE OUT ALSO TOOK PLACE ON NOVEMBER 17, 2018. THE EVENT WAS HOSTED BY FLAGLER HOSPITAL IN COLLABORATION WITH TOBACCO FREE FLORIDA AND ENCOURAGES SMOKERS TO MAKE A PLAN TO QUIT SMOKING OR PLEDGE TO HELP SOMEONE QUIT SMOKING.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 SUPPLEMENTAL INFORMATION 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 CENTER OPENED IN JANUARY 2014 AS THE ONLY DETOXIFICATION CENTER IN ST. JOHNS COUNTY. IT OFFERS MEDICAL DETOX, SUBSTANCE ABUSE RESIDENTIAL TREATMENT, SUBSTANCE ABUSE OUTPATIENT TREATMENT, AND MEDICATION MANAGEMENT FOR PEOPLE DIAGNOSED WITH A CO-OCCURRING MENTAL HEALTH DISORDER. AFTER 4 YEARS OF SERVING THE COMMUNITY, THE EPIC RECOVERY CENTER HAS HAD 3,484 ADMISSIONS, WITH APPROXIMATELY 50% OF ALL DETOX ADMISSIONS RELATED TO OPIATE ABUSE. 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. FURTHERMORE, DENTAL VISITS TO THE WILDFLOWER CLINIC HAVE INCREASED TO OVER 2,750 VISITS. BUILDING ON THIS SUCCESS, PARTNERS 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 1,400 ST JOHNS COUNTY YOUTH. 82% OF BAKER ACTS WERE DIVERTED. WITH HOSPITALS AVERAGING $3,900, THE MCRT ASSESSMENTS SAVED OUR COMMUNITY OVER $4.5 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 15 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. THIS YEAR, 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. 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 2019, 680 CLIENTS ENTERED THE CARE CONNECT HUB AND WERE MATCHED WITH SERVICES. PART V, SECTION B, LINE 7A: HTTPS://WWW.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX 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.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX PART V, SECTION B, LINE 16A: HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/CHARITY-CARE-AND-FINANCIAL-ASSISTANCE-POLICY.ASPX PART V, SECTION B, LINE 16B: HTTPS://WWW.FLAGLERHOSPITAL.ORG/DOCUMENTS/ATTESTATION-CHARITY-APPLICATION.PDF PART V, SECTION B, LINE 16C: HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY.ASPX 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 $16,759,197. OF THIS TOTAL, FLAGLER HOSPITAL'S PORTION OF BAD DEBT EXPENSE IS $16,795,867 AND OUTPATIENT SURGERY CENTER OF ST. AUGUSTINE, LLC'S PORTION OF BAD DEBT EXPENSE IS -$36,670. 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 A FULL TIME STAFF MEMBER DEDICATED TO OFFERING CONTINUING MEDICAL EDUCATION TO ALL PHYSICIANS IN THE ST. JOHNS COUNTY COMMUNITY, REGARDLESS OF THEIR AFFILIATION WITH THE HOSPITAL. THIS HELPS ENSURE THAT OUR LOCAL RESIDENTS HAVE ACCESS TO PHYSICIANS WHO ARE UP TO DATE ON THE LATEST ADVANCEMENTS IN MEDICAL CARE. THE CME COORDINATOR WORKED WITH PHYSICIANS TO PRESENT 53 PROGRAMS OF GRAND ROUNDS, MEDICAL SOCIETY MEETINGS, WEBCASTS 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 $383,891 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 12TH YEAR, THE ACADEMY HAD 42 THIRD YEAR STUDENTS ROTATING THROUGH VARIOUS DEPARTMENTS AT THE HOSPITAL FOR TRAINING, FOR A COMBINED TOTAL OF 5040 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 AN INDEPENDENT NON-PROFIT WHICH WAS FULLY SUPPORTED BY FLAGLER HOSPITAL THROUGH GRANTS. 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 72 NONPROFIT PARTNERS AND 2,013 USERS AND OVER 150 VOLUNTEER OPPORTUNITIES AS OF APRIL 2020. PART III, LINE 3: BASED ON COMPILED HOSPITAL BAD DEBT DATA FOR FY 19, WE ARE ESTIMATING THAT 50% OF TOTAL CHARGES FOR THE 3,203 PATIENT ACCOUNTS THAT SCORED BETWEEN 200-400% OR THAT WERE NOT SCORED WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF THEY WOULD HAVE COMPLIED WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY OR HAD BEEN ABLE TO BE PRESUMPTIVELY SCORED. PART III, LINE 4: 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 PATIENT ENGAGEMENT AND DIRECTOR 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. A LISTING OF THE MEMBERSHIP ORGANIZATIONS AND REPRESENTATIVES IS ATTACHED HERETO AS ATTACHMENT A.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. ACCORDING TO 2015 U.S. CENSUS DATA, THERE ARE 243,812 RESIDENTS IN FLAGLER HOSPITAL'S DEFINED COMMUNITY OF ST. JOHNS COUNTY.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 2017 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 6.8 MILLION VISITORS TO THE COUNTY IN 2016.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 FLAGLER COLLEGE 74 KING ST ST AUGUSTINE FL 32084 591157081 501(C)(3) 10000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ALL AMERICAN AIR CHARITABLE FOUNDATION 425 TRADE WIND LANE ST AUGUSTINE FL 32080 274254657 501(C)(3) 11500 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE INVESTING IN KIDS (INK) 40 ORANGE ST ST AUGUSTINE FL 32084 841452282 501(C)(3) 16500 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE JACKSONVILLE FC INC 2850 HODGES BLVD JACKSONVILLE FL 32224 592881219 501(C)(3) 17000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE AMERICAN HEART ASSOC 1101 NORTHCHASE PKWY MARIETTA GA 30067 135613797 501(C)(3) 17500 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ST JOHNS VOLUNTEERS 1 NEWS PLACE ST AUGUSTINE FL 32086 611767988 501(C)(3) 27861 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE BOYS AND GIRLS CLUB OF NE FLORIDA 555 W 25TH STREET JACKSONVILLE FL 32206 596167630 501(C)(3) 50000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE PGA TOUR INC 100 PGA TOUR BLVD PONTE VEDRA BEACH FL 32082 592774423 501(C)(3) 12500 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE ALPHA-OMEGA MIRACLE HOME INC 1797 OLD MOULTRIE ROAD ST AUGUSTINE FL 32084 650318958 501(C)(3) 6000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE CROOKSHANK ELEMENTARY SCHOOL 1455 NORTH WHITNEY STREET ST AUGUSTINE FL 32084 237103373 501(C)(3) 8000 OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE 10 0 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 520045 0 88285 0 360 0 89100 0 7357 0 705147 0 0 0 MURRAY S MARSH JR CFO 292312 0 25000 0 1013 0 60100 0 12647 0 391072 0 0 0 CARLTON DEVOOGHT CAO 283738 0 35000 0 277 0 34247 0 11012 0 364274 0 0 0 DONALD R CRIST VP OF OPERATIONS 219114 0 12500 0 7904 0 24548 0 17656 0 281722 0 0 0 MICHAEL HALL ADMINISTRATOR 170633 0 10000 0 945 0 10577 0 14683 0 206838 0 0 0 ANGELA CHRISTENSEN ADMINISTRATOR 147434 0 10000 0 1508 0 8743 0 5748 0 173433 0 0 0 NANGELA PULSFUS ADMINISTRATOR 170616 0 12500 0 4816 0 29211 0 17656 0 234799 0 0 0 DONNA WAGNER ADMINISTRATOR 153005 0 10000 0 907 0 9060 0 0 0 172972 0 0 0 MICHAEL C SANDERS CHIEF MEDICAL INFORMATICS 335995 0 12500 0 1236 0 17600 0 0 0 367331 0 0 0 MIGUEL A MACHADO EVP, CHIEF MEDICAL OFFICER 427723 0 25000 0 1714 0 17600 0 5748 0 477785 0 0 0 JULIA CLICK EVP, CHIEF HUMAN RESOURCES 218861 0 34421 0 1054 0 33338 0 17656 0 305330 0 0 0 GREGORY A GIBSON PHYSICIAN 200697 0 20500 0 8704 0 12727 0 14683 0 257311 0 0 0 JEFFREY A HURLEY DIRECTOR OF RISK MANAGEMENT 231277 0 12500 0 2311 0 56383 0 15208 0 317679 0 0 0 JOSEPH GORDY CEO - PART YEAR 254955 0 100000 0 61123 0 27112 0 0 0 443190 0 0 0 MARY K MANTESE FORMER CHIEF NURSING OFFICER 0 0 0 0 136171 0 0 0 0 0 136171 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 $136,171. THE ORGANIZATION CONTRIBUTED $35,000 TO A 457(F) PLAN FOR JASON BARRETT. THE ORGANIZATION CONTRIBUTED $17,700 TO A 457(F) PLAN FOR CARLTON DEVOOGHT. 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 2012-04-04 30000000 SEE PART VI 0 0 0 B ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 592146640 2017-09-28 71400000 SEE PART VI 0 0 0 A 30000000 30000000 2012 0 0 1 1 B 71400000 338361 592158 53517222 16952259 2019 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 PART I, LINE A, COLUMN F: FINANCING OF FACILITIES IMPROVEMENT PROJECTS, ACQUISITION AND INSTALLATION OF NEW ELECTRONIC MEDICAL RECORDS SYSTEM. PART I, LINE B, COLUMN F: CURRENT REFUNDING OF SERIES 2010A AND SERIES 2010B BONDS, 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 2010B BONDS. THOMPSON BAKER AGENCY INC MATT BAKER, CHAIRMAN, IS MAJORITY SHAREHOLDER OF THOMPSON BAKER AGENCY INC 1239707 INSURANCE PAYMENTS 0 FORM 990, PART VI, SECTION A, LINE 7B DURING THE FISCAL YEAR, THE SOLE MEMBER HAD THE AUTHORITY TO: 1) ADOPT OR REVISE A STRATEGIC PLAN 2) AMEND THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS 3) CONDUCT MERGERS, ACQUISITIONS AND SALES OF ALL OR SUBSTANTIAL PART OF CORPORATION'S ASSETS 4) LIQUIDATION AND DISSOLUTION 5) ELECTION AND REMOVAL OF THE CORPORATION'S OFFICERS AND DIRECTORS INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHAIRMAN OF THE CORPORATION'S BOARD OF DIRECTORS 6) APPROVAL OF CAPITAL AND OPERATING BUDGETS 7) ANY ACTIONS AFFECTING THE CORPORATION'S TAX EXEMPT STATUS 8) FUNDAMENTAL CHANGES IN MISSION OR DIRECTION 9) ENTRY INTO A MATERIAL AGREEMENT THAT INVOLVE ANNUAL PAYMENTS THAT EXCEED 2% OF THE CORPORATION'S TOTAL ANNUAL BUDGETED OPERATING EXPENSES, A SIGNIFICANT JOINT VENTURE, PROVIDES MANAGEMENT FOR THE CORPORATION'S ANNUAL NET PATIENT REVENUE 10) INCURRENCE, REFINANCING, PREPAYMENT OR DEFEASANCE OF DEBT IN THE EXCESS OF THE GREATER OF $10,000,000 OR 10% OF THE CORPORATION'S OUTSTANDING DEBT 11) SECURING A MORTGAGE, DEED OF TRUST, OR OTHER ENCUMBERANCE IN EXCESS OF THE GREATER OF $10,000,000 OR 10% OF THE CAPITAL BUDGET 12) INCURRENCY OF ANY UNBUDGETED CAPITAL EXPENSE IN EXCESS OF THE GREATER OF $5,000,000 OR 5% OF THE CORPORATION'S ANNUAL CAPITAL BUDGET 13) A CAPITAL EXPENDITURE OVERRUN IN EXCESS OF THE GREATER OF $5,000,000 OR 5% OF THE BUDGETED CAPITAL EXPENSE 14) INCURRENCE OF ANY UNBUDGETED OPERATING EXPENSE IN EXCESS OF 1% OF THE CORPORATION'S TOTAL ANNUAL OPERATING EXPENSES 15) SELECTION OF THE CORPORATIONS INDEPENDENT AUDITOR 16) ADOPTION OR REVISION OF CHARITABLE CARE POLICIES 17) DONATION OF MATERIAL FUNDS TO A PERSON OR ENTITY NOT AFFILIATED WITH THE SOLE MEMBER OR ANY OF ITS SUBSIDIARIES PROVIDED THAT THE SOLE MEMBER SHALL NOT BE REQUIRED TO REVIEW OR AUTHORIZE CONTRIBUTIONS TO A LOCAL CHARITY THAT DID NOT EXCEED $250,000 IN ANY YEAR 18) FORMATION OF A NEW MATERIAL ENTITY AS A SUBSIDIARY 19) ACTIONS TAKEN TO CURE ANY BREACH OF OR FAILURE TO COMPLY WITH COVENANTS IN BOND AND OTHER DEBT AGREEMENTS 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 12,665,752. MANAGEMENT AND GENERAL EXPENSES 9,754,853. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,420,605. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,461,006. MANAGEMENT AND GENERAL EXPENSES 5,023,802. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,484,808. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,764,947. MANAGEMENT AND GENERAL EXPENSES 1,525,597. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,290,544. OTHER FEES: PROGRAM SERVICE EXPENSES 337,011. MANAGEMENT AND GENERAL EXPENSES 144,979. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 481,990. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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