2019-11-13T19:22:16-06:00 2018-12-31 346565596 ERNST & YOUNG US LLP 201 NORTH FRANKLIN STREET SUITE 2400 TAMPA FL 33602 990 2018-01-01 590855412 TRUSTEES OF MEASE HOSPITAL INC TRUS 7274627697 601 MAIN STREET DUNEDIN FL 34698 RONALD BEAMON CFO 7274627697 2019-11-12 1 MELANIE MCPEAK P01346034 8132254800 73.184.197.104 2019-11-13 17:57:08 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 66FC02D03DBAC7EA2C5C7B5513D8D7164FCFC484 2018 2020-03-31 21:24:44Z GLENN WATERS 601 MAIN STREET DUNEDIN FL 34698 487213041 0 X SEE SCHEDULE O X 1938 FL TRUSTEES OF MEASE HOSPITAL, INC. WILL IMPROVE THE HEALTH OF ALL WE SERVE THROUGH COMMUNITY-OWNED HEALTH CARE SERVICES THAT SET THE STANDARD FOR HIGH-QUALITY, COMPASSIONATE CARE. 21 18 3073 819 40449 88510 955244 1581367 460195897 481637016 -657 70350 4743638 3924108 465894122 487212841 112108 109474 0 0 161666570 167126900 0 0 0 240927256 256552007 402705934 423788381 63188188 63424460 819861552 880583582 29678113 28499695 790183439 852083887 TRUSTEES OF MEASE HOSPITAL, INC. WILL IMPROVE THE HEALTH OF ALL WE SERVE THROUGH COMMUNITY-OWNED HEALTH CARE SERVICES THAT SET THE STANDARD FOR HIGH-QUALITY, COMPASSIONATE CARE. 0 0 346980972 109474 481997385 TRUSTEES OF MEASE HOSPITAL, INC. (TOM) IS A FULL-SERVICE 431-BED COMMUNITY HOSPITAL. DURING 2018, TOM PROVIDED IMPATIENT CARE TO 24,584 PATIENTS, TREATED 83,929 PATIENTS IN THE EMERGENCY DEPARTMENT, AND DELIVERED 2,223 BABIES. TROUGH EFFORTS OF THE MEDICAL ASSISTANCE PROGRAM AND THE HOSPITAL'S CHARITY CARE PROGRAM TOM SAW A NET COMMUNITY BENEFIT EXPENSE OF $38.7 MILLION. THE HOSPITAL ALSO PROVIDED OTHER COMMUNITY SERVICES TOTALING MORE THAN $3.1 MILLION. THESE INCLUDE HEALTH SCREENINGS, EDUCATIONAL PROGRAMS, SPONSORSHIPS AND RESEARCH. REFER TO SCHEDULE H FOR ADDITIONAL INFORMATION. 346980972 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 3073 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 21 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X JANICE POLO EVP & CFO 7278208021 2985 DREW STREET CLEARWATER FL 33759 JENNIFER BUCK TRUSTEE TILL FEBRUARY 1.00 0.00 X 0 0 0 ANDY BURWELL TRUSTEE/TREASURER 1.00 0.00 X X 0 0 0 JAMES CANTONIS TRUSTEE/IMM PAST CHAIR 1.00 1.00 X 0 0 0 RICK CHESLER TRUSTEE 1.00 0.00 X 0 0 0 KATIE COLE TRUSTEE 1.00 0.00 X 0 0 0 EARLE COOPER EX-OFFICIO TRUSTEE 1.00 0.00 X 0 0 0 KURT ERICKSON TRUSTEE/VICE CHAIR 1.00 1.00 X X 0 17100 0 V RAYMOND FERRARA TRUSTEE/IMM PAST CHAIR TILL FEBRUARY 1.00 1.00 X 0 0 0 ISAY GULLEY TRUSTEE 1.00 0.00 X 0 0 0 LONNIE KLEIN TRUSTEE TILL FEBRUARY 1.00 0.00 X 0 46073 0 GAY LANCASTER TRUSTEE/CHAIRMAN 1.00 1.00 X X 0 0 0 SUSAN LATVALA TRUSTEE/SECRETARY 1.00 1.00 X X 0 0 0 KEVIN MASON TRUSTEE 1.00 0.00 X 0 0 0 JORGE NAVAS TRUSTEE 1.00 0.00 X 0 0 0 CHRISTOS PITARYS TRUSTEE TILL FEBRUARY 1.00 0.00 X 0 0 0 VAKESH RAJANI TRUSTEE 1.00 0.00 X 0 0 0 NANCY RIDENOUR TRUSTEE 1.00 0.00 X 0 0 0 GREG SMITH TRUSTEE TILL FEBRUARY 1.00 0.00 X 0 0 0 DEBBIE WHITE TRUSTEE TILL FEBRUARY 1.00 0.00 X 0 0 0 BENJAMIN DAMSKER TRUSTEE 1.00 0.00 X 0 0 0 ROBERT ENTEL EX-OFFICIO TRUSTEE 1.00 0.00 X 0 0 0 CANDACE GLEWEN EX-OFFICIO TRUSTEE 1.00 0.00 X 0 0 0 RICHARD RODRIGUEZ EX-OFFICIO TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL SZOSTAK EX-OFFICIO TRUSTEE 1.00 0.00 X 0 22160 0 TINA TENRET TRUSTEE 1.00 0.00 X 0 0 0 TONJUA WILLIAMS TRUSTEE 1.00 0.00 X 0 0 0 GLENN WATERS EX-OFFICIO TRUSTEE/EVP, COO BAYCARE 1.00 60.00 X X 0 1549036 59994 CARL TREMONTI VP, CFO BAYCARE HOSP DIV TILL MAY 1.00 63.00 X 0 698208 26327 RONALD BEAMON VP, CFO BAYCARE HOSP DIV EFF MAY 1.00 13.00 X 0 310364 21585 LOUIS GALDIERI PRESIDENT TILL DECEMBER 1.00 46.00 X 0 608379 41465 MATTHEW NOVAK PRESIDENT EFF DECEMBER 45.00 1.00 X 0 315514 69191 JOHN POLLARD DIRECTOR, SURGICAL SVCS 45.00 0.00 X 195284 0 35374 REBECCA SCHULKOWSKI DIR, OPERATIONS MEASE 45.00 0.00 X 180001 0 31021 ROBIN LAPHAM DIRECTOR, PATIENT SVCS 45.00 0.00 X 192268 0 30703 MOHSEN HABIB MANAGER PHARMACY 45.00 0.00 X 198462 0 32746 MAIKEL BOLOS CLINICAL PHARMACIST 45.00 0.00 X 185780 0 21460 RODNEY CAVALIER CLINICAL PHARMACIST 45.00 0.00 X 198092 0 27451 RENEE BURDI DIR, PATIENT SVCS 45.00 0.00 X 179327 0 31033 JOSEPH SCHUMACHER CLINICAL PHARMACIST 45.00 0.00 X 163292 0 29379 KELLY CULLEN FORMER DIR, OPERATIONS 45.00 0.00 X 124382 0 6658 1616888 3566834 464387 104 1 1 0 THE HASKELL COMPANY 111 RIVERSIDE AVE JACKSONVILLE FL 32202 CONSTRUCTION SERVICES 12497949 FREEMANWHITE INC 8845 RED OAK BLVD CHARLOTTE NC 28217 CONSTRUCTION SERVICES/CONSULTING 3261234 BAY LINEN INC 11525 47TH ST N CLEARWATER FL 33762 LAUNDRY SERVICES 2481802 OB HOSPITALIST GROUP LLC 777 LOWNDES HILL RD GREENVILLE SC 29607 MEDICAL SERVICES 1479782 SAYYAHS CLEANING SERVICES INC 7703 ANN BALLARD RD TAMPA FL 33634 CLEANING SERVICES 1143761 43 1524016 57351 26114 1581367 HOSPITAL PATIENT CARE 623990 270511274 270511274 MEDICARE/MEDICAID PMNT 623990 209441298 209441298 RENTAL INC FROM AFFILI 532000 1684444 1684444 481637016 1213434 0 1213434 1213434 1213434 70550 200 0 -200 70550 70350 70350 CAFETERIA 722514 2309856 0 2309856 CIN EMPLOYEE CLINIC FE 900099 258318 258318 MISCELLANEOUS REVENUE 900099 142500 102051 40449 2710674 487212841 481997385 40449 3593640 109474 109474 441680 441680 140257286 140227527 29759 5306558 5305432 1126 11082313 11079962 2351 10039063 10015110 23953 248251 248251 360 360 1526 1526 15157790 14674825 482965 225547 225547 6845602 4663800 2181802 1077985 526298 551687 8435411 8416398 19013 541984 391696 150288 6129479 6129479 20080923 19092107 988816 8005425 8005425 UBI TAXES 5371 5371 MEDICAL SUPPLIES 78305028 78247021 58007 MANAGEMENT FEES 59706388 59706388 BAD DEBT EXPENSE 23883803 23883803 27901134 15980171 11920963 423788381 346980972 76807409 0 133805 138295 40638750 41115043 45683 43484 6667659 7540812 1554116 662679 463953434 276130342 168597503 187823092 698870 770514 2383420 1650060 599141746 640839603 819861552 880583582 18293705 22740242 75627 2584883 2059663 8799525 3624163 29678113 28499695 X 790183439 852083887 790183439 852083887 819861552 880583582 X 63424460 -1524012 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 200 0 1 1526 1726 0 SCHEDULE C PART II - B, LINE 1I, SUPPLEMENTAL INFORMATION LINE 1B AND 1G LOBBYING ACTIVITIES PERFORMED BY EMPLOYEES CONCERNING HEALTH ISSUES. LINE 1I DUES WERE PAID TO THE AMERICAN PHYSICAL THERAPY ASSOCIATION, FLORIDA SOCIETY OF HEALTH-SYSTEM PHARMACISTS, NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS, AACVPR, APIC, AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION, AND THE AMERICAN SOCIETY FOR HEALTHCARE ENGINEERING. THESE ASSOCIATIONS USE A PORTION OF THEIR DUES TO CONDUCT LOBBYING ACTIVITIES. 11886639 11886639 260305188 139888792 120416396 555164 291995 263169 161152126 135949555 25202571 30054317 30054317 187823092 DUE FROM AFFILIATES 640835468 INCOME TAX RECEIVABLE 4135 640839603 DEPOSITS 7519 ASSET RETIREMENT OBLIGATION ST 110000 EST THIRD PARTY SETTLEMENTS 3506644 3624163 X 461734471 0 461734471 25478370 25478370 487212841 399834023 0 399834023 23954358 23954358 423788381 PART X, LINE 2: MANAGEMENT BELIEVES THAT ALL TAX POSITIONS TAKEN WITH RESPECT TO EXEMPT STATUS ISSUES AND UBTI ISSUES, IF EXAMINED BY THE IRS WITH FULL KNOWLEDGE OF ALL MATERIAL FACTS, ARE MORE LIKELY THAN NOT TO BE SUSTAINED. THEREFORE, THE FULL BENEFITS OF THE TAX POSITIONS TAKEN ARE RECOGNIZED IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 23,883,803. CONTRIBUTIONS IN NET ASSETS 1,524,016. ROUNDING 1. G/L SALE OF ASSET 70,550. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 23,883,803. ROUNDING 5. G/L SALE OF ASSET 70,550. 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 13828120 307327 13520793 0.03380 41582275 16419921 25162354 0.06300 100127 34123 66004 0.00020 55510522 16761371 38749151 0.09700 1700313 0 1700313 0.00430 1199973 0 1199973 0.00300 226230 0 226230 0.00060 3126516 3126516 0.00790 58637038 16761371 41875667 0.10490 62662 0 62662 0.00020 26540 0 26540 0.00010 2402 0 2402 0.00000 91604 91604 0.00030 1 23883803 14937804 98118850 112400746 -14281896 X 1 1 1 1 TRUSTEES OF MEASE HOSPITAL INC 3231 MCMULLEN BOOTH RD CLEARWATER FL 33761 WWW.BAYCARE.ORG 4378 X X X TRUSTEES OF MEASE HOSPITAL INC 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 1 16 0 1 0 1 X 250.000000000000 0.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://BAYCARE.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE X HTTPS://BAYCARE.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE X HTTPS://BAYCARE.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 TRUSTEES OF MEASE HOSPITAL, INC. PART V, SECTION B, LINE 5: TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY TRUSTEES OF MEASE HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 66 COMMUNITY STAKEHOLDERS IN THE TRUSTEES OF MEASE HOSPITAL SERVICE AREA TOOK PART IN THE ONLINE KEY INFORMANT SURVEY, AS OUTLINED ON PAGE 8 OF THE CHNA. SEVERAL OF THE PARTICIPANTS RESPONDING TO THE SURVEY REPRESENT ORGANIZATIONS WHICH WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS. TRUSTEES OF MEASE HOSPITAL, INC. PART V, SECTION B, LINE 6A: CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:1. ST. ANTHONY'S HOSPITAL2. MORTON PLANT HOSPITAL ASSOCIATION3. TRUSTEES OF MEASE4. ST. JOSEPH'S HOSPITAL5. SOUTH FLORIDA BAPTIST HOSPITAL TRUSTEES OF MEASE HOSPITAL, INC. PART V, SECTION B, LINE 11: WHILE 14 AREAS OF OPPORTUNITY WERE IDENTIFIED WITHIN THE MEASE COUNTRYSIDE HOSPITAL AND MEASE DUNEDIN HOSPITAL SERVICE AREAS, CONCENTRATED EFFORTS WILL BE DEDICATED DURING THE 2017-2019 TIME PERIOD TO ADDRESSING THE FOLLOWING SIGNIFICANT HEALTH NEEDS OF OUR COMMUNITY AS IDENTIFIED IN THE MOST RECENT CHNA: - ACCESS TO HEALTHCARE SERVICES - DIABETES - HEART DISEASE & STROKE - INFANT HEALTH - MENTAL HEALTH - SUBSTANCE ABUSE - NUTRITION, PHYSICAL ACTIVITY & WEIGHTPLEASE SEE THE ATTACHED IMPLEMENTATION PLAN FOR SPECIFIC ACTIVITIES THAT ARE UNDERWAY TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS DURING THE 2017-2019 TIME PERIOD.BASED ON THE SCOPE/SCALE OF THE ISSUE, MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS' LEADERSHIP TEAM'S PERCEIVED ABILITY TO IMPACT THE ISSUE, THE AVAILABILITY OF EXISTING COMMUNITY RESOURCES ALREADY IN PLACE TO ADDRESS THE ISSUE AND CONSIDERING COMMUNITY STAKEHOLDER FEEDBACK, THE SIGNIFICANT HEALTH NEEDS IDENTIFIED DURING THE 2016 ASSESSMENT THAT ARE NOT DIRECTLY REFERENCED IN THE 2017-2019 CHNA IMPLEMENTATION STRATEGY, ARE LISTED BELOW:CANCER MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS REMAIN COMMITTED TO SUPPORTING THOSE AFFECTED BY CANCER. MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITAL'S LEADERSHIP BELIEVES THAT EXISTING HOSPITAL INITIATIVES AND NEW EFFORTS OUTLINED HEREIN TO IMPROVE ACCESS TO HEALTH SERVICES WILL HAVE A POSITIVE IMPACT ON AIDING THOSE AFFECTED BY CANCER AND THAT A SEPARATE SET OF INITIATIVES WAS NOT NECESSARY AT THIS TIME.DEMENTIA (INCLUDING ALZHEIMER'S DISEASE) MEASE COUNTRYSIDE HOSPITAL AND MEASE DUNEDIN HOSPITAL HAVE LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS DEMENTIA (INCLUDING ALZHEIMER'S DISEASE). WHILE THIS IS AN IMPORTANT ISSUE, OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.HIV/AIDS MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS HAVE LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS HIV/AIDS. OTHER COMMUNITY ORGANIZATIONS (INCLUDING RESOURCES WITHIN THE BAYCARE HEALTH SYSTEM) HAVE INFRASTRUCTURE IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.INJURY & VIOLENCE MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITAL'S LEADERSHIP BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF OTHER COMMUNITY ORGANIZATIONS. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.ORAL HEALTH MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS HAVE LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ORAL HEALTH. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.POTENTIALLY DISABLING CONDITIONS MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITAL'S LEADERSHIP BELIEVES THAT EFFORTS OUTLINED HEREIN TO IMPROVE ACCESS TO HEALTH SERVICES WILL HAVE A POSITIVE IMPACT ON AIDING THOSE WITH POTENTIALLY DISABLING CONDITIONS AND THAT A SEPARATE SET OF INITIATIVES WAS NOT NECESSARY AT THIS TIME.SEXUALLY TRANSMITTED DISEASES MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITAL'S LEADERSHIP BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. TRUSTEES OF MEASE HOSPITAL, INC. PART V, SECTION B, LINE 13B: PATIENTS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE ON THE PORTION OF HOSPITAL BILLS EXCEEDING 25% OF ANNUAL INCOME. TRUSTEES OF MEASE HOSPITAL, INC. PART V, SECTION B, LINE 18E: LIEN ACTION RELATED TO COLLECTIONS IS LIMITED TO PATIENTS INVOLVING AUTO LIABILITY INSURANCE. PART V, SECTION B, LINE 7A HTTPS://BAYCARE.ORG/HOSPITALS/MEASE-COUNTRYSIDE-HOSPITAL/ABOUT-US/COMMUNITY-HEALTH-NEEDS PART V, SECTION B, LINE 7B HTTPS://BAYCARE.ORG/HOSPITALS/MEASE-DUNEDIN-HOSPITAL/ABOUT-US/COMMUNITY-HEALTH-NEEDS 10 1 - MEASE COUNTRYSIDE SURGERY CENTER 1880 MEASE DR SAFETY HARBOR FL 34695 DAY SURGERY CENTER 2 - MEASE OUTPATIENT IMAGING 1840 MEASE DR STE 103 SAFETY HARBOR FL 34695 OUTPATIENT IMAGING CENTER 3 - MPM OUTPATIENT REHABIILATATION SERVICES 32672 US HIGHWAY 19 NORTH PALM HARBOR FL 34684 REHABILITATION SERVICES 4 - MEASE SPORTS MEDICINE CENTER 3251 MCMULLEN BOOTH RD STE 200 SAFETY HARBOR FL 34695 OUTPATIENT CLINIC 5 - MEASE HAND CLINIC 1840 MEASE DR STE 409 SAFETY HARBOR FL 34695 OUTPATIENT CLINIC 6 - MCH CARDIAC & PULMONARY REHABILITATION 1840 MEASE DRIVE SUITE 105 SAFETY HARBOR FL 34695 REHABILITATION SERVICES 7 - MCH SUSAN CHEEK NEEDLER BREAST CENTER 1840 MEASE DRIVE SUITE 103 SAFETY HARBOR FL 34695 IMAGING CENTER 8 - MEASE COUNTRYSIDE SLEEP DISORDERS CENTER 1840 MEASE DR SUITE 102 SAFETY HARBOR FL 34695 OUTPATIENT CLINIC 9 - BAYCARE WOUND CENTER 3890 TAMPA ROAD PALM HARBOR FL 34684 OUTPATIENT CLINIC 10 - BAYCARE OP SLEEP DISORDERS CENTER 12780 RACE TRACK RD SUITE 115 TAMPA FL 34684 OUTPATIENT CLINIC PART I, LINE 3C: PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND CANNOT PAY FOR HOSPITAL SERVICES ARE ELIGIBLE FOR CHARITY CONSIDERATION. THESE PATIENTS ARE SCREENED BY DESIGNATED TEAM MEMBERS IN OUR FINANCIAL ASSISTANCE DEPARTMENT. THE AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA) DEFINES CHARITY ELIGIBILITY AT 200 PERCENT OF THE FEDERAL POVERTY GUIDELINES, UNLESS THE TOTAL HOSPITAL BILL IS MORE THAN 25 PERCENT OF THE PATIENT'S ANNUAL INCOME. MEDICAID RECIPIENTS WHO HAVE EXCEEDED THEIR COVERAGE LIMITS ARE ALSO CONSIDERED FOR CHARITY CARE. TRUSTEES OF MEASE HOSPITAL, INC GOES ABOVE AND BEYOND THE AHCA REQUIREMENTS BY PROVIDING ADDITIONAL "HARDSHIP" CHARITY FOR PATIENTS WHO ARE AT 250 PERCENT OF THE FEDERAL POVERTY GUIDELINES. IN ADDITION, AN UNINSURED DISCOUNT OF 40% IS AUTOMATICALLY GIVEN TO ANY PATIENT WHO DOES NOT HAVE INSURANCE COVERAGE OR BENEFITS. THERE IS NO INCOME OR ASSET TEST REQUIRED FOR THE UNINSURED DISCOUNT. PATIENTS RECEIVE AN ADDITIONAL 10% DISCOUNT IF THE ACCOUNT IS PAID WITHIN 30 DAYS.PRESUMPTIVE FINANCIAL ASSISTANCE DECISIONS FOR UNINSURED ER PATIENTS MAY BE DETERMINED BASED ON THIRD PARTY ANALYTICS, USING A CREDIT INQUIRY PROCESS, UNDER THE FOLLOWING CIRCUMSTANCES: - UNINSURED ACCOUNTS OF PATIENTS NOT SEEN BY THE FINANCIAL ASSISTANCE TEAM OR WITHOUT A CURRENT FINANCIAL ASSISTANCE APPLICATION ON FILE - THE REPORTED FEDERAL POVERTY LEVEL (FPL) OF THE PATIENT MEETS THE CRITERIA FOR TRUSTEES OF MEASE HOSPITAL FINANCIAL ASSISTANCE (250%) PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE TO THE PUBLIC AND WAS PREPARED BY BAYCARE HEALTH SYSTEM INC, A RELATED ORGANIZATION. PART I, LINE 7: FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS COSTS (LINES A THROUGH D) ARE DETERMINED USING OUR COST ACCOUNTING SYSTEM, WHICH CAPTURES ALL INPATIENTS AND OUTPATIENTS, INCLUDING EMERGENCY ROOM PATIENTS. THE SYSTEM ALSO CAPTURES ALL PATIENT PAY TYPES - PRIVATE INSURANCE, MEDICARE, MEDICAID, UNINSURED AND SELF-PAY. THE COSTS HAVE BEEN OFFSET BY ANY PAYMENTS RECEIVED FROM MEDICAID OR ANY OTHER UNCOMPENSATED CARE PROGRAM. OTHER BENEFITS AT COST (LINES E THROUGH J, AS WELL AS AMOUNTS REPORTED IN PART II) WERE COMPILED BY THE COMMUNITY HEALTH DEPARTMENT USING THE CATHOLIC HEALTH ASSOCIATION GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $23,883,803 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. PART II, COMMUNITY BUILDING ACTIVITIES: MEASE HOSPITALS SUPPORT THE COMMUNITY THROUGH COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. THIS INCLUDES:- FUNDING SUPPORT FOR GENERATIONS CHURCH, THE ROTARY CLUB OF DUNEDIN, HUMANE SOCIETY OF PINELLAS, KIWANIS CLUB OF DUNEDIN AND THE CITY OF SAFETY HARBOR THAT ADDRESS THE ROOT CAUSES OF HEALTH AND SAFETY ISSUES AND PROMOTE ECONOMIC STABILITY - RECYCLING COSTS FOR DISPOSABLE ITEMS- TEAM MEMBER TIME DEDICATED TO WORKING WITH HEALTH CARE OBSERVERS, INTERESTED IN PURSUING A CAREER IN THE MEDICAL FIELD PART III, LINE 2: BAD DEBT EXPENSE IS REPORTED AS TOTAL BAD DEBT FOR THE FACILITY. THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE IS CALCULATED AS A CHARGE RATIO, DERIVED FROM DATA SAMPLING. THE RESULTING CHARGE RATIO IS THEN APPLIED TO TOTAL BAD DEBT ACCOUNTS OF THE ORGANIZATION, WHICH CALCULATES THE BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE. THE STATE OF FLORIDA REQUIRES THE PATIENT TO PROVIDE CERTAIN DOCUMENTATION IN ORDER TO QUALIFY FOR FINANCIAL ASSISTANCE. IN CASES WHERE THE PATIENT HAS NOT RESPONDED TO HOSPITAL REQUESTS OR BILLING STATEMENT ALERTS, THOSE ACCOUNTS ARE PROCESSED AS BAD DEBT, IF UNPAID. PART III, LINE 3: SEE PART III, LINE 2 PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE ON PAGE 12 OF THE BAYCARE HEALTH SYSTEM, INC. AND AFFILIATES NOTES TO COMBINED FINANCIAL STATEMENTS. PART III, LINE 8: COST REPORTS WERE USED TO REPORT MEDICARE ALLOWABLE COSTS. MEDICARE DEFINES ALLOWABLE COSTS AS THOSE APPROPRIATE AND HELPFUL IN DEVELOPING AND MAINTAINING THE OPERATION OF PATIENT CARE FACILITIES AND ACTIVITIES. IT SPECIFICALLY EXCLUDES CERTAIN COSTS THAT ARE NOT DIRECTLY RELATED TO PATIENT CARE. THE HOSPITAL INCURS ADDITIONAL EXPENSE RELATED TO THE PROVISION OF CARE TO MEDICARE PATIENTS THAT MEDICARE HAS DEEMED NON-ALLOWABLE. THIS ADDITIONAL EXPENSE INCLUDES COSTS OF PHYSICIAN SERVICES (EMERGENCY ON-CALL FEES, HOSPITALIST PROGRAM, RECRUITMENT, ETC.), ADVERTISING COSTS, CAFETERIA COSTS FOR MEALS SOLD TO VISITORS, ETC. THE HOSPITAL ATTEMPTS TO COLLECT COINSURANCE AND DEDUCTIBLES FROM MEDICARE BENEFICIARIES. TO THE EXTENT COLLECTION EFFORTS ARE UNSUCCESSFUL, MEDICARE REIMBURSES THE HOSPITAL AT 65% OF UNPAID AMOUNTS. THE FOLLOWING TABLE RECONCILES THE SURPLUS OR SHORTFALL FROM LINE 7 TO THE ACTUAL SURPLUS OR SHORTFALL. THE ADDITIONAL COSTS WERE ALLOCATED TO MEDICARE BASED UPON MEDICARE'S PERCENTAGE OF TOTAL ALLOWABLE COSTS. THE UNPAID COINSURANCE/DEDUCTIBLES WERE ESTIMATED USING HISTORICAL COLLECTION RESULTS. ANY SHORTFALL AMOUNTS HAVE NOT BEEN TREATED AS COMMUNITY BENEFIT. - LINE 7 SURPLUS OR (SHORTFALL) ($14,281,896) - ADDITIONAL NON-ALLOWABLE COSTS AND UNPAID/NON-REIMBURSED COINSURANCE/DEDUCTIBLES ($13,092,216) - TOTAL SURPLUS OR (SHORTFALL) ($27,374,112) PART III, LINE 9B: PATIENTS WHO ARE UNABLE TO PAY ARE ENCOURAGED BY BAYCARE HEALTH SYSTEM REPRESENTATIVES, VIA PERSONAL INTERVIEWS, SIGNAGE, ON PATIENT BILLING STATEMENTS, BROCHURES OR CUSTOMER SERVICE PHONE CALLS, TO SUBMIT FINANCIAL INFORMATION TO THE FINANCIAL ASSISTANCE DEPARTMENT TO DETERMINE ELIGIBILITY FOR PROGRAMS, SUCH AS COUNTY, MEDICAID, DISABILITY, VICTIMS OF CRIME, CHARITY, ETC. FOR THOSE PATIENTS WHO PROVIDE ALL THE NECESSARY DOCUMENTATION AND QUALIFY FOR CHARITY ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, (DEFINED IN PART I, LINE 3C), THE PATIENT'S ACCOUNT BALANCE WOULD BE WRITTEN OFF COMPLETELY TO CHARITY AND NOT BILLED TO THE PATIENT. PART VI, LINE 2: TRUSTEES OF MEASE HOSPITAL, INC IS COMMITTED TO MEETING THE NEEDS OF THE COMMUNITY IT SERVES. OUR QUALITY PHILOSOPHY IS MODELED AROUND UNDERSTANDING OUR CUSTOMERS' NEEDS IN THE COMMUNITIES IT SERVES. TRUSTEES OF MEASE HOSPITAL, INC ADDRESSES COMMUNITY HEALTH STATUS ASSESSMENTS BY ACCESSING EXISTING THIRD PARTY DATABASES PROFILING HEALTH STATUS INFORMATION FOR GEOGRAPHIES IT SERVES. THE ASSESSMENTS PROVIDE A PROFILE OF HEALTH STATUS INDICATORS IN COMPARISON TO STATE AVERAGES AND, IF AVAILABLE, NATIONAL BENCHMARKS. IN ADDITION, TRUSTEES OF MEASE HOSPITAL, INC CONDUCTS PHYSICIAN COMMUNITY NEED STUDIES THAT OUTLINE PHYSICIANDEFICITS BY SPECIALTY FOR THE GEOGRAPHIC AREA SERVED. STUDIES ARE ALSO CONDUCTED TO IDENTIFY GAPS IN GEOGRAPHIC ACCESS TO SERVICES SUCH AS PRIMARY CARE, OUTPATIENT SERVICES AND INPATIENT SERVICES. ALL OF THE ABOVE PROCESSES OCCUR ON AN ONGOING BASIS TO ASSIST TRUSTEES OF MEASEHOSPITAL, INC IN DEVELOPING INITIATIVES AND PROGRAMS/SERVICES TO ADDRESS IDENTIFIED HEALTH CARE NEEDS IN THE COMMUNITIES IT SERVES. PART VI, LINE 3: TRUSTESS OF MEASE HOSPITAL, INC FINANCIAL ASSISTANCE TEAM MEMBERS ARE DEDICATED TO ASSISTING PATIENTS IN OBTAINING ASSISTANCE THROUGH FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS OR THROUGH THE TRUSTEES OF MEASE HOSPITAL, INC FINANCIAL ASSISTANCE POLICY. SIGNAGE AND BROCHURES ARE AVAILABLE, AS WELL AS TEAM MEMBERS WHOSE FULL RESPONSIBILITY IS TO ASSIST PATIENTS IN THE EMERGENCY ROOM AND ON INPATIENT UNITS. THE FINANCIAL ASSISTANCE TEAM INTERVIEWS PATIENTS FOR ALL AVAILABLE PROGRAMS, ASSISTS THE PATIENTS IN COMPLETING APPLICATIONS TO GOVERNMENT AGENCIES AND FOR HOSPITAL CHARITY CARE, ADVISES PATIENTS REGARDING AVAILABLE COMMUNITY RESOURCES FOR HEALTH CARE, REVIEWS AND APPROVES PATIENT REQUESTS FOR CHARITY CARE, AND PROVIDES EDUCATION AND SUPPORT TO THE PATIENT THROUGHOUT THE ASSISTANCE PROCESS.IN ADDITION TO THE AFOREMENTIONED COMPREHENSIVE PROCESS, TRUSTEES OF MEASE HOSPITAL, INC ALSO INFORMS AND EDUCATES PATIENTS WHO MAY BE BILLED FOR PATIENT CARE, BUT MAY BE ELIGIBLE FOR CHARITY OR OTHER PROGRAMS, VIA PATIENT BILLING STATEMENTS AND CUSTOMER SERVICE REPRESENTATIVE CALLS. THE GOAL IN USING THESE VARIOUS MEANS IS TO EFFECTIVELY COMMUNICATE WITH THE ENTIRE PATIENT POPULATION SO THEY ARE INFORMED AND EDUCATED ABOUT THEIR ELIGIBILITY FOR ASSISTANCE. PART VI, LINE 4: MEASE HOSPITALS ARE ACUTE CARE FACILITIES SERVING PARTS OF HILLSBOROUGH, PASCO AND PINELLAS COUNTIES. THE AVERAGE HOUSEHOLD INCOME IN THIS AREA IS $3,856 BELOW THE STATE AVERAGE AND $13,600 BELOW THE NATIONAL AVERAGE. 11.9% OF HOUSEHOLDS HAVE ANNUAL HOUSEHOLD INCOME BELOW $15,000 PER YEAR. THE POPULATION SERVED IS PREDOMINANTLY CAUCASIAN AND HIGH-SCHOOL OR HIGHER EDUCATED. HISPANICS ARE THE SECOND LARGEST ETHNIC GROUP REPRESENTING 13.6% OF THE POPULATION. MEASE HOSPITALS ARE PART OF BAYCARE HEALTH SYSTEM THAT SERVES WEST CENTRAL FLORIDA. THE AREA SERVED BY THE MEASE HOSPITALS HAS 16 ACUTE CARE HOSPITALS (7 NOT-FOR-PROFIT), 2 LONG TERM ACUTE CARE HOSPITALS (1 NOT-FOR-PROFIT) AND 1 FOR-PROFIT REHABILITATION HOSPITAL. THERE ARE 8 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS IN MEASE HOSPITALS' SERVICE AREA. WITH THE OVER 65 POPULATION EXPECTED TO GROW 16.5% IN THE NEXT FIVE YEARS, THE HEALTH CARE NEEDS OF OUR SERVICE AREA ARE EXPANDING AND CHANGING. THE POPULATION SERVED BY MEASE HOSPITALS IS EXPECTED TO GROW 5.7% IN THE NEXT 5 YEARS. THIS EXPECTED GROWTH IS HIGHER THAN THE EXPECTED GROWTH RATE FOR THE UNITED STATES WHICH IS 3.5%. BASED ON FLORIDA INPATIENT DISCHARGE DATA FOR THE PERIOD OF 10/01/2017-9/30/2018, THE PAYER MIX FOR THE GEOGRAPHIC AREA CONSISTS OF 55.3% MEDICARE/MEDICARE HMO, 13.7% MEDICAID/MEDICAID HMO, 19.1% COMMERCIAL INSURANCE, 7.8% SELF PAY/NON-PAY, AND 4.0% OTHER. PART VI, LINE 5: RESIDENTS OF THE SMALL CITY OF DUNEDIN ENCOURAGED DR. JACK MEASE TO BUILD A HOSPITAL WITH THE COMMUNITY'S HELP IN 1937. TODAY MEASE DUNEDIN IS A 120-BED HOSPITAL COMMITTED TO CONTINUING MORE THAN 80 YEARS OF MEETING THE NEEDS OF THE COMMUNITY IT SERVES. MEASE COUNTRYSIDE HOSPITAL ORIGINALLY BEGAN AS A SATELLITE CLINIC TO MEASE DUNEDIN HOSPITAL. THE NEEDS OF THE COMMUNITY GREW ALONG WITH A HOUSING BOOM AND IN 1985, MEASE COUNTRYSIDE HOSPITAL OPENED. MEASE COUNTRYSIDE HOSPITAL HAS BEEN SERVING ITS FAST-GROWING COMMUNITY FOR MORE THAN 30 YEARS WITH THE SAME COMMITMENT AND IS A 311-BED FACILITY.MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS ARE PART OF MORTON PLANT MEASE HEALTH CARE. THE OTHER HOSPITALS INCLUDED IN MORTON PLANT MEASE HEALTH CARE ARE MORTON PLANT AND MORTON PLANT NORTH BAY. EVEN THOUGH MORTON PLANT AND MORTON PLANT NORTH BAY HOSPITALS FILE THEIR OWN TAX RETURN, THE FOUR HOSPITALS WORK TOGETHER AS MORTON PLANT MEASE HEALTH CARE (REFERRED TO AS MORTON PLANT MEASE) TO SUPPORT COMMUNITY HEALTH CARE NEEDS AND SERVICES. COMMUNITY INVOLVEMENTMEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS INVOLVES COMMUNITY MEMBERS AS AN ESSENTIAL COMPONENT OF THE BOARD OF TRUSTEES.CONDUIT FOR USING DONATED FUNDSPATIENT TRANSPORTATIONTHROUGH A GRANT FROM THE FLORIDA BLUE FOUNDATION AND A PARTNERSHIP WITH UBER TECHNOLOGIES, A NON-EMERGENCY TRANSPORTATION SOLUTION IS PROVIDED FOR LOW INCOME PATIENTS ACROSS BAYCARE'S FOUR-COUNTY SERVICE AREA TO ACCESS FOLLOW-UP HEALTH SERVICES. IN 2018, THE PROGRAM PROVIDED RIDES TO MORE THAN 5,800 DISCHARGED PATIENTS.ALLEGANY FRANCISCAN MINISTRIES (FAITH COMMUNITY NURSING GRANT) BAYCARE HAS RECEIVED FUNDING FROM ALLEGANY FRANCISCAN MINISTRIES TO PROVIDE CAPACITY AND SUPPORT TO OUR FAITH COMMUNITY NURSING PROGRAM TO REDUCE UNNECESSARY HOSPITAL UTILIZATION AND IMPROVE HEALTH OUTCOMES FOR PARTICIPANTS. ANNUAL FUNDING OF $160,000 SUPPORTS THIS WORK ACROSS BAYCARE HEALTH SYSTEM. ALLEGANY FRANCISCAN MINISTRIES (MEDICATION ASSISTANCE PROGRAM)BAYCARE HAS RECEIVED FUNDING FROM ALLEGANY FRANCISCAN MINISTRIES TO PROVIDE ASSISTANCE TO THOSE WHO FACE FINANCIAL BARRIERS IN GETTING THEIR NEEDED PRESCRIPTION MEDICATIONS. MEDICATION ASSISTANCE COORDINATORS WORK WITH PATIENTS TO DETERMINE IF THERE ARE VOUCHERS AVAILABLE OR WORK WITH THE PATIENT'S DOCTOR TO SEE IF A MORE COST EFFECTIVE, ALTERNATIVE MEDICATION IS AVAILABLE. ANNUAL FUNDING OF $65,000 PROVIDES SUPPORT FOR THIS PROGRAM ACROSS BAYCARE HEALTH SYSTEM.ECONOMIC IMPACTTHERE ARE 7,200 MORTON PLANT MEASE EMPLOYEES AND MORE THAN 1,300 PHYSICIANS WHO HAVE BROUGHT THE HOSPITALS' MISSION TO LIFE.BY INVITING THE NEXT GENERATION OF HEALTH CARE WORKERS TO LEARN FROM THE SKILL AND EXPERTISE OF OUR CURRENT TEAM MEMBERS, MORTON PLANT MEASE PROVIDES VALUABLE BENEFIT TO THE COMMUNITY. STUDENT CLINICAL EXPERIENCES AFFORD HEALTH CARE STUDENTS OPPORTUNITIES TO LEARN SKILLS AND KNOWLEDGE NECESSARY TO FUNCTION IN ACUTE CARE FACILITIES AND GAIN COMPETENCE IN CLINICAL TECHNIQUES. IN TOTAL, $1,199,973 IN STAFF TIME FOR NURSES, DIETITIANS, LAB TECHNOLOGISTS AND RESPIRATORY THERAPISTS WAS USED TO EDUCATE THESE FUTURE HEALTH CARE PROVIDERS ABOUT MANY ASPECTS OF PATIENT CARE. STUDENTS PURSUING CAREERS IN EMERGENCY MEDICAL SERVICES (EMS) ALSO COMPLETED INTERNSHIPS AND CLINICAL ROTATIONS AT MEASE HOSPITALS. IN 2018, EMS STUDENTS STUDIED AT OUR FACILITIES WITH TEAM MEMBERS DEVOTING MORE THAN $60,000 TOWARD THEIR TIME AND TRAINING. IN 2018, STUDENTS FROM SIX COLLEGES AND UNIVERSITIES ALSO BENEFITTED FROM CLINICAL INTERNSHIPS.CAMP NURSE JR. SEVENTH- AND EIGHTH-GRADE STUDENTS WHO ARE INTERESTED IN BECOMING A DOCTOR, NURSE OR OTHER HEALTH CARE PROFESSIONAL ATTENDED CAMP NURSE JR. AT MEASE DUNEDIN HOSPITAL. TAUGHT BY REGISTERED NURSES FROM MORTON PLANT MEASE HEALTH CARE, STUDENTS EXPERIENCED HEALTH CARE CAREERS THROUGH VISITS TO VARIOUS HOSPITAL DEPARTMENTS AND HANDS-ON ACTIVITIES SUCH AS WORKING WITH COMPUTERIZED PATIENT SIMULATORS DURING THE THREE-DAY SUMMER CAMP. GOOD NEIGHBORSMEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS PROVIDE FREE MEETING SPACE FOR A WIDE ARRAY OF COMMUNITY GROUPS INCLUDING SUPPORT GROUPS AND CIVIC ORGANIZATIONS.RECOGNITIONEXCELLENCE IN CLINICAL CARE - MEASE COUNTRYSIDE HOSPITAL HAS BEEN NATIONALLY RECOGNIZED AS THE BESTPERFORMING HOSPITAL IN THE U.S. 11 TIMES BY IBM WATSON HEALTH 100 TOP HOSPITALS AND IS THE ONLY FLORIDA HOSPITAL TO BE NAMED 11 TIMES.NURSING ALL FOUR MORTON PLANT MEASE HOSPITALS - MEASE COUNTRYSIDE, MEASE DUNEDIN, MORTON PLANT AND MORTON PLANT NORTH BAY ACHIEVED PATHWAY DESIGNATION FROM THE AMERICAN NURSES CREDENTIALING CENTER (ANCC), WHICH RECOGNIZES HEALTH CARE ORGANIZATIONS FOR POSITIVE PRACTICE ENVIRONMENTS WHERE NURSES EXCEL. NATIONALLY ACCREDITED BARIATRIC PROGRAMIN 2018, MEASE DUNEDIN HOSPITAL'S BARIATRIC PROGRAM WAS RE-ACCREDITED AS A COMPREHENSIVE CENTER BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP), IN RECOGNITION OF THE PROGRAM'S COMMITMENT TO PROVIDING AND SUPPORTING QUALITY IMPROVEMENT AND PATIENT SAFETY EFFORTS FOR METABOLIC AND BARIATRIC SURGERY PATIENTS.STROKE CAREALL FOUR MORTON PLANT MEASE HOSPITALS HAVE BEEN RECOGNIZED IN 2018 FOR PROVIDING QUALITY CARE TO STROKE PATIENTS WITH THE "GET WITH THE GUIDELINES" ACHIEVEMENT AWARDS FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION: MORTON PLANT, MEASE COUNTRYSIDE, MEASE DUNEDIN AND MORTON PLANT NORTH BAY HOSPITALS ALL RECEIVED THE STROKE GOLD PLUS ACHIEVEMENT AWARD MORTON PLANT, MEASE DUNEDIN AND MEASE COUNTRYSIDE ALSO RECEIVED TARGET STROKE HONOR ROLL ELITE RECOGNITION. RESPONDING TO NEEDSMORTON PLANT MEASE IS COMMITTED TO PROVIDING FINANCIAL AND OTHER SUPPORT TO NOT-FOR-PROFIT ORGANIZATIONS WHOSE MISSIONS ARE TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. IN 2018, MORTON PLANT MEASE PROVIDED FUNDING TO FREE CLINICS AND COMMUNITY BASED ORGANIZATIONS INCLUDING THE FOLLOWING: CLEARWATER FREE CLINICMORTON PLANT MEASE PROVIDES $300,000 ANNUALLY TO SUPPORT ONGOING OPERATIONS INCLUDING MEDICATION ASSISTANCE AND AN ON-SITE ADVANCED REGISTERED NURSE PRACTITIONER. LA CLINICA GUADALUPANALA CLINICA GUADALUPANA IS A FREE CLINIC THAT PROVIDES HEALTH CARE TO PINELLAS COUNTY'S RAPIDLY GROWING HISPANIC COMMUNITY. MORTON PLANT MEASE PROVIDES $60,000 ANNUALLY TO SUPPORT ONGOING OPERATIONS, WHICH INCLUDE SERVICES SUCH AS PRIMARY, GYNECOLOGICAL AND PEDIATRIC CARE, FREE HEALTH SCREENINGS AND IMMUNIZATIONS. WILLA CARSON HEALTH AND WELLNESS CENTERTHE WILLA CARSON HEALTH AND WELLNESS CENTER IN CLEARWATER PROVIDES PREVENTATIVE HEALTH CARE, WELLNESS AND EDUCATION SERVICES TO UNINSURED AND LOW-INCOME COMMUNITY MEMBERS AT NO CHARGE. MORTON PLANT MEASE PROVIDES $55,000 ANNUALLY TO SUPPORT ONGOING OPERATIONS. SERVICES PROVIDED INCLUDE BLOOD PRESSURE TESTS, DIABETES SCREENINGS, LEAD SCREENINGS, PHYSICALS AND TUBERCULOSIS (TB) TESTING. HOMELESS EMPOWERMENT PROGRAMMORTON PLANT MEASE PROVIDES $158,684 ANNUALLY TO SUPPORT THE HOMELESS EMPOWERMENT PROGRAM'S ON-SITE WELLNESS CLINIC OFFERING CHRONIC DISEASE SELF-MANAGEMENT PROGRAM WORKSHOPS, HEALTH AND WELLNESS NAVIGATOR SERVICES TO EXPEDITE ACCESS TO PRIMARY CARE, DIAGNOSTIC, AND PHARMACEUTICAL SERVICES, AS WELL AS CRISIS INTERVENTION/STABILIZATION SERVICES FROM THE BEHAVIORAL HEALTH NAVIGATOR. NORTH GREENWOOD COMMUNITY HEALTH FAIRIN AN EFFORT TO IMPROVE THE HEALTH OF THE RESIDENTS IN THE TRADITIONALLY LOW-INCOME NEIGHBORHOOD OF NORTH GREENWOOD, BAYCARE AND MORTON PLANT MEASE PARTNERED WITH MT. OLIVE AME CHURCH TO HOST A FREE COMMUNITY HEALTH FAIR. OUR FAITH COMMUNITY NURSES HELPED TO FACILITATE THE EVENT, BRINGING IN SERVICES AND HEALTH CARE PROVIDERS FROM THROUGHOUT BAYCARE AND THE COMMUNITY TO PROVIDE BLOOD PRESSURE SCREENINGS, BODY MASS INDEX/OBESITY SCREENINGS, TOTAL CHOLESTEROL TESTING, HEALTH RISK ASSESSMENTS, FLU VACCINES, DEPRESSION SCREENINGS AND MORE.ENROLLMENT ASSISTANCE IN 2018, FOUR FINANCIAL ASSISTANCE TEAM MEMBERS AT MEASE COUNTRYSIDE SCREENED UNINSURED AND UNDER-INSURED ER PATIENTS AND INPATIENTS AT THE BEDSIDE FOR MULTIPLE MEDICAID PROGRAMS AND COUNTY HEALTH CARE PLANS, THEN ASSISTED WITH THE COMPLETION OF APPLICATIONS IN ADDITION TO PROVIDING EDUCATION AND CONTINUOUS SUPPORT THROUGH THE PROCESS. THEIR EFFORTS LOGGED MORE THAN 2,300 HOURS OF BENEFIT FOR THE COMMUNITY SURROUNDING MEASE COUNTRYSIDE.(CONT-D AFTER PART VI, LINE 7 NARRATIVE) PART VI, LINE 6: TRUSTEES OF MEASE HOSPITAL, INC. IS PART OF BAYCARE HEALTH SYSTEM, INC. ("BAYCARE"), A LEADING, NOT-FOR-PROFIT HEALTH CARE SYSTEM THAT CONNECTS INDIVIDUALS AND FAMILIES TO A WIDE RANGE OF SERVICES AT 14 HOSPITALS AND HUNDREDS OF OTHER CONVENIENT LOCATIONS THROUGHOUT THE TAMPA BAY AND WEST CENTRAL FLORIDA REGIONS. INPATIENT AND OUTPATIENT SERVICES INCLUDE ACUTE CARE, PRIMARY CARE, IMAGING, LABORATORY, BEHAVIORAL HEALTH, HOME CARE AND URGENT CARE. BAYCARE'S ANNUAL "REPORT TO THE COMMUNITY" CAN BE VIEWED AT HTTPS://BAYCARE.ORG/ANNUAL-REPORT-2018.BAYCARE'S HOSPITALS ARE BARTOW REGIONAL MEDICAL CENTER, MEASE COUNTRYSIDE, MEASE DUNEDIN, MORTON PLANT, MORTON PLANT NORTH BAY, ST. ANTHONY'S, ST. JOSEPH'S, ST. JOSEPH'S CHILDREN'S, ST. JOSEPH'S WOMEN'S, ST. JOSEPH'S HOSPITAL-NORTH, ST. JOSEPH'S HOSPITAL-SOUTH, SOUTH FLORIDA BAPTIST, WINTER HAVEN AND WINTER HAVEN WOMEN'S.*BAYCARE WAS FOUNDED IN 1997 WHEN SEVERAL OF THE AREA'S NOT-FOR-PROFIT HOSPITALS CAME TOGETHER TO CREATE A HEALTH SYSTEM THAT WOULD ENSURE HIGH-QUALITY HEALTH CARE FOR EVERYONE IN THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. TODAY, BAYCARE IS A $4.2 BILLION, INTEGRATED HEALTH DELIVERY SYSTEM WITH 28,400 EMPLOYEES. IT PLAYS AN IMPORTANT ROLE AS AN ECONOMIC ENGINE, ANNUALLY GENERATING A $6.62 BILLION IMPACT ON THE REGION AND THE STATE. IN 2018, BAYCARE SPENT $2.09 BILLION TO PAY FOR THE SALARY AND BENEFITS OF ITS EMPLOYEES AND INVESTED $309 MILLION IN CAPITAL RESOURCES.BAYCARE'S CENTRALIZATION OF ADMINISTRATIVE FUNCTIONS IN A NUMBER OF AREAS, INCLUDING FINANCE, BUSINESS OFFICE, INFORMATION TECHNOLOGY, HUMAN RESOURCES, PERFORMANCE IMPROVEMENT, CLINICAL OUTCOMES, CARE MANAGEMENT, PLANNING, SUPPLY CHAIN AND MARKETING/COMMUNICATIONS, HAS PROVIDED A MANAGEMENT STRUCTURE THAT HELPS ITS HOSPITALS AND SERVICE LINES OPERATE MORE EFFICIENTLY AND CONTINUE STRIVING FOR CLINICAL EXCELLENCE. BAYCARE'S FINANCIAL STABILITY ALSO HELPS ENSURE THAT ITS HOSPITALS REMAIN FOCUSED ON THEIR SHARED MISSION TO IMPROVE THE HEALTH OF ALL THEY SERVE THROUGH COMMUNITY-OWNED SERVICES THAT SET THE STANDARD FOR HIGH-QUALITY, COMPASSIONATE CARE, REGARDLESS OF PATIENTS' ABILITY TO PAY.IN 2018, BAYCARE PROVIDED $462 MILLION IN TOTAL COMMUNITY BENEFIT, 11% OF BAYCARE'S REVENUES, WHICH INCLUDES $117 MILLION IN TRADITIONAL CHARITY CARE FOR UNINSURED PATIENTS, $311 MILLION IN MEDICAID AND OTHER INCOME-BASED PROGRAMS, AND $34 MILLION IN UNBILLED COMMUNITY SERVICES. ALL OF THESE ARE MEASURED IN UNREIMBURSED COST.*IN CERTAIN CASES, HOSPITAL LOCATIONS WITH THE SAME TAX IDENTIFICATION AND STATE LICENSE NUMBER ARE LISTED AS ONE FACILITY ON FORM 990, SCHEDULE H, CONSISTENT WITH IRS REPORTING GUIDELINES. PART VI, LINE 7 TRUSTEES OF MEASE HOSPITAL, INC. OPERATES IN THE STATE OF FLORIDA, WHICH DOES NOT REQUIRE A COMMUNITY BENEFIT REPORT TO BE FILED WITH THE STATE GOVERNMENT. PART VI, LINE 5 (CONT-D) CLINICAL RESOURCE MANAGEMENTIN 2018, THE CLINICAL RESOURCE MANAGEMENT PROGRAM PROVIDED $960,522 IN SERVICES. THIS PROGRAM INCLUDES PHARMACY, HOME HEALTH/DME, TRANSPORTATION, SKILLED NURSING FACILITIES, ASSISTED LIVING FACILITIES AND OTHER DISCHARGE NEEDS FOR PATIENTS. MANY PATIENTS ARE EITHER UNINSURED, UNABLE TO APPROPRIATELY CARE FOR THEMSELVES OR DO NOT HAVE A CAREGIVER.WOMEN'S & CHILDREN'S CARESERVING NORTH PINELLAS AND PASCO COUNTIES, THE WOMEN'S & CHILDREN'S CENTER AT MEASE COUNTRYSIDE HOSPITAL SEEKS TO COMBINE MODERN TECHNOLOGY WITH FAMILY-CENTERED CARE. BIRTHING, CHILDCARE AND BREASTFEEDING CLASSES ARE OFFERED TO EXPECTANT PARENTS.PRE-NATAL CARE FOR DRUG TREATMENT PATIENTSTO HELP ADDRESS THE SERIOUS ISSUE OF BABIES BORN TO DRUG-ADDICTED MOMS, MEASE COUNTRYSIDE OFFERS EXPECTANT MOMS ADDICTED TO DRUGS A PROGRAM THAT CROSSES THE CONTINUUM OF CARE FROM PRE-NATAL THROUGH THE HOSPITAL STAY. SERVICES INCLUDE AN OCCUPATIONAL THERAPIST, SPECIALIZING IN NEONATES TO WORK ONE-ON-ONE WITH PARENTS TO ENHANCE BONDING AND TEACH PARENTING SKILLS SUCH AS SOOTHING TECHNIQUES FOR BABIES SUFFERING THE EFFECTS OF DRUG WITHDRAWAL.BY PARTNERING WITH ST. JOSEPH'S CHILDREN'S HOSPITAL, MEASE COUNTRYSIDE HAS CONTINUED ITS COMMITMENT TO STRENGTHEN AND ADVANCE CHILDREN'S CARE IN NORTH PINELLAS AND SOUTH PASCO COUNTIES BY PROVIDING MORE ACCESS IN THE LOCAL COMMUNITY TO INNOVATIVE AND HIGH TECH CARE IN A FAMILY-CENTERED SETTING. THE PARTNERSHIP OFFERS: - PEDIATRIC EMERGENCY SERVICES - LEVEL III NEONATAL INTENSIVE CARE UNITS - ENHANCED 15-BED, PRIVATE INPATIENT CHILDREN'S UNIT WITH A CHILD LIFE SPECIALIST WHO WORKS WITH CHILDREN AND THEIR PARENTS TO BRING A SENSE OF NORMALCY TO THE EXPERIENCE OF HOSPITALIZATION - CHILDREN'S ADVOCACY PROVIDING EDUCATIONAL CLASSES AND COMMUNITY ACTIVITIES INCLUDING HOME SAFETY ASSESSMENTS, ASTHMA ASSESSMENTS, ASTHMA EDUCATION, CHILD PASSENGER SAFETY EDUCATION, BICYCLE AND PEDESTRIAN SAFETY EDUCATION, FALL PREVENTION EDUCATION, DROWNING PREVENTION EDUCATION, FIRE/BURN AND POISONING PREVENTION EDUCATION AND BRINGING AWARENESS OF FLORIDA KIDCARE INSURANCE - ST. JOSEPH'S CHILDREN'S SPECIALTY CENTER ON THE MEASE COUNTRYSIDE CAMPUS PROVIDES THE NORTH PINELLAS AND SOUTH PASCO COMMUNITIES GREATER ACCESS TO PHYSICAL, OCCUPATIONAL, SPEECH, AND SENSORY THERAPY PROGRAMS, PEDIATRIC PHYSICIAN SPECIALTY SERVICES AND CONVENIENT, ON-SITE PEDIATRIC AND LABORATORY SERVICESMEASE DUNEDIN BEHAVIORAL HEALTH CENTERTO PROVIDE ADDITIONAL ACCESS TO CONVENIENT, ACUTE INPATIENT MENTAL HEALTH SERVICES, BAYCARE HEALTH SYSTEM AND MEASE DUNEDIN HOSPITAL HAVE A 32-BED SPECIALIZED INPATIENT BEHAVIORAL HEALTH CENTER. THE BEHAVIORAL HEALTH CENTER FEATURES THREE SEPARATE UNITS ONE FOR ADULTS WITH 12 BEDS, ONE FOR CHILDREN AND ADOLESCENTS WITH 10 BEDS AND ONE FOR GERIATRIC PATIENTS WITH 10 BEDS. COMMUNITY SCREENINGS & COMMUNITY EDUCATIONMORTON PLANT MEASE SCREENED COMMUNITY MEMBERS FOR SUCH DISEASES AND CONDITIONS AS HIGH BLOOD PRESSURE, SKIN CANCER, MEMORY DISORDERS, SLEEP DISORDERS AND CARDIOVASCULAR DISEASE. IN ADDITION, MORTON PLANT MEASE GAVE FREE ATHLETIC PHYSICALS TO PINELLAS COUNTY HIGH SCHOOL STUDENTS AT A SPORTS PHYSICAL EVENT. OUR COMPREHENSIVE PHYSICALS INCLUDED CHECKS OF HEIGHT, WEIGHT, BLOOD PRESSURE, VISION AND LUNGS, AS WELL AS A MUSCULOSKELETAL EXAM. MEASE COUNTRYSIDE AND MEASE DUNEDIN PROVIDE FREE COMMUNITY HEALTH EDUCATION IN THE FORM OF SUPPORT GROUPS ON A WIDE VARIETY OF TOPICS. FAITH COMMUNITY NURSINGFAITH COMMUNITY NURSING OFFERS A UNIQUE PARTNERSHIP BETWEEN MORTON PLANT MEASE AND THE FAITH COMMUNITIES IN PINELLAS AND PASCO COUNTIES. OUR FAITH COMMUNITY NURSES AND HEALTH MINISTERS WORK TO IMPROVE THE HEALTH OF THEIR FAITH COMMUNITY BY ENCOURAGING PREVENTATIVE CARE AND REFERRING MEMBERS TO THE APPROPRIATE HEALTH RESOURCES. IN 2018, 131 NURSES HAD DIRECT CONTACT WITH FAITH COMMUNITY MEMBERS. THEY CONDUCTED MORE THAN 4,000 SCREENINGS AND HAD ALMOST 32,000 CLIENT ENCOUNTERS, VOLUNTEERING MORE THAN 16,000 HOURS WITHIN 67 LOCAL FAITH COMMUNITIES. VIRTUAL ICUBAYCARE HEALTH SYSTEM AND THE MORTON PLANT MEASE HOSPITALS HAVE TAKEN THE TREATMENT OF CRITICALLY ILL PATIENTS TO THE NEXT LEVEL WITH VIRTUAL ICU, A TELEMEDICINE-BASED PROGRAM. COMBINING MEDICAL EXPERTISE, TECHNOLOGY AND EXPERIENCED CRITICAL CARE NURSES AND DOCTORS, VIRTUAL ICU IS AN ELECTRONIC PATIENT MONITORING SYSTEM THAT USES REMOTE COMPUTER TECHNOLOGY AND PHYSICIANS TO ENHANCE THE CARE OF CRITICALLY ILL PATIENTS.VOLUNTEER ACTIVITIESIN 2018, 485 VOLUNTEERS PROVIDED 101,286 HOURS WHICH RESULTED IN 318,356 UNITS OF SERVICE FOR MEASE COUNTRYSIDE AND MEASE DUNEDIN HOSPITALS TO PROVIDE SERVICE TO MEET OUR COMMUNITY NEEDS THAT MIGHT OTHERWISE GO UNMET. THESE SERVICES INCLUDE PATIENT WELCOME VISITS, SURGERY VISITOR ASSISTANCE, TRAM/SHUTTLE RIDES, DISCHARGE ASSISTS, VOLUNTEER CHAPLAIN VISITS AND PATIENT COMPANION VISITS. IN ADDITION TO HOSPITAL SERVICES, THEY ALSO PROVIDED UNIQUE SUPPORT FOR CANCER PATIENTS AND THEIR FAMILIES THROUGH AN ALL-DAY, FREE CELEBRATION PICNIC. VOLUNTEERS PROVIDED 12,649 RIDES THROUGH CARELIFT, A FREE VAN TRANSPORTATION PROGRAM FOR PATIENTS NEEDING RIDES TO AND FROM THE HOSPITALS AND OUTPATIENT SERVICES FOR APPOINTMENTS AND TREATMENTS.MORTON PLANT MEASE AND ITS TEAM MEMBERS AND PHYSICIANS FROM THE TURLEY FAMILY HEALTH CENTER, ALONG WITH MORTON PLANT MEASE FAITH COMMUNITY NURSING AND PASTORAL CARE GAVE 47 FREE BACK-TO-SCHOOL PHYSICALS AND HANDED OUT 380 BACKPACKS FILLED WITH SCHOOL SUPPLIES AT THE NORTH GREENWOOD BACK TO SCHOOL WELLNESS FAIR. TEAM MEMBERS ALSO CONTRIBUTED TO THE HEALTH OF THE COMMUNITY BY PARTNERING WITH TAMPA BAY TROOP SUPPORT TO COLLECT AND SHIP NEEDED ITEMS TO TROOPS OVERSEAS. ITEMS DONATED INCLUDED BABY WIPES, PROTEIN BARS, SUNSCREEN, TRAIL MIX AND HAND SANITIZER. 1 HOMELESS EMERGENCY PROJECT 1120 N BETTY LANE CLEARWATER FL 33755 592729694 501(C)(3) 63474 HOMELESS SHELTER FUNDING LA CLINICA GUADALUPANA 1000 LAKEVIEW RD STE 4 CLEARWATER FL 33756 593348864 501(C)(3) 24000 MEDICAL CLINIC FUNDING WILLA CARSON HLTH RESOURCE CTR 1108 N MLK AVE CLEARWATER FL 33755 650743078 501(C)(3) 22000 MEDICAL CLINIC FUNDING 3 PART I, LINE 2: TRUSTEES OF MEASE HOSPITAL, INC. IS COMMITTED TO ASSISTING NON-PROFIT ORGANIZATIONS WHOSE FOCUS IS TO IMPROVE THE HEALTH AND WELLNESS OF THE COMMUNITIES WE SERVE. EACH CASH DONATION REQUEST IS REVIEWED BY TRUSTEES OF MEASE HOSPITAL, INC.'S SENIOR MANAGEMENT TEAM TO DETERMINE WHETHER THE ORGANIZATION IS ONE WE WANT TO DONATE TO, BASED ON THE ORGANIZATION'S MISSION, NON-PROFIT STATUS, AND USAGE OF FUNDS. ONCE APPROVED, WE REQUIRE PROPER DOCUMENTATION FROM THE ORGANIZATION OF ITS NON-PROFIT STATUS, AND AS NEEDED, FOLLOW-UP WITH THE ORGANIZATION TO ENSURE THE ACTIVITY OCCURRED. X 1 1 0 1 0 0 0 0 0 0 0 GLENN WATERS EX-OFFICIO TRUSTEE/EVP, COO BAYCARE 0 922335 0 352137 0 274564 0 18822 0 41172 0 1609030 0 14747 CARL TREMONTI VP, CFO BAYCARE HOSP DIV TILL MAY 0 404412 0 128903 0 164893 0 13750 0 12577 0 724535 0 49498 RONALD BEAMON VP, CFO BAYCARE HOSP DIV EFF MAY 0 220342 0 54022 0 36000 0 7903 0 13682 0 331949 0 0 LOUIS GALDIERI PRESIDENT TILL DECEMBER 0 357211 0 111573 0 139595 0 14712 0 26754 0 649845 0 43972 MATTHEW NOVAK PRESIDENT EFF DECEMBER 0 226377 0 74801 0 14336 0 47888 0 21303 0 384705 0 0 JOHN POLLARD DIRECTOR, SURGICAL SVCS 175803 0 19324 0 157 0 9603 0 25771 0 230658 0 0 0 REBECCA SCHULKOWSKI DIR, OPERATIONS MEASE 167078 0 12778 0 145 0 1838 0 29182 0 211021 0 0 0 ROBIN LAPHAM DIRECTOR, PATIENT SVCS 168217 0 22176 0 1875 0 9245 0 21458 0 222971 0 0 0 MOHSEN HABIB MANAGER PHARMACY 169690 0 12370 0 16402 0 9397 0 23349 0 231208 0 0 0 MAIKEL BOLOS CLINICAL PHARMACIST 152119 0 33444 0 217 0 8605 0 12855 0 207240 0 0 0 RODNEY CAVALIER CLINICAL PHARMACIST 136985 0 59879 0 1228 0 8489 0 18962 0 225543 0 0 0 RENEE BURDI DIR, PATIENT SVCS 149675 0 19839 0 9813 0 7297 0 23736 0 210360 0 0 0 JOSEPH SCHUMACHER CLINICAL PHARMACIST 151850 0 6686 0 4756 0 8242 0 21137 0 192671 0 0 0 KELLY CULLEN FORMER DIR, OPERATIONS 63995 0 22849 0 37538 0 0 0 6658 0 131040 0 0 0 PART I, LINE 1A RONALD BEAMON RECEIVED A HOUSING ALLOWANCE IN THE AMOUNT OF $12,000 DURING 2018 WHICH WAS INCLUDED IN HIS TAXABLE WAGES. PART I, LINE 3 THE FILING ORGANIZATION DOES NOT USE ANY OF THE OPTIONS LISTED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR. HOWEVER, THE RELATED ORGANIZATION, BAYCARE HEALTH SYSTEM INC, USES COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE AS A MEANS TO ESTABLISH THE CEO'S COMPENSATION OF THE FILING ORGANIZATION. PART I, LINE 4B GLENN WATERS - PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN. HE HAD $237,944 IN BENEFITS VEST IN 2018. THIS AMOUNT IS INCLUDED IN PART II (B)(III) OTHER COMPENSATION. THE PLAN MADE CASH DISTRIBUTION OF $93,631 IN 2018. CARL TREMONTI - PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN. HE HAD $137,675 IN BENEFITS VEST IN 2018. THIS AMOUNT IS INCLUDED IN PART II (B)(III) OTHER COMPENSATION. THE PLAN MADE CASH DISTRIBUTION OF $54,175 IN 2018. LOUIS GALDIERI - PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN. HE HAD $126,247 IN BENEFITS VEST IN 2018. THIS AMOUNT IS INCLUDED IN PART II (B)(III) OTHER COMPENSATION. THE PLAN MADE CASH DISTRIBUTION OF $49,678 IN 2018. VICKIE BURWELL SEE PART V 80147 COMPENSATION 0 THOMAS DORIA SEE PART V 382957 COMPENSATION 0 SCHEDULE L, PART IV VICKIE BURWELL IS A FAMILY MEMBER OF ANDY BURWELL, A DIRECTOR OF THE FILING ORGANIZATION. VICKIE BURWELL WAS PAID REASONABLE COMPENSATION AS AN EMPLOYEE OF THE FILING ORGANIZATION. THOMAS DORIA IS A FAMILY MEMBER OF LOUIS GALDIERI, A KEY EMPLOYEE OF THE FILING ORGANIZATION. THOMAS DORIA WAS PAID REASONABLE COMPENSATION AS AN EMPLOYEE OF THE FILING ORGANIZATION. X 26114 SALE PRICE 0 0 0 0 PART V, LINE 1A EFFECTIVE 2018, THE TOTAL NUMBER FROM BOX 3 OF FORM 1096 IS REPORTED BY BAYCARE HEALTH SYSTEM, INC, EIN 59-2796965, A RELATED ORGANIZATION THAT PROCESSES FORMS 1099 FOR ITS AFFILIATES. THIS IS A CHANGE FROM THE PRIOR YEAR REPORTING AS IT BETTER ALIGNS THE FORM 1096, BOX 3 REPORTING TO THE ISSUING EIN. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF TRUSTEES OF MEASE HOSPITAL, INC. IS MORTON PLANT MEASE HEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD SHALL CONSIST OF NO MORE THAN TWENTY-SIX (26) MEMBERS (EACH, A "TRUSTEE"), ALL OF WHOM SHALL BE APPOINTED BY THE MEMBER SUCH THAT AT ALL TIMES THE BOARD IS COMPRISED OF ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE TAXPAYER IS A PARTICIPANT, AS DEFINED IN THE SECOND RESTATED JOINT OPERATING AGREEMENT DATED AS OF MAY 23, 2006, AS AMENDED (THE "JOA"). UNDER THE JOA, BAYCARE HEALTH SYSTEM, INC. IS RESPONSIBLE FOR THE OPERATIONS OF THE PARTICIPANTS. THE JOA PARTICIPANTS INCLUDE THE TAXPAYER AND OTHER HOSPITALS AND NON-HOSPITAL ORGANIZATIONS. NOTICE OF THE JOA WAS PREVIOUSLY PROVIDED TO THE INTERNAL REVENUE SERVICE BY LETTER DATED JULY 1, 1997. THE MEMBER RESERVES TO ITSELF THE FOLLOWING TWO CATEGORIES OF ACTIONS: CLASS I MEMBER RESERVED RIGHTS AND CLASS II MEMBER RESERVED RIGHTS. A. CLASS I MEMBER RESERVED RIGHTS. 1. ADDITION, DELETION OR RECONFIGURATION OF SERVICES OF THE CORPORATION. 2. ESTABLISHMENT OF OVERALL CAPITAL AND OPERATING BUDGETS AND STRATEGIC PLANS APPLICABLE TO THE CORPORATION, INCLUDING THE USE OF THE FUNDS OF THE CORPORATION. 3. EXCLUSIVE AUTHORITY TO ENTER INTO MANAGED CARE CONTRACTS ON BEHALF OF THE CORPORATION AND ITS SUBSIDIARIES AND AFFILIATES. 4. APPROVAL OF CONTRACTS ON BEHALF OF THE CORPORATION (BUT THE CLASS I MEMBER MAY ESTABLISH POLICIES FROM TIME TO TIME PROVIDING THAT ONLY SPECIFIC TYPES OF CONTRACTS OR CONTRACTS INVOLVING OBLIGATIONS IN EXCESS OF SPECIFIED LEVELS NEED TO BE APPROVED BY THE CLASS I MEMBER). 5. AUTHORITY TO ESTABLISH FEES AND CHARGES ON BEHALF OF THE CORPORATION. 6. DETERMINATION OF WHETHER THE CORPORATION SHOULD JOIN ANY NETWORKS OR ALTERNATIVE OR INTEGRATED DELIVERY SYSTEMS. 7. ESTABLISHMENT OF EMPLOYMENT AND OTHER POLICIES APPLICABLE TO ALL PERSONNEL EMPLOYED BY THE CORPORATION. 8. APPROVAL OF THE PHILOSOPHY, MISSION STATEMENT AND PURPOSES OF THE CORPORATION. 9. APPROVAL OF CHANGES IN THE ARTICLES OF INCORPORATION OR IN THE BYLAWS OF THE CORPORATION. 10. APPROVAL OF THE MERGER, CONSOLIDATION, DISSOLUTION, SALE OR OTHER TRANSFER OF SUBSTANTIALLY ALL ASSETS OF THE CORPORATION, OR OTHER CHANGE IN CORPORATE FORM, CAUSING A FUNDAMENTAL REORGANIZATION OF THE CORPORATION. 11. APPROVAL OF THE INCURRENCE OF INDEBTEDNESS BY THE CORPORATION ABOVE CERTAIN LIMITS ESTABLISHED BY THE CLASS I MEMBER. 12. APPROVAL OF THE ESTABLISHMENT OF ADDITIONAL AFFILIATES OR SUBSIDIARIES OF THE CORPORATION. 13. ADOPTION OF STRATEGIC PLANS OR MAJOR CHANGES IN PROGRAMS OR SERVICES OF THE CORPORATION. 14. APPROVAL OF THE PURCHASE, SALE, TRANSFER, OR OTHER ENCUMBRANCE OF ASSETS OF THE CORPORATION ABOVE SPECIFIED LEVELS ESTABLISHED BY THE CLASS I MEMBER. B. CLASS II MEMBER RESERVED RIGHTS. 1. APPROVAL OF THE PHILOSOPHY, MISSION STATEMENT AND PURPOSES OF THE CORPORATION. 2. APPROVAL OF THE MERGER, CONSOLIDATION, DISSOLUTION, SALE OR OTHER TRANSFER OF SUBSTANTIALLY ALL ASSETS OF THE CORPORATION, OR OTHER CHANGE IN CORPORATE FORM, CAUSING A FUNDAMENTAL REORGANIZATION OF THE CORPORATION. 3. WITH REGARD TO ANY ASSETS OF THE CORPORATION NO LONGER REQUIRED IN THE OPERATIONS OF THE CORPORATION, APPROVAL OF ANY SALE OR OTHER DISPOSITION OF ANY ASSETS NOT IN THE ORDINARY COURSE WHICH HAVE A VALUE IN EXCESS OF $3 MILLION, AND WITH REGARD TO ALL OTHER ASSETS OF THE CORPORATION USED IN THE OPERATIONS OF THE CORPORATION, APPROVAL OF ANY SALE OR OTHER DISPOSITION OF SUCH ASSETS NOT IN THE ORDINARY COURSE (BUT THE FOREGOING IS NOT INTENDED TO LIMIT ANY TRANSFER OF THE LOCATION OF THE ASSETS FROM THE CORPORATION TO ANOTHER ENTITY IN CONNECTION WITH A DULY AUTHORIZED RECONFIGURATION OF SERVICES). 4. APPROVAL OF THE CLOSURE OF A HOSPITAL FACILITY OF THE CORPORATION. 5. CHANGE IN THE NAME OF A HOSPITAL FACILITY OF THE CORPORATION. 6. APPROVAL OF SUBSTANTIVE CHANGES IN THE BYLAWS OF THE ARTICLES OF INCORPORATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION AND REVIEWED BY THE CFO, AS WELL AS THE ORGANIZATION'S PAID PREPARER. PRIOR TO FILING WITH THE IRS, A FINAL COPY OF THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD VIA A WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES OF MEASE HOSPITAL, INC HAS TWO SEPARATE CONFLICT OF INTEREST PROCEDURES; ONE THAT RELATES TO BOARD MEMBERS AND ANOTHER THAT RELATES TO NON-BOARD MEMBER EMPLOYEES. BOTH GROUPS ARE REQUIRED ON AN ANNUAL BASIS TO COMPLETE, SIGN AND FILE AN ANNUAL DISCLOSURE STATEMENT DETAILING EXISTING OR POTENTIAL CONFLICTS OF INTERESTS. DISCLOSURE REQUIREMENTS OF BOARD AND COMMITTEE MEMBERS PRIOR TO ANY AND ALL BOARD OR COMMITTEE MEETINGS, EACH BOARD/COMMITTEE MEMBER SHALL REVIEW THE MEETING AGENDA FOR ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IN THE EVENT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ASSOCIATED WITH ANY AGENDA ITEM IS CONCLUDED BY A BOARD/COMMITTEE MEMBER AFTER SUCH REVIEW, THE IMPACTED BOARD/COMMITTEE MEMBER SHALL INFORM THE BOARD/COMMITTEE CHAIRPERSON OF THE CONFLICT IN ADVANCE OF THE MEETING. REQUIRED ACTION AFTER DISCLOSURE OF THE BOARD/COMMITTEE MEMBER'S ACTUAL OR POTENTIAL CONFLICT TO THE BOARD/COMMITTEE CHAIRPERSON AS SET FORTH ABOVE, THE FOLLOWING PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST WILL BE ADHERED TO BY EACH BOARD AND ALL COMMITTEES WITHOUT EXCEPTION: 1. THE BOARD/COMMITTEE CHAIRPERSON SHALL, UPON DISCLOSURE BY AN IMPACTED BOARD/COMMITTEE MEMBER, HAVE THE DISCRETION (BASED UPON THE SEVERITY OF THE ACTUAL OR POTENTIAL CONFLICT) TO EXCUSE THE IMPACTED BOARD/COMMITTEE MEMBER FROM THE BOARD/COMMITTEE DISCUSSIONS ON THAT AGENDA ITEM. 2. REGARDLESS OF WHETHER THE IMPACTED BOARD/COMMITTEE MEMBER IS ASKED TO LEAVE THE ROOM DURING THE AGENDA ITEM DISCUSSION, THE BOARD/COMMITTEE CHAIRPERSON SHALL NOTIFY ALL BOARD/COMMITTEE MEMBERS OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST SO EVERYONE IS AWARE OF THE SAID CONFLICT BEFORE ANY DISCUSSIONS AND/OR VOTE ON THE MATTER. 3. THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE BAYCARE ENTITY CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM AN INDIVIDUAL OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 4. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY AVAILABLE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BAYCARE ENTITY'S BEST INTEREST, AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO BAYCARE. AN INTERESTED BOARD/COMMITTEE SHALL NOT VOTE, PARTICIPATE IN, INFLUENCE, OR ATTEMPT TO INFLUENCE ANY DETERMINATION OR PROCEEDINGS. AS REQUESTED BY THE BOARD/COMMITTEE CHAIRPERSON, THE INTERESTED BOARD/COMMITTEE MEMBER MAY, HOWEVER, RESPOND TO QUESTIONS POSED BY THE BOARD/COMMITTEE REGARDING THE CONTRACT OR TRANSACTION. ANY SUCH CONTRACT OR TRANSACTION MUST BE AUTHORIZED BY A VOTE OF AT LEAST TWO-THIRDS (2/3) OF THE BOARD/ COMMITTEE MEMBERS ENTITLED TO VOTE AT A MEETING AT WHICH A QUORUM WAS PRESENT. ANY INTERESTED BOARD/COMMITTEE MEMBER MAY NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM. 5. THE MINUTES OF THE BOARD AND ALL COMMITTEES SHALL REFLECT THE FOLLOWING: A. THE NAME(S) OF THE BOARD/COMMITTEE MEMBER(S) WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD/COMMITTEE CHAIRPERSON'S DECISION AS TO WHETHER A CONFLICT OF INTEREST, IN FACT, EXISTED. B. THE NAMES OF THE BOARD/COMMITTEE MEMBERS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN ON THE SUBJECT AT ISSUE. C. THE INTERESTED BOARD/COMMITTEE MEMBER'S REMOVAL FROM THE ROOM (IF REQUESTED BY THE CHAIRPERSON), EXCLUSION FROM VOTING AND PARTICIPATION IN DISCUSSIONS, AND THE EXISTENCE OF A PROPER QUORUM. FOR EMPLOYEES, THE REVIEW OF CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS GOES TO THE CONFLICT OF INTEREST DETERMINATION COMMITTEE. THIS COMMITTEE CONSISTS OF THE BAYCARE CHIEF COMPLIANCE OFFICER, THE CORPORATE RESPONSIBILITY OFFICERS, AND THE BAYCARE VICE PRESIDENT OF TEAM RESOURCES. THIS COMMITTEE SHALL DETERMINE IF AN ACTUAL CONFLICT EXISTS AND ANY ACTION REQUIRED TO ADDRESS THE CONFLICT OF INTEREST SITUATION. FORM 990, PART VI, SECTION B, LINE 15B THE FILING ORGANIZATION DOES NOT DIRECTLY COMPENSATE SOME OF ITS TOP MANAGEMENT EMPLOYEES; RATHER COMPENSATION IS PAID BY A RELATED ORGANIZATION THAT ALSO FOLLOWS THE COMPENSATION POLICY OF THE COMPENSATION COMMITTEE. THE INDEPENDENT COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE'S PURPOSE IS TO PROVIDE OVERSIGHT FOR THE ORGANIZATION'S EXECUTIVE COMPENSATION PROGRAM, REVIEW AND APPROVE COMPENSATION AND BENEFITS FOR ALL "DISQUALIFIED PERSONS" SUBJECT TO THE INTERMEDIATE SANCTIONS REGULATIONS ISSUED UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE (INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER & CHIEF FINANCIAL OFFICER, OTHER SYSTEM AND ENTITY EXECUTIVES, AND OTHER DISQUALIFIED PERSONS AS DEFINED IN THE INTERMEDIATE SANCTIONS REGULATIONS (I.E., VOTING MEMBERS OF THE GOVERNING BODY, FAMILY MEMBERS, FORMER OFFICERS)), AND ESTABLISH THE COMPENSATION PHILOSOPHY FOR ALL OTHER EXECUTIVES. THIS COMMITTEE ENGAGES NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS TO ASSIST THEM IN REVIEW OF EXECUTIVE COMPENSATION. THE COMPENSATION CONSULTANTS PROVIDE A REVIEW OF EACH VICE PRESIDENT AND ABOVE IN THE SYSTEM TO DETERMINE IF THAT EMPLOYEE'S COMPENSATION IS REASONABLE WHEN COMPARED AGAINST MARKET STANDARDS. THE DATA REVIEWED COMES FROM COMPENSATION STUDIES THAT INCLUDE COMPARABLE COMPENSATION FOR SIMILARL QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE ORGANIZATION KEEPS CONTEMPORANEOUS MINUTES OF THE COMPENSATION COMMITTEES MEETINGS AND DECISIONS. EXTERNAL CONSULTANTS REVIEW COMPENSATION EVERY OTHER YEAR WITH THE LAST REVIEW OCCURRING IN 2017 BUT THE COMPENSATION COMMITTEE REGULARLY MONITORS COMPENSATION AND ALL OTHER PROCEDURES ARE FOLLOWED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 TRUSTEES OF MEASE HOSPITAL, INC. PUBLISHES ITS FINANCIAL STATEMENTS WITH THE AGENCY FOR HEALTH ADMINISTRATION. GOVERNING DOCUMENTS ARE AVAILABLE VIA SUNBIZ.ORG. FORM 990, PART XI, LINE 9: CONTRIBUTIONS IN NET ASSETS -1,524,016. ROUNDING 4. SECTION J HTTPS://BAYCARE.ORG/HOSPITALS/MEASE-COUNTRYSIDE-HOSPITAL/PATIENTS-AND-VI SITORS HTTPS://BAYCARE.ORG/HOSPITALS/MEASE-DUNEDIN-HOSPITAL/PATIENTS-AND-VISITO RS BAYCARE HEALTH SYSTEM INC 2985 DREW ST CLEARWATER FL 33759 592796965 SUPPORT SRVCS FL 501(C)(3) 12B N/A 0 MORTON PLANT HOSPITAL ASSOCIATION INC 300 PINELLAS STREET CLEARWATER FL 33756 590624462 HEALTH SRVCS FL 501(C)(3) 3 MPMHC 1 MORTON PLANT MEASE HEALTH SERVICES INC 8452 118TH AVE N LARGO FL 33773 592600684 HEALTH SRVCS FL 501(C)(3) 10 MPMHC 1 MORTON PLANT MEASE HEALTH CARE FOUND 1200 DRUID ROAD SOUTH CLEARWATER FL 33756 591751535 FUNDRAISING FL 501(C)(3) 12A MPHATOM 1 MORTON PLANT MEASE HEALTH CARE INC 300 PINELLAS STREET CLEARWATER FL 33756 592374556 SUPPORT SRVCS FL 501(C)(3) 12B N/A 0 GLOBAL HEALTH CARE INC 8452 118TH AVENUE NORTH LARGO FL 33773 591853449 HEALTH SRVCS FL MPHV C 1 MFP INC 628 BYPASS ROAD CLEARWATER FL 33764 592374569 COLLECTIONS FL MPHV C 1 MORTON PLANT HEALTH VENTURES INC 8452 118TH AVENUE NORTH LARGO FL 33773 592728600 HEALTH SRVCS FL MPMHC C 1 0 0 1 1 0 0 0 0 0 1 1 0 1 0 1 0 0 1 1 MORTON PLANT MEASE HEALTH SERVICES INC K 101255 FMV MORTON PLANT HOSPITAL ASSOCIATION INC O 3664728 FMV MORTON PLANT MEASE HEALTH SERVICES INC S 39073 FMV MORTON PLANT MEASE HEALTH SERVICES INC O 121913 FMV MORTON PLANT HOSPITAL ASSOCIATION INC R 141896 FMV