2018-08-14T13:07:16-05:00 2017-09-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2016-10-01 591917016 TALLAHASSEE MEMORIAL HEALTHCARE INC % WILLIAM A GIUDICE CFO TALL 8504315238 1300 MICCOSUKEE ROAD TALLAHASSEE FL 323085054 WILLIAM GIUDICE CFO 8504315238 2018-08-14 true ANTONIO C RUSSO P00858539 2673303000 2016 2022-09-23 18:48:47Z WILLIAM GIUDICE CFO 1300 MICCOSUKEE ROAD TALLAHASSEE FL 323085054 831714865 false X www.tmh.org X 1979 FL TALLAHASSEE MEMORIAL HEALTHCARE, INC. IS A PRIVATE 772-BED, COMMUNITY HEALTH CARE SYSTEM THAT PROVIDES CHARITABLE, COMPASSIONATE, LEADING-EDGE, PATIENT-CENTERED HEALTH CARE. 15 13 5919 661 1385372 1091544 1602289 1171428 546543742 573405029 -417496 1062221 179277014 194191278 727005549 769829956 203052 180008 0 0 287607480 301780937 0 0 0 398251675 420884448 686062207 722845393 40943342 46984563 920656319 962184865 606182402 540413377 314473917 421771488 X FOUNDED MORE THAN 60 YEARS AGO, TALLAHASSEE MEMORIAL HEALTHCARE INC. IS A PRIVATE, NOT-FOR PROFIT, 772-BED, COMMUNITY HEALTH CARE SYSTEM THAT PROVIDES CHARITABLE, COMPASSIONATE, LEADING -EDGE, & PATIENT-CENTERED HEALTH CARE. ITS MISSION: TRANSFORMING CARE. ADVANCING HEALTH. IMPROVING LIVES. false false 657908401 180008 768086179 DESIGNED TO MEET THE DIVERSE HEALTH CARE NEEDS OF THE BIG BEND REGION, TALLAHASSEE MEMORIAL HEALTHCARE, INC. (TMH) IS A COMPREHENSIVE, PRIVATE, NOT-FOR-PROFIT HEALTH CARE SYSTEM THAT SERVES 17 COUNTIES IN NORTH FLORIDA AND SOUTH GEORGIA. TMH INCLUDES A 772-BED ACUTE CARE HOSPITAL AND HAS A TIME-HONORED COMMITMENT TO PROVIDING PATIENT-CENTERED, WORLD-CLASS HEALTH CARE TO ITS COMMUNITY WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. TMH HOLDS A NUMBER OF IMPORTANT DISTINCTIONS WITHIN THE REGIONAL HEALTH SECTOR. TMH IS HOME TO THE BIG BEND'S ONLY ACCREDITED COMMUNITY HOSPITAL CANCER PROGRAM AND THE REGION'S ONLY STATE-DESIGNATED TRAUMA CENTER. TMH IS ALSO THE AREA'S ONLY HOSPITAL RECOGNIZED BY THE SOCIETY OF CHEST PAIN CENTERS AS AN ACCREDITED CHEST PAIN CENTER WITH PCI AND RESUSCITATATION AS WELL AS AN ACCREDITED ATRIAL FIBRILATION PROGRAM WITH EPS, BOTH THE HIGHEST ACCREDITATION LEVELS AVAILABLE BY THE AMERICAN COLLEGE OF CARDIOLOGY. TMH IS LICENCED AS NORTH FLORIDA'S ONLY COMPREHENSIVE STROKE CENTER AND IS THE ONLY FACILITY IN THE REGION PERFORMING MINIMAL INVASIVE STROKE INTERVENTIONS. TMH MAINTAINS THE AREA'S ONLY PEDIATRIC INTENSIVE CARE UNIT AND THE REGIONS ONLY NEONATAL INTENSIVE CARE UNIT. IN ALL, TMH IS THE SEVENTH-LARGEST HOSPITAL IN FLORIDA WITH A MEDICAL STAFF OF 570 + PHYSICIANS REPRESENTING 50+ DIFFERENT SPECIALTIES. TMH IS MANAGED BY A TEAM OF COMMUNITY CITIZENS WHO VOLUNTEER THEIR TIME AND EXPERTISE WITHOUT COMPENSATION. THE TMH BOARD OF DIRECTORS IS COMMITTED TO ITS COMMUNITY SERVICE MISSION AND MEMBERS SERVE WITHOUT COMPENSATION. THE ENERGY RESOURCES COMMITTED BY TMH AND ITS COLLEAGUES ARE PROOF OF THE FULFILLMENT OF ITS MISSION : TRANSFORMING CARE. ADVANCING HEALTH. IMPROVING LIVES. SEE SCHEDULE H, PART VI FOR ADDITIONAL DETAILS REGARDING SOME OF THE VARIOUS PROGRAM SERVICE ACCOMPLISHMENTS AND ADDITIONAL COMMUNITY BUILDING ACTIVITIES CONDUCTED BY TMH. 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X X X X true true X X X true X SEE SCH H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5, 6B (INPUT FROM COMMUNITY; COLLABORATION) TALLAHASSEE MEMORIAL HEALTHCARE, INC. ("TMH") COMPLETED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING THE YEAR ENDING SEPTEMBER 30, 2016. YOU MAY FIND THE COMPREHENSIVE RESULTS AT https://www.tmh.org/about-us/community-reports/community-need-report TO SUMMARIZE THE REPORT, TMH USED A VARIETY OF ASSESSMENT TOOLS TO DETERMINE THE NEEDS OF ITS COMMUNITY. AMONG THOSE ASSESSMENT TOOLS UTILIZED INCLUDED: - LEON COUNTY COLLABORATIVE DATA, 2016 - STEP UP FOR GADSDEN GOALS AND STRATEGIES, 2016 - COUNTYHEALTHRANKINGS.ORG, 2016 - FLORIDA CHARTS COUNTY MINORITY HEALTH PROFILE, 2014 - GADSDEN COUNTY COMMUNITY HEALTH COUNCIL, 2016 - JEFFERSON COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN, 2015 - TALLAHASSEE MEMORIAL COMMUNITY SURVEY, 2016 - TALLAHASSEE MEMORIAL COMMUNITY MEETINGS, 2016 - INTERVIEWS WITH MAYOR OF TALLAHASSEE AND CHAIR LEON COUNTY COMMISSION THE COMMUNITY HEALTH ASSESSMENT SURVEY CONSISTED OF 94 QUESTIONS ABOUT VARIOUS HEALTH TOPICS. THE SURVEY INSTRUMENT WAS ADAPTED FROM THE TOOLS CREATED BY HOUSTON DEPARTMENT OF HEALTH AND HUMAN SERVICES, FLORIDA DEPARTMENT OF HEALTH IN SARASOTA COUNTY, AND PACE-EH. QUESTIONS WERE SAMPLED FROM MODEL INSTRUMENTS THAT HAD BEEN PREVIOUSLY TESTED FOR VALIDITY. THE SURVEY HAD NINE SECTIONS: 1) ENVIRONMENTAL HEALTH/BUILT ENVIRONMENT; 2) CHILDRENS CONCERNS; 3) ACCESS TO CARE; 4) HEALTH AND WELLBEING; 5) HEALTH-RELATED BEHAVIORS; AND 6) DEMOGRAPHICS. QUESTIONS WERE PRIMARILY MULTIPLE CHOICE, WITH SELECT OPEN-ENDED OPPORTUNITIES. SURVEYS WERE ALL CODED WITH A UNIQUE IDENTIFICATION NUMBER. OF THE 330 SURVEYS ATTEMPTED IN SIX CENSUS TRACTS, 300 WERE COMPLETED. DURING THE COMMUNITY MEETINGS, RESIDENTS WERE PRESENTED WITH THE MAIN FINDINGS FROM THE CHA QUANTITATIVE SURVEY RESULTS. AFTER A PRESENTATION OF RESULTS AND SUPPORTING DATA, ATTENDEES AT EACH MEETING PARTICIPATED IN A FOCUSED CONVERSATION AND CONSENSUS BUILDING WORKSHOP. THE PROCESS FOLLOWED THE TECHNOLOGY OF PARTICIPATION FRAMEWORK. INDIVIDUALS WERE ASKED TO CONSIDER THE FOLLOWING SERIES OF QUESTIONS: - WHAT INFORMATION STOOD OUT TO YOU? - WHERE ARE YOU REALLY CLEAR? WHERE ARE YOU CONFUSED? WHAT CONCERNS YOU? WHAT FEELS CRITICAL? - WHAT QUESTIONS DID THIS RAISE FOR YOU? WHAT OTHER THINGS DO WE NEED TO CONSIDER? - WHAT SEEMS TO BE THE MOST CRITICAL ISSUE OR CONCERN FOR THE COMMUNITY? ATTENDEES WERE ASKED TO WRITE THEIR MOST CRITICAL CONCERNS INDIVIDUALLY ON SEPARATE PIECED OF PAPER. AFTERWARDS, THEY WERE GIVEN A CHANCE TO GROUP SIMILAR ISSUES/CONCERNS TOGETHER. ALL PARTICIPANTS HAD AN OPPORTUNITY TO AGREE OR DISAGREE WITH THE SIMILARITY BETWEEN ITEMS. AFTER ALL CONCERNS WERE GROUPED BY SIMILARITY, ATTENDEES WERE INSTRUCTED TO NAME EACH GROUP. THE WORDING DESCRIBED THEIR ANSWER TO THE ORIGINAL QUESTION WHAT ARE THE MOST CRITICAL ISSUES/PROBLEMS IN YOUR COMMUNITY? THESE RESULTS ALONG WITH THE OBJECTIVE DATA ANALYSIS INFORMED THE DEVELOPMENT OF THE COMMUNITY HEALTH IMPROVEMENT PLAN. TMH COLLABORATED WITH VARIOUS ORGANIZATIONS IN ORDER TO COMPLETE ITS CHNA. PLEASE SEE THE MOST RECENTLY COMPLETED CHNA FOR THIS INFORMATION: https://www.tmh.org/about-us/community-reports/community-need-report -------------------- PART V, SECTION B, LINE 7A & 10A (CHNA & IMP. PlAN AVAILABILITY TO PUBLIC) THE CHNA AND IMPLEMENTATION PLAN CAN BE ACCESSED AT: https://www.tmh.org/about-us/community-reports/community-need-report -------------------- PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) TALLAHASSEE MEMORIAL HEALTHCARE ("TMH") CONDUCTED THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016. IDENTIFICATION OF FIVE KEY HEALTH PRIORITIES EVOLVED FOLLOWED BY CREATION OF A 2017-2019 IMPLEMENTATION PLAN TO ADDRESS EACH OF THESE PRIORITY AREAS. THE FIVE KEY HEALTH PRIORITIES ARE (1) CHILDRENS CONCERNS (2) PERSONAL HEALTH (3) BEHAVIORAL HEALTH (4) ACCESS TO CARE AND (5) TOBACCO FREE. TMH SERVICE LINES WORK IN PARTNERSHIP WITH MANY COMMUNITY BASED ORGANIZATIONS TO ADDRESS THESE HEALTH NEEDS. THE FOLLOWING IS AN UPDATE OF PROGRESS MADE IN EACH PRIORITY AREA DURING FISCAL YEAR 2017. (1) CHILDRENS CONCERNS THE LONG-TERM GOAL FOR PRIORITY AREA, CHILDRENS CONCERNS, IS TO IMPROVE BREASTFEEDING RATES FOR MATERNAL PATIENTS. ONE STRATEGY IMPLEMENTED TO ADDRESS THIS GOAL IS TO ACHIEVE THE BABY FRIENDLY HOSPITAL DESIGNATION FROM THE WORLD HEALTH ORGANIZATION (WHO) AND UNITED NATIONS CHILDRENS FUND (UNICEF). BABY FRIENDLY IS A GLOBAL PROGRAM RECOGNIZING HOSPITALS AND BIRTHING CENTERS OFFERING AN OPTIMAL LEVEL OF CARE FOR INFANT FEEDING AND MOTHER/BABY BONDING. TMH IS THE ONLY HOSPITAL IN TALLAHASSEE CURRENTLY WORKING TO OBTAIN THE BABY-FRIENDLY HOSPITAL DESIGNATION WHICH LESS THAN 24 PERCENT OF FACILITIES WORLDWIDE HOLD. TMH IS COMMITTED TO BECOME THE REGIONS FIRST BABY-FRIENDLY HOSPITAL. DURING FISCAL YEAR 2017, IN PREPARATION FOR THE BABY FRIENDLY SITE VISIT, TMH WORKED TO IMPLEMENT ALL "10 STEPS TO SUCCESSFUL BREASTFEEDING" REQUIRED TO ACHIEVE BABY FRIENDLY DESIGNATION. THESE STEPS INCLUDE WRITTEN BREASTFEEDING POLICY, STAFF TRAINING, EDUCATION FOR MOMS AND PROVISION OF NOTHING BUT BREAST MILK FOR BABY UNLESS MEDICALLY INDICATED. TO CONTINUE SUPPORT FOR BREASTFEEDING ONCE MOM AND BABY HAVE LEFT THE HOSPITAL, TMH OFFERS "MILK WITH MOMMY", A FREE BREASTFEEDING SUPPORT GROUP THAT MEETS TWICE A WEEK AND IS LED BY A CERTIFIED LACTATION CONSULTANT. MILK WITH MOMMY IS OPEN TO ANYONE IN THE COMMUNITY AND OFFERS A CASUAL ENVIRONMENT FOR MOMS AND BABIES TO CONNECT WITH EACH OTHER. SINCE MEASURING HOW MUCH MILK A BABY RECEIVES CAN BE A CHALLENGE WHEN BREASTFEEDING, WE PROVIDE AN INFANT SCALE TO WEIGH A BABY BEFORE AND AFTER FEEDING. THIS VENUE ALSO PROVIDES A SOCIAL OUTLET FOR MOMS DURING THEIR TRANSITION AFTER DELIVERY. PARTICIPATION IN SUPPORT GROUPS HAS BEEN STABLE OVER THE LAST FEW YEARS WITH APPROXIMATELY 2,300 MOTHERS ATTENDING IN FISCAL YEAR 2017. OVER THE LAST TWO YEARS, TMH HAS EXPERIENCED SIGNIFICANT IMPROVEMENT IN TWO IMPORTANT MEASURES: INDUCTIONS AND BREASTFEEDING RATES. THERE HAS BEEN A REDUCTION OF NON-MEDICALLY INDICATED INDUCTIONS BEFORE 39 WEEKS FROM 7 PERCENT TO 4 PERCENT AND THE NUMBER OF MOTHERS WHO ATTEMPTED BREASTFEEDING DURING THEIR STAY INCREASED FROM 41 PERCENT TO 49 PERCENT. IN ADDITION, ALL NEW MOTHERS RECEIVE SAFE SLEEP EDUCATION IN THEIR TAKE-HOME PACKET. ANOTHER STRATEGY FOR THE CHILDRENS CONCERNS HEALTH PRIORITY IS INCREASING ACCESS TO PRENATAL SERVICES FOR LOW INCOME AND VULNERABLE POPULATIONS. THE TMH FAMILY PRACTICE RESIDENCY PROGRAM PARTNERS WITH FIVE COUNTY HEALTH DEPARTMENTS, INCLUDING GADSDEN, JEFFERSON, MADISON, TAYLOR AND WAKULLA COUNTIES, TO PROVIDE FULL SCOPE PRENATAL CARE, COUNSELING AND BIRTH CONTROL TO MEDICALLY UNDERSERVED MOTHERS. FAMILY PRACTICE RESIDENTS PROVIDE THESE SAME SERVICES AT BOND COMMUNITY HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER ("FQHC") IN LEON COUNTY. IN FISCAL YEAR 2017, OVER 1,900 WOMEN RECEIVED SERVICES FROM THE TMH RESIDENCY PARTNERSHIP WITH COUNTY HEALTH DEPARTMENTS. THE NUMBER OF WOMEN RECEIVING SERVICES WAS STABLE FROM 2016. IN 2017, TMH DEDICATED APPROXIMATELY 1150 PHYSICIAN HOURS, 380 NURSE PRACTITIONER HOURS AND OVER 450 NURSE HOURS TO THIS PRENATAL CARE. IN ADDITION, OVER 750 PHYSICIAN HOURS WERE DEVOTED TO CARING FOR 600 WOMEN AT BOND COMMUNITY HEALTH CENTER, FQHC, IN 2017. IN ADDITION TO THESE STRATEGIES OUTLINED IN OUR 2017-2019 IMPLEMENTATION STRATEGY, TMH ALSO SUPPORTS AND HOSTS OTHER HEALTH PROMOTION EVENTS IN THE COMMUNITY, SUCH AS THE MARCH OF DIMES WALK AND THE BABY AND FAMILY FAIR. EACH YEAR, TMH COLLEAGUES PARTICIPATE IN THE MARCH OF DIMES FUNDRAISING WALK. IN 2017, TMH COLLEAGUES RAISED $15,800, INCLUDING $10,000 SPONSORSHIP FROM TMH. THE MARCH OF DIMES USES FUNDS RAISED TO SUPPORT PROGRAMS AND SERVICES THAT BENEFIT LOCAL FAMILIES. ONE EXAMPLE IS A MONTHLY DINNER FOR THE NICU PARENTS AT TMH. CURRENT MARCH OF DIMES CAMPAIGNS ALSO INCLUDE SUPPORT FOR EDUCATION OF HEALTH CARE PROVIDERS AND CONSUMERS AGAINST NON-MEDICALLY INDICATED INDUCTIONS BEFORE 39 WEEKS. THE BABY & FAMILY FAIR IS A TMH ANNUAL EDUCATION AND HEALTH EVENT FOR BOTH EXPECTANT PARENTS AND FAMILIES WITH CHILDREN OF ALL AGES. IT SHOW CASES PRODUCTS AND SERVICES FOR THOSE WHO ARE MAKING IMPORTANT DECISIONS ABOUT PREGNANCY, CHILDBIRTH AND RAISING A FAMILY. APPROXIMATELY 400 FAMILIES PARTICIPATED IN THE BABY & FAMILY FAIR IN 2017. (2) PERSONAL HEALTH THE LONG-TERM GOAL FOR THE PRIORITY AREA, PERSONAL HEALTH, IS TO IMPROVE NUTRITION OF COMMUNITY MEMBERS IN AN EFFORT TO REDUCE THE IMPACT OF CHRONIC CONDITIONS SUCH AS DIABETES, OBESITY AND CARDIOVASCULAR DISEASE. IN 2015, TMH CREATED THE TMH FOR LIFE PROGRAM TO PROMOTE PERSONAL HEALTH AND IMPROVE HEALTH BEHAVIORS IN THE COMMUNITY. THE PROGRAM HAS FOUR QUADRANTS: HEALTHY EATING, ACTIVE LIVING, FIND YOUR HAPPY AND KNOW YOUR NUMBERS. THE QUADRANTS ARE DESIGNED TO OFFER SIMPLE MESSAGING, MOTIVATION AND EDUCATION. TMH FOR LIFE PROGRAM HOSTS EVENTS THAT ARE HANDS-ON AND EXPERIENTIAL; THEREFORE, PROVIDING PERSONAL ENGAGEMENT IN A HEALTH ENHANCING ACTIVITY SUCH AS WALKING, RUNNING, STRESS RELIEVING PRACTICE, GROCERY SHOPPING OR NUTRITIOUS EATING AND COOKING. IN 2017, TMH FOCUSED EFFORTS ON THE "HEALTHY EATING" QUADRANT WITH TWO MAIN STRATEGIES. ONE STRATEGY WAS TO ESTABLISH AND INCREASE PARTICIPATION IN A NUTRITION EDUCATION PROGRAM FOR SCHOOL AGE CHILDREN. THE SECOND STRATEGY WAS TO CONTINUE AND INCREASE PARTICIPATION IN GROCERY STORE TOURS IN LOW-INCOME, UNDERSERVED COMMUNITIES. TO ADDRESS THE FIRST STRATEGY, TMH HAS TEAMED UP WITH WOLFSON CHILDRENS HOSPITAL TO OFFER A RANGE OF AGE-APPROPRIATE, SCHOOL-BASED LESSONS THAT ENCOURAGE AND EMPOWER CHILDREN TO DEVELOP HEALTHY NUTRITION HABITS AND VITAL SAFETY SKILLS THAT IMPROVE OVERALL PHYSICAL AND SOCIAL WELL-BEING. IN 2017, TMH HIRED A CHILD HEALTH PROMOTION SPECIALIST TO DEVELOP AND EXECUTE THIS ROLE. THE PRIMARY FOCUS IN 2017 WAS BUILDING PARTNERSHIPS AND COLLABORATIVE RELATIONSHIPS WITH THE FOLLOWING: EARLY LEARNING COALITION, WHOLE CHILD LEON, EARLY CHILDHOOD OBESITY PREVENTION, SAFE KIDS COALITION AND LEON COUNTY SCHOOLS. IN 2018 AND BEYOND, THE CHILD HEALTH PROMOTION SPECIALIST WILL BEGIN OFFERING NUTRITION EDUCATION TO SCHOOL AGE CHILDREN USING TWO CURRICULUMS ENTITLED " I CAN EAT A RAINBOW"MISSION NUTRITION". FOR THE SECOND STRATEGY, IN 2017, THE TMH FOR LIFE PROGRAM HOSTED 18 GROCERY STORE TOURS LEAD BY A TEAM OF REGISTERED DIETITIANS. THE GOAL OF THE TOUR WAS TO EDUCATE THE PARTICIPANTS ON HOW TO READ THE NUTRITION FACTS LABEL, WHILE STILL FINDING CONVENIENT WAYS TO COOK AND SAVE. THIS INTERACTIVE, HANDS-ON EXPERIENCE ATTRACTED OVER 100 PEOPLE TO LEARN SIMPLE WAYS TO MAKE A LARGE IMPACT ON THEIR OVERALL HEALTH AND LIFESTYLE. APPROXIMATELY 25% OF PARTICIPANTS COMPLETED THE POST SURVEY. RESULTS SHOWED 20% INCREASE IN PARTICIPANTS STATING THAT THEY ATE 3-4 SERVINGS/DAY OF FRUITS AND VEGETABLES; 39% INCREASE IN PEOPLE STATING THEY READ THE NUTRITION FACTS LABEL MOST OF THE TIME (75-100% OF THE TIME); 32% INCREASE IN PEOPLE STATING THEY HAVE PURCHASED ITEMS WITH LOWER SODIUM AND 96% STATE THEY FEEL MORE CONFIDENT CHOOSING HEALTHIER ITEMS WHILE AT THE GROCERY STORE. IN ADDITION TO THE PERSONAL HEALTH STRATEGIES OUTLINED IN THE 2017-2019 IMPLEMENTATION PLAN, THE TMH FOR LIFE INITIATIVE FUNDS AND SUPPORTS A ROBUST SELECTION OF EVENTS AND PROGRAMS PROMOTING COMMUNITY HEALTH AND WELLNESS. IN 2017, TMH CONTINUED PARTICIPATION ON THE LOCAL INVEST HEALTH TEAM WORK WHICH BEGAN IN 2016. INVEST HEALTH IS A COLLABORATIVE INITIATIVE BETWEEN THE ROBERT WOOD JOHNSON FOUNDATION AND REINVESTMENT FUND THAT BRINGS TOGETHER DIVERSE LEADERS FROM MID-SIZED U.S. CITIES ACROSS THE NATION TO DEVELOP NEW STRATEGIES FOR INCREASING AND LEVERAGING PRIVATE AND PUBLIC INVESTMENTS TO ACCELERATE IMPROVEMENTS IN NEIGHBORHOODS FACING THE BIGGEST BARRIERS TO BETTER HEALTH. FIFTY MID-SIZED CITIES WERE SELECTED TO PARTICIPATE IN THIS LEARNING GRANT. TMH SERVED AS THE ANCHOR INSTITUTION FOR THE TALLAHASSEE INVEST HEALTH TEAM WHICH INCLUDED MEMBERS FROM FLORIDA A&M UNIVERSITY, CITY OF TALLAHASSEE AND DEPARTMENT OF HEALTH, LEON COUNTY. MEMBERS OF THE TALLAHASSEE TEAM TRAVELED TO NATIONAL CONVENINGS AND REGIONAL POD CONVENINGS TO LEARN ABOUT SOCIAL DETERMINANTS OF HEALTH, HEALTH DISPARITIES AND OBSERVE SOLUTIONS OTHER CITIES HAVE IMPLEMENTED TO TACKLE THESE PROBLEMS. THE TALLAHASSEE TEAM CHOSE TO FOCUS EFFORTS ON FRESH FRUIT AND VEGETABLE ACCESS IN SOUTHSIDE TALLAHASSEE. THIS COMMUNITY HAS EXPERIENCED TWO GROCERY STORES CLOSE IN PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: https://www.tmh.org/patients-and-visitors/transparency-billing-and-quality --------------- PART I, LINE 7 (BAD DEBT EXPENSE COSTING METHODOLOGY USED) THE BAD DEBT EXPENSE AMOUNT INCLUDED ON FORM 990, PART IX, COLUMN 25(A) WAS $122,307,863 FOR THE YEAR ENDED SEPTEMBER 30, 2017. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. -------------------- PART II (DETAIL OF COMMUNITY BUILDING ACTIVITIES) AS PART OF ITS COMMUNITY BENEFIT PROGRAM, TMH AND ITS COLLEAGUES CONTRIBUTE BOTH TIME AND DOLLARS TO A VARIETY OF LOCAL NONPROFIT ORGANIZATIONS, PARTICULARLY THOSE WHOSE MISSIONS HELP IMPROVE THE HEALTH AND WELFARE OF OUR COMMUNITY. DURING THE FISCAL YEAR, TMH CONTRIBUTED SIGNIFICANTLY IN CASH AND IN-KIND DONATIONS, INCLUDING ADMINISTRATIVE SUPPORT, TO MORE THAN 25 DIFFERENT NONPROFIT ORGANIZATIONS. SOME OF THE ORGANIZATIONS THAT BENEFITTED FROM THE GENEROSITY OF TMH COLLEAGUES WERE THE FOLLOWING: ALZHEIMER'S PROJECT AMERICAN CANCER SOCIETY AMERICAN HEART ASSOCIATION AMERICAN LUNG ASSOCIATION BIG BEND HOSPICE, INC. BOND COMMUNITY HEALTH CENTER CHILDREN'S HOME SOCIETY DOWN'S SYNDROME ASSOCIATION FOUNDATION FOR LEON COUNTY SCHOOLS FSU DANCE MARATHON /CHILDREN'S MIRACLE NETWORK LEUKEMIA & LYMPHOMA SOCIETY MARCH OF DIMES MEALS ON WHEELS RONALD MCDONALD HOUSE ROTARY CLUB SICKLE CELL FOUNDATION TALLAHASSEE SENIOR CENTER UNITED WAY OF THE BIG BEND -------------------- PART III, SECTION A, LINE 1 (BAD DEBT EXPENSE) TMH REPORTS BAD DEBT EXPENSE IN ACCORDANCE WITH GAAP AND AICPA GUIDELINES. HFMA STATEMENT NO. 15 HAS NOT BEEN ADOPTED BY THE AICPA. --------------- PART III, SECTION A, LINE 2 (BAD DEBT EXPENSE METHODOLOGY) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE). --------------- PART III, SECTION A, LINE 4 (BAD DEBT EXPENSE FOOTNOTE) THE BAD DEBT EXPENSE FOOTNOTE DISCLOSURE CAN BE FOUND ON PAGE 9 OF THE ELECTONICALLY ATTACHED FINANCIAL STATEMENTS FOR TALLAHASSEE MEMORIAL HEALTHCARE, INC. & SUBSIDIARIES. --------------- PART III, SECTION B (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF TMH AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, TMH PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY TMH TO PROVIDE SUCH SERVICES. AS A RESULT, TMH VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. --------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. --------------- PART VI, LINE 2 (NEEDS ASSESSMENT) SEE RESPONSE TO PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY)AND PART VI, LINE 4 (COMMUNITY INFORMATION) -------------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) TMH ATTEMPTS TO EDUCATE ALL PATIENTS, OR THEIR GUARANTORS, ABOUT THEIR FINANCIAL RESPONSIBILITY, AS WELL AS THEIR OPTIONS AND OPPORTUNITIES FOR ASSISTANCE WITH HOSPITAL BILLS. ALL PATIENTS ARE GIVEN THE OPPORTUNITY TO RECEIVE A GOOD FAITH ESTIMATE OF SERVICES TO BE PROVIDED ALONG WITH INFORMATION ABOUT FINANCIAL ASSISTANCE. SIGNS ARE POSTED IN CENTRAL REGISTRATION, AS WELL AS OTHER ENTRY POINTS IN THE HOSPITAL, PROVIDING PATIENTS WITH A PHONE NUMBER TO CALL FOR THIS INFORMATION. THOSE PATIENTS WHO ARE UNINSURED ARE ASKED TO COMPLETE A BRIEF APPLICATION FOR FINANCIAL ASSISTANCE. IT IS THROUGH THIS APPLICATION THAT TMH CAN ASSESS THE PATIENT'S NEED FOR FINANCIAL ASSISTANCE OR PROGRAM ELIGIBILITY. A PATIENT MAY BE REFERRED TO nTHRIVE, WHICH IS A CONTRACTED COMPANY THAT PROVIDES MEDICAID ELIGIBILITY SERVICES TO THE HOSPITAL. FOR THOSE WHO DO NOT SPEAK ENGLISH, TRANSLATION SERVICES ARE AVAILABLE. WHEN AN UNINSURED PATIENT PRESENTS IN A NON-EMERGENT SETTING, A FINANCIAL APPLICATION IS COMPLETED AND REVIEWED BY A CUSTOMER SERVICE REPRESENTATIVE. VARIOUS OPTIONS, RANGING FROM VOCATIONAL REHAB TO PAYMENT PLANS BASED ON A SLIDING FEE SCHEDULE, TO REFERRAL TO THE WECARE NETWORK, WHICH OFFERS FREE CARE, ARE EXPLORED. IN THE EVENT THAT THE PATIENT WOULD QUALIFY FOR MEDICAID, A REFERRAL IS MADE TO NTHRIVE. NTHRIVE, THROUGH THE STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES SERVICES, ASSISTS PATIENTS IN COMPLETING THE MEDICAID APPLICATION. IF THE PATIENT IS DISABLED, OR GOING TO BE DISABLED FOR AT LEAST A YEAR, NTHRIVE WILL ASSIST THE PATIENT IN APPLYING FOR DISABILITY. IF A PATIENT PRESENTS TO THE EMERGENCY ROOM, CARE IS PROVIDED PRIOR TO ASCERTAINING THE PATIENT'S COVERAGE AND/OR ABILITY TO PAY. ONCE THE PATIENT IS STABILIZED, THE STEPS OUTLINED FOR THE NON-EMERGENT SETTING ARE TAKEN. IN THE EVENT THAT A PATIENT DOES NOT QUALIFY FOR ANY STATE/FEDERAL PROGRAMS, AND IS UNINSURED, A CHARITY APPLICATION IS COMPLETED. IT IS THROUGH THIS PROCESS THAT A DETERMINATION IS MADE AS TO WHETHER THE PATIENT QUALIFIES FOR CHARITY OR THE SLIDING FEE SCHEDULE. THE HOSPITAL SPONSORED FINANCIAL ASSISTANCE PROGRAM (FAP) IS AVAILABLE FOR UNINSURED AND UNDERINSURED PATIENTS. FAP IS A CHARITY AND SLIDING SCALE DISCOUNT PROGRAM BASED ON THE PATIENT'S FAMILY INCOME AND HOUSEHOLD SIZE. PATIENTS WITH FAMILY INCOMES AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES OR WHOSE CHARGES EXCEED 25% OF THE ANNUAL FAMILY INCOME ARE ELIGIBLE FOR 100 % CHARITY OR FREE CARE. PATIENTS WITH FAMILY INCOMES BETWEEN 151% AND 400 % OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR SLIDING SCALE DISCOUNTS. THESE UNINSURED PATIENTS WILL BE RESPONSIBLE FOR A PERCENTAGE OF HOSPITAL CHARGES DETERMINED BY INCOME AND FAMILY SIZE. THE STATE OF FLORIDA HAS RECOGNIZED THE HIGH LEVEL OF UNCOMPENSATED CARE PROVIDED BY TMH BY DESIGNATING TMH AS A MEDICAID DISPROPORTIONATE SHARE PROVIDER. APPROXIMATELY 3% OF TMH'S GROSS REVENUES ARE PROVIDED WITHOUT COMPENSATION TO INDIGENT PATIENTS WITH NO FUNDING SOURCE AND ANOTHER 11 % OF THE GROSS REVENUES ARE GENERATED BY SERVICES TO PATIENTS COVERED UNDER THE MEDICAID PROGRAM AND MEDICAID HMOS. HTTP://MAP.HEALTHCAREFORFLORIDA.ORG/ A COPY OF OUR FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: https://www.tmh.org/patients-and-visitors/transparency-billing-and-quality --------------- PART VI, LINE 4 (COMMUNITY INFORMATION) TALLAHASSEE MEMORIAL HEALTHCARE IS LOCATED IN THE CAPITAL CITY OF TALLAHASSEE, FLORIDA, IN THE HEART OF THE STATE'S PANHANDLE. TMH'S PRIMARY SERVICE AREA IS A FOUR-COUNTY REGION (PSA) CONTAINING LEON, GADSDEN, WAKULLA, AND JEFFERSON COUNTIES WITH A POPULATION GREATER THAN 375,000. LEON COUNTY IS THE LARGEST COUNTY IN THE PSA REPRESENTING 75% OF THE FOUR COUNTY POPULATION. BASED IN LEON COUNTY, TMH SERVES A TRULY DIVERSE POPULATION. WITHIN THE FOUR-COUNTY REGION, THE UNEMPLOYMENT RATE RANGES FROM 3.5% TO 5.3%. THE NUMBER OF CHILDREN IN POVERTY RANGES FROM 18% IN LEON COUNTY TO 33% IN GADSDEN COUNTY. THE COLLEGE EDUCATION RATE IS STARKLY DIFFERENT IN THE SURROUNDING COUNTIES (AVERAGE OF 17.7%) COMPARED TO LEON COUNTY AT 45.2%. (SOURCE: FLORIDA OFFICE OF ECONOMIC & DEMOGRAPHIC RESEARCH). THE HOUSEHOLD INCOME IN THESE FOUR COUNTIES RANGES FROM $38,533 TO $54,078. AS THE LARGEST SAFETY NET HOSPITAL IN THE SERVICE AREA SPANNING 17 COUNTIES IN NORTH FLORIDA AND SOUTH GEORGIA, TMH HAS A LONG HISTORY OF IMPROVING HEALTH AND QUALITY OF LIFE THROUGHOUT THE REGION. DURING FISCAL YEAR 2017 BETWEEN, TMH EXPANDED ACCESS TO CARE BY BRINGING NEW PHYSICIANS FACILITIES AND TECHNOLOGIES TO THE AREA AND REACHED THE COMMUNITY WITH EDUCATIONAL EVENTS AND INITIATIVES. SUBSIDIZED MEDICAL CARE: AS A NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM, TMH OFTEN SUBSIDIZES HEALTH SERVICES THAT DO NOT GENERATE A POSITIVE OPERATING MARGIN BUT ARE NEEDED IN THE COMMUNITY. THE MAJORITY OF THESE SERVICES ARE PROVIDED BY THE METABOLIC HEALTH CENTER, THE TRANSITION CENTER, THE BIXLER TRAUMA & EMERGENCY, THE EMERGENCY CENTER - NORTHEAST AND RURAL CLINICS THROUGHOUT THE BIG BEND. THROUGH CLASSES AND INDIVIDUAL OR FAMILY COUNSELING SESSIONS ON TOPICS SUCH AS MANAGING AND TESTING BLOOD SUGAR CHOOSING HEALTHY FOODS, AND STARTING INSULIN AND NUTRITION THERAPY, THE DIABETES CENTER, LOCATED WITHIN THE METABOLIC HEALTH CENTER, HELPS PATIENTS BETTER MANAGE THEIR CONDITION AND AVOID COMPLICATIONS. NEARLY A THIRD OF THE DIABETES CENTER PATIENTS ACCESS CARE THROUGH SUBSIDIZED SERVICES. AN INNOVATIVE FACILITY DESIGNED TO REDUCE EMERGENCY ROOM VISITS AND HOSPITAL READMISSIONS, THE TRANSITION CENTER PROVIDES FOLLOW-UP CARE TO PATIENTS WHO MAY BE AT HIGH RISK FOR READMISSION AFTER LEAVING THE HOSPITAL. TMH'S RURAL CLINICS, INCLUDING FAMILY MEDICINE PRACTICES IN GADSDEN, JEFFERSON, TAYLOR, WAKULLA, AND CALHOUN COUNTIES ENSURE PATIENTS IN TALLAHASSEES SURROUNDING COMMUNITIES ARE ABLE TO RECEIVE CARE CLOSE TO HOME. SINCE 2009, THE BIXLER TRAUMA & EMERGENCY CENTER HAS OPERATED AS THE REGION'S ONLY LEVEL II TRAUMA CENTER. IN 2013, TMH ALSO OPENED THE EMERGENCY CENTER - NORTHEAST, EXPANDING EMERGENCY CARE OPTIONS FOR OUR SERVICE AREA. IMPROVING ACCESS TO HEALTHCARE: TMH HAS MADE MANY INVESTMENTS IN ORDER TO OFFER THE COMMUNITY GREATER ACCESS TO NEEDED HEALTHCARE SERVICES. IN ADDITION TO THE ESTABLISHMENT OF THE TRANSITION CENTER AND THE RECENT OPENING OF THE EMERGENCY CENTER NORTHEAST, TELEMEDICINE TECHNOLOGIES AND THE CONTINUAL DEVELOPMENT OF RESIDENCY PROGRAMS ALLOW MORE PEOPLE TO RECEIVE CARE AT TMH. VIRTUAL HEALTHCARE TOOLS KNOWN AS TELEMEDICINE ALLOW PHYSICIANS AND HEALTHCARE STAFF TO CONNECT WITH PATIENTS AND FELLOW PHYSICIANS FOR ONLINE CONSULTATIONS GREATLY EXPANDING ACCESS TO CARE FOR RESIDENTS OF OUR RURAL COMMUNITIES. RESIDENCY PROGRAMS IN FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, NURSING, AND PHARMACY IMPROVE ACCESS TO CARE AND HELP DEVELOP THE BIG BEND'S MEDICAL COMMUNITY. TALLAHASSEE MEMORIAL HEALTHCARE IS THE REGION'S SAFETY NET HOSPITAL. TRAUMA AND EMERGENCY SERVICES OPERATE AT A FINANCIAL LOSS. HOWEVER, THE PROVISION OF A DESIGNATED LEVEL II TRAUMA CENTER IS AN ESSENTIAL SERVICE FOR TMH'S SERVICE AREA. THE INCREASED COMPLEXITY AND VOLUME OF CARE PROVIDED IN THE EMERGENCY CENTER QUICKLY CAUSED THE FACILITY TO REACH CAPACITY AND RESULTED IN EXTENDED WAIT TIME FOR EMERGENT PATIENT CARE. BETWEEN THE BIXLER TRAUMA & EMERGENCY CENTER, EMERGENCY CENTER NORTHEAST AND OUR URGENT CARE, OVER 382 PATIENTS ARE SEEN DAILY. TMH'S TRAUMA PROGRAM HAS SEEN A 22 PERCENT INCREASE IN VOLUME SINCE 2014, AND THAT UPWARD TREND CONTINUES. THE MEDIAN PATIENT ARRIVAL TIME TO PATIENT PLACEMENT IN A BED HAS DECREASED TO 18 MINUTES FOR FISCAL YEAR 2017. MEDIAN DOOR TO PROVIDER EVALUATION 39.8 MINUTES. THE EMERGENCY CENTER NORTHEAST HAS CONTINUED TO EVOLVE AND TAKE ON A LARGER PATIENT POPULATION, INCLUDING THE OPENING OF A CHILDRENS EMERGENCY CENTER IN AFFILIATION WITH WOLFSONS CHILDRENS HOSPITAL. THE AVERAGE DAILY PATIENT COUNT WAS 87 IN 2014 AND THEY NOW SEE AN AVERAGE OF 117 PATIENTS A DAY. THIS HAS GREATLY INCREASED THE COMMUNITY ACCESS TO CARE. THE MEDIAN PATIENT ARRIVAL TIME ACCESS TO CARE TO PATIENT PLACEMENT IN A BED IS 18 MINUTES. THE MEDIAN PATIENT ARRIVAL TO PROVIDER EVALUATION TIME IS 35.8 MINUTES. THE NUMBER OF PATIENTS WHO LEFT BEFORE BEING SEEN HAS REMAINED BELOW THE NATIONAL AVERAGE AT 1.85 PERCENT IN 2017. REGIONAL ACCESS TO PHYSICIANS: IN CONTINUATION OF TMH'S COMMITMENT TO IMPROVE ACCESS TO HEALTHCARE IN SURROUNDING RURAL COMMUNITIES, TMH OPERATES FIVE FAMILY MEDICINE PRACTICES THROUGHOUT THE AREA WITH OFFICES LOCATED IN GADSDEN, JEFFERSON, TAYLOR, WAKULLA AND CALHOUN COUNTIES. PHYSICIAN PARTNERS HAS EXPANDED THE REGIONAL REFERRAL PROCESS FOR SPECIALTY CARE FOR THE SERVICE AREA AS WELL. INCLUDING THE SPECIALTIES OF BARIATRICS, CARDIOVASCULAR, ENDOCRINOLOGY, GENERAL SURGERY, GENETICS, MATERNAL-FETAL MEDICINE, NEUROLOGY, ONCOLOGY, NEUROLOGY, PAIN MANAGEMENT, PSYCHIATRY, PULMONARY, RHEUMATOLOGY, UROLOGY AND VASCULAR SURGERY. COMMUNITY INVOLVEMENT: TMH CONTINUES TO BE A KEY HEALTH PARTNER ON LOCAL HEALTH INITIATIVES AND ENCOURAGES PARTICIPATION FROM ITS LEADERS. BOARDS, GROUPS AND COUNCILS THAT WE WERE ACTIVELY ENGAGED IN THIS YEAR INCLUDE BUT ARE NOT LIMITED TO: BIG BEND AIDS ALLIANCE BIG BEND HEALTHCARE COALITION BIG BEND HOSPICE CAPITAL AREA HEALTHY START/MATERNAL CHILD EQUITY COLLABORATIVE CHILDRENS HOME SOCIETY CHOOSE TALLAHASSEE DEPARTMENT OF HEALTH MEDICAL SURGE PROGRAM ADVISORY TEAM -BUREAU OF PREPAREDNESS AND RESPONSE-DIVISION OF EMERGENCY PREPAREDNESS & COMMUNITY SUPPORT DOCTORS MEMORIAL HOSPITAL FAMU ADVISORY BOARD FLORIDA COUNCIL FOR COMMUNITY BEHAVIORAL HEALTH FLORIDA HOSPITAL ASSOCIATION FLORIDA ORGANIZATION OF NURSE EXECUTIVES (FONE) FLORIDA REGIONAL DOMESTIC SECURITY TASKFORCE FLORIDA SMART JUSTICE ALLIANCE FLORIDA SURGEON GENERAL DEPARTMENT OF HEALTH TASK FORCE GADSDEN HEALTH COUNCIL GEORGE E. WEEMS HOSPITAL GOODWILL INDUSTRIES-BIG BEND GOODWOOD MUSEUM & GARDENS GOVERNORS HURRICANE CONFERENCE JUNIOR LEAGUE OF TALLAHASSEE KEISER UNIVERSITY LEADERSHIP TALLAHASSEE LEON COUNTY EMS COLLABORATIVE GROUPS LEON COUNTY BEST PRACTICES IMPLEMENTATION ACADEMY (NATIONAL ASSOCIATION OF COUNTIES) LEON COUNTY SHERIFFS MENTAL HEALTH ADVISORY COMMITTEE MARCH OF DIMES MATERNAL MENTAL HEALTH AND DEPRESSION COALITION REFUGE HOUSE RONALD MCDONALD HOUSE SOUTHEASTERN UROLOGY SURGERY CENTER BOARD TALLAHASSEE CHAMBER OF COMMERCE TALLAHASSEE COMMUNITY COLLEGE FOUNDATION TALLAHASSEE PLASTICS BOARD THE AMERICAN CANCER SOCIETY THE AMERICAN HEART ASSOCIATION THE UNITED WAY OF THE BIG BEND THE MENTAL HEALTH COUNCIL OF THE BIG BEND THOMAS UNIVERSITY UNITED PARTNERS FOR HUMAN SERVICES WHOLE CHILD LEON YOUTH LEADERSHIP TALLAHASSEE EDUCATION & TRAINING PROGRAMS FOR MEDICAL PROFESSIONALS: TMH CONTRIBUTES MILLIONS OF DOLLARS EACH YEAR TO THE CLINICAL EDUCATION OF HEALTHCARE PROFESSIONALS. THIS INCLUDES TRAINING FOR FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE STUDENTS, FLORIDA A&M PHARMACY STUDENTS, HANDS-ON EXPERIENCE FOR NURSES FROM MANY DIFFERENT NURSING SCHOOLS THROUGHOUT NORTH FLORIDA AND SOUTH GEORGIA, AND CONTINUING MEDICAL EDUCATION FOR PHYSICIANS IN OUR COMMUNITY. TMH AWARDED A LAND GRANT TO TALLAHASSEE COMMUNITY COLLEGE (TCC) AS PART OF ITS PLAN TO DEVELOP A HEALTH EDUCATION PARTNERSHIP CAMPUS ON A PORTION OF THE 81.4 ACRES OF UNDEVELOPED LAND IT OWNS BEHIND THE HOSPITAL. IN AUGUST 2011, TMH WELCOMED MORE THAN 400 TCC STUDENTS TO THE HOSPITAL'S CAMPUS WITH THE OPENING OF THE NEW GHAZVINI CENTER FOR HEALTHCARE EDUCATION. THE 85,000-SQUARE-FOOT, THREE-STORY 63COMMONS SIX SIMULATION CENTERS, PLUS ADDITIONAL SPACE FOR EXPANSION AND A 296 SEAT AUDITORIUM. THE CENTER NOW HAS 530 STUDENTS ENROLLED. ONE OF TMH'S MOST SIGNIFICANT CONTRIBUTIONS TO THE EDUCATION FOR HEALTHCARE PROFESSIONALS IS THE TALLAHASSEE MEMORIAL FAMILY MEDICINE RESIDENCY PROGRAM, WHICH TRAINS PHYSICIANS WHO HAVE GRADUATED FROM MEDICAL SCHOOL IN THE SPECIALTY OF FAMILY MEDICINE. THE FAMILY MEDICINE RESIDENCY PROGRAM HAS PRODUCED 391 GRADUATES SINCE ITS INCEPTION IN 1973. OF THOSE, 250 HAVE CHOSEN TO REMAIN IN TMH'S SERVICE AREA HELPING TO ENSURE ACCESS TO PRIMARY HEALTHCARE OF RESIDENTS OF THE BIG BEND. IN THE FALL OF 2011, TALLAHASSEE MEMORIAL AND THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE ESTABLISHED A JOINT INTERNAL MEDICINE RESIDENCY PROGRAM FOR THE BIG BEND REGION. THE INTERNAL MEDICINE RESIDENCY PROGRAM CURRENTLY HAS 25 PART VI. LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) AS THE LARGEST SAFETY NET HOSPITAL IN THE SERVICE AREA SPANNING 17 COUNTIES IN NORTH FLORIDA AND SOUTH GEORGIA, TMH HAS A LONG HISTORY OF IMPROVING HEALTH AND QUALITY OF LIFE THROUGHOUT THE REGION. DURING FISCAL YEAR 2016, TMH EXPANDED ACCESS TO CARE BY BRINGING NEW PHYSICIANS FACILITIES AND TECHNOLOGIES TO THE AREA AND REACHED THE COMMUNITY WITH EDUCATIONAL EVENTS AND INITIATIVES. SUBSIDIZED MEDICAL CARE AS A NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM, TMH OFTEN SUBSIDIZES HEALTH SERVICES THAT DO NOT GENERATE A POSITIVE OPERATING MARGIN BUT ARE NEEDED IN THE COMMUNITY. THE MAJORITY OF THESE SERVICES ARE PROVIDED BY THE DIABETES CENTER, THE NEUROSCIENCE CENTER, THE TRANSITION CENTER, THE BIXLER TRAUMA & EMERGENCY, THE EMERGENCY CENTER - NORTHEAST AND RURAL CLINICS THROUGHOUT THE BIG BEND. THROUGH CLASSES AND INDIVIDUAL OR FAMILY COUNSELING SESSIONS ON TOPICS SUCH AS MANAGING AND TESTING BLOOD SUGAR CHOOSING HEALTHY FOODS, AND STARTING INSULIN AND NUTRITION THERAPY, THE DIABETES CENTER HELPS PATIENTS BETTER MANAGE THEIR CONDITION AND AVOID COMPLICATIONS. NEARLY A THIRD OF THE DIABETES CENTER PATIENTS ACCESS CARE THROUGH SUBSIDIZED SERVICES. THE NEUROSCIENCE CENTER PROVIDES A VARIETY OF SUPPORT SERVICES TO PATIENTS WITH INJURIES AND CONDITIONS AFFECTING BRAIN AND NERVOUS SYSTEM. AN INNOVATIVE FACILITY DESIGNED TO REDUCE EMERGENCY ROOM VISITS AND HOSPITAL READMISSIONS, THE TRANSITION CENTER PROVIDES FOLLOW-UP CARE TO PATIENTS WHO MAY BE AT HIGH RISK FOR READMISSION AFTER LEAVING THE HOSPITAL. TMH'S RURAL CLINICS, INCLUDING FAMILY MEDICINE PRACTICES IN GADSDEN, JEFFERSON, TAYLOR, WAKULLA, AND CALHOUN COUNTIES ENSURE PATIENTS IN TALLAHASSEE'S SURROUNDING COMMUNITIES ARE ABLE TO RECEIVE CARE CLOSE TO HOME. SINCE 2009, THE TALLAHASSEE MEMORIAL BIXLER TRAUMA & EMERGENCY CENTER HAS OPERATED AS THE REGION'S ONLY LEVEL II TRAUMA CENTER. IN 2013, TMH ALSO OPENED THE EMERGENCY CENTER - NORTHEAST, EXPANDING EMERGENCY CARE OPTIONS FOR OUR SERVICE AREA. IMPROVING ACCESS TO HEALTHCARE TMH HAS MADE MANY INVESTMENTS IN ORDER TO OFFER THE COMMUNITY GREATER ACCESS TO NEEDED HEALTHCARE SERVICES. IN ADDITION TO THE ESTABLISHMENT OF THE TRANSITION CENTER AND THE RECENT OPENING OF THE TALLAHASSEE MEMORIAL EMERGENCY CENTER - NORTHEAST TELEMEDICINE TECHNOLOGIES AND THE CONTINUAL DEVELOPMENT OF RESIDENCY PROGRAMS ALLOW MORE PEOPLE TO RECEIVE CARE AT TMH. VIRTUAL HEALTHCARE TOOLS KNOWN AS TELEMEDICINE ALLOW PHYSICIANS TO CONNECT WITH PATIENTS AND FELLOW PHYSICIANS FOR ONLINE CONSULTATIONS GREATLY EXPANDING ACCESS TO CARE FOR RESIDENTS OF OUR RURAL COMMUNITIES. RESIDENCY PROGRAMS IN FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, NURSING, AND PHARMACY IMPROVE ACCESS TO CARE AND HELP DEVELOP THE BIG BEND'S MEDICAL COMMUNITY. PROVIDING THE MOST COMPREHENSIVE EMERGENCY SERVICES PROGRAM IN THE REGION TALLAHASSEE MEMORIAL HEALTHCARE IS THE REGIONS SAFETY NET HOSPITAL. TRAUMA AND EMERGENCY SERVICES OPERATE AT A FINANCIAL LOSS. HOWEVER, THE PROVISION OF A DESIGNATED LEVEL II TRAUMA CENTER IS AN ESSENTIAL SERVICE FOR TMHS SERVICE AREA. THE INCREASED COMPLEXITY AND VOLUME OF CARE PROVIDED IN THE EMERGENCY CENTER QUICKLY CAUSED THE FACILITY TO REACH CAPACITY AND RESULTED IN EXTENDED WAIT TIME FOR EMERGENT PATIENT CARE. BETWEEN THE BIXLER TRAUMA & EMERGENCY CENTER, EMERGENCY CENTER NORTHEAST AND URGENT CARE, OVER 379 PATIENTS ARE SEEN DAILY. TMHS TRAUMA PROGRAM HAS SEEN A 26 PERCENT INCREASE IN VOLUME SINCE 2013, AND THAT UPWARD TREND CONTINUES. THE MEDIAN PATIENT ARRIVAL TIME TO PATIENT PLACEMENT IN A BED HAS DECREASED BY SIX MINUTES AT THE BIXLER TRAUMA & EMERGENCY CENTER FROM 2013 TO 2015. THE NUMBER OF PATIENTS THAT LEFT WITHOUT BEING SEEN HAS INCREASED FROM 4.6 PERCENT IN 2013 TO 6.5 PERCENT IN 2016 BECAUSE OF SIGNIFICANT INCREASES IN ORGANIZATIONAL PATIENT VOLUME. THE EMERGENCY CENTER NORTHEAST, WHICH OPENED IN AUGUST OF 2013, HAS CONTINUED TO EVOLVE AND TAKE ON A LARGER PATIENT POPULATION. THE AVERAGE DAILY PATIENT COUNT WAS 87 IN 2014 AND THEY NOW SEE AN AVERAGE OF 125 PATIENTS A DAY. THIS HAS GREATLY INCREASED THE COMMUNITY ACCESS TO CARE. THE MEDIAN PATIENT ARRIVAL TIME ACCESS TO CARE TO PATIENT PLACEMENT IN A BED IS 12 MINUTES. THE MEDIAN PATIENT ARRIVAL TO PROVIDER EVALUATION TIME IS 14 MINUTES. THE NUMBER OF PATIENTS WHO LEFT BEFORE BEING SEEN HAS REMAINED BELOW THE NATIONAL AVERAGE AT 1.85 PERCENT IN 2016. TMH INTRODUCED THE BEHAVIORAL HEALTH ACCESS CENTER IN 2013 TO PROVIDE IMPROVED ACCESS AND QUALITY OF CARE FOR MENTAL HEALTH EMERGENCIES OCCURRING THROUGHOUT THE BIG BEND REGION. APPROPRIATE PATIENTS WHO DO NOT REQUIRE EMERGENCY CARE CAN MOVE DIRECTLY TO THE ACCESS CENTER. BEHAVIORAL HEALTH ACCESS CENTER HAS DECREASED BEHAVIORAL HEALTH VOLUMES IN THE BIXLER TRAUMA & EMERGENCY CENTER BY 64 PERCENT, IMPROVING TIMELY ACCESS TO CARE FOR ALL PATIENT POPULATIONS. CONTINUING DEVELOPMENT OF THE STRATEGIC TMH PHYSICIAN PARTNERS REGIONAL EXPANSION PLAN IN CONTINUATION OF TMHS COMMITMENT TO IMPROVE ACCESS TO HEALTHCARE IN SURROUNDING RURAL COMMUNITIES, TMH OPERATES FIVE FAMILY MEDICINE PRACTICES THROUGHOUT THE AREA WITH OFFICES LOCATED IN GADSDEN, JEFFERSON, TAYLOR, WAKULLA AND CALHOUN COUNTIES. THROUGH OUR PRIMARY CARE RECRUITMENT EFFORTS IN RURAL COMMUNITIES, AND THE ADDITION OF NEW PROVIDERS, PATIENT VISITS WERE INCREASED BY OVER 3,128 VISITS OR 4 PERCENT OVER THE THREE-YEAR PERIOD. PHYSICIAN PARTNERS HAS EXPANDED THE REGIONAL REFERRAL PROCESS FOR SPECIALTY CARE IN RURAL COMMUNITIES AS SEEN BY THE INCREASE OF PATIENT VISITS OVER THE THREE-YEAR PERIOD. TMH CONTINUES TO BE A KEY HEALTH PARTNER ON LOCAL HEALTH INITIATIVES AND GROUPS SUCH AS THE UNITED WAY HEALTH COUNCIL, THE GADSDEN HEALTH COUNCIL, THE LEON COUNTY COMMISSION HEALTH NETWORK GROUP AND THE BOARDS OF BOTH DOCTORS MEMORIAL HOSPITAL AND THE GEORGE E. WEEMS HOSPITAL. TALLAHASSEE MEMORIAL ACCESS TO CARE HEALTHCARE WAS ALSO INSTRUMENTAL IN DEVELOPING A COMMUNITY ACTION GROUP ANCHORED BY SEVERAL COMMUNITY AGENCIES AND COMPANIES IN GADSDEN COUNTY CALLED STEP-UP FOR GADSDEN WITH THE AIM OF HELPING PEOPLE WHO LIVE IN GENERATIONAL POVERTY OBTAIN SUSTAINABILITY. CONTINUE TO BUILD THE TMH/FSU PHYSICIAN RESIDENCY PROGRAMS TMH CONTRIBUTES MILLIONS OF DOLLARS EACH YEAR TO THE CLINICAL EDUCATION OF HEALTHCARE PROFESSIONALS. THIS INCLUDES TRAINING FOR FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE STUDENTS, FLORIDA A&M PHARMACY STUDENTS, HANDS-ON EXPERIENCE FOR NURSES FROM MANY DIFFERENT NURSING SCHOOLS THROUGHOUT NORTH FLORIDA AND SOUTH GEORGIA, AND CONTINUING MEDICAL EDUCATION FOR PHYSICIANS IN OUR COMMUNITY. TMH HAS AWARDED A LAND GRANT TO TALLAHASSEE COMMUNITY COLLEGE (TCC) AS PART OF ITS PLAN TO DEVELOP A HEALTH EDUCATION PARTNERSHIP CAMPUS ON A PORTION OF THE 81.4 ACRES OF UNDEVELOPED LAND IT OWNS BEHIND THE HOSPITAL. IN AUGUST 2011, TMH WELCOMED MORE THAN 400 TCC STUDENTS TO THE HOSPITAL'S CAMPUS WITH THE OPENING OF THE NEW GHAZVINI CENTER FOR HEALTHCARE EDUCATION. THE 85,000-SQUARE-FOOT, THREE-STORY EDUCATIONAL CENTER INCLUDES SIX CLASSROOMS, 13 LABORATORIES, A MULTI-PURPOSE LIBRARY AND LEARNING COMMONS SIX SIMULATION CENTERS, PLUS ADDITIONAL SPACE FOR EXPANSION AND A 296 -SEAT AUDITORIUM. THE CENTER IS EXPECTED TO BE HOME TO AS MANY AS 900 STUDENTS WITHIN FIVE YEARS. ONE OF TMH'S MOST SIGNIFICANT CONTRIBUTIONS TO THE EDUCATION FOR HEALTHCARE PROFESSIONALS IS THE TALLAHASSEE MEMORIAL FAMILY MEDICINE RESIDENCY PROGRAM, WHICH TRAINS PHYSICIANS WHO HAVE GRADUATED FROM MEDICAL SCHOOL IN THE SPECIALTY OF FAMILY MEDICINE. THE FAMILY MEDICINE RESIDENCY PROGRAM HAS PRODUCED 363 GRADUATES SINCE ITS INCEPTION IN 1973. OF THOSE, 155 HAVE CHOSEN TO REMAIN IN TMH'S SERVICE AREA HELPING TO ENSURE ACCESS TO PRIMARY HEALTHCARE OF RESIDENTS OF THE BIG BEND. IN THE FALL OF 2011, TALLAHASSEE MEMORIAL AND THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE ESTABLISHED A JOINT INTERNAL MEDICINE RESIDENCY PROGRAM FOR THE BIG BEND REGION. THE INTERNAL MEDICINE RESIDENCY PROGRAM CURRENTLY HAS 26 RESIDENTS. DURING 2016, BOTH RESIDENCY PROGRAMS OPERATED AT A NET LOSS OF $9,533,353.72. IN EARLY 2014, THE TALLAHASSEE MEMORIAL HEALTHCARE BOARD OF DIRECTORS AND THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE ANNOUNCED PLANS TO CREATE A GENERAL SURGERY RESIDENCY PROGRAM IN TALLAHASSEE. THE PROGRAM, EXPECTED TO PRODUCE TWO NEW GENERAL SURGEONS A YEAR WHEN AT FULL CAPACITY, WILL BE THE FIRST SURGERY RESIDENCY PROGRAM IN NORTHWEST FLORIDA. THE GENERAL SURGERY RESIDENCY PROGRAM ACCEPTED THEIR FIRST RESIDENTS FOR ACADEMIC YEAR 2016-2017. THE GENERAL SURGERY RESIDENCY PROGRAM IS A 5 YEAR PROGRAM AND EXPECTS THEIR FIRST GRADUATION OF RESIDENTS TO BE JUNE 30, 2020. IMPROVING METABOLIC HEALTH TALLAHASSEE MEMORIAL HEALTHCARE WAS AN ACTIVE FOUNDING SPONSOR FOR THE STOMP OUT TYPE 2 DIABETES PROGRAM TARGETED AT LEON COUNTY SCHOOL STUDENTS, AND THEIR FAMILIES, TO PROMOTE HEALTHY WEIGHT AND EATING BEHAVIORS. DURING NATIONAL NUTRITION MONTH, REGISTERED DIETITIANS PROVIDED GARDENING AND NUTRITION EDUCATION TO OVER 350 PEOPLE IN SENIOR CENTERS, WORKSITES AND PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) NOT APPLICABLE --------------- PART VI, LINE 7 (STATE FILING OF COMMUNITY BENEFIT REPORT) NOT APPLICABLE --------------- true AMERICAN CANCER SOCIETY 2619 CENTENNIAL BLVD SUITE 101 TALLAHASSEE FL 32308 131788491 501(C)(3) 8000 SPONSORSHIP - RELAY FOR LIFE EVENTS AMERICAN HEART ASSOCIATION 2851 REMINGTON GREEN CIRCLE TALLAHASSEE FL 32308 135613797 501(C)(3) 19584 SPONSORSHIP - HEART WALK FLORIDA TAXWATCH RESEARCH INSTITUTE INC 106 N BRONOUGH ST TALLAHASSEE FL 32301 591918055 501(C)(3) 19164 MEMBERSHIP LEON COUNTY SCHOOL FOUNDATION 725 S CALHOUN ST TALLAHASSEE FL 32301 592852594 501(C)(3) 5930 SPONSORSHIP - STOMP (DIABETES) MARCH OF DIMES 1990 VILLAGE WAY 3 TALLAHASSEE FL 32308 131846366 501(C)(3) 10000 SPONSORSHIP - MARCH FOR BABIES TALLAHASSEE CHAMBER OF COMMERCE 300 E PARK AVE TALLAHASSEE FL 32301 590474165 11650 SPONSORSHIPS - AWARDS SPONSOR, RELOCATION PACKET GULF WINDS TRACK CLUB INC PO BOX 3447 TALLAHASSEE FL 32315 591896178 501(C)(3) 6000 SPONSORSHIP - TALLAHASSEE MARATHON WORD OF SOUTH A FESTIVAL OF LITERATURE & MUSIC PO BOX 861 TALLAHASSEE FL 32302 463527772 501(C)(3) 12500 SPONSORSHIP - WORD OF SOUTH 8 0 FORM 990, SCHEDULE I, PART I, LINE 2 DESCRIPTION OF GRANT PROGRAMS TALLAHASSEE MEMORIAL HEALTHCARE, INC. ("TMH") MAINAINS A SPONSORSHIP COMMITTEE WHICH OVERSEES THE ORGANIZATIONS SPONSORSHIP/GRANT-MAKING PROCESS. COMPLETED APPLICATION FORMS MUST BE SUBMITTED IN ORDER FOR TMH TO EVALUATE THE BENEFITS OF THE PROPOSED ACTIVITY- HOW THE PROPOSED SPONSORSHIP OPPORTUNITY ALIGNS WITH TMHS MISSION AND VISION, AS WELL AS HOW THE PROPOSED ACTIVITY CAN HELP THE COMMUNITY. APPLICATIONS AND FURTHER INFORMATION ARE AVAILABLE ON TMHS WEBSITE AT: HTTPS://WWW.TMH.ORG/SPONSORSHIP. X true true X X X X X true true false false false false false true false G MARK O'BRYANT EX-OFFICIO DIRECTOR & CEO 826558 0 200000 0 41038 0 261259 0 10904 0 1339759 0 0 0 WILLIAM GIUDICE CHIEF FINANCIAL OFFICER 466546 0 81045 0 13300 0 72214 0 10899 0 644004 0 0 0 JASON MOORE FORMER CHIEF OPERATING OFFICER 211805 0 56067 0 310470 0 15900 0 10767 0 605009 0 0 0 WARREN JONES FORMER CHIEF COMM. OFFICER 193162 0 37566 0 2138 0 14129 0 4533 0 251528 0 0 0 BARBARA ALFORD CHIEF CLINICAL OFFICER/CNO/VP 305641 0 33899 0 2195 0 45353 0 9953 0 397041 0 0 0 CYNTHIA BLAIR CHIEF IMPROVEMENT/PLNG OFFICER 212340 0 41301 0 3293 0 15416 0 0 0 272350 0 0 0 PAULA S FORTUNAS FRM CHIEF ADVANCEMENT OFFICER 83217 0 22980 0 52914 0 9606 0 1750 0 170467 0 0 0 DONALD LINDSEY CHIEF INFORMATION OFFICER 222200 0 28795 0 1277 0 24065 0 10787 0 287124 0 0 0 ROBERT L MOORE FORMER CHIEF HR OFFICER 84088 0 29830 0 184478 0 15900 0 1508 0 315804 0 0 0 DEAN WATSON MD CHIEF HEALTH OPS OFFICER 388255 0 60564 0 5744 0 54065 0 10788 0 519416 0 0 0 ELIOT B SIELOFF MD TMH SURGICAL SPECIALIST 729084 0 234858 0 3377 0 0 0 10375 0 977694 0 0 0 OVIDIU MARINA MD PHYSICIAN (RAD ONC) 311590 0 588434 0 180 0 15900 0 9868 0 925972 0 0 0 PHILIP V SHARP MD PHYSICIAN (RAD ONC) 492476 0 350082 0 414 0 15900 0 10788 0 869660 0 0 0 DHANANJAY D BENDRE MD PHYSICIAN (RAD ONC) 511366 0 189609 0 2414 0 15900 0 9959 0 729248 0 0 0 IMAN IMANIRAD MD PHYSICIAN (HEM/ONC) 446232 0 225970 0 162 0 15900 0 9953 0 698217 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A QUESTIONS REGARDING COMPENSATION DIRECTORS RECEIVE COMPLIMENTARY ACCESS TO TMH'S HEALTH CLUB, PREMIER HEALTH AND FITNESS CENTER. ---------------- FORM 990, SCHEDULE J, PART I, LINE 4A DEATIL OF SEVERANCE PAYMENTS SEVERANCE PAYMENTS WERE MADE TO THE FOLLOWING INDIVIDUALS DURING THE FISCAL YEAR ENDING 9-30-2017 AND WERE INCLUDED AS A COMPONENT OF COMPENSATION REPORTED ON FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) FOR EACH INDIVIDUAL: JASON MOORE- $212,316 ROBERT L. MOORE- $183,986 ---------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFED PLAN PARTICIPATION TMH MAINTAINS AN IRC SECTION 457(F) PLAN DESIGNED FOR CERTAIN SENIOR ADMINISTRATORS OF THE ORGANIZATION. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN THE TMH 457(F) PLAN AND/OR RECEIVED DISTRIBUTIONS DURING THE YEAR: G. MARK O'BRYANT- NO DISTRIBUTIONS BARBARA ALFORD- NO DISTRIBUTIONS WILLIAM GIUDICE- NO DISTRIBUTIONS DONALD LINDSEY- NO DISTRIBUTIONS MICKEY S. MOORE- NO DISTRIBUTIONS DEAN WATSON, MD- NO DISTRIBUTIONS STEPHANIE M. DERZYPOLSKI- NO DISTRIBUTIONS ---------------- FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS TMH MAINTAINS A VARIABLE COMPENSATION PROGRAM FOR CERTAIN MANAGERS THAT MAKE A BONUS PAYMENT BASED UPON ATTAINMENT OF INDIVIDUAL AND CORPORATE GOALS. INDIVIDUAL GOALS ARE ESTABLISHED AT THE BEGINNING OF THE FISCAL YEAR AND INCLUDE QUALITATIVE AND QUANTITATIVE RESULTS. CORPORATE GOALS ARE ESTABLISHED AT THE BEGINNING OF THE YEAR AND ARE BASED UPON THE BUDGET APPROVED BY THE BOARD OF DIRECTORS. NO PAYMENT IS MADE FOR VARIABLE COMPENSATION PAYMENT UNLESS THE ORGANIZATION MEETS OR EXCEEDS ITS BUDGETED OPERATING MARGIN FOR THE YEAR. UPON DETERMINATION THAT THE ACTUAL OPERATING MARGIN HAS MET OR EXCEEDED THE BUDGET VIA THE AUDITED FINANCIAL STATEMENTS, OTHER INDIVIDUAL AND CORPORATE GOALS ARE SCORED TO DETERMINE IF THEY MET OR EXCEEDED THE PRE-ESTABLISHED MEASUREMENT FOR THE YEAR. THE ACTUAL AMOUNT OF THE BONUS IS BASED UPON AN INDIVIDUAL'S BASE COMPENSATION FOR THE FISCAL YEAR AND THE PERCENTAGE ATTAINMENT OF INDIVIDUAL AND CORPORATE GOALS. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE TMH COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. A CITY OF TALLAHASSEE - SERIES 2015A 596000435 2015-05-28 111332927 REFUNDING 1992B, 2000 & 2015 BONDS false false false B CITY OF TALLAHASSEE - SERIES 2016A & 2016B 596000435 2016-02-02 272001300 M.T. MUSTIAN CTR CONSTRUCTION false false false A 4042927 0 111332927 0 0 0 1176569 0 0 0 110156358 0 2015 false true true true B 24521300 0 272001300 0 0 0 1790765 0 0 91953940 0 178256595 false false false true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true A true B true TIMOTHY FORTUNAS FAMILY MEMBER OF OFFICER 13342 EMPLOYMENT false PATRICIA F JONES FAMILY MEMBER OF OFFICER 16789 EMPLOYMENT false VIVIAN MOORE FAMILY MEMBER OF OFFICER 12095 EMPLOYMENT false STEPHANIE TRUMAN FAMILY MEMBER OF OFFICER 54835 EMPLOYMENT false MAD DOG CONSTRUCTION COMPANY SIMILAR DIRECTOR/OWNER 1062125 CONSTRUCTION SERVICES false X GENERAL SUPPLIES 86 77952 ACTUAL COST X OTHER ITEMS 3 1245 ACTUAL COST 0 false false false FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO TMH'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW AND RETURN PREPARATION. THE 2016 FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30 2017 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR FINANCE TEAM BEFORE IT WAS FILED TO THE IRS. THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE 990 AT THE MEETING OF THE COMITTEE PRIOR TO ITS FILING. ALL MEMBERS OF THE BOARD WERE AFFORDED THE OPPORTUNITY TO REVIEW THE FORM 990 PRIOR TO ITS FILING. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY AS PART OF OUR WRITTEN CONFLICTS OF INTEREST POLICY, OFFICERS, DIRECTORS TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF THEMSELVES AND THEIR FAMILY MEMBERS. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, A COPY OF OUR CONFLICT OF INTEREST POLICY IS AVAILABLE ON THE TMH WEBSITE. CONSOLIDATED FINANCIAL STATEMENTS ARE ALSO FILED WITH THE DIGITAL ASSURANCE CERTIFICATION, LLC, AGENCY FOR HEALTH CARE ADMINISTRATION. A COPY OF OUR FORM 990 IS ALSO FILED WITH THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES. --------------- FORM 990, PART VI, SECTION C, LINE 15 COMPENSATION REVIEW PROCESS COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY TMH PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE TO SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATION BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). --------------- FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILAVILITY TO PUBLIC OUR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, A COPY OF OUR CONFLICT OF INTEREST POLICY IS AVAILABLE ON THE TMH WEBSITE. CONSOLIDATED FINANCIAL STATEMENTS ARE ALSO FILED WITH THE DIGITAL ASSURANCE CERTIFICATION, LLC, AGENCY FOR HEALTH CARE ADMINISTRATION. A COPY OF OUR FORM 990 IS ALSO FILED WITH THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES. DIRECTORS REVIEWED THE 990 AT THE MEETING OF THE COMITTEE PRIOR TO ITS FILING. ALL MEMBERS OF THE BOARD WERE AFFORDED THE OPPORTUNITY TO REVIEW THE FORM 990 PRIOR TO ITS FILING. --------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGED IN NET ASSETS CHANGE IN ADDITIONAL PENSION LIABILITY $59,513,452 CHANGE IN FAIR VALUE OF DERIVATIVE 1,114,207 ADDITIONAL DEPRECIATION (103,120) LOSS ON EXTINGUISHMENT OF DEBT (211,531) ___________ TOTAL $60,313,008 --------------- MEDICUS SELECT LLC 1300 MICCOSUKEE ROAD TALLAHASSEE FL 32308 452980304 LEASED LABOR FL 0 1739453 TMH 1607 BUILDING LLC 1401 CENTERVILLE ROAD SUITE 210 TALLAHASSEE FL 32308 300957508 ACQUIRED PROP FL 4327 1879923 TMH SOUTHEAST COMMUNITY HEALTH SERVICES INC 1300 MICCOSUKEE ROAD TALLAHASSEE FL 32308 581434992 HOLDING CO FL 501(C)(25) N/A TMH true TALLAHASSEE MEMORIAL HEALTHCARE FDN 1300 MICCOSUKEE ROAD TALLAHASSEE FL 32308 591727645 FUNDRAISING FL 501(C)(3) 7 TMH true TALLAHASSEE MEMORIAL HEALTH VENTURES INC 1300 MICCOSUKEE ROAD TALLAHASSEE FL 32308 592717050 HOLDING COMPANY FL TMH C CORP 1599479 18096359 1.00000 true PRIME MERIDIAN HEALTH VENTURES INC 1309 THOMASVILLE ROAD TALLAHASSEE FL 32303 592668613 DIAG. IMAGING FL TMHV C CORP true TALLAHASSEE MEMORIAL TELEPHONE COMPANY 1309 THOMASVILLE ROAD TALLAHASSEE FL 32303 593395937 TELEPHONE COMM. FL TMHV C CORP true PREMIER HEALTH & FITNESS CENTER INC 3521 MACLAY BOULEVARD TALLAHASSEE FL 32312 592471569 FITNESS CENTER FL TMHV C CORP true true false true false false false false false false true true false false false true false true false false SOUTHEAST COMMUNITY HEALTH SERVICES A 675 FMV SOUTHEAST COMMUNITY HEALTH SERVICES K 655186 FMV TALLAHASSEE MEMORIAL HEALTHCARE FOUNDATION C 754492 FMV SOUTHEAST COMMUNITY HEALTH SERVICES O,Q 48982 FMV TALLAHASSEE MEMORIAL HEALTHCARE FOUNDATION O,Q 860345 FMV TALLAHASSE MEMORIAL HEALTCARE VENTURES INC A 1401864 FMV TALLAHASSEE MEMORIAL HEALTHCARE VENTURES INC K 270536 FMV DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES ____________________________________ ____________ _____________ TALLAHASSEE MEMORIAL HEALTHCARE INC. $ 79,152 $722,766,241 THIS ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED SEPTEMBER 30, 2017. THIS ELECTION HAS NOT BEEN REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2016. -------------------------------------- DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF NON-ELECTING ORGANIZATION EXPENDITURES EXPENDITURES ____________________________________ ____________ _____________ SOUTHEAST COMMUNITY HEALTH SRVS, INC. $ NONE $ 130,097 TALLAHASSEE MEMORIAL HEALTHCARE FND. NONE 2,050,622 ------------ ------------- $ NONE $ 2,180,719 TOTALS $ 79,152 $724,946,960 ============ =============